The results of an evaluation of the magnitude of occupational disease in the state of New York were presented, and approaches for extrapolating the data to derive improved national estimates of the incidence and prevalence of occupational disease in the United States were suggested. Accurate data on mortality from occupational disease were largely lacking, but a proportionate attributable risk approach was used to estimate occupational disease mortality in New York State. There were 167,000 deaths in the state each year. The estimated 5,000 to 7,000 deaths attributable to work related exposures therefore constituted 3 to 4% of the total deaths. Every year twice as many people died from work associated diseases as died from homicide and suicide combined. Morbidity from occupational illness was estimated using Workers' Compensation data, hospital discharge records, state disease registries, OSHA reports, and physicians' reports. It was estimated that there were about 34,000 cases of work related disease each year. This state contained slightly less than 10% of the nation's workforce. While a direct linear extrapolation of findings in New York State cannot be made to derive estimates of the national burden, a crude estimate suggested that 50,000 to 70,000 deaths each year in this country are a result of occupational disease and 350,000 new cases of occupational illness occur each year.