Prevention of occupational disease would require control measures in the work environment that either eliminate the physical or chemical agent or reduce the level to a point where men and women can work without incurring disease. An examination of the health and safety standards records of OSHA indicated that only 14 health standards were issued in the 10 years after the Occupational Safety and Health Act of 1970 was passed. Factors which inhibited the promulgation of standards include politics, lack of urgency, advocacy, multisector coverage, legal challenges, agency characteristics, and red tape within the government. Factors which promoted the promulgation of standards include politics, public outcry, health crises, narrow sector regulated, and adequate technical and legal resources. The author urges that alternative technologies must be considered as a means of eliminating hazards. NIOSH in concert with other federal agencies, academia, and industry could provide the leadership for such a new initiative. Substitutions for sand, certain solvents, and certain dyestuffs and intermediates could be addressed and recommendations made immediately.