Understanding and preventing occupational injuries and illnesses require focused efforts to identify, quantify, and track both health and their associated workplace conditions. Occupational safety and health surveillance activities provide the ongoing and systematic collection, analysis, interpretation, and dissemination of data needed for prevention. Current occupational safety and health surveillance data reveal the staggering human and economic losses associated with occupational injuries and illnesses. Much work remains to be done to reduce those losses, despite overall decreases in occupational injuries and illnesses in recent years. Our ability to survey and assess the state of occupational safety and health has improved over time. However, occupational safety and health surveillance data remain fragmented--collected for different purposes by different organizations using different definitions. We continue to have substantial gaps in surveillance information. Each surveillance system has limitations, particularly those that attempt to quantify occupational illness. Nonetheless, the data provide useful information for targeting and evaluating prevention efforts. To make these data more accessible, the National Institute for Occupational Safety and Health (NIOSH) has assembled this chartbook, which provides occupational safety and health surveillance information from different sources in a single volume. This initial work focuses on injury and illness outcomes rather on exposures and hazards. Included are contributions from several Federal agencies. Little information is included on public-sector employees or from State-bases surveillance systems. Future editions of the chartbook will target additional data sources to provide a more comprehensive picture of occupational injury and illness for the U.S. workforce. The data provided in this chartbook indicate encouraging decreases in the frequency of some occupational fatalities, injuries, and illnesses. Surveillance has helped to identify new and emerging problems and trends such as musculoskeletal disorders and asthma. Although our ability to monitor these outcomes has improved over time, this chartbook illustrates the continued fragmentation of occupational health surveillance systems as well as the paucity (or even total absence) of data for certain occupational disorders and groups. The data suggests a compelling need to improve, expand, and coordinate occupational safety and health surveillance activities to develop and augment the data needed to guide illness and injury prevention efforts. Working with government and non-government partners, NIOSH will continue efforts to enhance occupational health surveillance in the coming years.