While previous studies describe injuries to young adolescents occurring in the workplace, few focus on exposures to toxic substances. Yet low skill, entry-level jobs obtained by adolescents may pose the particular hazard of such exposures. Frequently, cleaning agents, solvents, paints and/or other chemicals are used by adolescents in these jobs to carry out their assigned tasks. Prevention of such incidents requires more information about their frequency and severity. However, job-related poisonings involving adolescents less than 18 years of age are unlikely to be reported either to federal or state agencies. Poison control centers sometimes get called about such toxic exposures and might serve as a resource for the surveillance of such injuries. This study investigated toxic exposure incidents in the workplace involving adolescents less than 18 years, using a national database provided by poison control centers. The purpose was to describe the frequency and severity of such poisonings, the agents involved, and any variation by geography or over time. An analysis of occupational toxic exposures occurring in the United States between 1993-1997 was performed using the Toxic Exposure Surveillance System (TESS) database compiled by the American Association of Poison Control Centers. Contingency tables with the Chi square statistic were used to test bivariate associations. A linear regression of proportions was performed to investigate the trend over time in the frequency of such poisonings. Multiple logistic regression analysis was used to compare the severity of exposures between regions of the country. Of 301,228 United States workplace toxic exposures occurring over this 5 year period, 8,779 (2.9%) involved adolescents less than 18 years of age. Males (63.9%) predominated; such toxic exposures were more commonly reported during the summer months (38.2% of all exposures occurred during June, July, and August), between the hours of 3-9 p.m. (45.7% of all calls), and as frequently during weekends as weekdays. The most common agents involved were: alkaline corrosives (13.2%), gases and fumes (12.1 %), cleaning agents (9.7%), bleaches (8.3%), drugs (7.4%), acids (7.1 %), and hydrocarbons (6.9%). In the majority of cases few symptoms developed and the patient could be managed at the workplace or at home (60.0%); however 37.0% of these children were assessed in a hospital emergency department and 3.0% required at least a brief hospitalization. In 14.2% of cases, the toxic injuries sustained were rated as moderately severe and 0.3% resulted in life-threatening symptoms; there were 2 deaths. Linear regression analysis of weekly proportions suggested that the frequency of occupational exposures occurring among adolescents versus exposures among adults increased over time (r2=0.03; p=0.003). More exposures overall were recorded in Southern states (32.5%) than other regions of the country, although a greater proportion of the severe exposures were reported from Central states (17.6%) compared to other regions of the country (mean=14.5%; p=0.001). This study found adolescent workplace toxic exposures to be a significant public health concern, accounting for almost 3% of all occupational toxic exposures reported to U.S. poison control centers. Such injuries more often involved males and more frequently occurred during evening hours and during summer months. Agents most often implicated were noxious gases and fumes, caustic chemicals, cleaners and bleaches. While many exposures were medically trivial, some required evaluation in a health care facility or hospitalization. A significant number of severe injuries were attributable to dermal or eye exposures to caustic substances. These adolescent toxic exposures were more common in Southern states but more severe in the Midwest region of the United States. The proportion of exposures involving teens increased from 1993-1997 in all sections of the United States, relative to occupational poisonings involving adults. This trend may reflect an increasing number of such exposures, an increasing number of adolescents working, and/or an increased utilization of poison control centers. This study also confirms the usefulness of poison control center-derived data in describing and monitoring workplace exposures involving adolescents that might not be reported elsewhere. These are sentinel events that suggest an even larger underlying problem involving business establishments that employ children. Further study is needed to define more precisely the circumstances surrounding such toxic exposures, the determinants of which adolescents at high risk, and the preventive strategies needed to avert some of these injuries.