Public awareness of the potential for healthcare to actually be the source of harm to patients through exposure to infectious agents, unintended error or known side effects of hazardous treatments has spawned a highly visible "patient safety" movement. Less visible, however, is the risk this same environment and these same hazards impose on the health of the women and men who work there. Although often thought of as clean and safe, workplaces in the Healthcare and Social Assistance (HCSA) sector are associated with many of the same types of exposures to chemicals and hazards found in "blue collar" industrial settings. The HCSA sector is burdened by the historical and entrenched belief that patient care issues supersede the personal safety and health of workers and that it is acceptable for HCSA workers to have less than optimal protections against the risks of hazardous exposures or injuries. Because patients and providers share the healthcare environment, efforts to protect patients and providers can be complimentary, even synergistic, when pursued through a comprehensive , integrated approach. In order to address occupational safety and health issues of the nation, including those of the HCSA sector, the National Institute for Occupational Safety and Health (NIOSH) is working with a range of partners to develop an updated National Occupational Research Agenda (NORA). Each industrial sector is being addressed by a group of experts and stakeholders called a NORA sector council. This document was developed by the NORA HCSA Sector Council to address the "state of the sector," including the magnitude and consequences of known and emerging health and safety problems, important knowledge gaps, and opportunities for research to improve the "state of the sector" over the next decade of NORA.