The current national system for work-related injuries and illnesses markedly underestimates the magnitude of these conditions. A more comprehensive system, such as the one developed for traumatic workplace fatalities, that is not solely dependent on employer based data sources is needed to better guide decision-making and evaluation of public health programs to reduce work-related conditions.

Variations in worker compensation claims between states are highlighted when legislators consider "reforms" to reduce workers' compensation costs. These reforms overlook the larger variation between companies within the same type of industry in the same state. Possible reasons for this variation between companies and its implication on reducing morbidity and health care costs are discussed.

A high-risk notification program is in progress for 4,862 former chromate and bichromate production workers. A previous mortality study of this cohort found a 29-fold increase in mortality for respiratory cancer. The increase was greater in black than white workers (80-fold vs. 15-fold). The cohort was compiled from Social Security Administration records. Notification was performed mainly using addresses on file with the Internal Revenue Service. At this time, 68% of the cohort has either been determined to have died or has been contacted. A description of the various steps of notification is included. This project has demonstrated that it is possible to perform high-risk notification in an economical manner even in the absence of employer personnel records or current addresses. The methodology used in this project is generalizable to other cohorts.