A serious, relatively unrecognized, occupational health problem involves the interaction of ethyl alcohol and chemical agents used in industry. Workers who drink alcohol and are exposed to certain chemical agents may experience adverse health effects such as nausea, dizziness, headache, and liver damage. This report reviews the synergistic interactions of ethanol with compounds such as the thiurams, amides, oximes, halogenated hydrocarbons, and metals. Also discussed is the effect of ethanol as a cofactor with vinyl chloride in the etiology of cancer.