OCCUPATIONAL illness is a major contributor to total v morbidity and mortality in the United States. It is estimated that 390, 000 new cases of occupational disease occur annually and that occupational illness results in tv some 100, 000 deaths each year. These figures may, however, understate the influence of occupational factors on health status (1). Former Secretary of Health, Education, and Welfare Joseph Califano, for example, stated that 20% of future cancers alone might be associated with occupational exposures (2).As recognition of the significance and extent of occupational exposure has expanded over the past few years, consumer groups and representatives of the labor movement have begun to insist that measures be taken to prevent or limit exposure to toxic substances, and that the capacity of the health care system be enhanced to meet the needs of exposed workers. In 1970, the Occupational Safety and Health Act was passed to protect workers from job-related injuries and illness. No similarly organized federal or private program has been mounted to address medical care issues.