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Most Occupational Safety and Health Administration (OSHA) inspections are based on employee complaints or targeting of industry groupings. Limited use has been made of illness data to target inspections and evaluation of such targeting is even more limited.This study compared 545 Michigan OSHA (MIOSHA) inspections performed as follow up to reports of work-related asthma (WRA) with 12,268 non-disease initiated OSHA inspections performed during the same time period (1989-2002).SENSOR asthma inspections were more likely to be conducted in larger, unionized employers. Although the likelihood of citations (∽50%), type of citation, and monetary penalties (∽30%) were not different between disease and non-disease initiated inspections, the number of citations and amount of monetary penalties were less in disease initiated inspections. Citations and penalties were more likely for small as compared to large employers, and were less likely at unionized worksites.Even without the availability of specific standards for agents that cause WRA, inspections triggered by a WRA index case are very much like other inspected worksites in terms of the prevalence of violations observed at the worksite. The advisability of making referrals to OSHA and additional ways to evaluate the effectiveness of this type of intervention model are discussed.