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Geographic analysis is now integral to public health surveillance, but has been underused for occupational injury/illness.Mapping and spatial statistics are used to examine national county-level mean establishment Lost Workday Injury/Illness (LWDII) rates in the Occupational Safety and Health Administration (OSHA) Data Initiative (ODI), 1997–2001. The following questions are explored: Does occupational injury/illness vary geographically at the county level?; Does variation remain after accounting for industry hazard?; Where are rates higher or lower than expected?The methods provide evidence of geographic variation in nonfatal occupational injury/illness rates, including after adjusting for industry hazard.Geographic analyses can improve intervention targeting, suggest risk factors for investigation, and make the case for targeting resources to prevention in hardhit areas, as well as improving ongoing surveillance. Am. J. Ind. Med. 51:680–690, 2008. © 2008 Wiley-Liss, Inc.