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The workplace is a significant contributor to injuries and injury fatalities in the United States. Unfortunately, the systems in place for collecting and coding injury data suffer from a number of limitations that make it difficult, if not impossible, to enumerate accurately the true scope and import of occupational injuries and injury fatalities. At present, there are no nationally agreed upon standards for defining, reporting, and recording occupational (and nonoccupational) injuries. This article examines and evaluates the major surveillance systems for the collection and recording of data on occupational injuries and injury fatalities and presents guidelines for establishing a model system of occupational injury surveillance. These guidelines should be valuable in designing a national data system that can measure the impact and effectiveness of injury prevention and control programs in the United States.