Surveillance is vital to the prevention of occupational diseases, injuries, and fatalities. It provides information necessary to document the magnitude of workplace health and safety problems, to set research priorities, and to target and evaluate interventions to improve worker safety and health. While there have been substantial improvements in surveillance of occupational diseases and injuries in the United States over the last decade, surveillance remains inadequate. There is no comprehensive, nationwide system of surveillance for occupational diseases, injuries and hazards. Current surveillance activities are fragmented, and there are significant surveillance gaps. Recognizing that States play an important and unique role in surveillance, NIOSH has provided financial support and technical assistance to State agencies since the early 1980's to assist in establishing and enhancing their occupational health and safety surveillance programs. Improved planning and coordination of surveillance activities is essential to more effectively use limited occupational safety and health resources. In 1998, NIOSH embarked on a process to assess current surveillance needs and to identify goals for the next decade. The Council of State and Territorial Epidemiologists, with support from NIOSH, established a Surveillance Planning Work Group to provide state input to this strategic planning process. Work Group findings and recommendations are summarized in this report.