Exposure assessment must stop being local.

Exposure assessment activities today are hampered by a narrow focus that is detrimental to preventive occupational health goals. Exposure data useful for disease prevention are not adequately collected, and exposure surveillance tools do not receive adequate attention. Professional recommendations to improve this state of affairs have been in existence since the early 1990s, but have not been widely adopted. Although the Government Performance and Results Act could help address these shortcomings--by enhancing exposure surveillance activities in the OSHA and NIOSH Strategic Plans--the agencies have not taken advantage of this opportunity. Their strategic plans rely largely on accident data to measure performance, despite the fact that occupational disease has a much larger toll. This article makes recommendations to address these shortcomings by increasing the role of exposure surveillance tools in the agency strategic plans.