Mandates for provider reporting systems have existed in a number of states for many years, but due to various shortcomings the potential for targeted surveillance of occupational illness and injury has not been realized. To achieve a more uniform, active approach to provider reporting, SENSOR will be created as a cooperative state-federal effort designed to develop local capability for the recognition, reporting, follow-up, and prevention of selected occupational disorders. To demonstrate the feasibility of this approach, NIOSH funded a small number of SENSOR projects in 1987. Ultimately, joint state-federal support will be essential to maintain SENSOR activity within a state. SENSOR should not be viewed as the sole approach to the surveillance of occupational illness and injury. Other approaches to the identification of cases of occupational illness or injury and to monitoring the trends of occurrence of these disorders have been developed by NIOSH and various states, and they will continue to function.