The New York State Heavy Metals Registry is a legislatively mandated program through which clinical laboratories, physicians, and health facilities report state residents 18 years of age and older with elevated levels of lead, mercury, arsenic, or cadmium in blood or urine. From 1982-86, the current employer was determined for 95.9 percent of 3,309 cases. Occupational exposures in 328 companies accounted for 82.8 percent of cases. The majority of companies were reported for lead (247 companies, 75.3 percent of total) or mercury (47 companies, 14.3 percent of total). Of the 247 companies reported to the Registry for lead, the Occupational Safety and Health Administration (OSHA) inspected 18 of 98 companies (18.4 percent) in the manufacturing sector, but only one of 149 companies (0.6 percent) outside the manufacturing sector. We conclude that the Registry effectively detects companies with heavy metals exposures, and is an especially useful adjunct to OSHA inspections outside the manufacturing sector.