Concern for the protection of workers' health is not new to medicine. Physicians in the 1400's raised awareness among colleagues as to the need to prevent the diseases of employment in mines. Society has responded to increasing levels of evidence as to the relationships between disease and certain worksites by making employers accountable for the individual and social costs incurred by poor workplace hygiene. This has occurred by the development of workers' compensation and occupational health and safety regulatory programs. The impact of these efforts has been to significantly reduce occupational disease and safety problems in industry. Increasing resources have also been given to the training of physicians in occupational medicine and research into links between occupations and disease. Increasing pressure to reduce public spending and to deregulate are challenging government's ability to continue research, training, technical information distribution, consultation and regulatory cleanup efforts to improve work conditions and thus reduce the incidence of occupational safety and health problems.