The Occupational Health Nurses in Agricultural Communities (OHNAC) program is a national surveillance program to identify and prevent agriculturally related illnesses and injuries. Locally based nurses work closely with health departments, hospitals, physicians, and other providers to identify and report sentinel health events. 2. Through OHNAC, sentinel health events are assessed and evaluated to identify occupational risk factors that may be applicable to the larger community of agricultural workers. This information is then disseminated nationally, locally, and to the individual workers. 3. The surveillance and investigation information is used to develop programs to prevent agricultural illnesses and injuries. The use of case based surveillance and subsequent data driven interventions has broad applicability for occupational health nurses in other industrial sectors.