No practical surveillance mechanism exists that collects information on injuries and illnesses associated with agricultural activities for most farms in the US. Dairy, Wisconsin’s most important agricultural activity, is no exception. This surveillance project focuses on injuries and illnesses in Wisconsin dairy farmers and workers, with particular emphasis on changes in the dairy industry and the effect these changes have on injury and illness patterns. The goal is to establish an active surveillance process using a recurring survey in order to inform policy and guide interventions designed to reduce the overall burden of injury and illness on this population. This project brings together a multidisciplinary team of investigators and builds on existing surveillance resources including the Wisconsin Department of Agriculture (USDA NASS), the Marshfield Epidemiologic Study Area (MESA) and Marshfield Clinic Electronic Medical Records (MCEMR). These resources will be used to further develop a surveillance system and identify high risk production practices related to injury and illness in dairy farmers and workers as well as information on changes in farming operations such as herd size, workforce, production methods, animal handling, and other work practices. Specifically, the investigators will: 1) Establish population-based estimates of incidence of injury and illnesses in dairy farmers and workers; 2) Develop and administer a recurring survey to establish estimates of injury and illness among dairy farmers and workers throughout the state of Wisconsin over time; and 3) Identify high risk activities and conditions associated with production processes and worker characteristics and track any detectable influence on the frequency of injury or illness in the dairy workforce. This study will be the first to establish population-based estimates of incidence and prevalence of work-related injuries and illnesses in dairy in Wisconsin. The project will also explore the value of electronic health records as a resource in surveillance. This project is closely linked to several projects with a focus on injury and risk reduction in dairy production as part of the newly created Upper Midwest Agricultural Safety and Health Center.