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Water supply systems around the world are subject to the effects of work-related accidents and environmental health-related illnesses. Some organizations have been deeply affected by fatal incidents. Even routine injuries and illnesses affecting all organizations can result in lost productivity, increased worker's compensation cost, and poor employee morale. Although a number of organizations are interested in preventing on-the-job injuries and illness, none focus on the water industry. The objectives of this project were to: (1) enhance understanding of the type and frequency of injuries that occur in the water industry and identify divisions and job activities that have higher work-related injury and illness rates; (2) identify the most successful strategies utilities have used to improve safety programs and performance; and (3) promote more uniform injury/illness tracking, prioritize injury/illness related safety issues that warrant greater research attention, develop research project scopes, and prioritize them based upon the criticality of the needs. Current performance when compared to other utilities (i.e., electric utilities) suggests that water utility executives and industry associations such as AWWA and AwwaRF should make concerted efforts to improve health and safety performance. The top three health and safety needs in the water industry are training, management commitment, and formal written health and safety programs. Originally published by AwwaRF for its subscribers in 2003 This publication can also be purchased and downloaded via Pay Per View on Water Intelligence Online - click on the Pay Per View icon below