Construction is one of the largest industries in the United States, with 13% of the gross national product and 5-6% of the labor force. It is also one of the most dangerous industries, accounting for 15% of occupational fatalities and 17% of all workers' compensation costs. In 1989, the Building and Construction Trades Department, AFL-CIO, completed an agreement with the National Institute for Occupational Safety and Health to develop a national labor-management initiative to improve occupational safety and health throughout the construction industry. The aim was to remedy a lack of research on construction occupational safety and health. The first years were spent on surveillance to characterize construction safety and health problems, development of awareness about safety and health issues among decisionmakers in the industry, and some limited interventions. A second phase was initiated in 1994, which focuses on intervention activities. Results from this joint program include a growth in annual federal construction safety and health research expenditure from $300,000 in 1989 to $12 million in 1995, a research network that now encompasses more than 30 institutions, a national conference that established an agenda to change construction safety and health, four regional conferences to develop coalitions and implementation strategies, and the development of a feasible goal to reduce fatality and injury rates by 80%. The program may already be having an impact. According to the Bureau of Labor Statistics, lost-time injury rates for construction for the three most recent years of reporting declined by 20%.