Background The United Union of Roofers, Waterproofers, and Allied Workers (UURWAW) is one of the 15 building and construction trades departments in the AFL-CIO. The U.S. roo®ng industry, including both roo®ng and waterproo®ng applications, both unionized and nonunionized, comprises about 25,000 ®rms, employing approximately 300,000 people, about 200,000 of whom are involved in the application of roofs. The speci®c toxins to which roofers may be exposed at the job site include, among others, bitumens (asphalt and/or coal tar pitch) as well as asbestos and ®berglass from roof removal operations. Excess deaths from occupational injuries are also of concern. Methods This study evaluated causes of mortality among 11,144 members of the UURWAW. Age-adjusted proportionate mortality ratios (PMRs) were computed with 95% con®dence intervals (CI) using U.S. age-, gender-, and race-speci®c proportional mortality rates for the years of the study, 1950±1996. Results Statistically signi®cant increased PMRs were found for all injuries (PMR 142, CI 134 ±150), especially falls (PMR 464, CI 419±513) and other injuries (PMR 121, CI 107±137), cancers of the lung (PMR 139, CI 131±148), bladder (PMR 138, CI 111 ± 170), esophagus (PMR 134, CI 107 ± 166), larynx (PMR 145, CI 106±193), and cancers of other and unspeci®ed sites (PMR 130, CI 112 ± 149), pneumoconioses and other nonmalignant respiratory diseases (PMR 115, CI 103±128), and homicides (PMR 153, CI 135±172). The occupational exposures which may have contributed to the excess risks of malignant and nonmalignant respiratory diseases include, among others, asphalt fumes, coal tar pitch volatiles and asbestos; however, cigarette smoking must also be considered a contributing factor. Conclusions The present study underscores the need to control airborne exposures to hazardous substances and especially to examine fall prevention efforts within the roo®ng industry. Am.