CONTEXT: Public health surveillance plays a crucial role in evaluating disease risk and providing timely evidence to policymakers and the public. However, surveillance of many occupational diseases is limited by existing surveillance infrastructure, which is heavily dependent on laboratory tests. OBJECTIVE: The present pilot study compared case data for 3 occupational lung diseases (ie, silicosis, asbestosis, and farmer's lung disease) from electronic case reports (eCR) with existing hospital discharge data in the state of Wisconsin to see if eCR-which sends health records directly from clinics when specific criteria are met-provided previously undetected cases of these reportable diseases. DESIGN: Case data for 3 reportable occupational lung diseases were pulled from eCR records within the Wisconsin Electronic Disease Surveillance System. In this retrospective cross-sectional study, a unique identifier was used to match eCR cases to hospital discharge data. SETTING AND PARTICIPANTS: This study was conducted using administrative data at a state health department to compare data systems and assess the utility of eCR for occupational health surveillance. MAIN OUTCOME MEASURES: The number and percentage of matched and unmatched cases were calculated to assess the overlap of the 2 data systems. For eCR cases, the median number of years since diagnosis was also assessed. RESULTS: The percentage of eCR cases that could not be matched to hospital discharge data ranged from 55% to 81.2%, depending on the disease of interest. The median length of time since diagnoses for eCR cases was multiple years, suggesting that most had long been missing from existing surveillance. CONCLUSIONS: This study suggests that eCR creates new potential in occupational health surveillance. eCR was found to provide previously undetected cases of occupational lung disease at a state health department and stands to improve the timeliness of case reporting as well.