Background: Silica is a pervasive and potentially deadly occupational hazard in construction. The occupational risk posed by silica has long been known, but efforts to use engineering controls to minimize dust generation in tuckpointing operations, a masonry restoration specialty, have been slow. Objectives: The objective of this study is to explore how local innovation in occupational safety and health may emerge, absent the establishment of national standards. Method:This study uses a case study to explore the adoption of local exhaust ventilation in tuckpointing operations in the Chicago area. Sources of data for this research include interviews with a diverse range of key informants and the review of archival material. Results: This case study found local unions, municipal regulators, contractors, and major public users of construction services played a central role in the events and milestones that led to the early adoption of local exhaust ventilation in Chicago. The adoption of local exhaust ventilation technology in Chicago demonstrates the potential for local actors to fill an important void when rulemaking in vital areas of occupational of health impedes effective national regulation.