Engineered nanomaterials (ENM) represent an emerging technology with a wide range of industrial and medical applications. The toxicity of nanomaterials may vary considerably depending on numerous variables, including but not limited to composition (including impurities), size, shape, charge, aggregation status, solubility, and surface characteristics. Although this poses a challenge to the development of occupational exposure limits (OELs), some OELs have recently been proposed for selected ENMs. Based on animal data and findings associated with ambient nanoparticulates, health concerns for ENMs have focused on cardiovascular and pulmonary endpoints. The potential for exposure to ENMs can occur across the lifecycle. A precautionary approach that focuses on prevention of potential exposures and toxicity evaluation aimed at the sustainable production of these potentially valuable new products is recommended. Although there is no consensus on the value of instituting routine medical surveillance targeted to workers with potential exposure to nanomaterials, the potential utility of nanomaterial worker exposure registries has received increasing attention.