Abrasive blasting with silica sand has long been associated with silicosis. Alternatives to sand are being used increasingly. While NIOSH has done extensive investigations of the respiratory effects of the substitutes for sand, the ergonomic effects of the substitutes have not been examined. Too often, hazards are shifted, and technologies that might save workers' lungs could do so at the expense of their musculoskeletal systems. Hence, the objective of this study was to examine the ergonomic effects of alternatives to sand. Multiple methods, both qualitative and quantitative, were used to yield numerous kinds of data for the analysis of exposures to abrasive blasters. PATH, a method for quantifying ergonomic exposure in non-routine work, was combined with interviews with workers, biomechanical modeling and noise level readings to assess the ergonomics of two abrasive blasting operations: high-pressure water and steel shot. Advantages and disadvantages of each medium are discussed. High-pressure water was slightly less ergonomically stressful, environmentally cleaner, much quieter and less dusty that steel shot, and it was reported to be slower on those tasks where both media could be used.