**[MAY 14, 1999]{.underline}**

Mr. John E. Plummer

Director

Office of Federal Agency Programs

Occupational Safety and Health Administration

U.S. Department of Labor

200 Constitution Avenue, NW

Washington, DC 20210

Dear Mr. Plummer:

Enclosed is the Annual Occupational Safety and Health Program Report for
Fiscal Year 1998 for the Department of Veterans Affairs (VA) as required
by 29 Code of Federal Regulations (CFR) 1960.74. Through the cooperative
efforts of our respective organizations, I hope to see further
accomplishments within VA in the area of employee safety and health.

If your staff has any questions concerning the report or the VA
Occupational Safety and Health program, they may contact Myrna J.
Aavedal, Ph.D., Occupational Safety and Health, at (202) 273-9744.

Sincerely,

***[/S/]{.underline}***

[ Eugene A. Brickhouse]{.underline}

[ Designated Agency Safety]{.underline}

[ and Health Official]{.underline}

# [Enclosure]{.underline}

## [AGENCY FISCAL YEAR 1998 ANNUAL REPORT ON]{.underline}

**[OCCUPATIONAL SAFETY AND HEALTH]{.underline}**

**[Department/Agency Name: ]{.underline}**[Department of Veterans
Affairs ]{.underline}

**[Authorized Point of Contact Name]{.underline}**[: Myrna J. Aavedal,
Ph.D. ]{.underline}

**[Title]{.underline}**[: Program Analyst ]{.underline}

**[Telephone Number: ]{.underline}**[(202) 273-9744 ]{.underline}

**[Fax Number: ]{.underline}**[(202) 273-9777 ]{.underline}

**[E-Mail Address: ]{.underline}**[ ]{.underline}

[I. ]{.underline}**[SAFETY AND HEALTH PROGRAM PERFORMANCE]{.underline}**

[ A. Injuries and Illnesses]{.underline}

[1. ]{.underline}***[What are the major causes of injuries and illnesses
at your Agency or Department]{.underline}***[?]{.underline}

[National Cemetery Administration (NCA). Two major concerns in this area
are the physical exertion needed to accomplish interments in all kinds
of weather conditions and terrain, and the hurried manner of completing
tasks that contributes to back injuries or other injuries through slips,
trips and falls.]{.underline}

[Veterans Benefits Administration (VBA). The major cause of injuries in
VBA are due to the lifting of heavy files which results in back
injuries.]{.underline}

[Veterans Health Administration (VHA). The major causes of injuries and
illnesses at VHA are activities that result in back injuries,
musculoskelatal exertion, slips, trips, and falls. Occupations that
require patient lifting, and moving, and other material handling are the
primary source of injuries.]{.underline}

[2. ]{.underline}***[What action has the Agency taken to correct these
hazards or remove employees from risk]{.underline}***[?]{.underline}

[NCA. When an injury occurs, victims are required to fill out an
accident report, receive counseling from local supervisory staff and
retraining when necessary, and are furnished additional personal
protective equipment when warranted. In addition, the incident report is
evaluated by area office safety staff to determine if site construction
or other modification is required to remove or abate the cause of the
injury. To prevent injuries, specialized training is provided through
videos and interactive training. Work actions are evaluated to assess
the need for protective equipment, mechanization, or increased
teamwork.]{.underline}

[Page 2.]{.underline}

[VBA. VBA has provided employees instructions on heavy lifting and they
have continued to work on reducing those occasions when the lifting of
large quantities of files is necessary.]{.underline}

[VHA. Developed an electronic tracking software called the "Automated
Safety Incident and Surveillance Tracking System, " or ASISTS, that is
compatible with VHA medical centers' computer language. ASISTS has the
capability of accurately identifying, tracking, and evaluating accidents
or illnesses when they occur. Each Veterans Integrated Service Network
(VISN) and VA Medical Center accident management team will utilize this
trend analysis capability to identify the root causes of these accidents
and help prevent future incidents.]{.underline}

[In August 1998, VHA sponsored a National Occupational Health and Safety
Conference that was attended by VA Safety Officers and Employee Health
Service staff. The conference provided staff training on topics of
special interest to VA occupational safety and health practitioners
including prevention of musculoskeletal injuries, ergonomics, and slips,
trips and falls.]{.underline}

[3. ]{.underline}***[What action has been taken to address the causes of
these hazards]{.underline}***[?]{.underline}

[NCA. OSH policies and procedures are reviewed, safety committees meet
regularly, and safety inspections are routinely scheduled to assess risk
issues. Tasks are re-engineered and re-thought to minimize operational
risk. ]{.underline}

[VBA. Files and folders, which are often quite large and bulky, are an
important aspect of VBA\'s business. Ergonomic chairs and office
furniture are provided and instructions on how to eliminate or reduce
back injuries are consistently offered.]{.underline}

[VHA. In addition to the above mentioned electronic tracking system, VHA
VISN safety staff also conduct annual OSH oversight evaluations of their
facilities, issue reports of OSH violations (based on the 29 CFR 1960),
and recommend abatement actions. An automated survey program has been
developed and is now in the testing phase. The automated system will
correlate OSH inspection information into reports that contain OSHA
regulatory references, provide analyses of facility risk, and furnish
management with pertinent OSH information in a timely
manner.]{.underline}

[Page 3.]{.underline}

[4. ]{.underline}***[Does your agency use injury and illness data to set
program priorities and objective]{.underline}***[?]{.underline}

[NCA. Injury data is used to determine training approaches in subsequent
monthly meetings, posted bulletins, or verbal advisories.]{.underline}

[VBA. As yet, the injury data are not used to set priorities in
VBA.]{.underline}

[VHA. VHA uses injury and illness data to establish OSH program
priorities and objectives. Injury and illness data has also been used to
set performance measures for VHA managers; prioritize education and
training objectives, health promotion and injury prevention goals; and
to focus our occupational health research agenda. The data is provided
by a department-wide, standardized computer workers' compensation
program tracking system that can be accessed by authorized VA staff on
their desktop computers. The tracking system improves employee injury
and illness claim tracking and case management.]{.underline}

[5. ]{.underline}***[Does your agency use injury and illness data to
evaluate the performance of top managers?]{.underline}***

[NCA. Yes. It is being written into the performance standards of all
field directors.]{.underline}

[VBA. As yet, the injury data is not included in the director\'s
performance measures within VBA.]{.underline}

[VHA. Yes. Beginning in 1998, specific goals and targets have been
identified for senior managers' performance standards.]{.underline}

[B. Written Safety and Health Program]{.underline}

***1.** **[Does your agency have an up-to-date written safety and health
program? Please attach a copy]{.underline}***[. Yes. VA has an
up-to-date written OSH program policy. VA Directive 7700, "Occupational
Safety and Health," and the accompanying Handbook 7700.1, provide OSH
direction to all VA administrations. See attached copy.]{.underline}

[a. ]{.underline}***[When was it last updated?]{.underline}***[ VA
Directive 7700 and Handbook 7700.1 were issued in July
1998.]{.underline}

[Page 4.]{.underline}

[b. ]{.underline}***[Does the written safety and health program reflect
current occupational safety and health policies and
procedures?]{.underline}***[ Yes. In addition, the VA OSH program allows
administrations the flexibility to establish new OSH programs in
accordance with OSHA regulations and other generally accepted guidelines
and standards, as appropriate.]{.underline}

[c. ]{.underline}***[Does the written safety and health program reflect
current organization structure?]{.underline}***[ Yes. Although
administrations have reorganized to implement the Government Results and
Performance Act and other veteran care management improvements, the
directive reflects the overall structure of VA
organizations.]{.underline}

[2. ]{.underline}***[Does your
Department]{.underline}**[']{.underline}**[s sub-agencies have separate
written safety and health programs specific to their operations? If so,
how does your Departmental program relate to the sub-agencies
programs?]{.underline}***[ ]{.underline}

[NCA. Yes, each area office has a Safety Officer responsible for overall
program direction. Safety issues are identified and addressed within
each of these areas by supervising area office directors (i.e. snake
bite measures in snake-prevalent areas; frostbite prevention in areas
with extreme low ambient temperatures; sunscreen; and personal hydration
issues in hot climates, etc.).]{.underline}

[VBA. VBA\'s regional offices often work with and rely upon co-located
medical centers. Typically, regional offices designated safety
coordinators are trained and familiar with safety and health policies,
and they respond appropriately when safety and health issues
arise.]{.underline}

[3. ]{.underline}***[Have agency managers, supervisors, employees and
employee representatives been provided with training to familiarize them
with the written safety and health program?]{.underline}***

[NCA. Yes.]{.underline}

[VBA. No. VBA\'s written program is not yet developed.]{.underline}

[C. Safety and Health Program Training]{.underline}

[1. ]{.underline}***[How does your agency ensure that managers,
supervisors, employees and employee representatives have been trained in
the requirements of the safety and health program?]{.underline}***

[NCA. Through Annual Safety Inspections, monthly safety meetings,
specialized training sessions, and individual familiarization with
equipment requirements, operations, and responsibilities.]{.underline}

[Page 5.]{.underline}

[VBA. In VBA, supervisory training and new employee orientations provide
managers, supervisors, and employees with information regarding VA
safety and health policies.]{.underline}

[VHA. Requirements of the OSH program are relayed through facility OSH
staff; National OSH workshops; teleconferences; monthly conference
calls; directives, information/alert bulletins; letters; and
consultation by VHA VISN safety and health staff.]{.underline}

[2. ]{.underline}***[How does your agency train managers, supervisors,
employees and employee representatives to recognize the hazards of their
work operations?]{.underline}***

[NCA. Annual training in a variety of subjects is completed at the
different organizational levels. Additional training is provided through
interagency cooperation with other Federal agencies. We also develop
effective training relationships with servicing medical centers or
supervisory area office training coordinators to schedule refresher or
new training sessions.]{.underline}

[VBA. The VBA safety coordinator occasionally attends national VA safety
and health training. Supervisors and employees are trained
locally.]{.underline}

[VHA. VHA provides training at the facilities in hazard recognition
through supervisors training new employees; commercially available
professional training courses; training courses developed in conjunction
with the Employee Education Service. Facility safety and health staff
offers training in hazard recognition using the VHA OSH Guidebooks as a
resource or training packages developed by the DASHO and their training
committees.]{.underline}

[3. ]{.underline}***[What training has your agency done to help managers
develop hazard abatement plans when abatement cannot be achieved within
30 workdays?]{.underline}***

[NCA. Special emphasis is placed on informing their managers of all
safety information and techniques through their bi-monthly safety
bulletins. This has resulted in timely resolution of hazardous
conditions in the workplace. If abatement cannot be accomplished within
30 workdays, managers are required to develop a written action plan in
conjunction with the Area Safety Officer.]{.underline}

[VBA. Abatement plans for hazards are not an issue for VBA because the
regional offices typically reside in GSA buildings or are co-located in
VHA medical centers.]{.underline}

[Page 6.]{.underline}

[VHA. VHA develops abatement plans within facility engineering
departments in consultation with the facility OSH staff, VISN OSH staff,
or OSH contractors. The engineering staffs have received OSH training
through courses available through the VHA Employee Education Campus in
North Little Rock, Arkansas.]{.underline}

[II. ]{.underline}**[ACCOMPLISHMENTS]{.underline}**

***[Please describe the major success story or stories of occupational
safety and health in your Agency during the reporting
period.]{.underline}***

[NCA. Over the past four years NCA has achieved a continued reduction in
their agency's OWCP roster. This reduction, in addition to a decrease in
lost time accidents, shows that their safety efforts are effective, and
achieving benefits for the agency that result in cost savings. NCA is
also experiencing a reduction of accidents through programs that foster
employee involvement.]{.underline}

[VBA. VBA has not provided specific examples of success
stories.]{.underline}

[VHA. The Under Secretary for Health has made occupational safety and
health a key component of VHA's reorganization efforts by establishing
annual OSH performance measures for supervisors and managers. These
measures provide emphasis and focus management attention on the value
and importance of organizational OSH programs.]{.underline}

[To support these efforts, VHA developed a real-time automated
management and tracking system for accidents and illnesses at each VA
medical facility. This accident and injury-tracking module is currently
in use and additional occupational health modules are in development.
Future phases of this project will add the capacity to track safety and
health issues such as medical surveillance, training, and other required
record keeping information. In addition to providing the capability to
track these issues locally, the database will allow the analysis of
national trends. ]{.underline}

[In addition, VHA has developed an automated data entry system for VISN
safety staff to use during facility OSH oversight inspections. This
system is in pilot testing now and will be used by all VlSNs beginning
in Fiscal Year 1999. These initiatives have provided a focus for
occupational safety and health efforts within VHA and have been a key
factor in reducing VHA's lost time case rates. ]{.underline}

[The Under Secretary for Health also created the Occupational and
Environmental Strategic Health Care Group to coordinate OSH activities
across VHA. This group not only coordinates all VHA OSH activities, but
also provides leadership and integration with clinical
activities.]{.underline}