VA Employee Occupational Health

Occupational and Environmental Medicine is a specialty service within the Department of Medicine at the San Francisco VA Health Care System (SFVAHCS). Under the leadership of Sandeep Guntur, MD, MPH, with Gina Solomon, MD, MPH, as the Section Chief, the team includes several part-time physicians (including Mehrdad Arjomandi, MD, and Amy Heinzerling, MD, MPH), 6 nurse practitioners, 2 RNs, 1 LVN, and 4 support staff.

The service includes Employee Occupational Health (EOH), Environmental Health, and Compensation and Pension (C&P).

EOH provides services to support the heath and readiness of VA employees, including: 

• Pre-placement evaluations of all employees, and annual administrative examinations for police and motor vehicle operators.
• Evaluations for emergency responders prior to deployment.
• Evaluation and management of worker injuries and illnesses, including communicable diseases and blood and body fluid exposures.
• Operation of medical surveillance programs (e.g., hearing conservation, respiratory protection, laser, animal handler).
• Response to issues that may endanger employee health (e.g., coccidiodes exposure in lab workers, formaldehyde in pathology, indoor air quality issues).

Our service also performs environmental health evaluations of Veterans including Toxic Exposure Screening, registry examinations, and Military Environmental Exposure (MEE) assessments. Several of our clinicians are trained and certified to conduct C&P examinations. They assist the Veteran population with disability benefits claims. 

OEM residents typically rotate at the SFVA for two months, during which they provide environmental and occupational health services to the Veterans and staff. Residents also participate in audiology evaluations, sleep medicine evaluations, post-traumatic stress disorder clinics, and work with the Radiation Safety Officer and Occupational Therapists.

As part of this rotation, the resident completes a Qualitative Improvement (QI) project to enhance the management and workflow of our service. Some recent QIs include:

• Enhancing the Hearing Conservation Program
• OSHA 300 log audit
• Aerosol Transmissible Disease Risk Stratification for Respiratory Protection
• Root Cause Analysis of a Coccidioides exposure at the SFVA microbiology laboratory.

To support educational activity, our service conducts monthly (third Thursday) VA clinical case conferences via Zoom.