Survey of Occupational Injuries and Ilnesses - State and Local

December 21, 2006

RE: Voluntary Completion of OSH Survey by Government Units
Dear Sir or Madam:
I am writing to request your assistance in expanding the Occupational Safety and Health (OSH) Survey in
Illinois. The purpose of the survey is to identify workplace injury and illness causes and then, with the
help of safety personnel, design procedures to reduce future injuries and illnesses. The accompanying
survey booklet is requesting injury and illness data for your governmental unit for calendar year 2006. At
present, your reporting is voluntary; however, we strongly encourage you to participate in this very
important survey. Last year’s participation was 88 percent and we would like to exceed that percentage
this year. Your participation provides needed data to ascertain occupations, types of injuries and illnesses
(strained backs, turned ankles, carpal tunnel, etc.), and the actions causing the injury or illness (lifting,
alighting, typing, etc) so that preventive intervention can be designed, implemented, and evaluated.
Reporting does not need to be time consuming. Here are suggestions to ease your burden. Submit your
survey response online at https://idcf.bls.gov. Your department timekeeper should have the numbers for
completing Section 1 on page 3. We suggest utilizing your OSHA Form 300 that you are required to keep
for the Illinois Department of Labor. Simply transfer the column totals from the OSHA Form 300A to
Section 2 on page 3 of the survey. If you have to report more than 30 incidents that resulted in lost
workdays (total of column H from the OSHA Form 300), please call us at (217) 524-2098 and we may be
able to cut your workload by selecting a sample of injuries and illnesses to report. If you have no cases to
report, you can also contact us at (217) 524-2098 and an intake person will be glad to take your
information. Please have sections 1 and 2 completed prior to calling.
Rather than completing the Case with Days Away from Work form, we will accept photocopies of either
the Workmen’s Compensation Form 45 or OSHA Form 301 (please add job titles) along with the OSHA
Form 300. These two documents will provide the information needed for the survey. When these tasks are
complete, sign the back of the booklet and mail it to us in the provided envelope.
Please take the time to complete the enclosed survey, as the information is important in reducing injuries
in the workplace. Thank you in advance for your participation.
Respectfully,

Lloyd L. Evans, Acting Manager
Occupational Disease Registry

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

NOTICE
Dear Public Sector Official:
Enclosed please find the annual Survey of Occupational Injuries and Illnesses for 2006.
Your participation is mandatory under Maine Public Law 1989, Chapter 712, which replaces
Public Law 91-596 that appears in the enclosed booklet. The first mail-out went out the second
week in January. This report must be completed and returned to our office even if no OSHA
recordable work-related injuries and illnesses occurred in your workplace. The Survey must be
completed and returned by the date shown on the cover.
If you have any questions or concerns please call Steve Laundrie at 624-6447.
Cordially,

Steve Laundrie
Statistician
Maine Department of Labor
Bureau of Labor Standards

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

NOTICE
Dear Fire Department/Rescue/Ambulance Official:
Enclosed please find the annual Survey of Occupational Injuries and Illnesses for 2006.
Your participation is mandatory under Maine Public Law 1989, Chapter 712 which replaces
Public Law 91-596 that appears in the enclosed booklet. This report must be completed and
returned to our office even if no OSHA recordable work-related injuries and illnesses occurred in
your workplace. Please note the following clarifications:
For Question 2 under Section 1 – Establishment Information, please be sure to include
all fire department employees, INCLUDING VOLUNTEERS, WHETHER PAID OR
UNPAID.
For Question 3, please count only the hours worked while the employees were conducting
fire department and/or rescue and/or ambulance activities. This should include time spent
working at the fire station, attending meetings, drilling, training, maintaining fire equipment,
fighting fires, and responding to other emergency calls. Also, if applicable, please include time
on call while on duty at a fire station. Do NOT include the time spent at home or time spent
working at another job, whether the firefighter is on call or not. If you do not have an exact
number for Question 3, we will accept an estimate of the total hours worked. ON THE NEXT
PAGE IS AN EXAMPLE OF HOW TO CALCULATE HOURS WORKED FOR A
VOLUNTEER FIRE DEPARTMENT.
NOTE: For injuries or illnesses with days away from work and/or restricted work activity
please count only the days lost as a fire department employee. Do not count days lost from
other jobs or vocations.
If you have any questions or concerns, please call Steve Laundrie at 624-6447.
Cordially,
Steve Laundrie
Statistician
Maine Department of Labor
Bureau of Labor Standards

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

HOW TO CALCULATE EMPLOYMENT AND
HOURS WORKED FOR A VOLUNTEER FIRE
DEPARTMENT
Below is an example of how to calculate the employment and total
hours worked for a volunteer fire department.
EXAMPLE:
Chief Don Smith of the Town A fire department received the Survey of
Occupational Injuries and Illnesses. He needs to calculate the average
employment and hours worked.
He has 25 volunteers, both firefighters and rescue people. He enters 25 for
the answer to Question 2 – average employment.
He calculates the total hours worked using the following method:
1) There is a monthly meeting for the entire department. He estimates that
on average about 20 people attend the meeting. An average meeting
lasts 2 hours. 20 people times 2 hours per meeting times 12 meetings
per year equals 480 hours.
2) For the firefighters, there are training sessions twice a month. He
estimates that about 18 people attend each training session. He
figures that an average training session lasts about 3 hours. 18 people
times 3 hours per session times 24 training sessions per year equals
1296 hours.
3) For the rescue people, there are training sessions once a month. He
estimates that about 10 people attend each training session. He
figures that an average training session lasts about 2 hours. 10 people
times 2 hours per session times 12 training sessions per year equals
240 hours.
4) As far as emergency calls are concerned, Chief Smith had 60 calls in
2002. There was quite a variety of calls but he estimates that an
average call involved about 14 firefighters and/or rescue people. He
also figures that each call lasted about an hour and a half. 14 people
times an hour and a half per call times 60 calls equals 1260 hours.
5) The total hours worked for 2004 equals 480 + 1296 + 240 + 1260 or
3276 hours. He answers question 3 with the number 3276.

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

NOTICE
Dear Municipal Public Works/Highway Official:
Enclosed please find the annual Survey of Occupational Injuries and Illnesses for 2006.
Your participation is mandatory under Maine Public Law 1989, Chapter 712 which replaces
Public Law 091-596 which appears in the enclosed booklet. This report must be completed and
returned to our office even if no OSHA recordable work-related injuries and illnesses occurred in
your workplace. Please note the following clarifications:
This survey covers municipal public works/highway employees and certain contract
workers only.
For Questions 2 and 3 under Section 1 - Establishment Information be sure to include
the employment and hours worked by municipal public works / highway department employees.
This includes all employees, whether paid or volunteer - including Workfare and Aspire
participants. Also, include the hours worked by contract employees if they are directly
supervised by a municipal public works official. Do NOT include information on contract
employees if they are NOT directly supervised by a municipal public works official.
If the municipal public works/highway department on the label does not exist, or all of
your employees are contracted and NOT directly supervised by a municipal public works official
then please return the survey booklet with a note indicating this.
NOTE: For injuries or illnesses with days away from work please count only the calendar
days lost as a public works / highway department employee. Do not count days lost from other
jobs or vocations.
If you have any questions please call Steve Laundrie at 624-6447.

Cordially,

Steve Laundrie
Statistician
Maine Department of Labor
Bureau of Labor Standards

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

NOTICE
Dear Municipal Central Office Official:
Enclosed please find the annual Survey of Occupational Injuries and Illnesses for 2006.
Your participation is mandatory under Maine Public Law 1989, Chapter 712, which replaces
Public Law 091-596 which appears in the enclosed booklet. This report must be completed and
returned to our office immediately even if no OSHA recordable work-related injuries and
illnesses occurred in your workplace. Please note the following clarifications:
For Questions 2 and 3, under Section 1 – Establishment Information, please be sure to
include all Municipal Central Office (Administration) Employees whether paid or unpaid
INCLUDING VOLUNTEERS, ELECTED, AND APPOINTED OFFICIALS AS WELL AS
INTERNS, WORKFARE/GENERAL ASSISTANCE WORKERS, and ASPIRE participants. Do
not include non-administrative employees such as firefighters, police officers, public
works/highway employees, librarians, parks and recreation employees, and school officials.
If you do not have an exact number for Question 3, we will accept an estimate of the total
hours worked. ON THE NEXT PAGE IS AN EXAMPLE OF HOW TO CALCULATE
EMPLOYMENT AND HOURS WORKED FOR MUNICIPAL GOVERNMENT ADMINISTRATION.
NOTE: For injuries or illnesses with days away from work please count only the days lost
as a Municipal Office employee. Do not count days lost from other jobs or vocations.
If you have any questions please call Steve Laundrie at 624-6447.
Cordially,

Steve Laundrie
Statistician
Maine Deparment of Labor
Bureau of Labor Standards

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

HOW TO CALCULATE EMPLOYMENT AND
HOURS WORKED FOR MUNICIPAL
ADMINISTRATION EMPLOYEES
Town A is a small municipality. Most municipal work is done by unpaid
volunteers. For municipal government, employment and hours worked are calculated as
follows:
1) The town office has a town clerk and a combination treasurer/tax
collector/administrative assistant. They work 18 hours a week. The hours
worked for these employees equals 2 employees times 18 hours per week times 50
work weeks a year equals 1800 hours.
2) The 3 members of the Board of Selectmen. These members along with the Town
Clerk meet for the regular Town Council meeting twice a month. Each meeting
lasts about 2 hours. The result is 4 employees times 2 hours per meeting times 24
meetings per year equals 192 hours.
3) There are 5 members of the Planning Board. These members as well as the
Administrative Assistant meet once a month for about an hour and a half.
The result is 6 employees times one hour and a half per meeting times 12
meetings per year equals 108 hours.
4) There are several municipal committees. The Budget Committee consists of 4
people meeting once a month for about two hours a meeting. This results in 4
employees times 2 hours per meeting times 12 meetings per year or 96 hours.
The Conservation Committee consists of 3 people meeting once a month for
about an hour a meeting. This results in 3 employees times 1 hour per meeting
times times 12 meetings per year or 36 hours. The Cemetary Committee
meets in the spring and summer only. There are 4 people meeting once a week for
6 months at about 2 hours per meeting. This results in 4 employees times 25
meetings per calendar year times 2 and hours per meeting or 200 hours. Since
these 4 employees work only a year, for this survey we count them as 2 yearround employees.
5) There are 2 Workfare participants who work at the central office. Each Workfare
employee works about 20 hours a week for a total of 40 hours per week times 50
weeks per year totalling 2000 hours.
6) The Annual Average Employment equals 2 + 3 + 5 + 4 + 3 + 2 + 2 = 21
employees.
7) The Total Hours Worked equals 1800 + 192 + 108 + 96 + 36 + 200 + 2000 =
4432 hours.

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

NOTICE
Dear County Administration Official:
Enclosed please find the annual Survey of Occupational Injuries and Illnesses for 2006.
Your participation is mandatory under Public Law 1989, Chapter 712 which replaces Public Law
091-596 which appears in the enclosed booklet. This report must be completed and returned to
our office even if no OSHA recordable work-related injuries and illnesses occurred in your
workplace. Please note the following clarifications:
For Questions 1 and 2, under Tell Us About Your Establishment’s Employees and
Hours They Worked, please be sure to include all County Central Office (Administration)
Employees whether paid or unpaid INCLUDING VOLUNTEERS, ELECTED, AND
APPOINTED OFFICIALS AS WELL AS INTERNS, WORKFARE/GENERAL ASSISTANCE
WORKERS, and ASPIRE participants. Do not include non-administrative employees such as
county jail employees, sheriffs department employees, district attorney employees, and so forth.
NOTE: For injuries or illnesses with days away from work please count only the days lost
as a Municipal Office employee. Do not count days lost from other jobs or vocations.
If you have any questions please call Steve Laundrie at 624-6447.

Cordially,

Steve Laundrie
Statistician
Maine Department of Labor
Bureau of Labor Standards

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

NOTICE
Dear County District Attorney Official:
Enclosed please find the annual Survey of Occupational Injuries and Illnesses for 2006.
Your participation is mandatory under Maine Public Law 1989, Chapter 712 which replaces
Public Law 091-596 which appears in the enclosed booklet. This report must be completed and
returned to our office even if no OSHA recordable work-related injuries and illnesses occurred in
your workplace. Please note the following clarification.
This survey pertains to county employees who work at the District Attorney’s Office on
the survey booklet label only. Do NOT include other county employees such as county clerks,
sheriffs, and so forth. Also, do not include information on state employees.
If you have any questions please call Steve Laundrie at 624-6447.

Cordially,

Steve Laundrie
Statistician
Maine Department of Labor
Bureau of Labor Standards

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

NOTICE
Dear County Jail Official:
Enclosed please find the annual Survey of Occupational Injuries and Illnesses for 2006.
Your participation is mandatory under Maine Public Law 1989, Chapter 712 which replaces
Public Law 091-596 which appears in the enclosed booklet. This report must be completed and
returned to our office even if no OSHA recordable work-related injuries and illnesses occurred in
your workplace. Please note the following clarification:
This survey pertains to employees who work at the County Jail only. Do not include
information on County Sheriff employees. Also do not include other county employees such as
the County Clerk, Register of Probate, Register of Deeds, and so forth.
If you have any questions please call Steve Laundrie at 624-6447.

Cordially,

Steve Laundrie
Statistician
Maine Department of Labor
Bureau of Labor Standards

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

NOTICE
Dear County Sheriff Official:
Enclosed please find the annual Survey of Occupational Injuries and Illnesses for 2006.
Your participation is mandatory under Maine Public Law 1989, Chapter 712, which replaces
Public Law 091-596 which appears in the enclosed booklet. This report must be completed and
returned to our office even if no OSHA recordable work-related injuries and illnesses occurred in
your workplace. Please note the following clarification.
This survey pertains to employees who work at the County Sheriff’s Office only. Do
not include other county employees such as county jail employees, county district attorney
employees, County Clerk, Register of Deeds, Register of Probate, and so forth.
If you have any questions please call Steve Laundrie at 624-6447.

Cordially,

Steve Laundrie
Statistician
Maine Department of Labor
Bureau of Labor Standards

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

NOTICE

Dear State District Attorney Official:
Enclosed please find the annual Survey of Occupational Injuries and Illnesses for 2006.
Your participation is mandatory under Public Law 1989, Chapter 712 which replaces Public Law
091-596 which appears in the enclosed booklet. This report must be completed and returned to
our office even if no OSHA recordable work-related injuries and illnesses occurred in your
workplace. Please note the following clarification:
This survey pertains to state employees who work at the District Attorney’s Office for
the Prosecutorial District listed on the label only. Please do not include information on any
county employees.
If you have any questions please call Steve Laundrie at 624-6447.

Cordially,

Steve Laundrie
Statistician
Maine Department of Labor
Bureau of Labor Standards

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
45 STATE HOUSE STATION
AUGUSTA, MAINE
0 4 3 3 3 - 0 0 45

LAURA A. FORTMAN
COMMISSIONER

JOHN ELIAS BALDACCI

WILLIAM A. PEABODY

GOVERNOR

DIRECTOR

NOTICE
Dear Central Office School Official:
Enclosed please find the annual Survey of Occupational Injuries and Illnesses for 2006.
Your participation is mandatory under Public Law 1989, Chapter 712 which replaces Public Law
091-596 which appears in the enclosed booklet. This report must be completed and returned to
our office even if no OSHA recordable work-related injuries and illnesses occurred in your
workplace. Please note the following clarifications:
For Questions 1 and 2, under Part 1A – Establishment Information, please be sure to
include all Central Office (Administration) Employees whether paid or unpaid INCLUDING
ELECTED AND APPOINTED OFFICIALS.
If you do not have an exact number for Question 2, we will accept an estimate of the total
hours worked. ON THE NEXT PAGE IS AN EXAMPLE OF HOW TO CALCULATE
EMPLOYMENT AND HOURS WORKED FOR SCHOOL ADMINISTRATION.
NOTE: For injuries or illnesses with days away from work please count only the days lost
as a School Administration employee. Do not count days lost from other jobs or vocations.
If you have any questions please call Steve Laundrie at 624-6447.
Cordially,

Steve Laundrie
Statistician
Maine Department of Labor
Bureau of Labor Standards

PHONE:

(207)624-6440 (Voice)

PRINTED ON RECYCLED PAPER

(800) 794-1110 TTY (HEARING IMPAIRED ONLY)

FAX:

(207)624-6449

HOW TO CALCULATE EMPLOYMENT AND
HOURS WORKED FOR A CENTRAL OFFICE OF A
SCHOOL DISTRICT OR SCHOOL DEPARTMENT
Below is an example of how to calculate the employment and total
hours worked for the central office of a school department.
EXAMPLE:
School Administrative District 9988 has a central office that happens to be
physically located in the high school. It still is considered to be a
SEPARATE establishment. There are 6 employees in this office. SAD 9988
has a school board consisting of 5 members. Also, SAD 9988 does NOT
have a bus garage so records of injuries and illnesses are maintained on the
log for the central office. There are 12 school bus drivers working roughly
¾ of a calendar year. 12 times ¾ equals 9. The average employment
(Question 1 under part 1A) equals 6 + 5 + 9 or 20 employees.
1) Inside this office is the superintendent, an assistant superintendent, 3
full-time employees, and 1 part-time employee. The superintendent
works an average of about a 50 hours per week year round. That
equals one employee times 50 hours per week times 50 workweeks
per year or 2500 hours. The 3 full-time employees work 40 hours per
week year round. 3 employees times 40 hours per week times 50
workweeks per year equals 6000 hours. The part-time employee
works 20 hours per week year round. One employee times 20 hours
per week times 50 workweeks per year equals 1000 hours.
2) The School Board meets once a week year-round. Each meeting lasts
about 2 hours. There are 5 members of the School Board. 5 employees
times 2 hours per meeting times 50 meetings per year equals 500
hours.
3) The School District has NO bus garage. The bus drivers have no fixed
establishment so they should be classified under the central office
(unless they work at another school facility). There are 12 bus drivers
working 4 hours per day for the school year only. 12 drivers times 4
hours per day times 183 school days equals 8784 hours.
4) The total hours worked equals 2500 + 6000 + 1000 + 500 + 8784 or
18784 hours. Question 2 on Part 1A equals 18784.

Statement on label placed on New Jersey government units:
Your participation in this survey is mandatory under the New Jersey Public
Employees Occupational Safety & Health Act (N.J.S.A. 34:6A-25 et seq.) covering
state and local government entities. Data obtained from government units are
considered public information, and, as such, will be published in summary form.