BILL NUMBER: AB 929 CHAPTERED
BILL TEXT
CHAPTER 427
FILED WITH SECRETARY OF STATE SEPTEMBER 30, 2005
APPROVED BY GOVERNOR SEPTEMBER 30, 2005
PASSED THE ASSEMBLY AUGUST 29, 2005
PASSED THE SENATE AUGUST 23, 2005
AMENDED IN SENATE AUGUST 15, 2005
AMENDED IN SENATE JUNE 28, 2005
AMENDED IN SENATE JUNE 13, 2005
AMENDED IN ASSEMBLY MAY 27, 2005
AMENDED IN ASSEMBLY APRIL 25, 2005
AMENDED IN ASSEMBLY APRIL 4, 2005
INTRODUCED BY Assembly Member Oropeza
FEBRUARY 18, 2005
An act to add Section 115061 to the Health and Safety Code,
relating to radiation technology.
LEGISLATIVE COUNSEL'S DIGEST
AB 929, Oropeza Radiologic technology: radiation exposure.
Under existing law, the State Department of Health Services
administers provisions that establish standards for, and regulates
sources of, ionizing radiation. Violation of these standards and
regulations is a crime.
This bill would require the Radiologic Health Branch of the
department to adopt regulations that require personnel and facilities
using radiation-producing equipment for medical and dental purposes
to maintain and implement medical and dental quality assurance
standards for the protection of the public health and safety. The
bill would require the adoption of regulations and the submission of
the regulations to the health committees of the Assembly and Senate
on or before January 1, 2008. By changing the definition of a crime,
this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. (a) The Legislature finds and declares all of the
following:
(1) (A) More than 300,000,000 medical and dental imaging
examinations and radiation therapy treatments are administered
annually in the United States. Proper use of ionizing radiation is an
extremely important life-saving therapy for many cancer patients.
Seven out of every 10 Americans undergo a medical or dental imaging
examination or radiation therapy treatment every year in the United
States.
(B) These procedures are useful in the diagnosis of medical
conditions. However, the administration of medical and dental imaging
examinations and the effect of these procedures on individuals have
a substantial and direct effect upon public health and safety.
(C) It is in the interest of public health and safety to minimize
unnecessary or inappropriate exposure to radiation from medical and
dental radiological procedures.
(2) In 2005, about 135,000 Californians will be diagnosed with
cancer and about 54,000 will die of the disease. Cancer incidence is
rising throughout the United States. In the United States, one in
three women and one in two men will face cancer during their
lifetime. Exposure to radiation such as through X-rays, CT scans,
fluoroscopy, and other medical and dental radiological procedures is
contributing to the high rates in the United States.
(3) In January 2005, the National Toxicology Program classified
x-radiation and gamma radiation as known human carcinogens. The
report stated that "exposure to these kinds of radiation cause many
types of cancer including leukemia and cancers of the thyroid, breast
and lung . . . Exposure to x-radiation and gamma radiation has also
been shown to cause cancer of the salivary glands, stomach, colon,
bladder, ovaries, central nervous system and skin." Diagnostic
radiation is valuable in the practice of medicine and dentistry
today. However, patients have a right to know that procedures
involving exposure to radiation entail risks as well as benefits.
(4) According to a leading scientist with the National Cancer
Institute, "More is known about the relationship between radiation
dose and cancer risk than any other human carcinogen, and female
breast cancer is the best quantified radiation-related cancer."
Breast cancer is the most commonly diagnosed cancer among women in
California and in the United States. Each year in California
approximately 21,000 women will be diagnosed with the disease and
4,000 will die from it.
(5) To reduce the risk of radiation-related cancer, physicians,
dentists, other health care providers, technologists, equipment
manufacturers, and the government share the responsibility to
minimize radiation exposure of patients. Exposures should be as low
as reasonably achievable without sacrificing image quality. Studies
have shown that often patients are not provided with sufficient
information on the merits and potential adverse effects of diagnostic
imaging procedures. In addition, the popularity of self-referred
whole body CT scans has increased concern among radiologists and
cancer specialists. The United States Food and Drug Administration
has never approved CT scans for screening any part of the body for
any specific disease, let alone for screening the whole body when
there are no specific symptoms of a disease. The American College of
Radiology states that "there is no evidence that total body CT
screening is cost efficient or effective in prolonging life."
Scientists at Columbia University found that a single full-body CT
scan exposes a person to a radiation dose nearly 100 times that of a
typical mammogram. Improving patient awareness and protection during
radiologic imaging is a critical step toward reducing a preventable
cause of cancer.
(6) According to the National Cancer Institute, children are
uniquely vulnerable to harm from radiation exposure because they are
more sensitive to radiation than adults. Children have a longer life
expectancy after exposure, creating a larger window of opportunity
for expressing radiation damage. For example, CT scans deliver a much
higher radiation dose than conventional X-rays. Approximately 2 to 3
million CT scan examinations are performed annually on children in
the United States. The use of CT scans has increased seven-fold in
the past 10 years.
(7) In 2001, the State of New Jersey developed and implemented a
"Quality Assurance Program" that has led to a reduction in ionizing
radiation exposure.
(b) It is the intent of the Legislature in enacting this act to
promote best practices as a proven means to reduce the exposure to
ionizing radiation, and increase and maintain diagnostic image
quality.
SEC. 2. Section 115061 is added to the Health and Safety Code, to
read:
115061. (a) In order to better protect the public and radiation
workers from unnecessary exposure to radiation and to reduce the
occurrence of misdiagnosis, the Radiologic Health Branch within the
State Department of Health Services shall adopt regulations that
require personnel and facilities using radiation-producing equipment
for medical and dental purposes to maintain and implement medical and
dental quality assurance standards that protect the public health
and safety by reducing unnecessary exposure to ionizing radiation
while ensuring that images are of diagnostic quality. The standards
shall require quality assurance tests to be performed on all
radiation-producing equipment used for medical and dental purposes.
(b) The Radiological Health Branch shall adopt the regulations
described in subdivision (a) and provide the regulations to the
health committees of the Assembly and the Senate on or before January
1, 2008.
(c) For purposes of this section "medical and dental quality
assurance" means the detection of a change in X-ray and ancillary
equipment that adversely affects the quality of films or images and
the radiation dose to the patients, and the correction of this
change.
SEC. 3. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.