BILL ANALYSIS                                                                                                                                                                                                    




                                                                  AB 1963
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          Date of Hearing:   April 6, 2010

           ASSEMBLY COMMITTEE ON ENVIRONMENTAL SAFETY AND TOXIC MATERIALS
                                Wesley Chesbro, Chair
                  AB 1963 (Nava) - As Introduced:  February 17, 2010
           
          SUBJECT  :   Pesticide Poisoning.

           SUMMARY  :   Requires laboratories (labs) that perform  
          cholinesterase (ChE) testing for the purpose of determining  
          workers' pesticide exposure to electronically report specified  
          test results to the Department of Pesticide Regulation (DPR).   
          Specifically,  this bill  :  

          1)Finds that pesticide regulation should be the joint  
            responsibility of the DPR and the Office of the Environmental  
            Health Hazards Assessment (OEHHA).

          2)Requires labs that perform ChE testing to report to the DPR  
            the test results for every person tested.

          3)Requires the medical supervisor ordering the ChE testing to  
            provide a copy of the ChE test results or any recommendations  
            to the tested individual within 14 days of receiving the  
            information.

          4)Specifies that all information reported under this bill will  
            be confidential, except that OEHHA, DPR, and the Department of  
            Public Health (DPH) may share the information only for the  
            purpose of surveillance, case management, investigation,  
            environmental assessment, environmental remediation, or  
            abatement with the appropriate county agricultural  
            commissioner or local health officer.

          5)Requires DPR to do all of the following:

             a)   Transmit the reported information to OEHHA and to the  
               DPH; and

             b)   Share information reported in an electronic format, as  
               needed, with the appropriate county agricultural  
               commissioner and conduct follow-up investigations on an as  
               needed basis; and

             c)   Prepare a report on the ChE testing program by December  









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               31, 2013, in consultation with OEHHA and DPH, and specify  
               issues the report may examine, including but not limited to  
               evaluating and assessing the program's effectiveness and  
               making recommendations to the Legislature.

          6)Authorizes OEHHA to review the test results, in consultation  
            with DPR and DPH, to provide a medical or toxicological  
            consultation to the medical supervisor of the person tested  
            and the Local Health Officer (LHO).

          7)Authorizes DPH to assess a fine of up to $200 per person  
            against any lab that knowingly fails to meet the reporting  
            requirements of this bill.

           EXISTING LAW  :

            1)  Requires any physician who knows or has reasonable cause  
              to believe that a patient is suffering from pesticide  
              poisoning or any disease or condition caused by a pesticide  
              to promptly report that fact to the LHO by telephone within  
              24 hours, and in writing within seven days (Health and  
              Safety Code (HSC) 105200).

            2)  Requires LHOs receiving the reports above to immediately  
              notify the county agricultural commissioner and, at the  
              LHO's discretion, to immediately notify the director of  
              OEHHA of each report received.  Requires LHOs to report to  
              the director of DPR, the director of OEHHA, and the director  
              of Industrial Relations each case reported to him or her  
              within seven days after receipt of the report. (HSC 105200).

            3)  Requires employers who have employees regularly handling  
              or exposed to organophosphate and carbamate pesticides to  
              have a written agreement with a physician to provide medical  
              supervision of those employees, and specifies employer  
              responsibilities for medical supervision, including testing  
              at certain intervals, investigating work practices when  
              employee ChE levels fall below 80% of baseline and removing  
              employees from the exposure if levels fall to 60% or less of  
              baseline, as specified.(Title 3, Section 6728,  California  
              Code of Regulations  ).

          FISCAL EFFECT  :   Unknown.

          COMMENTS:   









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           Need for the bill  .  According to the author, this bill is  
          necessary to allow state agencies to effectively monitor the  
          existing ChE medical monitoring program and to better protect  
          California farm workers who are routinely exposed to dangerous  
          levels of the pesticides that affect ChE levels.  The author  
          points out that submission of the reports contemplated in this  
          bill are made much easier in light of electronic reporting  
          capabilities than they would have been when the ChE monitoring  
          program was first established.  The Cholinesterase Medical  
          Supervision Program does not include any requirement for test  
          results to be delivered to any state agency responsible for  
          worker health; thus nearly three decades after this program was  
          enacted, it is impossible to judge its effectiveness.



           Background on cholinesterase testing.   According to the  
          OHHEA<1>, California regulations require employers to arrange  
          with a licensed physician for medical supervision of  
          agricultural workers who apply Toxicity Categories I and II  
          organophosphate and carbamate pesticides.  Medical supervision  
          is a surveillance program that monitors applicators of such  
          pesticides.  It consists of periodic measurements of  
          cholinesterase activity levels in applicators that are compared  
          to measurements of baseline cholinesterase activity levels,  
          which were established prior to exposure to  
          cholinesterase-inhibiting organophosphate and carbamate  
          pesticides.  
           
          Plasma and red blood cell (RBC) cholinesterase tests are the  
          only practical means available for measuring the effects of  
          exposure to pesticides that contain organophosphates and  
          carbamates. 
          Excessive exposure to these compounds can inhibit cholinesterase  
          activity levels sufficiently to induce serious illness. 

          Establishing an individual's baseline value for both plasma and  
          RBC cholinesterase activity is essential for medical  
          supervision.  The employer is required to follow the  
          recommendations of the medical supervisor concerning matters of  
          occupational health.  Under the regulations, the employer is  
          responsible for removing employees from exposure upon  


          ---------------------------
          <1> OHHEA,  Guidelines For Physicians Who Supervise Workers  
          Exposed To Cholinesterase-Inhibiting Pesticides  , 2002.








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          recommendation of the medical supervisor.

           Pesticide poisoning reporting.   California has two systems for  
          worker and consumer pestidice reporting and investigations.  One  
          program requires the reporting of all known or suspected cases  
          of pesticide poisoning to the local health officer, who in turn  
          reports it to State and local agriculture and worker safety  
          agencies.  In addition to this emergency reporting, workers who  
          are regularly using organophosphates and carbamates pesticides  
          are required to be under medical supervision that includes  
          regular blood test to determine whether the organophosphates and  
          carbamates are effecting the of ChE levels.  Under current  
          worker's medical supervision and reporting requirements, if a  
          worker is removed from work because his/her ChE activity levels  
          are depressed but the worker is asymptomatic, then these test  
          results are not reported as a suspected pesticide poisonings.  
           
           Prior related legislation.

           AB 1530 (Lieber) 2007.  This bill addressed the similar program  
          for ChE report to state Health and Pesticide regulatory  
          agencies.  The bill was held in the Senate Appropriations  
          Committee.

           Double Referral to Health Committee  .  Should this measure be  
          approved by this committee, the do pass motion must include the  
          action to re-refer the bill to the Assembly Committee on Health.

           REGISTERED SUPPORT / OPPOSITION  :  

           Support 

           Pesticide Action Network of North America (Cosponsor)
          Physicians for Social Responsibility - Los Angeles (Cosponsor)
          Health Officers Association of California (Cosponsor)
          ACT for Women and Girls
          American Congress of Obstetricians and Gynecologists  
          (California)
          California Labor Federation
          California Nurses Association
          California Public Health Association - North
          California Rural Legal Assistance Foundation
          Californians for Alternatives to Toxics
          Californians for Justice Collaborative
          Clean Water Action









                                                                  AB 1963
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          Commonweal
          East Yard Communities for Environmental Justice
          Environmental Center of San Luis Obispo County
          Fresno Coalition Again the Misuse of Pesticides
          Healthy Child Healthy World
          Natural Resources Defense Council
          Lideres Campesinas 
          Nevada County Citizens for Choice
          Pesticide Action Network
          Pesticide Watch
          Physicians for Social Responsibility - San Francisco Bay Chapter
          Sierra Club California
          Urban Habitat

           Opposition 
           
          None Received
           

          Analysis Prepared by  :    Robert Fredenburg/ E.S. & T.M. / (916)  
          319-3965