BILL ANALYSIS AB 1963 PageA 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 AB 1963 PageB 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: AB 1963 PageC 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. AB 1963 PageD 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 PageE 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