BILL ANALYSIS
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THIRD READING
Bill No: AB 2635
Author: Portantino (D)
Amended: 4/5/10 in Assembly
Vote: 21
SENATE PUBLIC SAFETY COMMITTEE : 7-0, 6/29/10
AYES: Leno, Cogdill, Cedillo, Hancock, Huff, Steinberg,
Wright
SENATE HEALTH COMMITTEE : 8-0, 6/16/10
AYES: Alquist, Strickland, Aanestad, Cedillo, Leno,
Negrete McLeod, Pavley, Romero
NO VOTE RECORDED: Cox
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 76-0, 5/13/10 (Consent) - See last page
for vote
SUBJECT : Communicable disease: involuntary testing
SOURCE : American Federation of State, County and
Municipal
Employees
DIGEST : This bill adds nonsworn employees of a law
enforcement agency whose job description includes the
collection of fingerprints to the list of persons who, when
exposed to an arrestee's bodily fluids, can have the
arrestee's blood tested for communicable diseases.
CONTINUED
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ANALYSIS :
Existing federal law, establishes the Occupational Exposure
to Bloodborne Pathogens Standard to address the significant
health risks many employees face as the result of
occupational exposure to blood and other potentially
infectious materials (OPIM) because they may contain
bloodborne pathogens, including, but not limited to
hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV
(human immunodeficiency virus).
Existing federal regulation, establishes regulations
applicable to all occupational exposure to blood or other
potentially infectious materials as defined, by the
Occupational Safety and Health Administration, under the
United States Department of Labor.
Existing state law:
1. Establishes a process whereby a peace officer,
firefighter, custodial officer, custody assistant,
uniformed employee of a law enforcement agency whose job
entails the care or control of inmates in a detention
facility, or emergency medical provider who, while
acting within the scope of his or her duties, is exposed
to an arrestee's blood or bodily fluids, may petition a
court for an order requiring testing of the blood or
bodily fluids for HIV, hepatitis B, and hepatitis C.
2. Declares legislative intent that information that may be
vital to the health and safety of custodial personnel,
custodial medical personnel, peace officers,
firefighters and emergency medical personnel who are put
at risk in the course of their official duties, be
obtained and disclosed in an appropriate manner in order
to ensure their health and their relief from groundless
fear of infection.
Existing state regulations establishes regulations
applicable to all occupational exposure to blood or other
potentially infectious materials (OPIM) as defined, by the
California Department of Industrial Relations, including
the use of universal precautions to prevent contact with
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blood or OPIM. Under circumstances in which differentiation
between body fluid types is difficult or impossible, all
body fluids shall be considered potentially infectious
materials.
This bill adds nonsworn employees of a law enforcement
agency whose job description includes the collection of
fingerprints to the list of persons who, when exposed to an
arrestee's bodily fluids, can have the arrestee's blood
tested for communicable diseases.
Background
Occupational exposure to bloodborne pathogens . Blood and
other potentially infectious materials have long been
recognized as a potential threat to the health of employees
who are exposed to these materials by percutaneous contact
(penetration of the skin). Other potentially infectious
materials (OPIM) can include human body fluids (semen,
vaginal secretions, amniotic fluid, saliva in dental
procedures, any body fluid visibly contaminated with blood,
etc.), any unfixed tissue or organ from a human living or
dead; or HIV-containing cell or tissue cultures, organ
cultures, and HIV- or HBV-containing culture medium or
other solutions as well as blood, organs, or other tissues
from experimental animals infected with HIV or HBV.
According to the National Institute for Occupational Safety
and Health, exposures to blood and other body fluids occur
across a wide variety of occupations. Health care workers,
as well as emergency response and public safety personnel,
can be exposed to blood through needlestick and other
sharps injuries, as well as through mucous membrane and
skin exposures. The pathogens of primary concern for the
Centers for Disease Control and Prevention (CDC) and the
National Institute for Occupational Safety and Health are
the HIV, hepatitis B virus (HBV), and hepatitis C virus
(HCV). According to CDC recommendations, wounds and skin
sites that have been in contact with blood or bodily fluids
should be washed with soap and water, and mucous membranes
should be flushed with water. Immediate evaluation must be
performed by a health care professional. The evaluation
should determine the type of exposure, infectious status of
the source, and the susceptibility of the exposed person in
order to determine the treatment course.
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Existing California regulations apply to all occupational
exposure to blood or other OPIM as defined, with specified
exceptions. The regulations define occupational exposure as
"reasonably anticipated skin, eye, mucous membrane, or
parenteral contact with blood or other potentially
infectious materials that may result from the performance
of an employee's duties." Some facilities and operations
are considered by Cal/OSHA to involve "occupational
exposure," as defined because the intrinsic nature of the
facility or operation is such that contact with blood or
OPIM is reasonably anticipated for at least some of the
employees involved with the facility or operation.
Under the regulations, employers of these facilities or
operations have the responsibility to conduct an exposure
determination to determine which tasks and procedures
involve occupational exposure as a part of complying with
the written Exposure Control Plan requirements. Employers
whose employees work in facilities other than those that
intrinsically involve occupational exposure are still
subject to regulations if the individual circumstances of
the facility or operation are such that the employee's
activities or tasks place them in contact with blood or
OPIM.
Each employer who has an employee(s) with occupational
exposure to blood or OPIM is required to document an
exposure determination. The exposure determination is made
without regard to the use of personal protective equipment
since employees are considered exposed even if they wear
personal protective equipment.
Post-exposure procedures . Workers who are stuck by a
needle or have any other type of exposure to blood or OPIM
must receive immediate confidential medical screening and
follow-up treatment. Treatment potentially includes
medications to prevent infection, according to current
Public Health Service guidelines, as soon as possible.
Post-exposure prophylaxis (PEP) is a short-term treatment
to reduce the likelihood of infection after exposure to a
number of contagious diseases, including HIV, HBV, and HCV.
PEP is considered a second line of defense when preventive
efforts have failed or were not possible, as is the case
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with sexual assault or occupational exposure.
In the case of HIV, PEP typically involves providing one or
several anti-HIV drugs within 72 hours of exposure, which
are then taken for a four- to six-week period. According
to the World Health Organization (WHO), in order for PEP to
be most effective in preventing HIV infection, treatment
should be commenced as soon as possible after exposure and,
ideally, within two to four hours. One of the first
examples of PEP effectiveness was reported in a 1995 study,
which showed fewer HIV infections after occupational
exposure among health care workers who used PEP versus
those who took no prophylaxis after exposure. A recent
Canadian study found that, of 160 patients who had been
exposed to HIV and received PEP treatment, only one
infection was reported.
CDC recommendations for HBV exposure include the initiation
of the hepatitis B vaccine series to an unvaccinated person
who has been exposed. PEP with hepatitis B immune globulin
(HBIG) and/or hepatitis B vaccine series should be
considered after an evaluation of the HBV status of the
source and the vaccination and vaccine-response status of
the exposed person. According to the CDC, in the
occupational setting, multiple doses of PEP for HBV
initiated within one week following exposure, provides an
estimated 75 percent protection from infection.
According to the CDC, the estimated risk for infection
after a needlestick or cut exposure to HCV-infected blood
is approximately 1.8 percent. Additionally, several
studies have attempted to assess the effectiveness of
potential post-exposure treatment for HCV, but have been
difficult to interpret. No clinical trials have been
conducted to assess postexposure use of antiviral agents
(interferon) to prevent HCV infection, and antivirals are
not FDA approved for this use. The CDC states that an
established infection might need to be present before
interferon can be an effective treatment.
Comments
The author's office introduced this bill to correct an
oversight in last year's AB 169 (Portantino), Chapter 417,
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Statutes of 2009. AB 169 includes nonsworn uniformed
officers to the category of employees (law enforcement and
medical services personnel) who, after exposure to an
arrestee's bodily fluids, may have that arrestee's blood
tested, either voluntarily or by court order, for specified
communicable diseases. It was brought to the author's
office attention that there are other employees who come
into contact with arrestees who are frequently exposed to
blood or other bodily fluids who are not covered by this
provision of law. This bill adds employees of law
enforcement agencies whose duties include the collection of
fingerprints.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 6/16/10)
American Federation of State, County and Municipal
Employees (source)
ARGUMENTS IN SUPPORT : The American Federation of State,
County, and Municipal Employees is sponsoring this bill.
They claim that recently fingerprint identification experts
(FIEs) within the Los Angeles Police Department were
required, by special order of the chief of police, to
gather fingerprints from suspected criminals while they
were hospitalized. However, this is a new duty for FIEs
and their classification doesn't have the same protections
granted to other law enforcement personnel. This bill adds
FIEs to the list of persons who may seek to have an
arrestee's blood tested, either voluntarily or by court
order, for specified communicable diseases when the FIE is
exposed to that arrestee's blood or bodily fluids while the
FIE is acting within the scope of his or her duties.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Bass, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,
Bradford, Brownley, Buchanan, Charles Calderon, Carter,
Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,
DeVore, Emmerson, Eng, Evans, Feuer, Fletcher, Fong,
Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick,
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Gilmore, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill,
Huber, Huffman, Jeffries, Jones, Knight, Lieu, Logue,
Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nava,
Nestande, Niello, Nielsen, V. Manuel Perez, Portantino,
Ruskin, Salas, Saldana, Silva, Smyth, Solorio, Audra
Strickland, Swanson, Torlakson, Torres, Torrico, Tran,
Villines, Yamada, John A. Perez
NO VOTE RECORDED: Caballero, Norby, Skinner, Vacancy
CTW:do 8/4/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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