BILL ANALYSIS Ó AB 1202 Page 1 Date of Hearing: May 8, 2013 ASSEMBLY COMMITTEE ON APPROPRIATIONS Mike Gatto, Chair AB 1202 (Skinner) - As Amended: April 17, 2013 Policy Committee: Labor and Employment Vote: 7-0 Urgency: No State Mandated Local Program: Yes Reimbursable: Yes SUMMARY This bill requires the Occupational Safety and Health Standards Board (OSHS Board) to adopt an occupational safety and health standard for the handing of antineoplastic and other hazardous drugs in health care facilities regardless of the setting. Specifically, this bill: 1)Requires the OSHS Board to consider input from hospitals, practicing physicians from impacted specialties (i.e. oncology), organizations representing health care personnel (i.e. nurses), and other stakeholders, and determine a reasonable time for facilities to implement new requirements imposed by the adopted standard. 2)Requires the standard, to the extent feasible, be consistent with and not exceed recommendations in the National Institute for Occupational Safety and Health (NIOSH) alert entitled "Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings," as updated in 2010. Further authorizes the standard to incorporate applicable updates and changes to NIOSH guidelines. 3)Defines antineoplastic drug as a chemotherapeutic agent that controls and kills cancer cells. 4)Defines hazardous drug as any drug so identified by NIOSH or any drug that meets at least one of six criteria, as specified. FISCAL EFFECT AB 1202 Page 2 One-time GF administrative costs, of approximately $170,000, to the Division of Occupational Safety and Health to develop regulations for adoption by the OSHS Board, as specified. Enforcement costs are expected to be minor, absorbable. COMMENTS 1)Background . The OSHS Board, a seven-member body appointed by the governor, is the standards-setting agency within the California/Occupational Safety Health (Cal/OSHA) program. The board has the responsibility to grant or deny applications for variances from adopted health and safety standards and respond to petitions for new or revised standards. The part-time, independent board holds monthly meetings throughout California. NIOSH is the federal agency within the Center for Disease Control (CDC) that is responsible for conducting research and making recommendations for the prevention of work-related injury and illness. In 2004, NIOSH issued an alert that identified more than 150 drugs as hazardous to both patient and healthcare workers. According to NIOSH, "Drugs are classified as hazardous if studies in animals or humans indicate that exposures to them have a potential for causing cancer, developmental or reproductive toxicity, or harm to organs. Many hazardous drugs are used to treat illnesses such as cancer or HIV infection. The 2004 list of drugs was updated in 2010 and 2013. The 2013 update includes 26 new drugs and notes, "these additions are new drugs or existing drugs that had new warnings from 2007 to 2009." Under current law, the OSHS Board has the authority to regulate the manufacture, handling and use of drugs that have anti-cancer properties or are used to treat cancer by employees. 2)Purpose . According to the CDC, "many hazardous drugs used to treat cancer bind to or damage DNA (for example, alkylating agents). Other antineoplastic drugs, some antivirals, antibiotics, and bioengineered drugs interfere with cell growth or proliferation, or with DNA synthesis. In some cases, the nonselective actions of these drugs disrupt the growth and function of both healthy and diseased cells, resulting in AB 1202 Page 3 toxic side effects for treated patients. These nonselective actions can also cause adverse effects in health care workers who are inadvertently exposed to hazardous drugs." The CDC estimates about 8 million U.S. healthcare workers are potentially exposed to hazardous drugs, including pharmacy and nursing personnel, physicians, operating room personnel, environmental services workers, workers in research laboratories, veterinary care workers, and shipping and receiving personnel. According to the author, "Workers can be exposed to contamination without even knowing it. This occurs when they create aerosols, generate dust, mix liquids, clean up spills or touch contaminated surfaces when they prepare, administer or dispose of hazardous drugs. Regardless of early concerns about exposure to hazardous drugs, current law provides no enforceable standards for the handling of hazardous drugs to ensure healthcare workers are protected. Unlike radiation, there are no federal or state regulations to limit healthcare workers' exposure to hazardous drugs. Implementing and regulating improved safety guidelines and standards will significantly reduce the risk of healthcare workers and patients being exposed to hazardous drugs. This includes developing procedures for properly using and maintaining equipment designed to protect workers from hazardous drug exposure." This bill requires the OSHS Board to adopt standards consistent with the 2004 NIOSH alert on hazardous drugs, as specified. Analysis Prepared by : Kimberly Rodriguez / APPR. / (916) 319-2081