BILL ANALYSIS �
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
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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
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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