BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1202
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          ASSEMBLY THIRD READING
          AB 1202 (Skinner)
          As Amended  May 24, 2013
          Majority vote 

           LABOR & EMPLOYMENT  7-0         APPROPRIATIONS      17-0        
           
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          |Ayes:|Roger Hern�ndez, Morrell, |Ayes:|Gatto, Harkey, Bigelow,   |
          |     |Alejo, Chau, Gomez,       |     |Bocanegra, Bradford, Ian  |
          |     |Gorell, Holden            |     |Calderon, Campos,         |
          |     |                          |     |Donnelly, Eggman, Gomez,  |
          |     |                          |     |Hall, Ammiano, Linder,    |
          |     |                          |     |Pan, Quirk, Wagner, Weber |
           ----------------------------------------------------------------- 

           SUMMARY  :  Requires the Occupational Safety and Health Standards  
          Board (Standards Board) to adopt a standard related to the  
          handling of antineoplastic drugs, as specified.  Specifically,  
           this bill  :  

          1)Requires the Standards Board to adopt a standard for the  
            handling of antineoplastic drugs in health care facilities  
            (regardless of the setting).

          2)Defines an "antineoplastic drug" as a chemotherapeutic agent  
            that controls or kills cancer cells.

          3)Requires the Standards Board to consider input from hospitals,  
            practicing physicians from impacted specialties including  
            oncology, organizations representing health care personnel  
            including registered nurses and pharmacists, and other  
            stakeholders.

          4)Provides that the standard shall, to the extent feasible, be  
            consistent with and not exceed recommendations in a 2004  
            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. 

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, this bill will result in one-time General Fund  
          administrative costs, of approximately $170,000, to the Division  








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          of Occupational Safety and Health to develop regulations for  
          adoption by the Standards Board, as specified.  Enforcement  
          costs are expected to be minor, absorbable.  

           COMMENTS  :  According to the author, millions of healthcare  
          workers are at risk of being exposed to antineoplastic drugs on  
          a daily basis.  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 antineoplastic  
          drugs, current law provides no enforceable standards for the  
          handling of these drugs to ensure healthcare workers are  
          protected.  Unlike radiation, there are no federal or state  
          regulations to limit healthcare workers' exposure to these  
          drugs.  Implementing and regulating improved safety guidelines  
          and standards will significantly reduce the risk of healthcare  
          workers and patients being exposed to antineoplastic drugs.   
          This includes developing procedures for properly using and  
          maintaining equipment designed to protect workers from hazardous  
          drug exposure.

          This bill is sponsored by Becton Dickinson and Company (BD  
          Medical), which is a global medical technology company that  
          states that it has "pioneered the development of  
          safety-engineered medical devises" and has "been at the  
          forefront of this field for over two decades."  BD Medical  
          argues that while national guidelines have been established by  
          NIOSH for handling antineoplastic drugs, compliance is voluntary  
          and has been reported to be sporadic.  They contend that it is  
          imperative that California develop comprehensive standards that  
          require healthcare facilities that handle these drugs to take  
          the necessary steps to protect their workforce.

          The California Nurses Association (CNA) supports this bill,  
          stating that registered nurses and healthcare workers must be  
          protected on the job after providing critical services to their  
          communities.

          CNA argues that registered nurses and healthcare workers by the  
          nature of their work, which involves ill patients, contagious  
          diseases, medical equipment and chemical exposures, are in  








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          constant danger of being exposed to a variety of illnesses, and  
          becoming sick or injured by their cumulative exposure.  Because  
          of the nature of patient care, combined with rising patient  
          acuity, more work related injuries and higher levels of exposure  
          to infectious disease are occurring.  In many cases nurses can  
          be exposed to harmful substances without even knowing it.   
          Nurses and other healthcare workers who transport, prepare,  
          administer and dispose of antineoplastic drugs can be exposed to  
          these toxic agents in the air or on work surfaces, clothing,  
          medical equipment and other surfaces.  As a result, nurses,  
          other healthcare workers and nonclinical workers are at risk for  
          exposure when they create aerosols, mix liquids, generate dust,  
          or touch contaminated surfaces if safe handling precautions are  
          not followed.  Exposure to these drugs can cause cancer,  
          reproductive and developmental problems, allergic reactions and  
          other adverse effects that can be irreversible even after  
          low-level exposures.
           

          Analysis Prepared by  :    Ben Ebbink / L. & E. / (916) 319-2091 


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