BILL ANALYSIS Ó Senate Appropriations Committee Fiscal Summary Senator Kevin de León, Chair AB 1202 (Skinner) - Occupational Safety and Health Standards: Hazardous Drugs Amended: May 24, 2013 Policy Vote: L&IR 4-0 Urgency: No Mandate: Yes Hearing Date: August 12, 2013 Consultant: Robert Ingenito This bill does not meet the criteria for referral to the Suspense File. Bill Summary: AB 1202 would require the Occupational Safety and Health Standards Board (OSHSB) to adopt an occupational safety and health standard for the handing of antineoplastic drugs in health care facilities. Fiscal Impact: The Department of Industrial Relations (DIR) estimates that it would incur a one-time cost of $85,000 (special funds) per year for a two-year period to implement the provisions of the bill, specifically conduct the necessary research, meet with stakeholders and draft regulations. Enforcement costs are anticipated to be minor and absorbable. Background: OSHSB, 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 National Institute for Occupational Safety and Health (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. AB 1202 (Skinner) Page 1 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." Antineoplastic Drugs (also known as cytotoxic drugs) are drugs or agents used in chemotherapy cancer treatments to prevent the development, maturation, or spread of cancerous cells. For the patients who take these drugs, side effects include hair loss, fatigue, blood problems, and other health hazards. Although developed for cancer treatments shortly after the end of the Second World War, concerns about occupational exposure were not raised until the 1970s. 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. Proposed Law: This bill would, among other things, do the following: Require OSHSB 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. Require the standard, to the extent feasible, be consistent with and not exceed recommendations in the 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. Define antineoplastic drug as a chemotherapeutic agent that controls and kills cancer cells. Related Legislation: SB 432 (DeLeon) of 2011 would have required OSHSB to develop an occupational safety and health standard for lodging housekeepers. SB 432 was held in the Assembly Appropriations Committee. AB 1202 (Skinner) Page 2