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)
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          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.








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