BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1202|
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THIRD READING
Bill No: AB 1202
Author: Skinner (D), et al.
Amended: 5/24/13 in Assembly
Vote: 21
SENATE LABOR & INDUSTRIAL RELATIONS COMMITTEE : 4-0, 6/26/13
AYES: Monning, Wyland, Leno, Yee
NO VOTE RECORDED: Padilla
SENATE APPROPRIATIONS COMMITTEE : 6-0, 8/12/13
AYES: De León, Walters, Gaines, Hill, Lara, Steinberg
NO VOTE RECORDED: Padilla
ASSEMBLY FLOOR : 78-0, 5/30/13 - See last page for vote
SUBJECT : Occupational safety and health standards: hazardous
drugs
SOURCE : Becton, Dickinson and Company
DIGEST : This bill requires the Occupational Safety and Health
Standards Board (OSHSB) to adopt a standard related to the
handling of antineoplastic drugs, as specified.
ANALYSIS : Existing law provides for OSHSB, which consists of
seven individuals appointed by the Governor for four year terms.
Two members must be from the field of management, two members
must be from the field of labor, one member must be from the
field of occupational health, one member must be from the field
of occupational safety and one member must be from the general
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public.
Existing law empowers OSHSB, by an affirmative vote of four or
more members, to adopt, amend, or repeal occupational safety and
health standards. The procedure to adopt, repeal, or amend
occupational safety and health standards must follow the process
for promulgating regulations, unless otherwise stated in Labor
Code.
Existing law requires that the Department of Occupational Safety
and Health (DOSH) enforce all occupational safety and health
standards adopted by OSHSB.
Existing law allows any employer to apply to OSHSB for a
permanent variance from any occupational safety and health
standard if the employer has an alternative practice or program
that will provide equal or superior safety for employees. The
OSHSB must issue the variance if it determines on the record
that the preponderance of evidence supports that the employer's
alternative practice or program are as safe as the standard.
Existing law requires that OSHSB develop or revise certain
specific occupational safety and health standards, including
bloodborne pathogens, hazardous substance removal work,
agricultural field sanitation, and lead-related construction.
This bill requires OSHSB to create an occupational safety and
health standard for the handling of antineoplastic drugs in
health care facilities regardless of the setting. In developing
the standard, the OSHSB must:
1. Consider input from hospitals, practicing physicians from
impacted specialties, including oncology, organizations
representing health care personnel, including registered
nurses and pharmacists, and other stakeholders.
2. Determine a reasonable time for facilities to implement new
requirements imposed by the adopted standard.
3. To the extent feasible, be consistent with and not exceed
recommendations in the National Institute for Occupational
Safety and Health (NIOSH) 2004 alert entitled "Preventing
Occupational Exposures to Antineoplastic and Other Hazardous
Drugs in Health Care Settings," as updated in 2010.
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This bill defines "antineoplastic drug" as a chemotherapeutic
agent that controls or kills cancer cells.
This bill also makes findings and declarations on the dangers of
inappropriate handling of antineoplastic drug in an occupational
setting.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee, the Department
of Industrial Relations 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 this bill, specifically conduct
the necessary research, meet with stakeholders and draft
regulations. Enforcement costs are anticipated to be minor and
absorbable.
SUPPORT : (Verified 8/14/13)
Becton, Dickinson and Company (source)
AFSCME, AFL-CIO
Association of Northern California Oncologists
California Healthcare Institute
California Labor Federation, AFL-CIO
California Nurses Association
California Pharmacists Association
California Professional Firefighters
Laborers' International Union of North America, Locals 777 and
792
National Lawyers Guild Labor and Employment Committee
SEIU California
ARGUMENTS IN SUPPORT : According to the author's office,
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, existing law provides no enforceable standards for the
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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
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,
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reproductive and developmental problems, allergic reactions and
other adverse effects that can be irreversible even after
low-level exposures.
ASSEMBLY FLOOR : 78-0, 5/30/13
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,
Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown,
Buchanan, Ian Calderon, Campos, Chau, Chávez, Chesbro, Conway,
Cooley, Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox,
Frazier, Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon,
Gorell, Gray, Grove, Hagman, Hall, Harkey, Roger Hernández,
Jones, Jones-Sawyer, Levine, Linder, Logue, Lowenthal,
Maienschein, Mansoor, Medina, Melendez, Mitchell, Morrell,
Mullin, Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson,
Perea, V. Manuel Pérez, Quirk, Quirk-Silva, Rendon, Salas,
Skinner, Stone, Ting, Wagner, Waldron, Weber, Wieckowski,
Wilk, Williams, Yamada, John A. Pérez
NO VOTE RECORDED: Holden, Vacancy
PQ:k 8/14/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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