BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 460
AUTHOR: Pavley
AMENDED: April 16, 2013
HEARING DATE: May 1, 2013
CONSULTANT: Moreno
SUBJECT : Prenatal testing program: education.
SUMMARY : Requires the Department of Public Health (DPH) to
include information regarding environmental health in the
California Prenatal Screening Program Prenatal Patient Booklet,
including a specified statement and three website addresses.
Existing law:
1.Establishes a prenatal testing program and requires DPH to
establish criteria for eligibility for the program.
2.Requires DPH to develop an education program designed to
educate physicians and surgeons and the public concerning the
uses of prenatal testing and the availability of the program.
This bill:
1.Requires DPH to include information regarding environmental
health in the California Prenatal Screening Program Prenatal
Patient Booklet including, but not be limited to, the
following statement:
"We encounter chemicals and other substances in everyday life
that may be harmful to a developing fetus. Fortunately, there
are steps you can take to reduce your exposure to these
substances at home, in the workplace, and in the environment.
Most Californians are unaware that a number of everyday
consumer products, even when used as directed, pose potential
harm. Prospective parents are encouraged to read more about
this topic to learn about simple actions to ensure a healthy
pregnancy."
2.Requires DPH to include in the booklet links to Internet Web
sites and informational brochures relating to environmental
health, including, but not limited to, the University of
California, San Francisco (UCSF) Program on Reproductive
Health and the Environment informational brochures, which
include the following:
Continued---
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a. The "Toxic Matters" brochure at:
http://prhe.ucsf.edu/prhe/pdfs/toxicmatters_readable.pdf
b. The "Work Matters" brochure at:
http://prhe.ucsf.edu/prhe/pdfs/WorkMattersBrochure_readable.
pdf
c. The "Pesticides Matter" brochure at:
http://prhe.ucsf.edu/prhe/pdfs/pesticidesmatter_readable.pdf
3.Requires DPH to send a notice to all
obstetrician-gynecologists informing them of the change to the
booklet. Requires DPH, in the notice, to encourage
obstetrician-gynecologists to discuss environmental health
with their patients and to direct their patients to the
appropriate page or pages in the booklet to provide their
patients with additional information.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
1.Author's statement. According to the author, exposure to
chemicals known to be harmful to reproductive health during
pregnancy can have negative effects on the development of an
unborn child resulting in health conditions later in life.
Common reproductive toxins such as mercury, often found in
fish and shellfish, can adversely affect a baby's growing
brain and nervous system. Also lead, found in some house
paints, dust and garden soils, can affect infant
neurodevelopment, resulting in lower IQs and impairment in
hearing and motor development later in life. Many pregnant
women are unaware of their level of exposure to harmful
reproductive toxins or where these toxins can be found.
Providing pregnant women with educational information on
environmental health will give them the tools they need to
limit their exposure to harmful reproductive toxins and give
their children a healthy start in life.
2.California Prenatal Screening Program Prenatal Patient
Booklet. In addition to requiring DPH to develop an
educational program regarding prenatal testing, regulations
require clinicians to provide information to certain pregnant
women in their care on the use and availability of prenatal
screening for birth defects, in a format provided or approved
by DPH, and to obtain a signed consent form from those women
consenting to participate. The booklet that is the subject of
SB 460 | Page
3
this bill is part of the Prenatal Screening (PNS) Program
within DPH's Genetic Disease Screening Program. According to
DPH, the purpose of the booklet is to describe the PNS Program
so that patients can knowledgeably consent to or decline
screening. The booklet discusses birth defects identified
through the PNS Program: Down Syndrome, Trisomy 18, Trisomy
13, Neural Tube Defects, Abdominal Wall Defects and
Smith-Lemli-Opitz syndrome. Pregnant women receive this
booklet at the time of prenatal screening; usually in weeks
10-18 of pregnancy. It is provided to prenatal care
clinicians along with prenatal screening supplies, which are
provided by DPH at the request of clinicians. DPH states that
the booklet was last printed in February 2013 and will be
uploaded to its Website by the end of May 2013. DPH reprints
booklets approximately every one to two years.
3.Support. The Breast Cancer Fund (BCF) writes that many
chemicals can alter normal development, including breast
development, and chemicals that disrupt the endocrine system.
In particular, it can alter normal breast development and set
a child on a path toward increased risk for developing the
disease later in life. BCF contends that despite these facts,
most pregnant women are not told about the presence of these
chemicals in their homes or ways to avoid them during
pregnancy. BCF states that including information about the
risks associated with certain chemicals and strategies to
avoid them in the prenatal screening booklet will provide
women with helpful links to learn more information should they
so choose. The California Healthy Nail Salon Collaborative
(CHNSC) states that pregnant women are exposed to hundreds, if
not thousands, of chemicals, and the placenta does not serve
as a protective barrier to the fetus. CHNSC writes that some
of these chemicals are known to cause cancer, birth defects,
developmental delays and endocrine disruption, and that many
are in nail salon products and common household products as
well. The American Congress of Obstetricians and
Gynecologist, District IX (California) writes that a startling
amount of new scientific evidence shows the impact of
environmental exposures on reproductive health including fetal
and childhood development, and that exposures from toxicants
can not only cause cancer and neurologic problems, but many
are particularly damaging to reproductive health as they are
estrogen mimickers, disrupting the endocrine system. Planned
Parenthood Affiliates of California states that the CDC's
nationwide testing program found 100 chemicals in monitored
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pregnant women, including chemicals known to be harmful to
reproductive health, such as lead, mercury, and organochlorine
pesticides.
4.Policy comment. As previously stated, the California Prenatal
Screening Program Prenatal Patient Booklet is provided to
pregnant women as part of DPH's Genetic Disease Screening
Program, and the information contained in it is germane to
that topic. This bill proposes to add information on
environmental health to that booklet, which seems to conflate
two separate issues. Including the information required under
this bill with information designed to inform patients about
genetic testing could imply that chemicals exposure could
somehow be detected as part of that testing.
SUPPORT AND OPPOSITION :
Support: Breast Cancer Fund (sponsor)
American Congress of Obstetricians and Gynecologists,
District IX (California)
Clean Water Action
California Healthy Nail Salon Collaborative
Junior Leagues of California
March of Dimes California Chapter
Planned Parenthood Affiliates of California
Oppose: None received.
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