Amended in Senate August 15, 2016

Amended in Senate August 1, 2016

Amended in Senate June 14, 2016

California Legislature—2015–16 Regular Session

Assembly BillNo. 2272


Introduced by Assembly Member Thurmond

February 18, 2016


An act to add Section 144.9 to the Labor Code, relating to occupational safety and health.

LEGISLATIVE COUNSEL’S DIGEST

AB 2272, as amended, Thurmond. Occupational safety and health standards: plume.

Under existing law, the Occupational Safety and Health Standards Board within the Department of Industrial Relations promulgates and enforces occupational safety and health standards for the state, including standards dealing with toxic materials and harmful physical agents.begin insert Under existing law, the Division of Occupational Safety and Health is required to enforce all occupational safety and health standards,end insertbegin insert as specified.end insert A violation of these standards and regulations under specific circumstances is a crime.

This billbegin delete would require the board, by June 1, 2018, to adopt standards to protect health care personnel and patients from plume, defined as noxious airborne contaminants generated as byproducts of the use of specific devices during surgical, diagnostic, or therapeutic procedures.end deletebegin insert would, by June 1, 2017, end insertbegin insertrequire the division to convene an advisory committee to develop a regulation that requires a health facility to evacuate or remove plume through the use of a plume scavenging system in all settings that employ techniques that involve the creation of plume and would authorize certain entities and people to be on the advisory committee, including, among others, practicing physicians and surgeons from affected specialties.end insert The bill would require thebegin delete board,end deletebegin insert division,end insert inbegin delete adopting these standards,end deletebegin insert developing the regulationend insert tobegin delete take into consideration and use as a benchmarkend deletebegin insert do certain things, including evaluating the use ofend insert certain standards adopted by specifiedbegin delete organizations.end deletebegin insert organizations as a benchmark.end insert The bill wouldbegin insert alsoend insert require thebegin delete board to use as the mandated requirement for plume scavenging systems recommendations ofend deletebegin insert division, when developing the proposed regulation, to take into consideration recommendations on the evacuation of plume fromend insert the federal Occupational Safety and Health Administration or National Institute for Occupational Safety and begin deleteHealth, where the board determines those recommendations are more effective in the evacuation of plume and would be more protective of occupational health than the described standards.end deletebegin insert Health. The bill would, by June 1, 2018, require the division to submit to the board the proposed regulation. The bill would, by July 1, 2019, require the board to adopt the proposed regulation.end insert

begin delete

The bill would require the board, as part of the standards, to include a requirement that employers provide training to all health care workers involved in procedures that involve the creation of plume, as specified.

end delete

The bill would provide that compliance with general room ventilation standards or the use of surgical masksbegin delete or respiratorsend delete does not satisfy the requirements for protection from surgical plumes under these provisions.begin insert The bill would provide that the use of respirators does not satisfy the requirements for protection from surgical plumes under these provisions, except as specified.end insert The bill would require the manufacturer of a plume scavenging system to provide evidence that the system meets specified minimum requirements when installed, operated, and maintained in accordance with the manufacturer’s instructions.

begin insert

The bill would specify that these provisions do not limit the authority of the division to develop, or limit the authority of the board to adopt, a regulation with a broader scope or broader application than required by these provisions.

end insert

By expanding the definition of an existing crime, this bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

P3    1

SECTION 1.  

Section 144.9 is added to the Labor Code, to
2read:

3

144.9.  

(a) As used in this section:

begin insert

4
(1) “Division” means the Division of Occupational Safety and
5Health.

end insert
begin delete

6(1)

end delete

7begin insert(2)end insert “Electrocautery device” means a device that is electrically
8heated to cut, ablate, or coagulate human tissue for therapeutic
9purposes.

begin delete

10(2)

end delete

11begin insert(3end insertbegin insert)end insert “Electrosurgical device” means a device that uses a radio
12frequency electric current passing through the patient to cut, ablate,
13or coagulate human tissue for therapeutic purposes.

begin delete

14(3)

end delete

15begin insert(4)end insert “Energy-based device” means a device that uses energy to
16ablate, cauterize, or mechanically manipulate target human tissue
17including lasers, electrosurgical generators, broadband light
18sources, ultrasonic instruments, plasma generators, bone saws, and
19drills.

begin insert

20
(5) “Health facility” means a health facility as defined in
21subdivision (a) of Section 1250 of the Health and Safety Code.

end insert
begin delete

22(4)

end delete

23begin insert(end insertbegin insert6)end insert “Plume” means noxious airborne contaminants generated
24as byproducts of the use of energy-based devices, electrosurgical
25devices, electrocautery devices, or mechanical tools during surgical,
26diagnostic, or therapeutic procedures.

begin delete

27(5)

end delete

28begin insert(end insertbegin insert7)end insert “Plume scavenging system” means smoke evacuators, laser
29plume evacuators, plume scavengers, and local exhaust ventilators begin delete30 that, when used in accordance with the manufacturer’s instructions,
31conform to the general requirement of the 2014 ISO Standard
3216571 to remove and neutralize at least 90 percent of plume at the
33site of origin and before plume can make ocular contact or contact
P4    1with the respiratory tract of health care personnel or patients.end delete
begin insert that
2capture and neutralize plume at the site of origin and before plume
3can make ocular contact or contact with the respiratory tract of
4employees.end insert

5(b) (1) Thebegin delete board shall, byend deletebegin insert division, by June 1, 2017, shall
6convene an advisory committee to develop a regulation that
7requires a health facility to evacuate or remove plume through the
8use of a plume scavenging system in all settings that employ
9techniques that involve the creation of plume. The advisory
10committee may include health facilities, practicing physicians and
11surgeons from affected specialties, registered nurses and other
12affected health care personnel, labor and specialty organizations
13representing affected registered nurses, labor and specialty
14organizations representing other affected health care personnel,
15and other stakeholders.end insert

16begin insert(end insertbegin insert2)end insertbegin insertend insertbegin insertByend insert June 1, 2018, begin delete adopt an occupational safety and health
17standard requiring a health facility, as defined in subdivision (a)
18of Section 1250 of the Health and Safety Code, to evacuate or
19remove plume through the use of a plume scavenging system in
20all settings that employ techniques that involve the creation of
21plume. Inend delete
begin insert the division shall submit to the board the proposed
22regulation end insert
begin insertrequiring a health facility to evacuate or remove plume
23through the use of a plume scavenging system in all settings that
24employ techniques that involve the creation of plume.end insert

25begin insert(3)end insertbegin insertend insertbegin insertInend insert developing thebegin delete standard,end deletebegin insert regulation,end insert thebegin delete boardend deletebegin insert divisionend insert
26 shallbegin delete take into consideration and use as a benchmarkend deletebegin insert do all of the
27following:end insert

28begin insert(end insertbegin insertA)end insertbegin insertend insertbegin insertEvaluate using as a benchmarkend insert the standards titled “Systems
29for evacuation of plume generated by medical devices” (ISO
3016571) adopted by the International Organization for
31Standardization and the standards titled “Plume scavenging in
32surgical, diagnostic, therapeutic, and aesthetic settings” (CSA
33Z305.13-13) adopted by the CSA Group.begin delete Where, in the
34determination of the board, recommendations of theend delete

35begin insert(B)end insertbegin insertend insertbegin insertTake into consideration recommendations on the evacuation
36of plume from theend insert
federal Occupational Safety and Health
37Administrationbegin delete orend deletebegin insert andend insert National Institute for Occupational Safety
38and begin delete Health are more effective in the evacuation of plume and would
39be more protective of occupational health than the ISO or CSA
P5    1standards, the board shall use those federal recommendations as
2the mandated requirement for plume scavenging systems.end delete
begin insert Health.end insert

begin delete

3(2) As part of the standard, the board shall include

end delete
begin insert

4
(C) Take into consideration the standards titled “Systems for
5evacuation of plume generated by medical devices” (ISO 16571)
6adopted by the International Organization for Standardization in
7developing a standard establishing how much plume shall be
8captured by a plume scavenging system.

end insert

9begin insert(end insertbegin insertD)end insertbegin insertend insertbegin insertIncludeend insert a requirementbegin insert in the regulationend insert for employers to
10provide trainingbegin delete and educationend delete to allbegin delete health care end delete workersbegin delete that will
11participateend delete
begin insert foreseeably participatingend insert in procedures that involve
12the creation of plume. The training shall include, but not be limited
13to,begin delete the appropriate use of the plume scavenging systems and
14equipment utilized by the facility, andend delete
general education on the
15contents of plume, the circumstances in which it is generated,begin delete andend delete
16 the associated health and safetybegin delete hazards.end deletebegin insert hazards, and appropriate
17use of the plume scavenging equipment and systems utilized by the
18health facility.end insert
The training shall be designed to provide an
19opportunity for interactive questions and answers with a person
20knowledgeable about occupational exposure to plume and the
21specific equipmentbegin delete utilized.end deletebegin insert utilized to scavenge plume.end insert

begin delete

22(3) In developing standards, the board may consider input from
23health facilities, practicing physicians from affected specialties,
24registered nurses and other affected health care personnel, labor
25and specialty organizations representing affected registered nurses,
26labor and specialty organizations representing other affected health
27care personnel, and other stakeholders.

end delete
begin insert

28
(c) The board shall, by July 1, 2019, adopt the proposed
29regulation of the division, except as specified in subdivision (f),
30requiring a health facility to evacuate or remove plume through
31the use of a plume scavenging system in all settings that employ
32techniques that involve the creation of plume.

end insert
begin delete

33(c)

end delete

34begin insert(end insertbegin insertd)end insert (1) Nothing in this section alters, amends, expands, or
35reduces existing general room ventilation standards or
36requirements. These plume scavenging standards are in addition
37to general room ventilation standards or requirements, and
38compliance with general room ventilation standards shall not satisfy
39the requirements of this section.

P6    1(2) Evidence that the plume scavenging system conforms to the
2minimum requirements of this section when installed, operated,
3and maintained in accordance with the manufacturer’s instructions,
4shall be provided by the manufacturer.

begin delete

5(d)

end delete

6begin insert(e)end insert The use of surgical masksbegin delete or respiratorsend delete shall not satisfy the
7requirements of this section.begin insert The use of respirators shall not satisfy
8the requirements of this section except when, due to medical
9necessity, the plume scavenging system is not able to be located
10where it effectively captures plume.end insert

begin insert

11
(f) This section shall not limit the authority of the division to
12develop a regulation, or the authority of the board to adopt a
13regulation, that is broader in scope or broader in application than
14 required by this section.

end insert
15

SEC. 2.  

No reimbursement is required by this act pursuant to
16Section 6 of Article XIII B of the California Constitution because
17the only costs that may be incurred by a local agency or school
18district will be incurred because this act creates a new crime or
19infraction, eliminates a crime or infraction, or changes the penalty
20for a crime or infraction, within the meaning of Section 17556 of
21the Government Code, or changes the definition of a crime within
22the meaning of Section 6 of Article XIII B of the California
23Constitution.



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