BILL NUMBER: AB 2272	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 15, 2016
	AMENDED IN SENATE  AUGUST 1, 2016
	AMENDED IN SENATE  JUNE 14, 2016

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.  Under existing law, the Division of Occupational Safety
and Health is required to enforce all occupational safety and health
standards,   as specified.  A violation of these
standards and regulations under specific circumstances is a crime.
   This bill  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.   would, by June
1, 2017,   require 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.  The bill would require
the  board,   division,  in 
adopting these standards,   developing the regulation
 to  take into consideration and use as a benchmark
  do certain things, including evaluating the use of
 certain standards adopted by specified  organizations.
  organizations as a benchmark.  The bill would
 also  require the  board to use as the mandated
requirement for plume scavenging systems recommendations of 
 division, when developing the proposed regulation, to take into
consideration recommendations on the evacuation of plume from 
the federal Occupational Safety and Health Administration or National
Institute for Occupational Safety and  Health, 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.   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.  
   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. 
   The bill would provide that compliance with general room
ventilation standards or the use of surgical masks  or
respirators  does not satisfy the requirements for
protection from surgical plumes under these provisions.  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.  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. 
    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. 
   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:

  SECTION 1.  Section 144.9 is added to the Labor Code, to read:
   144.9.  (a) As used in this section: 
   (1) "Division" means the Division of Occupational Safety and
Health.  
   (1) 
    (2)  "Electrocautery device" means a device that is
electrically heated to cut, ablate, or coagulate human tissue for
therapeutic purposes. 
   (2) 
    (3   )  "Electrosurgical device" means a device
that uses a radio frequency electric current passing through the
patient to cut, ablate, or coagulate human tissue for therapeutic
purposes. 
   (3) 
    (4)  "Energy-based device" means a device that uses
energy to ablate, cauterize, or mechanically manipulate target human
tissue including lasers, electrosurgical generators, broadband light
sources, ultrasonic instruments, plasma generators, bone saws, and
drills. 
   (5) "Health facility" means a health facility as defined in
subdivision (a) of Section 1250 of the Health and Safety Code. 

   (4) 
    (   6)  "Plume" means noxious airborne
contaminants generated as byproducts of the use of energy-based
devices, electrosurgical devices, electrocautery devices, or
mechanical tools during surgical, diagnostic, or therapeutic
procedures. 
   (5) 
    (   7)  "Plume scavenging system" means smoke
evacuators, laser plume evacuators, plume scavengers, and local
exhaust ventilators  that, when used in accordance with the
manufacturer's instructions, conform to the general requirement of
the 2014 ISO Standard 16571 to remove and neutralize at least 90
percent of plume at the site of origin and before plume can make
ocular contact or contact with the respiratory tract of health care
personnel or patients.   that capture and neutralize
plume at the site of origin and before plume can make ocular contact
or contact with the respiratory tract of employees. 
   (b) (1) The  board shall, by   division, by
June 1, 2017, shall 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. The
advisory committee may include health facilities, practicing
physicians and surgeons from affected specialties, registered nurses
and other affected   health care personnel, labor and
specialty organizations representing affected registered nurses,
labor and specialty organizations representing other affected health
care personnel, and other stakeholders. 
    (   2)     By  June 1, 2018,
 adopt an occupational safety and health standard requiring a
health facility, as defined in subdivision (a) of Section 1250 of
the Health and Safety Code, 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. In   the
division shall submit to the board the proposed regulation  
requiring 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. 
    (3)     In  developing the 
standard,   regulation,  the  board
  division  shall  take into consideration
and use as a benchmark   do all of the following: 
    (   A)     Evaluate using as a
benchmark  the standards titled "Systems for evacuation of plume
generated by medical devices" (ISO 16571) adopted by the
International Organization for Standardization and the standards
titled "Plume scavenging in surgical, diagnostic, therapeutic, and
aesthetic settings" (CSA Z305.13-13) adopted by the CSA Group.
 Where, in the determination of the board, recommendations of
the 
    (B)     Take into consideration
recommendations on the evacuation of plume from the  federal
Occupational Safety and Health Administration  or 
 and  National Institute for Occupational Safety and
 Health are more effective in the evacuation of plume and
would be more protective of occupational health than the ISO or CSA
standards, the board shall use those federal recommendations as the
mandated requirement for plume scavenging systems. 
Health.  
   (2) As part of the standard, the board shall include 

   (C) Take into consideration the standards titled "Systems for
evacuation of plume generated by medical devices" (ISO 16571) adopted
by the International Organization for Standardization in developing
a standard establishing how much plume shall be captured by a plume
scavenging system. 
    (   D)     Include  a
requirement  in the regulation  for employers to provide
training  and education  to all  health care
 workers that will participate  
foreseeably participating  in procedures that involve the
creation of plume. The training shall include, but not be limited to,
 the appropriate use of the plume scavenging systems and
equipment utilized by the facility, and  general education
on the contents of plume, the circumstances in which it is generated,
 and  the associated health and safety 
hazards.   hazards, and appropriate use of the plume
scavenging equipment and systems utilized by the health facility.
 The training shall be designed to provide an opportunity for
interactive questions and answers with a person knowledgeable about
occupational exposure to plume and the specific equipment 
utilized.   utilized to scavenge plume.  
   (3) In developing standards, the board may consider input from
health facilities, practicing physicians from affected specialties,
registered nurses and other affected health care personnel, labor and
specialty organizations representing affected registered nurses,
labor and specialty organizations representing other affected health
care personnel, and other stakeholders.  
   (c) The board shall, by July 1, 2019, adopt the proposed
regulation of the division, except as specified in subdivision (f),
requiring 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.  
   (c) 
    (   d)  (1) Nothing in this section alters,
amends, expands, or reduces existing general room ventilation
standards or requirements. These plume scavenging standards are in
addition to general room ventilation standards or requirements, and
compliance with general room ventilation standards shall not satisfy
the requirements of this section.
   (2) Evidence that the plume scavenging system conforms to the
minimum requirements of this section when installed, operated, and
maintained in accordance with the manufacturer's instructions, shall
be provided by the manufacturer. 
   (d) 
    (e)  The use of surgical masks  or respirators
 shall not satisfy the requirements of this section. 
The use of respirators shall not satisfy the requirements of this
section except when, due to medical necessity, the plume scavenging
system is not able to be located where it effectively captures plume.
 
   (f) This section shall not limit the authority of the division to
develop a regulation, or the authority of the board to adopt a
regulation, that is broader in scope or broader in application than
required by this section. 
  SEC. 2.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.