BILL ANALYSIS Ó AB 2272 Page 1 Date of Hearing: May 4, 2016 ASSEMBLY COMMITTEE ON APPROPRIATIONS Lorena Gonzalez, Chair AB 2272 (Thurmond) - As Introduced February 18, 2016 ----------------------------------------------------------------- |Policy |Labor and Employment |Vote:|5 - 1 | |Committee: | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | ----------------------------------------------------------------- Urgency: No State Mandated Local Program: YesReimbursable: No SUMMARY: This bill requires the Occupational Safety and Health Standards Board (Board) to adopt standards to protect healthcare personnel and patients from noxious airborne contaminants "plume" generated during specified medical procedures. Specifically, this bill: AB 2272 Page 2 1)Requires the Board to adopt by June 1, 2018, an occupational safety and health standard 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. 2)Requires the Board to take into consideration and use as a benchmark, specific standards adopted by the International Organization for Standardization (IOS) and the Canadian Standards Association (CSA). If the Board determines recommendations of the federal Occupational Safety and Health Administration or 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 must use those federal recommendations as the mandated requirement for plume scavenging systems. 3)Authorizes the Board to consider input from health facilities, practicing physicians from affected specialties, labor and specialty organizations representing affected registered nurses, labor and specialty organizations representing other affected health care personnel, and other stakeholders. 4)Specifies nothing in this bill 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. Prohibits the use of surgical masks or respirators to satisfy the requirement of this bill. 5)Defines the following for purposes of the bill: a. "Plume" to mean noxious airborne contaminants AB 2272 Page 3 generated as byproducts of the use of energy-based devices, electrosurgical devices, electrocautery devices, or mechanical tools during surgical, diagnostic, or therapeutic procedures. b. "Plume scavenging system" to mean smoke evacuators, laser plume evacuators, plume scavengers, and local exhaust ventilators that capture and neutralize at least 95 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 FISCAL EFFECT: The Occupational Safety and Health Standards Board indicates the costs associated with the development of a standard requiring a health facility to evacuate or remove plume, as specified, would be absorbable and within the scope of existing workload. The Board would rely on the recommended benchmarks developed by the CSA and ISO to guide their work. Unknown enforcement costs to the Division of Occupational Safety and Health (DOSH) once the bill is implemented. COMMENTS: 1)Purpose. According to the sponsors, the California Nurses Association/National Nurses United, operating room nurses are at significantly higher risk of severe persistent asthma as a result of occupational exposure to the dangerous and AB 2272 Page 4 infectious materials that can be found in surgical plume smoke. Information from the sponsor states, for example, surgeons are using smoke evacuators for laser procedures but not electrosurgery, which is actually more dangerous because this procedure emits more particulates. Adopting standards to remove these infectious airborne contaminants before they are dispersed into the surgical suite and surrounding areas, could make California a leader in the reduction of hazardous exposure to surgical plume which could prove beneficial both to health care providers and their patients. 2)Background. California would be the first state to create a standard related to plume exposure and removal if this bill were enacted. Both the privately run Joint Commission on Accreditation of Healthcare Organizations and federal NIOSH have called for the reduction of plume exposure to healthcare workers. This bill recommends the Board consider recommendations made by the CSA and the ISO. The CSA is a nationally recognized testing laboratory involved in a wide range of testing and standards drafting in the areas such as construction, automotive, aerospace, and personal protective equipment. The ISO is an independent, non-governmental international organization that provides specifications for products, services and systems, to ensure quality, safety and efficiency. The ISO has published more than 19,000 International Standards and related documents, covering almost every industry, from technology, to food safety, to agriculture and healthcare. 3)Opposition. The California Hospital Association, is opposed to this bill. It states the hospital, together with physicians, select devices that may generate plume as well as devices that could minimize exposure to plume because of the patient care considerations. The association is concerned that directing the Board to utilize specific guidance is too prescriptive. AB 2272 Page 5 Analysis Prepared by:Misty Feusahrens / APPR. / (916) 319-2081