BILL ANALYSIS Ó
AB 2272
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Date of Hearing: May 4, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
AB
2272 (Thurmond) - As Introduced February 18, 2016
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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:
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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
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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
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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
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Analysis Prepared by:Misty Feusahrens / APPR. / (916)
319-2081