BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session AB 2272 (Thurmond) - Occupational safety and health standards: plume ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: August 1, 2016 |Policy Vote: L. & I.R. 4 - 1 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: Yes | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: August 1, 2016 |Consultant: Robert Ingenito | | | | ----------------------------------------------------------------- This bill meets the criteria for referral to the Suspense File. Bill Summary: AB 2272 would require the Occupational Safety and Health Standards Board, by June 1, 2018, to adopt standards and require training and education to protect health care personnel and patients from exposure to vaporized human tissue. Fiscal Impact: The Department of Industrial Relations (DIR) indicates that costs associated with the Occupational Safety and Health Standards Board's development of standards requiring a health facility to evacuate or remove plume, as specified, would be within the scope of existing workload, and thus absorbable. However, DIR's Division of Occupational Safety and Health would incur unknown enforcement costs once the standards have been developed. AB 2272 (Thurmond) Page 1 of ? Background: Current law establishes the Occupational Safety and Health Standards Board (Board), within DIR, as the standards-setting agency for the Division of Occupational Safety and Health (DOSH). The Board promulgates and enforces occupational safety and health standards for the state including standards dealing with toxic materials and harmful physical agents. Additionally, current law stipulates that in promulgating standards dealing with toxic materials or harmful physical agents, the Board shall adopt standards to prevent employees from suffering adverse health effects even if these employees have regular exposure to a regulated hazard. Proposed Law: This bill would, among other things, do all of the following: Require the Board, by June 1, 2018, to adopt standards to protect health care personnel and patients from plume (see below) exposure through the use of plume scavenging systems. Mandate that in developing these standards, the Board will consider the most effective preexisting plume-related standards including those at the federal level. The Board may also consider input from health facilities, physicians, registered nurses, affected health care personnel, labor and specialty organizations representing affected registered nurses and health care personnel, and other stakeholders. Specify the Board to include as part of the standards a requirement for employers to provide training and education, as specified, to all health care workers that will participate in procedures that involve the creation of a plume. Define "plume" as vaporized human tissue or 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. These AB 2272 (Thurmond) Page 2 of ? plume-generating devices are also defined. Define devices that remove plume from the air as "plume scavenging systems" that include 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 before plume can make ocular contact or contact with the respiratory tract of health care personnel or patients. Staff Comments: The heat-generated (thermal) destruction of human tissue via cutting during therapeutic removal and burning (cauterization) is commonplace in a wide range of medical procedures. When human tissue is destroyed in this way, a smoke byproduct or "plume" is created. The plume can contain toxic gases and vapors such as benzene, hydrogen cyanide, and formaldehyde, biological aerosols (a suspension of living bacteria, viral particles or fungal spores), and viruses and blood fragments containing blood-borne pathogens, including multi-resistant strains. Surgical plume is also known to contain mutagenic (cancer producing) particles. At high concentrations, plume can also cause ocular and upper respiratory tract irritation in health care personnel. Under this bill, California would be the first state to create a standard related to plume exposure and removal. Any local government costs resulting from the mandate in this measure are not state-reimbursable because the mandate only involves the definition of a crime or the penalty for conviction of a crime. -- END -- AB 2272 (Thurmond) Page 3 of ?