BILL ANALYSIS Ó
AB 2272
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GOVERNOR'S VETO
AB
2272 (Thurmond)
As Enrolled September 9, 2016
2/3 vote
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|ASSEMBLY: |49-23 |(May 19, 2016) |SENATE: |25-13 |(August 24, |
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|ASSEMBLY: |52-26 |(August 30, | | | |
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Original Committee Reference: L. & E.
SUMMARY: Requires the Division of Occupational Safety and
Health (DOSH) to convene an advisory committee to develop a
regulation regarding the protection of health care personnel and
patients from exposure to vaporized human tissue, defined in
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this bill as "plume," among other things. Specifically, this
bill:
1)Requires that by July 1, 2019, the Occupational Safety and
Health Standards Board (Board) adopt the proposed regulations
from the advisory committee.
2)Allows the DOSH advisory committee to 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 and health care personnel, and
other stakeholders.
3)Mandates that in developing this regulation, the DOSH advisory
committee consider, and evaluate as a benchmark, preexisting
plume-related standards including those adopted at the federal
Occupational Safety and Health Administration and the National
Institute for Occupational Safety and Health, as well as other
private groups such as the International Organization for
Standardization.
4)Stipulates that the use of surgical masks do not qualify as
protection against plume.
5)States that the use of respirators does not qualify as
protection against plume except when, due to medical
necessity, a plume scavenging system is not able to be located
where it captures plume effectively.
6)Defines "plume" 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.
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7)Defines "plume scavenging system" as smoke evacuators, laser
plume evacuators, plume scavengers, and local exhaust
ventilators that capture and neutralize plume before it can
make ocular contact or contact with the respiratory tract of
health care personnel or patients.
The Senate amendments:
1)Require DOSH, by June 1, 2017 to form an advisory committee to
develop and submit to the Board by June 1, 2018, a regulation
to protect health care personnel and patients from plume
exposure through the use of plume scavenging systems, as
specified.
2)Require that by July 1, 2019, Board consider and adopt the
proposed regulations.
3)State the proposed regulations/standards shall include a
requirement that employers provide training to all health care
personnel involved in procedures creating exposure to
vaporized human tissue.
4)Specify that the regulation shall not limit the authority of
DOSH or the Board to develop or adopt regulations that are
broader in scope or application than those established in the
bill.
5)Make clarifying changes.
EXISTING LAW establishes the Board within the Department of
Industrial Relations (DIR) which promulgates and enforces
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occupational safety and health standards for the state including
standards dealing with toxic materials and harmful physical
agents.
FISCAL EFFECT: According to the Senate Appropriations
Committee, the 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 DOSH would incur
unknown enforcement costs once the standards have been developed
COMMENTS: According to the sponsors, the California Nurses
Association/National Nurses United, a Nurses' Health Study found
that operating room nurses, "were at significantly higher risk
of severe persistent asthma" as a result of occupational
exposure to the dangerous and infectious materials that can be
found in surgical plume smoke.<1> By adopting standards to
remove these infectious airborne contaminants before they are
dispersed into the surgical suite and surrounding areas,
California could be a leader in the reduction of hazardous
exposure to surgical plume which could prove beneficial both to
health care providers and their patients.
The Federal Occupational Safety and Health Administration (OSHA)
can cite hospitals for not making an effort to control smoke
emission in laser or electrosurgical procedures through a clause
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<1>
Nurses' Health Studies are among the largest ongoing
investigations of factors that influence nurses' health.
Started in 1976 and expanded in 1989, the information provided
by 238,000 dedicated nurse participants has led to insights on
health and disease.
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that covers all hazardous conditions. In Section 5(a)(1) of the
Occupational Safety and Health Act, OSHA's General Duty Clause
states:
Each employer shall furnish to each of his [sic] employees
employment and a place of employment which are free from
recognized hazards that are causing or are likely to cause
death or serious physical harm to his [sic] employees.
However OSHA's limited ability to enforce elimination of unsafe
practices involving such surgical procedures has led many to
stress the need for a more concentrated campaign.
GOVERNOR'S VETO MESSAGE:
"This bill would require the Occupational Safety and Health
Standards Board to adopt a regulation that requires a health
facility to remove plume through the use of plume scavenging
systems by July 1, 2019.
I agree with the author and sponsor that the potentially
hazardous effects of plume merits thorough review. By
specifically requiring the adoption of the regulation,
however, the bill divests the Standards Board of its
discretion to consider a proposed standard for adoption and
instead mandates it to do so. This Board was created as an
independent body and I believe that independence must be
maintained in order for it to effectively perform its mission
and protect all California workers."
Analysis Prepared by:
Lorie Alvarez / L. & E. / (916) 319-2091 FN:
0005104
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