BILL ANALYSIS Ó
AB 2892
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Date of Hearing: April 12, 2016
ASSEMBLY COMMITTEE ON ENVIRONMENTAL SAFETY AND TOXIC MATERIALS
Luis Alejo, Chair
AB 2892
(Committee on Environmental Safety and Toxic Materials) - As
Introduced February 29, 2016
SUBJECT: Pesticide poisoning
SUMMARY: Extends the sunset, from January 1, 2017, to January
1, 2019, on the requirement for laboratories to, as part of the
California Medical Supervision Program (Program), electronically
transmit specified agricultural worker pesticide exposure test
results to the Department of Pesticide Regulation (DPR).
EXISTING LAW:
1)Requires each employer, who has an employee who regularly
handles organophosphate or carbamate pesticides (OP/CB
pesticides), to contract with a physician to provide medical
supervision of the employee. (California Code of Regulations
(CCR), Title 3, § 6728 (b))
2)Delineates the employer's responsibilities for medical
supervision for employees regularly handling OP/CB pesticides,
including requiring baseline cholinesterase tests and follow
up tests after the employee has handled OP/CB pesticides, as
specified. (CCR, Title 3, § 6728 (c))
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3)Requires an employer to remove an employee from exposure to
OP/CB pesticides if the employee's cholinesterase level falls
below specified baseline values. (CCR), Title 3, § 6728 (e))
4)Requires a laboratory that performs cholinesterase testing on
human blood drawn in California under the Program, or drawn to
respond to alleged or known exposure to cholinesterase
inhibitors that resulted in illness, to report specified
information, including test results, to DPR. (Health and
Safety Code (HSC) § 105206 (a))
5)Requires the medical supervisor ordering a cholinesterase test
under the Program to note in the test order the purpose of the
test. (HSC § 105206 (c))
6)Requires the Office of Environmental Health Hazard Assessment
(OEHHA) to review the cholinesterase test results and
authorizes OEHHA to provide an appropriate medical or
toxicological consultation to the medical supervisor. (HSC §
105206 (e))
7)Requires, by December 31, 2015, DPR and OEHHA, in consultation
with the State Department of Public Health (DPH), to prepare a
report on the effectiveness of the medical supervision program
and on the utility of laboratory-based reporting of
cholinesterase testing for illness surveillance and
prevention. Clarifies that the joint report may include
recommendations to the Legislature that DPR and OEHHA deem
necessary. (HSC § 105206 (f))
8)Sunsets the cholinesterase result reporting requirements on
January 1, 2017. (HSC § 105206 (g))
9)Requires any physician and surgeon who knows, or has
reasonable cause to believe, that a patient is suffering from
pesticide poisoning or any disease or condition caused by a
pesticide to promptly report that fact to the local health
officer by telephone within 24 hours. (HSC § 105200)
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10)Requires OEHHA to develop and implement, in cooperation with
local health officers and state and local medical
associations, a program of medical education to alert
physicians and other health care professionals to the
symptoms, diagnosis, treatment, and reporting of pesticide
poisoning. (HSC § 105205)
FISCAL EFFECT: Unknown.
COMMENTS:
Need for the bill: The California Medical Supervision Program
(Program) is designed to protect workers who regularly mix,
load, or apply organophosphate and carbamate pesticides (OP/CB),
which are highly toxic pesticides. In order to ensure that the
Program is effective, agricultural worker pesticide exposure
data (cholinesterase test results) are transmitted to DPR. This
data transmission requirement sunsets on January 1, 2017. AB
2892 extends this sunset to January 1, 2019, so that the state
can continue to effectively evaluate and manage the Program.
Organophosphate and carbamate (OP/CB) pesticides: According to
DPR, both OPs and CBs work as a pesticide by inhibiting the
nerve enzyme cholinesterase, which breaks down the
neurotransmitter acetylcholine, leading to the death of an
insect. OPs and CBs can also affect humans by inhibiting
cholinesterase. High exposure to OPs/ CBs can cause a variety
of acute symptoms of neurological poisoning, including blurred
vision, diarrhea, increased respiratory secretions, tremors,
seizures, loss of consciousness, and death. The acute symptoms
can sometimes mimic other illnesses, and sometimes people can be
sub-clinically affected without showing major acute symptoms.
Due to the potential for sub-clinical effects or misdiagnosis of
the acute effects, it is useful to test for the depression of
cholinesterase in order to identify potential overexposure.
California Medical Supervision Program (Program): According to
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DPR, the Program was established in 1974 when the use of
cholinesterase-inhibiting pesticides was extremely prevalent in
California agriculture. While the use of
cholinesterase-inhibiting pesticides has declined over the
years, according to the most recent data, from 2008-2013 OP/CB
use remained at between 4.1 to 5.1 million pounds applied per
year.
The goal of the Program is to protect pesticide handlers from
excessive exposure to OPs and CBs. It requires employers to
contract with a licensed physician as a "medical supervisor" to
periodically test the cholinesterase level of workers who
regularly handle these pesticides. Under the Program, the
medical supervisor establishes baseline values of cholinesterase
during non-exposure periods for each employee, and periodically
measures cholinesterase activity levels while the worker handles
OPs/CBs. If the employee's cholinesterase is depressed below
certain levels, the employer must take immediate specified
actions to reduce exposure, such as promptly retesting the
employee, evaluating the work practices, or immediately removing
the employee from further exposure.
Reporting requirements: While the Program had been in existence
for more than 30 years, prior to 2010, the state received very
little information from the field to determine whether the
Program was effective. However, Assembly Bill (AB) 1963 (Nava,
Chapter 369, Statues of 2010) added Section 105206 to the Health
& Safety Code, which requires laboratories that conduct
cholinesterase tests as a part of the Program to report test
results to DPR. The results are then analyzed by DPR and OEHHA,
in consultation with the DPH.
AB 1963 also required, by December 31, 2015, DPR and OEHHA, in
consultation with the DPH, to prepare a report on the
effectiveness of the medical supervision program and on the
utility of laboratory-based reporting of cholinesterase testing
for pesticide illness surveillance and prevention. AB 1963
stated that the joint report may include recommendations to the
Legislature that DPR and OEHHA deem necessary.
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DPR and OEHHA submitted the resultant "The Report to the
California Legislature: California's Cholinesterase Test
Results" in December 2015, which found that overall, the Program
appears effective in protecting agricultural workers who handle
cholinesterase-inhibiting pesticides. The report did find,
however, that based on the data submitted from 2011-2013, the
utility of the data analysis is hampered by the inclusion of
thousands of records from individuals who are not in the
Program, and by missing data on the purpose of the
cholinesterase test. DPR and OEHHA laid out specific "future
directions," or actions that the two entities will take to
improve the Program and improve the utility of the data
collected. DPR and OEHHA also made two recommendations for
Program improvement: 1) Cholinesterase reporting should continue
at least through December 31, 2018, so that DPR and OEHHA can
obtain additional data with clearer information on the purpose
of the test and to allow further evaluation of the Program; and,
2) Transferring cholinesterase reporting responsibilities from
the laboratories to the medical supervisors may ultimately be a
more efficient way to implement the Program.
AB 2892 would enact the first recommendation by extending the
cholinesterase reporting requirement through January 1, 2019.
REGISTERED SUPPORT / OPPOSITION:
Support
California Rural Legal Assistance Foundation
Center for Farmworker Families
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Health Officers Association of California
Pesticide Action Network, North America
Physicians for Social Responsibility, Los Angeles
Physicians for Social Responsibility, San Francisco Bay Area
Chapter
Swanton Berry Farms
Opposition
None on file.
Analysis Prepared by:Shannon McKinney / E.S. & T.M. / (916)
319-3965
AB 2892
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