BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 2892


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          ASSEMBLY THIRD READING


          AB  
          2892 (Committee on Environmental Safety and Toxic Materials)


          As Amended  May 27, 2016


          Majority vote


           ------------------------------------------------------------------ 
          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Environmental   |6-0  |Alejo, Dahle, Gray,   |                    |
          |Safety          |     |Lopez, McCarty, Ting  |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Appropriations  |20-0 |Gonzalez, Bigelow,    |                    |
          |                |     |Bloom, Bonilla,       |                    |
          |                |     |Bonta, Calderon,      |                    |
          |                |     |Chang, Daly, Eggman,  |                    |
          |                |     |Gallagher, Eduardo    |                    |
          |                |     |Garcia, Roger         |                    |
          |                |     |Hernández, Holden,    |                    |
          |                |     |Jones, Obernolte,     |                    |
          |                |     |Quirk, Santiago,      |                    |
          |                |     |Wagner, Weber, Wood   |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
           ------------------------------------------------------------------ 


          SUMMARY:  Extends the sunset, from January 1, 2017, to January  








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          1, 2019, on the requirement for laboratories, as part of the  
          California Medical Supervision Program (Program), to  
          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.  
          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. 


          3)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. 


          4)Sunsets the cholinesterase result reporting requirements on  
            January 1, 2017. 


          FISCAL EFFECT:  According to the Assembly Appropriations  
          Committee, should this bill be enacted, it could result in  
          increased costs for the Office of Environmental Health Hazard  
          Assessment (OEHHA) to review cholinesterase tests of $300,000 to  
          $450,000 (general fund or special fund) over the extended  
          two-year period; and, minor, absorbable costs to DPR.









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          COMMENTS:  Organophosphate and carbamate (OP/CB) pesticides:   
          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 mimic other  
          illnesses, and 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 to OPs/ CBs.  


          California Medical Supervision Program (Program):  DPR reports  
          that 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, from  
          2008-2013 OP/CB use remained 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.   








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          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, 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 Department of Public Health (DPH).  


          AB 1963 also required, by December 31, 2015, DPR and OEHHA, in  
          consultation with 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.


          DPR and OEHHA submitted the resultant report, 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 that the  
          legislature would need to enact 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  








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          allow further evaluation of the Program; and, 2) That  
          transferring cholinesterase reporting responsibilities from the  
          laboratories to the medical supervisors may ultimately be a more  
          efficient way to implement the Program.


          This bill would enact the first recommendation in the report by  
          extending the cholinesterase reporting requirement through  
          January 1, 2019.




          Analysis Prepared by:                                             
                          Shannon McKinney / E.S. & T.M. / (916) 319-3965   
                                                                      FN:  
          0003323