BILL ANALYSIS Ó
SENATE COMMITTEE ON ENVIRONMENTAL QUALITY
Senator Wieckowski, Chair
2015 - 2016 Regular
Bill No: AB 2892
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|Author: |Committee on Environmental Safety and Toxic |
| |Materials |
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|Version: |6/16/2016 |Hearing |6/29/2016 |
| | |Date: | |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant:|Rachel Machi Wagoner |
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SUBJECT: Pesticide poisoning.
ANALYSIS:
Existing law:
1)Under California Code of Regulations (CCR), Title 3, §6728:
a) 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.
b) 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.
c) Requires an employer to remove an employee from exposure
to OP/CB pesticides if the employee's cholinesterase level
falls below specified baseline values.
2)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 the California
Department of Pesticide Regulation (DPR).
AB 2892 (Committee on Environmental Safety and Toxic Materials)
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3)Requires the medical supervisor ordering a cholinesterase test
under the Program to note in the test order the purpose of the
test.
4)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.
5)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.
6)Sunsets the cholinesterase result reporting requirements on
January 1, 2017.
7)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.
8)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.
This bill:
1) Extends the sunset on the requirement for laboratories to
electronically transmit specified agricultural worker
pesticide exposure test results to DPR under the California
Medical Supervision Program from January 1, 2017, to January
1, 2021.
AB 2892 (Committee on Environmental Safety and Toxic Materials)
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2) Requires that an employer satisfying his or her
responsibilities for medical supervision of employees who
regularly handle pesticides contract with a medical
supervisor registered with OEHHA.
3) Requires OEHHA to establish a procedure for registering and
deregistering medical supervisors and to establish
requirements for their performance.
4) Makes specified changes to the information a testing
laboratory is required to report to DPR.
Background
1) 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.
2) California Medical Supervision Program (Program): According
to 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
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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.
3) 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, Statutes 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.
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
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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.
Comments
1) Purpose of Bill. According to the author, while the
agricultural use of organophosphate and carbamate pesticides
has declined over the decades, millions of pounds of these
highly toxic pesticides are still applied every year in
California. The California Medical Supervision Program
(Program) is designed to protect agricultural workers who
regularly mix, load, or apply organophosphate and carbamate
pesticides. In order to ensure that the Program is effective,
agricultural worker pesticide exposure data (cholinesterase
test results) are transmitted to the Department of Pesticide
Regulation (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, and to prevent worker
pesticide illness due to the overexposure to organophosphate
and carbamate pesticides.
Related/Prior Legislation
AB 1963 (Nava, Chapter 369, Statutes of 2010) requires
clinical laboratories that perform cholinesterase testing
for the purpose of determining workers' pesticide exposure
to electronically report test results to the Department of
Pesticide Regulation (DPR).
SOURCE: Assembly Committee on Environmental Safety
and Toxic Materials
SUPPORT:
California Rural Legal Assistance Foundation
Center for Farmworker Families
Health Officers Association of California
AB 2892 (Committee on Environmental Safety and Toxic Materials)
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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 received
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