California Assembly Bill AB2272 Amended / Bill

 BILL NUMBER: AB 2272AMENDED BILL TEXT AMENDED IN SENATE AUGUST 15, 2016 AMENDED IN SENATE AUGUST 1, 2016 AMENDED IN SENATE JUNE 14, 2016 INTRODUCED BY Assembly Member Thurmond FEBRUARY 18, 2016 An act to add Section 144.9 to the Labor Code, relating to occupational safety and health. LEGISLATIVE COUNSEL'S DIGEST AB 2272, as amended, Thurmond. Occupational safety and health standards: plume. Under existing law, the Occupational Safety and Health Standards Board within the Department of Industrial Relations promulgates and enforces occupational safety and health standards for the state, including standards dealing with toxic materials and harmful physical agents.  Under existing law, the Division of Occupational Safety and Health is required to enforce all occupational safety and health standards,   as specified.  A violation of these standards and regulations under specific circumstances is a crime. This bill  would require the board, by June 1, 2018, to adopt standards to protect health care personnel and patients from plume, defined as noxious airborne contaminants generated as byproducts of the use of specific devices during surgical, diagnostic, or therapeutic procedures.   would, by June 1, 2017,   require the division to convene an advisory committee to develop a regulation that requires a health facility to evacuate or remove plume through the use of a plume scavenging system in all settings that employ techniques that involve the creation of plume and would authorize certain entities and people to be on the advisory committee, including, among others, practicing physicians and surgeons from affected specialties.  The bill would require the  board,   division,  in  adopting these standards,   developing the regulation  to  take into consideration and use as a benchmark   do certain things, including evaluating the use of  certain standards adopted by specified  organizations.   organizations as a benchmark.  The bill would  also  require the  board to use as the mandated requirement for plume scavenging systems recommendations of   division, when developing the proposed regulation, to take into consideration recommendations on the evacuation of plume from  the federal Occupational Safety and Health Administration or National Institute for Occupational Safety and  Health, where the board determines those recommendations are more effective in the evacuation of plume and would be more protective of occupational health than the described standards.   Health. The bill would, by June 1, 2018, require the division to submit to the board the proposed regulation. The bill would, by July 1, 2019, require the board to adopt the proposed regulation.   The bill would require the board, as part of the standards, to include a requirement that employers provide training to all health care workers involved in procedures that involve the creation of plume, as specified.  The bill would provide that compliance with general room ventilation standards or the use of surgical masks  or respirators  does not satisfy the requirements for protection from surgical plumes under these provisions.  The bill would provide that the use of respirators does not satisfy the requirements for protection from surgical plumes under these provisions, except as specified.  The bill would require the manufacturer of a plume scavenging system to provide evidence that the system meets specified minimum requirements when installed, operated, and maintained in accordance with the manufacturer's instructions.  The bill would specify that these provisions do not limit the authority of the division to develop, or limit the authority of the board to adopt, a regulation with a broader scope or broader application than required by these provisions.  By expanding the definition of an existing crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 144.9 is added to the Labor Code, to read: 144.9. (a) As used in this section:  (1) "Division" means the Division of Occupational Safety and Health.   (1)   (2)  "Electrocautery device" means a device that is electrically heated to cut, ablate, or coagulate human tissue for therapeutic purposes.  (2)   (3   )  "Electrosurgical device" means a device that uses a radio frequency electric current passing through the patient to cut, ablate, or coagulate human tissue for therapeutic purposes.  (3)   (4)  "Energy-based device" means a device that uses energy to ablate, cauterize, or mechanically manipulate target human tissue including lasers, electrosurgical generators, broadband light sources, ultrasonic instruments, plasma generators, bone saws, and drills.  (5) "Health facility" means a health facility as defined in subdivision (a) of Section 1250 of the Health and Safety Code.   (4)   (   6)  "Plume" means 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.  (5)   (   7)  "Plume scavenging system" means smoke evacuators, laser plume evacuators, plume scavengers, and local exhaust ventilators  that, when used in accordance with the manufacturer's instructions, conform to the general requirement of the 2014 ISO Standard 16571 to remove and neutralize at least 90 percent of plume at the site of origin and before plume can make ocular contact or contact with the respiratory tract of health care personnel or patients.   that capture and neutralize plume at the site of origin and before plume can make ocular contact or contact with the respiratory tract of employees.  (b) (1) The  board shall, by   division, by June 1, 2017, shall convene an advisory committee to develop a regulation that requires a health facility to evacuate or remove plume through the use of a plume scavenging system in all settings that employ techniques that involve the creation of plume. The advisory committee may 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, labor and specialty organizations representing other affected health care personnel, and other stakeholders.   (   2)     By  June 1, 2018,  adopt an occupational safety and health standard requiring a health facility, as defined in subdivision (a) of Section 1250 of the Health and Safety Code, to evacuate or remove plume through the use of a plume scavenging system in all settings that employ techniques that involve the creation of plume. In   the division shall submit to the board the proposed regulation   requiring a health facility to evacuate or remove plume through the use of a plume scavenging system in all settings that employ techniques that involve the creation of plume.   (3)     In  developing the  standard,   regulation,  the  board   division  shall  take into consideration and use as a benchmark   do all of the following:   (   A)     Evaluate using as a benchmark  the standards titled "Systems for evacuation of plume generated by medical devices" (ISO 16571) adopted by the International Organization for Standardization and the standards titled "Plume scavenging in surgical, diagnostic, therapeutic, and aesthetic settings" (CSA Z305.13-13) adopted by the CSA Group.  Where, in the determination of the board, recommendations of the   (B)     Take into consideration recommendations on the evacuation of plume from the  federal Occupational Safety and Health Administration  or   and  National Institute for Occupational Safety and  Health are more effective in the evacuation of plume and would be more protective of occupational health than the ISO or CSA standards, the board shall use those federal recommendations as the mandated requirement for plume scavenging systems.  Health.   (2) As part of the standard, the board shall include  (C) Take into consideration the standards titled "Systems for evacuation of plume generated by medical devices" (ISO 16571) adopted by the International Organization for Standardization in developing a standard establishing how much plume shall be captured by a plume scavenging system.   (   D)     Include  a requirement  in the regulation  for employers to provide training  and education  to all  health care  workers that will participate   foreseeably participating  in procedures that involve the creation of plume. The training shall include, but not be limited to,  the appropriate use of the plume scavenging systems and equipment utilized by the facility, and  general education on the contents of plume, the circumstances in which it is generated,  and  the associated health and safety  hazards.   hazards, and appropriate use of the plume scavenging equipment and systems utilized by the health facility.  The training shall be designed to provide an opportunity for interactive questions and answers with a person knowledgeable about occupational exposure to plume and the specific equipment  utilized.   utilized to scavenge plume.   (3) In developing standards, the board may consider input from health facilities, practicing physicians from affected specialties, registered nurses and other affected health care personnel, labor and specialty organizations representing affected registered nurses, labor and specialty organizations representing other affected health care personnel, and other stakeholders.   (c) The board shall, by July 1, 2019, adopt the proposed regulation of the division, except as specified in subdivision (f), requiring a health facility to evacuate or remove plume through the use of a plume scavenging system in all settings that employ techniques that involve the creation of plume.   (c)   (   d)  (1) Nothing in this section alters, amends, expands, or reduces existing general room ventilation standards or requirements. These plume scavenging standards are in addition to general room ventilation standards or requirements, and compliance with general room ventilation standards shall not satisfy the requirements of this section. (2) Evidence that the plume scavenging system conforms to the minimum requirements of this section when installed, operated, and maintained in accordance with the manufacturer's instructions, shall be provided by the manufacturer.  (d)   (e)  The use of surgical masks  or respirators  shall not satisfy the requirements of this section.  The use of respirators shall not satisfy the requirements of this section except when, due to medical necessity, the plume scavenging system is not able to be located where it effectively captures plume.   (f) This section shall not limit the authority of the division to develop a regulation, or the authority of the board to adopt a regulation, that is broader in scope or broader in application than required by this section.  SEC. 2. No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.