April 14, 2011

Governor signs precedent-setting healthcare worker safety laws

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Laws that would improve safety for workers who handle chemotherapy and other toxic drugs on the job and also establish a way to track occupational links to cancer were signed into law Wednesday by Gov. Chris Gregoire.

The companion bills are the first of their kind nationally, and could serve as a model for other states, said Bill Borwegen, health and safety director for the Service Employees International Union in Washington, D.C., which represents over 1 million healthcare workers. Borwegen called it a “great day” and said other states have a history of looking to Washington for templates on worker safety legislation.

“It is very important, and we’re the first state to do it” said Michael Silverstein, head of Washington’s Division of Occupational Safety and Health. “I would hope this would prod the federal government to do something similar.”

Both bills, which passed unanimously through the House and Senate, were sparked by stories by InvestigateWest on hazardous drug handling practices that appeared in the Seattle Times, on KCTS-9 and on MSNBC.com in July, 2010. The stories showed that lack of regulation was resulting in workplace contamination, potentially exposing workers to dangerous levels of chemotherapy agents and other hazardous drugs. Such exposures can result in irreversible effects that include cancer, reproductive harm and developmental problems.

“This is a victory,” said Dr. Melissa McDiarmid, Director of the Occupational Health Program at the University of Maryland School of Medicine, whose research has shown chromosomal damage in workers who handle chemotherapy. McDiarmid and other safety researchers have been pushing for decades to get tougher rules protecting workers who handle these drugs.

Improper handling of hazardous drugs can contaminate the air and work surfaces. Many of the drugs, which are colorless and odorless, can remain on surfaces for long periods of time and can be picked up on clothing and skin, McDiarmid said.

These kinds of drugs are increasingly being used outside of hospital oncology units in veterinarian offices and in outpatient clinics.

The federal Occupational Safety and Health Administration does not have enforceable standards, or set exposure limits for people handling these drugs.

SB 5594, sponsored by Sen. Jeanne Kohl-Welles, directs the state to enforce safe-handling rules based on guidelines established by the National Institute for Occupational Safety and Health. In 2004, NIOSH issued an alert with strict guidelines for handling chemotherapy and other agents to reduce exposures. The guidelines, however, are just that, and OSHA has not enforced them.

“It is unacceptable that health-care workers risk exposure to deadly chemicals on a daily basis while on the job.  This measure could literally save lives by requiring the development of workplace safety standards for these professionals,” Kohl-Welles said.

Safety advocates said the legislation could also serve as a model for protecting workers from other hazards they encounter in the workplace, such as solvents, disinfectants and other cleaning agents.

“This is going to set the stage for other toxic chemicals in the healthcare industry – and there are many of them,” said Karen Bowman, environmental specialist for the Washington State Nurses Association, which backed the bills.

The lawmaking has already gotten the attention of the federal government, which this week issued a letter to healthcare workplaces, advising them to update their safety practices. The letter, signed by NIOSH, OSHA, and The Joint Commission, which accredits healthcare institutions nationwide, highlighted the potential for serious adverse occupational health effects.

“We’re hoping this greases the skids at the federal level,” said McDiarmid.

In the short-term, however, she said having The Joint Commission sign the letter to healthcare employers was a key step. “Even an inference that the Joint Commission will be looking at this makes people sit up and take notice.”

The second bill, SB 5149, introduced by Sen. Karen Keiser, also represents a key step forward in protecting workers. The new law requires a cancer patient’s occupation be reported to the registry, and that if the patient is retired, the patient’s primary occupation before retirement be reported. That information, which is currently not routinely captured, will aid the state in tracking potential links between occupational exposures and cancer outcomes, something that is currently not possible.

“The fact is we’re in a black hole in terms of information about cancer and occupation or work,” said Keiser. “Now we’ll have the information that medical researchers, unions, — all kinds of people – will need to improve the health of workers.”

The passage of the laws has been an emotional experience for Chelsea Crump, whose mother, Sue, was featured in InvestigateWest’s stories. Sue Crump mixed chemotherapy as a pharmacist for more than two decades before dying in 2009 of pancreatic cancer. Chelsea Crump testified before several Senate committees about her mother’s dying wishes to see better protections put in place to protect upcoming generations of workers.

Gov. Gregoire thanked Chelsea Crump as she signed the bills.

It was a day that would have made her mother very happy, said Crump. “This is just what she wanted — for other people to be safe.”

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