HOUSE LABOR AND COMMERCE STANDING COMMITTEE April 5, 2000 3:28 p.m. MEMBERS PRESENT Representative Norman Rokeberg, Chairman Representative Andrew Halcro, Vice Chairman Representative Lisa Murkowski Representative John Harris Representative Tom Brice Representative Sharon Cissna Representative Jerry Sanders MEMBERS ABSENT All members present COMMITTEE CALENDAR HOUSE BILL NO. 440 "An Act relating to needle stick and sharps injury protections and the use of safe needles by health care facilities and health care professionals; relating to the vaccination of health care workers against diseases transmitted by blood borne pathogens; and providing for an effective date." - HEARD AND HELD; ASSIGNED TO SUBCOMMITTEE SPONSOR SUBSTITUTE for HOUSE BILL NO. 356 "An Act relating to pesticide use; and providing for an effective date." - HEARD AND HELD PREVIOUS ACTION BILL: HB 440 SHORT TITLE: PROTECTION FROM NEEDLE & SHARPS INJURIES Jrn-Date Jrn-Page Action 3/29/00 2753 (H) READ THE FIRST TIME - REFERRALS 3/29/00 2754 (H) L&C, FIN 4/05/00 (H) L&C AT 3:15 PM CAPITOL 17 BILL: HB 356 SHORT TITLE: TRACKING OF PESTICIDE USE Jrn-Date Jrn-Page Action 2/09/00 2147 (H) READ THE FIRST TIME - REFERRALS 2/09/00 2147 (H) L&C, RES, FIN 2/25/00 2308 (H) SPONSOR SUBSTITUTE INTRODUCED 2/25/00 2308 (H) READ THE FIRST TIME - REFERRALS 2/25/00 2308 (H) L&C, RES, FIN 2/25/00 2308 (H) REFERRED TO LABOR & COMMERCE 4/05/00 (H) L&C AT 3:15 PM CAPITOL 17 WITNESS REGISTER ANGIE SCHMITZ, Staff to Senator Kim Elton Alaska State Legislature Capitol Building, Room 504 Juneau, Alaska 99801 POSITION STATEMENT: Provided information on HB 440. MARY WEISS, Registered Nurse; Member of the Alaska Nurses Association PO Box 221514 Anchorage, Alaska 99522 POSITION STATEMENT: Testified in favor of HB 440. WANDA KATINSZKY, President Alaska Nurse Association 2931 Legacy Drive Anchorage, Alaska 99516 POSITION STATEMENT: Testified in favor of HB 440. DONNA THOMPSON, Registered Nurse and Hepatitis Victim (No address provided) POSITION STATEMENT: Testified on HB 440. MAGGIE FLANNAGAN, Registered Nurse 1722 Bellevue Loop Anchorage, Alaska 99513 POSITION STATEMENT: Testified on HB 440. CAROL CLAUSON, Registered Nurse 13200 Ridgeview Drive Anchorage, Alaska 99516 POSITION STATEMENT: Testified in favor of HB 440. DON NOVOTNEY, Registered Nurse Bartlett Regional Hospital 3260 Hospital Drive Juneau, Alaska 99801 POSITION STATEMENT: Testified in favor of HB 440. BARBARA HUFF TUCKNESS, Director of Governmental and Legislative Affairs Teamsters Union Local 959 306 Willoughby Avenue Juneau, Alaska 99801 POSITION STATEMENT: Testified in favor of HB 440. DWIGHT PERKINS, Deputy Commissioner Department of Labor and Workforce Development Post Office Box 21149 Juneau, Alaska 99811-0610 POSITION STATEMENT: Testified on HB 440. ROB EARL, Staff to Representative Cissna Alaska State Legislature Capitol Building, Room 420 Juneau, Alaska 99801 POSITION STATEMENT: Presented SSHB 356 and reviewed the changes encompassed in the proposed CS for SSHB 356, Version I. JANICE ADAIR, Director Division of Environmental Health Department of Environmental Conservation (DEC) 555 Cordova Street Anchorage, Alaska 99501 POSITION STATEMENT: Testified that DEC supports the concept of SSHB 356. DR. PETER NAKAMURA, Director Division of Public Health Department of Health & Social Services PO Box 240249 Anchorage, Alaska 99524-0249 POSITION STATEMENT: Testified on SSHB 356. KAY BROWN, former Representative Alaska State House of Representatives 1908 West Hillcrest Anchorage, Alaska 99517 POSITION STATEMENT: Testified in favor of SSHB 356. BOB GORMAN Alaska Cooperative Extension, UAF Anchorage - State Office 2221 East Northern Lights Anchorage, Alaska 99508-4143 POSITION STATEMENT: Noted his cautious support of SSHB 356. TOM JOHNSON, Safety Officer Aurora Environmental & Safety, Inc. 5902 Miley Drive Anchorage, Alaska 99504 POSITION STATEMENT: Testified in support of SSHB 356. JOHN CYR, President National Education Association - Alaska 114 Second Street Juneau, Alaska 99801 POSITION STATEMENT: Testified in favor of SSHB 356. RIVER BEAN, Owner Market Organics HC 4 Box 9043 Palmer, Alaska 99645 POSITION STATEMENT: Testified in support of SSHB 356. NEVA HASSANEIN Northwest Coalition for Alternatives to Pesticides P.O. Box 1393 Eugene, Oregon 97446 POSITION STATEMENT: Testified in support of SSHB 356. BOB SHAVELSON, Executive Director Cook Inlet Keeper P.O. Box 3269 Homer, Alaska 99603 POSITION STATEMENT: Testified in favor of SSHB 356. REGINA MANTEUFEL 1128 East 10th Avenue Anchorage, Alaska 99501 POSITION STATEMENT: Testified in favor of SSHB 356. GERAN TARR Alaska Community Action on Toxics P.O. Box 1233 Girdwood, Alaska 99587 POSITION STATEMENT: Testified in favor of SSHB 356. STACEY MARZ, Resource Coordinator Alaska Community Action on Toxics 10301 Stroganof Drive Anchorage, Alaska 99516 POSITION STATEMENT: During hearing on SSHB 356, discussed the efforts of Alaska Community Action on Toxics to collect information on pesticide use in Alaska. PAM MILLER, Biologist and Program Director Alaska Community Action on Toxics 135 Christensen, Number 100 Anchorage, Alaska 99501 POSITION STATEMENT: Testified in favor of SSHB 356 and offered amendments to the proposed CS for SSHB 356, Version I. ACTION NARRATIVE TAPE 00-43, SIDE A Number 0001 CHAIRMAN NORMAN ROKEBERG called the House Labor and Commerce Standing Committee meeting to order at 3:28 p.m. Members present at the call to order were Representatives Rokeberg, Halcro, Murkowski, Harris, Brice, Cissna and Sanders. HB 440-PROTECTION FROM NEEDLE & SHARPS INJURIES CHAIRMAN ROKEBERG announced the first order of business would be HOUSE BILL NO. 440, "An Act relating to needle stick and sharps injury protections and the use of safe needles by health care facilities and health care professionals; relating to the vaccination of health care workers against diseases transmitted by blood borne pathogens; and providing for an effective date." Number 0168 REPRESENTATIVE HALCRO moved to adopt the proposed CS for HB 440, Version D [1-LS1580\D Cramer 4/5/99], as the working document before the committee. There being no objection, it was so ordered. Number 0206 REPRESENTATIVE HARRIS explained that the bill had been called to his attention by the nurses' association and was being introduced in both the House of Representatives and the Senate. [HB 440 was sponsored by the House Community and Regional Affairs Standing Committee, which Representative co-chairs.] He invited testimony from Angie Schmitz, Staff to Senator Kim Elton, sponsor of the companion bill in the Senate. Number 0256 ANGIE SCHMITZ, Staff to Senator Kim Elton, Alaska State Legislature, came forward to testify. She stated: House Bill 440 brings needed protection to health care workers from accidental needle stick injuries. Health care workers are of particular risk on the job because of the danger of disease transmission. Accidental needle sticks can transmit blood borne diseases such as hepatitis B, hepatitis C and Human Immunodeficiency Virus (HIV), in addition to others. Nationwide, health care workers are estimated to suffer between 600,000 and 1 million accidental needle sticks per year. For the state of Alaska, that translates to approximately 1,300 to 2,200 needle sticks per year. Between 50,000 and 60,000 health care workers nationwide have contracted serious diseases from needle sticks in the last decade. On average, one health care worker per week is exposed to HIV. The seriousness of HIV is well known, but less well known are the serious effects of hepatitis C, which is now estimated to eventually lead to the deaths of more health care workers than does HIV. Medical workers are four times more likely than police officers to die from a job-related injury. Safer devices are available. They have been approved for marketing by the Food and Drug Administration (FDA), but many health care workers still do not have access to these devices. It is estimated that nationally only 15 percent of hospitals use safer devices. They cost a little bit more up front, but studies show that facilities can save money in the long term by reducing testing and follow-up care for workers who are accidentally exposed to diseases. The cost for testing following a high- risk needle stick is $3,000, even when no infection occurs. A serious infection can cost up to $1 million, including lost time and disability payments as well as treatment. California was the first state to pass a safer needle law. In that state, health care employers are expected to save $100 million per year thanks to reduced needle stick accidents. Five states have already passed safer needle legislation and there are bills similar to this one pending in 20 states besides Alaska. The American Nurses' Association has made safer needle legislation a national priority, and this bill is strongly supported by the Alaska Nurses' Association as well as the Teamsters and Laborers unions. Number 0450 MS. SCHMITZ continued: There are two parts to the bill. The first, Part A, requires health care facilities to evaluate safer devices. All of the other parts call for regulations from the Department of Labor concerning safer devices. Within those regulations, there is a requirement that safer needles be included as engineering work practice controls. There is one exception. If an evaluation committee at least half of whom are front-line health care workers determines that the devices jeopardize the care or safety of themselves or of the patient, then they may not be used. There is a requirement that facilities institute a procedure for selecting devices and include that in their exposure control plan, and a requirement that the exposure control plan be updated as new technology is developed, at least once a year. There is also a requirement for a sharps injury law, which records information about needle sticks, including the type and brand of the device involved. In addition, the Department of Labor can adopt regulations concerning other aspects of needle safety, including training and education requirements and measures to increase vaccinations. Also, the Department of Labor is required to assist employers in complying with these requirements, and they will need to compile a list of sources of information on safer devices. MS. SCHMITZ volunteered to speak to the changes between the original bill and the proposed CS. She explained that in the new CS, dentists are excluded from the requirements of the bill, based on [Alaska] Dental Society testimony that experience with these devices shows they are not particularly effective for intra-oral use. For example, Novocaine is not delivered well and there are problems with bulky devices. Also, no concerns about needle sticks have been voiced by dental hygienists. Therefore, references to dental devices have been removed from the definitions section. MS. SCHMITZ said that originally a six-month evaluation period was required. That has been changed to "as long as necessary to evaluate devices," and there is involvement of front-line health care workers in the decision about how long that should be. In addition, there were a couple of other places where wording was clarified. There [formerly] were references to an evaluation committee in a section that didn't talk about an evaluation committee. There was language in Section 1[(a)] which may have been interpreted to say one only needed to evaluate devices that were already in use, which was not the intent. Number 0666 REPRESENTATIVE HALCRO noted that the bill mandates that the Department of Labor and Workforce Development (DLWD) shall adopt certain regulations; however, he noted the absence of a fiscal note. He asked if there is one from that department. MS. SCHMITZ said a fiscal note has not been received from the DLWD. She theorized that much in HB 440 is what that department is already doing as part of federal Occupational Safety and Health Administration (OSHA) regulations and a recent compliance directive. Number 0756 MARY WEISS, Registered Nurse; Member, Alaska Nurses Association, testified via teleconference from Anchorage. She urged passage of HB 440. She believes it will greatly help protect health care workers, not just the doctors and nurses but also the laundry, housekeeping and nursing assistance employees throughout the state. CHAIRMAN ROKEBERG asked MS. Weiss if she worked in an institutional setting. MS. WEISS answered that she works as the Research Coordinator for the University of Alaska Anchorage School of Nursing. She offered to speak to the training the nursing students receive in the skills lab and she also offered to relate some of the concerns the students have, in clinical settings, with needles. She specified that her information is from the students, not from direct observation. CHAIRMAN ROKEBERG noted that there had been a request from the university to make sure that lancets were covered under this legislation. He asked if she had an opinion on that. MS. WEISS said yes, she made that suggestion to her director. Although the bill enumerates various types of needles, lancets are not included. In the university skills lab, students do some work with diabetic testing in which they use lancets. Any time that one is working with blood, there is some kind of risk for exposure. Therefore, she thought it would be good to mention lancets unless the desire was to keep them under "any other category of device used at the employer's facility where there is a sharp injury risk." Number 0895 CHAIRMAN ROKEBERG asked if lancets would be covered under blood- drawing devices. MS. WEISS explained that a lancet is not necessarily a blood drawing device. She referred to page 2, line 9, paragraph (8). Number 0931 REPRESENTATIVE HALCRO asked if there are any health care facilities that have voluntarily embraced needle stick prevention. MS. WEISS said she has heard that all three of the large hospitals in Anchorage have varying degrees of commitment to needle-less devices. That lack of standardization is one of the problems for students and faculty. Nursing students have mentioned one facility that they thought was especially good because it had a room that was set up with the exact materials used in a clinical setting; anyone could use the room and work with the equipment in order to get the feel of it. The students also thought this was a very good idea because they recognized their degree of inexperience was just manual dexterity; working with needles and working around blood is so critical that students want to be able to have [as high a] level of expertise as possible before they are actually in the [actual] setting. Although Ms. Weiss did not know if the three hospitals had accepted this voluntarily, she did know that there are some OSHA regulations regarding this; however she understood those to be voluntary guidelines. Number 1040 WANDA KATINSZKY, President, Alaska Nurses Association, testified via teleconference from Anchorage. She said the Alaska Nurses Association is a constituent member of the American Nurses Association. The state organization represents bargaining units at Central Peninsula General Hospital and Providence Alaska Medical Center. Therefore, she speaks for more than 6,000 nurses throughout Alaska. She informed the committee that she is also a registered nurse and has worked with hospital implementation of OSHA guidelines. MS. KATINSZKY remarked that she wished HB 440 were not necessary. However, the nurses' association has taken informal surveys throughout Alaska and those surveys have found a wide variation in the availability of safe needle products. She recognized that many facilities have done a good job implementing federal guidelines. However, the American Nurses Association is championing this cause due to the visible lack of response by employers. This problem with compliance was highlighted in the executive summary of the Maryland Study Group on Health Care Worker Safety, which states, "although the OSHA bloodborne pathogen standard includes language on the use of engineered sharps protection, it has not been an effective tool in promoting widespread use of engineered sharps injury protection." This study group [ultimately] recommended passing state legislation, which was enacted in 1999. MS. KATINSZKY reiterated earlier testimony that annually, health care workers suffer 600,000 to 1 million injuries from conventional needles and sharps. Of those injuries to health care workers, nurses suffer the majority. She asked, "Why is this allowed to happen when over 80 percent of needle stick injuries are preventable with use of safer needle devices?" Although these safer needle devices have been on the market for more than a decade, less than 15 percent of facilities nationwide have employed the use of these safer devices. MS. KATINSZKY asked, "What does it take to protect our health care workers?" She replied, "It will take strong state legislation instead of compliance directives, which is what we currently have." She pointed out that the compliance directives are merely interpretations of standards that change with different administrations. Therefore, a permanent solution, this legislation, is necessary. She also pointed out that compliance directives are subject to legal challenges and interpretations of the standard, and therefore passing a state law would remove ambiguity. MS. KATINSZKY stated that this bill makes good business sense because the employer is not required to purchase all safety devices but rather requires the employer to evaluate products using front-line workers to determine what works best in their particular facility. She expressed the need to use a scientific approach to evaluate the products and decrease the incidence of needle stick injury. She related her belief that done correctly, the cost of implementing these devices will decrease over time due to the cost savings realized from a reduction in exposure, follow-up and treatment. A study in California reported an estimated overall savings of over $100 million per year as a result of fewer needle stick injuries and the illnesses that result. She informed the committee that it is estimated that annually, 1,000 workers will become infected and according to the American Hospital Association, one serious infection by bloodborne pathogen can quickly add up to $1 million or more. CHAIRMAN ROKEBERG expressed concern about setting up an evaluation committee for a small doctor's office, perhaps staffed with just two people. "Who's on the committee?" he asked. Number 1293 MS. KATINSZKY said that is a good point in that it doesn't always take a committee to get things done. She thinks if she was in that facility and having to implement a program, her biggest concern would be determining where the injuries are occurring. She noted that syringes are the main [source of injuries]. CHAIRMAN ROKEBERG clarified that his question was how one would have a committee in a very small office. Number 1331 MS. KATINSZKY said the committee probably would consist of the nurse, assuming that there is a nurse, or the office manager where there are medical attendants rather than nurses. Number 1360 DONNA THOMPSON, Registered Nurse, testified via teleconference from Washington. She informed the committee that she has been a nurse for 16 years. Ms. Thompson related how she was exposed to hepatitis while working in the burn center in Anchorage in 1989. She explained that her exposure to hepatitis was through infected blood and body fluids during long dressing changes and tubbing. She was diagnosed in December of 1989 and in March of 1990 was in a coma and was transported to the University of Washington hospital in Seattle, where she had a liver transplantation. Ms. Thompson informed the committee that she has three children. The two youngest ones had to be immunized with gamma globulin at the time she was diagnosed with hepatitis. She related the difficulties that [this disease] created for her family. For herself, she was debilitated, during this short illness of three months, to the point where she didn't have the strength to get up to use the bathroom. Furthermore, it would be an hour ordeal to merely take a shower. Number 1482 MS. THOMPSON informed the committee that after about 21 days in the hospital she was discharged on an outpatient basis and remained in Seattle for close monitoring for another six weeks. After that time, she returned to Alaska. She noted that in total, she was off from work a little over a year and a half. When she returned, she had a lot of difficulty getting her job back because "they" were reluctant to rehire her due to her immunodepression status and the drugs that she would have take in order to maintain the transplant. However, she did successfully return to work, but only after threatening legal action. She informed the committee that she was never terminated from the hospital. MS. THOMPSON informed the committee that she worked in an outpatient care facility at that hospital for approximately three years. In 1992 [or 1993], after her liver transplant, she received her first needle stick, which was very devastating after going through the transplantation. She explained that the needle stick happened during an endoscopy procedure, during which the lights are down low and [the nurse is] watching a monitor and caring for the patient. She specified that the needle stick occurred after she had given the medication; she inadvertently stuck herself when she turned. She attributed the needle stick to the low lighting. Since that time, she has taken a break from nursing and is currently working in an office now. MS. THOMPSON informed the committee that she has been re- diagnosed with hepatitis again due to recurrence from the original exposure. Therefore, the virus is still present in her body, although the liver transplantation gave her a healthy liver. She said, "Now I'm reinfected. What my future is right now is uncertain. It just depends on the virus and how rapidly it does develop." She noted that, at the initial transplant, her pathologist projected her life expectancy would be to age 65. Now that she has active hepatitis again, she indicated that her life expectancy may be shorter than 65. CHAIRMAN ROKEBERG thanked Ms. Thompson very much for her testimony. Number 1711 MAGGIE FLANNAGAN, Registered Nurse and a health and safety officer for her union, which represents nurses at an acute health care facility in Alaska, testified via teleconference from Anchorage. She informed the committee that the nurses she represents are very upset that in the facility where they work, one person in authority can block hundreds of health care workers from having these protective devices. She said, "What our facility proves is that having the devices on site is not enough. We still have health care workers who do not have access to these protective devices." She explained that [the employees of this facility] are requesting a product evaluation committee that includes participation from front-line workers as well as a better tracking system of needle stick injuries, both of which are provided by this bill. With a better tracking system, the high-risk situations or procedures associated with these injuries can be identified and work can be done to reduce or eliminate these hazards. MS. FLANNAGAN emphasized that it is important for legislators to know that needle stick injuries are a silent epidemic. She indicated that for these health care workers, who have had their lives devastated after acquiring diseases from these injuries, to testify in public about the personal tragedies only furthers their pain. Therefore, she asked the legislators to hear their voices through her words. MS. FLANNAGAN explained that many of these individuals suffer the consequences of these needle stick injuries in silence because they're afraid to call friends, co-workers and family members. She noted that although the committee has heard about the risks of needle stick injuries related to HIV, Hepatitis B and C, there are 20 diseases that can be transmitted with these exposures. Ms. Flannagan returned to the fear that many of her co-workers have regarding sharing their stories in public, although they are sharing them in private. From those stories, Ms. Flannagan has heard of health care workers who have waited months, [and even] years, to see if their injury resulted in disease transmission. In the meantime, they need to use safe-sex precautions with their spouse and they worry about transmitting these infections to family members. Number 1840 MS. FLANNAGAN pointed out that these safer needle devices also protect the health care consumer. For example, in December a school nurse in Anchorage was performing a routine tuberculosis skin test on a child and accidentally used a needle that had already been used by someone else. In this case, Ms. Flannagan believes that a safer needle device could have protected this child. Furthermore, she believes that safer needle devices could prevent some of the incidents that she has witnessed across the nation. She informed the committee that she has worked with high-risk infants in four different hospitals across the nation and has found infants with needles in their beds, in their blankets and has even found a baby lying on a bare needle. MS. FLANNAGAN informed the committee that it is considered a safe practice to tape needles into the IV lines of newborns while delivering piggyback medication. However, she emphasized that the tape is not enough; this system does fail even with the best technique. She explained that in these situations usually a child is moving around and the tape will catch on the blanket which results in a bare needle in the bed with the child. Although the disease transmission in such an injury is very low, she asked why a child should endure such an injury when safety products are available. She also pointed out that other patients, patients who are sedated, confused, combative, or having seizures, are at risk with these kind of injuries. Furthermore, needles can be used as potential weapons against health care workers in the mental health [profession]. Number 1911 MS. FLANNAGAN remarked that many health care workers are injured through no fault of their own. For instance, nurses find needles in the beds of patients they are transporting or health care workers are stuck by other people or they find improperly disposed needles. Ms. Flannagan said, "What I'm asking you to understand is that no matter what the reason for the exposure, the blaming needs to stop, the protection needs to start, and our health care system needs to be made safer." She informed the committee that she has had a high-risk needle stick while drawing blood from an infant of a known intravenous drug abuser. Ms. Flannagan urged the committee "to consider this bill a matter of life and death for our health care providers." She urged the committee to support HB 440. Number 1979 CAROL CLAUSON, Registered Nurse, Alaska Nurses Association, testified by teleconference. She informed the committee that she had suffered a needle stick from a high-risk patient, a patient with a history of drug use. This incident was very traumatic to Ms. Clauson, who wondered who would [take care] of her young children if she had contracted a fatal bloodborne disease. Ms. Clauson noted her support of this legislation. In conclusion, she highlighted the importance of the involvement of front-line worker in the product evaluation of [safety devices of] this nature. Number 2026 DON NOVOTNEY, Registered Nurse, came forward to testify. He said he has been practicing as an infection control nurse for about 11 years. He gave a demonstration, saying: We have an intravenous (IV) tubing at the top connected to a bag. It [the tubing] comes down to a patient's hand. There are injection ports. We don't want needles in those injection ports. A needle hurts anybody who gets stuck with it. This [needle at the top] is far away from the patient, the one down here is a little closer. Sometimes blood can back up into there, and if there is a metal needle in there, and it pulls out, it's a danger. There are devices that screw into the connectors, the injection ports. There is also one that clips on like a clothespin. These ports are precut. They provide a safe IV set. There is blood drawing equipment. CHAIRMAN ROKEBERG asked about the IV: "If you want to avoid any kind of needle [and] use these other types of devices, what's the cost differential there?" MR. NOVOTNEY said they are very similar in price, a penny or two [difference]. CHAIRMAN ROKEBERG asked why they are not more universally used. Number 2093 MR. NOVOTNEY explained that the hospital where he works is affiliated with hundreds of hospitals; as a result, the group of hospitals has great buying power. They provide workers with one type of needle-safe tubing, not two or three or four like the industry provides. A hospital worker has only one choice. A hospital such as Columbia, which has great buying power because it negotiates a contract with the supplier, will provide a safe needle device from that supplier. He then turned to product evaluation, which he didn't foresee in hospitals of this size because such hospitals have negotiated a contract to buy from only one supplier in return for a price break. Therefore, if the hospital breaks that contract, its costs increase. Number 2136 MR. NOVOTNEY showed another device that goes into an injection port and connects to a large rubber tube that the lab uses to draw blood. CHAIRMAN ROKEBERG asked how one gets the blood out. MR. NOVOTNEY said: This is what a phlebotomist would use. There is a needle sticking out, a sharp needle on the end of this that plugs into a tube. There's some mechanics involved in all of this. We have to be responsible and pay attention. If I don't pay attention, I'm going to stick myself, even with a clean needle. Now, this needle that's been dangling here like this goes into a vein. And when you are finished, you slide a hard plastic cover up over it. CHAIRMAN ROKEBERG asked, "So the sheath is really the primary method of safety in that regard?" MR. NOVOTNEY agreed, but reminded the committee that a human being has to activate it. He continued: When I start an IV, this plastic part stays in the vein. I have a sharp needle here that nobody would want to get stuck with. We have a device that we have been using for about five or six years that slides up over the steel needle that makes it safe - unless it goes into a trash compactor. We're human beings. We may not activate this. Everyone has to take some responsibility in their practice. Number 2221 CHAIRMAN ROKEBERG asked if a percentage of the devices used in the institutional care facilities of this state have safe needle devices. Or is there a problem? MR. NOVOTNEY said he thinks there is a problem in regard to the availability of safe devices as well as [the fact that the users of these devices are ] human beings; for example, would a person use one when another device is quicker? He noted the difficulty in teaching an old dog new tricks. CHAIRMAN ROKEBERG asked about the availability of safe devices. MR. NOVOTNEY informed the committee that when he looked for [the safer device at his workplace], he found it on the back shelf behind just a plain needle and a steel syringe. He explained the safety device as follows: This is a safety syringe. After I give an intramuscular injection, it goes over the top, locks in place, and I can't disable it. But I still have to throw this in a sharps container as well as taking this one and putting a needle on it. MR. NOVOTNEY commented that half the needle sticks at the institution where he works can be found in the garbage. CHAIRMAN ROKEBERG asked if there is a cost differential. MR. NOVOTNEY said the traditional [needle stick] costs about six cents and the safer one costs about 13-14 cents; it's about double. CHAIRMAN ROKEBERG observed, "What you have in your hand is probably about the most used commodity in a medical setting." MR. NOVOTNEY clarified that in hospitals, very few injections are given because IV tubing is being used. However, in doctor's offices one would see syringes. He said, "And for all immunizations to bring immunization rates up in Alaska, they're using this." Mr. Novotney expressed his desire for the Emergency Medical Services [EMS] and the cities and boroughs [to use the safer alternatives]. He explained: When a patient comes to us, the EMS is not using the same thing we are using, a safe needle system, a needle-free system. They are at risk. When they move a person, we have to swap all of our tubing over because [it doesn't] fit. Number 2341 MR. NOVOTNEY turned to the use of lancets [in regard to diabetes]. He explained: This device [now] is activated. The pin is pulled out. It's ready to poke somebody. It's fired. I can't re- fire this now; it is covered up. There's a sharp device that you can't get at. The same thing goes with scalpel blades. In the operating room, they'll take a scalpel blade out of an aluminum packet, place it into a blade holder, use it on a patient, now it's dirty, and you have to take something like a pair of pliers or some kind of locking instrument, grasp it and pull it out. But any piece of metal is springy, and can spring out. Having a blade on a handle would be very good. The health care system already [is implementing] the exposure control plan that came out of the Center for Disease Control and was published in the Federal Register ..., [but] is it being enforced? I would put my money on it that the Department of Labor [and Workforce Development] that enforces OSHA in the State of Alaska has not visited many health institutions and looked at needle safety. If we could make them [syringes] all like this, it would be great. But we are still using syringes and needles. If we can eliminate that, there will be fewer needle sticks. Number 2433 REPRESENTATIVE HALCRO noted a reference made earlier to school nurses. He asked if there is any kind of safety device for the device used to give TB tests. MR. NOVOTNEY explained that previously a four-pronged testing device had been used. However, that device did not give accurate results. Therefore, Juneau schools now use a 1 cc syringe in order to go underneath the skin and inject one-tenth of a milliliter of purified protein derivative tuberculosis. Two days later, [the nurse] examines and evaluates [the site]. CHAIRMAN ROKEBERG thanked Mr. Novotney for the demonstration. He asked what the definition of "sharps" is. [Because of the tape change, some of Mr. Novotney's response was not recorded.] TAPE 00-43, SIDE B Number 0004 MR. NOVOTNEY indicated that anything that is sharp, usually made of metal - such as needles and IV starts that can pass through a [protective plastic] glove - would be considered a "sharp". Number 0041 BARBARA HUFF TUCKNESS, Director of Governmental and Legislative Affairs for Teamsters Union Local 959, came forward to testify. She provided the committee with a copy of a presentation on South Peninsula Hospital, in Homer, where there is a very proactive, safety-conscious hospital director. The South Peninsula Hospital hospital has been implementing many of the safer tools for the past four and a half years. In regard to whether there is a cost difference, Ms. Huff Tuckness said there is. She specified: The cost - as has been previously testified - even the initial testing for needle stick injuries runs $5,000- $6000. If, indeed, there is an actual infection, you are looking at up into millions of dollars. So from a short-term perspective, there is a difference in cost. From a long-term perspective, it is well worth the cost. MS. HUFF TUCKNESS commended South Peninsula Hospital for its proactive approach, but noted that in some of Alaska's other hospitals [such a proactive approach for safer tools] is not necessarily the case. She pointed out that this very small community hospital has had some very positive results. In conclusion, Ms. Huff Tuckness said, "We are supporting HB 440." Number 0138 CHAIRMAN ROKEBERG asked about the companion measure, SB 261. Ms. HUFF TUCKNESS said SB 261 was in the Senate Finance Committee and was expected to move tomorrow. CHAIRMAN ROKEBERG said, "I hope it gets cleaned up over there before it makes even further progress." REPRESENTATIVE CISSNA asked if the Senate version has changed from the version before this committee. MS. HUFF TUCKNESS answered that there is an identical [proposed] CS in each house. Number 0178 DWIGHT PERKINS, Deputy Commissioner, Department of Labor and Workforce Development, came forward to testify. As far as the allegation that the department has not been to any hospitals checking on this, he had made a note of that, he said, and will find out. CHAIRMAN ROKEBERG asked about a fiscal note. MR. PERKINS said there is not a fiscal note, and if the department had produced one, "It would have been a zero." He noted that he had provided this committee - and the committee hearing the companion bill - a three-page handout. The handout says that the requirements will enhance health care worker involvement and safety by requiring employer policies that work with potential at-risk parties in order to develop a common solution to injury prevention. He noted that OSHA had issued a compliance directive on November 5, 1999, which was subsequently adopted by the Labor Standards of the Occupational Safety and Health Program. He explained that states adopt the federal regulations by reference as they come out to be in compliance with the federal plan. CHAIRMAN ROKEBERG asked, "Are you saying that the regulations are already in place?" Number 0236 MR. PERKINS clarified that the regulations are in the process of being put in place; however, it will be two years before they are implemented by the federal government. He remarked that the department thinks this is a good piece of legislation. Furthermore, his staff and OSHA have been working with the sponsor of the Senate companion bill, and he thinks they have worked out the department's concerns. "To my knowledge we are OK with this legislation, we have no objection to it and it would be a zero fiscal note if there was one," he said. CHAIRMAN ROKEBERG asked how "evaluation committee" is defined in the regulations. MR. PERKINS replied that he did not know because he has not been personally involved with this particular piece of legislation. CHAIRMAN ROKEBERG asked if the department is going to enforce this. He also asked, "How do you enforce it against small employers? What size of a health care provider would this affect?" Number 0302 MR. PERKINS said he could get those answers. CHAIRMAN ROKEBERG told him it is not in the bill. He added: If they define employer as meaning an employer having an employee with occupational exposure to blood or other material potentially tainted with blood pathogens, that means a doctor with one nurse has to have an evaluation committee under this statute. It doesn't work. MR. PERKINS said he would have to check on that. There may be something in the regulations about that. CHAIRMAN ROKEBERG continued: Front-line health worker, then that means the nurse would tell the doctor he's gotta do that the way the bill is drafted now. This is probably good legislation but it is not drafted very artfully. MR. PERKINS said he knows this committee is well qualified to make the adjustments to the legislation. CHAIRMAN ROKEBERG remarked that he remains skeptical. "If you could bring back to this committee the regulatory scheme and how you do this with no cost and enforce it, that's what I'd like to know," he said. Number 0363 REPRESENTATIVE BRICE related his assumption "that if it is going to be under OSHA standards, that this standard would be investigated and reported just as any other OSHA violation might be." He pointed out that if he worked in a dangerous construction situation, he could call OSHA to come out and [perform an inspection]. MR. PERKINS affirmed that. REPRESENTATIVE BRICE surmised, then, that a nurse working with [devices] that are not in compliance with this bill could call OSHA and have them [perform an inspection]. MR. PERKINS replied, "We would be there." REPRESENTATIVE BRICE then addressed Chairman Rokeberg by saying that a committee could be anything; it could be made up of one or two people. CHAIRMAN ROKEBERG acknowledged that, but asked, "Don't you get my point, Tom?" REPRESENTATIVE BRICE said he understands what Chairman Rokeberg is saying, but he does not think it is wrong. CHAIRMAN ROKEBERG expressed the need to clarify it. He then addressed Representative Harris: This is a committee bill, but it has some support from the other side of the building. Because of that, I'd like to appoint a subcommittee to actually fix this bill, not the "black hole" subcommittee, but a real one. Number 0444 REPRESENTATIVE HALCRO suggested that Chairman Rokeberg's concern could simply be remedied by eliminating the word "committee" and inserting the word "process." Therefore, it would read as follows: "an employer shall establish an evaluation process ...", which doesn't mandate a committee. CHAIRMAN ROKEBERG said that is one of his major concerns. He expressed the need to hear from the "house business" and to clarify the "lancet" issue. In addition, he expressed the need to hear from the hospital groups and other health care providers, none of whom were represented at the meeting today. Therefore, Chairman Rokeberg announced that he wasn't going to close the public testimony on this bill because he is concerned that this is kind of a de facto health care mandate and thus he needs to be convinced otherwise, because it's a cost driver. However, he believes this is a good concept that shouldn't be lost. He asked Representative Harris if he wanted to work with a subcommittee of develop a CS. REPRESENTATIVE HARRIS said he would be happy to do it either way. CHAIRMAN ROKEBERG appointed a subcommittee consisting of Representatives Harris, Brice and Halcro "to come up with the answers to some of these questions." Number 0521 REPRESENTATIVE HALCRO acknowledged that the committee has not heard from the hospitals and other health care providers, "but my opinion from the testimony we've heard today, when they're charging $5 for a Tylenol with codeine, I'm sure they can afford seven cents extra for a needle that can protect their workers." CHAIRMAN ROKEBERG specified that he is more concerned about the small practitioner and "how this all fits together." "How do you have an evaluation committee or how do you have any enforcement of that rule at a small level. Quite frankly, I think this is probably a labor-management issue, and I don't know if the legislature needs to be right in the middle of that unless there is a public policy involved, and we need to be cognizant of that." He added, "I think we have a federal policy and . . .if we need a state statute to protect the workers properly, then we should do that." CHAIRMAN ROKEBERG announced that the committee would hold open public testimony on HB 440 and look forward to a report from the subcommittee on this bill. He indicated that other problematic bills will also result in the appointment of subcommittees in order to work out [the problems]. [HB 440 was held over.] [The committee took a brief at-ease.] HB 356-TRACKING OF PESTICIDE USE CHAIRMAN ROKEBERG announced the next order of business would be SPONSOR SUBSTITUTE for HOUSE BILL NO. 356, "An Act relating to pesticide use; and providing for an effective date." Number 0621 REPRESENTATIVE CISSNA, speaking as the sponsor of SSHB 356, requested that her staff present the bill and the changes encompassed in the proposed committee substitute (CS) that reflect the Department of Environmental Conservation (DEC) recommendations. REPRESENTATIVE HARRIS made a motion to adopt the proposed CS for SSHB 356, Version I [1-LS1360\I, Lauterbach, 4/5/00], as the working document. There being no objection, it was so ordered. Number 0671 ROB EARL, Staff to Representative Cissna, Alaska State Legislature, explained that SSHB 356 establishes a $150 registration fee per pesticide label registered in Alaska. Currently, Alaska is the only state that doesn't charge such a fee. The bill also establishes a $25 per year license fee for all certified pesticide applicators. He pointed out that DEC is planning on charging $75 for a three-year license in order to save in administrative expenses. MR. EARL said Section 4 of Version I establishes a DEC- administered pesticide use tracking system, which will be integrated into a statewide Geographic Information System (GIS) that is designed to reveal the extent of pesticide use in Alaska. Mr. Earl explained that the system would rely upon the applicators to report to the department the pesticide's name, rate, date, amount, location and method of application as well as the crop, commodity or site upon which the pesticide was applied and the target organism. Applicators would be required to keep these records for three years. MR. EARL noted that these records are already required; however, they are not currently submitted to DEC. He pointed out that the bill also allows for civil penalties to be imposed for failure to report pesticide usage. The bill also establishes a nine-member volunteer Pesticide Advisory Board, which will advise the department in regard to the tracking system and research ways to gauge the household use of pesticides as well as research mechanisms to increase public awareness on pesticide issues. He specified that the board will consist of the following membership: two pesticide applicators/dealers; two advocates for protection for pesticides; one agent of the public water supplier; one agent of the University's Cooperative Extension Service; one expert in pest control, epidemiology, fish and wildlife biology [and] children's health issues; and two public members. Number 0782 MR. EARL turned to the changes encompassed in Version I. A new Section 1 designates the receipts collected by DEC in Sections 2 and 3, for the registration and licensing fees, as program receipts. Those program receipts would be accounted for separately from the unrestricted general fund. MR. EARL pointed out that on page 2, line 17, subsection (b) of the proposed CS, formerly part of subsection (a), clarifies that the department will have the discretion to determine which pesticides it will track. This subsection further says that the department should seek and consider the advice of the Pesticide Advisory Board [when determining which pesticides the department will track]. On this point, Mr. Earl informed the committee that there are almost 3,000 different pesticide labels registered in the state. Most of those aren't implicated in serious public health or environmental hazards. Of these 3,000 pesticide labels, 1,114 are disinfectants or sanitizers which are exempt from reporting requirements as specified on page 2, lines 24-25. Therefore, choosing which of the remaining pesticide labels to track will be one of the more difficult aspects. The department has suggested that it will want to track the 49 restricted-use pesticides, which are of particular danger to people and the environment. The department has also indicated that it will add suspect pesticides to the list as they are identified by the Environmental Protection Agency (EPA), the department, or the Pesticide Advisory Board. MR. EARL directing the committee to page 3, line 9, paragraph (6), which had everything deleted except the location of the application. That is consistent with page 2, line 26, which allows the department to determine the specifics of application location that is to be reported. He indicated it is the sponsor's hope that the location of application is specific enough to differentiate between adjacent watersheds while general enough to preserve the privacy of individuals. MR. EARL then directed the committee to page 3, line 18, where the language "In addition to other civil or criminal penalties that may be applicable," was added to subsection (e). He explained, "Because without this addition, this [sub]section would have inadvertently invalidated DEC's ability to levy applicable sanctions already in statute." MR. EARL moved on to page 4, lines 3-4, which was shortened in order to correct an oversight by the original bill. Without this change, DEC would be required to report a nuisance that wasn't reported to it. Mr. Earl offered to answer any questions. Number 0933 REPRESENTATIVE BRICE referred to page 4, where the membership of the Pesticide Advisory Board is specified. He stated that he did not know what a person would be who has expertise in pest control, epidemiology, fish and wildlife biology and children's health issues. He inquired as to what type of professional would [meet such criteria]. MR. EARL related his assumption that it would be an "or" situation. REPRESENTATIVE BRICE refuted that and read the language on page 4, lines 22-28, which specifies that this member has [to have] some expertise in all of the areas listed. He asked if that was the intent as it seems fairly broad. REPRESENTATIVE CISSNA agreed that it seems fairly broad. REPRESENTATIVE BRICE related his assumption that the desire is probably to require membership of an individual that has expertise "in one of the following areas" that is listed. REPRESENTATIVE HALCRO directed the committee to page 4, lines 13- 17, paragraph (2), which seems to include the same sort of all- encompassing qualifications in lines 14 and 15. He echoed Representative Brice's earlier comment regarding what type of person this would be. Number 1110 JANICE ADAIR, Director, Division of Environmental Health, Department of Environmental Conservation, testified via teleconference. She informed the committee that the pesticide program is within the Division of Environmental Health. She also informed the committee that the department supports the concept of this bill. In her ten years with [the division], there has been one application for a pesticide permit. That application was from the [Alaska] railroad, but was withdrawn by the railroad before any action could be taken on the permit application; the application was withdrawn due to the public angst it created. Ms. Adair believes that there is a lot of concern in regard to pesticide use in the state. The CS would give information to the public, information that the public would like to have. CHAIRMAN ROKEBERG directed attention to the fiscal note and requested that Ms. Adair explain the fiscal note. MS. ADAIR informed the committee that this bill adds two fees. One of the new fees is a registration fee for pesticide labels. Currently, there are 3,000 pesticides registered in the state and thus $150 fee per label would amount to $450,000. The second fee is the licensing fee, which is currently issued for a three-year period and thus the $25 per year license fee would result in a $75 charge. At this time there are 860 certified applicators. With [those two fees], the revenue is generated. However, she pointed out that these [fees] are added to the list of statutory program receipts and thus wouldn't be considered general funds. This change would have to be made to the fiscal note if the CS is adopted. MS. ADAIR stated that the largest expense in this legislation is the creation of the GIS, for which [the department] has nothing similar. Furthermore, [the department] doesn't have the internal expertise to develop such a system; as a result, that system would have to be developed from scratch with some reliance on the Department of Natural Resources (DNR). This system would have to be compatible with DEC's computer system, which doesn't tie into the state's mainframe and thus the system would run on individual workstations. Furthermore, this system would have to be acceptable on the Internet in a user-friendly fashion. Moreover, the continuous changes in technology would necessitate the need for the system to function while incorporating technological changes. Ms. Adair anticipated [hiring] someone to work with the board and to perform the public education outreach, which is of extreme importance to the sponsor as well as [to the division]. An environmental technician [position] has been included for data entry, which is time-consuming for remote areas in particular. CHAIRMAN ROKEBERG inquired as to what the department currently does in the way of controlling pesticides. Number 1379 MS. ADAIR remarked that it is a small program that is 85 percent funded by the federal government [and thus] the department is only able to do what is required under the federal grant. She explained that [the department] certifies applicators for restricted-use pesticides. [The department] also performs training for those that work around pesticides. [The department] also performs marketplace inspections and in recent years [the department] has (indisc.) the registration program. CHAIRMAN ROKEBERG surmised, then, that the department would not enter the field and sample or control for pesticide use unless there is a special request. MS. ADAIR answered that such action would only be taken if there was a complaint, such as a complaint that an illegal pesticide is being used. Such a complaint has occurred. Ms. Adair mentioned that for some pesticide projects, the state requires a permit. Although [the department] doesn't have any state general funds, [the department] does perform that state-mandated work. She pointed out that [the department] issues permits for such things as mosquito control and potato blights. REPRESENTATIVE HALCRO pointed out that the sponsor statement says that the fees for registration will generate the revenue to support the program. However, [information in the committee packet] notes that when Oregon initiated this program there was a 20 percent decline in the number of registrations and licenses. Therefore, Representative Halcro inquired as to what would happen if the number of licenses declines, but the department still has the same operating costs with less revenue. MS. ADAIR replied that [the department] would come back before the legislature. Number 1529 DR. PETER NAKAMURA, Director, Division of Public Health, Department of Health & Social Services, noted that his testimony would be in reference to the original bill. He pointed out that neither the Division of Public Health nor the Department of Health & Social Services (DHSS) has any oversight responsibility, as identified in the bill. However, this is a health issue and as such, the [department and division] are concerned about the use of pesticides. DR. NAKAMURA remarked that often, after the fact, another effect [of a pesticide] is realized. Therefore, a system that merely monitors the location [that the pesticide] is used and the amount doesn't allow for a cause-and-effect analysis. For example, it was discovered after-the-fact that [due to] MTBE, a chemical used in fuel, practically all the water in California is contaminated. He pointed out that the use of [MTBE] was stopped in Alaska. DR. NAKAMURA agreed that it makes sense to have a register and to know where [these pesticides] are. For [the department and the division,] probably the greatest use [of this system] is to address the concerns of citizens who fear they are being poisoned from some of [these pesticides]. Often, there are concerns regarding cancer, but the information regarding whether the [pesticide] is or is not the cause is often unavailable. With this type of register, a possible cause can be implicated or eliminated. DR. NAKAMURA stated that some of the definitions in the bill should be clarified such as a "custom application." Furthermore, a "commercial use" should be defined as should the reference to a "broadcast chemical," which could include table salt that is used to melt ice or kill slugs. Therefore, the terms in the bill should be identified and clarified. He directed the committee to page 2, subsection (b), of the original bill which read as follows: "(b) The system established under (a) of this section must require all pesticide dealers in the state to report to the department the following information pertaining to the sale of pesticides to end users, including private residents and licensed pesticide applicators". Dr. Nakamura said he understood that language to mean that [DEC] would have to follow every citizen who purchased and applied a pesticide. REPRESENTATIVE CISSNA informed Dr. Nakamura that the proposed CS doesn't include that [language] and thus the individual commercial stores aren't part of this bill. DR. NAKAMURA turned to the creation of the board to monitor pesticides, which seemed to be rather challenging as there are many pesticides and chemicals. If a board is created to address each individual chemical, there would be many boards. Therefore, Dr. Nakamura suggested that this function could be included in an existing board. Dr. Nakamura expressed his belief that this is such an important function that it should be adequately funded whether through the collection of fees or bills or through an appropriation. In his nine years as a state health officer, he has found that Alaska is relatively young in this arena and thus the state is still identifying these needs and creating these capabilities. He reiterated the need to provide adequate funding to perform an appropriate job. REPRESENTATIVE CISSNA acknowledged that there has been concern in regard to the [connections] between pesticides and cancer. She asked if this would have an application for that type of problem. DR. NAKAMURA replied yes. He indicated that this may eliminate some of the concerns by citizens as well as possibly identifying a cause. Number 2011 KAY BROWN, former Representative, Alaska State Legislature, testified via teleconference. Ms. Brown spoke in favor of HB 356 and thanked Representative Cissna for bringing this forward. She related her belief that pesticide use in Alaska as well as across the country is an urgent public health problem requiring more attention from legislative bodies. Therefore, she supported all efforts to regulate the use of pesticides more tightly. As a cancer survivor, Ms. Brown has become concerned with the toxic chemicals that are used in the environment. Furthermore, it is well established that many of these chemicals are causing serious medical problems, including cancer. Although [these chemicals] are widely used, very little is known about them. She identified this bill as a first step, which she supported. BOB GORMAN, Alaska Cooperative Extension, UAF Anchorage - State Office, testifying via teleconference, informed the committee that he is a Pesticide Applicator and Training Coordinator for the Alaska Cooperative Extension, University of Alaska. He specified that his opinions are based on his professional views and not those of the University of Alaska. Mr. Gorman said that he is cautiously supportive of this bill because there is no current information base with regard to how much of what pesticides are used in what locations. Furthermore, he supported this bill because pesticides are important tools in pest management and thus it is important to ensure that [pesticides] are available in order to maintain the public health of humans and other living things. MR. GORMAN noted that he has two areas of concern. First, there is the need to protect the privacy of landowners who choose to use pesticides. Therefore, he believes that pesticides should be identified at the watershed level and thus collection of the information on a longitude and latitude basis could maintain the privacy of landowners. Second, probably the greatest use of pesticides in Alaska is from commercial applicators and homeowners. In all likelihood, the greatest use of pesticides can be found in urban areas with turf and ornamental applications and structural pest control. Although it may not be possible now to address homeowner use of pesticides, Mr. Gorman said he is more concerned with homeowner misuse of pesticides than commercial misuse. Number 2310 REPRESENTATIVE CISSNA acknowledged that the homeowner problem is a large problem and would expand this tracking system to the point at which it would be, as many feel, unwieldy. Therefore, one of the reasons for the tracking board is to work on the educational portion of this matter in order that people understand [what] they are purchasing at a store. She asked if Mr. Gorman felt that would help deal with [the homeowner] problem. MR. GORMAN identified [education] as a start. He mentioned that DEC has just started a new program called the Consumer Label Information [which] rewrites consumer labels in order to make them more readable and user-friendly. That [program] will help. He also mentioned that the Cooperative Extension Service and the Municipality of Anchorage have programs that address homeowner pesticide use. If this bill is enacted, he believes the next effort [should be] to have the retailer, at the point of sale, note the total volume of the pesticides sold to homeowners. Although there would be conjecture as to where those pesticides would be used, it would provide information as to what pesticides are being used and in what volume they are being sold to homeowners. [Due to a tape change, Representative Halcro's question was not recorded and Mr. Johnson's opening remarks were not recorded.] TAPE 00-44, SIDE A Number 0005 TOM JOHNSON, Safety Officer, Aurora Environmental & Safety, Inc., testifying via teleconference, said, "... Aurora Environmental & Safety." Mr. Johnson noted his support of [SSHB 356]. As a Safety Officer who has performed a number of community outreach and education programs on hazardous materials in the home, he has found that there is little awareness with regard to the hazards of pesticides as well as the hazards of general household chemicals. MR. JOHNSON said he would challenge anyone as far as a person's knowledge of what level or degree of poison the EPA warning labels would have - the degree of toxicity of the products that is being referred to. He specified that the EPA warning "Danger, poison" means that a few drops is deadly enough to kill a person, yet there is little awareness with regard to the toxicity. Therefore, Mr. Johnson felt it important that those who bring such a product into the home be more aware of the hazards. He pointed out that currently there is great emphasis being placed on weapon safety; however, these products have more of a potential of being a weapon of terror and are more easily available than any weapon. Therefore, he felt that education should be emphasized. MR. JOHNSON turned to the perspective of his profession, which is to protect workers for employers, who are required to provide safe workplaces for their employees. He said any means that could assist him in identifying potential hazards would create less problems in protecting his clients. Therefore, [SSHB 356] is a good starting point. REPRESENTATIVE HALCRO asked if the average homeowner purchasing weed killer is going to educate him/herself about what he or she is using. MR. JOHNSON replied no, but said that the effort has to be made. From a risk management and liability standpoint, he didn't believe the labels go far enough and thus organizations that sell these items could potentially face liability issues. Number 0329 JOHN CYR, President, National Education Association - Alaska (NEA-AK), testified in favor of [SSHB 356]. Mr. Cyr indicated that he was present due to the products that are used at schools. These are products whose names he could not pronounce nor did he know if these products were good, bad or indifferent. As a parent and a representative of the staff and the children, Mr. Cyr believes that people should know what is being sprayed in public places, especially around children. Therefore, NEA-AK believes this bill is a good start to review the information and establish [a system] in which the community can make decisions as to what should happen where children are. Number 0448 RIVER BEAN, Owner, Market Organics, testified via teleconference. He informed the committee that he and his wife have farmed commercially and organically for 12 years and thus he said that he knows there are alternatives to agricultural chemicals. Mr. Bean supported HB 356 as it is a good start. Although the bill doesn't include agriculture, it should. However, Mr. Bean opposed allowing DEC to determine which pesticides to exempt and which to register and track. MR. BEAN explained that often EPA has instituted a ban on previously authorized chemicals and often these have been chemicals which left residues on the food. He indicated that it may not be too long before the extreme rise in cancer rates and other diseases are directly linked to some of these toxins in the environment. Therefore, Mr. Bean felt that all chemicals should be registered and include the chemicals that farmers use. He indicated the need to be accountable for what one does to the environment as an obligation to the community. MR. BEAN said, "Relying on chemical applications to control pests, weeds and diseases is not sustainable farming on any scale." As an organic farmer, he expressed concern regarding the "drift factor" of chemical applications; a risk of toxic contamination due to drift [of chemicals applied nearby]. Furthermore, he expressed concern with regard to eliminating or killing living organisms in any environment as there is a reaction to every action. He noted that the employees that he has who have worked on chemically-dependent farms tell tales of ill health, neglected disposal practices and unchecked applications of chemicals. In conclusion, Mr. Bean reiterated his support of HB 356, which he identified as a good start. CHAIRMAN ROKEBERG asked if Mr. Bean sells some of his produce at the Anchorage Saturday Market. MR. BEAN replied yes. He informed the committee that soon he should be selling to the Ship Creek Market, the Eagle River Market and 100 families. CHAIRMAN ROKEBERG remarked that he was sure he had purchased some of Mr. Bean's produce. He felt that organic farming is growing in the [Matanuska-Susitna] Valley, and he hoped that it would continue to grow. Chairman Rokeberg asked if aerial spraying of pesticides is allowed in the Mat-Su Valley area. MR. BEAN related his belief that aerial spraying of pesticides is allowed in the Mat-Su Valley area, which is of concern because of the drift factor and unchecked contamination. In further response to Chairman Rokeberg, Mr. Bean said that aerial spraying of pesticides doesn't occur directly near his farm. However, he knows of other nearby farms that are adjacent to farms that spray chemicals. In further response to Chairman Rokeberg, Mr. Bean said that, to his knowledge, aerial spraying of chemicals is allowed in the state. He mentioned that the EPA authorized aerial spraying for the potato blight two years ago and he indicated that the EPA had authorized it again this year. Mr. Bean pointed out that there are alternatives to [aerial spraying] as well as organic practices that could be utilized. CHAIRMAN ROKEBERG noted that the bill title refers to pesticides; however, he was interested in whether the bill would encompass the application of other agricultural chemicals. REPRESENTATIVE CISSNA clarified that the bill does not include herbicides. She related her understanding that the farming community has been working on nontoxic solutions and has been performing responsible monitoring. She indicated that this information came from the Cooperative Extension Service. Therefore, [herbicides] were not included in this legislation. Number 0824 NEVA HASSANEIN testified via teleconference from Oregon. She informed the committee that she works with the Northwest Coalition for Alternatives to Pesticides and has a doctorate in environmental science. She further informed the committee that in the past three years she has done extensive research and worked with the political system in order to establish a comprehensive system to track the use of pesticides in Oregon. Ms. Hassanein noted her support of this legislation and identified it as a solid first step, although she did have some concerns. She clarified that the term pesticide is an umbrella term which includes herbicides, insecticides, fungicides, et cetera. She defined the term pesticide as follows: "A product that is designed to kill, damage or repel living organisms." Unless Alaska defines the term pesticide differently than it is in other parts of the country, she would assume that all of those chemicals would be included. MS. HASSANEIN noted that currently, only a few states have established systems to track the use of pesticides. The Oregon program was just signed into law last September and one of the key concepts of Oregon's law was the agreement that it needed to be comprehensive, including all types of applications. However, the current draft of HB 356 only includes commercial applications. In response to Dr. Nakamura's question regarding what is a commercial application, Ms. Hassanein explained that a commercial application is one made by a licensed commercial operator. She related her belief that it is important to include agriculture and governmental use as well as household use. MS. HASSANEIN said that the collection of information regarding pesticide use is essential to understanding how these pesticides move in the environment and how they affect human health. With a good tracking system, one would know where say, water should be monitored for particular chemicals. That is how these systems can be used, which is extremely important. In regard to Dr. Nakamura's comments disputing the need to create a board for every thing, Ms. Hassanein suggested placing a [sunset] on this board. Furthermore, Ms. Hassanein expressed concern with the department's open-ended authority to decide which pesticides would be included. She suggested that a time table should be laid out over the next three years or so. She remarked that Alaska is lucky in that it only has about 1,800 products that would be tracked under this system, while Oregon and California are tracking about 9,000 products. Therefore, she felt there is time to do a top-notch job. Number 1160 BOB SHAVELSON, Executive Director, Cook Inlet Keeper, testified via teleconference from Homer. He informed the committee that Cook Inlet Keeper represents about 650 citizens throughout the Cook Inlet area and beyond. [The Cook Inlet Keeper] is in favor of HB 356, which is a good start. He felt it fitting that the House Labor & Commerce Committee is reviewing this legislation as it is really a worker health issue. For example, last year at Western Homer Elementary there was a pesticide application by some workers, who weren't aware of some of the dangers of the pesticide that they were applying. Subsequent workers maintaining the field where the pesticide had been sprayed were unaware of its presence. Therefore, some of the reporting [requirements] in the bill will resolve such situations. This is a worker's issue in that many people rely on the rich fisheries in Cook Inlet and other areas for their livelihood and thus this legislation will help protect some of the commercial, recreational and subsistence fish resources. MR. SHAVELSON informed the committee that about a year and a half ago, a study for Cook Inlet was performed by the EPA. One remarkable finding was that many fish resources there have high levels of pesticides; no one is certain whether these pesticides are coming in via the Asian current or are draining off Alaska's land. Therefore, he felt that this legislation would help resolve some of those issues. Number 1297 REGINA MANTEUFEL testified via teleconference from Anchorage. She began by thanking Representative Cissna for HB 356, specifically the language referring to the total amount of product applied. Ms. Manteufel related a personal story from the time she lived in Salinas, California. At the time, there were no notices when there was aerial spraying of pesticides and because of this her brother is mentally retarded. When her brother was in his twenties, the pesticides stored in his fat cells resulted in the loss of control of his bladder. MS. MANTEUFEL related a story in which a boyfriend of hers, who sprayed pesticides for a living, died of cancer even though he wore all the safety gear. Furthermore, a friend of hers - due to exposure to pesticides as a field worker - had a miscarriage. Ms. Manteufel informed the committee that due to the water situation resulting from farms using pesticides in Salinas, California, she left. She also related a situation in her elementary school that she believes indicated that exposure to pesticides affected brain development. In conclusion, she expressed her belief that Alaska has the chance to do what is right, which is to pass this legislation in order that people don't go through the pain and suffering she has had to go through. Number 1551 GERAN TARR, Alaska Community Action on Toxics (ACAT), testified via teleconference from Anchorage. She testified in support of HB 356, which is a necessary and important first step in providing Alaskans the right to know about their exposure to potentially harmful chemicals in their daily lives. As the Pesticide Coordinator for the Right to Know Campaign, she has discussed this bill with many individuals and thus has found broad public support for this bill. She informed the committee that a poll conducted for the Alaska Conservation Alliance found that 93 percent of registered Alaskan voters support requiring disclosure and reporting of pesticide use. MS. TARR noted that people support this legislation for various reasons such as: public health and water quality protection, subsistence food safety and worker safety. She informed the committee that the following organizations support HB 356, the version in which all pesticides would have been tracked: the Alaska Action Center, the Alaska Center for the Environment, the Alaska CFIDS/FMS/GWS Association which is the Chronic Fatigue and Multiple Chemical Sensitivity Support Group, the Alaska Community Action on Toxics, the Alaska Conservation Alliance, the Alaska Public Interest Research Group, the American Lung Association of Alaska, Arctic Organic, the Brain Injury Association of Alaska, the Center for Marine Conservation, the Cook Inlet Keeper, the Injured Workers' Alliance, Kachemak Bay Conservation Society, the Mental Health Association of Alaska, the National Wildlife Federation of Alaska, the Native American Fish and Wildlife Society and the Northern Alaskan Environmental Center. She indicated that due to the timing of the legislation, some organizations have been unable to sign statements of support yet and thus she expected more broad support. REPRESENTATIVE CISSNA acknowledged that Ms. Tarr was very active in putting together some of the ideas for this legislation. She referred to the section in the CS regarding the membership of the Pesticide Advisory Board and asked if Ms. Tarr had any ideas with regard to the type of person that would fulfill the qualifications specified in paragraphs (2) and (5) on page 4, lines 13-17 and 22-24, respectively. MS. TARR said that there are many individuals that could fill those positions. She said that there are individuals who work for state or federal agencies, whose job description would cover this category. For example, there are individuals at both U.S. Fish & Game and Alaska Department of Fish & Wildlife who research the potential affects pesticides are having on wildlife in the state as well as water quality issues. Through that work, these individuals have dealt with alternatives to pesticides, pest management and the public's right to know. In regard to paragraph (5), she noted that many of the people with whom she works in ACAT have expertise in many of the categories listed. Although there may be people who aren't an expert in all the categories, they could certainly fulfill the need to have a broad base of knowledge to address the issue. Number 1818 STACEY MARZ, Resource Coordinator, Alaska Community Action on Toxics, testifying via teleconference from Anchorage, informed the committee that Barbara Williams had to leave and thus Ms. Marz wanted to read Ms. Williams' testimony and then submit her own. CHAIRMAN ROKEBERG suggested that Ms. Marz provide the teleconference moderator with Ms. Williams' written testimony, which would become part of the record. He then requested that Ms. Marz proceed with her testimony. MS. MARZ informed the committee that ACAT has begun to attempt to collect information regarding pesticide use in Alaska. This has proven to be a [difficult] task as the information is not readily available and must be systematically collected from all pesticide users. Much of the information collected thus far is from different sectors of the government. She noted that this information was collected because it is the easiest to collect due to public record laws which require disclosure. However, public record requests result in varying results due to the different record keeping systems within the institutions contacted. Although some of the institutions maintain comprehensive records regarding pesticide application, that was not the norm. Unfortunately, some [institutions] maintain nothing at all or merely note that an exterminator visited a premises. Ms. Marz pointed out that information about private pesticide use is very difficult to obtain as the only way to obtain such information is if there is voluntary disclosure by the private institution using pesticides. MS. MARZ stated that [ACAT] has found that use of pesticides in Alaska is widespread and occurs in many places that people frequent in daily life. She informed the committee that there is regular pesticide use in Anchorage, Fairbanks, Juneau, Palmer and Kenai. Pesticides are applied in locations such as private homes and yards, restaurants, nursing homes, schools, hospitals, airports, parks, gardens, greenhouse, the universities and farms. She noted that the target organism varies from different types of insects to different types of weeds. Ms. Marz stated that it is virtually impossible for an average citizen to access information, in an expedient and comprehensive manner, about pesticide use and exposure in Alaska. Furthermore, no one has the time or energy to systematically call all potential pesticide users in order to create a big picture perspective in regard to personal exposure. Therefore, a pesticide tracking system on the Internet would allow individuals to evaluate their own risks and minimize their exposure to toxic chemicals as well as decide how best to protect himself/herself and their family. Number 2002 PAM MILLER, Biologist and Program Director, Alaska Community Action on Toxics (ACAT), testified via teleconference from Anchorage. The mission of ACAT "is to protect human health and the environment from the toxic effects of contaminants and we also work to enhance public access to information about toxics and to build community action capabilities," she said. The ACAT strongly supports HB 356 as introduced by Representative Cissna. However, she had some recommendations that would strengthen the bill. MS. MILLER said enactment of this bill will be an important first step in ensuring the public's and workers' right to know about pesticide applications. Furthermore, this bill will provide necessary data for people to evaluate their risks and take whatever protective actions they deem necessary. [The ACAT] has worked with a number of chemically injured people, who are particularly susceptible to the health effects of pesticide exposure. Ms. Miller pointed out that a number of people are particularly vulnerable to pesticides, including pregnant women, children, adolescents, people with immune illnesses and women in menopause. MS. MILLER explained that ACAT's support for this bill stems from the group's research and experience working with the Anchorage School District regarding the use of pesticides in schools. The group's research demonstrated that the Anchorage School District used pesticides that are linked to serious health problems and, the group thinks, pose a special risk to children. However, teachers, parents and students were not notified about pesticide application. She noted that a group of parents, teachers and students worked with ACAT for nearly a year in order to address this problem, which culminated in a February 2000 decision of the Anchorage School Board to implement a policy requiring notification procedures and implementation of least toxic pest management. The organization believes it to be one of the most progressive in the country. MS. MILLER turned to specific recommendations of ACAT, which it believes will strengthen and ensure public health in the environment. Ms. Miller proposed the following amendments to CSSSHB 356. First, she recommended that on page 2, line 9, the word "shall" should be substituted for the word "may" and thus DEC would be required to charge registration fees, which would ensure annual income from pesticide label registration. She reminded the committee that Alaska is the only state that does not require such registration fees, which are generally paid by pesticide managers in other states. The second recommendation is on page 2, line 22, to remove the language "based in part on the frequency of pesticide application" and add a provision requiring all pesticide users to report all pesticides that are applied. She said it will be inefficient and costly to allow DEC to determine which pesticides require reporting. MS. MILLER noted that her written testimony included a series of justifications for this recommendation, which she urged committee members to review. She returned to Section 4 of the CS and referred the committee to Section 4(c) regarding the reporting requirement to DEC. While ACAT supports a pesticide use tracking system, ACAT urges the committee to make the reporting requirement apply to all pesticide applicators. Additionally, the word "shall" should be substituted for the word "may" in Section 4(b), which would require DEC to "establish regulations for the submission and dissemination of accurate data for the tracking system." Ms. Miller explained that the only way to have an accurate picture of pesticide use and exposure is with complete information - readily available to the public - provided by all pesticide applicators. MS. MILLER turned to Section 3(b) and again recommended that the word "shall" be substituted for the word "may" in order to require DEC to regulate the licensing of restricted-use pesticide applicators and custom, commercial and contract applicators of pesticides and broadcast chemicals. Although ACAT supports the imposition of civil penalties for applicators who fail to comply with the reporting requirement established in Section 3 of the proposed CS, it requests the addition of a citizen suit provision such as the one in the Federal Emergency Planning and Community Right to Know Act. She explained that this federal Act allows lawsuits to be filed for noncompliance with the reporting requirement. CHAIRMAN ROKEBERG asked who the Alaska Community Action on Toxics is. Number 2266 MS. MILLER responded that the Alaska Community Action on Toxics is a statewide membership organization that has over 300 individual members as well as Alaska tribes. It has been in existence approximately three years. She described its mission: The mission of Alaska Community Action on Toxics is to protect human health and the environment from the toxic effects of contaminants. We are dedicated to achieving environmental justice through a collaborative work with affected communities, tribes, environmental organizations and individual activists. We work to ensure responsible cleanup of contaminated sites and empower community involvement in cleanup decisions. We strive to stop the production, proliferation and release of toxic chemicals and work to enhance public access to information about toxics and to build community action capabilities. CHAIRMAN ROKEBERG asked if ACAT has full-time employees. MS. MILLER replied yes. Currently, ACAT has two full-time employees and some contract employees. REPRESENTATIVE CISSNA mentioned that ACAT was one of the citizen groups that worked to develop this bill. She Cissna thanked those who had testified today. CHAIRMAN ROKEBERG asked if anyone else wished to testify. There being no one, Chairman Rokeberg announced that HB 356 would be held. ADJOURNMENT There being no further business before the committee, the House Labor and Commerce Standing Committee meeting was adjourned at 5:50 p.m.