144.9.
(a) As used in this section, the following definitions apply:(1) “Board” means the Occupational Safety and Health Standards Board.
(2) “Division” means the Division of Occupational Safety and Health.
(3) “Electrocautery device” means a device that is electrically heated to cut, ablate, or coagulate human tissue for therapeutic purposes.
(4) “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.
(5) “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.
(6) “Health facility” means a health facility as defined in subdivision (a) of Section 1250 of the Health and Safety Code.
(7) “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.
(8) “Plume scavenging system” means smoke evacuators, laser plume evacuators, plume scavengers, and local exhaust ventilators that, when used in concert with other engineering controls and equipment, and to the extent technologically feasible, 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) By December 1, 2026, the division shall submit to the board a proposed regulation requiring a health facility to evacuate or remove plume to the extent technologically feasible through the use of a plume scavenging system in all settings that employ techniques that involve the creation of plume.
(2) In developing regulations, the division shall 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.
(B) Take into consideration recommendations on the evacuation of plume from the federal Occupational Safety and Health Administration and National Institute for Occupational Safety and Health.
(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 to all workers foreseeably participating in procedures that involve the creation of plume. The training shall include, but not be limited to, general education on the contents of plume, the circumstances in which it is generated, the associated health and safety 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 to scavenge plume.
(E) Include a requirement that a plume scavenging system be included as engineering or work practice controls.
(F) Include a requirement for appropriate practices and other controls necessary to prevent employee exposure to plume in situations where a plume scavenging system could interfere with a medical procedure.
(c) (1) By June 1, 2027, the board shall consider for adoption a proposed regulation of the division 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.
(2) Paragraph (1) does 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.
(d) (1) This section does not alter, amend, expand, or reduce existing general room ventilation standards or requirements. Any plume scavenging standards adopted by the board 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.
(e) (1) The use of surgical masks shall not satisfy the requirements of this section.
(2) The use of respirators shall not satisfy the requirements of this section except when, due to medical necessity, the plume scavenging system is unable to be located where it effectively captures plume.