AORN asks feds to avoid emergency order on EO levels H AORN has written to the assistant secre- taryof the US Department of Labor, asking the Occupational Safety and Health Administra- tion (OSHA) not to issue an emergency order lowering ethylene oxide (EO) exposure limits for workers. Recognizing that the current al- lowable exposure of 50 ppm (parts per million) is inadequate, AORN instead urged the agency to use the normal rule-making pro- cess. “This would permit a careful study of all the existing facts and hazards, as well as the opportunity for input from all affected groups,” said the Oct 7 letter signed by Nancy L Mehaffy, RN, president, and Elizabeth A Reed, RN, chairman of the Technical Practices Coordinating Committee.

A lawsuit filed in September by a labor union and a consumer group would force the gov- ernment to issue an emergency standard. Re- questing a new standard of 1 ppm time- weighted average and 5 ppm short-term expo- sure level are the American Federation of State, County, and Municipal Employees and Ralph Nader’s Public Citizen Health Research Group. A decision was expected in October.

AORN was concerned that the emergency measure ”would seriously jeopardize the qual- ity of patient care” because many hospitals would not be able to meet the new standards. This might mean some items could not be sterilized or would be improperly prepared for surgery. The inability of hospitals to use EO might increase infection rates due to improp- erly sterilized items, increase patient costs due

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to higher inventories of supplies or use of commercial sterilizing facilities, and generally lower the quality of care and availability of ser- vices, the letter pointed out.

Sidney Wolfe, MD, head of the consumer group, told American Medical News that the suit was filed because “the scientific evidence for carcinogenicity and chromosomal damage , . . is indisputable, and a few responsible companies and hospitals are currently protect- ing their workers by exposures of less than 1 ppm, thereby proving it is technically feasible to lower exposure to this level.”

In the normal rule-making process, OSHA would publish a notice in the Federal Register that it intends to issue a certain standard for EO exposure. Interested organizations and in- dividuals would then have an opportunity for public comment before a final rule was issued. AORN feels this is a more deliberate process for revising a standard on this complicated and controversial issue.

Meanwhile, another government agency has asked OSHA to take a look at its current permitted levels. Reporting on a study that EO exposure causes leukemia and malignant tumors in rats, the National Institute of Occupa- tional Safety and Health (NIOSH) recom- mended that, for the time being, hospitals vol- untarily assess exposure by their employees and reduce exposure to the extent possible.

California has begun issuing its own score for the nurse licensing exam. Since the exam was found to have an “adverse impact” on minorities and other groups earlier this year, the state’s Board of Registered Nursing has been looking for a way to ensure the exam is “job-related.” They are required to do this under state law.

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The board had discussed options, including developing its own licensing exam. Now they have decided to issue dual scores, reports JoAnn Smith, legislative representative for the California Nurses’ Association (CNA). One score will be for the entire State Board Test Pool Examination (the national licensing exam), and one will be for a Californiaversion. The California score will be determined by eliminating items that panels of nurses decide are not “job related” and grading the remaining questions. A panel has been appointed for each of the five exam sections. Applicants will receive both test scores, but passing will be based on the California score.

The panels had completed their work on the February and July exams in early October but had not released a report about how many questions of the exams were removed, Smith said.

Meanwhile, the nursing board was still con- sidering its proposal to extend interim permits for licensure applicants. The subject of a hot round of hearings this summer, the proposal would have allowed permittees to work as reg- istered nurses for up to 24 months while they are attempting to fulfill licensure requirements.

The board’s actions during the past year have raised serious questions for nurses. The legislature apparently has questions, too. In September, lawmakers approved a resolution mandating that a study be done about the ef- fects of extending the interim permits and withdrawing from the state board examination.

The medical licensing exam has come under scrutiny as well. An alternative exam sponsored by the medical board was over- turned by the state legislature. Unlike the nurs- ing exam, the proposed medical exam would have supplemented the national exam with questions in such areas as nutrition, geriatrics, and medical ethics. Ironically, a state law re- quired the board to make sure physicians are competent in these areas, so the board was in a quandry about what to do next, said a report in American Medical News.

rn Congress was still deliberating over ap- propriations in the early fall even though the new fiscal year started Oct 1. Final bills were not finished, so Congress passed a continuing resolution to keep current funding going into November. Meanwhile, preliminary figures for

nurse training, including nursing research, of $54.4 million had been set by the House and $62 million had been set by the Senate.

The ANA Washington office pointed out that these figures were 40% less than the 1981 original appropriation and over 20% less than the amount left after the President’s rescis- sions. Levels for nursing research were pro- jected at $5 million in the House and $2.5 mil- lion in the Senate. This is compared to the $3.5 billion allocated to biomedical research in the National Institutes of Health.

rn Politically active nurses came together in Washington, DC, Sept 9 and 10 for a national conference sponsored by the Nurses Coalition for Action in Politics (N-CAP). As the political arm of the American Nurses’ Association (ANA), N-CAP encourages nurses to get in- volved in political action and endorses and contributes to national candidates.

The 180 nurses attending learned about par- ticipating in campaigns, raising money for state political action committees, reaching other nurses, and getting out the vote. There was a reception attended by congressmen, senators, and their staffs.

Thirty-five states now have registered nurse political action committees. Phyllis Grillo, RN, an AORN member who chairs the Illinois group, said she had noticed a relationship be- tween how effective nurses are in responding to legislation at the state level and whether they have a political action committee. She noted that nurses in New Hampshire, where the nursing practice act was not renewed in a sunset review this summer, do not have a polit- ical arm.

N-CAP raises money for its campaign con- tributions from individual donations. If you are interested, contact N-CAP at Suite 408, 1030 15th St NW, Washington, DC 20005. Phone (202) 296-8015.

Patricia Patterson Associate editor

1008 AORN Journal, December 1981, Vol34, No 6