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October 15, 2019
Valley fever training required in California

Construction firms and other employers in California must begin training employees in Valley fever risks and control measures under a new state law. Employers must offer initial worker training by May 1, 2020.

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The amendment to the California Labor Code only applies to employers in 11 counties in the Central Valley region but could expand to others as the disease spreads.

Valley fever (also known as California fever, desert rheumatism, and San Joaquin fever) is a respiratory infection caused by spores of Coccidioides fungi, which grow in the soil. The spores become airborne when soil is disturbed by wind or digging, excavation, or other construction activity.

Training program requirements

Employers must offer initial and then annual training for all employees engaged in work expected to involve exposure to substantial dust disturbance. Employers also must provide training for new employees before assigning them to work sites. The training must cover:

  • What Valley Fever is and how it is contracted;
  • Areas, environmental conditions, and types of work that pose high risk of contracting Valley Fever;
  • Personal factors that put employees at higher risk of infection or disease development, including pregnancy, diabetes, having a compromised immune system due to conditions such as human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), having received an organ transplant, or taking immunosuppressant drugs such as corticosteroids or tumor necrosis factor inhibitors;
  • Personal and environmental exposure prevention methods such as water-based dust suppression, good hygiene practices when skin and clothing is soiled by dust, avoiding contamination of drinks and food, working upwind from dusty areas when feasible, wet cleaning dusty equipment when feasible, and wearing a respirator when exposure to dust cannot be avoided;
  • The importance of early detection, diagnosis, and treatment to prevent the disease from progressing; because the effectiveness of medication is greatest in the early stages of the disease;
  • Recognizing common signs and symptoms of Valley Fever, including cough, fatigue, fever, headache, joint pain or muscle aches, rash on upper body or legs, shortness of breath, and symptoms similar to influenza that linger longer than usual;
  • The importance of reporting symptoms to the employer and seeking prompt medical attention from a physician for appropriate diagnosis and treatment; and
  • Prognosis and common treatment for Valley Fever.

Employers may use existing materials on Valley Fever developed by federal, state, and local agencies. The federal Centers for Disease Control and Prevention, California Department of Public Health, and many local health departments have Valley Fever Resources employers can use.

The new law currently applies to employers in Fresno, Kern, Kings, Madera, Merced, Monterey, San Joaquin, San Luis Obispo, Santa Barbara, Tulare, and Ventura Counties but may be expanded to additional counties. It applies to employers in the 11 counties involved in the construction, alteration, painting, repairing, construction maintenance, renovation, removal, or wrecking of any fixed structure or its parts.

Employers may provide the Valley Fever training as a standalone program or incorporate it into their existing injury and illness prevention programs (IIPP). IIPP is one of California’s occupational safety and health standards with no corresponding federal standard.

Once a county has been identified as highly endemic—at least 20 cases of Valley Fever per 100,000 persons per year—employers in the county must provide training after the first year.

Disease’s spread

Cases of valley fever or Coccidioidomycosis have been tracked in the Southwest states of Arizona, California, Nevada, New Mexico, Texas, and Utah since the 1930s and 40s. However, cases have popped up in other parts of the country, including southeast, central Washington State. Over 20 states across the country have Valley Fever public health reporting requirements.

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