Title of Regulation: 18VAC120-40. Virginia Professional Boxing and Wrestling Events Regulations (amending 18VAC120-40-15, 18VAC120-40-240, 18VAC120-40-411.1; adding 18VAC120-40-85).

Statutory Authority: § 54.1-831 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comments: Public comments may be submitted until 5 p.m. on April 29, 2009.

Effective Date: May 14, 2009.

Agency Contact: Mark N. Courtney, Deputy Director for Licensing and Regulation, Department of Professional and Occupational Regulation, 9960 Mayland Drive, Suite 400, Richmond, VA 23233, telephone (804) 367-8537, FAX (804) 527-4403, or email mark.courtney@dpor.virginia.gov.

Basis: Section 54.1-831 of the Code of Virginia authorizes the Director of the Department of Professional and Occupational Regulation to promulgate regulations that implement the federal Professional Boxing Safety Act of 1996 (15 USC § 6301 et seq.).

Purpose: The regulations will protect the health and safety of ring officials, other participants in the event, and the public by reducing their risk of exposure to serious, life-threatening diseases.

Rationale for Using Fast-Track Process: These changes are expected to be noncontroversial and are necessary to protect the health and safety of ring officials, other participants, and the public by reducing their risk of exposure to serious, life-threatening diseases. The proposed changes are common sense and no participant, ring official, or member of the pubic would expect the Commonwealth of Virginia to allow an individual with a serious, life-threatening disease to participate in a contest that could facilitate the spread of the disease.

Substance: The proposed changes (i) require a participant in a boxing or mixed martial arts event to provide a negative test result for hepatitis B and C and HIV prior to participating in an event; (ii) require that the promoter of a boxing and mixed martial arts event provide a disinfecting solution at ringside; and (iii) clearly state that regulated medical waste must be disposed of in accordance with Virginia Waste Management Board regulations.

Issues: Participants in boxing and mixed martial arts events will now have to provide proof of the required negative tests; however, such tests are available at no cost from local health departments and are necessary to protect the health and safety of ring officials, other participants, and the public. There are no disadvantages to the public or the Commonwealth.

The Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Department of Professional and Occupational Regulation (DPOR) proposes to require boxers and participants in mixed martial arts matches to test negative for certain blood borne illnesses. DPOR also proposes to clarify that all regulated medical waste must be disposed of in accordance with Department of Environmental Quality (DEQ) regulations.

Result of Analysis. The benefits likely exceed the costs for several of these proposed changes. Costs and benefits are discussed below.

Estimated Economic Impact. The Department of Professional and Occupational Regulation (DPOR) proposes to newly require boxers and participants in mixed martial arts matches to provide negative results on tests for the antibodies associated with Acquired Immune Deficiency (AIDS) and hepatitis C, as well as a negative result for a hepatitis B surface antigen test (HBsAG), in order to be able to participate in scheduled matches. Tests will have to be conducted within 180 days of the event.

Affected boxers and mixed martial arts fighters will likely incur costs for this required testing. While local health departments offer tests for these diseases without fee, individuals are not typically able to set an appointment for testing and would typically experience long wait times. Individuals who choose to be tested at a local health department will likely incur implicit costs for time spent waiting for testing rather than working or engaging in some other alternate activity. Individuals who choose private testing will incur fees for a doctor’s office visit and for the costs of the tests given (testing kits for hepatitis B cost between $70 and $80, HIV and Hepatitis C kits cost approximately $50 each).

Requiring a negative result on generalized antibody tests for HIV and hepatitis C will likely produce a benefit for participants in covered events as it will, in most instances, eliminate the very small chance that they could catch these diseases through contact with the blood of their opponents. Both of these diseases can be deadly and cannot be cured. A small percentage of people who contract hepatitis C (about 20%) will be able to fight off the disease and will, as a consequence, temporarily test positive for antibodies without being contagious. The remaining 80% of affected individuals will be able to pass the disease to others. There is no hepatitis C antibody test currently available that can distinguish between antibodies that exist because an individual has recently cleared the disease from his body (and is not currently contagious) and antibodies that are carried by individuals who are contagious. Because these two diseases have very low to zero clearance rates¹ and the best antibody tests available cannot distinguish whether the disease has been recently cleared, the costs associated with antibody testing for these two diseases is likely outweighed by the benefit of eliminating the small chance that these devastating diseases would be spread through blood contact while fighting.

Testing for the antibodies of hepatitis B, however, presents a special case that benefits from different treatment in these proposed regulations. In contrast to hepatitis C, hepatitis B has a clearance rate of 90% to 98%. Individuals who contract, and then clear, hepatitis B will develop antibodies to the disease that make them immune to contracting the disease again. Additionally, there is a vaccine for hepatitis B which causes the body to produce antibodies which convey (likely temporary) immunity. While there is no curative medical treatment for hepatitis B once contracted, the chances of a healthy adult ending up with a hepatitis B infection that persists is relatively small (2% to 10%).

Hepatitis B also presents a special case because several antibody tests are available with results giving various pieces of information about the status of the tested individual.² A positive result on a hepatitis B surface antigen test (HBsAG), for instance, means that the individual has a current, active hepatitis B infection and is able to pass that infection to others. A positive test for antibodies to hepatitis B core antigens (anti-HBc or HBc-Ab test) combined with a negative result for the HBsAg test, indicates that the individual is immune after clearing a natural infection and is not contagious. A positive test for antibodies to hepatitis B surface antigens (anti-HBs), combined with negative results for both HBsAg and anti-HBc tests, would indicate immunity due to vaccination.

Because there are several tests available for hepatitis B antibodies, and because positive results on several of these tests are not necessarily indicative of an individual who is able to spread this disease, DPOR proposes to require fighters to present a negative result for the specific hepatitis B antibody test (HBsAG) that indicates the presence of the active disease. This proposed change will likely benefit fighters by eliminating the very small chance that they might contract hepatitis B through contact with the blood of an opponent who is contagious.

Although these regulations are currently silent on the disposal of medical waste, affected entities are generally bound by all statutory and administrative law in the Commonwealth. Accordingly, no affected entity is likely to incur any costs on account of the proposed reminder that they are bound by DEQ regulations for disposal of medical waste. On the other hand, these entities might benefit from having this explicit reminder in regulations that they are likely more familiar with.

Businesses and Entities Affected. These proposed regulations will affect all boxers and mixed martial arts fighters in the Commonwealth. DPOR reports that, on average, 100-125 individuals per year would be subject to the proposed testing requirements.

Localities Particularly Affected. No locality will be particularly affected by this proposed regulatory action.

Projected Impact on Employment. To the extent that requiring testing for the antibodies of certain diseases limits the number of eligible fighters in the Commonwealth, participation in boxing and mixed martial arts events may decrease marginally.

Effects on the Use and Value of Private Property. This regulatory action will likely have no effect on the use or value of private property in the Commonwealth.

Small Businesses: Costs and Other Effects. To the extent that affected fighters are private contractors who must declare their earnings as business revenues, they would qualify as small businesses. These individuals will incur costs for testing and, potentially, lost revenue on account of these proposed regulations.

Small Businesses: Alternative Method that Minimizes Adverse Impact. There is likely no alternative testing proposal that would be less intrusive/costly than these proposed regulations and would accomplish DPOR’s goal of decreasing the possibility of fighter’s spreading dangerous diseases.

Real Estate Development Costs. This regulatory action will likely have no effect on real estate development costs in the Commonwealth.

Legal Mandate. The Department of Planning and Budget (DPB) has analyzed the economic impact of this proposed regulation in accordance with § 2.2-4007.04 of the Administrative Process Act and Executive Order Number 36 (06). Section 2.2-4007.04 requires that such economic impact analyses include, but need not be limited to, the projected number of businesses or other entities to whom the regulation would apply, the identity of any localities and types of businesses or other entities particularly affected, the projected number of persons and employment positions to be affected, the projected costs to affected businesses or entities to implement or comply with the regulation, and the impact on the use and value of private property. Further, if the proposed regulation has adverse effect on small businesses, § 2.2-4007.04 requires that such economic impact analyses include (i) an identification and estimate of the number of small businesses subject to the regulation; (ii) the projected reporting, recordkeeping, and other administrative costs required for small businesses to comply with the regulation, including the type of professional skills necessary for preparing required reports and other documents; (iii) a statement of the probable effect of the regulation on affected small businesses; and (iv) a description of any less intrusive or less costly alternative methods of achieving the purpose of the regulation. The analysis presented above represents DPB’s best estimate of these economic impacts.

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¹ Clearance is defined here as the percentage chance that the body’s own immune system can fight off a disease so that the individual is no longer infected.

² Information about hepatitis B from Dr. Deborah Wexler at http://www.comeunity.com/adoption/health/hepatitis/wexler.html

Agency's Response to the Department of Planning and Budget's Economic Impact Analysis: Concur with the approval.

Summary:

The proposed amendments (i) require a participant in a boxing or mixed martial arts event to provide a negative test result for hepatitis B and C and HIV prior to participating in an event; (ii) require the promoter of an event to provide a disinfecting solution at ringside; and (iii) clarify that regulated medical waste must be disposed of in accordance with Virginia Waste Management Board regulations.

18VAC120-40-15. Applicability.

As referenced in this chapter and in § 54.1-828 of the Code of Virginia, boxing includes boxing, kick boxing, mixed martial arts, or similar contests. Individuals participating in these events are required to be licensed as a boxer. Requirements to obtain a boxer license are set forth in 18VAC120-40-70 and 18VAC120-40-80. Event licensing and conduct standards for boxing are set forth in 18VAC120-40-85, 18VAC120-40-230 through 18VAC120-40-410. Event licensing and conduct standards for kick boxing and other similar contests, including mixed martial arts, are set forth in 18VAC120-40-85, 18VAC120-40-411 through 18VAC120-40-411.21.

Individuals participating in wrestling events are required to be licensed as a wrestler. Requirements to obtain a wrestler license are set forth in 18VAC120-40-70 and 18VAC120-40-90. Event licensing and conduct standards for wrestling are set forth in 18VAC120-40-415 through 18VAC120-40-415.3.

18VAC120-40-85. Requirements for boxer or contestant prior to an event or contest.

Each boxer or contestant shall provide the department a negative test for the following prior to an event or contest:

1. Antibodies to the human immunodeficiency virus;

2. Hepatitis B surface antigen (HBsAg); and

3. Antibodies of virus hepatitis C.

Such tests shall be conducted within the 180 days preceding the event. A boxer or contestant who fails to provide the department with the required negative test results shall not be permitted to compete in the event or contest. The provisions of this section shall not apply to participants in a wrestling event.

18VAC120-40-240. Equipment to be provided by boxing promoters.

The promoter shall assure that each event shall have the following:

1. A fighting ring, which shall be in the shape of a square, a hexagon, or an octagon. A square ring shall not be less than 18 feet square inside the ropes and shall not exceed 20 feet square inside the ropes. A hexagon or octagon ring shall not be less than 18 feet (from any side to the opposite side) inside the ropes and shall not exceed 32 feet (from any side to the opposite side) inside the ropes.

The ring floor shall be padded with ensolite one inch thick or another similar closed-cell foam. The padded ring floor must extend at least 18 inches beyond the ring ropes and over the edge of the platform with a top covering of canvas or similar material tightly stretched and laced to the ring platform. Material that tends to gather in lumps or ridges or material with a slick covering shall not be used.

The ring platform shall not be more than five feet above the floor of the building and shall have suitable steps for use by boxers in their corners and by the ringside physician in a neutral corner.

Ring posts shall be of metal, not more than three inches in diameter, extending from the floor of the building to a height of 58 inches above the ring floor. The ring posts must be at least 18 inches away from the ropes.

There shall be four ring ropes not less than one inch in diameter, evenly spaced, with the bottom ring rope not less than 18 inches above the ring floor and the top ring rope not more than 52 inches above the ring floor. The ring ropes must be padded with a padding of closed cell padding of not less than 1/2 inch. Ropes are to be connected with soft rope ties six feet apart. All ring ropes are to be tight and approved by the department or its contractor.

All corners must be padded with approved pads. All turnbuckles are to be covered with a protective padding.

A ring stool and bucket shall be provided for each boxer's corner.

The ring shall have bright lights and light all four corners and middle of the ring equally. No lights shall shine into the face of the boxers or ringside judges; lights may only shine downward and not shine at any angle directly into the fighting ring area that may blind the boxers or judges.

The promoter shall provide a ringside restrictive barrier between the first row of ringside seats and the event official's area that will restrict the crowd from confronting either the boxers or event officials and will ensure that the boxers remain free from obstructions or distractions. The ringside barrier must be a minimum of eight feet from the outside edge of the ring.

2. A bell or gong located at the ring no higher than the floor level of the ring. The bell or gong must produce a clear tone easily heard by the boxers.

3. Locker rooms adequate in number and equipment to reasonably facilitate the boxer's activities before and after the contest. Separate locker rooms shall be provided when both male and female boxers are scheduled to compete. Locker rooms shall have restroom facilities available.

4. A fully equipped ambulance with a currently trained ambulance crew at the site of any boxing event for the entire duration of the event and any additional personnel or equipment required by 15 USC § 6304.

5. A notice to the nearest hospital and the persons in charge of its emergency room of the date, time, and location of the boxing event.

6. Boxing gloves of the proper weight that are set by weight classification by 18VAC120-40-295. Boxing gloves must have laces to secure proper fit. Gloves must have an attached thumb to the body of the glove. Gloves must be clean, free of cuts, have good laces, with no displacement or lumping of the padding material. Gloves used in world title fights shall be new and taken from the package just prior to issuing to the boxers. Gloves shall be inspected by the event inspector or his designee before each contest and those found defective shall be replaced before the contest begins. In all championship bouts, the boxers shall be gloved in the ring. A solution of 10% household bleach and water shall be used for cleansing of all gloves prior to and after each bout.

7. A sealed OTC pregnancy test kit, approved by the Food and Drug Administration, for each female boxer that will be given to the event inspector or his designee.

8. A clear plastic water bottle, a bucket containing ice, surgeon's adhesive tape and surgical gauze for each boxer.

9. A solution of one part bleach and nine parts water for disinfecting blood on the ring canvas or ropes shall be available ringside for use by staff stationed ringside to clean the ring canvas and ropes as needed.

10. The promoter shall provide each corner with biohazardous material bags and, after the event, shall discard all regulated medical waste in the proper manner in accordance with the Regulated Medical Waste Management Regulations (9VAC20-120) issued by the Virginia Waste Management Board and available from the Department of Environmental Quality.

18VAC120-40-411.1. Equipment to be provided by promoters.

The promoter shall assure that each event shall have the following:

1. A fighting ring that will be in the shape of a square, a hexagon, or an octagon. A square ring shall not be less than 18 feet square inside the ropes and shall not exceed 20 feet square inside the ropes. A hexagon or octagon ring shall not be less than 18 feet (from any side to the opposite side) inside the ropes and shall not exceed 32 feet (from any side to the opposite side) inside the ropes.

The ring floor shall be padded with ensolite one inch think or another similar closed-cell foam. The padded ring floor must extend at least 18 inches beyond the ropes and over the edge of the platform with a top covering of canvas or other similar material tightly stretched and laced to the ring platform. Material that tends to gather in lumps or ridges shall not be used.

The ring platform shall not be more than five feet above the floor of the building and shall have suitable steps for use of the contestants in their corners and by the ringside physician in a neutral corner.

Ring posts shall be of metal, not more than three inches in diameter, extending from the floor of the building to a height of 58 inches above the ring floor. The ring posts shall be at least 18 inches away from the ring ropes.

There shall be four ring ropes, no more than one inch in diameter, evenly spaced, with the bottom ring rope not less than 18 inches above the ring floor and the top ring rope not more than 52 inches above the ring floor. The bottom ring rope must be padded with a padding of closed cell padding of not less than 1/2 inch (recommend all ring roped be padded of the same thickness and material). Ropes are to be connected with soft rope ties six feet apart. All ring ropes are to be tight and approved.

All corners must be padded with approved pads. All turnbuckles are to be covered with a protective padding.

A ring stool and bucket shall be provided for each contestant's corner. The ring shall have bright lights and light all four corners and middle of the ring equally. No lights shall shine into the face of the contestants or ringside judges, lights may only shine downward and not shine at any angle directly into the fighting ring area that may blind the contestants or judges.

The promoter shall provide a ringside restrictive barrier between the first row of ringside seats and the event official's area that will prevent the crowd from confronting either the contestants or event officials. The ringside barrier must be a minimum of eight feet from the outside edge of the ring.

2. A bell or gong located at the ring no higher than the floor level of the ring. The bell or gong must produce a clear tone easily heard by the contestants.

3. Locker rooms adequate in number and equipment to reasonably facilitate the contestant's activities before and after the contest. Separate locker rooms shall be provided when both male and female contestants are scheduled to compete. Locker rooms shall have restroom facilities easily available.

4. A fully equipped ambulance with a currently trained ambulance crew at the site of any event for the entire duration of the event.

5. A notice to the nearest hospital and the persons in charge of its emergency room of the date, time and location of event.

6. Boxing gloves of the proper weight that are set by weight classification by rule. Boxing gloves must have laces to secure proper fit. Gloves must have an attached thumb to the body of the glove. Gloves must be clean, free of cuts, have good laces, with no displacement or lumping of padding material. Gloves used in world title fights shall be new and taken from the package just prior to issuing to the contestants. Gloves shall be inspected by the event inspector or his designee before each contest and those found defective shall be replaced before the contest.

7. A clear plastic water bottle, a bucket containing ice, surgeon's adhesive tape and surgical gauze for each contestant.

8. A sealed OTC pregnancy test kit, approved by the Food and Drug Administration, for each female boxer that will be given to the event inspector or his designee.

9. A solution of one part bleach and nine parts water for disinfecting blood on the ring canvas or ropes shall be available ringside for use by staff stationed ringside to clean the ring canvas and ropes as needed.

10. The promoter shall provide each corner with biohazardous material bags and, after the event, shall discard all regulated medical waste in the proper manner in accordance with the Regulated Medical Waste Management Regulations (9VAC20-120) issued by the Virginia Waste Management Board and available from the Department of Environmental Quality.