Required Awareness Training on Valley Fever Symptoms

I understand the Labor Code has been revised to address an increase in the number of reported cases of Valley Fever since 2016. As a small construction company, how will the revisions affect our operations?

Valley Fever awareness training is the emphasis of new Labor Code Section 6709, added by AB 203 (Salas; D-Bakersfield; Chapter 712), signed into law on October 19, 2019.

Section 6709 is specific to construction workers affected in a number of Central Valley counties. It requires employers performing earth-disturbing activities that create airborne dust to provide effective awareness training to employees about Valley Fever exposure.

Other outdoor occupations at risk for Valley Fever include wildland firefighters and oil and gas, agricultural, ranch and mine workers.

Valley Fever

Valley Fever (coccidioidomycosis) is a fungal respiratory infection caused by inhaling tiny fungal spores found in the soil — primarily in the top 2 to 12 inches — of dry, dusty areas in some parts of California.

When the soil where fungal spores are present is disturbed, either by high winds or through activities such as digging, grading, earth moving and operating vehicles, the spores become airborne and may be inhaled.

Symptoms are similar to the common cold or flu, resulting in misdiagnoses or the infected person going without treatment.

The law describes common signs and symptoms of Valley Fever as including fatigue, cough, fever, shortness of breath, headache, muscle aches or joint pain, rash on upper body or legs, and “symptoms similar to influenza that linger longer than usual.”

According to the California Department of Public Health (CDPH), the number of Valley Fever cases reported in the state has risen more than 50 percent since 2016, with 7,534 cases reported in 2017 and 8,187 cases reported in 2018.

There currently is no vaccine to prevent Valley Fever. The illness is not contagious, but because of the different ways the spores can become airborne, it can be difficult to identify where an exposure took place.

About 60 percent of people who become infected with Valley Fever have no symptoms and get better on their own, but in rare cases, the illness may become serious or fatal, according to the CDPH.


The training must contain, at a minimum, topics on transmission of Valley Fever, prevention methods, early detection and diagnosis, common treatment, personal risk factors that may create a higher risk for some individuals, and prognosis of the disease.

The Labor Code states that the training requirement applies to construction employers with employees at worksites where Valley Fever is “highly endemic,” including, but not limited to the counties of Fresno, Kern, Kings, Madera, Merced, Monterey, San Joaquin, San Luis Obispo, Santa Barbara, Tulare and Ventura.

Highly endemic means the annual incidence rate of Valley Fever is greater than 20 cases per 100,000 persons per year.

The legislation is specific about eight items that are to be included in training outlined by the regulation; some items appear to infringe on health privacy.

Injury and Illness Prevention Program (IIPP) training broadly covers several of the required items, but the law states that the Valley Fever training may be included in a standalone training program.

The eight prescribed training items listed in the law are:

  • What is Valley Fever and how is it contracted?
  • High risk areas and when chances for infection are greatest.
  • Information on personal health issues that could increase the risk of being infected.
  • Personal and work area exposure prevention methods.
  • Importance of early detection, diagnosis and treatment.
  • Recognizing symptoms.
  • Employee reporting of symptoms to expedite diagnosis and treatment.
  • Information on common treatment and prognosis.

The law states that training must be provided by May 1, 2020, and annually thereafter before an employee begins work that is reasonably anticipated to cause exposure to dust. Cal/OSHA can issue an order to take special action, citing the Labor Code.


Both Cal/OSHA and the CDPH have extensive online resources regarding Valley Fever.

The Cal/OSHA web page includes a link to the form the employer is required to fill out if a worker reports Valley Fever symptoms.

The CDPH web page includes a webinar and tailgate training guide for California construction workers.

Staff Contact: Mel Davis

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