I 
108TH CONGRESS 
1ST SESSION 
H. R. 373
To amend the Public Health Service Act to establish a program of research 
regarding the risks posed by the presence of dioxin, synthetic fibers, 
and other additives in feminine hygiene products, and to establish a 
program for the collection and analysis of data on toxic shock syndrome. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 27, 2003
Mrs. MALONEY (for herself, Ms. MILLENDER-MCDONALD, Ms. NORTON, Mr. 
KILDEE, Mr. LANTOS, Mr. HINCHEY, Mr. HOLDEN, Mr. MCNULTY, Ms. 
LEE, Mr. COOPER, and Mrs. CHRISTENSEN) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to establish a pro-
gram of research regarding the risks posed by the pres-
ence of dioxin, synthetic fibers, and other additives in 
feminine hygiene products, and to establish a program 
for the collection and analysis of data on toxic shock 
syndrome.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Robin Danielson Act’’.
TITLE I—RESEARCH REGARDING 
RISKS POSED BY DIOXIN, SYN-
THETIC FIBERS, AND OTHER 
ADDITIVES IN FEMININE HY-
GIENE PRODUCTS 
SEC. 101. FINDINGS. 
The Congress finds as follows: 
(1) Tampons are used by approximately 
73,000,000 women in the United States today, and 
the average woman may use as many as 16,800 
tampons in her lifetime. A woman on estrogen re-
placement therapy may use as many as 24,360 tam-
pons in her lifetime. 
(2) The Environmental Protection Agency and 
the International Agency for Research on Cancer, an 
arm of the World Health Organization, have con-
cluded that dioxins are a probable human carcinogen 
(cancer causing agent). 
(3) Dioxin is a byproduct of chlorine-bleaching 
processes used in the manufacture of paper prod-
ucts, including tampons, sanitary pads, panty liners, 
and diapers. 
(4) While bleaching processes that do not 
produce dioxin in any amount are available, most 
pulp and paper manufacturers, which produce the
raw materials used in tampons, currently use either 
elemental-chlorine or chlorine-dioxide bleaching proc-
esses. Both of these bleaching processes use chlorine 
and therefore produce dioxin. 
(5) The effects of dioxin from various sources 
are cumulative and can be measured 20 to 30 years 
after exposure. Women may be exposed to dioxin in 
tampons and other menstrual products for as long 
as 60 years over the course of their reproductive 
lives. 
(6) Internal documents of the Food and Drug 
Administration suggest the agency has not ade-
quately investigated the danger of dioxin in tam-
pons, according to a 1992 staff report of a sub-
committee of the Committee on Government Oper-
ations of the House of Representatives. 
(7) The Food and Drug Administration has his-
torically relied on data provided by manufacturers of 
feminine hygiene products in determining product 
safety. 
(8) Although the Food and Drug Administra-
tion currently requires tampon manufacturers to 
monitor dioxin levels in their finished products, the 
information is not readily available to the public.
(9) Recent studies have produced conflicting in-
formation about the link between dioxin exposure 
and increased risks for endometriosis. 
(10) The Environmental Protection Agency has 
concluded that people with high levels of exposure to 
dioxins may be at risk for other noncancer effects 
that could suppress the immune system, increase the 
risk of pelvic inflammatory disease, reduce fertility, 
and interfere with fetal and childhood development. 
(11) An independent study in 1991 found that 
tampons commonly included one or more of the fol-
lowing additives: Chlorine compounds, absorbency 
enhancers (such as surfactants like polysorbate-20), 
natural and synthetic fibers (such as cotton, rayon, 
polyester, and polyacrylate), deodorant, and fra-
grance. 
(12) Toxic Shock Syndrome (TSS) has been 
linked to tampon use and the absorbency of the tam-
pon. TSS is a rare bacterial illness that occurs most-
ly in menstruating women. During 1979 and 1980, 
the syndrome was responsible for at least 55 deaths 
and 1,066 nonfatal cases. 
(13) In response to a 1988 lawsuit, the Food 
and Drug Administration has required tampons to 
be labeled with reference to an absorbency standard
(e.g., super tampons must absorb between 9 and 12 
grams of liquid). 
(14) Independent research has shown that syn-
thetic fiber additives in tampons amplify toxin pro-
duction, which is associated with toxic shock syn-
drome. 
SEC. 102. NATIONAL INSTITUTES OF HEALTH; RESEARCH 
ON DIOXIN PURSUANT TO OFFICE OF RE-
SEARCH ON WOMEN’S HEALTH. 
Part F of title IV of the Public Health Service Act 
(42 U.S.C. 287d et seq.) is amended by adding at the end 
the following section: 
‘‘SEC. 486C. CERTAIN PROJECTS REGARDING WOMEN’S 
HEALTH. 
‘‘(a) DIOXIN IN FEMININE HYGIENE PRODUCTS.—
‘‘(1) IN GENERAL.—The Director of NIH, in 
collaboration with the Director of the Office, shall 
provide for the conduct or support of research to de-
termine the extent to which the presence of dioxin, 
synthetic fibers, and other additives in tampons and 
other feminine hygiene products—
‘‘(A) poses any risks to the health of 
women who use the products, including risks re-
lating to cervical cancer, endometriosis, infer-
tility, ovarian cancer, breast cancer, immune