I 
118TH CONGRESS 
1ST SESSION H. R. 4703 
To require research into the health consequences of the environmental impacts 
of nuclear war, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 18, 2023 
Ms. ESHOO introduced the following bill; which was referred to the Committee 
on Energy and Commerce 
A BILL 
To require research into the health consequences of the envi-
ronmental impacts of nuclear war, and for other pur-
poses. 
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 ‘‘Health Impacts of Nu-
clear War Act of 2023’’. 
SEC. 2. FINDINGS. 
Congress finds that— 
(1) nuclear weapons explosions would have dev-
astating health impacts, including immediate radi-
ation exposure, thermal burns, and blast injuries; 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
(2) a large body of scientific literature suggests 
that the impacts of wide-spread nuclear weapons ex-
plosions are likely to extend well beyond the imme-
diate effect of the explosions and may include long- 
lasting and catastrophic environmental effects, in-
cluding— 
(A) the generation of vast quantities of 
soot as a result of firestorms generated by nu-
clear explosions; 
(B) the injection of such soot into the 
stratosphere; 
(C) a significant reduction in sunlight 
reaching the Earth’s surface as a result of such 
soot, causing a significant reduction in Earth’s 
surface temperatures, substantial changes to 
precipitation and ocean circulation patterns, 
and a dramatic decrease in crop and fisheries 
yields; and 
(D) damage to the ozone layer as a result 
of such soot, causing increased ultraviolet radi-
ation at the Earth’s surface; 
(3) such an environmental catastrophe could 
impact the United States even if the nuclear weap-
ons explosions were outside the United States; 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
(4) the health consequences of such an environ-
mental catastrophe would be severe and long-lasting 
and may include— 
(A) increased cancer rates as a result of 
higher ultra-violet radiation levels or radioactive 
fallout; 
(B) malnutrition as a result of decreases in 
agricultural and fisheries productivity after an 
abrupt reduction in sunlight; 
(C) infectious disease spread due to dete-
riorated public health concerns and com-
promised immunity; 
(D) hypothermia, frostbite, and other con-
sequences of exposure to extreme cold; and 
(E) other, cascading effects, such as con-
sequences of widespread damage to critical in-
frastructure; 
(5) such health consequences may be even more 
damaging and long-lasting than the initial impact of 
nuclear explosions, and the prospects for recovery 
from such consequences are currently unclear; 
(6) such health consequences should be consid-
ered when preparing all-hazards emergency plans as 
a component of chemical, biological, radiological, and 
nuclear threats; 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
(7) the focus of existing Federal Government 
preparedness and planning for nuclear threats has 
primarily been on individual nuclear detonation inci-
dents, and not on responding to the long-term envi-
ronmental and health impacts; and 
(8) research into, and preparedness for, the 
health consequences of the environmental impacts of 
nuclear war is of critical importance to the national 
security of the United States. 
SEC. 3. HEALTH CONSEQUENCES OF THE ENVIRONMENTAL 
IMPACTS OF NUCLEAR WAR. 
Subtitle C of title XXVIII of the Public Health Serv-
ice Act (42 U.S.C. 300hh–31 et seq.) is amended by add-
ing at the end the following: 
‘‘SEC. 2827. HEALTH CONSEQUENCES OF THE ENVIRON-
MENTAL IMPACTS OF NUCLEAR WAR. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) ENVIRONMENTAL
IMPACTS
OF
NUCLEAR 
WAR.—The term ‘environmental impacts of nuclear 
war’ means changes to the environment resulting, ei-
ther directly or indirectly, from the explosion of nu-
clear weapons, including — 
‘‘(A) the generation of vast quantities of 
soot as a result of firestorms generated by nu-
clear explosions; 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
‘‘(B) the injection of such soot into the 
stratosphere; 
‘‘(C) a significant reduction in sunlight 
reaching the Earth’s surface as a result of such 
soot, causing a significant reduction in Earth’s 
surface temperatures, substantial changes to 
precipitation and ocean circulation patterns, 
and a dramatic decrease in crop and fisheries 
yields; 
‘‘(D) damage to the ozone layer as a result 
of such soot, causing increased ultraviolet radi-
ation at the Earth’s surface; and 
‘‘(E) other impacts, as determined by the 
Secretary. 
‘‘(2) HEALTH CONSEQUENCES OF THE ENVI-
RONMENTAL IMPACTS OF NUCLEAR WAR.—The term 
‘health consequences of the environmental impacts of 
nuclear war’ means adverse effects on the physical 
or mental well-being of individuals resulting, either 
directly or indirectly, from environmental impacts of 
nuclear war, including— 
‘‘(A) increased cancer rates as a result of 
higher ultra-violet radiation levels or radioactive 
fallout; 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
‘‘(B) malnutrition as a result of decreases 
in agricultural and fisheries productivity after 
an abrupt reduction in sunlight; 
‘‘(C) infectious disease spread due to dete-
riorated public health conditions and com-
promised immunity, including due to malnutri-
tion; 
‘‘(D) hypothermia, frostbite, and other 
consequences of exposure to extreme cold; and 
‘‘(E) other consequences, as determined by 
the Secretary. 
‘‘(3) NUCLEAR WAR.—The term ‘nuclear war’ 
means military conflict involving the detonation of 
multiple nuclear weapons. 
‘‘(b) RESEARCH GRANTS TO STUDY THE HEALTH 
CONSEQUENCES OF THE ENVIRONMENTAL IMPACTS OF 
NUCLEAR WAR.— 
‘‘(1) RESEARCH
AND
PREPAREDNESS
PRO-
GRAM.—The Secretary, in collaboration with the Di-
rector of the National Institutes of Health, the Di-
rector of the Centers for Disease Control and Pre-
vention, and the Assistant Secretary for Prepared-
ness and Response, shall develop and implement a 5- 
year research and preparedness program, which may 
include activities carried out by the Secretary, as 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
well as grants, contracts, and cooperative agree-
ments awarded to eligible entities, to address the 
health consequences of the environmental impacts of 
nuclear war. 
‘‘(2) COMPONENTS
OF
RESEARCH
AND
PRE-
PAREDNESS
PROGRAM.—The program may in-
clude— 
‘‘(A) scientific study of the potential health 
consequences of the environmental impacts of 
nuclear war, including the longevity of such ef-
fects and the prospects for recovery; 
‘‘(B) exercises and drills to understand 
possible health system response to the environ-
mental impacts of nuclear war; 
‘‘(C) identifying and addressing capability 
and capacity gaps for health system response to 
the environmental impacts of nuclear war; and 
‘‘(D) developing countermeasures to com-
bat the health effects of the environmental im-
pacts of nuclear war. 
‘‘(3) ELIGIBLE ENTITIES.—To be eligible to re-
ceive a grant, contract, or cooperative agreement de-
scribed in paragraph (1), an entity shall— 
‘‘(A) be— 
‘‘(i) a nonprofit entity; 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
‘‘(ii) a nonprofit research institution; 
or 
‘‘(iii) an institution of higher edu-
cation (as defined in section 102 of the 
Higher Education Act of 1965); and 
‘‘(B) submit an application to the Sec-
retary, at such time, in such manner, and con-
taining such information as the Secretary may 
require. 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this subsection, there are authorized to 
be appropriated $10,000,000 for each of fiscal years 
2024 through 2028. 
‘‘(c) ASSESSMENT AND RECOMMENDATIONS BY THE 
SECRETARY.— 
‘‘(1) ASSESSMENT.—The Secretary shall con-
duct an assessment of the ability of the health sys-
tems of the United States to respond to the health 
consequences of the environmental impacts of nu-
clear war, including— 
‘‘(A) an assessment of the possible health 
consequences of the environmental impacts of 
nuclear war; 
‘‘(B) an assessment of existing State and 
Federal governmental preparedness and re-
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
sponse authorities, capabilities, protocols, and 
plans to respond to the likely health con-
sequences of the environmental impacts of nu-
clear war; 
‘‘(C) an assessment of current counter-
measures to address the range of likely health 
impacts in the event of environmental impacts 
of nuclear war; 
‘‘(D) an assessment of the current sci-
entific uncertainties relating to the environ-
mental consequences of nuclear war, their 
health consequences, and their implications for 
preparedness; 
‘‘(E) recommendations for further sci-
entific research to address any uncertainties 
identified under subparagraph (D); and 
‘‘(F) identification and prioritization of the 
most critical preparedness and response gaps of 
the United States to address the health con-
sequences of the environmental impacts of nu-
clear war. 
‘‘(2) ASSESSMENT REPORT.—Not later than 1 
year after the date of enactment of the Health Im-
pacts of Nuclear War Act of 2023, the Secretary 
shall prepare and submit to the Committee on 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
Health, Education, Labor, and Pensions of the Sen-
ate and the Committee on Energy and Commerce of 
the House of Representatives a report that contains 
the findings of the study conducted under paragraph 
(1). 
‘‘(3) COORDINATION.—In carrying out the as-
sessment under paragraph (1), the Secretary shall 
coordinate with the following: 
‘‘(A) Each of the following heads of agen-
cies or departments (or the designees of such 
heads): 
‘‘(i) The Director of the National In-
stitutes of Health. 
‘‘(ii) The Assistant Secretary for Pre-
paredness and Response. 
‘‘(iii) The Director of the Centers for 
Disease Control and Prevention. 
‘‘(iv) The Assistant to the President 
for National Security Affairs. 
‘‘(v) The Director of the Office of 
Science and Technology Policy. 
‘‘(vi) The Secretary of Energy. 
‘‘(vii) The Under Secretary of Energy 
for Nuclear Security. 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
‘‘(viii) The Administrator of the Na-
tional Nuclear Security Administration. 
‘‘(ix) The Director of the Office of 
Science of the Department of Energy. 
‘‘(x) The Secretary of Commerce. 
‘‘(xi) The Under Secretary of Com-
merce for Oceans and Atmosphere. 
‘‘(xii) The Director of the National 
Center for Atmospheric Research. 
‘‘(xiii) The Secretary of the Interior. 
‘‘(xiv) The Director of the United 
States Geological Survey. 
‘‘(xv) The Administrator of the Envi-
ronmental Protection Agency. 
‘‘(xvi) The Director of the National 
Science Foundation. 
‘‘(xvii) The Secretary of Defense. 
‘‘(xviii) The Director of the Defense 
Threat Reduction Agency. 
‘‘(xix) The Chairman of the Joint 
Chiefs of Staff. 
‘‘(xx) The Secretary of State. 
‘‘(xxi) The Under Secretary of State 
for Arms Control and International Secu-
rity. 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS
fined in section 2827’’ after ‘‘infectious dis-
eases’’; 
(B) in subsection (d)(1), by inserting ‘‘, in-
cluding the health consequences of the environ-
mental impacts of nuclear war, as defined in 
section 2827’’ after ‘‘nuclear threats’’; and 
(C) in subsection (d)(2)(A), by inserting ‘‘, 
including with respect to the health con-
sequences of the environmental impacts of nu-
clear war, as defined in section 2827,’’ after 
‘‘Nation’’; and 
(8) in section 2811–1(c) (1)(A)(42 U.S.C. 
300hh–10a(c)(1)(A)), by inserting ‘‘and with respect 
to the health consequences of the environmental im-
pacts of nuclear war, as defined in section 2827’’ 
after ‘‘infectious diseases’’. 
Æ 
VerDate Sep 11 2014 
22:35 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6301
E:\BILLS\H4703.IH
H4703
kjohnson on DSK79L0C42PROD with BILLS