site’ means a Department of Energy facility where 
cleanup operations are being carried out, or have 
been carried out, under the environmental manage-
ment program of the Department of Energy. 
‘‘(2) HEALTH
STUDIES
REPORT.—The term 
‘health studies report’ means the report submitted 
under section 5(f) of the Toxic Exposure Safety Act 
of 2021. 
‘‘(c) AGREEMENT.—Not later than 60 days after the 
issuance of the health studies report, the Secretary of 
Health and Human Services shall enter into an agreement 
with the National Academy of Sciences to carry out the 
requirements of this section. 
‘‘(d) REVIEW OF SCIENTIFIC AND MEDICAL EVI-
DENCE.— 
‘‘(1) IN GENERAL.—Under the agreement de-
scribed in subsection (c), the National Academy of 
Sciences shall, for the period of the agreement— 
‘‘(A) for each area recommended for addi-
tional study under the health studies report 
under section 5(f)(2) of the Toxic Exposure 
Safety Act of 2021, review and summarize the 
scientific evidence relating to the area, includ-
ing— 
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‘‘(i) studies by the Department of En-
ergy and Department of Labor; and 
‘‘(ii) any other available and relevant 
scientific studies, to the extent that such 
studies are relevant to the occupational ex-
posures that have occurred at Department 
of Energy cleanup sites; and 
‘‘(B) review and summarize the scientific 
and medical evidence concerning the association 
between exposure to toxic substances found at 
Department of Energy cleanup sites and result-
ant diseases. 
‘‘(2) 
SCIENTIFIC
DETERMINATIONS
CON-
CERNING DISEASES.—In conducting each review of 
scientific evidence under subparagraphs (A) and (B) 
of paragraph (1), the National Academy of Sciences 
shall— 
‘‘(A) assess the strength of such evidence; 
‘‘(B) assess whether a statistical associa-
tion between exposure to a toxic substance and 
a disease exists, taking into account the 
strength of the scientific evidence and the ap-
propriateness of the statistical and epidemiolog-
ical methods used to detect an association; 
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‘‘(C) assess the increased risk of disease 
among those exposed to the toxic substance 
during service during the production and clean-
up eras of the Department of Energy cleanup 
sites; 
‘‘(D) survey the impact to health of the 
toxic substance, focusing on hematologic, renal, 
urologic, hepatic, gastrointestinal, neurologic, 
dermatologic, respiratory, endocrine, ocular, 
ear, nasal, and oropharyngeal diseases, includ-
ing dementia, leukemia, chemical sensitivities, 
and chronic obstructive pulmonary disease; and 
‘‘(E) determine whether a plausible biologi-
cal mechanism or other evidence of a causal re-
lationship exists between exposure to the toxic 
substance and disease. 
‘‘(e) ADDITIONAL SCIENTIFIC STUDIES.—If the Na-
tional Academy of Sciences determines, in the course of 
conducting the studies under subsection (d), that addi-
tional studies are needed to resolve areas of continuing 
scientific uncertainty relating to toxic exposure at Depart-
ment of Energy cleanup sites, the National Academy of 
Sciences shall include, in the next report submitted under 
subsection (f), recommendations for areas of additional 
study, consisting of— 
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‘‘(1) a list of diseases and toxins that require 
further evaluation and study; 
‘‘(2) a review the current information available, 
as of the date of the report, relating to such diseases 
and toxins; 
‘‘(3) the value of the information that would re-
sult from the additional studies; and 
‘‘(4) the cost and feasibility of carrying out ad-
ditional studies. 
‘‘(f) REPORTS.— 
‘‘(1) IN
GENERAL.—By not later than 18 
months after the date of the agreement under sub-
section (c), and every 2 years thereafter, the Na-
tional Academy of Sciences shall prepare and submit 
a report to— 
‘‘(A) the Secretary; 
‘‘(B) the Committee on Health, Education, 
Labor, and Pensions and the Committee on En-
ergy and Natural Resources of the Senate; and 
‘‘(C) the Committee on Natural Resources, 
the Committee on Education and Labor, and 
the Committee on Energy and Commerce of the 
House of Representatives. 
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‘‘(2) CONTENTS.—Each report submitted under 
paragraph (1) shall include, for the 18-month or 2- 
year period covered by the report— 
‘‘(A) a description of— 
‘‘(i) the reviews and studies conducted 
under this section; 
‘‘(ii) the determinations and conclu-
sions of the National Academy of Sciences 
with respect to such reviews and studies; 
and 
‘‘(iii) the scientific evidence and rea-
soning that led to such conclusions; 
‘‘(B) the recommendations for further 
areas of study made under subsection (e) for 
the reporting period; 
‘‘(C) a description of any classes of em-
ployees that, based on the results of the reviews 
and studies and in accordance with the rules 
promulgated by the Secretary under section 
3671A(b), qualify for inclusion in the Toxic 
Special Exposure Cohort under such section 
3671A; and 
‘‘(D) the identification of any illness that 
the National Academy of Sciences has deter-
mined, as a result of the reviews and studies, 
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should be a covered illness under section 
3671(2)(D). 
‘‘(g) LIMITATION ON AUTHORITY.—The authority to 
enter into agreements under this section shall be effective 
for a fiscal year to the extent that appropriations are 
available. 
‘‘(h) SUNSET.—This section shall cease to be effec-
tive 10 years after the last day of the fiscal year in which 
the National Academy of Sciences transmits to the Sec-
retary the first report under subsection (f).’’. 
SEC. 7. CONFORMING AMENDMENTS. 
The Energy Employees Occupational Illness Com-
pensation Program Act of 2000 (42 U.S.C. 7384 et seq.) 
is amended— 
(1) in the table of contents— 
(A) by redesignating the item relating to 
section 3614 as the item relating to section 
3616; 
(B) by inserting after the item relating to 
section 3613 the following: 
‘‘Sec. 3614. Information and outreach. 
‘‘Sec. 3615. National Academy of Sciences review.’’; 
(C) by inserting after the item relating to 
section 3671 the following: 
‘‘Sec. 3671A. Establishment of the Toxic Special Exposure Cohort.’’; 
and 
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(D) by inserting after the item relating to 
section 3681 the following: 
‘‘Sec. 3681A. Completion and updates of site exposure matrices.’’; 
and 
(2) in each of subsections (b)(1) and (c) of sec-
tion 3612, by striking ‘‘3614(b)’’ and inserting 
‘‘3616(b)’’. 
Æ 
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