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
system deficiencies, pelvic inflammatory disease,
and toxic shock syndrome; and
‘‘(B) poses any risks to the health of chil-
dren of women who used such products during
or before the pregnancies involved, including
risks relating to fetal and childhood develop-
ment.
‘‘(2) REQUIREMENT
REGARDING
DATA
FROM
MANUFACTURERS.—Research under paragraph (1)
shall include research to confirm the data on tam-
pons and other feminine hygiene products submitted
to the Commissioner of Food and Drugs by manu-
facturers of such products.
‘‘(3) DEFINITION.—For purposes of paragraph
(1), the term ‘feminine hygiene products’ means
tampons, pads, liners, and similar products used by
women with respect to menstruation or other gen-
ital-tract secretions.
‘‘(b) REPORTS.—Reports on the results of research
under subsection (a) shall be periodically submitted to the
Congress, the Commissioner of Food and Drugs, the Ad-
ministrator of the Environmental Protection Agency, and
the Chairman of the Consumer Product Safety Commis-
sion. Such reports shall be made available to the public
through the data system and clearinghouse program es-
tablished under section 486A, or through other appro-
priate means.’’.
TITLE 
II—COLLECTION 
AND
ANALYSIS OF DATA ON TOXIC
SHOCK SYNDROME
SEC. 201. FINDINGS.
The Congress finds as follows:
(1) Of the cases of toxic shock syndrome in the
United States, approximately 50 percent are related
to tampon use and approximately 50 percent occur
in nonmenstruating women and in men and children.
(2) The Centers for Disease Control and Pre-
vention (CDC) believes that women are at increased
risk for developing toxic shock syndrome due to a
false sense of security that there is no longer any
risk for developing the disease.
(3) The CDC has estimated that each year such
syndrome strikes more than 1,300 individuals.
Among women in the age group 12 through 44 who
use tampons or barrier contraceptives, between one
and two of every 100,000 will develop the syndrome.
(4) Epidemiological data on cases of toxic shock
syndrome are not systematically collected in the
United States, and information on cases seldom
travels beyond the victim’s circle of family and
friends.
(5) The CDC and the States should cooperate
to collect and analyze such data. Increasing the
amount of information on toxic shock syndrome will
lead to increased awareness about the disease in the
medical community, and may also lead to an in-
creased understanding of the causes of the syn-
drome.
SEC. 202. CENTERS FOR DISEASE CONTROL AND PREVEN-
TION; ESTABLISHMENT OF PROGRAM FOR
COLLECTION AND ANALYSIS OF DATA ON
TOXIC SHOCK SYNDROME.
Part B of title III of the Public Health Service Act
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 317O the following section:
‘‘COLLECTION AND ANALYSIS OF DATA ON TOXIC SHOCK
SYNDROME
‘‘SEC. 317P. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention, shall carry out a program to collect,
analyze, and make available data on toxic shock syndrome,
including data on the causes of such syndrome.
‘‘(b) NATIONAL INCIDENCE AND PREVALENCE.—In
carrying out the program under subsection (a), the Sec-
retary shall to the extent practicable determine the na-
tional incidence and prevalence of toxic shock syndrome.
‘‘(c) COOPERATION WITH STATES.—The Secretary
may carry out the program under subsection (a) directly
and through grants to States and local health depart-
ments.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for
each of the fiscal years 2002 through 2006.’’.
Æ