[Congressional Record (Bound Edition), Volume 145 (1999), Part 10]
[Extensions of Remarks]
[Pages 14072-14073]
[From the U.S. Government Publishing Office, www.gpo.gov]



  INTRODUCTION OF THE TAMPON SAFETY AND RESEARCH ACT OF 1999 AND THE 
                          ROBIN DANIELSON ACT

                                 ______
                                 

                        HON. CAROLYN B. MALONEY

                              of new york

                    in the house of representatives

                        Wednesday, June 23, 1999

  Mrs. MALONEY of New York. Mr. Speaker, earlier this year I introduced 
two important pieces of women's health legislation--H.R. 890, The 
Tampon Safety and Research Act of 1999, and H.R. 889, The Robin 
Danielson Act. The research and reporting called for in these bills 
will finally give women the accurate information they need to make 
informed decisions about their health as it relates to tampon use.
  Why is the issue of tampon safety important? Because tampons are used 
by 73 million American women--that's 53% of American women and almost a 
third of the total population. A woman may use as many as 16,500 
tampons in her lifetime. Given these numbers, shouldn't we be certain 
that these products are safe?
  I introduced two tampon safety bills because there are two separate 
issues that must be addressed.
  Why is The Tampon Safety and Research Act important? Because tampons 
and other related products often contain additives, synthetic fibers, 
and dioxin. Dioxin is a toxic by-product of the paper manufacturing 
process. Wood pulp, as well as the rayon used in nearly all tampons, 
undergo several production processes, including bleaching. The majority 
of pulp and paper producers use a chlorine bleaching method that 
results in the formation of dioxin and other contaminants. As a result, 
trace amounts of dioxin are present in most paper products, from toilet 
paper to tampons.
  Dioxin is also found in varying levels throughout the environment, 
but are women being subjected to additional and potentially avoidable 
exposures to dioxin through tampon use? Let me put dioxin in 
perspective, because we only have to consult recent history to know of 
the potentially disastrous effects of this substance. Dioxin is a 
member of the organochlorine group, which includes the contaminants 
found in Agent Orange, the Vietnam War-era defoliant, and at Love 
Canal.
  But let's consult the experts as well. According to a 1994 report 
issued by the Environmental Protection Agency, dioxin is a known 
cancer-causing agent in animals, as well as a probable human 
carcinogen. My bill is specifically concerned with the possible links 
between dioxin in tampons and ovarian, cervical, and breast cancers, as 
well as other potential hazards.
  A 1996 EPA study has also linked dioxin exposure with increased risks 
for endometriosis, an often painful menstrual-related condition that is 
a leading cause of infertility. Further, the EPA has concluded that 
people with high exposure to dioxin may be at risk for other effects 
which could suppress the immune system, increase the risk of pelvic 
inflammatory disease, reduce fertility, and possibly interfere with 
normal fetal and childhood development.
  The EPA conclusions regarding dioxin exposure are particularly 
alarming in light of a 1989 Food and Drug Administration report, which 
stated that ``possible exposures from all other medical device sources 
would be dwarfed by the potential tampon exposure.'' Why? Because the 
average woman may use as many as 16,500 tampons during her lifetime. If 
dioxin is putting women at risk, could the long-term use of tampons 
increase that risk?
  What makes these toxic residues in tampons even more disturbing is 
they come in direct contact with some of the most absorbent tissue in a 
woman's body. According to Dr. Philip Tierno, Jr., director of 
microbiology and immunology at New York University Medical Center, 
almost anything placed on this tissue--including trace amounts of 
dioxin--gets absorbed into the body.
  According to researchers, dioxin is stored in fatty tissue--just like 
that found in the vagina. And women have more body fat than men, 
possibly allowing them to more efficiently store dioxin from all 
sources, not just tampons. Worse yet, the effects of dioxin are 
cumulative, and can be measured as much as 20 or 30 years after 
exposure. This accumulation is cause for particular concern, because a 
woman may be exposed to dioxin in tampons for approximately 55 years 
over the course of her reproductive life.

  The question, of course, is why it is acceptable to have this toxic 
substance in tampons--despite the advice of an FDA scientist to the 
contrary. A 1989 agency document reported that ``the most effective 
risk management

[[Page 14073]]

strategy would be to assure that tampons, and menstrual pads for good 
measure, contain no dioxin.'' Why has there been far more testing on 
the possible health effects of chlorine-bleached coffee filters than on 
chlorine-bleached tampons and related products? My bill seeks to 
address this inadequacy, and finally give women the most accurate, up-
to-date information available regarding this critical health concern.
  Although the FDA currently requires tampon manufacturers to monitor 
dioxin levels in their finished products, the results are not available 
to the public. When I--as a Member of Congress--requested the 
information, the FDA told me it was proprietary and therefore could not 
be released. It should be noted the dioxin tests relied upon by the FDA 
are done by the manufacturers themselves, who, not surprisingly insist 
their products are safe. Some of my constituents have written to say 
that this is the equivalent of the fox guarding the henhouse.
  How much dioxin exposure is considered safe for humans? And does the 
fact that tampons are in direct contact with absorbent tissue, and for 
extended periods of time, make whatever levels of dioxin tampons 
possess even more dangerous? Is this the equivalent of a ticking time 
bomb, capable of increasing women's risks for several life-threatening 
or fertility-threatening diseases? Unfortunately there are no easy 
answers. We simply don't have instructive, persuasive evidence either 
way.
  Many experts believe, however, if the slightest possibility exists 
that dioxin residues in tampons could harm women, the dioxin should 
simply be eliminated. I also believe we should err on the side of 
protecting women's health. Tampon manufacturers are not required to 
disclose ingredients to consumers, although many have taken the 
positive step of voluntarily disclosing this information. 
Unfortunately, women are still being forced to take the word of the 
industry-sponsored research that these products are completely safe.
  I should also not that this is not the first time a Member of 
Congress has expressed concern about this issue. In 1992, the late 
Representative Ted Weiss of New York brought the issue up in a 
subcommittee hearing of the Committee on Government Operations. He did 
this after his staff had uncovered internal FDA documents which 
suggested the agency had not adequately investigated the danger of 
dioxin in tampons.
  My bill, The Tampon Safety & Research Act (H.R. 890), would direct 
the National Institutes of Health (NIH) to conduct research to 
determine the extent to which the presence of dioxin, synthetic fibers, 
and other additives in tampons and related menstruation products pose 
any health risks to women. An NIH study would provide American women 
with independent research, so they will not have to rely solely on 
research funded by tampon manufacturers.
  The second bill I have introduced, The Robin Danielson Act, calls for 
a program at the Centers for Disease Control and Prevention (CDC) to 
track instances of Toxic Shock Syndrome (TSS). This bill is named in 
memory of Robin Danielson, a 44 year-old mother of two who last year of 
TSS. This bill addresses the many potentially harmful additives in 
tampons, including chlorine compounds, absorbency enhancers, and 
synthetic fibers, as well as deodorants and fragrances. Most people are 
surprised to learn these additives are commonly found in these 
products.
  Toxic Shock Syndrome is a rare bacterial illness which caused over 50 
deaths between 1979 and 1980, when the link between tampons and TSS was 
first established. According to a 1994 study, of the Toxic Shock cases 
occurring in menstruating women, up to 99% were using tampons. 
Obviously Toxic Shock Syndrome is still a women's health concern, and 
its link to tampons has become more clear. We do not know enough about 
the potential risks associated with such additives. Independent 
research has already shown synthetic fiber additives in tampons amplify 
toxins, which are associated with Toxic Shock Syndrome.
  Reporting of TSS to the Centers for Disease Control and Prevention is 
currently optional and uneven. No one knows the actual number of TSS 
occurrences or deaths. Because doctors do not report all cases of TSS 
and because local health departments are swamped with other higher-
ranking concerns, Toxic Shock is greatly under-reported. My bill 
establishes a CDC program to implement mandatory collection of Toxic 
Shock Syndrome data.
  I want to share an excerpt from a letter written to me by a TSS 
survivor addressing the importance of The Robin Danielson Act and TSS 
research: ``I think women are misinformed about the dangers and risks 
that go with using tampons. I know that I remember hearing about it 
years ago but had always thought that tampons now were very safe to 
use. Apprently this is not true and many women today are dying from 
this disease and it goes unreported.
  Women, like Robin Danielson, are still dying from this terrible 
disease. It is imperative that we are able to accurately inform women 
of the risk of Toxic Shock associated with tampon use, and that women 
are well aware of that risk. We know there is a dangerous link between 
tampon use and TSS. What we don't know is how prevalent the disease is 
among tampon users. The only means to determine the current risk of 
Toxic Shock and to raise awareness of the disease is to require 
systematic reporting through the CDC.
  Currently, the CDC believes that women are at increased risk for 
developing Toxic Shock due to a false sense of security, believing that 
there is no longer a risk for developing the disease. To make matters 
worse, the diagnosis of Toxic Shock is difficult because the symptoms 
are flu-like and can be easily mis-diagnosed or ignored. Knowing the 
continued risk for contracting Toxic Shock is the only way to raise 
awareness among women and their physicians. More knowledgeable women 
and physicians will recognize TSS symptoms earlier, diagnose Toxic 
Shock more readily, and prevent needless deaths.
  The fact is, women do not have the information they need to make 
sound decisions about their health. For the sake of women's well-being, 
we need accurate, independent information. American women have a right 
to know about any potential hazards associated with tampons and other 
related products. It is only when women fully understand the 
consequences that they can make truly informed decisions about their 
reproductive health.
  Mr. Speaker, I hope my colleagues will join me in this fight to get 
accurate health information to the women of America. Their future 
fertility, and perhaps their lives, may depend on it.

                          ____________________