Nuclear Facilities Occupational Safety Improvement Act of 1991

Nuclear Facilities Occupational Safety Improvement Act of 1991 - Amends the Occupational Safety and Health Act of 1970 (OSHA) to apply it to certain Department of Energy (DOE) nuclear facilities (including specified defense, production, utilization, and waste storage or disposal facilities).

Directs the Secretary of Labor to promulgate specific regulations and standards to govern the application of OSHA to such facilities.

Requires the Secretary of Energy and each contractor operating such a facility to: (1) cooperate with the Secretary of Labor and the Secretary of Health and Human Services in the conduct of an inspection or investigation under OSHA at such facility; (2) grant access to it to enable the conduct of such inspection or investigation; and (3) provide all information necessary for such inspection or investigation. Authorizes the Secretary of Energy, to protect the confidentiality of information, to deny access to any person who has not been granted a security clearance or access authorization.

Provides for transfer and allocation of appropriations and personnel.

Directs the Secretary of Labor, by specified deadlines, to promulgate interim regulations and propose and promulgate final regulations to provide for specified types of health and safety training of employees at such DOE nuclear facilities.

Requires the National Institute for Occupational Safety and Health (NIOSH) and its Director to: (1) perform functions authorized by OSHA at such facilities; and (2) conduct health hazard evaluations, including ionizing radiation evaluations, at such facilities.

Requires medical examinations of employees at such DOE nuclear facilities. Requires all such employees to be given baseline medical examinations in accordance with guidelines developed by the Health Advisory Committee, and subsequent examinations, as recommended by the Committee, for their lifetime. Requires, where appropriate, such examinations for family members determined to be at high risk of disease because of an employee's exposure at the workplace. Requires that all former employees at such facilities and their families be offered participation in a medical surveillance program designed to focus on work-related exposure to toxic substances and radiation, including treatment for occupationally related illness. Requires all contractors with such facilities to maintain a full-time occupational health physician and supporting medical staff, in accordance with Committee guidelines. Establishes a Health Advisory Committee to: (1) review existing medical studies relating to the administration of such medical examination program; and (2) issue the aforementioned guidelines and standards for such program. Requires that all information from such medical examinations be available to individual employees and their representatives and that aggregate information from such examinations be available to the public. Requires that program costs be borne by DOE. Directs the Secretary of Labor, in coordination with the Secretary of Energy, to promulgate necessary regulations.

Requires each such DOE nuclear facility to establish a labor-management health and safety committee in accordance with specified guidelines.