; (B) as a result of that exposure, the individual or class has suffered an increased risk of developing a disease associated with exposure to PFAS; (C) as a result of that increased risk, there is a reasonable basis for the individual or class to undergo periodic diagnostic medical examinations of a nature or frequency that is different from or additional to what would be prescribed in the absence of the exposure; and (D) those medical examinations are effective in detecting a disease associated with exposure to PFAS. (2) Presumption of significant exposure (A) Individuals An individual plaintiff shall be presumed to have been significantly exposed to PFAS under paragraph (1)(A) if the individual— (i) demonstrates that— (I) the defendant engaged in any portion of a manufacturing process that created the PFAS to which the individual was significantly exposed, including any telomer, fluor­o­sur­fact­ant, or toll manufacturing process leading to the creation of the PFAS to which the individual was significantly exposed; and (II) the PFAS described in subclause (I) were released into 1 or more areas where the individual would have been exposed for a cumulative period of not less than 1 year; or (ii) offers testing results that demonstrate that PFAS or metabolites of PFAS have been or are currently detected in the body or blood serum of the individual. (B) Class actions In a class action, a presumption of significant exposure to PFAS under paragraph (1)(A) shall be established for the class by— (i) demonstrating that— (I) the defendant engaged in any portion of a manufacturing process that created the PFAS to which the class members were significantly exposed, including any telomer, fluorosurfactant, or toll manufacturing process leading to the creation of the PFAS to which the class members were significantly exposed