In E, to which North Americans are exposed is equivalent to that North Americans are exposed to. Hence in to which North Americans are exposed to, the second to would be redundant.
In D, you have a parallelism - two items connected with and. These items need to be parallel, i.e., both having the same function in the sentence: both verbs, both nouns, both relative clauses (e.g., starting with that), etc. If you look at D, you can't slice it in any way that fulfills the parallelism:
"many of the dioxins that are currently uncontrolled" (noun phrase) AND "North Americans are exposed to" (unfinished clause)
many of the dioxins "that are currently uncontrolled" (relative clause) AND "North Americans are exposed to" (unfinished clause)
many of the dioxins that are "currently uncontrolled" (modifier) AND "North Americans are exposed to" (unfinished clause)
This half-baked clause can't be parallel to anything... The easiest way to fulfill the parallelism, which is forced by the word and, is to add that, creating a relative clause parallelism:
many of the dioxins "that are currently uncontrolled" (relative clause) AND "that North Americans are exposed to" (relative clause)
Amit Moshe
Verbal Section Instructor
Economist GMAT