Repository for Oil and Gas Energy Research (ROGER)

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Unconventional gas drilling (UGD) has enabled extraordinarily rapid growth in the extraction of natural gas. Despite frequently expressed public concern, human health studies have not kept pace. We investigated the association of proximity to UGD in the Marcellus Shale formation and perinatal outcomes in a retrospective cohort study of 15,451 live births in Southwest Pennsylvania from 2007–2010. Mothers were categorized into exposure quartiles based on inverse distance weighted (IDW) well count; least exposed mothers (first quartile) had an IDW well count less than 0.87 wells per mile, while the most exposed (fourth quartile) had 6.00 wells or greater per mile. Multivariate linear (birth weight) or logistical (small for gestational age (SGA) and prematurity) regression analyses, accounting for differences in maternal and child risk factors, were performed. There was no significant association of proximity and density of UGD with prematurity. Comparison of the most to least exposed, however, revealed lower birth weight (3323 ± 558 vs 3344 ± 544 g) and a higher incidence of SGA (6.5 vs 4.8%, respectively; odds ratio: 1.34; 95% confidence interval: 1.10–1.63). While the clinical significance of the differences in birth weight among the exposure groups is unclear, the present findings further emphasize the need for larger studies, in regio-specific fashion, with more precise characterization of exposure over an extended period of time to evaluate the potential public health significance of UGD.

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Unconventional natural gas development uses horizontal drilling in conjunction with hydraulic fracturing to gain access to natural gas deposits which may be tightly held in shale deposits and unavailable to conventional vertical drilling operations. The intensive work required to extract this source of energy results in higher than usual numbers of vehicles involved, potential release of emissions from those vehicles in congested zones surrounding the drill site, and release of other contaminants from materials drawn back out of the borehole after fracturing of the shale. Typical contaminants would be diesel exhaust particulate and gases, volatile organic compounds and other hydrocarbons both from diesels and the drilling process, crystalline silica, used as part of the hydraulic fracturing process in kiloton quantities, and methane escaping from the borehole and piping. A rise in respiratory disease with proximity to the process has been reported in nearby communities and both silica and diesel exposures at the worksite are recognized respiratory hazards. Because of the relatively short time this process has been used to the extent it is currently being used, it is not possible to draw detailed conclusions about the respiratory hazards that may be posed. However, based on the traffic volume associated with each drill site and the number of drill sites in any locale, it is possible at least to compare the effects to that of large traffic volume highways which are known to produce some respiratory effects in surrounding areas.

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Pennsylvania sits atop the Marcellus Shale, a reservoir of natural gas that was untapped until the 2004 introduction of unconventional natural gas drilling operations (UNGDO) in the state. Colloquially known as fracking, UNGDO is a controversial process that employs large volumes of water to fracture the shale and capture gas; it has become a multi-billion dollar industry in Pennsylvania. We analyzed letters to the editor of the most widely circulated local newspaper in the most heavily drilled county in Pennsylvania (Bradford County) in order to characterize residents' concerns and their involvement in popular epidemiology-the process by which citizens investigate risks associated with a perceived environmental threat. We reviewed 215 letters to the editor that referenced natural gas operations and were published by The Daily Review between January 1, 2008 and June 8, 2013. We used NVivo 10 to code and analyze letters and identify major themes. Nvivo is qualitative data analysis software (http://www.qsrinternational.com/products_nvivo.aspx) that allows researchers to code and analyze "unstructured" data, including text files of any type (e.g., interview transcripts, news articles, letters, archival materials) as well as photographs and videos. Nvivo can be used to classify, sort, query, comment on, and share data across a research group. Letters demonstrated citizen engagement in beginning and intermediate stages of lay epidemiology, as well as discord and stress regarding four main issues: socio-economic impacts, perceived threats to water, population growth and implications, and changes to the rural landscape. Residents called for stronger scientific evidence and a balance of economic development and health and environmental protections. Citizens' distress regarding UNGDO appeared to be exacerbated by a dearth of information to guide economic growth and health, environmental, and social concerns. This analysis proposes locally informed questions to guide future surveillance and research.

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Modern forms of drilling and extraction have recently led to a boom in oil and gas production in the U.S. and stimulated a controversy around its economic benefits and environmental and human health impacts. Using an environmental justice paradigm this study applies Geographic Information Systems (GIS) and spatial analysis to determine whether certain vulnerable human populations are unequally exposed to pollution from unconventional gas wells in Pennsylvania, West Virginia, and Ohio. Several GIS-based approaches were used to identify exposed areas, and a t-test was used to find statistically significant differences between rural populations living close to wells and rural populations living farther away. Sociodemographic indicators include age (children and the elderly), poverty level, education level, and race at the census tract level. Local Indicators of Spatial Autocorrelation (LISA) technique was applied to find spatial clusters where both high well density and high proportions of vulnerable populations occur. The results demonstrate that the environmental injustice occurs in areas with unconventional wells in Pennsylvania with respect to the poor population. There are also localized clusters of vulnerable populations in exposed areas in all three states: Pennsylvania (for poverty and elderly population), West Virginia (for poverty, elderly population, and education level) and Ohio (for children).

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Hydraulic fracturing, also known as fracking, has been increasing exponentially across the United States, which holds the largest known shale gas reserves in the world. Studies have found that the high-volume horizontal hydraulic fracturing process (HVHFP) threatens water resources, harms air quality, changes landscapes, and damages ecosystems. However, there is minimal research focusing on the spatial study of environmental and human risks of HVHFP, which is necessary for state and federal governments to administer, regulate, and assess fracking. Integrating GIS and spatial kernel functions, we study the presently operating fracking wells across the state of Pennsylvania (PA), which is the main part of the current hottest Marcellus Shale in US. We geographically process the location data of hydraulic fracturing wells, 2010 census block data, urbanized region data, railway data, local road data, open water data, river data, and wetland data for the state of PA. From this we develop a distance based risk assessment in order to understand the environmental and urban risks. We generate the surface data of fracking well intensity and population intensity by integrating spatial dependence, semivariogram modeling, and a quadratic kernel function. The surface data of population risk generated by the division of fracking well intensity and population intensity provide a novel insight into the local and regional regulation of hydraulic fracturing activities in terms of environmental and health related risks due to the proximity of fracking wells.

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Benzene, toluene, ethylbenzene, and xylene (BTEX) are retrieved during fossil fuel extraction and used as solvents in consumer and industrial products, as gasoline additives, and as intermediates in the synthesis of organic compounds for many consumer products. Emissions from the combustion of gasoline and diesel fuels are the largest contributors to atmospheric BTEX concentrations. However, levels indoors (where people spend greater than 83% of their time) can be many times greater than outdoors. In this review we identified epidemiological studies assessing the noncancer health impacts of ambient level BTEX exposure (i.e., nonoccupational) and discussed how the health conditions may be hormonally mediated. Health effects significantly associated with ambient level exposure included sperm abnormalities, reduced fetal growth, cardiovascular disease, respiratory dysfunction, asthma, sensitization to common antigens, and more. Several hormones including estrogens, androgens, glucocorticoids, insulin, and serotonin may be involved in these health outcomes. This analysis suggests that all four chemicals may have endocrine disrupting properties at exposure levels below reference concentrations (i.e., safe levels) issued by the U.S. Environmental Protection Agency. These data should be considered when evaluating the use of BTEX in consumer and industrial products and indicates a need to change how chemicals present at low concentrations are assessed and regulated.

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Background: Radon is the second-leading cause of lung cancer worldwide. Most indoor exposure occurs by diffusion of soil gas. Radon is also found in well water, natural gas, and ambient air. Pennsylvania has high indoor radon concentrations; buildings are often tested during real estate transactions, with results reported to the Department of Environmental Protection (PADEP). Objectives: We evaluated predictors of indoor radon concentrations. Methods: Using first-floor and basement indoor radon results reported to the PADEP between 1987 and 2013, we evaluated associations of radon concentrations (natural log transformed) with geology, water source, building characteristics, season, weather, community socioeconomic status, community type, and unconventional natural gas development measures based on drilled and producing wells. Results: Primary analysis included 866,735 first measurements by building, with the large majority from homes. The geologic rock layer on which the building sat was strongly associated with radon concentration (e.g., Axemann Formation, median = 365 Bq/m3, IQR = 167–679 vs. Stockton Formation, median = 93 Bq/m3, IQR = 52–178). In adjusted analysis, buildings using well water had 21% higher concentrations (β = 0.191, 95% CI: 0.184, 0.198). Buildings in cities (vs. townships) had lower concentrations (β = –0.323, 95% CI: –0.333, –0.314). When we included multiple tests per building, concentrations declined with repeated measurements over time. Between 2005 and 2013, 7,469 unconventional wells were drilled in Pennsylvania. Basement radon concentrations fluctuated between 1987 and 2003, but began an upward trend from 2004 to 2012 in all county categories (p < 0.001), with higher levels in counties having ≥ 100 drilled wells versus counties with none, and with highest levels in the Reading Prong. Conclusions: Geologic unit, well water, community, weather, and unconventional natural gas development were associated with indoor radon concentrations. Future studies should include direct environmental measurement of radon, as well as building features unavailable for this analysis.

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Natural gas extraction, often referred to as "fracking," has increased rapidly in the U.S. in recent years. To address potential health impacts, passive air samplers were deployed in a rural community heavily affected by the natural gas boom. Samplers were analyzed for 62 polycyclic aromatic hydrocarbons (PAHs). Results were grouped based on distance from each sampler to the nearest active well. PAH levels were highest when samplers were closest to active wells. Additionally, PAH levels closest to natural gas activity were an order of magnitude higher than levels previously reported in rural areas. Sourcing ratios indicate that PAHs were predominantly petrogenic, suggesting that elevated PAH levels were influenced by direct releases from the earth. Quantitative human health risk assessment estimated the excess lifetime cancer risks associated with exposure to the measured PAHs. Closest to active wells, the risk estimated for maximum residential exposure was 2.9 in 10,000, which is above the U.S. EPA's acceptable risk level. Overall, risk estimates decreased 30% when comparing results from samplers closest to active wells to those farthest. This work suggests that natural gas extraction may be contributing significantly to PAHs in air, at levels that are relevant to human health.

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Public health concerns related to the expansion of unconventional oil and gas drilling have sparked intense debate. In 2012, we published case reports of animals and humans affected by nearby drilling operations. Because of the potential for long-term effects of even low doses of environmental toxicants and the cumulative impact of exposures of multiple chemicals by multiple routes of exposure, a longitudinal study of these cases is necessary. Twenty-one cases from five states were followed longitudinally; the follow-up period averaged 25 months. In addition to humans, cases involved food animals, companion animals and wildlife. More than half of all exposures were related to drilling and hydraulic fracturing operations; these decreased slightly over time. More than a third of all exposures were associated with wastewater, processing and production operations; these exposures increased slightly over time. Health impacts decreased for families and animals moving from intensively drilled areas or remaining in areas where drilling activity decreased. In cases of families remaining in the same area and for which drilling activity either remained the same or increased, no change in health impacts was observed. Over the course of the study, the distribution of symptoms was unchanged for humans and companion animals, but in food animals, reproductive problems decreased and both respiratory and growth problems increased. This longitudinal case study illustrates the importance of obtaining detailed epidemiological data on the long-term health effects of multiple chemical exposures and multiple routes of exposure that are characteristic of the environmental impacts of unconventional drilling operations.

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Natural gas extraction activities, including the use of horizontal drilling and hydraulic fracturing, may pose potential health risks to both human and animal populations in close proximity to sites of extraction activity. Because animals may have increased exposure to contaminated water and air as well as increased susceptibility to contaminant exposures compared to nearby humans, animal disease events in communities living near natural gas extraction may provide “sentinel” information useful for human health risk assessment. Community health evaluations as well as health impact assessments (HIAs) of natural gas exploration should therefore consider the inclusion of animal health metrics in their assessment process. We report on a community environmental health survey conducted in an area of active natural gas drilling, which included the collection of health data on 2452 companion and backyard animals residing in 157 randomly-selected households of Washington County, Pennsylvania (USA). There were a total of 127 reported health conditions, most commonly among dogs. When reports from all animals were considered, there were no significant associations between reported health condition and household proximity to natural gas wells. When dogs were analyzed separately, we found an elevated risk of ‘any’ reported health condition in households less than 1km from the nearest gas well (OR = 3.2, 95% CI 1.07–9.7), with dermal conditions being the most common of canine disorders. While these results should be considered hypothesis generating and preliminary, they suggest value in ongoing assessments of pet dogs as well as other animals to better elucidate the health impacts of natural gas extraction on nearby communities.

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Rapid global expansion of unconventional natural gas development (UNGD) raises environmental health concerns. Many studies present information on these concerns, yet the strength of epidemiological evidence remains tenuous. This paper is a review of the strength of evidence in scientific reporting of environmental hazards from UNGD activities associated with adverse human health outcomes. Studies were drawn from peer-reviewed and grey literature following a systematic search. Five databases were searched for studies published from January 1995 through March 2014 using key search terms relevant to environmental health. Studies were screened, ranked and then reviewed according to the strength of the evidence presented on adverse environmental health outcomes associated with UNGD. The initial searches yielded > 1000 studies, but this was reduced to 109 relevant studies after the ranking process. Only seven studies were considered highly relevant based on strength of evidence. Articles spanned several relevant topics, but most focussed on impacts on typical environmental media, such as water and air, with much of the health impacts inferred rather than evidenced. Additionally, the majority of studies focussed on short-term, rather than long-term, health impacts, which is expected considering the timeframe of UNGD; therefore, very few studies examined health outcomes with longer latencies such as cancer or developmental outcomes. Current scientific evidence for UNGD that demonstrates associations between adverse health outcomes directly with environmental health hazards resulting from UNGD activities generally lacks methodological rigour. Importantly, however, there is also no evidence to rule out such health impacts. While the current evidence in the scientific research reporting leaves questions unanswered about the actual environmental health impacts, public health concerns remain intense. This is a clear gap in the scientific knowledge that requires urgent attention.

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Objective Short-term exposure to ground-level ozone has been linked to adverse respiratory and other health effects; previous studies typically have focused on summer ground-level ozone in urban areas. During 2008–2011, Sublette County, Wyoming (population: ~10,000 persons), experienced periods of elevated ground-level ozone concentrations during the winter. This study sought to evaluate the association of daily ground-level ozone concentrations and health clinic visits for respiratory disease in this rural county. Methods Clinic visits for respiratory disease were ascertained from electronic billing records of the two clinics in Sublette County for January 1, 2008–December 31, 2011. A time-stratified case-crossover design, adjusted for temperature and humidity, was used to investigate associations between ground-level ozone concentrations measured at one station and clinic visits for a respiratory health concern by using an unconstrained distributed lag of 0–3 days and single-day lags of 0 day, 1 day, 2 days, and 3 days. Results The data set included 12,742 case-days and 43,285 selected control-days. The mean ground-level ozone observed was 47±8 ppb. The unconstrained distributed lag of 0–3 days was consistent with a null association (adjusted odds ratio [aOR]: 1.001; 95% confidence interval [CI]: 0.990–1.012); results for lags 0, 2, and 3 days were consistent with the null. However, the results for lag 1 were indicative of a positive association; for every 10-ppb increase in the 8-h maximum average ground-level ozone, a 3.0% increase in respiratory clinic visits the following day was observed (aOR: 1.031; 95% CI: 0.994–1.069). Season modified the adverse respiratory effects: ground-level ozone was significantly associated with respiratory clinic visits during the winter months. The patterns of results from all sensitivity analyzes were consistent with the a priori model. Conclusions The results demonstrate an association of increasing ground-level ozone with an increase in clinic visits for adverse respiratory-related effects in the following day (lag day 1) in Sublette County; the magnitude was strongest during the winter months; this association during the winter months in a rural location warrants further investigation.

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AbstractObjectives We examined the association between shale gas drilling and motor vehicle accident rates in Pennsylvania. Methods Using publicly available data on all reported vehicle crashes in Pennsylvania, we compared accident rates in counties with and without shale gas drilling, in periods with and without intermittent drilling (using data from 2005 to 2012). Counties with drilling were matched to non-drilling counties with similar population and traffic in the pre-drilling period. Results Heavily drilled counties in the north experienced 15–23% higher vehicle crash rates in 2010–2012 and 61–65% higher heavy truck crash rates in 2011–2012 than control counties. We estimated 5–23% increases in crash rates when comparing months with drilling and months without, but did not find significant effects on fatalities and major injury crashes. Heavily drilled counties in the southwest showed 45–47% higher rates of fatal and major injury crashes in 2012 than control counties, but monthly comparisons of drilling activity showed no significant differences associated with drilling. Conclusions Vehicle accidents have measurably increased in conjunction with shale gas drilling.

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Unconventional oil and gas (UOG) operations have the potential to increase air and water pollution in communities located near UOG operations. Every stage of UOG operation from well construction to extraction, operations, transportation, and distribution can lead to air and water contamination. Hundreds of chemicals are associated with the process of unconventional oil and natural gas production. In this work, we review the scientific literature providing evidence that adult and early life exposure to chemicals associated with UOG operations can result in adverse reproductive health and developmental effects in humans. Volatile organic compounds (VOCs) [including benzene, toluene, ethyl benzene, and xylene (BTEX) and formaldehyde] and heavy metals (including arsenic, cadmium and lead) are just a few of the known contributors to reduced air and water quality that pose a threat to human developmental and reproductive health. The developing fetus is particularly sensitive to environmental factors, which include air and water pollution. Research shows that there are critical windows of vulnerability during prenatal and early postnatal development, during which chemical exposures can cause potentially permanent damage to the growing embryo and fetus. Many of the air and water pollutants found near UOG operation sites are recognized as being developmental and reproductive toxicants; therefore there is a compelling need to increase our knowledge of the potential health consequences for adults, infants, and children from these chemicals through rapid and thorough health research investigation.

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Natural gas drilling sites employing hydraulic fracturing present a potential source of inhalation exposure to volatile organic compounds (VOCs) via the use of flowback pits. These open-air pits are used as a means of storing flowback water, a waste product of hydraulic fracturing, and represent an understudied source of VOC exposure for workers. The objective of this study was to assess this worker exposure and the resulting health risks for 12 VOCs present in flowback water stored in such an open reservoir on a drilling site. Flowback pit VOC mean, 2.5 percentile, and 97.5 percentile concentrations were used to model aqueous phase concentrations, and two models of volatilization were applied to estimate flux to the gas phase. A mass-balance approach was used to estimate gas phase concentrations that were, in turn, used to estimate worker exposure. A literature review was performed to determine VOC health effects, exposure limits, and worker protection methods. Neither model demonstrated an increased risk of adverse effects due to subchronic exposure at the 2.5 percentile and mean concentration values for the 12 VOCs as indicated by hazard quotients, hazard indices, or excess lifetime cancer risks; however, 97.5 percentile hazard indices approached 1 in one model and did demonstrate unacceptable risks in the evaluation of limitations. Either model may apply to worker health assessment depending upon industry practice; however, differing weather conditions, industry practice, and the small number of VOCs evaluated necessitate further research regarding worker risks and health effects. (C) 2014 Elsevier B.V. All rights reserved.

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Horizontal drilling, hydraulic fracturing, and other drilling and well stimulation technologies are now used widely in the United States and increasingly in other countries. They enable increases in oil and gas production, but there has been inadequate attention to human health impacts. Air quality near oil and gas operations is an underexplored human health concern for five reasons: (1) prior focus on threats to water quality; (2) an evolving understanding of contributions of certain oil and gas production processes to air quality; (3) limited state air quality monitoring networks; (4) significant variability in air emissions and concentrations; and (5) air quality research that misses impacts important to residents. Preliminary research suggests that volatile compounds, including hazardous air pollutants, are of potential concern. This study differs from prior research in its use of a community-based process to identify sampling locations. Through this approach, we determine concentrations of volatile compounds in air near operations that reflect community concerns and point to the need for more fine-grained and frequent monitoring at points along the production life cycle.

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Unconventional natural gas development (UNGD) using high-volume horizontal hydraulic fracturing (“fracking”) has vastly increased the potential for domestic natural gas production in recent years. However, the rapid expansion of UNGD has also raised concerns about its potential impacts on public health. Academics and government agencies are developing research programs to explore these concerns. Community involvement in activities such as planning, conducting, and communicating research is widely recognized as having an important role in promoting environmental health. Historically, however, communities most often engage in research after environmental health concerns have emerged. This community information needs assessment took a prospective approach to integrating community leaders’ knowledge, perceptions, and concerns into the research agenda prior to initiation of local UNGD. We interviewed community leaders about their views on environmental health information needs in three states (New York, North Carolina, and Ohio) prior to widespread UNGD. Interviewees emphasized the cumulative, long-term, and indirect determinants of health, as opposed to specific disease outcomes. Responses focused not only on information needs, but also on communication and transparency with respect to research processes and funding. Interviewees also prioritized investigation of policy approaches to effectively protect human health over the long term. Although universities were most often cited as a credible source of information, interviewees emphasized the need for multiple strategies for disseminating information. By including community leaders’ concerns, insights, and questions from the outset, the research agenda on UNGD is more likely to effectively inform decision making that ultimately protects public health.

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The rapid increase in unconventional natural gas (UNG) development in the United States during the past decade has brought wells and related infrastructure closer to population centers. This review evaluates risks to public health from chemical and nonchemical stressors associated with UNG, describes likely exposure pathways and potential health effects, and identifies major uncertainties to address with future research. The most important occupational stressors include mortality, exposure to hazardous materials and increased risk of industrial accidents. For communities near development and production sites the major stressors are air pollutants, ground and surface water contamination, truck traffic and noise pollution, accidents and malfunctions, and psychosocial stress associated with community change. Despite broad public concern, no comprehensive population-based studies of the public health effects of UNG operations exist. Major uncertainties are the unknown frequency and duration of human exposure, future extent of development, potential emission control and mitigation strategies, and a paucity of baseline data to enable substantive before and after comparisons for affected populations and environmental media. Overall, the current literature suggests that research needs to address these uncertainties before we can reasonably quantify the likelihood of occurrence or magnitude of adverse health effects associated with UNG production in workers and communities.

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“Fracking,” the common name for hydraulic fracturing is widely used to extract oil and gas, particularly from deep shale formations. A single well requires the use of millions of gallons of water and tons of sand. Air sampling results show that the majority of silica levels at hydraulic fracturing sites were above the Occupational Safety and Health Administration allowable standard and 84% were above Occupational Safety and Health Administration’s new proposed standard. These exposure levels put workers, particularly sand mover operators and T-belt operators who had the highest levels, at risk of silicosis and the other silica-related conditions of lung cancer, end-stage renal disease, chronic obstructive pulmonary disease, tuberculosis, and connective tissue disease. Because of the fracking industry’s demand for silica, sand mining has markedly increased, which has also increased the number of workers at risk of developing silicosis and other silica-related conditions in the mining industry. This paper reviews the parts of the country where health care providers should be most concerned about possible patients in their practice who are at risk from this newly recognized source of silica exposure and the appropriate medical testing to perform. However, given the long latency, 20 or more years, of most silica-related health conditions and the fact that fracking did not become widely used until the 2000s, it may be years before health care providers see clinical-related disease in their practices.

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Pennsylvania Marcellus Shale region residents have reported medical symptoms they believe are related to nearby Unconventional Natural Gas Development (UNGD). Associations between medical symptoms and UNGD have been minimally explored. The objective of this descriptive study is to explore whether shale region Pennsylvania residents perceive UNGD as a health concern and whether they attribute health symptoms to UNGD exposures. A questionnaire was administered to adult volunteers with medical complaints in a primary-care medical office in a county where UNGD was present. Participants were asked whether they were concerned about health effects from UNGD, and whether they attributed current symptoms to UNGD or to some other environmental exposure. There were 72 respondents; 22% perceived UNGD as a health concern and 13% attributed medical symptoms to UNGD exposures. Overall, 42% attributed one or more of their medical symptoms to environmental causes, of which UNGD was the most frequent. A medical record review conducted on six participants who attributed their medical symptoms to UNGD revealed that only one of these records documented both the symptoms in question and the attribution to UNGD. The results of this pilot study suggest that there is substantial concern about adverse health effects of UNGD among Pennsylvania Marcellus Shale residents, and that these concerns may not be adequately represented in medical records. Further efforts to determine the relationship between UNGD and health are recommended in order to address community concerns.

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The extraction of hydrocarbons from shale formations using horizontal drilling with high volume hydraulic fracturing (unconventional shale gas and tight oil extraction), while derived from methods that have been used for decades, is a relatively new innovation that was introduced first in the United States and has more recently spread worldwide. Although this has led to the availability of new sources of fossil fuels for domestic consumption and export, important issues have been raised concerning the safety of the process relative to public health, animal health, and our food supply. Because of the multiple toxicants used and generated, and because of the complexity of the drilling, hydraulic fracturing, and completion processes including associated infrastructure such as pipelines, compressor stations and processing plants, impacts on the health of humans and animals are difficult to assess definitively. We discuss here findings concerning the safety of unconventional oil and gas extraction from the perspectives of public health, veterinary medicine, and food safety.

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The use of natural gas that is obtained from high-volume hydraulic fracturing (fracking) may reduce carbon emissions relative to the use of coal and have substantial economic benefits for South Africa. However, concerns have been raised regarding the health and environmental impacts. The drilling and fracking processes use hundreds of chemicals as well as silica sand. Additional elements are either released from or formed in the shale during drilling. These substances can enter the environment in various ways: through failures in the well casing; via alternative underground pathways; as wastewater, spills and leaks on the wellpad; through transportation accidents; and as air pollution. Although many of these chemicals and elements have known adverse health effects, there is little evidence available on the health impacts of fracking. These health concerns have not yet been fully addressed in policy making, and the authors recommend that the voice of health professionals should be part of the public debate on fracking and that a full health impact assessment be required before companies are given the go-ahead to drill.

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Abstract Case study descriptions of acute onset of respiratory, neurologic, dermal, vascular, abdominal, and gastrointestinal sequelae near natural gas facilities contrast with a subset of emissions research, which suggests that there is limited risk posed by unconventional natural gas development (UNGD). An inspection of the pathophysiological effects of acute toxic actions reveals that current environmental monitoring protocols are incompatible with the goal of protecting the health of those living and working near UNGD activities. The intensity, frequency, and duration of exposures to toxic materials in air and water determine the health risks to individuals within a population. Currently, human health risks near UNGD sites are derived from average population risks without adequate attention to the processes of toxicity to the body. The objective of this paper is to illustrate that current methods of collecting emissions data, as well as the analyses of these data, are not sufficient for accurately assessing risks to individuals or protecting the health of those near UNGD sites. Focusing on air pollution impacts, we examined data from public sources and from the published literature. We compared the methods commonly used to evaluate health safety near UNGD sites with the information that would be reasonably needed to determine plausible outcomes of actual exposures. Such outcomes must be based on the pathophysiological effects of the agents present and the susceptibility of residents near these sites. Our study has several findings. First, current protocols used for assessing compliance with ambient air standards do not adequately determine the intensity, frequency or durations of the actual human exposures to the mixtures of toxic materials released regularly at UNGD sites. Second, the typically used periodic 24-h average measures can underestimate actual exposures by an order of magnitude. Third, reference standards are set in a form that inaccurately determines health risk because they do not fully consider the potential synergistic combinations of toxic air emissions. Finally, air dispersion modeling shows that local weather conditions are strong determinates of individual exposures. Appropriate estimation of safety requires nested protocols that measure real time exposures. New protocols are needed to provide 1) continuous measures of a surrogate compound to show periods of extreme exposure; 2) a continuous screening model based on local weather conditions to warn of periodic high exposures; and 3) comprehensive detection of chemical mixtures using canisters or other devices that capture the major components of the mixtures.

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Summary There is a push to increase production of unconventional gas in Australia, which would intensify the use of the controversial technique of hydraulic fracturing. The uncertainties surrounding the health implications of unconventional gas, when considered together with doubts surrounding its greenhouse gas profile and cost, weigh heavily against proceeding with proposed future developments. The health and environmental impacts of hydraulic fracturing have been the source of widespread public concern. A review of available literature shows a considerable degree of uncertainty, but an emerging consensus about the main risks. Gas is often claimed to be a less climate-damaging alternative to coal; however, this is called into question by the fugitive emissions produced by unconventional gas extraction and the consequences of its export. While the health effects associated with fracturing chemicals have attracted considerable public attention, risks posed by wastewater, community disruption and the interaction between exposures are of also of concern. The health burdens of unconventional gas are likely to fall disproportionately on rural communities, the young and the elderly. While the health and environmental risks and benefits must be compared with other energy choices, coal provides a poor benchmark.

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The oil and gas extraction industry is rapidly growing due to horizontal drilling and high volume hydraulic fracturing (HVHF). This growth has provided new jobs and economic stimulus. The industry occupational fatality rate is 2.5 times higher than the construction industry and 7 times higher than general industry; however injury rates are lower than the construction industry, suggesting injuries are not being reported. Some workers are exposed to crystalline silica at hazardous levels, above occupational health standards. Other hazards (particulate, benzene, noise, radiation) exist. In this article, we review occupational fatality and injury rate data; discuss research looking at root causes of fatal injuries and hazardous exposures; review interventions aimed at improving occupational health and safety; and discuss information gaps and areas of needed research. We also describe Wyoming efforts to improve occupational safety in this industry, as a case example. Am. J. Ind. Med. © 2014 Wiley Periodicals, Inc.

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The rapid rise in natural gas extraction using hydraulic fracturing increases the potential for contamination of surface and ground water from chemicals used throughout the process. Hundreds of products containing more than 750 chemicals and components are potentially used throughout the extraction process, including more than 100 known or suspected endocrine-disrupting chemicals. We hypothesized that a selected subset of chemicals used in natural gas drilling operations and also surface and ground water samples collected in a drilling-dense region of Garfield County, Colorado, would exhibit estrogen and androgen receptor activities. Water samples were collected, solid-phase extracted, and measured for estrogen and androgen receptor activities using reporter gene assays in human cell lines. Of the 39 unique water samples, 89%, 41%, 12%, and 46% exhibited estrogenic, antiestrogenic, androgenic, and antiandrogenic activities, respectively. Testing of a subset of natural gas drilling chemicals revealed novel antiestrogenic, novel antiandrogenic, and limited estrogenic activities. The Colorado River, the drainage basin for this region, exhibited moderate levels of estrogenic, antiestrogenic, and antiandrogenic activities, suggesting that higher localized activity at sites with known natural gas–related spills surrounding the river might be contributing to the multiple receptor activities observed in this water source. The majority of water samples collected from sites in a drilling-dense region of Colorado exhibited more estrogenic, antiestrogenic, or antiandrogenic activities than reference sites with limited nearby drilling operations. Our data suggest that natural gas drilling operations may result in elevated endocrine-disrupting chemical activity in surface and ground water., AffiliationsDepartment of Obstetrics, Gynecology and Women's Health and Division of Biological Sciences (C.D.K., A.M.H., S.C.N.), University of Missouri, Columbia, Missouri 65211; US Geological Survey (D.E.T.), Columbia Environmental Research Center, Columbia, Missouri 65201; and Departments of Statistics and Health Management and Informatics (J.W.D.), University of Missouri, Columbia, Missouri 65211

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Public health often deals with inconvenient truths. These are best communicated and acted on when public health agencies are independent of the organizations or individuals for whom the truths are inconvenient. The importance of public health independence is exemplified by the lack of involvement of the Pennsylvania Department of Health in responding to health concerns about shale gas drilling. Pennsylvania Department of Health involvement has been forestalled by the state governor, who has intensely supported shale gas development.

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High-volume horizontal hydraulic fracturing, a controversial new mining technique used to drill for shale gas, is being implemented worldwide. Chemicals used in the process are known neurotoxins, carcinogens, and endocrine disruptors. People who live near shale gas drilling sites report symptoms that they attribute to contaminated air and water. When they seek help from clinicians, a diagnosis is often elusive because the chemicals to which the patients have been exposed are a closely guarded trade secret. Many nurses have voiced grave concern about shale gas drilling safety. Full disclosure of the chemicals used in the process is necessary in order for nurses and other health professionals to effectively care for patients. The economic exuberance surrounding natural gas has resulted in insufficient scrutiny into the health implications. Nursing research aimed at determining what effect unconventional drilling has on human health could help fill that gap. Public health nurses using the precautionary principle should advocate for a more concerted transition from fossil fuels to sustainable energy. Any initiation or further expansion of unconventional gas drilling must be preceded by a comprehensive Health Impact Assessment (HIA).

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This report describes a previously uncharacterized occupational health hazard: work crew exposures to respirable crystalline silica during hydraulic fracturing. Hydraulic fracturing involves high pressure injection of large volumes of water and sand, and smaller quantities of well treatment chemicals, into a gas or oil well to fracture shale or other rock formations, allowing more efficient recovery of hydrocarbons from a petroleum-bearing reservoir. Crystalline silica (“frac sand”) is commonly used as a proppant to hold open cracks and fissures created by hydraulic pressure. Each stage of the process requires hundreds of thousands of pounds of quartz-containing sand; millions of pounds may be needed for all zones of a well. Mechanical handling of frac sand creates respirable crystalline silica dust, a potential exposure hazard for workers. Researchers at the National Institute for Occupational Safety and Health collected 111 personal breathing zone samples at 11 sites in five states to evaluate worker exposures to respirable crystalline silica during hydraulic fracturing. At each of the 11 sites, full-shift samples exceeded occupational health criteria (e.g., the Occupational Safety and Health Administration calculated permissible exposure limit, the NIOSH recommended exposure limit, or the ACGIH threshold limit value), in some cases, by 10 or more times the occupational health criteria. Based on these evaluations, an occupational health hazard was determined to exist for workplace exposures to crystalline silica. Seven points of dust generation were identified, including sand handling machinery and dust generated from the work site itself. Recommendations to control exposures include product substitution (when feasible), engineering controls or modifications to sand handling machinery, administrative controls, and use of personal protective equipment. To our knowledge, this represents the first systematic study of work crew exposures to crystalline silica during hydraulic fracturing. Companies that conduct hydraulic fracturing using silica sand should evaluate their operations to determine the potential for worker exposure to respirable crystalline silica and implement controls as necessary to protect workers. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a file containing controls and recommendations to limit worker exposures to respirable crystalline silica at hydraulic fracturing work sites.]

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OBJECTIVE: Evaluate whether childhood cancer incidence is associated with counties with hydraulic fracturing (HF). METHODS: We compared cancer incidence in children in Pennsylvania counties before and after HF drilling began, using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). RESULTS: The total number of cancers observed was close to expected both before drilling began (SIR = 0.94; 95% CI, 0.90 to 0.99) and after drilling (SIR = 1.02; 95% CI, 0.98 to 1.07) for counties with oil and natural gas wells. Analyses for childhood leukemia were also unremarkable (SIR for leukemia before drilling = 0.97 [95% CI, 0.88 to 1.06]; SIR for leukemia after drilling = 1.01 [95% CI, 0.92 to 1.11]). A slightly elevated SIR was found for central nervous system tumors after drilling (SIR = 1.13; 95% CI, 1.02 to 1.25). This was because of a slight excess in those counties with the fewest number of wells. CONCLUSIONS: This study offers comfort concerning health effects of HF on childhood cancers.

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The development of natural gas wells is rapidly increasing, yet little is known about associated exposures and potential public health consequences. We used health impact assessment (HIA) to provide decision-makers with information to promote public health at a time of rapid decision making for natural gas development. We have reported that natural gas development may expose local residents to air and water contamination, industrial noise and traffic, and community changes. We have provided more than 90 recommendations for preventing or decreasing health impacts associated with these exposures. We also have reflected on the lessons learned from conducting an HIA in a politically charged environment. Finally, we have demonstrated that despite the challenges, HIA can successfully enhance public health policymaking.

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The ethnographer's toolbox has within it a variety of methods for describing and analyzing the everyday lives of human beings that can be useful to public health practitioners and policymakers. These methods can be employed to uncover information on some of the harder-to-monitor psychological, sociocultural, and environmental factors that may lead to chronic stress in individuals and communities. In addition, because most ethnographic research studies involve deep and long-term engagement with local communities, the information collected by ethnographic researchers can be useful in tracking long- and short-term changes in overall well-being and health. Set within an environmental justice framework, this article uses examples from ongoing ethnographic fieldwork in the Marcellus Shale gas fields of Pennsylvania to describe and justify using an ethnographic approach to monitor the psychological and sociocultural determinants of community health as they relate to unconventional oil and gas development projects in the United States.

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Across the United States, the race for new energy sources is picking up speed and reaching more places, with natural gas in the lead. While the toxic and polluting qualities of substances used and produced in shale gas development and the general health effects of exposure are well established, scientific evidence of causal links has been limited, creating an urgent need to understand health impacts. Self-reported survey research documenting the symptoms experienced by people living in proximity to gas facilities, coupled with environmental testing, can elucidate plausible links that warrant both response and further investigation. This method, recently applied to the gas development areas of Pennsylvania, indicates the need for a range of policy and research efforts to safeguard public health.

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The introduction of natural gas drilling with high-volume hydraulic fracturing to Pennsylvania and neighboring states since 2004 has been accompanied by numerous reports of varied symptoms and illnesses by those living near these operations. Pollutants with established toxic effects in humans may be introduced into the environment at various points during gas extraction and processing. Some community residents, as well as employees of the natural gas industry, believe that their health has deteriorated as a result of these operations and have sought medical care from local practitioners, who may have limited access to immediate toxicological consultations. This article reviews taking an environmental exposure history in the context of natural gas activities, underscoring the importance of thorough and guided history-taking in the discovery of environmental exposure clusters. It also highlights the critical need for funding, research, and peer-reviewed studies to help generate the body of evidence that is needed by practitioners.

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High-volume horizontal hydraulic fracturing (HVHF) in unconventional gas reserves has vastly increased the potential for domestic natural gas production. HVHF has been promoted as a way to decrease dependence on foreign energy sources, replace dirtier energy sources like coal, and generate economic development. At the same time, activities related to expanded HVHF pose potential risks including ground- and surface water contamination, climate change, air pollution, and effects on worker health. HVHF has been largely approached as an issue of energy economics and environmental regulation, but it also has significant implications for public health. We argue that public health provides an important perspective on policymaking in this arena. The American Public Health Association (APHA) recently adopted a policy position for involvement of public health professionals in this issue. Building on that foundation, this commentary lays out a set of five perspectives that guide how public health can contribute to this conversation.

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Introduction: Concerns for health and social impacts have arisen as a result of Marcellus Shale unconventional natural gas development. Our goal was to document the self-reported health impacts and mental and physical health stressors perceived to result from Marcellus Shale development. Methods: Two sets of interviews were conducted with a convenience sample of community members living proximal to Marcellus Shale development, session 1 March–September 2010 (n=33) and session 2 January–April 2012 (n=20). Symptoms of health impacts and sources of psychological stress were coded. Symptom and stressor counts were quantified for each interview. The counts for each participant were compared longitudinally. Results: Participants attributed 59 unique health impacts and 13 stressors to Marcellus Shale development. Stress was the most frequently-reported symptom. Over time, perceived health impacts increased (P=0.042), while stressors remained constant (P=0.855). Discussion: Exposure-based epidemiological studies are needed to address identified health impacts and those that may develop as unconventional natural gas extraction continues. Many of the stressors can be addressed immediately.

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High-volume horizontal hydraulic fracturing of shale formations has the potential to make natural gas a significant, economical energy source, but the potential for harm to human health is often dismissed by proponents of this method. While adverse health outcomes of medical conditions with long latency periods will not be evident for years and will depend on the exposure, duration of exposure, dose, and other factors, we argue that it would be prudent to begin to track and monitor trends in the incidence and prevalence of diseases that already have been shown to be influenced by environmental agents. The dirty downside of modern, unconventional natural gas development, as well as the potential for harm, is discussed.