Health and Hydrofracking Katrina Smith Korfmacher, PhD Department of Environmental Medicine University of Rochester

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Health and HydrofrackingKatrina Smith
Korfmacher, PhDDepartment of Environmental
MedicineUniversity of Rochester
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Current engagement in issue

• Local networking re information/education
• National COEC network/UPenn network
• 3-state Information Needs Assessment
• OH, NC, NY
• 45 interviewees
• Perspectives on information sources, health
  issues, and research needs
• Local health dept. capacity building

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Goals

• (How) can public health professionals,
  researchers, and perspectives help?
• NOT to describe health effects or concerns

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What is the evidence on health effects of
hydrofracking?

• Depends on
• What is hydrofracking?
• What is a health effect?
• What counts as evidence?

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1What is hydrofracking?

• Industrial practice of injecting fluids into
  shale
• All activities at well site (drilling, fracking,
  flaring, storage of water/chemicals)
• Physical processes associated with unconventional
  shale gas extraction (trucks, compressor
  stations, pipelines)
• Changes in communities and economies resulting
  from shale gas development

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Horizontal hydraulic hydrofracturing. Courtesy
www.propublica.org/special/hydraulic-fracturing
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Filling a hydrofracturing reservoir. Courtesy of
www.shaleshock.org
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Photo (c) 2010, Sally S. Howard
A Hydrofracking Tank on double tractor trailer
Rt 15 near Trout Run, PA Nov, 2010
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Oct 1, 2009 about 20 miles south of Elmira, NY
and 35 miles north of Williamsport, PA. Total
disturbed area 105.1 acres. The reservoir holds
14,841,128 gallons of hydrofracking flowback
water. The tan area near B is being cleared for
a 8,515,651 gallon reservoir. Water for the site
will be withdrawn from the Fallbrook and Fellows
Creeks. A wetland exists immediately south of
this site the effects are unknown. Courtesy of
www.PaForestCoalition.org
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2. What is a health effect?

• Health impacts/symptoms directly caused by
  hydrofracking
• Changes in incidence of disease associated with
  increased hydrofracking
• Changes in environmental quality or animal health
  that could affect humans
• Well-being/quality of life (stress, conflict,
  wealth, sense of belonging/community)

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Worker health and safety

• Exposure occupational
• Typical industrial/mechanical injuries (falls,
  accidents)
• Chemical burns/exposures
• Air emissions
• Silica sand

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Surface water and health

• Exposure fish/game consumption, air, contact
  recreation, farm animals
• Fracking chemicals/flowback water
• Spills
• Waste water disposal
• Changes in water quantity/flow displacing other
  uses (agriculture, wildlife, etc.)

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Ground water and health

• Exposure private drinking water wells
• Methane
• Fracking chemicals
• NORM (Naturally Occurring Radioactive Materials)
• Naturally occurring heavy metals
• Chemical interactions

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Air quality and health

• Exposure inhaled by workers, neighbors, regional
  communities
• Diesel engines (trucks, compressors, etc.)
  particulates, ozone precursors
• Fugitive emissions from wells
• Evaporation from storage ponds
• Aggregate/cumulative impacts (18 of ozone due to
  gas development by 2020)

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Climate change and health

• Health effects of heat
• Indirect impacts through
• Flooding/drought
• Insects
• Agriculture
• Air quality

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(No Transcript)
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Disasters, accidents and health

• Flooding may wash chemicals into local
  waters/contaminate soil
• Earthquakes associated with injection wells
• Explosions/spills may cause injury or contaminate
  environment

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Community health

• Noise and light pollution
• Stress and mental health (environmental concerns,
  economic change, conflict)
• Population/community change (workers)
• Impacts on health services (visits to emergency
  room, disaster/spill response, new disease
  concerns)
• Increased housing costs/demand
• Benefits from improved economy

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3 What counts as evidence?

• Stories/reports from affected citizens, health
  care providers, or organizations
• Newspaper articles
• Evidence of past impact?
• Predictions of future impacts?
• Government agency reports
• Peer-reviewed publications

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Does uncertainty trump knowledge?

• What will be the extent of drilling, where, over
  what time?
• What engineering practices, control systems, and
  mitigation will be used?
• What chemicals are used, released, how much,
  where, when?
• What are the health effects of exposures?
• Accidents, spills, natural disasters

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Can decisions be science-based despite
uncertainty?

• More research is needed
• Precautionary principle
• Regulate, monitor and manage
• Pilot test (adaptive management)
• Uncertainty will persist
• Latency of health impacts
• Variation in geography/technology
• Long-term processes
• Unpredictable events

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Perspectives of public health

• Prevention
• Risk management
• Co-benefits
• Economic impacts
• Ethical issues

H. Frumkin et al., "Climate Change The Public
Health Response," American Journal of Public
Health 98 (3) (2008) 435-445
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Prevention

• Baseline monitoring of environmental and human
  health
• Modeling cumulative impacts
• Ongoing monitoring and adaptation
• Emergency preparedness planning

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Risk Management

• Systematically identifying, assessing, and
  mitigating multiple risks
• Life cycle analysis
• Health Impact Assessment (HIA)

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A special note on HIA

• NOT science or research
• Applying existing health knowledge to non-health
  decisions
• Process
• Scoping key health issues
• Assessing using existing quantitative and
  qualitative data
• Involves stakeholders
• Makes recommendations to decision makers
• www.healthimpactproject.org

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Co-benefits

• Increased environmental/health monitoring
• Develop GIS/analysis capacity
• Forge new community partnerships
• Emergency response capacity/training

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Economic impacts

• Timing matters (net present value)
• Prevention pays
• Distribution of costs/benefits affects health
  (see ethics)
• Cost effectiveness includes internalizing
  external (and future) costs

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Ethics

• Reducing health disparities
• Environmental justice
• Focus on vulnerable populations (children,
  asthmatics, pregnant women, etc.)
• Public participation/community based research
• Implications of long latency / intergenerational
  effects for equity

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Tapping into public health

• Beyond environment versus economics
• Public health professionals as a resource
• Communication networks
• Access to health data/analysis
• Local monitoring/management
• Body of experience includes
• Disaster response (Gulf Oil, flooding)
• Emerging disease
• Surveillance/epidemiology

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American Public Health Association

• The public health perspective has been
  inadequately represented in policy processes
  related to HVHF. Policies that anticipate
  potential public health threats, require greater
  transparency, use a precautionary approach in the
  face of uncertainty, and provide for monitoring
  and adaptation as understanding of risks
  increases may significantly reduce negative
  public health impacts of this approach to natural
  gas extraction.
• Policy statement 20125 The Environmental and
  Occupational Health Impacts of High-Volume
  Hydraulic Fracturing of Unconventional Gas
  Reserves is publicly available in the APHA
  policy statement database. Here is the direct
  link http//www.apha.org/advocacy/policy/policyse
  arch/default.htm?id1439

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Public health resources

• Health care providers (doctors, nurses)
• Health interest groups (APHA, ANHE, HSA,
  communities, insurance agencies)
• Local health departments (NACCHO)
• State/federal agencies (DOH, CDC)
• Medical associations
• Academics (epidemiology, toxicology, health
  behavior/education)
• Foundations and funders

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Horizontal Hydrofracturing Rig, November 2009 in
Moreland, PA. Wikipedia Commons photo by
Ruhrfisch