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Welcome to PSR's Environmental Health Policy Institute, where we ask questions -- then we ask the experts to answer them. Join us as physicians, health professionals, and environmental health experts share their ideas, inspiration, and analysis about toxic chemicals and environmental health policy.

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Unconventional Natural Gas Development: Exposure Symptoms in Southwestern Pennsylvania

By Beth Weinberger, PhD; Raina Rippel; and Celia Lewis, PhD

The Southwest Pennsylvania Environmental Health Project (EHP) is a nonprofit environmental health organization created to assist and support Washington County residents who believe their health has been, or could be, impacted by natural gas drilling activities.  Our mission is to respond to individuals’ and communities’ need for access to accurate, timely and trusted public health information and health services associated with natural gas extraction.

Unconventional natural gas development includes all stages of natural gas extraction:  the creation of a well site; the drilling of the well; the trucking in and out of water and chemicals; the fracking (fracturing) of the shale thousands of feet underground; the recovery of a portion of the fluid that comes back up (flowback); the storage of that fluid which includes chemicals added before the fracking as well as other material from within the shale; the on-going capture of natural gas; the processing of that gas through compressor stations and processing stations; and the use of pipelines to move the gas from the initial phase to the end user.

Array of Symptoms

In both home and office visits, EHP’s nurse practitioner sees residents of southwest Pennsylvania who have an array of health concerns which could plausibly be explained by exposure to pollutants and other impacts from natural gas activities. These health effects are consistent with medical and toxicological literature.  Many, if not all, are symptoms consistently reported across the country by people living in close proximity to unconventional natural gas development (UNGD).  Neither the individuals nor their physicians typically know what to do about these health effects. 

The most common symptoms documented by our nurse practitioner include skin rash or irritation, nausea, abdominal pain, and respiratory difficulties including nasal irritation, shortness of breath, difficulty breathing, and coughs.  Our nurse practitioner has also met with people who report headaches and dizziness, nausea, and eye and throat irritation. In addition to these, researchers in other parts of the country report increased fatigue, joint pain, muscle aches and weakness, among others, in people exposed to UNGD. 

An additional consequence of shale gas activity that is less tangible is the toll these operations take on residents’ mental health.  The sense of powerlessness and constant worry that residents experience is hard to overstate.  In addition to concerns about their health and the health of their families, people who are living amid drill pads, compressors or gas processing stations can feel under assault by an industry that does not take into account the public health implications of its activities.  Compounding this problem, at least in the case of Pennsylvania, many residents find that their health is not being adequately protected by state and local officials. 

The impact of the health risks or onset of medical conditions; the evident pollution; the often disrespectful treatment they receive; and the paucity of trusted information and support leave many residents depressed, anxious, and exhausted.  This in turn can affect their roles as employees, parents, spouses, and community members.  Over and above physical exposures, depression and anxiety over time can also contribute to the onset of medical problems or make existing problems worse.

Animal Deaths

Although EHP’s primary concern is with human health, it is worth noting that people are reporting to us, and to researchers elsewhere, illness, reproductive anomalies, and deaths of animals which are plausibly related to UNGD.  Residents have told us about unexplained illnesses and deaths of dogs, goats, and at least one horse; spontaneous abortions and stillborn animals; and animals with skin irritations, rashes, hair loss and vomiting.  With reproductive cycles much shorter in animals than humans and with their greater exposure to outdoor air, ponds, streams and puddles, animals serve as sentinels, and we believe their health effects may be a harbinger of human illnesses to come.    

When EHP began its project in 2011, based on the available information on gas extraction activities and their emissions, we thought that water would be the exposure pathway of highest concern and perhaps our central focus.  But while contaminated water poses significant risks, we have come to understand that air pollution is a major contributor to illnesses associated with UNGD.  If one has the resources (and many do not), he or she can reduce well water exposures by drinking and cooking with bottled water. In cases of suspected contamination, industry sometimes provides “water buffalos” to store water for household use.  Short of relocating altogether, however, it is difficult to buy one’s way out of polluted air.  We at EHP have turned our attention to understanding what may be in the air and how residents in the area might gain at least some control over their air exposures by using an in-house air filter and by using weather patterns to determine the flow of pollution.  There is, unfortunately, no fail-safe solution.  

Both contaminated water and contaminated air pose extreme challenges to public health professionals and health care providers.  First, companies in the gas extraction business are not compelled to reveal all the chemicals they use nor the amounts of those that they do report.  Second, the combinations of chemicals used may very well be unique and their reactions and synergistic effects on human health unknown.  Lastly, many if not most of the chemicals do not normally make their way to a general population.  These chemicals were often seen historically in industrial settings, and exposures to workers can more easily be calculated. 

‘No Fence Line’

With UNGD, essentially, there is no fence line—this is not a well-understood situation as found in Superfund sites in the past, or as related to industrial worker exposures. Given minimal distance between natural gas industrial activity and residential neighborhoods or farms, people are being exposed to chemicals of unknown type and combination, possibly in lower doses than in a traditional industrial setting, but in many cases chronically, and with incomplete information to pass along to healthcare providers.  Furthermore, standards that do exist for chemicals that are discharged into the air and water are often not health-protective and usually don’t take into consideration that pregnant women, infants and children, and other vulnerable populations are being exposed. Exposure standards are most often based on a healthy adult male, as would be associated with more typical worker exposures.

At present it appears that UNGD will be with us for a long while. We firmly believe it is time to move beyond the debate on whether standard operating procedures and/or accidents are causing medical problems.  Efforts must focus on the protection and improvement of public health. To that end, EHP has made the following recommendations to members of the Pennsylvania House of Representatives: a statewide registry of health symptoms plausibly linked to UNGD; a more active Department of Health which could provide information and training for health professionals; quick and full access for health care providers to knowledge of the chemical components of fracking and related processes; and an increase in objective research and analyses of exposures and health impacts.

UNGD is spreading quickly into neighborhoods, farms and towns in many parts of the country and, as we are witnessing in southwestern Pennsylvania, impacts can be acute or chronic and extremely stressful for individuals and communities.  EHP knows there is an imperative need for the medical community to fully address the health impacts from UNGD today, here and now.

Comments

Karen Glaub said ..

Interesting read. I hadn't thought about the animals being the first to react to air pollutants but it makes sense that they would. I can't understand why people are so reluctant to protect our air.

August 23, 2013

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