Leading up to Tuesday evening’s big reveal by University of Pittsburgh researchers and the Pennsylvania Department of Health on the results of three long-awaited health studies regarding shale gas development (fracking) and asthma, poor birth outcomes, and rare pediatric cancers, I warned readers of The PediaBlog not to expect any earthshaking findings. It turns out, I was wrong.
Fracking is the predominant method of extracting oil and gas locked in shale formations deep underground. After the well pad is built (well preparation) and the wells are drilled, hydraulically fractured, and completed (operations that can take several months), the well produces gas that returns to the surface over the next several years and decades (production), where it is used to generate electricity and heat, and to manufacture materials and products (plastics and petrochemicals). Huge volumes of fresh and recycled water, toxic chemicals (dozens of which are known human carcinogens), and sand are required to drill and frack an unconventional gas well and keep the cracks in the shale open. What returns to the surface initially (completion) is a large volume of the water that was pushed down the well to fracture the shale (salty and corrosive brine), the toxic chemicals just described, and water-soluble radioactive isotopes like radium 226, which has a half-life of 1,600 years.
In a press release issued after Tuesday evening’s event, several community and health organizations described what’s at stake for Pennsylvanians living near fracking operations:
Residents living near shale gas development experience a range of health impacts. These impacts include a higher risk of:
Respiratory problems like asthma, chronic bronchitis, and reduced lung function
Headaches, dizziness, skin rashes, and nausea
Hospitalization from heart-related complications
Cancers, particularly in those who are exposed over a long period of time
Preterm births, low birth weights, and birth defects in fetuses
Mental health issues from noise and light pollution and the associated stress of industry
“Approximately 1.5 million Pennsylvanians live within a half mile of oil and gas wells,” said Erica Jackson, manager of community outreach and support at FracTracker Alliance. “That number increases if you include those living near fracking waste treatment sites, making this a critical concern for communities across the state.”
Dozens of peer-reviewed, epidemiological health studies appear in the fracking science Compendium (now in its 8th edition from Concerned Health Professionals of New York and Physicians for Social Responsibility) along with more than 2,000 scientific studies, government reports, and media investigations showing harm to the health of people and other biological creatures, the environment, and Earth’s climate system. The three new health studies from Pitt were conducted in an 8-county area of southwestern Pennsylvania (Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Washington and Westmoreland) and they build on the mountain of evidence already revealed showing that fracking is dangerous to the health and safety of people living nearby.
The biggest bombshell of the evening came out of the asthma study (read the one-page summary and the full report for each study here):
We learned that there was a strong link between the production phase of unconventional natural gas development and severe exacerbations, emergency department visits and hospitalizations for asthma in people living within 10 miles of one or more wells producing natural gas. Specifically, people with asthma have a 4 to 5 times greater chance of having an asthma attack if they live near unconventional natural gas development wells during the production phase. We did not find such a link during the well preparation, drilling, or hydraulic fracturing phases.
Asthma is a very serious disease. A lot of people — children, teenagers, and adults young and old — suffer from asthma, which is a condition that can cause a lifetime of scary breathing problems, high medical bills, missed school and work, lost income opportunities, anxiety, additional health problems, and, in some cases, premature death.
This study shows that people living within 10 miles (10 miles!) of a fracked gas well had a much higher risk (4-5 times) of having an asthma exacerbation that was more likely to be severe and require a visit to an emergency room or a hospital bed compared with people living more than 10 miles away. When you are done reading that last sentence again, remember that in Washington County, PA, no one lives more than 10 miles from a fracked gas well or other major fracking site (pipeline, compressor station, gas processing facility) that leaks, spills, or belches pollution. Every resident of the county, therefore, is potentially at risk for developing and suffering from asthma.
The results also showed that increased asthma risk was closely associated with the final, production phase of fracking. While earlier phases (well preparation, drilling, and fracking) also emit chemicals and pollution, they also take a much shorter time to complete (weeks to months) compared with production, which lasts for years to decades. As the trend in Pennsylvania continues and more fracked wells are built, drilled, fracked and go into production, the risk to health in places like Washington County will persist and worsen for many years to come.
The second bombshell of the evening came from the cancer study:
Results indicated that children who lived within 1 mile of one or more wells had approximately 5 to 7 times the chance of developing lymphoma, a relatively rare type of cancer, compared to children who lived in an area without wells within 5 miles. Data suggest that those who lived closer to greater intensity of unconventional natural gas development activities had the highest risk.
The researchers were interested in finding out whether four rare cancers seen in young people were more common near fracking sites. While they found no correlation between proximity and leukemia, central nervous system tumors, and bone tumors (including Ewing sarcoma), learning that children, teenagers, and young adults living within 1 mile of one or more gas wells had a much greater risk of developing lymphoma was jarring. In reality, many families in Pennsylvania live much closer than 1 mile to shale gas wells; the legal setback distance from an unconventional well to a residence is only 500 feet. The increased lymphoma risk was observed at more than 10 times that distance!
Washington County is home to nearly 2,000 “active” shale gas wells, more than any other county in Pennsylvania. Many residents and families live within a mile of a producing well. Even if Pitt’s study found no evidence linking fracking to leukemia (as another recent study did) or Ewing sarcoma, the finding about lymphoma risk was unsettling to me and I’m sure other pediatricians living and working in southwestern Pennsylvania and other areas of the country where fracking operates. As shale gas development continues to expand throughout the county and state, more Pennsylvania parents may be at risk for receiving this terrible diagnosis in their children.
The results looking at birth outcomes were consistent with previous studies done in Pennsylvania. The researchers found that pregnant mothers living near fracking sites have a higher risk of delivering babies who are small for gestation age (SGA) and have lower than average birth weights (LBW). It’s important to note that both diagnoses — SGA and LBW — can have significant clinical consequence that last a lifetime.
The researchers also noticed this important finding that applies to all areas in southwestern Pennsylvania dealing with poor air quality on a regular basis:
Finally, the chance of being born prematurely was not specifically associated with unconventional natural gas development, but high levels of particulate air pollution from any source were associated with being born prematurely, consistent with previous studies from other researchers.
After the current round of studies from the University of Pittsburgh are consumed and digested by anxious residents, including parents, patients, and doctors, more studies will be suggested. But there is now abundant evidence — some of it known beyond a reasonable doubt and some of it correlated after careful, objective epidemiological research — that people who live near fracking sites in Pennsylvania are at higher risk for developing a multitude of health problems compared to Pennsylvanians who don’t live nearby. There is no need to wait (or time to waste) for even more corroborating evidence to appear before health protective policies are adopted by the governor, leaders in the state legislature, and Pennsylvania’s regulatory agencies.
In 2020, a Grand Jury convened by then-Attorney General Shapiro developed eight recommendations that could be acted on quickly to protect the public’s health. Without delay, and along with other recommendations from community and public health organizations, here is a good place to start:
Increase setback distances from homes and businesses to at least 2,500 feet (currently it is 500 feet) and further from vulnerable populations (eg. child care centers, schools, hospitals, nursing homes). These studies and others suggest that even 2,500 feet is too close; 1 mile (5,280 feet) wouldn’t be unreasonable considering Pitt’s lymphoma finding and Yale’s leukemia finding last year, while the fallout from the asthma bombshell screams for an even larger setback.
Companies should disclose all the chemicals they use to drill and frack gas wells. This will benefit doctors, patients, researchers, first responders, and community residents who can take specific actions to avoid exposures.
Consider the health impacts from the cumulative emissions from all fracking infrastructure in an area in order to assess risks and guide permitting decisions.
Stop ignoring the toxic and radioactive waste stream generated by fracking.
Develop and implement educational programs intended for doctors, nurses, therapists, hospitals, and health systems who lack training and resources to address environmental health problems like fracking in patients seeking care and advice.
Tuesday’s public meeting received intensive coverage from local, national, and global media outlets. Read some examples here, here, here, here, here, and here, and watch a recorded video of the event here. (My comments begin at 53:50.)
Previously published on The Pediablog - Dr. Ketyer is the social media medical advisor for AHN Pediatrics and editor of The Pediablog. He is also a member of the American Academy of Pediatrics Council on Environmental Health and Climate Change, medical advisor for Environmental Health Project, president of Physicians for Social Responsibility Pennsylvania, and Education and Outreach Workgroup chair for Cancer & Environment Network of Southwestern Pennsylvania. Dr. Ketyer served on the University of Pittsburgh’s External Advisory Board for the three studies, from June 2021 until his resignation from the board in October 2022.