Frequently Asked Questions for Health Professionals
What support can I get from EHP?
EHP has tools, services, and information related to shale gas development available to you and your patients or clients.
EHP can provide you with a Health Professional Toolkit. This toolkit includes a proposed case definition, a survey of patients for potential exposure, the Agency for Toxic Substance and Disease Registry (ATSDR) Exposure History form, and a toxicology sheet that lists some of the chemicals known to be emitted from shale gas development and related acute and chronic symptoms.
If you think your patients or clients may be impacted by shale gas development, you can refer them to EHP for home and health assessments which are specifically designed to determine if there are shale gas exposures. EHP can then further advise your patients or clients on how best to minimize their exposure within the home and advise them in monitoring their air and water (if well water). EHP can provide you with pamphlets for your patients or clients with advice on limiting exposure and tracking symptoms: Protecting Your Health from SGD and Tips for Talking to Your Provider.
EHP has other tools which are also available to you:
Access to current research and news related to shale gas and public health
How do I know if shale gas development may be impacting my patients or clients?
Know their zip codes.
With environmental exposure, proximity matters. You can determine how close your patients or clients live to shale gas development with tools available from both the DEP Oil and Gas maps (DEPMAPS) and FracTracker maps (FTMAPS). Read FracTracker's tool instructions here. Both sites allow you to measure the distance between two points. If you know your patients’ and clients' addresses, you can see what infrastructure is located near where they live, work, go to school, or play.
These maps do not show all gas-related infrastructure but do show wells and most compressor stations and processing plants. Other infrastructure like pig launching stations and metering stations are not shown. FracTracker has a separate map showing where gas storage wells are in the PA, OH, and WV tri-state area, as well as a national map that displays known pipelines and an abundance of other related information.
Exposures can happen where your patients or clients spend a significant amount of time. So if you suspect environmental exposure as the cause of symptoms, you may need to explore what infrastructure is near where they spend time.
What acute and chronic impacts are seen in impacted populations?
In 2017, EHP published Health Symptoms in Residents Living Near Shale Gas Activity in Preventive Medicine Reports which addresses acute symptoms, such as: headache, throat irritation, stress/anxiety, cough, and shortness of breath, to name a few. The symptoms that EHP has documented in our client population are supported by a growing body of scientific literature.
Chronic symptoms require a certain period of lag time to develop and affect enough in a population to attribute it to a particular source. A complication with shale gas development is the number of toxic chemicals in use, the uncertainty of what they do in combination, and the variability in dosage across populations. Some studies are beginning to show correlations, but it will take time to get a full assessment of impacts.
Many studies can be found in the Compendium of Scientific, Medical, and Media Findings Demonstrating Risks and Harms of Fracking (Unconventional Gas and Oil Extraction), which is in its 5th edition, updated in March 2018.
Studies can be accessed in Physicians, Scientists, and Engineers for Healthy Energy’s (PSE) Repository for Oil and Gas Energy Research (ROGER).
Additional information and research references can be found in the Shale Gas Extraction and Public Health A Resource Guide updated yearly in November by the PA League of Women Voters.
What body systems should be monitored for exposure?
Environmental exposures should be included in your differential diagnosis for practically all symptoms the patients present within all body systems. There is a growing body of peer-reviewed scientific and medical evidence linking exposure of children and adults to a wide array of chemicals used and extracted during shale gas development and adverse health impacts on nearly every organ and body system. Examples include:
the negative impact of particulate matter (PM 2.5) on lung growth and brain development in infants and young children, pulmonary function in children and adults, and the increased risk of lung cancer;
the impact of volatile organic compounds such as benzene on the hematologic system (leukemia) and toluene on the nervous system (permanent neurologic damage) [Potential Health Effects];
the role of polycyclic aromatic hydrocarbons as endocrine disrupting chemicals, potentially adversely affecting the normal growth and development of fetuses and children and causing cancer [EDCs]; and,
dermatologic, renal, and gastrointestinal changes resulting from exposure to a variety of chemicals used on well pads, etc. [Health symptoms in residents]
Read EHP's handout on mental health.
What recommendations do you suggest we make to patients with compromised immune systems and other individuals who are particularly vulnerable, including pregnant individuals, infants and children, those with pre-existing health conditions, and the elderly?
Pollution associated with shale gas development may contain nitrogen oxides (NOx), volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), particulate matter (PM), hazardous air pollutants (HAPs), endocrine disrupters (EDCs), and technically enhanced naturally occurring radioactive materials (TENORMs).
All populations need to be aware of environmental exposure hazards and need to take steps to limit exposure as much as possible. However, this is paramount when working with vulnerable populations, such as pregnant women, children, those with weakened immune systems and/or chronic medical conditions, and workers who labor outdoors. Such patients should be advised to pay close attention to air quality advisories (which can be accessed at https://www.airnow.gov/) and to limit their outdoor exposure on moderate and worse air quality days, especially if living or working within 1 ¼ miles of shale gas infrastructure. Outdoor air brought indoors through HVAC systems should be efficiently and effectively filtered.
If living with well water, the water should be monitored and tested. It should not be ingested or used on the skin if contamination is suspected. EHP can provide you with pamphlets for your patients with advice on limiting exposure and tracking symptoms: Protecting Your Health from SGD and Tips for Talking to Your Provider.
How is today's oil and gas industry different from previous energy industries?
Today’s air pollution, especially from shale oil and gas infrastructure, contains smaller sized particles or soot compared to the visible smog we remember from generations ago. Today, industrial operations like shale oil and gas emit particulate matter much smaller in size – less than 2.5 microns in diameter (or about 1/30th the diameter of a human hair) – and, thus, invisible.
Unfortunately, smaller invisible particles penetrate much deeper into the lung tissue where they can more easily be absorbed into the bloodstream, causing systemic health effects. Air pollution from shale oil and gas operations is also rich in the fumes and vapors present in fossil fuels – volatile organic compounds, polycyclic aromatic hydrocarbons, radon gas – which have significant health impacts from exposure.
Finally, methane, an extremely potent greenhouse gas, escapes from every point of shale oil and gas infrastructure. This makes shale gas a climate change accelerant that endangers every human living and those not-yet-born.
EHP has developed a factsheet, How Shale Gas Development (Fracking) Affects Public Health, that lays out the multiple risks to health and the environment from shale gas development.
In addition, the oil and gas industry has been exempted from many parts of federal environmental protections. Information on the exemptions, published by Earthworks, can be found in the document Loopholes for Polluters.
What other organizations are working on the public health impacts of shale gas development?
Many organizations are involved locally, regionally, and nationally. EHP offers the Where to Turn: A Resource Directory, which provides contact information and mission statements for these organizations.
How do I get more involved?
EHP is often asked for speakers who are versed in talking about the health impacts of environmental exposure related to shale gas development. If you would be interested in joining our speaker’s bureau and speaking publicly, please contact Debbie Larson, Medical Outreach Coordinator, at 724-260-5504, or email@example.com.
In addition, there are other advocacy organizations that would love to have you on board: