FAQs - Health Care Providers

EHP has tools, services, and information related to shale gas development available to you and your patients.

EHP can provide you with an Environmental Health Medical 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 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 on how best to minimize their exposure within the home and aid them in monitoring their air and water (if on well water). EHP can provide you with pamphlets for your patients with advice on limiting exposure and tracking symptoms: Protecting Your Health from UOGD 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
• Environmental Health Channel – which shows health survey data and PM2.5 data by zip code, and photo-narratives of impacted residents.
• Information about EHP’s national Shale Gas & Oil Health Registry and Resource Network.
• EHP has a wealth of factsheets and information that you can share with your patients, including one that explains the limitations of biomonitoring.

EHP tools and information can be accessed at environmentalhealthproject.org

KNOW YOUR PATIENTS’ ZIP CODES.

With environmental exposure, proximity matters. You can determine how close your patients live to shale gas development with tools available from both the DEP Oil and Gas maps (DEPMAPS) and FracTracker maps (FTMAPS). FracTracker tool instructions are available on EHP’s website. Both sites allow you to measure the distance between two points. If you know your patients’ 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 , metering stations, and pipelines are not shown. FracTracker has a separate map showing where gas storage wells are in the tri-state area – PA, OH, WV.

Exposures can happen where your patients 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.

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.

PA-based studies can be found in EHP’s Compilation of UNGD Health Studies Using Pennsylvania Data.

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.

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]

In addition, serious mental health impacts have been documented in residents living in proximity to UNGD. A literature review and a guide to mental health impacts are available on EHP’s website.

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 naturally occurring radioactive materials (NORMs).

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 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 UOGD and Tips for Talking to Your Provider.

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 which 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 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.

Many organizations are involved both locally, regionally, and nationally. EHP offers the Where to Turn Resource Directory which provides contact information and mission statements for these organizations.

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 being available to speak publicly, please contact Debbie Larson, Medical Outreach Coordinator, at 724-260-5504, or dlarson [at] environmentalhealthproject.org.

In addition, there are other advocacy organizations that would love to have you on board.

• Alliance of Nurses for Healthy Environments
• American Academy of Pediatrics: Council on Environmental Health
• American Lung Association
• Breathe Project
• Citizens for Radioactive Radon Reduction
• Clean Air Council
• Mom’s Clean Air Force 
• Pediatric Environmental Health Specialty Units
• Pennsylvania Medical Society
• Physicians for Social Responsibility - Pennsylvania