Who this is for: Mothers, families, the scientific community, and healthcare professionals. Description: Carol Kwiatkowski talks about the public health implications of natural gas development, with an emphasis on air pollution and the risks they might hold for vulnerable populations, including children and pregnant women. About The Speaker: Carol Kwiatkowski, Executive Director of TEDX, The Endocrine Disruption Exchange, and an Assistant Professor Adjunct at the University of Colorado Boulder. During her time at TEDX, she has created the Critical Windows of Development website, which presents a timeline of how the human body develops in the womb, with animal research showing when low-dose exposure to endocrine disrupting chemicals (EDCs) during development results in altered health outcomes.

1. Natural Gas Development, Public
Health, and Protecting the Most
Vulnerable Populations
Carol Kwiatkowski, PhD
Executive Director, TEDX
The Endocrine Disruption Exchange

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3. Durango Herald June 1, 2012
NPR Morning Edition November 3, 2009
ProPublica September 12, 2011
Inside Climate News March 21, 2012
The New York Times January 21, 2013
Huffington Post February 14, 2013
The Medical News March 19, 2012
The Times-Tribune August 26, 2013 3

4. Effects of
unconventional
natural gas
development
Image from John Adgate.
See Adgate et al. 2014. Potential Public
Health Hazards, Exposures and Health
Effects from Unconventional Natural Gas
Development. Environ Sci Technol:
doi:10.1024/es404621d.
4

5. Presentation Overview
• Natural gas operations
• Air pollution
– Sources
– Pollutants
– Health effects
• Endocrine disruption
and prenatal exposure
• Symptoms
• What you can do
5
Photo by Robert Donnan

6. Target formation
Water aquifer
Drill rig
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Animation by Kim Schultz, TEDX

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Photo by Robert Donnan
Drill rig Buildings

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Photo by Robert Donnan
Christmas trees
Frack trucks
Sand trucks
Frack tanks

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Acids Biocides
Breakers Clay stabilizers
Corrosion inhibitors Crosslinkers
Defoamers Foamers
Friction reducers Gellants
pH control Proppants
Scale control Surfactants
Functional categories of hydraulic
fracturing chemicals
Adapted from Colborn T, Kwiatkowski C, Schultz K, Bachran M. 2011. Natural gas operations from a
public health perspective. Human & Ecological Risk Assessment 17(5):1039-1056.

11. Worker pic
11Photo by Robert Donnan

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Photo by Robert Donnan

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15. Heater Treater
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Produced
water tanks
Condensate tanks

17. Condensates are feedstock for:
electronics, pesticides, plastics, shampoo, toys, cell
phones, pharmaceuticals, sporting goods, clothes,
cosmetics, furniture, computers, cars, detergents,
food additives, mattresses, fabrics, household
products, pots and pans, athletic equipment, food
color, airplanes, candy, food packaging, cleaning
products, toothpaste, glass, preservatives, TVs,
carpet, raingear, men’s toiletries,
receipts, laundry products, paint,
soap, deodorants, metals, shower
curtains, baby products, sunscreens
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18. Flare
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19. Compressor
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22. Drilling chemicals
Drilling pit evaporation
Fracking chemicals
Evaporation pits
Condensate tanks
Produced water tanks
Separators/heater treaters
Compressors
Venting and flaring
Pipelines, valves, pneumatics
Generators
Light and heavy trucks
Sources of air pollution
22

23. Methane (natural gas)
Carbon dioxide
Nitrogen oxides (NOx)
Volatile organic compounds
Hydrogen sulfide
Naturally occurring radioactive material (NORM)
Particulate matter
23Photo by Kevin Dirk

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Nitrogen Oxides (NOx) +
Volatile Organic Compounds (VOCs) +
Sunlight = Ozone
Ozone + Particulate Matter = Smog

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•Shortness of breath, pain when taking a deep breath
•Coughing, sore or scratchy throat
•Inflamed and damaged airways
•Aggravated lung diseases
•Asthma
•Emphysema
•Chronic bronchitis
•Greater susceptibility to lung infection
Effects of Ozone
US EPA http://www.epa.gov/air/ozonepollution/health.html

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27. An Exploratory Study of Air Quality
near Natural Gas Operations
•Weekly sampling over one year for VOCs, PAHs, carbonyls
and methane
•Independent laboratory analysis of samples
•EPA approved methods: TO-12/ PAMS Protocol; TO-15; TO-
11A; TO-13A; M18
Colborn T, Schultz K, Herrick L, Kwiatkowsi C. 2014. An exploratory study of air quality
near natural gas operations. Hum Ecol Risk Assess 20(1):86-105.
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28. Chemicals Detected in at Least 50% of Samples
Chemical name % Detects
methane, ethane, propane, toluene,
formaldehyde, acetaldehyde,
naphthalene
100%
isopentane, crotonaldehyde 90-99%
n-butane, isobutane, n-pentane, MEK &
butyraldehyde, acetone
80-89%
n-hexane, methylcyclohexane,
methylene chloride, phenanthrene
70-79%
m/p-xylenes, fluorene 50-69%
28

29. Health effect categories
Number of chemicals
with effects
Brain and nervous system 35
Liver and metabolic 33
Endocrine system 30
Other 29
Immune system 28
Cardiovascular and blood 27
Skin, eye, and sensory organ 25
Respiratory 25
Kidney 23
Genotoxic 23
Cancer and tumorigen 18
Gastrointestinal 14
Potential Health Effects
29

30. Polycyclic Aromatic Hydrocarbons (PAHs)
• Result from incomplete combustion and are also
present in petroleum sources, including crude oil
and produced water from oil and gas development
• Attach to ultra-fine particles and travel long
distances
• Can go from lungs directly into blood stream, can
also be ingested
• Are carcinogens
• Are endocrine disrupting chemicals
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Benzo[a]pyrene Naphthalene

31. What are endocrine disruptors?
Prenatal development is a critical exposure period
Effects can be permanent
Effects are seen at extremely low concentrations
31
Hormones are involved in:
development, reproduction,
thyroid and immune
function, intelligence and
behavior, metabolism, and
more.
Chemicals that
affect hormone
signaling.

32. Chemical name % Detects
Naphthalene 100%
Phenanthrene 76%
Fluorene 52%
* Indeno[1,2,3-cd]pyrene 38%
* Benzo[g,h,i]perylene 33%
* Dibenzo[a,h]anthracene 33%
* Benzo[a]pyrene 24%
* Benzo[b]fluoranthene 24%
* Benzo[k]fluoranthene 24%
* Benzo[a]anthracene 10%
* Chrysene 10%
Acenaphthylene 5%
PAHs Detected in Garfield County Air
* Associated with health effects in prenatal exposure studies 32

33. Effects of Prenatal Exposure to PAHs
•At birth: preterm, low birth weight, and smaller skull
circumference (Perera et al. 2004)
•At 3 years old: lower mental development scores (Perera
et al. 2006)
•At 5 years old: lower IQ scores (Perera et al. 2009)
• At 7 years old: attention and behavioral problems,
metabolic problems and obesity (Perera et al. 2012; Rundle et al.
2012)
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34. • BENZENE (in 44% of samples)
– Preterm birth, decreased prenatal growth, spina bifida
– Sperm abnormalities
– Increased asthma, wheeze, respiratory dysfunction,
bronchitis
– Immune dysfunction
• TOLUENE (in 100% of samples)
– Asthma and other respiratory functions
– Immune effects, allergic responses
– Cardiovascular disease
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Other chemicals of concern

35. Hormone Activity in Surface
and Ground Water
Hormone activity was higher in test
sites than control sites, where it was
nearly absent.
Chemicals used in natural gas
operations, some of which were
identified at the test sites by another
team of researchers, were also
hormonally active.
Kassotis CD, Tillitt DE, Davis JW, Hormann AM, Nagel SC. 2013. Estrogen and
androgen receptor activities of hydraulic fracturing chemicals and surface and
ground water in a drilling-dense region. Endocrinology: doi:10.1210/en.2013-1697.
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36. 124,842 births in 57 rural Colorado counties
1,823 children born with a congenital heart defect
The likelihood of having a child with a congenital heart
defect increased linearly with the increasing density and
proximity of natural gas wells to the mother’s residence
while pregnant.
McKenzie LM, Guo R, Witter RZ, Savitz DA, Newman LS, Adgate JL. 2014. Birth outcomes and maternal
residential proximity to natural gas development in rural Colorado. Environ Health Perspect: doi:
10.1289/ehp.1306722
Effects of Prenatal Exposure
Density/
proximity of gas
wells:
No wells
within 10 miles
Low
density/
proximity
Medium
density/
proximity
High
density/
proximity
% Heart Defects 1.3% 1.5% 1.6% 1.8%
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37. Shale Gas Development and Infant Health:
Evidence from Pennsylvania
• Living within 2.5 km (1.6 miles) of a well led to
– 25% increase in babies with ‘low birth weight’
– 18% increase in babies born ‘small for gestational age’
– 26% increase in APGAR scores below 8
• Effects were larger for lower SES children
• Some effects were detected up to 3.5 km (2.2
miles) from the wellhead
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Hill E. 2013. Unconventional Natural Gas Development and Infant Health: Evidence from Pennsylvania. Cornell
University: Working Paper, Charles Dyson School of Applied Economics and Management.
www.dyson.cornell.edu/research/researchpdf/wp/.../Cornell-Dyson-wp1212.pdf.

38. Reported symptoms
• Headaches, nausea, upper respiratory irritation,
nosebleeds (CO incident database)
• Fatigue, nasal irritation, throat irritation, sinus
problems, burning eyes, shortness of breath,
joint pain, feeling weak and tired, severe
headaches, sleep disturbance (PA survey)
• Stress over health, perceptions of corruption,
false information etc. (PA interviews)
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39. Challenges to exposure
research and treatment
• Need scientifically rigorous studies on
health affects and symptoms
• Many symptoms are similar to common
ailments (allergies, colds); other symptoms
don’t manifest until much later in life
(kidney, liver problems)
• Need to measure/model extreme events
and mixtures of air pollutants
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How much evidence is enough?
Photo by Robert Donnan
Pits
Flare

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42. What you can do
Educate yourself:
www.tedx.org
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44. What you can do
• Talk to local legislators –
town, county and state
– Full disclosure of
chemicals
– Monitoring of pollutants
– Best practices – and better
– Big setbacks
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• Find a local organization or start one of your own
– Collect baseline data if possible

45. What you can do
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•Engage the medical community
•Take a CME course http://www.psehealthyenergy.org/COURSES
•Alliance of Nurses for Healthy Environments
http://envirn.org/pg/groups/59988/fracking-and-public-health/
•Get medical associations involved
The following associations have told the US EPA to “…adopt the
strongest possible standards to reduce harmful emissions..” from
the oil and gas industry.
•American Lung Association
•American Public Health Association
•American Thoracic Society
•Asthma and Allergy Foundation of America
•Trust for America’s Health

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Photo by Kevin Dirk
Thank you
The staff at TEDX
Arkansas Community Foundation
Winslow Foundation
Cornell Douglas Foundation
New-Land Foundation
New York Community Trust
Wallace Genetic Foundation
Many individual donors
www.tedx.org