3. Background
UNGD Growth
Between 2007 and 2010, there were 2820 new unconventional
wells drilled in Pennsylvania, and expansion to 80,000 wells is
forecasted (Stacy et al., 2015).
In the United States, the production of natural gas is 23
trillion m3 in 2011 (Adgate, Goldstein, and McKenzie (2014).
Unconventional production in the Pennsylvania Marcellus
shale dramatically increased to 3048 billion m3 in 2013,
while the production was less than 10 billion m3 in 2009
(Joan A. Casey, 2015).
4. Background
What is “fracking” ?
Source: Ruth
McDermott-Levy, N.
K., and Barbara
Sattler. (2013).
Fracking, the
Environment, and
Health-New energy
practices may
threaten public
health. Environments
and Health, 113(6),
45-51. .
• Well pad construction
• Vertical drilling
• Horizontal drilling
• Preparation for hydraulic fracturing
• Hydraulic fracturing (AKA “fracking”)
• Flowback
• Waste disposal
• Cleanup and testing
• (Banerjee et al., 2012)
2 Km
Aquifer
0-4 weeks
0-2 weeks
0-6 weeks
4-8 weeks
2-5 weeks
2-8 weeks
0-6 weeks
0-4 weeks
5. Public Health Concerns
From UNGD
Methane gas leaks
into the air.
Chemicals for fracking have
the potential to contaminate
aquifers.
Rock formation is potentially
destabilized and this can cause
earthquakes.
UNGD activities
increase traffic.
6. Complete evidence regarding health impacts of gas drilling
cannot be obtained due to incomplete testing and disclosure of
chemicals, and non-disclosure agreement. Without rigorous
scientific studies, the gas drilling boom sweeping the world will
remain an uncontrolled health experiment on an enormous scale.
Michelle Bamberger and Robert Oswald
7. Specific Aims
• To explore and visualize the growth of Unconventional Natural Gas Development (UNGD) in
Pennsylvania.
• To highlight the scale of vulnerable populations at risk of the exposures from UNGD in
Pennsylvania, and the areas associated with environmental justice for future study.
• To conduct a systematic literature review to assess health effects from environmental exposure
to UNGD-related hazards.
10. Methods
Literature selection criteria:
• Epidemiology study about human
effects
• Quantitative linkage between UNGD
exposures and population health
effects (such as distance from the
nearest well site)
• UNGD-related exposures in
communities and households
surrounding UNGD
Literature search and review
Search terms Database Number of
Item
retrieved
Articles selected for
review, based on
and abstract
(Articles not listed if
identified in
search)
Articles
selected
analysis
• Unconventional natural gas
• Hydraulic fracturing
• Shale gas
• Health
• Residential health
• Community health
• Environmental health
Pub-Med 135 8 6
Web of
science
509 0 0
ProQuest 171 2 2
For each previously selected
peer-reviewed publication,
search identifies subsequent
articles that cited the paper
All articles
citing each
selected
article
3 1
11. Results
Birth outcome
First author,
year
Study
type
Study
period
Exposure assessment
Casey et al.
2016
Retrospective
cohort
2009-
2012
Stacy et al.
2015
Retrospective
cohort
2007-
2010
Mckenzie et al.
2014
Retrospective
cohort
1996-
2009
Term birth
weight
Preterm birth Small for gestational
age
Congenital Heart defects &
Neural Tube defects
Others
Casey et al. No findings Increased risk
OR=1.9 (4th vs. 1st)
95%CI: 1.2, 2.9
No findings N/A No findings
on low
Apgar score
Stacy et al. Increased risk
P = 0.02
No findings Increased risk
OR= 1.3 (4th vs. 1st)
95% CI: 1.10, 1.63
N/A N/A
Mckenzie et al. Protective effect Protective effect N/A Increased risks
CHDs: OR=1.3 (1.2, 1.5)
NTDs: OR =2.0 (1.0, 3.9)
No findings
on oral cleft
12. Discussion
Exposure Misclassification
1 Incomplete information on entire
maternal resident address.
2 Incomplete information of Birth day and
month.
Study Areas
Consistency
Demographics Of Mothers
Exposure Intensity 3 Surrogate exposure index
• Colorado vs. Pennsylvania
• Rural vs. Urban
• Southwest vs. Central & North
• White
• Hispanic
• African American
• 28 million VS. 11 billion
13. Results
Multiple
Symptoms
Survey
First Author,
year
Study
type
Study
period
Study area, sample
size
Rabinowitz et al.
2015
Cross-
sectional
2011-2012 Washington county, 492
individuals in 180 households
Ilya B. Slizovski,
2013
Cross-
sectional
2011-2012 Washington county, 492
individuals in 180 households
Steinzor et al.,
2013
Cross-
sectional
2011-2012 14 counties in PA, 108
individuals in 55 households
Exposure group:
Residents living in areas
< 1 Km
1-2 Km
>2 Km
from the nearest well
facility
<1500 ft.
>1500 ft. Dermal
(3rd vs. 1st)
OR=3.7
95% CI: 1.4-9.9
p=0.008
Dermal
OR=4.1,
95%CI: 1.4-12.3,
p=0.01
Upper Respiratory
OR=3.1
CI: 1.45-6.65, p=0.004
Throat Irritation
Frequent Nosebleeds
Persistent Cough
Loss Of Sense Of Smell
Skin Rashes
Eye Burning
Sinus Problems
Nasal Irritation
Severe Headaches
Swollen Painful Joints
Consistent finding on
increased reported
symptoms in higher
exposure group
14. Discussion
Exposure
Misclassification
• Randomized selection vs. word-of-mouth
• Response rate
Rabinowitz vs. Slizovski
Consistency
Steinzor et al.
• Respiratory vs. Upper respiratory
• Number of households in each group
• Reclassify the sub-category
• Most of the symptoms fits upper
respiratory in Rabinowitz
Selection Bias
15. Results
Other
Health
Outcomes
The Standardized Incidence Rates
(SIRs) for total cancers were 0.94
(95%CI: 0.90 to 0.99) before drilling
and 1.02 (95%CI: 0.98 to 1.07) after
drilling.
Central Neural System tumors
(SIR = 1.13, 95% CI: 1.02 to 1.25).
In central and north:
Vehicle cashes:
Increased RR from 2010-2012
(RR: 1.23, 1.20, 1.15, respectively,
p <0.01)
Heavy truck crashes increased
risk in year 2010 and 2011 (RR =
1.61, 1.65 respectively)
Cardiology inpatient prevalence rates
were significantly associated with the
number of wells (RR=1.0007,
Bonferroni p=0.0007) in the linear
model.
Quantile analyses,
Cardiology (4th vs. 1st RR = 1.27,
p=0.001)
Neurology (4th vs. 1st RR = 1.188,
p=0.062)
Both significant positive dose-
response
First author,
year
Study
type
Health
outcome
Exposure
assessment
Fryzek et al.
2013
Retrospectiv
e cohort
Childhood
cancer
Number of wells per county
4 groups (500, 1000, 2000)
Jemielita et al.
2015
Ecological
study
Inpatient
prevalence
rates
Linear model
Well density per km2
4 quartiles
Graham et al.
2014
Ecological
study
Traffic
accidents
18 most drilled counties vs.
demographically equivalent
counties without wells
16. Discussion
Exposure Misclassification
Fryzek et al.
limitations
Jemielita et al.
Graham et al.
• Exposure index (number vs. density)
• SIR vs. RR
• Lag function
• Confounding
• Inclusion of UNGD workers
• Ecology fallacy
• Inpatient prevalence rate vs.
Mortality/morbidity rate
• No individual data
• Potential confounder: road
infrastructure
17. Conclusion
The overall weight of evidence shows that there
is a strong indication that community health are
impacted by UNGD activities in various ways.
We acknowledge the limitation of the quantity
and quality of current studies to encourage
more researches.
However, the specific exposure is still
unknown and the results of the studies are not
entirely consistent.
18. 03
GIS project
• UNGD Growth
• Environmental Justice
• To explore and visualize the growth of
Unconventional Natural Gas
Development (UNGD) in
Pennsylvania.
• To highlight the scale of vulnerable
populations at risk of the exposures
from UNGD in Pennsylvania, and the
areas associated with environmental
justice for future study.
19. UNGD
Growth
Datasources:
• Pennsylvania Department of Environment Protection
• Date
• Geolocation
• U.S. Census 2010
• Average household income
• Race
• age
Year Total UNGD wells count Average well density among census tracts with
wells (Km2)
(Density range)
1995-1999 6 0.0127 (0.0037, 0.0225)
1995-2004 11 0.0091 (0.0036, 0.0731)
1995-2009 1101 0.0727 (0.0010, 0.7821)
1995-2015 8401 0.2634(0.0022, 1.7574)
20. GIS MODEL
Environmental justice is based on
the concept that hazardous
environmental exposures have
disproportionate impacts on people of
color and poor communities.
• Average household income
• Percentage of minority
Frumkin H. 2010. Environmental Health: From global to local. Second Edition
24. Conclusion
There are clear patterns of a disproportionate
growth of UNGD in Environmental Justice
areas.
The number of UNGD wells significantly
increased after 2004 in Northern and
Southwestern Pennsylvania.
25. Complete evidence regarding health impacts of gas drilling
cannot be obtained due to incomplete testing and disclosure of
chemicals, and non-disclosure agreement. Without rigorous
scientific studies, the gas drilling boom sweeping the world will
remain an uncontrolled health experiment on an enormous scale.
Michelle Bamberger and Robert Oswald
26. Future Research
1. To address Environmental
Justice issue associated with
UNGD activities;
2. Prospective studies should be
conducted to improve the
strength of overall evidence ;
3. To link exposure assessment
studies to health effects studies
27. 04 Acknowledgement
Great gratitude to all the people that
helped me with my CBMP in any way:
Dr. Anneclaire De Roos
Dr. Nickolas Procopio
Dr. Fagliano
Dr. Frank
Dr. Hamra
Dr. Liu
Kristi Kao
Mr. John Lee
Mr. Steve Melly
All my friends and awesome EOH
classmates
28. 05
References
Fryzek, J., Pastula, S., Jiang, X., & Garabrant, D. H. (2013). Childhood cancer incidence in Pennsylvania
counties in relation to living in counties with hydraulic fracturing sites. J Occup Environ Med,
55(7), 796-801. doi:10.1097/JOM.0b013e318289ee02
Jemielita, T., Gerton, G. L., Neidell, M., Chillrud, S., Yan, B., Stute, M., . . . Panettieri, R. A., Jr. (2015).
Unconventional Gas and Oil Drilling Is Associated with Increased Hospital Utilization Rates. PLoS
One, 10(7), e0131093. doi:10.1371/journal.pone.0131093
Joan A. Casey, D. A. S., Sara G. Rasmussen, Elizabeth L. Ogburn, Jonathan Pollak, Dione G. Mercer, and Brian
S. Schwartza. (2016). Unconventional natural gas development and birth outcomes in
Pennsylvania, USA. Epidemiology, 27(2), 163-172. doi:10.1097/eDe.0000000000000387
Peter M. Rabinowitz, I. B. S., Vanessa Lamers, Sally J. Trufan, Theodore R. Holford, James D. Dziura, Peter
N. Peduzzi, Michael J. Kane, John S. Reif, Theresa R. Weiss, Meredith H. Stowe. (2015). Proximity to
Natural Gas Wells and Reported Health Status: Results of a household survey in Washington
county, Pennsylvania. Environ Health Perspect, 123(1), 21-26.
Stacy, S. L., Brink, L. L., Larkin, J. C., Sadovsky, Y., Goldstein, B. D., Pitt, B. R., & Talbott, E. O. (2015).
Perinatal outcomes and unconventional natural gas operations in Southwest Pennsylvania. PLoS
One, 10(6), e0126425. doi:10.1371/journal.pone.0126425
Graham, J., Irving, J., Tang, X., Sellers, S., Crisp, J., Horwitz, D., . . . Carey, D. (2015). Increased traffic accident
rates associated with shale gas drilling in Pennsylvania. Accid Anal Prev, 74, 203-209.
doi:10.1016/j.aap.2014.11.003
Slizovskiy, I. B. (2013). Health Survey of households near shale gas extraction sites. (Degree of Master of
Public Health), Yale University, ProQuest LLC (2014). (1569248)
McKenzie, L. M., Guo, R., Witter, R. Z., Savitz, D. A., Newman, L. S., & Adgate, J. L. (2014). Birth outcomes
and maternal residential proximity to natural gas development in rural Colorado. Environ Health
Perspect, 122(4), 412-417. doi:10.1289/ehp.1306722
Stephanie Moller Hikel, K. M., April Zambelli-Weiner. (2011). Increased risk of childhood leukemia in
communities impacted by hydraulic fracturing in the Marcellus Shale Paper presented at the 23rd
Annual Conference of the International Society for Environmental Epidemiology (ISEE),
Barcelona, Spain.
Hill, E. L. (2013). Unconventional Natural Gas Development and Infant Health: Evidence from
Pennsylvania. Retrieved from http://ehp.niehs.nih.gov/isee/p-2-05-35/
Make bigger margins so the screen does not get cut off.
Increase the small categories size
This is good.
Explain the process better and more. How and why the two procedures.
Assessment and longitudinal analysis of health impacts and stressors perceived to result from unconventional shale gas development in the Marcellus Shale region.
Switch the place of these two parts.
Explain why you have two independent components and explain it more clearer.
Talk about the bullet points.
This is good.
Expand all the acronyms. Spend like one solid minute for each one of the studies, explain them.
Use animations to highlight which one you are talking about. Otherwise the rest of the contents are just distracting.
Be consistent of the results that you are showing to people. Maybe just include on OR or RR and then whether there’s dose response relationship.
Explain more details about the two matrix. Is Mckenzie a descriptive epi study?
Mention that for casey study, they are the first one that base the exposure assessment in relation to health risks on four separate phases of well development(pad, drilling, stimulation, production).
Lack of studies should go as conclusion instead of limitations. Limitations should be like biases, confounders, misclassifications, crappy data, and etc.
After the results, you can make a general conclusion and then go to limitations and then give another detailed conclusion. When you were talking about specific studies, you can bring up some limits so here when you discuss about limitations, it’ll make more sense.
The same issue as before. Just explain more about why they are from the same cohort survey but have different study design and results.
Lack of studies should go as conclusion instead of limitations. Limitations should be like biases, confounders, misclassifications, crappy data, and etc.
After the results, you can make a general conclusion and then go to limitations and then give another detailed conclusion. When you were talking about specific studies, you can bring up some limits so here when you discuss about limitations, it’ll make more sense.
Split them into three slides? But you don’t have to spend too much on each one of them. Just general stuff. Again, about which results to present, just pick one that is representative.
Lack of studies should go as conclusion instead of limitations. Limitations should be like biases, confounders, misclassifications, crappy data, and etc.
After the results, you can make a general conclusion and then go to limitations and then give another detailed conclusion. When you were talking about specific studies, you can bring up some limits so here when you discuss about limitations, it’ll make more sense.
Lack of studies should go as conclusion instead of limitations. Limitations should be like biases, confounders, misclassifications, crappy data, and etc.
After the results, you can make a general conclusion and then go to limitations and then give another detailed conclusion. When you were talking about specific studies, you can bring up some limits so here when you discuss about limitations, it’ll make more sense.
Bring up the aims again to remind people.
Explain more information about the data you have before you go into the map. You don’t have to mention all the calculation and techniques.
Make the two slides of GIS model into one. People are confused about this flow chart. Just incorporate the information to the second slides.
Make the two slides of GIS model into one. People are confused about this flow chart. Just incorporate the information to the second slides.
Show more information about the first two maps. What are the classes and scales.
Convert minority to Percentage.
And explain more how you combined them.
Move the labels up a little. And explain that these are census tract but you were labeling county.
And after this, have a slide of conclusion of your GIS project.
Lack of studies should go as conclusion instead of limitations. Limitations should be like biases, confounders, misclassifications, crappy data, and etc.
After the results, you can make a general conclusion and then go to limitations and then give another detailed conclusion. When you were talking about specific studies, you can bring up some limits so here when you discuss about limitations, it’ll make more sense.
