Local networking re: information/education


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Local networking re: information/education

  • Local networking re: information/education

  • National COEC network/UPenn “network”

  • 3-state “Information Needs Assessment”

  • Local health dept. capacity building



(How) can public health professionals, researchers, and perspectives help?

  • (How) can public health professionals, researchers, and perspectives help?

  • NOT to describe health effects or concerns



  • Depends on…

  • What is ‘hydrofracking’?

  • What is a ‘health effect’?

  • What counts as ‘evidence’?



Industrial practice of injecting fluids into shale

  • Industrial practice of injecting fluids into shale

  • All activities at well site (drilling, fracking, flaring, storage of water/chemicals)

  • Physical processes associated with unconventional shale gas extraction (trucks, compressor stations, pipelines)

  • Changes in communities and economies resulting from shale gas development











Health impacts/symptoms directly caused by hydrofracking

  • Health impacts/symptoms directly caused by hydrofracking

  • Changes in incidence of disease associated with increased hydrofracking

  • Changes in environmental quality or animal health that could affect humans

  • Well-being/quality of life (stress, conflict, wealth, sense of belonging/community)



Exposure: occupational

  • Exposure: occupational

  • “Typical” industrial/mechanical injuries (falls, accidents)

  • Chemical burns/exposures

  • Air emissions

  • Silica sand



Exposure: fish/game consumption, air, contact recreation, farm animals

  • Exposure: fish/game consumption, air, contact recreation, farm animals

  • Fracking chemicals/flowback water

  • Spills

  • Waste water disposal

  • Changes in water quantity/flow displacing other uses (agriculture, wildlife, etc.)



Exposure: private drinking water wells

  • Exposure: private drinking water wells

  • Methane

  • Fracking chemicals

  • NORM (Naturally Occurring Radioactive Materials)

  • Naturally occurring heavy metals

  • Chemical interactions



Exposure: inhaled by workers, neighbors, regional communities

  • Exposure: inhaled by workers, neighbors, regional communities

  • Diesel engines (trucks, compressors, etc.) – particulates, ozone precursors

  • Fugitive emissions from wells

  • Evaporation from storage ponds

  • Aggregate/cumulative impacts (18% of ozone due to gas development by 2020)



Health effects of heat

  • Health effects of heat

  • Indirect impacts through:

    • Flooding/drought
    • Insects
    • Agriculture
    • Air quality




Flooding may wash chemicals into local waters/contaminate soil

  • Flooding may wash chemicals into local waters/contaminate soil

  • Earthquakes associated with injection wells

  • Explosions/spills may cause injury or contaminate environment



Noise and light pollution

  • Noise and light pollution

  • Stress and mental health (environmental concerns, economic change, conflict)

  • Population/community change (workers)

  • Impacts on health services (visits to emergency room, disaster/spill response, new disease concerns)

  • Increased housing costs/demand

  • Benefits from improved economy



Stories/reports from affected citizens, health care providers, or organizations

  • Stories/reports from affected citizens, health care providers, or organizations

  • Newspaper articles

  • Evidence of past impact?

  • Predictions of future impacts?

  • Government agency reports

  • Peer-reviewed publications



What will be the extent of drilling, where, over what time?

  • What will be the extent of drilling, where, over what time?

  • What engineering practices, control systems, and mitigation will be used?

  • What chemicals are used, released, how much, where, when?

  • What are the health effects of exposures?

  • Accidents, spills, natural disasters…



“More research is needed”

  • “More research is needed”

  • Precautionary principle

  • Regulate, monitor and manage

  • Pilot test (adaptive management)

  • Uncertainty will persist

    • Latency of health impacts
    • Variation in geography/technology
    • Long-term processes
    • Unpredictable events


Prevention

  • Prevention

  • Risk management

  • Co-benefits

  • Economic impacts

  • Ethical issues



Baseline monitoring of environmental and human health

  • Baseline monitoring of environmental and human health

  • Modeling cumulative impacts

  • Ongoing monitoring and adaptation

  • Emergency preparedness planning



Systematically identifying, assessing, and mitigating multiple risks

  • Systematically identifying, assessing, and mitigating multiple risks

  • Life cycle analysis

  • Health Impact Assessment (HIA)



…NOT ‘science’ or ‘research’

  • …NOT ‘science’ or ‘research’

  • Applying existing health knowledge to non-health decisions

  • Process:

    • Scoping key health issues
    • Assessing using existing quantitative and qualitative data
    • Involves stakeholders
    • Makes recommendations to decision makers
  • www.healthimpactproject.org



Increased environmental/health monitoring

  • Increased environmental/health monitoring

  • Develop GIS/analysis capacity

  • Forge new community partnerships

  • Emergency response capacity/training



Timing matters (net present value)

  • Timing matters (net present value)

  • Prevention pays

  • Distribution of costs/benefits affects health (see “ethics”)

  • Cost effectiveness includes internalizing external (and future) costs



Reducing health disparities

  • Reducing health disparities

  • Environmental justice

  • Focus on vulnerable populations (children, asthmatics, pregnant women, etc.)

  • Public participation/community based research

  • Implications of long latency / intergenerational effects for equity



Beyond “environment versus economics”

  • Beyond “environment versus economics”

  • Public health professionals as a resource:

    • Communication networks
    • Access to health data/analysis
    • Local monitoring/management
  • Body of experience includes:

    • Disaster response (Gulf Oil, flooding)
    • Emerging disease
    • Surveillance/epidemiology


“The public health perspective has been inadequately represented in policy processes related to HVHF. Policies that anticipate potential public health threats, require greater transparency, use a precautionary approach in the face of uncertainty, and provide for monitoring and adaptation as understanding of risks increases may significantly reduce negative public health impacts of this approach to natural gas extraction.”

  • “The public health perspective has been inadequately represented in policy processes related to HVHF. Policies that anticipate potential public health threats, require greater transparency, use a precautionary approach in the face of uncertainty, and provide for monitoring and adaptation as understanding of risks increases may significantly reduce negative public health impacts of this approach to natural gas extraction.”

  • Policy statement 20125 “The Environmental and Occupational Health Impacts of High-Volume Hydraulic Fracturing of Unconventional Gas Reserves” is publicly available in the APHA policy statement database. Here is the direct link: http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1439



Health care providers (doctors, nurses…)

  • Health care providers (doctors, nurses…)

  • Health interest groups (APHA, ANHE, HSA, communities, insurance agencies)

  • Local health departments (NACCHO)

  • State/federal agencies (DOH, CDC…)

  • Medical associations

  • Academics (epidemiology, toxicology, health behavior/education)

  • Foundations and funders






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