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Red Barn SCOTT TOWNSHIP, Lawrence County,PA WCN 24/7 CC BY-NC 2.0
Flaring Fracking well. SCOTT TOWNSHIP, Lawrence County,PA WCN 24/7 CC BY-NC 2.0
Flaring at the Scott Township fracking well, Lawrence Co., Western Pennsylvania, WCN 24/7 CC BY-NC 2.0, Flickr

Excerpt from:
Unconventional Gas and Oil Drilling Is Associated with Increased Hospital Utilization Rates

Thomas Jemielita 1☯, George L. Gerton 2☯, Matthew Neidell 3, Steven Chillrud 4, Beizhan Yan 4, Martin Stute 4, Marilyn Howarth 2, Pouné Saberi 2, Nicholas Fausti 2, Trevor M. Penning 2, Jason Roy 1, Kathleen J. Propert 1, Reynold A. Panettieri, Jr. 2*
1 Department of Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America, 2 Center of Excellence in Environmental Toxicology (CEET), Airways Biology Initiative, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America, 3 Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York, United States of America, 4 Lamont-Doherty Earth Observatory of Columbia University, Palisades, New York, United States of America


Over the past ten years, unconventional gas and oil drilling (UGOD) has markedly expanded in the United States. Despite substantial increases in well drilling, the health consequences of UGOD toxicant exposure remain unclear. This study examines an association between wells and healthcare use by zip code from 2007 to 2011 in Pennsylvania. Inpatient discharge databases from the Pennsylvania Healthcare Cost Containment Council were correlated with active wells by zip code in three counties in Pennsylvania. For over-all inpatient prevalence rates and 25 specific medical categories, the association of inpatient prevalence rates with number of wells per zip code and, separately, with wells per km2 (separated into quantiles and defined as well density) were estimated using fixed-effects Poisson models. To account for multiple comparisons, a Bonferroni correction with associations of p<0.00096 was considered statistically significant. Cardiology inpatient prevalence rates were significantly associated with number of wells per zip code (p<0.00096) and wells per km2 (p<0.00096) while neurology inpatient prevalence rates were significantly associated with wells per km2 (p<0.00096). Furthermore, evidence also supported an association between well density and inpatient prevalence rates for the medical categories of dermatology, neurology, oncology, and urology. These data suggest that UGOD wells, which dramatically increased in the past decade, were associated with increased inpatient prevalence rates within specific medical categories in Pennsylvania. Further studies are necessary to address healthcare costs of UGOD and determine whether specific toxicants or combinations are associated with organ-specific responses.


The United States now leads the world in producing natural gas from shale formations. Shale gas accounted for 40% of all natural gas produced in 2012 [1–4]. In comparison to the early 2000s, natural gas production in the US has increased with more than a 30% increase in production, due in part to the cost-effective combination of horizontal drilling and hydraulic fracturing [1–4]. Unconventional gas and oil drilling (UGOD), including hydraulic fracturing or “fracking”, refers to all activities that extract natural gas and oil from rock formations. At distances from 1 to 2 miles below the earth's surface, tight rock formations impede natural gas and oil flow into a drill-hole [3]. Common reservoirs that contain natural gas and oils include: porous sand-stones, limestones, dolomite rocks, shale rocks, and coal beds. Hydraulic fracturing and horizontal drilling methods can effectively extract these resources. Typically, after drilling is complete, fissures are formed using a perforating gun; a mixture of water, proppants and hydraulic fracturing chemicals is then pumped into the rock [3,5]. Consequently, the fissures remain open to liberate the gas. These substances as well as contaminants released from the shale are present in the flowback water. Contaminants include naturally occurring radioactive materials [3,4], toxic organics and metals that may enter ground water, contaminating water supplies especially if leakage occurs from casement failure or from holding ponds for waste water [6,7]. Other toxicants and volatile organic compounds, such as benzene, ethylbenzene, toluene and xylene or radionuclides, have been seen in ground waters impacted by UGOD spills [8] or surface waters receiving UGOD-related waste water [9]. The general lack of published baseline (i.e., pre-UGOD) data has limited efforts to associate contamination in drinking water wells to UGOD activities [10]. Additionally, exhaust produced by diesel trucks and off-site diesel engines, as well as emissions from other UGOD activities (e.g., venting, flaring, compressor stations, etc.) may also affect local air quality with potential impact on health [11–13]. Plausibly, increased noise pollution, truck traffic, and psychosocial stress due to community change, which occur due to increased hydro-fracking activity, could impact public health [11]. Despite the growth in hydraulic fracturing, the health consequences of UGOD are unclear [3,4,14,15]. In Pennsylvania (PA), a rise in hydraulic fracturing has raised health concerns, especially since the Marcellus Shale formation underlies two-thirds of Pennsylvania [16]. In northeastern Pennsylvania, most wells were drilled for dry gas rather than gas and oil [17]. We postulate that increases in active or producing wells in Pennsylvania from 2007 to 2011 are associated with increases in inpatient prevalence rates. Three counties, which lie on the Marcellus Shale formation along the northern border of PA, were chosen for this study: Bradford, Susquehanna, and Wayne. Importantly, zip codes in Bradford and Susquehanna Counties significantly increased UGOD over this time period. These counties are some of the greatest producers of natural gas in Pennsylvania, generating 489 million cubic feet of natural gas from 598 wells in 2011 [18]. In contrast, zip codes in Wayne County have no active wells [18]. Specifically, we evaluated the association between inpatient prevalence rates and well density within 25 different medical categories, as well as overall inpatient prevalence rates.

Materials and Methods

This study is an ecological study with the goal of assessing the association between hydro-fracking activity and health care use. Zip code specific inpatient counts were obtained from the time frame of 2007–2011. Only zip codes from the counties Bradford, Susquehanna, and Wayne were considered. For our analysis, only inpatient records for people who resided in one of these three counties were included. Inpatient records of people who came to a hospital in these counties, but did not reside in one of these counties, were excluded. These counties were of particular interest, since Wayne had no hydro-fracking activity between 2007 and 2011, while Bradford and Susquehanna saw increased hydro-fracking activity. Inpatient counts were then converted into inpatient prevalence rates (details in Statistical Methods). Furthermore, for each zip code, we obtained the number of wells for each year in 2007–2011. In total, there were 67 zip codes considered, with five inpatient prevalence rates/well counts each. Inpatient prevalence rates were the primary outcome of interest with wells as the primary predicator of interest…


We posit that larger numbers of active hydraulic fracturing wells would increase inpatient prevalence rates over time due in part to increases in potential toxicant exposure and stress responses in residents evoked by increases in the hydraulic fracturing work force and diesel engine use. We recognize that a five-year observation period may limit our ability to discern a direct impact on health in the surrounding community but may offer an opportunity to assess hospital utilization rates over time. We examined over 95,000 inpatient records, and thus our study, to our knowledge, represents the most comprehensive one to date to address the health impact of UGOD. Our data suggests that some but not all medical categories were associated with increases in number of wells, along with increases in well density.

Specifically, cardiology inpatient prevalence rates were significantly associated with number of wells and well density, while neurology inpatient prevalence rates were significantly associated with well density. We are struck by the finding that these differences were observable within a short period of time from 2007–2011.
In summary, hydraulic fracturing as determined by well number or density had a significant association with cardiology inpatient prevalence rates, while well density had a significant association with neurology inpatient prevalence rates. While the clinical significance of the association remains to be shown, UGOD has just begun in Pennsylvania, and thus observing a significant association over this short time is remarkable. Further studies are warranted to compare toxicant exposure to number of wells and inpatient and outpatient studies. Our study also supports the concept that health care utilization should be factored into the value (costs and benefits) of hydraulic fracturing over time. PLOS ONE | DOI:10.1371/journal.pone.0131093 July 15, 2015, 18pp. Copyright: © 2015 Jemielita et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
” Emphasis added. Read the entire article here: http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/journal.pone.0131093&representation=PDF

While common sense suggests that a large part of the cardiology and neurology problems are noise related, especially in so short a time-frame, it is important to note that Technologically Enhanced Naturally Occurring Radionuclides (TENORM), such as uranium, radium, act as heavy metals and damage the kidneys. They act as both chemical poisons and radiological poisons. Damaged kidneys can lead to cardiovascular disease. Kidney damage may come from inhalation, as well as ingestion of uranium from food and water. This is more health hazards of uranium, radium, radon found here: http://www.epa.gov/ttnatw01/hlthef/radionuc.html

The Amish prove that being attentive to your environment is sufficient. You don’t need a study. But, you need someplace to escape to, which is increasingly difficult

Lancaster County Amish 03
Lancaster County Pennsylvania Amish. Photo by Utente via Wikipedia

Some Amish who use horse and buggy rather than automobiles and use no electricity fled eastern Ohio (which borders western Pennsylvania) after some fatal incidences where the horse and buggies were run over by oil trucks. Having fled Switzerland and elsewhere, largely due to religious persecution, they fled again due to the oil industry. According to Reuters (Dec. 20, 2013): “Some Amish, traditionalist Christians numbering about 280,000 across the United States, are sitting on prime drilling land in eastern Ohio, but many say the rapid development is encroaching on their pastoral way of life… many Amish are cashing out to escape the noise as their bucolic landscape of lush green hills becomes dotted with oil storage tanks and rumbles with the buzz of oil rigs./ “If all this traffic and development is crazy here today, what’s it going to be like in three or four years?” Eli Byler, a member of an Amish community in Ohio’s Guernsey County, said at his farmhouse,…
INSIGHT-To flee Ohio oil boom, Amish cash out by selling royaltieshttp://www.reuters.com/article/2013/12/20/energy-ohio-amish-idUSL2N0JH1XH20131220?feedType=RSS&feedName=rbssEnergyNews

Lancaster County Amish Photo from wikipedia: https://en.wikipedia.org/wiki/Amish#/media/File:Lancaster_County_Amish_03.jpg
Flaring at the Scott Township fracking well, Fracking in Lawrence County, Random WCN 24/7https://www.flickr.com/photos/wcn247/8203456780/in/album-72157646940158178/