John Krohn & Nicole Jacobs
EID Marcellus

New York officials keep saying uncertainty over public health is the reason for delay in the state but the record is clear and there’s plenty of data supporting the fact natural gas development is safe and will likely lead to health improvements in the Empire State.  The whole issue, in fact, is turning out to be phonier than actor Brian Dennehy’s military record.

Health is a topic most people discuss over the course of their lives. Whether it’s health care, personal health, or the health of family, friends and animals, it’s a topic of concern for each of us because we all want to ensure the health of ourselves, our families and our communities. In New York, health has become the center of the debate over natural gas with officials delaying approval of shale development because they claim additional health studies are needed.

Data collection of the impacts of health for workers and residents of any industry is always welcome to show what is being done right and where improvements are needed. It goes without saying, in any industry there will always be new studies, but they shouldn’t be used as an excuse for continued delays.

There’s plenty of data, and experience, showing natural gas development doesn’t negatively impact public health.  In fact, this data and the stringent regulatory program outlined in the SGEIS is what led  the New York Department of Health to conclude last year that hydraulic fracturing would not impact public health.

Energy In Depth has discussed health and studies associated with health relevant to natural gas development several times. In case you missed those, here’s a brief list worth perusing.

• *UPDATE IV* Eight Worst Inputs Used in Colorado Health Study
• Tilting at Wellheads
• Ozone Obfuscation on Shale Gas
• Data Show Public Health Impacts from Natural Gas Production Overstated
• Institute of Medicine Roundtable: Skewed View of Shale Development
• Actual Data Tell Very Different (and Very Good) Story on Worker Safety
• *UPDATE II* Public Health and Hydraulic Fracturing: A Review of the Data
• *UPDATE* Cornell Veterinarians Go Into “Beast Mode” on Shale

But, there are also many studies we haven’t covered in detail that are helpful to this discussion. These studies fall into two categories, namely those directly and indirectly related to natural gas development.

Studies Directly Related to Health & Natural Gas

Oil and natural gas development has existed for over 100 years in our country and around the globe. As such, it should come as no surprise there are studies looking directly at this development and its impacts on public and worker health.  Let’s take a look at some of them.

Australian Institute for Petroleum Health Surveillance Program – The University of Adelaide, Department of Public Health (2005)

The Australian Institute for Petroleum has sponsored the Health Watch study for over 25 years to monitor the long-term health of workers in the oil and natural gas industry. The study, independently conducted by the University of Adelaide, specifically looks at all causes of mortality amongst oil and gas workers and diagnosis of cancer and other lethal diseases.  It’s a longitudinal study as well as researchers contact former industry employees periodically to obtain current information on their health status to include in the data. Below are some of the findings from the 2005 edition.

• “The age-adjusted death rate in men is significantly less than in the general Australian male population. Death rates in all major disease categories – heart disease, cancer, respiratory disease, diseases of the digestive system, and external causes (accidents, violence etc) – are also significantly less than the corresponding rates for the male population. (emphasis added)
• “The chance of getting cancer is the same for men in this industry as for other Australians. This is so for all cancers combined and for most individual cancer types. “ (Page 42)
• “The proportion of women in the Health Watch program  remains very small and this prevents much detailed analysis. Women in the industry have death rates which  are lower than that of women in Australia generally. No cancer type has occurred in a statistically significant  excess, but the numbers of individual cancer types is too  low for meaningful analysis.” (Page 33)

Northeastern Pennsylvania Marcellus Shale Short-Term Ambient Air Sampling Report 

In 2011 the Pennsylvania Department of Environmental Protection (DEP) held a short-term (three month) study of ambient air quality near Marcellus Shale development in the northeastern region of the state, specifically in Susquehanna County. While this was not a cumulative or comprehensive study of emissions, it did provide a snapshot of area specific air quality near natural gas operations.

• “Results of the limited ambient air sampling initiative in the northeast region did not identify concentrations of any compound that would likely trigger air-related health issues associated with Marcellus Shale drilling activities.”

*NOTE: A similar report for SW Pa. came to the same conclusions. In addition,  data recently released by DEP showed that emissions from shale development make up less than 1 percent of most sources of air pollution in the Commonwealth.  That same data noted increasing utilization of natural gas has reduced harmful air pollutants in the state by over 500,000 tons.

Texas Commission on Environmental Quality report: A Commitment to Air Quality in the Barnett Shale

Upon receiving complaints about the air quality near natural gas operations in the Barnett Shale, the Texas Commission on Environmental Quality (TCEQ) installed state of the art, 24 hour air monitors near natural gas facilities to conduct studies and address concerns. Initial findings have been very positive showing no immediate health concerns and the agency plans to continue monitoring the region.

• “After several months of operation, state-of-the-art, 24-hour air monitors in the Barnett Shale area are showing no levels of concern for any chemicals. This reinforces our conclusion that there are no immediate health concerns from air quality in the area, and that when they are properly managed and maintained, oil and gas operations do not cause harmful excess air emissions.” (emphasis added)
• “These flights, along with subsequent studies, determined that—due to the location of the operations and the prevailing wind direction—emissions from oil and gas operations in the Barnett Shale area were not a significant factor in Dallas–Fort Worth ozone levels.”
• “From Aug. 1, 2009, to June 30, 2010, the TCEQ surveyed more than 560 sites using the GasFind IR camera. At approximately 450 of these sites, a handheld VOC sampler was also used. Based on observations with these instruments, 319 canister samples have been collected. In addition, samples have been collected via mobile Real-Time Automated Gas Chromatograph.”
• “Out of all the samples taken, the TCEQ has only found two instances of benzene exceeding short-term levels of concern. Subsequent sampling at these two locations has shown low levels of benzene.”

Uni Blake/Sue Mickley assessment of Denton County:

Public health researcher Sue Mickley, and Toxicologist, Uni Blake, live in the Delaware River Basin and New York, respectively, areas that have been under moratoriums on natural gas development for several years. While waiting on decisions to be made, they used the time to research potential health impacts that could result from natural gas development in their communities, looking at existing data and studies from communities where extensive development had been occurring for over a decade.

Specifically, they looked at data from the Barnett Shale (Ft. Worth area) and Denton County (Dish), Texas where claims have been made of increased illnesses including cancer as a result of development. It’s worth noting, these claims were later rebuffed by additional health experts in an Associated Press review titled “Some Fracking Critics Use Bad Science.”

Upon review Mickley and Blake noted that as development expanded rapidly in the Barnett, health in the local community improved despite a significant increase of elderly residents.

• “Health records indicate that while [Barnett shale] production increased, fewer residents were diagnosed with serious illnesses such as cancer, respiratory disease, strokes, and heart disease. This improvement occurred even as the population of residents age 65 or older increased by over 13,000, a significant uptick for any population segment.”

What About the Negative Health Effects of Unemployment and Financial Stress

So, it’s clear that natural gas development doesn’t negatively impact public health in areas where it’s occurred.  This includes individuals who have been exposed to the work sites, emissions and needed materials for over twenty years.  That’s certainly good news, that is, unless you are a landowner in the Southern Tier.  See, these residents have a different challenge.  Namely high unemployment and limited income.  Unlike natural gas development, these two stresses have been linked to negative health impacts for quite some time.  If only there was a solution that would reduce unemployment significantly throughout the region.

The story is simple really.  Access to health care through employment has been shown to increase health in communities. Also, multiple studies show that communities with higher levels of employment display lower levels of stress related illnesses. Along these lines, there is also a significant amount of information connecting unemployment with decreasing health.

Of course, you shouldn’t take our word for it.  Take a look at the research yourself.

Major Factors in the Prediction of National Life Expectancy: GDP and Unemployment 

This is Dr. M. Harvey Brenner’s 2011 testimony before the U.S. Senate Committee on Environment and Public Works. In it, Brenner discusses how income and employment impact a person’s life expectancy. His analysis of data shows an inverse relation between income and illness/early mortality, or as income increases, illnesses typically decline, and vice versa. Below are some of his findings:

• “At the individual level of analysis – i.e. in epidemiological studies- individual income is a standard and fundamental inverse predictor of illness and early mortality.” (Page 1)
• “In industrialized countries, the higher the level of income of individuals, the lower the illness and mortality rates attributed to the great majority of infections, chronic diseases and mental disturbances.” (Page 1)
• “The unemployment rate is well established as a risk factor for elevated illness and mortality rates in epidemiological studies performed since the early 1980’s.  In addition to influences of mental disorder, suicide and alcohol abuse and alcoholism, unemployment is also an important risk factor in cardiovascular disease and overall decreases in life expectancy.” (Page 3)
• “These studies demonstrated a temporal relationship between national levels of unemployment, on the one hand, and on the other age-adjusted mortality rates, cardiovascular mortality rates and suicide over a six year period following economic recessions in which unemployment was elevated.” (Page 3)
• “Most recently, the country-level relationship between unemployment and decreased life expectation has been confirmed for 31 industrialized contries for the year 2008.” (Page 4)
• “The most extensive and robust findings in epidemiology of mortality patterns in industrialized countries is that “socioeconomic status” is the single most dominant, pervasive (or powerful) factor that routinely influences comparative length of life among industrialized country populations.” (Page 6)

Summary Health Statistics for U.S. Children: National Health Interview Survey 

This study was conducted in 2009 by the U.S. Centers for Disease Control (CDC) and (from the report abstract, page 1),

present[ed] both age-adjusted and unadjusted statistics from the 2009 National Health Interview Survey (NHIS) on selected health measures for children under age 18, classified by sex, age, race, Hispanic origin, family structure, parent education, family income, poverty status, health insurance coverage, place of residence, region, and current health status.

• “Children in poor families were more likely to have ever been diagnosed with asthma (18%) or to still have asthma (14%) than children in families that were not poor (13% and 8%).” (Page 13)
• “Poverty status was associated with children’s health. About 44% of children in poor families were in excellent health compared with 65% of children in families that were not poor.” (Page 13)
• “Children in poor families were four times as likely to be in fair or poor health (4%) as children in families that were not poor (1%).” (Pa 13)

The Impact of Late Career Job Loss on Myocardial Infarction and Stroke: A 10 Year Follow-Up Using the Health and Retirement Survey (Published by Occupational and Environmental Medicine 2006) 

This was a longer-term (10 years) study conducted on individuals over 50 years of age who suffered from involuntary job loss later in their careers. This is relevant to areas like the Southern Tier where large factories, often the major employers of a community, have been slowly leaving and laying off long time employees with few options for re-employment elsewhere (example: IBM). The study found significant negative consequences for health in these individuals similar to those of younger employees losing their jobs, but with additional health risks as well. Below are some of the findings from the study:

•  “Over the 10 year study frame, 582 individuals (13.5% of the sample) experienced involuntary job loss. After controlling for established predictors of the outcomes, displaced workers had a more than twofold increase in the risk of subsequent MI (hazard ratio (HR) = 2.48; 95% confidence interval (CI) = 1.49 to 4.14) and stroke (HR = 2.43; 95% CI = 1.18 to 4.98) relative to working persons.”
• “Results suggest that the true costs of late career unemployment exceed financial deprivation, and include substantial health consequences. Physicians who treat individuals who lose jobs as they near retirement should consider the loss of employment a potential risk factor for adverse vascular health changes.”
• “Research has demonstrated that involuntary job loss after age 50 is a stressful life event that has significant negative consequences for health.^1,2,3,4 Whereas job loss, in general, may involve numerous outcomes that threaten somatic wellbeing and longevity,⁵ including loss of income and health and pension benefits,^6,7,8,9 increased tobacco use,¹⁰ and adverse changes in mental health,^{11,12,13,14,15} unemployment in the years directly leading to retirement carries additional risks.”
• “Our results (table 2​2)) indicate that involuntary job loss is associated with a more than twofold increase in the risk of MI relative to working individuals, in both unadjusted (hazard ratio (HR)=2.51; 95% confidence interval (CI)=1.52 to 4.17) and adjusted analyses.”

Effects of Unemployment on Mental and Physical Health

This is a study conducted in the 1980s, but the findings within still have relevancy today. Researchers assessed 300 men in six month increments and compared those unemployed with those employed (re-assigning anyone whose employment terminated during the study). They found:

“symptoms of somatization, depression, and anxiety were significantly greater in the unemployed than employed…Furthermore, unemployed men made significantly more visits to their physicians, took more medications and spent more days in bed sick than did employed inviduals…” (Abstract).

Read more from their findings below:

• “Despite some recent decreases in the numbers of persons unemployed, it has been estimated that more than 9 percent of the work force will be out of work in 1984.’ Individual accounts of the devastating impact this can have on day-to-day living cannot be ignored.” (Page 1)
• “Unemployment is considered a stressful event which has the potential for affecting mortality and/or morbidity whether one is examining national trends in health and death rates (macro) or specific changes in selected individuals over time (micro).” (Page 1)
• “In a detailed prospective study which focused directly on the worker facing unemployment, Kasl examined a variety of indicators of health and economic strain over a two-year period.  He found elevated depression, anxiety, and somaticism occurring as brief initial responses for some workers; for others the emotional strain did not end when unemployment ended. It is possible, then, that for some of the unemployed, psychiatric symptoms were chronic. “ (Page 1)
• “The Work and Unemployment Project,’ a panel study looking at the effects of involuntary loss of jobs by husbands, showed that being without work was strongly associated with higher levels of psychiatric symptoms.” (Page 1)
• “Other investigations dealing with psychological consequences of unemployment have shown that inpatient first admissions to hospitals in a state system are significantly related to economic downturn for low status occupational groups and that there are significant relationships between hospital re-admission rates for psychiatric reasons and unemployment.” (Page 1)

Perceived job insecurity and worker health in the United States 

This 2009 study looked at how one perceives his/her job security impacts his/her health, specifically with the previous trend of decline in the manufacturing sector. This study is particularly interesting as the renewed interest in natural gas and oil development in the United States has brought with it a resurgence of manufacturing as well once again making this a more stable job sector for workers.

Results from the study, which looked at two nationally recognized samples of the U.S. population over a period of three to nearly ten years, showed (from the abstract):

“persistent perceived job insecurity is a significant and substantively important predictor of poorer self-rated health in the American’s Changing Lives (ACL) and Midlife in the United States (MIDUS) samples, and of depressive symptoms among ACL respondents.”

More from that study:

•  “Even after adjusting for sociodemographic and job characteristics, health prior to  baseline, neuroticism, hypertension and smoking status, and objective employment  insecurity…perceived job insecurity remains a significant predictor of subsequent health.” (Page 7)

Effects of Unemployment on Health in a Community Survey: Main, Modifying and Mediating Effects

This study may be a bit older (1988) but that’s because the topic of how employment impacts the health of communities is not a new one, and the findings are still relevant today. For this particular study, researchers examined an area in southeastern Michigan with high unemployment levels. Below are quotes detailing some of their findings.

• “Results from a community survey in a sample of high-unemployment census tracts in southeastern Michigan showed significant elevations of depression, anxiety, somatization, and self-reported physical illness among the currently unemployed. These adverse effects were largely reversed by re-employment.” (Page 1)
• “…these results suggest that unemployment had a substantial effect on ill health until re-employment and a small residual effect thereafter.” (Page 2)
• “For all four outcomes, people with unemployment experience had significantly higher risks of extreme ill health than the stably employed- roughly 1.5 times as high.” (Page 5)
• “We can say with confidence, then, that the experience of unemployment in this sample was associate with levels of distress severe enough to warrant professional intervention. The risk of these extreme levels was estimated from the logistic regression analyses to be at least 50% greater among those with unemployment experience than among the stably employed” (Page 7)
• “It should be noted that measures of drinking, drug use, suicidal ideation, and hospital bed days were all found to be significantly associated with unemployment in the total sample.” (Page 8)
• “Our results document that unemployment had health-damaging effects in the population severe enough to be considered clinically significant.” (Page 13)
• “We found two clear mechanisms through which unemployment causes ill health.  First, financial strain is of great importance. In its absence, the effects of current unemployment were only half what they were in its presence.  Second, unemployment compounds the effects of unrelated life events.” (Page 14)

The above studies showed that throughout a period of nearly three decades there has been consistency of data demonstrating employment, including perception of employment, leads to health increases among workers and their families.

So, if an industry proven over 100 years to be safe is bringing employment to an area the health of that area should improve as it did in the Barnett Shale.

The verdict has been in for a long time and it’s time to stop pretending science and health are issues with natural gas development in New York. In reality, two agencies of New York’s government have already said shale development can occur safely in New York.  These studies, and those statements, show New York’s health issue is a purely political one, intended to provide an excuse for whatever is decided or, in this case, not decided.