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Exposure to Unconventional Oil and Gas Development and All-cause Mortality in Medicare Beneficiaries

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Longxiang Li
Longxiang Li
Longxiang Li
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Francesca Dominici at Harvard University
Francesca Dominici
Annelise Blomberg at Lund University
Annelise Blomberg
Falco J. Bargagli Stoffi at University of California, Los Angeles
Falco J. Bargagli Stoffi
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Little is known about whether exposure to unconventional oil and gas development is associated with higher mortality risks in the elderly and whether related air pollutants are exposure pathways. We studied a cohort of 15,198,496 Medicare beneficiaries (136,215,059 person-years) in all major US unconventional exploration regions from 2001 to 2015. We gathered data from records of more than 2.5 million oil and gas wells. For each beneficiary’s ZIP code of residence and year in the cohort, we calculated a proximity-based and a downwind-based pollutant exposure. We analysed the data using two methods: a Cox proportional hazards model and a difference-in-differences design. We found evidence of a statistically significant higher mortality risk associated with living in proximity to and downwind of unconventional oil and gas wells. Our results suggest that primary air pollutants sourced from unconventional oil and gas exploration can be a major exposure pathway with adverse health effects in the elderly.
Process diagram of our study design We obtained mortality information of all Medicare enrollees and then selected those residing in the study region. For each person-year of follow-up (indexed as (i,t) or (j,t) for different participants; k > 0 means successive years), we extracted data on the occurrence of death (F (false) means alive; T (true) means dead), individual-level covariates and the ZIP code of residence. The ZIP code of residence may have changed if the participant moved out of the original ZIP code. We calculated monthly UOGD exposures (PE and DE) based on the Enverus database and monthly prevailing wind-direction data. These monthly exposures were aggregated by year. Using the ZIP code for each person-year, the area of UOGD exposures (PE and DE) could be linked to individual records. Other area-based potential confounders such as socioeconomic factors and air-pollutant levels could also be linked to the records. SES, socioeconomic status.
Process diagram of our study design We obtained mortality information of all Medicare enrollees and then selected those residing in the study region. For each person-year of follow-up (indexed as (i,t) or (j,t) for different participants; k > 0 means successive years), we extracted data on the occurrence of death (F (false) means alive; T (true) means dead), individual-level covariates and the ZIP code of residence. The ZIP code of residence may have changed if the participant moved out of the original ZIP code. We calculated monthly UOGD exposures (PE and DE) based on the Enverus database and monthly prevailing wind-direction data. These monthly exposures were aggregated by year. Using the ZIP code for each person-year, the area of UOGD exposures (PE and DE) could be linked to individual records. Other area-based potential confounders such as socioeconomic factors and air-pollutant levels could also be linked to the records. SES, socioeconomic status.
… 
Map of the study area, which contains more than 120,000 active UOGD wells located in 9,244 ZIP codes as of December 2015 The study area was grouped into three subregions for subregional analysis. The northern subregion covers the Bakken and Niobrara formations. The eastern subregion covers the Marcellus and Utica formations. The southern subregion covers the Permian, Barnett, Eagle Ford, Haynesville, Woodford and Fayetteville formations.
Map of the study area, which contains more than 120,000 active UOGD wells located in 9,244 ZIP codes as of December 2015 The study area was grouped into three subregions for subregional analysis. The northern subregion covers the Bakken and Niobrara formations. The eastern subregion covers the Marcellus and Utica formations. The southern subregion covers the Permian, Barnett, Eagle Ford, Haynesville, Woodford and Fayetteville formations.
… 
UOGD exposure assessment in an example ZIP code and month (Washington, Pennsylvania 15301, August 2015) a, The locations of active UOGD wells, the 1 × 1 km grid population density and the prevailing monthly wind direction. b, The calculation of PE and DE metrics for an example grid in the ZIP code, which is outlined in bold in a. The proximity-based UOGD exposure (PE=IDWall=∑i=1N1di)\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$({\mathrm{PE}} = {\mathrm{IDW}}_{{\mathrm{all}}} = \mathop{\sum} \limits_{i=1}^{N} \frac {1} {d_i})$$\end{document} was calculated as the inverse-distance-weighted (IDW) of wells in all directions within a circular buffer with a radius of 5 km (set for illustration purposes) and was used in Model I of Analysis Set I. The UOGD exposure contributed by upwind wells (IDWup=∑j=1N1dj)\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$({\mathrm{IDW}}_{{\mathrm{up}}} = \mathop{\sum} \limits_{j=1}^{N} \frac {1} {d_j})$$\end{document} was calculated using the IDW of all wells that fall within the windward circular quadrant (pink-shaded area in b). The ratio between IDWup and IDWall is defined as the downwind-based exposure (DE = IDWup/IDWall) and was used in Model II of Analysis Set I. N, number of wells in circular buffer; n, number of wells in circular sectional buffer; d, distance between the well and the grid centre.
UOGD exposure assessment in an example ZIP code and month (Washington, Pennsylvania 15301, August 2015) a, The locations of active UOGD wells, the 1 × 1 km grid population density and the prevailing monthly wind direction. b, The calculation of PE and DE metrics for an example grid in the ZIP code, which is outlined in bold in a. The proximity-based UOGD exposure (PE=IDWall=∑i=1N1di)\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$({\mathrm{PE}} = {\mathrm{IDW}}_{{\mathrm{all}}} = \mathop{\sum} \limits_{i=1}^{N} \frac {1} {d_i})$$\end{document} was calculated as the inverse-distance-weighted (IDW) of wells in all directions within a circular buffer with a radius of 5 km (set for illustration purposes) and was used in Model I of Analysis Set I. The UOGD exposure contributed by upwind wells (IDWup=∑j=1N1dj)\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$({\mathrm{IDW}}_{{\mathrm{up}}} = \mathop{\sum} \limits_{j=1}^{N} \frac {1} {d_j})$$\end{document} was calculated using the IDW of all wells that fall within the windward circular quadrant (pink-shaded area in b). The ratio between IDWup and IDWall is defined as the downwind-based exposure (DE = IDWup/IDWall) and was used in Model II of Analysis Set I. N, number of wells in circular buffer; n, number of wells in circular sectional buffer; d, distance between the well and the grid centre.
… 
The results of Model I and Model II in Analysis Set I The estimated relative risk of mortality is shown, which is represented by the point estimate of the HR (centre point) and its 95% CI (error bar) associated with each level of proximity-based exposure to UOGD (PE) and subgroups of up- or down-wind exposure to UOGD (DE) within each PE level. Each PE level of exposure (low, medium-low, medium-high and high) and each subgroup of DE exposure (DE⁺ or DE⁻) was compared with the unexposed level. The unexposed level was defined as person-years for individuals whose residential addresses are distant from UOGD and COGD. a, Results from the Model I analysis, which investigated the relative risk of mortality associated with each PE level when compared with the unexposed level. b, Results from the Model II analysis, which investigated the association between PE and all-cause mortality in the DE⁺ and DE⁻ subgroups. We then compared the relative risks associated with the DE⁺ subgroup and the DE⁻ subgroup within each PE level using a t-test.
The results of Model I and Model II in Analysis Set I The estimated relative risk of mortality is shown, which is represented by the point estimate of the HR (centre point) and its 95% CI (error bar) associated with each level of proximity-based exposure to UOGD (PE) and subgroups of up- or down-wind exposure to UOGD (DE) within each PE level. Each PE level of exposure (low, medium-low, medium-high and high) and each subgroup of DE exposure (DE⁺ or DE⁻) was compared with the unexposed level. The unexposed level was defined as person-years for individuals whose residential addresses are distant from UOGD and COGD. a, Results from the Model I analysis, which investigated the relative risk of mortality associated with each PE level when compared with the unexposed level. b, Results from the Model II analysis, which investigated the association between PE and all-cause mortality in the DE⁺ and DE⁻ subgroups. We then compared the relative risks associated with the DE⁺ subgroup and the DE⁻ subgroup within each PE level using a t-test.
… 
Trends in all-cause mortality rate in the treatment group and comparison group pre- and post-drilling According to the drilling record of each UOGD well, we determined the year when drilling starts to take place in each ZIP code (intervention). For each ZIP code, calendar years before the drilling year were considered pre-drilling (x < 0), calendar years after drilling year were considered post drilling (x ≥ 0). In a ZIP code of treatment group, the PE increased from zero to medium-high or high level at the end of 2015. In a ZIP code of comparison group, the PE increased from zero to low or medium-low level. We calculated the average mortality rates for treatment and comparison group, regrouped by the difference between calendar year and drilling year.
+1
Trends in all-cause mortality rate in the treatment group and comparison group pre- and post-drilling According to the drilling record of each UOGD well, we determined the year when drilling starts to take place in each ZIP code (intervention). For each ZIP code, calendar years before the drilling year were considered pre-drilling (x < 0), calendar years after drilling year were considered post drilling (x ≥ 0). In a ZIP code of treatment group, the PE increased from zero to medium-high or high level at the end of 2015. In a ZIP code of comparison group, the PE increased from zero to low or medium-low level. We calculated the average mortality rates for treatment and comparison group, regrouped by the difference between calendar year and drilling year.
… 
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Articles
https://doi.org/10.1038/s41560-021-00970-y
1Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA. 2Department of Biostatistics, Harvard T. H. Chan
School of Public Health, Boston, MA, USA. 3Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. 4Present address:
Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden. ✉e-mail: lol087@mail.harvard.edu
Oil and natural gas development from low-permeability geo-
logical formations (known as unconventional oil and gas
development (UOGD)) has rapidly expanded over the past
decade. As of 2015, more than 100,000 onshore UOGD wells have
been drilled using directional drilling combined with multi-stage
high-volume hydraulic fracturing (fracking)1. A total of 17.6 million
US residents currently live within one kilometre of at least one active
well2. The annual percentage of newly completed oil and gas wells
that target unconventional formations increased from 2.3% in 2001
to 47% in 2015, and then to 71% in 2019. Compared with conven-
tional oil and gas development (COGD), UOGD generally involves
longer construction periods, larger well pads and requires larger
volumes of water, proppants and chemicals during the multi-stage
hydraulic fracturing process3. Owing to the rate of expansion and
larger theoretical environmental impacts, it is critical to study the
health effects and exposure pathway(s) of UOGD.
UOGD activities—including pad construction, well drilling,
hydraulic fracturing and production—have been associated with
increased human exposure to harmful agents4–7. UOGD-related
primary air contaminants include volatile organic compounds
(or VOCs)8, nitrogen oxides9 and naturally occurring radioac-
tive materials10,11. UOGD operations have also been associated
with elevated concentrations of organic compounds12, chloride
and total suspended solids in drinking water13. Higher levels of
UOGD-associated non-chemical exposures, such as noise14 and
night light15, have also been reported in nearby neighbourhoods.
Previous health-effects studies have found significant associations
between proximity-based exposure to UOGD and adverse prena-
tal16–19, respiratory20, cardiovascular21 and carcinogenic outcomes22.
The association between exposure to UOGD and all-cause
mortality among the elderly has not been quantified. In addition,
previous studies were conducted in specific geographical locations
and thus did not evaluate the heterogeneity in exposures and out-
comes across large geographical regions. Previous studies also did
not investigate the exposure pathway(s) through which UOGD
activities could lead to adverse health effects, primarily due to the
lack of any large-scale measurement of UOGD-sourced pollutants
in some intensively drilled regions. To address these gaps in the data
and characterize the spatiotemporal gradients of the UOGD-sourced
agents, investigators have designed proximity-based exposure (PE)
metrics of varying complexity23. Most of these PE metrics assumed
a uniform distance decay in the concentrations of UOGD-related
agents in all directions. Although this assumption largely holds for
noise and light pollution, which travel similarly in all directions, it
does not account for the directional dispersion of UOGD-sourced
airborne or waterborne pollutants in nearby environments. PE met-
rics could be improved by incorporating the transport mechanisms
of UOGD-sourced agents, such as wind direction and underground
water flow24. Accounting for the directional dispersion of agents
would also enable the investigation of potential exposure pathways.
Following the process shown in Fig. 1, we built an open cohort
of 15,198,496 Medicare beneficiaries (136,215,059 person-years)
residing in our study area (Fig. 2), which includes all major US
UOGD regions (Supplementary Note 1) from 2001 to 2015. We
also gathered location, construction and production records for
more than 2.5 million oil and gas wells. Rather than solely relying
on PE metrics, we calculated downwind-based exposure (DE) met-
rics, which incorporate the wind direction in the exposure assess-
ment (Fig. 3). On the basis of these two exposure metrics (PE and
DE), we conducted two sets of analyses (Analysis Set I and II) to
investigate whether or not living in proximity to and downwind of
UOGD wells is associated with higher mortality risks in Medicare
Exposure to unconventional oil and gas
development and all-cause mortality in
Medicare beneficiaries
Longxiang Li 1 ✉ , Francesca Dominici 2, Annelise J. Blomberg 1,4, Falco J. Bargagli-Stoffi 2,
Joel D. Schwartz1,3, Brent A. Coull1,2, John D. Spengler1, Yaguang Wei 1, Joy Lawrence1 and
Petros Koutrakis1
Little is known about whether exposure to unconventional oil and gas development is associated with higher mortality risks in
the elderly and whether related air pollutants are exposure pathways. We studied a cohort of 15,198,496 Medicare beneficia-
ries (136,215,059 person-years) in all major US unconventional exploration regions from 2001 to 2015. We gathered data from
records of more than 2.5 million oil and gas wells. For each beneficiary’s ZIP code of residence and year in the cohort, we cal-
culated a proximity-based and a downwind-based pollutant exposure. We analysed the data using two methods: a Cox propor-
tional hazards model and a difference-in-differences design. We found evidence of a statistically significant higher mortality
risk associated with living in proximity to and downwind of unconventional oil and gas wells. Our results suggest that primary
air pollutants sourced from unconventional oil and gas exploration can be a major exposure pathway with adverse health effects
in the elderly.
NATURE ENERGY | VOL 7 | FEBRUARY 2022 | 177–185 | www.nature.com/natureenergy 177
Content courtesy of Springer Nature, terms of use apply. Rights reserved
... After screening 3980 titles and abstracts, 52 studies met our inclusion criteria (Fig. 1). Two studies (Cairncross et al., 2022;Caron-Beaudoin et al., 2021) were set in Canada (British Columbia, Alberta), and the remainder were from US states including California, Colorado, New York, Ohio, Oklahoma, Pennsylvania, and Texas, with two spanning multiple states (Hu et al., 2022;Li et al., 2022). One study was industry-funded (Fryzek et al., 2013), and the majority (n = 38, 73%) were published after 2017 (Table 1). ...
... More recent studies further refined the IDW measure by development phase, well depth, and production volumes (Elliott et al., 2018;Koehler et al., 2018;McAlexander et al., 2020;Rasmussen et al., 2016;Tang et al., 2021;Tustin et al., 2017;Walker Whitworth et al., 2018). Several studies incorporated upwind/downwind or uphill/downhill directionality for air and water exposure measurement (Hill & Ma, 2022;Johnston et al., 2021;Li et al., 2022). Some researchers included flaring events Koehler et al., 2018;Willis et al., 2020), compressor engine activity (Koehler et al., 2018), and conventional oil and gas extraction as separate exposure covariates (Apergis et al., 2021;Elser et al., 2021;Schuele et al., 2022;Willis et al., 2020), or examined annual air (Apergis et al., 2021;Blinn et al., 2020;Brown et al., 2019;Hill, 2018;Hill & Ma, 2022;Hu et al., 2022;Li et al., 2022;McKenzie et al., 2017McKenzie et al., , 2019aTran et al., 2021;Willis et al., 2018) and water contamination (Hill, 2018;Hill & ** ALL: acute lymphoblastic leukemia *** "Any adverse" includes study outcomes included in the columns and others not included and falling under the same category ↑ = statistically significant increased risk; ↓ = statistically significant decreased risk; ↗/↘ = suggestive of an effect but non-significant (i.e., a p-value was between 0.05 and 0.1, and/or the lower CI was between 0.9 and 1.0, or authors reported a large effect magnitude); ↔ = nonsignificant alongside UOGD exposure metrics and/or model covariates. ...
... Several studies incorporated upwind/downwind or uphill/downhill directionality for air and water exposure measurement (Hill & Ma, 2022;Johnston et al., 2021;Li et al., 2022). Some researchers included flaring events Koehler et al., 2018;Willis et al., 2020), compressor engine activity (Koehler et al., 2018), and conventional oil and gas extraction as separate exposure covariates (Apergis et al., 2021;Elser et al., 2021;Schuele et al., 2022;Willis et al., 2020), or examined annual air (Apergis et al., 2021;Blinn et al., 2020;Brown et al., 2019;Hill, 2018;Hill & Ma, 2022;Hu et al., 2022;Li et al., 2022;McKenzie et al., 2017McKenzie et al., , 2019aTran et al., 2021;Willis et al., 2018) and water contamination (Hill, 2018;Hill & ** ALL: acute lymphoblastic leukemia *** "Any adverse" includes study outcomes included in the columns and others not included and falling under the same category ↑ = statistically significant increased risk; ↓ = statistically significant decreased risk; ↗/↘ = suggestive of an effect but non-significant (i.e., a p-value was between 0.05 and 0.1, and/or the lower CI was between 0.9 and 1.0, or authors reported a large effect magnitude); ↔ = nonsignificant alongside UOGD exposure metrics and/or model covariates. Two studies directly measured drinking water and/or air pollutants at participants' residences (Elliott et al., 2018;Steinzor et al., 2013) (Table 1; Online Resource 2). ...
The human health effects of unconventional oil and gas development (UOGD): A scoping review of epidemiologic studies
Article
Full-text available
  • Mar 2024
  • CAN J PUBLIC HEALTH
Objective Unconventional oil and gas development (UOGD, sometimes termed “fracking” or “hydraulic fracturing”) is an industrial process to extract methane gas and/or oil deposits. Many chemicals used in UOGD have known adverse human health effects. Canada is a major producer of UOGD-derived gas with wells frequently located in and around rural and Indigenous communities. Our objective was to conduct a scoping review to identify the extent of research evidence assessing UOGD exposure–related health impacts, with an additional focus on Canadian studies. Methods We included English- or French-language peer-reviewed epidemiologic studies (January 2000–December 2022) which measured exposure to UOGD chemicals directly or by proxy, and where health outcomes were plausibly caused by UOGD-related chemical exposure. Results synthesis was descriptive with results ordered by outcome and hierarchy of methodological approach. Synthesis We identified 52 studies from nine jurisdictions. Only two were set in Canada. A majority ( n = 27) used retrospective cohort and case–control designs. Almost half ( n = 24) focused on birth outcomes, with a majority ( n = 22) reporting one or more significant adverse associations of UOGD exposure with: low birthweight; small for gestational age; preterm birth; and one or more birth defects. Other studies identified adverse impacts including asthma ( n = 7), respiratory ( n = 13), cardiovascular ( n = 6), childhood acute lymphocytic leukemia ( n = 2), and all-cause mortality ( n = 4). Conclusion There is a growing body of research, across different jurisdictions, reporting associations of UOGD with adverse health outcomes. Despite the rapid growth of UOGD, which is often located in remote, rural, and Indigenous communities, Canadian research on its effects on human health is remarkably sparse. There is a pressing need for additional evidence.
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... Exposure to PM 2.5 has been associated with increased blood pressure and acute alteration in vascular function, which may contribute to hypertension, an AF risk factor (1,73,(76)(77)(78)(79). Interestingly, our results indicate that living near development of an O&G well site has a greater impact on older and female AF patients. Other studies also have observed that older adults living in close proximity to O&G well sites may bear greater health and mortality risks than younger adults (43,80). Additionally, prior studies report that both women and the elderly are at higher risk of mortality and CV mortality when exposed to elevated PM 2.5 levels (81). ...
Oil and gas development exposure and atrial fibrillation exacerbation: a retrospective study of atrial fibrillation exacerbation using Colorado's all payer claims dataset
Article
Full-text available
  • Jun 2024
Introduction Emerging risk factors for atrial fibrillation (AF) incidence and episodes (exacerbation), the most common and clinically significant cardiac arrhythmia, include air and noise pollution, both of which are emitted during oil and natural gas (O&G) well site development. Methods We evaluated AF exacerbation risk and proximity to O&G well site development by employing a novel data source and interrupted time-series design. We retrospectively followed 1,197 AF patients living within 1-mile of an O&G well site (at-risk of exposure) and 9,764 patients living >2 miles from any O&G well site (unexposed) for AF claims in Colorado's All Payer Claims Dataset before, during, and after O&G well site development. We calculated AF exacerbation risk with multi-failure survival analysis. Results The analysis of the total study population does not provide strong evidence of an association between AF exacerbation and proximity to O&G wells sites during (HR = 1.07, 95% CI: 0.94, 1.22) or after (HR = 1.01, 95% CI: 0.88, 1.16) development. However, AF exacerbation risk differed by patient age and sex. In patients >80 years living within 0.39 miles (2,059 feet) of O&G well site development, AF exacerbation risk increased by 83% (HR = 1.83, 95% CI: 1.25, 2.66) and emergency room visits for an AF event doubled (HR = 2.55, 95% CI: 1.50, 4.36) during development, with risk increasing with proximity. In female patients living within 0.39 miles of O&G well site development, AF exacerbation risk increased by 56% percent (95% CI: 1.13, 2.15) during development. AF exacerbation risk did not persist past the well development period. We did not observe increased AF exacerbation risk in younger or male patients. Discussion The prospect that proximity to O&G well site development, a significant noise and air pollution source, may increase AF exacerbation risk in older and female AF patients requires attention. These findings support appropriate patient education to help mitigate risk and development of mitigation strategies and regulations to protect the health of populations in O&G development regions.
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... 45 Within a 15 km radius, the relative proximity to active fracking wells was assessed using an inverse-distance-weighting method, which is described elsewhere. 46 Briefly, each zip code was divided into 1 × 1 km grid cells, and the distance between the center of the grid and the active fracking wells within a 15 km circular buffer was calculated. To account for the uneven distribution of participants within a zip code, the inverse of these distances was then added and averaged at a zip code level by taking a weighted average of the grid-level proximity measures according to the grid-level population density obtained from the Gridded Population of the World, version 4. 47 Race-and ethnicity-specific models were also dichotomized into whether the stillbirth occurred within 15 km of active fracking wells to examine whether the effect of proximity to fracking wells on the relationship between short-term increases in NO 2 exposure and stillbirth risk varied by race/ethnicity. ...
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... A climate mitigation strategy that entails a fossil fuel phase-out with limited CDR and CCS reliance would also bring about localized, near-term benefits from reduced air and water pollution 78,79 , human rights violations 80 , and biodiversity loss 81 , among others. For example, exposure to outdoor fine particulate matter pollution from fossil fuel combustion is estimated to lead to around 8.7 million premature deaths worldwide each year 82 , while an increasing number of studies are documenting adverse health impacts including premature birth, respiratory diseases, and cancer associated with living near fossil fuel extraction sites [83][84][85][86] . ...
Global fossil fuel reduction pathways under different climate mitigation strategies and ambitions
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The mitigation scenarios database of the Intergovernmental Panel on Climate Change’s Sixth Assessment Report is an important resource for informing policymaking on energy transitions. However, there is a large variety of models, scenario designs, and resulting outputs. Here we analyse the scenarios consistent with limiting warming to 2 °C or below regarding the speed, trajectory, and feasibility of different fossil fuel reduction pathways. In scenarios limiting warming to 1.5 °C with no or limited overshoot, global coal, oil, and natural gas supply (intended for all uses) decline on average by 95%, 62%, and 42%, respectively, from 2020 to 2050, but the long-term role of gas is highly variable. Higher-gas pathways are enabled by higher carbon capture and storage (CCS) and carbon dioxide removal (CDR), but are likely associated with inadequate model representation of regional CO 2 storage capacity and technology adoption, diffusion, and path-dependencies. If CDR is constrained by limits derived from expert consensus, the respective modelled coal, oil, and gas reductions become 99%, 70%, and 84%. Our findings suggest the need to adopt unambiguous near- and long-term reduction benchmarks in coal, oil, and gas production and use alongside other climate mitigation targets.
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... A study of over 15 million Medicare beneficiaries found "evidence of a statistically significant higher mortality risk associated with living in proximity to and downwind of unconventional oil and gas wells" [113]. ...
Fossil fuel racism in the United States: How phasing out coal, oil, and gas can protect communities
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Full-text available
  • Jun 2023
Fossil fuels — coal, oil, and gas — lie at the heart of the interconnected crises we face, including climate change, racial injustice, and public health. Each stage of the fossil fuel life cycle — extraction, processing, transport, and combustion — generates toxic air and water pollution, as well as greenhouse gas (GHGs) emissions that drive the global climate crisis. Addressing the harmful effects of energy decisions, including unequal risk distribution across various governance levels, supply chains, and political jurisdictions, is a complex task for policymakers and society. A deeper understanding of how harms are embodied within fossil fuel life cycles is needed. This paper provides a narrative review of recent studies within the United States (U.S.) that document both public health harms and disproportionate impacts along the fossil fuel life cycle. In the U.S. the public health hazards from air and water pollution, and risks associated with climate change, fall disproportionately on Black, Brown, Indigenous, and poor communities. “Sacrifice zones” and systemic racism are deeply intertwined within the fossil-fuel based economy. We argue systemic racism subsidizes the fossil fuel industry by enabling it to externalize the costs of pollution and environmental degradation onto communities of color. We position “fossil fuel racism” as a subset of environmental racism and argue that this framing is useful because it shifts analytical and political focus to the systems and structures which are actively protecting and promoting continued production of fossil fuels. We discuss the implications of this body of research for climate policy, and outline how poorly designed “carbon-centric” policies—which focus narrowly on GHGs reduction—could fail to alleviate the racialized disparities or potentially worsen it for some communities. We emphasize the need to move beyond carbon-centric approaches to climate solutions to more integrative approaches to policy design that can improve public health, tackle the global climate crisis, and rectify our legacy of fossil fuel racism. Specifically we call for a managed phase out of fossil fuel production and the enactment of wider programs of social, economic, and democratic reforms via a Green New Deal. Adequately addressing the climate crisis and fossil fuel racism require political and policy solutions that disrupt the power and actions of the fossil fuel industry and their state allies.
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... We also saw increased GWV among communities with older populations, which may pose public health challenges given the physiologic susceptibilities of the elderly to environmental stressors, including degraded drinking water quality (Beaudeau et al., 2014;Geller & Zenick, 2005;Hong, 2013). Indeed, a recent national scale study found statistically significant increases in all-cause mortality among elderly populations living near UOG sites, highlighting the urgency of research focused on these vulnerable populations (Li et al., 2022). Additional empirical work is needed to elucidate the social processes that drive these observed associations, for instance, whether the association between elevated GWV and greater elderly populations is the result of aging in place (i.e., Are elderly residents more likely to own and lease their mineral rights?) or migration (i.e., Are elderly people moving into retirement destinations that host intensive UOG activities?) (Smith & Trevelyan, 2019). ...
Social Vulnerability and Groundwater Vulnerability to Contamination From Unconventional Hydrocarbon Extraction in the Appalachian Basin
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Unconventional oil and gas (UOG) development, made possible by horizontal drilling and high-volume hydraulic fracturing, has been fraught with controversy since the industry's rapid expansion in the early 2000's. Concerns about environmental contamination and public health risks persist in many rural communities that depend on groundwater resources for drinking and other daily needs. Spatial disparities in UOG risks can pose distributive environmental injustice if such risks are disproportionately borne by marginalized communities. In this paper, we analyzed groundwater vulnerability to contamination from UOG as a physically based measure of risk in conjunction with census tract level sociodemographic characteristics describing social vulnerability in the northern Appalachian Basin. We found significant associations between elevated groundwater vulnerability and lower population density, consistent with UOG development occurring in less densely populated rural areas. We also found associations between elevated groundwater vulnerability and lower income, higher proportions of elderly populations, and higher proportion of mobile homes, suggesting a disproportionate risk burden on these socially vulnerable groups. We did not find a statistically significant association between elevated groundwater vulnerability and populations of racial/ethnic minorities in our study region. Household surveys provided empirical support for a relationship between sociodemographic characteristics and capacity to assess and mitigate exposures to potentially contaminated water. Further research is needed to probe if the observed disparities translate to differences in chemical exposure and adverse health outcomes.
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... 13 As documented in several reviews, [13][14][15][16] studies have linked exposure to natural gas extraction with asthma exacerbations, [17][18][19] adverse pregnancy outcomes, 20-35 cardiovascular disease, [36][37][38] adverse mental health outcomes, 39,40 and mortality. 41 Flaring-a form of waste disposal-from natural gas development sites also has measurable adverse health impacts. 18,42 Natural gas extraction has been associated with increased concentrations of radioactive particles in the air. ...
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Full-text available
  • Apr 2023
Energy policy decisions are driven primarily by economic and reliability considerations, with limited consideration given to public health, environmental justice, and climate change. Moreover, epidemiologic studies relevant for public policy typically focus on immediate public health implications of activities related to energy procurement and generation, considering less so health equity or the longer-term health consequences of climate change attributable to an energy source. A more integrated, collective consideration of these three domains can provide more robust guidance to policymakers, communities, and individuals. Here, we illustrate how these domains can be evaluated with respect to natural gas as an energy source. Our process began with a detailed overview of all relevant steps in the process of extracting, producing, and consuming natural gas. We synthesized existing epidemiologic and complementary evidence of how these processes impact public health, environmental justice, and climate change. We conclude that, in certain domains, natural gas looks beneficial (e.g., economically for some), but when considered more expansively, through the life cycle of natural gas and joint lenses of public health, environmental justice, and climate change, natural gas is rendered an undesirable energy source in the United States. A holistic climate health equity framework can inform how we value and deploy different energy sources in the service of public health.
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Mitigating the Invasive Method of Hydraulic Fracturing Through a Phase Out Policy Plan
Article
  • Apr 2024
Hydraulic fracturing, or fracking, is a process used to extract natural gas from shale deposits deep below the surface. Fracking is heralded as a “clean” energy source compared to other extraction methods due to comparatively low carbon emissions. The fracking industry decreases the U.S.’s dependence on foreign nations for energy and brings valuable job opportunities when sites are first established; however, affected communities do not experience the benefits of these economic “booms” for long. Concerns like increased cancer risk from air and water contamination are linked to fracking activity. Fracking operators are not required to disclose the contents of ‘proprietary’ fracking fluids used in extraction, which are known to contain chemicals that threaten public and environmental health. Fracking has detrimental effects on national public health and contributes to climate change through elevated methane emissions. Therefore, to help mitigate these challenges, we recommend a phase out plan including 1) increasing setback requirements and eliminating any exemptions, 2) managing methane (CH₄) leakages and improving monitoring systems on all sites, 3) mandating disclosure reports, and 4) mandating the collection of preliminary data to facilitate a bottom-up approach to management. We use Pennsylvania as a case study due to the state’s prevalence of fracking and the current policies and regulations in place for drilling.
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Unconventional oil and gas development and ambient particle radioactivity
Article
Full-text available
  • Oct 2020
Unconventional oil and natural gas development (UOGD) expanded extensively in the United States from the early 2000s. However, the influence of UOGD on the radioactivity of ambient particulate is not well understood. We collected the ambient particle radioactivity (PR) measurements of RadNet, a nationwide environmental radiation monitoring network. We obtained the information of over 1.5 million wells from the Enverus database. We investigated the association between the upwind UOGD well count and the downwind gross-beta radiation with adjustment for environmental factors governing the natural emission and transport of radioactivity. Our statistical analysis found that an additional 100 upwind UOGD wells within 20 km is associated with an increase of 0.024 mBq/m³ (95% confidence interval [CI], 0.020, 0.028 mBq/m³) in the gross-beta particle radiation downwind. Based on the published health analysis of PR, the widespread UOGD could induce adverse health effects to residents living close to UOGD by elevating PR.
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Fracking and infant mortality: fresh evidence from Oklahoma
Article
Full-text available
  • Nov 2019
  • ENVIRON SCI POLLUT R
This paper explores the impact of shale gas and oil fracking wells on infants’ health at birth across Oklahoma counties. The empirical analysis makes use of the Dumitrescu-Hurlin causality test, as well as the (long-run) Pooled Mean Group method. The results clearly document that there is a unidirectional relationship between fracking activities and three alternative indexes of infants’ health at birth, as well as a significant impact of fracking on infants’ health indicators. In addition, the results illustrate the substantial role of fracking through the drinking water quality channel.
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Assessing exposure to unconventional natural gas development: using an air pollution dispersal screening model to predict new-onset respiratory symptoms
Article
Full-text available
  • Aug 2019
Various exposure estimates have been used to assess health impact of unconventional natural gas development (UNGD). The purpose of this study was to (1) use an air pollution dispersal screening model and wind direction to characterize the air emissions from UNGD facilities at each residence and (2) assess association of this exposure estimate with respiratory symptoms. Respiratory symptoms were abstracted from health records of a convenience sample of 104 adults from one county in southwestern PA who had completed a standard clinical interview with a nurse practitioner. Using publicly available air emission data, we applied a “box” air pollution dispersion screening model to estimate the median ambient air level of CO, NOx, PM 2.5, VOCs, and formaldehyde at the residence during the year health symptoms were reported. Sources and median emissions were categorized as north, south, east, or west of the residence to account for the effect of wind direction on dispersion. Binary logistic regression was performed for each respiratory symptom. Number of sources had varying magnitudes of association with some symptoms (i.e., cough, shortness of breath, and “any respiratory symptom”) and no association with others (i.e., sore throat, sinus problems, wheezing). Air emissions were not associated with any symptom.
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Potential Human Health Effects Associated with Unconventional Oil and Gas Development: Review of the Epidemiologic Literature and Identification of a Path Forward
Article
  • Oct 2019
The full publications from HEI Energy and the Research Committee can be downloaded at https://hei-energy.org/. There are two reports. One is a systematic review of the epidemiology literature and the other is a companion exposure report.
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Hazardous Air Pollutants Associated with Upstream Oil and Natural Gas Development: A Critical Synthesis of Current Peer-Reviewed Literature
Article
  • Apr 2019
Increased energy demands and innovations in upstream oil and natural gas (ONG) extraction technologies have enabled the United States to become one of the world's leading producers of petroleum and natural gas hydrocarbons. The US Environmental Protection Agency (EPA) lists 187 hazardous air pollutants (HAPs) that are known or suspected to cause cancer or other serious health effects. Several of these HAPs have been measured at elevated concentrations around ONG sites, but most have not been studied in the context of upstream development. In this review, we analyzed recent global peer-reviewed articles that investigated HAPs near ONG operations to (a) identify HAPs associated with upstream ONG development, (b) identify their specific sources in upstream processes, and (c) examine the potential for adverse health outcomes from HAPs emitted during these phases of hydrocarbon development.
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Characterizing Flaring from Unconventional Oil and Gas Operations in South Texas Using Satellite Observations
Article
  • Jan 2019
Over the past decade, increases in high-volume hydraulic fracturing for oil and gas extraction in the United States have raised concerns with residents living near wells. Flaring, or the combustion of petroleum products into the open atmosphere, is a common practice associated with oil and gas exploration and production, and has been under-examined as a potential source of exposure. We leveraged data from the Visible Infrared Imaging Spectroradiometer (VIIRS) Nightfire satellite product to characterize the extent of flaring in the Eagle Ford Shale region of south Texas, one of the most productive in the nation. Spatiotemporal hierarchical clustering identified flaring sources, and a regression-based approach combining VIIRS information with reported estimates of vented and flared gas from the Railroad Commission of Texas enabled estimation of flared gas volume at each flare. We identified 43,887 distinct oil and gas flares in the study region from 2012-2016, with a peak in activity in 2014 and an estimated 4.5 billion cubic meters of total gas volume flared over the study period. A comparison with well permit data indicated the majority of flares were associated with oil-producing (82%) and horizontally-drilled (92%) wells. Of the 49 counties in the region, 5 accounted for 71% of the total flaring. Our results suggest flaring may be a significant environmental exposure in parts of this region.
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Relationships between Indicators of Cardiovascular Disease and Intensity of Oil and Natural Gas Activity in Northeastern Colorado
Article
  • Dec 2018
Background: Oil and natural gas (O&G) extraction emits pollutants that are associated with cardiovascular disease, the leading cause of mortality in the United States. Objective: We evaluated associations between intensity of O&G activity and cardiovascular disease indicators. Methods: Between October 2015 and May 2016, we conducted a cross-sectional study of 97 adults living in Northeastern Colorado. For each participant, we collected 1-3 measurements of augmentation index, systolic and diastolic blood pressure (SBP and DBP), and plasma concentrations of interleukin (IL)- 1β, IL-6, IL-8 and tumor necrosis factor alpha (TNF-α). We modelled the intensity of O&G activity by weighting O&G well counts within 16 km of a participant's home by intensity and distance. We used linear models accounting for repeated measures within person to evaluate associations. Results: Adjusted mean augmentation index differed by 6.0% (95% CI: 0.6, 11.4%) and 5.1% (95%CI: -0.1, 10.4%) between high and medium, respectively, and low exposure tertiles. The greatest mean IL-1β, and α-TNF plasma concentrations were observed for participants in the highest exposure tertile. IL-6 and IL-8 results were consistent with a null result. For participants not taking prescription medications, the adjusted mean SBP differed by 6 and 1 mm Hg (95% CIs: 0.1, 13 mm Hg and -6, 8 mm Hg) between the high and medium, respectively, and low exposure tertiles. DBP results were similar. For participants taking prescription medications, SBP and DBP results were consistent with a null result. Conclusions: Despite limitations, our results support associations between O&G activity and augmentation index, SBP, DBP, IL-1β, and TNF-α. Our study was not able to elucidate possible mechanisms or environmental stressors, such as air pollution and noise.
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Shale gas development and infant health: Evidence from Pennsylvania
Article
  • Aug 2018
This research exploits the introduction of shale gas wells in Pennsylvania in response to growing controversy around the drilling method of hydraulic fracturing. Using detailed location data on maternal addresses and GIS coordinates of gas wells, this study examines singleton births to mothers residing close to a shale gas well from 2003 to 2010 in Pennsylvania. The introduction of drilling increased low birth weight and decreased term birth weight on average among mothers living within 2.5 km of a well compared to mothers living within 2.5 km of a permitted well. Adverse effects were also detected using measures such as small for gestational age and APGAR scores, while no effects on gestation periods were found. In the intensive margin, an additional well is associated with a 7 percent increase in low birth weight, a 5 g reduction in term birth weight and a 3 percent increase in premature birth. These results are robust to other measures of infant health, many changes in specification and falsification tests. These findings suggest that shale gas development poses significant risks to human health.
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Exposure Assessment Using Secondary Data Sources in Unconventional Natural Gas Development and Health Studies
Article
  • Apr 2018
Studies of unconventional natural gas development (UNGD) and health have ranked participants along a gradient of geographic information system (GIS)-based activity that incorporated distance between participants’ home addresses and unconventional natural gas wells. However, studies have used different activity metrics, making results comparisons across studies difficult. Existing studies have only incorporated wells, without accounting for other components of development (e.g., compressors, impoundments, flaring events), for which it is often difficult to obtain reliable data, but may have relevance to health. Our aims were to: (1) describe, in space and time, UNGD-related compressors, impoundments, and flaring events; (2) evaluate whether and how to incorporate these into UNGD activity assessment; (3) evaluate associations of these different approaches with mild asthma exacerbations. We identified 361 compressor stations, 1,218 impoundments, and 216 locations with flaring events. A principal component analysis identified a single component that was approximately an equal mix of the metrics for compressors, impoundments, and four phases of well development (pad preparation, drilling, stimulation, and production). However, temporal coverage for impoundments and flaring data was sparse. Ultimately, we evaluated three UNGD activity metrics, including two based on existing studies and a novel metric that included well pad development, drilling, stimulation, production and compressor engine aspects of UNGD. The three metrics had varying magnitudes of association with mild asthma exacerbations, although the highest category of each metric (vs. the lowest) was associated with the outcome.
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