A PSNA Environmental Health Committee Update

Public Health Implications of Hydraulic Fracturing for Natural Gas Extraction: Nursing Role

By Carly Cruz, MSN, RN

While natural gas extraction has a significant role in our country’s energy resources, public health professionals have raised concerns about ground and surface water contamination and public health implications of exposures to the toxins used in this process (Riddlington, Dutzik, Van Heeke, Garber, & Masur, 2015).  High-volume hydraulic fracturing is the process of natural gas extraction by which fluid is injected into a horizontal well at a high pressure causing shale rock to crack, resulting in fissures which guide the natural gas to flow into the well (Earth Works, 2013).  During this process, methane gas and toxic chemicals leach out from the system and contaminate nearby surface water, which is used by local communities.  Wastewater, tainted by high levels of radioactive and toxic chemicals, is managed using various methods, including open air waste pits, stored and transported for reuse, treated and disposed of into rivers and streams, and has even been sprayed on roads, further increasing concerns for public health risks related to exposure to these toxic chemicals (Olmstead, Muehlenbachs, Shih, Chu, & Krupnick, 2013).

The United States House of Representatives Committee on Energy and Commerce noted in the (2011) report, Chemicals Used in Hydraulic Fracturing, that over 650 of the chemicals used in fracking are known human carcinogens and listed as hazardous pollutants (Waxman, Markey, & DeGette, 2011).  Substances (kerosene, diesel fuel, benzene, ethylbenzene, lead, uranium, mercury, radium, formaldehyde, hydrochloric acid, and hexavalent chromium) have been documented in fracking fluid (Earth Works, 2013; Waxman, Markey, & DeGette, 2011).  These carcinogens, endocrine disruptors, and neurotoxins are toxic to the skin, eyes, sensory organs, respiratory, gastrointestinal, nervous, immune, renal, and cardiovascular systems (Riddlington et al., 2015).

Those affected have reported negative health effects and illnesses ranging from rashes, headaches, nosebleeds, asthma, reproductive disorders, and cancer.  While all ages are affected, children, the elderly, and pregnant women are most at risk.  Children are more vulnerable to the impacts of gas extraction as their bodies are still developing; older adults have weaker immune systems, which make them more susceptible to toxic pollutants (Riddlington et al., 2015).  Children are at increased risk for negative health impacts when well sites are within one mile of schools, hospitals, and nursing homes, potentially placing our most vulnerable populations at an increased risk for illness and long term health effects (Riddlington et al., 2015).

The American Nurses Association (ANA) House of Delegates calls on nurses to “collaborate with others in calling for a national moratorium on new permits for unconventional oil and natural gas extraction (fracking) throughout the country until human and ecological safety can be ensured” (American Nurses Association, 2012).  It seeks for a mandated moratorium on fracking operations and associated structures until there is a required minimum setback of one mile relative to schools, daycares, hospitals, and nursing home facilities.  In addition, it seeks a ban on the use of open storage pools and toxic chemicals in fracking fluid.  A public health registry for healthcare professionals and affected individuals to report health impacts associated with fracking and other natural gas activities in Pennsylvania is one initiative.  Reports would include exposure history and symptoms.  It would not limit reports based on depth of the well.  Organizing and developing an information exchange for professionals and community members is essential for effective information dissemination throughout at risk populations in affected communities.

Given the health risks, it is not surprising that health professionals across Pennsylvania are signaling a need to take action on fracking.  Through partnerships with local advocates, funders, healthcare professionals, state and local policymakers, and other organizations, nurses will be more effective in creating policy change.

If you are interested in joining the public health coalition to improve policy and protect affected communities, please lend your support here (PennEnvironment, 2014).



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