Other documented adverse health indicators among residents living near drilling and fracking operations variously include exacerbation of asthma as well as increased rates of hospitalization, ambulance runs, emergency room visits, self-reported respiratory problems and rashes, motor vehicle fatalities, trauma, drug abuse, and gonorrhea. Pennsylvania residents with the highest exposure to active fracked gas wells were nearly twice as likely to experience a combination of migraine headaches, chronic nasal and sinus symptoms, and severe fatigue.