Compendium of Scientific, Medical, and Media Findings Demonstrating Risks and Harms of Fracking (Unconventional Gas and Oil Extraction)

Sixth Edition

June 2019

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About this Report

The Compendium is organized to be accessible to public officials, researchers, journalists, and the public at large. The reader who wants to delve deeper can consult the reviews, studies, and articles referenced herein. In addition, the Compendium is complemented by a fully searchable, near-exhaustive citation database of peer-reviewed journal articles pertaining to shale gas and oil extraction, the Repository for Oil and Gas Energy Research, that was developed by PSE Healthy Energy and which is housed on its website (

For this sixth edition of the Compendium, as before, we collected and compiled findings from three sources: articles from peer-reviewed medical or scientific journals; investigative reports by journalists; and reports from, or commissioned by, government agencies. Peer-reviewed articles were identified through databases such as PubMed and Web of Science, and from within the PSE Healthy Energy database. We included review articles when such reviews revealed new understanding of the evidence.


Knowledge base

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As is revealed in the Repository for Oil and Gas Energy Research (ROGER), the database of literature maintained by PSE Healthy Energy, the number of peer-reviewed publications relevant to assessing the environmental, socioeconomic, and public health impacts of shale gas development doubled between 2011 and 2012. It doubled again between 2012 and 2013.32

This trend continues. More than half of the peer-reviewed scientific papers on the risks and harms of fracking have been published since January 2016. Indeed, 20 percent (355 studies) of the now more than 1,700 available studies were published in 2018 alone.

As of April 16, 2019, there were 1,778 published peer-reviewed studies that pertain to shale and tight gas development archived in the ROGER database.33

This body of evidence clearly reveals both potential and actual harms. Specifically, PSE’s statistical analysis of the scientific literature available from 2009 to 2015 demonstrates that:

  • 69 percent of original research studies on water quality found potential for, or actual evidence of, fracking-associated water contamination,
  • 87 percent of original research studies on air quality found significant air pollutant emissions, and
  • 84 percent of original research studies on human health risks found signs of harm or indication of potential harm


A follow-up analysis using the same criteria for inclusion found that 90.3 percent of all original research studies published from 2016-2018 on the health impacts of fracking found a positive association with harm or potential harm


Introduction to fracking

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Earlier scientific predictions are now bolstered by extensive empirical data, confirming that the public health risks from unconventional gas and oil extraction are real, the range of adverse environmental impacts wide, and the negative economic consequences considerable. Our examination of the peer-reviewed medical, public health, biological, earth sciences, and engineering literature uncovered no evidence that fracking can be practiced in a manner that does not threaten human health.

 The incomplete picture created by lack of transparency in regard to chemicals used, produced, emitted, or created during the drilling and fracking process complicates the task of identifying potential hazards and exposure pathways. Nevertheless, the evidence to date indicates that fracking operations pose severe threats to health, both from water contamination and from air pollution.


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In the air around drilling and fracking operations and their attendant infrastructure, researchers have measured strikingly high levels of toxic pollutants, including the potent carcinogen benzene and the chemical precursors of ground-level ozone (smog). In some cases, concentrations of fracking-related air pollutants in communities where people live and work exceed federal safety standards. Research shows that air emissions from fracking can drift and pollute the air hundreds of miles downwind.


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Emerging Trends

Regulations are simply not capable of preventing harm.

Studies reveal inherent problems in the natural gas and oil extraction process, such as well integrity failures caused by aging or the pressures of fracking itself, and in the waste disposal process. These issues lead to water contamination, greenhouse gas emissions, air pollution with carcinogens and other toxic chemicals, earthquakes, and a range of environmental and other stressors inflicted on communities.

Some of fracking’s many component parts—which include the subterranean geological landscape itself—are simply not controllable.

The injection of ever-increasing volumes of fluids into an ever-increasing number of wells creates significant deformations in the shale. These are translated upwards, a mile or more, to the surface. Along the way, these “pressure bulbs” can impact, in unpredictable ways, faults and fissures in the overlying rock strata, including strata that intersect fresh water aquifers. Such pressure bulbs may mobilize contaminants left over from previous drilling and mining activities. (See footnotes 370, 371.) No set of regulations can obviate these potential impacts to groundwater.

No set of regulations can eliminate earthquake risks. (See footnote 752.) In spite of growing knowledge about the mechanics of how fracking and the underground disposal of fracking waste trigger earthquakes via activation of faults, no model can predict where or when earthquakes will occur or how powerful they will be. New research demonstrates that induced earthquakes can occur many miles from fracking sites. (See footnote 73.)

Regulations cannot prevent air pollution. The state of California determined that fracking can have “significant and unavoidable” impacts on air quality, including driving pollutants to levels that violate air quality standards. (See footnote 173.) In northeastern Colorado, ambient levels of atmospheric hydrocarbons have continued to increase even with stricter emission standards.

Tighter state regulations and tougher enforcement, including unannounced visits by state health inspectors equipped with infrared cameras, have reduced leaking methane and toxic vapors at individual well sites, but total air emissions continue to rise as the total number of wells continues to increase.

Leakage rates among active wells are wildly variable: Four percent of wells nationwide are responsible for fully half of all methane emissions from drilling and fracking-related activities. Predicting which wells will become “super-emitters” is not possible, according to a 2016 survey of 8,000 wells using helicopters and infrared cameras. Further, much of this leakage is engineered into the routine operation of fracking extraction, processing, and transport infrastructure, as when vapors are vented through release valves in order to regulate pressure.

Long after they are decommissioned, well sites continue to leak in ways that are not always fixable. Abandoned wells are a significant source of methane leakage into the atmosphere, and, based on findings from New York and Pennsylvania, may exceed cumulative total leakage from oil and gas wells currently in production. Plugging abandoned wells does not always reduce methane emissions, and cement plugs themselves deteriorate over time.


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Fracking and natural gas are incompatible with climate solutions.

On the grounds that natural gas emits, when combusted, only 53 percent of the carbon dioxide emitted by coal, early promoters of fracking argued that natural gas could serve as a “bridge fuel” while renewable energy sources ramp up. Scientific evidence now disproves these claims and shows that natural gas is as damaging to the climate as coal, and may be worse.

methane can, pound for pound, trap 86 times more heat than carbon dioxide.


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Real-world methane leakage rates from drilling and fracking operations greatly exceed earlier estimates. Methane escapes into the atmosphere from all parts of the extraction, processing, and distribution system, all the way to the burner tip. In the heavily drilled Barnett Shale of northeastern Texas, methane emissions were shown to be 50 percent higher than the EPA had estimated. Fracking operations and associated infrastructure contributed 71-85 percent of the methane emissions in the region.

Much of the methane emitted from drilling and fracking activities and associated infrastructure originates not from accidental leaks but from purposeful losses that are inherent to the design of the industry’s machinery or to normal operating use and are, therefore, not possible to mitigate.

Instead, methane levels began to rise in 2007 and then shot up sharply in 2014.

Robert Howarth used isotopic analysis to identify shale gas and oil extraction as the source of at least one-third of total   methane emissions, showing that the North American fracking boom is globally important in the current rise in global methane levels and “may well be the leading cause of the increased flux.”


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3) Fracking and the disposal of fracking waste threaten drinking water.

Cases of drinking water sources contaminated by drilling and fracking activities, or by associated waste disposal, are proven. Contamination occurs through three confirmed pathways: spills; discharge of fracking waste into rivers and streams; and underground migration of chemicals, including gas, into drinking water wells.

Methane and fracking-related contaminants can reach drinking water sources through cracks in well casings, through spaces between the casing and the wellbore, through naturally occurring fractures and fissures connecting shale layers with aquifers, and through abandoned wells. Methane migration into drinking water aquifers can change water chemistry in ways that mobilize metals or release hydrogen sulphide

Researchers working in Texas found 19 different fracking-related contaminants—including cancer-causing benzene—in hundreds of drinking water samples collected from the aquifer overlying the heavily drilled Barnett Shale, thereby documenting widespread water contamination. In Pennsylvania, a solvent used in fracking fluid was found in drinking water wells near drilling and fracking operations known to have well casing problems. In California, state regulators admitted that they had mistakenly allowed oil companies to inject drilling wastewater into aquifers containing clean, potable water.


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With increasing volumes of wastewater now exceeding the storage capacity for underground injection wells—and with underground injection linked to earthquake risk—Texas, Colorado, and New Mexico are now petitioning the EPA to allow release of fracking wastewater into rivers and streams and to allow its use for irrigation and watering livestock. These practices further imperil drinking water sources.

A 2018 study found that water used for U.S. fracking operations increased by 770 percent per well between 2011 and 2016, while the amount of wastewater generated increased by 1,440 percent.

4) Drilling and fracking contribute to toxic air pollution and ground-level ozone at levels known to have health impacts.

More than 200 airborne chemical contaminants have been detected near drilling and fracking sites. Of these, 61 are classified as hazardous air pollutants, including carcinogens; 26 are endocrine-disrupting compounds that have been linked to reproductive, developmental, and neurological damage. (See footnotes 134, 146.) Drilling and fracking operations emit fine particles and vapors that combine to create ground-level ozone (smog). Exposure to these pollutants is known to cause premature death, exacerbate asthma, and contribute to poor birth outcomes and increased rates of hospitalization and emergency room visits.


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Emissions from flare stacks contribute to ozone creation and include several carcinogens, notably benzene and formaldehyde. Flaring also releases carbon monoxide, soot, and toxic heavy metals.

A 2017 study of plume samples from gas flares in North Dakota found that incomplete combustion from flaring is responsible for 20 percent of the total emissions of methane and ethane from the Bakken shale fields

5) Public health problems associated with drilling and fracking include poor birth outcomes, reproductive and respiratory impacts, and cancer risks.

Poor pregnancy outcomes and exacerbation of asthma

Studies …consistently find impairments to infant health, including elevated risks for low birth weight and preterm birth

poorer infant health and significantly lower birth weight

40 percent increase in the risk of preterm birth among infants

elevated incidence of neural tube defects and congenital heart defects

elevated levels of muconic acid—a marker of benzene exposure—in the urine of pregnant women living near fracking sites


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Elevated levels of barium and strontium in urine and hair samples of indigenous women living in an area of intense fracking activity

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.

higher rates of leukemia among children and young adults living in areas dense with oil and gas wells, while a Yale University research team reported that carcinogens involved in fracking operations had the potential to contaminate both air and water in nearby communities in ways that may increase the risk of childhood leukemia. The Yale team identified 55 known or possible carcinogens that are known to be used in fracking operations and that may be released into the air and water. Of these, 20 are linked to leukemia or lymphoma.

As we went to press, the Pittsburgh Post-Gazette documented 27 cases of Ewing’s sarcoma, a rare bone cancer that tends to strike young people, in four counties in southwestern Pennsylvania that are at the center of the Marcellus Shale fracking boom. Six cases occurred in the same school district. (The typical rate is 250 cases of Ewing’s sarcoma per year in the United States as a whole. The cancer has no known cause.) There are also high numbers of other childhood cancers in the region, which is home to several polluting legacy industries… calls for more comprehensive investigations are ongoing.


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6) Occupational health and safety risks for workers are severe and include both physical and chemical hazards.

Drilling and fracking operations are exempt from federal Occupational Safety and Health Administration (OSHA) standards designed to prevent catastrophic releases of toxic, flammable, or explosive chemicals in workplaces. They are also exempt from OSHA rules written for the construction industry designed to prevent falls and other accidents on the job. Although announced by the agency as forthcoming in 1983, federal safety regulations for the oil and gas industry have never materialized

Fatality rate data for the oil and gas industry are limited, but available data in the seven years leading up to 2015 show fatality rates in oil and gas extraction that are four to seven times the national fatality rate

Fatality rates among workers in the oil and gas extraction sector in North Dakota were seven times the national fatality rates in this industry, which itself has more deaths from fires and explosions than any other private industry.


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7) Earthquakes are a proven consequence of both

fracking and the underground injection of fracking waste.

Injection of fracking wastewater into underground disposal wells is a known trigger of earthquake swarms in multiple locations, as demonstrated by several major studies, using different methodologies. Newer research in Canada, Oklahoma, and China links the practice of fracking itself to earthquakes, including some that take place many miles from well sites and many years later, suggesting that seismic risks have been previously underestimated with much larger areas at risk and for longer periods of time.


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A 2017 study of the Fort Worth Basin showed that a recent swarm of small earthquakes in northern Texas was originating in long-inactive fault lines in deep formations where fracking wastewater was being injected. Human activity is the only plausible explanation. (See footnote 499.) Another study using satellite-based radar imagery provided proof that the migration of fracking wastewater into faults increased pressures in ways that triggered a 4.8-magnitude earthquake in east Texas in 2012, while a third study documented the rupture of a fault plane that set off a 4.9-magnitude earthquake in Kansas in 2014 immediately following a rapid increase in fracking wastewater injection nearby.

In China’s Sichuan Province, a series of recent earthquakes have been linked to fracking, including one in December 2018 with a magnitude of 5.7, the largest fracking-induced earthquake to date. The likely cause was reactivation of unmapped faults by underground fluid pressure.75 In February 2019, three additional earthquakes, all with a magnitude of over four, struck Sichuan Basin, killing two people, injuring 13, and damaging 20,000 homes


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8) Fracking infrastructure poses serious potential exposure risks to those living nearby.

Drilling and fracking activities are relatively short-term operations, but compressor stations are semi-permanent facilities that pollute the air 24 hours a day as long as gas is flowing through pipelines. Day-to-day emissions from compressor stations are subject to highly episodic variations due to pressure changes and maintenance-related deliberate releases and can create periods of potentially extreme exposures. Compressor stations generally have shorter emissions stacks than other polluting facilities such as power plants, which means their harmful emissions are more concentrated at ground level than if released from a greater height. As we went to press, a new study of air emissions from 74 compressor stations in New York State found 39 chemicals known to be human carcinogens and documented large releases of greenhouse gases


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Fracking infrastructure in the United States also includes 400 underground gas storage facilities in 31 states, with aging equipment and scant federal oversight. The four-month leak at the nation’s fifth largest facility, Aliso Canyon in southern California, between October 2015 and February 2016 resulted in exposures of a large suburban population to an uncontrollable array of chemicals. With a release of nearly 100,000 metric tons of methane, it became the worst methane leak in U.S. history. (See footnote 1185.)

The Aliso Canyon blow-out exposed residents in the region to benzene spikes, high ongoing odorant releases, hydrogen sulfide at levels far above average urban levels, and many other contaminants of concern. More than 8,300 households were evacuated and relocated, with residents reporting multiple symptoms, including headaches, nosebleeds, eye irritation, and nausea. In May 2019, state investigators announced that the cause of the massive leak at Aliso Canyon was rupture of a well casing caused by microbial corrosion within a well that had been originally drilled in 1954. Over the years, the casing had come in contact with groundwater.82 The report also faulted the operator, SoCalGas, for failure to monitor and investigate more than 60 previous leaks at the gas storage complex.


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LNG is purified methane in the form of a bubbling, super-cold liquid. It is created through the capital-intensive, energy-intensive process of cryogenics and relies on evaporative cooling to keep the methane chilled during transport. Explosive and with the ability to flash-freeze human flesh, LNG creates acute security and public safety risks. Its greenhouse gas emissions are 30 percent higher than conventional natural gas due to refrigeration, venting, leaks, and flaring, which is used to control pressure during regasification. The need to strip volatile impurities such as benzene from the gas prior to chilling it also makes LNG liquefaction plants a source of toxic air pollutants.


9) Drilling and fracking activities bring naturally occurring radioactive materials to the surface.

 Naturally occurring radioactive materials that occur in shale layers containing oil and natural gas are brought to the surface in the solid waste removed during drilling (drill cuttings) and in fracking wastewater. Radionuclides can also build up in pipes and equipment, and fracking itself can open pathways for the migration of radioactive materials. Exposure to increased radiation levels from fracking materials is a risk for both workers and residents.

Radon levels in Pennsylvania homes have risen since the advent of the fracking boom, and buildings in heavily drilled areas have significantly higher radon readings than areas without well pads—a discrepancy that did not exist before 2004.


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A variety of radioactive substances—including radium, thorium, and uranium—have been detected in fracking wastewater. A 2018 study in the Marcellus Shale region showed that extreme salinity, as well as the chemical composition of fracking fluid, interacts with the shale during the fracking process in ways that mobilize radium and make fracking wastewater radioactive.


10) Drilling and fracking activities harm wildlife through multiple pathways.

Animals serve as sentinels for chemical exposures that may also affect human residents who share their environment


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The combination of ongoing drought and lack of disposal options has resulted in the diversion of fracking wastewater to farmers for irrigation of crops, raising concerns about contaminated water potentially affecting food crops and draining into groundwater. Investigative reports in 2015

revealed that Chevron Corporation piped 21 million gallons of recycled oil and gas wastewater per day to farmers for crop irrigation. Tests showed the presence of several volatile organic compounds, including acetone, which is linked in lab studies to kidney, liver, and nerve damage.

These activities project fracking’s impacts onto geographically distant populations, especially in cases where wastewater is used in crop irrigation and livestock watering. Food is a troubling possible exposure route to fracking chemicals, in part because so little is known about these chemicals. According to a hazard assessment of chemicals used in California oil drilling operations that reuse wastewater for livestock watering and other agricultural purposes, more than one-third of the 173 chemicals used are classified as trade secrets: Their identities are entirely unknown. Of the remainder, ten are likely carcinogens, 22 are toxic air contaminants, and 14 had no toxicity data available. Estimating risks to consumers of the food produced with wastewater irrigation is thus not possible


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13) The economic instabilities of fracking exacerbate public health risks.

Fracking is not a stable business. Although the fracking boom has lifted U.S. oil and gas production to all-time highs, shale wells drilled in the past five years are pumping significantly less oil and gas than their operators predicted to their investors. Because the production of individual shale wells falls precipitously over the course of a few years, operators must continue drilling new wells at an ever-swifter pace to maintain growth targets—even as owners are under pressure to cut costs in the face of price declines.

The result is lack of profits, dependency on Wall Street financing and low interest rates, and asset sell-offs throughout the fracking industry as a whole. (See footnote Olson, Wall St. J., Jan 2, 2019.) Between 2008 and 2018, leading fracking companies spent $230 billion more than they earned, covering the gap with debt.99

Even as oil prices have rebounded somewhat during the past two years, fracking companies are, collectively, still spending more on drilling than they receive by selling oil and gas. By 2018, only five of the largest 20 fracking companies were making more cash than they spent, and the stock prices of all 29 shale producers fell.100, 101


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In both North Dakota’s Bakken Shale and western Texas’ Permian Basin, cost-cutting pressures, coupled with a desperate rush to drill new oil wells to compensate for declining rates of production from older wells, have meant that waste natural gas generated as a byproduct of oil drilling is simply vented or flared rather than captured, in order to speed up the rate of oil drilling.105, 106 By April 2019, the amount of natural gas burned off via flaring in the Permian oil fields had reached a record high and exceeded the amount of gas needed to power every residence in Texas.107 Flaring, a leading source of toxic air pollution and smog, is a public health menace.108

Independent economic analyses also show that the promise of local job creation has been greatly exaggerated, with many jobs going to out-of-area workers. Reports show that oil and gas jobs increasingly will be lost to automation.

With the arrival of drilling and fracking operations, communities have experienced steep increases in rates of crime including sex trafficking, rape, assault, drunk driving, drug abuse, and violent victimization—all of which carry public health consequences, especially for women. Social costs include road damage, failed local businesses, loss of affordable rental housing, and strains on law enforcement and municipal services. School districts report increased stress. Economic analyses have found that drilling and fracking activities threaten property values and can diminish tax revenues for local governments. Additionally, drilling and fracking on private lands pose an inherent conflict with mortgages and property insurance due to the hazardous materials used and the associated risks.


14) Fracking raises human rights and environmental justice issues.

Inequalities in opportunities to participate in environmental decision-making and uneven impacts of environmental hazards along racial and socioeconomic lines are signature issues of environmental justice. In multiple regions where fracking is practiced, well pads and associated infrastructure are disproportionately sited in non-white, indigenous, or low-income communities.

A 2019 analysis of socio-demographic characteristics of people living close to drilling and fracking operations in the states of Colorado, Oklahoma, Pennsylvania, and Texas found strong evidence that minorities, especially African Americans, disproportionately live near fracking wells.111


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Similarly, a pattern of racially biased permitting was documented in the heavily fracked Eagle Ford area of southern Texas where a public health research team showed that disposal wells for fracking wastewater were more than twice as common in areas where residents are more than 80 percent people of color than in majority white communities.112 Since 2007, more than 1,000 waste disposal wells have been permitted in the Eagle Ford Shale region where groundwater is the primary source of drinking water

South Coast Air Quality Management District records show that oil drilling operations in Los Angeles neighborhoods released into the air 21 million pounds of toxic chemicals between June 2013 and February 2017. These emissions included crystalline silica, hydrofluoric acid, and formaldehyde.116

Across California, gas-fired power plants are disproportionately located in disadvantaged communities, as classified by an environmental justice screening tool developed by the state Office of Environmental Health Hazard Assessment.117 More than three-quarters of the 21,397 new oil wells drilled in California between 2011 and 2018 are located in low-income minority communities, according to state data

in western Pennsylvania showing that among nearly 800 gas wells, only two were drilled in communities where home values exceeded $200,000.

Similarly, in Ohio, geographic evidence reveals that disposal wells for fracking wastewater are disproportionately located in lower-income, rural communities.



Three international human rights bodies have called for prohibitions on fracking. In February 2019, the Committee on Elimination of Discrimination Against Women, which monitors the implementation of the 1979 United Nations treaty that serves as an international bill of rights for women, called on the United Kingdom to ban fracking on the ground that fracking damages communities and imperils the climate in ways that disproportionately harm women and girls living in rural areas.128, 129 In October 2018, the United Nations Committee on Economic, Social and Cultural Rights warned Argentina that its plans for large-scale fracking in the Vaca Muerta Shale region would create adverse economic and cultural rights impacts on the indigenous Mapuche people.130 In May 2018, the Permanent People’s Tribunal, a Rome-based forum focused on human rights violations, issued an advisory opinion based on a two-year investigation that collected testimonies and reports from scientists and fracking-impacted communities.


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15) Health professionals are increasingly calling for bans or moratoria on fracking, based on a range of health hazards and as reviews of the data confirm evidence for harm.

In July 2016, the UK health professional organisation Medact, released an updated assessment of the potential health impacts of shale fracking in England, concluding that the United Kingdom should abandon its policy to encourage shale gas extraction and urged an “indefinite moratorium” on fracking.

Also in 2016, in a unanimous vote of the society’s 300-member House of Delegates, the Pennsylvania Medical Society called for a moratorium on new shale gas drilling and fracking in Pennsylvania and an initiation of a health registry in communities with pre-existing operations.


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All together, findings to date from scientific, medical, and journalistic investigations combine to demonstrate that fracking poses significant threats to air, water, human health, public safety, community cohesion, long-term economic vitality, biodiversity, seismic stability, and climate stability.

The rapidly expanding body of scientific evidence compiled and referenced in the present volume is massive, troubling, and cries out for decisive action. Across a wide range of parameters, from air and water pollution to radioactivity to social disruption to greenhouse gas emissions, the data continue to reveal a plethora of recurring problems and harms that cannot be sufficiently averted through regulatory frameworks. There is no evidence that fracking can operate without threatening public health directly and without imperiling climate stability upon which public health depends. The only method of mitigating its grave harm to public health and the climate is a complete and comprehensive ban on fracking.

In closing, we cite comments by epidemiologist Irena Gorski, co-author of the 2019 review of fracking’s health concerns published in the Oxford Research Encyclopedia of Global Public Health. Her words speak for all who have contributed to this Compendium:

What we found pushes back against the narrative we often hear that say we don’t know enough about the health impacts yet. We have enough evidence at this point that these health impacts should be of serious concern to policymakers interested in protecting public health….As a fossil fuel, natural gas extraction and use is contributing to climate change, of course. But before conducting this study, I didn’t realize the amount of evidence we have that it may be even worse than coal. We included this in our study because climate change has its own contributions to health impacts. These indirect impacts will take longer to appear than the direct health impacts, but they have the potential to be significant


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Compilation of Studies and Findings


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Medical and scientific calls for more study, reviews confirming evidence for harm, and calls for increased transparency and science-based policy

March 29, 2019 – Doctors for the Environment Australia announced the reinforcement of its position that no new gas extraction of any kind should occur in Australia. Its position was largely informed by the wealth of literature from the United States documenting adverse health findings. The organization’s review found growing evidence of direct health impacts as well as a clear potential for indirect impacts of gas and oil mining on essential environmental determinants of health. “These concerns include risks to a stable climate, air quality, water quality, water security, food security, community cohesion and, in some locations, geological stability. The cumulative impacts of these industries on the wider requirements for good health and wellbeing are extremely concerning


February 1, 2019 – Natural gas extraction via fracking is associated with “preterm birth, high-risk pregnancy, and possibly low birth weight; three types of asthma exacerbations; and nasal and sinus, migraine headache, fatigue, dermatologic, and other symptoms,” according to a review covering research through mid-2017.

The Johns Hopkins Bloomberg School of Public Health scientists cited the methodological robustness of these studies and the biological plausibility of the links found. Further, they included in their review the contribution of fracking to climate change and its further health impacts. Authors expressed serious doubt that the risks of fracking can be managed. “Some have suggested that regulations will prevent health impacts, but no health studies provide guidance on what regulations, if any, will get the health effects to go away.” The authors further noted that the fracking boom has, in many regions, outpaced the ability of science to document health impacts with long latencies, such as cancer and neurodegenerative diseases. The review concluded that the results of early health studies “should give pause” about whether and how shale gas fracking should proceed and referenced the several U.S. states and nations that have disallowed fracking, citing health concerns.


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December 12, 2018 – “The healthcare community has a professional mandate to protect society from harm to human health. We have a responsibility to help society move away from fossil fuels and accelerate the transition to renewable energy,” wrote a team of medical professionals in an editorial for the British Medical Journal. Citing the “overwhelming” evidence that fossil fuels pose serious threats to public and planetary health, the group identified divestment from fossil fuel corporations as a strategy that increasing numbers of medical professional groups are taking, as part of fulfilling that professional mandate


August 16, 2018 – The closer one lives to fracking sites, the more likely one is to experience toxic exposures and a related number of health impacts. Setbacks less than one quarter mile (1,320 feet) from drilling and fracking operations are not sufficient to protect public health, and additional setbacks are needed to protect vulnerable groups and settings, according to an expert panel assembled in Pennsylvania. “Vulnerable groups were defined by the panelists as children, neonates, fetuses, embryos, pregnant women, elderly individuals, those with pre-existing medical or psychological conditions, and those with pre-existing respiratory conditions. Vulnerable settings were defined as schools, day care centers, hospitals, and long-term care facilities. The panel, which consisted of 18 health care providers, public health practitioners, environmental advocates, and researchers/scientists, was brought together to compare existing minimum setback requirements against research about the health impacts of living near fracking activity. The panel was unable to come to agreement on a minimum safe setback distance between one quarter and two miles. It also noted that the failure to achieve consensus on this issue reflects uncertainties based on limited data of real-time toxic emissions from

drilling and fracking operations, the limited number of scientific studies available, and the potential for episodically recurrent periods of high exposures.


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April 4, 2018 – Two scholars critiqued the wide-ranging consultation on unconventional gas extraction, including fracking, which was commissioned by the Scottish government and published in November 2016.1416

Noting that the Scottish assessment is more comprehensive than assessments conducted in the United States and elsewhere, the authors wrote, “The public health impact assessment in particular is underpinned by what appears to be a rigorous and transparent examination of existing scientific literature drawing on external peer review at some stages.” However, they also went on to say that some of the conclusions drawn “appear to be optimistic readings of data and experience. For example, assessments of the ability of industry and regulators to control fracking effects on public health do not stand up to scrutiny.” They identified several other ways in which the health impact assessment’s conclusions were not always supported by the evidence it reviewed and if the assessment had overlooked areas of concern. For example, the literature on social impact assessments, as well as health research addressing questions of well-being and mental health, were neglected. Nevertheless, these scholars recommended the Scottish consultation as a research and policy tool.