Abstract

Over the past ten years, unconventional gas and oil drilling (UGOD) has markedly expanded in the United States. Despite substantial increases in well drilling, the health consequences of UGOD toxicant exposure remain unclear. This study examines an association between wells and healthcare use by zip code from 2007 to 2011 in Pennsylvania. Inpatient discharge databases from the Pennsylvania Healthcare Cost Containment Council were correlated with active wells by zip code in three counties in Pennsylvania. For overall inpatient prevalence rates and 25 specific medical categories, the association of inpatient prevalence rates with number of wells per zip code and, separately, with wells per km2 (separated into quantiles and defined as well density) were estimated using fixed-effects Poisson models. To account for multiple comparisons, a Bonferroni correction with associations of p<0.00096 was considered statistically significant. Cardiology inpatient prevalence rates were significantly associated with number of wells per zip code (p<0.00096) and wells per km2 (p<0.00096) while neurology inpatient prevalence rates were significantly associated with wells per km2 (p<0.00096). Furthermore, evidence also supported an association between well density and inpatient prevalence rates for the medical categories of dermatology, neurology, oncology, and urology. These data suggest that UGOD wells, which dramatically increased in the past decade, were associated with increased inpatient prevalence rates within specific medical categories in Pennsylvania. Further studies are necessary to address healthcare costs of UGOD and determine whether specific toxicants or combinations are associated with organ-specific responses.

Highlights

  • The United States leads the world in producing natural gas from shale formations

  • Even though the statistical analysis is done at the zip code level, a county level demographic table is an informative summary of the zip codes that are within the counties

  • We recognize that a five-year observation period may limit our ability to discern a direct impact on health in the surrounding community but may offer an opportunity to assess hospital utilization rates over time

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Summary

Introduction

The United States leads the world in producing natural gas from shale formations. In comparison to the early 2000s, natural gas production in the US has increased with more than a 30% increase in production, due in part to the cost-effective combination of horizontal drilling and hydraulic fracturing [1,2,3,4]. Unconventional gas and oil drilling (UGOD), including hydraulic fracturing or “fracking”, refers to all activities that extract natural gas and oil from rock formations. After drilling is complete, fissures are formed using a perforating gun; a mixture of water, proppants and hydraulic fracturing chemicals is pumped into the rock [3,5]. The fissures remain open to liberate the gas These substances as well as contaminants released from the shale are present in the flowback water. Increased noise pollution, truck traffic, and psychosocial stress due to community change, which occur due to increased hydro-fracking activity, could impact public health [11]

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