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A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

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Page 1: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

A Medical Perspective on Oil and Gas Development

Mansfield TX October 29, 2014

Anne C. Epstein MD, FACPLubbock TX Board of Health

Page 2: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Health Risksof Oil and Gas Development

1. Toxic Air Emissions: Benzene

2. Human Health Impacts Associated with Air Emissions

3. Risk of Groundwater Contamination

4. The Precautionary Principle and Public Health

Image credit: Zach Long/Lubbockonline (Seminole)

Page 3: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Toxic Air Emissions: BenzeneA highly toxic carcinogen that occurs naturally in oil and gas•VOC-volatile organic compoundLong-term health effects•Leukemia- a “Group 1 Carcinogen”•Life-threatening anemia •Immune system suppression•Possible fetal abnormalitiesHigh levels of exposure•Coma, seizures, irregular heart rhythms, fluid in the lungs, deathChildren and developing fetuses are more vulnerable to all toxic air emissions

ATSDR August 2007, ww.atsdr.cdc.gov/toxicprofiles/tp3.pdf, CDC Emergency Safety and Health DatabasePaulson, Testimony before House Subcommittee Feb 2014

Page 4: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

NIOSH Study of Oil & Gas Worker VOC Exposure August 2014

• Measured worker exposure to VOCs at 6 completion sites in Colorado & Wyoming

• 15 of 17 benzene samples exceeded the recommended 8 hr exposure limits for workers gauging flowback or production tanks

• Benzene exposures were variable, unpredictable, and sometimes very high:– 200 ppm close to open tank

hatches- several readings– Recommended 15 min exposure

limit: 1 ppm• Conclusions: Benzene levels reached

concentrations that potentially pose health risks for workers

Esswein et al, J of Occupational and Environmental Hygiene, 11:10, 01 Aug 2014

A flowback technician gauging a flowback tank through a hatch on top of the tank

Page 5: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

TCEQ Barnett Shale Study 2009

• 94 monitoring sites surveyed 2009– Flyover, GasFindIR cameras, VOC monitors

• Air samples collected at 73 sites• Benzene was detected above the long term health based

comparison value (> 1.4 ppb) at 21 monitoring sites in 12 different areas

• 2 sites required immediate action for value > 180 ppb– 1 compressor station:1100 ppb – 1 gas well: 15,000 ppb (5 feet from the well)– Both repaired, came into compliance

TCEQ Interoffice Memo Jan 27, 2010, “Health Effects Review of Barnett Shale Formation Area Monitoring Projects” and Sadlier & Honeycutt, “TCEQ Barnett Shale Update” 2010

Page 6: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

VOC emissions captured on infrared camera by TCEQ 2009

Page 7: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Heavy VOC emissions captured by infrared camera at Aruba facility in the Barnett Shale

Screenshot of a TCEQ video posted by D. Hasemyer, Center for Public Integrity, May 28 2014

Page 8: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Air Toxin Concentrations During Well Completion in Garfield County CO

(McKenzie et al, Science of the Total Environment, 22 March 2012)

Page 9: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Flyover Air Monitoring in Colorado

Airborne measurements of air pollutants – 12 flights in May 2012

Correlated with atmospheric data

Results: Benzene emissions were between 7 and 9 times higher than estimated by State of Colorado inventories

Petron et al, American Geophysical Union, May 2014

Page 10: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Human Health Impacts Associated with O & G Air Emissions

Page 11: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Health Impact Assessment from the Colorado School of Public Health 2012

Measured hazardous air pollutants at different distances from O&G wells

Near: 500 feet and less from a wellFar: > ½ mile from a well

Found elevated levels of hazardous air pollutants near wells : Benzene, Toluene, Ethyl benzene, Xylene (BTEX)

Calculated the risk of illness under 2 different scenarios:Subchronic: short term , high intensity- well completionsChronic: long-term , lower intensity- well production

McKenzie et al, Science of the Total Environment 22 March, 2012

Page 12: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Non-cancer Hazard Indexes by duration of exposure and distance from Source

Adgate , National Academy of Health Workshop, 2012

Page 13: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Hazard indexes by health end point: Near wells, 20 month exposure scenario

(Adgate 2012, National Academies of Health, Health Impact Assessment of Shale Gas Extraction: Workshop Summary)

Page 14: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Birth Outcomes and Maternal Residential Proximity to Natural Gas Development in Rural Colorado

The data: 1996 - 2009 •All birth records in rural Colorado (Rural sites chosen to avoid air pollution from cities)•All hospital and clinic records of birth defects•Records of location and year built for all gas wells in rural ColoradoTotal 124,842 births•Researchers analyzed level of maternal exposure to gas wells: how far away and how many gas wells at the time of birth•3 groups: low, medium, and high exposure•Reference group: no gas wells within 10 miles

McKenzie et al, Environmental Health Perspectives, 28 January 2014

Page 15: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Birth Outcomes and Maternal Residential Proximity to Natural Gas Development in Rural Colorado

McKenzie et al, Environmental Health Perspectives, 28 January 2014

Number of babies born with Congenital Heart Disease

Compared to 0 wells w/in 10 miles:

10% increased risk for 1-3 wells/ mile , low exposure (281 births)

20% increased risk for 4-124 wells/ mile, medium exposure (300 births)

30% increased risk for > 125 wells/ mile, high exposure (355 births)

Statistical significance p< 0.001Adjusted for multiple factors

Page 16: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Rabinowitz et al (Yale), Environmental Health Perspectives Sept 2014

• Subjects: Randomly chosen, 180 households/ 494 individuals with a private water well in Washington County PA

• Exposure: 624 active natural gas wells in Washington County in 2012

• Study: Survey regarding health symptoms

Image credit: B. Mark Schmerling (Washington County)

Page 17: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Rabinowitz et al, Environmental Health Perspectives Sept 2014

Page 18: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

ResultsRabinowitz et al, Environmental Health Perspectives Sept 2014

Compared to people living > 2 km from the nearest gas well, People living < 1 km away had a greater incidence of: •Upper respiratory symptoms (39% vs 18%)•Skin symptoms (13% vs 3%)•Average number of reported symptoms (3.3 vs 1.6)Results statistically significant even after adjustment for multiple factorsImage from Parr Family, Lisa Parr’s daughter, Emma (published by CNN) TX

Page 19: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Confirmed Cancer Cluster in Barnett Shale: Flower Mound TX

• Breast Cancer– 369 cases, expected number

303 (2002-2011)– 99% confidence interval

statistically significant

• Benzene – Possible cause of breast

cancer

Texas Department of State Health Services, July 30, 2014.

Institute of Medicine 2011, “Breast Cancer and the Environment”

Image credit: National Cancer Institute

Page 20: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Private Drinking Water Wells and Risks due to Groundwater Contamination

• 15 million Americans rely on private drinking water wells that use groundwater

• Drinking contaminated groundwater can cause human illness

• EPA regulations that protect the public water supply do not apply to private wells

• Water quality testing is at the owner’s discretion

http://www.cdc.gov/healthywater/drinking/private/wells/

Page 21: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Groundwater Contamination from Oil and Gas Activities in Pennsylvania

Reported by the Pennsylvania Dept. of Environmental Protection, August 28, 2014•243 cases where “DEP determined that a private water supply was impacted by oil and gas activities” 2008 – 2014•1.2 % of the total number of wells

Hess, PA Environmental Digest Aug 29, 2014DEP, Regional Determination Letters, Aug 29 20I4Image credit: AP Photo/Ralph Wilson

Page 22: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Groundwater Contamination from Oil and Gas Development in Texas

Reported by the Railroad Commission of Texas•532 total cases in 2013•72 new cases in 2013– Benzene, other BTEX,

Hydrocarbons, crude oil, and other toxins

Texas Groundwater Protection Committee, “Joint Groundwater Monitoring and Contamination Report 2013,” April 2014

Page 23: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Groundwater Contamination from Surface Spills in Colorado

• 77 spills of oil or produced water reported in 1 year (July 2010-July 2011) that contaminated groundwater

• Benzene exceeded maximum contaminant levels in groundwater - 90%

• 16% of the spills had not been remediated as of May 2012

• Average spill: 1000 gallons

Gross et al, Journal of the Air & Wastewater Management, 20 March 2013, Image credit Lubbockwater.com

Page 24: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Casing and Cementing Failures in Pennsylvania 2000-2012

•41,000 oil and gas wells – After 2009, most were unconventional

wells•Data source: state inspection reports (DEP) •Results

– Overall structural failure rate = 1.9%– Unconventional wells in drilling boom

area failure rate = 9.18%– Each additional inspection prior to 2009

increased the chances of finding a structural failure by 17.7%

Ingraffea et al, PNAS May 30, 2014Graphic by Al Granberg/ProPublica

Page 25: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Toxic Effects of Arsenic in Drinking Water

• Arsenic : a major public health concern according to the World Health Organization

• Colorless and tasteless: may be undetected in drinking well water for many years

• Long term exposure effects– Cancer of the skin, bladder, lungs, and

possibly of the kidney, liver, and prostate. “Group 1 Carcinogen”

– Diabetes, kidney disease, high blood pressure, heart attacks and stroke

– Blood cell, liver, and nerve ending damage

– Skin thickening and rashes– In pregnant women: spontaneous

abortion, stillbirth

WHO, “Exposure to Arsenic: a Major Pubic Health Concern” 2010

Image credit: woodleywonderorks/Flickr

Page 26: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

Arsenic in Private Water Wellsin the Barnett Shale, Texas

• 100 private water wells sampled– 91 from active area

• ( 1 or more gas wells within a 5 km radius)

– 4 from non-active area • (no gas wells within a 14

km radius)– 5 from reference site outside

the Barnett Shale• (no gas wells within a 60

km radius)• Compared with historical data

from 330 private wells from the same area 1989-1999, before gas development

Fontenot et al, Environmental Science and Technology 25 July 2013

Page 27: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

% of Water Wells with Arsenic/ Selenium Levels Greater than Maximum Contaminant Limits

Fontenot et al, J. Environ Sci. Technology, July 31, 2013

Page 28: A Medical Perspective on Oil and Gas Development Mansfield TX October 29, 2014 Anne C. Epstein MD, FACP Lubbock TX Board of Health

The Precautionary Principle• “When an activity raises threats of harm to the

environment or human health, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically.”

– Endorsed by the US Government *– Endorsed by the American Public Health Association as a

“cornerstone of preventive public heath policy and practice”**

1998 Wingspread Statement on the Precautionary Principle*in signing the Rio Declaration on Environment and Development in 1992**American Journal of Public Health 91(3), March 2001, pl. 495