delivered testimony of professor margaret rafferty, r.n., at hydrofracking forum (4/25/12)

8/2/2019 Delivered Testimony of Professor Margaret Rafferty, R.N., at Hydrofracking Forum (4/25/12)

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TESTIMONY

New York State SenatePublic Forum on Hydraulic FracturingApril 25, 2012

Senator Tony AvellaMARGARET A. RAFFERTY DNP, MPH, RN

TestimonyThank you for inviting me to testify today. As a doctorally prepared nurse educator in

continuous practice in New York State since 1975, I wish to emphasize that we simply do notknow enough about how the development of unconventional natural gas resources affects humanhealth. Clean air and water are the foundations of our well-being. Contaminating our air andwater supply with the toxic chemicals used inhigh volume horizontal hydraulic fracturing couldcompromise these cornerstones of our existence. Pregnant women, infants. children and theelderly would be especially vulnerable. Even with robust regulation, natural disaster and humanerror are inevitable. We recently saw the tremendous damage and destruction that HurricaneIrene caused in New York State.

I oppose hydraulic fracturing because not enough has been done to study what effect thisdrilling process has on the health of Americans including the citizens of our State (Heinkel-Wolfe,2011). Only one comprehensive Human Health Risk Assessment was done prior to the initiation ofdrilling (McKenzie, Witter &Adgate, 2011). Despite calls for more research, funding forepidemiological studies has not materialized. Meanwhile, some people who live near drilling sitesreport symptoms which include sinus problems, throat irritation, allergies, weakness and fatigue,eye irritation, nasal irritation, joint pain, muscle aches and pains, breathing difficulties, visionimpairments, severe headaches, skin irritation and increased cancer rates (Law, 2011; PediatricEnvironmental Health Specialty Unit Mount Sinai Hospital, 2011). Not one case study appears inthe medical literature describing an incident with a patient affected by hydraulic fracturing (Werntz,2011). No research exists to provide guidance to clinicians


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The longer we wait, the more we learn about the effects of this new technology. After yearsof complaints about air quality near drilling sites, the American Lung Association recently issued astatement that there is "irrefutable evidence of serious threats to human health from air pollutantsemitted during oil and natural gas production" (American Lung Association [ALA], 2012, p. 1).This announcement came on the heels of the U.S. Environmental Protection Agency's regulationsrequiring the industry to decrease emissions from natural gas production (Environmental ProtectionAgency [EPA], 2012). Three weeks ago, the United States Geological service reported thatinjection wells are linked to earthquakes.

The chemicals that play an integral role in hydraulic fracturing are another cause of publichealth concern. Fracturing fluid is a mixture of water, chemicals and sand (United States Houseof Representatives Committee on Energy and Commerce, 2011). According to the DEC report,drilling companies have disclosed the use of 322 unique chemicals in 235 products in our State(New York State Department of Environmental Conservation [NYSDEC], 2011). The identityof some ofthc fracturing chemicals that will be used in New York State remains unknown(NYSDEC, 2011).

Many ofthc pending bills require full disclosure of the chemicals used in hydraulicfracturing. If passed, these laws would help practicing clinicians make diagnostic decisions.Several prominent physicians, including Dr. Bernard Goldstein, a member of the NationalAcademies of Science Institute of Medicine, have demanded full disclosure (Goldstein, 2011).Fracturing products, some of which are known neurotoxins, carcinogens and endocrinedisrupters, are highly diluted when used to fracture shale rock, (Bishop, 3/28/20 I 1; Colborn,Kwiatkowski, Schultz, &Bachran, 2011).

Meanwhile, the roads leading to water contamination are many: transportation spills, well

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casing leaks, leaks through fractured rock, drilling site discharge and wastewater disposal allprovides well-documented paths (Rozell &Reaven, 2011). Dr. Theo Colborn, the co-author ofone of the few peer-reviewed articles on natural gas drilling, cited a broad range of potentialtoxicity of the chemicals deployed: over 75% of the chemicals could affect the skin, eyes, othersensory organs, respiratory system and gastrointestinal systems; 25% could cause cancer andmutations; 37% of the chemicals could affect the endocrine system and almost 40-50% couldaffect the nervous, immune or cardiovascular system and the kidneys (Colborn, et al, 2011).Some examples of these chemicals are "benzene, toluene, ethyl benzene, xylene, ethylene glycol,glutaraldehyde and other biocides, hydrochloric acid and hydrogen-treated light petroleumdistillates" (Pediatric Environmental Health Specialty Units [PEHSU], 2011). To make mattersworse, nothing is known about the synergetic effects of mixing hydraulic fracturing chemicalswith the metals and radionuc1ides that exist naturally in the shale rock (Goldstein, 2011).

As more health professionals become aware of possible health implications of unconventionaldrilling, many have voiced concerns (Covey, 2011; Duggan, 2010; Goldstein, 2011; Finkel & Law,2011; McKenzie, Witter, &Adgate, 2011; Texas Medical Association, 2011). A number of myfellow health professionals in New York State commented that the dSGElS report did not include acomprehensive Health Impact Analysis. I share their concern. Therefore, S6772 which requires aHealth Impacts Assessment for horizontal gas drilling and high-volume hydraulic fracturing has mystrong support.

In closing, I urge the application of the precautionary principle (Finkel & Law, 2011). Thereis no credible medical evidence that high volume hydraulic fracturing is safe. I ask the NewYork State Senate to urge the DEC to delay permitting high-volume hydraulically fractured wellsuntil scientists and other health care professionals deem this activity to be medically safe and

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until its impact on human health is better understood.

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ReferencesAmerican Lung Association. (2012). Natural gas and oil production standards will protect

health and reduce toxic air pollution. Retrieved from http://www.lung.orglpress-roomlpress-releases/natural-gas-and-oil-standars.html

Bishop, R. E. (3/28/2011). Chemical and biological risk assessment/or natural gas extraction inNew York. Retrieved 5111/2011, from http://sustainableotsego.orglRisk AssessmentNatural Gas Extraction

Colborn, T., Kwiatkowski, c., Schultz, K., &Bachran, M. (2011). Natural gas operations from apublic health perspective. International Journal of Human and Ecological RiskAssessment. Retrieved from http://www.endocrinedisruption.com/home.php

Covey, S. (2011). Local experiences related to the Marcellus Shale industry. Retrieved fromhttp://stateimpact.npr.orgpennsylvanial20 11/081l7troy-corrununity-hospitals-report

Duggan, D. (2010, November 26, 2010). Commentary: Insufficient evidence hydrofracking safe,says Dr David Duggan, president of Onondaga County Medical Society [Syracuse.comcomment]. Retrieved from http://blog.syracuse.comlopinionl/print.htrnl

Environmental Protection Agency. (2012). Oven'iew offinal amendments to air regulations forthe oil and gas industry, Retrieved from http://www.epa.gov/airquality/oilandgas

Environmental Protection Agency. (n.d.). EPA's study of hydraulic fracturing and its potentialimpact on drinking water resources. Retrieved from http://www.epa.govlhfstudy

Finkel, M., & Law, A. (2011, May). The rush to drill for natural gas: A public health cautionarytale. American Journal of Public Health, lOJ, 784-785.

Goldstein, B. D. (2011). Potential health effects of Marcellus Shale activities: The need forpublic health surveillance (Powerpoint Slides). Retrieved from Center for Health

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http://sustainableotsego.orglrisk/http://www.endocrinedisruption.com/home.phphttp://stateimpact.npr.orgpennsylvanial20/http://blog.syracuse.comlopinionl/print.htrnlhttp://www.epa.gov/airquality/oilandgashttp://www.epa.govlhfstudy/http://www.epa.govlhfstudy/http://www.epa.gov/airquality/oilandgashttp://blog.syracuse.comlopinionl/print.htrnlhttp://stateimpact.npr.orgpennsylvanial20/http://www.endocrinedisruption.com/home.phphttp://sustainableotsego.orglrisk/


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Environments & Communities: httpl/:www.chec.pitt.eduHeinkel-Wolfe, P. (2011, August 31). Breast cancer rate climbs up: Six counties including

Denton have state's highest incidence rates. Denton Record Chronicle. Retrieved fromhttp://www.dentonrc.comlsharedcontentl dws/drcllocalnews/storiesIDRC _Breast , Cancer

Law, A. (2011, May 26). Public Hearing on the Health Impacts of Hydraulic Fracturing (NewYork State Assembly Testimony). Assembly Standing Committee on EnvironmentalConservation: New York State Assembly.

McKenzie, L.M., Witter, R. Z., Newman, L. S., & Adgate, J. L. (2012). Human health riskassessment of air emissions from development of unconventional natural gas resources.Science of the Total Environment, 424,79-87. doi: 10.1016/j.scitotenv.2012.02.018

McKenzie, L., Witter, R., &Adgate, J. (2011, February). Screening level human health riskassessment for Battlement Mesa health impact assessment (White Paper). Retrieved fromColorado School of Public Health: http://www. ucdenver.edu

New York State Department o f Envi ro nmen ta l Cons erv ati on . (20ll). Revised draft supplementalgeneric environmental impact statement on the oil, gas and solution mining regulatoryprogram. Retrieved from New York State Department of Environmental Conservation:http.r/www.dec.ny .gov

Pediatric Environmental Health Specialty Unit Mount Sinai HospitaL (2011, April 27). Letter toSenator Krueger. New York State Senate: Mount Sinai Children's Environmental HealthCenter.

Pediatric Envirorunental Health Specialty Units. (2011, August). PEHSU Information on NaturalGas Extraction and Hydraulic Fracturing for Health Professionals (White Paper).Retrieved from PEHSU: http:www.aoec.orglpehsuldocumentslhydraulicw

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http://httpl/:www.chec.pitt.eduhttp://www.dentonrc.comlsharedcontentl/http://http.r/www.dec.nyhttp://http.r/www.dec.nyhttp://www.dentonrc.comlsharedcontentl/http://httpl/:www.chec.pitt.edu


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fracturing_ andchildren _2011_ health_prof. pdfRozell, D. 1., &Reaven, S. J. (2011). Water pollution risk associated with natural gas extraction

from the Marcellus Shale. Risk Analysis, 1-12. doi: 10.1111/j.1539-6924.2011.01757.xRetrieved from

Texas Medical Association. (2011). Summary of Actions House of Delegates. Retrieved fromhttp.Zwww.texmed.org

United States House of Representatives Committee on Energy and Commerce. (2011).Chemicals used in hydraulic fracturing. Retrieved from www.congress.org:

Werntz, C. (2011). Worker health concerns in Marcellus Shale work. Paper presented at the 2ndAnnua l Conf ere nc e Health Effects of Shale Gas Extraction, University of Pittsburgh.Video retrieved from http://www.shalegas.pitt.edu

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http://http.zwww.texmed.org/http://www.congress.org/http://www.shalegas.pitt.edu/http://www.shalegas.pitt.edu/http://www.congress.org/http://http.zwww.texmed.org/


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Natural Gas and Oil Production Standards will Protect Health and Reduce Toxic Air Pollu ... Page lof2

AMERICANLUNGASSOCIATION*Fightingfor Air

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Natural Gas and Oil Production Standards will ProtectHealth and Reduce Toxic Air Pollution

Statement from AI Rizzo/ MOl Chair of the Board of theAmerican Lung AssociationWashington, D.C. (AprillS, 20l2)-New natural gas and oil production safeguardsannounced today by U.S. Environmental ProtectIon Agency (EPA) will curb harmful airpollution, The American Lung Association welcomes the new standards, which address airpollution emitted from the production, processing, transmission and storage of oil andnatural gas.The cleanup of air pollution from oil and natural gas wells is essential toprotect public health and growing in importance as the industry expands. We applaudEPA'sresponse to this rapidly expanding source of air poUution.Natural gas production is expanding into highly populated areas of the country.The growthin oil and gas development across the nation means that many more people would be atrisk from these pollutants had EPAnot provided strong, effective standards for reducingemissions. The adoption of these safeguards against air pollution from oil and natural gasproduction, as required under the Clean Air Act, will help protect the public from life-threatening pollution. Limiting emissions from oil and natural gas production will yieldtremendous benefits and significantly reduce adverse health effects.We have seen irrefutable evidence of serious threats to human health from air pollutantsemitted during oif and natural gas production, induding sulfur dioxide, nitrogen oxide, andvolatile organic compounds (VOCs), including air toxlcs such' as benzene andFormaldehyde, as well as increasing levels of ozone and particulate matter.Thesepollutants can worsen asthma, cause heart attacks, and harm the circulatory, respiratory,nervous, and other essential and vital life systems. They are also linked to cancer,developmental disorders, and even premature death. People most at risk of harm frombreathing these air pollutantswill benefit the most from these standards, including:infants, children and teenagers; older adults; pregnant women; people with asthma andother lung diseases; people with cardiovascular disease; diabetics; people with lowincomes; and healthy adults who work or exercise outdoors.EPAmust safeguard the air we breathe, and these commonsense measures to address airpollution from oil and natural gas production will definitely help protect the health of thosemost at risk.

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About the American Lung AssociationNow in its second century, the American Lung Association is the leading organizationworking to save lives by improving lung health and preventing lung disease. With yourgenerous support, the American Lung Association is "Fighting for Air" through research,education and advocacy. For more information about the American Lung ASSOCiation,aCharity Navigator Four Star Charity and holder of the Better Business Bureau Wise GivingGuide Seal, or to support the work it does, call l-800-LUNG-USA (1-800-586-4872) orvisit www.lung.org.

httn./rwww .1una. orz/nress- room/mess- releases/natural-cas- and-0il-standards. html 4/1912012
http://www.lung.org./http://www.lung.org./


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PEHSU Infonnation on Natural Gas Extraction and Hydraulic Fracturing for HealthProfessionals

The Ped ia tric E nv iro nmen ta l H ea lth S pe cia lty Units (PEHSU ) Network e nc ou ra ge familie s,pediatric ians, and communities to w ork together to ensure that children are protected frome xp os ure to e nv iro nmen ta l h az ard s.BackgroundN atural gas extraction from shale is a com plex process w hich inc ludes: 1) building access roads,centra lized w ater and flow back hold ing ponds and of the site itse lf; 2) construction of p ipe linesand com pressor stations; 3) drilling; 4) hydraulic fracturing; 5) capturing the natura l gas; 6)an d d isp osa l (or re cyc lin g) o f, tlo wba ck w ate r a nd d rill c uttin gs,H yd rau lic fra ctu ring , also kn ow n as hyd rofrac kin g o r fra cking , u ses a c om bin ation o f w ater;sand, and chem icals injected into the ground under high pressure to re lease natura l gas. TheH F process is also used in som e parts of the country for extracting oil. This process hasbecome much more common in the US over the last decade. It was first used for natura l gas inC olo ra do, W yomin g, a nd T exas, T he p ra ctic e ha s re ce ntly sp re ad into o th er sta te s, in clu din gW est V irg inia, Pennsylvania, and N ew York, The figure below is a diagram of the process:

~EPA Definition ofHydraulic Fracturing Lifecycle:~".Site Prep water

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Health Is suesQ ue stio ns re ga rd in g th e p oss ib le h ea lth e ffe cts o f Natu ra l g as e xtra ctio n/H yd ra ulic fra ctu rin g(NGE /H F) have been raised about w ater and air quality. T o ensure that children's health isp art of th e o ng oing e valu ation o f p ossib le huma n he alth e ffe cts of NGE /H F, t he P ed ia tricE nv iro nmen ta l H ea lth S pe cia lty Unit (PEHSU ) n etwork , w hic h c on sis ts o f e xp erts th ro ug ho utthe c oun try d edIc ated to pre ven ting ad verse p ed iatric he alth o utc om es from e nviro nm en talc au se s, d ev elo ped th is fact sh ee t. A distin ct c ha llen ge in d isc ussin g th ese p ossib le he altheffects is the lack of research regarding the hum an health effects of N GE /H F. M ost of theresearch to date focuses on ecosystem health. B ecause m any questions rem ainunansw ered, the P EHSU netw ork recommends a precautionary approach to toxicants ingeneral and to the NGE /H F process spedficallv,Water Contamina tionO ne of the potentia l routes of exposure to toxies from the N GE/H F process is thecontam ination of drinking w ater, induding public w ater supplies and private w ells. This canoccur w hen geologic fractures extend into groundw ater or from leaks from the natural gasw ell if it passes through the w ater table. In addition, drilling fluid, chem ical spills, anddisposal p it leaks m ay contam inate surface w ater supplies. A study conducted in N ew Y orkand P ennsylvania found that m ethane contam ination of private drinking w ater w ells w asassociated w ith proxim ity to active natura l gas drilling. (O sborne SG, et aI., 2011). W hilem any of the chem icals used in the drilling and fracking process are proprietary, the listinc lu de s b en ze ne , to lue ne, eth yl be nzen e, xylen e, eth yle ne glyc ol, gluta ra lde hyde an d oth erb io cid es, hvd ro ch lon c a cid , a nd h ydrog en trea te d lig ht p etrole um d istilla te s. T he sesubstances have a w ide spectrum of potentia l toxic effects on hum ans ranging from cancerto a dve rse e ffe cts o n the re pro du ctive , ne uro log ic al, an d en doc rine system s (A TSDR1Colborn T, et al, U .S . E PA 2009).A i r Po llut ionS ources of a ir pollu tion around a drilling fac ility inc lude diesel exhaust from the use ofm achinery and heavy trucks, and fugitive em issions from the drilling and NGE jH F processes.T he se a ir p ollu ta nts a re a ss oc ia te d with a spectrum of adverse health outcom es in hum ans.In cre ase s in pa rtic ulate m atter air p ollutio n, fo r e xam ple , h ave be en linke d to re spira to ryillne sses, w he ezin g in in fa nts, c ardio va sc ula r e ve nts, an d prem atu re d ea th (La den F , et aI,Lew tas 3, R yan PH , et ai, Sacks 3D, et a l). S ince each fracturing event at each w ell requiresup to 2,400 industrial truck trips, residents near the site and along the truck routes m ay beexposed to increased levels of these air pollu tants (N ew Y ork S tate D ECDMR, 2009).V olatile organic com pounds can escape capture from the w ells and com bine w ith nitrogenoxides to produce ground-level ozone (C DPH E 2008, C DPH E 2010). D ue to its inf iammatorye ffec ts on the re spira to ry trac t, g ro und -le ve l o zon e ha s be en linke d to asthma e xac erb atio nsand respiratory deaths. E levated ozone levels have been found in rural areas of W yom ing,partially attributed to natura l gas drilling in these locations. (W yom ing D epartm ent ofEnvironm ental Q uality, 2010). In an air sam pling study from 2005 to 2007 conducted inC olo rad o, rese arc hers fo un d th at air b en ze ne co nc en tra tion s a pp ro ac he d o r e xc ee de dh ea lth -b as ed s ta nd ard s a t s ite s a ss oc ia te d with oil or gas drilling (G arfie ld C ounty P HD ,

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2007). B enzene exposure during pregnancy has been associated w ith neural tube defects(lupo P J, e t a l), decreased birth param eters (S lam a R , et aI., 2009), and childhood leukem ia(Whitworth KW ,e t aI., 2008).NQlse Pol lut ionN oise p ollu tio n from the d rilling pro cess an d re sultin g tru ck traffic h as n ot b ee n o ptim allyevaluated, but since drilling sites have been located in close proxim ity to housing in m anylo ca tio ns , n ois e fr om these indus tr ia l s our ces might impact sleep, and that has beenassociated with negative effects on learning and other aspects of daily living (S tansfe ld S A,et al, 20031WHO 2011).Spec ia l Sus ceptib ility o f Ch ild re nC hildren are m ore vulnerable to environm ental hazards. They eat, drink, and breathe m orethan adults on a pound for pound basis. R esearch has also show n that children are not ableto m eta bo lize som e toxic an ts as w ell a s ad ults d ue to imm ature d eto xific atio n pro ce sse s.M oreover, the fetus and young child are in a critica l period of developm ent w hen toxice xp osu res c an h ave profo und ne gative e ffec ts.Recommendat ionsIn light of the lack of research investigating the potentia l adverse hum an health effects fromgas and oil w ell operatlons located in c lose proxim ity to hum an habitation, as w ell asc onsid erin g th e u niqu e vu ln era bility o f c hildre n, the PEHSU ne tw ork re commen ds th efollowing:

C ontinuing the surveillance of w ater quality, noise levels, and air pollu tion in areasw here NGE /H F sites are lo ca te d n ea r c ommun itie s.

M onitoring the health im pacts of persons liv ing in the area, preferably w ith cohortstudies. Increasing the aw areness of com munity healthcare providers about the possib leh ea lth c on se qu en ce s o f exp osure s from th e NGE /H F pro ce sse s, ind udin g o cc up atio nal

exposures to w orkers and the issue of take-hom e toxies (e.g., c loth ing and bootsc ontamin ated w ith d rilling m ud s).

D isdosure of all chem icals used in the drilling and NGE/HF and product dewatering toen su re th at a cu te exp osure s a re ha nd led a ppro pria te ly an d to e nsure tha t su rve illa ncep ro grams a re optim iz ed .

G iven the short half-lives of votatlle organic com pounds and the fact that many of theNGE /H F chem icals have not been disc losed, bio logic testing should not be pursuedunless there has been a know n, direct exposure.

In addition to the annual testing for coliforms and nitrates recom mended by the U.s.E PA and the American A cadem y of P ediatrics (A AP ), the A AP guidance recommendstha t f am il ie s with private drinking w ater w ells in NGE /H F areas should consider testingthe w ells before drilling begins and on a regular basis thereafter for chloride, sodium ,barium , strontium , and VOCS in consultation w ith their local or state healthdepartment.

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As in va lu ab le re so urc es fo r th eir lo ca l, sta te , a nd re gio na l c ommun itie s, h ea lthprofessionals should advocate for hum an health effects to be a part of the discussionre ga rd in g NGE/HF .For further information, please contact your regional Pediatric Environmental HealthSpecialty Unit, available at www.pehsu.net.References:Agency for Toxi c Subs tances and D isease Regist ry (ATSDR). 2007 . Toxi co logi ca l p ro fi le f or Benzene . A tl an ta , GA :U .S . Department o f H ea lth and Human Ser vic es , P ub lic H ea lt h Serv ic e.Americ an A cademy o f Ped ia tric s (AAP), Comm it te e on Env ir onmen ta l H ea lth and Comm itte e on In fe ctio us D is ea se .D rin kin g Wa te r from P riv ate We lls and R is ks to Children. Ped ia t rics 2009;123:1599-1605.Colb orn ~ Kw ia tk ow sk i C, S ch ultz K , B ac hra n M . N atu ra l G as Ope ra tio ns from a P ub lic H ea lth P ers pe ctiv e. INP R E S S : Accep ted fo r p ub lic atio n in th e In te rn atio na l J ou rn al o f H uman a n d E co lo gic al R is k A s s es sm e nt September4, 2010. Expected publ ica tion : September-October 2011 .C olo ra do D ep artm en t o f P ub lic H ea lth a nd E nv iro nmen t (CDPHE ). P ub lic H ea lth Im plic atio ns o f Amb ie nt A irE xp os ure s a s Mea su re d in Rura l a n d U rb an O il &Gas D ev elo pmen t A re as - a n A na ly sis of 2008 A ir S amp lin g Data ,Gar fie ld Count y, C olo ra do . 2 010.C olo ra do D ep artm en t o f P ub lic H ea lth a nd E nv iro nmen t (CDPHE ). P ub lic H ea lth Im plic atio ns o f Amb ie nt A irE xp os ure s to V ola tile O rg an ic C ompo un ds a s Mea su re d in Rura l, U rb an , a nd O il & Gas Deve lopmen t A reas, Ga rf ie ldCount y, CO lo rado . 2 008.Etzel RA, ed., American Academy of Ped ia tric s (MP), C omm itte e o n E nv iro nmen ta l H ea lth . N ois e. In : P ed ia tricE nv iro nmen ta l H ea lth . 200 ed. Elk Gave Vi llage, IL: Ameri can Academy of Pediatr ics; 2003:311321.Friedman MS, Powe ll KE f Hu twagne r L, Graham LM , Teague WG . Impact of changes in t ra nspo rta tio n andc ommutin g b eh av io rs d urin g th e 1996 S ummer O lym pic game s in Atlanta on air qua lity a nd child hood asthma.JAMA 2001;285:897 905.Ga rfie ld County Pub lic H ea lth Depar tment (GCPHD) . Ga rfie ld County Ambient A ir Quality Monito rin g Study June2 00 5-May 2 00 7. G . C . P . H. D ep artm en t. G arfie ld C ou nty , CO.Lad en F , Neas LM , Docker y DW, Schwart z J. AsSOCia tio no f fin e par tic ula te ma tte r from d iff ere nt s ou rces w it h dailym orta lity in s ix U .S . C itie s. E nv iro n H ea lth P ers pe ct. 2 00 0 O cto be r; 1 08 (1 0): 9 41 -9 47 .Lewtas J. A ir pollu tio n combus tio n em is sio ns : C ha ra cte riz atio n o f cau sa tiv e agents and mechan isms assoc ia te dw it h cance r, r ep roduc tive , and ca rd iovascu la r effects. Mutat Res. 2007 NOV-Dec;636(1-3):95133.lupo PJ, Symanski E, Wa lle r DK , Chan W , Langlo is PH, Can fie ld MA , Mitchell LE . 2011 . Ma te rna l Exposure toAmb ie nt le ve ls o f B en ze ne a nd N eu ra l T ub e D efe cts amo ng O ffs prin g: T ex as , 1 99 9-2 00 4. E nv iro n H ea lth P ers pe ct119:397-402.New Yor k S ta te Depar tment o f E nv iro nment al C onse rvatio n D iv is io n of Mine ra l Resou rces. D ra ft Supp lemen ta lG en eric E nv iro nmen ta l Im pa ct S ta teme nt On T he O il, G as a nd S olu tio n M in in g Reg ula to ry P ro gram. 2 00 9.Osborn SG , V en go sh A I Wamer NR , Jackson RB . Me thane con tam inatio n o f d rin kin g wate r a ccompanyin g gas -welld ri ll ing and hydrau li c f rac tu ri ng . PNAS 2011. dol: 10.1073/pnas.1100582108

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Pandya R J , Solomo n 6 , K in ne r A , B alm es JR. D ie se l E xh au st a nd A sthma : H yp oth es es a nd Mole cu la r Mec ha nismso f Ac ti on . Env ir o n Hea lt h Per sped ll0 (s uppl 1 ): 103- 112 ( 2002 ).R od ie r, PM . D ev elo pin g b ra in a s a t ar ge t o f to xic ity . E nv iro n H ea lth P ers pe ct. 1 99 5 Sept; 103(Suppl 6) :73-76.Ryan PH , LeMaste rs GK, 6 iswas P ,Lev in L, Hu S , L in dsey M, Bernstein D I, L ock ey J, Villareal M, Khurana HersheyGK, Grinshpun SA . A COmpa ris ono f P ro xim ity and l and Use Regre ss io n T ra ffic E xposur e Mode ls and Wheezin g inInfants. Environ Health Perspect. 2007; 115:278-284. .S acks JD, S tane k lW, Luben TI, J oh ns DO , B uc kle y B J, B rown JS, e t a 1.2011. Part icu la te Ma tt er -I nduced Heal thEffects: Who Is Suscept ib le? Envi ron Heal th Pe rspec t 119:446-454.S lama R, Th iebaugeo rges 0, Goua V, Ausse l L , Sacco P , Bohet A , e t a 1. 2 009. Ma te rnal P er sona lE xposur e t oA ir bo rne Benzene and In tr au te rin e G rowth . E nv ir on Hea lth Per spec t 1 17 :1 313- 1321 .S ta ns fe ld SA, Ma theson MP . Nois e pollu tio n: n on -aud it ory e ffe c ts on hea lt h. B rit is h M e d ic a l B u lle tin 2 00 3; 6 8:243-257.U .S . E nv iro nmenta l P ro te ct io n Agency. Ou tdoo r A ir -I ndus tr y, B us in es s, a nd Home :O il a nd Natural Gas Production - Add it iona l In formation. h t tp : //www.epa.gov loaqps001/community /deta l ls /oH~gas add! in fo .h tm l. la st u pdated 06/ 05 /0 9. A cce ssed 04/ 21 /1 1.U .S . E nv iro nmenta l P ro te c tio n Agency. H ealth a sses sment document fo r d ie se l e ng in e e xhaust . P repa red by theNa tio na l C en te r f or E nv ir onmen ta l A sses sment , Wash in gto n, DC , fo r the Offic e o f T ranspo rta tio n and A ir Qualit y;EPN600 /8 -9 0/ 057F . A va ila ble f rom : Natio na l T echn ic a l In fo rma ti on Ser vi ce , S pri ng fie ld , VA ; PB2002 -107661, andhtto:llwww.epa.gov/nceaU .S . Envi ronmen ta l P ro tec ti on Agency. P ri va te D rink ing Wate r We ll s. h ttQ :/ lwa te r. epa .aov/dr ink fl nf o/we ll /f aq .c fm .la st u pd ate d 05/04/11. Accessed 04/29/11.Whitworth K W , SymanSki E , Cok er A l 2 00 8. C hild ho od L ymph oh emato po ie tic c an ce r In dd en ce a nd H az ard ou s A irPollu ta nts in Sou thea st T exas , 1 995- 2004 . Env ir on Healt h Per spec t 1 16 :1 576-1580.Wo rld H ea lth O rg an iz atio n. B urd en o f d is ea se from env ir onmen ta l n ois e - Quan tif ic at io n o f h ea lt hy lif e years lostin E uro pe . 2 01 1.Wyom ing Department o f E nvir onmen ta l Quality . Ozone Nonatt ainmen t In fo rma tio n P roposed Ozone Nonatt ainmen tA re a - S ub le tte C ou nty a nd P ortio ns of L In co ln and Swee twa te r COun tie s, L as t u pdat ed Janua ry 2010.h tt p: // deg .s ta te .\Ny .us faqd/ozone%20Nonat ta inment%20Informat ion .aSD Accessed 6 /17 /2011 .T his mate ria l w as d ev elo pe d b y th e A ss od atio n o f O c cu pa tio na l a nd E nv iro nmen ta l C lin ic s (AOEq and fundedu nd er th e c oo pe ra tiv e a gre emen t awa rd n umbe r 1 06 11 '5 00 01 18 0 2 from th e A ge nc y fo r T ox ic S ub sta nc es a ndDisease Registry (ATSDR). .A c know ledgement : T he U .S . Env iro nmenta l P ro te ct io n Agency (EPA ) suppo rts th e PEHSUby p ro vid in g f unds toATSDR under In te r- Agen cy Agr eemen t number DW-75- 92301301 -0 . N eit he r EPAno r ATSDRendo rse the purchaseo f a ny c ommerd al p ro du cts o r s erv ic es men no ne d in PEHSUpu blic atio ns .

5August 2011

delivered testimony of professor margaret rafferty, r.n., at hydrofracking forum (4/25/12)

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