Liam O’Fallon: Good afternoon, and welcome to the Partnerships for Environmental Public Health Web Seminar, titled Hydraulic Fracturing and Environmental Public Health. My name is Liam O’Fallon, and I am the Coordinator for the Partnerships for Environmental Public Health Program at the National Institute of Environmental Health Sciences, Division of Extramural Research and Training. I’ll be the Moderator for today’s session. I’m pleased to introduce to you our two presenters today, Dr. Jill Kriesky from the Graduate School of Public Health at the University of Pittsburgh, and Dr. Roxana Witter from the Colorado School of Public Health. Dr. Kriesky is replacing Dr. Goldstein, who sends his regrets for not being able to participate in today’s webinar. The first presentation will be given by Dr. Jill Kriesky, who joined the Graduate School of Public Health at the University of Pittsburgh in August of 2011. Her responsibilities include both research and community outreach on Marcellus shale drilling for the Graduate School, and she is also the Senior Project Coordinator for the Center for Healthy Environments and Communities in the Environmental and Occupational Health Department. Prior to her current work, Kriesky directed the Appalachian Institute and Service for Action Center at Wheeling Jesuit University where she developed service projects and experiential learning, research and outreach opportunities on economic, environmental, and health issues. She also served as the Director of West Virginia University’s Service Learning and the Director of West Virginia Campus Compact. Today she will provide a brief overview of the unconventional natural gas drilling process, discuss with us the public health implications, and note the importance of sustainability approaches that encompass environmental, economic, social and health dimensions. Dr. Kriesky? Jill Kriesky: Hi. Thanks, Liam, for that introduction and for the opportunity to speak today. Let me begin first by just giving a bit of background on our experience here in Southwestern Pennsylvania, where I live and work. Drilling, unconventional gas drilling activity started here in earnest. We usually use the year 2008. Prior to that in 2007 there were 16 wells drilled in the State, and 2008 that jumped to 193, and then continued to grow very rapidly and today there are over 5,000 wells drilled in Pennsylvania. And this is Marcellus shale gas in this region. In addition, our office here at the Center for Healthy Environments and Communities began in 2010 developing something called FracTracker, which is an online blog and data tool that allows participants to learn about shale gas drilling in the region, and we continue to collect data on air and water quality problems related to shale gas and also potential health impacts. And, with Dr. Goldstein, I have also been involved in the examination of the role of public health and policy development around Marcellus shale. So, with that, I’d like to get started. We thought we should start with a simple overview about the shale gas drilling process. For those of you who are new to the subject, for many, many years there has been conventional gas drilling, and on the left side of the slide you’ll see a well that has a pipe that goes down vertically and that’s the sort of gas drilling that has happened here in Pennsylvania and around the country for quite a long time. Unconventional or nonconventional natural gas drilling involves both that vertical drilling, but also as the well on the right shows very deep drilling and then a component that’s almost horizontal, which also can go out quite a distance, and that’s a relatively new technology. The pipes are put down in the ground, perforated, and water and chemicals are forced into the – through the holes to fracture the shale and release the gas. So the – I’ve just put pictures in here to talk briefly about what the process looks like from the ground and, again, this is not in a lot of detail, but if you start with the photo in the upper left, the beginning of the process starts with bringing in the equipment and materials that will be needed to set up the fracking site. And this, the whole process can take three weeks or more for a single well, starts with clearing a pad that’s perhaps four to six acres in size, depending upon the number of wells that will be at the pad. Then the trucks come in with water and chemicals for this process. And the rule of thumb is that it takes about a thousand truck trips per well frac. So once the well, the site is prepared, the well is drilled, the casing goes down, the perforation I mentioned before occurs, the water and chemicals are forced into the shale and the process of drilling and extracting gas begins. Some of the water that is forced down comes back up and is in some places typically kept in ponds, so that third photograph, if you’re going clockwise, shows a bit of a fracking pond. I’ve heard very wide estimates of how much water comes up, depending upon where the drilling is occurring, can be anywhere from 10% of the water forced down to 90% of the water forced down comes back with those chemicals, and as these are kept in ponds, in some cases that’s put into trucks and shipped out. Then there is a flaring process that takes the impurities out of the gas and once the gas is turned up then pumping starts. So that last photograph, that sort of a scene at the countryside is actually a compressor station where the gas is compressed and then piped out to other destinations. So before talking specifically about the impacts on the environment and health of this particular process, this is a slide that Dr. Goldstein uses regularly, sort of based on his experience. And I think it’s very applicable to what we seem to be seeing with shale gas drilling. So when industry starts a new activity, before the health and safety information is fully available. Reports of adverse health outcomes start to crop up, and certainly that is the case with shale gas drilling in our region. There are reports of headaches and rashes and stomach upset and muscle fatigue and a whole range of health outcomes that people are associating with being near this activity. A major public concern that arises, and then we find ourselves in a place where there’s an inability to establish the cause and effect relationship primarily because it hasn’t — we haven’t actually had a good study of the exposure or information, we don’t have that information, and as a result we can’t really definitively say what’s causing the issue. Okay, in addition, there are three other points that we think bear mentioning here at the start. The first is that over time the industry is getting better and will continue to get better at this natural gas extraction process, both for economic and environmental reasons. Every bit of gas that escapes from the processes is gas that is not going to be sold, and every bit of fracking fluid that isn’t recycled is something that has to be replaced at a cost to the company. So we understand that things will get better, and actually if it seems like there’s an argument to be made both economically and environmentally is the delay actually would be better and that these things could develop, the processes could develop in a way that serve both economic and environmental concerns. In addition, we make the point that the public health threat from extraction is due to the potential exposures to chemicals and physical agents, which is where most of the attention has been focused, but also due to safety issues and psychosocial disruptions that occur for individuals and communities where this happens. And both I and Dr. Witter will be talking more about that today. And, finally, there will always be surprises, and I think the one that comes to mind to me most visibly is the earthquakes that occurred in northern or central Ohio at the beginning of this year that seem to be related to the injection of wastewaters underground. And no one really expected that would be a byproduct of natural gas drilling, but now it seems as though it may be. And, finally, there’s plenty of controversy around shale gas drilling, and we’re all familiar with that I think. But there are also a couple of contradictions and confusions that we think add to the controversy and maybe can be clarified. The first has to do with what hydrofracking really is and is it causing groundwater contamination. Certainly, industry and governmental representatives will say that there’s no proven incident where hydrofracking has caused groundwater contamination. Yet the public has heard certainly plenty about the fact that water contamination has occurred as a result of unconventional gas drilling. So here we just want to point out that, you know, if you just take hydrofracking to be that process that I explained at the beginning, which is running the pipe underground, perforating it, and breaking open the shale, that first statement there is probably accurate. However, many people in areas where drilling is occurring really look at the whole process, the multiple pictures I showed you is the hydrofracking process. And certainly in the entire process starting from clearing of the site to shipping out of the gas, there are a lot of opportunities for water contamination and so it’s really a definitional issue here at stake. The second question is whether or not we’re dealing with a new process or an old process, and sometimes we hear, oh, hydrofracking has been around forever and this is – so we know what we’re doing when we do it. On the other hand, we hear it’s new technology that’s a game changer in terms of energy use in this country. And, again, maybe both are true, that vertical drilling that use some of the concepts of fracking certainly has been around for a long time, but the process we’re looking at today, in unconventional gas drilling with going thousands of feet underground and then going horizontally using millions of gallons of water and chemicals to aid that process isn’t a new process made possible by new technology. So then the question becomes, you know, well, why are we so worried about this? And I think, actually in this kind of way of categorizing things from Dr. Witter, and I think this is a good way to look at it, there are multiple pathways to adverse health impacts here. There are chemicals in use that make their way through the pathways of air and water and soil. There are industrial activities where worker health and safety is at stake. Again, the multiple diesel trucks used to transport water, chemicals, and equipment to sites are the sources of traffic accidents. There are also issues of explosions and fires. Just this week there was an explosion in Ohio that killed a worker. And then as also part of that industrial activity are the noises that come from this – the whole drilling process. And then a pathway that I think people may not immediately think of are what the process or the growth of the industry does in the community, the psychosocial and lifestyle changes that occur when suddenly thousands of trucks are traveling through your otherwise very rural community and disruptions of increased populations who are working on the sites and various related issues are sources of health impacts that we’ll talk about later. And, finally, I think the question we won’t talk about because we simply don’t have time is the impact of the global changes, what does shale gas drilling mean for the development of sustainable energy, and what is its contribution to climate change? These are questions that are also heavily debated. So I think let’s talk first a bit about water, and here the big concern relates to the fracking compounds and especially increasingly we think the mixtures that result from sending water underground with fracking compounds in it and the chemical reactions that occur that cause there to be new mixtures as a result, the combination of those fracking compounds with naturally occurring chemicals. So the questions here are where are the chemicals going, what hazards are they posing, both to humans and to the environment, how much of it is there, how long does it exist in the environment and then, again, what is the interaction between those fracking chemicals and what occurs naturally underground. And particularly here in southwestern Pennsylvania the question has arisen about technologically enhanced, naturally occurring radiation or TE-NORM there. We know these exist underground, and so the question arises that when the deposits are being worked for drilling purposes for – to reach the shale gas what’s going to happen to the radioactivity, will there be more in drinking water, will radon be off-gassed into basements near drilling sites? These are questions that have arisen and not been fully answered yet. So this is a list of the types of additives that go into fracking fluids, and fracking chemicals are a very small part of the fluids that get injected underground. Estimates that I’ve seen suggest that between two and 10 million gallons of water are used to frack a well and only 0.5% of that fluid is – are the fracking chemicals, but when you’re talking about that many millions of gallons of water you’re talking about thousands of gallons of fracking chemicals, and so here’s the list provided on the Earthworks website of the kinds of chemicals, why these are added, what the role is in the process of fracking and then, again, what the chemicals are. So one of the issues that concerns us a lot here in Pennsylvania relates to what we can learn about these chemicals and, in particular, what we can learn about the mixture. Just this past spring a new law was passed in Pennsylvania, Act 13, to regulate some of what goes on in the industry, and that Act does call for disclosure of most chemicals, except for those that are proprietary. But there are some things that drillers are not required to disclose. And particularly number three raises some concerns. They are not required to disclose chemicals that are the incidental results of chemical reactions or chemical process with naturally occurring materials that occur underground. So, in other words, when these mixtures are formed and they come back in this flow back or produce water, the drillers are not required to report what’s in that. That’s – those are the liquids that go into these fracking ponds, and it has sometimes been released in various ways through leaks and pipes and leaks in the ponds into the environment. And there’s no requirement in Pennsylvania that these – that we be told what’s in these mixtures. And, you know, I point this out because other states, including Colorado, in fact, our law was patterned after Colorado’s. Ohio is currently considering legislation that’s patterned after these laws, as well, and I believe Louisiana has similar laws. So across the country the potential exists that we not learn what’s in the mixtures. Okay, I’d like to talk for a couple of minutes here about air quality, too. What we know is that there’s very little monitoring, with the exception of some work that’s been done in Colorado there has not been very much monitoring, at all, of the gases that are released at every, potentially at every stage of the process. But what we do know is that, of course, methane is the main gas that comes out of this. This may be relatively low in terms of human toxicity, but we also know that hydrogen sulfide, which is more toxic and even more toxic the chemicals we know as the BTEX, the benzene, toluene, ethyl benzene, and xylene, those chemicals which are important human toxins with cancer and non-cancer endpoints are byproducts that are being released into the air. The second air question is particularly important for folks, like us, who live in pretty populated areas that are already struggling with I would say legacy air pollution kind of problems, that a single gas well would be considered, I think typically considered a nonpoint source. And typically we say, well, like an individual farm, that doesn’t pose an immediate danger with its nitrogen runoff, but if you aggregate all the farms in a farming region, that can cause significant problems. Right now, the thousands of shale gas wells in our region are local, considered local sources. They are not aggregated for purposes of measuring pollution, and potentially they pose both local and aggregate risks. These three maps real quickly will show you what air pollution problems already exist, and if you can make out this is looking at Ohio, West Virginia, Maryland, and Pennsylvania. The cluster of red counties in southwest Pennsylvania that shows up on all three maps are areas of non-attainment, according to EPA, for particulate matter 2.5 and for ozone. So we’re already out of attainment. We know that the sorts of gases that are released from the shale drilling process potentially contribute further so that our air pollution problems are likely to worsen. Okay, and a legitimate concern, and I want to be careful and clear about the way I say that, is we know that the chemicals from the air and the water are linked with asthma, cancer, heart disease, diabetes, nervous system problems and mental health problems. We know that about the chemicals. What we do not know is what is the exposure of people living in shale gas drilling communities, so we do not know the actual risk to individuals that are in a community and that’s simply because these sorts of epidemiological studies that might answer that question definitively have not been done. Okay, in terms of the mental health issues, I want to take just a moment to mention this because what you learn when you go into a community where drilling is occurring, most immediately is the stress under which residents find themselves. And it’s the stress of not knowing what’s not going on with the air and the water, but it’s also stress from the noise and concern about traveling on the local roads that are suddenly populated with hundreds of trucks and which the roads are degraded from all the truck traffic. People concerned about the loss in their property value as a result of water contamination or potential water contamination, air pollution are – in our communities there are a lot of farms, people have lost farm animals that they believe have died or been exposed, due to exposures. There’s an increase in sort of the disagreements, the tension within communities based on whether people support or don’t support the drilling. And then for low income people especially, people who have always been sort of on the economic edge of things, the influx of individuals into the community that work in the shale gas industry has really caused a shortage of housing and has in some situations forced people out of existing housing so that their landlords can increase rents and rent to people who can – who are working in the industry and can pay more. There are similar sorts of community wide impacts, as well, that the non-drilling industry, especially those related to tourism are concerned about the pollution. There’s an increased need to use all sorts of government services and especially related to road maintenance. There are especially in areas that don’t have a lot of excess housing, a lot of housing issues. The establishment of what are known as man camps where shale gas workers live who are only there temporarily and in some communities new experiences with homelessness that they haven’t seen. And, again, on a sort of community wide level divisiveness between people who are the haves, people who are benefitting from drilling through jobs or leases and people who are not seeing economic benefits. So I’d like to wrap-up here with just the point we took a look at last fall here in our part of the State. At a hearing at which pros and cons were given by community members, we did an analysis of the people who are opposed to drilling. These are the classifications of their comments. And you can see that environmental concerns, of course, are very high. But if you look at general health concerns, almost two-thirds of the people opposed are worried for health reasons, so health is clearly on the mind of residents in shale gas drilling regions. And I would say it’s also on the minds of the governments, the government representatives, the elected officials who are trying to deal with this. These are three quotes from President Obama, the Governor of Maryland, and the Governor of Pennsylvania, all of whom set up Commissions to study the problem. And at each – in each of these statements they make clear that we need to take a look at this from the governmental perspective because there are issues of public health and safety that are of concern to the community. All of them recognize that, yet when the Commissions were put together public health has just not been at the table, whether we’re looking at the Federal Energy Department Panel or the State Panels, there was not one person on any of those Panels with the background in public health. And so if the discussion goes forward the concerns of public health we believe have not been particularly well represented in Pennsylvania, when the new legislation passed the Department of Health was not among the 17 departments funded for – to do research or any kind of administration of issues surrounding shale gas drilling. So, in conclusion, what we find is that production is ahead of health and environmental research. The impact, the health impacts can come from many sources, and public health as a community has not really been at the table, as studies of shale gas drilling have proceeded. So, with that, I’d like to close and just thank Dr. Goldstein, my colleagues at FracTracker and CHEC and the Heinz Endowment. Liam O’Fallon: Dr. Kriesky, thank you very much for your presentation today. We’ve been getting a couple of questions coming in and if there are more questions please submit them using the GoToWebinar question box. One of the questions that we have received already is can environmentalists or public health officials independently test the waters to figure out what types of chemicals are in, I’m assuming, the fracking ponds? Jill Kriesky: The fracking ponds? Well, my understanding is that the fracking ponds are typically kind of corded off because that’s sort of an industrial worksite, so once a drilling company makes an agreement with a landowner to go on their land to use it that that becomes private property in terms of the company’s use. So I’m not familiar of cases where individuals have been allowed to actually go and get that liquid, yes. Liam O’Fallon: All right, thank you. There’s another question about FracTracker, is FracTracker.org only for the western PA region? Jill Kriesky: Oh, no, not, at all. It focuses more on Marcellus shale, but is increasingly bringing in data in its data tool for much – its hope is to go nationwide. And in terms of its blog where it collects information and research and popular publications on shale gas drilling it’s very comprehensive, so I encourage people to look at that. Liam O’Fallon: All right. And the final question before we transition it over to Dr. Witter is is there evidence for groundwater contamination from stored flow back water in the Marcellus shale? Jill Kriesky: Well, I believe the answer to that is yes. This is not my particular area of expertise, but I would point the person asking the question toward the situation in Dimock, Pennsylvania, where there’s contamination of water and a variety of studies looking into whether, you know, where the contamination came from. Liam O’Fallon: All right. Well, again, thank you very much Dr. Kriesky for your presentation. Others have written in and thanked you for the nice overview. So now I would like to introduce Dr. Roxana Witter, and she is an Assistant Research Professor in the Department of Environmental and Occupational Health in Colorado School of Public Health. Dr. Witter’s research on identifying and mitigating potential health effects of natural gas drilling on human health focuses on understanding the impacts of chemical emissions on physical health, as well as the impacts of community change on psychosocial health. Dr. Witter is the principal investigator for the Health Impact Assessment, Natural Gas Drilling in Battlement Mesa, Colorado. She’s also Co-Program Director for the Occupational and Environmental Medicine Residency and Co-Course Director of Environmental and Occupational Interdisciplinary Symposia Unit in the Colorado School of Public Health. Today Dr. Witter will highlight the research her team has conducted as part of the Health Impact Assessment in Battlement Mesa, a residential community in Colorado facing natural gas development. Dr. Witter? Roxana Witter: Hello. Thank you very much, Liam, for inviting me to speak today. Today, like you said, I’ll be speaking about some of the community impacts of natural gas development and how these impacts could affect health. And I’m going to base much of what I’m saying on our work that we did in Battlement Mesa, and I’ll give you just a little bit of background on this Health Impact Assessment. It was in 2010 and into 2011 when colleagues and I at the Colorado School of Public Health conducted this Health Impact Assessment for a proposed natural gas project in Battlement Mesa, which is in Garfield County in Western Colorado. The proposed project involved 200 wells on 10 well pads. The area is really a residential area. There’s no other industry in Battlement Mesa. There’s about 5,000 residents in Battlement Mesa and almost half of whom are under the age of 18 or over the age of 65, which signaled to us that there was a significant part of the population that could be particularly susceptible to a variety of kinds of exposures. We were asked to figure out what the possible health impacts would be from this development on the community and what could be done prior to development to avoid those health impacts. Our project did focus on the well sites and the impacts that were in the community, and we didn’t address health impacts of activities that may have occurred outside the community, including waste transported away from the well sites and nor did we address health impacts of regional air pollution on the scale that Dr. Kriesky was talking about earlier, such as ozone pollution. We – that was not within the scale of this project. The impact assessment determined that there were three main categories of potential exposures that could impact health, and you’ve seen these now from Dr. Kriesky’s slides. And we categorize them similarly, chemicals, chemical exposures in Battlement Mesa. Primarily we were concerned about chemical exposures in the air with a potential for exposure from water contamination. And then there were nonchemical stressors that we felt were important to discuss in the Health Impact Assessment, including noise and traffic that could occur from industrial activities and then the community changes that could occur just from the changing demographics and the industrialization of the community itself. The possible adverse health impacts included physical health impacts related to chemicals in the air and water, and then physical health impacts related to noise, safety risks that could be associated with traffic, and other industrial activities, and then the psychosocial stress that was related – could be related to community changes. As a part of the Health Impact Assessment we proposed over 70 specific recommendations to reduce the risk of impacts and risk of exposures. And I think important to note is that included in the recommendations there were several that recommended ongoing monitoring of a variety of different kind of exposures and then development of adaptive management plans so that if the monitoring picked up on problems then there were ways that the problems could be addressed. So the sources of nonchemical stressors include – were from the industrial activities, and noise can be a big concern, particularly for people living fairly close to the drill pads. Drill rigs are very noisy, there are generators that are used to power the rigs and to power the fracking operations and these generators are very noisy. And then, of course, trucks coming and going from the well pads can be very noisy, as well. Traffic, again, moving industrial equipment and moving fluids, particularly the frack water and the waste, and then traffic associated with moving large numbers of workers to all the variety of sites. And then, of course, the community changes, demographic changes and industrialization. And I’m going to go through these in a little bit more detail in the coming slides. So on this slide you see an example of noise levels that can occur during drilling. And there were two sampling occasions that occurred. The first number represents drilling without any noise mitigation, and the second number represents drilling with noise blankets placed on top of the generators to try and dampen some of the noise of the generators. And, as you can see, the noise at 100 feet without any mitigation was measured to be 83 decibels and with mitigation a decrease down to 78 decibels. And you can go out to 1,000 feet and there was noise still pretty high at 69 decibels and with mitigation at 65 decibels. And I’ve put over on the bottom right just for reference what the decibel levels are for a variety of different noise generators that we’re all familiar with, so a quiet room is in the range of about 30 decibels, ranging down to a lawnmower, which is in the range of 90 decibels. And you can see that even at 1,000 feet the noise is pretty loud and the level of a loud kitchen exhaust fan, and if a well pad is being developed with 20 wells on the pad, as what was being proposed for Battlement Mesa, the drilling operations could take several weeks and perhaps even into a couple months and then move into fracking operations which could have noise levels approximately the same. And so you are talking about noise being produced at pretty high levels for probably several months on a single well pad, if that well pad is being developed for several wells. We do know that noise can have health impacts. Even at these noise levels, which are below the levels that can cause permanent hearing loss, which is the basis of occupational noise standards, health effects and symptoms can occur at much lower levels. And so at 30 decibels people can have sleep disturbance. At higher levels fatigue, cognition and mood can be impacted, and school performance can be impacted. And we – there are several studies that document that road noise and railway noise can impact blood pressure, cardiovascular disease, and cardiovascular mortality. So the impacts of noise are pretty well documented. We also have to remember that although we’re talking about the noise at a well pad, when people are living near haul routes, where there’s a lot of trucks that may be going by servicing well pads at another location, they may be subject particularly to the road noise as many, many hundreds of trucks that could be going by their homes. And so many of these exposures not only can occur right at the well pad, but may occur remotely from the well pad in other areas that are servicing the natural gas development. The truck traffic, as Dr. Kriesky mentioned, can be significant. There are estimates that it takes about 1,000 trucks per well to develop a well. In our study the industry had proposed a pipe system where they were going to bring water in and waste out through pipes, and this was going to decrease the trucks significantly, down to several hundred rather than 1,000. But this is not a very common plan I don’t think for many well pads. Still the normal operations still involve using trucks to move water and waste. Again, thinking about where trucks come and go, truck traffic can impact not only the well and the well pads and the people that live nearby, but also the people that live along haul routes, people that are trying to use those roads for other, for their own normal daily lives. And truck traffic can occur around the clock, so it’s not always a nine to five operation, but well development is often a round the clock operation. There’s a variety of exposures that are associated with truck traffic, including diesel exhaust, road dust, noise, and vibration. And this can be particularly a problem if the – if there’s a hill, the trucks then sometimes need to use engine brakes to go up and down the hill and grind gears to go up and down the hill. So sometimes it’s not just a rumbling that goes by, but repeatedly trucks with additional noise. And then, of course, safety risks, and this was really one of the major concerns that we had in Battlement Mesa was the idea of trucks using the same routes as school buses and that children were using to get to and from schools. We know that traffic is a known safety hazard. We know that when the number of vehicles increase there’s an increased risk of motor vehicle injury and death for drivers, pedestrians, and bicyclists. We also know that large trucks are more likely to be involved in fatal accidents than passenger vehicles, and we also know that when the speed of vehicles increase so does the potential for severe injury occur if an accident does happen. So another aspect of community impacts that I’d like to discuss is how a rapid increase in natural gas development can change other measureable aspects of a community and contribute to stress for people living in the community. Dr. Kriesky touched on this earlier, and I’m going to give you some examples of what we were able to document in Garfield County. This graph here shows the number of well starts in Garfield County, starting from December of 1996 and going out till the projected number of wells for December of 2012. And you can see that, or in the earlier years there was a rather steady and perhaps slow increase, that started to increase more dramatically in 2003. And then I’ve put red bars around the years 2005 to 2009 to really when the county really started feeling impacts of rapid natural gas development, and the rapid increase continued until 2008, and then there was a very sharp decrease in 2009, which we attribute to a decrease in natural gas prices, increased production in other areas, including in Pennsylvania and just the national recession. Throughout the decade of 2000 to 2009 Garfield County saw very rapid increase in population, up 28% in the decade, and in the last five years half of that at 14%. This next slide shows you some of the other community metrics for the same time periods. On the top you can see the same graph that I showed you on the previous slide, which I just left in here for reference, and that’s the well starts in the community, in the county. Then on the bottom left there’s the number of police arrests in one of the towns in Garfield County. And, as you can see, the number of police arrests follows a similar pattern where nearly – there was nearly double in the number of arrests starting, if you look at 2008 and then look up at – I’m sorry, starting in 2000 and then looking up at 2008. And then when the industry dropped off in 2009 there was a very quick drop-off to almost half, back to baseline really of the number of police arrests in that community. And this can have an impact if the community isn’t prepared and able to increase the number of police officers. It can really overwhelm a community if they’re not ready for this kind of change. The next graph shows the rate of sexually transmitted infections in Garfield County, and this just shows the years 2005 to 2009. But you can see in the blue bars is the rate of chlamydia infections. The smaller red bars is the rate of gonorrhea infections. But you can really see that there is a rapid increase in the rate of infections going up to 2009 – I’m sorry, 2008, and then dropping off again in 2009. And then, finally, the last graph demonstrating that school enrollment was also impacted, and in 2000 – beginning in 2005, starting to see an increase in school enrollments and then a sharp decrease again in 2009. And what we heard from community members is that the industry was really impacting the fabric of their community, and what these data show is that not only could we document that population numbers changed, but if we looked we could use existing data to see how other aspects of the community were being impacted, as well. And so for many of the people that we talked to when we were doing the Health Impact Assessment, they were concerned over all of the exposures, including concerns over the chemical exposures, the potential for air pollution and water contamination, their concerns over noise, traffic, including traffic accidents and traffic volumes, and then the community changes. And, as Dr. Kriesky alluded to, concerns about the newcomers versus the old-timers, the industrialization of what was their residential community, and then economic shift from farming and tourism to a more industrial economic basis for their community. There was a sense of loss of self-determination and then the concerns about the strains on community services and roads. And for many of the community members this is one of the most important aspects, the most important impacts that they were feeling, this psychosocial stress. Many of the residents provided public comments to our Health Impact Assessment, and they described the psychosocial stress they were experiencing. And here I’ve just given a couple of examples. “I feel angry…impending events weigh on my mind…stress, anger, anxiety, feelings of helplessness and worry about possible health problems.” And then the second one was someone describing his own distress and what he saw in people around him. “There’s been personal distress, including depression, anxiety and insomnia…we don’t know what will happen or when.” And I’m sure this sounds familiar to other people who may be involved in other areas of the country where natural gas is being developed. And although we suspect that this kind of stress has impacts on health the exact mechanisms of how stress may impact health and being able to measure that is currently active areas of research. We know that psychological stress can increase cortisol levels via the hypothalamic, pituitary adrenal access. We know that stress also increases catecholamine’s, including adrenalin and noradrenaline due to the sympathetic nervous system. And we’re discovering that inflammatory mediators are produced by the immune system in response to stress, and all of this provides sort of a pathologic mechanism for impacting blood pressure, cardiac disease, metabolic disease, lung disease and mental health. And so links between chronic stress and these health endpoints are areas of current investigation, mostly looking at these varieties of mechanisms. So here I’ve just produced sort of an overall framework for thinking about how natural gas could impact health, and using the three categories of exposures that we described in our HIA and have been used in other areas, as well. We think about natural gas development producing potential for chemical exposures, the industrial activity producing a variety of exposures, and then community changes. And we can think about how all of these can contribute to psychosocial stress, can contribute to safety hazards, can impact individuals, as well as communities, and how there is interplay between individuals and communities. And really the take-home message is that there’s a lot of interaction between all the possible exposures to individuals and communities, and when we think about addressing any one of these exposures, any one of these health outcomes either in research or in trying to develop solutions we need to do the research, develop the solutions, and then step back and think about how it fits into the larger picture and understand that there is interplay and interaction between a lot of these potential exposures and outcomes. I do think that there are opportunities currently to prevent community impacts and protect public health. First, I think the planning process should be comprehensive and transparent so that the big picture of how an entire locality or an entire region can be considered and think about the entire system of natural gas development, stepping back from the individual well pad, and think about how cumulative impact of many wells could impact communities. Local involvement is important because the residents will know what needs and concerns need to be addressed, and including people at the local level will help address some of the frustration and stress that could otherwise be contributing to poor health outcomes. And local governments need to have adequate funding to implement proactive and mitigative measures for communities. Demographic changes need to be addressed and thought about in the planning stages so that they can – so that there are opportunities to mitigate these shifts. It may involve a more controlled development, perhaps more slow development so that certain areas aren’t developed so rapidly and have such a huge shift in their demographics that we know and can demonstrate can impact communities. The industry does have best practices and many companies utilize best practices, however, they’re not uniformly utilized. Best practices can reduce impacts to air, water, noise, and traffic, and these just need to be utilized much more regularly within the industry. Ongoing monitoring is important so that residents and the industry can know when things are going well and when things need to be addressed to protect the health of the residents and the community. And then adaptive management plans need to be developed so that when something needs to be addressed there’s a mechanism for having it occur. In summary, chemical and nonchemical exposures do occur when natural gas resources are developed. Health impacts may occur if the levels of exposure are sufficient. Non-chemical exposures, including noise, traffic and community changes could lead to physical health impacts, safety risks, and psychosocial stress, and these are areas of future research needs. In conclusion, I do think that there are opportunities to decrease environmental exposures in communities, and that involves addressing noise and traffic and changes to the community, as well as addressing chemical emissions. Thoughtful planning prior to project initiation could be more effective and less costly than later mitigation efforts, and management plans that include monitoring and ongoing adaptation can decrease exposures and they help reassure community members. And I’d like to acknowledge my colleagues at the Colorado School of Public Health, Dr. John Adgate is our Department Chair, and he’s been very involved in the Health Impact Assessment and other projects related to this topic. Lisa McKenzie, Lee Newman, Ken Scott, and Kaylan Stinson have also been very involved with the HIA, as well as other projects. The HIA was supported by Garfield County. We were supported, as well, for training to do the Health Impact Assessment by the Pew Health Impact Project. And then, of course, the Colorado School of Public Health supported us in many other ways. So thank you very much. Liam O’Fallon: Well, thank you very much Dr. Witter. Appreciate your nice presentation, and we have a few questions that have come in. And thanks to everybody for submitting questions. And the first one we’ll do here – on April 3rd an administrative complaint was against several Federal and North Carolina State Agencies was submitted with regard to environmental justice protection in North Carolina’s fracking legislation. It wasn’t successful. Have you had to address the legal rights of low income, minority, and tribal populations in your research? Roxana Witter: We have not had any direct involvement with environmental justice issues with our work, although it is certainly something that should be considered and part of the planning when natural gas is developed. But, no, it hasn’t been part of what we’ve addressed in the past as yet. Liam O’Fallon: All right. Another question is how long are the well rigs typically in place and are the companies required to restore the site to a natural condition afterwards? Roxana Witter: The – out here in Colorado the projection for the wells, the life of the wells is about 20 to 30 years. Now the drill rigs, themselves, are not onsite for more than, you know, depending on how many wells are being drilled, more than a month or a couple of months. And then, of course, then they’re fracking and the well development occurs. And once all of it gets down to a production phase the piping remains there for the whole development period. Now there are times when a well needs to be maintained and at times to be stimulated and sometimes a company will come back and refrack a well, they call it a re-stimulation often, and so some of the process may reoccur during that 20 to 30 production timeframe. And because there’s this ongoing maintenance that is needed for these wells many of the wells in Colorado and many of the well pads are left as they are for the production period and they’re not reclaimed until after the production of those wells is over, so 20 to 30 years down the line. We haven’t reached that point of reclamation of these large pads with several wells on them, we haven’t reached that reclamation point yet here in Colorado. Liam O’Fallon: All right. Thank you. Another question is how did the information gathered from the HIA change the planning process and development of the project, itself? Roxana Witter: Well, interestingly, the development has not yet occurred in Battlement Mesa. And I’m not really sure when it will occur, you know, the drilling has decreased, although it hasn’t stopped, it’s decreased in the area and that may be a part of why it hasn’t happened in Battlement Mesa, as yet. But I do know that there has been approval for increased air monitoring in Battlement Mesa. There has been some development around the outside of the community, but the well pads within the community haven’t been developed. But the county has approved and is starting – if they haven’t started yet they will be starting soon, increasing the air monitoring within the community. So that has, or that is in the process of occurring. As far as the development, itself, we’ll see how much of the recommendations will be adapted, but there – and we’ve thought of it as the recommendations are a menu of options that the county commissioners could use to – as part of the planning and there wasn’t necessarily an expectation that all of the recommendations would be adapted, but that this was our recommendations from a public health standpoint. Liam O’Fallon: All right. We will take one more, specifically for you, and then if there are – we’re starting to get some more general questions, as well. But let’s see here. So in terms of were you able to obtain baseline health data to determine any trends? Roxana Witter: That was part of what the Health Impact Assessment did, is that we tried to characterize the health of the community. Now the Health Impact Assessment looked at Battlement Mesa before any development occurred within the community, so that is what we have is a baseline of the health of the community. And we did that using available data from the State Health Department, as well as some data from the Colorado Hospital discharge data set. And what we determined was the community is really a pretty healthy community when we compared it to other parts, to the rest of Colorado. You know, they had no higher risk of any kinds of admissions to hospitals or cancers or reasons for mortality, and so that was part of our Health Impact Assessment, was doing a baseline look so that that is – we can then compare if that was needed in the future to be able to look at baseline and then look at future health. Liam O’Fallon: All right. Excellent. Thank you. All right, so I have some questions for both presenters, and just in terms of managing expectations for everybody on the – who is participating we may, in fact, not get to all questions. If we aren’t we’ll send the questions out to the presenters to get their feedback so that we have them answered for later. So if we don’t get to your question, I’m sorry, and we will address it after the webinar. The first question here is – let’s see, could you generally characterize the duration of exposure to noise impacts to people living near a single well pad? How much does cumulative impacts to exposure from impacts, such as noise or lagoon admissions affect a single resident living to well pad spacings typically occurring – and this one is in the Colorado study location? But I think for both people, both presenters? Jill Kriesky: Roxana, do you want to do that first? Roxana Witter: Yes, yes, I think the question is is how long might people be exposed to noise? And it can really depend quite a bit on what’s going on on that well pad. That was just one example of one monitoring, sampling study that I was able to locate. But on a particular well pad if there are five wells being developed it’s going to be shorter than if there’s 20 wells being developed. Sometimes the geography of the area may impact how the noise travels, so if the well pad is on a hill or in a slight valley that might significantly change the amount of noise. If the company makes good efforts to install noise barriers that, too, might significantly change the level of noise. And so I just want to make sure that we understand that it can be very variable from well pad to well pad, and I just use that example to show that noise can be an issue. It may or may not be an issue on each individual site and the length of time can really vary depending on how many wells are being developed. Jill Kriesky: And I think all that I would add is that depending upon where you are in relation to multiple well pads, too. Roxana Witter: That’s right. Jill Kriesky: That, you know, you could be – there may be one well pad on your property even, but your neighbor may also have one, too, so you may also be exposed to noise from another well pad nearby. And Dr. Witter pointed this out in her presentation, too, that if you are on a hauling route where the trucks continue to go by, even if they’re not drilling right near you that will be a continued source of noise over time, it won’t be specifically from the drilling pad but as part of the drilling process. Roxana Witter: That’s right. Liam O’Fallon: Excellent. Thank you very much. Another – the next question is the speakers both presented a good overview and framework and showing some associations, but what can we say about, one, what is known that is measurements of chemical exposures versus potentials for exposures and, two, the relative need for mandatory, that is legislative, regulatory approaches rather than voluntary planning and management? Jill Kriesky: Well, I can take a first shot at this. Essentially we do not, so far as I know and I don’t believe it’s out there, we do not have a study that has monitored the specific exposures of individuals to the fracking process yet in this country and probably anywhere. And so we have some information, and Dr. Witter can talk about this, it’s out of Colorado, in terms of air emissions within a half mile and outside of a half mile of a drilling site, but we still don’t – I mean we know what has come out of those sites, we don’t know what the exposure of individuals are. So that’s where in my presentation I tried to stress that we don’t really have specific exposure information collected in a systematic kind of way. So, and I think this speaks then to one of the original points I made is that the development of the industry is happening so much faster than the development of the research, that what we have are pockets of significant concerns based on what people feel are potential health impacts, but we don’t have those definitive studies that would all would agree are showing the health impacts of the drilling. Roxana Witter: I agree. There’s been very little data available. The study that Dr. Kriesky mentions that came out of our group here in Colorado utilized some air monitoring data that was collected in Garfield County at the perimeter of several well pads, and that information was used to develop a health risk assessment. And the short answer to the health risk assessment was that there are possibly some risks, particularly to and more significantly in non-cancer health risks. There was, according to the calculations an increase in risk for things like what we – what people are reporting, things like headaches, mucous membrane irritation, those kinds of short-term health symptoms. But the epidemiologic studies that would answer the questions about what the risks, the true risks are from given exposures, both the exposure data and the epidemiologic data is just not available at this time. Part of what our risk assessment was was to provide policymakers, particularly the policymakers in Garfield County, with information that they could use if they were so inclined to be proactive in terms of trying to reduce the exposure that we believe could be possible and try and reduce the exposures before they happen. Liam O’Fallon: All right. Thank you. So here’s another one, this question is for both presenters – government oversight by an expert committee charged with protecting the public health in the EPA, NIOSH, and OSHA and other federal agencies seems like a good idea, my question is in creating such a committee can we issue a conflict of interest to be dealt with in a way similar to how NIH grant applications and review panels handle potential conflicts of interest or the perception of conflict of interest? In other words, identifying the people in organizations who have a financial or other interest in the potential outcome of the proposed research and those entities recuse themselves from the discussion and the decisions related to the proposals with which they are in conflict? So having a similar type of committee put in place, does that seem feasible? Roxana Witter: I don’t want to get too far out of my area of expertise because I’m not involved in policymaking and I don’t – but it seems like that that might be, you know, something to consider, something to discuss. Dr. Kriesky, I don’t know if you guys have more to offer? Jill Kriesky: Well, I guess what I would say it sounds like a good idea to me. I mean it – but what I would say, based on our experience here is, in the State of Pennsylvania, is the legislation was developing, you know, much of this is subject to political forces that are kind of outside the area of expertise and area of influence I think of most public health folks. And, you know, it is an election year and I don’t – I think we can all agree that this is a politically pretty hot topic, so I don’t anticipate that kind of expert committee being put together and certainly in 2012 because I think there are a lot of political issues related to this, as well. Liam O’Fallon: All right. Okay. So I’ve got a couple of questions related to water, and so I’m going to try to combine these. So what is the source of the water for the fracking process? And in Colorado, especially now there’s a drought here and given the scarcity of surface and groundwater in western Colorado where is the water being obtained for drilling and fraking operations? Roxana Witter: Water is being purchased by companies and it’s coming from a variety of places. And in Battlement Mesa and in Garfield County, not necessarily everywhere in Garfield County but certainly for Battlement Mesa the water was going to be coming from and will in the future if and when they develop, will be coming from the Colorado River. And they were able to secure the water rights for – that they needed, and water rights and water law in the West is very complicated, and I won’t even begin to try to discuss it because I cannot understand it. But companies are able to secure, purchase water, both surface water, such as coming from the Colorado River or other rivers, or groundwater, and they’re able to use the groundwater, as well. There are increasingly companies that are recycling their water, and there’s a wide variety of estimates of how much water or how much is being recycled. I don’t – and it may be, you know, from some companies, say 20% to 30%, others might say their recycling 60% to 70%. Certainly, that is an improvement and has been improving over the last several years, and as Dr. Kriesky alluded to, the industry continues to improve and that is one of the ways that they are improving is in trying to reduce some of the water that’s being used. It is a concern here in Colorado about how much water will be used and where the – who is selling their water rights, who does not then get the water that the industry gets, and that’s part of the discussion that’s ongoing here in Colorado. Jill Kriesky: And I would just add that this is one aspect of the industry that really varies from place to place. Pennsylvania has abundant water resources. There are concerns about withdrawing too much water from streams, and there are situations where communities that are in drought conditions, they’ll need to have that water usage curtailed. I believe I just heard yesterday that Susquehanna County in the northeastern part of the State is limiting the amount of water that natural gas drillers can withdraw from some of the streams in that County because of drought-like conditions there. So we just have a different situation, but still concerns related to weather conditions. Liam O’Fallon: Well, here’s a final question for today’s webinar is what resources are available for landowners in the areas being drilled to educate and protect themselves? Roxana Witter: Do you want to talk a little bit more about the FracTracker? Jill Kriesky: Yeah, well, I would say, yes, FracTracker is certainly a resource and the value of FracTracker as a resource is that it provides other resources, so it has comprehensive lists of where to go for information on a wide variety of topics. I think in any individual community, they actually have just started developing sort of a database of organizations in various communities across the country that would have information more relevant to that community, so particularly for landowners who are thinking about leasing mineral rights and all that’s entailed in that process, I would expect that that would be something that you’d want a local resource for because of differences in laws and things across states. So you can probably find some of that on FracTracker as they begin to develop it. But certainly there are local environmental organizations that even before the advent of drilling for shale gas were concerned about water quality issues and could help with issues around water quality testing, certainly in this area. Many organizations encourage people who are going to have drilling nearby to get sort of baseline water quality testing of well water for people who were on well water, there are a lot of those people in Pennsylvania, in rural Pennsylvania, so rural resources and watershed organizations are a good place to go for that kind of information, as well. And then I think some national organizations might be helpful in this way. The Sierra Club is – had some interest in the topic of fracking, and you could go to sort of national level and work through them to figure out what the closest resource is. Roxana Witter: In the west there’s University of Colorado Natural Resources Law Center has this site that they maintain that has, again, several different kinds of resources regarding oil and gas development, and that may be a place, a starting place for communities in the West to look. Sorry, one of their web pages is the Inter Mountain Oil and Gas Best Management Practices Project. Liam O’Fallon: Excellent. Well, I would like to thank both of you for your presentations today, and your answers to all the questions. There are still many questions here, and we will follow up with you with the remaining questions. But before we conclude today’s webinar just three quick announcements. First, your feedback is extremely important to us, so please take a couple of moments after the webinar to fill out an evaluation form. This enables us to improve upon our webinars. The second is to keep in touch with PEPH. We have a listserv and an e-news, that you can sign up by e-mailing [email protected] You should see that address on your screen. And, three, we have some upcoming webinars. Next month we will have a webinar on August 8th at noon Eastern Time where you can hear about a project in Mebane, North Carolina that’s using community owned and managed research to address environmental health issues faced by the residents there, and also hear about research and policy work of the Green Science Policy Institute on Flame Retardants and Children’s Sleepwear. September we’re going to have a webinar focused on Environmental Health Disparities. So you can keep track of those types of events by following us on the PEPH Events page. So, in conclusion, I would like to thank our presenters, Jill Kriesky and Roxana Witter, for their time and their information today. Thank you, all, very much. This concludes our webinar for July. I wish you all a very good weekend.