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Tuesday, July 26, 2016

Despite Provocative Headlines, New Pa. Study Fails to Link Fracking to Asthma

by Seth Whitehead, Energy in Depth

Researchers at Johns Hopkins University and Geisinger Health Systems have teamed up again to release another study of the potential impacts of oil and gas development in the Marcellus, this time focusing on exacerbations of asthma attacks. This new study claims those who live near shale gas wells are “1.5 to four times likelier to have asthma attacks than those who live far away.”
Just to provide some quick context, this is the same team of researchers who published a study claiming premature birthrates were higher in counties closest to shale wells, even though theywere right in line with the national premature birth rate. One of the researchers that stands out is Brian Schwartz, a fellow at the Post Carbon Institute which has called fracking a “virus.” Considering that background, it’s not surprising that, despite the fact that study after study, including data from the Environmental Protection Agency, has shown that fracking does not harm air quality, the researchers apparently started the study with the following preconceived (and debunked) assumption.
“UNGD has been associated with air quality and community social impacts. Psychosocial stress, exposure to air pollution, including from truck traffic, sleep disruption, and reduced socioeconomic status are all biologically plausible pathways for UNGD to affect asthma exacerbations.”
As the researchers likely intended, the study produced provocative headlines like “Health study shows connection between asthma attacks and gas drilling” even though it actually doesn’t show that and the authors openly admit that. Here are some important things to keep in mind when reading this study:
Fact #1: Authors admit they have no data to link asthma exacerbations to fracking
By comparing the electronic health records of 35,508 asthma patients “with and without exacerbations” treated at Geisinger Clinic between 2005 and 2012, the authors claim to have identified 20,749 mild asthma exacerbation instances (new oral corticosteroid medication order), 1,870 moderate (emergency department visit) and 4,782 severe (hospitalization) asthma exacerbations that they claim show an “association” to residential proximity to natural gas development.
“Association” is the key word in the latter sentence — the authors concede right off the bat they have no data to show causation attributable to shale development:
“Residential UNGD activity metrics were statistically associated with increased risk of mild, moderate, and severe asthma exacerbations. Whether these associations are causal awaits further investigation, including more detailed exposure assessment.” (pg. 1)
Reuters rightly reported that “The study doesn’t prove fracking causes asthma or makes symptoms worse.”
Fact #2: Data show counties with highest number of asthma sufferers have little to no shale development; Includes no data for Washington County, which has the most shale wells
One would think that if you were going to study whether fracking contributed to asthma exacerbations you could want to compare patients with exacerbations in counties with shale development to patients with exacerbations in counties without shale development. But the researchers didn’t do that. Instead, they only looked at whether patients with exacerbations lived near a shale well.
What’s more than a little interesting is the fact the areas researchers studied (outlined in the graphic below in gray) which had the highest concentrations of asthma sufferers have little no shale gas production. Energy In Depth has added the names of three high production counties — Bradford and Tioga, which were included in the study, and Washington County:

Curiously, the county with the most shale gas wells in the state, Washington County, wasn’t even included in the study. A vast majority of Geisinger’s patients reside in the counties highlighted in dark blue, each of which have little to no natural gas development.
So based on the graphic above, it is clear that a vast majority of the 35,000-plus asthma patients included in the evaluation live in areas with little-to-no development. Which begs the question: How relevant could the relatively small number of patients included in the study who reside close to natural gas wells be considering a vast majority of Pennsylvania residents who live in areas with shale development were not included in the study?
All of this brings us back to the question of why the researchers didn’t compare data county-by-county. For instance, although between just 21 and 63 Geisinger asthma patients live in Bradford County — which has the second-most shale wells as any county in the state — data comparing Bradford County asthma exacerbation rates with counties with no shale development might have given a better picture of whether there was an association. But maybe the data didn’t support the researchers’ narrative, and therefore wasn’t included in the study?
What’s more, not only were a vast majority of Pennsylvanians who actually live close to natural gas wells not included in the study, the researchers included 72 patients who reside in New York state, which has, of course, banned fracking.
Fact #3: Researchers admit severe exacerbations occurred in patients who smoked or were overweight – yet they still suggest it’s because of fracking
Not surprisingly, the researchers’ data revealed that smokers and people who were older or obese suffered the most severe asthma exacerbations:
“Compared with patients with mild and moderate exacerbations, patients with severe exacerbations were more likely to be female, older, current smokers, and obese.”
The fact that the researchers failed to prove causation isn’t surprising considering asthma has numerous triggers including airborne allergens, animal dander, mold, smoke, cockroaches and dust mites. According to the Mayo Clinic,
Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

  • Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites
  • Respiratory infections, such as the common cold
  • Physical activity (exercise-induced asthma)
  • Cold air
  • Air pollutants and irritants, such as smoke
  • Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
  • Strong emotions and stress
  • Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
  • Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
The researchers also concede that one of the study’s limitations is that it doesn’t consider what the patients’ occupations are, which could be major contributors to exacerbating their asthma.
Interestingly, in a recent radio interview, Dr. Theodore Them, the Chief of Occupational and Environmental Medicine for Guthrie Health Systems in Bradford County, Pa. noted that studies on shale often leave out the very crucial element of “confounders” as the authors here have done. As Dr. Them put it,
“And there can be confounders such as smoking habits, drinking habits, drug use that never get accounted for in these studies and cause people to come to the wrong conclusions.”  (28:36-30:09)
Fact #4: Multiple Pennsylvania studies have shown the oil and gas industry is not impacting air quality in areas of development.
Schwartz states in the study’s press release, “We are concerned with the growing number of studies that have observed health effects associated with this industry,” but it is more likely that he and his colleagues are actually concerned that there are numerous studies showing the opposite is true. Just to name a few:
  • A recent Pennsylvania report commissioned by Fort Cherry School District in southwest Pennsylvania actually examined air emissions at a nearby well site in Washington County — the state’s most active shale county — and “did not show anything remarkable with respect to chemicals detected in the ambient air. When volatile compounds were detected, they were consistent with background levels measured at the school and in other areas in Washington County. Furthermore, a basic yet conservative screening level evaluation shows that the detected volatile compounds were below health-protective levels.”
  • Another recent Marcellus study led by researchers at Drexel University found low levels of air emissions at well sites. As they explained, “we did not observe elevated levels of any of the light aromatic compounds (benzene, toluene, etc.)” and “there are few emissions of nonalkane VOCs (as measured by PTR-MS) from Marcellus Shale development.” Another Pennsylvania study by Professional Service Industries, Inc., commissioned by Union Township in Pennsylvania that found “Airborne gas and TVOC levels appear to have been at or near background levels for the entire monitoring periods in the three locations monitored.”
  • The Pa. DEP conducted air monitoring northeast Pennsylvania and concluded that the state “did not identify concentrations of any compound that would likely trigger air-related health issues associated with Marcellus Shale drilling activities.” A similar report for southwestern Pennsylvania came to the same conclusion.
  • A peer-reviewed study looking at cancer incidence rates in several Pennsylvania counties found “no evidence that childhood leukemia was elevated in any county after [hydraulic fracturing] commenced.”
There are several more examples of studies using direct measurements finding low emissions throughout the country that the researchers apparently chose to ignore when making the stereotypical activist claim that, “Unconventional natural gas development (UNGD) has community and environmental impacts.”
Even studies conducted by fracking opponents have shown no elevated health risk near fracking sites, albeit after they garnered the desired headlines. A corrected version of a 2015 University of Cincinnati found that polycyclic aromatic hydrocarbon (PAH) emissions in Carroll County, Ohio, are well below levels deemed of concern by the U.S. Environmental Protection Agency. The original retracted study exaggerated cancer risk by 725,000 percent due to what the researchers later claimed was an “honest calculation error.”

Fact #5: Improved U.S. air quality — courtesy of fracking — is actually reducing asthma
Not only does the Johns Hopkins asthma study dismiss the aforementioned Marcellus studies that have shown low emissions at well sites, it also ignores the fact that fracking is the No. 1 reason that three pollutants linked to asthma — nitrogen oxide (NOx), sulfur dioxide (SO2) and fine particulate matter (PM 2.5) are all in rapid decline.
A recent study of the U.S.’s top 100 biggest power plants, which account for 85 percent of the country’s electricity, found that SO2 emissions are down 80 percent, while NOx emissions are down 75 percent. PM 2.5 levels decreased 60 percent from 2005 to 2013, according to data from the U.S. Environmental Protection Agency (EPA) and the U.S. Energy Information Administration (EIA).
The reasons for these declines is obvious, considering power plants have traditionally been the biggest source of this pollution and power plants just happen to be shifting from coal to natural gas at a record pace. Natural gas emits one-third the nitrogen oxide as coal and just one percent of the sulfur oxide of coal, and the two pollutants combine to form PM 2.5.
Recent World Health Organization data indicates that the U.S. is reducing these air pollutants while much of the world continues to struggles, which WHO states contributes to increased risk of asthma and other health problems: 
“As urban air quality declines, the risk of stroke, heart disease, lung cancer, and chronic and acute respiratory diseases, including asthma, increases for the people who live in them.”
Ironically, the U.S.’s progress in improving air quality, thanks in large part to the Marcellus Shale, is perhaps most evident in New York, which has infamously banned fracking.
The “Big Apple” has the cleanest air in over 50 years, thanks to an increased use of natural gas from Pennsylvania’s Marcellus Shale. Former NYC Mayor Michael Bloomberg laid this out in a press release in 2013, stating:
“Today, because of the significant improvements in air quality, the health department estimates that 800 lives will be saved each year and approximately 1,600 emergency department visits for asthma and 460 hospitalizations for respiratory and cardiovascular issues will be prevented every year. The City expects further improvements in air quality and the future health of all New Yorkers as buildings continue to convert to cleaner fuels over the next several years.”
In 2005-2007, it’s estimated that PM2.5 levels in New York City contributed to over 3,100 deaths, over 2,000 hospitalizations for cardiovascular and respiratory disease, and 6,000 emergency department visits for asthma annually.
Democratic presidential nominee Hillary Clinton has also developed a factsheet that explains how natural gas reduces asthma attacks:
“This shift has also yielded significant public health benefits, avoiding thousands of premature deaths and more than 100,000 asthma attacks in 2015 alone.”
So, even assuming for a moment that the Johns Hopkins study’s “association” of asthma exacerbation could actually be proven as causal, it is clear that shale development has done far more to reduce asthma and other troublesome ailments than it has done to make them more prevalent.
Fact #6: Study conducted and funded by fracking opponents
We have to give Schwartz some credit: after producing numerous studies that fail to disclose that he’s a fellow at the anti-fracking Post Carbon Institute (something EID has brought to lightwith his previous studies) he finally disclosed that fact in this latest study:
“Conflict of Interest Disclosures: Dr Schwartz is a Fellow of the Post Carbon Institute (PCI), serving as an informal advisor on climate, energy, and health issues. He receives no payment for this role. His research is entirely independent of PCI and is not motivated, reviewed, or funded by PCI. No other disclosures are reported.”
The study also received funding from the Robert Wood Johnson Foundation: at least three of itsboard members are also on the board of World Wildlife Fund, which has made it clear that it is, “against the use of fracking to extract shale gas – or any other ‘unconventional’ fuels – from the ground.”
The study also used satellite data from Skytruth, a group that is against hydraulic fracturing and indeed all industrial activity. Skytruth is funded by numerous anti-fracking groups, including the Tides Foundation, Greenpeace, Oceana and the Heinz Endowments.
Conclusion
The researchers claim this study “adds to a growing body of evidence tying the fracking industry to health concerns.” Problem is, the study — and many others like it — actually doesn’t have any evidence to prove causation, while numerous studies that actually provide real evidence that fracking is reducing asthma throughout the U.S. continue to be overlooked.

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