To frack or not to frack: understanding community concerns about health and hydraulic fracturing
Greiner, Lydia Hallacher
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BACKGROUND: Over the past decade hydraulic fracturing, the high-pressure injection of water and chemicals into an oil or gas well, has been widely adopted to maximize oil and gas recovery despite debate about potential health impacts. Often the debate is contentious and complicated by incomplete information. The purpose of this dissertation was to implement and assess the usefulness of a process for communities to identify, prioritize, and respond to potential health effects of hydraulic fracturing. METHODS: The study was conducted in a community in Kern County, California, the epi-center of hydraulic fracturing in the state. Mixed methods were used to develop an inventory of known or potential health effects associated with exposure to hydraulic fracturing: a systematic review of literature published before April 1, 2017 to determine health outcomes reported in exposed communities; a Delphi study to elicit expert opinion; and focus groups to determine residents’ health concerns. The resulting inventory of 60 health effects derived from one or more of these sources was presented to community residents in ballot form and multi-voting was used to prioritize health effects. Focus group and multi-voting results were used to develop an action plan. RESULTS: The Delphi panel endorsed 13 health outcomes associated with hydraulic fracturing for oil and/or gas; all but one were reported in the scientific literature. Focus groups generated 17 health effects; 13 of these were reported in the scientific literature and/or endorsed by the Delphi panel. Multi-voting results indicated that priority health effects were: problems with sleep; breathing; eyes, ears, nose, and throat; heart disease and hypertension; cancer; headache; nausea; and a group of symptoms known as “Shale Gas Syndrome”. CONCLUSION: The process described in this dissertation could be used by communities across the US that are debating the potential health impacts of hydraulic fracturing. It engages community residents, requires few resources, and can be completed in a relatively short period of time. The results can inform a community-specific response to the priority health concerns identified.