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Fracking and Health

Fracking and Health

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Health impacts of fracking
Health impacts of fracking

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Published by: James "Chip" Northrup on Jun 05, 2013
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12/07/2013

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On the Cover
 A
JN This Month
20
 
 A
JN
 
 
June 2013
 
 
Vol. 113, No. 6
 
ajnonline.com
 
On the Web
 AJN 
’s Web site,www.ajnonline.com, offers access to current and past issues (from 1900 on), podcasts, article collections,news alerts—and much more. Bookmark our blog, Off the Charts (http://ajnoffthecharts.com), to read frequent updatesand share your thoughts on what you see in your nursing world. Join us on Facebook (www.facebook.com/AJNfans), fol-low us on Twitter (http://twitter.com/AmJNurs), and be sure to download the new AJN app on your iPad.
WHAT WE’RE BLOGGING ABOUT
“Good Medicine,” by Marcy Phipps, RN, describes how music was the best medicine for one patient recovering from atraumatic brain injury (http://wp.me/prthD-3Oo). 
In “The Hands of Strangers,”
 AJN 
clinical managing editor Karen Roush reflects on the Boston Marathon bombing(http://wp.me/prthD-3Ob). 
When should crucial conversations about death be had with critically ill patients? Oncology nurse Julianna Paradisi dis-cusses her ideas on end-of-life education in “Birdcages: An Oncology Nurse on Crucial Information Patients Need AboutDying” (http://wp.me/prthD-3NB).
WHAT READERS ARE SAYING ON TWITTER, FACEBOOK, AND OUR BLOG
“My hospital has just created an order set called ‘Integrative Therapy.’ It includes choices like aromatherapy, massage, and Reiki. Iam amazed!”
“I can only imagine what it might be like, confined to an ICU bed, unable to control the sounds assault-ing your ears.”
“I have seen much death and dying over my 30 plus years as a nurse and personally as a health care proxy. There is no tidy solution and I have yet to see a scenario that played out as I would have imagined.
“I still think quality caregoes back to being able to have reasonable debates across disciplines instead of shooting orders and lists at eachother.”
 JUNE PODCASTS
Monthly highlights:
Listen to
 AJN 
editors discuss the contents of the June issue.
Behind the article:
Editor-in-chief Shawn Kennedy speaks with 
the authors of “Assessing Sleep in Adolescents Through a Better Understanding of Sleep Physiology.”
the authors of “Fracking, the Environment, and Health.”
O
n our cover this month is a photograph of WashingtonCounty, Pennsylvania, resident Jenny Smitzer. The jarof contaminated tap water she holds turned that color af-ter drilling for natural gas began in 2005 above her farm.Smitzer still showers in that water, but it is undrinkable, soshe must drink bottled water. This photograph is one of morethan four dozen on the subject of hydraulic fracturing, or frack-ing, by photographer Les Stone that appear on the Web site Pho-todocumentary by Les Stone (http://lesstonepublishorperish.blogspot.com), where he also writes about the harmful effectsthat extraction of natural gas from deep rock formations hashad on rural Pennsylvania.Eleven U.S. states currently engage in fracking,and eight more are either considering or preparing forthis method of gas drilling. The gas-rich area calledthe Marcellus shale, which is located beneath parts of Pennsylvania, Ohio, New York, and West Virginia, is beingtargeted by energy companies for drilling. In June 2012,the American Nurses Association passed a resolutioncalling for a moratorium on new drilling permits forfracking because of concern over the technique’s poten-tially harmful impact on human health and the environ-ment. This resolution, titled “Nurses’ Role in Recognizing,Educating and Advocating for Healthy Energy Choices,”also called on nurses to become engaged in energypolicy. For more on the potential health hazards causedby fracking, see “Fracking, the Environment, and Health”in this issue.—
Michael Fergenson, senior editorial coordinator 
 
 
ENVIRONMENTS & HEALTH
ajn@wolterskluwer.com
 
 A
JN
 
 
June 2013
 
 
Vol. 113, No. 6
45
Fracking, the Environment, and Health
New energy practices may threaten public health.
M
elissa Owen became concerned when her10-year-old son developed such severe nose-bleeds that she used tampons to stop thebleeding. Soon after, a blistering rash appeared onhis skin, and his sister began having similar nose-bleeds. The Colorado family’s physician attributedthese symptoms to air pollution caused by the use of hydraulic fracturing—“fracking”—to extract natu-ral gas in their community. He recommended theymove.In northeastern Pennsylvania, the Micelles familythought signing a lease to allow fracking operationson their farm would relieve some of their financialburden. But within the first week of drilling, ElizabethMicelles noticed a sweet odor and a metallic taste inher mouth; by the second week, she and her husbandand three children were experiencing fatigue, dizzi-ness, vomiting, headaches, and nosebleeds. A visit totheir NP and laboratory tests revealed that each hadmeasurable levels of benzene, a known human car-cinogen, in their blood.These acute health problems are common amongpeople living in communities in which “unconven-tional” oil and natural gas extraction, such as frack-ing, occurs. (These examples are composites based onthe experiences of families affected by fracking ascompiled by the Damascus Citizens for Sustainabil-ity.
1
) Common symptoms or complications amongpeople living near fracking sites include
2-4
•
fatigue.
•
burning eyes.
•
dermatologic irritation.
•
headache.
•
upper respiratory (difficulty breathing), gastroin-testinal (severe abdominal pain), musculoskeletal(backache), neurologic (confusion, delirium),immunologic, sensory (smell and hearing), vas-cular, bone marrow (nosebleeds), endocrine, andurologic problems.
•
the risk of endocrine disruption.
•
changes in quality of life and sense of well-being.Longitudinal reports from long-term exposure to con-taminated air and water from gas extraction don’texist, but anecdotal reports make clear that the re-moval of fossil fuels from the earth directly affectshuman health. It’s well known, for instance, that thecombustion of fossil fuels emits greenhouse gases thatcontribute to climate change,
5
and increased rates of asthma, cardiovascular disease, and lung cancer are allassociated with our reliance on and use of fossil fuelenergy, including coal, oil, and natural gas.
2, 6-8
Children are at higher risk than adults for develop-ing asthma and suffering complications from asthmaowing to poor air quality, which can be caused by theburning of fossil fuels.
9, 10
As the population ages,older adults become more vulnerable to climate-related extremes in temperature and ambient airpollution from fossil fuels because of comorbiditiesand age-related changes, such as decreased respira-tory reserve and the slowing of cardiac compensa-tory mechanisms.
11-14
Moreover, there are numerousoccupational hazards for the fossil fuel extractionworkforce, ranging from noise concerns
15, 16
to ma-jor injuries
17
and respiratory irritants that result inchronic disease.
18
Despite these health concerns and efforts to insti-tute a moratorium on fracking until its environmen-tal and health effects are better understood, the UnitedStates continues to rely heavily on fossil fuel energy.Currently, 36% of annual U.S. energy consumptionis derived from petroleum, 26% from natural gas,20% from coal, and 8% from nuclear sources, withonly 9% supplied by renewable energy, such as windand solar power.
19
President Obama’s administra-tion has repeatedly emphasized its plan to continuedevelopment of all energy sources—including a sig-nificant expansion of drilling and fracking operationsfor natural gas and oil. Although the extraction of these nonrenewable sources of energy help the UnitedStates to meet its current energy demands and secu-rity needs, it’s critical that the human and ecologichealth threats associated with fracking be better un-derstood and addressed.
FRACKING
Extracting natural resources trapped within the porespaces of low-permeable rock, such as shale, typi-callyrequires drilling deep—up to 8,000 feet.
20
Usinga process called high-volume hydraulic fracturing,or fracking, areas of weakness and small fractures
By Ruth McDermott-Levy, PhD, RN,Nina Kaktins, MSN, RN, andBarbara Sattler, DrPH, RN
 
46
 
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June 2013
 
 
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ENVIRONMENTS & HEALTH
that already exist in the rock are further opened. De-pending on the characteristics and depth of the rock,fracking a single well requires the high-pressure injec-tion of anywhere from 2 to 10 million gallons of water mixed with sand
21
and 80 to 300 tons of haz-ardous and nonhazardous chemicals.
22
Colborn and colleagues compiled a list of chemi-cals known to be used during natural gas extraction.
3
Of the more than 350 that were investigated further,75% were found to potentially affect the respiratoryand gastrointestinal systems, the liver, and varioussensory organs. Moreover, more than half of thesechemicals could affect the brain and nervous system.
3
It’s estimated that 15% to 80% of the fluid containingthese chemicals flows back through the well to thesurface,
20
where it’s usually stored at the well site intanks or open, lined pits, awaiting transport to treat-ment facilities or to deep-well injection sites for per-manent disposal.Fracking operations have grown exponentiallysince the mid-1990s, when technologic advancesand increases in the price of natural gas made thistechnique economically viable. Fracking is currentlytaking place in Arkansas, California, Colorado,Louisiana, North Dakota, Oklahoma, Pennsylva-nia, Texas, Virginia, West Virginia, and Wyoming.Other states, such as Alabama, Indiana, Maryland,Michigan, Mississippi, New Jersey, New York, andOhio, are either considering or preparing for drill-ing using this method. Vermont has permanentlybanned fracking, and New York and North Carolinahave instituted temporary bans. New Jersey currentlyhas a bill before its legislature to extend a 2012 mora-torium on fracking that recently expired, whereasMaryland has decided not to approve fracking permitsuntil a state panel studying its safety has completeditsfinal report, which is expected in mid-2014. Al-though a fracking moratorium was recently lifted inthe United Kingdom, the government is proceedingcautiously because of concerns about earthquakesand the environmental impact of drilling. Frackingis currently banned in France and Bulgaria.
HEALTH RISKS
It’s believed that the potential health consequences of fracking begin at the onset of drilling and may lastlong after the operation has concluded. Researchershave described an array of environmental factors andhealth risks associated with fracking and other ex-traction processes.
6, 23, 24
These include water and aircontamination; increased intensity in diesel-truck traf-fic volume; constant, elevated noise levels; occupa-tional hazards; and stress within rural communitiesfrom a swelling population made up of drilling crews
When Jodie Simons and Jason Lamphere put a lighter to their faucet, the high methane content of the water sets it on fire. Sincegas drilling started in their Pennsylvania neighborhood, they’ve been without clean drinking or bathing water. High levels of methanein drinking water can create a risk of explosions and asphyxiation hazards for households. Photo by Nina Berman / NOOR / Redux.

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