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Introduction

Natural gas extraction from shale formations—which includes hydraulic fracturing—is increasingly in the news as the use of extraction technologies has expanded, rural communities have been transformed seemingly overnight, public awareness has increased, and regulations have been developed. The governmental public health system, which retains primary responsibility for health, was not an early participant in discussions about shale gas extraction; thus public health is lacking critical information about environmental health impacts of these technologies and is limited in its ability to address concerns raised by regulators at the federal and state levels, communities, and workers employed in the shale gas extraction industry.

In public health, there is an increasing awareness of the importance of a “health-in-all” policy approach to protecting human health (IOM, 2011). Central to this approach is the use of health impact assessments to inform decisions by providing a structured process that uses scientific data, professional expertise, and stakeholder input to identify and evaluate the public health consequences of policy and program proposals. In 2011 the National Research Council (NRC) published a report, Improving Health in the United States: The Role of Health Impact Assessment, which provides recommendations on how to conduct health impact assessments and discusses how these can be used to minimize adverse health effects and optimize the beneficial effects of the policy or program assessed (NRC, 2011).

Members of the Institute of Medicine (IOM) Roundtable on Environmental Health Sciences, Research, and Medicine recognized the need to discuss the human health impact of shale gas extraction through the lens of a health impact assessment; to that end, it convened a public workshop in Washington, DC, in 2012. Through invited presentations and discussions, participants examined the state of the science regarding shale gas extraction, the direct and indirect environmental health impacts of shale gas extraction, and the use of health impact assessment as a tool that can help decision makers identify the public health consequences of



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1 Introduction Natural gas extraction from shale formations—which includes hydraulic fracturing—is increasingly in the news as the use of extraction technologies has expanded, rural communities have been transformed seemingly overnight, public awareness has increased, and regulations have been developed. The governmental public health system, which retains primary responsibility for health, was not an early participant in discussions about shale gas extraction; thus public health is lacking critical information about environmental health impacts of these technologies and is limited in its ability to address concerns raised by regulators at the federal and state levels, communities, and workers employed in the shale gas extraction industry. In public health, there is an increasing awareness of the importance of a “health-in-all” policy approach to protecting human health (IOM, 2011). Central to this approach is the use of health impact assessments to inform decisions by providing a structured process that uses scientific data, professional expertise, and stakeholder input to identify and evaluate the public health consequences of policy and program proposals. In 2011 the National Research Council (NRC) published a report, Improving Health in the United States: The Role of Health Impact Assessment, which provides recommendations on how to conduct health impact assessments and discusses how these can be used to minimize adverse health effects and optimize the beneficial effects of the policy or program assessed (NRC, 2011). Members of the Institute of Medicine (IOM) Roundtable on Environmental Health Sciences, Research, and Medicine recognized the need to discuss the human health impact of shale gas extraction through the lens of a health impact assessment; to that end, it convened a public workshop in Washington, DC, in 2012. Through invited presentations and discussions, participants examined the state of the science regarding shale gas extraction, the direct and indirect environmental health impacts of shale gas extraction, and the use of health impact assessment as a tool that can help decision makers identify the public health consequences of 1

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2 HEALTH IMPACT ASSESSMENT OF SHALE GAS EXTRACTION shale gas extraction. The statement of task for the workshop can be found in Box 1-1. The workshop was organized by an independent planning committee in accordance with the procedures of the NRC. The planning group included Rob Donnelly, Lynn Goldman, George Gray, Andrew Maguire, Linda McCauley, Aubrey Miller, Christopher Portier, and Scott Tinker; their role was limited to planning the workshop. They developed the agenda topics and selected and invited expert speakers and discussants to address identified topics. This summary was prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. All views presented in the summary are those of the individual workshop participants. The summary does not contain any findings or recommend- ations by the planning committee or the Roundtable. The workshop was moderated by roundtable members and featured presentations and discussion. Chapter 2 presents a summary of opening remarks and two opening presentations—one that frames the objectives of the workshop and one that describes health impact assessment. Chapter 3 provides a summary of presentations that describe the process of shale gas extraction and the geographic footprint or changes that occur in the environment. Chapter 4 summarizes occupational hazards associated with shale gas extraction and potential impacts on communities. Chapters 5 and 6 summarize presentations on the impact of shale gas extraction on air quality and water resources, respectively. Chapter 7 summarizes presentations on the broad topic of sustainable energy options and the need to ensure health in all approaches. Chapters 8 and 9 present perspectives from those in the research community and federal agency representatives, respectively, regarding research gaps and opportunities. Highlights from the concluding discussion are provided at the end of Chapter 9. BOX 1-1 Statement of Task An ad hoc committee will plan and conduct a public workshop on the human health impacts of shale gas extraction. The workshop will feature invited presentations and discussions to look at the state of the science in shale gas extraction, direct and indirect environ- mental health impacts of shale gas extraction, and the role of health impact assessments in minimizing health impacts. The committee will develop the workshop agenda, select invited speakers and discussants, and moderate the discussions. A workshop summary will be prepared by a designated rapporteur in accordance with National Research Council policies and procedures.

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INTRODUCTION 3 REFERENCES IOM (Institute of Medicine). 2011. For the public’s health: Revitalizing law and policy to meet new challenges. Washington, DC: The National Academies Press. NRC (National Research Council). 2011. Improving health in the United States: The role of health impact assessment. Washington, DC: The National Academies Press.

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