The Importance of Public Health Agency Independence: Marcellus Shale Gas Drilling in Pennsylvania

Abstract

Public health often deals with inconvenient truths. These are best communicated and acted on when public health agencies are independent of the organizations or individuals for whom the truths are inconvenient. The importance of public health independence is exemplified by the lack of involvement of the Pennsylvania Department of Health in responding to health concerns about shale gas drilling. Pennsylvania Department of Health involvement has been forestalled by the state governor, who has intensely supported shale gas development.

The decline in independence of governmental public health agencies was deplored in the seminal 1988 Institute of Medicine report The Future of Public Health.¹ Further decline has been noted,² as has evidence of the importance of public health agency independence in high-stakes issues with powerful industries such as tobacco control policies³ and waste control at industrial food animal production sites.⁴

An example of the perils of the lack of public health agency independence in high-stakes issues is evident in Pennsylvania in relation to the sudden burst of Marcellus shale drilling activity. Public concerns about potential adverse health impacts have been repeatedly voiced, and instances of groundwater contamination have been well publicized.^5–8 An American Public Health Association policy statement has addressed the role of public health professionals in this issue.⁵ Yet full control of the Pennsylvania Department of Health (PADOH) by a governor strongly supporting shale gas drilling, along with the lack of independent local county and municipal public health agencies in affected areas, has effectively prevented public health authorities from responding.

MARCELLUS SHALE

The Marcellus shale underlying many of the northeastern states is rich in tightly bound natural gas that is now accessible because of advances in drilling technology, including the ability to bend the well pipe horizontally into the shale layer perhaps a mile underground; use comparatively very large volumes of water and very high pressures to hydrofracture the shale; and do so consecutively up to a dozen times from each well.⁵ Much of the injected fluid is returned to the surface containing not only hydrofracturing chemicals but also brine and other naturally occurring agents of potential concern. Unlike disposal in western states, the safe disposal of this fluid has been problematic, as Pennsylvania does not have deep underground injection capacity.⁹ Drilling tightly bound Marcellus shale gas in Pennsylvania has grown rapidly from 8 new wells in 2005 to 1974 wells in 2011. More than 20 000 are planned. Well drilling pads occupy multiple acres and are associated with roads, heavy diesel truck traffic, compressor stations, and pipelines. Drilling activity is predominantly in rural areas dependent on wells for drinking water. A recent study with cooperating industry was notable for the very wide range of total air emissions and emission rates of hydrocarbons from different sites,¹⁰ a finding consistent with the highly variable response of residents living near drilling sites and the report of community air pollution in Colorado.¹¹

Public concern about health consequences has been expressed to governmental advisory committees.⁶ Studies have identified Pennsylvanians who believe their health has been affected by hydrofracturing.^7,8 Highly publicized industrial incidents, including failure of well casings and leakage of impoundments, have contributed to these concerns. Shale gas development also has public support, particularly within communities that benefit financially. But even in these communities, 57.7% report that Marcellus shale drilling is a significant or moderate threat to the environment and the public health of the region.¹²

Under Governor Tom Corbett, elected in 2011 on a platform strongly supporting shale gas development and with $1.3 million in campaign support from the industry, PADOH involvement in any shale gas–related activities has been virtually nonexistent. Soon after inauguration the governor appointed a 31-member Marcellus Shale Commission, which included the heads of 8 state offices, but no representatives from the PADOH or any other health professional.⁶ The commission’s recommended funding to the PADOH for registry activities was ignored. The result is that the state’s shale gas drilling impact fee, which raises more than $200 million yearly, now funds 17 different state agencies, subagencies, and commissions—but not the PADOH. Furthermore, the PADOH has not been allowed to divert any of its $838 million budget for routine surveillance, training, or other public health activities related to the Marcellus shale. Illustrative is a recent hearing held by the Pennsylvania House Democratic Policy Committee, at which testimony was requested from the Departments of Environmental Protection and of Conservation and Natural Resources. But, although the hearing specifically included human health issues related to hydrofracturing, the legislators did not even bother to invite the PADOH, as it is inactive in the Marcellus shale issue.¹³ Also illustrative is that Pennsylvania is a leader in environmental health tracking, having been one of the handful of states funded by the Centers for Disease Control and Prevention for this purpose since 2002. But this PADOH program has not been allowed to address the shale gas issue.

PUBLIC HEALTH AND IMPORTANCE OF INDEPENDENCE

The organization of public health in Pennsylvania puts the governor in complete control of the shale gas health issue. The PADOH is a state government agency little different from any other state agency. Pennsylvania is 1 of 16 states without any general oversight function from an independent state board of health or an appointed advisory board.² Furthermore, to the extent that Pennsylvania has independent local health departments, they are not pertinent thus far to the shale gas issue. The 10 independent county or municipal health departments (among 67 counties) are primarily in highly populated areas that have yet to see significant Marcellus shale drilling activity. The remainder of the state is covered solely by the PADOH.

Under Governor Corbett there has been a tendency to choose political appointees who do not have graduate education in a health field, an issue that led to editorial criticism by a major newspaper that had supported his election.¹⁴ Recently, almost half of the state health centers, particularly in rural areas, where Marcellus shale drilling is heaviest, have been closed. An independent board of health would expect to be involved in vetting senior management personnel selections and in decisions about geographical distribution of health services.

LACK OF TRANSPARENCY

The director of the Centers for Disease Control and Prevention, Thomas Frieden,^15(p1858) recently listed “Promoting Free and Open Information” at the top of a list describing “Potential Public Health Actions of a Responsive Government.” Goldstein et al. have previously documented the many contradictory statements made by industry and state government that obfuscate the risks of shale gas drilling.¹³ Lack of transparency is also evident in Pennsylvania’s Marcellus shale state law. The provisions related to hydrofracturing chemicals and trade secrets have received the most attention. But of greater concern is that industry is given the right not to disclose any information on what is in the flow back fluids that must be disposed of at the surface. Specifically excluded is information about any chemicals that were present “naturally,” “unintentionally,” “incidentally,” as a “result of a chemical reaction,” or “in trace amounts.”¹³ This would shield the pesticide industry from disclosing the presence of dioxins in Agent Orange and wallboard manufacturers from reporting dangerous levels of naturally occurring radioactivity. Although the governor’s office could and did exclude the PADOH from meetings that crafted this legislative language, it would have been more difficult to exclude an independent board of health.

The lack of transparency and the absence of any health authority willing to listen to complaints are themselves having a health impact. Pennsylvanians who believe their health has been affected by drilling were less likely to list physical stressors, such as noise (45% of sample), than issues of trust and transparency—including the belief that complaints were being ignored (58%).⁷ This social amplification of risk perception could be lessened were PADOH actively responding to public concerns.

BENEFITS OF INVOLVING PUBLIC HEALTH

Ironically, the governor’s quashing of PADOH involvement is harmful not only to citizens but also to the success of the industry within Pennsylvania. It contrasts with the situation in New York, where Marcellus shale drilling has been halted pending completion of the state health department’s ongoing peer-reviewed evaluation of potential adverse health consequences. New York state authorities could not completely ignore expressions of health concerns, in part because the state is fully covered by independent county or municipal boards of health responsive to local governance and capable of launching surveillance or other public health activities independent of the wishes of the governor. New York’s delay will likely benefit New Yorkers. Drilling companies are getting better at preventing costly pollution-causing incidents, such as loss of well integrity, recycling the chemicals they must buy, avoiding environmental release of the hydrocarbons they sell, and extracting an ever larger portion of the tightly bound shale gas. If hydrofracturing does occur in New York, this delay to ensure consideration of health issues inevitably will lead to minimizing risk and maximizing gas productivity and industry income. In Pennsylvania, by contrast, in the absence of PADOH performing traditional public health surveillance, there is little information that might support industry’s claim of no community health effects from their operations or help defend them when the statistically inevitable disease clusters lead to toxic tort suits.¹³

Balancing risks and benefits and taking a longer-term view are central to public health. For example, the US Food and Drug Administration must balance the value of rapidly approving a new drug with its potential for harm. But once approved, the new drug will always be available. By contrast, there is a limited supply of shale gas. The key trade-off is between the benefits and risks of beginning natural gas extraction in Pennsylvania now for perhaps a 30-year period versus 5 years from now ending 5 years later. Unfortunately, this is a far longer period than the political life cycle.

CONCLUSIONS

Governors rightfully pursue policies that they believe improve the economy of their state, and shale gas drilling may benefit public health through replacing coal, thereby decreasing greenhouse gas emissions and the release of air pollutants. But neither excuses failing to protect the local public and workers against the health risks of this technology or considering longer-term sustainability issues. The blatant manner with which the Commonwealth of Pennsylvania has utilized its control of the state public health agency to prevent its response to a legitimate public health concern exemplifies why loss of an independent public health function is dangerous to the public. The issue extends well beyond shale gas to the future role of public health in maximizing benefits and minimizing risks of new technologies that are central to a sustainable future.