Poster #302 Health and the Natural Gas Industry

Las Vegas — The introduction of hydraulic fracturing, or “fracking,” in an Appalachian region in southwestern Pennsylvania has created a variety of health concerns for the surrounding community and healthcare providers should be ready to recognize symptoms, according to two speakers at the American Association of Nurse Practitioners 2013 National Conference.

The region’s abundance of Marcellus Shale, sedimentary rock that contains an estimated 500 trillion cubic feet of natural gas, has attracted gas companies seeking to extract the precious resource, but the negative health effects of the industry are not yet fully understood, Lenore K. Resick, PhD, CRNP, FNP-BC, NP-C, FAANP, of Duquesne University School of Nursing in Pittsburgh and Joyce M. Knestrick, PhD, CRNP, FAANP, of Frontier Nursing University in Kentucky, explained during a poster presentation.

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Fracking involves drilling wells as deep as 8,000 feet underground and pumping down fluids that create fissures in the rock, which in turn allows natural gas to be released and pumped back up to the surface for collection. Dangerous chemicals are currently used to induce these cracks, and there is growing concern that the process has contaminated the water supply and air, harming local residents.

So Resick, Knestrick and colleagues conducted a qualitative study in response to complaints by several women in the area, who said that local government officials and healthcare providers have not addressed their fracking-related grievances.

They interviewed 14 women aged 35 to 89 years, who resided near the fracking sites some of whom had lived as many as 60 years in their current home, and performed a literature review to determine local attitudes toward health, as well as potential health risks associated with fracking.

Some of the residents reported symptoms such as burning eyes, a sweet metallic taste, headaches, rashes and nose bleeds were common among residents. The majority of study respondents expressed feeling a sense of powerlessness in regard to environmental changes that could potentially harm their health.

A cross-section illustration of fracking, or drilling for natural gas.This illustration demonstrates how fracking can contaminate water supplies. Credit: Gwen Shockey / Science Source

The exact composition of chemicals natural gas companies use in the fracking process remains unknown, it is considered “proprietary information.” However, approximately one fourth of the known chemicals used in fracking are “associated with malignancies, act as endocrine disrupters, and are thought to cause problems with the nervous, immune and cardiovascular systems,” results of the literature review indicate.

Skin, eye and respiratory irritation are common, according to the literature. “You feel like you can’t swallow…you feel like you can’t breathe,” one survey respondent said.

Reports of laboratory test results for airborne chemicals among those living near fracking sites show moderate levels of benzene and toluene, causing some residents to purchase cancer insurance in preparation for a future diagnosis.

The extent of the negative health effects due to chemicals used in fracking is still unknown.  “It’s too early for epidemiological studies,” Resick and Knestrick emphasized.Not only are gas companies not required to reveal their materials, but the novelty of fracking means that the long-term effects of the practice cannot be determined until years into the future.

Yet exposure to dangerous materials is only part of the problem for the local residents, who have been bombarded by the sights, smells and sounds of fracking. The burning of gases at some drilling sites causes “flaring” and continuous light throughout the day and night, and the noise from diesel trucks making numerous trips to and from the wells is disruptive.

“There is so much noise, 24/7,” commented one survey respondent, “they can hit small pets…they run over things.”

Furthermore, the fear of toxic chemicals and the sense of a loss within the community have had profound psychological effects on study respondents. “Sleeplessness, stress and fatigue,” were other commonly reported symptoms.

“We are not in control of our lives,” one respondent told the researchers. “I feel like I’m stuck in a bad dream.” 

Resick and Knestrick hope that their study will help primary care healthcare providers treat the locals in the area more effectively.

“Our findings suggest that health care providers serving patients living in this region need to assess potential and
actual environmental issues that are impacting physical and mental health,” they said. “Questions to consider adding to the assessment include location of living space to industrial activity location or wind direction, source of drinking water, and perceptions of environmental safety and related mental health concerns.”

They encourage primary care clinicians treating patients exposed to fracking to consider referrals to specialists with experience dealing with environmental and industrial exposure.

“Future research on how changes in the environment as a result of fracking affect the health of individuals and communities over time is needed,” they said.


  1. Resick LK, Knestrick JM. Poster #302. “Health and the Natural Gas Industry: What Every NP Needs to Know.” Presented at: American Association of Nurse Practitioners 2013 National Conference. June 19-23, 2013; Las Vegas.
  2. Resick LK et al. Journal of Environmental Studies and Sciences. doi: 10.1007/s13412-013-0119-y .