Policy recommendations regarding public health risks associated with hydraulic fracturing and shale gas: a scoping review

This thesis examines policy recommendations which pertain to public health risks associated with hydraulic fracturing of shale gas in the United States. Regulation of hydraulic fracturing on the federal and state levels has been neither uniform nor consistent, and several exemptions exist which make it difficult to monitor the safety of hydraulic fracturing. The past decade has seen rapid expansion of unconventional drilling of natural gas through hydraulic fracturing. There are multiple types of health impacts which are associated with hydraulic fracturing during all phases of operations. Yet despite the manifold health impacts related to this new technology, public health experts have not played a significant role in the evaluation of policy, and public health itself has not been a major factor. At the same time, recommendations concerning public health on the policy level have been repeatedly made during the past three and a half years. A scoping review has therefore been applied to this topic as a preliminary, yet comprehensive assessment of the available literature and research. An explanation of the methodology and practicality behind scoping reviews has been included in the methods section. A total of 22 sources were charted as relevant for this thesis after systematic searches were conducted in several databases to scope the available material. The charted sources were analyzed by statistical and content-based criteria, and the recommendations made by the charted sources were listed in seven categories. These charted recommendations illuminate significant deficits with regard to public health and were discussed on the basis of how their implementation is necessary to positively influence health. Some charted recommendations were calls for general action, while others were more specific. Hydraulic fracturing is a complex process, and a multifaceted, holistic approach is necessary to prompt positive change. Based on the material charted, this thesis concludes by recommending a precautionary stance towards hydraulic fracturing from a public health perspective which follows five specific steps to protect health: 1) evaluate health risks on a national level; 2) establish a national board to objectively weigh the health risks with potential economic benefits; 3) evaluate risks in comparison to other fuel sources to determine which forms of energy should be pursued and where risks can be minimized to justify extraction; 4) evaluate health risks through objective, scientific studies; and 5) encourage, enable and mandate transparency wherever necessary