chief medical officer of health’s recommendations ......3 executive summary while large-scale...
Post on 08-Jul-2020
0 Views
Preview:
TRANSCRIPT
Chief Medical Officer of Health’s Recommendations Concerning Shale Gas
Development in New Brunswick
Office of the Chief Medical Officer of Health (OCMOH) New Brunswick Department of Health
September 2012
Cover photo:
“TightGas”wellsintheMcCullyFieldnearPenobsquis,NBPhotofromNBDNR–http://www.gnb.ca/0078/minerals/Images/Carbon_Photo-60.jpg
Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
ProvinceofNewBrunswickPO6000,FrederictonNBE3B5H1
www.gnb.ca
2012.09
ISBN978-1-55471-717-0 8935
Table of ContentsMessage from the Chief Medical Officer of Health 1
Executive Summary 3
Summary of Recommendations 8
Part 1 - Guiding Principles for Protection of Public Health 11
1.DeterminantsofHealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
2.PublicHealthEthicalConsiderations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
3.HealthObjectivesRelatedtoDevelopmentofaShaleGasIndustryinNB . . . . . . . . . . . . . . . . . . . . . 16
Part 2 - What We Know Now and What We Don’t Know Now 17
1.ShaleGas–TheNewBrunswickContext . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
2.ExperiencefromOtherJurisdictions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.WhatWeDon’tKnowNow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Part 3 - Recommendations for Protection of Public Health 33
1.ProtectionofHealthandCommunityWellbeingRelatedtoChangesintheSocialEnvironment. . . . . . . 36
2.ProtectionofHealthRelatedtoChangesinBoththeSocialandPhysicalEnvironments . . . . . . . . . . . . 40
3.ProtectionofHealthRelatedtoChangesinthePhysicalEnvironment . . . . . . . . . . . . . . . . . . . . . . . 42
4.ProtectionofFutureGenerations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
5.ImplementationandOversight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Part 4 - Conclusions 59
Acknowledgements 62
Appendix - Summary of findings and recommendations related to public health and shale gas in other jurisdictions (selected references) 63
References 71
AllinternetlinkscitedinthisdocumentweresuccessfullyaccessedonAugust28,2012exceptasnoted.
Whoever wishes to investigate medicine properly, should proceed thus: in the first place to consider the seasons of the year, and what effects each of them produces for they are not
at all alike, but differ much from themselves in regard to their changes. Then the winds, the hot and the cold, especially such as are common to all countries, and then such as are
peculiar to each locality. We must also consider the qualities of the waters, for as they differ from one another in taste and weight, so also do they differ much in their qualities. In the same manner, when one comes into a city to which he is a stranger, he ought to consider its situation, how it lies as to the winds and the rising of the sun; for its influence is not the
same whether it lies to the north or the south, to the rising or to the setting sun.
These things one ought to consider most attentively, and concerning the waters which the inhabitants use, whether they be marshy and soft, or hard, and running from elevated and
rocky situations, and then if saltish and unfit for cooking; and the ground, whether it be naked and deficient in water, or wooded and well watered, and whether it lies in a hollow,
confined situation, or is elevated and cold; and the mode in which the inhabitants live, and what are their pursuits, whether they are fond of drinking and eating to excess, and given
to indolence, or are fond of exercise and labour, and not given to excess in eating and drinking.
“On Airs, Waters and Places”, Hippocrates, c. 400 BCE
1
Message from the Chief Medical Officer of HealthDoctorshaveknownforthousandsofyearsthattheenvironmentgreatlyimpactsuponhumanhealth.Hippocrates,theGreekphysicianoftenreferredtoasthe“fatherofWesternmedicine”,firstwroteaboutittwenty-fivecenturiesago.FortunatelytodayinNewBrunswickbothresidentsandvisitorsstillfindhereahealthyandpleasingenvironment.Indeedourvastnetworksofriversystemsarerenownedfortheirfishingandotherrecreationalpursuits.Thekeyinitiativeofcreatingandmaintaininghealthyenvironmentshoweverrequiresongoingattention:wemustcontinuetoinvestinwhattrulymakespeoplehealthy.Thisrequirestheeffortofanentirecommunityledandsupportedbyawhole-of-governmentapproach.
Section41oftheCanadianMedicalAssociationCodeofEthicsreadsthataphysicianshould‘recognizethatcommunity,societyandtheenvironmentareimportantfactorsinthehealthofindividualpatients’.Increasingly,doctorsareexpressingtheirconcernswhenanyofthesefactorsimpactnegativelyupontheirpatients.Becauseofourtrainingandexperienceinenvironmentalhealth,weasPublicHealthdoctorshaveaparticularandimportantroletoplay.Furthermore,itispartofourmandatetoadvocate,andprovidemeaningfulinformationsothatpeople,communities,organizationsandgovernmentshavetheknowledgenecessarytomaketheappropriatedecisionswhenfacedwithbalancingthepotentialbenefitsandharmsofagivensituation.Likeanyotherdoctor,wemustconsiderallourpatients–inthiscasetheentirepopulationpresentandfuture–andgivethoughtfuladviceforactionsthatwillpromotefairopportunitiesforindividuals,familiesandcommunitiestoenjoygoodhealth.
Virtuallyeveryindustryhaspotentialhealthimplicationsassociatedwithit.Thetype,thefrequencyandtheseverityvariesconsiderablywiththenatureandcomplexityoftheindustry–sotoowithshalegasproduction.
ThegasandoilindustryisnotnewtoNewBrunswick.However,itisonlyinthelast10yearsorsothatthecombinationoftechnologieshasbeendevelopedthatmakesitfeasibletoextractgasfromthelayersofshaledeepintheearthinaneconomicallyviableway.Themethodologiesusedarecomplexandstillevolving.Withshalegasproduction,wenotonlyhavetoconsiderwhatthehealthimpactsarefromtheknownconventionalpartoftheindustrybutalsofactorinthoseconsiderationsthatrelatetothenew.
Withindustry,theremayofcoursebeeconomicbenefitswhichshouldhaveapositiveimpactonhealthstatus.However,wecannotsimplyassumethatmoremoneyequatestoahealthierpopulation–themoneyneedstobeutilisedstrategically.Economicfactorsaside,theultimatedecisiontoallowindustryexpansiontoproceedwillneedtotakeintoaccountwhatappearstohavebecomeapolarizedpublicdebate,possiblyaresultofboththevaluesbasednatureofthediscussionandvaryingdegreesofthepublic’sunderstandingofthefacts.Whenpeopledon’tunderstandanissue,orfeeltheirvaluesarebeingcompromised,thishasanadversebearingontheirhealthandwellbeing.
AsChiefMedicalOfficerofHealth,Iamthereforeprovidingtheserecommendationstoourgovernmenttoofferadviceonmeasuresthatshouldbeputinplacetomaximizethehealthbenefitsandminimizethehealthrisksrelatedtoshalegasdevelopmentifthedecisionistakentogoaheadwithit.Inaddition,thisdocumentisintendedtoprovideinformationtothemanyotherswhohavearoletoplayinprotectingthehealthofthepublic.Thisworkisbasedonexperiencefromotherjurisdictions,areviewoftheavailableliterature,andexpertopinionfromavarietyofpublichealthandenvironmentalhealthprofessionals.Asthisprocessdevelops,newknowledgeemergesandourunderstandingevolves,someoftheserecommendationsmayneedtobeadaptedoradjusted.
Currently,thepeopleofNewBrunswickareamongsomeofthemostprivilegedintheworld,enjoyingoneofitsmostbeautifulsocialandphysicalenvironments;therefore,atthispointintime,wemustensurethatwealldoourbesttopreservethatforourselvesandthegenerationstocome.
Dr.EilishClearyChiefMedicalOfficerofHealthNewBrunswickDepartmentofHealth
2 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
3
Executive SummaryWhilelarge-scaledevelopmentofashalegasindustryinNewBrunswickmayofferaneconomicgrowthopportunityfortheprovince,itwillbeimportanttoensurethattheoverallhealthgainsaregreaterthanthelosses.Economicstatusofindividualsandcommunitiescanbeanimportantdeterminantoftheirhealth,howevertherearemanyotherfactorsresultingfromindustrydevelopmentthatcanhavestrongnegativeimpacts.Unlesspropercontrolsareputinplacethereisariskofspoilinganybenefitsfromeconomicgainsthroughadversehealthoutcomes.
IfanexpansionoftheunconventionalgasindustrytakesplaceinNewBrunswick,Governmentneedstotaketargetedandstrategicactionsaimedatpreventionandmitigationofnegativehealthimpacts,whichincludesbuildingcapacityinlocalandprovincialservicesandinfrastructure.Thesewillneedtobeputinplacepriortofurtherdevelopmentascurrentinfrastructure,capacity,processesandlegislationarenotadequatetomeettheseneeds.Inaddition,asthisindustryisnewandevolving,monitoringofthehealthofthepopulationwillbeimportantonanongoingbasistodetectadverseimpacts.Thiswillallowformodifications,includingifwarranted,aslowdownorhaltingoffurtherdevelopment.Accordingly,theChiefMedicalOfficerofHealth(CMOH)hasdevelopedtherecommendationsinthisdocumentwhichshebelievesarenecessaryinordertoprotectthehealthofthepublic.
Whiletherehasbeenconsiderablediscussionamongstthepublicaboutpotentialimpactsonwater,itisimportanttorememberthatcleanwaterandhealthyairarenottheonlyimportantrequirementsanddeterminantsofhealth.Theproposedareasforactionaddresspotentialhealthimpactsresultingfromchangesineitherthesocialorphysicalenvironment.Protectionofthehealthoffuturegenerationsisalsoconsideredinordertoensurelong-termsustainabilityoftheseactions.Asthepracticeofpublichealthresultsfromanassessmentofacomplexbalanceoffactors,andoftenhastocontendwithuncertainties,itisimportantthatitbeinformedbyastrongtheoreticalfoundation.Therefore,alloftherecommendationsaregroundedintheguidingprinciplesforprotectionofpublichealth,includingscientificknowledgeandreasonablejudgementofthedeterminantsofhealth,ethicalconsiderations,publichealthvaluesandprinciples,andtheresultinghealthobjectives.
Thisreportidentifiestheknownissuesthatshouldbeaddressedandtheunknownswhichrequirefurtherinvestigation.Therecommendationsproposeactionsthatshouldbetakeninareassuchashealthequity,assessmentofhealthimpacts,monitoringofhealthandenvironmentalimpacts,strengtheningoftheplanningprocess,ensuringtransparencyandcommunityparticipation,fillingknowledgegaps,requiringappropriateenvironmentalcontrols,andenablingmoreeffectivegovernmentoversight.Attentionisneededinordertoprotectvulnerablepopulationssuchaschildren,andthoseforwhomtheenvironmentplaysaparticularlystrongfoundationtotheirhealthsuchasFirstNationspeoples.
Thisdocumentwasdevelopedthroughacriticalreviewoftheexperienceofshalegasdevelopmentinotherjurisdictionsthroughthelensofanticipatedimpacts(bothpositiveandnegative)topublichealth.Othersourcesofinformationincludereviewsofcasestudiesreportedinthescientificliteratureandotherreports,currentemergingissuesinconferenceproceedings,discussionswithpublichealthandenvironmentalexperts,mediareports,andlisteningtothecurrentpublicdebateonshalegas.ThiswasdonewithaviewtoprovidingrecommendationstoGovernmentforusepriortoandduringanyexpansionoftheindustryinNewBrunswick.
Manyoftheserecommendationsarecomplementarytothoseproposedinthedocumententitled“ResponsibleEnvironmentalManagementofOilandGasActivitiesinNewBrunswick-RecommendationsforPublicDiscussion”(May2012)whichwasdevelopedtooutlinemeasuresrequiredtoprotecttheenvironment.Thisdocumentbuildsuponandenhancestheproposedenvironmentalmeasuresasdeemednecessaryinordertoprovideaddedprotectionforhumanhealth.TherecommendationsthatresultedareintendedtohelpinformtheGovernment’sriskmanagementandregulatoryframeworkinsuchawaythatitwillbeabletoprovideappropriate,andcomprehensivepublichealthpromotionandprotectionalongwithitsothergoals.Thisdocumentisalsointendedtoprovideinformationtothemanyotherswhohavearoletoplayinprotectingthehealthofthepublic.
4 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Withrespecttothescopeofthisdocument,theprimaryfocusisonhealthrisks.However,somemeasureshavebeenincludedinordertomaximizepossiblehealthbenefits.Notincludedareotherpotentialimpactswhichcouldbebothpositive(e.g.economicgainsintermsofincome,employment,energy)andnegative(e.g.greenhousegases,tourism,fishing,hunting,ecosystemdamageandearthquakeactivity).Thereareotherswithingovernmentandamongstpartnerswhoarebetterpositionedintermsofexpertisetospeaktothesematters.
ItisimportanttonotethattheCMOH’srecommendationsarenotafullassessmentofallhealthrisksastheyapplyintheNewBrunswickcontext.However,itisintendedtohelpstartaconversationonpotentialhealthimpactsfromshalegasdevelopmentandwhatcanbedoneaboutthem.
TheworkofbuildingahealthypopulationbelongstoallofsocietyandsomanyoftherecommendedactionswillrequireconsiderableworkfromindividualsandorganizationsinthecommunityaswellasfromGovernmentandindustry.Becauseoftheirtrainingandexpertise,PublicHealthprofessionalswillhaveaparticularlyimportantroletoplayinleadershipandcontentknowledge.IdeallyNewBrunswickshouldbebuildingefficienciesandexpandingknowledgethroughapan-Canadianapproachwhenpossible.
Thecostoffundingtheserecommendationshasnotyetbeendetermined.Itisrecognizedtheymaynotbeinsignificantandtherecouldbeopportunitytohavemuchofthecostsabsorbedbyindustry.Thisadviceisbasedonwhatshouldberoutinepublichealthpracticeforallenvironmentalhealthprograms.Theknowledgeusediscurrent,butastherearemanydataandinformationgapsitwillneedtoevolve.Inparticular,itwillbekeytohearpublicthoughtsandperceptionstobetterinformfutureactions.Animplementationgroupshouldbeestablishedandanoversightmechanismputinplace.
Document OverviewPart 1ofthisdocumentoutlinestheguidingprinciplesforprotectionofpublichealth,includingaspectsofthedeterminantsofhealth,ethicalconsiderations,publichealthvaluesandprinciples,andthederivedhealthobjectives.Thisinformationprovidesabackgroundforthereasoningbehindpublichealthpromotion,preventionandprotectiondecisions,andfortherecommendationsherein.
Themaindeterminantsofpopulationhealtharefactorsthatimpactthesocialandphysicalenvironments.Inadditiontoprotectingthephysicalenvironment,investmentinimprovingthesocialdeterminantsofhealthtodaywilltranslateintobetterhealthequity,improvedpopulationhealthandlessmoneyspentontreatmentandrehabilitationtomorrow.
Ethicalconsiderations,valuesandprinciplesguideallactionsintendedtoimprove,promoteandprotecthealthbecausethepracticeofpublichealthisalwaysabalancingactbetweenknownsandunknownsanddecisionsoftenneedtobemadeinthefaceofuncertainty.
Thehealthobjectives,valuesandprinciplesdescribethedifferentpiecesofworkthatneedtobeundertakentomakeadifferencethroughimprovedhealthofthepopulation.However,actionontheseissuesneedstocomefromoutsidethehealthsectoraswellasfromwithinit.ThePublicHealthsectorshouldplayaleadershiprole,butachievingtheseoutcomesneedstoinvolvecollaborative,multi-sectoralpartnershipsacrossthewholecommunity.
Part 2ofthisdocumentexaminestheNewBrunswickcontext,summarizesthekeyfindingsfromareviewofexperienceinotherjurisdictionsandoutlinesmanyknowledgegapswithrespecttoshalegasandpublichealthingeneral.Italsocontainsanoverviewofsomeoftheworkbeingundertakenelsewherewhichwillassistincontributingtotheknowledgebaserelatedtothisindustry.
5
1. Shale gas – the New Brunswick context
WhiletheoilandgasindustryisnotinitselfnewtoNewBrunswick,thecombinationoftechnologiesandmethodologiesthatenablerecoveryofgasfromtheshalelayersisrecent.Thishasledtoconsiderableinterestasitisbelievedthatthereisarichreserveintheprovincealthoughitisnotuniformlydistributedthroughout.Thiswouldmeanthatnotallcommunitieswouldbeequallyimpactedbyanypotentialdevelopment.Thereiscurrentlynoestimateavailableoftherate,size,density,locationorproductioncapacityofthepotentialdevelopmentwhichhasmadeitdifficulttodoafullassessmentonpotentialhealthimpacts.
2. Experience from other jurisdictions
Theprincipallessonsnotedwerethattherearesocialandcommunityhealthrisksfromthisindustrywhichcanbecompoundedbyinequitiescausedamongstthelocalpopulace.Onecouldexpectthatasaresultofeconomicgainsduetoincreasedincome,energyandemployment,therewouldbeanindirectpositivebenefitinhealthstatusasaresultofthisindustry,howeverclearevidencetosupportthiswasnotfoundinthecourseofthisreview.
Therearesignificantdatagapsthatlimitassessmentofhealthrisksandtodatetherehasbeenlimitedinvolvementinshalegasissuesbypublichealthofficialsandexperts.Thepublicdiscussiononshalegashasbeendominatedbychemicaltoxicityconcernsbutmanyotherfactorsofpotentialconcerntopublichealthalsoneedattention.Fewstudieshavebeenundertakenthatconsidertheoverallpotentialimpactsonhealthandthephysicalandsocialenvironmentsovertheentirelifetimeoftheindustry.
OneparticularpossiblesocialandcommunityhealthriskthattheProvincewillneedtoguardagainstisthe“BoomtownEffect”thatcanariseduringeconomicdevelopment.Thiseffectoccurswhenarapidchangeinpopulation,industrializationandeconomicprosperityalsoleadstoahostofsocialillsthatimpactcommunityhealth.Thesecanincludeincreasedratesofcrime,drugandalcoholabuse,sexually-transmittedinfections(STIs),anddomesticviolence;inadequatesupplyandqualityofhousing;increasedcostofliving;increasedcommunitydissatisfaction;increasedmentalhealthandsocialservicescaseloads;increasedhospitaladmissions;insufficientinfrastructure;andinsufficientcapacityinpublicservices,includingpolicing,localgovernment,socialservices,andhealthcare.
TheBoomtownEffectisthoughttobemoreintenseforsmallcommunitieswithatraditionalwayoflifethatdidnotpreviouslyinvolvetheindustrialsectorresponsiblefortheboom,sotheremaybearisktoNewBrunswickcommunitiesunlessthiseffectisanticipatedandmitigatedthroughstrategicinvestments.
Potentialimpactstothephysicalenvironmentincludemorethanjusttheriskofreleasesofthechemicalspresentinhydraulicfracturingfluidsthatarethemainfocusofthecurrentpublicdebateaboutshalegas.Aportionofthesefluidsflowsbacktothesurfacewiththenaturalgasstream,andthesewastesmaycontainnaturalcontaminants(suchaspetroleum,heavymetals,radioactivityandhighsaltconcentrations)fromdeepunderground,sowastemanagementisanenvironmentalandhealthissue.Therearefurtherpotentialhealthrisksduetoairquality,noise,vibration,continuousilluminationandphysicalhazardsduetoextensiveheavytrucktraffic.Inadditiontothepotentialfortoxicityorphysicalinjury,thereareotherpossiblehazardstomentalhealthandcommunitywellbeingthatresultfromafeelingoflackofcontroloverone’sdestinyinlocalcommunitiesinthefaceoftheseissues.
3. What we don’t know now
Someofthekeyinformationgapsidentifiedduringthisreviewincludealackofstandardmethodsforpreventingandmitigatingsocialimpacts,alackofhealthstatusstudiesbeforeandduringgasdevelopment,andalackofsystematichealthimpactassessments.Informationneededtoassesstoxicityrisksmayalsobelacking,suchasthetoxicologicalcharacteristicsofindustryproductsandwastes,
6 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
andaccurateexposuredataisusuallynotavailable.Thereisalsoalackofknowledgeabouttheextent,locationsandrateofdevelopmentwhichmakesitverydifficulttoforecastlocaleffectsofspecificprojectsandtoassessthepotentialforcumulativeeffectsovertime.
TherearemanyimportantpiecesofworkthatarecurrentlyunderwayinCanadaandtheUSwhichwillcontributeimportantdetailonaspectsoftheshalegasindustryanditsconnectiontohealth.Morestudyisneeded,andwhileNewBrunswickwillbenefitfromthesefindingstheywillnotsubstituteforin-provincehealthimpactassessments.
Part 3ofthisdocumentdescribes30recommendationsthattheCMOHbelievesarenecessarytoaddressthekeyfindingsandtoprotectorenhancepopulationhealththroughappropriatemanagementoftheshalegasindustry.Theserecommendationsmaybegroupedintothefollowingcategories:
1. Protection of health and community wellbeing related to changes in the social environment
Includesrecommendationsforoptimizingequitabledistributionofrisksandrewards;revenuesharing;identifyingaroleforlocalgovernmentsinplanningthelocationofgasindustryinfrastructure;identifyingaroleforPublicHealthincommunityplanning;andimplementingatransparentconsultativeprocesswiththepublicandotherstakeholdersontheimplementationprocessfortheserecommendations.
2. Protection of health related to changes in both the social and physical environments
Includesrecommendationsfordevelopingarequirementtosubmitahealthimpactassessment(HIA)aspartofthestandardProjectRegistrationprocess;developingaprotocolformonitoringofhealthstatusofpersonsliving,working,attendingschoolorplayinginproximitytotheindustry;andforlinkingthisinformationtoenvironmentalmonitoringdataandsocioeconomicdata.
3. Protection of health related to changes in the physical environment
Includesrecommendationsformonitoringnetworksforambientairandwaterquality;provisionsforwastewaterhandling,testing,transportation,treatmentanddisposal;fullandtimelydisclosureofchemicalsused;lesstoxicalternativesforhydraulicfracturingfluids;safesetbackdistancesthatconsiderhumanhealthfactors;limitinghealthimpactsfromnoise,vibrationandcontinuousillumination;trafficmanagementplans;emergencyresponsetraining;andpromotionandprotectionforthehealthofworkers.
4. Protection of future generations
Includesrecommendationsforaplantoanticipateandmitigatethe“BoomtownEffect”;astrategichealthimpactassessment;identifyingareastobeexcludedfromdevelopment;astrategiclanduseplanthatconsidershealthequity;considerationofvulnerableanddisadvantagedpopulations;considerationofFirstNations;astrategicwatermanagementplan;andpublicreportingofenvironmentalandhealthmonitoringdata.
5. Implementation and oversight
Includesrecommendationsforstrengtheninggovernmentoversightcapacityandresources;strikinganimplementationgrouptooverseeimplementationoftheCMOH’srecommendations;establishinganon-goingdialogueamongcommunity,government,academicsandindustry;andcreatingamulti-disciplinaryadvisorycommitteetoCabinet.
7
Part 4ofthisdocumentoutlinestheconclusionsuponwhichtherecommendationsarebased.ThemandateoftheOfficeoftheChiefMedicalOfficerofHealthistoimprove,promoteandprotectthehealthofthepeopleinNewBrunswick.BasedonthisworkitisclearthatifthedecisionistakentoexpandtheshalegasindustryinNewBrunswick,Governmentmusttaketargetedandstrategicactionsaimedatpreventionandmitigation,includingbuildingcapacityinlocalandprovincialservicesandinfrastructure,inordertominimizetherisksofnegativeimpactsonhealth.
Thelearningsfromotherjurisdictionsthathaveundergonerecentdevelopmentofthisindustryindicatethatitwillbenecessarytolookathealthinbroadterms,andso,inadditiontophysicalfactors,planswillneedtoaddressthesocialdeterminantsofhealth.Thiswillbeparticularlyimportantifthereisanexpectationofbenefittingthehealthofthepopulationthougheconomicgains.ThereviewalsofoundthattherearemajorinformationgapsthatwillneedtobefilledthroughresearchandongoingmonitoringofhealthsurveillanceaswellasrequiringHealthImpactAssessments.
Processissueshavebeenidentifiedwhichhighlighttheneedforopenness,transparencyandavailabilityofreliableinformation.Participationoflocalcommunitiesandgovernmentswillbekeytoensuringthatthemostinformeddecisionsaboutplanningandmitigationcanbeputinplace.Todatethereisnotenoughinformationavailableaboutthespecificway(intermsofscope,size,wellpaddensity,rate,etc.)thatthedevelopmentoftheshalegasindustrywouldunfold,butthisinformationwillbeimportanttoenablestrategicprojectplans,landandwateruseplanningandtoinformassessmentsofpotentialcumulativeimpacts.
Insummary,theCMOHhasprovidedtherecommendationsinthisdocumenttoinformGovernmentdecision-making.Thisadviceisthebestpossibleatthistimegiventheassessmentoflimitedcurrentknowledgeandsomayhavetoevolveovertime.Absentfromtheinputstodatehasbeenconsultationwiththepublicandthisisconsideredakeynextstep.Inaddition,thisdocumentisintendedtoprovideasolidinformationbaseforthatdiscussion.Itisrecognizedthattheserecommendationswouldrequireaformalimplementationandoversightstructureandrequireparticipationfromacrossthecommunity.
Whiletherecommendationsinthisdocumentmayseemonerous,rathertheyshouldbeseenasroutinepublichealthpractice.Itisimportanttoconsidertheimpactthatindustrycanhaveonhumanhealth.Insodoing,NewBrunswickcouldbealeaderinestablishingapathtobalancethecontentiousandsometimespolarizedviewswithinsocietyregardingtheincreasingnumberofvitalissuesofenvironmentalhealth-locallyandglobally.
8 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Summary of Recommendations1. Protection of Health and Community Wellbeing Related to Changes in the Social Environment
Recommendation 1.1:TheProvinceshouldestablishmechanismstomeasure,monitor,andoptimizeequitabledistributionofrisksandrewardsthatmaximizebenefitstothesocioeconomicdeterminantsofhealthforallNewBrunswickers
Recommendation 1.2:TheProvinceshoulddevelopamethodbasedonaclearsetofprincipleswithinputfromPublicHealththatwillenhancetheproposedrevenuesharingapproachsothatanappropriateportionofmoniesfromroyaltiesandothersourceswillhelptooffsetnegativeimpactsonthesocialdeterminantsofhealth
Recommendation 1.3:TheProvinceshouldimplementstructuresandprocessestoensurearoleforlocalgovernmentsinplanningthelocationofgasindustryinfrastructuresuchasroads,wellpads,pipelines,compressorstationsandwaterstorageandtreatmentfacilities
Recommendation 1.4: TheProvinceshouldimplementstructuresandprocessestoensurearoleforPublicHealthincommunityplanninginordertoensurethatthebuiltenvironmentisoptimizedforthedeterminantsofhealth
Recommendation 1.5: TheProvinceshouldundertakeatransparentconsultativeprocesswithrepresentativemembersandsectorsofthepublicandotherstakeholdersontheimplementationprocessfortheserecommendationsinordertoachievebetterhealthoutcomes
2. Protection of Health Related to Changes in Both the Social and Physical Environments
Recommendation 2.1: TheProvinceshouldimplementarequirementforsubmittingaHealthImpactAssessment(HIA),preparedaccordingtothespecificationsofDepartmentofHealth(DH),aspartofthestandardProjectRegistrationprocessmanagedbyDepartmentofEnvironmentandLocalGovernment(DELG).
Recommendation 2.2: TheProvinceshoulddevelopandimplementaprotocolformonitoringthehealthstatusofpersonsliving,working,attendingschoolorplayinginproximitytotheindustry.
Recommendation 2.3: TheProvinceshoulddevelopandimplementmethodstolinkhealthstatusinformationtoenvironmentalmonitoringdataandsocioeconomicstatusdata.
3. Protection of Health Related to Changes in the Physical Environment
Recommendation 3.1: TheProvinceshouldputinplacemonitoringnetworksforambientairandwaterquality,aswellasdrinkingwaterqualityinthelocalareasexpectedtohaveanindustrypresence,inadvanceofindustrydevelopmentandcontinuingthroughoutthelifetimeofdevelopment,productionandpost-production.
Recommendation 3.2: TheProvinceshouldputinplacespecialprovisionsforwastewaterhandling,testing,transportation,treatmentanddisposal.
Recommendation 3.3: TheProvinceshouldrequirefullandtimelydisclosureofallchemicalcompounds(ratherthanproductsorcompoundclasses)whichmustincludetheiridentities,concentrationsandquantities.
Recommendation 3.4: TheProvinceshouldrequirethatallhydraulicfracturingfluidscontainadditivesthataretheleasttoxicofanyavailablealternatives.
9
Recommendation 3.5: TheProvinceshoulddevelopandimplementreasonable,safesetbackdistancesapprovedbyPublicHealththatconsiderhumanhealthandwhicharebasedonexposureriskassessmentsinadditiontoestablishedprecedents.
Recommendation 3.6: TheProvinceshoulddevelopandimplementstandardsapprovedbyPublicHealthtolimithealthimpactsfromnoise,vibrationandcontinuousillumination.
Recommendation 3.7: TheProvinceshouldrequiresite-specifictrafficmanagementplansforallprojects,includingrouteplansanddesignatedtimesofdayforheavytruckmovements.
Recommendation 3.8: TheProvinceshouldenhancelocalandprovincialemergencyresponsetraining,capacityandpreparednesstorespondtothemostlikelyandmostseriousemergenciesthatmightposeathreattohumanhealth.
Recommendation 3.9: TheProvinceshouldenhancethemechanismsthatareinplacetopromoteandprotectthehealthofworkersintheindustryandotherswhomaybeattheworksites(governmentinspectors,supportindustryworkers,emergencyresponders,etc.).
4. Protection of Future Generations
Recommendation 4.1: TheProvinceshoulddevelopaplanforanticipatingandmitigatingthe“BoomtownEffect”.
Recommendation 4.2: TheProvinceshouldundertakeaStrategicHealthImpactAssessment(StrategicHIA)toestimatethelong-termcumulativehealthandsocialbenefitsandcosts.
Recommendation 4.3: TheProvinceshoulddesignateareasthataretobeexcludedfromdevelopment,includingdrinkingwatershedsandwellfields,sensitivenaturalareas,specifiedagriculturallands,andotherareasofspecialsignificance(scopetobedefined).
Recommendation 4.4: TheProvinceshouldprepareastrategiclanduseplanwithconsiderationsofhealthequityandwithinputfromPublicHealthandotherexpertsandstakeholders.
Recommendation 4.5: TheProvinceshouldimplementaprocessthatwillallowplanningandregulatorydecisionstoconsidervulnerableanddisadvantagedpopulationsthatareatgreaterrisktoenvironmentalcontaminants.
Recommendation 4.6: TheProvinceshouldrequirethatplanningandregulatorydecisionsconsiderFirstNationsevenifreservelandsarenotdirectlyaffected.
Recommendation 4.7: TheProvinceshouldprepareastrategicwatermanagementplantoprotectthequalityandavailabilityofwaterforpublicwatersupplies,privatewellwatersuppliesandfreshwateringeneral.
Recommendation 4.8: TheProvinceshouldencourage,promoteandfinanciallysupportresearchinNewBrunswick,suchaslong-termlongitudinalhealthstudiesandresearchonpotentialhealtheffects,socialimpacts,andotheraspects.
Recommendation 4.9: TheProvinceshouldcommittoperiodicallyreviewingandreportingtothepubliconenvironmentalandhealthmonitoringdata.
5. Implementation and Oversight
Recommendation 5.1: TheProvinceshouldestablishsufficientcapacityandresourcestoenablerelevantGovernmentdepartmentstooverseethedevelopmentofthisindustryincludingconducting
10 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
projectreviewsandapprovals,inspections,monitoring,enforcementandmanagementofenvironmental,healthorsocialconsequences.
Recommendation 5.2: TheProvinceshouldestablishanimplementationgroupfortherecommendationsinthisreportthatisledbyPublicHealthandincludesrepresentativesfromotherrelevantgovernmentdepartmentsandotherstakeholders.
Recommendation 5.3: TheProvinceshouldsponsoraseriesofsummitsledbyPublicHealthtobetterunderstandandcommunicatepublichealthinformationandissuesandtofosteraneffectiveongoingdialogueamongcommunity,government,academicsandindustry.
Recommendation 5.4: TheProvinceshouldcreateamulti-disciplinaryAdvisoryCommitteetoCabinetchargedwithreviewinggovernmentoversightthroughoutthelifetimeoftheindustryinNB.
11
Part 1
Guiding Principles for Protection of Public Health
12 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
1. Determinants of HealthTakentogether,thesocialandphysicalenvironmentsarethemaininfluencesonpopulationhealth.Ingeneral,theloweraperson’ssocialandeconomicpositionis,theworsetheirhealth,soaddressingthesocialdeterminantsofhealthisfundamentaltoachievinghealthequity.Investmentinthesocialdeterminantsofhealthtodaytranslatesintobetterpopulationhealthandlessmoneyspentontreatmentandrehabilitationtomorrow.WhileGovernmentprograms,policiesandlawprovideopportunitiesforimprovements,theactionneededtoimprovehealthequitymustcomefromoutsidethehealthsectoraswellasfromwithin.
TheWorldHealthOrganizationdefineshealthas“a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”(WHO1948).Healthisinfluencedbyabroadrangeofbothindividualandcollectivefactors,andtheirinteractions:thesefactorsarereferredtoas‘determinantsofhealth’.ThePublicHealthAgencyofCanadaliststwelvekeydeterminantsofthehealthofapopulation(seesidebar).TheUSCentersforDiseaseControlandPreventionhasaverysimilarlist,butinsteadgroupsthemunderfivekeycategories:genesandbiology,healthbehaviours,socialenvironmentorsocialcharacteristics,physicalenvironmentortotalecology,andhealthservicesormedicalcare(CDC2012).Theimportanceofthesedeterminantsofhealthhasbroadagreementworldwideamongfirstministers,healthministers,andmanylocal,provincial,nationalandinternationalorganizations.Thisdocumentwillfocusprincipallyonthedeterminantsofhealthrelatedtochangesinthesocialandphysicalenvironments.
Theimpactonhealthfromeachofthesedeterminantsvaries,butresearchestimatesthatingeneralthehealthofapopulationdependsprincipallyonthesocialandeconomicdeterminants,whichamounttoroughlyhalfofthetotalinfluenceonhealth(SenateofCanada2008).Thisestimatealsoattributesapproximately25%ofthepopulation’shealthtothehealthcaresystem,15%tobiologyandgeneticfactors,andabout10%tothephysicalenvironment.Anotherestimate(CDC2012andTarlov1999)suggeststhatthecombinedinfluenceofsocial/societalcharacteristics(thesocialenvironment)andthetotalecologyofalllivingthings(thephysicalenvironment)amountstomorethanhalfofthetotalinfluenceonpopulationhealth,followedtoaprogressivelylesserextentbyhealthbehaviours,medicalcare,andlastlygenesandbiology.
Theseestimateslendsupporttosocialandeconomiccircumstancesaspowerfuldeterminantsofhealth,andinrecentyearstherehasbeenwidespreadinternationalattentiontothisissue.Mostrecently,theWorldHealthOrganizationorganizedthe‘WorldConferenceonSocialDeterminantsofHealth’inBrazilinOctober2011,whichunderlinedthataddressingthesocialdeterminantsofhealthisacornerstoneofpublichealthpractice.Inotherwords,sustainabledevelopmentequatestohealthierCanadians,asshownbelowinPHAC’sdescriptionoftherelationshipbetweenthekeydeterminantsofhealthandthethreepillarsofsustainabledevelopment.
Determinants of Health (PHAC 2012)
• incomeandsocialstatus
• socialsupportnetworks
• educationandliteracy
• employment/workingconditions
• socialenvironments
• physicalenvironments
• personalhealthpracticesandcopingskills
• healthychilddevelopment
• biologyandgeneticendowment
• healthservices
• gender
• culture
“Investing in the social determinants of health upfront is strategic and
advantageous”
Part I: Guiding Principles for Protection of Public Health 13
Relationship between Key Determinants of Health and the Three Pillars of Sustainable Development
Inbroadterms,bettersocialandeconomicconditionsleadtoahealthierpopulation.IthasbeennotedthatastheirincomeincreasesCanadianshavelesssickness,longerlifeexpectanciesandimprovedhealth(FPTACPH1999).TheimprovementinhealthstatusamongCanadiansoverthepastcenturyandwhytherearestillimportantdifferencesinhealthstatusamongCanadianscanbelargelyexplainedbythesocialdeterminantsofhealth(SenateofCanada2009).
Addressingthesocialdeterminantsofhealthisfundamentaltoachievinghealthequity.Healthequityis“when everyone has the opportunity to ‘attain their full health potential’andnooneis ‘disadvantaged from achieving this potential because of their social position or other socially determined circumstance’”(CDC2008).Healthinequitiesaretheconsequencesofsystematic,unequalandunjustdistributionofthesocialandeconomicresourcesandconditionsthatgiverisetothesocialdeterminantsofhealth.However,healthinequitiescanbereduced:governmentpolicyandlawaretheforcesthatprovideanopportunitytodoso.Furthermore,investinginthesocialdeterminantsofhealthupfrontisstrategicandadvantageous:notonlyarehealthyandproductivecitizensmoreableandlikelytocontributetotheeconomyandtothetaxbase,investmentinthesocialdeterminantsofhealthtodaytranslatesintosmalleramountsofmoneybeingspentontreatmentandrehabilitationtomorrow.
Lastly,itisveryimportanttonotethatactiontoaddressthesehealthissuesmustcomefromacrossthewholeofthecommunity.Forexample,theWorldHealthOrganization(WHO2008)hasstatedthat:
“The health sector will also play a leadership and advocacy role in the development of policies to deal with the social determinants of health. But lack of health care is not the cause of the huge global burden of illness: water-borne diseases are not caused by lack of antibiotics but by dirty water, and by the political, social, and economic forces that fail to make clean water available to all; heart disease is caused not by a lack of coronary care units but by the lives people lead, which are shaped by the environments in which they live; obesity is not caused by moral failure on the part of individuals but by the excess availability of high-fat and high-sugar foods. The main action on social determinants of health must therefore come from outside the health sector.”
Social/Cultural• Social status• Social support networks• Education• Social environment• Personal health practices• Coping skills• Healthy child development• Gender and culture
Nature/Environment• Physical environment (clean air, clean and abundant water, food safety, etc.)• Biological and genetic endowment
Economy• Income• Employment• Working conditions
Sustainable Development =Healthier Canadians
http://www.phac-aspc.gc.ca/about_apropos/sd-dd/health-sante-eng.php
14 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
2. Public Health Ethical ConsiderationsThepracticeofpublichealthisalwaysabalancingact.Decisionsoftenneedtobemadeinthefaceofscientificuncertaintyandwithoutclearresearchevidenceofbenefitorharm.However,thefailuretoactmayproduceevengreaterrisktohealth.
Ethicalconsiderationsunderlieallpublichealthobjectives,andbyextension,therecommendationsinthisdocument.Ethicsareasfundamentaltopublichealthpracticeandprofessionalismasisevidence-baseddecision-making.Publichealthethicsareastandardofcareaswellasadutyofcare.Theyarethevaluesandprinciplesthatguideactionsintendedtoimprove,promoteandprotecthealth,andtheymustbereliedonparticularlyinthefaceofuncertaintyandcontroversy.
Publichealthethicsisoftenmoreclearlyunderstoodwhencomparedtoclinicalethics.TheprovincialChiefMedicalOfficerofHealth(CMOH)andtheRegionalMedicalOfficersofHealtharephysiciansandhavethesameethicalobligationsasanyotherphysicianwould,butintheircasethe“patient”isthepublicratherthananindividual.Asaresult,thefollowingcomparisonscanbemade:
• Theultimateobligationofphysiciansandotherhealthcareprovidersistoactinthebestinterestsoftheindividualpatientbeforethem:thisisknownasfiduciaryresponsibility.In public health, the duty of care is toward the community or society as a whole.
• Intheclinicalsetting,theindividualpatientseeksoutthehealthcareproviderandanyinterventionislegitimizedbyinformedconsent.With public health interventions, informed consent could be contextualized as transparency – an open decision-making process where the Public has the right to be informed about the reasons for decisions and the right to appeal.
• Clinicalethicsisorientedtoautonomy,whilethe orientation in public health is essentially communitarian (namely, what is good for the whole community, not just the individual).
Ultimatelythissimplytranslatesto,whatisthecostofbeingwrongaboutestimatingrisk?Ifwebelievetherisksaremoderateandacceptableandcanbemitigatedbutwearewrong,whatistheworstthatcouldhappen?Ifwebelievetherisksareextremeandunacceptableandwearewrong,thenwhat?
Becausepublichealthdecisionmakingdependsonanassessmentofcomplexandinteractingfactors,keyvaluesandethicalprinciplesareusedforguidance.Inadditiontogeneralvaluessuchasaccountability,respect,integrityandcollaboration,thefollowingarethemainethicalconsiderations,valuesandprinciplesthatunderlieallpublichealthobjectivesandwhichgiverisetotherecommendations.
“The practice of public health is always a balancing act”
Part I: Guiding Principles for Protection of Public Health 15
Public Health Ethical Considerations
• Autonomy–actionstakentoprotectpublichealthshouldrespectself-governance,self-determination,andinformeddecision-making
• BeneficenceandNon-maleficence–dogood;i.e.protectthePublic’shealth,andrefrainfromdoingharm
• Burden of Proof –theburdenofproofthatanactivityisnotharmfulfallsonthoseundertakingitratherthanonPublicHealthauthoritiestoprovethattheactivityisharmful
• Communitarianism–applywhatisgoodforthewholecommunity,notjustindividuals
• Equity and Distributive Justice–alwaysseekequitabledistributionofbenefitsandburdens.Thisprincipleappliestobothsocialandenvironmentaljustice
• Evidence-based–riskassessmentanddecisionmakingshouldalwaysbeevidence-informed
• Harm Principle–toprotectthepublicfromharm,PublicHealthauthoritiesmayhavetotakeactionsthatrestrictindividuals’liberty
• Leadership–PublicHealthauthoritieshaveafiduciaryresponsibilitytoprotectthepublic
• Precautionary Principle–whenanactivityoroccurrenceraisesthreatsofseriousorirreversibleharmtohumanhealthortheenvironment,precautionarymeasuresshouldbetakenevenifsomecauseandeffectrelationshipsarenotfullyestablishedscientifically
• Prevention–afocusonprimordial(stepstakenpriortoemergenceofproblems)andprimary(directcontrolmeasures)preventionisalwayspreferabletomitigationofimpactsandremediationofproblemsaftertheyoccur
• Proportionality(LeastRestrictiveMeansPrinciple)–restrictionsimposedshouldbeproportionaltowhattheproblemwarrants,usingtheleastrestrictivemeanstoachievethedesiredoutcome
• Reciprocity–ifindividualsareaskedtocurtailtheirlibertiesforthepublicgood,thereisareciprocalobligationonthepartofsocietytoensurethattheydonotsufferunduehardshipfromcomplying
• Transparency–thedecision-makingprocessshouldbeopen,thespecificsofbalancingrisksandbenefitsshouldbeclearlyexplainedtothePublic,andthereshouldbeanappealprocess
• Utilitarianism–achievethegreatestgoodforthegreatestnumber
16 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
3. Health Objectives Related to Development of a Shale Gas Industry in NBJustasaclinicaldoctorhasarangeoftreatmentoptionsavailabletomanageapatient,sotoohasPublicHealthanumberofwaysitcanintervenetoachievethedesiredoutcomesofimprovedhealthofthepopulation.Thesecanbedescribedashealthobjectivesandrepresentthedifferentpiecesofworkthatneedtobeundertakeninordertomakeadifference.Theydescribewhatmustbeachievedratherthanwhohasresponsibility.Fulfillingtheseobjectivesgoesfarbeyondtheworkofthepublichealthsector,whichhowevermustplayaleadershiprole.Achievingtheoutcomeswillinvolvecollaborative,multi-sectoralpartnershipsacrossthewholecommunity.
1. ADVOCACY, LEADERSHIP & PARTNERSHIP–PromoteandprotectthehealthofNew Brunswickersthroughleadership,partnership(intragovernmentalandwiththepublic,industry, academiaetc.),innovationandactioninpublichealthduringallphasesoftheshalegas industryinNB.
2. PROVISION OF INFORMATION–Generateanddisseminateinformationfromapublic healthperspective(healthhazardidentification,exposureassessment,riskassessmentand characterization,riskcommunication)whichwillsupportevidence-baseddecisionmakingfor policyandpracticeandhelptoensurethatallphasesoftheshalegasindustryinNBaredone safelyandresponsibly.
3. PREVENTION OF PUBLIC HEALTH HAZARDS–Identify,preventandrespondtohealthhazards thatposearisktopublichealthduringallphasesoftheshalegasindustryinNB.Fulfilling thisobjectivewillinvolveplanning,implementingandevaluatingriskassessmentandmanagement strategiestoaddressthesehazards,aswellasenforcement,andenhancingdatacollectionsystems forpopulationhealthassessment,surveillanceanddissemination.
4. PUBLIC HEALTH EMERGENCY PREPAREDNESS–Prepareforandrespondtopublichealth emergenciesthatmayariseduringallphasesoftheshalegasindustry.
5. HEALTHY WORK ENVIRONMENT–Promoteahealthyworkenvironmentforthoseemployedby andincloseproximitytotheshalegasindustry.
6. COMMUNICABLE DISEASE PREVENTION AND CONTROL–Anticipate,preventandcontrol communicablediseasesgiventhepotentialfortheincreaseinpopulationanditsdensityin communitieshostingtheshalegasindustry.
7. SOCIAL DETERMINANTS OF HEALTH EMPHASIS–Continuetobuildhealthyandresilientpeople, communitiesandenvironmentsbyusingapopulationbasedhealthapproachthataddresses thesocialdeterminantsofhealth,andmakeseffective,efficientandequitableuseoftheeconomic opportunitiesfromtheshalegasindustryinNB.
8. NATIONAL AGENDA–Participateincollaborationwithfederal/provincial/territorialpublichealth agenciesacrossCanadatorefinepublichealthrolesandresponsibilitiesinthecontextofashalegas industryandtofacilitatenationalapproachestopublichealthpolicyandplanninginthissector.
9. SCHOLARLY ACTIVITY–Contribute,throughscholarlyactivityandresearch,tothebodyof knowledgeonthepublichealthimpactsoftheshalegasindustryandtheirmitigation.
17
Part 2
What We Know Now and What We Don’t Know Now
18 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
1. Shale Gas – The New Brunswick ContextDespiteexperienceinthisprovincewiththeoilandgasindustryoveralongtimeframe,theshalegasindustryisinitsinfancyinNewBrunswick.Currentconditionsmayresultinaboominactivityashasalreadytakenplaceinotherjurisdictions.Howthiswouldaffectdifferentcommunitiesandregionsisnotyetknown,butboththepotentialrisksandbenefitsmaybedifferentbetweendifferentareasoftheprovince.
WhiletheoilandgasindustryisnotnewtoNewBrunswick,ithashistoricallybeenarelativelyminorcomponentofeconomicactivityintheprovince.AlthoughthelargestoilrefineryinCanadaislocatedinSaintJohn,almostallofthecrudeoilprocessedtherecomesfromforeignsources,andtherehashistoricallybeenonlysmallscalelocaloilandgasproduction.
Thefirstoilwellintheprovince,andindeedoneoftheearliestinNorthAmerica,wasdrilledin1859nearDover,inWestmorlandCounty,andthefirstsuccessfulgaswellintheProvincebeganproductionin1909nearStoneyCreekinAlbertCounty(St.Peter,2000;FundyEngineering/AtlanticaCentreforEnergy,2011).Todateover300oilandgaswellshavebeenconstructedintheProvince,withmostoftheactivityinfirsthalfofthe20thcentury,littleactivitypost-1950,andaresurgenceofinterestinthe1990s(St.Peter,2000).Sincethen,approximately40newoilwellsand40gaswellshavebeendrilledandthereare30producinggaswellsatpresent(NBNGG,2011).
Withrespecttothenewtechnologiesusedinshalegasdevelopment,NewBrunswickhashadsomelimitedexperienceinrecentyears.Since1990,49oilandgaswellshavebeenfracturedbyvariousmethods(includinghydraulicfracturingandliquefiedpetroleumgasorLPGfracturing)and9wells(5gasand4oil)haveuseddirectionaldrilling(NBNGG,2011).However,sofaronlyahandfulofwellshaveusedallofthehallmarksofmodernshalegastechnology(directional“horizontal”drillingintoshalesourcerockasopposedtosandstonereservoirrockandhigh-volumemultistageslick-waterhydraulicfracturing).Theseinclude2exploratorywellsintheElginarea:CorridorResourcesGreenRoadB-41,whichwasthefirsthorizontalshalegaswellinNewBrunswick,beguninJune2010,andG-59(FundyEngineering/AtlanticaCentreforEnergy,2011;GLJPetroleumConsultantsLtd,2011).
Atpresentthereisconsiderableinterestinexploration,andninegascompaniescurrentlyholdleasesorlicensestosearchinspecificareasoftheprovincethatamounttoapproximately20%ofitslandarea(seeFigure1).Thisinteresthasarisenbecauseofrecentestimatesofgasreservesthatsuggestthattheremaybeaworld-classshaleplayintheprovince,potentiallyevenricherthantheBarnettShaleinTexas(FundyEngineering/AtlanticaCentreforEnergy,2011)andduetotheexistingMaritimesandNortheastPipelineinfrastructure(builtin2000toconveynaturalgasfromtheSableIslandoffshorefieldtoNewEngland).TheProvinceisthereforepoisedtoexperiencegrowthinthisindustryinthenearfuture,andifgasyieldsandeconomicfactorsarefavourable,aboominactivitymayoccurasithasinotherjurisdictions.
OneimportantfactortonotealsofromFigure1isthatnotallgeographicareasoftheProvincehavethepotentialtobedirectlyinvolvedinoraffectedbyshalegasdevelopment.Thisisalsotrueinotherjurisdictions(see,e.g.,NatureConservancy2010;Considine,2010;SierraResearchInc.2011)andissimplyaconsequenceofthelocalgeology(i.e.thedevelopmentwillonlyoccurwheretheresourceexists).ThiseffecthasimplicationsinthatboththepotentialrisksandbenefitscouldbedifferentbetweendifferentNewBrunswickcommunitiesandregions.
Part 2: What We Know Now and What We Don’t Know Now 19
Figure 1 (from NBDNR, 2012)
Oil and Natural Gas Licences/Leases, New Brunswick
20 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
2. Experience from Other JurisdictionsBecausetherehasbeenlittledirectexperiencetodateinNewBrunswick,therecommendationsinthisdocumentdrawonexperiencefromotherjurisdictionswheretheshalegasindustryhasalreadyundergonesignificantexpansionand/orstudy,suchastheUSstatesofPennsylvania,Texas,Colorado,WyomingandNewYork,amongstothers,aswellasotherprovincesinCanada.NewBrunswickisinthefortunatepositionofbeingabletolearnfrombothpositiveandnegativeexperienceselsewhere.
Theprincipallessonsnotedwerethattherearesocialandcommunityhealthrisksfromthisindustrywhichcanbecompoundedbyinequitiescausedamongstthelocalpopulace.Likelytherecouldbeindirectbenefitsfromeconomicgainsduetoincreaseincome,energyandemployment,howeverclearevidencetosupportapositiveimpactonhealthstatusrelatedtothisindustrywasnotfoundinthisreview.
Therearesignificantdatagapsthatlimitassessmentofhealthrisksandtherehasbeenlimitedinvolvementofpublichealthofficialsandexpertsinshalegasissuestodate.Finally,fewstudieshavebeenundertakenthatconsidertheoverallpotentialimpactsonhealthandtheenvironmentovertheentirelifetimeoftheindustry.
Someoftheprincipallessonsrelatedtopublichealthfromexperienceinotherjurisdictionsareitemizedhere.
a. There are significant data gaps that limit the ability to thoroughly assess risks to public health.
Someofthepublichealthknowledgegapsthathavebeenidentifiedincludedevelopmentofapproachestoplanningforsocialimpacts,alackofpriorhealthstatusstudies,alackofcomprehensivehealthimpactassessments,specificchemicaltoxicityinformationonchemicalsusedbytheindustry,chemicaltoxicityinformationonwastes,alackofexposuredata,apoorabilitytoforecasttheextent,rateandlocationsofdevelopment,andlittleinformationoncumulativeorfulllife-cycleeffects.TheseissuesarediscussedinmoredetailinSection3(WhatWeDon’tKnow)below.
b. In cases where the public health impacts of shale gas development have been considered, there are some common themes regarding types of potential hazards to public health.
OCMOHstaffhaveidentifiedsomecommonthemesregardingwhattypesofpotentialhazardstopublichealthshouldbeconsidered:Appendix1listssomeofthefindingsandrecommendationsfromstudies,healthimpactassessments,commissionreportsandotherpublishedinformationthatspeaksdirectlyorindirectlytopotentialpublichealthimpacts.
FromtheinformationinAppendix1andothersourcesthetypesofpotentialhazardsidentifiedinclude:
• PHYSICAL-Physicalhazardsduetoaccidents,malfunctions,emergencies,etc.
• ENVIRONMENTAL –Hazardstothequalityofair,water,soilorfood
• MENTAL–Mentalhealthimpactstoindividuals
• SOCIOECONOMIC–Impactstocommunities
• OTHER –Otherimpacts,suchascumulativeeffects,radiation,etc.
Part 2: What We Know Now and What We Don’t Know Now 21
ThesepotentialhazardsformpartofthebasisoftheframeworkusedfortherecommendationsinPart3.
c. The public discussion on shale gas has been dominated to date by chemical toxicity concerns and as a result many other factors of potential concern to public health also need attention.
Thefocusinthepublicdiscoursetodateonwaterandhydraulicfracturingchemicalsrunstheriskofoverlookingotherconsiderationsthatarepotentiallyevenmoreproblematic,suchascommunityhealthissues.Mostmediareportsrelatingtopublicconcernsovershalegasdevelopmenthavefocussedalmostentirelyontheimpactfromhydraulicfracturingchemicalstodrinkingwaterwells.Therehavealsobeenasmallernumberofreportsaboutconcernsrelatedtoairquality,butthesetwoissuesaloneaccountforalmostallofthepublicdiscourseaboutpotentialhealtheffects.
Withregardtothescientificandmedicalliterature,factorssuchaspotentialimpactstocommunityhealth,mentalhealthandsocioeconomicwellbeinghavealsonotbeenaswidelyreportedorstudiedassomeoftheissuessurroundingpotentialenvironmentaltoxicants.Theseareneverthelessveryimportantdeterminantsofhealth,andareofinteresttothepublichealthcommunityworldwide,sotherehasrecentlybeenanincreaseinthelevelofattentiontotheseissues.
Furthermore,someofthestudiesthataddresscommunityhealthissueshavepointedoutsomepotentialnegativeconsequenceswhenplanningfordevelopmentdidnotadequatelytakethesefactorsintoaccount.SomeofthesementalhealthandsocioeconomicimpactsarediscussedfurtherinSections2eand2fbelow.
Anotherareathatneedsbetterunderstandingisthepotentialforphysicalinjury,bothattheworksiteitselfandinthevicinityofdevelopment.Therearepotentialhazardsthatwarrantfurtherconsideration:forexample,ithasbeenestimatedthatupto2,000trucktripsareneededperwelldeveloped(EuropeanParliament2011;NewYorkDEC2011)andtheseareoftenonruralroadsthatwerenotdesignedforsuchtraffic.Asaresult,thepotentialforincreasedtrucktrafficaccidentsthatcouldimpactresidentsneardevelopmentareasisaconcern.
d. Public Health officials and experts have often been late to the table or absent from discus-sions about shale gas regulation in other jurisdictions
AlthoughhealthconcernsareoftennotedasanimportantpreoccupationamongthePublic,therehasbeenanotablelackofparticipationbyPublicHealthagenciesinmanyoftheongoinginitiativestoregulatetheindustryelsewhere.Thismaybeduetoagenerallackofunderstandingaboutthepotentialimpactsonhealth,littleprecedenttodrawonforlearningsorplansthatcouldbefollowed,anarrowingofthescopeofwhat“health”means,and/orabeliefthatengineeringcontrolsandregulationscanmitigateallofthepotentialimpacts.
InoneexamplenotedinNewYorkstate,agroupofover250concernedhealthprofessionalsandorganizationswrotetothestategovernorinOctober2011regardingthelackofconsiderationofhumanhealthimpactsduringtheNewYorkStateDraftSupplementalGenericEnvironmentalImpactStatementprocess(alargescalemulti-yearstrategicreviewofpotentialrisks),andthelackofahealthprofessionalrepresentativeonthestate’sHighVolumeHydraulicFracturingAdvisoryPanel(NewYorkHealthProfessionals2011).
Furthermore,thisissuehasbeenillustratedelsewhere(Goldstein2012)bytheobservationthathealtheffectstypicallyrankamongthemostimportantpreoccupationsstatedbyopponentstoshalegas,butneverthelessthreerecentmajorUSadvisorycommissionsstudyingshalegasissues(onefederalandthestatesofMarylandandPennsylvania),allofwhichreferexplicitlytoprotectionofpublichealthintheirmandates,appointednocommissionerswithexpertiseinpublichealth,
22 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
medicalhealthorenvironmentalhealth(outof51personsintotal).Inaddition,nostateorU.S.federalgovernmentagencieswithdirectpublichealthresponsibilities(e.g.thefederalDepartmentofHealthandHumanServices,theNationalInstituteofEnvironmentalHealthSciences,theCenterforDiseaseControl,theAgencyforToxicSubstancesandDiseaseRegistry,orsimilarstatedepartmentsandagencies)participatedintheproceedingsofanyofthesecommissions.
e. There have been economic benefits associated with expansion of the industry, but this may come with socioeconomic risks that can adversely impact individual and community wellbeing
Theeconomicbenefitsofshalegasdevelopmentarepotentiallyverylarge.Large-scaleincreasesinemployment,taxandroyaltyrevenuescouldhavethepotentialtoimproveoverallhealthstatusinthisProvince.However,thesepotentialimprovementscanbelimitedorevencounteractedbynegativesocialimpactsthatcanariseduringaneconomicboom(thisisknownasthe“BoomtownEffect”).Thesenegativeimpactscanincludeincreasesincrime,drugandalcoholabuse,sexually-transmittedinfections(STIs),anddomesticviolence.Aninadequatesupplyandpoorqualityofhousingalongwithincreasedcostoflivingresultingfromtheboomcanleadtoincreasedcommunitydissatisfaction.Theseproblemscanbefurthercompoundedduetoinadequateinfrastructureandpublicservicescapacity(includingpolicing,localgovernment,mentalhealthservices,socialservices,andhealthcare)thatcanlagfarbehindthegrowingneedforthem.
BecausetheBoomtownEffectisthoughttobemoreintenseforsmallcommunitieswithatraditionalwayoflifethatdidnotpreviouslyinvolvetheindustrialsectorresponsiblefortheboom,theremaybearisktoNewBrunswickcommunitiesunlessthiseffectisanticipatedandmitigatedthroughstrategicinvestments.
OneestimateofeconomicactivityintheMarcellusShale(Considine2010)foundthatthecontributiontotheregionaleconomyinthestatesofPennsylvaniaandWestVirginiain2009was$4.8billion,withover57,000directandindirectjobscreated,leadingtoincreasedlocal,stateandfederaltaxrevenuesof$1.7billion.Thisisperhapsthemostactiveshalegasareaintheworld,however,sotheseestimatesmaybeunrealisticforNewBrunswick,buttheyneverthelessillustratethepossibilitiesforeconomicbenefits.
RoyaltiesonCrown-ownedresourcesarealsoanimportantconsiderationintheNewBrunswickcontext,astheyrepresentaverylargepotentialsourceofgovernmentrevenue.PossibleroyaltiesfortheProvinceofNewBrunswick(FundyEngineering/AtlanticaCentreforEnergy,2011)wereestimatedtobeupto$225millionannuallyatfulldevelopment,totalling$5.7billionoverthelifeoftheindustryifallestimatedresourcescanbefullyexploited(althoughbasedonnaturalgaspricesatthetimeofwriting,theseestimateswouldhavetobeadjusteddownbyabout40%).
IncreasesinemploymentlevelsandrevenuesfromtaxesandroyaltieshavethepotentialtoimprovehealthstatusinthisProvince.Socioeconomicstatusofapopulationisastrongpredictorofhealthstatus,soemployingpersonswhowerepreviouslyunemployed,orenablingthemtotakeuphigherpayingpositions,orimprovingsocialprogramsthroughincreasedgovernmentrevenuesshouldresultinhealthbenefitstothepopulation.
However,thesepotentialimprovementsinhealthstatusduetoimprovedeconomicstatuscanbelimitedorevencounteractedbytheBoomtownEffect(alsoknownastheBoomtownImpactModel).Therehavebeenmanydocumentedcasessincethe1970s(Jacquet2009)ofenergyboomtownswherearapidchangeinpopulation,industrializationandeconomicprosperityalsoledtoahostofsocialillsthatimpactedcommunityhealth.Theseincludeincreasedratesofcrime,drugandalcoholabuse,sexually-transmittedinfections(STIs),anddomesticviolence;inadequatesupplyandqualityofhousing;increasedcostofliving;increasedcommunitydissatisfaction;increasedmentalhealthandsocialservicescaseloads;increasedhospitaladmissions;insufficient
Part 2: What We Know Now and What We Don’t Know Now 23
infrastructure;andinsufficientcapacityinpublicservices,includingpolicing,localgovernment,socialservices,andhealthcare.
TheBoomtownImpactModelwasshowntobeaclosefittoacasestudyofnaturalgasdevelopmentinSubletteCountyWyoming(Jacquet2009)andsimilarimpactshavebeencommonlyencounteredinothercommunitieswherelarge-scaleenergydevelopmentshavetakenplace.SomecurrentCanadianexamplesofenergyboomtownswheresucheffectscanbeseenincludeFortMcMurrayAlberta(oilsandsdevelopment),aswellasFortNelson,FortSt.John,DawsonCreekandothercommunitiesinnortheasternBritishColumbia(shalegas).
IntheFortMcMurrayregion(RegionalMunicipalityofWoodBuffalo),anumberofnegativesocialimpactstypicaloftheBoomtownEffectwerenoted,andtheoverallcommunityhealthstatuswasfoundtobelowerthantheprovincialaverage,evenwhenthemajorcentresofCalgaryandEdmonton,whichgenerallyhavebetterhealthstatusthanruralareas,wereexcludedfromthedata(RoyalSocietyofCanada2010).Inspiteoftheevidentproblems,theRoyalSocietyreportstatedthat“we were unable to identify any public health intervention programs specifically targeted towards resolving these conditions…A coordinated public health effort needs to be organized to address the evident health disparities”andthat“suchhealthdisparitiesaredifficulttoreconcilewiththewealththeregiongenerates”.
OtherreportsofidentifiedsocialissuesintheFortMcMurrayareaincludedlevelsofreportedcrimeperpoliceofficerthatwerethreetimesthenationalaverage(Ruddell2011),asevereshortageoffamilyphysicians,withonly14ofthemforapopulationof82,000(aratiothatwasone-sixththatofEdmonton)andinadequatehospitalfacilitiesdespitehavingthethird-busiestemergencyroominAlberta(Sauve2007).Theseissuespointtoageneralprobleminboomtownswhereinfrastructureandpublicservicecapacitycanlagfarbehindthegrowingneedforthem.
NortheasternBCalsoshowstypicalboomtownissues,suchasincreasedsubstanceabuseanddemandforpublichealthservicesforyoungfamilies(Medd,undated)andhigherthanprovincialaverageratesofteenpregnancy,STIs,men’shealthissues,andsocioeconomicindicatorslikeschooldropoutrates,illiteracy,andchildpovertyinspiteofverylowunemployment(Badenhorst2012).Thecommunitydemographicsalmostcertainlyplayarole:themedianageofthepopulationisalmost10yearsyoungerthantheprovincialaverage,thereisapreponderanceofyoungmales(eithersingleorwithyoungfamilies),gasindustryworkershaveanaverageannualsalarymorethandoubletheprovincialaverageforfull-timeworkers,andthetransientpopulation,whichhaslittlestakeinthecommunitybutneverthelessoverwhelmslocalservices,ismuchgreaterthanthebase(e.g.FortNelson’spopulationofabout5,000swellsseasonallytoasmuchas15,000,seeMedd).
TheBCMinistryofHealthrecentlycommissioneda3-phaseHumanHealthRiskAssessmentforNortheasternBCthathasjustcompletedPhase1.Inaddition,communityleadershavebeencallingforthedevelopmentofaPublicHealthPlanfortheregiontoaddressthemanycommunityhealthissuesinadditiontoenvironmentalhealthconcerns(Badenhorst2012).
f. There can be inequitable distribution of risk and reward to the local populace
Althoughallresidentsinagasdevelopmentareashareinthepotentialrisks,inmanycasesnotallofthemhavegainedfromitthoroughemploymentoraccesstorevenues,andindeedmanyofthespecializedjobsmaybetakenbynon-residentworkerswhoalreadyhavethenecessaryexpertise.Inaddition,evenwhenlocalpeoplearehiredsomeexistinglocalbusinessesandlocalpublicservicescansufferduetolossoftheiremployeestothegasindustry.
Inadditiontothefactorsnotedintheprevioussections,thepositiveeffectofeconomicgainscanbefurtherlimitedduetoinequitabledistributionofriskandrewardamonglocalresidents(Gever2011;Perry2011;Brasier2011).Forexample,allofthepeopleinagivencommunitywillsharein
24 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
therisks(realorperceived)ofhavingtheindustrylocatednearby,butonlysomeofthemwillgainfromit:somepeoplewillbenefitfromnewjobsintheindustryorjobsservingtheindustry,butobviouslynotallofthemwill,andsomelong-standinglocalbusinessesandpublicserviceswillbeadverselyaffectedbylossoftheiremployeestohigher-payingjobsinthegasindustry.Similarly,somepeoplewillgaineconomicallybyleasingaccesstotheirlandtothegascompanies,whiletheirneighbourswon’t.Insomejurisdictionstherehaveevenbeenafewreportsofinequitytotheextentwheresomeparticipantsintheindustrygetrichandmoveaway,leavingtheirnon-participantneighboursbehindtoshoulderalloftheriskswithnoneoftherewards.
Anotherlimitingfactoristhethreatthataportionofjobscreated,includingmanyofthemorespecializedandhigherpayingjobsmaygototransientworkersandnon-residents,asthenecessaryexpertisealreadyexistselsewherebutisuncommoninNewBrunswickduetolimitedpreviousexperiencewiththeoilandgasindustry.Inadditiontoless-than-anticipatedimprovementsinthesocioeconomicstatus(andthereforehealthstatus)ofthelocalpeople,thiseffectcouldalsoleadtolessgrowthoftheProvincialtaxbaseandlessdevelopmentoftheskilledknowledgebasethanmighthavebeendesiredorexpected.
Unlikesomejurisdictionswherethemineralrightsareinprivatehands,NewBrunswickisfortunateinthatallmineralrightsarevestedintheCrown,andsotheProvincewillhaveaccesstoincomefromroyaltiesthatcouldhelptomitigatetheeffectsstemmingfromthesefactors.However,theGovernmentofNewBrunswickwouldhavetoreinvesttheserevenuesstrategicallytobringsocioeconomicandhealthstatusbenefitstoallwhoshareintherisk,otherwisethisopportunitywillbelost.
g. More discussion is needed on the potential cumulative impacts of the industry over its lifetime
Whilethepotentialhealthandenvironmentalrisksofindividualwellpadscanbeevaluatedinordertopreventormitigatenegativeimpacts,itismuchmoredifficulttodothisforthetotalimpactsofallofthelargenumberofwellpadsthatwouldbedevelopedovera20-,50-oreven100-yeartimeframeshouldamajorexpansionofthegasindustrytakeplace.
Althoughcumulativeeffectsareacknowledgedasanimportantconsideration,todatetherehavebeenfewstudiesthatconsidertheoverallpotentialimpactsonhealthandtheenvironmentovertheentirelifetimeoftheindustry.Thescarcityofcumulativeimpactassessmentsmaystemfromthefactthatthescaleoftheindustry,rateofdevelopment,duration,andpreciselocationsofgaswelldevelopmentareverydifficulttopredict.Thisisbecauseindustrydevelopmentgenerallyvariesdependingoneconomicfactorsandwherethebestgasyieldsareobtained,whichmakesitverydifficulttodifficulttoforecastlocaleffectsofspecificprojectsandtoassessthepotentialforcumulativeeffectsovertime.
Asanillustrationofthepotentialscaleofdevelopment,oneofthefewpublishedcumulativeenvironmentaleffectsforecasts(NatureConservancy,2010)predictsthatamediumdevelopmentscenarioinPennsylvaniacouldresultindrilling60,000newgaswellsinthatstateoverthenext20years.Assessingtheenvironmentalandhealthimplicationsofthesewelldevelopmentsoneatatimeasindividualprojectscouldrisk“missingtheforestforthetrees”,butreliablepredictionofcumulativeimpactsislimitedbytheuncertaintyinpossiblefuturescenarios.
Anotherimportantfactorinestimatingcumulativeeffectsisthedensityofwelldevelopment.In2006,theJonahFieldinWyoming(Figure2)had533existinggaswellson497padsin2006(USDepartmentoftheInterior,2006)butan“infillproject”toaddafurther3,100wells(somebydirectionaldrillingandsomebywayofmanynewpadsconstructedbetweentheexistingones)wasapprovedandisongoing.Thecurrentwellspacingisonewellpadforevery40acres,andtheinfillingprojectwillreducethisspacingtoaslittleas10acresforeverypad(whereeachpadisitselfupto3acresinsize).
Part 2: What We Know Now and What We Don’t Know Now 25
ItisacknowledgedthattheJonahfieldisaconventionalgas/tightsandfieldandnotashalegasdevelopmentandwasdevelopedpredominatelywithouttheuseofrecenthorizontaldrillingtechnologies.Nonetheless,itprovidesausefulillustrationofwhatcanresultifcumulativeeffectslikewellpaddensityandpermittingoflaterinfillingarenotaddressedpriortodevelopment.Betteruseofhorizontaldrillingtechnologiesandmulti-wellpadswouldhaveresultedinvastlylesssurfacedisturbanceandalowerdensityofwellpads.NewYorkStatehashistoricallyalsouseda40-acrewellpadspacing(16padspersquaremile)forconventionalverticalgaswellsandalsoallowsinfillingtohigherdensitiesincertaincases,butthestate’sDepartmentofEnvironmentalConservation(NewYorkDEC,2011)forecaststhatwithexpandeduseofdirectionaldrillingandmulti-wellpadsinshalegasexploitation,thewellpaddensitywillbeless:9padspersquaremile(onepadper71acres)forasinglehorizontalwellperpad,andaslowasonepadpersquaremile(onepadper640acres)ifmulti-wellpadsaremandatedandifinfillingisnotcarriedout.Overallsurfacedisturbanceforaccessroadsandpipelineswillalsobelessifmulti-wellpadsareused.
Figure 2: Satellite photo of part of the Jonah Field, Wyoming (retrieved from Google Earth 2012/02/08, image dated 2006/08/14). The light spots are gas well pads, the dark rectangles are water pits for either hydraulic fracturing fluid or flowback/produced water and the light lines are access roads or pipeline networks. Approximate spacing between the pads (yellow line) is 400 metres, which equates to a pad density of 1 pad per 16 hectares (1 pad per 40 acres) prior to the infilling project. The Jonah Infill Project Drilling Area extends over approximately 30,500 acres (about 120 km2) in total.
26 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
3. What We Don’t Know Now
a. Public Health knowledge gaps
Significantknowledgegapsrelatingtounconventionalgasdevelopmentstillexist.Theseknowledgegapsrequirefurtherinvestigationduetotheirimportanceintheassessmentoftherisksassociatedwithpotentialpublichealthimpacts.Someofthekeyinformationgapsincludemethodsforpreventingandmitigatingsocialimpacts,alackofhealthstatusstudiesbeforeandduringgasdevelopment,andalackofsystematicHealthImpactAssessments.Informationneededtoassesstoxicityrisksmayalsobelacking,suchasthetoxicologicalcharacteristicsofindustryproductsandwastes,andaccurateexposuredataisusuallynotavailable.Finally,alackofknowledgeabouttheextent,locationsandrateofdevelopmentmakesitverydifficulttoforecastlocaleffectsofspecificprojectsandtoassessthepotentialforcumulativeeffectsovertime.
1. Planning for social impacts.Atpresentthereisnostandardapproachforminimizingthe BoomtownEffect.Thesignificanceofthisgapshouldnotbeunderestimated.Unlessaplan isputinplaceforassessing,preventingandmitigatingthenegativeimpactsoftheBoomtown Effect,thesocialandcommunityhealthrisksmayreduceorevenoutweighthepotential economicbenefitsofshalegasdevelopment.
Duetothelackofastandardapproach,onewillhavetobedeveloped.However,theabilityoftheProvincetodothiswillbegreatlylimitedbythelackofaccurateforecastsforthescaleoftheindustry,rateofdevelopment,duration,andpreciselocationsofgaswelldevelopment(seealsopoint7below).Thus,moreinformationonthesefactorswillbeneededinordertoprepareaneffectiveplanfordealingwithsocialandcommunityhealthimpacts.
2. Health status studies.Otherjurisdictionswhereshalegasdevelopmenthasalreadytaken placehaveingeneralnotconductedtargetedstudiesofpopulationhealthstatuspriorto, duringorpost-development(Schmidt2011).Asaresult,monitoringsystemstodetectchanges inhealthstatustypicallydonotexist,andlittleisknownaboutpotentialdirectconsequences tohealthresultingfromgasdevelopment.
Inaddition,thelackofawell-definedbaselinedescriptionofhealthstatuspriortodevelopmentthatcanbeusedforcomparisonisaseriousproblem.Evenifhealthstudieswerenowtobeundertakeningasdevelopmentareastoaddressthegap,retrospective(backwards-looking)studiesthatdonothavebaselinehealthstatusdatapriortodevelopmentarealwayslessconclusivethanprospective(forward-looking)studiesthatdohaveit.
3. Health impact assessments (HIAs). Therehasbeenagenerallackofcomprehensiveanalysis andforecastingofpotentialhealtheffectsinnearbycommunitiesthatcouldarisefromlarge- scaleunconventionalgasdevelopmentprojects.However,suitablemethodologiestofillthis gapsuchasHealthImpactAssessments(HIA)areavailableandshouldbeused.
Thereisonenotablecasetodate(ColoradoSchoolofPublicHealth2011)whereacomprehensiveHIAhasbeenconductedinashalegasdevelopmentarea.Thisstudyidentifiedpotentialrisksrelatedtochemicalexposures,accidents,psychologicalimpacts(suchasdepression,anxietyandstress)andsocialimpacts,andproposedover70recommendationsforminimizingtherisks.
Otherhealthimpactstudieshavealsobeenconducted(WolfEagleEnvironmental2009,ATSDR2010,EasternResearchGroup/SageEnvironmentalConsulting2011,etc.)butthesehavebeenfocusedonlyontoxicchemicalexposures,usuallyviaasingleexposureroute(e.g.airtoxicsordrinkingwater)anddonotcomprehensivelyassessallpotentialhealthimpacts.
Part 2: What We Know Now and What We Don’t Know Now 27
4. Chemical toxicity information on products used by the industry.Theprecisenature ofchemicalsusedbytheindustryateachlocation,theamountsusedandtoxicological informationaboutthemcanoftenbelacking.Thiscanoccurevenwhentherehasbeen disclosureofthechemicalsinuse,asdisclosurerulesdesignedprincipallyfortransparency andaccountabilitymaynotbesufficientlystringentfortoxicologicalriskassessment.Thisgap canmakeriskassessmentforpotentialchemicalexposuresverydifficultorimpossible.
Inadditiontoknowledgegapsabouttoxicityofsomeoftheknownchemicals,thisissueisgreatlycomplicatedbythedifficultyofidentifyingwhichchemicalsareinuse.Therearevariousestimatesofthenumberandnatureofchemicalsusedinunconventionalgasdevelopment(INSPQ2010;NewYorkDEC2011;USEPA2011;USCongress2011;Colbornetal.2011)buttherearelikelyuptoathousandchemicalspotentiallyinuse,andalthoughonlytenortwentyofthesemaybeusedatagivensite,theprecise“recipe”canvarysignificantlyfromonewelltothenext.
Furthermore,evenwhentherehasbeendisclosuretheingredientinformationprovidedsometimesincludesonlyageneraldescriptionofcontents,chemicalcategoriesratherthanspecificchemicalcompoundnames,orproprietaryingredientsthatarenotnamed.Inaddition,MaterialSafetyDataSheets(MSDS)areoftenusedfordisclosure,butthesemustonlyidentifythechemicalsinaproductthataredeemedtobehazardousinanoccupationalsetting.Asaresult,MSDSmightnotincludeotherchemicalsintheproductthatcouldbehazardousviaenvironmentalexposureroutes(USDOE2011a).Forexample,onestudy(Colbornetal.2011)notedthatoutof944productssurveyed,theirMSDSspecificallyidentifiedlessthan1%ofthetotalchemicalcontentin407(43%)oftheproducts.
Inordertoaddressthisgap,thecommitmenttochemicaldisclosuremustbecompleteenoughtoprovidethespecificinformationrequiredfortoxicityriskassessments(chemicalidentitiesofallcompounds,toxicologicalinformation,anddose,i.e.thequantitiesandconcentrationsused).Disclosurerulesdesignedprincipallyfortransparencyandaccountabilitymaynotbesufficientlystringenttorequirethisnecessaryinformation.
5. Chemical toxicity information on wastes.Solidandliquidwastesforeachgaswellsiteare notalwaysfullycharacterized,andmaybequitevariablefromonewelltothenext.Asaresult, toxicologicalinformationforexposureriskassessmentscanbelacking.
Wastessuchasdrillspoilsandflowback/producedwatercancontainnotonlythechemicalsusedbytheindustryandtheirbreakdownproducts,butalsopotentiallyhazardousnaturallyoccurringcompoundsrecoveredfromunderground.Thesecanincludevaryingamountsofradioactiveisotopes,liquidandgaseouspetroleumhydrocarbons,othergasessuchashydrogensulphide,heavymetalsandhighlevelsofsalts.Asaresultofthewidevariation,agenerictoxicologicalprofileofwastescannotbeprepared.
Furthermore,theeffectivenessofwastewatertreatmentandmethodsforsolidsdisposalmaynotbeappropriateforthesetypesorconcentrationsofwastesinallcases.Ifsuchwasteweretobetreatedinappropriatelyitcouldleadtounexpectedhumanexposurestocontaminants.
Inordertoaddressthisgap,solidandliquidwastesforeachgaswellsiteshouldbecharacterizedsothattoxicologicalinformationcanbeobtainedforexposureriskassessments.Characterizationcanalsobeusedtoensurethatappropriatewastetreatmentsystemsareusedinallcasesandtoprovidemeasuresforevaluatingtheeffectiveperformanceofthesetreatmentsystems.
28 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
6. Exposure data.Accurateexposuredatahasbeenverydifficulttoobtain,inpartbecause emissionsofchemicalscanbequitedifferentatdifferentlocationsandtimes,buttargeted monitoringofair,waterandwastescouldhelptobridgethisgap.
Theidentitiesandquantitiesofchemicalsusedoremitted,identificationofpotentialexposureroutestothesechemicalsviaair,waterandwastes,andthetimelinesanddurationofexposuresareallareaswhereinformationneededtoassesshealthriskislacking.Furthermore,theissueiscomplicatedinthatemissionsaredispersedbothspatially(becausethedevelopmentoccursatmanysmallsitesratherthanonelargeindustrialsite)andtemporally(becausedifferentemissionswilloccuratdifferenttimesduringthelifetimeofwellconstruction,completion,developmentandproduction,andbecausethesestagescanoverlapwhenmanywellsaredevelopedononepadormanypadsaredevelopedinsequence).However,appropriatetargetedbaselineandongoingmonitoringofair,waterandwastescouldhelptobridgethisgap.
7. Extent, locations and rate of development. Todateithasnotbeenpossibletoestimate wellpaddensitiesthatmightoccurintheNewBrunswickcontext,norinwhatlocalities theymightoccur,oroverwhatextentoflandarea,asthisisexpectedtodependonwhere profitablegasdiscoveriesaremade.Thissignificantlylimitstheabilitytoforecastthepotential cumulativeimpactstohealthandtheenvironmentinthisprovince.However,examples liketheJonahFieldandexistingfieldsinNewYorkstateandelsewhereshouldbehelpful inassessingpossiblecumulativeimpactsofvariousdevelopmentscenariosoncemore informationbecomesavailable.
Theextent,locationsandrateofdevelopmentarealsoimportantfactorsinassessingpotentialsocialimpacts(discussedinpoint1,above)sobetterinformationonthesefactorswillhelptoaddressthisgapaswell.
b. Ongoing work that may help to inform some of the knowledge gaps
AnumberofmajoreffortsarecurrentlyongoinginCanadaandtheUnitedStatesthatshouldhelptoinformsomeoftheseknowledgegaps.Noneofthem,however,willtouchonallpotentialhealthoutcomesrelatedtogasdevelopment(forexample,noneofthemspecificallyaddressthesocialdeterminantsofhealthindetail),andnotalloftheknowledgegapswillbefilledoncetheseeffortsarecomplete.Theoutcomesofthesestudieswillbeveryvaluableinformation,buttheyarenotasubstituteforconductinghealthimpactassessmentsintheNewBrunswickcontext.
Keyhealthtopicsbeingaddressedincludeareviewofthestateofknowledgeofpotentialhealthhazardsfromshalegasdevelopmentviadrinkingwaterandairexposureroutes(HealthCanada),ariskassessmentoffactorsidentifiedaspublicconcernsabouthealthrelatedtogasdevelopment(ProvinceofBritishColumbia)andasmallenvironmentaljusticestudyaspartofalargerenvironmentalimpactstudy(USEnvironmentalProtectionAgency).
Otherstudiesaremainlyenvironment-focussed,suchasidentifyingpotentialimpactstogroundwater(USEnvironmentalProtectionAgency),identifyingchemicalsinuseandmanagementstrategiesforthem(EnvironmentCanada),strategicreviewsofpossibleenvironmentalimpactsingeneral(NewYorkstateandtheProvinceofQuébec)andthestateofknowledgeaboutenvironmentalimpactsandmitigationoptions(CouncilofCanadianAcademies).However,sincethephysicalenvironmentisadeterminantofhealth,thesestudieswillalsohaveabearingonhealth.
Part 2: What We Know Now and What We Don’t Know Now 29
Anoverviewoftheseinitiativesfollowsbelow:
1. HealthCanada’sHealthyEnvironmentsandConsumerSafetybranchiscurrentlyundertaking areviewofthestateofknowledgeofpotentialhealthhazardsfromshalegasdevelopment viadrinkingwaterandairexposureroutes(HealthCanada2011).Thiseffortispartofawider initiativebyaGovernmentofCanadaInterdepartmentalTaskTeamworkingonaScienceand PolicyIntegrationPilotProject(Energy/WaterNexus–ShaleGas).
Thisstudywillhelptoidentifypossiblehealthhazardsduetoimpactstothephysicalenvironment,andassuchwillbeusefulinformationforNewBrunswickinconductingHIAsorriskassessments,butitisnotdesignedtoaddressalldeterminantsofhealth.
2. InJanuary2012theBritishColumbiaMinistryofHealthcontractedtheFraserBasinCouncil toundertakeahumanhealthriskassessmentofoilandgasdevelopmentinnortheastBritish Columbia(seewww.hhra.ca).Thisassessmentwillconsistofthreephases:
1. Publicengagementtoinformthescopeandtermsofreferenceandidentifyconcerns relatingtooilandgasdevelopment
2. Ahumanhealthriskassessmentbasedonfindingsfromphaseoneandacomprehensive scientificreviewofevidence
3. ReportingfindingstotheProvince,stakeholdersandthePublic
Phase1concludedinMarch2012followingaseriesofcommunitypublicmeetingsandonlineconsultations.Atthetimeofwriting,noinformationabouttheoutcomesoftheseconsultationsorabouttermsofreferenceortimelinesfortheremainderoftheprojecthadyetbeenpublished.
Oncecomplete,muchoftheoutcomeofthisstudyshouldbeapplicabletotheNewBrunswickcontext,andwillhelptoinformhealthprotectionstrategieshere.
3. TheUnitedStatesEnvironmentalProtectionAgency(USEPA,www.epa.gov/hfstudy/index. html)wascommissionedbytheUSCongressin2010toinvestigatepotentialimpactsof hydraulicfracturingondrinkingwaterandgroundwater.Althoughthiswillprobablybethe mostdefinitivestudyeverregardingpotentialimpactstowater,itisnotdesignedtoassessall possiblehealthrisksandassuchisnotacomprehensiveHealthImpactAssessment.
ThestudyplanwasfinalizedinNovember2011andwillincludeanalysisofexistingdata,casestudies(fiveretrospectiveandtwoprospectivestudysites),scenarioevaluations,laboratorystudies,andtoxicityassessments.Aninterimreportisexpectedattheendof2012andthefullreportwillbeavailablesometimein2014.
Mostofthereportwillfocusonwellconstruction,chemicalsinhydraulicfracturingfluid,handlingmethods,wastedisposalandtestingofwaterforimpacts,butthereisalsoanenvironmentaljusticecomponentthatwillexaminewheregaswellsgasarelocatedversusdemographics,whichmayprovidesomelimitedinformationonhealthequity(seehttp://www.epa.gov/hfstudy/ProgressUpdate02_2012.pdf).
ThisUSEPAefforthasoftenbeentoutedasthe“definitivestudy”butthereareconcernsthatthescopeistoolimitedforacompleteHealthImpactAssessment(BambergerandOswald,2012).Basedonareviewofthestudyplan,OCMOHstaffagreesthat,withtheexceptionofthe
30 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
environmentaljusticecomponent,thisprojectwillonlyaddressthephysicalenvironmentasadeterminantofhealthandisnotacompleteassessmentofpotentialhealthimpactsfromgasdevelopment.
4. TheNewYorkStateDepartmentofEnvironmentalConservation(DEC)isintheprocess ofcompletingadraftSupplementalGenericEnvironmentalImpactStatement(dSGEIS, seeNewYorkDEC2011)regardinghigh-volumehydraulicfracturingusedintheshalegas industryinordertosatisfytherequirementsoftheStateEnvironmentalQualityReviewAct. Additionally,thedSGEISisintendedtoinformfuturerevisionsoradditionstotheDEC’s regulationsassociatedwithhigh-volumehydraulicfracturingincludingmitigationmeasures thatwouldpreventorminimizeanysignificantadverseimpacts,andcriteriaandconditionsfor futurepermitapprovalsandotherregulatoryaction.
ThedSGEISwassubmittedforafirstroundofpublicreviewandcommentin2009.Theextensivepubliccommentsrevealedsignificantconcernswithpotentialcontaminationofgroundwaterandsurfacedrinkingwatersupplies,potentialforgasmigration,impactsfromdisposalofsolidandliquidwastes,andconsiderationofvisual,noise,traffic,communitycharacterandsocioeconomicimpacts.Accordingly,in2010thestateGovernororderedtheDECtoissueareviseddSGEIS,whichwaspublishedinSeptember2011(NewYorkDEC2011).TheExecutiveOrderalsoprovidedthatnopermitsauthorizinghigh-volumehydraulicfracturingwouldbeissueduntiltheSGEISwasfinalized.
Atpresent,publicconsultationsontheSeptember2011dSGEIShaveconcluded.AreporttotheGovernoronthestatusoftheFinalSGEISandtheregulatoryconditionsthattheNewYorkDECbelievesarenecessarytoincludeinoilandgaswellpermitsinordertoprotectpublichealthandtheenvironmentisstillpending.
5. AsmandatedbytheLoi sur la qualité de l’environnement,theprovinceofQuébecengaged theBureau d’audiences publiques sur l’environnement(BAPE)toconductapublicinquiry andprepareareporton thesustainabledevelopmentofshalegasindustryinQuébec,which waspublishedinFebruary2011(BAPE2011a).Thetestimonysubmittedtothisinquiryincluded areportfromtheInsitut national de la santé publique du Québec onthestateofknowledge oftherelationshipbetweenshalegasactivitiesandpublichealth(INSPQ2010)aswellas testimonyfromPublicHealthofficialsinseveralregionsofQuébec(BAPE2011b).
AsaresultoftheBAPEreport,theprovinceofQuébeccommissionedastrategicenvironmentalevaluation(Québec2011)toaddresstheknowledgegapsindeterminingtheenvironmentalrisksthatshalegasexplorationandproductionmightentail.Whilethisevaluationisongoing,theBAPEreportrecommendedthatexplorationcouldcontinue,buthydraulicfracturingshouldnotbeauthorizedexceptforwhatisrequiredaspartoftheevaluation.AfinalreportontheoutcomesofthisstrategicenvironmentalevaluationisexpectedbyNovember2013.
6. TheCouncilofCanadianAcademieswascommissionedbythefederalMinisterofEnvironment inSeptember2011toundertakeanauthoritativeandevidence-basedassessmenttoanswer thefollowingquestion:“Whatisthestateofknowledgeofpotentialenvironmentalimpacts fromtheexploration,extraction,anddevelopmentofCanada’sshalegasresources,andwhat isthestateofknowledgeofassociatedmitigationoptions?”Theassessmentisexpectedto take18to24monthstocomplete(http://www.scienceadvice.ca/en/assessments/in-progress/ shale-gas.aspx).However,thisassessmentdoesnotappeartoconsideranyotherdeterminants ofhealthbesidesenvironmentalexposures.
Part 2: What We Know Now and What We Don’t Know Now 31
TheCouncilofCanadianAcademiesisanindependentnot-for-profitbodythatsupportsscience-basedassessmentstoinformpublicpolicy,andencompassestheRoyalSocietyofCanada,theCanadianAcademyofEngineeringandtheCanadianAcademyofHealthSciences.
7. AtthesametimeastherequesttotheCouncilofCanadianAcademies,EnvironmentCanada wasalsotaskedtodevelopaninternalworkplantoexamineanypotentialenvironmental consequencesofshalegasdevelopment.Atpresent,EnvironmentCanadaisworkingin conjunctionwithHealthCanadatoundertakeaninformationgatheringexercisetofill informationgapsontheidentityandquantitiesofchemicalsubstancesbeingusedinhydraulic fracturingacrossCanada,aswellasrelatedmanagementpractices.Thisexerciseisexpectedto becompletedbythewinterof2012.
32 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
33
Part 3
Recommendations for Protection of Public Health
34 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Recommendations for Protection of Public HealthAsriskisafunctionofhazardandexposure,increasedactivitynecessarilyimpliesincreasedrisk.ItistimelythereforeforGovernmenttobetterunderstandtheriskandbenefitsassociatedwiththeshalegasindustrypriortofurtherdevelopmentinNewBrunswick.Tothatend,theCMOHhasdevelopedtherecommendationsinthisdocumenttosupporttheGovernment’sriskmanagementandregulatoryframeworkinsuchawaythatitwillbeabletoprovideappropriate,completeandcomprehensivepublichealthpromotionandprotectionalongwithitsothergoals.
TheCMOHbelievesthatitisimportantfortheProvincetoenactthefollowingrecommendationsinordertoprotectpublichealthshouldanexpansionoftheunconventionalnaturalgasindustrytakeplace.Manyoftheserecommendationswillneedtobeenactedpriortoexpansionoftheindustry,alongwithmanyothersthatwillhavetobeinplacethroughouttheentirelifetimeoftheindustryinthisprovince.Thefundingoftheirimplementationandongoingmaintenancewillnotbeinsubstantialanditisrecommendedthatoptionsforindustryleviesbeexploredasamatterofpriority.
TheserecommendationsweredevelopedbasedonananalysisconductedbystaffintheOfficeoftheChiefMedicalOfficerofHealth(OCMOH)thatissummarizedintheinformationinthisreport.Thisanalysisincludedacriticalreviewofexperiencesinotherjurisdictions,recommendationsproposedelsewhere,casestudiesreportedinthescientificliteratureandotherreports,aswellascurrentandemergingissuesdiscussedinconferenceproceedings.
Eachrecommendationisgroundedinpublichealthpromotionandpracticeandclearlylinkedtothepublichealthethics,valuesandprinciples(outlinedinPart1)mostrelevanttoit.Pendinginputfrompublicandotherstakeholders,aswellasnewlearnings,theserecommendationsmayneedtobeadaptedandwillevolve.Manyoftheserecommendationsarecomplementarytothoseproposedinthedocumententitled“ResponsibleEnvironmentalManagementofOilandGasActivitiesinNewBrunswick-RecommendationsforPublicDiscussion”(May2012)whichwasdevelopedtooutlinemeasuresrequiredtoprotecttheenvironment.Thisdocumentbuildsuponandenhancestheproposedenvironmentalmeasuresasdeemednecessaryinordertoprovideaddedptotectionforhumanhealth.
Therecommendationsaregroupedandsummarizedintothefollowingcategoriesforeaseofreference:
1. Protection of health and community wellbeing related to changes in the social environment
Includesrecommendationsforoptimizingequitabledistributionofrisksandrewards;revenuesharing;identifyingaroleforlocalgovernmentsinplanningthelocationofgasindustryinfrastructure;identifyingaroleforPublicHealthincommunityplanning;andimplementingatransparentconsultativeprocesswiththepublicandotherstakeholdersontheimplementationprocessfortheserecommendations.
2. Protection of health related to changes in both the social and physical environments
Includesrecommendationsfordevelopingarequirementtosubmitahealthimpactassessment(HIA)aspartofthestandardProjectRegistrationprocess;developingaprotocolformonitoringofhealthstatusofpersonsliving,working,attendingschoolorplayinginproximitytotheindustry;andforlinkingthisinformationtoenvironmentalmonitoringdataandsocioeconomicdata.
3. Protection of health related to changes in the physical environment
Includesrecommendationsformonitoringnetworksforambientairandwaterquality;provisionsforwastewaterhandling,testing,transportation,treatmentanddisposal;fullandtimelydisclosureofchemicalsused;lesstoxicalternativesforhydraulicfracturingfluids;safesetbackdistancesthatconsiderhumanhealthfactors;limitinghealthimpactsfromnoise,vibrationandcontinuousillumination;trafficmanagementplans;emergencyresponsetraining;andpromotionandprotectionforthehealthofworkers.
Part 3: Recommendations for Protection of Public Health 35
4. Protection of future generations
Includesrecommendationsforaplantoanticipateandmitigatethe“BoomtownEffect”;astrategicHealthImpactAssessment;identifyingareastobeexcludedfromdevelopment;astrategiclanduseplanthatconsidershealthequity;considerationofvulnerableanddisadvantagedpopulations;considerationofFirstNations;astrategicwatermanagementplan;andpublicreportingofEnvironmentalandHealthmonitoringdata.
5. Implementation and oversight
Includesrecommendationsforstrengtheninggovernmentoversightcapacityandresources;strikinganimplementationgrouptooverseeimplementationoftheCMOH’srecommendations;establishinganon-goingdialogueamongcommunity,government,academicsandindustry;andcreatingamulti-disciplinaryadvisorycommitteetoCabinet.
36 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
1. Protection of Health and Community Wellbeing Related to Changes in the Social EnvironmentRecommendation 1.1: The Province should establish mechanisms to measure, monitor and optimize equitable distribution of risks and rewards that maximize benefits to the socioeconomic determinants of health for all New Brunswickers
TheWorldHealthOrganizationhasnotedthatwidesocioeconomicdisparitieswithincountriesandcommunitieshavebeenassociatedwithpooreroverallhealthoutcomes(WHO2008).Asaresult,theProvinceneedstosafeguardagainstinadvertentlydevelopingdisparitiesthatmaystemfromgasdevelopmentinordertomaximizebenefitstothehealthandsecurityofNewBrunswickcommunities.Thisisnotsimplyaboutasenseoffairness–therearerealhealthconsequencesfromnotaddressingthisissue.
Itisimportanttodistinguishinequityfrominequalityinthiscontext:inequalityreferstounequaldistributionofpotentialbenefitsandriskswithinapopulation,butinequityasusedheremeansthatinsomesituationsthesedifferencesareunjust,unfair,andavoidable(St-Pierre2010;WHO2008).
Somesourceshavenotedthateconomicbenefitsfromdevelopmentoftheshalegasindustryinotherjurisdictionshavebeeninequitablyshared,assomeresidentsinagivenlocalityhavebenefittedfinanciallywhileothershaven’t,eventhoughthepotential(orperceived)healthandenvironmentalrisksarebornebyallpeoplewholiveincloseproximitytotheindustry.Theserisksareparticularlyacutewheretherearealreadyvulnerablepopulations(seeRecommendation4.5).
Althoughsomeinequalityinreceivingeconomicbenefitsisunavoidable,thisinequalityprogressestoinequitywhensomeofthepeoplewhobeartheriskhavenoaccesstotherewards.Thisseparationof“haves”and“have-nots”resultingfromthearrivaloftheshalegasindustryhasinsomecasespittedneighbouragainstneighbourandcontributedtoerosionofthesocialfabricofcommunities(Perry2011;Brasier2011).
Becausesocioeconomicinequityhascommunityhealthconsequences,theProvinceneedstoensurethatthesetypesofinequalitiesareminimizedinordertosafeguardthehealthandsecurityofcommunitiesinNewBrunswick.ThisisthereasonwhytheWorldHealthOrganizationhascalledfor“health equity in all policies, systems and programmes”asacornerstoneofimprovinghealthstatus(WHO2008).ThispositionwasechoedinCanadabytheStandingSenateCommitteeonSocialAffairs,ScienceandTechnology,whichcalledforgovernmentstoimplement “a health lens in all policies” (SenateofCanada2009).
Safeguardinghealthequityisnotsimplyaboutfairness,butisakeytopreventingsomenegativehealthoutcomesthatmayinadvertentlyariseasaresultofdevelopment.
Recommendation 1.2: The Province should develop a method based on a clear set of principles with input from Public Health that will enhance the proposed revenue sharing approach so that an appropriate portion of monies from royalties and other sources will help to offset negative impacts on the social determinants of health
Aportionofroyaltiesandotherrevenuesshouldbeallocatedforinvestmentsdesignedspecificallytoaddressthesocialdeterminantsofhealthinthoselocalareaswithgasdevelopmentandelsewhereintheprovince.Inaddition,upfrontcontributions,potentiallyfundedbyindustry,willberequiredpriortogasdevelopmentsothattheseimprovementsdonotlaguntilasignificantroyaltystreamisestablished.PublicHealthshouldapprovetheprinciplesuponwhichtheseinvestmentdecisionsarebased.
ThisapproachaddsanextradimensiontotherevenuesharingapproachalreadyproposedbytheNewBrunswickNaturalGasGroup(NGG2012c)whichrecommendsreturningaportionofroyaltyrevenuestocommunitiesinthevicinityofnaturalgasdevelopmentandtolandownerswhohostnaturalgasfacilitiesontheirpropertybutwhichdoesnotspeakspecificallytoutilizingrevenuesforimprovementsinhealth.
Insomeotherjurisdictions(e.g.certainU.S.states)mineralrightsareprivatelyheldandtheroyaltiesgodirectlytothemineralrightsowneronly(whomayormaynotalsoownthesurfacerights).Thelandownerswherethegasindustryinfrastructureisphysicallylocatedalsoobtainsomedirecteconomicbenefitfromleasingtheirsurfacerightstothegascompanies,buttherearenodirecteconomicbenefitsfromroyaltiestoanyotherlocalresidentswhoneverthelessshareintherisks(realorperceived)fromhavingtheindustrylocatednearby.Thisisamajorsourceofdisparityandcancreate“winners”and“losers”ineachgasdevelopmentarea.
InNewBrunswicktheCrownholdsallofthesub-surfacemineralrights,whichmeansthatthemajorityofdirecteconomicbenefitsfromroyaltieswillnotgotomineral-rightsspeculatorswhomaynotberesidentinthedevelopmentareas(ashassometimesbeenthecaseinotherjurisdictions).However,astheseroyaltiesaregeneralgovernmentrevenue,thereiscurrentlynorequirementforthesefundstobeappliedtothecommunitieswheretheroyaltiesweregenerated.Intheabsenceofaformulatoreturnanappropriateportionofthesemoniestothelocalcommunities,theProvinceriskshavingasimilardisparityashasbeenseeninsomeUSjurisdictions,withthelocalcommunityas“losers”,butwiththegovernmentbeingthe“winners”inplaceofprivateinterests.
Thetypesofstrategicinvestmentneededandtheappropriateportionsofrevenuewillhavetobedeterminedinsuchawayastomaximizebenefitstothesocialdeterminantsofhealthbothatthelocalandattheprovinciallevels,sothatthereisanoverallhealthbenefittoNewBrunswickaswellastothelocalcommunities.Toensurethatdecisionsarefoundedonpopulationhealthbasedprinciples,PublicHealthexpertisewillneedtobeengaged.
Inaddition,Governmentwillhavetomakesomestrategicinvestmentsbeforesignificantroyaltyrevenuesareobtained.Thiswillensurethatappropriatecapacitytoaddressthesocialdeterminantsofhealthisnotdelayeduntilafterroyaltyrevenuesreachsignificantlevels,assuchadelaycouldcontributetopublicservicecapacitylaggingbehindandbeingoutstrippedbythegrowingneedforit(seecautionsregardingthisissueinRecommendations4.1and5.1).Optionsshouldbeexploredforgeneratingtherequiredupfrontfundingfromindustry.
Health Objectives supported: advocacy, leadership & partnership, provision of information, social determinants of health emphasis
Public Health Values supported:
beneficence & non-maleficence, communitarianism, equity & distributive justice, leadership, prevention, utilitarianism
Part 3: Recommendations for Protection of Public Health 37
Recommendation 1.2: The Province should develop a method based on a clear set of principles with input from Public Health that will enhance the proposed revenue sharing approach so that an appropriate portion of monies from royalties and other sources will help to offset negative impacts on the social determinants of health
Aportionofroyaltiesandotherrevenuesshouldbeallocatedforinvestmentsdesignedspecificallytoaddressthesocialdeterminantsofhealthinthoselocalareaswithgasdevelopmentandelsewhereintheprovince.Inaddition,upfrontcontributions,potentiallyfundedbyindustry,willberequiredpriortogasdevelopmentsothattheseimprovementsdonotlaguntilasignificantroyaltystreamisestablished.PublicHealthshouldapprovetheprinciplesuponwhichtheseinvestmentdecisionsarebased.
ThisapproachaddsanextradimensiontotherevenuesharingapproachalreadyproposedbytheNewBrunswickNaturalGasGroup(NGG2012c)whichrecommendsreturningaportionofroyaltyrevenuestocommunitiesinthevicinityofnaturalgasdevelopmentandtolandownerswhohostnaturalgasfacilitiesontheirpropertybutwhichdoesnotspeakspecificallytoutilizingrevenuesforimprovementsinhealth.
Insomeotherjurisdictions(e.g.certainU.S.states)mineralrightsareprivatelyheldandtheroyaltiesgodirectlytothemineralrightsowneronly(whomayormaynotalsoownthesurfacerights).Thelandownerswherethegasindustryinfrastructureisphysicallylocatedalsoobtainsomedirecteconomicbenefitfromleasingtheirsurfacerightstothegascompanies,buttherearenodirecteconomicbenefitsfromroyaltiestoanyotherlocalresidentswhoneverthelessshareintherisks(realorperceived)fromhavingtheindustrylocatednearby.Thisisamajorsourceofdisparityandcancreate“winners”and“losers”ineachgasdevelopmentarea.
InNewBrunswicktheCrownholdsallofthesub-surfacemineralrights,whichmeansthatthemajorityofdirecteconomicbenefitsfromroyaltieswillnotgotomineral-rightsspeculatorswhomaynotberesidentinthedevelopmentareas(ashassometimesbeenthecaseinotherjurisdictions).However,astheseroyaltiesaregeneralgovernmentrevenue,thereiscurrentlynorequirementforthesefundstobeappliedtothecommunitieswheretheroyaltiesweregenerated.Intheabsenceofaformulatoreturnanappropriateportionofthesemoniestothelocalcommunities,theProvinceriskshavingasimilardisparityashasbeenseeninsomeUSjurisdictions,withthelocalcommunityas“losers”,butwiththegovernmentbeingthe“winners”inplaceofprivateinterests.
Thetypesofstrategicinvestmentneededandtheappropriateportionsofrevenuewillhavetobedeterminedinsuchawayastomaximizebenefitstothesocialdeterminantsofhealthbothatthelocalandattheprovinciallevels,sothatthereisanoverallhealthbenefittoNewBrunswickaswellastothelocalcommunities.Toensurethatdecisionsarefoundedonpopulationhealthbasedprinciples,PublicHealthexpertisewillneedtobeengaged.
Inaddition,Governmentwillhavetomakesomestrategicinvestmentsbeforesignificantroyaltyrevenuesareobtained.Thiswillensurethatappropriatecapacitytoaddressthesocialdeterminantsofhealthisnotdelayeduntilafterroyaltyrevenuesreachsignificantlevels,assuchadelaycouldcontributetopublicservicecapacitylaggingbehindandbeingoutstrippedbythegrowingneedforit(seecautionsregardingthisissueinRecommendations4.1and5.1).Optionsshouldbeexploredforgeneratingtherequiredupfrontfundingfromindustry.
Health Objectives supported: advocacy, leadership & partnership, provision of information, social determinants of health emphasis
Public Health Values supported:
beneficence & non-maleficence, communitarianism, equity & distributive justice, leadership, prevention, utilitarianism Health Objectives supported:
advocacy, leadership & partnership, provision of information, social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, communitarianism, equity & distributive justice,
leadership, prevention, transparency, utilitarianism
38 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Recommendation 1.3: The Province should implement structures and processes to ensure a role for local governments in planning the location of gas industry infrastructure such as roads, well pads, pipelines, compressor stations and water storage and treatment facilities
Providinglocalgovernmentswithsomeofthedecisionmakingpowerinplanningofinfrastructurecouldhelptoprovidecommunityhealthbenefitsbyreducingstressandanxietyamongthepeopleaffectedandimprovelocalinputintogasdevelopments.ThezoningpowerspossessedbydifferenttypesoflocalgovernmentsinNewBrunswickisasignificantchallengetoimplementingthisrecommendation,buttheongoingworkontheAction Plan for a New Local Governance System in New Brunswick(NBDLG2011)isanopportunitytoovercomethislimitation.Conversely,failuretotakeactiononthisissuecouldbeasourceofhealthinequitybetweenNewBrunswickersbasedsolelyonwheretheylive.
Lackoflocalcontroloverthelocationofindustryinfrastructurehasbeenacommonlyheardissueinotherjurisdictions(Jacquet2009).Sincelackofcontroloverdestinyisabroad-basedriskfactorfordisease(Wallerstein1992),thiscanhaveimportantimplicationsforhealthstatus,mentalhealthandsocialwell-beingofcommunities.Involvinglocalgovernmentwouldalsoenableupfrontpreventionandmitigationincludingreinforcementofroads,moreappropriatesitingofwellpads,andenhancementoflocalservices.
Providinglocalgovernmentswithsomeofthedecision-makingpowercouldempowerthelocalcommunitytoparticipateintheprocessandtherebyachievedevelopmentthatismoreacceptabletolocalresidents.Suchempowermentwouldspeaktoself-determination,informedconsent,socialjustice,andalocalvoice,allofwhichcanleadtopositiveoutcomesforsocialwellbeingandmentalhealthofindividuals.
Aparticularchallengetoimplementingthisrecommendationwillbetomakethezoningcapabilitiesoflocalgovernmentsasconsistentaspossibleinordertoensureequitybetweenmunicipalities,ruralcommunitiesandlocalservicedistrictswithrespecttodecisionsthataffectthem.Atpresent,localservicedistrictsinNBdonothavethesamezoningpowersasmunicipalitiesorruralcommunities,andthereisalsosomevariabilitywithincategories(RSNB1973).However,thecurrentworkontheAction Plan for a New Local Governance System in New Brunswick(NBDLG2011)providesanidealopportunitytoaddressthisissue.
Withrespecttoshalegasdevelopment,thisdifferenceinzoningpowersispotentiallyasourceofhealthinequitybetweenNewBrunswickersbasedsimplyonwheretheylive.TheProvinceshouldseekwaystoremovethisinequityasmuchaspossiblesothatRecommendation1.3canbeeffectivelyimplemented.
Recommendation 1.4: The Province should implement structures and processes to ensure a role for Public Health in community planning in order to ensure that the built environment is optimized for the determinants of health
Thebuiltenvironmentisthesumofthehuman-madesurroundingsandthenaturalenvironmentinthecommunitieswherepeoplelive,work,andplay,anditcanhaveaprofoundeffectoncommunityhealth
Health Objectives supported: advocacy, leadership & partnership, provision of information, social determinants of health emphasis
Public Health Values supported:
autonomy, beneficence & non-maleficence, communitarianism, equity & distributive justice, leadership, prevention, transparency, utilitarianism
Part 3: Recommendations for Protection of Public Health 39
outcomes.Asaresult,publichealthneedstobeconsideredaspartofthecommunityplanningprocess.Suchanapproach,andengagementoftrainedexpertise,couldcontributetolongtermeconomicandsocialdevelopmentforNewBrunswickthroughthegrowthofhealthycommunities.
ThePan-CanadianPublicHealthNetworkhasstatedthat “urban planning decisions can advance or hamper health goals”(PCPHN2009).Similarly,theWorldHealthOrganizationhasstatedthat“communities and neighbourhoods that ensure access to basic goods, that are socially cohesive, that are designed to promote good physical and psychological well-being and that are protective of the natural environment are essential for health equity”(WHO2008).Essentially,thisdescribesacommunitywherethebuiltenvironmenthasbeenconstructedwiththedeterminantsofhealthinmind.
However,otherjurisdictionswhereshalegasdevelopmenthasproceededrapidlymaynothavehadthebenefitofgrowththroughappropriatebuiltenvironments.Forexample,FortNelson’sBC’spopulationofabout5,000swellsseasonallytoasmuchas15,000(Meddundated)andduringpeakperiodsofactivitymorepeopleresidein“mancamps”thaninthetownitself(Badenhorst2012).Themancampresidentshavelessofastakeinthecommunitythantheywouldiftheyweretobecomeresidents,butrelyingonabuiltenvironmentbasedontemporaryhousingdoesnotencouragethis.Unrestrainedandpoorlyplannedcommunitygrowthcanleadtolossofsocialcohesion,inadequatehousingandalloftheothersocialillstypicaloftheBoomtownEffect.
Incontrast,afocusoncommunityplanningwiththedeterminantsofhealthinmindcanleadtoagrowingcommunitythatisamoredesirableplacetolive,whichcouldencouragesettlementratherthantemporaryaccommodation.InNewBrunswick,suchanapproachcouldleadtohealthiercommunitiesandcontributetolongtermeconomicandsocialdevelopmentfortheprovince.RealizingsuchbenefitsisoneofthereasonswhytheWorldHealthOrganizationrecommends“[placing] health and health equity at the heart of urban governance and planning”(WHO2008).
Recommendation 1.5: The Province should undertake a transparent and consultative process with representative members and sectors of the public and stakeholders on the implementation process for these recommendations in order to achieve better health outcomes
TheCMOHbelievesthatitisofthehighestimportancethatthePublicarefullyinformedofallidentifiedpotentialrisksandbenefitsrelatedtoshalegasdevelopmentandthattheimplementationprocessisasinclusiveandtransparentaspossibleinordertomaximizebenefitstothesocialdeterminantsofhealth.
Ithasbeennotedelsewherethatapublicperceptioncanremainthatengagementandeducationonshalegasissueswereinsufficientevenwhengovernmentshaveundertakenpublicconsultations(Meddundated).Researchhasalsoshownthatpublictrustingovernmentsregardingshalegasissuesisnotnearlyashighasforotheractorssuchasscientistsandeducation-basedsources,andtrustintheindustryisevenlower(Brasier2011).Thisresearchalsoindicatedthatdespitecommunicationeffortsthereisstillaneedforevenmoreinformationontheprocessesandimpactsofgasdevelopment,ideallyfromthesourcesthatthePublicperceivestobethemostcredible,andthat“moreeducationcanprovideaneutralspacefordialogandlearning”(Stedman2011).
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, communitarianism, equity & distributive justice,
leadership, prevention, transparency, utilitarianism
40 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Publicconsultationandparticipationinthedecision-makingandplanningprocessbeyondsimplyreceivinginformationprovidedbygovernmentorotherpartieshelpstorespectpublichealthvaluesandprinciplessuchasautonomy,communitarianism,reciprocity,andtransparency.Furthermore,thiswoulddemonstrateadesireforcollaborationwithandarespectforthePublic,whichareimportantfactorsinbuildingtrust.Forthesereasons,theCMOHproposestomaketheprocessofimplementingtheserecommendationsthesubjectofapublicconsultationprocess.
TheProvinceofNewBrunswickhasalreadyundertakenaseriesofpublicinformationsessionsdesignedtohelpinformresidentslivinginpotentialdevelopmentareas,andhaslaunchedawebsite(www.gnb.ca/naturalgas)withextensiveinformation.InMay2012,aseriesofpublicconsultationsonspecificrecommendationspreparedbytheNewBrunswickNaturalGasGroup(NBNGG2012a-e)wasalsoannounced.ConsultationwiththepublicandkeystakeholdersonimplementationoftheCMOH’srecommendationswouldbuildupontheeffortsmadetodateandsofurtherstrengthentheGovernment’scommitmenttoopennessandtransparency.
2. Protection of Health Related to Changes in Both the Social and Physical EnvironmentsRecommendation 2.1: The Province should implement a requirement for submitting a health impact assessment (HIA), prepared according to the specifications of Department of Health (DH), as part of the standard Project Registration process managed by Department of Environment and Local Government (DELG)
HIAareseldomrequiredaspartofenvironmentalassessmentsbyanyjurisdiction,despiteprovidingafocusonhumanhealthoutcomesthatmightnototherwisebeexamined.TheProvinceshouldimplementamandatoryrequirementforsubmittinganHIAthatincludesassessmentofshortterm,cumulativeandlong-termhealthimpactstothegeneralpublicandanyvulnerablepopulationsforeachshalegasprojectregisteredundertheDELGprojectregistrationprocess.Thiswouldincreasethebreadthofprotectionbyspecificallyfocusingonidentification,preventionandmitigationofhealthimpactsassociatedwithgasdevelopment.
AtpresenttheenvironmentalprojectassessmentprocessincludesDepartmentofHealth(DH)asaTechnicalReviewCommitteemember,butdoesnothaveamandatoryrequirementforHumanHealthRiskAssessment(HHRA)orHealthImpactAssessment(HIA),althoughthesecanberequiredforaparticularprojectifrequestedbyDH.
HHRAsandHIAsdifferinseveralrespects:HHRAsareexpert-driven,quantitative,haveanarrowfocusonhowparticularcontaminantsaffectphysicalhealth,anddonotconsidersocioeconomicstatusorothersocialorhealthissues.Incontrast,HIAsarestakeholderdriven,qualitative,haveabroadfocusonmultipledeterminantsofhealth,andexaminethedistributionofhealthrisksacrossapopulation(TorontoPublicHealth,2010).Giventhesedifferencesandthebroadspectrumofpotentialhealthimpactsnotedthroughoutthisdocument,HIAisthepreferredmethodologyforgeneralapplication.
ThegenerallackofHIAaspartofenvironmentalassessmentshasbeennotedelsewhere.InareviewoftheenvironmentalandhealthimpactsofCanada’soilsandsindustry,theRoyalSocietyofCanada
Health Objectives supported: advocacy, leadership & partnership, provision of information, social determinants of health emphasis
Public Health Values supported:
autonomy, communitarianism, reciprocity, transparency, utilitarianism
Part 3: Recommendations for Protection of Public Health 41
concludedthattheenvironmentalimpactassessment(EIA)processusedbytheProvinceofAlbertaandinsomecasesbytheCanadianEnvironmentalAssessmentAgencywas“seriously deficient in formal Health Impact Assessment (HIA) and quantitative socioeconomic impact assessment (SEIA)” (RoyalSocietyofCanada2010).
AspartofanimprovedapproachtoDHreviewofallindustrialprojects,arequirementforconductinganHIAshouldalsobeextendedtoindustrialprojectsinothersectorsaswell(scopetobedefined).DHshoulddesignatemplatefortherequirementsofthesesubmissionstoensureconsistencyandcomprehensivenesswithrespecttoenvironmentalexposuresandtheothertypesofpotentialhealththreatsidentifiedinPart2Section2b.Furthermore,itmaybepossibletodesignsuchatemplateincollaborationwithotherFederal/Provincial/TerritorialpartnersacrossCanadatoensureacoordinatednationalapproach.
Finally,inthesamewaythatDELGhastheabilitytorequireafullEnvironmentalImpactAssessmentwhenwarranted,DHshouldcontinuetobeabletorequireamoredetailedHIAoraquantitativeHHRAifdeemednecessaryforaparticularproject.
Recommendation 2.2: The Province should develop and implement a protocol for monitoring the health status of persons living, working, attending school or playing in proximity to the industry
Therehasbeenagenerallackoftargetedstudiesofpopulationhealthstatuspriorto,duringorpost-developmentoftheshalegasindustry(Schmidt2011)andthishascontributedtouncertaintyaboutwhethermeasurestoprotecthealthareeffective.NewBrunswickshoulddevelopandimplementsuchamonitoringsystempriortoanysignificantexpansionoftheindustryinordertocapturethepre-developmentstatusandtodetectanychangesinhealthstatusgoingforward.
Recommendationsinotherjurisdictions(PAGovernor’sCommission2011;PACitizen’sCommission2011)havecalledfora“population-basedhealthregistry”asakeyfactorinassessingwhetherenvironmentalandhealthprotectionmeasuresareeffective.Designofsuchahealthregistrycouldincludeavarietyofhealthstatusindicators(emergencyroomvisits,admissionanddischargerecords,callsto811NBTele-Care/Télé-Soins,etc.)andshouldasmuchaspossiblebuilduponexistingsourcesofdata.ThepowerofsuchasystemwouldbeincreasedbyalsoimplementingRecommendation2.3,whichwouldpermitmorein-depthanalysisoftrendsandrootcauses.
Suchasystemneedstobeclear,measurableandtimelysothatitcanbeusedfordecisionmakinganditshouldbringthesamelevelofscrutinytothisareaascurrentlyexistsfore.g.communicablediseaseoutcomes.
Implementationofthisrecommendationmustbedonepriortoanysignificantexpansionoftheindustrytocapturethepre-developmentstatusandimplementaprospectivestudydesignasdiscussedinPart2,Section3a2).
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
42 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Recommendation 2.3: The Province should develop and implement methods to link health status information to environmental monitoring data and socioeconomic status data
Tomaximizetheeffectivenessofahealthstatusmonitoringsystem(Recommendation2.2)theProvinceshouldalsodevelopandimplementmethodstolinkhealthdatatoenvironmentalandsocioeconomicdata.Thiswouldprovidepowerfulanalyticalcapabilitytoinvestigatecause-and-effectrelationshipsforanyhealthstatuschangesnoted(bothpositiveandnegative).
Furthermore,itislikelythattherewillbecasesofdiseaseclustersinfuture,whethercausallyrelatedornot(Goldstein2011).Havinganinformationsystemthattracksbothhealthstatusandenvironmentalstatuswouldbeveryvaluableininvestigatinganysuchissuesthatmightoccurinordertoseewhetherornotenvironmentalfactorsmaybecontributingtotheeffect.Inaddition,addingthesocioeconomicdimensionwouldallowamorecompleteanalysiswithrespecttoallofthedeterminantsofhealth.
Althoughtheremaybemanychallengesintermsofdevelopingkeymeasuresandindicators,linkingdatabasesacrossseveralpartneragencies,andtheneedforobtainingdatabefore,duringandafterdevelopment,workshouldbestartedimmediatelyandconcurrentlywithdevelopingthesystemdescribedinRecommendation2.2.Becauseofthescaleoftheproblemandthetimeframethismaybebestapproachedasapilotprojectinaparticulararea,witheventualextensiontoallareasoftheProvince.
3. Protection of Health Related to Changes in the Physical EnvironmentRecommendation 3.1: The Province should put in place monitoring networks for ambient air and water quality, as well as drinking water quality in the local areas expected to have an industry presence, in advance of industry development and continuing throughout the lifetime of development, production and post-production
Implementationofmonitoringnetworksforairandwaterquality(includingdrinkingwaterquality)isessentialforensuringthatenvironmentalprotectionmeasuresareadequateandthathumanhealthisprotected.Monitoringmustbeinplacepriortosignificantdevelopmentinordertocapture
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based,
leadership, precautionary principle, prevention, transparency, utilitarianism
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
healthy work environment, social determinants of health emphasis
Public Health Values supported: beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based,
leadership, precautionary principle, prevention, transparency, utilitarianism
Part 3: Recommendations for Protection of Public Health 43
thebaselinestatusforcomparisonoffutureresults.Monitoringmustalsobeongoingandcontinuethroughoutthelifetimeoftheindustryandbeyondbecausetheremaybealongtimebetweencontaminantreleaseandimpacttoareceptor(suchasadrinkingwaterwell).
Lackofbaselinedataavailabilitypriortoindustrydevelopmenthasbeencitedbymanysourcesasalimitingfactorinassessingthesuccessorfailureofenvironmentalprotectionmeasures.
Furthermore,monitoringeffortsshouldbeongoingandnotberestrictedtoonly“before”and“after”snapshots,becauseifimpactsdooccurtheywouldtypicallynotbeevenlydistributedintimeorlocation,andsorelyingononeortwodiscretesamplingeventscouldoverlookimpactsandleadtooverconfidenceintheenvironmentalquality.
Tobesuccessful,thiseffortwouldhavetobemulti-facetedandincludemonitoringofe.g.surfacewaterwatersheds,thegroundwatertable,privatedrinkingwaterwells,andpublicwatersupplies.Furthermore,theProvincewouldneedtoensurethatsufficientdata(i.e.frequency,durationandlocations)areavailableonenvironmentalcontaminantsandenvironmentalqualitytopermitanalysisofwhethercontrolmeasuresareworking.Monitoringthroughoutthelifespanoftheindustryandbeyondisessentialbecausemanyenvironmentalcontaminantscancauseimpactsalongtimeafterrelease(forexample,groundwatercontaminantsthatmaytakealongtimetotravelfromthereleaselocationtoadrinking-waterwell).
Inaddition,airqualitymonitoringprogramsshouldconsidernotonlylocalairqualityimpactsbutalsothepotentialforregionalairqualityeffectsdueto,e.g.ozoneandNOx.
Recommendation 3.2: The Province should put in place special provisions for wastewater handling, testing, transportation, treatment and disposal
Wastewaterhandlingisacriticalcontrolpointintheprotectionofpublichealthwithrespecttohydraulicfracturingactivities.Specialtreatmentanddisposalprocesseswillbeneededbecausethepotentialcontaminantsaredifferentfromthoseinotherindustrialormunicipalwastewaters.
UndertheproposedstandardsintheResponsible Environmental Management of Oil and Gas Activities in New Brunswickdiscussiondocuments(NBNGG2012a-b),considerableeffortwillbespentoncontainmentinthegeologicalformation(greatdepth+microseismicmonitoringtoverifycontainment)andinthewellbore(casingstandardsandtesting).Consequently,handlingoftheflowbackandproducedwateronceitreachesthesurfaceisoneofthemostlikelysourcesofexposure:ifacontaminationepisode,spillorleakweretooccuritcouldleadtoexposureofthepopulationtoenvironmentalcontaminants.
Salts,hydrocarbons(includinggases,volatiles,semi-volatilesandheavierhydrocarbons),heavymetals,radioisotopesandfrackingadditivesareallpotentialcontaminantsthatcanmakethiswastequitedifferentfromotherindustrialwastes.Inaddition,typicalwastewatertreatmentplants(suchasmunicipaltreatmentplants)arenotoptimizedforremovingthesecontaminants,whichmaybeinadvertentlydischargedinthetreatedwaterasaresult.Treatmentplantsludgedisposalmightbeproblematicalsoduetothepotentialpresenceofthesecontaminantsinsediments.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
healthy work environment
Public Health Values supported: beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based,
leadership, precautionary principle, prevention, transparency, utilitarianism
44 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Thepotentialcontaminantsinthesewastesaresufficientlydifferentfromthoseinotherindustrialormunicipalwastewaterstowarrantspecialconsideration.Undernocircumstancesshouldthewastewaterbetreatedbyafacilitythatisnotspecificallydesignedforthetypesofcontaminantsexpected(e.g.municipalwastewatertreatmentplantsshouldneverbeusedtotreatflowbackorproducedwater).Furthermore,landapplicationofsludgefromthiswasteshouldnotbehandledinthesamewayasconventionalwastes.
Theappropriateprovisionswillneedtobedefined,butcouldincludeaspectssuchasenhancedwastecharacterizationrequirementsandspecialmonitoringprovisionsfordesignatedwastehandlingfacilitiesthatusespecializedtreatmentprocesses.
Recommendation 3.3: The Province should require full and timely disclosure of all chemical compounds (rather than products or compound classes) which must include their identities, concentrations and quantities
Thisrecommendationisintendedtoprovidegreatercertaintyastothelevelofchemicaldisclosureneededtoevaluatepotentialhealthrisks.Properriskassessmentrequiresfullknowledgeofthespecificidentitiesofallchemicalcompounds,theirconcentrations,theamountsused,andtheirtoxicologicalcharacteristics.Suchdisclosurewillalsoensurethatthemostappropriatemonitoringparametersareusedforairandwaterqualitymonitoring(Recommendation3.1).
TheProvincehasalreadyannounced(GNB2011)thattherewillbearequirementforfulldisclosureofchemicalsusedinhydraulicfracturing.Thisshouldbeenhancedsothatidentificationofchemicalsisappropriateforconductinghumanhealthandenvironmentalriskassessmentsandmonitoringbyappropriateauthoritiesasrequired.Informationneedstobemadeavailableonatimelybasistoenableproperpatientevaluation.Furthermore,therequirementfordisclosureshouldextendtoallchemicalsusedbytheindustry,notjustthosethatareusedasingredientsinhydraulicfracturingfluids.Responsibilityfordevelopmentofthespecificdisclosurerequirementsframeworkcouldbeassignedtotheimplementationgroup(seeRecommendation5.2).
AsnotedinPart2,Section3a4),therearemanychallengesinassessingthechemicaltoxicityofproductsusedbytheindustry,inmanycasesbecauseoflackofclarityiningredientinformationevenwhenitisdisclosed.Toavoidthis,theProvinceshouldrequiredisclosureofallspecificchemicalcompoundsandtheirquantitiessothatinformationonspecificenvironmentalfates,transportcharacteristicsandtoxicologicalprofilescanbegatheredaspartofaproperriskassessment.
Furthermore,chemicalingredientinformationneedstobeavailableinatimelyfashion,withappropriateleadtimesfore.g.EIAreviews.Finally,asmuchinformationaspossibleshouldbereleasedpubliclytoincreasepublicconfidenceintheoversightprocess.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
healthy work environment
Public Health Values supported: beneficence & non-maleficence, burden of proof, communitarianism,
evidence-based, leadership, precautionary principle, prevention, transparency
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
healthy work environment
Public Health Values supported: beneficence & non-maleficence, burden of proof, communitarianism, evidence-based, leadership,
precautionary principle, prevention, proportionality, transparency
Part 3: Recommendations for Protection of Public Health 45
Thepotentialcontaminantsinthesewastesaresufficientlydifferentfromthoseinotherindustrialormunicipalwastewaterstowarrantspecialconsideration.Undernocircumstancesshouldthewastewaterbetreatedbyafacilitythatisnotspecificallydesignedforthetypesofcontaminantsexpected(e.g.municipalwastewatertreatmentplantsshouldneverbeusedtotreatflowbackorproducedwater).Furthermore,landapplicationofsludgefromthiswasteshouldnotbehandledinthesamewayasconventionalwastes.
Theappropriateprovisionswillneedtobedefined,butcouldincludeaspectssuchasenhancedwastecharacterizationrequirementsandspecialmonitoringprovisionsfordesignatedwastehandlingfacilitiesthatusespecializedtreatmentprocesses.
Recommendation 3.3: The Province should require full and timely disclosure of all chemical compounds (rather than products or compound classes) which must include their identities, concentrations and quantities
Thisrecommendationisintendedtoprovidegreatercertaintyastothelevelofchemicaldisclosureneededtoevaluatepotentialhealthrisks.Properriskassessmentrequiresfullknowledgeofthespecificidentitiesofallchemicalcompounds,theirconcentrations,theamountsused,andtheirtoxicologicalcharacteristics.Suchdisclosurewillalsoensurethatthemostappropriatemonitoringparametersareusedforairandwaterqualitymonitoring(Recommendation3.1).
TheProvincehasalreadyannounced(GNB2011)thattherewillbearequirementforfulldisclosureofchemicalsusedinhydraulicfracturing.Thisshouldbeenhancedsothatidentificationofchemicalsisappropriateforconductinghumanhealthandenvironmentalriskassessmentsandmonitoringbyappropriateauthoritiesasrequired.Informationneedstobemadeavailableonatimelybasistoenableproperpatientevaluation.Furthermore,therequirementfordisclosureshouldextendtoallchemicalsusedbytheindustry,notjustthosethatareusedasingredientsinhydraulicfracturingfluids.Responsibilityfordevelopmentofthespecificdisclosurerequirementsframeworkcouldbeassignedtotheimplementationgroup(seeRecommendation5.2).
AsnotedinPart2,Section3a4),therearemanychallengesinassessingthechemicaltoxicityofproductsusedbytheindustry,inmanycasesbecauseoflackofclarityiningredientinformationevenwhenitisdisclosed.Toavoidthis,theProvinceshouldrequiredisclosureofallspecificchemicalcompoundsandtheirquantitiessothatinformationonspecificenvironmentalfates,transportcharacteristicsandtoxicologicalprofilescanbegatheredaspartofaproperriskassessment.
Furthermore,chemicalingredientinformationneedstobeavailableinatimelyfashion,withappropriateleadtimesfore.g.EIAreviews.Finally,asmuchinformationaspossibleshouldbereleasedpubliclytoincreasepublicconfidenceintheoversightprocess.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
healthy work environment
Public Health Values supported: beneficence & non-maleficence, burden of proof, communitarianism,
evidence-based, leadership, precautionary principle, prevention, transparency
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
healthy work environment
Public Health Values supported: beneficence & non-maleficence, burden of proof, communitarianism, evidence-based, leadership,
precautionary principle, prevention, proportionality, transparency
Recommendation 3.4: The Province should require that all hydraulic fracturing fluids contain additives that are the least toxic of any alternatives available
Intheinterestoffocusingonprevention,theProvinceshouldrequirethathydraulicfracturingfluidsareofaslowtoxicityaspossiblebasedoncurrentlyavailableinformation.Thiswouldaddanadditionalsafeguardtothemanylayersofengineeredcontainmentofhydraulicfracturingfluidsandflowback/producedwastewaterasproposedbytheNaturalGasGroup(NBNGG2012a-b),sothatintheeventofafailureofcontainmenttheimpactwouldbealowaspossible.
Implementationofthisrecommendationwillrequiredevelopmentofastandardizedapproachforassessingthetoxicpotentialofhydraulicfracturingfluids.Thisisnecessarybecausetheassessmentoftoxicityiscomplex:itdependsuponthenatureofthepossibletoxicants,theirconcentrationsandoverallamounts,theirenvironmentalfateandtransportcharacteristicsintheeventofaspill,theexistenceofanexposureroute,andthedurationofexposure.
Thecurrentstateofsciencerelatedtoaparticularchemicalcompound’senvironmentalfateandbioavailabilityintheeventofanexposurealsoinfluencestheassessmentoftoxicityrisk,andpastassessmentsmaychangeasnewinformationbecomesavailable.Furthermore,toxicitycanresultfrombothdirecthumanexposureandtoxicitytotheenvironmentthatcouldleadindirectlytotoxiceffectsinhumans.Allofthesefactorswillneedtobetakenintoaccountinthedevelopmentoftheapproachto
beused.
Recommendation 3.5: The Province should develop and implement reasonable, safe setback distances approved by Public Health that consider human health and which are based on exposure risk assessments in addition to established precedents
Thestateofknowledgeastowhatconstitutesappropriatesetbackdistancescontinuestoevolve,andmanyjurisdictionshavemandatedspecificsetbackdistancesonlytohavetoincreasethematalaterdateoncenewinformationbecameavailable.NewBrunswickshoulddevelopsetbackdistancesbasedonminimizingimpactstothedeterminantsofhealthinadditiontousingprecedentsfromotherjurisdictionssothatthesesetbackscanbedemonstratedasbeingreasonableandsafe.
Health Objectives supported: provision of information, prevention of public health hazards, healthy work environment
Public Health Values supported:
beneficence & non-maleficence, burden of proof, communitarianism, evidence-based, precautionary principle, prevention, transparency
46 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Therequiredsetbackdistancesbetweennaturalgasdevelopmentsandnearbypopulationvarygreatlybetweenjurisdictions.TherecommendedsetbacksintheResponsible Environmental Management of Oil and Gas Activities in New Brunswickdiscussiondocuments(NBNGG2012a-b)arebaseduponthemoststringentofthesethatarecurrentlyinuseelsewhere.
However,otherjurisdictionssuchasColoradoandPennsylvaniahaveincreasedtheirrequiredsetbacksovertimeasnewinformationemerged.Inordertoincreaseconfidenceandreducethepossibilityofrepeatedlychangingsetbacksinfuture,thisRecommendationproposesbuildingonthecurrentapproachbyconductingexposureriskassessmentstopossiblechemicalspills,airpollution,noise,illuminationandotherfactors,andalsobyaskingthepublicabouttheirattitudestowardacceptability.Thisapproachmaysimplyvalidatethatthecurrentproposedsetbacksareprotective,oritmayindicatethatadditionalprotectionisrequired:eitherway,conductingthisworkintheNewBrunswickcontextandwithafocusonthedeterminantsofhealthwouldaddtothelevelofcertainty.
Recommendation 3.6: The Province should develop and implement standards approved by Public Health to limit health impacts from noise, vibration and continuous illumination
Noise,vibrationandcontinuousilluminationareknowntobeissuesaffectinghealthandqualityoflifeforresidentsneartogaswelldevelopmentsites(ColoradoSchoolofPublicHealth2011;INSPQ2011).InordertoaddresstheseissuesinNewBrunswick,thisRecommendationbuildsupontheNaturalGasGroupproposalregardingnoiselevels(NBNGG2012a-b)byextensiontotheseotherpotentialhealthhazards.Developmentofstandardsforthesefactorscouldbeconductedaspartoftheworktowarddevelopingsetbackdistancesbasedonexposureriskassessments(Recommendation3.5).
Impactsduetonoise,vibrationandcontinuousilluminationcanarisefromactivitiessuchasgeneraltrucktraffic,wellpadconstruction,welldrilling,siteoperations,flaringandgascompressors.
Becausethesetypesofimpactscanariseindifferenttimeframes(e.g.duringdifferentphasesofwelldevelopmentandsubsequentdevelopmentofothernearbywellpads)andpotentiallyfrommanysitesneartoareceptor,astrategicapproachtopreventingandmitigatingtheseeffectsisneededratherthanaddressingthemoneatatime.Thisshouldbeundertakenpriortoinitialdevelopmentandshouldaddresseffectsthatcouldoccurthroughoutcumulativedevelopmentofmultiplewellpadsinagivenareaoverthelongterm.
TheapproachtoaddressingtheseconsiderationscouldbuildupontheproposalsintheResponsible Environmental Management of Oil and Gas Activities in New Brunswickdiscussiondocuments(NBNGG2012a-b)regardingnoiselevels,withextensiontootherpotentialhealthhazardsincludingvibrationandillumination.Thisworkcouldalsobeconductedaspartoftheworktowarddevelopingsetbackdistancesbasedonexposureriskassessments(Recommendation3.5).
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards
Public Health Values supported:
beneficence and non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, transparency, utilitarianism
Part 3: Recommendations for Protection of Public Health 47
Recommendation 3.7: The Province should require site-specific traffic management plans for all projects, including route plans and designated times of day for heavy truck movements
Adramaticincreaseinheavytrucktrafficonsmallruralroadsthatwerenotnecessarilydesignedforsuchtrafficisoneoftheconsistentlyrepeatedissuesfoundinotherjurisdictions(seePart2Section2c).Thisadditionaltrafficcanleadtoariseinairpollution,damagetoroadinfrastructure,increasedriskoftrafficaccidents,andhazardousmaterialsspills.Trafficcanalsocontributetoadditionalnoiseandvibration(seeRecommendation3.6)sopublichealthcouldbeadverselyaffectedinmanywaysunlesssuitableprecautionsaretaken.
Thehighvolumeoftrucktrafficatcertainstagesofgaswelldevelopmentcanbeincompatiblewithotherusesfortheseroads.However,carefulplanningofroutesandtimingoftruckmovementscanhelptomitigatetheriskoftrafficaccidents(forexample,bysimplemeasuressuchasnotpermittingtruckmovementsatthesametimesofdayasschoolbustrips).
Acomprehensivetrafficmanagementplanthatensuresthatthemostsuitableroutesareused,reducespeaktrucktrafficintensityandminimizesrisktootherroadusersshouldberequiredforeveryworksite.Inaddition,monitoringofmotorvehicleinjuries(seeRecommendation2.2)couldbeusedasaspecificindicatoroftheimpact(bothpositiveandnegative)ontrafficsafety.
Recommendation 3.8: The Province should enhance local and provincial emergency response training, capacity and preparedness to respond to the most likely and most serious emergencies that might pose a threat to human health
Shalegasdevelopmentstypicallyconsistofmanyindustrialsitesspreadoverawidearea,soproperemergencyresponseisachallenge.Particularchallengestoovercomeincludeensuringthatsufficientemergencyresponsestaffcapacityexistsnearby,thatthesestaffareappropriatelytrained,thatworksitescanbefoundeasilyintheeventofanemergency,thateffortsarecoordinatedamongmanyagenciesandthatemergencyplansaretestedtoensurethattheywillworkasdesignedwhenneeded.
TheProvinceshouldverifythatsufficientemergencyresponsecapacityexistsinthelocalareasneargaswelldevelopmentsandaugmentstaffcapacityinanyareasthatarelacking.Inaddition,theProvinceshouldprovideappropriatedetailedtrainingtohazmatworkers,volunteerandprofessionalfirefighters,
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards
Public Health Values supported:
beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
Health Objectives supported: advocacy, leadership & partnership, provision of information,
prevention of public health hazards, healthy work environment
Public Health Values supported: beneficence and non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based,
leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
48 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
DepartmentofEnvironmentandLocalGovernmentinspectors,WorkSafeNBstaff,hospitalemergencyroomstaff,andothersasneeded,toensurethattheyhavetheknowledgeofindustrypracticesrequiredtosafelyandquicklyrespondtoanyemergencies.TheProvinceshouldputinplacemechanismsandresourcestoensurethattheplanning,responseandrecoveryactionsandplansofthemanydifferentagenciesareoptimalintermsofstandards,integration,coordination,andgovernance.
Furthermore,theProvinceshouldconsidermandatory911addressingofallworksites,aswellasdevelopmentandmandatorytestingofemergencyplans,asithasbeennotedinotherjurisdictionsthatimplementationofemergencyresponseplanshasoftenbeenunsuccessfulduetothemanylogisticalhurdlestobeovercome.Forexample,thereisauniquechallengeinthat,unlikemostindustries,therearemanyindustrialsitesspreadoverawidearea,andresponsibilityforresponsemaybefragmented.
Finally,notethatthesepreparationsalsoneedtoconsiderthelongertermresponseandrecovery.
Recommendation 3.9: The Province should enhance the mechanisms that are in place to promote and protect the health of workers in the industry and others who may be at the work sites (government inspectors, support industry workers, emergency responders, etc.)
Protectingandpromotingthehealthofindustryworkersandotherswhomaybeworkingattheworksitesisanimportantcomponentofoverallpublichealthprotectionandpromotion,butachievingthiswillrequirespecialefforts.Forexample,trackinginjuriesandaccidentsmaybedifficultamongtransientworkers,anditmayalsobedifficulttodeliverhealthpromotionandinjurypreventionprogramstothemduetotheircontinualrotationinandoutofthelocalarea.Carefuloversightofsafetypracticesandongoingprovisionoftargetedtrainingwillbeneededtoensuresafeworksitesandahealthyworkforce.
Experienceinotherjurisdictionshasshownthatsafetypracticesarenotalwaysconsistentwithbestpractices(Werntz2011)andthatsomecompaniesarefarbetterthanotherswithrespecttopreventingenvironmentalviolations(Goldstein2011),whichcanbeinferredtobeanindicatorofhowresponsibletheiroperationsareoverall.Asaresult,carefulgovernmentoversightofsafetypracticesandprovisionoftargetedtrainingwillbenecessarytoensureasafeworkenvironmentforallworkersinthisindustry.Inparticular,WorkSafeNBmayneedadditionalresourcestoproperlyoverseethisindustry.
Inaddition,overcomingtheselimitationswillrequirefurtherenhancementstoexistingprogramssuchaspublichealthpromotionactivitiesinordertoeffectivelyreachallworkersinvolveddirectlyorindirectlywiththeindustry.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
healthy work environment
Public Health Values supported: beneficence & non-maleficence, burden of proof, evidence-based, leadership, precautionary principle,
prevention, proportionality
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
public health emergency preparedness, healthy work environment
Public Health Values supported: beneficence & non-maleficence, evidence-based, leadership,
precautionary principle, prevention, proportionality
Part 3: Recommendations for Protection of Public Health 49
4. Protection of Future GenerationsRecommendation 4.1: The Province should develop a plan for anticipating and mitigating the “Boomtown Effect”
ThehighlynegativehealthandsocialconsequencesoftheBoomtownEffecthavethepotentialtospoilthebenefitsofeconomicgainsunlesstheProvinceispreparedandreadytoheadofftheseproblemsbeforetheyoccur.ForNewBrunswicktorealizethefullbenefitsofeconomicgrowththatmayresultfromexpansionoftheshalegasindustry,itisessentialfortheProvincetomitigatetheappearanceofthiseffect.Furthermore,theProvinceneedstobepreparedforthe“bust”phasethatinevitablyfollowsanyboom(ofteninrepeatingboom/bustcycles).
Althoughtheword“Boomtown”mayseemverypositive,the“BoomtownEffect”referstoaseriesofpotentialnegativeoutcomesonindividualandcommunitywellbeingthatcanresultfollowingasuddenanddramaticincreaseinindustrialactivityandthelargeinfluxofpeoplethatcomeswithit.AsnotedinPart2,Section2e,theBoomtownEffectisacommonresultofenergydevelopmentsincaseswheretherateofdevelopmentoutstripsthecapacityofthelocalcommunitytoabsorbthegrowth.
Boomtownthreatssuchasincreasesinsexually-transmittedinfections(STIs),drugabuse,crime,familyviolenceandprostitutionareveryrealthreatsunlesspreventativeactionsaretaken.Inaddition,poorhealthoftransientworkers,displacementoflocalpeopleduetorisinghousingcostsandtemporarycommunitieswithpoorlivingconditions(“mancamps”)cancompoundthemisery.Finally,lossofpublicsectorworkerstotheindustryanddemandsfornewinfrastructurethatcontinuallyoutstripcapacitycanweakenGovernment’sabilitytodosomethingabouttheseproblems.Takentogether,thesenegativeconsequencesoftheBoomtownEffecthavethepotentialtospoilthebenefitsofeconomicgainsunlesstheProvinceispreparedandreadytoheadofftheseproblemsbeforetheyoccurthroughstrategicinvestmentsincommunitycapacity.
Inaddition,inthelongtermtheProvincealsoneedstobepreparedforthe“bust”thatwillinevitablyfollowanyboom(ofteninrepeatingboom/bustcycles).Incaseswherethishasoccurredinthepast,effectshavebeenseensuchasnewinfrastructurethatisnolongerneeded,economicdepression,out-migrationofworkers,andover-capacityofhousing,retailservicesandgovernmentservices(Jacquet2009).Assuch,boom/bustcyclesarea“Catch-22”,asmanyofthethingsthatarelackingintheboomphasearethesamethingsthatareinoversupplyintheeventofadownturn,whichpresentssignificantdifficultiesforproperplanning.Ideally,diversifyingthelocaleconomywhentimesaregoodcouldhelptomitigatethebustphases,butthisisnoteasilyaccomplished.
Accordingly,theProvincewillhavetoimplementspecificandtargetedactionsindealingwiththeabovepotentialnegativeoutcomesinadvanceofdevelopmentandthroughoutthelifetimeoftheindustryinordertorealizerealsocioeconomicandhealthstatusbenefitsforNewBrunswickersalongwiththeeconomicgains.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards, communicable
disease prevention and control, social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, communitarianism, equity & distributive justice, evidence-based, leader-
ship, precautionary principle, prevention, transparency, utilitarianism
50 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Recommendation 4.2: The Province should undertake a Strategic Health Impact Assessment (Strategic HIA) to estimate the long-term cumulative health and social benefits and costs
Recommendation2.1proposesundertakingsite-specificHIAasameansofprioritizingrisksthatwillrequiremanagementforindividualprojects,buttheintentofthisrecommendationistocarryoutamoreglobally-focussedassessmentacrossthefullextentofindustrydevelopmentinNewBrunswick.Assuch,astrategicHIAwouldincludedevelopmentscenarioscoveringtheentirelifespanoftheindustryacrossallpotentiallocationstobedevelopedinNB.
Sincethetotalextentofdevelopmentisunknowninadvance,thisapproachwillofnecessitydependonvariousscenarios(e.g.low,medium,highdevelopment)inordertoforecastpossibleoutcomes.Thesemodelswillhelptoinformthenature,extent,andtimingofstrategicinterventionsthattheProvincewillneedtomakeinordertoappropriatelymanagethegrowthinsuchawayastooptimizebenefitsforandreducerisktohealthandsociety.
Thereareonlyafewexamplestodateofhealthimpactassessmentscarriedoutinotherjurisdictions,suchastheBattlementMesaHIA(ColoradoSchoolofPublicHealth2011)andtheseingeneralhavebeensite-specific.However,otherjurisdictionsareundertakingorhaveproposedstrategicenvironmentalimpactassessments(NewYorkDEC2011;BAPE2011a;Québec2011)orfulllifecycleanalysisofcostsandbenefitstosociety(EuropeanParliament2011),anddevelopmentsintheseprojectswillhelptoinformastrategicHIAforNewBrunswick.
Recommendation 4.3: The Province should designate areas that are to be excluded from development, including drinking watersheds and wellfields, sensitive natural areas, specified agricultural lands, and other areas of special significance (scope to be defined)
Thisrecommendationproposesapreventionstrategytoavoidcommonsituationsthatcouldotherwiseleadtohumanexposureroutesintheeventofaccidents,spillsorreleasesofcontaminants,ornegativeimpactstootherdeterminantsofhealth.Italsoprotectsareasthathavehighvalueinordertoavoidirretrievablelossorcostlyremediation.Ensuringthepreservationofthesehighvalueareasandprotectingthemfromanypossiblenegativeimpactwouldresultinapositiveimpacttothedeterminantsofhealthbothtodayandforfuturegenerations.
ThisrecommendationisalsolinkedtoRecommendation1.4(roleforPublicHealthincommunityplanning)andRecommendation3.5(setbacks).
Recommendationstoexcludespecificsensitiveareasfromdevelopmenthavepreviouslybeenmadeinotherjurisdictions(NewYorkDEC2011;EuropeanParliament2011;USDOE2011a-b)butadditionalworkwouldbeneededamongpartneragenciesinNBtomoreclearlydefinethezonestobeexcludedfromdevelopmentandexaminetherisksandbenefitsofeachofthesedesignationsintheNewBrunswickcontext.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice,
evidence-based, leadership, precautionary principle, prevention, transparency, utilitarianism
Part 3: Recommendations for Protection of Public Health 51
Recommendation 4.2: The Province should undertake a Strategic Health Impact Assessment (Strategic HIA) to estimate the long-term cumulative health and social benefits and costs
Recommendation2.1proposesundertakingsite-specificHIAasameansofprioritizingrisksthatwillrequiremanagementforindividualprojects,buttheintentofthisrecommendationistocarryoutamoreglobally-focussedassessmentacrossthefullextentofindustrydevelopmentinNewBrunswick.Assuch,astrategicHIAwouldincludedevelopmentscenarioscoveringtheentirelifespanoftheindustryacrossallpotentiallocationstobedevelopedinNB.
Sincethetotalextentofdevelopmentisunknowninadvance,thisapproachwillofnecessitydependonvariousscenarios(e.g.low,medium,highdevelopment)inordertoforecastpossibleoutcomes.Thesemodelswillhelptoinformthenature,extent,andtimingofstrategicinterventionsthattheProvincewillneedtomakeinordertoappropriatelymanagethegrowthinsuchawayastooptimizebenefitsforandreducerisktohealthandsociety.
Thereareonlyafewexamplestodateofhealthimpactassessmentscarriedoutinotherjurisdictions,suchastheBattlementMesaHIA(ColoradoSchoolofPublicHealth2011)andtheseingeneralhavebeensite-specific.However,otherjurisdictionsareundertakingorhaveproposedstrategicenvironmentalimpactassessments(NewYorkDEC2011;BAPE2011a;Québec2011)orfulllifecycleanalysisofcostsandbenefitstosociety(EuropeanParliament2011),anddevelopmentsintheseprojectswillhelptoinformastrategicHIAforNewBrunswick.
Recommendation 4.3: The Province should designate areas that are to be excluded from development, including drinking watersheds and wellfields, sensitive natural areas, specified agricultural lands, and other areas of special significance (scope to be defined)
Thisrecommendationproposesapreventionstrategytoavoidcommonsituationsthatcouldotherwiseleadtohumanexposureroutesintheeventofaccidents,spillsorreleasesofcontaminants,ornegativeimpactstootherdeterminantsofhealth.Italsoprotectsareasthathavehighvalueinordertoavoidirretrievablelossorcostlyremediation.Ensuringthepreservationofthesehighvalueareasandprotectingthemfromanypossiblenegativeimpactwouldresultinapositiveimpacttothedeterminantsofhealthbothtodayandforfuturegenerations.
ThisrecommendationisalsolinkedtoRecommendation1.4(roleforPublicHealthincommunityplanning)andRecommendation3.5(setbacks).
Recommendationstoexcludespecificsensitiveareasfromdevelopmenthavepreviouslybeenmadeinotherjurisdictions(NewYorkDEC2011;EuropeanParliament2011;USDOE2011a-b)butadditionalworkwouldbeneededamongpartneragenciesinNBtomoreclearlydefinethezonestobeexcludedfromdevelopmentandexaminetherisksandbenefitsofeachofthesedesignationsintheNewBrunswickcontext.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice,
evidence-based, leadership, precautionary principle, prevention, transparency, utilitarianism
Recommendation 4.4: The Province should prepare a strategic land use plan with considerations of health equity and with input from Public Health and other experts and stakeholders
Ithasbeennotedthatduetoarapiddecreaseovertimeintheyieldofgasfromanyindividualgaswell,large-scaleshalegasproductionrequiresongoingdrillingofnewwellsandconstantdevelopmentofnewlandinordertoensureacontinuousorincreasingsupplyofgas(Considine,2010).Asaresult,thepotentialforconflictsoverlandusemaynevergoaway.
Indeed,theseconflictsmaybecomeevenmoreacuteinfuture.Itislikelythatintheearlystagesofdevelopmentintheprovince,wellsiteswouldbechosenthatareasfarremovedfrompopulatedareasaspossible,butstillaccessiblebyroad.Astheselocationsbecomedeveloped,newdevelopmentislikelytobecomeincreasinglynear-urban,andultimately,urban.Thus,itispossiblethatthetypesofcommunitiesthathostnearbyshalegassiteswillchangeasthedevelopmentoftheindustryprogresses.Thishasimportantimplicationsforassessingpotentialimpactstothedeterminantsofhealthovertimeandintothefuture.
Aproactivestrategicapproachtolanduseplanningwithconsiderationforhealthequitywouldhelptostreamlinedevelopmentandalsominimizenegativeimpactstothedeterminantsofhealth.SuchaprocesscouldalsoencompassworkrelatedtoRecommendation1.4(roleforPublicHealthincommunityplanning),Recommendation3.5(setbacks)andRecommendation4.3(designatingzonestobeexcludedfromdevelopment).
Recommendation 4.5: The Province should implement a process that will allow planning and regulatory decisions to consider vulnerable and disadvantaged populations that are at greater risk to environmental contaminants
Vulnerableanddisadvantagedpopulationsdeservespecialconsideration,notonlytoensureafair,justandequitablesocietybutalsobecausetheyarethemosteasilyaffectedandmostlikelytosufferadverseimpactstothedeterminantsoftheirhealth.Inaddition,goodcontrolofhealthimpactsforthemostvulnerablewillresultinbettercontrolofhealthimpactsforthegeneralpopulation.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, transparency, utilitarianism
52 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
ItwasnotedinPart1thatsocioeconomicstatusisstronglylinkedwithhealthstatus.Asaresult,peoplewithlowsocialandeconomicstatuscanbeviewedasavulnerablepopulation,becausetheirhealthstatusalreadysuffersduetotheconditionsaffectingtheirsocialdeterminantsofhealth.Accordingly,anyadditionalimpactstoanyofthedeterminantsofhealtharemorelikelytoaffectthispopulationmoreprofoundlythanthegeneralpopulation.SuchpotentialimpactstovulnerablepopulationsshouldbeidentifiedaspartofHealthImpactAssessments(Recommendation2.1)andapproachestohealthequity(Recommendation1.1).
Childrenprovideagoodexampleofanothertypeofvulnerablepopulation.Theyhavespecialvulnerabilitiesduetolowerbodyweight(whichcanresultinahigherbodyburdenofenvironmentalcontaminants),aswellasfasterrespiratoryandmetabolicratesthatcanmakethemmoreprofoundlyaffectedbycontaminants.Theyalsohaveuniqueexposureroutes(e.g.crawling,playareas,handtomouthbehavior)andsensitivelifecyclestagesduringgestation,growthanddevelopmentwherecertaincontaminantexposurescancauselifelongdamage.Asaresult,itisnotappropriatetosimplyconsiderthemassmallerversionsofadultswithrespecttoenvironmentalhealthissues.
Furthermore,childrenarethefutureofourprovinceanddeservespecialprotectionsuchasarticulatedintheUNConventionontheRightsoftheChild(UN1990),whichwasdevelopedbecauseitwasrecognizedthatpeopleunder18yearsofageoftenneedspecialcareandprotectionthatadultsdonot.TheConventionhasbecomealegallybindinginstrumentofInternationalLawandstates,inpart:
Article 24: 1. States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health
Article 27: 1. States Parties recognize the right of every child to a standard of living adequate for the child’s physical, mental, spiritual, moral and social development
Vulnerableanddisadvantagedpopulationsshouldalwaysbeconsideredinplanningandregulatorydecisionsbecausetheyarethemosteasilyaffectedandmostlikelytosufferadverseimpactstothedeterminantsoftheirhealth.Furthermore,goodcontrolofhealthimpactsforthemostvulnerablewillalsotranslateintobettercontrolforthegeneralpopulationaswell.
Recommendation 4.6: The Province should require that planning and regulatory decisions consider First Nations even if reserve lands are not directly affected
BecauseFirstNationscommunitiescanfacegreaterchallengesrelatedtohealthandsocioeconomicstatuscomparedtothegeneralpopulationofCanada,theycanbeconsideredasavulnerablepopulation.Asaresult,planningandpolicydecisionsshouldmakespecialconsiderationsforhealthequityofFirstNationspeople.Definingtheseconsiderationswillrequireanin-depthengagementwithFirstNationsleadersandorganizations.Thiswillbeneededevenifreservelandsarenotdirectlyaffectedbygasdevelopment,asFirstNationspeopleshaveastrongsenseofprotectingthenaturalenvironmentthatextendstooff-reserveareasthatarepartoftheirtraditionalterritory.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidenced-based,
leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
Part 3: Recommendations for Protection of Public Health 53
ItwasnotedinPart1thatsocioeconomicstatusisstronglylinkedwithhealthstatus.Asaresult,peoplewithlowsocialandeconomicstatuscanbeviewedasavulnerablepopulation,becausetheirhealthstatusalreadysuffersduetotheconditionsaffectingtheirsocialdeterminantsofhealth.Accordingly,anyadditionalimpactstoanyofthedeterminantsofhealtharemorelikelytoaffectthispopulationmoreprofoundlythanthegeneralpopulation.SuchpotentialimpactstovulnerablepopulationsshouldbeidentifiedaspartofHealthImpactAssessments(Recommendation2.1)andapproachestohealthequity(Recommendation1.1).
Childrenprovideagoodexampleofanothertypeofvulnerablepopulation.Theyhavespecialvulnerabilitiesduetolowerbodyweight(whichcanresultinahigherbodyburdenofenvironmentalcontaminants),aswellasfasterrespiratoryandmetabolicratesthatcanmakethemmoreprofoundlyaffectedbycontaminants.Theyalsohaveuniqueexposureroutes(e.g.crawling,playareas,handtomouthbehavior)andsensitivelifecyclestagesduringgestation,growthanddevelopmentwherecertaincontaminantexposurescancauselifelongdamage.Asaresult,itisnotappropriatetosimplyconsiderthemassmallerversionsofadultswithrespecttoenvironmentalhealthissues.
Furthermore,childrenarethefutureofourprovinceanddeservespecialprotectionsuchasarticulatedintheUNConventionontheRightsoftheChild(UN1990),whichwasdevelopedbecauseitwasrecognizedthatpeopleunder18yearsofageoftenneedspecialcareandprotectionthatadultsdonot.TheConventionhasbecomealegallybindinginstrumentofInternationalLawandstates,inpart:
Article 24: 1. States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health
Article 27: 1. States Parties recognize the right of every child to a standard of living adequate for the child’s physical, mental, spiritual, moral and social development
Vulnerableanddisadvantagedpopulationsshouldalwaysbeconsideredinplanningandregulatorydecisionsbecausetheyarethemosteasilyaffectedandmostlikelytosufferadverseimpactstothedeterminantsoftheirhealth.Furthermore,goodcontrolofhealthimpactsforthemostvulnerablewillalsotranslateintobettercontrolforthegeneralpopulationaswell.
Recommendation 4.6: The Province should require that planning and regulatory decisions consider First Nations even if reserve lands are not directly affected
BecauseFirstNationscommunitiescanfacegreaterchallengesrelatedtohealthandsocioeconomicstatuscomparedtothegeneralpopulationofCanada,theycanbeconsideredasavulnerablepopulation.Asaresult,planningandpolicydecisionsshouldmakespecialconsiderationsforhealthequityofFirstNationspeople.Definingtheseconsiderationswillrequireanin-depthengagementwithFirstNationsleadersandorganizations.Thiswillbeneededevenifreservelandsarenotdirectlyaffectedbygasdevelopment,asFirstNationspeopleshaveastrongsenseofprotectingthenaturalenvironmentthatextendstooff-reserveareasthatarepartoftheirtraditionalterritory.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
FirstNationspeoplealsodeservespecialconsiderationbecauseoftheirholisticsenseofwellbeingthatincludesspiritual,emotional,physicalandmentalaspectsthatgrowoutofrespectfortraditions,cultureandtheenvironment.Forexample,FirstNations’traditionsandcultureincludeastrongsenseofprotectingthesustainabilityofMotherEarth:air,landandwaterareextremelyimportant,andthewellbeingofFirstNations’peoplesispowerfullyintertwinedwiththeharmonyoftheenvironment.TheyhavetraditionallyusednaturalresourcesasrequiredfortheirneedsandthegreatergoodbutatthesametimestrivetorespecttheEarthandensurethatresourcesareprotectedforfuturegenerations.Infact,inallmajordecisions,FirstNations’peoplestraditionallyalwaysconsidertheimpactontheseventhgenerationtocome.
ThereverenceofFirstNations’peoplestowardnatureextendstolandsoff-reserve,andFirstNationscommunitiestypicallyutilizemanyoftheseareasastheirtraditionalterritory.Asaresult,itisnotsufficienttosimplydesignatereservesasareasthataretobeexcludedfromdevelopment,andamorein-depthengagementwithFirstNationsisneededtoensurethatbenefitstothesocialdeterminantsofhealtharemaximizedandrisksareminimized.
Recommendation 4.7: TheProvinceshouldprepareastrategicwatermanagementplantoprotectthequalityandavailabilityofwaterforpublicwatersupplies,privatewellwatersuppliesandfreshwateringeneral
Theshalegasindustryispotentiallyasignificantwateruser,andalthoughotherindustriesmayuseasmuchormorewater,theindustrycouldaddsignificantdemandstotheprovincialandlocalwaterbudgetsresultinginconflictsoverwateruse.
Sincelowerwatertablescanresultinchangesinwaterchemistryandriskofmicrobiologicalcontamination,quantityandqualityofwaterareinextricablylinked.Furthermore,sufficientavailabilityofdrinkingwaterofappropriatequalityisessentialforcommunityprosperityandsustainability.
Oneestimateofwaterusagebytheshalegasindustrystatesthatabout5milliongallons(approximately20millionlitres)areneededtodevelopeachgaswellintheMarcellusShale(PAGovernor’sCommission2011).Althoughthetotalquantityusedannuallyinthiscasewassimilartoorlessthanmanyotherindustries,alargescaledevelopmentoftheindustryinNewBrunswickcouldneverthelessaddsignificantdemandsonwateravailability.Thiscouldpotentiallyleadtoconflictingwateruses,suchasobtainingfreshwaterfromasmallmunicipalsupplyresultinginover-pumpingthewellstomeettotaldemand.
AlthoughtheNewBrunswickNaturalGasGrouphasrecommendedahierarchyofwatersourceswherefreshwaterisusedasalastresort(NBNGG1012a-b),wateruseplanningshouldstillbecarriedoutbecausewastewaterfromhydraulicfracturingoperationswillimpactthequalityofreceivingwatersandtheamountofwaterentering,storedwithinorleavingawatershed.
54 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Inaddition,trackingofactualinjectedhydraulicfracturingwatervolumesandcomparisontorecoveredvolumesofflowback/producedwatershouldbeafundamentalcomponentofwateruseplanninginordertoensureonanongoingbasisthatforecastswereaccurateandthatwatermanagementmeasuresaresufficient.
Recommendation 4.8: The Province should encourage, promote and financially support research in New Brunswick, such as long-term longitudinal health studies and research on potential health effects, social impacts, and other aspects
NewBrunswickhasanopportunitytopositionitselfasaleaderinnotonlytheshalegasindustry,butalsointheprotectionofhealthandtheenvironmentinrelationtothisindustry.Aclearcommitmenttosupportingresearchintheseareas(suchaslong-termlongitudinalhealthstudiesandresearchonpotentialhealtheffects,socialimpacts,andotheraspects)wouldsolidifytheProvince’sreputationasaleaderinthesefields.
Inaddition,NewBrunswickhasanenviableadvantageinthatarelatively“cleanslate”currentlyexistssothatlongitudinalstudieswillhaveasuitablebaselineconditionthatcanimprovetheconfidenceinresearchresults.ThisisanadvantagethatotherjurisdictionsmaynothaveandNewBrunswickshouldcapitalizeonittofosterleadingedgeresearchintheprovince.
Researchofthiskindisimportanttopublichealthprotectionbecauseitverifieswhetherornotcontrolmeasures,suchasinvestmentsincommunityhealthandhealthimpactassessmentsarehavingthedesiredeffect.Thus,researchoutcomesandimprovementsinscientificknowledgecanbeusedtoinformindustryexpansionthroughoutthelifetimeoftheindustryintheprovinceandelsewhere,bothnationallyandinternationally.
NewBrunswickshouldactquickly(e.g.establishpilotprojectsatleastintheverynearterm)inordertobegincapitalizingontheconditionsthatcurrentlyexistthatcanaidinthedevelopmentofworld-classresearchprogramsinourprovince.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis, national agenda, scholarly activity
Public Health Values supported: benficence & non-maleficence, communitarianism, equity & distributive justice,
evidence-based, leadership, precautionary principle, prevention, transparency, utilitarianism
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
Part 3: Recommendations for Protection of Public Health 55
Recommendation 4.9: The Province should commit to periodically reviewing and reporting to the public on environmental and health monitoring data
Recommendations2.2,2.3and3.1,aswellassomerecommendationsbytheNaturalGasGroup(NBNGG2012a,b)proposeestablishingavarietyofenvironmentalandhealthmonitoringsystemsinordertoprovidequalitycontroldataduringallphasesofthegasindustryinNewBrunswick.However,establishingthesemonitoringsystemsisonlyonepartofthepuzzle:theremustbeaclearcommitmenttoanalyzingthedata,reportingonthefindings,interpretingwhattheytellusregardingtheeffectivenessofcontrolmeasuresandregulations,andwhetheranychangesareneededasaresult.ThesereportsalsoneedtobemadepublicinordertoensuretransparencyandearnthetrustofthePublic.
Therearemanylogisticalquestionsstilltoanswerregardingresponsibilityforproducingthesereportsinatimelyfashion,enforcementofcorrectiveactionsifwarrantedbythefindings,andresourcesneeded(seeRecommendation5.1)butthecommitmentisneededasafirststep.Ideally,acommitmenttopublicreportingwouldbemadebyGovernmentasawholebywayofapublicpositionstatementonthisissue,andthespecificreportingmechanismswouldbethenimplementedbyindividualdepartments.
5. Implementation and OversightRecommendation 5.1: The Province should establish sufficient capacity and resources to enable relevant Government departments to oversee the development of this industry including conducting project reviews and approvals, inspections, monitoring, enforcement and management of environmental, health or social consequences
Asshalegasdevelopmentactivityincreasestherewilllikelybeadditionalstrainonallimplicatedgovernmentdepartmentsandaboominactivitycouldcreateasuddenandsevereshortageofgovernmentcapacityintheseareas.AproactiveapproachisnecessarytoprotectboththesocialandphysicalenvironmentsandtoaverttheconditionsthatcanleadtothenegativeimpactsoftheBoomtownEffect(Recommendation4.1).
ImplementationoftheserecommendationsandthoseproposedbytheNewBrunswickNaturalGasGroup(NBNGG2012a-b)willrequireaninitialupfrontinvestmentinthecapacityofavarietyofgovernmentdepartmentsinordertoprepareforthearrivaloftheindustry.WithrespecttotheDepartmentofHealthinparticular,additionalresourceswouldberequiredtodevelopstrategicapproachestomanagingthesocialdeterminantsofhealth(Recommendationsinsections1and4),tomonitorandanalyzepopulationhealthstatuswithinthecontextofenvironmentalmonitoringdata(Recommendations2.2,2.3and4.11),toreviewandoverseeHIAstudies(Recommendation2.1)andprovidecommentstoenvironmentalimpactassessmentsforindividualprojects(Recommendations
Health Objectives supported: advocacy, leadership & partnership, provision of information,
prevention of public health hazards, social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
56 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
insection3),toundertakeastrategicHIA(Recommendation4.2),andtopartnerwithandassistotheragenciesthatwillbeleadingimplementationofotherrecommendations.
Furthermore,additionalcapacityinmedicalhealthservicedeliveryintermsofdoctors,nurses,healthcarefacilities;publichealthservices;mentalhealthservices;andsocialserviceswillalsoberequired.Othergovernmentdepartmentsandagenciesthatwouldalsorequireadditionalcapacitybuildingincludebutarenotlimitedto:RegionalHealthAuthorities,SocialDevelopment,EnvironmentandLocalGovernment,NaturalResources,PublicSafety,TransportationandInfrastructure,EducationandEarlyChildhoodDevelopment,andothers.
Inaddition,asshalegasdevelopmentactivityincreasestherewilllikelybeadditionalstrainonallimplicatedgovernmentdepartments,whichcouldleadtoasuddenandsevereshortageofgovernmentcapacityintheseareasevenifinitialcapacityinvestmentshavealreadybeenmade.
Thus,inordertoproperlyoverseeandmanageanyenvironmental,healthorsocialconsequences,governmentcapacityshouldincreaseinitiallythroughupfrontinvestmentsandagainonanongoingbasisalongwithindustryactivityasrequired.ThisproactiveapproachisnecessarytoavertsomeoftheconditionsthatcanleadtothenegativeimpactsoftheBoomtownEffect(Part2,Section2eandRecommendation4.1)andhelpprotectboththesocialandphysicalenvironments.
Onepossiblewaytoprovideforthiswouldbetotieaportionofroyalties1oranindustrylevytoprovidingfundingforgovernmentoversightandpublicservicessothatfundingwouldincreaseasindustrialactivityincreases.Asanexample,Pennsylvaniahasproposedtolevyaper-well“ImpactFee”totaling$160,000pergaswellscaledoverthefirst10years2ofeachwell’slifetimetoprovidefundingatthestateandlocallevelsforavarietyofgovernmentservicesneededtobenefitthehostcommunities,toaidpublicprotection,andtohelpoffsetanydetrimentaleffectsofdevelopment(PAGovernor2011).Thesefundswouldbeprovidedwithstrictrulesforhowtheymaybeusedbythevariousagenciesthatreceivethem,andareintendedforsuchthingsasinfrastructure,emergencypreparedness,affordablehousing,socialservices,increasedjudicialsystemcosts,andinspection,oversightandenforcement.AtPennsylvania’scurrentrateofwelldevelopment,thislevywouldraise$120Millionintotaldesignatedfundsinthefirstyearandgrowingtonearly$200Millionperyearafterthesixthyear.
Anotherpossiblemechanismwouldbetoensurethatenforcementpenaltiesareappropriateandthatfundsfromthemcouldalsobedirectedtoenhancinggovernmentcapacity.
1NotethatinNewBrunswick’scaseasimilarobjectivecouldbeattainedthroughdesignatingaportionofroyalties–Penn-sylvaniadoesnotrequireanygasroyaltiespayabletotheStateandsoaseparatefeewasnecessary.2NotealsothatthespecificsofPennsylvania’sfundingformulaandfundinglevelarenotdirectlyapplicabletotheNewBrunswickcontextbecausemanymoregovernmentservicesinPennsylvaniaareprovidedatthelocalandcountylevelsthanattheStatelevel,becauselevelsofindustryactivityarenotlikelytobesimilar(atleastinitially)andbecausehealthcarecostsaregenerallynotbornebygovernmentinPennsylvania.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: beneficence & non-maleficence, communitarianism, equity & distributive justice, evidence-based, leadership,
precautionary principle, prevention, transparency, utilitarianism
Part 3: Recommendations for Protection of Public Health 57
Recommendation 5.2: The Province should establish an implementation group for the recommendations in this Report that is led by Public Health and includes representatives from other relevant government departments and other stakeholders
Sinceimplementationoftheserecommendationswillrequireactionfromoutsideofthehealthsectoraswellasfromwithinit,itisrecommendedthatanimplementationgroupbestruckthatisledbyPublicHealth(i.e.OCMOH)butwhichhasrepresentationfromabroadersetofstakeholders.AsnotedunderRecommendation5.1regardingagenciesthatwillbesubjecttoresourceandcapacityissues,thisgroupshouldincludebutisnotlimitedtoRegionalHealthAuthorities,theDepartmentsofSocialDevelopment,EnvironmentandLocalGovernment,NaturalResources,PublicSafety,TransportationandInfrastructure,Culture,TourismandHealthyLiving,EducationandEarlyChildhoodDevelopment,andothersasappropriate.
NotethattheimplementationgroupwouldalsobechargedwithensuringthatatransparentandconsultativeprocesswiththePublicandotherstakeholdersisundertakenwithrespecttotheactualimplementationprocesstobeused(seeRecommendation1.5).
HavingthisimplementationgroupledbyPublicHealthwillensurethattheactionsandtimelinesundertakenwillremainfocusedonappropriateprotectionofpublichealthaspertheintentoftherecommendationsinthisdocument.
Recommendation 5.3: The Province should sponsor a series of summits led by Public Health to better understand and communicate public health information and issues and to foster an effective ongoing dialogue among community, government, academics and industry
Implementationofthisrecommendationwouldestablishanongoingframeworkforcommunicationofchangesinscienceandtechnology,updatesabouttheprogressoftheindustryintheprovince,andaforumfordiscussionofchangingconcernsasdevelopmentprogresses.Committingtokeepingallpartiesinformednowandintothefutureisanimportantaspectofriskcommunication,andwouldprovideanenhancedleveloftransparencygoingforward.
CreatingsuchanongoingforumwouldplaceNewBrunswickinthenationalspotlightasaprogressiveleaderindevelopingcreativesolutionstothemulti-facetedissuesrelatedtothepotentialeffectsofshalegasdevelopmentonboththesocialandphysicalenvironments.
AconferenceheldinMonctonJune3-5,2012(FORUMe2012)wasagoodinitialopportunitytobringtogetherthesesectors,butatrulyeffectiveopenandinformedexchangeofideaswillrequireanongoingforum.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: communitarianism, equity & distributive justice,
evidence-based, leadership, precautionary principle, prevention, transparency, utilitarianism
58 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Recommendation 5.4: The Province should create a multi-disciplinary Advisory Committee to Cabinet charged with reviewing government oversight throughout the lifetime of the industry in NB
TheNewBrunswickNaturalGasGroupandcontributorsfromothergovernmentdepartmentshavelaidthegroundworkforresponsiblemanagementofnaturalgasactivitiesinNewBrunswickbutthereneedstobeanongoingresponsibilitycentre.ThisisneededtoensurethattheGovernmentcanadapttochangingconditionsinthefutureandcanupdaterequirementsasnewinformationbecomesavailable.Suchagroupwouldensurethatregulationsandotherprotectivemeasuresderivedfromtheworktodateareworkingasintended(throughe.g.periodicreviewoflegislation,non-compliances,violations,monitoringdata,etc.)andthattheycontinuetoimproveinfuturesoastooptimizesustainability.Inaddition,suchagroupcouldbechargedwithreviewingthestatusofimplementationofrecommendationsandevaluatingtheeffectivenessofthem.
Asaresultofthecomplexnatureandwidescopeofspecializationsrepresentedintherecommendationstodate,thisgroupwouldofnecessityhavetobemulti-disciplinaryandexperiencedinnaturalgasindustryissues.Membershipandtermsofreferenceofsuchacommitteecouldbedevelopedfollowingpublicandstakeholderconsultation.
AnAdvisoryCommitteetoCabinetisrecommendedastheappropriatelevelforsuchabodybecauseitwouldbeaccountabletotheelectedgovernmentoftheday,coulddrawontheexpertisehousedinanyorallgovernmentdepartmentsandwouldnotbedominatedbytheprerogativesofanyonedepartment.
Health Objectives supported: advocacy, leadership & partnership, provision of information, prevention of public health hazards,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice, evidence-based, leadership, precautionary principle, prevention, proportionality, transparency, utilitarianism
Health Objectives supported: advocacy, leadership & partnership, provision of information,
social determinants of health emphasis
Public Health Values supported: autonomy, beneficence & non-maleficence, burden of proof, communitarianism, equity & distributive justice,
evidence-based, leadership, precautionary principle, prevention, transparency, utilitarianism
59
Part 4
Conclusions
60 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
ThemandateoftheOCMOHistoimprove,promoteandprotectthehealthofthepeopleinNewBrunswick.Inlightofthepotentialscaleoftheproposedshalegasindustryandthepublicdebateontheissueofitsdevelopment,itisofutmostimportancethatOCMOHfulfillitsmandatebyhelpingGovernmentunderstandhowthisindustrycouldpotentiallyimpactthehealthofthepeopleinNewBrunswickandproviderecommendationsastohowtoplanandprepare.Theserecommendationsarebasedoncurrentknowledge,butastherearemanydataandinformationgapstheadvicewillneedtoevolve.Inparticularitwillbekeytohearpublicthoughtsandperceptionstobetterinformfutureactions.Inordertodotheworkanimplementationgroupwillneedtobeestablishedandoversightmechanismputinplace.Asallofsocietyhasaroleinthehealthofthepopulation,itwillbeimportantthattheparticipationintheworkextendswellbeyondthetraditionalhealthsector.
Theshalegasindustryisinitsinfancyinthisprovince.Iftheindustryisdevelopedtoitsfullpotential,ithastheabilitytogreatlypositivelyandnegativelyimpactthehealthofthepeopleinNewBrunswick,andsopropercontrolsandmechanismstoprotectandmonitorhealthmustbeputinplacetoreducetheriskofspoilingthepotentialbenefitsfromeconomicgainsthroughadversehealthoutcomes.Actionshouldbetakenwellinadvanceofanyproposedexpansion.Currentinfrastructure,capacity,processesandlegislationarenotadequatetomeettheneeds.Thefundingoftheserecommendationswillnotbeinsignificant;howevertheremaybeopportunitytohavemuchofthecostsabsorbedbytheindustry.
SomeofthekeyfindingsaresummarizedbelowandincludealackofparticipationfromPublicHealthinotherjurisdictions’regulatoryregimeswhereindustryexists;lackofinformationneededtoassesstoxicityrisks;lackofaccurateexposureandhealthdata;lackofstandardmethodsforpreventingandmitigatingsocialimpacts;lackofhealthstatusstudiesbeforeandduringgasdevelopment;andalackofsystematichealthimpactassessments.Alackofinformationabouttheextent,locationsandrateofdevelopmentmakesitverydifficulttoforecastlocaleffectsofspecificprojectsandtoassessthepotentialforcumulativeeffectsovertime.
Takentogether,thesocialandphysicalenvironmentsarethemaininfluencesonpopulationhealth.Ingeneral,theloweraperson’s(orcommunity’s)socialandeconomicpositionis,theworsetheirhealth,soaddressingthesocialdeterminantsofhealthisfundamentaltoachievinghealthequity.Governmentpolicyandlawaretheforcesthatprovideanopportunitytoachievehealthequityandsotheserecommendationstogovernmentincludewaystosupporttheequitableandjustdistributionofthesocialandeconomicresourcesandconditionsthatgiverisetothesocialdeterminantsofhealth.
Althoughthepublichasvoicedapreoccupationwithhealthconcerns,therehasbeenanotablelackofparticipationbyPublicHealthagenciesinmanyoftheongoinginitiativestoregulatetheindustryelsewhere.Thismaybeduetoagenerallackofunderstandingaboutthepotentialimpactsonhealth,littleprecedenttolearnfrom,orplansthatcouldbefollowed,anarrowingofthescopeofwhat“health”means,and/orabeliefthatengineeringcontrolsandregulationscanmitigateallofthepotentialimpacts.Systematicandearlyinclusionoftrainedexpertisewouldensurethatapublichealthlenswasbroughttobearwhichwouldcertainlyhelpidentifyandsolvemanypotentialissues.Thiscomplementarybuttargetedfocusonhumanhealthisessentialnotonlyforshalegasbutformostindustrialdevelopment.
Thepublicdiscussiononshalegashasbeendominatedtodatebychemicaltoxicityconcernsand hasfocusedonwaterandhydraulicfracturingchemicals;whiletheseareimportant,thereisariskofoverlookingotherpotentiallymoreproblematicconsiderations,suchascommunityhealthissuesandthepotentialforphysicalinjury.Thescientificandmedicalliteraturehasnotwidelyreportedorstudiedfactorssuchaspotentialimpactstocommunityhealth,mentalhealthandsocioeconomicwellbeingbutratheralsohasbeenfocusedonissuessurroundingpotentialenvironmentaltoxicants.Theunbalanceddiscussionhighlightstheneedforopenandinformedsharingofinformationandinparticulargooddatatobeproducedthroughroutinesurveillanceandtargetedresearch.AsmanyjurisdictionsacrossCanada,theUS,Europeandtheworldarefacingsimilarconcerns,significantadvantagescouldbegarneredbycollaboratingwithothers.
Potentialforphysicalinjury,bothattheworksiteitselfandinthevicinityofdevelopmentissignificantandwarrantscarefulplanning.Localgovernmentandcommunityinvolvementinplanninganddevelopmentcould
Part 4: Conclusions 61
helppreventmorbidityandmortality:forexample,toreducethepotentialforincreasedtrucktrafficaccidentsthatcouldimpactresidentsneardevelopmentareas.Ensuringthatthereareappropriatemechanismsinplacetolookafterworkers’andvisitors’healthandsafetybothonandoffsite,andoptimalemergencyresponsecapacitywillalsobeimportantinreducingtheconsequencesfromphysicalthreats.
Inadditiontoknowledgegapsabouttoxicityofsomeoftheknownchemicals,thisissueisgreatlycomplicatedbecauseitcanbedifficultsimplytoidentifywhichchemicalsareinuseateachlocation.Solidandliquidwastesforeachgaswellsitearevariableandnotalwaysfullycharacterized.Asaresult,agenerictoxicologicalprofileofwastescannotbeprepared.Inordertoaddressthisgap,solidandliquidwastesforeachgaswellsiteshouldbecharacterizedsothattoxicologicalinformationcanbeobtainedforexposureriskassessmentsandthatappropriatewastetreatmentsystemsareusedinallcases.
Theeconomicbenefitsofshalegasdevelopmentarepotentiallyverylargeandifappropriatelymanagedcouldcontributetoimprovingtheoverallhealthstatusinthisprovince.Socioeconomicstatusofapopulationisastrongpredictorofhealthstatus,soemployingtheunemployed,orenablinghigherincomesorimprovingsocialprogramsshouldresultinhealthbenefits.However,thesepotentialimprovementscanbelimitedorevencounteractedbynegativesocialimpactsthatcanariseduringaneconomicboom(“BoomtownEffect”)e.g.increasedratesofcrime,drugandalcoholabuse,sexually-transmittedinfections(STIs),domesticviolence,inadequatesupplyandqualityofhousing,andincreasedcostofliving.Theseproblemscouldbemitigatedbyimprovinginfrastructureandpublicservicescapacity(includingpolicing,localgovernment,mentalhealthservices,socialservices,andhealthcare).
BecausetheBoomtownEffectisthoughttobemoreintenseforsmallcommunitieswithatraditionalwayoflife,theremaybearisktoNewBrunswickcommunitiesunlessthiseffectisanticipatedandmitigatedthroughstrategicinvestments.Thepositiveeffectofeconomicgainscanbefurtherlimitedduetoinequitabledistributionofriskandrewardamonglocalresidents.AtpresentthereisnostandardapproachforhowtopreventormitigatetheBoomtownEffect,sothiswillhavetobedeveloped,ideallyincollaborationwithnationalpartners.Moreinformationonaccurateforecastsforthescaleoftheindustry,rateofdevelopment,duration,andpreciselocationsofgaswelldevelopmentwillbeneededinordertoprepareaneffectiveplanfordealingwithsocialandcommunityhealthimpacts.Involvementoflocalgovernmentsandcommunitieswouldallowmitigatingmeasurestobetargetedandmoreeffective.
Therearegapsinexistingdatasetstoassessboththeenvironmentalandhealtheffectsfromthisindustry.Accurateexposuredatahasbeenverydifficulttoobtain,inpartbecauseemissionsofchemicalscanbequitedifferentatdifferentlocationsandtimes,buttargetedmonitoringofair,waterandwastescouldhelptobridgethisgap.Well-definedbaselinedescriptionofhealthstatusandmonitoringsystemstodetectchangesinhealthstatustypicallydonotexist,andlittleisknownaboutpotentialdirectconsequencestohealthresultingfromgasdevelopment.Therehasbeenagenerallackofcomprehensiveanalysisandforecastingofpotentialhealtheffectsinnearbycommunitiesthatcouldarisefromlarge-scaleunconventionalgasdevelopmentprojects.However,whateversuitablemethodologiestofillthisgap(suchasHealthImpactAssessments(HIA)etc)areavailableshouldbeused.Moreinformationonaccurateforecastsforthescaleoftheindustry,rateofdevelopment,duration,andpreciselocationsofgaswelldevelopmentwillbeneededinordertoprepareaneffectiveplanfordealingwithsocialandcommunityhealthimpacts.
Whilethepotentialhealthandenvironmentalrisksofindividualwellpadscanbeevaluatedinordertopreventormitigatenegativeimpacts,itismuchmoredifficulttodothisforthetotalimpactsofallofthelargenumberofwellpadsthatwouldbedevelopedovera20-,50-oreven100-yeartimeframeshouldamajorexpansionofthegasindustrytakeplace.TodateithasnotbeenpossibletoestimatewellpaddensitiesthatmightoccurintheNewBrunswickcontext,norinwhatlocalitiestheymightoccur,oroverwhatextentoflandarea,oratwhatrateofdevelopment.Theseareexpectedtodependonwhereprofitablegasdiscoveriesaremade.Thisinformationwillbeessentialinordertobetterforecastthepotentialcumulativeimpactstohealthandtheenvironmentinthisprovinceandthusinformfurtherrecommendationsifneeded.
62 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Poorlyplannedsitelocationsandintensiveresourceusecouldhaveanegativeimpactonthehealthandwellbeingofindividualsandcommunities.Accesstocleanair,goodqualitywater,recreationalfacilitiesandotherattributesofahealthycommunityareessential.Astrategiclanduseandwatermanagementplan,aswellasdesignationofprotectedareasandsetbacks,andconsiderationofpublichealthaspartofthecommunityplanningprocesswillbeimportantinpreservingthequalityandlengthoflifeforthepeopleofthisprovince.Theseplansmustgiveconsiderationtovulnerablepopulationssuchaschildren,andthoseforwhomtheenvironmentplaysaparticularlystrongfoundationtotheirhealthsuchasFirstNationspeoples.
AnumberofmajoreffortsarecurrentlyongoinginCanadaandtheUnitedStatesthatshouldhelptoinformsomeoftheknowledgegapsoutlinedabove.Theoutcomesofthesestudieswillbeveryvaluableinformation,buttheyarenotasubstituteforconductinghealthimpactassessmentsintheNewBrunswickcontext.Itisessentialthereforethatthemechanismsandcapacitytodointernalassessmentsaredeveloped.Therewouldhoweverbegreatvalueindevelopingapan-Canadianapproachinordertodevelopconsistentandhighqualityframeworksandtemplatesinanefficientmanner.
Therecommendationsdescribeactionsthatarenecessarytoprotectorenhancepopulationhealththroughpropermanagementoftheshalegasindustry.Itisrecognizedthatfundingwillbeneededforgovernmenttocompleteorimplementsomeoftherecommendationsherein.Somemayrequirelegislationchangeandallwillrequiretheworkofmanypartnersbothwithinandoutsideofgovernment.Whiletherecommendationsinthisdocumentmayseemonerous,rathertheyshouldbeseenasroutinepublichealthpractice.Itisimportanttoconsidertheimpactthatindustrycanhaveonhumanhealth.
TakingsuchproactiveandpositiveactionwillcertainlyestablishNewBrunswickasaleaderinafieldofcriticalglobalimportance.
AcknowledgementsIwouldliketoexpressmygratitudetoallthosewhocontributedtothedevelopmentofthisdocumentandrecommendationswithspecialthankstoDr.ToddArsenault,Dr.JoAnnMajerovich,andKarenWhitefortheirdedicationandpassion.Thiswasaspecialprojectthataroseunexpectedly,soinadditiontoworktime,theteamputinmanyhoursoftheirpersonaltimetoseethistocompletion.Specialthankstoallcontributorsandpeerreviewers,especiallyDr.BillCookforsharinghisexpertiseinpublichealthvaluesandethicsandDr.JoelKettnerforhiswisecommentary.IwouldalsoliketoexpressgratitudetoourfellowpublichealthprofessionalsandMedicalOfficersofHealthacrossCanadaandtheUS,HealthCanada,andotheragencieswhotookthetimeoutoftheirbusyschedulestoreviewandcommentonourdocument.Finally,thankyoutoalltheenergeticOCMOHstaffandwhohavecontributed,reviewed,andcommentedonthisdocument.
63
AppendixSummary of findings and recommendations related
to public health and shale gas in other jurisdictions (selected references)
64 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Colorado (ColoradoSchoolofPublicHealth,2011)BattlementMesaHealthImpactAssessment,ColoradoSchoolofPublicHealth,February,2011http://www.garfield-county.com/environmental-health/battlement-mesa-health-impact-assessment-ehms.aspx
Eightareasofconcernwerereviewed(needtomitigatenegativeimpacts/supportpositiveimpacts):
1. AirQuality
2. WaterandSoilQuality
3. TrafficandTransportation
4. Noise,VibrationandLight
5. CommunityWellness
6. Employment/Economy
7. HealthCareInfrastructure
8. Accidents/Malfunctions
>70recommendationshttp://www.garfield-county.com/public-health/documents/8_HIA_2nd_draft_findings-recommendations.pdf
Majoronesare:
• Reducechemicalexposures
• Decreaseemissions
• Monitorairandwater
• Safeindustrialoperations
• Movetrafficoffresidentialroads
• Accidentprevention
• Emergencyplanning
• Stakeholdercommunication
• Communityadvisoryboard
Gapsidentifiedincluded:
• Baselineandongoingair,groundwater,surfacewater,andsoildataaroundwellpadsandthecentralizedwaterstoragefacility
• Collectionandanalysisofbaselineandongoinghealthinformation(thereportrecommendsthathealthstudiesshouldinclude“measurements related to physical health, lifestyle and social cohesion, education, crime, sexually transmitted infection, mental health and suicide, substance abuse, and economic impacts”)
• Specifictimelinesfordevelopmentandmaintenanceactivities
Appendix 65
New York (NewYorkHealthProfessionals2011)LettertoNewYorkStateGovernorAndrewCuomofromover250concernedHealthProfessionalsandOrganizationsregardingomissionofhumanhealthimpactsintheNewYorkSGEISprocess,Oct.5,2011
• Letterhttp://www.psehealthyenergy.org/data/lettertoGovCuomofinal.pdf
• PressReleasehttp://www.psehealthyenergy.org/data/Release_Medical_Authorites_Urge_Cuomo_to_Order_Health_Assessment_of_Fracking_final_10-5-11.pdf
(Excerpt)Dear Governor Cuomo,
On behalf of the undersigned organizations and health professionals, we are writing with regard to the revised draft of the Supplemental Generic Environmental Impact Statement (SGEIS) on the Oil, Gas, and Solution Mining Program issued in full in September 2011. We are greatly concerned about the omission of a critical issue related to the development of natural gas using high-volume hydraulic fracturing, or “fracking”:humanhealthimpacts.
For the reasons detailed below, we believe that the Department of Environmental Conservation (DEC) must correct this oversight in the continued stages of the State Environmental Quality Review Act (SEQRA) process.
Specifically, we request that the draft SGEIS be supplemented to include a full assessment of the public health impacts of gas exploration and production. This should include analysis of the existing documentation of the baseline health status of the New York State population; systematic identification and analysis of direct and indirect health effects; a cumulative health impacts analysis that includes a reasonable “worst case” assessment; and any potential measures to eliminate these impacts.
Notably, a comprehensive assessment of health impacts is likely to include information—such as mounting costs for health care and air and water pollution mitigation—that could inform how DEC and other agencies, such as the Department of Health (DOH), evaluate and assess cumulative impacts and how DEC reviews any proposed gas development permit applications. A comprehensive Health Impact Assessment (HIA) would be the most appropriate mechanism for this work, conducted by an independent entity such as a school of public health. This request is based in part on the fact that the New York DOH is unwilling to perform this function. Please refer to attached communication from Dr. Howard A. Freed, director of the DOH Center for Environmental Health, stating that “another methodology such as Health Impact Assessment would not provide significant additional information that is not already being covered” in the SGEIS. The undersigned disagree with this conclusion because the SGEIS does not, in fact, consider health impacts.
Next, we believe that a comment period of less than 180 days is not acceptable, for either the medical profession or the public. The medical profession was not adequately consulted during the scoping of the SGEIS and had little input into the draft SGEIS. A minimum of 180 days is necessary for health professionals to review and comment on the current draft SGEIS which must be reviewed in its entirety since there is no chapter dedicated to human health. The 96 day comment period which DEC has now proposed is also not enough to afford the public an adequate opportunity to express its concerns about potential health impacts given that DEC is also asking the public to comment on draft regulations during that same time period, and that potentially drill-impacted communities are now facing significant post- Irene challenges.
Finally, we strongly request that an independent health professional be appointed to the High Volume Hydraulic Fracturing Advisory Panel, such as a medical doctor with public health experience.
66 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Pennsylvania (PAGovernor’sCommission,2011)Governor’sMarcellusShaleAdvisoryCommissionReport,July22,2011
http://www.portal.state.pa.us/portal/server.pt/community/marcellus_shale_advisory_commission/20074
96recommendations(seereport,Chapter9),intheareasof:
1. Infrastructure
2. PublicHealth,SafetyandEnvironmentalProtection
3. LocalImpactandEmergencyResponse
4. EconomicandWorkforceDevelopment
ThebulkofthisreportwasnotconcerneddirectlywithPublicHealthissues,butthoserecommendationsthathadadirectbearingonHealthwere:
9.2.37 – The Department of Health should work in partnership with the Commonwealth’s graduate schools of public health and other appropriate medical institutions to better protect and enhance the public health interests of citizens, such as through the establishment of the population-based health registry and curriculum development.
9.2.38 – The Department of Health should collect and evaluate clinical data provided by health care providers.
9.2.39 – The Department of Health should routinely evaluate and assess Marcellus Shale-related environmental data, such as air, water, solid waste, and fish and other food samples, that is collected from a variety of entities, such as PA DEP, US EPA, the US Geologic Survey, water works or treatment facilities, industry and academic partners.
9.2.40 – The Department of Health should create, or oversee the creation of, a population-based health registry with the purpose of characterizing and following over time individuals who live in close proximity (i.e. one mile radius) to gas drilling and production sites.
9.2.41 – The Department of Health should establish a system to provide for the timely and thorough investigation of and response to concerns and complaints raised by citizens, health care providers or public officials.
9.2.42 – The Department of Health should educate health care providers on the presentation and assessment of human illness that may be caused by material in drilling constituents.
9.2.43 – The Department of Health should establish public education programs regarding the constituents used in the drilling process, potential pathways to humans, and at what level, if any, they have the potential to cause human illness.
Pennsylvania (continued) (PACitizen’sCommission,2011)“MarcellusShale:ACitizensView”,CitizensMarcellusShaleCommission,October24,2011http://citizensmarcellusshale.com
Overahundredrecommendationscoveringawidevarietyoftopics,including:
• GeneralRecommendations
• BetterControlAirEmissionsEmanatingfromGasProductionandTransmissionFacilities
• ReducethePotentialforWastewaterDegradationofSurfaceWaters
• BetterProtectPropertyOwnersfromGasProductionImpacts
• CreateRevenueSourcesfromNaturalGasExtraction
• ProtectPublicLandsandWaters
Appendix 67
• BetterProtectthePropertyRightsofCitizens
• LimitWaterWithdrawalstoProtectOtherUses
• ProtectingAquifers
• ReduceImpactsfromPipelinesandTransmissionFacilities
• BetterProtectPublicHealth
• LongandShortTermEmploymentImpact
• ImproveEnforcementofEnvironmentalLaws
• AddressImpactsonIndividualsandCommunities
Thespecificrecommendationsunder“BetterProtectPublicHealth”include:
• Immediately create a health registry and database to track illnesses in drilling communities; use pre-existing data gathered in other states where appropriate. Adequate funding must be supplied to the PA Department of Health to cover the costs of creating a health registry and database.
• Industry should be required to disclose both the identities and amounts of each chemical (by common name and brand name) used in the hydraulic fracturing process to help health officials understand the likely health effects and treat exposures.
• Occupational health of shale gas workers should be monitored by the Department of Labor and Industry.
Pennsylvania (continued) (PennEnvironment 2011)“IntheShadowoftheMarcellusBoom:HowShaleGasExtractionPutsVulnerablePennsylvaniansatRisk”,PennEnvironmentResearchandPolicyCenter,May,2011http://www.pennenvironment.org/news/pae/new-report-shale-gas-extraction-poses-risk-vulnerable-populations-pennsylvania
PolicyrecommendationstotheStateinclude:
…these new protections do not go far enough. Instead of enabling more and faster gas extraction, state leaders and the Pennsylvania Department of Environmental Protection should increase oversight of gas companies and hydraulic fracturing. Among needed improvements are:
• The Commonwealth should designate pristine places and locations near where people live or work off-limits to gas extraction
• Pennsylvania should strengthen its clean water laws
• Pennsylvania should require gas companies to halt the use of toxic chemicals in the hydraulic fracturing process
• The state should recognize the public’s right to know by requiring gas companies to report to the general public as well as the DEP the types and amounts of chemicals used during drilling and fracturing and the composition and disposal of wastewater, in a timely fashion and on a well-by-well basis
• Pennsylvania should increase the resources available to state regulators for enforcing the law
• The Commonwealth should increase bonding requirements for gas companies
• The DEP should revoke drilling privileges for the worst offenders
ThereportalsocallsforspecificimprovementstoFederallegislation(SafeDrinkingWaterAct,CleanWaterAct,CleanAirAct,NationalEnvironmentalPolicyAct,ResourceConservationandRecoveryAct,andtheToxicsReleaseInventoryundertheEmergencyPlanningandCommunityRight-to-KnowAct).
68 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
Québec (INSPQ,2010)«Étatdesconnaissancessurlarelationentrelesactivitésliéesaugazdeschisteetlasantépublique–RapportPréliminaire»,InstitutnationaldesantépubliqueduQuébec,Directiondelasantéenvironnementaleetdelatoxicologie,Novembre2010,ISBN:978-2-550-60591-1(PDF)http://www.inspq.qc.ca/pdf/publications/1177_RelGazSchisteSantePubRapPreliminaire.pdf
ThisreportreviewsthecurrentstateofknowledgeregardinglinksbetweenPublicHealthandshalegasactivities.Thesefactorswerediscussedunderthefollowingheadings(translatedfromFrenchintheoriginaldocument):
1. TechnologicalrisksthatcouldleadtoPublicHealthemergencies2. Risksrelatedtoairpollution3. Risksrelatedtowatercontamination4. Risksofeffectstoqualityoflife5. Identifyingareaswhereknowledgeneedstobedevelopedinordertoassesstheriskstothe
QuébecpopulationFindingsincluded:
• Technologyrisks
• Accidentsandincidentshavebeendocumentedthatresultineffectsrangingfromlightinjuriestodeathsamongworkersaswellasthegeneralpopulation
• Multiplecauses
• Notenoughinfotoestimatefrequencies,however
• Implementingemergencyresponseplansisamajorchallenge
• Airpollution
• ActivitiescancontributetolocalincreasesinNOx,SOx,VOCs,etc.
• Effectsofthesepollutantsarewellknown,butexposurelevelsarenotanddependonmultiplefactors,sotheoverallhealthriskcannotbeestimated
• Waterpollution
• Theprocessusesand/ordischargesmanychemicals,someofwhichareknowntobetoxic
• Fewstudiesonwatercontaminationinthevicinityofgaswelldevelopments
• Somecasesofgroundwatercontamination(byavarietyofsubstances)suspectedtobecausedbyshalegasactivities,butnoneconfirmed
• However,somecasesofmethaneintrusionsintohomesviadrinkingwaterwells(whichhaveresultedinafewexplosionsofhomesandsomedeaths)havebeenlinkedtoshalegasactivities
• Wastewatermanagementisamajorissue
• Thenature,toxicity,environmentalconcentrationsandexposurelevelsforavarietyofchemicalconstituentsinthewastewaterareunknown,sotheoverallhealthriskcannotbeestimated
• Asaresultofsuspectedcasesandtheknowledgegaps,theUSEPAwasmandatedtodoanexhaustivestudyonhealthandenvironmentalimpactstosourcesofdrinkingwaterresultingfromhydrofracturingactivities;preliminaryresultsareexpectedinlate2012
• QualityofLife
• Riseincertainnuisancesfornearbyresidents:traffic,noise,luminosityandvibrations
• Socialeffectsnotedinmanycases,duetotheriseinpopulationandthe“boomtowneffect”
• Shorttermimprovementineconomicactivity,butsomenegativeeffectsinthemiddleandlongterm
• Newsocialdynamicsanddemandforincreasedservicesandinfrastructure
ItisnotcurrentlypossibletoestimatethehealthrisktothepopulationinQuébecduetothelackofcertainkeyinformationineachofthethemesabove
Appendix 69
US Department of Energy (USDOE,2011aandb)ShaleGasSubcommitteeoftheSecretaryofEnergyAdvisoryBoard,Ninety-DayReport,August11,2011http://shalegas.energy.gov/resources/081111_90_day_report.pdf
ShaleGasSubcommitteeoftheSecretaryofEnergyAdvisoryBoard,SecondNinetyDayReport,November18,2011http://www.shalegas.energy.gov/resources/111011_90_day_report.pdf
Reportrecommendations(abridged)
• Improvepublicinformationaboutshalegasoperations
• Improvecommunicationamongstateandfederalregulators
• Improveairquality
• collectmethaneandotherairemissionsdataandmakethesedatapublicallyavailable
• analyzethefulllifecycleGHGfootprintofshalegasoperationscomparedtootherfuels
• expandeffortstoreduceairemissionsusingproventechnologiesandpractices
• Protectionofwaterquality
• Measureandpubliclyreportthecompositionofwaterstocksandflow
• Manifestalltransfersofwateramongdifferentlocations
• Adoptbestpracticesinwelldevelopmentandconstruction,especiallycasing,cementing,andpressuremanagement
• Fieldstudiesonpossiblemethaneleakagefromshalegaswellstowaterreservoirs
• Requirebackgroundwaterqualitymeasurementsandreporting
• Modernizerulesandenforcementtoensureprotectionofdrinkingandsurfacewaters
• Disclosureoffracturingfluidcomposition
• Reductionintheuseofdieselfuelforsurfacepowerinfavorofnaturalgasenginesorelectricitywhereavailable
• Managingshort-termandcumulativeimpactsoncommunities,landuse,wildlife,andecologies
• Useofmulti-welldrillingpadstominimizetransporttrafficandnewroadconstruction
• Evaluationofwateruseatthescaleofaffectedwatersheds
• Formalnotificationofanticipatedenvironmentalandcommunityimpacts
• Preservationofuniqueand/orsensitiveareasasoff-limitstodrillingandsupportinfrastructureasdeterminedthroughanappropriatescience-basedprocess
• Undertakingscience-basedcharacterizationofimportantlandscapes,habitatsandcorridorstoinformplanning,prevention,mitigationandreclamationofsurfaceimpacts
• Establishmentofeffectivefieldmonitoringandenforcementtoinformongoingassessmentofcumulativecommunityandlanduseimpacts
• Continuousimprovementofbestpractice
• ResearchandDevelopment
70 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
European Union (EuropeanParliament,2011)“Impactsofshalegasandshaleoilextractionontheenvironmentandonhumanhealth”,DirectorateGeneralforInternalPolicies,PolicyDepartmentA:EconomicandScientificPolicy,EuropeanParliament,June2011http://www.europarl.europa.eu/document/activities/cont/201107/20110715ATT24183/20110715ATT24183EN.pdf
Recommendations(notethosepertainingspecificallytoEuropeanUnionlawarenotincludedhere):
• In the framework of a Life Cycle Analysis (LCA), a thorough cost/benefit analysis could be a tool to assess the overall benefits for society and its citizens. A harmonized approach to be applied throughout EU27 should be developed, based on which responsible authorities can perform their LCA assessments and discuss them with the public
• It should be assessed whether the use of toxic chemicals for injection should be banned in general. At least, all chemicals to be used should be disclosed publicly, the number of allowed chemicals should be restricted and its use should be monitored. Statistics about the injected quantities and number of projects should be collected at European level
• Regional authorities should be strengthened to take decisions on the permission of projects which involve hydraulic fracturing. Public participation and LCA assessments should be mandatory in finding these decisions
• Where project permits are granted, the monitoring of surface water flows and air emissions should be mandatory
• Statistics on accidents and complaints should be collected and analysed at European level
• Where projects are permitted, an independent authority should collect and review complaints
• Because of the complex nature of possible impacts and risks to the environment and to human health of hydraulic fracturing consideration should be given to developing a new directive at European level regulating all issues in this area comprehensively
71
References
72 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
ReferencesATSDR 2010 -“EvaluationofContaminantsinPrivateResidentialWellWater,Pavillion,Wyoming”,AgencyforToxicSubstancesandDiseaseRegistry,August31,2010http://www.atsdr.cdc.gov/hac/PHA/Pavillion/Pavillion_HC_Well_Water_08312010.pdf
Badenhorst 2012 –Dr.CharlBadenhorst,MedicalHealthOfficer,BoardofNorthernHealth,FortSt.John,BritishColumbia.Personalcommunication,April27,2012.
Bamberger and Oswald 2012 – “ImpactsofGasDrillingonHumanandAnimalHealth”,Bamberger,M,andREOswald,NewSolutions,Vol.22(1)51-77,2012.http://www.psehealthyenergy.org/data/Bamberger_Oswald_NS22_in_press.pdf
BAPE 2011a –«Développementdurabledel’industriedesgazdeschisteauQuébec-Rapportd’enquêteetd’audiencepublique»,Rapport273duBureaud’audiencespubliquessurl’environnementduQuébec(BAPE),Février2011,ISBN978-2-550-61069-4(PDF)http://www.bape.gouv.qc.ca/sections/rapports/publications/bape273.pdf
BAPE 2011b –«Développementdurabledel’industriedesgazdeschisteauQuébec:MémoireprésentéauBureaud’audiencespubliquessurl’environnementparlesdirectionsdesantépubliqueMauricieetCentre-du-Québec/Chaudière-Appalaches/Montérégie»,273DM100,Novembre2010http://www.bape.gouv.qc.ca/sections/mandats/Gaz_de_schiste/documents/DM100.pdf
Brasier 2011–“CommunityImpactsofNaturalGasDevelopmentintheMarcellusShale:AResearchSummary”presentedbyKathyBrasier,PhD,atthe2ndAnnualConferenceontheHealthEffectsofShaleGasExtractionhostedbytheUniversityofPittsburghGraduateSchoolofPublicHealth,PittsburghPA,USA,November18,2011.
• Videoathttp://www.shalegas.pitt.edu/index.php?q=node/10
CDC 2008 –“PromotingHealthEquity:AResourcetoHelpCommunitiesAddressSocialDeterminantsofHealth”.BrennanRamirezLK,BakerEA,MetzlerM.Atlanta:U.S.DepartmentofHealthandHumanServices,CentersforDiseaseControlandPrevention,2008.http://www.cdc.gov/nccdphp/dach/chhep/pdf/SDOHworkbook.pdf
CDC 2012–CentersforDiseaseControlandPrevention,FrequentlyAskedQuestions–SocialDeterminantsofHealthhttp://www.cdc.gov/socialdeterminants/FAQ.html(accessedMay30,2012)
Colborn et al. 2011–“NaturalGasOperationsfromaPublicHealthPerspective”,Colborn,T.etal.,HumanandEcologicalRiskAssessment17,1039-1056,2011.Preprintavailableathttp://www.endocrinedisruption.com/files/GasManuscriptPreprintforweb12-5-11.pdf
Colorado School of Public Health 2011 –BattlementMesaHealthImpactAssessment,ColoradoSchoolofPublicHealth,February,2011http://www.garfield-county.com/environmental-health/battlement-mesa-health-impact-assessment-ehms.aspx
Considine 2010 –“TheEconomicImpactsoftheMarcellusShale:ImplicationsforNewYork,Pennsylvania,andWestVirginia.AReporttotheAmericanPetroleumInstitute”byTimothyJ.Considine,NaturalResourceEconomicsInc.,July14,2010http://www.api.org/~/media/Files/Policy/Exploration/API-Economic-Impacts-Marcellus-Shale.ashx
Eastern Research Group / Sage Environmental Consulting 2011-“CityofFortWorthNaturalGasAirQualityStudy–FinalReport”,EasternResearchGroupInc.andSageEnvironmentalConsultingLP,July13,2011http://fortworthtexas.gov/uploadedFiles/Gas_Wells/AirQualityStudy_final.pdf
European Parliament 2011–“Impactsofshalegasandshaleoilextractionontheenvironmentandonhumanhealth”,DirectorateGeneralforInternalPolicies,PolicyDepartmentA:EconomicandScientificPolicy,EuropeanParliament,June2011http://www.europarl.europa.eu/document/activities/cont/201107/20110715ATT24183/20110715ATT24183EN.pdf
References 73
FORUMe 2012–“FORUMe:Evolvingsocialvalues,naturalresourcesandtheeconomy”,conferencehostedbyL’UniversitédeMoncton’sClément-CormierResearchChairinEconomicDevelopmentincollaborationwiththeUniversityofNewBrunswick,MonctonNB,June3-5,2012http://www.amiando.com/FORUMeParticipate.html
FTPACPH 1999 - “TowardaHealthyFuture:SecondReportontheHealthofCanadians”,PreparedbytheFederal,ProvincialandTerritorialAdvisoryCommitteeonPopulationHealthfortheMeetingofMinistersofHealth,Charlottetown,P.E.I.,September1999(accessedJuly31,2012)http://www.phac-aspc.gc.ca/ph-sp/report-rapport/toward/pdf/toward_a_healthy_english.PDF
Fundy Engineering / Atlantica Centre for Energy 2011 –“ConsiderationsforResponsibleGasDevelopmentoftheFrederickBrookShaleinNewBrunswick”,FundyEngineeringandtheAtlanticaCentreforEnergy,March25,2011,http://www.atlanticaenergy.org/uploads/file/ACfE%20Shale%20Gas%20Paper%20-%2025%20March%202011%20FINAL.pdf
Gever 2011-Gever,J.,“SpecialReport:GasDrillingBringsStress,SocialIlls”,MedPageToday,December5,2011http://www.medpagetoday.com/PublicHealthPolicy/EnvironmentalHealth/30010
GLJ Petroleum Consultants 2011–“CorridorResourcesInc.ElginContingentResourcesEffectiveDecember31,2010”,GLJPetroleumConsultantsLtd.,March5,2011http://www.corridor.ca/investors/documents/ElginContingentResourcesSum.pdf
GNB 2011–“Provinceannouncesstrongerrequirementsfornaturalgasdevelopment”,GovernmentofNewBrunswicknewsreleaseJune23,2011http://www2.gnb.ca/content/gnb/en/news/news_release.2011.06.0703.html
Goldstein 2012–“MissingfromtheTable:RoleoftheEnvironmentalPublicHealthCommunityinUSGovernmentalAdvisoryCommissionsRelatedtoMarcellusShaleDrilling”,BernardD.Goldstein,JillKriesky,andBarbaraPavliakova,EnvironmentalHealthPerspectivesaheadofprintonlineversion,January10,2012,http://dx.doi.org/10.1289/ehp.1104594
Goldstein 2011–“PublicHealth,SustainabilityandtheMarcellusShale”,presentedbyBernardD.Goldstein,MD,atthe2ndAnnualConferenceontheHealthEffectsofShaleGasExtractionhostedbytheUniversityofPittsburghGraduateSchoolofPublicHealth,PittsburghPA,USA,November18,2011.
• Videoathttp://www.shalegas.pitt.edu/index.php?q=node/10
Health Canada 2011 –“ShaleGas:HealthCanadaActivities”,presentationbyRichardCharronattheNaturalGasDevelopment–PublicHealthWorkshop,FrederictonNB,Dec.2,2011
INSPQ 2010 –«Étatdesconnaissancessurlarelationentrelesactivitésliéesaugazdeschisteetlasantépublique–RapportPréliminaire»,InstitutnationaldesantépubliqueduQuébec,Directiondelasantéenvironnementaleetdelatoxicologie,Novembre2010,ISBN:978-2-550-60591-1(PDF)http://www.inspq.qc.ca/pdf/publications/1177_RelGazSchisteSantePubRapPreliminaire.pdf
Jacquet 2009–“EnergyBoomtowns&NaturalGas:ImplicationsforMarcellusShaleLocalGovernments&RuralCommunities”,NERCRDRuralDevelopmentPaperNo.43,TheNortheastRegionalCenterforRuralDevelopment,PennsylvaniaStateUniversity,preparedbyJeffreyJacquet,January2009http://nercrd.psu.edu/publications/rdppapers/rdp43.pdf
Medd (undated)–Medd,LM,“PopulationHealthandOilandGasActivities:APreliminaryAssessmentoftheSituationinNortheasternBC”,NorthernHealth,undatedhttp://www.northernhealth.ca/Portals/0/About/NH_Reports/documents/OilandGasreport.pdf
Nature Conservancy 2010–“PennsylvaniaEnergyImpactsAssessment,Report1:MarcellusShaleNaturalGasandWind”,TheNatureConservancy,WesternPennsylvaniaConservancyandAudubonPennsylvania,November15,2010http://www.nature.org/media/pa/pa_energy_assessment_report.pdf
74 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
NBDLG 2011–“ActionPlanforaNewLocalGovernanceSysteminNewBrunswick”,NewBrunswickDepartmentofLocalGovernment,December2011http://www2.gnb.ca/content/dam/gnb/Departments/lg-gl/pdf/ActionPlanLocalGovernance.pdf
NBDNR 2012 –MapofOilandNaturalGasLicenses/LeasesinNewBrunswickhttp://www.gnb.ca/0078/minerals/PDF/Oil_NG_Agreements-e.pdf
NBNGG 2011 –“ShaleGas:TheNewBrunswickApproach”,presentationbyMarkWiesoftheNewBrunswickNaturalGasGroupattheNaturalGasDevelopment–PublicHealthWorkshop,FrederictonNB,Dec.2,2011
NBNGG 2012a–“ResponsibleEnvironmentalManagementofOilandGasActivitiesinNewBrunswick:ExecutiveSummaryofRecommendations”,NewBrunswickNaturalGasGroup,May2012http://www2.gnb.ca/content/dam/gnb/Corporate/pdf/ShaleGas/en/ExecSummary.pdf
NBNGG 2012b–“ResponsibleEnvironmentalManagementofOilandGasActivitiesinNewBrunswick:RecommendationsforPublicDiscussion”,NewBrunswickNaturalGasGroup,May2012http://www2.gnb.ca/content/dam/gnb/Corporate/pdf/ShaleGas/en/RecommendationsDiscussion.pdf
NBNGG 2012c–“ResponsibleEnvironmentalManagementofOilandGasActivitiesinNewBrunswick:SharingofRoyaltyRevenuesfromNaturalGasActivitiesinNewBrunswick,ADiscussionDocument”,NewBrunswickNaturalGasGroup,May2012http://www2.gnb.ca/content/dam/gnb/Corporate/pdf/ShaleGas/en/RevenueSharing.pdf
NBNGG 2012d–“ResponsibleEnvironmentalManagementofOilandGasActivitiesinNewBrunswick:CaseStudiesandLessonsLearned”,NewBrunswickNaturalGasGroup,May2012http://www2.gnb.ca/content/dam/gnb/Corporate/pdf/ShaleGas/en/CaseStudies.pdf
NBNGG 2012e–“ResponsibleEnvironmentalManagementofOilandGasActivitiesinNewBrunswick:ListofReferences”,NewBrunswickNaturalGasGroup,May2012http://www2.gnb.ca/content/dam/gnb/Corporate/pdf/ShaleGas/en/ListOfReferences.pdf
New YorkDEC 2011 –“DraftSupplementalGenericEnvironmentalImpactStatement(SGEIS)ontheOil,GasandSolutionMiningRegulatoryProgram”,NewYorkStateDepartmentofEnvironmentalConservation, Draft2September2011http://www.dec.ny.gov/energy/75370.html
New York Health Professionals 2011 –LettertoNewYorkStateGovernorAndrewCuomofromover250concernedHealthProfessionalsandOrganizationsregardingomissionofhumanhealthimpactsintheNewYorkSGEISprocess,Oct.5,2011
• Letterhttp://www.psehealthyenergy.org/data/lettertoGovCuomofinal.pdf
• PressReleasehttp://www.psehealthyenergy.org/data/Release_Medical_Authorites_Urge_Cuomo_to_Order_Health_Assessment_of_Fracking_final_10-5-11.pdf
PA Citizen’s Commission 2011–“MarcellusShale:ACitizensView”,CitizensMarcellusShaleCommission,October24,2011http://citizensmarcellusshale.com
PA Governor’s Commission 2011 –PennsylvaniaGovernor’sMarcellusShaleAdvisoryCommissionReport,July22,2011http://files.dep.state.pa.us/PublicParticipation/MarcellusShaleAdvisoryCommission/MarcellusShaleAdvisoryPortalFiles/MSAC_Final_Report.pdf
PA Governor 2011–“GovernorCorbettAnnouncesPlanstoImplementKeyRecommendationsofMarcellusShaleAdvisoryCommission”,PennsylvaniaOfficeoftheGovernor,Oct.3,2011newsreleasehttp://www.governor.state.pa.us/portal/server.pt?open=18&objID=1201686&mode=2
PCPHN 2009–“BringingHealthtothePlanningTable:AProfileofPromisingPracticesinCanadaandAbroad”,Pan-CanadianPublicHealthNetwork,2009http://www.phac-aspc.gc.ca/publicat/2009/be-eb/pdf/be-eb-eng.pdf
References 75
PennEnvironment 2011–“IntheShadowoftheMarcellusBoom:HowShaleGasExtractionPutsVulnerablePennsylvaniansatRisk”,PennEnvironmentResearchandPolicyCenter,May,2011http://www.pennenvironment.org/news/pae/new-report-shale-gas-extraction-poses-risk-vulnerable-populations-pennsylvania
Perry 2011–“’It’slikewe’relosingourlove’:DocumentingandEvaluatingSocialChangeinBradfordCounty,PAduringtheMarcellusShaleGasBoom(2009-2011)”presentedbySimonaPerry,PhD,atthe2ndAnnualConferenceontheHealthEffectsofShaleGasExtractionhostedbytheUniversityofPittsburghGraduateSchoolofPublicHealth,PittsburghPA,USA,November18,2011.
• Videoathttp://www.shalegas.pitt.edu/index.php?q=node/10
PHAC–SustainableDevelopmentandPublicHealthhttp://www.phac-aspc.gc.ca/about_apropos/sd-dd/health-sante-eng.php
PHAC 2012 –“WhatDeterminesHealth?”PublicHealthAgencyofCanadawebpageaccessedMay17,2012http://www.phac-aspc.gc.ca/ph-sp/determinants/index-eng.php
Québec 2011–Comitédel’évaluationenvironnementalestratégiquesurlegazdeschiste,GouvernementduQuébec,http://ees-gazdeschiste.gouv.qc.ca/
Royal Society of Canada 2010–“EnvironmentalandHealthImpactsofCanada’sOilSandsIndustry”,TheRoyalSocietyofCanadaExpertPanel,December2010.Executivesummaryavailableathttp://www.rsc.ca/documents/expert/RSC_ExP_ExecutiveSummary_ENG_Dec14_10_FINAL_v5.pdf
RSNB 1973-MunicipalitiesAct,RSNB1973,ChapterM-22;CommunityPlanningAct,RSNB1973,ChapterC-12,bothavailableathttp://laws.gnb.ca/en/BrowseTitle
Ruddell 2011–Ruddell,R,“BoomtownPolicing:RespondingtotheDarkSideofResourceDevelopment”,Policing5(4),328-342,2011.Abstractathttp://policing.oxfordjournals.org/content/5/4/328.abstract
Sauve 2007–Sauve,M,“Canadiandispatchesfrommedicalfronts:FortMcMurray”,Can.Med.Assoc.Journal117(1),p.26,2007http://www.cmaj.ca/content/177/1/26.long
Schmidt 2011–Schmidt,CW,“BlindRush?ShaleGasBoomProceedsAmidHumanHealthQuestions”,EnvironHealthPerspect.119,a348-a353,2011.http://dx.doi.org/10.1289/ehp.119-a348
Senate of Canada 2008–“PopulationHealthPolicy:IssuesandOptions”,FourthReportoftheSubcommitteeonPopulationHealthoftheStandingSenateCommitteeonSocialAffairs,ScienceandTechnology,TheSenateofCanada,April2008http://www.parl.gc.ca/Content/SEN/Committee/392/soci/rep/rep10apr08-e.pdf
Senate of Canada 2009–“AHealthy,ProductiveCanada:ADeterminantofHealthApproach”,FinalReportoftheSubcommitteeonPopulationHealthoftheStandingSenateCommitteeonSocialAffairs,ScienceandTechnology,TheSenateofCanada,June2009http://www.parl.gc.ca/Content/SEN/Committee/402/popu/rep/rephealthjun09-e.pdf
Sierra Research Inc. 2011–“ScreeningHealthRiskAssessmentSubletteCounty,Wyoming”,SierraResearchInc.,January2011http://www.sublettewyo.com/DocumentView.aspx?DID=438
Stedman 2011–“NaturalGasDevelopment:ViewsofNewYorkandPennsylvania
ResidentsintheMarcellusShaleRegion”,Stedman,R.etal.,CornellUniversityCommunity&RegionalDevelopmentInstitute,Research&PolicyBriefSeries,Issue39,January2011http://devsoc.cals.cornell.edu/cals/devsoc/outreach/cardi/publications/upload/Policy_Brief_Jan11-draft08.pdf
St. Peter 2000–“OilshalesandoilandnaturalgasinNewBrunswick:Historicalandcurrentindustryrelatedactivities”,byC.St.Peter,NewBrunswickDepartmentofNaturalResourcesandEnergy,MineralsandEnergyDivision,InformationCircular2000-5,2000http://www.gnb.ca/0078/minerals/pdf/ONG_History-E.pdf
76 Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick
St-Pierre 2010–St-Pierre,L,“HIAandInequities:HIASeries”.NationalCollaboratingCentreforHealthyPublicPolicy,March2010http://www.ncchpp.ca/133/Publications.ccnpps?id_article=317
Tarlov 1999 –Tarlov,AR,“PublicPolicyFrameworksforImprovingPopulationHealth”,AnnalsoftheNewYorkAcademyofSciences896(SocioeconomicStatusandHealthinIndustrialNations:Social,PsychologicalandBiologicalPathways),281-293,1999.
Toronto Public Health 2010–“HealthImpactAssessmentinRelationtoExaminingHealthInequities”,TorontoPublicHealth,January22,2010http://www.simcoemuskokahealth.org/Libraries/JFY_Communities/787_-_CAP_Jan_22_-_HIA_Metrolinx_1.sflb.ashx
UN 1990 –ConventionontheRightsoftheChild,UnitedNations,enteredintoforceSeptember2,1990http://www2.ohchr.org/english/law/crc.htm
US Congress 2011 –“ChemicalsUsedinHydraulicFracturing”,UnitedStatesHouseofRepresentativesCommitteeonEnergyandCommerce,MinorityStaff,April2011http://democrats.energycommerce.house.gov/sites/default/files/documents/Hydraulic%20Fracturing%20Report%204.18.11.pdf
US Department of the Interior 2006–“RecordofDecision,JonahInfillDrillingProject,SubletteCounty,Wyoming”,USDepartmentoftheInterior,BureauofLandManagement,March14,2006http://www.blm.gov/pgdata/etc/medialib/blm/wy/information/NEPA/pfodocs/jonah.Par.5187.File.dat/00rod2.pdf
USDOE 2011a–ShaleGasSubcommitteeoftheSecretaryofEnergyAdvisoryBoard,Ninety-DayReport,August11,2011http://shalegas.energy.gov/resources/081111_90_day_report.pdf
USDOE 2011b–ShaleGasSubcommitteeoftheSecretaryofEnergyAdvisoryBoard,SecondNinetyDayReport,November18,2011http://www.shalegas.energy.gov/resources/111011_90_day_report.pdf
USEPA 2011–“DraftPlantoStudythePotentialImpactsofHydraulicFracturingonDrinkingWaterResources”,EPA/600/D-11/001/February2011,UnitedStatesEnvironmentalProtectionAgency,OfficeofResearchandDevelopment,2011.http://water.epa.gov/type/groundwater/uic/class2/hydraulicfracturing/upload/HFStudyPlanDraft_SAB_020711-08.pdf
Wallerstein 1992–Wallerstein,N.,“Powerlessness,Empowerment,andHealth:ImplicationsforHealthPromotionPrograms”,AmericanJournalofHealthPromotion:January/February1992,Vol.6,No.3,pp.197-205.Abstractathttp://www.ajhpcontents.com/doi/abs/10.4278/0890-1171-6.3.197?journalCode=hepr
Werntz 2011–“OccupationalHealthIssuesofMarcellusShaleDrillingandHydraulicFracturing”,presentedbyCarlWerntz,DOandMPH,atthe2ndAnnualConferenceontheHealthEffectsofShaleGasExtractionhostedbytheUniversityofPittsburghGraduateSchoolofPublicHealth,PittsburghPA,USA,November18,2011.
• Videoathttp://www.shalegas.pitt.edu/index.php?q=node/10
WHO 1948-PreambletotheConstitutionoftheWorldHealthOrganizationasadoptedbytheInternationalHealthConference,NewYork,19June–22July1946;signedon22July1946bytherepresentativesof61States(OfficialRecordsoftheWorldHealthOrganization,no.2,p.100)andenteredintoforceon7April1948http://whqlibdoc.who.int/hist/official_records/constitution.pdf
WHO 2008–“Closingthegapinageneration:Healthequitythroughactiononthesocialdeterminantsofhealth”,WorldHealthOrganizationCommissiononSocialDeterminantsofHealth,2008http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf
Wolf Eagle Environmental 2009 –“TownofDISHTexasAmbientAirMonitoringAnalysisFinalReport”,WolfEagleEnvironmental,September15,2009http://townofdish.com/objects/DISH_-_final_report_revised.pdfPHAC-SustainableDevelopmentandPublicHealthhttp://www.phac-aspc.gc.ca/about-apropos/sd-dd/health-sante-eng.php
top related