recommendations: shale gas development
TRANSCRIPT
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Chief Medical Officer of Healths
Recommendations Concerning Shale Gas
Development in New Brunswick
Office of the Chief Medical Officer of Health (OCMOH)
New Brunswick Department of Health
September 2012
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Cover photo:
TightGaswellsintheMcCullyFieldnearPenobsquis,NBPhotofromNBDNRhttp://www.gnb.ca/0078/minerals/Images/Carbon_Photo-60.jpg
Chief Medical Officer of Healths Recommendations
Concerning Shale Gas Development in New Brunswick
ProvinceofNewBrunswickPO6000,FrederictonNBE3B5H1
www.gnb.ca
2012.09
ISBN978-1-55471-717-0 8935
http://www.gnb.ca/0078/minerals/Images/Carbon_Photo-60.jpghttp://www.gnb.ca/http://www.gnb.ca/http://www.gnb.ca/0078/minerals/Images/Carbon_Photo-60.jpg -
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Table of Contents
Message 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 Dont Know Now 17
1.ShaleGasTheNewBrunswickContext . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
2.ExperiencefromOtherJurisdictions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.WhatWeDontKnowNow. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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.
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Whoever wishes to investigate medicine properly, should proceed thus: in the rst place toconsider the seasons o the year, and what efects each o them produces or they are not
at all alike, but difer much rom 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 o the waters, or as they diferrom one another in taste and weight, so also do they difer much in their qualities. In thesame 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 o the sun; or its inuence is not thesame 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 theinhabitants use, whether they be marshy and sot, or hard, and running rom elevated and
rocky situations, and then i saltish and unt or cooking; and the ground, whether it benaked and decient in water, or wooded and well watered, and whether it lies in a hollow,
conned situation, or is elevated and cold; and the mode in which the inhabitants live, andwhat are their pursuits, whether they are ond o drinking and eating to excess, and given
to indolence, or are ond o exercise and labour, and not given to excess
in eating and drinking.
On Airs, Waters and Places, Hippocrates, c. 400 BCE
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Message from the Chief Medical Officer of Health
Doctorshaveknownforthousandsofyearsthattheenvironmentgreatlyimpactsuponhumanhealth.Hippocrates,theGreekphysicianoftenreferredtoasthefatherofWesternmedicine,firstwroteaboutittwenty-fivecenturiesago.FortunatelytodayinNewBrunswickbothresidentsandvisitorsstillfindhereahealthyandpleasingenvironment.Indeedourvastnetworksofriversystemsarerenownedfortheirfishingandotherrecreationalpursuits.Thekeyinitiativeofcreatingandmaintaininghealthyenvironmentshowever
requiresongoingattention:wemustcontinuetoinvestinwhattrulymakespeoplehealthy.Thisrequirestheeffortofanentirecommunityledandsupportedbyawhole-of-governmentapproach.
Section41oftheCanadianMedicalAssociationCodeofEthicsreadsthataphysicianshouldrecognizethatcommunity,societyandtheenvironmentareimportantfactorsinthehealthofindividualpatients.Increasingly,doctorsareexpressingtheirconcernswhenanyofthesefactorsimpactnegativelyupontheirpatients.Becauseofourtrainingandexperienceinenvironmentalhealth,weasPublicHealthdoctorshaveaparticularandimportantroletoplay.Furthermore,itispartofourmandatetoadvocate,andprovidemeaningfulinformationsothatpeople,communities,organizationsandgovernmentshavetheknowledgenecessarytomaketheappropriatedecisionswhenfacedwithbalancingthepotentialbenefitsandharmsofagivensituation.Likeanyotherdoctor,wemustconsiderallourpatientsinthiscasetheentirepopulationpresentandfutureandgivethoughtfuladviceforactionsthatwillpromotefairopportunitiesforindividuals,familiesandcommunitiestoenjoygoodhealth.
Virtuallyeveryindustryhaspotentialhealthimplicationsassociatedwithit.Thetype,thefrequencyandtheseverityvariesconsiderablywiththenatureandcomplexityoftheindustrysotoowithshalegasproduction.
ThegasandoilindustryisnotnewtoNewBrunswick.However,itisonlyinthelast10yearsorsothatthecombinationoftechnologieshasbeendevelopedthatmakesitfeasibletoextractgasfromthelayersofshaledeepintheearthinaneconomicallyviableway.Themethodologiesusedarecomplexandstillevolving.Withshalegasproduction,wenotonlyhavetoconsiderwhatthehealthimpactsarefromtheknownconventionalpartoftheindustrybutalsofactorinthoseconsiderationsthatrelatetothenew.
Withindustry,theremayofcoursebeeconomicbenefitswhichshouldhaveapositiveimpactonhealthstatus.However,wecannotsimplyassumethatmoremoneyequatestoahealthierpopulationthemoneyneedstobeutilisedstrategically.Economicfactorsaside,theultimatedecisiontoallowindustryexpansiontoproceedwillneedtotakeintoaccountwhatappearstohavebecomeapolarizedpublicdebate,possiblyaresultofboth
thevaluesbasednatureofthediscussionandvaryingdegreesofthepublicsunderstandingofthefacts.Whenpeopledontunderstandanissue,orfeeltheirvaluesarebeingcompromised,thishasanadversebearingontheirhealthandwellbeing.
AsChiefMedicalOfficerofHealth,Iamthereforeprovidingtheserecommendationstoourgovernmenttoofferadviceonmeasuresthatshouldbeputinplacetomaximizethehealthbenefitsandminimizethehealthrisksrelatedtoshalegasdevelopmentifthedecisionistakentogoaheadwithit.Inaddition,thisdocumentisintendedtoprovideinformationtothemanyotherswhohavearoletoplayinprotectingthehealthofthepublic.Thisworkisbasedonexperiencefromotherjurisdictions,areviewoftheavailableliterature,andexpertopinionfromavarietyofpublichealthandenvironmentalhealthprofessionals.Asthisprocessdevelops,newknowledgeemergesandourunderstandingevolves,someoftheserecommendationsmayneedtobeadaptedoradjusted.
Currently,thepeopleofNewBrunswickareamongsomeofthemostprivilegedintheworld,enjoyingoneofitsmostbeautifulsocialandphysicalenvironments;therefore,atthispointintime,wemustensurethatwealldoourbesttopreservethatforourselvesandthegenerationstocome.
Dr.EilishClearyChiefMedicalOfficerofHealthNewBrunswickDepartmentofHealth
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Executive Summary
Whilelarge-scaledevelopmentofashalegasindustryinNewBrunswickmayofferaneconomicgrowthopportunityfortheprovince,itwillbeimportanttoensurethattheoverallhealthgainsaregreaterthanthelosses.Economicstatusofindividualsandcommunitiescanbeanimportantdeterminantoftheirhealth,howevertherearemanyotherfactorsresultingfromindustrydevelopmentthatcanhavestrongnegativeimpacts.Unlesspropercontrolsareputinplacethereisariskofspoilinganybenefitsfromeconomicgains
throughadversehealthoutcomes.
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.
ManyoftheserecommendationsarecomplementarytothoseproposedinthedocumententitledResponsibleEnvironmentalManagementofOilandGasActivitiesinNewBrunswick-RecommendationsforPublicDiscussion(May2012)whichwasdevelopedtooutlinemeasuresrequiredtoprotecttheenvironment.Thisdocumentbuildsuponandenhancestheproposedenvironmentalmeasuresasdeemednecessaryinordertoprovideaddedprotectionforhumanhealth.TherecommendationsthatresultedareintendedtohelpinformtheGovernmentsriskmanagementandregulatoryframeworkinsuchawaythatitwillbeabletoprovideappropriate,andcomprehensivepublichealthpromotionandprotectionalongwithitsothergoals.Thisdocumentisalsointendedtoprovideinformationtothemanyotherswhohavearoletoplayinprotectingthehealthofthepublic.
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4 Chie Medical Oicer o Healths 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.
ItisimportanttonotethattheCMOHsrecommendationsarenotafullassessmentofallhealthrisksastheyapplyintheNewBrunswickcontext.However,itisintendedtohelpstartaconversationonpotentialhealth
impactsfromshalegasdevelopmentandwhatcanbedoneaboutthem.
TheworkofbuildingahealthypopulationbelongstoallofsocietyandsomanyoftherecommendedactionswillrequireconsiderableworkfromindividualsandorganizationsinthecommunityaswellasfromGovernmentandindustry.Becauseoftheirtrainingandexpertise,PublicHealthprofessionalswillhaveaparticularlyimportantroletoplayinleadershipandcontentknowledge.IdeallyNewBrunswickshouldbebuildingefficienciesandexpandingknowledgethroughapan-Canadianapproachwhenpossible.
Thecostoffundingtheserecommendationshasnotyetbeendetermined.Itisrecognizedtheymaynotbeinsignificantandtherecouldbeopportunitytohavemuchofthecostsabsorbedbyindustry.Thisadviceisbasedonwhatshouldberoutinepublichealthpracticeforallenvironmentalhealthprograms.Theknowledgeusediscurrent,butastherearemanydataandinformationgapsitwillneedtoevolve.Inparticular,itwillbekey
tohearpublicthoughtsandperceptionstobetterinformfutureactions.Animplementationgroupshouldbeestablishedandanoversightmechanismputinplace.
Document Overview
Part 1ofthisdocumentoutlinestheguidingprinciplesforprotectionofpublichealth,includingaspectsofthedeterminantsofhealth,ethicalconsiderations,publichealthvaluesandprinciples,andthederivedhealthobjectives.Thisinformationprovidesabackgroundforthereasoningbehindpublichealthpromotion,preventionandprotectiondecisions,andfortherecommendationsherein.
Themaindeterminantsofpopulationhealtharefactorsthatimpactthesocialandphysicalenvironments.In
additiontoprotectingthephysicalenvironment,investmentinimprovingthesocialdeterminantsofhealthtodaywilltranslateintobetterhealthequity,improvedpopulationhealthandlessmoneyspentontreatmentandrehabilitationtomorrow.
Ethicalconsiderations,valuesandprinciplesguideallactionsintendedtoimprove,promoteandprotecthealthbecausethepracticeofpublichealthisalwaysabalancingactbetweenknownsandunknownsanddecisionsoftenneedtobemadeinthefaceofuncertainty.
Thehealthobjectives,valuesandprinciplesdescribethedifferentpiecesofworkthatneedtobeundertakentomakeadifferencethroughimprovedhealthofthepopulation.However,actionontheseissuesneedstocomefromoutsidethehealthsectoraswellasfromwithinit.ThePublicHealthsectorshouldplayaleadershiprole,butachievingtheseoutcomesneedstoinvolvecollaborative,multi-sectoralpartnershipsacrossthe
wholecommunity.
Part 2ofthisdocumentexaminestheNewBrunswickcontext,summarizesthekeyfindingsfromareviewofexperienceinotherjurisdictionsandoutlinesmanyknowledgegapswithrespecttoshalegasandpublichealthingeneral.Italsocontainsanoverviewofsomeoftheworkbeingundertakenelsewherewhichwillassistincontributingtotheknowledgebaserelatedtothisindustry.
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1. Shale gas the New Brunswick context
WhiletheoilandgasindustryisnotinitselfnewtoNewBrunswick,thecombinationoftechnologiesandmethodologiesthatenablerecoveryofgasfromtheshalelayersisrecent.Thishasledtoconsiderableinterestasitisbelievedthatthereisarichreserveintheprovincealthoughitisnotuniformlydistributedthroughout.Thiswouldmeanthatnotallcommunitieswouldbeequallyimpactedbyanypotentialdevelopment.Thereiscurrentlynoestimateavailableoftherate,size,density,locationorproductioncapacityofthepotentialdevelopmentwhichhasmadeitdifficulttodo
afullassessmentonpotentialhealthimpacts.
2. Experience from other jurisdictions
Theprincipallessonsnotedwerethattherearesocialandcommunityhealthrisksfromthisindustrywhichcanbecompoundedbyinequitiescausedamongstthelocalpopulace.Onecouldexpectthatasaresultofeconomicgainsduetoincreasedincome,energyandemployment,therewouldbeanindirectpositivebenefitinhealthstatusasaresultofthisindustry,howeverclearevidencetosupportthiswasnotfoundinthecourseofthisreview.
Therearesignificantdatagapsthatlimitassessmentofhealthrisksandtodatetherehasbeenlimitedinvolvementinshalegasissuesbypublichealthofficialsandexperts.Thepublicdiscussiononshalegashasbeendominatedbychemicaltoxicityconcernsbutmanyotherfactorsofpotentialconcernto
publichealthalsoneedattention.Fewstudieshavebeenundertakenthatconsidertheoverallpotentialimpactsonhealthandthephysicalandsocialenvironmentsovertheentirelifetimeoftheindustry.
OneparticularpossiblesocialandcommunityhealthriskthattheProvincewillneedtoguardagainstistheBoomtownEffectthatcanariseduringeconomicdevelopment.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.Inadditiontothepotentialfor
toxicityorphysicalinjury,thereareotherpossiblehazardstomentalhealthandcommunitywellbeingthatresultfromafeelingoflackofcontroloveronesdestinyinlocalcommunitiesinthefaceoftheseissues.
3. What we dont know now
Someofthekeyinformationgapsidentifiedduringthisreviewincludealackofstandardmethodsforpreventingandmitigatingsocialimpacts,alackofhealthstatusstudiesbeforeandduringgasdevelopment,andalackofsystematichealthimpactassessments.Informationneededtoassesstoxicityrisksmayalsobelacking,suchasthetoxicologicalcharacteristicsofindustryproductsandwastes,
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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;andimplementingatransparentconsultativeprocesswiththepublicandotherstakeholdersontheimplementationprocessforthese
recommendations.
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;fullandtimelydisclosureof
chemicalsused;lesstoxicalternativesforhydraulicfracturingfluids;safesetbackdistancesthatconsiderhumanhealthfactors;limitinghealthimpactsfromnoise,vibrationandcontinuousillumination;trafficmanagementplans;emergencyresponsetraining;andpromotionandprotectionforthehealthofworkers.
4. Protection of future generations
IncludesrecommendationsforaplantoanticipateandmitigatetheBoomtownEffect;astrategichealthimpactassessment;identifyingareastobeexcludedfromdevelopment;astrategiclanduseplanthatconsidershealthequity;considerationofvulnerableanddisadvantagedpopulations;considerationofFirstNations;astrategicwatermanagementplan;andpublicreportingofenvironmentalandhealthmonitoringdata.
5. Implementation and oversight
Includesrecommendationsforstrengtheninggovernmentoversightcapacityandresources;strikinganimplementationgrouptooverseeimplementationoftheCMOHsrecommendations;establishinganon-goingdialogueamongcommunity,government,academicsandindustry;andcreatingamulti-disciplinaryadvisorycommitteetoCabinet.
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Part 4ofthisdocumentoutlinestheconclusionsuponwhichtherecommendationsarebased.ThemandateoftheOfficeoftheChiefMedicalOfficerofHealthistoimprove,promoteandprotectthehealthofthepeopleinNewBrunswick.BasedonthisworkitisclearthatifthedecisionistakentoexpandtheshalegasindustryinNewBrunswick,Governmentmusttaketargetedandstrategicactionsaimedatpreventionandmitigation,includingbuildingcapacityinlocalandprovincialservicesandinfrastructure,inordertominimizetherisksofnegativeimpactsonhealth.
Thelearningsfromotherjurisdictionsthathaveundergonerecentdevelopmentofthisindustryindicatethat
itwillbenecessarytolookathealthinbroadterms,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,NewBrunswickcouldbealeaderinestablishingapathtobalancethecontentiousandsometimespolarizedviews
withinsocietyregardingtheincreasingnumberofvitalissuesofenvironmentalhealth-locallyandglobally.
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Summary of Recommendations
1. 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.
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Recommendation 3.5: TheProvinceshoulddevelopandimplementreasonable,safesetbackdistancesapprovedbyPublicHealththatconsiderhumanhealthandwhicharebasedonexposureriskassessmentsinadditiontoestablishedprecedents.
Recommendation 3.6: TheProvinceshoulddevelopandimplementstandardsapprovedbyPublicHealthtolimithealthimpactsfromnoise,vibrationandcontinuousillumination.
Recommendation 3.7: TheProvinceshouldrequiresite-specifictrafficmanagementplansforall
projects,includingrouteplansanddesignatedtimesofdayforheavytruckmovements.Recommendation 3.8: TheProvinceshouldenhancelocalandprovincialemergencyresponsetraining,capacityandpreparednesstorespondtothemostlikelyandmostseriousemergenciesthatmightposeathreattohumanhealth.
Recommendation 3.9: TheProvinceshouldenhancethemechanismsthatareinplacetopromoteandprotectthehealthofworkersintheindustryandotherswhomaybeattheworksites(governmentinspectors,supportindustryworkers,emergencyresponders,etc.).
4. Protection of Future Generations
Recommendation 4.1: TheProvinceshoulddevelopaplanforanticipatingandmitigatingtheBoomtownEffect.
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
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projectreviewsandapprovals,inspections,monitoring,enforcementandmanagementofenvironmental,healthorsocialconsequences.
Recommendation 5.2: TheProvinceshouldestablishanimplementationgroupfortherecommendationsinthisreportthatisledbyPublicHealthandincludesrepresentativesfromotherrelevantgovernmentdepartmentsandotherstakeholders.
Recommendation 5.3: TheProvinceshouldsponsoraseriesofsummitsledbyPublicHealthtobetter
understandandcommunicatepublichealthinformationandissuesandtofosteraneffectiveongoingdialogueamongcommunity,government,academicsandindustry.
Recommendation 5.4: TheProvinceshouldcreateamulti-disciplinaryAdvisoryCommitteetoCabinetchargedwithreviewinggovernmentoversightthroughoutthelifetimeoftheindustryinNB.
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Part 1Guiding Principles for
Protection of Public Health
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1. Determinants of Health
Takentogether,thesocialandphysicalenvironmentsarethemaininfluencesonpopulationhealth.Ingeneral,thelowerapersonssocialandeconomicpositionis,theworsetheirhealth,soaddressingthesocialdeterminantsofhealthisfundamentaltoachievinghealthequity.Investmentinthesocialdeterminantsofhealthtodaytranslatesintobetterpopulationhealthandlessmoneyspentontreatmentandrehabilitationtomorrow.WhileGovernmentprograms,policiesandlawprovideopportunitiesforimprovements,theactionneededtoimprovehealthequitymustcomefromoutside
thehealthsectoraswellasfromwithin.
TheWorldHealthOrganizationdefineshealthasa state o complete physical, mental andsocial well-being and not merely the absence
o disease or inirmity(WHO1948).Healthisinfluencedbyabroadrangeofbothindividualandcollectivefactors,andtheirinteractions:thesefactorsarereferredtoasdeterminantsofhealth.ThePublicHealthAgencyofCanadaliststwelvekeydeterminantsofthehealthofapopulation(seesidebar).TheUSCenters
forDiseaseControlandPreventionhasaverysimilarlist,butinsteadgroupsthemunderfivekeycategories:genesandbiology,healthbehaviours,socialenvironmentorsocialcharacteristics,physicalenvironmentortotalecology,andhealthservicesormedicalcare(CDC2012).Theimportanceofthesedeterminantsofhealthhasbroadagreementworldwideamongfirstministers,healthministers,andmanylocal,provincial,nationalandinternationalorganizations.Thisdocumentwillfocusprincipallyonthedeterminantsofhealthrelatedtochangesinthesocialandphysicalenvironments.
Theimpactonhealthfromeachofthesedeterminantsvaries,butresearchestimatesthatingeneralthehealthofapopulationdependsprincipallyonthesocialandeconomicdeterminants,whichamounttoroughlyhalfofthetotalinfluenceonhealth(SenateofCanada2008).Thisestimatealsoattributesapproximately25%ofthepopulationshealthtothehealthcaresystem,15%tobiologyandgeneticfactors,andabout10%tothephysicalenvironment.Anotherestimate(CDC2012andTarlov1999)suggeststhatthecombinedinfluenceofsocial/societalcharacteristics(thesocialenvironment)andthetotalecologyofalllivingthings(thephysicalenvironment)amountstomorethanhalfofthetotalinfluenceonpopulationhealth,followedtoaprogressivelylesserextentbyhealthbehaviours,
medicalcare,andlastlygenesandbiology.
Theseestimateslendsupporttosocialandeconomiccircumstancesaspowerfuldeterminantsofhealth,andinrecentyearstherehasbeenwidespreadinternationalattentiontothisissue.Mostrecently,theWorldHealthOrganizationorganizedtheWorldConferenceonSocialDeterminantsofHealthinBrazilinOctober2011,whichunderlinedthataddressingthesocialdeterminantsofhealthisacornerstoneofpublichealthpractice.Inotherwords,sustainabledevelopmentequatestohealthierCanadians,asshownbelowinPHACsdescriptionoftherelationshipbetweenthekeydeterminantsofhealthandthethreepillarsofsustainabledevelopment.
Determinants o Health (PHAC 2012)
incomeandsocialstatus
socialsupportnetworks
educationandliteracy
employment/workingconditions
socialenvironments
physicalenvironments
personalhealthpracticesandcopingskills
healthychilddevelopment
biologyandgeneticendowment
healthservices
gender
culture
Investing in the socialdeterminants o healthupront is strategic and
advantageous
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2. Public Health Ethical Considerations
Thepracticeofpublichealthisalwaysabalancingact.Decisionsoftenneedtobemadeinthefaceofscientificuncertaintyandwithoutclearresearchevidenceofbenefitorharm.However,thefailuretoactmayproduceevengreaterrisktohealth.
Ethicalconsiderationsunderlieallpublichealthobjectives,andbyextension,therecommendationsinthisdocument.Ethicsareasfundamentaltopublichealthpracticeandprofessionalismasisevidence-
baseddecision-making.Publichealthethicsareastandardofcareaswellasadutyofcare.Theyarethevaluesandprinciplesthatguideactionsintendedtoimprove,promoteandprotecthealth,andtheymustbereliedonparticularlyinthefaceofuncertaintyandcontroversy.
Publichealthethicsisoftenmoreclearlyunderstoodwhencomparedtoclinicalethics.TheprovincialChiefMedicalOfficerofHealth(CMOH)andtheRegionalMedicalOfficersofHealtharephysiciansandhavethesameethicalobligationsasanyotherphysicianwould,butintheircasethepatientisthepublicratherthananindividual.Asaresult,thefollowingcomparisonscanbemade:
Theultimateobligationofphysiciansandotherhealthcareprovidersistoactinthebestinterestsoftheindividualpatientbeforethem:thisisknownasfiduciaryresponsibility.In public health, the dutyo care is toward the community or society as a whole.
Intheclinicalsetting,theindividualpatientseeksoutthehealthcareproviderandanyinterventionislegitimizedbyinformedconsent.With public health interventions, inormed consent could becontextualized as transparency an open decision-making process where the Public has the right to be
inormed about the reasons or decisions and the right to appeal.
Clinicalethicsisorientedtoautonomy,whilethe orientation in public health is essentiallycommunitarian (namely, what is good or the whole community, not just the individual).
Ultimatelythissimplytranslatesto,whatisthecostofbeingwrongaboutestimatingrisk?Ifwebelievetherisksaremoderateandacceptableandcanbemitigatedbutwearewrong,whatistheworstthatcouldhappen?Ifwebelievetherisksareextremeandunacceptableandwearewrong,thenwhat?
Becausepublichealthdecisionmakingdependsonanassessmentofcomplexandinteractingfactors,keyvaluesandethicalprinciplesareusedforguidance.Inadditiontogeneralvaluessuchasaccountability,respect,integrityandcollaboration,thefollowingarethemainethicalconsiderations,valuesandprinciplesthatunderlieallpublichealthobjectivesandwhichgiverisetotherecommendations.
The practice o publichealth is alwaysa balancing act
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Part I: Guiding Principles or Protection o Public Health 15
Public Health Ethical Considerations
Autonomyactionstakentoprotectpublichealthshouldrespectself-governance,self-determination,andinformeddecision-making
BeneficenceandNon-maleficencedogood;i.e.protectthePublicshealth,andrefrainfromdoingharm
Burden of ProoftheburdenofproofthatanactivityisnotharmfulfallsonthoseundertakingitratherthanonPublicHealthauthoritiestoprovethattheactivityisharmful
Communitarianismapplywhatisgoodforthewholecommunity,notjustindividuals
Equity and Distributive Justicealwaysseekequitabledistributionofbenefitsandburdens.Thisprincipleappliestobothsocialandenvironmentaljustice
Evidence-basedriskassessmentanddecisionmakingshouldalwaysbeevidence-informed Harm Principletoprotectthepublicfromharm,PublicHealthauthoritiesmayhavetotake
actionsthatrestrictindividualsliberty
LeadershipPublicHealthauthoritieshaveafiduciaryresponsibilitytoprotectthepublic
Precautionary Principlewhenanactivityoroccurrenceraisesthreatsofseriousorirreversibleharmtohumanhealthortheenvironment,precautionarymeasuresshouldbetakenevenifsomecauseandeffectrelationshipsarenotfullyestablishedscientifically
Preventionafocusonprimordial(stepstakenpriortoemergenceofproblems)andprimary(directcontrolmeasures)preventionisalwayspreferabletomitigationofimpactsandremediationofproblemsaftertheyoccur
Proportionality(LeastRestrictiveMeansPrinciple)restrictionsimposedshouldbeproportionaltowhattheproblemwarrants,usingtheleastrestrictivemeanstoachievethedesiredoutcome
Reciprocityifindividualsareaskedtocurtailtheirlibertiesforthepublicgood,thereisareciprocalobligationonthepartofsocietytoensurethattheydonotsufferunduehardshipfrom
complying Transparencythedecision-makingprocessshouldbeopen,thespecificsofbalancingrisks
andbenefitsshouldbeclearlyexplainedtothePublic,andthereshouldbeanappealprocess
Utilitarianismachievethegreatestgoodforthegreatestnumber
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3. Health Objectives Related to Development of a Shale Gas Industry
in NB
Justasaclinicaldoctorhasarangeoftreatmentoptionsavailabletomanageapatient,sotoohasPublicHealthanumberofwaysitcanintervenetoachievethedesiredoutcomesofimprovedhealthofthepopulation.Thesecanbedescribedashealthobjectivesandrepresentthedifferentpiecesofworkthatneedtobeundertakeninordertomakeadifference.Theydescribewhatmustbeachievedratherthanwhohasresponsibility.Fulfillingtheseobjectivesgoesfarbeyondtheworkofthepublichealth
sector,whichhowevermustplayaleadershiprole.Achievingtheoutcomeswillinvolvecollaborative,multi-sectoralpartnershipsacrossthewholecommunity.
1. ADVOCACY, LEADERSHIP & PARTNERSHIPPromoteandprotectthehealthofNew Brunswickersthroughleadership,partnership(intragovernmentalandwiththepublic,industry, academiaetc.),innovationandactioninpublichealthduringallphasesoftheshalegas industryinNB.
2. PROVISION OF INFORMATIONGenerateanddisseminateinformationfromapublic healthperspective(healthhazardidentification,exposureassessment,riskassessmentand characterization,riskcommunication)whichwillsupportevidence-baseddecisionmakingfor policyandpracticeandhelptoensurethatallphasesoftheshalegasindustryinNBaredone
safelyandresponsibly.
3. PREVENTION OF PUBLIC HEALTH HAZARDSIdentify,preventandrespondtohealthhazards thatposearisktopublichealthduringallphasesoftheshalegasindustryinNB.Fulfilling thisobjectivewillinvolveplanning,implementingandevaluatingriskassessmentandmanagement strategiestoaddressthesehazards,aswellasenforcement,andenhancingdatacollectionsystems forpopulationhealthassessment,surveillanceanddissemination.
4. PUBLIC HEALTH EMERGENCY PREPAREDNESSPrepareforandrespondtopublichealth emergenciesthatmayariseduringallphasesoftheshalegasindustry.
5. HEALTHY WORK ENVIRONMENTPromoteahealthyworkenvironmentforthoseemployedby andincloseproximitytotheshalegasindustry.
6. COMMUNICABLE DISEASE PREVENTION AND CONTROLAnticipate,preventandcontrol communicablediseasesgiventhepotentialfortheincreaseinpopulationanditsdensityin communitieshostingtheshalegasindustry.
7. SOCIAL DETERMINANTS OF HEALTH EMPHASISContinuetobuildhealthyandresilientpeople, communitiesandenvironmentsbyusingapopulationbasedhealthapproachthataddresses thesocialdeterminantsofhealth,andmakeseffective,efficientandequitableuseoftheeconomic opportunitiesfromtheshalegasindustryinNB.
8. NATIONAL AGENDAParticipateincollaborationwithfederal/provincial/territorialpublichealth agenciesacrossCanadatorefinepublichealthrolesandresponsibilitiesinthecontextofashalegas industryandtofacilitatenationalapproachestopublichealthpolicyandplanninginthissector.
9. SCHOLARLY ACTIVITYContribute,throughscholarlyactivityandresearch,tothebodyof knowledgeonthepublichealthimpactsoftheshalegasindustryandtheirmitigation.
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Part 2
What We Know Now and
What We Dont Know Now
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1. Shale Gas The New Brunswick Context
Despiteexperienceinthisprovincewiththeoilandgasindustryoveralongtimeframe,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(directionalhorizontaldrillingintoshalesourcerockasopposedtosandstonereservoirrockandhigh-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,aboominactivitymayoccurasithasinother
jurisdictions.
OneimportantfactortonotealsofromFigure1isthatnotallgeographicareasoftheProvincehavethepotentialtobedirectlyinvolvedinoraffectedbyshalegasdevelopment.Thisisalsotrueinother
jurisdictions(see,e.g.,NatureConservancy2010;Considine,2010;SierraResearchInc.2011)andissimplyaconsequenceofthelocalgeology(i.e.thedevelopmentwillonlyoccurwheretheresourceexists).This
effecthasimplicationsinthatboththepotentialrisksandbenefitscouldbedifferentbetweendifferentNewBrunswickcommunitiesandregions.
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Part 2: What We Know Now and What We Dont Know Now 19
Figure 1 (from NBDNR, 2012)
Oil and Natural Gas Licences/Leases, New Brunswick
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20 Chie Medical Oicer o Healths Recommendations Concerning Shale Gas Development in New Brunswick
2. Experience from Other Jurisdictions
BecausetherehasbeenlittledirectexperiencetodateinNewBrunswick,therecommendationsinthisdocumentdrawonexperiencefromotherjurisdictionswheretheshalegasindustryhasalreadyundergonesignificantexpansionand/orstudy,suchastheUSstatesofPennsylvania,Texas,Colorado,WyomingandNewYork,amongstothers,aswellasotherprovincesinCanada.NewBrunswickisinthefortunatepositionofbeingabletolearnfrombothpositiveandnegativeexperienceselsewhere.
Theprincipallessonsnotedwerethattherearesocialandcommunityhealthrisksfromthisindustrywhichcanbecompoundedbyinequitiescausedamongstthelocalpopulace.Likelytherecouldbeindirectbenefitsfromeconomicgainsduetoincreaseincome,energyandemployment,howeverclearevidencetosupportapositiveimpactonhealthstatusrelatedtothisindustrywasnotfoundinthisreview.
Therearesignificantdatagapsthatlimitassessmentofhealthrisksandtherehasbeenlimitedinvolvementofpublichealthofficialsandexpertsinshalegasissuestodate.Finally,fewstudieshavebeenundertakenthatconsidertheoverallpotentialimpactsonhealthandtheenvironmentovertheentirelifetimeoftheindustry.
Someoftheprincipallessonsrelatedtopublichealthfromexperienceinotherjurisdictionsareitemizedhere.
a. There are signicant data gaps that limit the ability to thoroughly assess risks to publichealth.
Someofthepublichealthknowledgegapsthathavebeenidentifiedincludedevelopmentofapproachestoplanningforsocialimpacts,alackofpriorhealthstatusstudies,alackofcomprehensivehealthimpactassessments,specificchemicaltoxicityinformationonchemicalsusedbytheindustry,chemicaltoxicityinformationonwastes,alackofexposuredata,apoorabilitytoforecasttheextent,rateandlocationsofdevelopment,andlittleinformationoncumulativeorfulllife-cycleeffects.TheseissuesarediscussedinmoredetailinSection3(WhatWeDontKnow)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
MENTALMentalhealthimpactstoindividuals
SOCIOECONOMICImpactstocommunities
OTHER Otherimpacts,suchascumulativeeffects,radiation,etc.
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Part 2: What We Know Now and What We Dont Know Now 21
ThesepotentialhazardsformpartofthebasisoftheframeworkusedfortherecommendationsinPart3.
c. The public discussion on shale gas has been dominated to date by chemical toxicity concernsand as a result many other factors of potential concern to public health also need attention.
Thefocusinthepublicdiscoursetodateonwaterandhydraulicfracturingchemicalsrunstheriskofoverlookingotherconsiderationsthatarepotentiallyevenmoreproblematic,suchascommunity
healthissues.Mostmediareportsrelatingtopublicconcernsovershalegasdevelopmenthavefocussedalmostentirelyontheimpactfromhydraulicfracturingchemicalstodrinkingwaterwells.Therehavealsobeenasmallernumberofreportsaboutconcernsrelatedtoairquality,butthesetwoissuesaloneaccountforalmostallofthepublicdiscourseaboutpotentialhealtheffects.
Withregardtothescientificandmedicalliterature,factorssuchaspotentialimpactstocommunityhealth,mentalhealthandsocioeconomicwellbeinghavealsonotbeenaswidelyreportedorstudiedassomeoftheissuessurroundingpotentialenvironmentaltoxicants.Theseareneverthelessveryimportantdeterminantsofhealth,andareofinteresttothepublichealthcommunityworldwide,sotherehasrecentlybeenanincreaseinthelevelofattentiontotheseissues.
Furthermore,someofthestudiesthataddresscommunityhealthissueshavepointedoutsomepotentialnegativeconsequenceswhenplanningfordevelopmentdidnotadequatelytakethesefactorsintoaccount.SomeofthesementalhealthandsocioeconomicimpactsarediscussedfurtherinSections2eand2fbelow.
Anotherareathatneedsbetterunderstandingisthepotentialforphysicalinjury,bothattheworksiteitselfandinthevicinityofdevelopment.Therearepotentialhazardsthatwarrantfurtherconsideration:forexample,ithasbeenestimatedthatupto2,000trucktripsareneededperwelldeveloped(EuropeanParliament2011;NewYorkDEC2011)andtheseareoftenonruralroadsthatwerenotdesignedforsuchtraffic.Asaresult,thepotentialforincreasedtrucktrafficaccidentsthat
couldimpactresidentsneardevelopmentareasisaconcern.
d. Public Health ocials 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,anarrowingofthescopeofwhathealthmeans,and/orabeliefthatengineeringcontrolsandregulationscanmitigateallofthepotentialimpacts.
InoneexamplenotedinNewYorkstate,agroupofover250concernedhealthprofessionalsandorganizationswrotetothestategovernorinOctober2011regardingthelackofconsideration
ofhumanhealthimpactsduringtheNewYorkStateDraftSupplementalGenericEnvironmentalImpactStatementprocess(alargescalemulti-yearstrategicreviewofpotentialrisks),andthelackofahealthprofessionalrepresentativeonthestatesHighVolumeHydraulicFracturingAdvisoryPanel(NewYorkHealthProfessionals2011).
Furthermore,thisissuehasbeenillustratedelsewhere(Goldstein2012)bytheobservationthathealtheffectstypicallyrankamongthemostimportantpreoccupationsstatedbyopponentstoshalegas,butneverthelessthreerecentmajorUSadvisorycommissionsstudyingshalegasissues(onefederalandthestatesofMarylandandPennsylvania),allofwhichreferexplicitlytoprotectionofpublichealthintheirmandates,appointednocommissionerswithexpertiseinpublichealth,
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22 Chie Medical Oicer o Healths 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 benets associated with expansion of the industry, but this maycome with socioeconomic risks that can adversely impact individual and community
wellbeing
Theeconomicbenefitsofshalegasdevelopmentarepotentiallyverylarge.Large-scaleincreasesinemployment,taxandroyaltyrevenuescouldhavethepotentialtoimproveoverallhealthstatusinthisProvince.However,thesepotentialimprovementscanbelimitedorevencounteractedbynegativesocialimpactsthatcanariseduringaneconomicboom(thisisknownastheBoomtownEffect).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,orimprovingsocialprogramsthroughincreasedgovernmentrevenues
shouldresultinhealthbenefitstothepopulation.
However,thesepotentialimprovementsinhealthstatusduetoimprovedeconomicstatuscanbelimitedorevencounteractedbytheBoomtownEffect(alsoknownastheBoomtownImpactModel).Therehavebeenmanydocumentedcasessincethe1970s(Jacquet2009)ofenergyboomtownswherearapidchangeinpopulation,industrializationandeconomicprosperityalsoledtoahostofsocialillsthatimpactedcommunityhealth.Theseincludeincreasedratesofcrime,drugandalcoholabuse,sexually-transmittedinfections(STIs),anddomesticviolence;inadequatesupplyandqualityofhousing;increasedcostofliving;increasedcommunitydissatisfaction;increasedmentalhealthandsocialservicescaseloads;increasedhospitaladmissions;insufficient
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Part 2: What We Know Now and What We Dont 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,theRoyalSocietyreportstatedthatwe were unable to identiy any public health intervention programs speciically targeted towardsresolving these conditionsA coordinated public health eort needs to be organized to address theevident health disparitiesandthatsuchhealthdisparitiesaredifficulttoreconcilewiththewealththeregiongenerates.
OtherreportsofidentifiedsocialissuesintheFortMcMurrayareaincludedlevelsofreportedcrimeperpoliceofficerthatwerethreetimesthenationalaverage(Ruddell2011),asevereshortageoffamilyphysicians,withonly14ofthemforapopulationof82,000(aratiothatwasone-sixththatofEdmonton)andinadequatehospitalfacilitiesdespitehavingthethird-busiestemergencyroominAlberta(Sauve2007).Theseissuespointtoageneralprobleminboomtownswhereinfrastructureandpublicservicecapacitycanlagfarbehindthegrowingneedforthem.
NortheasternBCalsoshowstypicalboomtownissues,suchasincreasedsubstanceabuseanddemandforpublichealthservicesforyoungfamilies(Medd,undated)andhigherthanprovincialaverageratesofteenpregnancy,STIs,menshealthissues,andsocioeconomicindicatorslikeschooldropoutrates,illiteracy,andchildpovertyinspiteofverylowunemployment(Badenhorst2012).Thecommunitydemographicsalmostcertainlyplayarole:themedianageofthepopulationisalmost10yearsyoungerthantheprovincialaverage,thereisapreponderanceofyoungmales(eithersingleorwithyoungfamilies),gasindustryworkershaveanaverageannualsalarymorethandoubletheprovincialaverageforfull-timeworkers,andthetransientpopulation,whichhaslittlestakeinthecommunitybutneverthelessoverwhelmslocalservices,ismuchgreaterthanthebase(e.g.FortNelsonspopulationofabout5,000swellsseasonallytoasmuchas15,000,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
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24 Chie Medical Oicer o Healths Recommendations Concerning Shale Gas Development in New Brunswick
therisks(realorperceived)ofhavingtheindustrylocatednearby,butonlysomeofthemwillgainfromit:somepeoplewillbenefitfromnewjobsintheindustryorjobsservingtheindustry,butobviouslynotallofthemwill,andsomelong-standinglocalbusinessesandpublicserviceswillbeadverselyaffectedbylossoftheiremployeestohigher-payingjobsinthegasindustry.Similarly,somepeoplewillgaineconomicallybyleasingaccesstotheirlandtothegascompanies,whiletheirneighbourswont.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 itslifetime
Whilethepotentialhealthandenvironmentalrisksofindividualwellpadscanbeevaluatedinordertopreventormitigatenegativeimpacts,itismuchmoredifficulttodothisforthetotalimpactsofallofthelargenumberofwellpadsthatwouldbedevelopedovera20-,50-oreven100-yeartimeframeshouldamajorexpansionofthegasindustrytakeplace.
Althoughcumulativeeffectsareacknowledgedasanimportantconsideration,todatetherehavebeenfewstudiesthatconsidertheoverallpotentialimpactsonhealthandtheenvironmentovertheentirelifetimeoftheindustry.Thescarcityofcumulativeimpactassessmentsmaystemfromthefactthatthescaleoftheindustry,rateofdevelopment,duration,andpreciselocationsofgaswelldevelopmentareverydifficulttopredict.Thisisbecauseindustrydevelopmentgenerallyvariesdependingoneconomicfactorsandwherethebestgasyieldsareobtained,whichmakesitverydifficulttodifficulttoforecastlocaleffectsofspecificprojectsandtoassessthepotentialforcumulativeeffectsovertime.
Asanillustrationofthepotentialscaleofdevelopment,oneofthefewpublishedcumulativeenvironmentaleffectsforecasts(NatureConservancy,2010)predictsthatamediumdevelopmentscenarioinPennsylvaniacouldresultindrilling60,000newgaswellsinthatstateoverthenext
20years.Assessingtheenvironmentalandhealthimplicationsofthesewelldevelopmentsoneatatimeasindividualprojectscouldriskmissingtheforestforthetrees,butreliablepredictionofcumulativeimpactsislimitedbytheuncertaintyinpossiblefuturescenarios.
Anotherimportantfactorinestimatingcumulativeeffectsisthedensityofwelldevelopment.In2006,theJonahFieldinWyoming(Figure2)had533existinggaswellson497padsin2006(USDepartmentoftheInterior,2006)butaninfillprojecttoaddafurther3,100wells(somebydirectionaldrillingandsomebywayofmanynewpadsconstructedbetweentheexistingones)wasapprovedandisongoing.Thecurrentwellspacingisonewellpadforevery40acres,andtheinfillingprojectwillreducethisspacingtoaslittleas10acresforeverypad(whereeachpadisitselfupto3acresinsize).
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ItisacknowledgedthattheJonahfieldisaconventionalgas/tightsandfieldandnotashalegasdevelopmentandwasdevelopedpredominatelywithouttheuseofrecenthorizontaldrillingtechnologies.Nonetheless,itprovidesausefulillustrationofwhatcanresultifcumulativeeffectslikewellpaddensityandpermittingoflaterinfillingarenotaddressedpriortodevelopment.Betteruseofhorizontaldrillingtechnologiesandmulti-wellpadswouldhaveresultedinvastlylesssurfacedisturbanceandalowerdensityofwellpads.NewYorkStatehashistoricallyalsouseda40-acrewellpadspacing(16padspersquaremile)forconventionalverticalgaswellsandalsoallowsinfillingtohigherdensitiesincertaincases,butthestatesDepartmentofEnvironmental
Conservation(NewYorkDEC,2011)forecaststhatwithexpandeduseofdirectionaldrillingandmulti-wellpadsinshalegasexploitation,thewellpaddensitywillbeless:9padspersquaremile(onepadper71acres)forasinglehorizontalwellperpad,andaslowasonepadpersquaremile(onepadper640acres)ifmulti-wellpadsaremandatedandifinfillingisnotcarriedout.Overallsurfacedisturbanceforaccessroadsandpipelineswillalsobelessifmulti-wellpadsareused.
Figure 2: Satellite photo o part o the Jonah Field, Wyoming (retrieved rom Google Earth 2012/02/08, image
dated 2006/08/14). The light spots are gas well pads, the dark rectangles are water pits or either hydraulic
racturing luid or lowback/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 o 1 pad
per 16 hectares (1 pad per 40 acres) prior to the inilling project. The Jonah Inill Project Drilling Area extendsover approximately 30,500 acres (about 120 km2) in total.
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3. What We Dont 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.
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4. Chemical toxicity information on products used by the industry.Theprecisenature ofchemicalsusedbytheindustryateachlocation,theamountsusedandtoxicological informationaboutthemcanoftenbelacking.Thiscanoccurevenwhentherehasbeen disclosureofthechemicalsinuse,asdisclosurerulesdesignedprincipallyfortransparency andaccountabilitymaynotbesufficientlystringentfortoxicologicalriskassessment.Thisgap canmakeriskassessmentforpotentialchemicalexposuresverydifficultorimpossible.
Inadditiontoknowledgegapsabouttoxicityofsomeoftheknownchemicals,thisissue
isgreatlycomplicatedbythedifficultyofidentifyingwhichchemicalsareinuse.Therearevariousestimatesofthenumberandnatureofchemicalsusedinunconventionalgasdevelopment(INSPQ2010;NewYorkDEC2011;USEPA2011;USCongress2011;Colbornetal.2011)buttherearelikelyuptoathousandchemicalspotentiallyinuse,andalthoughonlytenortwentyofthesemaybeusedatagivensite,thepreciserecipecanvarysignificantlyfromonewelltothenext.
Furthermore,evenwhentherehasbeendisclosuretheingredientinformationprovidedsometimesincludesonlyageneraldescriptionofcontents,chemicalcategoriesratherthanspecificchemicalcompoundnames,orproprietaryingredientsthatarenotnamed.Inaddition,MaterialSafetyDataSheets(MSDS)areoftenusedfordisclosure,butthesemustonlyidentifythechemicalsinaproductthataredeemedtobehazardousinanoccupationalsetting.Asa
result,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.Ifsuchwastewere
tobetreatedinappropriatelyitcouldleadtounexpectedhumanexposurestocontaminants.Inordertoaddressthisgap,solidandliquidwastesforeachgaswellsiteshouldbecharacterizedsothattoxicologicalinformationcanbeobtainedforexposureriskassessments.Characterizationcanalsobeusedtoensurethatappropriatewastetreatmentsystemsareusedinallcasesandtoprovidemeasuresforevaluatingtheeffectiveperformanceofthesetreatmentsystems.
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6. Exposure data.Accurateexposuredatahasbeenverydifficulttoobtain,inpartbecause emissionsofchemicalscanbequitedifferentatdifferentlocationsandtimes,buttargeted monitoringofair,waterandwastescouldhelptobridgethisgap.
Theidentitiesandquantitiesofchemicalsusedoremitted,identificationofpotentialexposureroutestothesechemicalsviaair,waterandwastes,andthetimelinesanddurationofexposuresareallareaswhereinformationneededtoassesshealthriskislacking.Furthermore,theissueiscomplicatedinthatemissionsaredispersedbothspatially(becausethedevelopmentoccurs
atmanysmallsitesratherthanonelargeindustrialsite)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
AnumberofmajoreffortsarecurrentlyongoinginCanadaandtheUnitedStatesthatshouldhelp
toinformsomeoftheseknowledgegaps.Noneofthem,however,willtouchonallpotentialhealthoutcomesrelatedtogasdevelopment(forexample,noneofthemspecificallyaddressthesocialdeterminantsofhealthindetail),andnotalloftheknowledgegapswillbefilledoncetheseeffortsarecomplete.Theoutcomesofthesestudieswillbeveryvaluableinformation,buttheyarenotasubstituteforconductinghealthimpactassessmentsintheNewBrunswickcontext.
Keyhealthtopicsbeingaddressedincludeareviewofthestateofknowledgeofpotentialhealthhazardsfromshalegasdevelopmentviadrinkingwaterandairexposureroutes(HealthCanada),ariskassessmentoffactorsidentifiedaspublicconcernsabouthealthrelatedtogasdevelopment(ProvinceofBritishColumbia)andasmallenvironmentaljusticestudyaspartofalargerenvironmentalimpactstudy(USEnvironmentalProtectionAgency).
Otherstudiesaremainlyenvironment-focussed,suchasidentifyingpotentialimpactsto
groundwater(USEnvironmentalProtectionAgency),identifyingchemicalsinuseandmanagementstrategiesforthem(EnvironmentCanada),strategicreviewsofpossibleenvironmentalimpactsingeneral(NewYorkstateandtheProvinceofQubec)andthestateofknowledgeaboutenvironmentalimpactsandmitigationoptions(CouncilofCanadianAcademies).However,sincethephysicalenvironmentisadeterminantofhealth,thesestudieswillalsohaveabearingonhealth.
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Anoverviewoftheseinitiativesfollowsbelow:
1. HealthCanadasHealthyEnvironmentsandConsumerSafetybranchiscurrentlyundertaking areviewofthestateofknowledgeofpotentialhealthhazardsfromshalegasdevelopment viadrinkingwaterandairexposureroutes(HealthCanada2011).Thiseffortispartofawider initiativebyaGovernmentofCanadaInterdepartmentalTaskTeamworkingonaScienceand PolicyIntegrationPilotProject(Energy/WaterNexusShaleGas).
Thisstudywillhelptoidentifypossiblehealthhazardsduetoimpactstothephysicalenvironment,andassuchwillbeusefulinformationforNewBrunswickinconductingHIAsorriskassessments,butitisnotdesignedtoaddressalldeterminantsofhealth.
2. InJanuary2012theBritishColumbiaMinistryofHealthcontractedtheFraserBasinCouncil toundertakeahumanhealthriskassessmentofoilandgasdevelopmentinnortheastBritish Columbia(seewww.hhra.ca).Thisassessmentwillconsistofthreephases:
1. Publicengagementtoinformthescopeandtermsofreferenceandidentifyconcerns relatingtooilandgasdevelopment
2. Ahumanhealthriskassessmentbasedonfindingsfromphaseoneandacomprehensive
scientificreviewofevidence3. 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).
ThisUSEPAefforthasoftenbeentoutedasthedefinitivestudybutthereareconcernsthatthescopeistoolimitedforacompleteHealthImpactAssessment(BambergerandOswald,2012).Basedonareviewofthestudyplan,OCMOHstaffagreesthat,withtheexceptionofthe
http://www.hhra.ca/http://www.epa.gov/hfstudy/index.htmlhttp://www.epa.gov/hfstudy/index.htmlhttp://www.epa.gov/hfstudy/ProgressUpdate02_2012.pdfhttp://www.epa.gov/hfstudy/ProgressUpdate02_2012.pdfhttp://www.epa.gov/hfstudy/ProgressUpdate02_2012.pdfhttp://www.epa.gov/hfstudy/ProgressUpdate02_2012.pdfhttp://www.epa.gov/hfstudy/index.htmlhttp://www.epa.gov/hfstudy/index.htmlhttp://www.hhra.ca/ -
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environmentaljusticecomponent,thisprojectwillonlyaddressthephysicalenvironmentasadeterminantofhealthandisnotacompleteassessmentofpotentialhealthimpactsfromgasdevelopment.
4. TheNewYorkStateDepartmentofEnvironmentalConservation(DEC)isintheprocess ofcompletingadraftSupplementalGenericEnvironmentalImpactStatement(dSGEIS, seeNewYorkDEC2011)regardinghigh-volumehydraulicfracturingusedintheshalegas industryinordertosatisfytherequirementsoftheStateEnvironmentalQualityReviewAct. Additionally,thedSGEISisintendedtoinformfuturerevisionsoradditionstotheDECs regulationsassociatedwithhigh-volumehydraulicfracturingincludingmitigationmeasures thatwouldpreventorminimizeanysignificantadverseimpacts,andcriteriaandconditionsfor futurepermitapprovalsandotherregulatoryaction.
ThedSGEISwassubmittedforafirstroundofpublicreviewandcommentin2009.Theextensivepubliccommentsrevealedsignificantconcernswithpotentialcontaminationofgroundwaterandsurfacedrinkingwatersupplies,potentialforgasmigration,impactsfromdisposalofsolidandliquidwastes,andconsiderationofvisual,noise,traffic,communitycharacterandsocioeconomicimpacts.Accordingly,in2010thestateGovernororderedtheDECtoissueareviseddSGEIS,whichwaspublishedinSeptember2011(NewYorkDEC2011).The
ExecutiveOrderalsoprovidedthatnopermitsauthorizinghigh-volumehydraulicfracturingwouldbeissueduntiltheSGEISwasfinalized.
Atpresent,publicconsultationsontheSeptember2011dSGEIShaveconcluded.AreporttotheGovernoronthestatusoftheFinalSGEISandtheregulatoryconditionsthattheNewYorkDECbelievesarenecessarytoincludeinoilandgaswellpermitsinordertoprotectpublichealthandtheenvironmentisstillpending.
5. AsmandatedbytheLoi sur la qualit de lenvironnement,theprovinceofQubecengaged theBureau daudiences publiques sur lenvironnement(BAPE)toconductapublicinquiry andprepareareporton thesustainabledevelopmentofshalegasindustryinQubec,which
waspublishedinFebruary2011(BAPE2011a).Thetestimonysubmittedtothisinquiryincluded areportfromtheInsitut national de la sant publique du Qubeconthestateofknowledge oftherelationshipbetweenshalegasactivitiesandpublichealth(INSPQ2010)aswellas testimonyfromPublicHealthofficialsinseveralregionsofQubec(BAPE2011b).
AsaresultoftheBAPEreport,theprovinceofQubeccommissionedastrategicenvironmentalevaluation(Qubec2011)toaddresstheknowledgegapsindeterminingtheenvironmentalrisksthatshalegasexplorationandproductionmightentail.Whilethisevaluationisongoing,theBAPEreportrecommendedthatexplorationcouldcontinue,buthydraulicfracturingshouldnotbeauthorizedexceptforwhatisrequiredaspartoftheevaluation.AfinalreportontheoutcomesofthisstrategicenvironmentalevaluationisexpectedbyNovember2013.
6. TheCouncilofCanadianAcademieswascommissionedbythefederalMinisterofEnvironment inSeptember2011toundertakeanauthoritativeandevidence-basedassessmenttoanswer thefollowingquestion:Whatisthestateofknowledgeofpotentialenvironmentalimpacts fromtheexploration,extraction,anddevelopmentofCanadasshalegasresources,andwhat isthestateofknowledgeofassociatedmitigationoptions?Theassessmentisexpectedto take18to24monthstocomplete(http://www.scienceadvice.ca/en/assessments/in-progress/ shale-gas.aspx).However,thisassessmentdoesnotappeartoconsideranyotherdeterminants ofhealthbesidesenvironmentalexposures.
http://www.scienceadvice.ca/en/assessments/in-progress/shale-gas.aspxhttp://www.scienceadvice.ca/en/assessments/in-progress/shale-gas.aspxhttp://www.scienceadvice.ca/en/assessments/in-progress/shale-gas.aspxhttp://www.scienceadvice.ca/en/assessments/in-progress/shale-gas.aspx -
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TheCouncilofCanadianAcademiesisanindependentnot-for-profitbodythatsupportsscience-basedassessmentstoinformpublicpolicy,andencompassestheRoyalSocietyofCanada,theCanadianAcademyofEngineeringandtheCanadianAcademyofHealthSciences.
7. AtthesametimeastherequesttotheCouncilofCanadianAcademies,EnvironmentCanada wasalsotaskedtodevelopaninternalworkplantoexamineanypotentialenvironmental consequencesofshalegasdevelopment.Atpresent,EnvironmentCanadaisworkingin conjunctionwithHealthCanadatoundertakeaninformationgatheringexercisetofill informationgapsontheidentityandquantitiesofchemicalsubstancesbeingusedinhydraulic fracturingacrossCanada,aswellasrelatedmanagementpractices.Thisexerciseisexpectedto becompletedbythewinterof2012.
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Part 3
Recommendations for
Protection of Public Health
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Recommendations for Protection of Public HealthAsriskisafunctionofhazardandexposure,increasedactivitynecessarilyimpliesincreasedrisk.ItistimelythereforeforGovernmenttobetterunderstandtheriskandbenefitsassociatedwiththeshalegasindustrypriortofurtherdevelopmentinNewBrunswick.Tothatend,theCMOHhasdevelopedtherecommendationsinthisdocumenttosupporttheGovernmentsriskmanagementandregulatoryframeworkinsuchawaythatitwillbeabletoprovideappropriate,completeandcomprehensivepublichealthpromotionandprotectionalongwithitsothergoals.
TheCMOHbelievesthatitisimportantfortheProvincetoenactthefollowingrecommendationsinordertoprotectpublichealthshouldanexpansionoftheunconventionalnaturalgasindustrytakeplace.Manyoftheserecommendationswillneedtobeenactedpriortoexpansionoftheindustry,alongwithmanyothersthatwillhavetobeinplacethroughouttheentirelifetimeoftheindustryinthisprovince.Thefundingoftheirimplementationandongoingmaintenancewillnotbeinsubstantialanditisrecommendedthatoptionsforindustryleviesbeexploredasamatterofpriority.
TheserecommendationsweredevelopedbasedonananalysisconductedbystaffintheOfficeoftheChiefMedicalOfficerofHealth(OCMOH)thatissummarizedintheinformationinthisreport.Thisanalysisincludedacriticalreviewofexperiencesinotherjurisdictions,recommendationsproposedelsewhere,casestudiesreportedinthescientificliteratureandotherreports,aswellascurrentandemergingissuesdiscussedinconferenceproceedings.
Eachrecommendationisgroundedinpublichealthpromotionandpracticeandclearlylinkedtothepublichealthethics,valuesandprinciples(outlinedinPart1)mostrelevanttoit.Pendinginputfrompublicandotherstakeholders,aswellasnewlearnings,theserecommendationsmayneedtobeadaptedandwillevolve.ManyoftheserecommendationsarecomplementarytothoseproposedinthedocumententitledResponsibleEnvironmentalManagementofOilandGasActivitiesinNewBrunswick-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;developingaprotocolformonitoringofhealthstatusofpersonsliv