On 28th January at the Killyhevlin Hotel, Enniskillen, the Fermanagh Fracking Awareness Network were delighted to host a presentation by Dr Eilish Cleary, Chief Medical Officer for Health, New Brunswick, Canada. As explained in our post of 11th December, Dr. Cleary has recently produced a report about the public health implications of shale gas development using fracking. Dr Cleary was on a family holiday to Ireland and very kindly agreed to speak about her report to medical professionals, elected representatives, and concerned residents in and around Fermanagh.
The large audience was welcomed by Dr. Carroll O’Dolan, the chair of FFAN, who thanked all who had been involved in making the event possible, especially Dr. Cleary herself and the owners and staff of the Killyhevlin Hotel. Carroll then introduced the first speaker, Gary McFarlane.
Gary was appointed as the Director for the Chartered Institute of Environmental
Health (CIEH) in Northern Ireland in late 2001 The CIEH is a national, professional, charitable organisation whose mission is to maintain, enhance and promote improvements in public health through knowledge, understanding and campaigning. As director he is involved in contributing to the development of healthy public policy, reestablishing the critical links between environment and health within the context of sustainable development and public health. Gary is also currently the co-chair of the Public Health Alliance, is a board member of Sustainable Northern Ireland and Northern Ireland Environment Link. He chairs the advisory board to the environmental
health undergraduate programme at the University of Ulster and has been appointed to the Safe Food Scientific Advisory Committee.
He spoke eloquently of his vision of health, as not simply the absence of disease but as a state of complete well-being; social, and emotional, as well as physical and psychological. Within this context, the lack of research into the health and environmental implications of fracking and shale gas exploitation is deeply worrying. The Environmental Protection Agency in the United States is at last now beginning to investigate the effects of fracking on groundwater, but it is also essential to consider its effect on soil and its indirect effects on tourism, agriculture etc. Only such a complete investigation can give anything like a full picture of the real results of fracking for human health.
The view of the Chartered Institute of Environmental Health is that the precautionary principle should be the foundation of policy in this, as in other areas. As such, any proposals for shale gas development should be carefully analysed not only by means of an Environmental Impact Assessment but also with a Health Impact Assessment. Furthermore, such a study should look particularly at the effects of the industry upon health inequalities and upon those in our society who are already the most vulnerable.
Dr Eilish Cleary, the main speaker of the evening, addressed the audience next. If there was one message, she said, that they should take away with them, it was the importance of asking questions. It is only by asking the right questions, and being determined to find answers, that we can keep ourselves and our communities safe and healthy.
Her presentation was divided into three parts: the first looking at the functions and principles of public health, the second at the shale gas industry and the third at the report which she, together with colleagues, produced in New Brunswick.
Public health as a discipline covers a wide range of functions including measuring and monitoring the health of individuals within society, preventing disease and injury, preparing emergency responses, and protecting the health of the public from the many hazards which assail it. The prerequisites for good health have been identified as peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice and equity. If any of these are lacking, it becomes difficult or impossible for an individual or a community to achieve or maintain a truly healthy life. In common with other disciplines, public health recognises the ‘three-legged stool’ model of sustainability, that it depends upon environmental, social and economic factors, and that unless all these areas are nurtured, a society cannot be said to be sustainable.
In a complex world, much of public health work is necessarily concerned with risk management. When faced with potential or actual damage, disease or injury, there is a range of responses that may be taken. Earliest, most effective and least expensive is prevention, making sure that the damage does not occur in the first place. If this is not carried out, then less effective and more expensive paths must be taken; mitigation, response or recovery and remediation.
Within this context, Dr Cleary then went on to consider the risks to human health which are posed by shale gas development. There are several pathways by which humans can be exposed to contamination caused by the industry, principally inhalation (breathing in toxic substances), dermal contact (through the skin), ingestion (eating or drinking contaminated food or drink) and maternal (the exposure of an unborn child to contamination while in its mother’s womb). Each of these pathways can bring people into contact with different types of contamination. For example, machinery and vehicles involved in shale gas activities produce several different types of toxic emissions including particulate matter, carbon monoxide and nitric oxides.
The effects of the various types of contamination on health are wide-ranging, including reproductive, dermal (skin), and haemologic (blood) disorders. Full details of the pathways, types of potential contamination and their effects can be found in Dr. Cleary’s report here.
Faced with this type of problem, Dr. Cleary suggested that the conventional way of looking at the situation is fundamentally flawed. This traditional approach tends to begin with the industry and its processes, then considering its effect on the environment and finally upon public health. Suppose we instead began with the requirements for a healthy population, those factors identified earlier as including peace, social justice, a stable eco-system and sustainable resources? Then proposals for industrial activity could be more accurately assessed according to whether they contributed to, or destroyed, those fundamental building blocks of health.
Sadly, we are a long way from such an approach today. The situation that Dr Cleary was faced with in New Brunswick was that the government had already made the decision to go ahead with shale gas extraction. The question that she was faced with, therefore, was not whether or not such activities should be carried out – that one had already been answered by others – but what measures could push the situation in the direction of being a net benefit, rather than a loss, for the health of New Brunswick’s people.
Given both the constraints of this situation and the lack of research and evidence available, it was not possible for the New Brunswick report to be a complete overview of all the public health impacts threatened by shale gas development. Instead, it was more a survey of what is currently known upon the subject, and, perhaps more importantly, what is not known. There are a disturbing number of data gaps including the health status of affected populations, details of their exposure, information about the toxicity of chemicals used in the extraction processes and those contained in waste products, health impact assessments, forecasting and analysis of the cumulative and lifestyle impacts of the industry’s activities and their consequences. One of the most significant achievements of Dr. Cleary’s report is in identifying these gigantic holes in what is currently known about shale gas and human health.
A particular problem related to shale gas extraction is that the industry typically begins in any location on a very small scale but that development thereafter is extremely rapid. This speed of growth, and the inevitable implications for the health of local people, requires proper planning before the first development; it is not sufficient to rely upon ad hoc measures as the activity increases.
In line with the general pattern of absent information, there is little clear data from locations where shale gas extraction is already underway. There are, however, certain common themes which emerge from the evidence available. These are: physical accidents occurring on and off-site, air and water quality problems, a loss of community cohesion, the boomtown effect and mental health issues. It is important to note the breadth of these problems and that the difficulties related to shale gas exploitation are emphatically not only those of chemical toxicity.
To date, public health experts and officials have been largely absent from the discussions about fracking and therefore unable to present their concerns. These, in addition to the direct impacts, would include the inequitable distribution of risk and reward in the industry, and the potential risks to economic well-being, to governments, to the environment as well as those to public health. The life-cycle of the shale gas industry is not yet clear; there are widely varying estimates as to the length of time for which a well would be viable but it is likely to be short in the context of a community’s experience and the well-being of future generations.
Mistakes in this industry can be very large and very costly and it is therefore not enough simply to have rules which regulate its activities. Dr. Cleary’s recommendations to her government therefore included the setting up of various consultative and overseeing projects and groups, a genuine dialogue between communities, governments, academics and the industry, an effective role for local government, the public reporting of data and a balanced distribution of the risks and rewards.
She closed by emphasising that final decisions have to be made by the communities who would have to live with shale gas exploitation and its consequences.
Questions were invited from the audience and these were numerous and detailed, including issues of water contamination, the length of time needed before public health effects would be assessed, the unlikelihood of claims that fracking could be carried out ‘without chemicals’ and the implications of the industry’s exemption, in the United States, from key environmental legislation.
A statement was read on behalf of Dr. Geralyn McCarron, a GP originally from Fermanagh and now working in Australia, who has witnessed the severe health problems created by the shale gas industry in Queensland. Her statement was featured in our last post and is available here.
Further questions concerned the proposed study by the Irish Environmental Protection Agency into the feasibility and consequences of fracking in Ireland, and the absence from its draft terms of reference of any health impact assessment, the possibility of pilot projects, the need for, and general absence of baseline studies and the fact that, to date, the New Brunswick government have not implemented any of Dr. Cleary’s recommendations. There was some criticism of Dr. Cleary for her clear position, stated at the outset, that she would not enter into the political debate as to the general advisability of otherwise of shale gas exploitation, but that her role, as she saw it, was the provision of information.
Some criticism was also made of FFAN for discussing issues of regulation rather than simply calling for an outright ban on fracking. FFAN’s position is that shale gas exploitation using fracking is a dangerous and unnecessary activity which should not go ahead in Fermanagh or elsewhere. In order to achieve this end it is vital to inform the public and other decision-makers of all the issues and potential effects of the industry. Ultimately it is the responsibility of local people to decide whether or not they want fracking in Fermanagh. If they do not, each individual needs to speak out clearly to ensure that his or her voice is heard by those elected to represent us.
Finally, closing remarks were given by Dr John Graham, who is a retired public health physician who has moved back to Fermanagh having grown up there and trained at Queen’s. He was a health service chief executive in Germany and the Middle East and worked as a medical policy director in Whitehall. He commissioned a major international epidemiological research programme to investigate Gulf War Syndrome and worked in Washington DC for the White House in collaboration with the Institute of Medicine.
John drew upon his own experience in relation to Gulf War Syndrome to emphasise the vital importance of obtaining firm evidence before irrevocable decisions are made and in particular the necessity for the Irish EPA and any other reporting body to include health impact assessments in their analysis.
The evening was a valuable opportunity for people in Fermanagh and beyond, especially those concerned with public health, to discover more about the potential side-effects of shale gas development. In particular, Dr. Cleary’s presentation encouraged the audience to become more aware of the gaps in our current knowledge and the need for comprehensive analysis of medical, environmental, social and economic factors before potentially disastrous decisions are made. FFAN are grateful to Dr. Cleary for giving up her valuable personal time, while on holiday, to speak on this subject, to the other speakers, the Killyhevlin Hotel and to all who attended the event.