Recommendations: Shale Gas Development

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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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2 Chie Medical Oicer o Healths Recommendations Concerning Shale Gas Development in New Brunswick


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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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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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11

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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17

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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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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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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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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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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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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33

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

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Recommendations: Shale Gas Development

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