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Hydraulic fracturing for oil and gas is linked to an array of health harms, including cancer, cardiovascular disease, asthma and birth defects, according to the latest compilation of studies on the impact of fracking on human health.

The ninth edition of a “compendium” of scientific, medical, government and media reports on the industry’s health effects, released Thursday, contains references to almost 2,500 papers that add to evidence that fracking has an array of negative impacts on human health, the authors say. 

The number of studies collected is now more than six times what it was when the first compendium was published in 2014, but the conclusions are the same, said Dr. Sandra Steingraber, the lead author, and a member of Physicians for Social Responsibility and Concerned Health Professionals of New York, which jointly published the 637-page document.

Many of the studies were based in Pennsylvania, which produces more natural gas from fracking than any other U.S. state except Texas, and has a relatively high population of about 12 million people, giving researchers more opportunity to determine the effects of fracking on public health than in more sparsely populated fracking states such as Wyoming.

“The new studies corroborate and support the older studies and we can see the same patterns in state after state where fracking is practiced,” Steingraber said. “The fact that there is lots of new data that support the older data means that the case against fracking is ever more damning.”

The Marcellus Shale Coalition, a trade group representing Pennsylvania’s natural gas industry, immediately rejected the compendium, dismissing the studies as “junk science” peddled by critics, and arguing that half the documents are not peer-reviewed because they are news stories.

“It’s an undeniable fact that safe, responsible natural gas development is an absolute winner for Pennsylvania’s environment and economy,” said the coalition’s president, David Callahan, in a statement. “Our air is cleaner, our economy stronger and our nation more energy secure because of the natural gas being produced from underneath our feet. We’re proud of our members’ work to produce the energy we need in a responsible and environmentally friendly manner—as confirmed by any number of highly credible, peer-reviewed government, academic and non-profit studies.”

In noting that a wealth of new data has confirmed earlier studies, Steingraber said that while researchers have known since 2017 that children living near fracking sites in Colorado have higher rates of leukemia than their peers who don’t live in those locations, new studies in Pennsylvania are now showing the same thing, she said.

The Yale School of Public Health found in a study published in 2022 that Pennsylvania children who grew up within a mile of a natural gas well are twice as likely as other children to develop the most common form of juvenile leukemia. The study, included in the new compendium, also found that children born to pregnant women who lived near fracking wells were nearly three times as likely as other newborns to be diagnosed with leukemia.

In August 2023, research by the University of Pittsburgh, also part of the new compendium, showed that children living within a mile of a natural gas production well were seven times as likely to suffer from lymphoma, a rare kind of childhood cancer, than those who had no such wells within five miles of their homes. 

Overall, the studies in the new compilation found evidence that people who live near unconventional oil and gas production and distribution sites, such as well pads and compressor stations, are exposed to toxic airborne pollutants such as benzene and formaldehyde, diesel exhaust, fine particles and nitrous oxides, leading to respiratory and skin problems, nervous system complaints, and heart issues at higher rates than in other sectors of the population.

More than 200 of the studies found that groundwater in the United States is being contaminated by some 2 billion gallons of water a day forced underground at high pressure during fracking, or injected into some 187,000 disposal wells that take highly toxic fracking waste. 

“Studies from across the United States provide irrefutable evidence that groundwater contamination has occurred as a result of fracking activities and is more likely to occur close to well pads,” the compendium said.

Surface waters, too, have been contaminated by spills and intentional discharges of toxic wastewater from fracking, also known as produced water, increasing downstream radioactivity and polluting waters with heavy metals, endocrine disruptors and toxic disinfection byproducts, the compilation said. 

Of about 1,000 chemicals used in fracking, some 100 are estimated to be endocrine disruptors of human reproductive and developmental systems, and at least 48 are potentially carcinogenic, it said. 

Whether residents are exposed to soil, water or air contamination from the fracking industry, the result is a “public health crisis” given that some 17.6 million Americans live within a mile of at least one active oil and gas well, the compendium said.

It also included studies on links between fracking and climate change, and concluded that the industry is a major contributor to the emission of methane, a potent greenhouse gas, through leaks during production, distribution and use.

The Marcellus Shale Coalition cited a review by Pennsylvania and Colorado epidemiologists of literature on health outcomes of people living near oil and gas operations, published in 2019 by the International Journal of Environmental Research and Public Health. The review concluded that four of 20 studies had only a “moderate” level of certainty that there was a link between fracking and negative health outcomes, while the remainder had a “low” certainty.

The review looked at links between fracking and various types of cancer, including all childhood cancers, and concluded that the evidence was lacking. “Overall, the weight of evidence is insufficient for all but one of the cancer outcomes since there is only one study for each,” the review said.

Steingraber accused the coalition of using an outdated study to sow uncertainty about the harms of its practices.

“Casting doubt on both the health harms and climate harms of oil/gas extraction and combustion is what this industry consistently does—as did the tobacco and lead paint industries before them,” she said.

Since 2018, when the Pennsylvania/Colorado study ended, there have been 51 non-media reports on fracking and health, and they are “all damning,” Steingraber said. “Many trends that were just emerging in 2019 have become more certain and many earlier results have been corroborated by further study,” she said.

Another study in Colorado in 2019 suggested a possible link between fracking and high blood pressure, but the compendium team excluded it because the 97-person sample size was too small. Then in 2020, a major study of 12,000 heart patients in Pennsylvania found “strong associations” between fracking and two kinds of heart failure, Steingraber said. 

Meanwhile, the gas trade group highlighted another 2019 analysis by HEI scientists, a nonprofit, of 25 fracking and health studies, and concluded there wasn’t enough evidence to establish a clear link between fracking and negative health outcomes.

“Data and study limitations prevented the committee from determining whether exposures originating directly from UOGD contributed to the assessed health outcomes, either within individual studies or across the body of literature,” the analysis concluded. “The limitations include the lack of quantified exposures, the potential for residual confounding, inconsistencies in design and results across studies, and the limited number of studies for any one outcome.”

In Pennsylvania, criticism of the fracking industry has extended to the state’s Department of Environmental Protection, which was accused by a grand jury in 2020 of failing to regulate the industry effectively, and has long faced public claims that it doesn’t do enough to protect the environment from fracking.

The DEP said on Thursday that it aims to do a better job of protecting the public from fracking, and is reviewing its regulations in light of the grand jury report—which was headed by Josh Shapiro, then attorney general, and now governor.

Josslyn Howard, a spokeswoman for the agency, said it is considering regulations that would allow the DEP to approve the siting and layout of well pads, identifying best practices for well operators and expanding its team of fracking experts. The department also supports legislation to expand setbacks for well pads from homes and other buildings.

The Pennsylvania branch of the American Petroleum Institute, the oil industry’s leading trade group, said the compendium’s inclusion of news reports exaggerates its conclusions.

“While our industry supports comprehensive, objective and rigorous peer-reviewed research, it’s important to recognize that the compendium primarily relies on quantity rather than quality,” said Stephanie Catarino Wissman, executive director of the API-PA. “This overreliance on media reports can lead to an inflation of the study count, ultimately resulting in misleading statistics.”  

Steingraber dismissed the accusation that news reports of the harms of fracking are not credible because they are not peer-reviewed. She said investigative journalism is sometimes fueled by freedom-of-information requests revealing documents that are not available to scientists, or that those reports may corroborate scientific findings.

“Investigative reporting helps us scientists break through the secrecy of this industry which enjoys many legal exemptions from our federal statutes,” Steingraber told Inside Climate News. 

Government reports included in the compendium are not peer-reviewed, as academic research is, but provide important information that is verified before publication, Steingraber said. For example, the compendium includes a study by the Congressional Research Service on the consequences of a potential terrorist attack on liquefied natural gas terminals, she said.

The compendium concluded that there is now ample evidence that fracking is not compatible with human health or a stable climate, and said it’s not possible to make it safe through regulation.

“The vast body of scientific studies now published on hydraulic fracturing in the peer-reviewed scientific literature confirms that the public health and climate risks from fracking are real and the range of environmental harms wide,” the copendium  said.

“The only method of mitigating its grave threats to public health and the climate is a complete and comprehensive ban on fracking. Indeed, a fracking phase-out is a requirement of any meaningful plan to prevent catastrophic climate change.”