The refinery of the future.

Fossil fuels-coal, oil and gas-supply most of the world's energy and also form the basis of many products essential for everyday life. Their use is the largest contributor to the carbon dioxide emissions that drive global climate change, prompting joint efforts to find renewable alternatives that might enable a carbon-neutral society by as early as 2050. There are clear paths for renewable electricity to replace fossil-fuel-based energy, but the transport fuels and chemicals produced in oil refineries will still be needed. We can attempt to close the carbon cycle associated with their use by electrifying refinery processes and by changing the raw materials that go into a refinery from fossils fuels to carbon dioxide for making hydrocarbon fuels and to agricultural and municipal waste for making chemicals and polymers. We argue that, with sufficient long-term commitment and support, the science and technology for such a completely fossil-free refinery, delivering the products required after 2050 (less fuels, more chemicals), could be developed. This future refinery will require substantially larger areas and greater mineral resources than is the case at present and critically depends on the capacity to generate large amounts of renewable energy for hydrogen production and carbon dioxide capture.

Risk factors for cooking-related burn injuries in children, WHO Global Burn Registry.

OBJECTIVE: To assess the characteristics of cooking-related burn injuries in children reported to the World Health Organization Global Burn Registry. METHODS: On 1 February 2021, we downloaded data from the Global Burn Registry on demographic and clinical characteristics of patients younger than 19 years. We performed multivariate regressions to identify risk factors predictive of mortality and total body surface area affected by burns. FINDINGS: Of the 2957 paediatric patients with burn injuries, 974 involved cooking (32.9%). More burns occurred in boys (532 patients; 54.6%) than in girls, and in children 2 years and younger (489 patients; 50.2%). Accidental contact and liquefied petroleum caused most burn injuries (729 patients; 74.8% and 293 patients; 30.1%, respectively). Burn contact by explosions (odds ratio, OR: 2.8; 95% confidence interval, CI: 1.4-5.7) or fires in the cooking area (OR: 3.0; 95% CI: 1.3-6.8), as well as the cooking fuels wood (OR: 2.2; 95 CI%: 1.3-3.4), kerosene (OR: 1.9; 95% CI: 1.0-3.6) or natural gas (OR: 1.5; 95% CI: 1.0-2.2) were associated with larger body surface area affected. Mortality was associated with explosions (OR: 7.5; 95% CI: 2.2-25.9) and fires in the cooking area (OR: 6.9; 95% CI: 1.9-25.7), charcoal (OR: 4.6; 95% CI: 2.0-10.5), kerosene (OR: 3.9; 95% CI: 1.4-10.8), natural gas (OR: 3.0; 95% CI: 1.5-6.1) or wood (OR: 2.8; 95% CI: 1.1-7.1). CONCLUSION: Preventive interventions directed against explosions, fires in cooking areas and hazardous cooking fuels should be implemented to reduce morbidity and mortality from cooking-related burn injuries.

Noise concerns of residents living in close proximity to hydraulic fracturing sites in Southwest Pennsylvania.

OBJECTIVE: Noise associated with nontraditional gas industry (NTGI) sites (e.g., hydraulic fracturing well pads, compressor stations, processing plants) may create disturbances and anxiety in rural populations. This study evaluated levels of concern among residents of Southwestern Pennsylvania residing near NTGI sites. DESIGN: Noise measurements were collected inside and outside residences, and surveys were administered to residents. RESULTS: Daytime instantaneous sound levels ranged between 45.0 and 61.0 dBA. Dosimeter studies recorded day-night levels (Ldn ) of 53.5-69.4 dBA outside and 37.5-50.1 dBA inside, exceeding United States Environmental Protection Agency guidelines. Respondents indicated the NTGI noise disturbed their sleep, and the majority of respondents (96%) reported being worried about their overall health as a result of the noise. CONCLUSIONS: Health care professionals serving rural areas impacted by hydraulic fracturing (fracking) should be aware of potential noise stressors on the populations they serve.

Damp housing, gas stoves, and the burden of childhood asthma in Australia.

OBJECTIVE: To determine the proportion of the national childhood asthma burden associated with exposure to dampness and gas stoves in Australian homes. DESIGN: Comparative risk assessment modelling study. Setting, participants: Australian children aged 14 years or less, 2011. MAIN OUTCOME MEASURES: The population attributable fractions (PAFs) and number of disability-adjusted life years (DALYs) for childhood asthma associated with exposure to damp housing and gas stoves. RESULTS: 26.1% of Australian homes have dampness problems and 38.2% have natural gas as the main energy source for cooktop stoves. The PAF for childhood asthma attributable to damp housing was 7.9% (95% CI, 3.2-12.6%), causing 1760 disability-adjusted life years (DALYs; 95% CI, 416-3104 DALYs), or 42 DALYs/100 000 children. The PAF associated with gas stoves was 12.3% (95% CI, 8.9-15.8%), corresponding to 2756 DALYs (95% CI, 1271-4242), or 67 DALYs/100 000 children. If all homes with gas stoves were fitted with high efficiency range hoods to vent gas combustion products outdoors, the PAF and burden estimates were reduced to 3.4% (95% CI, 2.2-4.6%) and 761 DALYs (95% CI, 322-1199). CONCLUSIONS: Exposure to damp housing and gas stoves is common in Australia, and is associated with a considerable proportion of the childhood asthma burden. Strategies for reducing exposure to indoor dampness and gas combustion products should be communicated to parents of children with or at risk of asthma.

Unconventional natural gas development and pediatric asthma hospitalizations in Pennsylvania.

BACKGROUND: Pediatric asthma is a common chronic condition that can be exacerbated by environmental exposures, and unconventional natural gas development (UNGD) has been associated with decreased community air quality. This study aims to quantify the association between UNGD and pediatric asthma hospitalizations. METHODS: We compare pediatric asthma hospitalizations among zip codes with and without exposure to UNGD between 2003 and 2014 using a difference-in-differences panel analysis. Our UNGD exposure metrics include cumulative and contemporaneous drilling as well as reported air emissions by site. RESULTS: We observed consistently elevated odds of hospitalizations in the top tertile of pediatric patients exposed to unconventional drilling compared with their unexposed peers. During the same quarter a well was drilled, we find a 25% increase (95% CI: 1.07, 1.47) in the odds of being hospitalized for asthma. Ever-establishment of an UNGD well within a zip code was associated with a 1.19 (95% CI: 1.04, 1.36) increased odds of a pediatric asthma hospitalization. Our results further demonstrate that increasing specific air emissions from UNGD sites are associated with increased risks of pediatric asthma hospitalizations (e.g. 2,2,4-trimethylpentane, formaldehyde, x-hexane). These results hold across multiple age groups and sensitivity analyses. CONCLUSIONS: Community-level UNGD exposure metrics were associated with increased odds of pediatric asthma-related hospitalization among young children and adolescents. This study provides evidence that additional regulations may be necessary to protect children's respiratory health from UNGD activities.

Evaluating a groundwater supply contamination incident attributed to Marcellus Shale gas development.

High-volume hydraulic fracturing (HVHF) has revolutionized the oil and gas industry worldwide but has been accompanied by highly controversial incidents of reported water contamination. For example, groundwater contamination by stray natural gas and spillage of brine and other gas drilling-related fluids is known to occur. However, contamination of shallow potable aquifers by HVHF at depth has never been fully documented. We investigated a case where Marcellus Shale gas wells in Pennsylvania caused inundation of natural gas and foam in initially potable groundwater used by several households. With comprehensive 2D gas chromatography coupled to time-of-flight mass spectrometry (GCxGC-TOFMS), an unresolved complex mixture of organic compounds was identified in the aquifer. Similar signatures were also observed in flowback from Marcellus Shale gas wells. A compound identified in flowback, 2-n-Butoxyethanol, was also positively identified in one of the foaming drinking water wells at nanogram-per-liter concentrations. The most likely explanation of the incident is that stray natural gas and drilling or HF compounds were driven ∼ 1-3 km along shallow to intermediate depth fractures to the aquifer used as a potable water source. Part of the problem may have been wastewaters from a pit leak reported at the nearest gas well pad-the only nearby pad where wells were hydraulically fractured before the contamination incident. If samples of drilling, pit, and HVHF fluids had been available, GCxGC-TOFMS might have fingerprinted the contamination source. Such evaluations would contribute significantly to better management practices as the shale gas industry expands worldwide.

Regional ozone impacts of increased natural gas use in the Texas power sector and development in the Eagle Ford shale.

The combined emissions and air quality impacts of electricity generation in the Texas grid and natural gas production in the Eagle Ford shale were estimated at various natural gas price points for the power sector. The increased use of natural gas in the power sector, in place of coal-fired power generation, drove reductions in average daily maximum 8 h ozone concentration of 0.6-1.3 ppb in northeastern Texas for a high ozone episode used in air quality planning. The associated increase in Eagle Ford upstream oil and gas production nitrogen oxide (NOx) emissions caused an estimated local increase, in south Texas, of 0.3-0.7 ppb in the same ozone metric. In addition, the potential ozone impacts of Eagle Ford emissions on nearby urban areas were estimated. On the basis of evidence from this work and a previous study on the Barnett shale, the combined ozone impact of increased natural gas development and use in the power sector is likely to vary regionally and must be analyzed on a case by case basis.

The use of health impact assessment for a community undergoing natural gas development.

The development of natural gas wells is rapidly increasing, yet little is known about associated exposures and potential public health consequences. We used health impact assessment (HIA) to provide decision-makers with information to promote public health at a time of rapid decision making for natural gas development. We have reported that natural gas development may expose local residents to air and water contamination, industrial noise and traffic, and community changes. We have provided more than 90 recommendations for preventing or decreasing health impacts associated with these exposures. We also have reflected on the lessons learned from conducting an HIA in a politically charged environment. Finally, we have demonstrated that despite the challenges, HIA can successfully enhance public health policymaking.

Exposure to Oil and Gas Fracking Sites Linked to Adverse Birth Outcomes.

Policymakers and regulators are urged to take note as evidence mounts.

Quantification of the global and regional impacts of gas flaring on human health via spatial differentiation.

Globally, gas flaring caused 350 million tonnes of CO2 emissions in 2018. In addition to climate change, this burning practice also has other negative consequences for humans (e.g., respiratory problems) and the environment. The aim of this paper is to quantify the impact of flaring on human health (at the global and country level) via the calculation of the number of disability-adjusted life years (DALYs) caused by the combustion of associated gas. For this quantification, gas flaring emissions were linked with midpoint indicators (e.g., climate change) in life cycle assessment (LCA) for all selected countries. Regionalised characterisation factors (CFs) were applied in the impact assessment to allow for spatial differentiation. The global impact on human health caused by flaring was obtained by taking the sum for all countries. The results show that these flaring emissions globally cause 4.83 × 105 DALYs or 6.19 × 10-5 DALYs/person on an annual basis. This amounts to 0.12% of the total DALYs related to air pollution (from PM2.5) caused by all polluting sectors and 6.51% of the total DALYs related to climate change. To quantify these impacts, this study uses a country perspective rather than considering local characteristics. Thus, if more precise information at a more local level (e.g., city level) is sought, additional factors (e.g., meteorological conditions) should be taken into account. Finally, future research should also focus on the benefits of gas flaring reduction techniques to enable the selection of the most promising technologies for the elimination of gas flaring and its effects.

Exposure assessment of adults living near unconventional oil and natural gas development and reported health symptoms in southwest Pennsylvania, USA.

Recent research has shown relationships between health outcomes and residence proximity to unconventional oil and natural gas development (UOGD). The challenge of connecting health outcomes to environmental stressors requires ongoing research with new methodological approaches. We investigated UOGD density and well emissions and their association with symptom reporting by residents of southwest Pennsylvania. A retrospective analysis was conducted on 104 unique, de-identified health assessments completed from 2012-2017 by residents living in proximity to UOGD. A novel approach to comparing estimates of exposure was taken. Generalized linear modeling was used to ascertain the relationship between symptom counts and estimated UOGD exposure, while Threshold Indicator Taxa Analysis (TITAN) was used to identify associations between individual symptoms and estimated UOGD exposure. We used three estimates of exposure: cumulative well density (CWD), inverse distance weighting (IDW) of wells, and annual emission concentrations (AEC) from wells within 5 km of respondents' homes. Taking well emissions reported to the Pennsylvania Department of Environmental Protection, an air dispersion and screening model was used to estimate an emissions concentration at residences. When controlling for age, sex, and smoker status, each exposure estimate predicted total number of reported symptoms (CWD, p<0.001; IDW, p<0.001; AEC, p<0.05). Akaike information criterion values revealed that CWD was the better predictor of adverse health symptoms in our sample. Two groups of symptoms (i.e., eyes, ears, nose, throat; neurological and muscular) constituted 50% of reported symptoms across exposures, suggesting these groupings of symptoms may be more likely reported by respondents when UOGD intensity increases. Our results do not confirm that UOGD was the direct cause of the reported symptoms but raise concern about the growing number of wells around residential areas. Our approach presents a novel method of quantifying exposures and relating them to reported health symptoms.

Air Pollutant Exposure and Stove Use Assessment Methods for the Household Air Pollution Intervention Network (HAPIN) Trial.

BACKGROUND: High quality personal exposure data is fundamental to understanding the health implications of household energy interventions, interpreting analyses across assigned study arms, and characterizing exposure-response relationships for household air pollution. This paper describes the exposure data collection for the Household Air Pollution Intervention Network (HAPIN), a multicountry randomized controlled trial of liquefied petroleum gas stoves and fuel among 3,200 households in India, Rwanda, Guatemala, and Peru. OBJECTIVES: The primary objectives of the exposure assessment are to estimate the exposure contrast achieved following a clean fuel intervention and to provide data for analyses of exposure-response relationships across a range of personal exposures. METHODS: Exposure measurements are being conducted over the 3-y time frame of the field study. We are measuring fine particulate matter [PM < 2.5µm in aerodynamic diameter (PM2.5)] with the Enhanced Children's MicroPEM™ (RTI International), carbon monoxide (CO) with the USB-EL-CO (Lascar Electronics), and black carbon with the OT21 transmissometer (Magee Scientific) in pregnant women, adult women, and children <1 year of age, primarily via multiple 24-h personal assessments (three, six, and three measurements, respectively) over the course of the 18-month follow-up period using lightweight monitors. For children we are using an indirect measurement approach, combining data from area monitors and locator devices worn by the child. For a subsample (up to 10%) of the study population, we are doubling the frequency of measurements in order to estimate the accuracy of subject-specific typical exposure estimates. In addition, we are conducting ambient air monitoring to help characterize potential contributions of PM2.5 exposure from background concentration. Stove use monitors (Geocene) are being used to assess compliance with the intervention, given that stove stacking (use of traditional stoves in addition to the intervention gas stove) may occur. CONCLUSIONS: The tools and approaches being used for HAPIN to estimate personal exposures build on previous efforts and take advantage of new technologies. In addition to providing key personal exposure data for this study, we hope the application and learnings from our exposure assessment will help inform future efforts to characterize exposure to household air pollution and for other contexts. https://doi.org/10.1289/EHP6422.

Design and Rationale of the HAPIN Study: A Multicountry Randomized Controlled Trial to Assess the Effect of Liquefied Petroleum Gas Stove and Continuous Fuel Distribution.

BACKGROUND: Globally, nearly 3 billion people rely on solid fuels for cooking and heating, the vast majority residing in low- and middle-income countries (LMICs). The resulting household air pollution (HAP) is a leading environmental risk factor, accounting for an estimated 1.6 million premature deaths annually. Previous interventions of cleaner stoves have often failed to reduce exposure to levels that produce meaningful health improvements. There have been no multicountry field trials with liquefied petroleum gas (LPG) stoves, likely the cleanest scalable intervention. OBJECTIVE: This paper describes the design and methods of an ongoing randomized controlled trial (RCT) of LPG stove and fuel distribution in 3,200 households in 4 LMICs (India, Guatemala, Peru, and Rwanda). METHODS: We are enrolling 800 pregnant women at each of the 4 international research centers from households using biomass fuels. We are randomly assigning households to receive LPG stoves, an 18-month supply of free LPG, and behavioral reinforcements to the control arm. The mother is being followed along with her child until the child is 1 year old. Older adult women (40 to <80 years of age) living in the same households are also enrolled and followed during the same period. Primary health outcomes are low birth weight, severe pneumonia incidence, stunting in the child, and high blood pressure (BP) in the older adult woman. Secondary health outcomes are also being assessed. We are assessing stove and fuel use, conducting repeated personal and kitchen exposure assessments of fine particulate matter with aerodynamic diameter ≤2.5µm (PM2.5), carbon monoxide (CO), and black carbon (BC), and collecting dried blood spots (DBS) and urinary samples for biomarker analysis. Enrollment and data collection began in May 2018 and will continue through August 2021. The trial is registered with ClinicalTrials.gov (NCT02944682). CONCLUSIONS: This study will provide evidence to inform national and global policies on scaling up LPG stove use among vulnerable populations. https://doi.org/10.1289/EHP6407.

Design and Rationale of the Biomarker Center of the Household Air Pollution Intervention Network (HAPIN) Trial.

BACKGROUND: Biomarkers of exposure, susceptibility, and effect are fundamental for understanding environmental exposures, mechanistic pathways of effect, and monitoring early adverse outcomes. To date, no study has comprehensively evaluated a large suite and variety of biomarkers in household air pollution (HAP) studies in concert with exposure and outcome data. The Household Air Pollution Intervention Network (HAPIN) trial is a liquified petroleum gas (LPG) fuel/stove randomized intervention trial enrolling 800 pregnant women in each of four countries (i.e., Peru, Guatemala, Rwanda, and India). Their offspring will be followed from birth through 12 months of age to evaluate the role of pre- and postnatal exposure to HAP from biomass burning cookstoves in the control arm and LPG stoves in the intervention arm on growth and respiratory outcomes. In addition, up to 200 older adult women per site are being recruited in the same households to evaluate indicators of cardiopulmonary, metabolic, and cancer outcomes. OBJECTIVES: Here we describe the rationale and ultimate design of a comprehensive biomarker plan to enable us to explore more fully how exposure is related to disease outcome. METHODS: HAPIN enrollment and data collection began in May 2018 and will continue through August 2021. As a part of data collection, dried blood spot (DBS) and urine samples are being collected three times during pregnancy in pregnant women and older adult women. DBS are collected at birth for the child. DBS and urine samples are being collected from the older adult women and children three times throughout the child's first year of life. Exposure biomarkers that will be longitudinally measured in all participants include urinary hydroxy-polycyclic aromatic hydrocarbons, volatile organic chemical metabolites, metals/metalloids, levoglucosan, and cotinine. Biomarkers of effect, including inflammation, endothelial and oxidative stress biomarkers, lung cancer markers, and other clinically relevant measures will be analyzed in urine, DBS, or blood products from the older adult women. Similarly, genomic/epigenetic markers, microbiome, and metabolomics will be measured in older adult women samples. DISCUSSION: Our study design will yield a wealth of biomarker data to evaluate, in great detail, the link between exposures and health outcomes. In addition, our design is comprehensive and innovative by including cutting-edge measures such as metabolomics and epigenetics. https://doi.org/10.1289/EHP5751.

Public Health and Unconventional Oil and Gas Extraction Including Fracking: Global Lessons from a Scottish Government Review.

Unconventional oil and gas extraction (UOGE) including fracking for shale gas is underway in North America on a large scale, and in Australia and some other countries. It is viewed as a major source of global energy needs by proponents. Critics consider fracking and UOGE an immediate and long-term threat to global, national, and regional public health and climate. Rarely have governments brought together relatively detailed assessments of direct and indirect public health risks associated with fracking and weighed these against potential benefits to inform a national debate on whether to pursue this energy route. The Scottish government has now done so in a wide-ranging consultation underpinned by a variety of reports on unconventional gas extraction including fracking. This paper analyses the Scottish government approach from inception to conclusion, and from procedures to outcomes. The reports commissioned by the Scottish government include a comprehensive review dedicated specifically to public health as well as reports on climate change, economic impacts, transport, geology, and decommissioning. All these reports are relevant to public health, and taken together offer a comprehensive review of existing evidence. The approach is unique globally when compared with UOGE assessments conducted in the USA, Australia, Canada, and England. The review process builds a useful evidence base although it is not without flaws. The process approach, if not the content, offers a framework that may have merits globally.