title: Unconventional Gas and Oil Drilling Is Associated with Increased Hospital Utilization Rates.
abstract: Over the past ten years, unconventional gas and oil drilling (UGOD) has markedly expanded in the United States. Despite substantial increases in well drilling, the health consequences of UGOD toxicant exposure remain unclear. This study examines an association between wells and healthcare use by zip code from 2007 to 2011 in Pennsylvania. Inpatient discharge databases from the Pennsylvania Healthcare Cost Containment Council were correlated with active wells by zip code in three counties in Pennsylvania. For overall inpatient prevalence rates and 25 specific medical categories, the association of inpatient prevalence rates with number of wells per zip code and, separately, with wells per km2 (separated into quantiles and defined as well density) were estimated using fixed-effects Poisson models. To account for multiple comparisons, a Bonferroni correction with associations of p<0.00096 was considered statistically significant. Cardiology inpatient prevalence rates were significantly associated with number of wells per zip code (p<0.00096) and wells per km2 (p<0.00096) while neurology inpatient prevalence rates were significantly associated with wells per km2 (p<0.00096). Furthermore, evidence also supported an association between well density and inpatient prevalence rates for the medical categories of dermatology, neurology, oncology, and urology. These data suggest that UGOD wells, which dramatically increased in the past decade, were associated with increased inpatient prevalence rates within specific medical categories in Pennsylvania. Further studies are necessary to address healthcare costs of UGOD and determine whether specific toxicants or combinations are associated with organ-specific responses.
authors.affiliation: Department of Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors.forename: Thomas
authors.initials: T
authors.lastname: Jemielita
authors.affiliation: Center of Excellence in Environmental Toxicology (CEET), Airways Biology Initiative, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors.forename: George L
authors.initials: GL
authors.lastname: Gerton
authors.affiliation: Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York, United States of America.
authors.forename: Matthew
authors.initials: M
authors.lastname: Neidell
authors.affiliation: Lamont-Doherty Earth Observatory of Columbia University, Palisades, New York, United States of America.
authors.forename: Steven
authors.initials: S
authors.lastname: Chillrud
authors.affiliation: Lamont-Doherty Earth Observatory of Columbia University, Palisades, New York, United States of America.
authors.forename: Beizhan
authors.initials: B
authors.lastname: Yan
authors.affiliation: Lamont-Doherty Earth Observatory of Columbia University, Palisades, New York, United States of America.
authors.forename: Martin
authors.initials: M
authors.lastname: Stute
authors.affiliation: Center of Excellence in Environmental Toxicology (CEET), Airways Biology Initiative, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Howarth
authors.affiliation: Center of Excellence in Environmental Toxicology (CEET), Airways Biology Initiative, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors.forename: Pouné
authors.initials: P
authors.lastname: Saberi
authors.affiliation: Center of Excellence in Environmental Toxicology (CEET), Airways Biology Initiative, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Fausti
authors.affiliation: Center of Excellence in Environmental Toxicology (CEET), Airways Biology Initiative, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors.forename: Trevor M
authors.initials: TM
authors.lastname: Penning
authors.affiliation: Department of Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors.forename: Jason
authors.initials: J
authors.lastname: Roy
authors.affiliation: Department of Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Propert
authors.affiliation: Center of Excellence in Environmental Toxicology (CEET), Airways Biology Initiative, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.
authors.forename: Reynold A
authors.initials: RA
authors.lastname: Panettieri
mesh_terms: D000328:Adult; D004781:Environmental Exposure; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D000067071:Hydraulic Fracking; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D018570:Risk Assessment