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Queensland University of Technology
CRICOS No. 000213J
Application of Health Risk Assessment in Coal Seam Gas
Developments
Narrabri Forum August 2018
Professor Melissa HaswellDiscipline Lead, Health, Safety and Environment
School of Public Health and Social WorkQUT
CRICOS No. 000213Ja university for the worldreal R
In keeping with the spirit of Reconciliation, I acknowledge the Traditional Owners of the lands on which we meet – the Kamilaroi People and pay my
respects to Elders – past, present and emerging.
CRICOS No. 000213Ja university for the worldreal R
This Talk
• Give an overview of the approaches used in various ways to assess possible predicted risks and impacts associated with activities that may affect human health through the environment
• Compare the advantages and disadvantages of these approaches
• Discuss the precautionary principle vs risk management• Open up discussion about what a Health Impact Assessment on CSG in Narrabri could look and feel like
CRICOS No. 000213Ja university for the worldreal R
There are two main
pathways/tools in
environmental health
assessment
CRICOS No. 000213Ja university for the worldreal R
Human health risk assessment is…
• A process of estimating the potential impact of a chemical, biological, physical or social agent on a specified human population under a specific set of conditions and for a certain time frame’ enHealth
CRICOS No. 000213Ja university for the worldreal R
Underlying Assumptions of Health Risk Assessments
–Risks to human health from environmental hazards can be quantified–Underlying concept behind most environmental health assessment–Assists in making ‘rational’ decisions for reducing risks and guiding allocation of resources
‘
CRICOS No. 000213Ja university for the worldreal R
HRA framework– Issue identification- what matters?– Hazard identification- which chemicals, what potential effects?
– Dose-response assessment- what level will cause health effects?
– Exposure assessment- who might be affected and how?
– Risk characterisation- overall picture
CRICOS No. 000213Ja university for the worldreal R
CRICOS No. 000213Ja university for the worldreal R
Environmental impact assessment
• Relies on scientific and predictive evidence• Often takes a tight definition of health• Building health into EIA, rarely with public health or medical expertise• Project focussed• Epidemiological approaches with an a focus on health risk assessment
CRICOS No. 000213Ja university for the worldreal R
Advantages of HRA• Based on available scientific evidence (epidemiology, toxicology)• Concrete information – Numerical - ➠ management decisions• Compare different risks ➠ appropriate allocation of resources• Can easily be incorporated into other assessments, including HIA
Disadvantages of HRA alone• Focuses predominantly on individual toxins• Limited by limited data ➠ lack of definitive outcome• May be scientifically weak due to assumptions made • Risk assessment outnumbers risk management research • Only superficially addresses equity, essential to public health• Community values and voice often excluded, experts only• Has no mechanism to include qualitative information
Figure taken from Hays & Shenkoff (2016), Towards an understanding of the environmental and public health impacts of unconventional gas development: a categorical assessment of the peer-‐reviewed scientific literature, 2009-‐2015. PLOS One http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154164
NSW Chief Scientist report
Evidence continues to build – rapid increase in peer reviewed publications on shale gas mining, very few on CSG
see ROGER database, https://www.psehealthyenergy.org/our-‐work/shale-‐gas-‐research-‐library/
CRICOS No. 000213Ja university for the worldreal R
Current scientific research and development in risk assessment
– Development of new models for assessing dose response
– Investigation of pathways between exposure to a carcinogen ➠ induction of cancer
– Assessing individual variability– Assessing mixtures of chemicals– Developing biomarkers– Putting psycho-social and socio-economic dimensions to the health impacts
CRICOS No. 000213Ja university for the worldreal R
http://green.24.com/the-definition-of-fracking/ UNSW Medicine Teaching materials
Fracking is only one part of the process that carries health concerns
CRICOS No. 000213Ja university for the worldreal R
Vulnerabilities & exposures are changing:Risk Assessments need to keep up
• Populations changing, e.g. ageing, chronic disease• Populations growing, resource restrictions• Populations moving: new development areas, urbanisation, concentration of hazards and people
• Socio-economic and health inequality growing
• Ambient temperatures rising, rainfall changing• Extreme situations increasing (floods, droughts, heat)• Disasters causing greater exposures• Environmental resilience shrinking
CRICOS No. 000213Ja university for the worldreal R
Complex Problems - Holistic approach?
• If WHO defines health as 'Not only the absence of disease, but also the presence of physical, mental and emotional well-being.‘
then...• Do we need to think holistically about the role the environment plays, not only in disease, but also in promoting and protecting human health, wellbeing, less measurable but very important?
• Especially when we consider the implications of environmental change? (loss?)
CRICOS No. 000213Ja university for the worldreal R
Australian EH Strategy (2016-2020) : preventing disease and injury through healthy
environments http://www.health.gov.au/internet/main/publishing.nsf/content/A12B57E41EC9F326CA257BF0001F9E7D/$File/S
tanding-Committee-Strategic-Plan-2016-2020.pdf
Environmental health activities often taken the traditional approach of responding to environmental threats to health as they emerge, without necessarily developing integrated responses or addressing threats beyond the currently observable. This may function well for issues such as asbestos contamination but for emerging global
environmental health threats, such as climate change, a different response is required. The nature of these threats
implies that the response needs to be anticipatory, integrated, and requires the consideration of higher level
determinants and indirect pathways.
CRICOS No. 000213Ja university for the worldreal R
John L. Adgate *†, Bernard D. Goldstein ‡, and Lisa M. McKenzie †Environ. Sci. Technol., 2014, 48(15), pp 8307–8320Copyright © 2014 American Chemical Society
Potential Public Health Hazards, Exposures and Health Effects from Unconventional Natural Gas Development
Grief and loss among Aboriginal people witnessing fragmentation,
destruction, locked out of traditional lands & disconnected
from country, further disempowerment
Smells, lights and noises associated with drilling, fracking; major increase in heavy transport
Fragmentation, road kills, weeds, toxic and saline spills, air/water pollution
Growing evidence of seepage of fugitive emissions enhancing risk and intensities of fires especially in
dry bush landRisks of spills, accidents in transport, waste water overflow & human error
WELLBEING OFOUR YOUNGPEOPLE & FAMILIES
SECURITY OFOUR CLIMATE IN
CRISIS
RISKS TO OURAIR QUALITY,
AQUIFERS& WATER
CATCHMENTSRISKS TO
OUR ECONOMICWELLBEING
SECURITY OF OURAGRICULTURE &
FOOD SUPPLY
SECURITY OF OURLANDSCAPE,
BIODIVERSITY, & CULTURAL &
NATURALHERITAGE
SAFETY OF OURCOMMUNITIES
SECURITY OFAUSTRALIA’S
IDENTITY & GLOBALREPUTATION
UNCONVENTIONAL GASEXPLORATION AND
MINING
What health and wellbeing concerns are people talking
about?
Crowding out renewable energy investment and development
Locking China and export partners economically to carbon fuels for development that will accelerate climate danger
Distress, division, conflict in communities and disturbing interactions with police
Depression and anxiety among mining workforce and risk for affected communities,
may also heighten suicide risk
High paying, but insecure employment, risk of serious debt stress at young age
No time to lose – fossil fuel mining keeps us tracking worst climate trajectory (>2o rise)
and life, health and economic loss
Carbon emissions enhancing global warming and increasing extreme climatic events: droughts, floods,
cyclones, heatwaves & catastrophic fires
Growing evidence and experience seismic activity linked to
some aspects ofunconventional gas
mining
Heightened risk of traffic accidents, wear and tear on roads
International condemnation as countries suffer from our expanding fossil fuel industry and our land, coast & national icons and world heritage are impacted
Rising community anger and distrust of political leaders from broken election promises and concerns being ignored,
belittled, overruled Widespread experience of solastalgia: sorrow and yearning for cherished places destroyed or pocked with
wells
Serious questions about our commitment to health and wellbeing of future generations
Deepening citizen mistrust of the political systems
Carbon advantage questioned –drilling, infrastructure and fugitive methane emissions may be worse
than oil and coal
Risk of structural damage to shallow aquifers leading to loss of accessible water to
deeper aquifers
Soil and water pollution risks: Carcinogens, mutagens, endocrine disruptors, irritants, sensitisers, organ-‐ damaging substances, excessive saltWater scarcity risks – depletion of a potential future resource to deal with climate stress
Air pollution risks, e.g.:Volatile organic compounds, poly aromatic compounds, diesel fumes, ozone, methane, CO2,
Massive port expansions for gas export impacting our coastline
Wildlife disturbed, corridors restricted, affecting our threatened biodiversity
Loss of landscape values as pristine wilderness is increasingly fragmented with drill pads and connecting roads expanding over large areas
Skills depletion to high salaries crippling other industries
Mining causing rise in Aussie dollar and crippling exports
Environmental impact on landscape harming tourismand public use
Profits going overseas: Problems stay here
Threat to property values, high rents but unsellable, serious concerns in small towns
Lost competitiveness of manufactured goods and tertiary education, net job loss
Depletion of useable fresh water supplies for irrigation & livestock
Compromised agricultural and pastoralist activities, e.g. risk of soil contamination with salt and toxins and risks of illnesses and reproductive problems in
livestock
Distress and anger among farmers and serious mistrust of govt and companies over water, land rights & autonomy
Threat to our food security and the clean and green image of Australia’s agriculture
Dual economic burden of the “carbon bubble” AND climate change
Haswell & Grand Ortega, 2013
CRICOS No. 000213Ja university for the worldreal R
A stepwise process
Health ImpactAssessment: A practical guide.
http://hiaconnect.edu.auhttp://hiaconnect.edu.au/wp-
content/uploads/2012/05/Health_Impact_Assessment_A_Practical_Guide.pdf
I sincerely thank Dr Patrick Harris, formerly of the Centre for Primary Health Care and Equity at UNSW
for some of the visual material shown here, and for giving me a deep appreciation for HIA.
CRICOS No. 000213Ja university for the worldreal R
http://hiaconnect.edu.au/old/other_australian_initiatives.htm
CRICOS No. 000213Ja university for the worldreal R
A combination of procedures, methods and tools by which a policy, program or project may be assessed for its potential and often unanticipated effects on the health of the population and the distribution of these impacts within the population.
Gothenburg Consensus Paper
European Centre for Health Policy (1999) Gothenburg Consensus Paper on Health Impact Assessment: main concepts and suggested approach, WHO Europe: Brussels (adapted by Mahoney & Morgan).
CRICOS No. 000213Ja university for the worldreal R
The Environmental Determinants of Health ---Good health depends on a working and living environment conducive to both physical & mental health, including:
• Clean air
• Water safety and security
• Secure supply of nutritious, safe & affordable food
• Stable and safe climate
• Meaningful livelihood
• Resilient and cohesive communities
http://www.local.gov.uk/web/guest/health/-/journal_content/56/10180/3511260/ARTICLE
CRICOS No. 000213Ja university for the worldreal R
What are our basic human needs for health and wellbeing provided by a healthy environment?
How can we put these things into the equation if they are at risk of a development?
• Physical needs – clean and sufficient water, food and air adequate housing, protection from danger, access to appropriate and affordable health care
• Emotional needs – living a life consistent with one’s values, authentic identity, caring and nurturing relationships, hope for the future, inner peace, justice
• Social needs – cohesive and resilient families and communities, common goals, respect for differing cultures and perspectives
• Cultural needs – sharing of beliefs, rituals, expressions, ways of doing things that connect people to life’s meaning and purpose
• Spiritual needs – harmony in connection to things outside ourselves - to the land and sea, plants and animals, to a higher meaning or being, to the past and the future
CRICOS No. 000213Ja university for the worldreal R
UNSW Leaders in HIA
http://hiaconnect.edu.au/
CRICOS No. 000213Ja university for the worldreal R
Types of HIAs
• Mandated
• Decision Support HIAs
• Advocacy HIAs
• Community-Led HIAs
CRICOS No. 000213Ja university for the worldreal R
CRICOS No. 000213Ja university for the worldreal R
Like policy, HIA is both a technical document and a tactical process
CRICOS No. 000213Ja university for the worldreal R
But this will depend on differing levels of depth
CRICOS No. 000213Ja university for the worldreal R
And this depends on resources available
CRICOS No. 000213Ja university for the worldreal R
CRICOS No. 000213Ja university for the worldreal R
ProblemIdentification& Needs
Assessment
Planning& Proposal Development
Impact Assessment& Revision
Implement-ation
MonitoringExpected &UnexpectedOutcomes
Evaluation & Follow-Up
Review
CRICOS No. 000213Ja university for the worldreal R
Health Impact Assessment vsHealth Risk Assessment
• HRA focuses on specific issues / HIA on broad and multiple interrelated issues
• HRA aims to be scientifically and technically accurate / HIA to be accurate, complete and build in diversity of impacts
• HRA uses a narrower definition of health (measurable aspects)
• HRA arises from disciplines of epidemiology and toxicology / HIA uses mixed methods (qual and quant)
• One or more HRA may form part of a HIA
CRICOS No. 000213Ja university for the worldreal R
HIA is more sensitive to environmental justice perspectives
– Assumes that some level of risk is acceptable Who decides? Who benefits? Who suffers?
– Who decides what impacts are important? Physical, social, cultural health
– Examines if risks disproportionately distributed – Democratic, involving community – Those bearing the risk burden are often unknown and unidentified ➠ gives voice
CRICOS No. 000213Ja university for the worldreal R
Equity : Who is gaining, who is losing?Intergenerational (today) – Intragenerational (tomorrow)
• It is not possible to look at social health without considering differential impacts on different groups of people (eg urban/rural/remote)• Forces a greater discussion of values• Raises issues of differences between target groups/ priority populations/ and equity• Participation valued and given strong voice as evidence
Production for export already in dramatic rise
Fugitive emissions already in dramatic riseeven when the industry is in its infancy
Responding to climate change is the biggest health challenge of our time.
Lancet Commission on Health and Climate 2015 (2015). Health and climate change. http://climatehealthcommission.org/the-‐report/
CRICOS No. 000213Ja university for the worldreal R
Children are particularly vulnerable to the whole range of negative impacts from the proposed development that we have discussed: air pollution, noise, diesel exhaust, distress, water security risks and climate change -
The vulnerability, sensitivity, and resiliency of the developing embryo, infant,child, and adolescent to the effects of environmental chemicals, drugs, and physical agents as compared to the adult. Pediatrics, 2004, 113(Suppl.):932–1172.
And have the most to gain from our decisions and commitment to win-win innovations today.
CRICOS No. 000213Ja university for the worldreal R
Approaches to environmental hazards
• Precautionary approach• In absence of scientific information (proof) err on side of caution (precautionary principle)
• In general favoured by affected communities• Banning of chemicals, processes => substitution with less harmful substances
• Risk assessment approach• Base decisions on available scientific evidence• Define acceptable and unacceptable risk• Avoid unnecessary burden on industry by use of overconservative standards
CRICOS No. 000213Ja university for the worldreal R
Risk Management Approach
• Fully assess the whole spectrum of risks to health, wellbeing, environment for the lifetime of the potential impacts
• Put in regulations that address them• Do rigourous baseline assessments • Continuously monitor to have an early warning system• “Fix” any problems as soon as possible• Feedback into the knowledge of the operation so regulations can become more protective (it won’t happen again)
• Ensure that the community is not held in the dark
CRICOS No. 000213Ja university for the worldreal R
There are two main
pathways/tools in
environmental health
assessment
What would an HIA of further CSG expansion in Narrabri and region look like?
Grief and loss among Aboriginal people witnessing fragmentation,
destruction, locked out of traditional lands & disconnected
from country, further disempowerment
Smells, lights and noises associated with drilling, fracking; major increase in heavy transport
Fragmentation, road kills, weeds, toxic and saline spills, air/water pollution
Growing evidence of seepage of fugitive emissions enhancing risk and intensities of fires especially in
dry bush landRisks of spills, accidents in transport, waste water overflow & human error
WELLBEING OFOUR YOUNGPEOPLE & FAMILIES
SECURITY OFOUR CLIMATE IN
CRISIS
RISKS TO OURAIR QUALITY,
AQUIFERS& WATER
CATCHMENTSRISKS TO
OUR ECONOMICWELLBEING
SECURITY OF OURAGRICULTURE &
FOOD SUPPLY
SECURITY OF OURLANDSCAPE,
BIODIVERSITY, & CULTURAL &
NATURALHERITAGE
SAFETY OF OURCOMMUNITIES
SECURITY OFAUSTRALIA’S
IDENTITY & GLOBALREPUTATION
UNCONVENTIONAL GASEXPLORATION AND
MINING
What health and wellbeing concerns are people talking
about?
Crowding out renewable energy investment and development
Locking China and export partners economically to carbon fuels for development that will accelerate climate danger
Distress, division, conflict in communities and disturbing interactions with police
Depression and anxiety among mining workforce and risk for affected communities,
may also heighten suicide risk
High paying, but insecure employment, risk of serious debt stress at young age
No time to lose – fossil fuel mining keeps us tracking worst climate trajectory (>2o rise)
and life, health and economic loss
Carbon emissions enhancing global warming and increasing extreme climatic events: droughts, floods,
cyclones, heatwaves & catastrophic fires
Growing evidence and experience seismic activity linked to
some aspects ofunconventional gas
mining
Heightened risk of traffic accidents, wear and tear on roads
International condemnation as countries suffer from our expanding fossil fuel industry and our land, coast & national icons and world heritage are impacted
Rising community anger and distrust of political leaders from broken election promises and concerns being ignored,
belittled, overruled Widespread experience of solastalgia: sorrow and yearning for cherished places destroyed or pocked with
wells
Serious questions about our commitment to health and wellbeing of future generations
Deepening citizen mistrust of the political systems
Carbon advantage questioned –drilling, infrastructure and fugitive methane emissions may be worse
than oil and coal
Risk of structural damage to shallow aquifers leading to loss of accessible water to
deeper aquifers
Soil and water pollution risks: Carcinogens, mutagens, endocrine disruptors, irritants, sensitisers, organ-‐ damaging substances, excessive saltWater scarcity risks – depletion of a potential future resource to deal with climate stress
Air pollution risks, e.g.:Volatile organic compounds, poly aromatic compounds, diesel fumes, ozone, methane, CO2,
Massive port expansions for gas export impacting our coastline
Wildlife disturbed, corridors restricted, affecting our threatened biodiversity
Loss of landscape values as pristine wilderness is increasingly fragmented with drill pads and connecting roads expanding over large areas
Skills depletion to high salaries crippling other industries
Mining causing rise in Aussie dollar and crippling exports
Environmental impact on landscape harming tourismand public use
Profits going overseas: Problems stay here
Threat to property values, high rents but unsellable, serious concerns in small towns
Lost competitiveness of manufactured goods and tertiary education, net job loss
Depletion of useable fresh water supplies for irrigation & livestock
Compromised agricultural and pastoralist activities, e.g. risk of soil contamination with salt and toxins and risks of illnesses and reproductive problems in
livestock
Distress and anger among farmers and serious mistrust of govt and companies over water, land rights & autonomy
Threat to our food security and the clean and green image of Australia’s agriculture
Dual economic burden of the “carbon bubble” AND climate change
Haswell & Grand Ortega, 2013
In Australia:• Doctors for the Environment Australia• Australian Medical Association (CSG)• Public Health Association of Australia• Climate and Health Alliance (which itself has
numerous health organisations members)
In the United States:• American Academy of Paediatrics • American Public Health Association• Physicians for Social Responsibility• Many other health and medical groups….
Many health organisations have expressed serious concern about the health uncertainties linked to
unconventional gas and call for precautionary principle – i.e. ‘if in doubt, turn it off’
until safety is proven. These include:
https://ama.com.au/ausmed/if-‐doubt-‐turn-‐csg-‐ama
CRICOS No. 000213Ja university for the worldreal R
For further information, contact:
Professor Melissa [email protected]