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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 Haswell Discipline Lead, Health, Safety and Environment School of Public Health and Social Work QUT

ApplicationofHealthRisk) AssessmentinCoalSeamGas ... · Queensland) University) ofTechnology CRICOS&No.&000213J ApplicationofHealthRisk) AssessmentinCoalSeamGas) Developments NarrabriForumAugust2018

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Page 1: ApplicationofHealthRisk) AssessmentinCoalSeamGas ... · Queensland) University) ofTechnology CRICOS&No.&000213J ApplicationofHealthRisk) AssessmentinCoalSeamGas) Developments NarrabriForumAugust2018

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

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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.

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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

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CRICOS  No.  000213Ja  university  for  the worldreal R

There  are  two  main  

pathways/tools  in  

environmental  health

assessment

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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

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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

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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

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CRICOS  No.  000213Ja  university  for  the worldreal R

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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

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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

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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/

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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  

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http://green.24.com/the-definition-of-fracking/ UNSW Medicine Teaching materials

Fracking is  only  one  part  of  the  process  that  carries  health  concerns

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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

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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?)

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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.

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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

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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

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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.

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http://hiaconnect.edu.au/old/other_australian_initiatives.htm

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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).

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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

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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

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UNSW  Leaders  in  HIA

http://hiaconnect.edu.au/

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Types  of  HIAs

• Mandated

• Decision  Support  HIAs

• Advocacy  HIAs

• Community-­Led  HIAs

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CRICOS  No.  000213Ja  university  for  the worldreal R

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CRICOS  No.  000213Ja  university  for  the worldreal R

Like  policy,  HIA  is  both  a  technical  document  and  a  tactical  process

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But  this  will  depend  on  differing  levels  of  depth

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CRICOS  No.  000213Ja  university  for  the worldreal R

And  this  depends  on  resources  available  

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CRICOS  No.  000213Ja  university  for  the worldreal R

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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

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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

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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

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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

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Production  for  export  already  in  dramatic  rise

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Fugitive  emissions  already  in  dramatic  riseeven  when  the  industry  is  in  its  infancy

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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/

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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.

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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  

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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

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CRICOS  No.  000213Ja  university  for  the worldreal R

There  are  two  main  

pathways/tools  in  

environmental  health

assessment

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What  would  an  HIA  of  further  CSG  expansion  in  Narrabri  and  region  look  like?

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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

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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

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CRICOS  No.  000213Ja  university  for  the worldreal R

For  further  information,  contact:

Professor  Melissa  [email protected]