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Unconventional natural gas development and hospitalizations: evidence from Pennsylvania, United States, 2003-2014.

ABSTRACT: OBJECTIVES:To examine relationships between short-term and long-term exposures to unconventional natural gas development, commonly known as fracking, and county hospitalization rates for a variety of broad disease categories. STUDY DESIGN:This is an ecological study based on county-level data for Pennsylvania, United States, 2003-2014. METHODS:We estimated multivariate regressions with county and year fixed effects, using two 12-year panels: all 67 Pennsylvania counties and 54 counties that are not large metropolitan. RESULTS:After correcting for multiple comparisons, we found a positive association of cumulative well density (per km2) with genitourinary hospitalization rates. When large metropolitan counties were excluded, this relationship persisted, and positive associations of skin-related hospitalization rates with cumulative well count and well density were observed. The association with genitourinary hospitalization rates is driven by females in 20-64 years group, particularly for kidney infections, calculus of ureter, and urinary tract infection. Contemporaneous wells drilled were not significantly associated with hospitalizations after adjustment for multiple comparisons. CONCLUSIONS:Our study shows that long-term exposure to unconventional gas development may have an impact on prevalence of hospitalizations for certain diseases in the affected populations and identifies areas of future research on unconventional gas development and health.

SUBMITTER: Denham A

PROVIDER: S-EPMC6408296 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Unconventional natural gas development and hospitalizations: evidence from Pennsylvania, United States, 2003-2014.

Denham A A Willis M M Zavez A A Hill E E

Public health 20190121

<h4>Objectives</h4>To examine relationships between short-term and long-term exposures to unconventional natural gas development, commonly known as fracking, and county hospitalization rates for a variety of broad disease categories.<h4>Study design</h4>This is an ecological study based on county-level data for Pennsylvania, United States, 2003-2014.<h4>Methods</h4>We estimated multivariate regressions with county and year fixed effects, using two 12-year panels: all 67 Pennsylvania counties and ...[more]

PMID: 30677623

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Project description:BackgroundInfectious disease epidemiology has changed over time, reflecting improved clinical interventions and emergence of threats such as antimicrobial resistance. This study investigated infectious disease hospitalizations in the United States from 2001 to 2014.MethodsEstimated rates of infectious disease hospitalizations were calculated by using the National (Nationwide) Inpatient Sample. Infectious disease hospitalizations were defined as hospitalizations with a principal discharge diagnosis of an infectious disease. Diagnoses according to site of infection and sepsis were examined, as was occurrence of in-hospital death. The leading nonsepsis infectious disease secondary diagnoses for hospitalizations with a principal diagnosis of sepsis were identified.ResultsThe mean annual age-adjusted infectious disease hospitalization rate was 1,468.2 (95% CI, 1,459.9-1,476.4) per 100,000 population; in-hospital death occurred in 4.22% (95% CI, 4.18-4.25) of infectious disease hospitalizations. The mean annual age-adjusted infectious disease hospitalization rate increased from 2001-2003 to 2012-2014 (rate ratio, 1.05; 95% CI, 1.01-1.09), as did the percentage of in-hospital death (4.21% [95% CI, 4.13-4.29] to 4.30% [95% CI, 4.26-4.35]; P = .049). The diagnoses with the highest hospitalization rates among all sites of infection and sepsis diagnoses were the lower respiratory tract followed by sepsis. The most common nonsepsis infectious disease secondary diagnoses among sepsis hospitalizations were "urinary tract infection," "pneumonia, organism unspecified," and "intestinal infection due to Clostridium [Clostridioides] difficile."ConclusionsAlthough hospital discharge data are subject to limitations, particularly for tracking sepsis, lower respiratory tract infections and sepsis seem to be important contributors to infectious disease hospitalizations. Prevention of infections that lead to sepsis and improvements in sepsis management would decrease the burden of infectious disease hospitalizations and improve outcomes, respectively.

Dataset Information

Unconventional natural gas development and hospitalizations: evidence from Pennsylvania, United States, 2003-2014.

Publications

Unconventional natural gas development and hospitalizations: evidence from Pennsylvania, United States, 2003-2014.

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