STEVE INSKEEP, HOST:
This week, we're examining the stories of people who live near natural gas wells and are getting sick. We heard stories yesterday of people in Pennsylvania and Colorado. But it takes more than one person's story to make a connection between pollution and illness. Scientists say they want to study detailed information on a large group of people over a long period of time. And there is an effort to do that in the mountains of northern Pennsylvania.
NPR's Jon Hamilton reports.
JON HAMILTON, BYLINE: Energy companies have drilled about 5,000 gas wells in Pennsylvania's Marcellus Shale, and they plan to drill thousands more. So northern Pennsylvania is a pretty good place to ask whether all that drilling is affecting people's health. But researchers say there's another compelling reason to do a study here.
(SOUNDBITE OF TYPING)
HAMILTON: It's a database of electronic health records on hundreds of thousands of people who live near the Marcellus Shale. Without records like this, it would be almost impossible to figure out whether drilling is affecting public health.
DR. PAUL SIMONELLI: So, here, I'm bringing a patient up.
HAMILTON: Dr. Paul Simonelli says those records mean that all kinds of information is just a few keystrokes away.
SIMONELLI: And what is immediately available here is all the office visits this particular patient has had in our system. This patient's been seen in our system well over a dozen times, and this dates back to 2001.
HAMILTON: The database is one of just a handful in the nation that are so large and comprehensive. It belongs to the Geisinger Health System, which includes doctors, hospitals and health insurance plans. Geisinger helps provide care for more than two million Pennsylvanians.
Simonelli is the director of thoracic medicine at the system's gleaming headquarters in Danville. He says eventually, researchers hope to use the database to see whether there's a link between gas drilling and a wide range of diseases, such as cancer and diabetes. But they plan to start by focusing on just one health problem: asthma.
SIMONELLI: This is our pulmonary function lab. So if people were to come in to get pulmonary function testing, this is where they'd be, down this corridor.
HAMILTON: Simonelli says people with asthma and other lung problems are very sensitive to some of the air pollutants that come from natural gas production. He says you can actually measure the effect these pollutants have on an asthma patient's lungs.
MARY ELLEN NORQUEST: I want you to put the mouthpiece in your mouth, between your teeth, lips tight. I'm going to put nose clips on your nose so the air doesn't escape through there.
HAMILTON: A technician named Mary Ellen Norquest shows how.
NORQUEST: And a deep breath in.
(SOUNDBITE OF PATIENT BREATHING DEEPLY)
NORQUEST: Keep pushing. Keep pushing. Push, push, push. Keep pushing. Keep pushing. A couple more seconds.
HAMILTON: Simonelli says the results of tests like this one all end up in the system's database. And that sort of information should make it possible to study the health effects of one pollutant that often forms near gas operations. It's ground-level ozone, or smog. Simonelli says when ozone levels rise, asthma patients start looking for help.
SIMONELLI: The first line of therapy are primary care physicians, and clearly, they'll start seeing more business. We see it in the specialty clinics, such as my own, where we'll be messaged by lots of patients that I'm getting worse, what should I do. People come in the emergency rooms.
About 6 percent of people in the U.S. have asthma. That means Geisinger has records on tens of thousands of asthma patients. And Simonelli says most of these patients live in rural areas, where ozone wasn't a problem before gas drilling.
So we're talking about an enormous number of people who are potentially at risk to have their conditions worsened by these exposures.
HAMILTON: The Geisinger database should be able to reveal any change, because its records go back more than a decade. One scientist who believes in the Geisinger effort is Brian Schwartz, an environmental epidemiologist at Johns Hopkins in Baltimore. He's working with Geisinger on the project. Schwartz says the system's information is so detailed, that it's possible to gather information about specific groups of asthma patients - say, those who live within a mile of a gas well.
DR. BRIAN SCHWARTZ: How much medications they're using, are they being admitted to the hospital, are they requiring emergency department visits, are they using more inhalers.
HAMILTON: Schwartz says Geisinger is in a unique position to measure the effects of a huge natural experiment. That's because in Pennsylvania, large-scale drilling came relatively recently. In places like Texas, most wells were already operating by the time researchers started looking into health effects. And Schwartz says other places don't have Geisinger's trove of electronic health records that go back long before the gas boom started.
SCHWARTZ: Because we have 10 years of health data, but the drilling has mainly been for the past five years, we have a period with information on asthma patients and controls before drilling, a period after drilling. And so I think it's a very powerful design that can answer a number of questions right now.
HAMILTON: There's one big hitch, though. The asthma study alone is likely to cost nearly a million dollars, and no one has offered to pay for it yet. Even so, Schwartz is optimistic. One reason is that the research has strong support at Geisinger, from the CEO on down.
David Carey, who directs the system's Weis Center for Research, says there's a good reason.
DAVID CAREY: If you look at the map, the geographic footprint of our patient catchment area, this is literally going on in our backyard.
HAMILTON: So Carey and other Geisinger officials have been promoting the study to scientists and funding agencies. And Carey says the response has been positive, in part because the health system is seen as a neutral party in the national debate about fracking and shale gas production.
CAREY: We're not out to get anybody. We just want to let the facts lead us wherever they will. So if we do find that there are environmental exposures that are harming people's health, we'll say it. If we find evidence that there's nothing to worry about we'll say that, too.
HAMILTON: Carey hopes to have an answer before a lot more drilling takes place in the Marcellus Shale.
Jon Hamilton, NPR News.
INSKEEP: Our series continues this afternoon on ALL THINGS CONSIDERED, with the story of a Texas town at the center of the fracking boom.
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