Update: “The Pennsylvania attorney general’s office filed 15 criminal charges against Cabot Oil & Gas Corp, nine of them felonies. Cabot has not yet entered a plea.” – USA Today, PressConnects, 22 June 2020. 

The Pittsburgh Post-Gazette had been running a series of articles since March of 2019 following an investigation by the Pennsylvania Department of Health and the US Centers for Disease Control about multiple cases of Ewing sarcoma, a rare childhood bone cancer, that were reported in the southwestern part of the state. 1

As the Post-Gazette observed, across the United States there are only 200-250 cases of Ewing sarcoma diagnosed each year. According to the paper, 6 cases of Ewing sarcoma have been diagnosed in one Washington County school district since 2008. In close by Westmoreland County, there have been 12 cases diagnosed from 2011 to early 2018. A health department spokesman told the paper that this particular cancer was not one of the common cancers his department reports on annually and the science is limited on its causes. 1

For readers who are unfamiliar with Ewing’s Sarcoma, here is a video about a young girl named Eve and her fight against this childhood cancer in the UK.

Eve was diagnosed with Ewing’s Sarcoma, a rare type of cancer that forms in bone or soft tissue, in 2015.

A coalition of concerned citizens wants to know if the cancers are related to environmental factors. According to the Post-Gazette, “Washington County has historic radiation issues related to a uranium mill tailings disposal site in North Strabane, near Canonsburg, where the U.S. Department of Energy continues to report background or below background levels of radiation. Another concern is the widespread drilling and fracking of more than 1,000 shale gas wells, which produce wastewater with radioactive components, among other pollutants. The township now sits downwind from a phalanx of compressor stations and a hilltop cryogenics plant, a major source of pollution.” 1

The Post-Gazette’s Editorial Board added a clear sense of urgency with an editorial in April 2019 pleading, “Spare no effort: Investigators must get to the bottom of cancer scare…There may be a monster among us, one striking down adolescents and young adults but about which little is known…Because the cases have occurred in fracking country, there’s concern that something associated with natural gas production is involved.” 2


Just two months later, an unusual paper was published in the open-access International Journal of Environmental Research and Public Health. Health scientists from the Colorado Department of Public Health and the Pennsylvania Department of Health (CO-PA) teamed up to evaluate the quality of existing epidemiologic literature on potential adverse health effects of living near oil and natural gas (ONG) operations [a.k.a. fracking] in the U.S. Their finding?

“ONG regulatory policy has not been informed by robust epidemiologic research literature. Now, 15–20 years since the widespread application of hydraulic fracturing and horizontal drilling in states as diverse as Colorado, Pennsylvania, Texas, and Kansas, the epidemiologic literature on the potential health effects of ONG operations is still inadequate to definitively guide policy, as evidenced by the mainly low certainty and conflicting studies reviewed here.” 3

It is not so unusual that a review of the literature was undertaken to assess the quality of research undertaken thus far. What is remarkable is that the CO-PA public health officials knew they were sorely lacking solid scientific data on which to base the policies that regulate fracking industry practices stating, “The industry surrounding ONG expanded faster than evidence-based epidemiologic research could respond.” 3

The health scientists from Pennsylvania and Colorado used the limitations of existing research as a chance to highlight that “the identities and exposure levels of substances people are exposed to when living, working, or going to school near ONG development have not been well characterized. Epidemiologic studies that include more controlled designs with direct measurement of exposure and diagnosed health outcomes are needed to confirm or dispute the associations published in the literature.” 3

The Marcellus Shale Coalition (MSC), the trade organization that works on behalf of Pennsylvania’s shale gas industry, provided their own summary of the Colorado and Pennsylvania health department epidemiologic research in a November 2019 “Public Health Research Statement” sharing “key facts & background info”: “Research from the Pa. Dept. of Health & Colorado Dept. of Health concluded the majority of studies tying negative health outcomes to shale development were rated ‘low certainty’ and limited in design. Most, according to the research, had ‘conflicting evidence (mixed), insufficient evidence, or in some cases, a lack of evidence of the possibility for harmful health effects.’ 4 MSC added their own italics to the quotes and did not add the context that the PA-CO researchers used these shortcomings as a rationale for the need for more robust research.

One example of research the Colorado-Pennsylvania team felt rated as “low certainty” was a study by Fryzek and colleagues5 from the EpidStat Institute (a provider of epidemiology and biostatistics services6) entitled, “Childhood Cancer Incidence in Pennsylvania Counties in Relation to Living in Counties with Hydraulic Fracturing Sites.” Fryzek et al. offered this conclusion in their study abstract, “This study offers comfort concerning health effects of HF [hydraulic fracturing] on childhood cancers.” 5

In identifying the limitations of the Fryzek study, the CO-PA team had this to say, “For studies of cancer, it is crucial for researchers to consider what would be an appropriate time frame from exposure to ONG [oil and natural gas] operations to the potential development of cancer. ONG operations began in earnest in the late 2000s in Pennsylvania, but Fryzek et al. used data only through 2009; this truncated period between community exposure and cancer endpoint is a major limitation5. As noted elsewhere7, the study period was not matched to the theoretical lag period or latency period for adult carcinogenesis.” 3 The CO-PA team did not mention that the Fryzek study discloses that it was funded with a grant from America’s Natural Gas Alliance.

In late 2019, the governor of Pennsylvania, Tom Wolf, pledged $3 million for the state Department of Health “to undertake two research projects that will help to better understand the possible health effects related to the natural gas industry, in particular as they pertain to confirmed cases of Ewing Sarcoma and other childhood cancers in southwestern Pennsylvania.” 8

In a joint statement responding to the governor’s announcement of the new public health research initiative, the Marcellus Shale Coalition and other Pennsylvania oil and gas trade associations stated, “The concerns in these communities are shared with our industry. We live here too and have no higher priority than protecting and ensuring the health and safety of our communities, especially our kids and grandkids.” 4

Considering the recent news coverage of what parents feel is a tragic spike in these childhood cancers, it is controversial whether the industry is truly making it their priority.

On another front, The Morning Call, an online news outlet, reported in late 2019 that the head of the Pennsylvania Department of Environmental Protection’s oil and gas office confirmed that members of his agency have testified before a state grand jury that is investigating the shale gas industry “over environmental concerns.” 9 So far, all agencies are in a “no comment” mode. We will continue to follow the story.


1Templeton D, Hopey D. CDC, State Officials Investigating Multiple Cases of Rare Cancer in Southwestern Pa. 28 March 2019. Pittsburgh Post-Gazette.

2Pittsburgh Post-Gazette Editorial Board. Spare No Effort: Investigators Must Get To The Bottom of Cancer Scare. Editorial. 3 April 2019.

3Bamber AM et al. A Systematic Review of the Epidemiologic Literature Assessing Health Outcomes in Populations Living near Oil and Natural Gas Operations: Study Quality and Future Recommendations. International Journal of Environmental Research & Public Health. 2019 Jun 15;16(12). pii: E2123.

4Marcellus Shale Coalition. MSC-API-PIOGA Public Health Research Statement. 22 November 2019.

5Fryzek J et al. Childhood cancer incidence in Pennsylvania counties in relation to living in counties with hydraulic fracturing sites. Journal of Occupational and Environmental Medicine. 2013;55:796–801. a pdf of the study paper can be found here with the research support listed at the bottom of the first page.

6EpidStat Institute. Epidemiology and Biostatistics Overview and Services.

7Goldstein BD, Malone S. Obfuscation does not provide comfort: response to the article by Fryzek et al on hydraulic fracturing and childhood cancer. Journal of Occupational and Environmental Medicine. 2013 Nov; 55(11):1376-8.

8KDKA, CBS Pittsburgh. Pennsylvania To Spend $3M To Study Possible Link Between Fracking And Spike In Childhood Cancer. 22 November 2019.

9The Morning Call. Pennsylvania Grand Jury Probing Shale Gas Industry Over Environmental Concerns. 22 November, 2019.

Update:  Associated Press: Pennsylvania Attorney General Files 15 Criminal Charges against Fracking Company Cabot. USA Today, PressConnects, 22 June 2020.

Categorized in: