PITTSBURGH — On Tuesday, EHN reporter Kristina Marusic was presented two awards from the Press Club of Western Pennsylvania for her reporting on toxic pollution caused by extractive industries in western Pennsylvania.
The Golden Quills competition honors excellence in print, broadcast, photography, videography and digital journalism in western Pennsylvania and nearby counties in Ohio and West Virginia. This was the 59th year for the annual awards, which were presented at an awards dinner in Pittsburgh on May 30.
Marusic's reporting on Shell's new plastics plant in western Pennsylvania and the oil and gas industry's use of PFAS (per- and polyfluoroalkyl substances), submitted together under the headline, "Energy Justice and Environmental Health in Western Pennsylvania,” won a first place prize in the science/environment non-daily written journalism category, and also received one of four Best in Show Ray Sprigle Memorial Awards.
"It's an honor to have my work recognized through these awards," Marusic said. "I hope my reporting continues to make an impact in Western Pennsylvania."
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PITTSBURGH — Hospitals save lives — but they’re also complex ecosystems that generate toxic waste, rely on fossil fuels and instigate health problems due to harmful emissions.
Change comes hard to healthcare institutions, but a growing movement of doctors, nurses, medical school students and hospital system executives are working to clean up the industry.
Around 650 health care professionals from around the world gathered in Pittsburgh last week to strategize about ways to reduce waste and air pollution, disinvest from fossil fuels, better integrate communities, drive down the industry’s climate-warming emissions and hear success stories from people on the front lines of this work.
“[This] is not just a conference — we’re intentionally building a movement,” said Gary Cohen, president and co-founder of Health Care Without Harm, the organization that hosts the CleanMed conference, during his opening remarks. “This is the work of our lifetime. Are we ready to get going?”
Healthcare’s environmental toll
Ironically, the healthcare industry takes a significant toll on the environment in ways that negatively impact human health. The sector accounts for an estimated 4.4% of total global greenhouse gas emissions and up to 9.8% of U.S. greenhouse gas emissions.
Health damages from the U.S. healthcare sector’s pollution – including greenhouse gasses, carcinogenic emissions and other toxic air pollutants – from 2003-2013 are estimated to have cost Americans more than 400,000 years of full health, defined as years lived free of disease or disability. It’s estimated that nearly eight million, or one in five deaths globally, are caused by air pollution — more than the number of deaths caused by AIDS, malaria and tuberculosis combined.
Institutional investments are also problematic: The U.S. has more than 1,200 private hospital systems, which invest an estimated $10 billion in fossil fuels.
Cleaning up the healthcare sector
People who have successfully initiated new sustainability programs or policies at their organizations shared tools and tips.
Credit: Kristina Marusic for Environmental Health News
The doctors and nurses attending CleanMed were joined by operations managers, sustainability directors, budget analysts, medical device providers and health-care-strategy consultants, along with people in numerous other roles.
People who have successfully initiated new sustainability programs or policies at their organizations shared tools and tips.
Elizabeth McLellan was one of those people. In the early 2000s, while working as a nurse administrator at Maine Medical Center, she was troubled by the huge volume of unused supplies like gloves, gowns, gauze, bandages and masks going into the trash because they’d been left in a patient’s room or opened in an operating room.
McLellan had lived and worked abroad and knew there was a dire need for these supplies in other parts of the world, so she started collecting them. There was nowhere on site at her hospital to store the supplies she saved, so she took them home.
By 2009 the bottom floor of her house was filled with about 11,000 pounds of rescued medical supplies, which she eventually figured out how to warehouse, ship and donate to hospitals in need around the world. After running the project entirely by herself for years, McLellan scaled the operation into a regional nonprofit, Partners for World Health, with 10 staff members and 800 volunteers, that has saved more than 180,000 pounds of medical supplies from landfills and shipped them to countries in need including Ukraine, Syria, Turkey, Zambia, Haiti, Ethiopia, South Sudan and Kenya.
“It’s easier to ask for forgiveness than for permission,” she said in a session about hospitals making progress toward becoming zero-waste. “That has worked my whole career, and it worked for this project, too.”
In one of two talks about reducing single-use plastics, Dr. Sara Angelilli, director of perioperative education at the Allegheny Health Network, talked about implementing reusable respirators. Dr. Preetri Preeti Mehrotra, a senior medical director at Beth Israel Deaconess Medical Center, shared tips on finding the people who “can help pull the levers,” and discussed both infection control and financial benefits in switching to reusable products. And Daniel Vukelich, president of the Association of Medical Device Reprocessors, cautioned about the false promise of “chemical recycling” of single-use plastics, which is associated with a host of climate and environmental health concerns. Health Care Without Harm is also calling for the global plastics treaty currently in its second round of talks this week in Paris, to not allow medical exemptions.
Other health care professionals shared advice about incorporating environmental justice and community health advocacy into clinical care by setting and meeting renewable energy goals, managing hazardous pharmaceutical waste, getting clinicians involved in climate action and increasing patient access to healthy and sustainable foods inside hospitals and at home. Health Care Without Harm partners with hospitals around the world to help them meet these types of goals through its Practice GreenHealth program.
“In the last year or two, hospitals are increasingly looking beyond their four walls when talking about community resilience and environmental health,” Paul Bogart, executive director of Health Care Without Harm, told EHN. “They’re starting to think about economic drivers of community health and social determinants of health — things like housing, transportation, employment and exposure to polluting facilities.”
“That type of work, for many health care institutions, is just beginning,” Bogart added. “Those relationships with community leaders are just beginning.”
Why Pittsburgh?
Walking along the Allegheny River with scenic views of the city’s iconic yellow bridges, the group learned about how pollution from the steel industry was once so bad that Pittsburgh was nicknamed “hell with the lid off."Credit: Kristina Marusic for Environmental Health News
Attendees representing at least 15 countries, including Argentina, Australia, Belgium, Brazil, Japan, Nepal, South Korea and Taiwan attended the CleanMed conference.
Previous conferences have been held in cities across the U.S. and across the world, and conference organizers connect what’s happening locally with the broader movement.
“The fossil fuel and petrochemical industries require externalizing harm,” said Cohen during a plenary on building partnerships between health care institutions and community advocacy. “We need to understand who is harmed by an economy that’s based on fossil fuels and toxic chemicals … What does it mean for the health care industry to truly partner with these communities to help build community health, wealth and resilience?”
Ferguson, 49, yearned to go back to her East Palestine home, a two-story duplex, but didn’t dare. Being there made her sick. She fears toxic chemicals that leaked from broken and burned railroad cars have made their way into a creek that runs under her house. The smell hits her as soon as she walks in the front door. She wonders, “What will these poisons do to my mother if we move back?”
PITTSBURGH — Hospitals save lives — but they’re also complex ecosystems that generate toxic waste, rely on fossil fuels and instigate health problems due to harmful emissions.
Change comes hard to healthcare institutions, but a growing movement of doctors, nurses, medical school students and hospital system executives are working to clean up the industry.
Around 650 health care professionals from around the world gathered in Pittsburgh last week to strategize about ways to reduce waste and air pollution, disinvest from fossil fuels, better integrate communities, drive down the industry’s climate-warming emissions and hear success stories from people on the front lines of this work.
“[This] is not just a conference — we’re intentionally building a movement,” said Gary Cohen, president and co-founder of Health Care Without Harm, the organization that hosts the CleanMed conference, during his opening remarks. “This is the work of our lifetime. Are we ready to get going?”
Healthcare’s environmental toll
Ironically, the healthcare industry takes a significant toll on the environment in ways that negatively impact human health. The sector accounts for an estimated 4.4% of total global greenhouse gas emissions and up to 9.8% of U.S. greenhouse gas emissions.
Health damages from the U.S. healthcare sector’s pollution – including greenhouse gasses, carcinogenic emissions and other toxic air pollutants – from 2003-2013 are estimated to have cost Americans more than 400,000 years of full health, defined as years lived free of disease or disability. It’s estimated that nearly eight million, or one in five deaths globally, are caused by air pollution — more than the number of deaths caused by AIDS, malaria and tuberculosis combined.
Institutional investments are also problematic: The U.S. has more than 1,200 private hospital systems, which invest an estimated $10 billion in fossil fuels.
Cleaning up the healthcare sector
People who have successfully initiated new sustainability programs or policies at their organizations shared tools and tips.
Credit: Kristina Marusic for Environmental Health News
The doctors and nurses attending CleanMed were joined by operations managers, sustainability directors, budget analysts, medical device providers and health-care-strategy consultants, along with people in numerous other roles.
People who have successfully initiated new sustainability programs or policies at their organizations shared tools and tips.
Elizabeth McLellan was one of those people. In the early 2000s, while working as a nurse administrator at Maine Medical Center, she was troubled by the huge volume of unused supplies like gloves, gowns, gauze, bandages and masks going into the trash because they’d been left in a patient’s room or opened in an operating room.
McLellan had lived and worked abroad and knew there was a dire need for these supplies in other parts of the world, so she started collecting them. There was nowhere on site at her hospital to store the supplies she saved, so she took them home.
By 2009 the bottom floor of her house was filled with about 11,000 pounds of rescued medical supplies, which she eventually figured out how to warehouse, ship and donate to hospitals in need around the world. After running the project entirely by herself for years, McLellan scaled the operation into a regional nonprofit, Partners for World Health, with 10 staff members and 800 volunteers, that has saved more than 180,000 pounds of medical supplies from landfills and shipped them to countries in need including Ukraine, Syria, Turkey, Zambia, Haiti, Ethiopia, South Sudan and Kenya.
“It’s easier to ask for forgiveness than for permission,” she said in a session about hospitals making progress toward becoming zero-waste. “That has worked my whole career, and it worked for this project, too.”
In one of two talks about reducing single-use plastics, Dr. Sara Angelilli, director of perioperative education at the Allegheny Health Network, talked about implementing reusable respirators. Dr. Preetri Preeti Mehrotra, a senior medical director at Beth Israel Deaconess Medical Center, shared tips on finding the people who “can help pull the levers,” and discussed both infection control and financial benefits in switching to reusable products. And Daniel Vukelich, president of the Association of Medical Device Reprocessors, cautioned about the false promise of “chemical recycling” of single-use plastics, which is associated with a host of climate and environmental health concerns. Health Care Without Harm is also calling for the global plastics treaty currently in its second round of talks this week in Paris, to not allow medical exemptions.
Other health care professionals shared advice about incorporating environmental justice and community health advocacy into clinical care by setting and meeting renewable energy goals, managing hazardous pharmaceutical waste, getting clinicians involved in climate action and increasing patient access to healthy and sustainable foods inside hospitals and at home. Health Care Without Harm partners with hospitals around the world to help them meet these types of goals through its Practice GreenHealth program.
“In the last year or two, hospitals are increasingly looking beyond their four walls when talking about community resilience and environmental health,” Paul Bogart, executive director of Health Care Without Harm, told EHN. “They’re starting to think about economic drivers of community health and social determinants of health — things like housing, transportation, employment and exposure to polluting facilities.”
“That type of work, for many health care institutions, is just beginning,” Bogart added. “Those relationships with community leaders are just beginning.”
Why Pittsburgh?
Walking along the Allegheny River with scenic views of the city’s iconic yellow bridges, the group learned about how pollution from the steel industry was once so bad that Pittsburgh was nicknamed “hell with the lid off."Credit: Kristina Marusic for Environmental Health News
Attendees representing at least 15 countries, including Argentina, Australia, Belgium, Brazil, Japan, Nepal, South Korea and Taiwan attended the CleanMed conference.
Previous conferences have been held in cities across the U.S. and across the world, and conference organizers connect what’s happening locally with the broader movement.
“The fossil fuel and petrochemical industries require externalizing harm,” said Cohen during a plenary on building partnerships between health care institutions and community advocacy. “We need to understand who is harmed by an economy that’s based on fossil fuels and toxic chemicals … What does it mean for the health care industry to truly partner with these communities to help build community health, wealth and resilience?”
PITTSBURGH — A group of about 50 health care workers including doctors, nurses and public health officials from across the U.S. attended an “environmental justice walking tour” in Pittsburgh this morning.
They’re here for CleanMed, a three-day conference on sustainability in the healthcare industry. Participants in the pre-conference tour walked along the river trail downtown, learning about the city’s industrial past and ongoing problems with pollution.
Walking along the Allegheny River with scenic views of the city’s iconic yellow bridges on a clear, sunny day, the group learned that pollution from the steel industry was once so bad Pittsburgh was nicknamed “hell with the lid off.” They heard the story of the deadly Donora smog incident nearby that spurred the creation of the federal Clean Air Act, and learned about the ways early industrialists like Andrew Carnegie and Henry John Heinz shaped the city.
During a stop in front of the Point State Park fountain, many tour participants pulled out their phones to take pictures of fully loaded coal barges.
“Even seeing all of that coal in the barges is interesting,” Katya Simkhovich, a relationship manager at Ceres, a nonprofit that helps corporations (including those in the health care sector) reach their sustainability goals, told Environmental Health News (EHN). “When you work in the sustainability space every day, it’s easy to forget that’s still happening. It’s kind of a harsh reminder that the wheels keep turning even while we're trying to reinvent which wheels we’re using.”
Glenn Olcerst, an advocate with the community group Rail Pollution Protection Pittsburgh, talked about the threats posed by budget cuts and lack of maintenance on the rail lines, pointing to the recent train derailment in East Palestine, Ohio.
Credit: Kristina Marusic for Environmental Health News
The tour also made a stop beneath a rusty, visibly dilapidated Norfolk Southern rail bridge that crosses the river in front of the convention center where the conference is being held. Glenn Olcerst, an advocate with the community group Rail Pollution Protection Pittsburgh, talked about the threats posed by budget cuts and lack of maintenance on the rail lines, pointing to the recent train derailment in East Palestine, Ohio, as an example of what can go wrong.
“If that happened here, they’d have to evacuate 300,000 people,” Olcerst said. “This is a problem for Pittsburgh, but this is also a nationwide problem.”
The rail line represents a primary route for hazardous chemicals and explosive oil and gas products on the East Coast, according to Olcerst, and travels through 27 of Pittsburgh’s most populated neighborhoods. He also noted that an estimated 70% of Pittsburgh's low-income minority communities live within a blast zone, a clear example of environmental injustice.
Human rights healthcare approach
Walking along the Allegheny River with scenic views of the city’s iconic yellow bridges, the group learned about how pollution from the steel industry was once so bad that Pittsburgh was nicknamed “hell with the lid off."
Credit: Kristina Marusic for Environmental Health News
After the two-hour walking tour, the group met with local environmental justice advocates for a roundtable discussion.
NaTisha Washington, an environmental justice organizer for 412 Justice, said it’s challenging to convey to residents that many of their health issues are related to the region’s environmental challenges, particularly in the face of disinformation being spread by polluting industries in the region.
“These industries tell people the air here used to be bad, but now it’s fine,” she said. “I had childhood asthma, and when I was in school it seemed like it was just normal for one in every three kids to have it. It wasn't until I got into environmental justice work that I found out we had higher than average rates of childhood asthma and that our air pollution was driving that.”
Jackie Smith, a Professor of Sociology at the University of Pittsburgh and local organizer with the Pittsburgh Human Rights City Alliance, discussed local initiatives to take a human rights-centered approach to health care, noting that access to healthy food and housing, along with clean air and water, are just as important to health as access to medical care and treatment are.
“Caring for people’s health doesn’t just take place in clinics and hospitals,” Smith said. “We’ve got to look upstream and put our energy into addressing the problems that put people in clinics and hospitals in the first place.”
Fracking companies used more than 282 million pounds of hazardous chemicals from 2014 to 2021 with no federal oversight, according to a new study.
The study, published in Environmental Pollution, is the first to examine the “Halliburton Loophole,” which exempts fracking from federal regulation under the Safe Drinking Water Act.
The provision, passed by Congress as part of the Energy Policy Act of 2005, was endorsed by then-Vice President Dick Cheney, who formerly served as the CEO of Halliburton. The company patented fracking technologies in the 1940s and is still one of the top suppliers of fracking fluids in the world.
The study found that from 2014 through 2021, 62% to 73% of reported fracking jobs each year used at least one chemical that’s categorized as harmful to human health and the environment under the Safe Drinking Water Act.
These chemicals include carcinogens like formaldehyde, arsenic and benzene; possible carcinogens like acrylamide and naphthalene; and ethylene glycol, which can damage the kidneys, nerves and respiratory system.
According to the study, the fracking industry reported using at least 250 million pounds of ethylene glycol, 10 million pounds of naphthalene, 1.8 million pounds of formaldehyde, 4.6 million pounds of acrylamide, 7.5 million pounds of benzene and 590 pounds of arsenic from 2014 to 2021, in addition to more than a dozen other chemicals regulated under the Safe Drinking Water Act.
Fracking, or hydraulic fracturing, extracts natural oil and gas from the Earth by drilling deep wells and injecting huge volumes of water and chemicals at high pressure. Previous research has shown that fracking chemicals can wind up in drinking water and impact human health. Only a handful of the toxic chemicals used by the industry are regulated in drinking water, and those that aren’t may not be filtered or monitored by public water utilities. The Environmental Working Group, a public health advocacy nonprofit, estimates that current levels of contamination in drinking water — most of which meet legal standards — could cause 100,000 cancer cases in the U.S.
“Because of the Halliburton Loophole and gaps in reporting, the environmental health and justice impacts of fracking aren’t being properly assessed,” Vivian Underhill, lead author of the study and a postdoctoral researcher at Northeastern University, told Environmental Health News (EHN).
Underhill said the quantities of these chemicals are likely an underestimate, since not all states require disclosure of fracking chemicals, and most states requiring disclosure allow companies to keep some chemicals secret if they say the mixtures are proprietary.
During the same time period, fracking companies reported using about 7.2 billion pounds of proprietary chemicals – more than 25 times the total mass of chemicals listed under the Safe Drinking Water Act that they reported. There’s no way to know what proportion of those chemicals are hazardous.
“We saw proprietary chemicals in 77% of disclosures in 2015, and that number was up to 88% in 2021,” said Underhill. “The use of trade secrets is steadily increasing, and that’s definitely concerning.”
A backroom deal with public consequences
How the “Halliburton Loophole” lets fracking companies pollute water with no oversightCredit: Alpha Photo/flickr
The Safe Drinking Water Act regulates both public drinking water contaminants and the injection of toxic chemicals underground.
Other industries that inject hazardous chemicals underground where they could contaminate water supplies, like mining and hazardous waste disposal, are subject to federal regulations under the Safe Drinking Water Act. The fracking industry is exempt from these regulations.
“The oil and gas program under the Safe Drinking Water Act was already weak, but the Halliburton Loophole gouged it even bigger for fracking specifically,” Erik Olson, an attorney, Safe Drinking Water Act expert and senior strategist at the Natural Resources Defense Council, told EHN. “Oil and gas wells are basically to be regulated by the states under a much more flexible oversight scheme, and those programs are very weak in many states with a big oil and gas presence.”
Previous research has demonstrated public health harms from this lack of oversight in states like Pennsylvania and Colorado.
The fracking industry agreed to publicly disclose some chemicals it uses in response to public concern about threats to water. But Underhill and Olson say those disclosures aren’t useful because of the trade secrets provision.
“This study shows us that there are a lot of very toxic chemicals being injected underground by this industry,” Olson said. “But it’s hard to say there’s any kind of meaningful disclosure if we still don’t know what most of these chemicals are or how toxic they are.”
Stronger fracking regulations
Bryan and Ryan Latkanich in front of the fracking infrastructure that was formerly on their Pennsylvania property in the summer of 2019.
Credit: Kristina Marusic for Environmental Health News
In light of their findings, Underhill and her coauthors are urging Congress to repeal the Halliburton Loophole and regulate the fracking industry under the Safe Drinking Water Act.
“It was Halliburton’s CEO who first and most strongly lobbied for this loophole, and that company is indeed benefiting most from this exemption today,” said Underhill.
Halliburton did not respond to numerous requests for comment.
Olson is also in favor of closing the Halliburton Loophole. “This loophole was a backroom deal folded into legislation with no public debate, and they’ve never justified to the public why it’s needed,” he said. “That’s because it’s not needed. It was just raw political power that enabled them to get it enacted.”
Underhill and her coauthors are also urging Congress to pass a law requiring full disclosure of all chemicals used in fracking, including proprietary chemicals, and housing it in a centralized database with federal oversight.
The American Petroleum Institute, a trade association representing the oil and gas industry, opposes that idea. The organization’s “issue paper” on chemical disclosures for the fracking industry notes that fracking fluid producers have agreed to disclose details about proprietary chemicals to health care professionals, emergency responders and regulatory agency representatives “when it is appropriate.”
The paper acknowledges that trade secrets have caused concern, but concludes, “the compromise of limited disclosure when need is justified is a sound response. Protection of [intellectual property] rights is fundamental to the free market economy in which we all work and thrive.”
Making data on fracking chemicals more accessible
Researchers are just starting to figure out the cumulative impacts of the Halliburton Loophole because, until recently, it was difficult to obtain nationwide data on fracking disclosures.
The industry uses a site called FracFocus for public disclosures. While it’s possible to look at chemical disclosures for individual wells through the site, it’s virtually impossible to obtain data in a format that allows for large-scale analysis.
But a new, open-source program called Open-FF is changing that.
“I was trying to get information from FracFocus and I realized it’s not really a database,” Gary Allison, who developed Open-FF, told EHN. “It takes a lot of work to get the data to the point where you can actually use it.”
One issue was that FracFocus uses non-standardized names for companies and chemicals. For example, Allison had to account for more than 80 variations of the word “Halliburton” including misspellings, typos and abbreviations to make it possible to search the database for all chemicals made by the company.
“Before now, it was incredibly hard to download data from FracFocus that allows for systematic analysis or investigation,” Underhill said. “Now this data can finally be used effectively by researchers.”
Allison noted that anyone can use the program — not just scientists and researchers.
“Most people don’t have fluency in chemistry, so it can be really overwhelming to look at these data sheets and make sense of what’s happening,” he said. “I hope to get Open-FF to the point where members of the public can easily log into the site and find out what chemicals are being put into the ground near their homes.”
Walking along the Allegheny River with scenic views of the city’s iconic yellow bridges, the group learned about how pollution from the steel industry was once so bad that Pittsburgh was nicknamed “hell with the lid off."Credit: Kristina Marusic for Environmental Health News 
How the “Halliburton Loophole” lets fracking companies pollute water with no oversightCredit: Alpha Photo/flickr
