**5. Health research needs**

Considering the diverse range of potential health risks emanating from UOG operations and the role that local factors such as regulations, geology, climate, proximity to population centers, etc. play, there are a number of open research questions that should be addressed. Arguably the most pressing issue is the lack of information about UOG activities followed by the need for toxicological and epidemiological studies.

 In particular, the major information gaps and uncertainties regarding our understanding of the health risks of UOG development impact the ability of regulators, healthcare professionals, communities, and individuals to take appropriate measures to protect against them, to inform others, and to work with the industry to mitigate the negative effects of UOG. The most important issues to be addressed from a research and data development perspective are shown in **Table 1**.

These gaps and uncertainties should be systematically addressed in future studies, which require improved cooperation between UOG producers, federal, *Human Health Risks of Unconventional Oil and Gas Development Using Hydraulic Fracturing DOI: http://dx.doi.org/10.5772/intechopen.82479* 


## **Table 1.**

*List of proposed research and development activities needed to fully understand and mitigate the risks of UOG on worker and public health.* 

state and local government, and community health and environmental advocacy groups. FracFocus, an industry-sponsored database providing information on hydraulically fractured wells and the HFF used, is a step towards addressing this information gap, but it is voluntary, incomplete, and lacks some important functionality.

Occupational health risks would benefit from better surveillance and reporting, especially of injuries. Focus should be on monitoring exposure to benzene, toluene, silica, aliphatic hydrocarbons, diesel exhaust, HFF chemicals, hydrogen sulfide, NORM, and traffic related exposures [4]. In addition, studies on both chronic and acute exposures are relevant in the occupational health context.

 The proposed before-and-after monitoring of water and air quality, in the context of planned UOG development, could provide a stronger foundation to accurately and conclusively determine if contamination events occurred and what their source was. The variable and locally specific context of UOG development calls for studies that assess the magnitude and duration of human exposure to stressors during the various life cycle phases of UOG wells. For example, HFF mixture, geology, type of unconventional resource, and environmental factors all influence the potential for exposure and resulting health effects. In addition, the dense clustering of wells typical for UOG development creates the risk of aggregate effects that need to be further assessed.

With regard to psychosocial and community health impacts, current knowledge could be enhanced through greater involvement of community organizations as a source of information and for building trust between community members on the one hand and scientists, public health officials, and regulators on the other. These community organizations can furthermore serve as a bridge for continued outreach, education, and data collection after studies have been completed. UOG producers could rebuild trust by actively engaging with the community in the planning processes of new UOG development, providing fact-based information about the development, and supporting community activities aimed at identifying and reducing sources of stress. Public-private partnerships, such as the Health Effects Institute, have been able to bridge the trust-deficit and can serve as a model for working to solve the often-contentious health issues [4].
