Fracking associated with asthma flare-ups

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Workers at a Statoil USA site in Texas's Eagle Ford shale formation dig out ground in mid-June to prepare to tie in a pipeline extension for a fracking project into an existing pipeline, in Runge, Texas, U.S, June 7, 2016. Producers have been hoping for a sustained rally in crude oil to support more drilling. REUTERS/David Gaffen
A fracking rig flares gas during an anti-fracking protest by Greenpeace activists outside the Houses of Parliament in London, Britain February 9, 2016. REUTERS/Stefan Wermuth
CRESCENT, OK - MARCH 31: Oil field workers pull pipes from a fracking well March 31, 2016 near, Crescent, Oklahoma. The United States Geological Survey estimates that more than 7 million people live in areas at risk of human-induced earthquake damage. (Photo by J Pat Carter/Getty Images)
 In this June 9, 2014 file photo, drivers and their tanker trucks, capable of hauling water and hydraulic fracturing liquid, line up near a natural gas burn off flame and storage tanks in Williston, N.D. According to a 2005-12 study at Geisinger Clinic in Pennsylvania, fracking may worsen asthma in children and adults who live near natural gas drilling sites. People with asthma are vulnerable to air pollution, and diesel exhaust from heavy truck traffic involved in the process may be one of the culprits, although the study doesn't prove what caused patients' symptoms. (AP Photo/Charles Rex Arbogast)
One of two beluga whales that washed ashore in Turnagain Arm south of Anchorage, Alaska, lays on the beach . A national environmental group, the Center for Biological Diversity, has asked the National Marine Fisheries Service to block plans in Cook Inlet by an oil company for hydraulic fracturing, the extraction of oil and gas from rock by injecting high-pressure mixtures of water, sand or gravel and chemicals, because of possible harmful effects on endangered belugas. (AP Photo/Al Grillo, File)
In this Oct. 9, 2009, file photo, Kathy Butek with the Alaska Veterinary Pathology Service, center right in yellow, and a group of volunteers examine a dead Beluga whale found laying on the mud flats near downtown Anchorage, Alaska. A national environmental group, the Center for Biological Diversity, has asked the National Marine Fisheries Service to block plans in Cook Inlet by an oil company for hydraulic fracturing, the extraction of oil and gas from rock by injecting high-pressure mixtures of water, sand or gravel and chemicals, because of possible harmful effects on endangered belugas. (AP Photo/Al Grillo, File)
 In this March 29, 2013, file photo, a worker helps monitor water pumping pressure and temperature, at a hydraulic fracturing and extraction site, outside Rifle, in western Colorado. The Colorado Supreme Court has struck down attempts by two cities to ban or delay fracking. The Monday, May 2, 2016, ruling is a victory for the oil and gas industry and for state officials who say only state government can regulate energy, not cities or counties. (AP Photo/Brennan Linsley, File)
 In this March 29, 2013, file photo, workers tend to a well head during a hydraulic fracturing operation outside Rifle, in western Colorado. The Colorado Supreme Court has struck down attempts by two cities to ban or delay fracking. The Monday, May 2, 2016, ruling is a victory for the oil and gas industry and for state officials who say only state government can regulate energy, not cities or counties. (AP Photo/Brennan Linsley, File)
Karen Dike, center, a nurse from Longmont, Colo., talks to anti-fracking activists outside the Colorado Convention Center as the Oil and Gas Task Force meets inside to put the final touches on recommendations for Colorado Gov. John Hickenlooper to consider in the settlement of disputes over oil and gas drilling Tuesday, Feb. 24, 2015, in Denver. The meeting comes as some activists have renewed a campaign to banning the use of hydraulic fracturing in the state. (AP Photo/David Zalubowski)
Local residents and members of Resist AIM Pipeline standing on the sidewalk at the entrance of a pipeline construction site demanding the halting of the project as requested by Governor Andrew Cuomo. (Photo by Erik McGregor/Pacific Press/LightRocket via Getty Images)
People protest against fracking and neighborhood oil drilling in Los Angeles, California, U.S., May 14, 2016. REUTERS/Lucy Nicholson
Anti-fracking protesters write messages on a wall with chalk during a demonstration outside County Hall in Preston, Britain June 24, 2015. Lancashire County Council is debating an application by shale gas firm Cuadrilla Resources to frack on the Fylde coast, local media reported. REUTERS/Andrew Yates
People protest against fracking and neighborhood oil drilling in Los Angeles, California, U.S., May 14, 2016. REUTERS/Lucy Nicholson
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(Reuters Health) - For asthma patients, living near fracking sites is associated with more symptom flare-ups that require medication and hospital care, a U.S. study suggests.

Air pollution has long been known to worsen asthma. But less is known about the impact of fracking, which involves pumping water, sand and chemicals into the ground to free oil and gas reserves from rock formations.

"Residents of communities undergoing (fracking) and those nearby can be exposed to noise, light, vibration, heavy truck traffic, air pollution, social disruption and anxiety," Sara Rasmussen of Johns Hopkins University in Baltimore told Reuters Health by email.

Rasmussen and colleagues reviewed data on nearly 35,500 asthma patients treated at the Geisinger Clinic in more than 35 counties in Pennsylvania from 2005 to 2012. Fracking took off in the state around the start of the study period; by the end, 6,253 wells had been drilled.

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The researchers identified 20,749 mild asthma flare-ups, when patients got new drugs prescribed to manage symptoms, 1,870 cases of moderate worsening when patients visited the emergency department and 4,782 severe instances when patients were hospitalized.

The asthma patients who lived closest to a large number or bigger active wells were 50 percent more likely than those living further away to have severe exacerbations during the site preparation stage, researchers report in JAMA Internal Medicine.

During the production stage, which can last several years, asthma patients were more than four times as likely to have mild flare-ups when they lived closest to bigger or more fracking sites.

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The study doesn't prove fracking causes asthma or makes symptoms worse, and it also doesn't explain why asthma flare-ups appear more likely when people live closer to fracking sites.

One limitation of the study is that researchers didn't know where patients worked or what they did for a living, both of which might influence their proximity to fracking sites. And the analysis was based on patients' most recent address, which didn't account for residential moves during the study period.

Even so, the analysis is the first to link fracking to objective respiratory outcomes for asthma patients, the authors conclude.

Still, after accounting for other factors like obesity and smoking that might influence whether asthma patients experience complications, the link was strong, said Dr. Steve Georas, an environmental health researcher at the University of Rochester Medical Center in New York who wasn't involved in the study.

"This study should be a wake-up call to patients and physicians, and prompt additional research into the reasons for the associations" between fracking and asthma flares, Georas said by email.

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Fracking has proliferated across the U.S. in recent years. In Pennsylvania alone, fracking supporters say the industry has supplied hundreds of thousands of jobs and brought in billions of dollars.

But critics have raised concerns about health risks and environmental problems such as groundwater contamination, increased earthquake activity and exacerbation of droughts.

People who live near fracking sites can take precautions to protect against asthma flare-ups, said Michael Jerrett, an environmental health researcher at the University of California, Los Angeles who wasn't involved in the study.

"Central air conditioning with a proper filter might get some of the potential contaminants," Jerrett said by email. "For children, consider where they play outside, and when you're planning heavy exercise you might not want to be in the park right by the fracking site."

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