Editor's Note: This article was produced as a project for the California Endowment Health Journalism Fellowships, a program of USC's Annenberg School for Communcation & Journalism. View the slideshow at the end.

Beneath the farms, orchards and vineyards of Central and Southern California lies a prehistoric soup worth a fortune. The mineral-rich Monterey and Santos shale formations stretching 1,750 square miles across the San Joaquin Valley and the Los Angeles Basin hold a watery mixture of oil and gas – but it’s the oil that may trigger another gold rush. That is, if companies can figure out a profitable way to tap it.

The U.S. Energy Information Administration reported that the contiguous 48 states hold an estimated 23.9 billion barrels of recoverable oil, of which an astounding 15 billion barrels are in the Monterey/Santos formations. California has been plumbed for oil extraction and production for 150 years, but getting to the Monterey’s mother lode is no easy task.

“Producing Monterey Shale oil could make panning for gold look easy,” wrote David Brown in the American Association of Petroleum Geologists’ publication The Explorer. The formation is fractured and faulted. But that’s not all. The shale is, on average, almost 1,900 feet thick and 11,200 feet deep. This makes accessing the oil tricky, and conventional methods won’t suffice.

Increasingly, companies are turning to new technologies. In California they’ve tried using water and steam flooding, gravel packing, and acidization (injecting hydrochloric or hydrofluoric acid) to coax the oil to the surface. And then there is hydraulic fracturing, or fracking, where a mixture of chemicals, water and sand are forced at high pressure underground vertically, and sometimes horizontally as well.

It has only been in recent years that high-volume hydraulic fracturing and horizontal fracking have become common in oil and gasfields. On the East coast, companies are primarily fracking for gas, but in California it’s the oil they’re after. (Gas is a byproduct that is typically burned off.)

“What is new, and potentially alarming, are projections of dramatically increased fracking activity in California brought on by the availability of new techniques,” wrote Michael Kiparsky and Jayni Foley Hein in a report, “Regulation of Hydraulic Fracturing in California: A Wastewater and Water Quality Perspective,” from the University of California-Berkeley School of Law's Center for Law, Energy and the Environment.

“Such developments have outstripped the ability of responsible agencies to effectively oversee fracking activity,” the report states. “This topic is important in part because fracking has long-term implications: once fracking has been conducted, its effects may be impossible to reverse.”

Fracking has led to an oil rush in states like North Dakota and Texas and a gas rush on the East Coast in the Marcellus Shale, but fracking and increased drilling activity have come with reports of pollution to air and water, as well as risks to public and environmental health. And that has many in California concerned.

Is the state about to embark on a new gold rush, and if so, at what cost? The state’s Division of Oil, Gas and Geothermal Resources (DOGGR) permitted drilling in 3,676 wells last year, but the agency doesn’t require any special permits for fracking. In fact, finding out how many wells have been fracked and where can be difficult, because the reporting isn’t required – although companies can voluntarily offer the information at FracFocus.

When it comes to the health impacts of fracking and drilling in California, there are more questions than answers.

Change in the Air

Tom Frantz knows the wide, flat streets of Shafter, California well. A retired math teacher, Frantz grew up in the small agricultural community near the south end of the San Joaquin Valley in Kern County. Almond trees, the family business for four generations and counting, surround his home.

Over the last decade the town has changed; there are mega-dairies nearby, contributing particulate matter, methane, and ammonia to the already dismal air pollution in the valley, which has some of the nation’s worst air quality. Agriculture still reigns, but crops like cotton have fallen in popularity. Besides almonds, driving through Shafter you’ll see pistachios, grapes, potatoes, alfalfa, black-eyed peas, and more.

And there are other changes. Ten years ago you may have seen one or two oil pump jacks see-sawing out in the fields. Today, farmland is giving way to more and more oil extraction, says Frantz. Documents from Vintage Production, a subsidiary of oil giant Occidental, reveal that the company fracked 36 wells around Shafter from the beginning of 2011 to April of 2013, and a total of 85 wells in Kern County, the state’s drilling hotbed.

This keeps Frantz busy as he has turned a watchful eye (and camera) on operations in his town.

“They are drilling right under the town itself,” said Frantz. “We know that because quite a number of people are getting monthly [royalty] checks, and the nearest well could be as far as a mile away. So it would seem they are drilling horizontally under town and they are drilling out in prime farmland. They took out 40 acres for headquarters for tanks, and they are flaring gas they don’t want.”

Vintage has set up its local operations on a now dusty lot that used to be a rose farm. The company’s arrays of pipes and tanks and trucks are punctuated with a tower that has been flaring gas since 2011, sometimes 24 hours a day, although the company has reduced the amount of gas being burned and built a wall around part of it to reduce noise after complaints from nearby residences.

During last summer, Frantz said the 20-foot stack’s 20-foot flame was visible over the almond trees from his home three miles away. He worries about the air pollution.

Gas flaring can emit numerous pollutants such as benzene, formaldehyde, polycyclic aromatic hydrocarbons (PAHs, including naphthalene), acetaldehyde, acrolein, propylene, toluene, xylenes, ethyl benzene and hexane, according to the Ventura County Air Pollution Control District.

Oil and gas operations can also release volatile organic compounds (VOCs) and nitrogen oxides (NOx) that can be dangerous to human health and contribute to ground-level ozone, which has been found to increase emergency rooms admissions, according to a 2011 study published in the journal Human and Ecological Risk Assessment. “Gas field ozone has created a previously unrecognized air pollution problem in rural areas, similar to that found in large urban areas,” the study found. In 2012, documents submitted to the San Joaquin Valley Unified Air Pollution Control District show that Vintage’s gas flare in 2012 emitted 68 pounds of nitrogen oxides and 88 pounds of volatile organic compounds.

Rural Sublette County in Wyoming, a sparsely populated area with heavy oil and gas activity (it went from 1,900 wells in 2000 to 10,000 in 2008), found its air quality out of compliance with EPA standards due to ground-level ozone.

A health study done by the county revealed an increase of 3 percent in respiratory-related visits to healthcare providers for every 10 parts per billion increase in ground-level ozone that occurred the day before. Ground-level ozone was observed at levels of 19 parts per billion to 84 parts per billion. “Adverse respiratory-related effects following ground-level ozone exposure have been extensively documented in numerous studies and include induction of respiratory illness symptoms, increased asthma attacks, increased hospital admissions, increased daily mortality, and other markers of morbidity,” the report stated.

In California there is also interest in understanding how air quality may be impacted. The Southern California Air Quality Management District (SCAQMD), the agency charged with air pollution control for Orange County as well as parts of Los Angeles, Riverside and San Bernardino Counties, is worried about oilfield activity and the impacts of fracking. The agency just passed Rule 1148.2 that will help it gather information about the potential impacts of drilling on public health.

The rule goes beyond existing state regulations and requires that drilling companies report which chemicals they are using and how much – regardless of whether companies consider the blend of fracking fluid they use a trade secret (which is currently how they escape reporting on the contents). “The rule also requires reporting of combustion equipment activity; fugitive dust emissions from on-site mixing operations and potential hydrocarbon and toxic emissions from drilling and fluids that return to the surface,” SCAQMD reports.

Air pollution from drilling operations can come in many forms, including dust from road building and drilling; pollution from flaring of gas, as in Shafter; fumes from diesel trucks and generators; and emissions from drilling mud. As SCAQMD explains, “There is a concern for potential volatile organic compounds (VOCs) and toxic emissions in the re-circulated drilling mud if it is open to the atmosphere as it returns to surface and into open pits or tanks during separation of cuttings and other conditioning activities.”

These would be hazards during the fracking and drilling phases, but even after the well is producing, the flowback may include chemicals used while fracking, and also what’s been trapped underground, “including brines, heavy metals, radionuclides, and organics,” reports SCAQMD. “Flowback that returns to the surface and goes into pits or tanks that are open to the atmosphere has the potential to emit organic compounds and hazardous or toxic air pollutants into the air.”

But that’s not all. There can also be leaks of fugitive gas throughout the entire process – including at the well pad and when the gas is piped to compressor stations and refineries, said Theo Colborn, founder and president of the Endocrine Disruption Exchange (TEDX), who specializes in studying endocrine disrupting chemicals. These emissions can contain not just methane but other “hitchhiker chemicals,” said Colborn, such as hydrocarbons known as BTEX – benzene (a known carcinogen), toluene, ethylbenzene, and xylene.

Colborn and colleagues Kim Schultz, Lucille Herrick, and Carol Kwiatkowski recently completed a year-long study of air quality near natural gas operations in Garfield County, Colorado. From a location seven-tenths of a mile from a well site, they took air samples before drilling and during drilling, fracking, and production.

“Methylene chloride, a toxic solvent not reported in products used in drilling or hydraulic fracturing, was detected 73 percent of the time; several times in high concentrations,” the study reported. “A literature search of the health effects of the non-methane hydrocarbons revealed that many had multiple health effects, including 30 that affect the endocrine system, which is susceptible to chemical impacts at very low concentrations, far less than government safety standards.”

Other chemicals identified can have wide-ranging health impacts, too, like polycyclic aromatic hydrocarbons (PAHs), which have been shown to lead to development problems and lower IQ scores in studies where the exposure level was lower than what Coburn found in Colorado.

The study also found 39 different volatile organic compounds (including benzene, methane, ethane, and propane) and eight different carbonyls such as formaldehyde and acetaldehyde. The concentrations of chemicals found during the study were lower than government standards. But, the study says, government standards are useful when a person (typically the size of a grown man), is exposed to high concentrations of a chemical in a short amount of time – typical of what may happen in a workplace if there is a spill or leak. But what happens if you live in a neighborhood where oil and gas extraction or production goes on around the clock? In such cases a resident may be exposed to lower level doses but over a much longer (even constant) period of time.

Scientists are also just beginning to understand how the presence of two or more chemicals when combined (not to mention hundreds at once) may affect a person’s health. A new study from Texas Tech showed that safe doses of arsenic and estrogen, when combined, could cause cancer in prostate cells.

It’s also important that regulators and public health officials understand the cumulative impact of oil and gas development instead of analyzing the potential impacts one well at time. Areas like Colorado’s Garfield County have more than 10,000 wells. Although these wells are drilled for gas, Colborn says that health impacts from drilling for oil in California are a concern, too. “They are the same gases,” she said. “They’re just in lesser concentrations.”

Mixing Oil and Water

A Chevron billboard on the outskirts of Bakersfield about 20 minutes south of Shafter declares that agriculture and oil can grow together. And indeed they have thus far, but not entirely without incident. The valley, home to industrial-scale agriculture operations, has some of the most productive farmland in the country and also has a long history of oil extraction, going back more than 100 years. In Bakersfield, suburban subdivisions of ranch-style homes dead-end at the massive Kern River oilfield, which tapped its first commercial well in 1899, but still boasts more than 9,000 active wells stretching as far as the eye can see in the hazy air.

About 20 miles west, a stretch of Route 33 between Lost Hills and Taft — dubbed the Petroleum Highway — is home to several oilfields, to which the Standard Oil empire owed its ascension decades ago. Today it looks like an apocalyptic expanse of industrial activity, miles upon miles of pumpers, boilers and pipelines erected on a desolate landscape.

Or so it seems. Some people do farm nearby, including cotton growers Starrh and Starrh, which sued oil company Aera Energy, claiming that wastewater from oil production was dumped into unlined pits and seeped under the farm, contaminating the groundwater. Starrh and Starrh won its lawsuit in 2004, although the fight has continued as it contested that the money awarded for damages was too low.

Farming and oil production are a uneasy match, especially when it comes to water issues, which are already contentious in California. Fracking and increased drilling activity may add to the potential woes.

In October 2012, Frantz was filming some activity at a well in Shafter a day before it was going to be fracked. His camera captured white and black liquids being discharged into an unlined pit. His video grabbed the attention of the Central Valley Regional Water Quality Control Board, which demanded a report from the company responsible: Vintage Production.

In a letter to the water board, Vintage president Alan E. White, wrote, “We are making progress toward our goal of ceasing the use of unlined sumps in areas proximate to active agricultural land uses.” The area in question was also in the city of Shafter, near homes, businesses, and municipal water wells.

Vintage vowed to investigate the matter and later admitted that “small quantities of fluids from surface equipment lines” were discharged. The water board reported in July that 89 to 175 barrels (3,738 to 7,350 gallons) of mostly drilling fluids were dumped.

The risks to water quality from fracking operations can be great. Kiparsky and Hein’s UC Berkeley report stated, “Risks to water quality stem primarily from: improper storage and handling of fluids at the well site, including spills and improper lining of pits; injection of wastewater into disposal wells, which can trigger earthquakes; and potential for groundwater contamination due to failure of well integrity.”

The risk does not simply come from the moment the well is fracked, but from the entire industrial activity of oil and gas extraction, which includes fracking. But the authors write, “There are few peer-reviewed scientific studies on the water-related aspects of fracking, and fewer still focused on California.”

Of concern is the fact that “between 2005 and 2009, oil and gas service companies used hydraulic fracturing products containing 29 chemicals that are (1) known or possible human carcinogens, (2) regulated under the Safe Drinking Water Act for their risks to human health, or (3) listed as hazardous air pollutants under the Clean Air Act,” wrote Kiparsky and Hein.

Not only can releases of toxic water (intentional or accidental) happen during drilling, fracking or production of a well, but also the inevitable wastewater is usually re-injected – either in disposal wells underground, or back into a producing well. (That happens 90-95 percent of the time in California.) If the cement casing fails (as in the Deepwater Horizon disaster in the Gulf), then contamination of water supplies can result. The disposal of fracking wastewater in underground injection wells has also been linked to earthquakes in a report by the National Research Council.

There are three big problems in determining if oil and gas operations have contaminated water. All the chemicals in use are not known, so they can’t be tested for, or if found in the water, can’t be linked to specific operations. Fracking has been exempt from parts of the Clean Water Act and the Safe Drinking Water Act, among other federal regulations, as ordered by the Bush administration’s 2005 Energy Policy Act.

The second problem is that most communities (and individuals) don’t have baseline tests that record water quality prior to drilling, and industry is not usually required to perform those tests before drilling. This also makes it difficult to determine whether an oil and gas operation is at fault if ground or surface water is contaminated.

The third issue is a culture of secrecy in the industry.

“I’ve never seen a more difficult circumstance for public health science to be practiced, and a lot of that has to do with the deception and secrecy of this industry, which was able to exempt itself from many of our laws that give us the right to know and require cumulative impact studies,” said Sandra Steingraber, a biologist and expert on environmental links to cancer and human health. “There is a lot of baseline data, in terms of emissions, that we can’t turn into exposure data because we don’t even know what to test for. In many states, including Pennsylvania, doctors themselves are under gag orders."

Provisions in Pennsylvania’s Act 13, passed last year, include a confidentiality clause designed to protect companies’ trade secrets, but which some healthcare professionals fear limits their ability to share crucial information with the public and perhaps also other medical professionals and patients.

“We have set up a situation where we are unrolling all these exposures across the land — we’ve got pregnant women, children, elderly people that, let’s say, already have congestive heart failure or emphysema or other respiratory problems and are at high risk, and we’re exposing them to a changing kaleidoscope of air pollutants, water pollutants, light at night, and noise pollution. All these things may interact in ways we dimly understand,” said Steingraber, who has become outspoken about the potential health impacts from gas drilling and infrastructure..

“But we can’t even do the studies because the doctors can’t talk, and the people themselves can’t even tell their stories.”

The standard practice when people near drilling operations have their water polluted is that companies bring “replacement water,” usually in the form of a large plastic container called a “water buffalo.” In exchange, residents sign nondisclosure agreements that do not reveal their settlement terms or any of the health impacts they suffered.

“We need to know what’s going on if we’re going to have a reasonable democracy and make reasonable decisions,” said the Sierra Club’s Nipp. “And they’re doing their best to keep us in the dark. They should be telling us these things — not just with air, but with water quality.”

From City to Country

Kern County may have some of the most activity, but it’s not the only place where companies are or may soon be seeking unconventional shale oil. Orange, Ventura, Monterey, and Santa Barbara counties are all in play.

Los Angeles County is also a prime target. Paul Ferrazi lives in Culver City, a community next to the country’s largest urban oilfield – the Inglewood in Los Angeles. In the last few years Ferrazi says he’s seen an increase in activity.

“There has been more and more drilling rigs in the oilfield – more noise from drilling, lots of vibrations, things falling off the mantles, and lots of odors,” he said. Community members later found out that PXP, the company running operations in the oilfield, had done two test wells to try out high-volume hydraulic fracking in the field (they’d also vertically fracked 21 wells, and 166 wells using “gravel packing”).

The information came to light in a report ordered after PXP had an uncontrolled release of gases in 2006 that warranted evacuations. The report was conducted by the Houston-based firm Cardno Entrix (which is currently embroiled in a conflict-of-interest controversy over its assessment of the Keystone XL tar sands pipeline) and it asserted that fracking was safe. But local residents, who have already feared health problems ranging from asthma to cancer could be caused by drilling activity, think differently.

One million people live within five miles of the oilfield.

“We don’t know what the damages would be right away,” said resident Stephen Murray, “We might find out 40 years from now what the damage is.”

It’s not just urban areas that may be at risk. So are wild lands.

The Center for Biological Diversity was among a group of environmental organizations that recently won a lawsuit against the Bureau of Land Management for selling off mineral leases of public land to oil and gas operations for development without analyzing the environmental impacts.

“The BLM has responsibility under federal law to analyze the environmental impacts of the actions it takes before it actually takes them,” said CBD’s Kassie Siegel. “They didn’t do any real analysis of the impacts of fracking before selling off those rights to oil companies. The BLM is selling off our public lands for private profit by oil companies and they’re doing it really, really cheaply.”

The leases in the lawsuit were not in existing oilfields. For example, the Williams Hill Campground in Southern Monterey County, would have been ringed with leases. It’s an area of little development – farms and ranches giving way to forested hills. “It’s a great example of fracking spreading intense industrial development into new areas,” said Siegel.

And she adds, “We have no reason to believe that fracking for oil is less damaging than fracking for natural gas. We have no reason to believe the chemicals used are different. But, of course, we don’t know because we don’t have disclosure of all the chemicals.”

The disclosure of chemicals could change, but only partially. The Division of Oil, Gas, and Geothermal Resources is taking comments on a draft of proposed regulations, which some people believe fall short of what should be necessary for protecting public health. The guidelines say companies must reveal what’s in their fracking fluid, unless they can prove it is a trade secret.

The Ventana chapter of the Sierra Club in Monterey County wrote a response to DOGGR, stating, “It is our contention the issue of chemical disclosure is crucial to public health. It appears as if oil and gas companies do not wish the public to view a list of the chemicals they use and thus to understand the grave threats posed to public health and water resources.”

Its letter also pointed out that the draft makes no mention of “when and if DOGGR will send its own agency inspectors to active well sites, ‘slickwater’ discharge pits, and injection wells. This may not be regarded by you as a code issue, but the authority (and obligation) to inspect without prior notice is fundamental to effectively protecting the pubic interest,” the group wrote.

The draft regulations also contain no language requiring baseline water testing and while wastewater, including frackwater, is not allowed into unlined pits, “the proposed regulations neither describe nor define any new requirements detailing how these very large volumes of polluted water are to be disposed of,” the letter states.

Additionally, the California Oil and Gas Report stated, “DOGGR’s draft rules do not address other controversial aspects of hydraulic fracturing, such as impacts on air quality and related seismic activity.”

The California Independent Petroleum Association didn’t return interview requests, but Mike Flores and Olman J. Valverde, wrote in the California Oil and Gas Report that, “Industry representatives say cost remains a primary concern with any new regulations, even as they declined to estimate how much oil producers’ costs would rise under [the] proposal.”

A half-dozen bills were put forth in the state’s legislative session to strengthen regulations or impose a moratorium until more studies can be conducted on the potential risks. But the only bill that remains alive is Senate Bill 4 by Sen. Fran Pavley, D-Agoura Hills. “The bill would set up a permitting system, require energy companies to share more information with the state and with property owners and have the California Natural Resources Agency commission a study on the environmental repercussions of fracking,” Jeremy B. White reported in the Sacramento Bee.

In the next year, California may have new (and perhaps stronger) regulations for oil and gas exploration, but it’s unclear if they will be based on scientific standards. Steingraber believes that any community contemplating energy extraction should conduct a comprehensive health impact assessment (HIA). People need to know “what the medical costs will be for the community,” she said.

“In some cases those will include deaths. The community might want to know, for example, will this project kill more people than it employs? That’s one of those basic questions that an HIA can give you an answer for. That’s what we have asked for with fracking. That’s not what’s being done anywhere across the land.”

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