Tiongco, 57, recently filed a lawsuit against an Arkansas-based energy company that drills land a quarter-mile from her property. Southwestern Energy, she said, moved in two years ago and swiftly destroyed her livelihood: the alpaca farm and the dolls she handcrafts from alpaca fleece.

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Southwestern Energy spokesperson Christina Fowler would not comment on the lawsuit but said the company “meets or exceeds” federal standards.

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“I can’t relax ever,” Tiongco says. “They’re tearing everything up. They’re putting something in the water that hurt my hair and killed my animals.” She’s seeking at least $75,000 in damages.

Tiongco isn’t alone in reporting these symptoms near fracking areas. The National Institutes of Health on Wednesday unveiled the largest independent study to investigate the impact of fracking on nearby residents. America’s mixed views on fracking aside, the survey of residents of southern Pennsylvania found that people with ground-fed water wells living near hydraulic fracturing sites are twice as likely to report skin and respiratory problems.

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The survey does not establish causation — it’s not clear that fracking is leading to the effects reported by respondents in the NIH survey. Among the most common complaints in these areas: unexplained hair loss, persistent rashes, sore throats and nose bleeds.

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Fracking proponents call the Yale-led study baseless. Katie Brown, spokesperson for the pro-oil and gas-drilling group Energy in Depth, said it was “just a poll” that contradicts evidence from “direct measurements.” Fracking sites are closely monitored for possible pollutants, she said.

To say the least, fracking has become a politically fraught issue. Environmentalists argue this practice of pumping fluids into underground rock to extract oil and natural gas contaminates drinking water. The Department of Energy, however, tracked chemicals injected into eight western Pennsylvania wells and found no contamination in the local water supply. An analysis by the Wall Street Journal determined at least 15.3 million Americans have lived within a mile of a oil or gas well since 2000.

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To compile the NIH survey, two years ago researchers from Yale and the University of Washington drove door to door surveying 492 residents in 180 homes that all use well water in Washington County, Pa., home to more than 600 fracking sites. (Tiongco, who lives 230 miles away in Susquehanna County, is a neighbor to one of the state’s thousands of other wells.)

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The researchers needed a baseline, said Meredith Stowe, an associate research scientist at the Yale School of Medicine. Little was known about the impact of fracking on public health.

Researchers compared proximity of the Pennsylvania gas wells over a year to the frequency of self-reported skin, respiratory, gastrointestinal, cardiovascular and neurological ailments. Residents less than a mile from fracking sites, they found, sought more medical attention for skin and respiratory maladies than those who live farther away.

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The study, published in Environmental Health Perspectives, doesn’t prove fracking causes any one illness. But it raises health concerns, Stowe said. And it may provide some explanation for why doctors found undiagnosable skin lesions in Avella, Pa., to name one prominent example.

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“This is just the start,” Stowe said. “More research is needed down the road.”

Recently in Texas, a family wracked with migraines and nausea won $2.9 million in an unprecedented fracking lawsuit. Tiongco hopes her court battle, one of several in Pennsylvania, will help her move.

She’s trying to sell her farm but worries that the fracking next door has reduced its value. At a local hair stylist’s recommendation, she recently installed a $1,500 water filter. Still, Tiongco dreads showering and drinks only bottled water.

“I can’t believe I have to live like this,” she said, “but I don’t trust what comes from the ground anymore.”

She gave the rest of her alpacas to friends in upstate New York. Luckily, her barn contains enough fleece to stock her Etsy shop with dolls for the next two years.