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Two prominent public health organizations are pressing the State Department to study the public health implications of the Keystone XL pipeline before reaching a decision on its approval. Ad Policy

“There is an increasing recognition that the environments in which people live, work, learn and play have a tremendous impact on their health,” reads a letter sent Friday to Secretary of State John Kerry by the American Public Health Association (APHA) and the National Association of County and City Health (NACCHO). “The administration will certainly benefit by having a clear understanding of how the proposed Keystone XL pipeline could impact the public’s health, including the health of our most vulnerable citizens.”

The letter asks for a “comprehensive” assessment to include a review of scientific studies regarding the health effects of processing tar sands. Those could include increases in respiratory conditions like asthma, exposure to heavy metals, cancer and occupational health and safety risks affecting workers involved in tar sands production, said Georges Benjamin, the executive director of APHA. APHA is the oldest organization of health professionals in the country, representing providers, officials, educators and policy makers. NACCHO represents 2,700 local health departments.

“It raised our concern,” Benjamin said of the pipeline proposal. “We’re not saying don’t build it, and we’re not saying do build it. We want to make sure the decision is data-driven and has a health component to it. At the end of the day, they’re going to make a decision based on a complicated set of metrics, but we think health ought to be one.”

Whom the pipeline might put at greatest risk is a question that “absolutely needs to be though about,” Benjamin added. “If they put it through communities already economically and physically, from a health perspective, devastated, there is going to be a disparate impact when something bad happens, like a pipeline leak.”

NACCHO’s associate executive director David Dyjack said health risks could arise at each step of production, from extraction to transportation to consumer use, but that how the local effects of tar sands differed from other fossil fuels production cycles is not well understood. “We are advocating for smart and informed decision making,” Dyjack said. “The uncertainty around the tar sands led us to submit the letter—why don’t we get some clarity?”

The letter from APHA and NACCH follows a similar one sent in March by National Nurses United, and a February letter from Democratic Senators Barbara Boxer and Sheldon Whitehouse.

“Everybody’s looking at every other issue but public health,” Boxer said on a conference call with reporters on Friday . “It’s crucial that these groups be listened to.”

Supporters of the pipeline have criticized Boxer and Whitehouse’s calls for a public health study as a delay tactic. Boxer said she wasn’t sure how long an assessment would take, but that a review of existing peer-reviewed research should be relatively simple. Whitehouse argued there is “no urgency” to bring Alberta’s tar sands oil through the United States. “The tar sands are not going anywhere,” he said. “We don’t want to be in situation where we rush now in order to regret later.”

Meanwhile, KXL’s proponent are asking the administration to speed up its decision making process. Eleven Democratic Senators sent a letter to the White House on Thursday asking the administration to approve the pipeline by May 31. The signees include Mary Landrieu of Louisiana, Mark Begich of Alaska, Mark Pryor of Arkansas, John Walsh of Montana and Kay Hagan of North Carolina, all facing challenging re-election races in conservative states with significant fossil fuel interests.

Asked about the political implications of the pipeline decision, Boxer said her colleagues will “do what they have to do to represent their states well and follow their conscience. What we’re doing is just saying that, when it comes to public health and the survival of the planet, you need to pay attention to that, whether it’s an election year or an off-election year.”

“We’re already seeing misery,” Boxer said, referring to reports of high rates of cancer near production regions in Alberta, Canada, and pollution from the piles of petroleum coke, a tar sands byproduct, in several cities in the American Midwest. “There’s a lot of money and a lot of power behind [the pipeline], but I do believe at end of day people want to make sure that their kids are healthy.”