Unconventional Natural Gas Development and Hospitalization for Heart Failure in Pennsylvania

Tara P McAlexander; Karen Bandeen-Roche; Jessie P Buckley; Jonathan Pollak; Erin D Michos; John William McEvoy; Brian S Schwartz

doi:10.1016/j.jacc.2020.10.023

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Unconventional Natural Gas Development and Hospitalization for Heart Failure in Pennsylvania

Journal article

Open access

Peer reviewed

Unconventional Natural Gas Development and Hospitalization for Heart Failure in Pennsylvania

Tara P McAlexander, Karen Bandeen-Roche, Jessie P Buckley, Jonathan Pollak, Erin D Michos, John William McEvoy and Brian S Schwartz

Journal of the American College of Cardiology, v 76(24), pp 2862-2874

15 Dec 2020

DOI: https://doi.org/10.1016/j.jacc.2020.10.023

PMID: 33303076

Featured in Collection : UN Sustainable Development Goals @ Drexel

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Abstract

Adult

Aged

Aged, 80 and over

Case-Control Studies

Female

Heart Failure - epidemiology

Heart Failure - etiology

Hospitalization - statistics & numerical data

Humans

Hydraulic Fracking

Male

Middle Aged

Pennsylvania - epidemiology

Petroleum Pollution - adverse effects

Growing literature linking unconventional natural gas development (UNGD) to adverse health has implicated air pollution and stress pathways. Persons with heart failure (HF) are susceptible to these stressors. This study sought to evaluate associations between UNGD activity and hospitalization among HF patients, stratified by both ejection fraction (EF) status (reduced [HFrEF], preserved [HFpEF], not classifiable) and HF severity. We evaluated the odds of hospitalization among patients with HF seen at Geisinger from 2008 to 2015 using electronic health records. We assigned metrics of UNGD activity by phase (pad preparation, drilling, stimulation, and production) 30 days before hospitalization or a frequency-matched control selection date. We assigned phenotype status using a validated algorithm. We identified 9,054 patients with HF with 5,839 hospitalizations (mean age 71.1 ± 12.7 years; 47.7% female). Comparing 4th to 1st quartiles, adjusted odds ratios (95% confidence interval) for hospitalization were 1.70 (1.35 to 2.13), 0.97 (0.75 to 1.27), 1.80 (1.35 to 2.40), and 1.62 (1.07 to 2.45) for pad preparation, drilling, stimulation, and production metrics, respectively. We did not find effect modification by HFrEF or HFpEF status. Associations of most UNGD metrics with hospitalization were stronger among those with more severe HF at baseline. Three of 4 phases of UNGD activity were associated with hospitalization for HF in a large sample of patients with HF in an area of active UNGD, with similar findings by HFrEF versus HFpEF status. Older patients with HF seem particularly vulnerable to adverse health impacts from UNGD activity.

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20 citations in Web of Science

18 citations in Scopus

Details

Title: Unconventional Natural Gas Development and Hospitalization for Heart Failure in Pennsylvania
Creators: Tara P McAlexander - Johns Hopkins University
Karen Bandeen-Roche - Johns Hopkins University
Jessie P Buckley - Bloomberg
Jonathan Pollak - Bloomberg
Erin D Michos - Johns Hopkins Medicine
John William McEvoy - Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; National Institute for Preventive Cardiology, National University of Ireland, Galway, Ireland.
Brian S Schwartz - Johns Hopkins University
Publication Details: Journal of the American College of Cardiology, v 76(24), pp 2862-2874
Publisher: Elsevier
Grant note: R21 ES023675 / NIEHS NIH HHS T32 ES007141 / NIEHS NIH HHS
Resource Type: Journal article
Language: English
Academic Unit: Epidemiology and Biostatistics
Web of Science ID: WOS:000599402900009
Scopus ID: 2-s2.0-85096821441
Other Identifier: 991019167466704721