Was he right? A medical follow-up on Marcellus Shale and STDs

Democratic State Rep. Mike Sturla set off a Capitol kerfuffle this week when he combined two hot-button phrases - Marcellus Shale drilling and sexually transmitted diseases - in one hastily worded e-mail, suggesting that the former was spreading the latter "amongst the womenfolk."

Republicans promptly pounced, accusing Sturla of disparaging Pennsylvania's rural females in his note to Capitolwire.

Neither political party offered - or, apparently, asked for - solid evidence of a link or lack of one. Nor, apparently, had any health-care providers analyzed their own data, at least not publicly.

At The Inquirer's request, Susquehanna Health did a quick comparison of partial numbers from two of its clinics in one hospital in Lycoming County, where drilling has boomed in the last year or so.

The findings:

Gonorrhea diagnoses for the year ending June 30 were more than double the previous year and quadruple the year before that.

Chlamydia was up 26 percent in one year and 33 percent over two years.

The actual numbers - from the family-planning and STD clinics at Williamsport Regional Medical Center - are small. The numbers for syphilis and HIV are so small that they can't accurately support a trend (which, in both cases, would be down).

Raw numbers are not as meaningful as rates. Big population increases, particularly in sparsely populated counties like those that are experiencing an influx of rig workers, should drive up all sorts of numbers: STDs, cancer, colonoscopies. Calculating a rate requires accurate population data, which is not available and may never be, since much of the population rise is due to transient workers.

Nor is there any proof tying the statistics to the shale workers. Clinics do not typically ask for employment information, and workers, well aware of the stigma attached to STDs, do not volunteer it.

"Who knows, maybe we are giving it to them," said Desiree Rockwell, who cited anecdotal reports of increased STDs in neighboring Bradford County, where she heads the social services group Partners in Family and Community Development.

She and others were wary about blaming industry workers for a trend without clear evidence. But Susan Browning, director of community health and benefit for Susquehanna Health, said that the anecdotes began around the same time that outside workers arrived in droves.

"This kind of came upon us in a wave," she said. "Internally, there were reports through our own emergency department and center for reproductive health that, 'Hey, there seem to be more STDs and they seem to be in young men with a western accent.' "

Lisa Davis, director of the Pennsylania Office of Rural Health, said that she had seen no data but that sudden population increases do have all sorts of potential impacts.

"If you are looking at a prolonged influx of people who are not rooted in the community, who work long hours, who get paid well, when they get off, they try and unwind," she said, adding that their activities could lead to issues like "STDs, or alcohol and drugs, or drunk driving, or whatever you want to say."

Davis, whose office is a federal-state partnership based at Pennsylvania State University, emphasized that she was describing a gut feeling and knew of no evidence linking STDs and drilling activity.

She said she was working with a group to develop a tool capable of collecting statistics that could link industry or employment with various community trends, including health. Only those kind of data can prove cause and effect.

Pennsylvania Department of Health statistics on sexually transmitted diseases cannot do that. They are very up to date, with annual data for every county through 2010 and preliminary data through June. But they are reported by county of residence - and transient workers typically give their residence as in another state.

Health officials in Texas, Wyoming, and Utah - three states that experienced drilling booms before Pennsylvania - said the same thing.

Matthew Mietchen, an epidemiologist with the Utah Department of Health, said he had heard anecdotal reports of STDs rising in heavily drilled areas, but numbers from transients did not show up in his statistics.

"I think it raises questions about surveillance, how are states looking at this kind of issue and should we be looking at something different?"

Mietchen said he would like to figure out a better way to track the trends, but did not have the resources to do so.

Sturla, who represents Lancaster County, said that was the point he wanted to make with his remark about womenfolk.

Drilling affects local communities, he said, and additional resources are needed to study and help them.