Experience within the oil and gas suggests that health is a critical issue both to the project workforce and the surrounding communities. The oil and gas faces a complex agenda that increasingly requires an evaluation of health, social and environmental impacts throughout all of its operations. This concern is often expressed in all phases of exploration, production, refining and marketing activities. Initially, the impact assessment focused on environmental performance; however, over the past several years, the ‘license to operate’ has encompassed both environmental and social performance. These issues are sometimes considered part of the overall corporate social responsibility movement. While health and safety issues have always received the highest priority for any project, the traditional focus was on worker health and safety within the geographical boundaries of a proposed project. Community health outreach programmes and assessments have frequently been performed but not considered a mandatory performance requirement. Within the context of environmental and social issues, the oil and gas is increasingly asked to address problems that, traditionally, are ‘outside the fence line’ and considered responsibilities of the host government. A similar evolution and expansion of assumed responsibilities for the industry has been advocated by many stakeholders in the international public health community. Oil and gas companies need to understand and consider the potential public health impact of their overall activities and projects on host societies in order to understand and address their responsibilities appropriately.
Rationale for strategic health management
There is growing recognition that the success of petrochemical and gas industry extends beyond the health of the work-force and is linked to the health of the host community. Addressing health concerns may have both social and economic benefits and foster future economic development. Timely and lasting improvements in community health are difficult to achieve and do not occur passively. Members of industry, sharing common principles and a common vision, must be prepared to engage host governments and other key stakeholders actively in co-operative consultation to plan actions that may achieve the desired outcomes. Planning and coordinating such critical interactions over the life of a project is strategic health management.
Strategic Health Management (SHM) is systematic, co-operative planning throughout the project life cycle to maintain the health of the work-force and promote lasting improvements in the health of the host community.
Benefits of SHM include, but are not limited to:
• improved health of the workforce and dependents, and reduced
health
costs through better host community health care
systems
and infrastructure;
• improved health status in the surrounding host community
through promotion of primary health initiatives;
• increased opportunity for future economic development and sus-
tainability of changes in host
community health status through
strategic planning;
• enhanced industry relationships with the host community, includ-
ing government, the local
health system, and civil society through
co-operative consultation;
• improved corporate reputation through proactive focus on
health.
Health Impact Assessment
Health Risk Assessments (HRA) and Health Impact Assessments (HIA) are critical to the development of a SHM plan. When feasible, assessments of health risks related to the workforce and work place should be conducted along with assessments of health impacts related to the surrounding community. Multi-functional teams of suitably qualified personnel should carry out the assessments.
‘Impact Assessment’describes the systematic analysis of the lasting or significant changes, positive or negative, intended or not, in people’s lives and the natural environment brought about by a given action or series of actions. HIA can be used at any stage of the life cycle, whether this is new country entry, exploration and development, modification of an existing activity or closure of previous projects. HIA makes recommendations to mitigate impacts and enhance health opportunities as part of the planning process for health outreach programmes that extend beyond the fence line and into surrounding communities. HIA seeks to identify and estimate the lasting or significant changes of different actions on the health of a defined population. These changes can be positive or negative, intended or not, single or cumulative. The overall mitigation strategy is further developed into an implementation plan that includes a long-term monitoring (surveillance) programme. The overall programme should be periodically evaluated and reviewed. The HIA process contains many of the ideas and practices articulated by ‘strategic health management (SHM)’.
The HIA may be conducted as part of an Environmental Impact Assessment (EIA) or Social Impact Assessment (SIA). A baseline study is carried out as part of this activity. For the purpose of SHM, it is essential to consider the potential for the project to impact positively on the surrounding community over time. In this way, longer-term goals can be set and plans developed to achieve those goals through co-operative stakeholder activities.
Toxic health impact of gas & petrochemical complexes on host community
A large number of chemicals involved in petroleum refining and chemical manufacturing are toxic in various ways. In particular, many aromatic amines, nitrosamines, organometallics, halogenated hydrocarbons have been shown to be mutagens, carcinogens, or both. Because some of these substances are released into atmosphere, it is possible that communities surrounding petroleum and chemical plants are placed at increased risk of cancer and other adverse health outcomes.
Death from lung cancer for females was associated significantly with residential petrochemical air pollution.
In both males and females, residential exposure to petroleum and chemical air emissions in Contra Costa County, California was associated with an increased incidence of cancer of the buccal cavity and pharynx.
Several population-based case-control studies show an increased risk of kidney cancer related to exposure to petroleum products.
The SEARCH International Childhood Brain Tumor Study (1218 cases) supports the hypothesis that paternal preconceptional exposure to polycyclic aromatic hydrocarbons increases the risk of brain tumors in children.
Children's dwellings in the neighbourhood of oil refineries predisposes to acute childhood leukemia.
Moderate increases in risk for lung, bladder and lymphohematopoietic neoplasms in the population resident within 2 km from the center of the petrochemical plant in South-eastern Italy.
Residential exposure to petrochemicals is associated with an elevated risk of leukemia among adults in their 20s, according to a report in the American Journal of Epidemiology (2006).
In Taiwan, almost all bone, brain, and bladder cancer deaths registered were within 3 km of petrochemical complexes.
There was an excess of multiple myeloma within 7.5 km the petrochemical plant , South Wales.
Increased risks of term low-birth-weight infants in a petrochemical industrial city with high air pollution levels was reported.
Materials chemically very toxic to humans are used in the petrochemical industry and their complex by products show additive or synergic effects in the human body. It is known that air pollutants produced by this industry added with other pollutants become more toxic, causing much damage to the respiratory system. Research found that the prevalence of acute respiratory symptoms and asthma was higher among children living near petrochemical complexes than those in control areas.
The residents of the exposed to sour gas in rural area in southwestern Alberta reported an excess number of symptoms and health problems.
In southern Brazil, it was found a correlation between low birth weight and geographical proximity of mother's residence to the petrochemical plant or residence on the way of wind direction.
There was an excess of respiratory symptoms in Canadian population living downwind from two natural gas refineries.
Acute irritation (eye irritation, nausea, throat irritation, and chemical odor perception) were significantly more common in petrochemical-polluted area.
Children in the petrochemical area had significantly more upper respiratory symptoms and asthma compared to control group.
There is a relationship between proximity to industry and occurrence of otitis media with effusion in school children.
In Beijing, China, an increased risk of spontaneous abortion was found associated with the exposure to petrochemicals, including benzene, gasoline, and hydrogen sulphide.
Increased risk of preterm delivery in areas with air pollution from a petroleum refinery plant was reported in Taiwan.
Congenital cleft deformities are more in areas with gas flares and petroleum refinery.
Quality of life in oil and gas industry in Knowledge-based Economy
In the old economy, the goal of economic development was almost always to "get big". In Knowledge-based economy, the goal should be to "get prosperous" meaning to create higher wages and better jobs, expand opportunities for all of the region's citizens, reduce poverty, and improve the quality of life.
The vision for SHM is to achieve lasting improvements in local health support capability through proactive partnerships among key stake-holders in industry, government and civil society, to enhance quality of life for all.
Traditionally, the location decisions of petrochemical and gas industry have been driven primarily by factors such as land costs, labor costs and access to materials and markets. Today, however, quality of life (QOL) for employees is becoming an important factor as well. Therefore, the interest in QOL strategies as an economic development strategy has grown considerably. Policy makers see QOL strategies as a potentially effective means of business development while furthering other developmental goals such as reducing congestion, improving air and water quality, preserving the local natural environment and open space, and upgrading cultural and recreational amenities for residents.
The arguments in favor of basing an economic development strategy on amenities and QOL over traditional industrial recruitment strategies are based upon both equity and efficiency grounds. QOL is increasingly being viewed as a viable justification and operational paradigm for community planning efforts. QOL is an attractive concept for planners because it entails a comprehensive and proactive approach to local action. Under a QOL paradigm economic development expenditures become a long-term investment in the community, in other words, allowing local communities to have their cake and eat it too. This is particularly attractive to advocates of sustainable development and smart growth, as residents grow increasingly concerned over the problems caused by unabated growth, such as traffic congestion, air quality, public safety and losing the feelings of community.