From the Departments of Environmental Health Sciences.
Biostatistics, Yale School of Public Health, New Haven, CT.
Sex Transm Dis. 2020 Apr;47(4):254-260. doi: 10.1097/OLQ.0000000000001127.
Fossil fuel extraction from deep shale rock formations using new drilling technologies such as hydraulic fracturing has rapidly increased in the Unites States over the past decade. Increases in nonlocal, specialized workers to meet the demands of this complex industry have been suggested to influence the rates of sexually transmitted infections (STIs) in counties with shale drilling activity; these associations may vary geographically. In this multiregion analysis, we examine the associations between shale drilling activity and rates of 3 reportable STIs in Colorado, North Dakota, and Texas, states with active shale drilling.
We obtained annual reported rates of chlamydia, gonorrhea, and syphilis from the Centers for Disease Control and Prevention, number of active shale wells from Enverus (formerly known as DrillingInfo), and sociodemographic covariates from the US Census Bureau. We used multivariable mixed-effects Poisson regression modeling to estimate rate ratios (RR) with 95% confidence intervals (CIs) adjusted for potential confounders and secular trends.
In Texas, county-years with high drilling activity had 10% increased rates of chlamydia (RR, 1.10; 95% CI, 1.04-1.17) and 15% increased rates of gonorrhea (RR, 1.15; 95% CI, 1.04-1.28), compared with county-years with no drilling. No statistically significant associations were reported for syphilis or for any STIs in Colorado or North Dakota.
Associations between shale drilling and chlamydia and gonorrhea in Texas may reflect increased risk in areas with higher drilling activity and a greater number of major metropolitan areas. Interstate differences highlight the need for local epidemiology to prioritize community health policies.
在美国，过去十年中，使用水力压裂等新钻井技术从深层页岩岩层中提取化石燃料的活动迅速增加。为满足这一复杂行业的需求，非本地的专业工人数量增加，有人认为这会影响到有页岩钻探活动的县的性传播感染（STI）率；这些关联可能因地理位置而异。在这项多区域分析中，我们研究了科罗拉多州、北达科他州和德克萨斯州（这三个州都有活跃的页岩钻探活动）的页岩钻探活动与三种报告的 STI 率之间的关联。
我们从疾病控制与预防中心获得了衣原体、淋病和梅毒的年度报告发病率，从 Enverus（前身为 DrillingInfo）获得了活跃的页岩井数量，以及从美国人口普查局获得了社会人口统计学协变量。我们使用多变量混合效应泊松回归模型，根据潜在混杂因素和季节性趋势调整后，估计了比率比（RR）及其 95%置信区间（CI）。
在德克萨斯州，与无钻探的县年相比，高钻探活动的县年的衣原体发病率增加了 10%（RR，1.10；95%CI，1.04-1.17），淋病发病率增加了 15%（RR，1.15；95%CI，1.04-1.28）。在科罗拉多州或北达科他州，梅毒或任何其他 STI 均未报告有统计学意义的关联。
在德克萨斯州，页岩钻探与衣原体和淋病之间的关联可能反映了钻探活动较多和有更多主要大都市区的地区风险增加。州际差异突出表明需要地方流行病学来优先考虑社区健康政策。
