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The human health effects of unconventional oil and gas (UOG) chemical exposures: a scoping review of the toxicological literature

  • Élyse Caron-Beaudoin ORCID logo EMAIL logo , Hélène Akpo , Mary M. Doyle-Waters , Lisa A. Ronald , Michael Friesen , Tim Takaro , Karen Leven , Ulrike Meyer and Margaret J. McGregor
Published/Copyright: July 11, 2024

Abstract

Many chemicals associated with unconventional oil and natural gas (UOG) are known toxicants, leading to health concerns about the effects of UOG. Our objective was to conduct a scoping review of the toxicological literature to assess the effects of UOG chemical exposures in models relevant to human health. We searched databases for primary research studies published in English or French between January 2000 and June 2023 on UOG-related toxicology studies. Two reviewers independently screened abstracts and full texts to determine inclusion. Seventeen studies met our study inclusion criteria. Nine studies used solely in vitro models, while six conducted their investigation solely in animal models. Two studies incorporated both types of models. Most studies used real water samples impacted by UOG or lab-made mixtures of UOG chemicals to expose their models. Most in vitro models used human cells in monocultures, while all animal studies were conducted in rodents. All studies detected significant deleterious effects associated with exposure to UOG chemicals or samples, including endocrine disruption, carcinogenicity, behavioral changes and metabolic alterations. Given the plausibility of causal relationships between UOG chemicals and adverse health outcomes highlighted in this review, future risk assessment studies should focus on measuring exposure to UOG chemicals in human populations.

Introduction

Hydraulic fracturing is a fossil fuel extraction technique that consists of injecting large volumes of fracking fluid (a mixture of water, sand or other proppants, and a variety of chemicals used as, for example, biocides, friction reducers, scale inhibitors, clay stabilizers, surfactants, acids, corrosion inhibitors, gelling agents, foaming agents or pH adjustors [1]) in the rock formation to create fractures, freeing the trapped fossil fuel (e.g., natural gas) for extraction [2]. Unconventional oil and gas (UOG) operations generate large quantities of wastewaters (flowback fluids and produced water) whose physical properties vary considerably depending on the rock formation [3]. These wastewaters contain hydraulic fracturing chemicals, and constituents naturally present in the oil and gas deposits such as volatile organic compounds (VOCs; such as benzene, toluene, ethylbenzene, xylenes [commonly referred as BTEX], acetate, acetone, dichloromethane and chloroform [4], [5], [6]), radioactive elements, and trace metals (e.g., arsenic, strontium, barium, manganese) [3], [6], [7], [8], [9], [10], [11]. Local contamination of soil, air and water in proximity to unconventional oil and gas (UOG) operations has been demonstrated in various studies [12], [13], [14], [15], [16], [17], [18].

As highlighted in recent reviews [19], 20], a growing number of epidemiological studies are showing deleterious health effects in communities living in the vicinity of UOG operations. Health effects associated with proximity to UOG include birth outcomes (e.g., preterm birth, low birth weight, and congenital abnormalities) [21], [22], [23], [24], [25], [26], [27], [28], self-reported health symptoms (e.g., rashes/skin problems, nose bleeds, stuffy nose, cough, blocked sinuses and fatigue) [29], 30], asthma exacerbations [31], 32], as well as adverse cardiovascular [33] and mental health [34], 35] outcomes. A number of studies found that exposure to ambient air pollutants (e.g., carbon monoxide, nitrogen dioxide, particulate matter and VOCs) in various areas of the world not necessarily impacted by UOG, is associated with many of these health outcomes, including birth outcomes [36], 37], and respiratory and cardiovascular diseases [38], 39]. Although limited in number, toxicological research initiatives are working towards elucidating some of the underlying mechanisms of toxicity explaining the associations between proximity to UOG and health outcomes. Indeed, some chemicals associated with UOG, such as acrylamide, benzene, bisphenol A, dibutyl phtalate and strontium, are reproductive and developmental toxicants in humans [40], carcinogenic and mutagenic [41], 42], endocrine disruptors [43], [44], [45], [46], and can promote oxidative stress [47], [48], [49], [50], [51], [52], [53]. All of these mechanisms of toxicity are known to be implicated in the etiology of multiple diseases identified in the UOG epidemiological literature. A review used FracFocus data to describe the chemicals used in hydraulic fracturing for oil production in California, their frequency, function, and potential acute toxicity for aquatic and mammalian species. Of the approximately 300 chemicals used for unconventional oil production in California, many of these, including solvents and surfactants, lacked toxicity data. For example, the authors found that toxicity data was unavailable for five of the most frequently used chemicals. For the chemicals with available toxicity data, the data was often incomplete [54].

An assessment of acute and chronic health hazards of hydraulic fracturing chemicals published in 2015 compiled health hazard information for 113 individual chemicals reported to be used in hydraulic fracturing fluids in North Dakota. The health hazard acute endpoints found to be the most associated with hydraulic fracturing fluids constituents included respiratory tract irritation, as well as eye and skin irritation or damage. Chronic toxicity endpoints were not available for the majority of chemicals [55]. It is important to note that health hazards were identified based on the information reported for individual chemicals in Safety Data Sheets and publicly available databases, such as the Agency for Toxic Substances and Disease Registry and the European Chemicals Agency. A review of the toxicological literature published in 2020 was limited to experimental studies evaluating the endocrine disrupting potential of exposure to a mixture of 23 UOG chemicals [46]. Our primary objective was to update and expand on these reviews to include toxicological studies published between January 2000 to June 2023 examining toxicity on multiple endpoints associated with UOG chemicals whose effects were measured specifically in the context of UOG (i.e., using mixtures of UOG chemicals, samples of UOG wastewater) in models (in vivo or in vitro) relevant for human health.

Methods

Our review is a companion paper of our recent scoping review of epidemiological studies regarding the human health effects of UOG [56].

Data sources and searches

We defined UOG using hydraulic fracturing as the injection of fluids under pressure great enough to fracture shale and tight rock formations. An experienced biomedical librarian (MDW) conducted comprehensive searches in MEDLINE, and Embase (through OVID) for all published studies in English or French from 2000 to June 16, 2023. The toxicology search concepts are listed in Supplementary Material Table S1.

Study selection

We included toxicological studies that investigated harmful effects in in vitro (cellular) or animal assays exposed to UOG chemicals in the context of UOG, i.e., that chemicals (either individual or in mixtures) had to mimic the UOG components (e.g., components of hydraulic fracturing fluid; air emissions; water contamination by UOG activities; or UOG wastewaters). We excluded studies that assessed the impact of UOG chemicals (1) individually and in studies not related to UOG; (2) on in vitro and animal models not relevant to human health (e.g., yeast, aquatic species models, birds). We further excluded studies that had no control group and were not peer-reviewed. Reviews and conference abstracts were also excluded.

Titles and abstracts of studies were first screened to determine initial eligibility for full-text review using COVIDENCE [57], a web-based screening and data extraction tool. Both screening and full text review were completed by two independent reviewers. Disagreements at either stage were resolved through discussion until achieving consensus or, if required, the input of a third reviewer.

Due to the wide heterogeneity of models, exposures (i.e., chemicals used, pathways, duration), outcomes and methodological approaches, a formal bias tool evaluating the quality of selected studies was not applied.

Data extraction, synthesis, and analysis

Given the variation in models, exposure (i.e., chemicals, pathways, duration) and outcome definitions, data synthesis was descriptive. Relevant information extracted from in vitro toxicological studies included: first author; publication year; journal; funding source; study objective; model (i.e., cell line, tissue culture, source); UOG chemicals or samples tested; endpoints of interest; main findings. Relevant information extracted from animal toxicological studies included: first author; publication year; journal; funding source; study objective; model (i.e., animal species, strain, sex, age); exposure treatments (UOG chemicals or samples tested; concentrations, route and duration of exposure); endpoints of interest; and main findings.

Data were extracted directly into the Health Assessment Workplace Collaborative (HAWC) platform (https://hawcproject.org). HAWC is a publicly available web-based tool designed for data extraction of animal bioassay and in vitro studies [58], 59]. Data were independently extracted first by one member of the study team for all selected studies. A second member of the team then verified the exactitude of the data extraction process for each study, and summarized the extracted data descriptively in order to highlight main findings. The main findings from each study from each stream (in vitro and animal models) were synthesized in tables.

A PRISMA flow diagram visually summarises the screening and selection process is presented in Figure 1. One screening and selection process was conducted for both this scoping review and our companion paper [56].

Figure 1: 
Summary of selection of studies included in this scoping review.
Figure 1:

Summary of selection of studies included in this scoping review.

Results

6,886 records were identified through the searches. After duplicates were removed, 4,367 titles and abstracts were reviewed independently by two reviewers, of which 17 met our inclusion criteria. Nine studies used solely in vitro models to study the toxicity of UOG chemicals, while six conducted their investigation solely in mice. Two studies [44], 60] incorporated both in vitro and animal models in their design. All studies were published after 2014.

Relevant information extracted from the 11 in vitro toxicological studies are presented in Table 1. In terms of exposure conditions, four studies used real water samples impacted by UOG (e.g., produced, flowback or wastewater, drinking water, surface water, groundwater) [45], [61], [62], [63]. Three studies used various lab-made mixtures of UOG chemicals [44], 45], 64]. One study investigated the effects of three biocides, a surfactant, a friction reducer and a coal seam geogenic [65]. One recent study used UOG wastewater samples treated by various oxidation processes [66]. Another recent study used drinking water samples containing UOG wastewater and then treated by chlorination or chloramination, two disinfectant treatments used in municipal water treatment plants [61].

Table 1:

Characteristics (UOG chemicals or samples tested; models; endpoints; main findings; deleterious effects) of included in vitro toxicological studies.

Lead author, year UOG chemicals/samples tested Models Endpoints Main findings Deleterious effects
Abraham (2023)
  1. Impacted water: Produced water diluted 100-fold with raw river water

  2. Chlorine impacted drinking water: 13.5 mg/L chlorine in impacted water

  3. Chlorine river water: 6.0 mg/L chlorine in raw river water

  4. Chloramine impacted drinking water: 13.5 mg/L chloramine in impacted water

  5. Chloramine river water: 6.0 mg/L chloramine in raw river water

Toxicity values based on mammalian cell assays (CHO cells; hamster; ovary)
  1. Calculated cytotoxicity and genotoxicity using the TIC-Tox method based on toxicity values established in mammalian cell assays

  1. Chlorine impacted drinking water: 5X calculated cytotoxicity compared to chlorine river water; 2X calculated genotoxicity compared to chlorine river water

  2. Chloramine impacted drinking water: 5X calculated cytotoxicity compared to chloramine river water; 2X calculated genotoxicity compared to chloramine river water

  1. Cytotoxicity

  2. Genotoxicity

Bain (2018)
  1. Biocides: Bronopol (BP), glutaraldehyde (GA), tetrakis(hydroxymethyl)phosphonium sulfate (THPS)

  2. Surfactant: 2-Butoxyethanol

  3. Friction reducer: Polyacrylamide

  4. Coal seam geogenic: o-cresol

Luciferase report assays (CALUX®) using U-2 OS cell line (human; epithelial; osteosarcoma)
  1. Activity of the estrogen (ER), androgen (AR), progesterone (PR), glucocorticoid (GR) and PPARγ receptors

  1. BP: Disruption of all receptors activity at cytotoxic concentrations

  2. GA: Disruption all receptors activity at cytotoxic conc; ↑ of ER-CALUX at 6.25µM

  3. THPS: Disruption all receptors activity at cytotoxic concentrations; ↑ of ER-CALUX at 6.25–25µM

  4. 2-Butoxyethanol: no significant effects

  5. Polyacrylamide: no significant effects

  6. o-cresol: no significant effects

Endocrine disruption
Bamberger (2019)
  1. Surface water samples collected in Susquehanna County

  2. Groundwater samples collected in Susquehanna County

  1. YCM3 strain for ligand-induced Aryl hydrocarbon receptor (AhR) signaling

  2. Transfected Ishikawa cells (human; epithelial, dometrial carcinoma)

  1. Activity of Ah receptor in YCM3

  2. Activity of ER, AR, PR and GR receptors

  1. Surface water: ↑ AhR in 8 samples close to impaired natural gas wellsa

  2. Ground water: ↑ AhR in 14 samples close to impaired natural gas wells

  3. Endocrine receptor antagonism (type of water samples not mentioned): 17/53 samples exhibited ↓ activity for at least one receptor; no association with presence of impaired natural gas wells

  4. Endocrine receptor agonism: 20 surface water samples and 2 groundwater samples exhibited ↑ ER activity; no association with presence of impaired natural gas wells

  5. a reported compromised integrity of casing and cement

Endocrine disruption
Crosby (2018)
  1. Wastewaters from unconventional oil/gas well

  1. Liver cells (HepG-2 cells (human; epithelial; hepatoma) and rat hepatocytes)

  2. HK-2 cells (human; epithelial; kidney)

  1. Gene expression (cell-cell communication)

  2. Quantification of proteins implicated in cellular metabolism: AhR; CYP1A1; NQO1; GST

  3. Wound healing inhibition

  1. Gene expression: ↓ genes implicated in gap junction formation, tight junction formation, cellular matrix adhesion, focal adhesion, apoptosis, cell-cell adhesion and communication (1:100 dilution); ↑ gene implicated in purine biosynthesis (1:100 dilution)

  2. Proteins: ↓ NQO1

  3. Wound healing: ↓ wound closure with increasing concentrations; no wound closure at highest concentration

  1. Cytotoxicity

  2. Impaired cellular communication

Kassotis (2014)
  1. Surface and groundwater samples from drilling-dense region

  2. 12 chemicals used in natural gas operations

Firefly luciferase reporter gene assay in transfected HepG-2 (human; epithelial; hepatoma) and MCF-7 cells (human; epithelial; adenocarcinoma of the mammary gland)
  1. Activity of AR (in HepG-2 cells) and ER (in MCF-7 cells)

  1. Chemicals: Exhibited anti-ER and anti-AR activities

  2. Water samples: Exhibited ER (89 % of samples) anti-ER (41 % of samples), AR (12 % of samples) and anti-AR (46 % of samples) activities. Large differences amongst sites. Agonist or antagonist receptor activities were higher in drilling-dense regions compared to reference sites.

Endocrine disruption
Kassotis (2015)
  1. 24 commonly used UOG chemicals

  2. Equimolar mixture of 9 chemicals (9-mix)

  3. Equimolar mixture of 23 chemicals (23-mix (no BPA))

  4. Equimolar mixture of 24 chemicals (24-mix (contains BPA))

Reporter gene assay in transfected Ishikawa (human; epithelial, endometrial carcinoma) and HepG-2 cells (human; epithelial; hepatoma)
  1. Activity of ER, AR, PR, TR, GR

  1. Individual chemicals: 21 chemicals anti-ER, 21 chemicals anti-AR, 12 anti-PR, 7 anti-TR, 10 anti-GR. 1 ↑ ER, 1 ↑PR, 2 ↑ TR. Most potent antagonist activities for ER.

  2. Mix-9: No agonist activities. No antagonist activities for PR, TR and GR. Disruption of ER and AR.

  3. Mix-23: No agonist activities. Disruption of ER, AR, PR, TR and GR.

  4. Mix-24: Disruption of ER, AR, PR, TR and GR.

Endocrine disruption
Kassotis (2016)
  1. Surface water at a West Virginia injection well disposal site

  2. Surface water upstream of a West Virginia injection well disposal site

  3. Surface water downstream of a West Virginia injection well disposal site

Reporter gene assay in transfected Ishikawa cells (human; epithelial, endometrial carcinoma)
  1. Activity of ER, AR, PR, TR, GR

  2. Toxicity via CMV-β-Gal activity in the ER activity screen in Ishikawa human cells

  1. At disposal site: Anti-ER, AR, PR, TR and GR. No agonist activities. Moderate to high toxicity at 40X.

  2. Upstream: No antagonist activities. Low agonist activities for PR. No toxicity.

  3. Downstream: Anti-ER, AR, PR, TR and GR. No agonist activities. Moderate to high toxicity at 40X.

  1. Endocrine disruption

  2. Cytotoxicity

Kassotis (2018)
  1. Mixture of 23 commonly used UOG chemicals

  2. UOG wastewaters

  3. Surface water downstream from UOG well pad and retention pond

  4. Surface water on private property with historical UOG spill

  5. Surface water at UOG well pad

  1. 3T3-L1 cells (mouse; fibroblast; embryo)

  2. PPARγ reporter assay in HEK-293 cells (human; epithelial; kidney)

  1. Triglyceride accumulation

  2. Pre-adipocyte proliferation

  3. Cell viability

  1. 23-mix: ↑ triglyceride accumulation; ↑ pre-adipocyte proliferation; ↓ cell viability; no activation of PPARγ

  2. Water samples: ↑ triglyceride accumulation; ↑ pre-adipocyte proliferation; ↓ cell viability; ↑ PPARγ activity

  3. Field blanks: no effects

Impaired metabolic health
Kassotis (2020)
  1. Surface and groundwater samples from drilling-dense region in Colorado

  2. Reference water sample from area with no UOG

  3. Wastewater samples

Reporter gene assay in transfected Ishikawa cells (human; epithelial, endometrial carcinoma)
  1. Activity of ER, AR, PR, TR and GR

  1. Water samples from medium drilling-intensity: ↑ agonist activity for ER, AR, PR and TR compared to reference; ↑ anti-ER and AR activity compared to reference

  2. Water samples from high drilling-intensity: ↑ agonist activity for ER, AR and TR compared to reference; ↑ anti-ER, AR and GR activity compared to reference

  3. Water samples upstream of UOG: ↑ agonist activity for ER, and AR compared to reference; ↑ anti-ER, AR, PR and GR activity compared to reference

  4. Wastewater samples: ↑ anti-ER, AR and PR activity compared to reference

Endocrine disruption
Yao (2015)
  1. Flowback water samples

BEAS-2B cells (human; epithelial; lung)
  1. Cytotoxicity

  2. Colony formation in soft agar (carcinogenicity)

  3. Cell migration

  4. Transcription profile

  5. Trace metals update in cells

  1. Flowback water: ↓ cell viability after 10 days exposure to 4 %; ↑ colony numbers at 0.5 %; different cell morphology and growth rate after exposure; ↑ migration capacity; ↑ expression of genes in inflammation, cell migration, cell proliferation and wnt signaling pathway; ↓ expression of genes implicated in apoptosis, adherent junction and endocytosis

  2. Barium: ↓ cell viability; uptake in cells

  3. Strontium: no effect on cell viability; uptake in cells

Carcinogenic potential
Zhuang (2023)
  1. Produced water samples from China treated or not by oxidation technology

V79 cells (Chinese hamster; fibroblast; lung)
  1. Cytotoxicity

  2. DNA damage assessed by Comet assay

  1. Produced water: ↑ cell shrinkage after 48 h at 5 and 30 mg/mL; ↓ cell viability after 48 h at 3, 5 and 7 mg/mL; ↓ cell viability after 12, 24 and 48 h at 9–30 mg/mL; no DNA damage

  2. Treated produced water: ↑ cell shrinkage after 48 h at 5 and 30 mg/mL; ↓ cell viability after 12, 24 and 48 h at 7–30 mg/mL; ↑ DNA damage after 12, 24 and 48 h at 50–800 µg/mL

  1. Acute cytotoxicity

  2. Acute genotoxicity

In vitro models ranged from mammalian cells to reporter assays, and to transfected cells. Most studies used human cells, while a few used hamster and mouse cells. All studies used monocultures. Endpoints included cytotoxicity (6 of 11 studies), genotoxicity (2/11), hormone receptor activity (6/11), gene and protein expression (2/11), wound healing inhibition (1/11), uptake of chemicals in cells (1/11), triglyceride accumulation (1/11), cell proliferation (1/11), carcinogenicity (1/11) and cell migration (1/11).

All studies found deleterious effects associated with exposure to UOG chemicals or samples. In particular, Abraham et al. [61] found significant cytotoxicity and genotoxicity associated with chlorinated or chloraminated drinking water samples containing UOG wastewater using the TIC-Tox method. Bain et al. [65] used the CALUX® assay and reported endocrine disruption on multiple hormone receptors (estrogen, androgen, progesterone, glucocorticoid and PPARγ) following exposure to biocides, surfactant, friction reducer and coal seam geogenic compounds. Bamberger et al. [62] found that surface and groundwater samples collected in a dense UOG region exhibited endocrine disruption activity, including an increase in the activity of the aryl-hydrocarbon receptor (AhR) in samples close to impaired natural gas wells, as well as several endocrine receptor antagonism and agonism. Crosby et al. [63] found that exposure to wastewater samples in liver and kidney cells led to impaired expression of genes implicated in cellular communication. Kassotis et al. [[43], [44], [45, 67] found evidence of endocrine disruption in multiple studies, with impaired receptor activities both in reporter gene assays and in transfected cells exposed to surface and groundwater samples, either from drilling-dense regions or in mixtures of commonly-used UOG chemicals. To our knowledge, Kassotis et al. [45] is the first study investigating the toxicity of UOG, specifically the endocrine disruption potential of UOG. Notably, in Kassotis et al. [43], the antagonist activities of several hormone receptors were seen in surface water at an injection well disposal site and downstream. In Kassotis et al. [64], impaired metabolic health – with triglyceride accumulation and pre-adipocyte proliferation, was observed in mouse fibroblast cells exposed to a mixture of 23 UOG chemicals, UOG wastewater and surface water at a UOG well pad. Yao et al. [60] investigated the carcinogenic effects of flowback water samples in human lung cells and found that exposed cells had higher migration capacity and increased expression of genes implicated in inflammation, proliferation and migration. Genes promoting apoptosis, endocytosis and adherent junctions were inhibited. Additionally, Zhuang et al. [66] measured the cytotoxicity and DNA damage caused by exposure of Chinese hamster lung fibroblast cells to UOG produced water, when treated or not by oxidation. The authors found that treated produced water induced greater DNA damage than untreated produced water.

Relevant information extracted from the eight toxicological studies using animal assays are presented in Table 2. In terms of exposure conditions, seven studies used lab-made mixtures of UOG chemicals [44], [68], [69], [70], [71], [72], [73] and one study used BEAS-2B cells exposed to flowback water and then injected subcutaneously in female mice [60]. Animals were exposed to lab-made mixtures of UOG chemicals in drinking water for varied amounts of time.

Table 2:

Characteristics (UOG chemicals or samples tested; models; endpoints; main findings; deleterious effects) of included animal toxicological studies.

Lead author, year UOG chemicals/samples tested Models Endpoints Main findings Deleterious effects
Animal assays

Balise (2019) Mixture of 23 commonly used UOG chemicals at 1.5, 150 of 1,500ug/kg/day in drinking water for 5 weeks prior to mating, and between gestational day 0 until PND21. C57BL/6J female mice offspring aged to 7 months
  1. Body weight and composition

  2. Spontaneous activity

  3. Energy expenditure

  4. Glucose tolerance

  1. 1.5 ug/kg/day: ↓ total and resting energy expenditure during dark cycle. ↓ resting energy expenditure during light cycle.

  2. 150 ug/kg/day: ↓ total and resting energy expenditure during dark cycle. ↓ spontaneous activity during dark cycle.

  3. 1,500 ug/kg/day: ↓ total energy expenditure during light cycle. ↓ spontaneous activity during light cycle.

  4. No difference between exposure groups in body weight, body composition and in glucose tolerance.

Behavioral changes
Balise (2019) Mixture of 23 commonly used UOG chemicals at 1.5, 15, 150 and 1,500 μg/kg/day in drinking water for 5 weeks prior to mating, and between gestational day 0 until PND21. C57BL/6J female mice offspring aged to 12 months and given a 3 day high fat, high sugar diet (HFHSD) challenge
  1. Body weight and composition

  2. Spontaneous activity

  3. Energy expenditure

  4. Glucose tolerance

  5. Liver triacylglycerol

  6. Serum insulin

  7. Pancreas analysis

  1. 1.5 μg/kg/day: Alterations in exploratory behavior; ↑ non-resting energy expenditure and activity during light cycle; ↓ periuterine fat pad weight

  2. 15 μg/kg/day: Alterations in exploratory behavior; ↑ non-resting energy expenditure and activity during light cycle; ↓ periuterine fat pad weight

  3. 150 μg/kg/day: Alterations in exploratory behavior; ↑ non-resting energy expenditure and activity during light cycle; ↓ periuterine fat pad weight

  4. 1,500 μg/kg/day: ↑ non-resting energy expenditure and activity during light cycle; ↓ body weight; ↓ periuterine fat pad weight; ↑ brown fat pad weight

No difference between exposure groups in fat and lean mass; total food consumption and food bouts; insulin concentrations; estrus cyclicity.
  1. Behavioral changes

  2. Impaired metabolic health

Boule (2018) Mixture of 23 commonly used UOG chemicals at 30 and 300 μg/kg/day in drinking water from gestational day 0 until PND21. Male and female C57BL/6J mice offspring challenged with infectious agents (house dust mite (HDM) extract-induced allergic airway disease; influenza A virus (IAV); autoimmune encephalomyelitis (EAE)) after exposure
  1. Immune cells populations

  2. Onset of symptoms

  1. 30 μg/kg/day: ↑ granulocyte monocyte precursors in females

  2. 30 μg/kg/day + HDM challenge: ↓ CD4+ T cells in females; ↑ Th2and Th17 cells in females; ↓ Treg: Th2 cells radio in males and females; ↑ airway macrophages in females; ↑ airway eosinophils and lymphocytes in males and females

  3. 30 μg/kg/day + IAV challenge: no significant effects

  4. 30 μg/kg/day + EAE challenge: ↑ Th1 cells in females; ↓ Treg: Th1 cells ratio in females; ↑ Treg: Th17 cells ratio in females; earlier disease onset in females; higher disease scores in females

  5. 300 μg/kg/day: ↓ bone marrow cells in females; ↑ hematopoietic stem cells in females; ↑ Gr1+CD11b+ myeloid cells in male and female spleen

  6. 300 μg/kg/day + HDM challenge: ↑ Th17 cells in females; ↓ Treg: Th2 cells radio in females; ↑ airway macrophages in females

  7. 300 μg/kg/day + IAV challenge: ↑ viral nucleoprotein (NP)-specific CD8+ T cells

  8. 300 μg/kg/day + EAE challenge: Earlier disease onset in females

No difference between exposure groups in body weights, number of pups per litter or sex ratio among exposure groups.
Immune dysregulation
Kassotis (2015) Mixture of 23 commonly used UOG chemicals at 3, 30, 300, and 3,000 μg/kg/day in drinking water, from gestational day 11 until birth Male C57BL/6J mice offspring
  1. Anogenital distances

  2. Fully retained nipples

  3. Body and organ weights

  4. Serum testosterone

  5. Sperm assessment

  1. 3 μg/kg/day: ↑testis weights at PND21 and 85; ↑heart weight and cardiac myocyte diameter at PND21; non-significant ↓ anogenital distance

  2. 30 μg/kg/day: ↓sperm count at PND85; non-significant ↓ anogenital distance

  3. 300 μg/kg/day: ↑testis weights at PND21; ↓sperm count at PND85; ↑body and thymus weight at PND21; non-significant ↓ anogenital distance

  4. 3,000 μg/kg/day: ↑testis weights at PND85; ↑serum testosterone at PND85; non-significant ↓ anogenital distance

No difference between exposure groups in sperm morphology.
Endocrine disruption
Kassotis (2016) Mixture of 23 commonly used UOG chemicals at 3, 30, 300, and 3,000 μg/kg/day in drinking water, from gestational day 11 until birth Female C57Bl/6 mice offspring
  1. Ovarian follicle assessment

  2. Serum hormones

  3. Heart assessment

  1. 3 μg/kg/day: ↓FSH and LH. ↓prolactin. Disrupted folliculogenesis. ↑body weight at PND7, PND13 and PND21. ↓uterine weight at PND85. ↑ovary weight at PND85. ↑collagen deposition in heart at PND85.

  2. 30 μg/kg/day: ↓FSH and LH. ↓prolactin. Disrupted folliculogenesis. ↑collagen deposition in heart at PND85.

  3. 300 μg/kg/day: ↑GH and TSH. ↓prolactin. Disrupted folliculogenesis. ↑ body weight at PND7, PND13 and PND21. ↓ovary weight at PND85

  4. 3,000 μg/kg/day: ↓FSH and LH. ↓prolactin. Disrupted folliculogenesis.

No difference between exposure groups in estradiol serum levels.
  1. Endocrine disruption

  2. Developmental disruption

O’Dell (2021) Mixture of 23 commonly used UOG chemicals in drinking water at a final concentration of 0.1 μg/mL for each chemical for at least 8 weeks Adult (6–8 weeks) male and female C57Bl/6 mice challenged with infectious agents (house dust mite (HDM) extract-induced allergic airway disease; influenza A virus (IAV); autoimmune encephalomyelitis (EAE)) after exposure
  1. Cellularity of primary and secondary immune organs

  2. Immune system function

  1. Immunologically-naïve female mice: ↑ in thymocytes. ↑ peripheral lymph node cells. ↓ percentage of CD19+ cells in spleen.

  2. Immunologically-naïve male mice: ↓ bone marrow cells.

  3. HDM female mice: ↑ number of Th2 cells in lymph nodes. ↑ airway eosinophils. ↓ airway macrophages and lymphocytes

  4. HDM male mice: ↑ airway macrophages.

  5. Influenza A female mice: no difference in morbidity of immune cells populations.

  6. Influenza A male mice: ↓ CD8+ T-cells, CTL and virus NP-specific specific CD8+ T cells. ↓ number of cells in lymph nodes. ↓ number of CD4+ cells. No difference in morbidity.

  7. EAE female mice: ↑ severity of disease. ↓ number of Treg cells.

  8. EAE male mice: ↓ number of TH1 cells.

Altered immune system
Sapouckey (2018) Mixture of 23 commonly used UOG chemicals at 3, 30, 300, and 3,000 μg/kg/day in drinking water, from gestational day 11 to birth Female C57Bl/6 mice offspring
  1. Morphology of mammary glands

  2. Immunohistochemical analysis for ERα and Ki67 (marker of cell proliferation)

  3. Apoptotic cells in mammary tissue

  1. 3 μg/kg/day: ↑Ki67-positive cells; ↑ proliferation/apoptosis ratio.

  2. 300 μg/kg/day: ↑ducts in adult mice; ↑volume mammary epithelium in adult mice

  3. 3,000 μg/kg/day: ↑volume mammary epithelium

No difference between exposure groups in prepubertal mammary gland morphology.
Mammary gland development
Yao (2015) BEAS-2B cells transformed by flowback water injected subcutaneously in left and rank flanks Female athymic nude mice (Nu/J) aged 6–8 weeks with BEAS-2B cells tumor xenografts
  1. Tumor formation

  1. Injection of flowback water-treated BEAS-2B cells: 5/6 mice developed tumors with diameters ranging from 0.2 to 1cm

  2. Injection of control BEAS-2B cells: no tumor (n=1)

Carcinogenic potential

All studies used mice, including C57BL/6 J (7 of eight studies) or athymic nude mice (1/8). Two studies used both males and females, while five and one studies used only females and males, respectively. Six studies used offspring, while two studies used adult mice. Endpoints included body weight (3/8); energy, activity and behavior (2/8); metabolic health endpoints such as glucose tolerance, liver triacylglycerol, insulin and pancreas analysis (2/8); immune cells populations and immune response (2/8); endocrine endpoints such as anogenital distances, serum hormones, sperm and ovarian follicle assessments and mammary gland development (3/8); heart assessment (1/8); and tumor formation (1/8).

All studies found deleterious effects associated with exposure to UOG chemicals. In particular, Balise et al. [68] found that exposure to a mixture of 23 commonly used UOG chemicals at concentrations from 1.5 to 1,500 μg/kg/day in drinking water prior to mating, and between gestational day 0 until postnatal day 21 (PND21), led to disruption of energy expenditure in female mice offspring. A follow-up study in adult female mice challenged with a high fat, high sugar diet also showed impaired behavior (decreased sleep, increased exploratory behavior) and metabolic health (decreased fat pad weight) [69]. Results from Boulé et al. [70] showed that exposure to a mixture of 23 commonly used UOG chemicals at 30 and 300 μg/kg/day in drinking water from gestational day 0 to PND21 in male and female mice offspring challenged with various infectious agents led to disruptions in immune cell populations. A follow-up study conducted by O’Dell et al. [72] in adult male and female mice challenged with the same infectious agents also noted altered immune cells populations, with distinct effects in males and females. Kassotis et al. [44] found that exposure to the same mixture at concentrations from 30 to 3,000 μg/kg/day in drinking water from gestational day 11 until birth led to disruption in testis and heart weight, and a decrease in sperm count and anogenital distance in male offspring. A study from the same group conducted in female offspring showed altered levels of various hormones such as FSH, LH, prolactin, GH and TSH, as well as disrupted folliculogenesis and collagen deposition in the heart [71]. Using the same experimental design, Sapouckey et al. [73] also noted an increase in mammary ducts and volume of the mammary epithelium in these female offspring. The study conducted by Yao et al. [60] injected human lung epithelial cells exposed to UOG flowback water into female athymic nude mice to generate solid human tumor xenografts. The authors found that five out of six mice injected with the flowback water-treated cells developed tumor xenografts. As well, one control mouse was injected with normal cells, which did not form any tumors.

Discussion

A scoping review published in 2020 that examined the human health outcomes associated with exposure to UOG activity highlighted that very few studies investigated mechanisms of toxicity underpinning the associations between UOG exposure and health outcomes [20]. Our review included only 17 studies, comprising nine using solely in vitro models, six conducted solely in animal models, and two using both in vitro and animal models. Notably, among the in vitro studies included in the review, all found deleterious effects associated with exposure to UOG chemicals or samples on a variety of endpoints, such as cytotoxicity, endocrine disruption, triglyceride accumulation and carcinogenesis. In terms of exposure, most studies used drinking, surface or groundwater samples from UOG-intensive regions [43], 45], 61], 62], 64], 67], while five studies used wastewater or produced water samples [60], 63], 64], 66], 67] and four studies were conducted with lab-made mixtures of UOG chemicals [44], 45], 64], 65]. All animal studies included in this review also reported significant impacts of UOG exposure on a range of endpoints, including behavioral changes, metabolic health, immune dysregulation, endocrine disruption, developmental disruption, carcinogenesis and mammary gland development. In terms of exposure, most studies used lab-made mixtures of UOG chemicals to exposure animals through drinking water [44], [68], [69], [70], [71], [72], [73]. One study used BEAS-2B cells previously exposed to flowback water to induce tumor xenografts in mice [60].

More than a 1,000 different chemicals have been identified as commonly-used compounds in UOG operations for a variety of functions, such as proppants, biocides, friction reducers, scale inhibitors, clay stabilizers, surfactants, acids, corrosion inhibitors, gelling agents, foaming agents and pH adjustors [1]. Assessing the toxicity of UOG chemicals is a complicated enterprise, in part due to the lack of toxicological information for the majority of chemicals used in this industry [40] and the withholding of information on proprietary or trade secret grounds. Elliott et al. [40] evaluated 1,021 chemicals used in hydraulic fracturing for their reproductive and developmental toxicity and found that for the 24 % of chemicals with available toxicity information, 43 and 40 % of them were reproductive and developmental toxicants, respectively. Trickey et al. [74] investigated disclosure forms submitted to FracFocus, the US hydraulic fracturing chemical registry, and determined that 18 % of the chemicals imported in FracFocus were not identifiable and marked as confidential, proprietary or trade secret. Yost et al. (2016) used a list of 1,173 chemicals associated with the UOG industry (1,076 chemicals used in the hydraulic fluid, and 134 chemicals identified in wastewaters) and compiled the available chronic oral reference values (i.e., amount of the chemical that can be ingested every day without significantly increasing the risk of adverse health effects over a lifetime) for these 1,173 chemicals. Their analysis revealed chronic oral reference values were available for only 90 of the 1,076 chemicals reported in hydraulic fracturing fluids and 83 of the 134 chemicals reported in wastewaters. Chemicals for which chronic oral reference values were available included well studied heavy metals (e.g., arsenic, cobalt, cadmium), organic compounds (e.g., benzene, phosphine, benzyl chloride), polycyclic aromatic hydrocarbons (e.g., benzo [a] pyrene) and pesticides (e.g., heptachlor, aldrin, dieldrin). The authors also identified 36 chemicals frequently used in UOG operations: chronic oral reference values were not available for 28 of these chemicals (including, but not limited to, quartz-alpha, hydrochloric acid, isopropanol, diammonium peroxydisulfate, guar gum, sodium hydroxide, glutaraldehyde, sodium chloride, potassium hydroxide, ethanol, solvent naphtha, ammonium chloride) [75].

The main deleterious effects identified in the toxicological studies included in our review are aligned with the current epidemiological literature on the associations between exposure to UOG activity and human health outcomes. A recent review conducted by our team identified 52 studies where investigated health outcomes were plausibly attributable to exposure to UOG chemicals, with birth outcomes being the most widely studied health effects. The majority of studies found significant deleterious effects, including on maternal, birth and infant outcomes, respiratory and cardiovascular outcomes, childhood cancer, hospital admissions, self-reported health symptoms, and mortality [56].

Endocrine disruption, as identified in multiple toxicological studies included in this review, is a plausible mechanism that could explain the higher odds of negative maternal and birth outcomes observed in multiple epidemiological studies conducted in the UOG context [21], 23], [25], [26], [27], [28, 76], 77]. Toxicological data on individual chemicals known to be used or emitted by UOG operations can be used to contextualize the results of the studies included in this review, and the plausibility of the epidemiological literature findings. For example, certain VOCs (e.g., BTEX) and trace elements (e.g., barium, strontium, arsenic) are emitted by UOG operations [3], 6], 8], 10], 11], 14], 78]–85] with some congeners being known or suspected endocrine disruptors and human carcinogens [86], [87], [88], [89], [90], [91].

Limitations and future opportunities

The wide range of models, exposures and outcomes measured in the various studies included in our review made it challenging to apply a formal bias tool to evaluate the quality of studies, which is a limitation of our review. Furthermore, our review focuses on the toxicity of UOG mixtures and environmental samples and does not provide a comprehensive overview of the toxicological data relevant to all individuals chemicals. All in vitro studies identified in this review used monocultures. This is an important limitation of the identified studies, since cell-cell communication and interactions with the extracellular matrix, which cannot be evaluated in monocultures systems, play important roles in cellular function, behavior, and the development of disease [92]. More complex in vitro systems, such as co-cultures and organ-on-chip systems, are more physiologically-relevant and accurate to study how cells interact with each other and their environment and should be prioritized in future research endeavors [93], [94], [95], [96], [97].

Rodents are not always an accurate model to use in toxicity testing. For example, studies have shown that the metabolism of environmental contaminants, including endocrine disruptors, differ between rodent species and humans [98], [99], [100]. Researchers should ensure that the animal models used are relevant for the human disease of interest and share similar mechanisms of action [100]. Another important limitation of the animal studies included in the review is the fact that they all used drinking water as the pathway of exposure to UOG chemicals or samples, therefore not considering other relevant pathways of exposure. Indeed, studies have demonstrated impacts of UOG activity on local air quality [79], [101], [102], [103], [104], making inhalation an appropriate additional exposure pathway to use in future studies. Future toxicological studies could focus on the inhalation pathway by using innovative cellular models at the Air-Liquid Interface (ALI). Indeed, pulmonary cell systems at the ALI allow for a better replication of the airway physiology, the possibility of repeating and chronic exposure scenarios and the delivery of contaminants in aerosol similar to inhalation in humans [105]. In addition, animal models can be exposed to air pollutants in various types of exposure chambers [106]. Other considerations to improve the appropriate selection of models include: selection of the most sensitive species possible, accounting for species differences in metabolism of contaminants (for example, by using humanized transgenic rodents; conducting prior testing of contaminants metabolism in cellular models of various species, and using physiologically based pharmacokinetic [PBPK] modeling to predict the contaminants metabolism and behavior in humans [107], 108]); ensuring that the animal model presents the relevant target and outcome; ensuring animals of both sexes are included when relevant; and consideration of the latency period between exposure and effect in the design of the study [100].

The studies we identified offered little background on their choice of exposure concentrations, highlighting the need for more toxicological studies using physiologically-relevant models, environmentally-relevant concentrations of UOG chemicals based on biomonitoring studies, and exposure pathways relevant to real-life exposure scenarios.

Conclusions

There is a growing body of evidence of an association between proximity to UOG operations and adverse human health outcomes. Our review highlighted multiple mechanisms of toxicity associated with UOG chemicals, including endocrine disruption, genotoxicity, impaired cellular communication, impaired metabolic health biomarkers, behavioral changes, immune dysregulation, and carcinogenesis. This review also highlights the sparsity of studies using mixtures of UOG chemicals and environmentally-relevant samples, and suggests models and exposure methods that could be prioritized in future research.


Corresponding author: Élyse Caron-Beaudoin, Department of Health and Society, 33530 University of Toronto Scarborough , Ontario, Canada, Department of Physical and Environmental Sciences, 33530 University of Toronto Scarborough , Ontario, Canada; and Department of Pharmacology & Toxicology, University of Toronto, Ontario, Canada, E-mail:

Funding source: Rural Coordination Centre of British Columbia

Award Identifier / Grant number: N/A

Funding source: University of British Columbia Centre for Rural Health Research

Award Identifier / Grant number: N/A

Acknowledgments

The authors would like to thank Tamera Panjalingam, Anna Thompson, Siddharthan Lakshmanan and Ruchika Gautam for research support. We thank Dr. Reza Afshari for his assistance with study selection.

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: Élyse Caron-Beaudoin: Conceptualization, Methodology, Validation, Investigation, Data Curation, Formal analysis, Visualization, Writing – original draft, Project administration. Hélène Akpo: Investigation, Data Curation, Formal analysis, Visualization. Mary M. Doyle-Waters: Conceptualization, Methodology, Validation, Investigation, Visualization, Writing – review & editing. Lisa Ronald: Conceptualization, Methodology, Validation, Writing – review & editing. Michael Friesen: Conceptualization, Methodology, Validation. Tim Takaro: Conceptualization, Methodology, Writing – review & editing. Karen Levin: Conceptualization. Ulrike Meyer: Conceptualization, Methodology, Funding acquisition. Margaret J. McGregor: Conceptualization, Methodology, Investigation, Writing – review & editing, Project administration, Funding acquisition.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: This work was supported by the Rural Coordination Centre of BC–Rural Physician Research Grant and the UBC Department of Family Practice Centre for Rural Health Research.

  6. Data availability: Not applicable.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/reveh-2024-0076).


Received: 2024-05-17
Accepted: 2024-06-18
Published Online: 2024-07-11
Published in Print: 2025-06-26

© 2024 Walter de Gruyter GmbH, Berlin/Boston

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