CHAPTER 2.2 DOMESTIC WATER AND SANITATION
Box 2.2.3: Health and environmental concerns about fracking
Improvements in technologies for horizontal drilling and hydraulic fracturing (fracking) have made it possible to produce large volumes of natural gas, particularly shale gas, from low-permeability geological formations. Fracking typically involves high-pressure injection of chemicals deep underground. The most significant development and exploitation of shale gas has taken place in North America, but shale deposits containing potentially large amounts of natural gas and oil exist in other parts of the world. Fracking is controversial because of widespread concerns about its health and environmental effects (Carpenter 2016; Porter et al. 2015; Jackson et al. 2014; Manuel 2010). These concerns include: drinking water contamination resulting from the injection of chemicals deep underground during the fracking process (US EPA 2015; Vidic et al. 2013; Entrekin et al. 2011); emissions of greenhouse gases associated with fracking operations, including fugitive methane emissions (Miller et al. 2013); and seismic activity, which can occur when water or other fluids are injected deep underground. Chemicals used in fracking can enter both surface and groundwater. Despite growing concerns about rapid and extensive fracking, the data required to address these health and environmental threats (e.g. on the chemicals used, construction standards for wells, and means of disposing of contaminated water) are extremely difficult to obtain (Polson et al. 2015). Confidentiality requirements related to legal investigations, combined with the rapid rate of development and limited funding for research, are among impediments to peer-reviewed research on fracking’s impacts. Scientists and members of the public have called for a moratorium on fracking, but this call has up until now mostly been unheeded (Phillips 2016; Revkin 2014; Howarth et al. 2011). Medical research, which in general is often flawed by failure to examine gender differences, is particularly lacking in this field (Westerveldt 2015; Johnson et al. 2014; UNDP 2011). Very little published data on the public health effects of fracking include gender analysis. A recent study by Casey et al. (2016) suggests an association between unconventional natural gas development activity and preterm birth. Concerns about the health effects of fracking on women can be evaluated against the general understanding that health problems related to chemicals are frequently gender-differentiated, and that gender-differentiated data on these exposures is therefore badly needed (Labrèche et al. 2015; UNDP 2011; WHO 2004).
contamination was gendered, with females, younger respondents and respondents in larger households experiencing more distress than males, older respondents or respondents in smaller households (Schade et al. 2015).
Sanitation and wastewater Sanitation access, use, and toilet debates
In 2015 an estimated 2.4 billion people did not have access to “improved” sanitation (WHO 2016; UNICEF and WHO 2015). The number of people without access to safe sanitation is unrecorded, but is likely to be several orders of magnitude higher. According to official estimates, during the period of the Millennium Development Goals (1990-2015) use of “unimproved” sanitation facilities fell from 46% to 32% globally. That means the MDG target to halve the proportion of the population without sustainable access to basic sanitation was missed by around 700 million people (UNICEF and WHO 2015).
While almost all developed countries had achieved “universal sanitation coverage” by 2015, only four
of nine developing regions had met the sanitation target. The share of the population served by improved sanitation was particularly low in parts of Oceania, Sub-Saharan Africa and Southern Asia (Figure 2.2.4) (UNICEF and WHO 2015).
In addition to large discrepancies in sanitation coverage and its progress in different world regions, there are significant inequalities in access to improved sanitation between rural and urban areas. Despite the overall reduction of inequalities during the MDG period, sanitation provision in rural areas lags far behind that in urban ones (UNICEF and WHO 2015): 82% of the urban global population – but only 51% of the rural global population – has access to improved sanitation. From 1990 to 2015 the number of people living in rural areas without access to improved sanitation fell by 16%, and open defecation rates in these areas decreased by only 13% (Figure 2.2.5).
In areas that are not very densely populated, centralized sanitation and wastewater systems are often not considered affordable for public investment, while commercial sanitation companies have shown little interest in investing in rural and remote areas. This
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