• Rachel Mash, Jolynn Minnaar, and Bob Mash.
• Environmental co-ordinator of the Anglican Church of Southern Africa; Department of Family Medicine, Stellenbosch University, South Africa. rmash@mweb.co.za.
• S. Afr. Med. J. 2014 Feb 26; 104 (5): 332-5.

AbstractThe use of natural gas that is obtained from high-volume hydraulic fracturing (fracking) may reduce carbon emissions relative to the use of coal and have substantial economic benefits for South Africa. However, concerns have been raised regarding the health and environmental impacts. The drilling and fracking processes use hundreds of chemicals as well as silica sand. Additional elements are either released from or formed in the shale during drilling. These substances can enter the environment in various ways: through failures in the well casing; via alternative underground pathways; as wastewater, spills and leaks on the wellpad; through transportation accidents; and as air pollution. Although many of these chemicals and elements have known adverse health effects, there is little evidence available on the health impacts of fracking. These health concerns have not yet been fully addressed in policy making, and the authors recommend that the voice of health professionals should be part of the public debate on fracking and that a full health impact assessment be required before companies are given the go-ahead to drill. 

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