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"Our examination…uncovered no evidence that fracking can be practiced in a manner that does not threaten human health," states a blistering 266-page report released today by Concerned Health Professionals of New York and the Nobel Peace Prize-winning group, Physicians for Social Responsibility. Drawing on news investigations, government assessments and more than 1,200 peer-reviewed research articles, the study finds that fracking – shooting chemical-laden fluid into deep rock layers to release oil and gas – is poisoning the air, contaminating the water and imperiling the health of Americans across the country. "Fracking is the worst thing I've ever seen," says Dr. Sandra Steingraber, one of the report's eight co-authors, a biologist who has worked as a public health advocate on issues like breast cancer and toxic incinerators. "Those of us in the public health sector started to realize years ago that there were potential risks, then the industry rolled out faster than we could do our science." In recent years, the practice has expanded from rural lands to backyards, farms, and within sight of schools and sources of drinking water. "Now we see those risks have turned into human harms and people are getting sick," says Steingraber. "And we in this field have a moral imperative to raise the alarm."

The researchers behind the report, titled "Compendium of Scientific, Medical and Media Findings Demonstrating Risks and Harms of Fracking," are quick to point out that fracking, or "unconventional oil and gas extraction," extends far beyond the idea of a single well obediently gurgling up natural gas or oil. Fracking is part of a complicated extraction process with a spider web of infrastructure that extends many miles from the well pad. At virtually every turn, the process contains public health hazards. Residents living near an active site breathe air laced with carcinogens, including benzene and formaldehyde, and research has shown an increased risk of asthma, a decrease in infant health and worrisome effects on the development of a fetus, such as preterm births and birth defects. "Pregnant women have a major risk, not only themselves but they're carrying a fetus whose cells are multiplying continuously," says Dr. Lynn Ringenberg, a retired Army colonel and the president-elect of Physicians for Social Responsibility. "If those cells get hit by some toxic chemical from fracking, it may not manifest itself for years."

Fracking sites have caught fire – others have exploded, as happened last month in Belmont County, Ohio – torching chemicals whose dangerous components local fire chiefs may be surprised to learn are an industry secret. Communities have long feared the fracking process can contaminate underground aquifers with hazardous chemicals and research in Texas and Pennsylvania has now confirmed this to be the case. Fracked gas flows via pipelines, whose leaks and explosions are now well-documented. Piped gas must continuously be re-pressurized at compressor stations which have been documented to emit methane, fine particulate matter, as well as benzene, formaldehyde and other known human carcinogens. Report co-author Dr. Kathleen Nolan, a pediatrician and bioethicist who has examined numerous people sickened by fracking-related contamination, describes the harrowing case of one western Pennsylvania family. "They would see a yellow fog, kind of like a chemical mist coming from the compressor station," says Nolan. "Their two youngest children, nine and 11, started having tics where their muscles would go into spasms, those spasms would persist even when they were asleep."

Then there's the issue of the waste that flows back up a fracked well. Although the industry calls it "brine" or "produced water," this material contains carcinogenic chemicals, can be flammable and, in much of the country, also contains radioactive elements from deep below the surface. Occasionally, this toxic waste is used to frack new wells. Often, it is hauled by trucks that must weave around narrow local roads to sites called injection wells, where this hazardous slurry is injected deep into the earth, a process that has repeatedly been linked to earthquakes. In 2016, in Barnesville, Ohio a truck spilled approximately 5,000 gallons of fracking wastewater when it crashed beside a stream that leads into one of the village's main reservoirs.

Last November a truck carrying fracking waste overturned near Coolville, Ohio and emptied fluid into a culvert that connects to a creek. Residents were prepared; they'd been living for years with the menace of injection wells, including what resident Susie Quinn calls a "chemical factory like smell" around their homes. Like many in the region, she spends free time researching risks the industry and her own government have failed to protect her against. More than a week after the frack truck overturned, she visited the site to take samples, but forgot gloves. "About an hour and twenty minutes later all the fingers on my left hand were burning underneath my fingernails," says Quinn. Tests later revealed the culvert was loaded with barium, as well as strontium, whose isotopes can be radioactive.

In West Virginia and Pennsylvania, radioactive fracking waste is being processed at facilities like Antero Clearwater in Doddridge County, West Virginia, which claims it can produce water clean enough to be discharged back into nearby local waterways. But Antero's websitecontains scant details on how this is done, and radioactivity experts, like Dr. Marvin Resnikoff, a nuclear physicist and international consultant on radioactive waste, remain concerned. "The radioactive levels at the Marcellus shale formation are off the charts," he says, referring to the gas-rich layer that underlies much of West Virginia and Pennsylvania. "What is radioactive underground is still radioactive when it’s brought to the surface," says Resnikoff. "This is not alchemy where radioactivity disappears." A tour last February with local residents through heavily-fracked Doddridge County revealed Antero's facility, located just six miles from Doddridge County High School, was emitting tremendous amounts of steam that drifted away in the wind. "There may be radioactive elements in the steam," says Resnikoff.

The "Harms of Fracking" report also highlights astonishing risks for an often overlooked group in the public health discussion on fracking: The workers. Fracking has created 1.7 million jobs, says the U.S. Chamber of Commerce, and the industry has potentially exposed workers on the ground to extremely dangerous conditions. "These are killing jobs," says report co-author Dr. Sandra Steingraber. "We have actually detected benzene in the urine of workers at levels known to raise the risks of leukemia." Dr. Pouné Saberi, a Philadelphia-based occupational and environmental medicine physician says workers face a wealth of risks, but their injuries rarely show up in the data, for a variety of reasons. They often work as non-unionized sub-contractors, allowing parent oil and gas companies to avoid reporting injuries, and the oil and gas industry is exempt from certain worker safety rules. Also, doctors and major Pennsylvania health care providers that service the industry, potentially a valuable source of worker data, says Saberi, rarely mention anything negative about fracking. "There is a code of silence that exists," she says. Plus, workers themselves rarely report injuries or hazards, for fear of losing their jobs.

"If you asked too many questions, you were labeled a tree-hugger and you were gone," says former fracking waste truck driver Randy Moyer, who describes his stomach-turning experience on a website called Shalefield Stories. "Every day was different," he writes. "Some days I'd carry mud, but most days I'd haul wastewater from fracked wells…It was an endless parade of trucks on those back roads." Moyer was never told the contents of the waste he was hauling. At the well-site, waste was kept in a makeshift pit, and when loading his truck Moyer often had to climb in and squeegee out material. To avoid getting their boots wet, "some guys would go in there in their bare feet." Moyer was given no safety gear, aside from a flame-resistant coat, because, he explains, "If the public sees guys in hazmat suits they're going to start to ask questions." As one would anticipate from a human being with direct exposure to radioactive waste, Moyer became quite sick.

"My tongue, lips, and limbs all swelled up," he writes. "I've had three teeth snap off. The first two broke while I was eating garlic bread and spaghetti. I have burning rashes all over my body that jump from place to place." Moyer has seen over 40 specialists across West Virginia and Pennsylvania. "One told me that I had bed bugs. Another said it must be a food allergy."

The report, which is in its fifth edition, flips the narrative on an energy rush that is quite literally powering the nation. Fracking has "bolstered our economy and energy security" says Seth Whitehead, a consultant with Energy in Depth, a website affiliated with the Independent Petroleum Association of America. The numbers bear out: Fossil fuels supply the U.S. with a majority of its electricity, and gas has overtaken coal as America's number one power source. Meanwhile, about 60 percent of the gas produced in America and 48 percent of the oil now comes from unconventional oil and gas deposits. Fracking has helped ease America off foreign fossil fuels. And the boom extends far beyond the well pads.

Ethane, one of many components in fracked gas, serves as the base ingredient for the production of numerous plastics and petrochemicals. On the Gulf Coast, these industries are making big investments in infrastructure to take advantage of America's newly abundant cheap gas. "With more than $35 billion in planned chemical plant expansions in our area over the next five years, these are the 'good old days,'" Chad Burke, President of the Economic Alliance Houston Ship Channel Region, posted on the organization's website. The American Chemistry Council bullishly estimates that over the next decade the plastics industry will generate over 300,000 jobs. "The surge of natural gas production from shale has reversed the fortunes of the U.S. plastics industry," states a 2015 Council report.

But these glowing numbers rarely take into account the fracking boom's epic toll on public health, the American landscape and the world's climate. In fact, against a mounting pile of personal testimony and scientific data, the industry continues to claim it is doing nothing wrong. "The science clearly indicates that, with an emphasis on prevention…energy production can and is being done right, and that hydraulic fracturing is not leading to widespread, systemic effects to drinking water resources," Stephanie Wissman, an Executive Director with the American Petroleum Institute, stated at a recent meeting of the Delaware River Basin Commission. "It's sad," Marcellus Shale Coalition spokesperson Erica Clayton Wright wrote in an email, "that some shoddy so-called 'studies' focused on attacking American energy and the tens of thousands of hardworking Pennsylvanians that work across the industry are the subject of fake news stories like these."

But the science on fracking is getting more difficult to dismiss. "With fracking," says Steingraber, "we had six peer reviewed articles in 2009 pointing to possible public health risks. By 2011 we had 42. Now there are more than 1200." Some states are indeed listening to the scientists. New York, Maryland and Vermont have banned fracking, and even Florida's state legislature is seriously considering a ban. "The chickens are going to come home to roost," says Ted Auch, an environmental scientist with FracTracker Alliance. He believes that as negative impacts on health and water supplies continue to stack up, the fracking industry will have an increasingly difficult time gaining investors, an issue highlighted in a December article in the Wall Street Journal. "Shale has been a lousy bet for most investors," the article states, referring to the deposits where fracking typically occurs. Within the past decade, says the Journal article, "energy companies…have spent $280 billion more than they generated from operations on shale investments."

As a result, many companies have taken extreme measures to politically protect their investments. Last month, Wyoming became the third state, after Iowa and Ohio, to introduce a bill criminalizing protest activities like the ones undertaken at Standing Rock. “It is a war,” says Tina Smusz, a retired emergency medicine and palliative care physician and Virginia-based member of Physicians for Social Responsibility. “And in this war one of your most valuable weapons is science.”