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1 | Project: Oil and Gas Health Survey | ||||||||||||||||||||||||||
2 | No. | Contribution | Responses | Author | |||||||||||||||||||||||
3 | 1 | In the survey, you all rightly note the risk of perception bias in the survey (i.e., those most concerned with oil and gas development are most likely to notice/respond to the survey). Unless there is an attempt to adjust for this, it is quite likely this survey over samples so called "concerned respondents". This seems to be validated by the correlation you noted between level of concern impacting the frequency of symptoms reported regardless of distance from a UOGD site. Was any attempt made to adjust for this? Thank you. | We analyzed our results by first looking at all 427 respondents (regardless of environmental concerns for air, odor, and noise) and found sigificantly greater frequencies of upper respiratory and acute symptoms within one mile of unconventional oil and gas development (UOGD). When we looked at the 239 repondents that reported the most concern about air, odor, noise, we saw that frequencies (summed Likert scores) for all symptom categories were significantly greater within 1 mile of UOGD than for those living > 2 miles away from UOGD. When we looked at the 181 respondents that were least concerned, we saw that frequencies of all symptom categories were less within 1 mile compared to > 2 miles. Because concern over noise, odors, and air pollution is a major confounder, we reported the separate analysis for each group, rather than adjusting in the main analysis. Because 239 respondents were in the most concerned category and 181 were in the least concerned category, those most concerned citizens were not over sampled and it does not appear that those most concerned were much more likely to respond to the survey than those with less concern. It is also important to note that biases go both ways. | Nick Reiland | |||||||||||||||||||||||
4 | 2 | I will be out of town on the 26th and am sorry to miss the town hall! One question is: Are you applying more of the emission data captured by AJAX and Boulder AIR to the survey answers given? I'm thinking of wind direction and how emissions could affect the symptoms reported more specifically. That likely would take more study and correlative analysis so I understand if it would be too much to do and maybe the survey responses of a two week time period are not able to be correlated. Thanks for your work! | Our analysis did involve looking at the air quality data captured by Broomfield's air quality monitoring system (AQM) in the fourth quarter of 2021. We pulled out all of the survey responses that were downwind of known plumes (as captured by our AQM system). However, we did not have enough residents respond from those downwind locations during a two week timeframe after a plume occurred to further analyze. Additional research could help us understand how emissions might be associated with symptoms. In our presentation, we have outlined how additional research (such as land use regression modeling) could help us understand possible exposure scenarios at household locations at various distances. | PeleRB | |||||||||||||||||||||||
5 | 3 | Question 1: Why was a significant population of impacted residents excluded from the survey? Those of us in unincorporated Adams County suffered through 3 months of carcinogenic Gibson D822 drilling mud overwhelming our neighborhood. At that time, our health concerns were discounted and ignored by CCOB, COGCC and CDPHE. You missed a substantial set of impacted residents. Not only did we suffer the Gibson D822, but we have been subjected to multiple benzene spikes in this area as well as weeks of sleep deprivation from noise. Question/Request 2: PLEASE update your map on slide 4.2 to make it very clear that the unincorporated AdCo residents were purposely excluded from this study. The visual presented by that map makes it look like no one lives in our neighborhood. You need to make it very clear that there is a significant impacted population that was not sampled that reported many incidents/symptoms (and continues to do so). | The objective of this research was to understand symptoms at various proximities to unconventional oil and gas development within the City and County of Broomfield (CCOB). This was stated on slide 3. Overall Goal. The text on slide 4.2 indicates that households were randomly selected throughout CCOB and the map clearly indicates the boundary of CCOB in black outline. The basemap does not include households or neighborhoods within or around CCOB in order to protect confidentiality of those that received a survey. The design of this research was to survey randomly selected households within CCOB using a well-established fishnet sampling methodology conducted in ArcGIS 10.8.1 and as such, no residents were purposely excluded. | Unincorporated AdCo impacted residents | |||||||||||||||||||||||
6 | 4 | This study is incomplete and should not be published until the larger effected population, Adams County, is included. The map pictured in the study indicates the location of approximately 83 wells but 78% of the wells are located more closely to Adams County residents with only 22% more directly impacting Broomfield residents. Using a map indicating all the wells but failing to gather more information from those most affected by a larger quantity of wells is a major flaw in this survey and its results should be cautioned. | The objective of this research was to understand symptoms near and away from unconventional oil and gas sites within the City and County of Broomfield (CCOB). This research was designed by an experienced team of researchers that are well-suited to conduct an epidemiological investigation for the City and County of Broomfield and the University of Colorado's Multiple Institutional Review Board approved this research design. The findings reflect symptoms reported across CCOB and therefore is not considered an incomplete study per the research objective. | Pam Wanek | |||||||||||||||||||||||
7 | 5 | How much money is the CCOB willing to spend on this oil and gas witch hunt? Didn't the city manager indicate we are in fiscal distress? Now we are hiring an individual to access health issues? If you have people on your payroll to do surveys and find fault with the oil and gas companies they will give you results to appease the council, true or not. Don't ask environmentalist if there are problems with oil and gas and don't ask a barber if you need a haircut. Stop the group think and stop the needless spending. | An overview of the study costs can be viewed at the following website: https://www.broomfieldvoice.com/oil-and-gas-health-survey | Tom Wayne | |||||||||||||||||||||||
8 | 6 | 1. Going forward, how do you plan to use the Health Survey results to protect the health & safety of Broomfield residents, especially those living within 2000 feet? 2. There are Adams County residents living very close to some of the wells. Were they also surveyed? Do you expect that Adams County residents would have similar survey results and impacts as the Broomfield residents did? How can Adams County residents be compensated for their misery over these last few years? 3. Are the Broomfield oil and gas staff, and the folks in the Broomfield Health Department surprised by the results of the survey? Are any city council members surprised? 4. Is this current city council planning on engaging the city council members of the 2017 city council, who approved the 84 wells, within 2000' of homes, on the survey results? This would also include the two mayors who were in office during the approval and subsequent dealings with Extraction/Civitas. I feel that they should know how their approval of the MOU impacted the residents living near the wells during and after drilling/fracking. 5. Knowing what the survey found, do you think the Risk Analysis was done properly and found the true risks for oil and gas operations? If the city could have a re-do what would be done differently? | The City and County of Broomfield is in the process of evaluating next steps and how this study can be used to continue our efforts to protect the health and safety of Broomfield residents. Adams County residents were not included in the survey as the objective of the research was to understand health symptoms reported by Broomfield residents living in proximity to unconventional oil and gas wells. Thank you for your comments. | BAMcLeod | |||||||||||||||||||||||
9 | 7 | ~~What will this council do with these results? ~~Will the study just be filed in a drawer, or will it be sent to the governor and the state legislatures, giving them some real data so the state can stop approving wells? ~~What will be done to compensate Broomfield residents for what they have endured, or for future illnesses, such as leukemia or other serious health issues brought on by these oil and gas operations? Will a fund be made and set aside to help pay for future medical expenses, should residents be diagnosed with illnesses? ~~What about the residents impacted by Broomfield's oil and gas operations, who don't live in Broomfield? | The City has shared the findings with CDPHE staff at the Air Pollution Control Division, COGCC staff, COGCC Commissioners, and other local and regional governments that participate in the Broomfield hosted monthly oil and gas roundtable. We are also in discussions to present the findings to the Air Quality Control Commission. Finally, the study’s authors are presently seeking publication in a peer-reviewed journal. The study’s findings can be used by policy and decision makers to make better informed decisions about future energy development in residential areas. However, the study’s findings do not establish causation. The City will consider conducting additional follow up research and continue its current, ongoing efforts around inspecting, monitoring, reporting, and following up with oil and gas operators to protect public health, safety and welfare. | BAMcLeod | |||||||||||||||||||||||
10 | 8 | I feel these questions are futile but here goes, what is the city planning to do for those that have Health issues, Will they have a health plan put in place a clinic, health insurance, you may want to think about that since originally the City did nothing, were is all that oil and gas money going? | See response to question 7. Revenues related to oil & gas provide funds for general use. | Concerned | |||||||||||||||||||||||
11 | 9 | Are there any health studies to predict if persons who had these acute symptoms due to VOC exposure will develop certain chronic symptoms later? Can any effort be made to follow up in 10-20 years with the same individuals who replied to the survey to find out if they have developed cancer, severe respiratory issues, neurological issues, premature babies, etc? These future survey connections with the respondents would have to be made immediately due to transient residents. Will this encourage funding of a biomarker study of residents who will unfortunately be subjected to similar VOC exposure elsewhere? Residents who were willing to be guinea pigs for a biomarker study approached the CDPHE and Dr. McKenzie with a study inquiry in 2018 but were told there was no funding for it. There is anecdotal evidence from health complaints filed with Broomfield that the survey results would have shown even greater health impacts if the Adams County residents who were in close proximity to the pre-production pads during the survey and even earlier during Interchange B pre-production had been included. We were told that Dr. McKenzie had a reason to exclude the Adams County residents in designing the study. Could Dr. McKenzie share that reason? Do the researchers think that the survey results would have shown even greater health impacts if it were completed earlier during the pre-production phases at Livingston since there are 7000 families who live within 2 miles of Livingston? This health study shows that the most protective level of BMPs in Colorado are still inadequate in protecting the health of a dense residential population within 2 miles of an unconventional oil and gas development. Does the City of Broomfield plan to formally present this data to the COGCC and CDPHE in meetings that will be public? Conclusion: “Possible explanations for the increase in symptoms reported near multi-well, horizontal oil and gas sites include exposure to volatile organic compounds associated with pre-production oil and gas activities.” Will there be any further work done to tie these health study results to the extensive AQM data from Ajax/CSU or Boulder Air? For example, how could AQM data be used to investigate if Neoflo drilling mud (which is exposed to the air when drill cuttings are brought to the surface) is connected to these symptoms? | Staff is not aware of any predictive studies that are underway which aim to understand if acute symptoms can cause chronic symptoms later in life. Following up with residents about health conditions later in life presents several challenges. Per IRB, and due to resident confidentiality, we do not know the names of residents that submitted a survey. Additionally, it is unlikely that follow up with residents with a more serious diagnosis later in life would result in a large enough sample size for statistical analysis. We do not know if this study will encourage funding of a biomarker study. The study design was never intended to include residents in adjacent counties. The objective of this research from the beginning was to understand the health of Broomfield residents near and away from UOGD. The researchers cannot speculate what the outcome would have been if this same study were done during pre-production at the Livingston site. The researchers shared the study findings with CDPHE staff in a meeting on 5/25. The results were also shared with COGCC staff via email and with the Comissioners at the June 1 hearing. The researchers have made recommendations for future research in the presentation slides, which incorporates how we can further utilize our AQM data. | JlimBroomfield | |||||||||||||||||||||||
12 | 10 | What will council and city staff be doing in the next 30 days to change this? The next 90 days? The next 120 days? And in the next year? Thank you for listing/bulleting out the actions that will be taken in each phase such that these impacts are stopped and no longer experienced by residents. | See response to question 7. The results do not provide Broomfield with a basis to take any immediate action to stop ongoing operations. Broomfield remains committed to protecting public health safety, and welfare and will continue to evaluate future information and take appropriate action. The City does not have any specific 30 day, 90 day, 120 day, or 1 year plans. | jd | |||||||||||||||||||||||
13 | 11 | Will the health complaints that have been filed over the past several years be considered as data points to support the findings of this survey? Otherwise, what will be done with that data (the hundreds of health complaints) that residents have filed in relation to oil and gas chemical exposures since 2019? | The health concerns that have been filed to CCOB's Public Health Department are presented each quarter alongside our air quality monitoring reports. These reports are publicly available for community members, policymakers and the public to review. This data has been and continues to be informative to the design of larger research studies such as this one. For example, symptoms reported in the health complaint database informed the symptoms included in the survey. | Mackenzie Carignan | |||||||||||||||||||||||
14 | 12 | What responsibility does Broomfield as a municipality see itself having in relation to thee results? Does 301 weigh into this responsibility? What steps is Broomfield willing to take to protect the health and safety of its residents now that the survey results back up the anecdotal impacts that residents have been reporting for years? | Broomfield did not have the ability to prohibit oil and gas development when Extraction proposed and pursued its drilling plan, which resulted in the 2017 Operator Agreement. See response to question 7. | Mackenzie Carignan | |||||||||||||||||||||||
15 | 13 | Now that health impacts have been quantified by this study, would the city consider setting up a fund (perhaps collecting funds from XOG or using some sort of tax revenue from the O&G industry) to support residents who will likely continue to experience health impacts from this oil and gas development? Does the city expect residents to shoulder the financial burden caused by this development that we never wanted, especially as we consider longer-term impacts like cancer and reproductive harm? | The City cannot speculate what health outcomes may occur as this was not a predictive study. See response to question 7. | Mackenzie Carignan | |||||||||||||||||||||||
16 | 14 | 1. Can CCOB have a meeting with COGCC to share this data and discuss in depth what it means for Colorado residents living near these industrial mega fracking pads? 2. Will this info be used in making decisions about future oil and gas operations, not just in Broomfield but in surrounding areas? 3. Has there been any discussion of next steps, follow up, or how to reach out to residents that have filed health complaints? | The research team has met with CDPHE to share the findings on May 25. At the June 1st COGCC hearing, Dr. Weisner presented and discussed the findings to Commissioners and the public. The City and County of Broomfield is in the process of evaluating next steps and how this study can be used to continue our efforts to protect the health and safety of Broomfield residents. CCOB will use this study to the best of its ability to inform future oil and gas operations in adjacent jurisdictions. Researchers made future recommendations and outlined these in the study presentation. | Lizzie | |||||||||||||||||||||||
17 | 15 | This is not a question but a comment, and I was directed to submit here. If these health study results surprise you, you haven't been paying attention. Dozens of residents have been reporting these symptoms for years. Literally years. I have a folder in my photos titled "nosebleeds" that contains about 40 photographs of the nosebleeds in our family. Most are of my youngest daughter, aged 10 (now), who has been having these nosebleeds for two years now. Over 100 nosebleeds were reported by children 0-17 since fracking began. The story goes like this: residents raised red flags early on (2107, 2018), concerned about how multiple industrial mega fracking pads will impact residents' health (mental and physical) , especially children and the elderly, who live close to the pads. We asked for someone-- anyone--to consider the health impacts that may befall ourselves and our children. We were dismissed. We asked again during the HAZID meeting: where are the considerations for health and safety? There were none. BMPs, we were told. Worst case scenario is traffic and motor vehicle accidents. Fast forward to Gibson mud and those extreme chemical exposures, the noise that left neighborhoods full of people without sleep for weeks on end, the vibrations, the air quality monitoring equipment capturing dangerous spikes of known carcinogens, fires at active pads, and now this. The impacted residents who live near these pads, both Broomfield and Adams County residents, have been terrorized by this industry for three years. Then when we appeal for some kind of sane action to protect our health and safety, we are gaslit by every organization and system you can imagine, from the city of Broomfield itself to the COGCC to the CDPHE-- double the trauma, double the fun. We are not surprised, nor are we happy about this. Many of us have been hoping for three years: HOPING TO BE WRONG ABOUT SOMETHING, anything really. But we're never wrong. We have always known the damage that this operation would bring to our community. We've lived in the cesspool and breathed the poisons, all the while hoping that everyone telling us "not to worry about it, everything is safe, BMPS, best in class" are right. But now we know: it's not just the crazy, loud residents who file over and over again who are experiencing health impacts. It's more common than not that residents are experiencing symptoms. And now people will either be surprised or outraged or will be nothing at all. "There's nothing we can do" has become a popular mantra. I put my money on that as a result. | Thank you for your comments. | Mackenzie Carignan | |||||||||||||||||||||||
18 | 16 | I have comments and one question. I read the results of the health survey. I am not surprised as myself and many other residents have been reporting these symptoms and concerns for years. If you are surprised, you haven't been doing your job. And maybe you need to find a new job since protecting your citizens isn't a priority like it should be. I do know some council members have been pushing this for us and I am so appreciative of their time and effort to do everything they can to help us. Question....I would love to know what you are going to do now that you have these results. I don't want to assume you will do nothing as you have in the past. I would love to be surprised but I am not counting on it. | becky | ||||||||||||||||||||||||
19 | 17 | The overall goal of the research was to determine if residents living near UOGD sites within CCOB experience a greater frequency and number of health symptoms than residents living at further distances. 1. In the invitation the description of the purpose of the study likely induced selection bias by informing the participants the study was evaluating resident health around UOGD. While not explicitly stated, this implies to the participant that UOGD is impacting resident health. Therefore, it likely influenced residents with symptoms that were aware that they lived close to UOGD to participate more than individuals who were unaware. In addition, the City of Broomfield has been public about potential health effects from oil and gas activity. Inviting residents to participate in a self-report study in a community publicly fighting against UOGD would bias community members with symptoms to perceive that these are due to UOGD, which would in turn motivate them to participate in the study. The study solely relies on self-reported symptoms for evaluating the residents’ health near UOGD, from a population that has been influence by the City of Broomfield and the researchers of this study to believe that their symptoms are due to UOGD. This would induce exposure suspicion bias, rumination bias, and obsequiousness bias where participants are almost collaborating with the researchers, and possibly mimicry bias where participants may have a benign or common symptom that is then reported and attributed in this study to oil and gas activity. These biases would influence the study to show more symptoms near UOGD. This study is flawed in design because it is biasing the results to show increased symptoms near UOGD when in reality the association is not there (type 1 error). The study further demonstrates the influence of these biases with the analysis of symptoms by setback distances stratified by the level of concern on slide 21. When adults most concerned about the top three environmental complaints are separated from those least concerned, the significance of increased symptoms near UOGD is lost. This indicates that the residents with high concern over oil and gas are driving the significant findings in the aggregated results. The researchers lightly touch on this in their conclusions, but it should be highlighted as a major finding of this study. If perception was not playing a role in the study, then we would expect to see significantly increased symptoms across all residents, including those with the least concern. The researchers do not address the risk of selection bias nor make any statements about the risk for type 1 error in the limitations of the study. 2. This study is a cross-sectional design, meaning that the distance to UOGD and number of symptoms were collected at the same time. This design cannot determine if the distance to UOGD or the symptoms came first. NO causal conclusions may be drawn from cross-sectional analyses. Cross-sectional designs are intended to generate new research questions that can be studies with stronger epidemiological designs. 3. The methods for symptom groups and counting likely over-weighted number of symptoms by included correlated symptoms in the same group. For example, if someone reports nausea, they are more likely to also report vomiting and as the methods are written that would be counted twice. By counting these as two symptoms instead of a yes/no experiences of gastrointestinal symptoms, it is weighting the number of symptoms and potentially further biasing the results if this weighting was differential between those living near UOGD and those living farther than 2 miles. 4. The description of the methods for counting the symptoms and the Likert scale is not clear enough and cannot be reproduced. I recommend stating slide 14 more clearly, especially the difference between “Total number of symptoms (number reported at least once in past 14-days)” and “Frequency of total number of symptoms (sum of Likert Scores).” 5. The exposure in the study is a proxy and there are no measured individual chemical exposures from UOGD for the residents’ reported symptoms. 6. The researchers should report the sample sizes for the groups in the analyses on slides 21 and 22. The wide confidence intervals indicate that there were low sample sizes and inadequate power for these analyses. 7. The researchers claim the study strengths include randomly selected households implying that this study has randomization in it. They randomly selected which houses to send invitations to; however, there is a large amount of selection bias present in this study proven by the results of the analysis by most/least concern for oil and gas. This selection bias negates any benefits from randomization. Implying that this is a strength of the study is misleading. 8. The researchers performed multiple comparisons in their study testing the same population over 40 (slides 21 and 22) times without correcting their level of significance or mentioning that level or significance was corrected. These multiple tests increase the likelihood of type 1 error by chance, because at an alpha of 0.05 or a 95% confidence level done over 100 statistical tests, 5 will be significant purely by chance. 9. This study was conducted in a COVID pandemic when Broomfield County had as many as 44 cases reported per day. The symptoms included in the study could have been from COVID-19. The researchers did not address that these symptoms could have been happening in this time and space from a global COVID-19 pandemic. Data Source: https://broomfield.org/3356/Cases | Thank you for your comments. | Katelyn Hall | |||||||||||||||||||||||
20 | 18 | 1) The <1 mile group lives in closest proximity to E470, compared to the 1-2 mile and >2 mile groups. This highway is a source of airborne hydrocarbons, particulate matter, and potential odors from vehicle traffic and paving work. Is there a reason that the study analysis did not account for this potential exposure source? 2) The percentage of surveyed residents aged 65+ in the <1 mile group (about 58%) was much higher than that for the 1-2 mile group (~26%) and >2 mile group (~35%). Persons aged 65+ are significantly more susceptible to moderate and severe COVID symptoms than are younger persons. With an uptick in COVID cases in CCOB occurring during the study period, and an age demographic in the <1 mile group more likely to exhibit COVID symptoms, did the study authors consider COVID-19 cases as a potential confounder of the symptom reporting, especially for respiratory symptoms and fatigue? 3) Slide 21 of the study presentation shows the results of symptom reporting divided into respondents who were concerned (left-hand figure on the slide) vs respondents who were less concerned (right-hand figure on the slide) about oil and gas impacts on health and the environment. If reported symptoms were actually due to physical exposure to oil and gas-related chemicals in the air, then BOTH graphs should show significant differences between symptom frequency and distance. However, the graph shows just the opposite. All the differences in in symptom frequency due to distance from wellpads is only seen in the concerned group, not in the less concerned group. Does this not clearly show that symptom frequency is driven by perception bias and not physically caused by differences in air quality? 4) The COGCC map of producing wells indicates some of the <1 to <2 mile residences north of E470 are closer to active wells not in the survey study than they are to the wellpads that are part of the study. Would the study authors provide justification for not considering these active wells in their analysis? Do the authors have an opinion as to why these relatively close producing wells are not associated with an increase in reported symptoms? | The objective of this study was to understand symptoms reported by Broomfield residents and proximity to unconventional oil and gas operations located within Broomfield. The study accounted for many covariates, including age, but was not designed to understand exposure related to living near highways. Additionally, Broomfield's air quality montioring system did not detect elevated levels of pollutants from E470 during the time health symptoms were collected, rather, most of the air plumes detected had direct hydrocarbon signatures characteristic of "down hole" oil and gas activity, not traffic emissions. Additionally, because respondents living within 1 mile and greater than 2 miles were equally likely to be living near a major roadway (Northwest Parkway, Highway 36), proximity to a major roadway was not likely a major confounder. An uptick in COVID-19 cases began at the conclusion of the research (late December) and cases were elevated throughout the entire City and County of Broomfield during this time. For these reasons, the COVID pandemic was not likely a major confounder. We also note that our stratified analysis by age and race, both known to be associated with COVID incidence, indicate that neither age or race confounded the results.This study results cannot conclude why those living within one mile of a UOGD with a greater concern for air, odor, and noise reported a greater frequency of certain symptoms but the researchers do offer possible explanations on slide 6.4 and this was discussed at length during the public Oil and Gas Community Town Hall on May 26, 2022. It is important to note that the biases on slide 6.4 can results in under or over reporting of symptoms and are likely present in the most and least concerned groups. | Michael Lumpkin | |||||||||||||||||||||||
21 | 19 | Questions for the health study: 1. How do you know the benzene in the air did not go a lot higher than 25ppb? I ask because Ajax was doing some dicey things including triggering the canisters too soon and only caturing small events. In one if Ajax's responses it was stated this was intentional. Ajax was trying to capture small events or the early shoulder of larger events. This is not what residents want and internationally setting it up to measure lower concentrations are inappropriately misleading. In addition, the study suggests the trigger canisters should remain open a lot longer than 60 seconds. Can CCOB get on this finally? 2. This study has reiterated what other studies have found and what everyone has always known. We are tolerate of headaches and sore throats and the other short term effects. However, we are very worried about the long term effects. This is what residents wanted to see not this. This was on a long list that Tami Yellco presented to us that was supposed to protect us. CCOB how can this study protect us? 3. Will CCOB please consider discontinuing these studies and saving the tax payer money? This study failed to address what we wanted which was the long term health effects (several elasped months) such as the lung/trachea chemical burns and cornea damage published in the your Public Health system. The women's eye doctor filled out your PH forms and the woman had been a long term patient so all of this that occured during drilling at Livingston should be in the study. Broomfield, this information should be in this study but the graveness of it is not. Why not? What is going on here? Where is your transparency as you waste tax payer dollars? 4. The Adams County residents should have been part of the post card study especially since you made them breath Gibson D822 for 4 months and then immediately discontinued the use of Gibson after 4 days at Livingston. | Thank you for your comments. The researchers are unable to comment on speculation about higher air quality monitoring numbers. The objective of this research was not investigate long-term health impacts but rather, to analyze symptoms reported by Broomfield residents living in proximity to UOGD sites. To ensure transparency about the study, details can be found on the the following website: https://www.broomfieldvoice.com/oil-and-gas-health-survey | Kathy Swan Bogard | |||||||||||||||||||||||
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