Module 7: Regional Case Example: SW Pennsylvania

Health systems across SWPA (e.g., University of Pittsburgh Medical Center (UPMC), Allegheny Health Network (AHN), and the network of Federally Qualified Health Centers serving Mon Valley and shale-impacted communities — see millions of patients annually. Clinicians who routinely take environmental and occupational exposure histories are positioned to surface symptoms earlier, connect patients to mitigation, and contribute to the surveillance picture that informs regional priorities.

• Where SWPA stands. The region’s clinical infrastructure is deep. CENSWPA partner organization, the Environmental Health Project, produced a Health Professional Toolkit for clinicians to support continued medical education about the health harms associated with shale gas development (SGD) as related to physical and mental health of patients and clients, including a module on cancer risk.
• Where the work goes next. Routine integration of environmental and occupational exposure histories into clinical practice — particularly in primary care and pediatric practices serving fenceline and shale-impacted communities — remains uneven across SWPA’s major health systems. Building this into clinical training pipelines and continuing professional development is the next-phase opportunity.
  • Example Objective: Increase environmental and occupational exposure history-taking among SWPA clinicians.
  • Example Intervention Strategy: Partner with UPMC, AHN, and FQHC networks to integrate environmental and occupational exposure history training into clinical education and continuing professional development, with priority focus on practices serving Mon Valley and shale-impacted communities.

A distinctive feature of SWPA’s intervention landscape is the depth of community-facing air quality monitoring and information available. This capacity did not emerge by accident. It reflects a coordinated, sustained, and community-driven strategy to expand air quality monitoring networks so that emissions data could not be ignored by regulators and to put information directly into the hands of residents who need it to protect their health. These tools now support both daily decisions for affected residents and the steady stream of community-generated evidence that strengthens advocacy for stronger regulatory oversight.

• Where SWPA stands. Smell PGH (Carnegie Mellon’s CREATE Lab), the Breathe Cam platform, and a growing set of community-led monitoring initiatives — including the Beaver County Marcellus Awareness Community’s Eyes on Air, Group Against Smog and Pollution’s (GASP’s) EPA-funded fenceline monitoring partnerships, among other efforts — collectively give SWPA residents one of the densest community air quality information environments in the country. This is in addition to government air quality alert systems, such as the Allegheny County Health Department’s hourly air quality data, and U.S. EPA’s AirNow.
• Where the work goes next. Awareness and use of these tools vary significantly across communities, and the integration between resident-level monitoring data and regulatory enforcement remains incomplete. Promoting use of these tools in clinical, educational, and community-organizing settings — and tightening their connection to advocacy on emission standards and enforcement — extends their reach.
  • Example Objective: Increase the use of real-time air quality information among Mon Valley and other SWPA residents and support its connection to advocacy for stronger regulatory action.
  • Example Intervention Strategy: Promote awareness of and access to community air monitoring tools through community organizations, schools, and clinical practices, with explicit linkage to advocacy partners (GASP, the Breathe Project, PennEnvironment, ACCAN) working on air quality enforcement and emission standards.