The health burden and racial-ethnic disparities of air pollution from the major oil and gas lifecycle stages in U.S.

Karn Vohra https://orcid.org/0000-0001-6570-0663, Eloise A. Marais https://orcid.org/0000-0001-5477-8051, Ploy Achakulwisut
Science Advances
22 Aug 2025

Abstract
The United States has one of the world’s largest oil and gas (O&G) industries, yet the health impacts and inequities from pollutants produced along the O&G lifecycle remain poorly characterized. Here, we model the contribution of major lifecycle stages (upstream, midstream, downstream, and end-use) to air pollution and estimate the associated chronic health outcomes and racial-ethnic disparities across the contiguous US in 2017. We estimate lifecycle annual burdens of 91,000 premature deaths attributable to fine particles (PM2.5), nitrogen dioxide (NO2), and ozone, 10,350 PM2.5-attributable preterm births, 216,000 incidences of NO2-attributable childhood-onset asthma, and 1610 lifetime cancers attributable to hazardous air pollutants (HAPs). Racial-ethnic minorities experience the greatest disparities in exposure and health burdens across almost all lifecycle stages. The greatest absolute disparities occur for Black and Asian populations from PM2.5 and ozone, and the Asian population from NO2 and HAPs. Relative inequities are most extreme from downstream activities, especially in Louisiana and Texas.

INTRODUCTION
The United States (US) is the world’s largest oil and natural gas (O&G) producer (1). The O&G industry accounts for 8% of the US economy (2). Since around 2008, substantial expansion of O&G exploration and extraction and increasing consumption of O&G-derived products have been spurred by a combination of technological progress enabling the widespread production of unconventional O&G, cheaper O&G products, and decline in demand for coal (3, 4). Yet, there is growing recognition of the need to phase out O&G to meet the Paris Agreement’s temperature goal (5–7), as well as increasing concerns among the public, researchers, and policymakers over the local health impacts of air, water, and waste pollution from O&G activities in the US, particularly the disproportionate burden on marginalized groups (8–11).

The O&G lifecycle includes four major stages: “upstream” exploration and extraction; “midstream” storage and transmission; “downstream” alterations to the extracted material through processes like oil refining, gas processing, and synthesis of petrochemical products; and “end-use” activities that include additional storage and transmission to reach consumers and ultimate consumption of O&G products for energy and non-energy purposes. All these stages produce air pollutants that either directly harm public health or undergo reactions in the atmosphere to form additional health-damaging pollutants (12). Activities such as well drilling and completion, hydraulic fracturing, venting and flaring, oil refining, gas processing, and O&G combustion in the transportation and power sectors are all direct or precursor sources of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) (13–19). The O&G sector is the largest industrial source of volatile organic compounds (VOCs) in the US (20). O&G production also generates hazardous air pollutants (HAPs) and radioactive by-products, enhancing airborne radioactivity downwind of extraction sites (21, 22). The health outcomes of concern from long-term exposure to air pollutants from the O&G lifecycle include, but are not limited to, multi-cause premature deaths (23–25) and preterm births (26) for PM2.5, premature death from chronic respiratory diseases for O3 (27), childhood-onset asthma for NO2 (28), and cancers for HAPs (29). There are many more adverse health outcomes that have been attributed to specific O&G lifecycle stages that are more challenging to quantify, due to lack of robust information relating exposure to health risk. For upstream and midstream activities, these include migraines, fatigue, depression, high-risk pregnancy, gestational hypertension and eclampsia, sleeping disorders, and endocrine and developmental disruption such as neural tube and oral cleft defects (30–38). Downstream activities include low birth weight, spontaneous abortion, congenital malformations, and diseases of the kidney, liver, and thyroid (39). End-use activities include adverse reproductive outcomes and respiratory illnesses such as wheezing (40). It is also increasingly apparent that health risks linked to exposure to air pollutants from the O&G sector are most severe for marginalized ethnic communities in the US (9, 10, 41–44).

https://www.science.org/doi/10.1126/sciadv.adu2241?id=qxMAwSYJQM&twclid=2-2c2fz74xal1ldbc01ur4hqlaj

In summary:
Breathe Project@BreatheProject
A new study estimates the health cost of the oil and gas industry including lifecycle annual burdens of 91,000 premature deaths to PM2.5, nitrogen dioxide (NO2), and ozone as well as 216,000 incidences of NO2-attributable childhood-onset asthma.

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