Background: The United States has experienced a boom in natural gas production due to recent technological innovations that have enabled this resource to be produced from shale formations.Objectives: We reviewed the body of evidence related to exposure pathways in order to evaluate the potential environmental public health impacts of shale gas development. We highlight what is currently known and identify data gaps and research limitations by addressing matters of toxicity, exposure pathways, air quality, and water quality.Discussion: There is evidence of potential environmental public health risks associated with shale gas development. Several studies suggest that shale gas development contributes to ambient air concentrations of pollutants known to be associated with increased risk of morbidity and mortality. Similarly, an increasing body of studies suggest that water contamination risks exist through a variety of environmental pathways, most notably during wastewater transport and disposal, and via poor zonal isolation of gases and fluids due to structural integrity impairment of cement in gas wells.Conclusion: Despite a growing body of evidence, data gaps persist. Most important, there is a need for more epidemiological studies to assess associations between risk factors, such as air and water pollution, and health outcomes among populations living in close proximity to shale gas operations.Citation: Shonkoff SB, Hays J, Finkel ML. 2014. Environmental public health dimensions of shale and tight gas development. Environ Health Perspect 122:787–795; http://dx.doi.org/10.1289/ehp.1307866

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Increased energy demands and innovations in upstream oil and natural gas (ONG) extraction technologies have enabled the United States to become one of the world's leading producers of petroleum and natural gas hydrocarbons. The US Environmental Protection Agency (EPA) lists 187 hazardous air pollutants (HAPs) that are known or suspected to cause cancer or other serious health effects. Several of these HAPs have been measured at elevated concentrations around ONG sites, but most have not been studied in the context of upstream development. In this review, we analyzed recent global peer-reviewed articles that investigated HAPs near ONG operations to ( a) identify HAPs associated with upstream ONG development, ( b) identify their specific sources in upstream processes, and ( c) examine the potential for adverse health outcomes from HAPs emitted during these phases of hydrocarbon development.