Adverse health effects of industrial wind turbines

Response to Mr. Barnard's Rapid Response: "Authors Ignore Strong Evidence, Cite Weak Minor Studies

We are pleased to see the interest generated by our article in the CFP May issue. Much of the feedback has been constructive and should help advance awareness of the health risks of placing industrial wind turbines (IWTs) too close to humans.

However, the opinions expressed in Authors Ignore Strong Evidence, Cite Weak Minor Studies 1 by self-declared blogger Mike G. Barnard deserve comment.

For example, the Society for Wind Vigilance is not an anti-wind campaigning organization. It is a not-for- profit organization whose purpose is to ensure:

"Safe siting of wind turbine facilities based on human health research.

Education through the dissemination of facts and references on the risk of adverse health effects of human exposure to industrial wind turbines.

Working constructively with interested parties to ensure that guidelines for wind turbine facilities will protect the health and safety of communities; and to achieve vigilance monitoring and long term surveillance regarding the risks to health of industrial wind turbines." (2)

Society board members are peer reviewed authors on the effects of IWTs (3,4,5,6,7).

The term IWT:

Mr. Barnard states the term "industrial wind turbine" (IWT)is emotionally laden propaganda terminology.

Our use of the term "IWTs" is not intended to invoke an emotional response, but to differentiate consumer turbines from industrial scale turbines which have a blade radius of over 40 meters, are over 140 meters in height, generate multiple mega watts of electricity and produce approximately 105 dBA of sound power.

An indexed journal:

Mr. Barnard references our statement "Suggested causes of symptoms include a combination of wind turbine noise, infrasound, dirty electricity, ground current, and shadow flicker." and comments that the "... source for this deceptive and pseudoscience-laden statement is an article in an unindexed journal." 1

The reference cited Havas and Colling (2011)(8) is published in the Bulletin of Science Technology and Society which is indexed on multiple search engines including Google Scholar and Scirus.

About 18 reviews:

Mr. Barnard states we "do not cite the 18 reviews world wide of the peer-reviewed evidence ... that found no evidence of harm from wind turbines to human health ..." (1).

We were aware of and carefully reviewed the 18 articles. We found significant weaknesses including the failure to consider indirect health effects. Horner et al (2011) conducted an audit and commented on the completeness, accuracy and objectivity of these references (5).

One of the "18 reviews" cited in our article is Colby et al (2009) (9), a panel literature review sponsored by The American Wind Energy Association and the Canadian Wind Energy Association.

Colby et al. (2009) co authors, Dr. David Colby and Dr. Geoff Leventhall, have provided consulting services to members of the wind energy industry and wind industry trade associations. In other references, Dr. Colby (10) and Dr. Leventhall (11) state:

"It appears that there is no specific Wind Turbine Syndrome, but there are stress effects from low levels of noise, either high frequency or low frequency noise, which affect a small number of people. It is the audible swoosh- swoosh which, when it occurs, is the cause ...",

In a 2009 reference Dr Leventhall states:

"I am happy to accept these symptoms, as they have been known to me for many years as the symptoms of extreme psychological stress from environmental noise... what Pierpont describes is effects of annoyance by noise - a stress effect" (12).

Other references listed in the "18 reviews" support our conclusions. For example, the Minnesota Department of Health (2009) concludes:

"The most common complaint in various studies of wind turbine effects on people is annoyance or an impact on quality of life. Sleeplessness and headache are the most common health complaints and are highly correlated (but not perfectly correlated) with annoyance complaints. Complaints are more likely when turbines are visible or when shadow flicker occurs. Most available evidence suggests that reported health effects are related to audible low frequency noise." (13)

In addition, the National Research Council (2007) states: "...to the extent that wind-energy projects create negative impacts on human health and well-being, the impacts are experienced mainly by people living near wind turbines who are affected by noise and shadow flicker." (14)

Noise annoyance - a health effect:

Symptoms associated with noise annoyance include stress, sleep disturbance, headache, difficulty concentrating, irritability, fatigue, dizziness or vertigo, tinnitus, anxiety, heart ailments, and palpitation (15,16,17).

Health Canada's Dr. David Michaud states:

"According to the World Health Organization (WHO), health should be regarded as "a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity" (World Health Organization 2001). Under this broad definition, noise induced annoyance is an adverse health effect." (18)

According to the WHO (19) "Noise seriously harms human health and interferes with people's daily activities at school, at work, at home and during leisure time ..." and notes the main health risks of noise identified include annoyance.

Maschke and Niemann (2006) of the WHO pan-European LARES study state:

"The results of the LARES study in relation to severe annoyance by neighbourhood noise demonstrate that neighbourhood noise must be classified as a serious health endangerment for adults." (20)

Health effects expected:

Mr. Barnard comments: "Wind turbine noise under Canada's setbacks is a non-issue as they are formulated to achieve WHO noise annoyance compliance." (1)

WHO (1999) (21) and WHO (2009) (22) do not provide noise annoyance compliance criteria for IWTs.

Some governments in Canada have developed IWT noise limits which are expected to result in adverse health effects.

In June 30, 2009, then a federal Minister and Member of Parliament, the Honourable Rona Ambrose, states:

"Health Canada provides advice on the health effect of noise and low- frequency electric and magnetic fields from proposed wind turbine projects, particularly for environmental assessments done under the Canadian Environmental Assessment Act. To date, their examination of the scientific literature on wind turbine noise is that the only health effect conclusively demonstrated from exposure to wind turbine noise is an increase of self-reported general annoyance and complaints (i.e., headaches, nausea, tinnitus, vertigo)." (23)

On July 16, 2013, it was reported that Rona Ambrose is the Hon. Minister of Health, Health Canada.

Health Canada employees have proposed a "justification" for a 45 dBA IWT sound level criteria (24,25,26). The authors predict this noise criteria will result in an increase in percentage highly annoyed.

Based on dose response data for wind turbines Health Canada Wind Turbine Noise Study Team Member, Sabine Janssen, reports with a highest allowed immission level of 45 dB(A) it could be expected that "... less than 14% of the exposed population to be highly annoyed indoors by wind turbines and less than 29% to be highly annoyed outdoors." (27)

A Freedom of Information request from the Ontario Ministry of Environment states:

"It appears compliance with the minimum setbacks and the noise study approach currently being used to approve the siting of WTGs will result or likely result in adverse effects ...". (28) HGC Engineering is a member of the Canadian Wind Energy Association. Mr. Brian Howe, president of HGC Engineering "... speaks frequently at Canadian Wind Energy Association (CanWEA) Symposiums ... prepared a "best practices" guide for CanWEA (2007) and provided input for the assessment methods in the Ontario Green Energy and Green Economy Act (2009)." (29)

The Ontario Ministry of Environment report prepared by HGC Engineering (HGC, 2010) concludes:

"The audible sound from wind turbines, at the levels experienced at typical receptor distances in Ontario, is nonetheless expected to result in a non-trivial percentage of persons being highly annoyed ... [r]esearch has shown that annoyance associated with sound from wind turbines can be expected to contribute to stress related health impacts in some persons." (30)

Conclusion

Mr. Barnard comments that health effects are related to the negative attitude of the individual exposed to IWTs. Some researchers have found that the IWTs were initially welcomed into communities for their perceived economic 7 and/or environmental (31) benefits. "The reported adverse impacts were unexpected." (4) The 2011 Ontario Real Estate Association Form 220 (32) requires a residential Seller Property Information Statement disclosure of environmental issues including "toxic waste", "soil contamination", "land fills" and "wind turbines" planned for the immediate area.

The adverse health effects of audible and inaudible noise are significant. Their effects are underestimated and under appreciated by some. We are guided by the references and the desire to safeguard the health and well-being of those living in the environs of IWTs. Harm can be avoided by siting IWTs a protective distance from residents. The acknowledgment that health effects occur in some is an important step towards achieving this goal.

References

1. Mike G. Barnard. Authors ignore strong evidence, cite weak minor studies. Available from: http://www.cfp.ca/content/59/5/473/reply. Accessed 2013 May 22.

2. The Society for Wind Vigilance. Canada Not-for-profit Corporations Act form 4031 Articles of Continuance.Jun 19, 2012

3. Krogh CME, Gillis L, Kouwen N, Aramini J. WindVOiCe, a self- reporting survey: adverse health effects, industrial wind turbines, and the need for vigilance monitoring. Bull Sci Technol Soc 2011;31(4):334-45.

4. Krogh CME. Industrial wind turbine development and loss of social justice? Bull Sci Technol Soc 2011;31(4):321-33.

5. Horner B, Jeffery RD, Krogh CME. Literature reviews on wind turbines and health: are they enough? Bull Sci Technol Soc 2011;31(5):399-413.

6. Hanning CD, Evans A. Wind turbine noise. BMJ 2012;344:e1527.

7. Nissenbaum MA, Aramini JJ, Hanning CD. Effects of industrial wind turbine noise on sleep and health. Noise Health 2012;14(60):237-43.

8. Havas M, Colling D. Wind turbines make waves: why some residents near wind turbines become ill. Bull Sci Technol Soc 2011(5);31:414-26.

9. Colby WD, Dobie R, Leventhall G, Lipscomb DM, McCunney RJ, Seilo MT, et al. Wind turbine sound and health effects. An expert panel review. Washington, DC: American Wind Energy Association, Canadian Wind Energy Association; 2009. Available from: www.canwea.ca/pdf/talkwind/Wind_Turbine_Sound_and_Health_Effects.pdf. Accessed 2013 Mar 27.

10. Dr. Colby's presentation to Nova Scotia Department of Energy. March 4, 2010

11. Leventhall, H. G., Wind Turbine Syndrome: An Appraisal. February 2010, Retrieved from: http://www.windustry.org/wind-turbine-syndrome-myths-and-facts-webinar

12. Leventhall, H. G. (2009, October). Wind turbine syndrome: An appraisal. Testimony before the Public Service Commission of Wisconsin (PSC Ref#121877 20). Retrieved from http://www.co.whatcom.wa.us/pds/pc/pdf/20101115- noise-vibrationtestemony-geoff-leventhall_1.pdf

13. Minnesota Department of Health [website]. Public health impacts of wind turbines. St Paul, MN: Minnesota Department of Health; 2009. Available from:www.health.state.mn.us/divs/eh/hazardous/topics/windturbines.pdf. Accessed 2013 Mar 26.

14. National Research Council. (2007). Committee on environmental impacts of wind-energy projects. Environmental impacts of windenergy projects. Washington, DC: National Academies Press.

15. Leventhall, G. (with Pelmear, P., & Benton, S.). (2003). A review of published research on low frequency noise and its effects. Retrieved from http://westminsterresearch.wmin.ac.uk/4141/

16. Leventhall, H. G. (2004). Low frequency noise and annoyance. Noise & Health, 6, 59-72.

17. Schust, M. (2004). Effects of low frequency noise up to 100 Hz. Noise Health, 6, 73-85.

18. Michaud DS, Keith SE, McMurchy D. Noise annoyance in Canada. Noise Health 2005;7(27):39-47.

19. WHO, WHO-Europe - Noise and health - Home web site Cited March 15, 2009

20. Niemann H, Bonnefoy X, Braubach M, Hecht K, Maschke C, Rodrigues C, Robbel N. (2006) Noise-induced annoyance and morbidity results from the pan-European LARES study. Noise Health 2006;8:63-79

21. Berglund, B., Lindvall, T., & Schwela, D. H. (1999). Guidelines for community noise. Geneva, Switzerland: World Health Organization.

22. World Health Organization Europe. Night noise guidelines for Europe. Copenhagen, Denmark: World Health Organization Europe; 2009. Available from: www.euro.who.int/__data/assets/pdf_file/0017/43316/E92845.pdf. Accessed 2013 Mar 27.

23. Correspondence from the Honourable Rona Ambrose, June 30, 2009

24. Keith SE, Michaud DS, Bly SHP (n.d.), A justification for using a 45 dBA sound Level Criterion For Wind Turbine Projects

25. Keith SE, Michaud DS, Bly SHP (2007), A proposal for evaluating the potential health effects of wind turbine noise for projects under the Canadian Environmental Assessment Act. Second International Meeting on Wind Turbine Noise, Lyon France September 20 -21 2007

26. Keith SE, Michaud DS, Bly SHP (2008), A proposal for evaluating the potential health effects of wind turbine noise for projects under the Canadian Environmental Assessment Act. J Low Freq Noise V A 2008, 27:253-265.

27. Janssen Sabine A., Vos Henk , Eisses, Arno, Pedersen Eja. (2011) A comparison between exposure-response relationships for wind turbine annoyance and annoyance due to other noise sources, J. Acoust. Soc. Am. 130 (6), December 2011

28. Ontario Ministry of Environment, Internal Correspondence, Obtained through Freedom of Information request (2011).

29. Howe Gastmeier Chapnik Limited web site, Retrieved from http://www.acoustical-consultants.com/about-hgcengineering- acoustical-engineers/vibration-and-noise-control-management-team/brian- howe-hgc-engineering/ cited March 10, 2013

30. Howe Gastmeier Chapnik Limited. Low frequency noise and infrasound associated with wind turbine generator systems. A literature review. Toronto, ON: Ontario Ministry of the Environment; 2010. Available from: www.ene.gov.on.ca/stdprodconsume/groups/lr/@ene/@resources/documents/resource/stdprod_092086.pdf. Accessed 2013 Mar 27.

31. Shepherd D, McBride D, Welch D, Dirks KN, Hill EM. Evaluating the impact of wind turbine noise on health-related quality of life. Noise Health 2011;13(54):333-9.

32. Ontario Real Estate Association. Seller property information statement form 220 for use in the province of Ontario. Revised 2011.

Conflict of Interest:

Dr Jeffery, Ms Krogh, and Mr Horner are on the Board of Directors for the Society for Wind Vigilance, an international federation of physicians, acousticians, engineers, and other professionals who share scientific research on the topic of health and wind turbines.

I have known about turbines for a few years, but was not worried until I heard about infrasound noise effects. Here is a link to an Audiologist and professor Washington University (St. Louis):

http://oto2.wustl.edu/cochlea/wind.html

He is speaking out both as an audiologist, and as a scientist doing research on the inner ear. Look at his refernces and see published papers that show infrasound (at levels turbines produce) is *measureable* in animal studies.

Any scientist should be concerned! The question is not whether infrasound causes hearing problems, it is at what *level* and *exposure* we should expect problems.

Finally, I have been motivated to record wind turbines for myself. For samples and discussion please visit my page:

http://Soundmann.com

Richard Mann, Waterloo ON

Conflict of Interest:

I own a cottage in the Samsung area (Dunnville, Haldimand)

Let's see if a patients perspective is accepted by this publication. The authors are correct in their assessments. Our family physicians of many years knew the only change in our life was the industrial wind complex. And when we were out of the wind site our symptoms improved. Our doctors did not work in the same clinics or even in the same towns. They did not care about policy, energy production, ideology or letters after their name. Our physicians cared for each of the 11 family members, as do other family physicians in Ontario. As was/has been offered to all governing officials, government engineers, health professionals, researchers and anyone else, go to our homes and do the research that has been presented by peer reviewed references in this article.

Your words are easy to write...but when the actual human trial walks into your office for your care...what then? As a teacher of 32 years I never stop learning and neither should our health professionals.

Here is evidence from not one, but 5 families within one project as presented to Standing Committee on The Green Energy and Economy Act, April 15,2009, The last group, The Ripley Group. http://www.ontla.on.ca/web/committee- proceedings/committee_transcripts_details.do?locale=en&BillID=2145&ParlCommID=8856&Date=2009 -04-15&Business=&DocumentID=23801

Our goal on this day was to fix the mess at our site and prevent the harm from happening to others.

Sandy MacLeod

Conflict of Interest:

None declared

As physicians, it is our responsibility to ensure that we are scientific and evidence-based in our approaches, and that we do not contribute to misinformation. Andrew Wakefield's fraudulent 1998 paper on the alleged link between the MMR vaccine and autism, and the ensuing vaccine scare it created, clearly demonstrates the potential for physicians to create alarm and influence public opinion within the general population (1). Similarly, the extensive media coverage devoted to the alleged pattern of adverse health effects of wind turbines understandably creates an anticipatory fear in some that they will experience adverse effects from wind turbines. Professor Simon Chapman, noting that complaints arise after exposure to anti-wind turbine publicity, has termed "wind turbine syndrome," coined by Dr. Nina Pierpont (2), a "communicated" disease (3) (a disease that spreads by being talked about). It is imperative that an evidence-based, informed approach is taken when investigating the human health effects of exposure to wind turbines.

In this article, the authors' statement that "owing to the lack of adequately protective siting guidelines, people exposed to IWTs can be expected to present to their family physicians in increasing numbers" is both alarmist and inappropriate. The Ontario Ministry of the Environment has established specific noise level exposures, which are consistent with World Health Organization (WHO) recommendations. The Ontario guidelines specify a minimum wind turbine setback of 550 meters in order to ensure that the sound limit modeled and measured at the nearest residence does not exceed 40 decibels averaged hourly (4). The WHO Night Noise Guidelines for Europe specify that 40 decibels averaged annually should be the target for the night noise guideline to protect the public, including vulnerable groups such as children, the elderly, and those who are chronically ill (5). As a result, the Ontario guidelines are compliant with the WHO recommendations and exceed them, given that they specify an hourly average. Furthermore, the Ministry of the Environment has developed a compliance protocol for wind turbine noise, whereby the Ministry will review any concerns regarding wind turbine noise and investigate them fully (4). In the event that there are complaints regarding sound exposure, physicians should be aware that they can recommend their patient to contact the Ministry of the Environment's Spills Action Centre to log those complaints and request to have measurements done to ensure compliance (6).

An evidence-based, informed approach should be taken when investigating any environmental exposure. Taking a proper exposure history of any patient who complains of possible environmental exposures causing health problems is imperative. The CMAJ article entitled, "Identifying and managing adverse environmental health effects: taking an exposure history," (7) outlines the standard questions for taking an exposure history. This should include information on the community in which the person lives, hobbies, description of the home, occupation, personal habits, diet and drugs used (7). Core elements of an exposure history are also outlined in Table 2 in "Case studies in environmental medicine: taking an exposure history," published by the US Department of Health and Human Services (8). Through this exposure assessment, existing medical problems should be clearly documented. These are the natural fluctuations in chronic disease that may be temporally associated with wind turbine exposure, but not necessarily causatively associated. In this instance, the main question at hand is whether exposure to wind turbine technology can possibly cause the myriad of symptoms and health complaints that have been presented.

To be able to state that one's symptoms are caused by a particular event or exposure is a complex science. A number of guidelines have been developed to enable a critical evaluation of evidence from epidemiological studies to infer a causal relationship. Sir Bradford Hill's criteria (9) for establishing causation provide a framework through which to determine causal associations. An important criterion for causation is biological plausibility, which seeks to determine whether, based on current scientific evidence and knowledge, there is a known biological mechanism that could cause the outcome observed from the exposure. Given the high prevalence of chronic conditions in our aging population (10), new onset and exacerbations of illness will be temporally associated with exposure to wind turbines by random chance alone. Therefore, even in cases where exposure to wind turbine noise precedes a patient's medical complaints, this is not sufficient evidence to infer causation. The health complaints that have been reported, including headache, fatigue, dizziness, nausea, insomnia, and depression, are very common, nonspecific clinical conditions and are subjective in nature. The Chief Medical Officer of Health Report on Wind Turbines states that "while some people living near wind turbines report symptoms such as dizziness, headaches, and sleep disturbance, the scientific evidence available to date does not demonstrate a direct causal link between wind turbine noise and adverse health effects" (11). No biologically plausible mechanism has been described to account for a causal link between wind turbine noise and reported symptoms.

Another criterion is biological gradient or dose response pattern, whereby an individual who has greater exposure will be more likely to experience symptoms than an individual with less exposure. There is evidence that exposure to sound levels greater than 75 decibels can result in a human health effect, such as hearing loss (12). However, there is no evidence that biological effects observed below the stipulated level of 40 decibels are harmful to health (5). According to the Chief Medical Officer of Health report, "the sound level from wind turbines at common residential setbacks is not sufficient to cause hearing impairment or other direct adverse health effects" (11). As discussed above, the symptoms included within Dr. Robert McMurtry's case definition are common, nonspecific, and highly subjective symptoms that are often linked to medical problems that are unrelated to wind turbine exposure. While Dr. McMurtry's case definition has been published (13), it has not been validated or accepted by the mainstream medical community, and has not been coded in the International Classification of Diseases.

A scientific, evidence-based approach necessitates an understanding of the strength of evidence. The strongest scientific evidence comes from double-blind, randomized, placebo-controlled trials, whereas the weakest evidence comes from case series. In their classic text, Experimental and Quasi-Experimental Designs for Research, Campbell and Stanley state that case series have a total absence of controls and are thus of almost no scientific value (14). Case series are anecdote, not science. They generate hypotheses but they must be validated. Appropriate controls and comparisons are required for more robust experimental design and hence reliable and valid conclusions. Much of the evidence demonstrating the alleged link between wind turbine exposure and health effects has been methodologically flawed due to small sample sizes, the potential for substantial selection bias, and flawed sampling methods. For example, Nissenbaum et al.'s (15) findings have been questioned due to a lack of sound measurements in the original study, a small number of participants (n=78), the fact that the purpose of surveys was not hidden from participants, which would introduce selection bias, and the lack of effort to control for the impact of anti-wind farm propaganda. The results of the study by Shepherd et al. (16) must also be interpreted with caution due to a number of methodological flaws, including a small sample size (n=39), flawed sampling leading to a potential for selection bias, a lack of noise exposure levels for the control group, and a lack of information collected on whether turbines were visible or participants' attitudes towards wind turbines. It is also of note that Shepherd et al.'s results are directly contradicted by the findings of a much larger study of 1277 participants, which found that self-reported quality of life was highest for residents living closest to wind farms and lowest for those living more than 1500 metres from wind farms (17).

The authors cite the 1948 WHO definition of health, which is the "state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (18). Using this definition, the authors argue that indirect effects, such as annoyance, constitute adverse health effects resulting from wind turbine exposure. In 1986, the WHO defined health as "the extent to which an individual or group is able to satisfy needs, realize aspirations, and to change or cope with the environment. Health is a resource for everyday life, not the object of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities" (19). Highlighting the ability of an individual to change or cope with the environment emphasizes the importance of acquiring the skills and resources necessary for resilience. Hence, one of the key components of health would include resiliency and the ability to respond to and recover from annoyances. Resilience will be a health asset, a capability, and a positive adaptation that will allow people to cope with adversity and to reach their full potential.

Noise annoyance is a subjective reaction related to a number of individual and situational variables, aside from the characteristics of the noise (20). In regards to wind turbine exposure, credible, peer- reviewed studies have shown that annoyance and health complaints are more strongly related to being able to see the turbines, the attitude towards them, and whether economic benefit is derived from them than the turbine sound itself (21,22). Annoyance is a state that is under the control of the individual. It must also be stated that annoyance is not a medical condition and does not have a DSM-IV associated diagnosis. Defining annoyance as a health effect brings up a number of philosophical and methodological challenges. Recognizing these, the WHO has taken the approach of excluding annoyance as a health outcome in assessing the global burden of disease (12). If we medicalize annoyance, we will be opening a Pandora's box that we will be unable to close.

To date, the scientific literature does not provide convincing evidence of direct, adverse health effects resulting from wind turbine exposure. The Ministry of the Environment has established appropriate, evidence-based regulations and a compliance protocol for wind turbines in Ontario in order to protect the public. Given the current regulated sound pressure levels and setbacks, physicians can be confident that patients living in the vicinity of wind turbines are not being exposed to sound intensities that will cause harm to human health.

Kieran Moore, MD, CCFP(EM), FCFP, FRCPC, MPH, W. David Colby, MSc, MD, FRCPC, Erin McSorley, BA, MPH Candidate

References

1. Godlee F, Smith J, Marcovitch H. Wakefield's article linking MMR vaccine and autism was fraudulent. BMJ 2011;342:c7452.

2. Pierpont N. Wind turbine syndrome: a report on a natural experiment. Santa Fe, NM: K- Selected Books; 2009.

3. Chapman S. The sickening truth about wind farm syndrome. New Scientist 2008 Oct 8; 2885.

4. Ontario Ministry of the Environment. Compliance protocol for wind turbine noise: guideline for acoustic assessment and measurement. Toronto: Ministry of the Environment.

5. World Health Organization. Night noise guidelines for Europe. Geneva: World Health Organization; 2009.

6. Ontario Ministry of the Environment [website]. Wind energy: compliance and enforcement;[updated 2011 Sept; cited 2013 June 1]. Available from http://www.ene.gov.on.ca/environment/en/subject/wind_energy/STDPROD_089073.html.

7. Marshall L, Weir E, Abelsohn A, Sanborn MD. Identifying and managing adverse environmental health effects: taking an exposure history. CMAJ 2002 Apr 16;166(8):1049-55.

8. Agency for Toxic Substances and Disease Registry. Case studies in environmental medicine: taking an exposure history. U.S. Department of Health and Human Services; 2000.

9. Webb P, Bain C. Essential epidemiology: an introduction for students and health professionals. 2nd ed. Cambridge: Cambridge University Press; 2011.

10. Fiest KM, Currie SR, Williams JVA, Wang J. Chronic conditions and major depression in community-dwelling older adults. J Affect Disord 2011 Jun;131(1-3):172-8.

11. Chief Medical Officer of Health. The potential health impact of wind turbines. Toronto: Ministry of Health and Long-Term Care; 2010.

12. Concha-Barrientos M, Campbell-Lendrum D, Steenland K. Occupational noise: assessing the burden of disease from work-related hearing impairment at national and local levels.Geneva: World Health Organization; 2004.

13. McMurtry RY. Toward a case definition of adverse health effects in the environs of industrial wind turbines: facilitating a clinical diagnosis. Bull Sci Technol Soc 2011;31(4):316-20.

14. Campbell DT, Stanley JC. Experimental and quasi-experimental designs for research. Belmont: Wadsworth Publishing; 1966.

15. Nissenbaum MA, Aramini JJ, Hanning CD. Effects of industrial wind turbine noise on sleep and health. Noise Health 2012;14(60):237-43.

16. Shepherd D, McBride D, Welch D, Dirks KN, Hill EM. Evaluating the impact of wind turbine noise on health-related quality of life. Noise Health 2011;13(54):333-9.

17. Mroczek B, Kurpas D, Karakiewicz B. Influence of distances between places of residence and wind farms on the quality of life in nearby areas. Ann Agric Environ Med 2012;19:692-6.

18. World Health Organization. Definition of health. In: Preamble to the Constitution of the World Health Organization. Geneva: World Health Organization; 1948. Available from www.who.int/about/definition/en/print.html. Accessed 2013 June 1.

19. Ottawa Charter for Health Promotion. First international conference on health promotion. 1986 Nov 21; Ottawa: World Health Organization.

20. Fields JM. Effect of personal and situational variables on noise annoyance in residential areas. J Acoust Soc Am 1993;130:3746-53.

21. Pederson E, Perrson WK. Perception and annoyance due to wind turbine noise: a dose-response relationship. J Acoust Soc Am 2004;116:3460 -70.

22. Pederson E, van den Berg F, Bakker R, Bouma J. Response to noise from modern wind farms in the Netherlands. J Acoust Soc Am 2009;126(2):634 -43.

Conflict of Interest:

None declared

Dr.Pellizari correctly raises the issue of "amplitude modulation" (AM) or "blade swoosh." One of the best analyses of wind project noise was submitted by Richard James, a founding member of the INCE, who provided expert testimony at the ERT hearing for Suncor's Kent Breeze wind project. In particular he spoke about the known effects of wind shear which "enhance" the blade-swoosh noise.

Under normal day-time conditions, blade-swoosh is 1-3 dBA, barely noticeable. Under conditions of night-time wind shear, actual field measurements show impulsive AM increases 5-15 dBA (see pg.4 of Mr.James' report, link below). As Mr.James stated, this is no longer a "swoosh", it is a distinctive, audible "thump" that will cause sleep disturbance. Repeat over a period of time and lots of physiological symptoms will develop.

SW Ontario is known for its very high values for night-time wind shear. The "wind masts" set up by wind companies are providing confirming data. From pg.7 of Mr.James' report, "A high wind shear at night is very common and must be regarded a standard feature of the night time atmosphere in the temperate zone and over land." The wind industry knows this is so. Building taller turbines with longer blades more efficiently accesses this phenomenon, leading to a greater percentage of power production from night -time operations. The MOE has had an "impulsive noise" (AM) penalty developed 40 years ago for industries such as metal stamping plants. A 5 dBA penalty is assessed to such operations. The MOE refuses to apply the penalty to the wind industry, ignoring the complaints of excessive AM which have been verified by its own field officers' reports. James also provides a very good discussion of infrasound and low frequency noise (LFN).

Mr. James was one of the first acousticians to identify LFN from heating/ventilation (HVAC) systems as a cause (there are others) of "sick building syndronme." Mr.James submissions about amplitude modulation (AM) and wind shear effects was unchallenged by either counsel or any other witnesses. Unfortunately neither the industry nor the MOE have made any positive move to address this noise issue. No wonder rural citizens are so cynical about our administrative organizations.

Richard James Report:

http://ckwag.org/pdfs/James%20Report%20CKWA-1.pdf

Conflict of Interest:

The interest is direct. I live in a township that will have 3 wind projects totaling 70 turbines.

As co-ordinator of VOW (Victims of Wind) in Ontario I can guarantee the harm to families impacted by wind turbines and the infrastructure is genuine and it is an appalling situation. Documentation of health impacts have been reported through formal government channels, through ministry reporting protocols, through health care workers,through politicians, standing committee testimony and first-hand accounts through media.

This is not some mysterious phenomenon but is a direct result of loud, cyclical noise being imposed on sleeping residents, low frequency noise penetrating buildings causing vibration and events of dirty electricity. This has been documented by testimony, engineering reports and research worldwide.

The Ontario government was warned both by hired acousticians and by senior ministry field officers that the impacts being reported were not frivolous and will affect a non-trivial percentage of the population - their own words. When it comes to conversations on medical authorities and independent researchers make note that after repeated requests, ministry and health agency authorities have refused to meet with impacted residents but out of genuine concern and duty of care, independent researchers have. I have many communications to support my statement. We are told that public health departments are not equipped to deal with this new public health issue and do not have the mandate or funds to wade into it.

The continued attempt to discount the staggering documentation and research, thousands of filed complaints and abandoned homes over the past 7 years is stunning.

My husband and I were happy, healthy and thriving before an industrial turbine project began operating around our home. We had welcomed the turbine project but our health declined rapidly from sleep deprivation and adverse health events brought on by audible and low frequency noise and electrical problems and we had to leave our home. We are just one of many impacted families. People do not leave their homes on a lark and when you have multiple families across this province who have, along with those who are unable to but are complaining about the same conditions then common sense dictates the first place you would start to investigate would be talking to the affected families. There has been no effort to communicate, conduct research or even offer temporary mitigation measures by the government. Instead, impacted families have been shut out of the process and independent professionals are conducting the research that the government should have.

What would be appreciated by all affected was if serious effort was devoted to actually reading the research instead of generating opinion based on personal belief systems. It would open some eyes.

Conflict of Interest:

Co-ordinator of a community support network for impacted families

From the use of the inflammatory qualifier "industrial" in the title to the declaration of "Competing Interests" at the end, this article is anti-wind turbine propaganda. Although designated as "Commentary", the peer reviewed status implies some level of endorsement. I asked almost every physician with expertise about wind turbines and health in Canada if they had been asked to review this article and none had.

The article is replete with unreferenced and often alarmist statements, selective citations (e.g. quoting the WHO definition of health to support the concept that annoyance itself is a health effect, without mentioning that the WHO does not use annoyance as a measured health end point) (1) and statements relying on unscientific references. If these were edited from the article, little would remain.

The omission of discussion about the plethora of evidence that contradicts the thesis of the authors(2) is especially troubling for a peer-reviewed article in a leading journal.

Aldous Huxley said "Great is truth, but still greater from a practical point of view, is silence about truth. By simply not mentioning certain subjects...propagandists have influenced opinion much more effectively than they could have by the most eloquent denunciations."

The physicians who might form their opinion based on this article deserve a more scientific and balanced discussion.

W. David Colby, MSc, MD, FRCPC

1. Concha-Barrientos M, Campbell-Lendrum D, Steenland K 2004. Occupational noise:assessing the burden of disease from work-related hearing impairment at national and local levels (WHO Environmental Burden of Disease No.9) WHO Geneva. 2. Simonetti T, Chapman S, 2012. Summary of main conclusions reached in 17 reviews of the research literature on wind farms and health. U of Sydney http://tobacco.health.usyd.edu.au/assets/pdfs/WindHealthReviews.docx

Conflict of Interest:

None declared

The article was an examination of the human health impact of wind turbines, not an exhaustive comparative analysis of the positive and negative aspects of all forms of electricity generation. Thus I fail to see what relevance emissions from other forms of generation would have to this article.

The single largest source of GHG emissions in the provincef Ontario, according to Statistics Canada, is transportation, then electricity generation followed very closely by agriculture and industry.

As to a wind farm's lack of toxic emissions, I submit that we have merely exported them to developing nations, where we can't see them and aren't directly affected by them:

A typical 100 MW wind project would generate approximately:

a) 20,000 square meters of destroyed vegetation,

b) 6 million cubic meters of toxic air pollution,

c) 33 million gallons of poisoned water,

d) 600 million pounds of highly contaminated tailing sands, and

e) 100,000 pounds of radioactive waste.

This might be an acceptable environmental impact if we were to receive something of greater value in return. However many studies using empirical data such as Bentek's have shown that Wind Generation does not reduce fossil fuel consumption, nor does it reduce CO2 emissions due to the type of fossil fuel generation used to back Wind up and the inefficiencies Wind generates in the conventional plants backing it up.

Ultimately Wind Generation is dependent on fossil fuels and coal cradle to grave, it can't even operate without being connected to a grid powered by conventional generation.

Conflict of Interest:

None declared

We agree with the observations that individuals that are angry or annoyed are bound to experience symptoms such as stress or sleep disturbance. Empathy from their primary care provider is always a good approach. However, the commentary, as a whole, was hyperbolic and not something that family physicians should rely upon for advice or as a reference.

The statement that "industrial wind turbines can harm human health if sited too close to residents" was misleading and could be interpreted as a reality rather than a caution. In fact, the tone of Dr. Jeffery and colleagues' commentary, right from the use of "industrial" in the title to the characterization of "serious" harm from stress-related symptoms was disproportionate to the actual risk and will now, no doubt, be used to further fuel the debate (1).

We'd like to recommend an alternate source of evidence-informed information, produced by the National Collaborating Centre for Environment and Health (NCCEH) in 2010 and recently revised in 2013, is available on line at: http://www.ncceh.ca/sites/default/files/Wind_Turbines_Feb_2013.pdf

Sound and noise are both considered in this review. A comparison of wind turbines to other sources of noise, compiled into a figure, shows that at setbacks of 350 metres, the noise from wind turbines is equivalent to indoor background sound, or 35 to 50 dBA (2). The NCCEH review also describes how the aerodynamic modulation of turbine noise (swishing sound) may make it more annoying than steady sound. Studies from Europe have estimated that 14% of the population will be highly annoyed, indoors, by this sound. But it is important to note that research shows that annoyance with wind turbine sound is modified by visual perception, a belief that the turbines are intrusive, and a lack of direct economic benefit. Surely, there is more at play here than just the noise exposure.

Additionally, the World Health Organization (WHO) guidelines on night noise concluded that there was no sufficient evidence that biological effects observed at levels below 40dB are harmful to health (3). Here in Ontario, current setbacks are 550 metres, making noise a non-health issue.

We found it striking that much of the evidence for the adverse effects reported in the commentary was no stronger than a case report. Health Canada is currently conducting a cross-sectional field study to evaluate self-reported health impacts and symptoms if illness against objective bio-markers of stress and the sound levels of wind turbines, including low frequency noise. The results will be available in 2014.

In the meantime, a nation-wide telephone survey was conducted asking Canadians about environmental noise that they are annoyed by and 5.9% and 13.8% were extremely annoyed and very annoyed respectively...by children outside their home! (4). Shall we ask for setbacks for kids as well?.

Rosana Pellizzari, MD, CCFP, MSC, FRCPC and Farhan Asrar MD, MSc, MPH

Correspondence: Dr. Rosana Pellizzari, Medical Officer of Health, Peterborough County-City Health Unit, 10 Hospital Drive, Peterborough, ON K9J 8M1; email rpellizzari@pcchu.ca

References:

1) Jeffery RD, Krogh C, Horner B. Adverse health effects of industrial wind turbines. Can Fam Physician May 2013 59: 473-475

2) Rideout K, Copes R, Bos C. Wind Turbines and Health. National Collaborating Centre for Environmental Health February 2013 accessed on line at http://www.ncceh.ca/sites/default/files/Wind_Turbines_Feb_2013.pdf

3) World Health Organization Europe. & Hurtley, Charlotte. & World Health Organization. Regional Office for Europe. (2009). Night noise guidelines for Europe. Copenhagen, Denmark: World Health Organization Europe, http://www.euro.who.int/__data/assets/pdf_file/0017/43316/E92845.pdf

4) Michaud D S, Keith S E, McMurchy D. Noise annoyance in Canada. Noise Health 2005;7:39-47

Conflict of Interest:

None declared

If you want to write something worthwhile then challenge our Prime Minister for his unbelievable shortsightedness of the massive oilsand pollution in this country. Sorry but your article is a waste of space as physicians have little time to read such dribble.

Conflict of Interest:

None declared

Mr. Gideon Forman did not mention that a typical 100 MW wind project generates twenty thousand square metres of destroyed vegetation, six million cubic metres of toxic air pollution, thirty-three million gallons of poisoned water, six hundred million pounds of highly contaminated tailing sands, and one hundred thousand pounds of radioactive waste (source: John Droz, physicist and environmental activist).

Mr. Forman said that "Windmills...do not produce smog; do not produce elements of acid rain; and do not contribute to climate change". Firstly, the wind structures being used in Ontario are industrial wind turbines not windmills. Windmills are much smaller and have a simple mechanism usually employed for pumping water. Industrial wind turbines connected to the grid must be backed up by fossil fuel (coal, oil, natural gas)generators. Because wind is unpredictable, fossil fuel generators must be available to take over when the wind decreases or stops completely. When the wind generators are producing electricity, fossil fuel generators are required to run also. In fact, as the wind increases and decreases, fossil fuel generators ramp up and down to take over and to back off production. The result, which is well known, is to produce and release to the atmosphere more carbon dioxide than would be the case for a fossil fuel generator operating at a constant rate. There is no saving on carbon dioxide emissions. In Denmark, after a few thousand industrial wind turbines had been installed, no fossil fuel generators had been shut down and in 2006 emissions of carbon dioxide had increased by 36 percent. (source: Michael Trebilcock, Law and Economics, University of Toronto).

Mr. Forman said, referring to industrial wind turbines, "they help us to phase-out energy sources which do cause these adverse effects". However, the Ontario government is building new gas plants (eg. Oakville and Mississauga were chosen to host these) because as more industrial wind turbines are put into service, more fossil fuel backup must be available. The truth is - industrial wind generation depends on fossil fuel backup. It does not help us to phase out fossil fuel use. It increases our dependency on fossil fuels.

Mr. Forman mentions that CAPE researchers cited a 2008 German study on nuclear power plants. Germany is in the process of shutting down its nuclear power plants and is planning to erect many more offshore wind turbines. At the same time, Germany will bring into service twenty-three new coal-powered generating plants. China is building fifty gigawatts of new coal-powered electrical generators per year.

Ross McKitrick (Environmental Economics, University of Guelph) makes it clear that no correlation can be established between emissions from coal-fired plants and respiratory problems of Ontario residents. Further, emissions of PM2.5 from coal-fired plants in Ontario since 2005 accounts for only 0.2 percent of the emissions of PM2.5 from all sources. The economics of industrial wind turbines is and will be disastrous to the economy of Ontario. (Report of the Office of the Auditor General of Ontario, December 2011).

Conflict of Interest:

None declared

In Australia, and presumably elsewhere, the area of adverse event reporting, as it relates to drugs and medical devices, is a surveillance-based system that relies on expert assessment. Pre-marketing trials of drugs do not provide any assurance that everything is known. Many drugs have been withdrawn off the market because their use was associated with unacceptable side effects in post-marketing trials, or reports of peculiar side effects that had nothing to do with their expected pharmacological effects. One such example is Vioxx (rofecoxib), another is thalidomide.

However, similar surveillance systems for non-medical technologies are rather wanting. There is no pre-marketing assessment and certainly no regular mechanism which assesses "post-marketing experience".

Despite the reports of thousands of adverse effects on health by wind turbines, authorities have done little. We now have two studies performed by Shepherd et al 2012, and Nissenbaum et al 2013, which both come to similar conclusions that wind turbines are associated with harm to human health (links below). There are no studies to the contrary!

This article represents a wakeup call for health professionals who prejudice or harden their attitudes against those suffering from wind turbines as supposedly suffering from a little stress or adjustment issues. Such judgments are best left for cold-minded politicians who are willing to harm some citizens for the sake of the well-being of others.

1. http://docs.wind-watch.org/NAH_2011.pdf

2. http://www.noiseandhealth.org/article.asp?issn=1463-1741;year=2012;volume=14;issue=60;spage=237;epage=243;aulast=Nissenbaum

Conflict of Interest:

None declared

My interest in wind turbines is both personal and professional. It is interesting previous posters have not declared their competing interests.

I live in the County of Haldimand which is currently seeing the installation of over 200 wind turbines stretching along the coastline of Lake Erie, from Port Dover to Dunnville.

Knowing that my home,farm and community will soon be encircled by operating wind turbines I have spent the last several years trying to understand the foundations for concerns, issues, reported adverse effects and opposition to the wind projects.

My initial first concerns were focused upon the devastating bat and raptor kills from the operations of these machines. Adverse human health effects soon quickly became the main area of my studies.

In the 2010 literature review from Dr Arlene King was tabled and after taking the time to review the listed, cited references, I came away with a very distinct sense that something was missing in the official discussion. It was the lack of any consideration for indirect health effects. This glaring omission highlighted the need for consideration and implementation of the Precautionary Principle by all health entities and governmental bodies.

Contacting the researchers who were studying impacted communities I expanded my learning and have now also spoken directly with families and individuals who were reporting adverse health impacts. Individuals and families who were so severely impacted they had to leave to their homes for relief.

Please take the time to go through the listed references in the above article. What resonates the most to me are the "new experts" testimonies from the individuals and families who are reporting adverse symptoms from being exposed to operating wind turbines .

Primary and preventative health care is based upon taking a good clinical history. The first person reports of intrusive symptoms are powerful indicators of illness. Even more telling is that the symptoms are resolved or improved when people leave the vicinity of the turbine exposure. Dose response has been demonstrated in several peer reviewed studies.

"Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death." WHO re: importance of social justice.

I do not grant consent to being exposed to operating turbine emission for myself, my family or my son. Consent is not being granted by other members of my community. Exposing us against our will is not ethical.

Conflict of Interest:

My home and farm will in the very near future be surrounded by operating wind turbines.

This is a deeply misleading article by long time anti-wind activists that may lead unwary medical practitioners to inappropriately attribute symptoms to wind turbines and possibly exacerbate pre-existing conditions. It ignores the vast majority of evidence and opinions of medical professionals in assessments world wide that wind turbines do not cause health impacts.

The authors -- Jeffrey, Krogh and Horner - do not cite the 18 reviews world wide of the peer-reviewed evidence and anecdotal health claims that found no evidence of harm from wind turbines to human health outside of easily mitigated noise annoyance. Most recently, the Australian state of Victoria's Health Department released the results of their assessment and clearly state that wind turbines do not cause health impacts. [1]

They ignore the research from the University of Nottingham in the UK by Claire Lawrence et al that shows that wind turbine noise annoyance is unrelated to the level of sound and directly correlates to the attitudes about wind energy and personality traits of the person claiming annoyance. [2], [3]

They ignore the work from the University of Auckland by Fiona Crichton et al that shows that symptoms attributed to wind turbines are actually caused by the nocebo effect via anti-wind turbine material claiming health impacts. [4]

They ignore the work of Professor Chapman of the University of Sydney's Department of Public Health currently published on the USyd eScholarship site and undergoing peer-review with a major international journal that shows that only 1 in 272 people near wind farms complained at all, and that complaints were most strongly correlated to efforts of anti- wind campaigners near wind farms. [5]

They rely on work of lower quality such as the Nissenbaum, Aramini and Hanning study published in Noise and Health that significantly overstated the conclusions that could be drawn from the data they collected. The scatter did not allow the fit that they claimed, the data actually showed that all residents in both the study and control group suffered from poor sleep by the PQSI and Epworth scales and they ignored the long-standing efforts by Nissenbaum to promote ill health causation in the study sites as a potential source of increased stress on the study participants. Two separate critiques of this pointing out the failings have been published in Noise and Health. [6], [7] As all three authors of that study are also Advisory Board members of the Society for Wind Vigilance, it is unreasonable to expect that the authors of this piece are unaware of the critiques. [12] (Note: I am the author of one of the published critiques.)

They rely on Pierpont's 2009, unpeer-reviewed and vanity press- published "Wind Turbine Syndrome". The methodological and bias errors in that material are rife: advertising for individuals who blamed their health symptoms on wind farms via anti-wind campaigning groups, phone interviews only with 23 individuals, acceptance of hearsay evidence related to an additional 15 individuals, no medical history evaluation, acceptance of self-reporting and attribution without direct clinical assessment, questions formulated to be likely to increase symptom number and severity, and no control group. From this very weak base, Dr. Pierpont named a syndrome and wrote a 294-page book with 60+ pages of charts, graphs and tables. Dr. Pierpont and her husband had been vocal and deeply hostile anti-wind campaigners for years before the study and publication of the book and continue in this role now. This material has been rejected as being of poor quality and low evidentiary value by each of the 18 reviews previously cited. To quote one of the reviews: "There is no evidence for a set of health effects from exposure to wind turbines that could be characterized as a "Wind Turbine Syndrome." [8]

They also rely on WindVOiCe, a self-reporting survey with such poor formulation that it was likely to create stress and exacerbate minor and normal symptoms experienced by large percentages of the population, causing them to be misattributed to wind turbines. This online health survey was not created or supervised by an appropriate medical ethics oversight committed and has been removed.

The authors slip a set of possible causes of health impacts due to wind turbines into their opening remarks as if they were reasonable and supportable: "Suggested causes of symptoms include a combination of wind turbine noise, infrasound, dirty electricity, ground current, and shadow flicker." Wind turbine noise under Canada's setbacks is a non-issue as they are formulated to achieve WHO noise annoyance compliance. The infrasound assertion is pseudoscience; humans evolved with infrasound exceeding the levels produced by wind turbines and in fact the human cardio-vascular system creates higher levels of infrasound in the inner ear than any produced at source by wind energy. [9] Dirty electricity is also pseudoscience and ground current is unrelated to wind turbines where it occurs. Shadow flicker occurs a few minutes a day a few days a year in some homes and is not a risk factor for any serious ailments. [10] Their source for this deceptive and pseudoscience-laden statement is an article in an unindexed journal.

While establishing that they are on the Advisory Board of the Society for Wind Vigilance, they significantly understate the nature of the Society. It has been an active anti-wind campaigning organization for several years and prior to any peer-reviewed material and against all of the peer-reviewed evidence and cross-literature reviews has maintained an unsupported assertion of 2 kilometer setbacks and larger setbacks for wind turbines placed on ridges or offshore. [11]

Throughout this piece, the authors use the emotionally laden term "industrial wind turbine". This phrase was focus-tested by Koch Brother backed anti-renewables organizations a decade ago and found to be the most effective phrase to create antipathy to wind energy. It is not neutral language as would be expected in a medical journal, but propaganda terminology.

Professor Chapman, Ms. Crichton's and Ms. Lawrence's and their teams' work makes it clear that anti-wind rhetoric and fears raised by anti-wind campaigners are a primary cause of health impacts near wind farms. This article is already being used by anti-wind campaigners in other parts of the world as evidence to support their case.

That Jeffrey, Krogh and Horner persist in attempting to raise health fears related to wind turbines in light of the strong evidence that they do not cause health issues is problematic. That they are attempting to enlist general practitioners across Canada in their attempts is of deep concern.

References [1] List of all reviews related to wind farms and health internationally, maintained by the University of Sydney Department of Public Health http://tobacco.health.usyd.edu.au/assets/pdfs/publications/WindHealthReviews.pdf

[2] Noise levels and noise perception from small and micro wind turbines, Jennifer Taylor, Carol Eastwick, Claire Lawrence, Robin Wilson, Renewable Energy, Volume 55, July 2013, Pages 120-127, http://www.sciencedirect.com/science/article/pii/S0960148112007665

[3] The influence of negative oriented personality traits on the effects of wind turbine noise, Jennifer Taylor, Carol Eastwick, Robin Wilson, Claire Lawrence, Personality and Individual Differences, Volume 54, Issue 3, February 2013, Pages 338-343, http://www.sciencedirect.com/science/article/pii/S0191886912004783

[4] Can Expectations Produce Symptoms From Infrasound Associated With Wind Turbines? Crichton, Fiona; Dodd, George; Schmid, Gian; Gamble, Greg; Petrie, Keith J. Health Psychology, Mar 11 , 2013, No Pagination Specified. doi: 10.1037/a0031760, http://psycnet.apa.org/psycinfo/2013- 07740-001/

[5] Spatio-temporal differences in the history of health and noise complaints about Australian wind farms: evidence for the psychogenic, "communicated disease" hypothesis. , Simon Chapman, Alexis St. George, Karen Waller, Vince Cakic, http://ses.library.usyd.edu.au/handle/2123/8977?mode=full&submit_simple=Show+full+item+record

[6] Letter to Editor: Are the findings of "Effects of industrial wind turbine noise on sleep and health" supported?, Christopher A Ollson, Loren D Knopper, Lindsay C McCallum, Melissa L Whitfield-Aslund, Noise and Health, Year : 2013, Volume : 15, Issue : 63, Page : 148-150 http://www.noiseandhealth.org/article.asp?issn=1463- 1741%3Byear%3D2013%3Bvolume%3D15%3Bissue%3D63%3Bspage%3D148%3Bepage%3D150%3Baulast%3DOllson

[7] Letter to Editor: Issues of wind turbine noise, Mike Barnard, Noise and Health, Year : 2013, Volume : 15, Issue : 63, Page : 150-152, http://www.noiseandhealth.org/article.asp?issn=1463- 1741;year=2013;volume=15;issue=63;spage=150;epage=152;aulast=Barnard

[8] Analysis of the Research on the Health Effects from Wind Turbines, including Effects from Noise, Maine Department of Health and Human Services, 2012, http://www.maine.gov/dhhs/reports/health-effects- from-wind-turbines-2-12.pdf

[9] Infrasound from Wind Turbines - Fact, Fiction or Deception? by Geoff Leventhall in Vol.34 No.2 (2006) of the peer-reviewed journal Canadian Acoustics http://www.cleanenergycouncil.org.au/technologies/wind/turbinefactsheets/mainColumnParagraphs/0/text_files/file1/06 -06Leventhall-Infras-WT-CanAcoustics2.pdf

[10] Update of UK Shadow Flicker Evidence Base Final Report, UK Department of Energy and Climate Change, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/48052/1416 -update-uk-shadow-flicker-evidence-base.pdf

[11] The Society for Wind Vigilance issues a Global Guideline for the Minimum Siting Distance of Industrial Wind Turbines, April 4, 2012, http://www.windvigilance.com/news

[12] Society for Wind Vigilance Advisory Group, http://www.windvigilance.com/home/advisory-group

Conflict of Interest:

I author a blog which cites peer-reviewed studies and credible organization's reports to debunk disinformation about wind energy as a purely voluntary effort. barnardonwind.wordpress.com.

The mainstream 'green' position on wind turbines generally assumes that wind power reduces human production of greenhouse gases, and that some people may suffer some discomfort. It argues that wind power, while not perfect is of net benefit, and there is no way of reducing greenhouse gas emissions without human cost.

Such assumptions are often accepted on ideological grounds, whereas a more careful critique suggests they are flawed. For example, wind turbines are uneconomic unless they receive very large subsidies. Moreover, wind requires backup when the wind is not blowing. Coal continues to be burnt while it is in standby mode (at least at 90% capacity), and coal consumption at power stations, according to industry figures, has not decreased. Dieter Helm (Professor of Energy Policy at Oxford University) considers that there has been much 'hype' about wind power and its ability to curb carbon emissions.

Because ideology has primarily driven the green argument, issues related to the adverse health effects of industrial wind turbines have been either denied or downplayed considerably. This article flags the importance of paying critical attention to the adverse health effects of wind turbines as a significant public health concern.

In Australia, both the Greens and Doctors for the Environment Australia invoke the precautionary principle in relation to coal seam gas, but ignore it in relation to wind turbines. Ironic indeed when companies like AGL are involved in both wind farms and coal seam gas, the latter mining activity producing low frequency noise emissions similar to those produced by wind turbines. If the precautionary principle were used, setbacks from houses of at least 10 km would be justified, given the lack of a systematic research base to support the safety of wind turbines.

Conflict of Interest:

None declared

Virtually absent from this article is any discussion of the hazards posed by other forms of energy generation.

Coal-fired facilities, for instance, are a significant source of chromium and arsenic (carcinogens), sulphur dioxide (acid rain), dioxin, and of course greenhouse gases. Ontario's coal plants, for example, were once the single largest source of GHGs in the province.

Atomic energy is worrisome as well. Research done by the Canadian Association of Physicians for the Environment (CAPE) found that, "All functioning reactors routinely release radioactive material into the air and into the water used to cool them." As well, citing a 2008 German study, the CAPE researchers found "an unequivocal positive relationship between a child's risk of being diagnosed with leukemia, and residential proximity to the nearest nuclear power plant."

No one argues wind mills are perfect but they stack up rather well when compared with other sources of electricity. Wind mills do not cause cancer; do not release toxic waste; do not produce smog; do not produce elements of acid rain; and do not contribute to climate change. Indeed, they help us to phase-out energy sources which do cause these adverse effects.

Conflict of Interest:

None declared