Canadian family physicians can expect to see increasing numbers of rural patients reporting adverse effects from exposure to industrial wind turbines (IWTs). People who live or work in close proximity to IWTs have experienced symptoms that include decreased quality of life, annoyance, stress, sleep disturbance, headache, anxiety, depression, and cognitive dysfunction. Some have also felt anger, grief, or a sense of injustice. Suggested causes of symptoms include a combination of wind turbine noise, infrasound, dirty electricity, ground current, and shadow flicker. Family physicians should be aware that patients reporting adverse effects from IWTs might experience symptoms that are intense and pervasive and might feel further victimized by a lack of caregiver understanding.
There is increasing concern that energy generation from fossil fuels contributes to climate change and air pollution. In response to these concerns, governments around the world are encouraging the installation of renewable energy projects including IWTs. In Ontario, the Green Energy Act was designed, in part, to remove barriers to the installation of IWTs. Noise regulations can be a considerable barrier to IWT development, as they can have a substantial effect on wind turbine spacing, and therefore the cost of wind-generated electricity. Industrial wind turbines are being placed in close proximity to family homes in order to have access to transmission infrastructure. In Ontario and elsewhere, some individuals have reported experiencing adverse health effects resulting from living near IWTs. Reports of IWT-induced adverse health effects have been dismissed by some commentators including government authorities and other organizations. Physicians have been exposed to efforts to convince the public of the benefits of IWTs while minimizing the health risks. Those concerned about adverse effects of IWTs have been stereotyped as “NIMBYs” (not in my backyard).
Global reports of effects
During the past few years there have been case reports of adverse effects. A 2006 Académie Nationale de Médecine working group report notes that noise is the most frequent complaint. The noise is described as piercing, preoccupying, and continually surprising, as it is irregular in intensity. The noise includes grating and incongruous sounds that distract the attention or disturb rest. The spontaneous recurrence of these noises disturbs the sleep, suddenly awakening the subject when the wind rises and preventing the subject from going back to sleep. Wind turbines have been blamed for other problems experienced by people living nearby. These are less precise and less well described, and consist of subjective (headaches, fatigue, temporary feelings of dizziness, nausea) and sometimes objective (vomiting, insomnia, palpitations) manifestations. A 2009 literature review prepared by the Minnesota Department of Health summarized case reports by Harry (2007), Phipps et al (2007), the Large Wind Turbine Citizens Committee for the Town of Union (2008), and Pierpont (2009). These case studies catalogued complaints of annoyance, reduced quality of life, and health effects associated with IWTs, such as sleeplessness and headaches. In 2010, Nissenbaum et al used validated questionnaires in a controlled study of 2 Maine wind energy projects. They concluded that “the noise emissions of IWTs disturbed the sleep and caused daytime sleepiness and impaired mental health in residents living within 1.4 km of the two IWT installations studied.” Reports of adverse health effects and reduced quality of life are also documented in IWT projects in Australia and New Zealand. A 2012 board of health resolution in Brown County in Wisconsin formally requested financial relocation assistance for “families that are suffering adverse health effects and undue hardships caused by the irresponsible placement of industrial wind turbines around their homes and property.” An Ontario community-based self-reporting health survey, WindVOiCe, identified the most commonly reported IWT-induced symptoms as altered quality of life, sleep disturbance, excessive tiredness, headache, stress, and distress. Other reported effects include migraines, hearing problems, tinnitus, heart palpitations, anxiety, and depression. In addition, degraded living conditions and adverse socioeconomic effects have been reported. In some cases the effects were severe enough that individuals in Ontario abandoned their homes or reached financial agreements with wind energy developers. After considering the evidence and testimony presented by 26 witnesses, a 2011 Ontario environmental review tribunal decision acknowledged IWTs can harm human health:
This case has successfully shown that the debate should not be simplified to one about whether wind turbines can cause harm to humans. The evidence presented to the Tribunal demonstrates that they can, if facilities are placed too close to residents. The debate has now evolved to one of degree.
Indirect effects and annoyance
When assessing the adverse effects of IWTs it is important to consider what constitutes human health. The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Despite being widely accepted, the WHO definition of health is frequently overlooked when assessing the health effects of IWTs. Literature reviews commenting on the health effects of IWTs have been produced with varying degrees of completeness, accuracy, and objectivity. Some of these commentators accept the plausibility of the reported IWT health effects and acknowledge that IWT noise and visual effects might cause annoyance, stress, or sleep disturbance, which can have other consequences. However, these IWT health effects are often discounted because “direct pathological effects” or a “direct causal link” have not been established. In 2010, the Ontario Chief Medical Officer of Health released The Potential Health Impact of Wind Turbines, which acknowledged that some people living near wind turbines report symptoms such as dizziness, headaches, and sleep disturbance but concluded “the scientific evidence available to date does not demonstrate a direct causal link between wind turbine noise and adverse health effects.” The lead author of the report, Dr Gloria Rachamin, acknowledged under oath that the literature review looked only at direct links to human health. Focusing on “direct” causal links limits the discussion to a small slice of the potential health effects of IWTs. The 2011 environmental review tribunal decision found that serious harm to human health includes “indirect impacts (e.g., a person being exposed to noise and then exhibiting stress and developing other related symptoms).” According to the night noise guidelines for Europe:
Physiological experiments on humans have shown that noise of a moderate level acts via an indirect pathway and has health outcomes similar to those caused by high noise exposures on the direct pathway. The indirect pathway starts with noise-induced disturbances of activities such as communication or sleep.
Pierpont documented symptoms reported by individuals exposed to wind turbines, which include sleep disturbance, headache, tinnitus, ear pressure, dizziness, vertigo, nausea, visual blurring, tachycardia, irritability, problems with concentration and memory, and panic episodes associated with sensations of internal pulsation or quivering when awake or asleep. The American Wind Energy Association and the Canadian Wind Energy Association convened a panel literature review that determined these symptoms are the “well-known stress effects of exposure to noise,” or in other words, are “a subset of annoyance reactions.” Noise-induced annoyance is acknowledged to be an adverse health effect. Chronic severe noise annoyance should be classified as a serious health risk. According to the WHO guidelines for community noise, “[t]he capacity of a noise to induce annoyance depends upon many of its physical characteristics, including its sound pressure level and spectral characteristics, as well as the variations of these properties over time.” Industrial wind turbine noise is perceived to be more annoying than transportation noise or industrial noise at comparable sound pressure levels. Industrial wind turbine amplitude modulation, audible low frequency noise, tonal noise, infrasound, and lack of nighttime abatement have been identified as plausible noise characteristics that could cause annoyance and other health effects.
Health effects in Ontario expected
Evidence-based health studies were not conducted to determine adequate setbacks and noise levels for the siting of IWTs before the implementation of the Ontario renewable energy policy. In addition, provision for vigilance monitoring was not made. It is now clear that the regulations are not adequate to protect the health of all exposed individuals. A 2010 report commissioned by the Ontario Ministry of the Environment 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.
Consequently, physicians will likely be presented with patients reporting health effects. Family physicians should be aware that patients reporting adverse effects from IWTs might experience symptoms that are intense and pervasive and that they might feel further victimized by a lack of care-giver understanding. Those adversely affected by IWTs might have already pursued other avenues to mitigate the health effects with little or no success. It will be important to identify the possibility of exposure to IWTs in patients presenting with appropriate clinical symptoms.
Industrial wind turbines can harm human health if sited too close to residents. Harm can be avoided if IWTs are situated at an appropriate distance from humans. 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. The documented symptoms are usually stress disorder–type diseases acting via indirect pathways and can represent serious harm to human health. Family physicians are in a position to effectively recognize the ailments and provide an empathetic response. In addition, their contributions to clinical studies are urgently needed to clarify the relationship between IWT exposure and human health and to inform regulations that will protect physical, mental, and social well-being.
This article has been peer reviewed.
La traduction en français de cet article se trouve à www.cfp.ca/content/59/5/e218.
- Roy D. Jeffery, MD FCFP, Family physician, Northeastern Manitoulin Family Health Team, Little Current, Ont.
- Carmen Krogh, Retired pharmacist, former Editor-in-Chief of the Compendium of Pharmaceutical Specialties.
- Brett Horner, CMA, Certified Management Accountant.
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.
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Response to comments
[Canadian Family Physician September 2013 vol. 59 no. 9 921-925]
We are pleased to see the interest generated by our article in the May issue.1 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 by blogger Mike G. Barnard deserve comment.2
The Society for Wind Vigilance is not an “anti-wind” campaigning organization. It is a not-for-profit organization, the purpose of which is to ensure safe positioning of wind turbine facilities based on human health research; educate through the dissemination of facts and references on the risk of adverse health effects of human exposure to IWTs; work constructively with interested parties to ensure that guidelines for wind turbine facilities will protect the health and safety of communities; and achieve vigilance monitoring and long-term surveillance regarding the risks to health of IWTs.3 Society board members are authors of peer-reviewed articles on the effects of IWTs.4–8
The term industrial wind turbine
Mr Barnard states that the term industrial wind turbine is “emotionally laden” and “propaganda terminology.”2
Our use of the term is not intended to invoke an emotional response, but to differentiate consumer turbines from industrial-scale turbines that have a blade radius of greater than 40 m, are greater than 140 m in height, generate multiple megawatts of electricity, and produce approximately 105 dBA of sound power.
Mr Barnard states we “do not cite the 18 reviews worldwide of the peer-reviewed evidence … that found no evidence of harm from wind turbines to human health …”2
We were aware of and carefully reviewed the 18 articles. We found some reviews had substantial 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.6
One of these aforementioned 18 reviews that was cited in our article was a panel literature review (Colby et al, 2009) sponsored by the American Wind Energy Association and the Canadian Wind Energy Association.9
Two authors of that paper, 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 Colby10 and Dr Leventhall11 mentioned that
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 stated:
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 that
[T]o 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 palpitations.15–17
Health Canada’s Dr David Michaud explains that
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, “Noise seriously harms human health and interferes with people’s daily activities at school, at work, at home and during leisure time.”19 The WHO also notes the main identified health risks of noise include annoyance.
Niemann et al (2006), the authors of the WHO pan-European LARES (Large Analysis and Review of European housing and health Status) 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.”2
The WHO does not provide noise annoyance compliance criteria for IWTs.21,22
Some governments in Canada have developed IWT noise limits that are expected to result in adverse health effects. In correspondence dated June 30, 2009, the Honourable Rona Ambrose, then a federal Minister and Member of Parliament, wrote that
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).
Health Canada employees have proposed a “justification” for a 45-dBA IWT sound level criterion.23–25 The authors predict this noise criterion will result in an increase in the percentage of those who are highly annoyed.
Based on dose-response data for wind turbines, Janssen et al report that, with a highest allowed immission level of 45 dBA, it is expected that “… less than 14% of the exposed population [will] be highly annoyed indoors by wind turbines and less than 29% [will] be highly annoyed outdoors.”26
From internal correspondence obtained through a Freedom of Information request from the Ontario Ministry of Environment,
It appears compliance with the minimum setbacks and the noise study approach currently being used to approve the siting of WTGs [wind turbine generators] will result or likely result in adverse effects …
HGC Engineering is a member of the Canadian Wind Energy Association (CanWEA). Mr Brian Howe, president of HGC Engineering,
… [S]peaks frequently at [CanWEA] Symposiums … prepared a “best practices” guide for CanWEA in 2007 and provided input on the assessment methods contained in the Ontario Green Energy and Green Economy Act (2009).27
The Ontario Ministry of Environment report prepared by HGC Engineering concludes:
The audible sound from wind turbines, at the levels experienced at typical receptor distances in Ontario, is nonetheless expected to result in a nontrivial 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.28
Mr Barnard writes that health effects are related to the negative attitude of the individual exposed to IWTs.2 Some researchers have found that the IWTs were initially welcomed into communities for their perceived economic8 or environmental29 benefits. “The reported adverse impacts were unexpected.”5 The 2011 Ontario Real Estate Association Form 220 (Seller Property Information Statement) requires disclosure of environmental issues when selling residential property, including toxic waste, soil contamination, landfills, and wind turbines planned for the immediate area.30
The adverse health effects of audible and inaudible noise are substantial. Their effects are underestimated and underappreciated 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 placing IWTs at a protective distance from residents. The acknowledgment that health effects occur in some is an important step toward achieving this goal.
- Jeffery RD, Krogh C, Horner B. Adverse health effects of industrial wind turbines. Can Fam Physician 2013;59:473-5. (Eng), e218–21 (Fr).
- Barnard MG. Authors ignore strong evidence, cite weak minor studies [Rapid Response]. Can Fam Physician 2013 May 21. Available from: www.cfp.ca/content/59/5/473/reply. Accessed 2013 May 22.
- The Society for Wind Vigilance [website]. Home. Welcome to The Society for Wind Vigilance. The Society for Wind Vigilance; 2013. Available from: www.windvigilance.com. Accessed 2013 Aug 14.
- 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. [full text]
- Krogh CME. Industrial wind turbine development and loss of social justice? Bull Sci Technol Soc 2011;31(4):321-33. [full text]
- 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. [full text]
- Hanning CD, Evans A. Wind turbine noise. BMJ 2012;344:e1527. [full text]
- Nissenbaum MA, Aramini JJ, Hanning CD. Effects of industrial wind turbine noise on sleep and health. Noise Health 2012;14(60):237-43.
- 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.
- Erickson v. Director, Ministry of the Environment. Environmental Review Tribunal Nos. 10-121 and 10-122. Dr. Colby’s presentation to Nova Scotia Department of Energy. 2010 Mar 4. p. 29. Exhibit 90.
- Colby WD, Leventhall HG. Wind turbine syndrome: myths and facts [webinar]. Windustry; 2010.
- Leventhall HG. Wind turbine syndrome: an appraisal. Testimony before the Public Service Commission of Wisconsin. Public Service Commission of Wisconsin; 2009. PSC Ref No. 121877 20.
- 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.
- National Research Council, Committee on Environmental Impacts of Wind Energy Projects. Environmental impacts of wind-energy projects. Washington, DC: The National Academies Press; 2007.
- Leventhall G. A review of published research on low frequency noise and its effects. London, UK: Department for Environment, Food and Rural Affairs; 2003.
- Leventhall HG. Low frequency noise and annoyance. Noise Health 2004;6(23):59-72.
- Schust M. Effects of low frequency noise up to 100 Hz. Noise Health 2004;6(23):73-85.
- Michaud DS, Keith SE, McMurchy D. Noise annoyance in Canada. Noise Health 2005;7(27):39-47.
- World Health Organization Europe [website]. Noise. Geneva, Switz: World Health Organization; 2009. Available from: www.euro.who.int/en/what-wedo/health-topics/environment-and-health/noise. Accessed 2009 Mar 15.
- Niemann H, Bonnefoy X, Braubach M, Hecht K, Maschke C, Rodrigues C, et al. Noise-induced annoyance and morbidity results from the pan-European LARES study. Noise Health 2006;8(31):63-79.
- Berglund B, Lindvall T, Schwela DH, editors. Guidelines for community noise. Geneva, Switz: World Health Organization; 1999.
- 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.
- Keith SE, Michaud DS, Bly SHP. A justification for using a 45 dBA sound level criterion For wind turbine projects. Canadian Acoustics 2008;36(3):54-5.
- Michaud DS, Keith SE. Evaluating the potential health impacts of wind turbine noise for environmental assessments; Paper presented at: Second International Meeting on Wind Turbine Noise; 2007 Sep 20–21; Lyon, France.
- Keith SE, Michaud DS, Bly SHP. A proposal for evaluating the potential health effects of wind turbine noise for projects under the Canadian Environmental Assessment Act. J Low Freq Noise Vib Active Control 2008;27(4):253-65.
- Janssen SA, Vos H, Eisses AR, Pedersen E. A comparison between exposure-response relationships for wind turbine annoyance and annoyance due to other noise sources. J Acoust Soc Am 2011;130(6):3746-53.
- HGC Engineering [website]. Brian Howe, President, HGC Engineering. Mississauga, ON: HGC Engineering; 2013. Available from: www.acoustical-consultants.com/about-hgcengineering-acoustical-engineers/vibration-and-noise-control-management-team/brian-howe-hgc-engineering/. Accessed 2013 Mar 10.
- HGC Engineering. 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.
- 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.
- Ontario Real Estate Association. Seller property information statement: residential. Don Mills, ON: Ontario Real Estate Association; 2011.
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