Resource Documents: Health (421 items)
Documents presented here are not the product of nor are they necessarily endorsed by National Wind Watch. These resource documents are provided to assist anyone wishing to research the issue of industrial wind power and the impacts of its development. The information should be evaluated by each reader to come to their own conclusions about the many areas of debate.
Author: Court of Appeals of Indiana
‘Over the course of two hearings, the BZA had the opportunity to carefully consider the statutory setback requirement of Section 6.4 and its implications on the life, health, and safety of the surrounding landowners. It received evidence in favor of the project and in opposition of constructing the windfarm. Ultimately, and based on the evidence presented at the hearings, the BZA, in its approved Findings of Fact, explicitly found that “an additional setback is necessary to protect health and safety on non-participating properties and owners, and imposes as a condition on the grant of the special exception a minimum setback of 2,300 feet, to be measured from the center of the WECS turbine to the non-participating property line.”’
Author: McMurtry, Robert; and Krogh, Carmen
Some people living in the environs of industrial wind turbines (IWTs) report experiencing adverse health effects (AHE/IWT). Reported effects include annoyance, sleep disturbance, stress-related health impacts and reduced quality of life. In some cases, families have effectively abandoned their homes, been billeted by wind energy developers or have negotiated financial agreements with developers.
McMurtry and Krogh presented Diagnostic criteria for adverse health effects in the environs of wind turbines to assist medical practitioners presented with patients reporting AHE/IWTs. Noise and Health published the views of McCunney et al. that presented critical commentary on these AHE/IWT diagnostic criteria as well as its predecessor, which were presented by McMurtry.
In this response, McMurtry and Krogh present a critical analysis of the commentary contained in the presentation of McCunney et al.
References cited to support the content of this response include the following:
- Peer-reviewed references;
- References written by or for members of the wind energy industry;
- Expert testimony;
- Other References
Noise & Health 2016;18(85):399–402
McCunney et al. asserted that they contrasted the McMurtry and Krogh criteria with the Institute of Medicine guidelines for the development of clinical guidelines and itemized ‘key points’ in the two tables reproduced below.
In the work of McCunney et al., Table 2 states ‘[a]ll of the symptoms and conditions in the case definition are common and nonspecific, and have numerous causes’. The medical significance of this table item remains a mystery as numerous medical conditions have common symptoms. The third-order criteria presented in the case definition by McMurtry and Krogh are symptoms consistent with the ‘well-known stress effects of exposure to noise’,[1,5] which ‘are familiar to environmental noise control officers and other “on the ground” professionals’.
McCunney et al.’s co-authors, Drs. Colby and McCunney and others, were paid by the wind industry to prepare a report that examined the potential health impacts of wind turbines. Their report shows Colby et al. stating that their authors ‘undertook extensive review, analysis, and discussion of the large body of peer reviewed literature on sound and health effects in general, and on sound produced by wind turbines’. On the basis of this review, Colby et al. determined the documented symptoms of ‘wind turbine syndrome’ (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) ‘are not new’ and have been published previously in the context of ‘annoyance’ and are the ‘well-known stress effects of exposure to noise’.
The key aspect is that these symptoms cluster in some affected individuals exposed to IWTs. It is important that a simple method be available for family practitioners to assess appropriately the range of symptoms reported. McMurtry and Krogh have outlined such a method.
The next item listed by McCunney et al. in Table 2 states ‘[t]he case definition lacks the requirement to confirm reports of symptoms with medical records and diagnostic studies’. This statement is erroneous. McMurtry and Krogh have specified that a licensed practitioner must conduct a thorough history, physical examination and investigation and rule out alternative explanations before ‘presumed diagnosis’ of AHE/IWT is warranted. To achieve the category of ‘confirmed diagnosis’ McMurtry and Krogh have specified that additional investigative procedures are required and have proposed sophisticated investigative procedures, such as ‘measurements electrophysiologically and by biomarkers’. Reader feedback has since commented that given the accumulation of evidence for a causal link between sleep disturbance and cardiovascular disease, it is not prudent to wait for serious events to accrue. Therefore, it would be expedient to measure intermediate phenotypes, such as biomarker, which are known to lie along the patho-physiological pathway between health and disease.
In the article by McCunney et al., the third item that ‘[a]ll medical information, with two exceptions, is subjective’ in Table 2 is irrelevant. It is a normal clinical practice for physicians to diagnose and treat patients displaying subjective symptoms. For example, this practice assists with incidence and surveillance of arthritis and management of postoperative and other pain such as migraine headache.
McCunney et al. expressed concern that ‘[t]he case definition does not meet essential criteria for clinical guidelines, most notably by lack of committee involvement in the development of the guidelines, as the AHE/IWT reflects two authors perspective’. McCunney et al. then present the reader with contradictory information in Table 3 stating that the case definition was ‘developed by one author’. As described by McMurtry, the origin of the criteria and their genesis stemmed from a 3-day symposium during which 11 experts presented their perspectives. The symposium proceedings were published in a special edition of a peer-reviewed journal. McCunney et al. omitted the disclosure of this information.
McCunney et al. alleged that McMurtry and Krogh ‘lack of indication of potential conflicts of interest’ and stated that the conflicts of interest statement was ‘[n]ot done’. McCunney et al. provided no explanation or reference to support these allegations.
As health professionals, McMurtry and Krogh understand the obligation of authors to declare conflicts of interest. Had McCunney et al. approached McMurtry and Krogh with these unsupported allegations, they would have been advised there is no undeclared conflict of interest. McMurtry and Krogh declare they: complied fully with the Journal of the Royal Society of Medicine conflict of interest requirements; and at no time have McMurtry or Krogh: been paid to serve as experts on IWTs; received funding or grants to publish on IWTs; received financial remuneration for their services or research on IWTs.
McMurtry and Krogh would have further advised that the obligation to state potential conflicts of interest would also extend to the authors of McCunney et al. Any statement of potential conflicts of interest should include Drs. McCunney, Mundt and Colby relationships with the wind industry including, but not limited to, payments received from the wind industry to serve as experts and/or prepare reports for the wind industry that examined the potential health impacts of wind turbines. McCunney et al. disclosed that some of its authors served as experts in several litigation matters on behalf of wind farm developers and wind turbine manufacturers. This declaration by McCunney et al. is incomplete as it omits disclosure of payments received for other services, such as payments to prepare report(s) for the wind industry that examined the potential health impacts of wind turbines.
The criticism by McCunney et al. of research based on self-reports including that of the validated questionnaires is puzzling given such a practice in research is widely utilized in medical and psychological clinical research. The World Health Organization LARES study provided a relevant example of research that employed a health questionnaire filled in by/for individuals (including children) and concluded ‘for chronically strong annoyance a causal chain exists between the three steps health – strong annoyance – increased morbidity’.
Drs. Colby and McCunney themselves also have cited research based on self-reporting questionnaires (i.e. Møller and Lydolf, 2002; Mirowska and Mroz, 2000) in support of the Colby et al. determination that ‘wind turbine syndrome’ symptoms are the ‘well-known stress effects of exposure to noise’.
McCunney et al. state in Table 3, ‘Data collection method given: Not done’. Once again, McCunney et al. have presented readers with erroneous information. Under the heading ‘Methods’ McMurtry and Krogh state:
‘A revised case definition was developed through a variety of methods including a review of self-reporting surveys published in the peer-reviewed literature and other sources; interviews and correspondence with neighbours reporting health effects; incident reports posted on the Internet; testimony under oath during judiciary proceedings of neighbours reporting health effects; personal dialogue with physicians; and grey literature. We searched PubMed and Google Scholar for articles published since 2000 that included the terms “wind turbine health”, “wind turbine survey”, “wind turbine symptoms”, “wind turbine self reports” and “wind turbine noise”. A PubMed search with the search term “case definition” obtained additional background relating to case definitions for emerging diagnostic challenges’.
Another item listed by McCunney et al. in Table 3 concerned quality of evidence. The quality of the papers quoted in McMurtry and Krogh is affirmed by other peer-reviewed publications such as the meta-analysis presented by Onakpoya et al. McMurtry and Krogh citations included the clinical review of Jeffery et al., which confirmed the reported ‘effects from exposure to IWTs are consistent with well-known stress effects from persistent unwanted sound’. Also cited was the 2010 review written by a member of the Canadian Wind Energy Association (CanWEA), which concluded ‘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. As with sounds from many sources, research has shown that annoyance associated with sound from wind turbines can be expected to contribute to stress related health impacts in some persons’.
The final item listed by McCunney et al. in Table 3 stated ‘Evidence supporting recommendations: Not done’. This statement has the potential to mislead readers as McMurtry and Krogh provided citations throughout to support its content. McMurtry and Krogh’s recommendation that a licensed practitioner conduct a thorough history, physical examination and investigation and rule out alternative explanations is consistent with ‘the requirement to confirm reports of symptoms with medical records and diagnostic studies’ listed by McCunney et al. in Table 2.
McCunney et al. presented a display of ‘combinatorics’ claiming ‘[t]he point of this exercise was to quantitatively evaluate the scientific validity of the proposed case definition if it were to be used as intended’.
Beginning a mathematical exercise with erroneous assumptions will inevitably lead to misleading results as has occurred in McCunney et al. McMurtry and Krogh’s diagnostic criteria required that all of the four first-order criteria be either positive or not. If all of the four diagnostic criteria were not positive, then no further investigation was indicated. If all four were positive, then the next step was to advance to the second-order criteria, which required that three of the four be positive before establishing a ‘probable diagnosis’. Third-order criteria were not required to achieve ‘probable diagnosis’. Investigative steps were next required to determine if ‘presumed diagnosis’ was warranted. The calculations presented by McCunney et al. do not reflect these case definition requirements and are simply irrelevant.
The ‘risks to patients’ claimed in the conclusions of McCunney et al. is not supportable. McMurtry and Krogh have published in a medical journal as the case definition is intended to be used by licensed medical practitioners trained in diagnostic procedures. The case definition requires application of professional medical judgement and diligence including the conduct of a thorough history, physical examination and investigation to rule out alternative explanations. It is not intended to be used in mechanical mathematical exercises absent of medical diagnostic diligence. McCunney et al. cannot claim its exercise quantitatively evaluates ‘the scientific validity of the proposed case definition if it were to be used as intended’. McCunney et al.’s exercise in math has the potential to mislead readers as it fails to use the case definition as it is presented and intended.
McMurtry and Krogh invited, and have received, commentary, which to date has been positive and constructive. Critical commentary can be informative when accurate, and relevant. Conversely, commentary based on erroneous and irrelevant information has the potential to mislead readers and should be viewed with caution.
McCunney et al. should have focused their commentary on the current version of the case definition. Instead, McCunney et al. erratically jump between the 2014 ‘revised case definition’ and the superseded McMurtry with much of its commentary focused on the latter.
It has been acknowledged that the manuscript by McCunney et al. was ‘rejected’ by a peer-reviewed Canadian medical journal before being accepted by Noise and Health.
The references cited in this analysis support the conclusion that the examination by McCunney et al. contains erroneous and irrelevant commentary, which has the potential to mislead readers.
This critical analysis of McCunney et al. cites references that confirm that reported AHE/IWT are consistent with well-known stress effects from persistent unwanted sound.[1,5] Annoyance is an acknowledged health effect.[17–19] A causal chain exists between strong annoyance and increased morbidity, and chronically strong annoyance must be classified as a serious human health risk.
The CanWEA has published a media release, which advised those impacted by wind turbine annoyance stating:
‘The association has always acknowledged that a small percentage of people can be annoyed by wind turbines in their vicinity. … When annoyance has a significant impact on an individual’s quality of life, it is important that they consult their doctor’.
McMurtry and Krogh’s diagnostic criteria is a tool provided to assist practicing physicians who are presented with such patients. The first- and second-order criteria identified individuals who domicile with IWTs in their vicinity and who were experiencing symptoms including annoyance or an impact on their quality of life. These criteria were in keeping with the acknowledgements and advice contained in CanWEA’s 2011 media release. Third-order criteria were used to enhance the understanding of patients’ illness experience and were not essential for satisfying the Diagnostic Criteria.
The content of the article by McCunney et al. suggests that its authors may not have understood the procedure presented for diagnosing patients suffering from ‘annoyance’ and the ‘well-known stress effects of exposure to noise’. While this response does not address all the weaknesses contained in the analysis by McCunney et al., it is our hope it will help clarify understanding of this diagnostic tool. We invite readers to explore the work of McMurtry and Krogh, and as always we welcome constructive commentary.
|1||Jeffery RD, Krogh CM, Horner B. Industrial wind turbines and adverse health effects. Can J Rural Med 2014;19:21-6. PubMed PMID: 24398354. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24398354.[Last accessed 2016 Nov 15].|
|2||McMurtry RY, Krogh CM. Diagnostic criteria for adverse health effects in the environs of wind turbines. JRSM Open 2014;5:1-5. doi: 10.1177/2054270414554048. PMID: 25383200 [PubMed] PMCID: PMC4221978. Available from: http://www.ncbi.nlm.nih.gov/pubmed/?term=Diagnostic+criteria+for+adverse+health+effects+in+the+environs+of+wind+turbines. [Last accessed 2016 Nov 15].|
|3||McCunney RJ, Morfeld P, Colby WD, Mundt KA. Wind turbines and health: An examination of a proposed case definition. Noise Health 2015;17:175-81. Available from: http://www.noiseandhealth.org/text.asp?2015/17/77/175/1606782. [Last accessed 2016 Nov 15].|
|4||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;31:316. doi: 10.1177/0270467611415075. Available from: http://bst.sagepub.com/content/31/4/316. [Last accessed 2016 Nov 15].|
|5||Colby WD, Dobie R, Leventhall G, Lipscomb DM, McCunney RJ, Seilo MT et al. Wind Turbine Sound and Health Effects: An Expert Panel Review. Prepared for American Wind Energy Association and Canadian Wind Energy Association; 2009. Available from: http://www.canwea.ca/pdf/talkwind/Wind_Turbine_Sound_and_Health_Effects.pdf. [Last accessed 2016 Nov 15].|
|6||Technical Hearing before the State of Vermont Public Service Board heldFebruary 10, 2011. Docket Number 7628. p. 37.|
|7||Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK et al. Arthritis and Rheumatism, Part I, vol. 58. American College of Rheumatology; 2008. p. 15-25. doi: 10.1002/art.23177. Available from: http://www.commed.vcu.edu/Chronic_Disease/arthritisimpactjan08.pdf. [Last accessed 2016 Nov 15].|
|8||The Society for Wind Vigilance. First International Symposium on the Global Wind Industry and Adverse Health Effects. Picton, Ontario, Canada. October 29–31, 2010. Available from: http://www.windvigilance.com/international-symposium. [Last accessed 2016 Nov 15].|
|9||SAGE Publications. Bulletin of Science, Technology and Society (BSTS). Table of Contents – August 2011, 31(4). Available from: http://bst.sagepub.com/content/31/4.toc. [Last accessed 2016 Nov 15].|
|10||McMurtry R. Order of Canada, June 30, 2011. Available from: http://www.gg.ca/document.aspx?id=14175. [Last accessed 2016 Nov 15].|
|11||Cheryl Gallant Presents Carmen Krogh With Diamond Jubilee Medal, February 11, 2014. Available from: http://cherylgallant.com/2014/02/11/cheryl-gallant-presents-carmen-krogh-diamond-jubilee-medal/. [Accessed 2016 Nov 15].|
|12||World Health Organization. Large Analysis and Review of European Housing and Health Status (LARES). Preliminary Overview; 2007.|
|13||Niemann H, Maschke C. WHO LARES: Final Report: Noise Effects and Morbidity. Geneva, Switzerland: World Health Organization; 2004.|
|14||Onakpoya IJ, O’Sullivan J, Thompson MJ, Heneghana CJ. The effect of wind turbine noise on sleep and quality of life: A systematic review and meta-analysis of observational studies. Environ Int 2015;82:1-9. Available from: http://www.sciencedirect.com/science/article/pii/S0160412015001051. [Last accessed 2016 Nov 15].|
|15||HGC. Low Frequency Noise and Infrasound Associated with Wind Turbine Generation Systems. A Literature Review. Ontario Ministry of Environment; 2010. RFP December 2010.|
|16||Case Nos.: 15-011. Dingeldein v. Ministry of Environment and Climate Change. Environmental Review Tribunal. Transcript of Dr. McCunney, May 11, 2015. p. 71.|
|17||Health Canada, It’s Your Health, Community Noise Annoyance 2005, (September). ISBN # H50-3/192-2005E-PDF. Catalogue # 0-662-41546-9, © Her Majesty the Queen in Right of Canada, represented by the Minister of Health; 2005. Available from: http://www.hc-sc.gc.ca/hl-vs/alt_formats/pacrb-dgapcr/pdf/iyh-vsv/life-vie/community-urbain-eng.pdf. [Last accessed 2016 Nov 15].|
|18||Michaud DS, Keith SE, McMurchy D. Noise annoyance in Canada, Noise Health 2005;7:39-47. PMID: 16105248 [PubMed – indexed for MEDLINE]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16105248. [Last accessed 2016 Nov 15].|
|19||Berglund B, Lindvall T, Schwela DH. Guidelines for Community Noise. Geneva, Switzerland: World Health Organization 1999.|
|20||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;8:63-79.|
|21||The Canadian Wind Energy Association. The Canadian Wind Energy Association Responds to October 14, 2011 Statement by Wind Concerns Ontario, Media Release (2011, October 14). PDF Available on request.|
Author: Smith, Michael; Ögren, Mikael; Thorsson, Pontus; Pedersen, Eja; and Persson Waye, Kerstin
In accordance with the EU energy policy, wind turbines are becoming increasingly widespread throughout Europe, and this trend is expected to continue globally. More people will consequently live close to wind turbines in the future, and hence may be exposed to wind farm noise. Of particular concern is the potential for nocturnal noise to contribute towards sleep disturbance of nearby residents. To examine the issue, we are implementing a project titled Wind Turbine Noise Effects on Sleep (WiTNES). In a pilot study described in this paper, we performed an initial investigation into the particular acoustical characteristics of wind turbine noise that might have the potential to disturb sleep. Six young, healthy individuals spent 5 nights in our sound exposure laboratory. During the final 3 nights of the study, the participants were exposed to wind turbine noise, which was synthesised based on analysis of field measurements. Exposures involved periods of different amplitude modulation strengths, the presence or absence of beats, different blade rotational periods, and outdoor LAEq,8h=45 or 50 dB with indoor levels based on the windows being fully closed or slightly open. Physiological measurements indicate that nights with low frequency band amplitude modulation and LAEq,8h=45 dB, slightly open window (LAEq,8h=33 dB indoors) impacted sleep the most. The presence of beats and strong amplitude modulation contributed to sleep disturbance, reflected by more electrophysiological awakenings, increased light sleep and wakefulness, and reduced REM and deep sleep. The impact on sleep by these acoustic characteristics is currently the focus of interest in ongoing studies.
Michael G. Smith, Mikael Ögren, Pontus Thorsson, Eja Pedersen, and Kerstin Persson Waye
University of Gothenburg, Sweden (MGS, MÖ, KPW).
Chalmers University of Technology Sweden (PT).
Lund University, Sweden (EP).
Presented at the 22nd International Congress on Acoustics, Buenos Aires, 5–9 September 2016
Wind Turbine Noise and Human Health: A Four-Decade History of Evidence that Wind Turbines Pose Risks
Author: Punch, Jerry; and James, Richard
The primary aims of the linked article are to provide our reference sources for much of the information in that earlier series [background, evidence, and how the ear and brain process infrasound], as well as to update that information. We do so by addressing 12 specific position statements frequently made by the wind industry, its trade associations, and other surrogates. We address these position statements, many of which are revealed to be little more than unfounded talking points, by a comprehensive review of the literature, including that from industry proponents and from those who are independent of the industry.
This article is the culmination of about 15 years of our combined experience with wind turbine noise issues. We first submitted an article resembling the current one to an international journal, Noise & Health, where it received multiple reviews by a single reviewer. We addressed all but two of that reviewer’s criticisms, namely that the manuscript was too lengthy for publication in the journal and the reviewer’s insistence that we accept the notion that infrasound at levels produced by wind turbines cannot cause adverse health effects. Underlying that reviewer’s position was the belief that “What you can’t hear, you can’t feel.”
In fact, decades of research have shown that the dynamically amplitude-modulated short bursts of energy, or pressure pulsations, are a characteristic of all modern industrial wind turbine emissions. These pressure peaks can be perceived by humans at levels far below the commonly accepted thresholds of perception and can lead to adverse symptoms such as sleep disturbance, headaches, tinnitus, ear pain, vertigo, and nausea.
The editor of Noise & Health offered an additional review cycle by a second reviewer. We chose instead to withdraw the manuscript from consideration because we were unwilling to either shorten it considerably or to mischaracterize the literature on the subject at hand.
We are grateful to Hearing Health & Technology Matters for allowing us to share this information through its widely accessible website.
This paper has been reviewed both by the anonymous Noise & Health reviewer and by three other reviewers who have substantial professional experience in the area of wind turbine noise. We gratefully acknowledge the helpful contributions of Keith Johnson, Esq., Michael Nissenbaum, MD, and Daniel Shepherd, PhD.
Mr. Johnson provided a review from the perspective of an attorney who represents interveners in wind turbine siting cases. Dr. Nissenbaum provided a review from the perspective of a medical professional and expert in how ionizing and non-ionizing radiation affects humans. Dr. Shepherd provided a review from the perspective of a psychoacoustician with experience in how wind turbine sound affects people. Each of these reviewers’ comments on earlier versions of our manuscript led to the final document. The opinions or assertions contained herein, however, are the personal views of the authors and are not to be construed as reflecting the views of Michigan State University or Central Michigan University.
The article’s unusual length stems not only from the number of topics covered, but also from our desire to quote literally and liberally from researchers and others on matters related to some of the key points in support of the link between wind turbine noise and adverse health effects. Given the length, interested readers will likely require multiple sessions to read the article in its entirety.
Even though wind turbine noise does not normally cause hearing loss, we believe that audiologists, particularly those interested in community noise, should embrace the notion that all forms of noise, if sufficiently intense and prolonged, can be detrimental to public health. Audiologists should also be sensitive to the non-auditory aspects of acoustic energy, including dynamically modulated infrasound and low-frequency sound.
It is worth noting that two of the seven co-authors of the original white-paper report of the American Wind Energy Association (AWEA) and the Canadian Wind Energy Association (CanWEA), which promoted the idea that wind turbines were harmless, were audiologists. We believe that the basic conclusions of that paper, which was not peer reviewed and written by a panel hand-picked by wind industry trade associations, unjustifiably favored the wind industry. It is particularly noteworthy that those major wind industry associations have acknowledged the audiology profession as having a credible say on the issue of wind turbine noise.
Interestingly, now that the tide is turning against the wind industry in many ways and in many places, its advocates are trying to discredit the views of audiologists, physicians, acousticians, and others who speak out in opposition of wind-energy development in populated areas. Concerned audiologists, especially those with expertise in cochlear and vestibular responses to noise and vibration, need to be heard on this issue.
Finally, let it not be said that either of us believes in making any less than the best possible effort to develop clean and efficient sources of energy. Rather, we hope that our article will be instrumental in promoting public health through a better understanding of the issues underlying the potentially harmful effects of audible and inaudible noise from industrial wind turbines when the turbines are sited too close to where people live and work.
Jerry Punch, Professor Emeritus, Department of Communicative Sciences and Disorders, Michigan State
University, East Lansing
Richard James, E-Coustic Solutions; and Adjunct Professor, Department of Communication Disorders,
Central Michigan University, Mt. Pleasant
Many expert-review panels and some individual authors, in the U.S. and internationally, have taken the position that there is little literature to support concerns about adverse health effects (AHEs) from noise emitted by industrial wind turbines (IWTs). In this review, we systematically examine the literature that bears on some of the particular claims that are commonly made in support of the view that a causal link is non-existent. Investigation of the veracity of those claims requires that multiple topics be addressed, and the following specific topics were targeted for this review: (1) emissions of infrasound and low-frequency noise (ILFN) by IWTs, (2) the perception of ILFN by humans, (3) the evidentiary bases for establishing a causative link between IWTs and AHEs, as well as the physiological bases for such a link, (4) recommended setback distances and permissible noise levels, (5) the relationship between annoyance and health, (6) alternative causes of the reported health problems, (7) recommended methods for measuring infrasound, (8) foundations for establishing a medical diagnosis of AHEs due to IWTs, (9) research designs useful in establishing causation, (10) the role of psychological expectations as an explanation for the reported adverse effects, (11) the prevalence of AHEs in individuals exposed to IWTs, and (12) the scope and quality of literature addressing the link between IWT noise and AHEs. The reviewed evidence overwhelmingly supports the notion that acoustic emissions from IWTs is a leading cause of AHEs in a substantial segment of the population.