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Resource Documents: Videos (68 items)


Unless indicated otherwise, documents presented here are not the product of nor are they necessarily endorsed by National Wind Watch. These resource documents are shared here 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. • The copyrights reside with the sources indicated. As part of its noncommercial effort to present the environmental, social, scientific, and economic issues of large-scale wind power development to a global audience seeking such information, National Wind Watch endeavors to observe “fair use” as provided for in section 107 of U.S. Copyright Law and similar “fair dealing” provisions of the copyright laws of other nations.

Date added:  October 3, 2014
Videos, WildlifePrint storyE-mail story

Behavior of bats at wind turbines

Author:  Cryan, Paul; et al.

Bats are dying in unprecedented numbers at wind turbines, but causes of their susceptibility are unknown. Fatalities peak during low-wind conditions in late summer and autumn and primarily involve species that evolved to roost in trees. Common behaviors of “tree bats” might put them at risk, yet the difficulty of observing high-flying nocturnal animals has limited our understanding of their behaviors around tall structures. We used thermal surveillance cameras for, to our knowledge, the first time to observe behaviors of bats at experimentally manipulated wind turbines over several months. We discovered previously undescribed patterns in the ways bats approach and interact with turbines, suggesting behaviors that evolved at tall trees might be the reason why many bats die at wind turbines.

Wind turbines are causing unprecedented numbers of bat fatalities. Many fatalities involve tree-roosting bats, but reasons for this higher susceptibility remain unknown. To better understand behaviors associated with risk, we monitored bats at three experimentally manipulated wind turbines in Indiana, United States, from July 29 to October 1, 2012, using thermal cameras and other methods. We observed bats on 993 occasions and saw many behaviors, including close approaches, flight loops and dives, hovering, and chases. Most bats altered course toward turbines during observation. Based on these new observations, we tested the hypotheses that wind speed and blade rotation speed influenced the way that bats interacted with turbines. We found that bats were detected more frequently at lower wind speeds and typically approached turbines on the leeward (downwind) side. The proportion of leeward approaches increased with wind speed when blades were prevented from turning, yet decreased when blades could turn. Bats were observed more frequently at turbines on moonlit nights. Taken together, these observations suggest that bats may orient toward turbines by sensing air currents and using vision, and that air turbulence caused by fast-moving blades creates conditions that are less attractive to bats passing in close proximity. Tree bats may respond to streams of air flowing downwind from trees at night while searching for roosts, conspecifics, and nocturnal insect prey that could accumulate in such flows. Fatalities of tree bats at turbines may be the consequence of behaviors that evolved to provide selective advantages when elicited by tall trees, but are now maladaptive when elicited by wind turbines.

Paul. M. Cryan
Fort Collins Science Center, United States Geological Survey (USGS), Fort Collins, CO
P. Marcos Gorresen
Hawaii Cooperative Studies Unit, University of Hawaii, Hilo, HI
Cris D. Hein
Michael R. Schirmacher
Bat Conservation International, Austin, TX
Robert H. Diehl
Northern Rocky Mountain Science Center, USGS, Bozeman, MT
Manuela M. Huso
Forest and Rangeland Ecosystem Science Center, USGS, Corvallis, OR
David T. S. Hayman
Department of Biology, Colorado State University, Fort Collins, CO
Department of Biology, University of Florida, Gainesville, FL

Paul D. Fricker
MathWorks, Natick, MA
Frank J. Bonaccorso
Pacific Island Ecosystems Research Center, USGS, Hawaii National Park, HI
Douglas H. Johnson
Northern Prairie Wildlife Research Center, USGS, Saint Paul, MN
Kevin Heist
Conservation Biology Graduate Program, University of Minnesota, Saint Paul, MN 55108
David C. Dalton
Wildlife Engineering, Tucson, AZ 85745

PNAS (Proceedings of the National Academy of Sciences of the United States of America) 2014; published ahead of print September 29, 2014; doi: 10.1073/pnas.1406672111

Download original document: “Behavior of bats at wind turbines
Download “Supporting Information”

Movie S1. Bat making a single directed approach toward a turbine before changing course and flying away at ∼0530 hours on September 9, 2012. Blade rotation 14 rpm, wind out of the southwest (225°) at 4.4 m/s, and 44% moon illumination.

Movie S2. Bat making repeated looping approaches to leeward side of wind turbine at ∼0109 hours on August 29, 2012. Blade rotation <1 rpm, wind out of the east-northeast (58°) at 5.4 m/s, and 93% moon illumination.

Movie S3. A hoary bat (Lasiurus cinereus; identified acoustically) air-brakes, hovers, and then makes repeated approaches after flying downwind past a wind turbine with curtailed blades at ∼0100 hours on August 25, 2012. Blade rotation <1 rpm, wind out of the southeast (131°) at 7.2 m/s, and no moon illumination.

Movie S4. Near-infrared, close-up video of a bat closely approaching and investigating the upper parts of a turbine at ∼0430 hours on September 19, 2013. Blade rotation <1 rpm, wind out of the west-southwest (257°) at 2.7 m/s, and no moon illumination.

Movie S5. Bat making repeated close approaches to a turbine monopole at ∼2150 hours on August 19, 2012. No blade rotation, wind out of the north-northwest (330°) at 0.4 m/s, and no moon illumination.

Movie S6. Near-infrared, close-up video of a bat closely following a slow moving turbine blade (shadowed on far side of monopole) at ∼0240 hours on July 19, 2013 (before monitoring with thermal cameras began). Blade rotation <1 rpm, wind out of the east-northeast (70°) at 7.5 m/s, and no moon illumination.

Movie S7. Two bats chasing each other near wind turbine at ∼2320 hours on August 5, 2012. No blade rotation, wind out of the north-northwest (321°) at 4.6 m/s, and no moon illumination.

Movie S8. Bat repeatedly returning to turbine after close encounters with spinning blades at ∼0150 hours on August 22, 2012. Blade rotation 14 rpm, wind out of the east (93°) at 8.0 m/s, and no moon illumination.

Movie S9. Bat exhibiting serpentine flight in lee of wind turbine monopole and blades at ∼0500 hours on September 29, 2012. No blade rotation, wind out of the northeast (315°) at 5.8 m/s, and 96% moon illumination.

Movie S10. Two hoary bats (Lasiurus cinereus) interacting in midair on the leeward side of a wind turbine at ∼0200 hours on August 25, 2012. The species identification was made from concurrent acoustic calls recorded from the turbine nacelle, in which navigation and social calls characteristic of this species were heard during the close midair approaches. No blade rotation, wind out of the south-southeast (157°) at 8.3 m/s, and no moon illumination.

Movie S11. Bat flying upwind to investigate leeward areas of a wind turbine with blades rotating at full speed at ∼0350 hours on July 31, 2012. Bat makes several upwind passes through the moving blades of the turbine without clear indication that it perceives and avoids the fast-moving blades before moving through their plane of motion. Blade rotation speed 14 rpm, wind out of the southwest (228°) at 7.2 m/s, and 95% moon illumination.

Movie S12. Bat flying upwind toward moving turbine blades at ∼0600 hours on August 17, 2012 and repeatedly returning to investigate after close encounters with blades. Blade rotation speed 14 rpm, wind out of the north-northwest (324°) at 7.6 m/s, and no moon illumination.

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Date added:  August 21, 2014
Australia, Health, VideosPrint storyE-mail story

Wind Farms and Human Health Scientific Forum

Author:  Various

On Tuesday 7 June 2011 NHMRC [National Health and Medical Research Council, Australia] conducted a scientific forum on the possible health effects of wind turbines. The forum provided an opportunity for NHMRC to hear the latest international scientific evidence and to engage with stakeholders over the range of issues for which there is public concern.

Panel One: current evidence on health impacts
Professor Geoffrey Leventhall
Professor Mariana Alves-Pereira

Download presentation (PDF):  Wind Farms and Human Health – Geoff Leventhall
Download presentation (PDF):  Low Frequency Noise and Health Effects – Mariana Alves-Pereira

Panel Two
Dr Bob Thorne – human perception and infrasound
Dr Simon Chapman – psycho-social factors

Download presentation (PDF):  Wind Farm Noise : Assessment and Management – Bob Thorne
Download presentation (DOC):  Psycho-social mediators of reported annoyance and putative health-related symptoms associated with wind turbines: a discussion starter – Simon Chapman

Panel Three: personal stories
Dr Sarah Laurie (Chair)
Ms Bernie Janssen
Mr Donald Thomas
Mr David Page

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Date added:  August 2, 2014
Australia, Health, Noise, Vermont, VideosPrint storyE-mail story

Wind noise and adverse health effects

Author:  Reider, Sandy

Public Service Board Hearing, July 29, 2014:

Good afternoon. My name is Sandy Reider, I am a primary care physician in Lyndonville, and I have been practicing clinical medicine in Vermont since I received my license in 1971. In the interest of full disclosure, I am not being paid for involvement in this issue, nor did I seek this out; rather, it found me by way of a patient I had known well for several years, and who, in late 2011, suddenly developed severe insomnia, anxiety, headaches, ringing ears, difficulty concentrating, and frequent nausea, seemingly out of the blue. This puzzled us both for a few months before we finally came to understand that he suffered from what was, then, a relatively new clinical entity known as “wind turbine syndrome”, related in his particular case to the comparatively small NPS 100 KW turbine that began generating power atop Burke Mountain in the fall of 2011. In the course of the 2012 legislative session, I described this patient in detail in testimony for the Senate Natural Resources and Health Care Committees, as well as the Governor’s Siting Commission. Since his symptoms were so typical and similar to those described by thousands of other individuals living too close to large wind turbines all over the globe, I have attached my testimony for the Senate Health Care Committee and encourage you to review it for its very characteristic description of what it is that this board, I trust, hopes to mitigate by recommending more protective sound standards for these industrial wind installations. I should add that I have seen 4 additional patients living close to the large Sheffield and Lowell projects, as well as an individual living near another single NPS 100KW turbine in Vergennes. All presented with similar, though not identical, symptoms to those described in my testimony.

That there have already been so many complaints here in Vermont related to wind turbines suggests that the current noise standards may be inadequate. Either the utilities have been regularly out of compliance with the current existing standards ( Shirley Nelson’s detailed daily records suggest this has indeed occurred with some regularity ) and/or that the scientific data and studies upon which the current noise standards are based is incomplete, or possibly just plain wrong.

Over the past 2 years I have reviewed much of the relevant scientific literature, and out of my 42 years of experience and perspective as a clinician, respectfully offer the following observations and comments.

Firstly, I do not doubt at all that these large turbines can and do cause serious health problems in a significant number of persons living nearby, even though the vibrational-acoustic mechanisms behind this harm are not yet completely understood (1,5). Repetitive sleep disruption is the most often cited adverse effect, and disturbed sleep and its resulting stress over time is known to cause or exacerbate cardiovascular illnesses (2), chronic anxiety and depression, as well as worsening of other pre-existing medical problems . This is especially concerning for the most vulnerable among us … children, the elderly, those who are naturally sensitive to sound, or prone to motion sickness or migraine headaches, and, as mentioned, those who are unwell to start with.

The position adopted by developers of large industrial wind projects, and thus far supported by regulatory and health agencies, has been that there is no evidence of a direct effect on health from wind turbines; rather, that the claimed adverse health effects are indirect, due mainly to the individual’s negative attitude about the wind turbines ( so-called “nocebo” effect ), and therefore it is their fault, it’s all in their heads, and so on. Not only is this incorrect, it is disingenuous. There is simply no clinical justification for ignoring harm being done to individuals and communities, whether direct or indirect, on these grounds… simply put, harm is harm, whatever the mechanism.

However, good evidence for direct adverse effects has existed since the mid-80’s when Neil Kelley headed a group of researchers, under the auspices of the US Department of Energy and NASA, and found conclusive evidence that adverse effects, very similar to those that describe “wind turbine syndrome”, were due primarily to very low frequency sound and inaudible infrasound (6). This role of infrasound was subsequently confirmed by Kelley’s team under controlled laboratory conditions, and resulted in a complete redesign of turbines from the downwind trestle-mounted turbines to today’s upwind turbine on a single massive tower. Furthermore, he recommended protective maximum levels of this low frequency sound.

[T]he joint radiation levels (expressed in terms of acoustic intensity and measured external to a structure) in the 8, 16, 31.5 and 63 Hz standard (ISO) octaves should not exceed band intensity threshold limits of 60, 50, 40 and 40 dB (re 1 pWm –2) more than 20% of the time. These figures compare favorably with a summary of low-frequency annoyance situations by Hubbard.

( It is worth noting that very often infrasound levels are higher inside a building than outside, the structure acting as a resonating chamber and amplifying the lower “vibration” frequencies. Thus measurements for low frequency sound should be made inside the structure as well as outside. Also, low frequency sound levels are not only building design and geometry specific, but also site specific, especially in a place like Vermont where the topography and climactic conditions are so variable. There may be unacceptable indoor infrasound levels in one home, while another home over the hill may have undetectable or very low levels. )

The wind industry’s assertion that the Kelley study is irrelevant and that infrasound levels are negligible with the current, newer turbine design and may be ignored is unfounded, and more recent evidence confirms this ( 2012 Falmouth study by Ambrose and Rand ( Bob Thorne’s excellent quality of life study in 2011 (12); Steven Cooper’s preliminary results in Australia, final results due in September 2014 (11); and others ). The aforementioned studies were performed by independent professional acousticians not connected to the wind industry. Incidentally, the severely affected patient described in my 2012 testimony never did perceive any audible noise from the turbine ( and this is quite typical, the sound is more felt than heard ), nor did he harbor any feelings pro or con about the installation when his problems began, though after he understood the source of his ill-health, I have no doubt that the “nocebo” effect may have added to his stress, adding insult to injury. He has since abandoned that home, and is once again sleeping soundly and feeling well.

The current sound standards, based as they are on dBA weighted acoustic measurements, gives particular weight to audible frequencies in the soundscape, but very little or no weight to low sound frequencies and infrasound, particularly below 10 Hz, which comprises a significant proportion of the sound generated by large turbines . People do not hear dBA, they hear qualitatively different sounds, birds, insects, running water, wind in the trees, etc. … basing noise criteria solely on this single number ignores the unique nature of the sound produced by large wind turbines, with its constantly changing loudness, frequency, harmonics, pitch, and impulsive quality. It is precisely these qualities that make the sound feel so intrusive and annoying, especially in quiet rural environments where these projects are usually located (12). Parenthetically, the word “annoying” is somewhat misleading, as it implies a minor, temporary, or occasional nuisance that perhaps might be mostly ignored, rather than what it is: a repetitive stressor that can degrade one’s short and long term health and well being, and from which there is no escape over the lifetime of the project short of having to abandon one’s home.

It is worth repeating here that the current Public Service Board threshold of 45 dBA of audible sound, averaged over an hour, has never been proven safe or protective, and that most studies agree that audible sound should not exceed 35 dBA, or 5dBA above normal background sound levels. (this is especially important in rural areas where background noise is minimal). The level should be a maximum , not an hourly average. Above 35 dBA there are likely to be significantly more complaints, particularly difficulty sleeping.


Before concluding, I would like to emphasize that the bulk of scientific evidence for adverse health effects due to industrial wind installations comes in the form of thousands of case reports like the patient I described. One or two sporadic anecdotal cases can legitimately be viewed with a wait-and-see skepticism, but not thousands where the symptoms are so similar, along with the ease of observing exposure and measuring outcomes, wherever these projects have been built. I agree with Epidemiologist Carl Phillips, who opined that “these case reports taken together offer the most compelling scientific evidence of serious harm. Just because the prevailing models have failed to explain observed adverse health effects does not mean they do not exist”, and, as he succinctly, though in my opinion a bit too harshly, concluded: “The attempts to deny the evidence cannot be seen as honest scientific disagreement and represent either gross incompetence or intentional bias” (13).

I am aware that the members of the PSB bear a heavy responsibility for Vermont’s overall energy future and have many other issues on their plate besides this one. Rather than presenting you with a long list of literature references most of which would likely go unread ( but they are included just in case ), I recommend a careful review of just one study in particular: Bob Thorne, a professional acoustician in Australia, presented an excellent and well thought out clinical study to the Australian Senate in 2011 (12). It really does cover the waterfront, including WHO quality of life measures, audible and infrasound measurements, and health measures, in a balanced and scientific way. For your convenience there is a hard copy of this study included with my presentation today.

His comprehensive ( including the full sound spectrum, not only dBA weighted sound ) and protective recommendations for sound criteria are reasonable, and if adopted, would be likely more acceptable to neighboring households and communities. However, given that wind developers are these days building bigger turbines atop taller towers in order to maximize power generation and profits, adoption of these safer limits would necessitate siting the installations farther from dwellings. A 1-2 km setback is not nearly sufficient; significant low frequency sound pressure measurements have been recorded in homes 3-6 miles from large projects in Australia.

The outcomes of the study are concerned with the potential for adverse health effects due to wind farm modified audible and low frequency sound and infrasound. The study confirms that the logging of sound levels without a detailed knowledge of what the sound levels relate to renders the data uncertain in nature and content. Observation is needed to confirm the character of the sound being recorded. Sound recordings are needed to confirm the character of the sound being recorded.
The measures of wind turbine noise exposure that the study has identified as being acoustical markers for excessive noise and known risk of serious harm to health (significant adverse health effects)
1. Criterion: An LAeq or ‘F’ sound level of 32 dB(A) or above over any 10 minute interval, outside;
2. Criterion: An LAeq or ‘F’ sound level of 22 dB(A) or above over any 10 minute interval inside a dwelling with windows open or closed.
3. Criterion: Measured sound levels shall not exhibit unreasonable or excessive modulation (‘fluctuation’).
4. Criterion: An audible sound level is modulating when measured by the A-weighted LAeq or ‘F’ time-weighting at 8 to 10 discrete samples/second and (a) the amplitude of peak to trough variation or (b) if the third octave or narrow band characteristics exhibit a peak to trough variation that exceeds the following criteria on a regularly varying basis: 2dB exceedance is negligible, 4dB exceedance is unreasonable and 6dB exceedance is excessive.
5. Criterion: A low frequency sound and infrasound is modulating when measured by the Z- weighted LZeq or ‘F’ time-weighting at 8 to 10 discrete samples/second and (a) the amplitude of peak to trough variation or (b) if the third octave or narrow band characteristics exhibit a peak to trough variation that exceeds the following criteria on a regularly varying basis: 2dB exceedance is negligible, 4dB exceedance is unreasonable and 6dB exceedance is excessive.
6. Definitions: ‘LAeq’ means the A-weighted equivalent-continuous sound pressure level [18]; ‘F’ time-weighting has the meaning under IEC 61672-1 and [18]; “regularly varying” is where the sound exceeds the criterion for 10% or more of the measurement time interval [18] of 10 minutes; and Z-weighting has the meaning under AS IEC 61672.1 with a lower limit of 0.5Hz.
7. Approval authorities and regulators should set wind farm noise compliance levels at least 5 dB(A) below the sound levels in criterion (1) and criterion (2) above. The compliance levels then become the criteria for unreasonable noise.
Measures (1-6) above are appropriate for a ‘noise’ assessment by visual display and level comparison. Investigation of health effects and the complex nature of wind turbine noise require the more detailed perceptual measures of sound character such as audibility, loudness, fluctuation strength, and dissonance.

To exclude careful independent well designed case studies like Thorne’s ( and others ) in a review of the scientific literature that purports to be thorough is, I repeat, a serious omission and is not “scientific”. Careful consideration of these independent well done studies, if nothing else, should encourage regulatory agencies to adopt a much more precautionary approach to the siting of today’s very big industrial wind projects in order to adequately protect public health. For better or worse, in today’s “information age” we are perhaps too fascinated by computers and mountains of data, but truth is truth, wherever you find it, even in small places.

Thank you very much for taking the time to address this issue, and for listening.

Respectfully Submitted,


Many thanks to Sarah Laurie, CEO of the Waubra Foundation, for her tireless work, and generosity in sharing so much information. www.waubrafoundation.org.au

1. Pierpont, Nina. 2009. From the executive summary of her peer reviewed study. http://waubrafoundation.org.au/resources/wind-turbine-syndrome-executive-summary/
2. Capuccio et al. 2011. Sleep Duration predicts cardiovascular outcomes: a systemic review and meta-analysis of prospective studies. European Heart Journal 32:1484-1492. http://waubrafoundation.org.au/resources/sleep-duration-predicts-cardiovascular-outcomes/
3. Nissenbaum, M, Hanning, C, and Aramini, J. 2012. Effects of industrial wind turbines on sleep and health. Noise and Health, October. https://www.wind-watch.org/documents/effects-of-industrial-wind-turbine-noise-on-sleep-and-health/
4. Shepherd, D, et al. 2011. Evaluating the impact of wind turbine noise on health related quality of life. Noise and Health, October. http://waubrafoundation.org.au/resources/evaluating-impact-wind-turbine-noise-health-related-quality-life/
5. Arra, M, and Lynn, Hazel. 2013. Powerpoint presentation to the Grey Bruce Health Unit, Ontario: Association between wind turbine noise and human distress. http://waubrafoundation.org.au/resources/association-between-wind-turbine-noise-and-human-distress/
6. Kelley, ND, et al. 1985. Acoustic noise associated with Mod 1 turbine, its impact and control. http://waubrafoundation.org.au/resources/kelley-et-al-1985-acoustic-noise-associated-with-mod-1-wind-turbine/
7. James, Richard. 2012. Wind turbine infra and low frequency sound: warning signs that went unheard. Bulletin of Science, Technology and Society 32(2):108-127, accessed via Professor Colin Hansen’s submission to the Australian Federal Senate Inquiry Excessive Noise from Windfarms Bill (Renewable Energy Act) November 2012 http://waubrafoundation.org.au/resources/testimony-hansenc-excessive-noise-bill-inquiry-submission/. James references another useful bibliography of references of the early NASA research, compiled by Hubbard & Shepherd, 1988: Wind turbine acoustic research—bibliography with selected annotation; http://waubrafoundation.org.au/resources/hubbard-h-shepherd-k-nasa-wind-turbine-acoustics-research/
8. Hubbard, H. 1982. Noise induced house vibrations and human perception. https://waubrafoundation.org.au/resources/hubbard-h-1982-noise-induced-house-vibrations-human-perception/
9. Ambrose, Stephen, and Rand, Robert. 2011. Bruce McPherson infrasound and low frequency noise study. http://waubrafoundation.org.au/resources/bruce-mcpherson-infrasound-low-frequency-noise-study/
10. Schomer, Paul, et al. 2013. A proposed theory to explain some adverse physiological effects of the infrasonic emissions at some wind farm sites. http://waubrafoundation.org.au/resources/schomer-et-al-wind-turbine-noise-conference-denver-august-2013/
11. http://waubrafoundation.org.au/2014/pacific-hydro-commended-initiating-wind-turbine-noise-acoustic-survey/
12. http://waubrafoundation.org.au/resources/wind-farm-generated-noise-and-adverse-health-effects/. Also see: Thorne, Bob. 2011. The Problems With “Noise Numbers” for Wind Farm Noise Assessment.
 Bulletin of Science, Technology and Society 31:262. 
DOI: 10.1177/0270467611412557. http://bst.sagepub.com/content/31/4/262
13. Phillips, Carl. 2011. Properly interpreting the Epidemiological evidence about the health effects of Industrial Wind turbines on nearby residents. Bulletin of Science, Technology and Society vol 31 No 4 (August 2011) pp 303-315. http://waubrafoundation.org.au/resources/properly-interpreting-epidemiologic-evidence-about-health-effects/

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Date added:  May 14, 2014
Health, Human rights, Noise, VideosPrint storyE-mail story

Harm from wind turbines – What has been known for decades

Author:  Krogh, Carmen

University of Waterloo Seminar, May 7, 2014


1948: Definition of health

Constitution of the World Health Organization:

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”

Acknowledgement: Annoyance

Annoyance is acknowledged to be an adverse health effect.

  1. Health Canada, Community Noise Annoyance, Its Your Health (2005, September)
  2. Michaud, D. S., Keith, S. E., & McMurchy, D., “Noise Annoyance in Canada”, Noise Health, 7, 39-47 (2005)
  3. Pedersen, E., & Persson Waye, K., “Wind Turbine Noise, Annoyance and Self-Reported Health and Well Being in Different Living Environments”, Occupational and Environmental Medicine, 64, 480-486 (2007) doi:10.1136/oem.2006.031039
  4. Suter, A. H., Noise and Its Effects, Washington, DC: Administrative Conference of the United States (1991)
  5. New South Wales. Parliament. Legislative Council. General Purpose Standing Committee No. 5, Rural Wind Farms (2009, December)

Definition: Sound versus noise

World Health Organization defines noise as “unwanted sound.” [Berglund, B., Lindvall, T., & Schwela, D. H., Guidelines for Community Noise, Geneva, Switzerland: World Health Organization (1999)]

Sound meters can assess sound; however, humans assess “noise.”

Humans are being considered as “objective measuring instruments (New Experts), whose reports and descriptions must be taken seriously and quantified by technical measurements.” [Bray, Wade, Acoustical Society of America 164th Meeting, Kansas City, MO, 22‐26 October, 2012, 2aNS6, Relevance and applicability of the Soundscape concept to physiological or behavioural effects caused by noise at very low frequencies which may not be audible. www.acoustics.org/press/164th/Bray_2aNS6.html]

2009: Commonly reported symptoms

Dr. Nina 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. [Pierpont, N., Wind Turbine Syndrome: A Report on a Natural Experiment, Santa Fe, NM: K-Selected Books (2009)]

“I am happy to accept these symptoms … what Pierpont describes is effects of annoyance by noise – a stress effect …” —Geoff Leventhall, Wind turbine syndrome – an appraisal

“… well-known stress effects of exposure to noise …” —David Colby et al., Wind turbine sound and health effects: an expert panel review

“… Wind Turbine Syndrome is the result of stress from annoyance by audible noise from wind turbines …” —Geoff Leventhall, Wind farms and human health

Noise: Direct and indirect pathways

World Health Organization, Night Noise Guidelines for Europe, 2009:

High sound level:  direct cause of stress
Moderate sound level:  indirect pathway to annoyance and stress, via disturbance of activities, sleep, and communication and cognitive and emotional response

Stress reactions of autonomic nervous system and endocrine system (pituitary, adrenal) affect biological risk factors involving blood pressure and viscosity, cardiac output, and blood lipids, glucose, and clotting factors – which lead to manifest disorders, namely cardiovascular diseases, including hypertension, arteriosclerosis, and ischemic heart disease.

2010: Ontario Chief Medical Officer of Health:

“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.” [emphasis added; Chief Medical Officer of Health. The potential health impact of wind turbines. www.health.gov.on.ca/en/public/publications/minis try_reports/wind_turbine/wind_turbine.pdf

CMOH report only looked at direct links.

2011: Direct and indirect impacts

“… The Tribunal has found above that “serious harm to human health” includes both direct impacts (e.g., a passer-by being injured by a falling turbine blade or a person losing hearing) or indirect impacts (e.g., a person being exposed to noise and then exhibiting stress and developing other related symptoms). This approach is consistent with both the WHO definition of health and Canadian jurisprudence on the topic.” [Case Nos.: 10-121/10-122 Erickson v. Director, Ministry of the Environment Environmental Review Tribunal, Decision, p 190]

The ERT Decision expressed concerns “… about the Director’s apparent lack of consideration of indirect health effects and the need for further work on the MOE’s practice of precaution …” [p 206]

Government Policies

1986 Policy: Health Canada

“It is clear … that existing policies and practices are not sufficiently effective to ensure that Canadian men and women of all ages and backgrounds can have an equitable chance of achieving health … Conflicting interests may exist between sectors.” —Achieving health for all: a framework for health promotion [emphasis added]

2008 Policy: World Health Organisation

“Different government policies, depending on their nature, can either improve or worsen health and health equity.” —Closing the gap in a generation

2009: Green Energy Act, Ontario

Preamble: The Government of Ontario is committed to fostering the growth of renewable energy projects, which use cleaner sources of energy, and to removing barriers to and promoting opportunities for renewable energy projects and to promoting a green economy. [emphases added]

Industry-led: government-supported

Message from Co-Chair Geoff Munro, Chief Scientist & Assistant Deputy Minister, Innovation and Energy Technology Sector, Natural Resources Canada:

“This Wind Technology Roadmap is an industry-led, government-supported initiative that has developed a long-term vision for the Canadian wind energy industry and identified the major technology gaps and priorities to achieve a major increase in deployment of wind energy in Canada.”

Yesterday’s and Today’s Industrial Wind Turbines


Real property value: Denmark

“An erector of a wind turbine has a duty to pay compensation for loss of value of real property following the erection of the wind turbine. the size of the loss of value is determined by an appraisal authority.” [Danish Energy Agency, “Loss of value to real property due the erection of wind turbines”, www.ens.dk/en- US/supply/Renewable-energy/WindPower/Onshore-Wind-Power/Loss-of-value-to-real-property/Sider/Forside.aspx, cited August 21, 2012]

2011 Ontario disclosure

“3. Are there any hydro generating projects planned for the immediate area? eg: Wind Turbines” [Ontario Real Estate Association, Seller Property Information Statement, Form 220 for use in the Province of Ontario, Revised 2011]


Other research

2004: Special edition: Noise & Health

“It is difficult for residents to protect themselves against low frequency emissions.”

“Conventional methods of assessing annoyance, typically based on A-weighed equivalent sound level, are inadequate for low frequency noise and lead to incorrect decisions by regulatory authorities.

Experiments with both animals and humans have shown that the vibroacoustic stress or causes thickening of cardiovascular structures (cardiac muscle and blood vessels).

2007: Examples of reviews

LFN-exposed animal models: “LFN is an agent of disease and the respiratory tract is one of its preferential targets.” —Branco NA et al, 2007, Respiratory pathology in vibroacoustic disease: 25 years of research. [Review] Revista Portuguesa de Pneumologia. 13(1):129- 35, 2007 Jan-Feb [27 refs]

Patients and animals: “At present, infrasound (0-20 Hz) and low-frequency noise (20-500 Hz) (ILFN, 0-500 Hz) are agents of disease that go unchecked. … Frequency-specific effects are not yet known, valid dose-responses have been difficult to identify, and large-scale epidemiological studies are still lacking.” —Alves-Pereira M & Branco NA, Vibroacoustic disease: biological effects of infrasound and low-frequency noise explained by mechanotransduction cellular signalling. [Review] Progress in Biophysics & Molecular Biology. 93(1-3):256-79, 2007 Jan-Apr. [123 refs]

2011 Review

“There is sufficient research and history to link the sensitivity of some people to inaudible amplitude-modulated infra and low-frequency noise to they type of symptoms described by those living near industrial wind turbines. This information should have served as a warning sign.”

—James, Richard R. Wind Turbine Infra and Low-Frequency Sound: Warnings Signs That Were Not Heard DOI: 10.1177/0270467611421845, Bulletin of Science Technology & Society published online 15 December 2011, http://bst.sagepub.com/content/early/2011/11/07/0270467611421845

Other research

1982 Investigation

Downwind 2 MW MOD turbine, Boone, North Carolina [N.D. Kelley et al., A methodology for assessment of wind turbine noise generation]:

“unexpected noise complaints from a few residents within 3 km”

“… hypothesize one of the causal factors related to annoyance associated with the pulsating pressure fields in the rooms measured is a coupling with human body resonances … creating a sensation of a whole-body vibration.” [emphasis added]

“This perception is more noticeable indoors…”

1987 Proposed Metric

N.D. Kelley, A proposed metric for assessing the potential of community annoyance from wind turbine low-frequency noise emissions, November 1987, Presented at Windpower’87 Conference and Exposition, October 5-8, 1987, San Francisco, California:

“… over a range of 5-100 Hz …

“4. Calculate the equivalent PLSL or PC levels at the reference distance of 1 km …

“Add 15 dB to the results of step (4)”

[PLSL = predicted low-frequency sound level; PC = predicted C-weighted]


Birgitta Berglund and Peter Hassmen, Sources and effects of low-frequency noise, J Acoust Soc Am 99 (5), May 1996:

Further research is needed in relation to a number of features and outcomes of low-frequency noise. These needs include the following.
(1) In general, there has been too little research on the role of different frequency spectra of noise in the production of effects on humans. Greater consideration of this factor in many studies of noise is desirable.
(2) Most of the research of adverse effects of low-frequency noise in humans has used short durations of exposure. It is of great importance to research prolonged exposures …” [emphases added]

2000: WHO on low-frequency noise in general

“Health effects due to low-frequency components in noise are estimated to be more severe than for community noises in general” —World Health Organization, Guidelines for Community Noise, 2000 www.euro.who.int/mediacentre/PR/2009/20091008_1

2004: Low-frequency noise exposure in general

“… chronic psychophysiological damage may result from long-term exposure to low-level low frequency noise.”

“The claim that their ‘lives have been ruined’ by the noise is not an exaggeration …”

Low frequency noise annoyance

“Those exposed may adopt protective strategies, such as sleeping in their garage if the noise is less disturbing there. Or they may sleep elsewhere, returning to their own homes only during the day.”

[Leventhall HG. Low frequency noise and annoyance. Noise Health [serial online] 2004 [cited 2009 Dec 31]; 6:59-72. Available from: www.noiseandhealth.org/text.asp?2004/6/23/59/31663

2007: National Research Council:

“Low-frequency vibration and its effects on humans are not well understood. Sensitivity to such vibration resulting from wind-turbine noise is highly variable among humans…. studies on human sensitivity to very low frequencies are recommended.” —National Research Council (NRC). Environmental Impacts of Wind Energy Projects, 2007, Washington, DC [emphasis added]

2007: Wind turbine noise characteristics

“Sound generated by wind turbines has particular characteristics and it creates a different type of nuisance compared to usual urban, industrial, or commercial noise.”

[Soysai, H., and O. Soysai. Wind farm noise and regulations in the eastern United States. 2007. Proceedings of the Second International Meeting on Wind Turbine Noise. Lyon, France: September 20-21, 2007. INCE/Europe.]

2008: Wind turbine noise is more annoying

“… wind turbine sound is relatively annoying, more so than equally loud sound from aircraft or road traffic.”

“… and (more) sound mitigation measures must be considered.”

—Pedersen et al., 2008, Project WINDFARMperception, Visual and acoustic impact of wind turbine farms on residents, Netherlands

2010 to 2014: Inner ear research

2010: “In this review, we consider possible ways that low frequency sounds, at levels that may or may not be heard, could influence the function of the ear.” [Salt, Alec N. and Hullar, T.E. Responses of the ear to low frequency sounds, infrasound and wind turbines. Department of Otolaryngology, Washington University School of Medicine, St. Louis, MO, 63110, USA. Hearing Research 2010 Sep 1; 268(1-2):12-21. Epub 2010 Jun 16]

2011: “Based on our current knowledge of how the ear works, it is quite possible that low-frequency sounds at the levels generated by wind turbines could affect those living nearby.” [Salt, Alec N. and Kaltenbach, James A. Infrasound From Wind Turbines Could Affect Humans Bulletin of Science Technology & Society 2011 31: 296, DOI: 10.1177/0270467611412555 https://journals.sagepub.com/doi/abs/10.1177/0270467611412555

2012: “… we have to be concerned that sounds that are not perceived are clearly transduced by the ear and may still affect people in ways that have yet to be fully understood.” [Salt, Alec N. and Lichtenhan, Jeffery T. Perception-based protection from low- frequency sounds may not be enough Invited paper presented at Inter-noise 2012, New York City, NY]

2014: “Based on well-established principles of the physiology of the ear and how it responds to very low-frequency sounds, there is ample justification to take this problem more seriously than it has been to date.” [Salt AN and Lichtenhan JT, How Does Wind Turbine Noise Affect People? Acoustics Today. A publication of the Acoustical Society of America. Volume 10: Issue One: Winter 2014]

Acknowledgements 2012–2014

2012: Wisconsin: Brown County Board of Health

“Therefore, be it resolved that the Brown County Board of Health formally requests temporary emergency financial relocation assistance from the State of Wisconsin for those Brown County families that are suffering adverse health effects and undue hardships caused by the irresponsible placement of industrial wind turbines around their homes and property. The State of Wisconsin emergency financial assistance is requested until the conditions that have caused these undue hardships are studied and resolved, allowing these families to once again return safely to their homes and property.”

2012: A Cooperative Measurement Survey and Analysis of Low Frequency and Infrasound at the Shirley Wind Farm in Brown County, Wisconsin. Prepared cooperatively by: Channel Islands Acoustics, Camarillo, California; Hessler Associates, Haymarket, Virginia; Rand Acoustics, Brunswick, Maine; and Schomer and Associates, Champaign, Illinois. Report number 122412-1. Issued December 24, 2012.

“The four investigating firms are of the opinion that enough evidence and hypotheses have been given herein to classify LFN and infrasound as a serious issue, possibly affecting the future of the industry. I thould be addressed beyond the present practice of showing that wind turbine levels are magnitudes below the threshold of hearing at low frequencies.” [emphasis added]

2012: Massachusetts: Falmouth Health Department (June 11, 2012)

“The Falmouth Board of Health requests that Mass DPH immediately initiate a health assessment of the impacts of the operation of wind turbines in Falmouth. This appeal is compelled by two years of consistent and persistent complaints of health impacts during turbine operation. … Due to the increasing intensity of the reported health impacts, the Board is considering emergency actions. To determine the appropriateness of such actions, the Board requests immediate guidance on interim measures to protect the health of affected individuals while the complete health assessment is being conducted.”

2012: Town of Falmouth vs. Town of Falmouth Zoning Board of Appeals and Others

“By order of the court, preliminary injunction shall issue until further order of the courts. 1. The Town of Falmouth, its Selectmen, agents and persons acting in concert shall be restrained from operating the Wind Turbines located at the Waste Water Treatment Facility except during the hours of 7am to 7pm, every day of the week except Sunday.”

—Superior Court Civil Action No. BACV 2013-00281, November 21, 2013

Judicial processes in other venues

2012: Supreme Court Bavaria Germany: 3 dB addition for pulsed noise for the E82 and compensation

2012: High Court UK: Viewscape/landscape

2013: Supreme Court Portugal: Removal of 4 turbines and compensation

Children and vulnerability to noise

WHO: vulnerable groups

Direct and indirect effects

Direct: ear damage

Indirect (physiological and psychological effects):

—World Health Organization, Children and Noise, Children’s Health and the Environment, WHO Training Package for the Health Sector, www.who.int/ceh

Pre-existing medical conditions

[1] Cristina Becchio, Morena Mari, Umberto Castiello, (2010). Perception of Shadows in Children with Autism Spectrum Disorders PLoS ONE | May 2010 | Volume 5 | Issue 5 | e10582. Retrieved from www.plosone.org

[2] Catherine Purple Cherry and Lauren Underwood. The ideal home for the autistic child: physiological rationale for design strategies. Autism Science Digest: The Journal Of Autismone, Issue 03 Retrieved from www.purplecherry.com.

[3] Flavia Cortesi, Flavia Giannotti, Anna Ivanenko, Kyle Johnson (2010). Sleep in children with autistic spectrum disorder, Sleep Medicine 11 (2010) 659–664.

[4] Hartmut Ising, Martin Ising (2002), Chronic cortisol increases in the first half of the night caused by road traffic noise. Noise and Health 2002,4(16):13-21. Retrieved from www.noiseandhealth.org/article.asp?issn=1463-1741;year=2002;volume=4;issue=16;spage=13;epage=21;aulast=Ising

[5] Bockelbrink A, Willich SN, Dirzus I, Reich A, Lau S, Wahn U, Keil T. (2008) Environmental noise and asthma in children: sex specific differences J Asthma. 2008 Nov;45(9):770-3.

[6] Neut D, Fily A, Cuvellier JC, Vallée L (2011). The prevalence of triggers in paediatric migraine: a questionnaire study in 102 children and adolescents. J Headache Pain. 2011 Nov 1. [Epub ahead of print]

[7] Doreen Wagner, Velitchko Manahilov, Gunter Loffler, Gael E. Gordon, and Gordon N. Dutton, Visual Noise Selectively Degrades Vision in Migraine Investigative Ophthalmology & Visual Science, April 2010, Vol. 51, No. 4. Retrieved from www.iovs.org/content/51/4/2294.full.pdf

[8] Ising H, Lange-Asschenfeldt H, Moriske HJ, Born J, Eilts M., Low frequency noise and stress: bronchitis and cortisol in children, Noise Health. 2004 Apr-Jun;6(23):21-8

[9] Gilboa T. Epilepsia. 2011 Dec 9. Emotional stress-induced seizures: Another reflex epilepsy? doi: 10.1111/j.1528-1167.2011.03342.x. [Epub ahead of print]

[10] Epilepsy Facts – Epilepsy Canada Cited March 2012, Retrieved from www. epilepsy@epilepsy.ca

2003: Children and possible irreversible negative consequences

“It is likely that children represent a group which is particularly vulnerable to the non-auditory health effects of noise.” [emphasis added]

“… there is a possible risk that exposure to an environmental stressor such as noise may have irreversible negative consequences for this group …” [emphasis added]

[Stephen A Stansfeld and Mark P Matheson (2003), Noise pollution: non-auditory effects on health, British Medical Bulletin 2003; 68: 243–257. DOI: 10.1093/bmb/ldg033 Retrieved from http://bmb.oxfordjournals.org/content/68/1/243.full.pdf]

2009 Children & learning

“The American National Standards Institute emphasizes that school buildings’ sound isolation should prevent two types of noise: … outside of the school building … within the school building such as unwanted speech.”

[Robert Ljung, Patrik Sorqvist and Staffan Hygge (2009), Effects of road traffic noise and irrelevant speech on children’s reading and mathematical performance. Noise and Health, Oct-Dec 2009. http://www.noiseandhealth.org/article.asp?issn=1463-1741;year=2009;volume=11;issue=45;spage=194;epage=198;aulast=Ljung]

2010: Long-term sleep disturbances in children: A cause of neuronal loss

“Animal experiments unequivocally show that sleep loss even for three or four days can adversely and permanently affect neurophysiological functions and neurogenesis.”

“This review summarises the increasing evidence … that chronic disturbances of sleep adversely affect brain development … Pediatric neurologists, the scientific community and the public must be aware of these recent scientific developments. Further studies are urgently required.”

—James E. Jan et al., European Journal of Paediatric Neurology 14 (2010) 380-390

2012: WHO: short- and long-term health problems

“Noise is an underestimated threat that can cause a number of short- and long-term health problems, such as for example sleep disturbance, cardiovascular effects, poorer work and school performance, hearing impairment, etc.”

—World Health Organization Noise Facts and Figures, cited December 23, 2012, http://www.euro.who.int/en/what-we-do/health-topics/environment-and-health/noise/facts-and-figures

Low frequency noise guidelines

2009: Low frequency noise guidelines

“It is proposed that wind turbines would not be permitted less than 550 metres from the nearest dwelling and this minimum setback would increase with the number and loudness of turbines. It is also proposed that there would be setback distances from all roads, railways, and property side and rear lot lines, and there would be ongoing requirements to monitor and address low frequency noise and vibrations.’ —John Gerretsen, Minister of the Environment (Ontario), email July 13, 2009, 3:56 pm

2009: LFN/infrasound guidelines

“… CanWEA submits that the proposed requirement for infrasound or low frequency noise monitoring as a condition of the REA be removed.” —CanWEA EBR Posting 010-6516 (Proposed Ministry of the Environment Regulations to Implement the Green Energy and Green Economy Act. 2009) – CanWEA’s Supplemental Submission Dated July 24, 2009, EBR Comment ID 123788. Signed Robert Hornung President.

2011: LFN/infrasound guidelines

In fact, according to our analyses, the most economical turbines, the 3 MW category, are the ones that will be strongly affected by the new rules. This applies to open terrain in particular, where in future low frequency noise will dictate and increase the distance requirements to neighbours for close to half of the projects that we are already aware of over the next 2 to 3 years. … The proposed low frequency limit values may hinder the development of onshore wind in Denmark, including meeting our commitments in relation to the EEC. Ultimately, we consider there is a danger that the regulations will be coped by other countries and accordingly this will provide an obstacle to the popularisation of wind energy at a global level. Both issues will damage Vestas as a business, including affecting Danish activities.” [emphases added]

—Ditleve Engel, Chief Executive Officer, Vestas Wind Systems, letter 29 June 2011

Wrap up

2009: Health effect “conclusively demonstrated”

“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 (e.g, headaches, nausea, tinnitus, vertigo).” [emphasis added]

—Correspondence from the Honourable Rona Ambrose, June 30, 2009

2010: ON Freedom of Information

“… the setback distances should be calculated using a sound level limit of 30 to 32 dBA at the receptor, instead of the 40 dBA sound level limit.” [emphasis added]

“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 …”

—MOE memorandum, Ontario Senior Environmental Officer, April 9, 2010

2010: Setbacks and noise levels expected to adversely affect some

“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.” [emphases added]

—Low frequency Noise and Infrasound Associated with Wind Turbine Generation Systems, A Literature Review, Ontario Ministry of Environment. RFP December 10, 2010 [MOE consultant report]

2011: Environmental Review Tribunal

“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.”

—Case Nos. 10-121/10-122 Erickson v. Director, Ministry of the Environment Environmental Review Tribunal, Decision, p 207

2013: Health Canada wind turbine noise study

“Dr. Michaud acknowledged that there is credible scientific support for an association between wind turbine noise and community annoyance. He explained that the study will help to build the evidence base to determine the link between nosie created by wind turbines, including infrasound and low frequency, and variables like sleep disturbance, stress, quality of life and annoyance.”

—Dr. David Michaud, meeting with MP Poilieve, June 2013 newsletter

2012–2014: Reported wind turbine health effects

Austrian Medical Association Issues Warning, Calls for Comprehensive Studies on Wind Turbine Noise and minimum safety distances to populated areas. April 30 2014 http://waubrafoundation.org.au/2014/austrian-medical-association-issues-warning-calls-for-comprehensive-studies-wind-turbine-noise/

Roy D. Jeffery, Carmen M.E. Krogh, and Brett Horner, Industrial wind turbines and adverse health effects Can J Rural Med 2014;19(1) www.cma.ca/multimedia/staticContent/HTML/N0/l2/cjrm/vol-19/issue-1/pdf/pg21.pdf

Enbom H and Enbom IM, Infrasound from wind turbines: An overlooked health hazard,” Läkartidningen, vol. 110 (2013), pp. 1388-89.

Roy D. Jeffery, Carmen Krogh, and Brett Horner, Adverse health effects of industrial wind turbines Can Fam Physician 2013; 59: 473-475 (Commentary) www.cfp.ca/content/59/5/473.full

Roy D. Jeffery MD FCFP, Carmen Krogh, Brett Horner CMA, Adverse health effects of industrial wind turbines, Letter to editor, Vol 59: September • septembre 2013, Canadian Family Physician • Le Médecin de famille canadien

Hanning, Christopher D. and Evans, Alun Editorial: Wind turbine noise British Medical Journal, BM J2 012;344. doi: 10.1136/bmj.e1527 (8 March 2012)

Nissenbaum, Michael A.; Aramini, Jeffery J.; and Hanning, Christopher D. Effects of industrial wind turbine noise on sleep and health Noise & Health, September-October 2012, Volume 14, p 243

1999: WHO precaution in general

“… where there is a reasonable possibility that public health will be damaged, action should be taken to protect public health without awaiting full scientific proof.” [emphasis added]

—World Health Organization, Guidelines for Community Noise, WHO (1999). www.who.int/docstore/peh/noise/guidelines2.html

Children: precaution

Policy Interpretation Network on Children’s Health and Environment:

“Policies that may protect children’s health or may minimise irreversible health effects should be implemented, and policies or measures should be applied based on the precautionary principle, in accordance with the Declaration of the WHO Fourth Ministerial Conference on Environment and Health in Budapest in 2004.”

—Report WP7 Summary PINCHE policy recommendations, Policy Interpretation Network on Children’s Health and Environment (PINCHE) QLK4-2002-02395



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