Systematic Review of the Human Health Effects of Wind Farms
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Exhibit A4-2c Systematic review of the human health effects of wind farms CAICOS PROVIDER 00123M Page 1 of 296 adelaide.edu.au seek LIGHT Exhibit A4-2c © National Health and Medical Research Council, 2015 ISBN (online): 978-0-9923968-0-0 Internet site: http://www.nhmrc.gov.au/ The National Health and Medical Research Council commissioned this research from: A/Prof Tracy Merlin Adelaide Health Technology Assessment (AHTA) Skye Newton School of Population Health Benjamin Ellery University of Adelaide Joanne Milverton Adelaide, South Australia Claude Farah This document should be cited as: Merlin, T, Newton, S, Ellery, B, Milverton, J & Farah, C 2015, Systematic review of the human health effects of wind farms, National Health and Medical Research Council, Canberra. Conflicts of interest The authors of this document have no financial or other conflicts of interest pertaining to wind farms or wind turbines. Acknowledgments We would like to acknowledge the comprehensive peer review of this document by the NHMRC Wind Farms and Human Health Reference Group and the methodological peer review undertaken by the National Collaborating Centre for Environmental Health (NCCEH, Canada); the feedback was helpful and contributed to the rigour of analysis and reporting in this document. With thanks to Ms Jessica Tyndall, Flinders University Librarian, for her assistance in developing the grey literature search; and Professor Persson Waye for providing additional clarification with respect to her publications. This document was edited by Jo Mason at MasonEdit, Adelaide. Minor amendments published in February 2015 The following amendments to the contents of this report were published in February 2015: Addition of a footnote in Table 27 and in Appendix B, indicating that the apparent error in the data presented in the table was directly transcribed from the source material (page 98 and page 251). A minor change to the definition of the term Odds Ratio in the Glossary (page 187). Minor corrections to data in the evidence tables in Appendix B (page 230 and page 240). These changes had no impact on the presentation or interpretation of results in the body of the report. •. •. ~ THE UNIVERSITY •••••••·••:•:·• ••••. 0 ..• • •• A H T.A AdelaideHealth TecflnolOgy ~ /ADELAIDE · Assessment ~ Page 2 of 296 Exhibit A4-2c CONTENTS EXECUTIVE SUMMARY ....................................................................................................... 9 INTRODUCTION ............................................................................................................... 19 Objective of the review .................................................................................. 19 Rationale for the review ................................................................................. 19 Review questions ............................................................................................ 21 Background review questions ............................................................... 21 Systematic review questions ................................................................. 22 WIND TURBINES AND WIND FARMS ................................................................................ 24 Wind farms in Australia .................................................................................. 24 How power is produced by wind turbines...................................................... 25 REVIEW METHODOLOGY ................................................................................................. 27 Methodology to address background review questions ................................ 27 Methodology to address systematic review questions .................................. 30 Literature search strategy ..................................................................... 30 Study selection criteria .......................................................................... 31 Exclusion criteria ................................................................................... 32 Process of literature selection............................................................... 32 Critical appraisal of selected evidence .................................................. 34 Data extraction and synthesis ............................................................... 38 Quality assurance .................................................................................. 40 RESULTS OF SEARCHES .................................................................................................... 41 Background review questions (mechanistic and parallel evidence)............... 41 Systematic review questions (direct evidence) .............................................. 41 NOISE .............................................................................................................................. 59 Sound perception and distance ...................................................................... 61 Infrasound and low-frequency noise (ILFN) ................................................... 62 Mechanisms by which noise might affect health ........................................... 62 Sound from wind turbines .............................................................................. 64 Measurement of sound from wind turbines .................................................. 66 3 Page 3 of 296 Exhibit A4-2c Systematic literature review ........................................................................... 73 Association between wind turbine noise and physical health effects .. 73 Association between wind turbine noise and mental health effects ... 78 Association between wind turbine noise and quality of life................. 81 Other relevant outcomes ...................................................................... 83 Summary ............................................................................................. 100 Parallel evidence ........................................................................................... 106 Infrasound and low-frequency noise .................................................. 108 Summary ............................................................................................. 121 SHADOW FLICKER .......................................................................................................... 124 Predicting the extent of shadow flicker from a wind turbine ...................... 124 Frequency thresholds and seizure risk from shadow flicker or blade glint . 125 Systematic literature review ......................................................................... 127 Summary ............................................................................................. 129 Parallel evidence ........................................................................................... 133 Summary ............................................................................................. 136 ELECTROMAGNETIC RADIATION .................................................................................... 138 Levels of EMF emitted from wind turbines .................................................. 139 Systematic literature review ......................................................................... 140 Parallel evidence ........................................................................................... 141 Summary ............................................................................................. 158 WIND TURBINE EXPOSURE AND HUMAN HEALTH EFFECTS ASSESSED AGAINST MODIFIED BRADFORD HILL CAUSALITY GUIDELINES ....................................................... 160 ALTERNATIVE EXPLANATIONS FOR REPORTED ASSOCIATIONS ....................................... 163 Attitudes towards wind farms ...................................................................... 163 Visibility of turbines ...................................................................................... 163 Financial gain from the site of turbines ........................................................ 163 Community decision-making on site of turbines .......................................... 164 Age and design of turbines ........................................................................... 164 Nocebo effect ............................................................................................... 164 4 Page 4 of 296 Exhibit A4-2c LIMITATIONS IN THE EVIDENCE-BASE AND SUGGESTIONS FOR FURTHER RESEARCH ....... 165 ONGOING RESEARCH ..................................................................................................... 166 International research .................................................................................. 166 Australian research ....................................................................................... 167 CONCLUSIONS ............................................................................................................... 169 Do wind turbines cause adverse health effects in humans? ........................ 169 REFERENCES .................................................................................................................. 171 GLOSSARY AND ABBREVIATIONS ................................................................................... 181 APPENDIX A – SEARCH STRATEGIES ............................................................................... 196 APPENDIX B – EVIDENCE TABLES FOR INCLUDED ARTICLES ............................................. 198 Study NL-07 ..................................................................................................