PLEASANT RIDGE EXHIBIT 55 Wind Turbines and Health: A Modified Scoping Review April 2011 An accredited local public health agency affiliated with Queen’s University Authors: Paul Masotti, PhD. (formerly) Research Associate, Research and Evaluation Division, KFL&A Public Health Matthew Hodgetts, MA, PhD (cand). (formerly) Research Assistant, KFL&A Public Health This report has been prepared for Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health. The opinions expressed herein are the opinions of the authors and do not necessarily represent those of KFL&A Public Health. For more information contact: Kathleen O’Connor, Director, Research and Evaluation KFL&A Public Health 221 Portsmouth Ave., Kingston, ON K7M 1V5 Tel: 613-549-1232, ext. 1578 Email: [email protected] Kingston Cloyne Napanee Sharbot Lake 221 Portsmouth Ave., P.O. Box 59 41 Dundas Street, P.O. Box 149 Kingston, ON K7M 1V5 Cloyne, ON Napanee, ON Sharbot Lake, ON Tel: (613) 549-1232 K0H 1K0 K7R 1Z5 K0H 2P0 Or 1-800-267-7875 Tel: (613) 336-8989 Tel: (613) 354-3357 Tel: (613) 279-2151 Fax: (613) 549-7896 Fax: (613) 336-0522 Fax: (613) 354-6267 Fax: (613) 279-3997 Working together for better health www.kflapublichealth.ca Table of Contents EXECUTIVE SUMMARY ..................................................................................................................................................... 3 INTRODUCTION ................................................................................................................................................................... 3 RESEARCH QUESTIONS ................................................................................................................................................... 19 METHODS ............................................................................................................................................................................. 19 Stage 1 – Identifying the Research Question ................................................................................................................. 19 Stage 2 - Identifying Relevant Studies/Documents (wind turbines & health and noise & health) ................................. 19 Stage 3 – Study/Document Selection for More Detailed Analysis ................................................................................. 20 Stage 4 – Charting the Data ............................................................................................................................................ 21 Stage 5 – Collating, Summarizing and Reporting the Results ........................................................................................ 22 RESULTS ............................................................................................................................................................................... 22 1) Wind Turbines and Health - Published Peer Reviewed Research .............................................................................. 22 2) Wind Turbines and Health - Grey/Self-Published Research ...................................................................................... 52 3) Government and Industry – Technical Information & Guidelines ........................................................................... 110 4) Community –Based Organizations, Advocacy groups and News Media ................................................................. 126 5) Research – Noise and Health in other settings ......................................................................................................... 138 SUMMARY AND CONCLUSIONS – NOISE AND HEALTH IN OTHER SETTINGS ............................................. 158 IMPLICATIONS ................................................................................................................................................................. 163 MAIN CONCLUSIONS ...................................................................................................................................................... 164 MAIN CONTRIBUTIONS ................................................................................................................................................. 165 APPENDIX 1: DOCUMENT ANALYSIS TEMPLATE ................................................................................................. 166 REFERENCES .................................................................................................................................................................... 167 Wind Turbines and Health: A Modified Scoping Review i MAIN MESSAGES Overview - The increased use of wind turbines has created a situation where there have been strong negative reactions from community-based organizations (CBOs) with acceptance issues and conclusions that wind turbines cause ill health. However, government and Public Health support the assertion that there is no evidence of adverse health effects. CBO conclusions typically are based upon individual claims and several case studies reported on the internet; whereas, Public Health generally relies on the limited wind turbine research and expert opinion. To address the different conclusions and to better understand the situation, we conducted a modified scoping review of the literature from multiple sources: wind turbine and health, noise and health, government and industry, and advocacy groups and news media. 1) A review of the literature in the five categories does not provide evidence of and does not suggest the likelihood of a causal relationship between ill health and wind turbine noise emissions that meet Canadian and international guidelines. Two large sample European studies (N = 754 & 725) using masked surveys found no association between self-reported health outcomes and sound exposure levels. Evidence from the noise and health evidence base supports the lack of health effect findings from the large sample studies and the conclusions that wind turbine noise exposure levels are below levels known to cause ill health. 2) The case series and other studies that are highly reported on the internet in CBO websites had significant methods problems such as: a) self-selection of subjects who had previously concluded the wind turbines were causing ill health and who also knew the purpose of the survey, b) use of a symptoms check list and proxy respondents, and c) use of terms such as ‘affected’ or ‘victims’ in the recruitment process. These issues serve to significantly decrease confidence in results and conclusions from those studies. In addition, case studies can never be used to make conclusions of causal relationships. 3) Debate exists about whether annoyance is a feeling or state or a negative health outcome. Wind turbine research indicates a dose-response between noise and annoyance exists. The research indicates that a small percentage of people are very annoyed by wind turbine noise and that only a small percentage of annoyance is explained by the noise itself and that other factors exert a considerable influence (e.g., attitudes, can see the source, culture, ability to control the noise, mental health, financial benefits and perceived importance). There exists an intermediate pathway that includes knowing of the existence of the wind turbines and seeing and/or hearing them which then goes through the individual characteristics before the response is annoyance. Thus, we cannot attribute the annoyance (and effects of chronic annoyance) to the wind turbine noise alone. 4) Addressing local acceptance will require better approaches to the public consultation process including community equity issues. Public Health and government need to develop a better response such as: a) improved knowledge broker activities that include public education; b) developing a more comprehensive web presence which implements strategies to ensure credible websites and documents appear among the first results of internet searches; and c) providing the public with access to the tools to assess the validity of the health related information they find. 5) Research - Although our main finding is that wind turbine and the noise and health evidence do not support conclusions that wind turbines cause ill-health, there is a need to conduct further rigorous research in multiple settings that do not rely on self-reported health outcomes and where noise exposure is measured (not modeled) both outside and inside residences. 6) There is need of a formal complaint resolution mechanism that can provide effective remedies for residences with complaints. This mechanism should involve sound pressure level measurements at the residences (inside and outside) under different wind conditions and a pre-determined resolution/adjudication process. Wind Turbines and Health: A Modified Scoping Review 2 EXECUTIVE SUMMARY INTRODUCTION Medical Officers of Health at local Public Health Agencies are frequently approached by individuals and community-based organizations (CBOs) with strongly expressed concerns about health impact of wind turbines. Consequently, local Public Health agencies have identified wind turbines as a priority issue that warrants attention. The rapid increase in current and planned use of wind turbines as a source of renewable energy has created a situation where there are often strong negative reactions from community groups and an inadequate response from Public Health and provincial government. The result is two groups with opposing conclusions. Provincial governments and Public Health generally