Dr. Mark Roberts Testimony, Ex. ____, Exhibit 2a Page 1 of 139 Review of additional evidence for NHMRC Information Paper: Evidence on Wind Farms and Human Health FINAL REPORT Prepared for NHMRC by Australasian Cochrane Centre (ACC) and Monash Centre for Occupational and Environmental Health (MonCOEH) December 2014 1 Dr. Mark Roberts Testimony, Ex. ____, Exhibit 2a Page 2 of 139 Contents Authors and contributors .......................................................................................................... 1 Declarations of Interest ................................................................................................................... 1 Background ................................................................................................................................ 2 Independent Systematic Review ..................................................................................................... 2 NHMRC Information Paper ............................................................................................................. 2 Context for this review of additional evidence ............................................................................... 3 Objectives .................................................................................................................................. 3 Methods ..................................................................................................................................... 3 Criteria for considering studies for inclusion ...................................................................................... 4 Search methods for identification of studies ...................................................................................... 4 Electronic searches .......................................................................................................................... 4 Data collection and analysis ................................................................................................................ 4 Selection of studies for Direct Evidence .......................................................................................... 4 Selection of studies from the Submissions for Supporting Evidence .............................................. 5 Data extraction and assessment of methodological quality ........................................................... 5 Synthesis .......................................................................................................................................... 6 Results ........................................................................................................................................ 6 Repeat systematic literature search for Direct Evidence .................................................................... 6 Submitted literature (‘the Submissions’) ............................................................................................ 8 Summary of studies of Direct Evidence .............................................................................................. 9 Limitations ....................................................................................................................................... 9 Summary characteristics ............................................................................................................... 10 Study quality and bias ................................................................................................................... 10 Results ........................................................................................................................................... 11 Conclusions of studies of Direct Evidence ........................................................................................ 12 Table 1a – Characteristics of Included Studies (Direct Evidence) ..................................................... 13 Table 1b – Results of Included Studies (Direct Evidence) and Commentary .................................... 26 Summary of studies of Supporting Evidence .................................................................................... 32 Background Evidence .................................................................................................................... 32 Mechanistic Evidence .................................................................................................................... 35 Parallel Evidence ........................................................................................................................... 36 Conclusions of studies of Background Evidence ............................................................................... 37 Table 2 – Characteristics of Included Studies (Background, Mechanistic and Parallel Evidence) .... 38 Background Evidence .................................................................................................................... 38 Mechanistic Evidence .................................................................................................................... 56 Parallel Evidence ........................................................................................................................... 62 References ............................................................................................................................... 69 Included studies – Direct Evidence ................................................................................................... 69 Included studies – Background, Mechanistic and Parallel Evidence ................................................ 69 1 Dr. Mark Roberts Testimony, Ex. ____, Exhibit 2a Page 3 of 139 Additional references .................................................................................................................... 71 Appendix 1 – Systematic Review Questions ........................................................................... 72 Appendix 2 – Database search strategies ............................................................................... 73 Appendix 3 – Background Review Questions .......................................................................... 75 Appendix 4 – Citations from the repeat literature search ...................................................... 76 Appendix 5 – Submitted literature .......................................................................................... 80 Appendix 6 – Data extraction forms for included studies....................................................... 99 2 Dr. Mark Roberts Testimony, Ex. ____, Exhibit 2a Page 4 of 139 Authors and contributors The following staff of the Monash Centre for Occupational and Environmental Health and Australasian Cochrane Centre were involved in planning and conducting the review, and contributed to the preparation of the report. Coordinating Team Name Position Contribution Malcolm Sim Professor Project co-lead, study selection, data extraction and appraisal, critical interpretation of data, preparation of summary tables, drafting report Steve McDonald Senior Research Fellow Project co-lead, literature searching, study selection, drafting and editing of report Geza Benke Senior Research Fellow Study selection, data extraction and appraisal, critical interpretation of data, preparation of summary tables, input to report Ewan MacFarlane Research Fellow Study selection, data extraction and appraisal, critical interpretation of data, preparation of summary tables Additional project staff Christina Dimitriadis Research Officer Data extraction and appraisal, preparation of summary tables Ella Kee Research Officer Data extraction and appraisal, preparation of summary tables Miyoung Kim Research Officer Literature searching Mina Roberts Research Officer Data extraction and appraisal, preparation of summary tables Declarations of Interest All authors declare they have no financial, personal or professional interests that could be construed to have influenced the conduct or reporting of this review of additional evidence. 1 Dr. Mark Roberts Testimony, Ex. ____, Exhibit 2a Page 5 of 139 Background Independent Systematic Review In August 2012, the National Health and Medical Research Council (NHMRC) commissioned an independent reviewer to undertake a comprehensive review of existing scientific literature on the possible effects of wind farms on human health (‘the Independent Review’). This review considered a wide range of evidence, comprising both peer reviewed and non-peer reviewed literature. The Independent Review was supplemented by a call (in September 2012) for submissions of evidence for consideration in the systematic review. The purpose of the systematic literature review was to determine whether there was evidence to establish that emissions from wind farms cause human health effects (Direct Evidence). A background literature review was also conducted to investigate the physiological mechanisms by which the emissions of wind farms could produce adverse health effects (Mechanistic Evidence) and whether health effects had been observed from similar emissions in other exposure settings (Parallel Evidence). A comprehensive search of the available scientific literature was conducted by the reviewer in October 2012. While 2848 papers were identified in the literature search for the systematic review component of the Independent Review, and an additional 506 references were submitted to NHMRC for consideration, only 161 papers were found to be relevant to the topic and were