MIU, Alm.del - 2013-14 - Bilag 71: Henvendelse af 20/8-13 fra Holbæk Kommune om problemer hos naboer med kæmpevindmøller (anmodning om foretræde for udvalget)

Suggestions for Pre Construction Health AssessmentsFor individuals exposed to operating wind turbinesor other sources of infrasound and low frequency noise (ILFN)as at 13thSeptember, 2012What follows are suggestions for busy rural clinicians confronted with sick patients, and very little easilyaccessible information. They are based on the current limited collective knowledge about the acute and longerterm consequences of exposure to operating wind turbines, and infrasound and low frequency noise (ILFN).Recent measurements of wind turbine ILFN inside and outside the homes of sick people which are correlatingwith specific symptoms have focused our attention on the existing evidence of harm from this sound energy.It should be noted from the outset that other pathological agents which have been suggested by variousresearchers to be potentially implicated in some of the pathology being reported by residents living nearindustrial wind turbines include ground (seismic) vibration, rapid changes in barometric pressure, and electromagnetic radiation. There is limited information available about each of these in the context of wind turbines,so there has been a focus in this document on the existing evidence with respect to ILFN exposure.The guidelines will need to be adapted according to individual clinical circumstances and presenting pathology.They have been written with the busy rural clinician in mind, hence the justifications for some of thesuggestions may not be immediately obvious. The major sources of information have been listed in theRecommended Reading section, but there is also a wealth of material cited in the Waubra Foundationdocuments listed at the very end of the appendices. Any specific queries can be directed to me and I will tryand answer as quickly as possible. Email is preferable,[email protected],but if urgent, mymobile is 0439 865 914.The information has been compiled from a variety of sources, nationally and internationally, including cliniciansat the “front line” seeing these sick people, researchers, acousticians, as well as directly from the experiencesof the people affected themselves. There are a limited number of relevant peer reviewed studies, which arecited through the text and in the recommended reading section, which will be of benefit to those seekingfurther information.In summary, there is a wide range of reaction to exposure to operating wind turbines, from immediate severeonset of vestibular dysfunction symptoms or migraine (“wind turbine syndrome”) to no apparent response inthe short term. As the duration of exposure increases more people report a range of other symptomsgenerally consistent with the myriad of consequences from chronic severe physiological stress and sleepdeprivation. In addition, tissue pathology and symptoms related to Vibroacoustic Disease (VAD) are also beingreported, together with focal organ damage also noted in animal studies of chronic infrasound exposure.Tel: 61 + 3 8640.0105E: [email protected]www.waubrafoundation.com.au

Pre Construction History, Examination and Investigationsa. Clinical HistoryUseful specific features to record include:history of motion sickness, migraines, existing inner ear conditions; as these, together withextremes of age have been linked to increased susceptibility to developing symptomsdocumentation of past noise exposure; pre existing hearing damage, and sensitivity to noisedocumentation of past & current medical and psychiatric conditions, including particularlyhypertension, ischemic heart disease, arrythmias, diabetes, thyroid disorders, inflammatorydisorders, epilepsy, autism, Post Traumatic Stress Disorder (PTSD), Anxiety, Depression.

b. Examination:blood pressure (even in young fit people significant blood pressure elevation has been documentedwith exposure to wind turbines; (see alsohttp://www.wind-watch.org/documents/an-investigation-on-the-physiological-and-psychological-effects-of-infrasound-on-persons/cognitive assessment (in order to detect subtle changes in cognition and memory which have beenobserved to occur post exposure); for example either or both those listed below:1.The Montreal Cognitive Assessment Battery:can identify mild cognitiveimpairment, http://www.mocatest.org/2.The Trailmaking test:a timed, simple test of spatial and divided attentionhttp://www.granddriver.net/data/media/docs/UIowa_trailMaking.pdfmental health assessment questionnaires (for later comparison with repeat testing), to formallydocument current mental state with particular reference to validated questionnaires screening forthe presence of anxiety, depression, and PTSD.Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale, again, for later comparison withrepeat testing. Dr Daniel Shepherd’s peer reviewed published study provides clear evidence of aneffect on sleep quality, and sleep deprivation is the commonest symptom reported by residentsliving near wind turbines. Dr Shepherd’s paper is available fromhttp://www.wind-watch.org/documents/evaluating-the-impact-of-wind-turbine-noise-on-health-related-quality-of-life/

and low frequency noise (ILFN) from other sources especially in quiet country environments);baseline routine blood tests including kidney and liver function, complete blood picture, thyroidfunction including T3 and T4, fasting blood sugar and Hba1c, and cholesterol;focal organ damage has been noted with chronic exposure to infrasound in animal studies (studynumber 58 in the following literature review :http://www.wind-watch.org/documents/infrasound-brief-review-of-toxicological-literature/, and metabolic abnormalities of blood sugar regulationand thyroid function have been reported by a number of clinicians and have been included inProfessor Robert McMurtry’s proposed Case Definition (downloadable fromhttp://www.wind-watch.org/documents/wind-turbine-noise-and-health-special-issue-of-bulletin-of-science-technology-society/baseline night time salivary cortisol(for comparison with post exposure to ILFN). A number ofthese investigations have been done in Ontario and in the US and have shown marked differencesbetween exposed and non exposed states, (see also section 10 of Leventhall’s 2003 DEFRA review,athttp://www.wind-watch.org/documents/review-of-published-research-on-low-frequency-noise-and-its-effects/)Baseline comprehensive hearing tests by an audiologist and review by ENT specialistif a historyof pre existing inner ear pathology has been noted. People with preexisting inner ear pathology orindustrial deafness seem to be more susceptible to developing problems, and numerous residentshave developed abnormalities having previously had normal hearing.Baseline comprehensive visual tests,by an optometrist and/or review by existing opthalmologistCardiac Echocardiography,with particular attention to pericardial thickness and the state of thecardiac valves. Abnormalities of collagen (and other abnormalities) have been reported inassociation with long term exposure to infrasound and low frequency noise by Professor MarianaAlves Pereira, and have been given the name of VAD or Vibro Acoustic Disease. (seehttp://www.wind-watch.org/documents/vibroacoustic-disease-biological-effects-of-infrasound-and-low-frequency-noise-explained-by-mechanotransduction-cellular-signalling/) Recentlyabnormalities of mitral and triscuspid valves in German citizens exposed long term (18 years) tomuch smaller wind turbines have been reported to me by those residents. Concurrently, aTaiwanese research team has just shown abnormalities in echocardiographs of workers with higherILFN doses (seehttp://www.noiseandhealth.org/article.asp?issn=1463-1741;year=2012;volume=14;issue=59;spage=155;epage=158;aulast=Chao.Professor Alves Pereira has also documented abnormal pericardial thickness and mitral valveabnormality in a child exposed to an ILFN rich environment in utero and post conception for 10years.(http://www.wind-watch.org/documents/public-health-and-noise-exposure/ )Professor Pereira’s presentation to the Australian National Health and Medical Research Councilworkshop in Canberra on June 7th, 2011 (http://www.nhmrc.gov.au/media/events/2011/wind-farms-and-human-health-scientific-forum-7-june-2011)

What Residents Can Do:keep detailed personal health journals contemporaneously; both when exposed to the turbinesand when away from home. Note if the turbines have been turning at the time symptoms areexperienced, if known; and the more detail that can be given to locate the precise date and time ofsymptoms, weather and wind conditions at the time will be very useful. See the following:http://www.windturbinesyndrome.com/2012/wind-turbine-syndrome-chapmans-caution-and-personal-health-journals/?var=cnathoroughly record all symptoms and episodes of illness, no matter how trivial, especially infective,for all family members; and episodes of disturbed sleep;closely monitor growth, development, and language and cognitive development in children, withparticular focus on language acquisition, mental arithmetic and memory & concentration;especially if there is any regression once turbines have commenced operating.also monitor mood changes, disruptive and aggressive behaviour in children; and note any changesin their behaviour and sleep patterns when at home (with turbines operating) compared to whenaway or when the turbines are off for more than a day.liase closely with school teachers, so parents may be alerted to any learning difficulties at school ina timely fashion; and ensure that teachers are aware of what abnormalities have been reported.The most detailed information comes from Dr Nina Pierpont’s study, available in her book, whichcan be purchased at cost fromwww.windturbinesyndrome.com. Part of the book including thesection written for health professionals and the raw case data containing details of what changeswere noted in the children in the study was kindly submitted to the Australian Federal SenateInquiry, and that submission (number 13) may be accessed viahttp://www.aph.gov.au/Parliamentary_Business/Committees/Senate_Committees?url=clac_ctte/impact_rural_wind_farms/index.htmmonitor blood pressures (especially with severe headaches) as markedly elevated blood pressureshave been noted in many people including young adults, which have reverted completely back tonormal or usual baseline when well away from operating wind turbines;consider a trial of antioxidants (given their reported benefit to rodents in one experiment withprolonged exposure to infrasound). These might include multivitamins. This is NOT based on peerreviewed published medical research, rather observations in one animal study looking at chronicinfrasound exposure, where clear benefits to the group of rats given antioxidants were noted whencompared to controls who did not receive this intervention (see study number 58 in the followingweblink:http://www.wind-watch.org/documents/infrasound-brief-review-of-toxicological-literature/)actively try to manage stress, (eg exercise & meditation) and try and organise time away fromexposure to operating turbines if needed, and able to do so; especially overnight.

Post Construction History, Examination and InvestigationsAs indicated by the clinical context and presenting problems, together with past medical history:detailed history of new symptoms with correlation of exposure to operating wind turbines, (wellkept personal health journals can help greatly here, as people’s short term memory is oftenimpaired, but patterns of symptoms occurring with exposure to operating wind turbines andcertain wind directions and weather conditions can be quickly identified);detailed health and sleep history especially correlated to turbine operation, climatic conditions,wind direction and estimate of wind speed, and time of day or night, where possible;Detailed health history of illnesses or symptoms whenawayfrom turbine exposure (eg holidays,and turbines off for maintenance);In North America, comparative repeat night time salivary cortisol, and more extended serumcortisol testing has been found to be markedly elevated with exposure, but returns to normal whenrepeated again after cessation of exposure to ILFN (when residents also report feeling “better”);comparative repeat cognitive, sleep, and mental health questionnaire assessments as indicated –see preconstruction health check list for details.

Other investigations, which may be indicated in specific situations where specific pathology is suspected or hasbeen identified, include:24 hour blood pressure monitoring;sleep studies (comparing “in home” and “away from home” if possible);specific blood pathology indicated by the clinical picture (kidney, liver, CBP, clotting, thyroidfunction, blood glucose & Hba1c);specific radiological investigation where focal pathology is suspected, including brain MRI whereindicated (eg cognitive deficits being reported, suspicion of late onset epilepsy).Referral if indicated to sleep, ENT, Endocrine, Cardiac, Opthalmology, Psychiatric, Psychological,Optometrist, Audiologist and other relevant health professionals.

Recommended Further ReadingHarry, Dr Amanda“Wind turbines, Noise and Health” 2007http://www.wind-watch.org/documents/wind-turbines-noise-and-health/Leventhall, et al 2003 Literature for DEFRA (UK Department of Food and Rural Affairs)“Review of Published Research on Low Frequency Noise and Its Effects”, especially page 49, and section 10http://www.wind-watch.org/documents/review-of-published-research-on-low-frequency-noise-and-its-effects/Pierpont, Dr Nina“Wind Turbine Syndrome, A report on a Natural Experiment”Published by K Selected Books, Santa Fe NM 2009Available fromwww.windturbinesyndrome.comMcMurtry, Professor Robert“Toward a Case Definition of Adverse Health Effects in the Environs of Industrial Wind Turbines: Facilitating aClinical Diagnosis”Bulletin of Science Technology and Society 2011 31:316http://bst.sagepub.com/content/31/4/316downloadable from:http://www.wind-watch.org/documents/wind-turbine-noise-and-health-special-issue-of-bulletin-of-science-technology-society/Ambrose, Stephen & Rand, Robert“Bruce McPherson Infrasound and Low Frequency Noise Study” 2011http://www.wind-watch.org/documents/bruce-mcpherson-infrasound-and-low-frequency-noise-study/Frey, Barbara and Hadden, Peter“Wind Turbines and Proximity to Homes: The Impact of Wind Turbine Noise on Health”2012http://www.wind-watch.org/documents/wind-turbines-and-proximity-to-homes/

A wealth of news items, videos and documents, with a very useful search function, not confined to healthissues.For further specific information, please do not hesitate to get in touch with me.Dr Sarah Laurie, CEO Waubra Foundation[email protected]0439 865 914Appendix 1Extract from Leventhall et al 2003 report for the UK Dept of Food and Rural Affairs on the effects of LowFrequency Noise on Human Health“12.2 Effects on health.In an epidemiological survey of low frequency noise from plant and appliances in ornear domestic buildings, the focus was on health effects (Mirowska and Mroz, 2000). …A control group of dwellings had comparable conditions to the test group, with similar A-weighted levels,except that there was no low frequency noise. There were 27 individuals in the test group and 22 in the controlgroup.The test group suffered more from their noise than the control group did, particularly in terms of annoyanceand sleep disturbance. They were also less happy, less confident and more inclined to depression.The comparison of the symptoms between the tested group and the control group show clear differences, as inTable 5. “The symptoms in this table and pattern of exposure are the same as those later described by Dr Nina Pierpontas "windturbine syndrome".Professor Leventhall has now agreed with this publicly on numerous occasions,including while being cross examined in a court case in Ontario (seehttp://www.wind-watch.org/documents/audit-national-health-and-medical-research-council-public-statement-2010-and-rapid-review-2010/).

PersonalIn April 2002, a sudden illness requiring immediate surgery and follow up necessitated Dr. Laurie withdrawingfrom practice as a rural general practitioner. It was not until 2010 that her own health and otherresponsibilities made it possible for Dr Laurie to consider returning to practice. During this extended period DrLaurie did not continue to renew her registration, nor was she able to formally participate in the continuingmedical education required to maintain her fellowships in RACGP and ACRRM. Regardless, Dr Laurie remains aqualified medical doctor.In April 2010, when Dr. Laurie was preparing to re-enter the medical workforce, a wind energy project wasannounced for the hills near her home. A concerned neighbour drew Dr. Laurie’s attention to Dr AmandaHarry’s survey from 2003 (seehttp://www.wind-watch.org/documents/wind-turbines-noise-and-health/).This local development proposal has since been withdrawn, however Dr. Laurie’s professional concern aboutthe reported adverse health effects from exposure to operating wind turbines, and the lack of proper researchcontinues.

Experience with Wind Turbine/ILFN Health ProblemsIn the second half of 2010 Dr. Laurie commenced intensive fieldwork, visiting and listening to over 100 sickneighbours of wind projects and other industrial developments with noise pollution issues in South EasternAustralia, liaising with acousticians and concerned medical practitioners in Australia, Western Europe, UnitedKingdom, and North America.In October 2010, Dr. Laurie attended the first International Symposium on Adverse Health Effects of WindTurbines in Ontario, organized by the Society for Wind Vigilance (www.windvigilance.com), and ever since hasliaised closely with other professionals and researchers who gave presentations at that symposium.Dr Laurie’s work has included: recommendations about setback distances for new wind projects based uponher gathering of evidence of health impacts at multiple projects; encouraging acoustic measurements byindependent acousticians, assisting researchers to connect with sick residents; making submissions to relevantauthorities and politicians; educating other medical practitioners; and where invited, educating concernedcommunity groups and affected individuals.This work has unfortunately and inappropriately attracted unpleasant comments and misleading publicstatements concerning Dr Laurie’s professional qualifications from sections of the wind industry and its vocal,well intentioned but generally ignorant supporters, who are unwilling to accept that there is a very realproblem which must be addressed, and who prefer instead to “shoot the clinical messenger”.

Legal & Committee InvolvementShortly after commencing her fieldwork, Dr. Laurie was approached to help give expert evidence in a court casein Adelaide. The academic who ultimately gave evidence for the wind developer agreed that witnesseswere”sick” and they were “stressed”, but then blamed that on what he called “scaremongering”.Unfortunately, the court did not have the benefit of a survey conducted by Dr. David Iser from Toora, Victoriawho had gathered clinical evidence of identical serious ill health from his patients living near the Toora windproject as far back as 2004, well before there was any public knowledge of these problems. In this particularcase, the judges preferred the “expert“ advice of the academic to field evidence from Dr Laurie.Shortly after this, in July 2011, judges in a similar court in Ontario found that thereareadverse health effectsfrom wind turbines, and that further research is required. A range of international experts in acoustics andhealth gave evidence for both developers and the appellants. In that case, Professor Geoffrey Leventhall, oneof the acousticians for the Wind Developer, admitted that he knew of the symptoms of “wind turbinesyndrome” as they were identical to those occurring from exposure to low frequency noise, known to beemitted by wind turbines as well as other sources. The quote from the Canadian judgment is below:“This case has successfully shown that the debate should not be simplified to one about whether wind turbines cancause harm to humans.The evidence presented to the Tribunal demonstrates that they can, if facilities are placed tooclose to residents. The debate has now evolved to one of degree."(p. 207) (Emphasisadded)Environmental Review Tribunal, Case Nos.: 10-121/10-122 Erickson v. Director, Ministry of the Environment, Dated this 18th dayof July, 2011 by Jerry V. DeMarco, Panel Chair and Paul Muldoon, Vice-Chair,

In July 2012 Dr. Laurie was asked by the Canadian lawyer for an upcoming case to provide independent expertwitness testimony for that case. She has agreed to do so. The name of that case is Haldimand Wind ConcernsV Ministry of Environment, ERT case No 12 – 073. The hearings will commence in September 2012.Dr Laurie’s own field work, and extensive knowledge of the field work of others including acoustic and psychoacoustic measurements and physiological research, is widely appreciated. Her help, knowledge and advice issought by doctors, acousticians and researchers working in this field in Australia and overseas. Her ability tounderstand the acoustic and human health evidence has contributed considerably to the general communityunderstanding of the existing known pathophysiological pathways which make this condition so devastating toa significant proportion of wind project neighbours.

Important Submissions, Letters and Documents by Dr LaurieFederal Senate Inquiry into the Social & Economic Impact of Rural Wind Farms, February 2011submission number 390 at the following weblink:http://www.aph.gov.au/Parliamentary_Business/Committees/Senate_Committees?url=clac_ctte/impact_rural_wind_farms/index.htmalso accesssible at the following:http://www.windwatch.org/documents/submission-to-the-australian-federal-senate-inquiry-on-rural-wind-farms/Oral evidence given to Federal Senate Inquiry, given on 29th March 2011http://www.wind-watch.org/documents/sarah-laurie-address-to-australian-senate-inquiry/Explicit Cautionary Notice 29th June, 2011http://waubrafoundation.com.au/~waubra/Y2NpZD0xJmNhaWQ9MTMmYWlkPSZjcmM9MTQ0OTg1MjMyOA%3D%3DLetter to Prime Minister Gillard 3rdMarch, 2012http://www.wind-watch.org/news/2012/03/09/letter-to-australian-prime-minister-from-dr-sarah-laurie/NSW Planning Department Draft Guidelines March, 2012http://www.wind-watch.org/documents/response-to-nsw-planning-department-draft-guidelines-for-wind-developments/Wind Turbine Acoustic Pollution Assessment Requirements 11thMay, 2012http://www.wind-watch.org/documents/wind-turbine-acoustic-pollution-assessment-requirements/Opinion piece “ Silent epidemic” 28thMay 2012-08-28http://www.wind-watch.org/news/2012/05/31/acoustic-pollution-a-silent-epidemic/Submission to NSW Director General of Planning re Mt Bodangora, 8thAugust 2012http://www.wind-watch.org/documents/comments-on-wind-turbine-noise-and-its-health-effects/E: [email protected]www.waubrafoundation.com.au

RELEVANT PROFESSIONAL QUALIFICATIONS AND EXPERIENCE

Bachelor of Medicine, Bachelor of Surgery awarded 1995, Flinders University, South

Australia

Fellowship of Royal Australian College of General Practitioners, (RACGP) awarded July 1999

Fellowship of Australian College of Remote and Rural Medicine, (ACCRM) awarded March

2000

Clinical examiner, RACGP 2001

Member of State Council, Australian Medical Association of South Australia, 2001.