Health impacts of wind turbines

This report presents the results of a rapid, desk based analysis of peer reviewed UK and international literature from the last four years on the effects of wind turbines on human health. The review covers literature specified by the Scottish government, peer-reviewed original studies and recent peer-reviewed literature reviews. Recent original studies consist mostly of cross-sectional studies and case studies on the effects of wind turbines on local residents. All studies present evidence for annoyance due to wind turbine noise and most concur that there is evidence for sleep disturbance in the presence of wind farms but not necessarily from noise. Both results are in agreement with the effects of noise from other environmental sources. Other health effects are increasingly reported in the presence of wind turbines but the reviewed literature does not provide firm scientific evidence of a causal relationship with wind turbines or even more specifically wind turbine noise. The most widely quoted cross-sectional studies show correlations between annoyance and visual impact, economic benefit and attitude related to wind turbines. Wind turbine sound is reported to be comparatively weakly related to annoyance and inseparable from the other contributing factors. Literature on low frequency noise and infrasound (LFIS) can be categorised as reviews, sound level measurements around windfarms and discussion of mechanisms of perception and response. A Swedish review finds no evidence to support ‘wind turbine syndrome’ while another concludes that further research is required. Regarding noise measurements, there are concerns that a new generation of wind turbines will produce a sound with a spectrum shifted down in frequency. However, a study in Australia concluded that infrasound levels near windfarms were no higher than elsewhere and that higher levels in urban areas were probably due to traffic and other human activity rather than wind turbines. Some other studies found measured sound levels near wind farms to conform with a range of criteria for LFIS. Papers by Salt et al. propose that LFIS may differentially stimulate structures in the human inner ear, and may instigate health effects even when inaudible. The authors seek to build a speculative case utilising experimental data gleaned from guinea pigs and some observations on human experiences with specific pathological conditions. Based upon the documents submitted, the proposal is unproven, and would need clear data from hypothesis driven independent research in humans in order to be credible. A proposal by US consultants that motion sickness-like symptoms reported at one wind farm might be caused by acoustic excitation of the balance organs is not new and has previously been discounted as an explanation for similar reported effects not involving wind turbines. Other evidence on acoustic stimulation of the balance organs has been noted but not reviewed. Health effects from other wind turbine related sources such as shadow flicker have been reported in several studies and guidelines to be less of a problem. Careful wind farm design and operational restrictions are suggested to be sufficient to minimise the impact. The mitigation strategies have been found to vary widely internationally with some countries and federal states using fixed noise limits, others using noise limits relative to existing background levels and many like the UK using a combination of both. Set-back distances are also used internationally but have a number of disadvantages. The relevant UK guideline document ETSU-R-97 aims to provide a reasonable degree of protection to noise sensitive listeners; without unduly restricting the development of wind turbine renewable energy resources. In the international comparison the ETSU-R-97 guidelines tends to result in comparatively low noise limits although direct comparisons between fixed and relative noise limits are difficult. ETSU-R-97 has been criticised for its inconsistent implementation and relative complexity. Good practice guidelines by the Institute of Acoustics which aim to address the implementation issues are due to be published in May

UK-wide support infrastructure for low frequency noise sufferers ('LFN Network')

The project was set up to meet a need for improved treatment of Low Frequency Noise (LFN) complaints in cases where no noise source could be found. Such cases can be highly distressing for the complainant and difficult to handle by the Environmental Health Officers (EHOs) concerned and so tend to result in disproportionate use of resources. The hypothesis is that, irrespective of the (unknown) cause of the LFN perception, the perception may be lessened through application of techniques specifically adapted from the field of tinnitus and hyperacusis therapy. The aim of the project was therefore to establish, on a trial basis, a national network of treatment centres for sufferers of LFN located within the existing network of tinnitus clinics in the UK. A network of nine audiology centres was established, including eight with a good geographical spread in England and one in Scotland. A treatment protocol, specific to LFN cases, was then developed through discussions with the centres and a referral pathway was also established. Each centre made contact initially with EHOs in one or two local authorities in their vicinity to offer the service which was widened to a larger catchment area if sufficient referrals were not forthcoming. Fourteen subjects took part, eleven of which were referred from EHOs, the remaining three being self-referred. Outcome measures were based on a combination of validated questionnaires for general health, anxiety, depression, tinnitus handicap (with LFN substituted for tinnitus) and hyperacusis, combined with visual-analogue scales specifically developed for LFN to measure the pitch and loudness of the perceived LFN and the associated distress. Qualitative and open questions were also used. Potential benefits to EHOs of being able to make referrals were evaluated by semi-structured telephone interviews in which five EHOs participated. Generally, EHOs were very positive about the service and wanted it to continue. It was clear that LFN cases require significant resources which can be reduced if the referral service is available. Audiologists’ experience was evaluated in a similar way: they were generally willing to take part in the scheme and wanted it to continue and there was a feeling that they would have liked more referrals to get more experience in the use of the protocol. The results showed a mixed picture with some clients, three in particular, showing improved scores across a range of measures with little or no benefit for others and a worsening for one case. The improvement of some clients is positive given the lack of options available for this client group, however, the success of the approach can be considered partial at best. The questionnaire scores indicated that individuals taking part were significantly agitated, stressed and distressed. Those individuals with LFN complaint have a significant clinical need although in the main they were not clinically anxious or depressed. The model proposed of stress and increased auditory gain is a plausible explanation for the symptoms noted in LFN cases. In particular, the involvement of the sympathetic autonomic nervous system, and of the emotional brain, is likely to be a faithful representation of the clinical situation. A number of useful signposts for future development were derived. First, EHOs as well as audiologists should ideally receive training in best practice to help them to handle the particular sensitivities of LFN cases. More awareness and information for GPs is also recommended. A simplification of the referral route, potentially going direct to the audiologist rather than via the GP would also be beneficial. A strong argument for the continuation of the service is that some EHOs are now taking the initiative in contacting audiologists independently to refer LFN complainants in ‘No Noise Found’ cases. Without adequate training things could be made worse but access to a specific LFN protocol and associated training is likely to increase the chances of success significantly. It is recommended that existing guidance for EHOs be extended to include details of audiology services, guidelines for EHOs in making referrals and reference to the LFN treatment protocol. Using data from the study two independent estimates of the incidence rates of LFN cases can be derived. It is estimated that there are up to 160 complainants per year in the NHS corresponding to 0.32 cases per 100 thousand per year. The incidence rate based on referrals made by EHOs is 1.01 per 100 thousand per year within local authorities. It is not known to what extent, if any, these populations overlap

Hyperacusis: major research questions

Background: Hyperacusis is a troublesome symptom that can have a marked negative impact on quality of life.Objectives: To identify major research questions in hyperacusis.Materials and methods: Review of gaps in knowledge regarding hyperacusis, and where opportunities may lie to address these.Results: Eight major research questions were identified as priorities for future research. These were: What is the prevalence of hyperacusis in adults and children? What are the risk factors associated with hyperacusis? What is the natural history of hyperacusis? How is ‘pain hyperacusis’ perceived? What mechanisms are involved in hyperacusis? What is the relationship between hyperacusis and tinnitus? Can a questionnaire be developed that accurately measures the impact of hyperacusis and can be used as a treatment outcome measure? What treatments, alone or in combination, are effective for hyperacusis?Conclusion: This clinical/researcher-led project identified major research questions in hyperacusis. A further development to identify patient-prioritized research will follow

Factors associated with success in guide dog training

Tests of motor laterality and behavioral reactivity, as well as salivary cortisol concentrations, were examined in this pilot study to identify dogs best suited to guide dog work. Over a 14-month period, lateralization tests were conducted and cortisol concentrations were determined on 3 separate occasions, and temperament testing was performed on 2. Potential guide dogs (N = 43) involved in this study were 5 golden retrievers (4 males, 1 female) and thirty-eight Labrador retrievers (8 black males, fifteen yellow males, 5 black females, and ten yellow females). Results from these tests were then compared with the ultimate success of the dogs in the Guide Dogs NSW/ACT training program. This comparison produced evidence that motor lateralization (particularly the rate at which both paws were used during the Kong Test and the lateralization index during the Tape Test), reactions to an unfamiliar dog, the latency for dogs to drop and rest during an uninterrupted period, and the dog\u27s color and breed were predictive of ultimate success. This study also identified 14 months of age as a more accurate time to assess dogs for these traits than either 6 months of age or at the age at which they completed their training (ranging from 14 to 20 months of age)

Size and emotion or depth and emotion? Evidence, using Matryoshka (Russian) dolls, of children using physical depth as a proxy for emotional charge

Background: The size and emotion effect is the tendency for children to draw people and other objects with a positive emotional charge larger than those with a negative or neutral charge. Here we explored the novel idea that drawing size might be acting as a proxy for depth (proximity).Methods: Forty-two children (aged 3-11 years) chose, from 2 sets of Matryoshka (Russian) dolls, a doll to represent a person with positive, negative or neutral charge, which they placed in front of themselves on a sheet of A3 paper. Results: We found that the children used proximity and doll size, to indicate emotional charge. Conclusions: These findings are consistent with the notion that in drawings, children are using size as a proxy for physical closeness (proximity), as they attempt with varying success to put positive charged items closer to, or negative and neutral charge items further away from, themselves

Engaging leaders at two hierarchical levels in organizational health interventions: insights from the intervention team

Purpose: Although visible leader support is an essential ingredient for successful organizational health interventions, knowledge on how leaders at different hierarchical levels engage with interventions is underdeveloped. The purpose of this paper is to explore leader engagement by drawing from the experiences of the intervention team. Design/methodology/approach: Data from semi-structured interviews with the team responsible for implementing an organizational health intervention in two large UK organizations were used to examine how leaders at strategic (senior management) and operational (line managers) positions engaged with the intervention. Findings: Thematic analysis uncovered 6 themes and 16 sub-themes covering the leaders’ initial reactions to the intervention, barriers to leader engagement, ways in which the intervention team dealt with these barriers, factors facilitating and factors accelerating leader engagement, and differences in engagement between leadership levels. Research limitations/implications: This study can inform research into the conditions for optimizing leader engagement in organizational health interventions and beyond. Insights also emerged on the roles of leaders at different hierarchical levels and the value of perspective taking for intervention implementation. Practical implications: Recommendations for bolstering the engagement of leaders in interventions are offered, that apply to all leaders or separately to leaders at strategic or operational levels. Originality/value: The experiences of the intervention team who sought to engage leaders at different organizational levels to support the intervention are invaluable. Understanding how leader engagement can be maximized can better equip intervention teams for delivering successful interventions