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When medical practitioners mislead: Trio targets family doctors with bad information

When medical practitioners mislead: Trio targets family doctors with bad information
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This article is reposted from the Barnard on Wind blog with the permission of the author, Mike Barnard.

Three Canadians–two with current and historical medical credentials–have  jointly written a commentary in Canadian Family Physician (CFP), a peer-reviewed medical journal which is the official publication of the College of Family Physicians of Canada. They warn of negative health impacts from wind energy that family physicians should watch for near wind generation sites and warn that physicians should expect to see a large number of issues due to the rapid spread of wind energy.  It is being referenced around the world mere days after its publication with citations in the UK and Australia by anti-wind campaigning groups claiming that it is evidence of wind energy health impacts.

The article is entitled Adverse health effects of industrial wind turbines and is published in the May 2013 issue of the journal. The authors are Roy D. Jeffery, MD FCFP, a family physician in the Northeastern Manitoulin Family Health Team in Little Current, Ont.; Carmen Krogh, a retired pharmacist whose professional career would lead one to expect deep care in published commentaries; and Brett Horner, a Certified Management Accountant.

This is a deeply misleading article by long time anti-wind activists that may lead unwary medical practitioners to inappropriately attribute symptoms to wind turbines and possibly exacerbate pre-existing conditions. It ignores the vast majority of evidence and opinions of medical professionals in assessments worldwide that wind turbines do not cause health impacts.

The authors–Jeffrey, Krogh and Horner–do not cite the 19 reviews worldwide of the peer-reviewed evidence and anecdotal health claims that have found no evidence of harm from wind turbines to human health outside of easily mitigated noise annoyance. Most recently, the Australian state of Victoria’s Health Department released the results of their assessment and clearly state that wind turbines do not cause health impacts. [1]

They disagree with much more strongly credentialed Canadian public health professionals such as Dr. David Colby and Dr. Arlene King, to name two primary figures among the overwhelming majority. Drs. King and Colby participated in and led formal cross-disciplinary reviews of all of the peer-reviewed literature and anecdotal claims in 2009 and 2010, respectively, which found no health impacts from wind energy. [14], [15]

They ignore the research from the University of Nottingham in the U.K. by Claire Lawrence et al that shows that wind turbine noise annoyance is unrelated to the level of sound and directly correlates to the attitudes about wind energy and personality traits of the person claiming annoyance. [2], [3]

They ignore the work from the University of Auckland by Fiona Crichton et al that shows that symptoms attributed to wind turbines are actually caused by the nocebo effect via anti-wind turbine material claiming health impacts. [4]

They ignore the work of Professor Chapman of the University of Sydney’s Department of Public Health, currently published on the USyd eScholarship site and undergoing peer review with a major international journal as of May 2013, that shows that only 1 in 272 people near wind farms complained of health or noise impacts, the majority of wind farms received no complaints at all and that complaints were most strongly correlated to efforts of anti- wind campaigners near wind farms. [5]

They rely on work of lower quality such as the Nissenbaum, Aramini and Hanning study published in Noise and Health that significantly overstated the conclusions that could be drawn from the data they collected. The scatter did not allow the fit that they claimed, the data actually showed that all residents in both the study and control group suffered from poor sleep by the PQSI and Epworth scales and they ignored the long-standing efforts by Nissenbaum to promote ill health causation in the study sites as a potential source of increased stress on the study participants. Two separate critiques of this pointing out the failings have been published in Noise and Health. [6], [7] As all three authors of the Noise and Health study are also Advisory Board members of the Society for Wind Vigilance, it is unreasonable to expect that the authors of this piece, also Advisory Board Members, are unaware of the failings of this study. [12] (Note: I am the author of one of the two published critiques.)

They rely on Pierpont’s 2009, unpeer-reviewed and vanity press-published Wind Turbine Syndrome. The methodological and bias errors in that material are rife: advertising for individuals who blamed their health symptoms on wind farms via anti-wind campaigning groups, phone interviews only with 23 individuals, acceptance of hearsay evidence related to an additional 15 individuals, no medical history evaluation, acceptance of self-reporting and attribution without direct clinical assessment, questions formulated to be likely to increase symptom number and severity, and no control group. From this very weak base, Dr. Pierpont named a syndrome and wrote a 294-page book with 60+ pages of charts, graphs and tables. Dr. Pierpont and her husband had been vocal and deeply hostile anti-wind campaigners for years before the study and publication of the book and continue in this role now. This material has been rejected as being of poor quality and low evidentiary value by each of the 19 reviews previously cited. To quote one of the reviews selected randomly: “There is no evidence for a set of health effects from exposure to wind turbines that could be characterized as a 'Wind Turbine Syndrome.'" [8]

They also rely on WindVOiCe, a self-reporting survey with such poor formulation that it was likely to create stress and exacerbate minor and normal symptoms experienced by large percentages of the population, causing them to be misattributed to wind turbines. This online health survey was not created or supervised by an appropriate medical ethics oversight committee and has been removed.

The authors slip a set of possible causes of health impacts due to wind turbines into their opening remarks as if they were reasonable and supportable:

Suggested causes of symptoms include a combination of wind turbine noise, infrasound, dirty electricity, ground current, and shadow flicker.

Wind turbine noise under Canada’s setbacks such as those mandated by Ontario’s Regulation 359/09 is a non-issue as they are formulated to achieve WHO noise annoyance compliance. The infrasound assertion is pseudoscience; humans evolved with infrasound exceeding the levels produced by wind turbines and in fact the human cardiovascular system creates higher levels of infrasound in the inner ear than any produced by wind energy. [9] Dirty electricity is also pseudoscience and ground current is unrelated to wind turbines where it occurs. Shadow flicker occurs a few minutes a day a few days a year in some homes and is not a risk factor for any serious ailments. [10]

Their source for this deceptive and pseudoscience-laden statement is an article in an unindexed journal which publishes irregularly, The Bulletin of Science, Technology & Society. For those unfamiliar with unindexed journals, they are considered of lower credibility than indexed journals; a corollary is that BSTS has no impact factor and articles in it are rarely if ever cited. The editor of the journal, an Associate Professor from the University of Toronto, assembled with the assistance of members of the Society for Wind Vigilance a collection of very poorly structured articles related to wind and health which would not have been able to pass peer review in a more stringent journal. They were published en masse in the August 2011 issue of BSTS. Subsequently, they are often cited by those attempting to create credibility for studies and commentaries which purport to find health issues with wind energy, such as the commentary under discussion here.

While establishing that they are on the Advisory Board of the Society for Wind Vigilance, the authors significantly understate the nature of the Society. It has been an active anti-wind campaigning organization for several years and prior to any peer-reviewed material and against all of the peer-reviewed evidence and cross-literature reviews has maintained an unsupported assertion of 2-kilometer setbacks and larger setbacks for wind turbines placed on ridges or offshore. [11] Googling the Society finds that it is referenced almost entirely from anti-wind energy websites.

Throughout this commentary, the authors use the emotionally laden term “industrial wind turbine”. This phrase was focus-tested by Koch brother-backed anti-renewables organizations a decade ago and found to be the most effective phrase to create antipathy to wind energy. It is not neutral language as would be expected in a medical journal, but propaganda terminology.

Professor Chapman, Ms. Crichton’s and Ms. Lawrence’s and their teams’ work makes it clear that anti-wind rhetoric and fears raised by anti-wind campaigners are a primary cause of health impacts near wind farms. This article is already being used by anti-wind campaigners in other parts of the world as evidence to support their case.

The failings of the peer review process to catch the reliance on very weak sources and lack of balance with much stronger evidence which contradicts the commentary is worth paying attention to because it exposes how easy it is for manipulative authors in the wind energy space to seed weak studies into peer-reviewed journals and then reference them. Peer-reviewed journals should strongly consider care in selection of peer reviewers to find ones with depth in the evidence related to wind energy and health to avoid the appearance of validity to allow articles such as this to slip by unchallenged.  Deeply experienced professionals such as Dr. David Colby of Ontario, Dr. Arlene King of Ontario, Geoff Leventhall, a widely published acoustician from the United Kingdom, Professor Simon Chapman of Australia and Ms. Fiona Crichton of New Zealand are obvious candidates for peer review of wind energy and health-related articles. These statements should in no way be taken as a criticism of Canadian Family Physician; they are a victim of this deceptive effort just as the doctors who read it are and most of all any patients who are ill-advised as a result.

That Jeffrey, Krogh and Horner persist in attempting to raise health fears related to wind turbines in light of the strong evidence that they do not cause health issues is problematic. That they are attempting to enlist general practitioners across Canada in their attempts is of deep concern.

References

[1] List of all reviews related to wind farms and health internationally, maintained by the University of Sydney Department of Public Healthhttp://tobacco.health.usyd.edu.au/assets/pdfs/publications/WindHealthReviews.pdf

[2] Noise levels and noise perception from small and micro wind turbines, Jennifer Taylor, Carol Eastwick, Claire Lawrence, Robin Wilson, Renewable Energy, Volume 55, July 2013, Pages 120-127, http://www.sciencedirect.com/science/article/pii/S0960148112007665

[3] The influence of negative oriented personality traits on the effects of wind turbine noise, Jennifer Taylor, Carol Eastwick, Robin Wilson, Claire Lawrence, Personality and Individual Differences, Volume 54, Issue 3, February 2013, Pages 338-343, http://www.sciencedirect.com/science/article/pii/S0191886912004783

[4] Can Expectations Produce Symptoms From Infrasound Associated With Wind Turbines?Crichton, Fiona; Dodd, George; Schmid, Gian; Gamble, Greg; Petrie, Keith J. Health Psychology, Mar 11 , 2013, No Pagination Specified. doi: 10.1037/a0031760, http://psycnet.apa.org/psycinfo/2013-07740-001/

[5] Spatio-temporal differences in the history of health and noise complaints about Australian wind farms: evidence for the psychogenic, “communicated disease” hypothesis. , Simon Chapman, Alexis St. George, Karen Waller, Vince Cakic, http://ses.library.usyd.edu.au/handle/2123/8977?mode=full&submit_simple=Show+full+item+record

[6] Letter to Editor: Are the findings of “Effects of industrial wind turbine noise on sleep and health” supported?, Christopher A Ollson, Loren D Knopper, Lindsay C McCallum, Melissa L Whitfield-Aslund, Noise and Health, Year : 2013, Volume : 15, Issue : 63, Page : 148-150, http://www.noiseandhealth.org/article.asp?issn=1463-1741%3Byear%3D2013%3Bvolume%3D15%3Bissue%3D63%3Bspage%3D148%3Bepage%3D150%3Baulast%3DOllson

[7] Letter to Editor: Issues of wind turbine noise, Mike Barnard, Noise and Health, Year : 2013, Volume : 15, Issue : 63, Page : 150-152, http://www.noiseandhealth.org/article.asp?issn=1463-1741;year=2013;volume=15;issue=63;spage=150;epage=152;aulast=Barnard

[8] Analysis of the Research on the Health Effects from Wind Turbines, including Effects from Noise, Maine Department of Health and Human Services, 2012, http://www.maine.gov/dhhs/reports/health-effects-from-wind-turbines-2-12.pdf

[9] Infrasound from Wind Turbines – Fact, Fiction or Deception? by Geoff Leventhall in Vol.34 No.2 (2006) of the peer-reviewed journal Canadian Acousticshttp://www.cleanenergycouncil.org.au/technologies/wind/turbinefactsheets/mainColumnParagraphs/0/text_files/file1/06-06Leventhall-Infras-WT-CanAcoustics2.pdf

[10] Update of UK Shadow Flicker Evidence Base Final Report, UK Department of Energy and Climate Change, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/48052/1416-update-uk-shadow-flicker-evidence-base.pdf

[11] The Society for Wind Vigilance issues a Global Guideline for the Minimum Siting Distance of Industrial Wind Turbines, April 4, 2012, http://www.windvigilance.com/news

[12] Society for Wind Vigilance Advisory Group, http://www.windvigilance.com/home/advisory-group

[13] Turbine foes try to forge national opposition movement, Lydia DePillis, Greenwire: Monday, September 24, 2007, http://www.eenews.net/stories/57559

[14]  Wind Turbine Sound and Health Effects An Expert Panel Review, W. David Colby, M.D. et al, Prepared for: American Wind Energy Association and Canadian Wind Energy Association, December 2009, http://www.canwea.ca/pdf/talkwind/Wind_Turbine_Sound_and_Health_Effects.pdf

[15]  The Potential Health Impact of Wind Turbines, Chief Medical Officer of Health (CMOH) Report May 2010, http://health.gov.on.ca/en/common/ministry/publications/reports/wind_turbine/wind_turbine.pdf

Additional Resources:

Wind farms don’t make people sick, so why the complaints?
Humans evolved with infrasound; is there any truth to health concerns about it?
“Wind turbine syndrome” is more wind than syndrome
A study in Noise and Health shows that wind farms cause people to lose sleep.  How reliable is this study?

Medical ethics violations by anti-wind lobbyists such as Sarah Laurie receiving attention
Not just NIMBYs: understanding anti-wind energy campaigners

Note: a version of this post was originally published as a Rapid Response to the commentary at http://www.cfp.ca/content/59/5/473.full#responses where it joined two well-informed responses by professionals engaged in public health challenging the article and a fourth response which was an ideological attack on global warming.

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[The following material is added by AWEA.]

Useful articles on the nocebo effect:

New Yorker blog,"The Nocebo Effect: How We Worry Ourselves Sick"
Media Matters for America blog,"NPR Gives Wind Power Hypochondriacs a Platform"
Slate,"Can Wind Turbines Make You Sick?"
The Conversation,"How the power of suggestion generates wind farm symptoms"

Related articles:

Opinion: Health effects of wind towers hyped by media, May 28, 2013
Falmouth votes to keep turbines; Australian sound study confirms others, May 24, 2013
Wind farm neighbors stressed, but it's not the turbines, April 21, 2013
New Yorker explains nocebo effect, NPR airs junk science, April 8, 2013
Science: Anti-wind groups appear to spread illnesses they complain of, March 21, 2013
Ontario resident's personal testimony: 'Anti-wind groups make me sick', March 13, 2013
GMP reports on Kingdom Community Wind sound levels, March 5, 2013
South Australia study finds infrasound from wind farms not a concern, February 4, 2013
Science proves that wind energy is safe for Wisconsin, January 9, 2013
Ontario tribunal turns down anti-wind appeal, December 26, 2012
Reason trumps fear in Australian debate on wind energy and sound, December 5, 2012
Nissenbaum paper on turbine sound recycles claims on wind energy and health already found inadequate by courts and expert panel, November 16, 2012
Negative oriented personality traits and wind turbine sound, November 2, 2012
Quality of research on wind farms published in the Bulletin of Science, Technology and Society, September 25, 2012
Wind energy associations: Wind 'one of safest forms of electricity', July 30, 2012
'Say No to Wind Turbines'–and Yes to ?, July 25, 2012
Fact check: On turbine sound, it's Bryce vs. science, July 24, 2012
Fourteen wind energy myths debunked, June 20, 2012
Wind turbines not a threat to human health, another study finds, May 31, 2012
Fact check: Lomborg lacking on wind's economics, emissions reductions, March 23, 2012
Public opinion watch: Ontarians: Wind power one of safest forms of electricity generation, March 6, 2012
Opinion: Wind turbines are good for our health, March 2, 2012
Review of wind turbine sound studies gives debate needed balance, February 28, 2012
Anti-wind-farm ‘astroturfers’ in Australia, February 27, 2012
NBC4's 'iReporter' lacks context on wind turbine sound, February 14, 2012
Fact check: Bryce misleads again on land, sound, resource use, January 31, 2012
Despite science, wind turbine sound sparks discussion in Wisconsin, January 30, 2012
Massachusetts clears wind of health effects after independent experts review evidence, January 20, 2012
Opinion: Dr. W. David Colby: Turbines and health, December 2, 2011
Canadian researchers: No direct link between wind turbines and health, November 29, 2011
Wind power: A quiet solution to climate change, June 27, 2011
Sierra Club Canada 1.1: Time to confront anti-wind fear campaign, June 15, 2011
Environmental Defence (Canada): 'No basis' for health impact claims, June 6, 2011
Sierra Club Canada: Time to confront anti-wind disinformation campaign, June 3, 2011
WINDPOWER report: New study finds minimal low-frequency and infrasound impact from wind turbines, May 25, 2011
Does the sound of money soothe Wind Turbine Syndrome?, April 25, 2011
WHO guidelines on sound are … guidelines, March 28, 2011
Scientists, doctor weigh in on wind and health, November 30, 2010
Wind turbine sound: The neighbors speak, March 18, 2010
Expert panel concludes wind turbine sounds not harmful to human health, December 15, 2009

 

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