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

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.

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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 world wide that wind turbines do not cause health impacts.

The authors — Jeffrey, Krogh and Horner – do not cite the 19 reviews world wide of the peer-reviewed evidence and anecdotal health claims that have found no evidence of harm from wind turbines to human health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 UK 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 cardio-vascular 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.

This blog post was based on a Rapid Response — a moderated online comment on a peer-reviewed published article — that I submitted. Krogh, Horner and Jeffery, interestingly enough, responded to my Rapid Response at self-serving and increasingly inaccurate length.

Of course, I wasn’t the only one who tore the Commentary to shreds. Here’s a sample from the Rapid Responses. Oddly, Krogh et al didn’t respond to the thrashing they received from these fine people. I would encourage people to read Krogh et al’s response to me, but you’d be much better served and informed by reading the full texts of the excellent RRs I’ve quoted here.

  • In this article, the authors’ statement that “owing to the lack of adequately protective siting guidelines, people exposed to IWTs can be expected to present to their family physicians in increasing numbers” is both alarmist and inappropriate.

    Kieran Moore, Associate Medical Officer of Health at KFL&A Public Health, W. David Colby, Chatham-Kent Medical Off

  • From the use of the inflammatory qualifier “industrial” in the title to the declaration of “Competing Interests” at the end, this article is anti-wind turbine propaganda. Although designated as “Commentary”, the peer reviewed status implies some level of endorsement. I asked almost every physician with expertise about wind turbines and health in Canada if they had been asked to review this article and none had.

    The article is replete with unreferenced and often alarmist statements, selective citations (e.g. quoting the WHO definition of health to support the concept that annoyance itself is a health effect, without mentioning that the WHO does not use annoyance as a measured health end point) (1) and statements relying on unscientific references. If these were edited from the article, little would remain.

    W. David Colby, Chatham-Kent Medical Officer of Health, Professor, Schulich School of Medicine & Dentistry, Western University

  • We agree with the observations that individuals that are angry or annoyed are bound to experience symptoms such as stress or sleep disturbance. Empathy from their primary care provider is always a good approach. However, the commentary, as a whole, was hyperbolic and not something that family physicians should rely upon for advice or as a reference.

    Dr. Rosana Pellizzari, Medical Officer of Health Dr. Farhan Asrar, Peterborough County-City Health Unit

  • Virtually absent from this article is any discussion of the hazards posed by other forms of energy generation.

    Coal-fired facilities, for instance, are a significant source of chromium and arsenic (carcinogens), sulphur dioxide (acid rain), dioxin, and of course greenhouse gases. Ontario’s coal plants, for example, were once the single largest source of GHGs in the province.

    Dr. Jeffrey and his colleagues conclude in their article that “industrial wind turbines can harm human health”. Unfortunately the remainder of their commentary provides no evidence that this is so.

    Gideon Forman , Executive Director, Canadian Association of Physicians for the Environment

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 Health http://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 Acoustics http://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:

  1. Wind farms don’t make people sick, so why the complaints?
  2. Humans evolved with infrasound; is there any truth to health concerns about it?
  3. “Wind turbine syndrome” is more wind than syndrome
  4. A study in Noise and Health shows that wind farms cause people to lose sleep.  How reliable is this study?
  5. Medical ethics violations by anti-wind lobbyists such as Sarah Laurie receiving attention
  6. 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.

One comment

  1. […] article is reposted from the Barnard on Wind blog with the permission of the author, Mike Barnard. Three Canadians–two with current and […]

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