1. Is Annoyance Our Issue? The Public Health Perspective on Wind Turbines (WT) Arlene King, MD, MHSc, FRCPC Former CMOH, Ontario Adjunct Professor, Dalla Lana School of Public Health, University of Toronto PHPC CPD Symposium, May 2015

2. Conflict of Interest Disclosure I have had a financial relationship within the last 6 months with an IT organization, Skylight Health Inc., from which I have received payment for consulting services related to its Vaccine Tracking System

3. Overview Context Literature on Potential Health Impacts CMOH Report and Response Annoyance Conclusions

4. Context Robust data on the adverse human health impact of burning fossil fuels “Human-induced global climate change” and concern about “ecological determinants of health” (Opening Plenary, May 25, Public Health 2015, Vancouver, BC)

5. Context - II “One of the major challenges we face is the enormous environmental and health impact resulting from the extraction, transportation, use and export of fossil fuels …” “…greater use of sustainable technologic alternatives …” “...taking action on fossil fuels … and creating alternative energy sources...” (May 28, 2015 Post-conference session, Public Health 2015, Vancouver, BC)

6. Context - III Ontario, among many other jurisdictions, adding “green” alternatives to suite of energy- producing technologies (eg, solar, wind) Policy lead with Ministries of Energy and/or Environment – not Health Health had not been invited to offer a perspective on energy-producing technologies

7. Context - IV Well-publicized public health concerns about wind turbine/wind turbine farms in Ontario – MOHs in some parts of the province highly engaged Few, if any, reviews done in Canada, by Canadian public health officials; little, if any Canadian data (2009) CMOH believed that alleged health concerns should be subject to a rigorous, arms’ length scientific review and causality assessment which could be used province-wide

8. Scientific Review - Methods Office of the CMOH convened a technical working group to conduct a scientific review of the literature on the potential health impacts of wind turbines (2009-2010) Membership included the Ontario Agency for Health Protection and Promotion (now known as Public Health Ontario), the Ministry of Health and Long Term Care, and several Medical Officers of Health, with the support of the Council of Medical Officers of Health (COMOH)

9. Chief Medical Officer of Health Report Chief Medical Officer of Health Report (May 2010)

10. Summary of the Review “While some people living near WT report symptoms such as dizziness, headaches and sleep disturbance, the scientific evidence to date does not demonstrate a direct causal link between wind turbine noise and adverse health effects The sound level from wind turbines at common residential setbacks is not sufficient to cause hearing impairment or other direct health effects, although some people may find it annoying”

11. Other Review Specifics No evidence of adverse health effects from low frequency sound and infrasound generated by WT (well below the level where known health effects occur) WT are not a significant source of EMF exposure WT shadow flicker is not a potential health concern WT are not a significant physical hazard, if properly sited, operated and maintained

12. Other Review Specifics - II “Community engagement at the outset of planning for wind turbines is important and may alleviate health concerns about wind farms Concerns about fairness and equity may also influence attitudes towards wind farms and allegations about effects on health. These factors deserve greater attention in future developments”

13. Response Well organized, highly respected and vocal individuals and groups mobilized community, provincial and national responses to the CMOH Report Multiple briefings, Committee appearances related to Report Law suits against the Crown and WT companies, requesting Office of the CMOH representation Considerable, sustained, largely negative media coverage requiring Office responses Multiple complaints to the CPSO Prolific, hostile letters to the CMOH, some requiring responses; safety concerns expressed by Office staff

14. Scientific Review II Updated literature review was requested from Public Health Ontario by the CMOH in 2012, to determine whether revisions to the CMOH Report were needed The final review was received in July 2013, following peer review and revisions Findings unchanged; more literature on annoyance related to WT The 2010 CMOH Report was not revised

15. Annoyance Some people might find sound of WT annoying; it has been suggested that annoyance may be a reaction to the characteristic “swishing” or fluctuating nature of WT sound (2010 CMOH Report) For a given sound pressure level, wind turbines do produce more annoyance than other community noise sources (July 2013)

16. Annoyance - II Whether this is related to characteristics and timing of the noise, the visual appearance of wind turbines and their influence on the landscape, the status of WT as a relative new source of noise, factors related to the distribution of benefits and process of siting WT developments, or a combination of these factors is not certain (July 2013)

17. Conclusions Scope of literature review important – Differences of opinion remain on whether annoyance should have been included as a potential health impact Consider whether providing a public health perspective on an issue could result in “ownership”, and the unintended consequences (opportunity costs) Consider how that perspective should be generated and conveyed to the policy lead Report should have included context for the review (eg, public concerns, need for rigorous, independent review, alternative energy sources known to result in negative health impacts)

18. Acknowledgements Staff of the Office of the CMOH Ministry of Health and Long Term Care, Public Health Division, Health Protection and Environmental Health team, past and present Public Health Ontario – Dr. Ray Copes and team Council of Medical Officers of Health of Ontario