Wind turbines and health: An examination of a proposed case definition

Abstract

Renewable energy demands have increased the need for new wind farms. In turn, concerns have been raised about potential adverse health effects on nearby residents. A case definition has been proposed to diagnose “Adverse Health Effects in the Environs of Industrial Wind Turbines” (AHE/IWT); initially in 2011 and then with an update in 2014. The authors invited commentary and in turn, we assessed its scientific merits by quantitatively evaluating its proposed application. We used binomial coefficients to quantitatively assess the potential of obtaining a diagnosis of AHE/IWT. We also reviewed the methodology and process of the development of the case definition by contrasting it with guidelines on case definition criteria of the USA Institute of Medicine. The case definition allows at least 3,264 and up to 400,000 possibilities for meeting second- and third-order criteria, once the limited first-order criteria are met. IOM guidelines for clinical case definitions were not followed. The case definition has virtually no specificity and lacks scientific support from peer-reviewed literature. If applied as proposed, its application will lead to substantial potential for false-positive assessments and missed diagnoses. Virtually any new illness that develops or any prevalent illness that worsens after the installation of wind turbines within 10 km of a residence could be considered AHE/IWT if the patient feels better away from home. The use of this case definition in the absence of a thorough medical evaluation with appropriate diagnostic studies poses risks to patients in that treatable disorders would be overlooked. The case definition has significant potential to mislead patients and its use cannot be recommended for application in any health-care or decision-making setting.

Response to McCunney et al.: Wind turbines and health: An examination of a proposed case definition

“…asserted that they contrasted the McMurtry and Krogh criteria with the Institute of Medicine guidelines for the development of clinical guidelines and itemized ‘key points’[3] in the two tables reproduced below.…”

“…[3] The medical significance of this table item remains a mystery as numerous medical conditions have common symptoms. The third-order criteria presented in the case definition by McMurtry and Krogh[2] are symptoms consistent with the ‘well-known stress effects of exposure to noise’,[15] which ‘… are familiar to environmental noise control officers and other “on the ground” professionals’.…”

“…in Table 2 states ‘[t]he case definition lacks the requirement to confirm reports of symptoms with medical records and diagnostic studies’. [3] This statement is erroneous. McMurtry and Krogh have specified that a licensed practitioner must conduct a thorough history, physical examination and investigation and rule out alternative explanations before ‘presumed diagnosis’ of AHE/IWT is warranted.…”

“…In the article by McCunney et al ., the third item that ‘[a]ll medical information, with two exceptions, is subjective’[3] in Table 2 is irrelevant. It is a normal clinical practice for physicians to diagnose and treat patients displaying subjective symptoms.…”

“…Noise and Health published the views of McCunney et al . [3] that presented critical commentary on these AHE/IWT diagnostic criteria as well as its predecessor, which were presented by McMurtry. [4]…”