Health Effects Related to Wind Turbine Sound, Including Low-Frequency Sound and Infrasound

Abstract

A narrative review of observational and experimental studies was conducted to assess the association between exposure to wind turbine sound and its components and health effects in the general population. Literature databases Scopus, Medline and Embase and additional bibliographic sources such as reference sections of key publications and journal databases were systematically searched for peer-reviewed studies published from 2009 to 2017. For the period until early 2015 only reviews were included, while for the period between January 2015 and January 2017 all relevant publications were screened. Ten reviews and 22 studies met the inclusion criteria. Most studies examined subjective annoyance as the primary outcome, indicating an association between exposure levels and the percentage highly annoyed. Sound from wind turbines leads to a higher percentage of highly annoyed when compared to other sound sources. Annoyance due to aspects, like shadow flicker, the visual (in) appropriateness in the landscape and blinking lights, can add to the noise annoyance. There is no evidence of a specific effect of the low-frequency component nor of infrasound. There are indications that the rhythmic pressure pulses on a building can lead to additional annoyance indoors. Personal characteristics such as noise sensitivity, privacy issues and social acceptance, benefits and attitudes, the local situation and the conditions of planning a wind farm also play a role in reported annoyance. Less data are available to evaluate the effects of wind turbines on sleep and long-term health effects. Sleep disturbance as well as other health effects in the vicinity of wind turbines was found to be related to annoyance, rather than directly to exposure.

Full text

Acoust Aust
DOI 10.1007/s40857-017-0115-6
REVIEW PAPER
Health Effects Related to Wind Turbine Sound, Including
Low-Frequency Sound and Infrasound
Irene van Kamp1·Frits van den Berg2
Received: 15 June 2017 / Accepted: 15 September 2017
© Australian Acoustical Society 2017
Abstract A narrative review of observational and experimental studies was conducted to assess the association between
exposure to wind turbine sound and its components and health effects in the general population. Literature databases Scopus,
Medline and Embase and additional bibliographic sources such as reference sections of key publications and journal databases
were systematically searched for peer-reviewed studies published from 2009 to 2017. For the period until early 2015 only
reviews were included, while for the period between January 2015 and January 2017 all relevant publications were screened.
Ten reviews and 22 studies met the inclusion criteria. Most studies examined subjective annoyance as the primary outcome,
indicating an association between exposure levels and the percentage highly annoyed. Sound from wind turbines leads to a
higher percentage of highly annoyed when compared to other sound sources. Annoyance due to aspects, like shadow flicker,
the visual (in) appropriateness in the landscape and blinking lights, can add to the noise annoyance. There is no evidence of
a specific effect of the low-frequency component nor of infrasound. There are indications that the rhythmic pressure pulses
on a building can lead to additional annoyance indoors. Personal characteristics such as noise sensitivity, privacy issues and
social acceptance, benefits and attitudes, the local situation and the conditions of planning a wind farm also play a role in
reported annoyance. Less data are available to evaluate the effects of wind turbines on sleep and long-term health effects.
Sleep disturbance as well as other health effects in the vicinity of wind turbines was found to be related to annoyance, rather
than directly to exposure.
Keywords Health effects ·Wind turbine sound ·Infrasound ·Low-frequency noise ·Observational studies ·Experimental
studies
1 Introduction
Globally, the use of sustainable sources of energy such as
biomass, water power, solar and wind energy is increasing in
order to reduce the use of fossil fuel. Worldwide targets are
set for an increase in sustainable energy. As a result, it can be
expected that the number of wind farms will keep growing
BIrene van Kamp
Irene.van.kamp@rivm.nl
1National Institute for Public Health and the Environment,
Netherlands, Antonie van Leeuwenhoeklaan 9, 3721 MA
Bilthoven, The Netherlands
2GGD Amsterdam Public Health Service, Nieuwe
Achtergracht 100, 1018 WT Amsterdam, The Netherlands
in the years to come and more people will have them in their
immediate living environment. Most people have a positive
attitude towards alternative energy sources; for example, in
the Netherlands in 2006 90% of the population was positive
about solar energy and 79%1was positive about wind energy.
However, although the benefits at national and global level
are recognized, viz. a reduction in atmospheric carbon diox-
ide concentration, at a local level people often oppose wind
farm plans. The awareness of the consequences of a wind
farm can lead to intense, and sometimes emotional discus-
sions about the need for wind energy, the suitability of the
area, the visual and aesthetic aspects and noise-related issues
1Special Eurobarometer, Attitudes towards energy. European Com-
mission (2006).
123

Acoust Aust
are not uncommon. Health effects of living in the vicinity of
the turbines are often part of the discussion. The association
between wind turbines and human responses is a complex
one, and many factors play a role in the public debate. At
the local level attention is often focused on the potentially
negative health effects of living near a wind turbine.
This paper addresses the state of the art regarding health
effects related to wind turbine sound and is based on a
manuscript prepared at the request of the Noise and NIR
Division of the Swiss Federal Office for the Environment
(Bundesamt für Umwelt). Although several excellent reviews
on this topic have been published, we think it is worthwhile
to publish this narrative review because several large stud-
ies have been completed after publication of the most recent
meta-analysis [1]. Also, this review addresses the effects to
living in the vicinity of wind turbines (WT’s) in a broader
physical and social context and includes the evidence for
possible health effects of the low-frequency and infrasound
components. And finally, we made an effort to write a text
that is accessible for a broader audience.
In this text we use the word ‘sound’ when it refers to sound
in a neutral sense. The sound of WT’s is not always perceived
as negative as the word ‘noise’ (meaning: unwanted sound)
would suggest. The term WT noise is quite common but in
our opinion only correct when it refers to negative effects,
such as in ‘noise annoyance’. When it does, we may also use
the word ‘noise’.
In line with the definition of health as ‘a state of complete
physical, mental, and social well-being and not merely the
absence of disease or infirmity’ of the World Health Orga-
nization (WHO) [2], noise annoyance and sleep disturbance
are considered here as health effects [3]2[4].
Because this review aims at a broad audience, it might be
useful to explain briefly WT sound itself. We therefore start
in Sects. 1.1 to 1.3 with an explanation of the sound produced
by and heard from a wind turbine and what sound levels occur
in practice. After a description of methods used in this review
in Sects. 2and 3first summarizes the evidence from existing
reviews. This is followed by a more detailed description of
studies not covered in these reviews. In both parts the key
issue is how sound from a wind turbine can affect people,
especially neighbouring residents, and in what way and to
what degree other factors are important to take into account.
This is repeated in Sect. 4for sound at (very) low frequencies
that allegedly can affect people in other ways than ‘normal’
sound does. Here we use the term ‘normal’ sound casually
when it is easily recognizable as sound and can be heard; this
2Although high annoyance is not classified as a disease in the Inter-
national Classification of Disease (ICD-9; ICD-10), it does affect the
well-being of many people and therefore may be considered to be a
health effect falling within the WHO definition of health.
does not include infrasound or low levels of other sound that
are normally considered to be inaudible.
Our conclusions from reading and interpreting all the sci-
entific information are summarized in Sect. 5that concludes
the main text.
1.1 Sound Production and Character
An overview of wind turbine sound sources can be found in a
number of publications such as [5–8]. For the tall, modern tur-
bines most sound comes from flowing air in contact with the
wind turbine blades: aerodynamical sound. The most impor-
tant contributions are related to the atmospheric turbulence
hitting the blades (inflow turbulence sound) and air flowing
at the blade surface (trailing edge sound).
•Turbulence at the rear or trailing edge of a blade is gen-
erated because the air flow at the blade surface develops
into a turbulent layer. The frequency with the highest
(audible) sound energy content is usually in the range of
a few hundred Hz up to around 1000–2000Hz. At the
blade tips conditions are somewhat different due to air
flowing towards the tip, but this tip noise is very similar
to trailing edge noise and usually not distinguished as a
relevant separate source.
•Inflow turbulence is generated because the blade cuts
through turbulent eddies that are present in the inflow-
ing air (wind). This sound has a maximum sound level at
around 10Hz.
•Thickness sound results from the displacement of air by
a moving blade and is insignificant for sound production
when the air flows smoothly around the blade. However,
rapid changes in forces on the blade result in sudden
sideways movements of the blade and sound pulses in
the infrasound region. This leads to the typical wind tur-
bine sound ‘signature’ of sound level peaks at frequencies
between about 1–10 Hz. These peaks cannot be heard, but
can be seen in measurements.
Inflow turbulence sound is important in the low- and middle-
frequency range, overlapping with trailing edge sound at
medium and higher frequencies. As both are highly speed
dependent, sound production is high where the speed is high
and highest near the fast rotating tips of the blades. Wind tur-
bine sound can sometimes be tonal, i.e. one can hear a specific
pitch. This can be mechanical sound from the gear box and
other devices in the turbine which was a relevant source for
early turbines. Another possible source is an irregularity on
a blade, but this is apparently rare and can be mended.
When the sound penetrates into a dwelling, the building
construction will attenuate the higher frequencies better than
the lower frequencies. As a result, indoor levels willbe lower
and the sound inside is of a lower pitch, as higher frequencies
123

Acoust Aust
are more reduced than low frequencies. This is true for every
sound coming from outside. Wind turbine sound changes
over time. An important feature is the variation of the sound at
the rhythm of the rotating blades. This variation in synchrony
with the blade passing frequency is also called the amplitude
modulation (AM) of the sound [6,9–12].
1.2 Human Hearing
Most environmental sounds with a level of 40dBA will
approximately have the same loudness for human hearing
because the A-weighting (that is implied by the A in dBA) is
based on the loudness curve of 40 phon (which equals 40dB
at 1000Hz). Such a low to moderate loudness is comparable
with actual wind turbine sound levels at many residences near
wind farms. Therefore, A-weighting should give a (nearly)
correct estimate of the loudness of a sound. With hearing
tests this was confirmed in the Japanese wind turbine sound
study [13]. A-weighting is less correct at lower sound levels;
application of A-weighting to low levels (roughly <30dBA)
may allow for more low-frequency sound. Of course, this
concerns sound levels that are already low and usually will
comply with limits. It is because of the combination of our
hearing capacities at different frequencies and the sound level
of the different wind turbine sources that trailing edge sound
is the most dominant sound when outside and not too far from
a wind turbine. The sound will shift to lower frequencies at
larger distances or indoors, and then inflow turbulent sound
can be more important.
When a sound is ‘subaudible’, the level of that sound is
below the hearing threshold and thus below the level it can
be audible. Usually the ‘normal’ threshold (hearing thresh-
old of young adults without hearing problems, according to
the international standard ISO 326) is used. As there is a
variation between individuals, the normal threshold is the
hearing threshold separating the 50% best hearing from the
50% that hear less well. For an individual often that normal
hearing threshold is taken as an indication, but for that person
of course the individual hearing threshold is relevant. Hear-
ing acuity may differ considerably between persons. Hearing
generally deteriorates with age, but this is typically less so at
lower frequencies when compared to higher frequencies.
1.3 Sound Levels in Practice
For a modern turbine, the maximum sound power level is in
the range between 100 and 110dBA. ‘Sound power’ is the
total amount of sound radiated from a source. For a listener
on the ground close to a turbine, the outdoor sound level
will not be more than about 55dBA. At residential locations
this is often less and in most studies there are few people,
if any, exposed to an average sound level of over 45dBA.
For a wind turbine, maximum sound levels are not much
higher than average sound levels. For two turbine types in
a temperate climate, it was shown that the sound level from
these two types at high power is 1–3dB above the sound level
averaged over a long time [14].
Measurements on many types of modern wind turbines
show that most sound energy is radiated at low and infrasound
frequencies and less at higher frequencies (approximately
100–2000Hz). However, because of the lower sensitivity of
human hearing at low frequencies, audibility is greater at the
higher frequencies. In the last decades wind turbines have
become bigger and onshore wind turbines now can have sev-
eral megawatts (MW) electric power. 2 MW turbines produce
9–10dB more sound power when compared to 200kW tur-
bines [15,16]. Over time the amount of low-frequency sound
(10–160Hz) increases at nearly the same rate as the total
sound level. Depending on what the reference situation is,
this is somewhat less according to one author [15], some-
what more according to the other [16].
1.4 Aspects Other than Sound
Apart from sound, visual aspects, safety and vibrations
related to wind turbines may also have an impact on the
environment and the people living in it. Economic benefit,
intrusion in privacy and acceptance of the wind turbines and
other sources of disturbance are relevant to understand lev-
els of annoyance. Also, personal and contextual aspects can
determine the level of annoyance due to wind turbines.
2 Method
2.1 Data Sources and Search
This paper summarizes the present knowledge available
about the association between wind turbine sound and health.
It is based on several literature searches and reviews recently
performed in the Netherlands [17,18] and updated with lit-
erature until February 2017, using the same method. Some
papers from the most recent conference on Wind Turbine
Noise (May 2017) have also been added to the overview in
Sect. 4.
For this review a systematic literature search was per-
formed at three moments in time (2000–2012; 2012–2015;
and 2015–2017) using the same protocol. Observational as
well as experimental studies described in the peer review lit-
erature in the period between 2009 and 2017 were included.
Language was restricted to German, English, French and
Dutch. The databases Scopus, Medline and Embase (note:
only 2015–2017) were searched because these studies do
not appear in the available reviews yet and they are of high
value as they build on earlier evidence. The search strategy
is described in Table 1.
123

Acoust Aust
Tabl e 1 Key search terms and
search profile 1 (Wind turbine* or wind farm* or windmill* or wind park* or wind power or wind energy).ti. (550)
2 Turbine noise*.tw. and wind/ (33)
3 (Power plants/ or energy-generating sources/ or electric power supplies/) and wind/ (187)
4 (Low frequency noise* or low frequency sound* or infrasound or infrasonic noise* or infrasonic
sounds or infrasonic frequencies or low frequency threshold or (noise* adj4 low frequenc*)).ti.
(500)
5 1 or 2 or 3 or 4 (1113)
6 (Wind turbine* or wind farm* or windmill* or wind park* or wind power or wind energy).ab. (803)
7 (Low frequency noise* or low frequency sound* or infrasound or infrasonic noise* or infrasonic
sounds or infrasonic frequencies or low frequency threshold or (noise* adj4 low frequenc*)).ab.
(1487)
8 Noise*.ti. (26930)
9 (6 or 7) and 8 (498)
10 (Impact or perception* or perceive* or health* or well-being or “quality of life” or syndrome*).ti.
(1456358)
11 (Annoyance or annoying or annoyed or aversion or stress or complaints or distress or disturbance or
adversely affected or concerns or worries or noise problems or noise perception or noise reception
or noise sensitivity or (sensitivity adj3 noise) or sound pressure level* or sleep disturbance* or
sleep quality or cognitive performance or emotions or anxiet* or attitude*).tw. (1260490)
12 (Social barrier* or social acceptance or popular opinion* or public resistance or (living adj4
vicinity) or (living adj4 proximity) or (residing adj4 vicinity) or (residing adj4 proximity) or
living close or “living near” or residents or neighbors or neighbours).tw. (105942)
13 (Soundscape or landscape or visual annoyance or visual interference or visual perception or visual
impact or visual preferences or visual assessment or visual effects or perceptual attribute*).tw.
(41227)
14 (Effects adj4 population) or dose-response relationship* or exposure-response relationship* or
dose response or exposure response or human response or health effects or health aspects or
health outcome*).tw. (136924)
15 (Flicker or reflection).ti. (10980)
16 Environmental exposure/ or noise/ae or environmental pollution/ae (79725)
17 Loudness perception/ or psychoacoustics/ or auditory perception/ or auditory threshold/ or sensory
thresholds/ or visual perception/ or motion perception/ (130572)
18 Sleep disorders/ or emotions/ or anger/ or anxienty/ or quality of life/ or epilepsy/ or attitude/ or
affect/ or pressure/ or aesthetics/ or social environment/ or risk factors/ (1232239)
19 (Physiopathology or adverse effects).fs. (3235762)
Language: English or Dutch or French or German
Search period: 2009–2017
Duplicates removed
Exclude animals/not humans
We aimed to include low-frequency sound and infrasound
in this review, but there are less publications and reviews
specifically addressing this part of the spectrum. Also, the
(alleged or studied) effects of infrasound and low-frequency
sound are different from the effects of ‘normal’ sound. As a
consequence, this topic is reviewed separately and is based
on all relevant publications from the literature search (Fig. 1).
2.2 Inclusion Criteria
Only studies were included in which it was mentioned in the
title, abstract or summary that the association was studied
between the sound or noise of wind turbines and a reaction or
effect concerning health or well-being. Also, studies address-
ing participation during the building process were accepted
for review. This implied that the association between expo-
sure to wind turbine (low-frequency) sound and annoyance,
health, well-being or activity disturbance in the adult popu-
lation was studied.
For a first selection the following criteria were used.
Inclusion: papers address human health effects, perception,
opinion, concern in relation to wind turbines. Exclusion:
papers address non-human effects such as ecosystem effects,
animals, papers solely about technical aspects of the wind
turbines, papers regarding health effects of sound but not
related to wind turbines. This resulted in total in 202 possi-
123

Acoust Aust
Fig. 1 Flowchart of selection process
bly relevant studies for the period between January 2015 and
February 2017.
The papers for the period from January 2015 to February
2017 were grouped in seven categories: review, health effects,
case studies, offshore, low-frequencysound/infrasound, visual
aspects, social and not relevant. All reviews and health
effects studies were included for full paper examination.
All low-frequency sound/infrasound studies were examined
for inclusion in the separate review. Offshore studies were a
priori excluded; papers from the other categories were recon-
sidered after reading the abstracts.
Lastly, after full examination of the reviews and low-
frequency sound/infrasound and health effect papers by the
two authors, a final decision was made about inclusion in this
review.
2.3 Procedure and Study Quality Assessment
This review is primarily based on results from epidemiolog-
ical studies at population level and smaller-scale laboratory
experiments.
The results have been divided into three sections. The dif-
ference in material between both periods (up to and since
2015) resulted in two sections: first we review the reviews
(Sect. 3.1), and then we review original studies most of which
are from the second period (3.2). The effects of infrasound
and low-frequency sound are summarized in a third part
(Sect. 4).
The main results are summarized per outcome. For the
key studies, the study design and outcomes are discussed in
more detail. For this review primarily scientific publications
are used, from both peer-reviewed journals and conference
proceedings. In some cases results are discussed which were
described in non-scientific (‘grey’) literature. Also, some
publications are mentioned that are often used in the debate
(discourse) about the risks of living in the vicinity of wind
turbines.
As usual, all material from the selected literature has been
read and analysed, but not necessarily included as refer-
ence, e.g. because the study was less relevant than originally
thought or in case of doubling with other references (e.g. a
conference paper and an article from the same authors and
study). A meta-analysis on (part of) the data was not consid-
ered in the time frame of this assignment.
3 Results
Annoyance and sleep disturbance are the most frequently
studied health effects of wind turbine sound as is also the case
for sound from other sources. After a short explanation of
the health effects addressed in the literature, the overall con-
clusions from key reviews are summarized. Then the main
findings for annoyance, sleep disturbance and other health
effects are described in more detail, sometimes referring to
the underlying publications. The influence of personal, situa-
tional and contextual factors on these effects is also included.
Then in Sect. 3.2 the most recent original studies (2015–
2017) are described separately in more detail while following
the same structure.
Effects that are mentioned as specific effects of infrasound
and/or low-frequency sound are treated in Sect. 4.
3.1 Evidence Until Early 2017: Reviews
People can experience annoyance or irritation, anger or dis-
turbance from wind turbine sound, or when they feel that
their environmental quality and quality of life deteriorates
due to the siting of wind turbines near their homes.
The number of publications on wind turbine sound and its
health effects has increased considerably in the past 10years,
including peer-reviewed articles, conference papers and pol-
icy documents (Table 2).
A remarkable number of nineteen reviews were published
in the period between 2009 and 2017. These include sys-
tematic reviews as well as policy preparing reviews. Some
reviews were dismissed after reading the full text, since
they were highly anecdotal, no health impact was estimated,
incomplete or only concerned occupational exposure, etc.
123

Acoust Aust
Tabl e 2 Reviews (2009–2017) selected for this paper
First author year
and reference
Studies included Meta-analysis
Number of
studies
evaluated
Number of participants Time range Exposure Outcomes
Knopper, (2011)
[21]
15 studies Na 2003 and 2011 Aspects of wind turbines broadly Physiological and self-reported health
effects, annoyance, stress, sleep
disturbance, insomnia, anxiety
No
Harrison, (2015)
[27]
Review of
reviews
Na 2015 Low-frequency noise, levels
<100dB SPL
Wind turbine syndrome. Vertigo,
nausea and nystagmus, aural
fullness, hyperacusis, and tinnitus
No
Ellenbogen
(MPED),
(2012) [22,23]
4 studies
(peer-reviewed
and 4 non-peer-
reviewed
Na 2011 Aspects of wind turbines broadly:
noise, shadow flicker, visual
aspects, ice throw
Annoyance, sleep, health effects
(self-reported, diagnosed)
No
Merlin, (2013)
[19]
7 studies 2309 (79–754) 1981–2012 Infrasound/noise, electromagnetic
interference, shadow flicker,
blade glint
Adverse health effects (broad) Yes
SHC, (2013) [20] Na Noise (including low-frequency
noise, infrasound and vibrations)
shadow flicker electromagnetic
fields
Adverse health effects (broad) No
Schmidt, (2014)
[24]
36 studies 300–3000 2014 A-weighted sound exposure,
<30 dB >, infrasound, LFN,
distance
Health, annoyance, tinnitus, vertigo,
epilepsy, headache
No
MacCunney,
(2014) [25]
20/14 studies Na 2014 Distance, exposure, LFN
infrasound
Sleep, cardiovascular, health,
symptom, condition, disease
No
Knopper, (2014)
[26]
60 studies Na 2014 Noise, environmental change(s),
wind, farm(s), infrasound, wind
turbine(s),LFN,EMF,
neighbourhood change
Annoyance, sleep disturbance,
epilepsy, stress, health effect (wind
turbine, syndrome
No, due to
methodologi-
cal,
heterogeneity
Council of
Canadian
Academies,
(2015) [28]
38 studies Na 2009–2014 WT noise: a weighted SPL,
infrasound, low-frequency sound
and amplitude modulation
Annoyance sleep disturbance, tress,
tension, health-related quality of life,
vibroacoustic disease, cardiovascular
system, endocrine system, immune
system, musculoskeletal system,
nervous system (general), nervous
system (auditory), psychological
health, respiratory system
No
Onakpoya,
(2016) [1]
8 studies 2433 2000–2014 >and <40 dB, distance Annoyance and sleep disturbance Yes
123

Acoust Aust
The remaining ten recent and leading reviews and policy
documents (described in 11 manuscripts: [1,19–28]draw
comparable conclusions about the health effects of wind
turbine sound: in general, an association is found between
annoyance and the level of wind turbine sound. Also, an
association between sound level and sleep disturbance is con-
sidered plausible, even though a direct relation is uncertain
because of the limited number of studies with sometimes
contradictory results. Perceived stress is related to chronic
annoyance or to the feeling that environmental quality and
quality of life has diminished due to the placement of wind
turbines, and there is sufficient evidence that stress can neg-
atively affect people’s health and well-being in people living
in the vicinity of wind turbines [20].
Next to sound, vibration, shadow flicker, warning lights
and other visual aspects have been examined in the reviews.
There are no studies available yet about the long-term health
effects. Such longitudinal studies (studies comparing the sit-
uation at different moments in time) might be useful to gain
more insight in the causal pathways of the different factors.
However, they can still only examine the strength of tem-
poral associations across a range of relevant variables and
to establish causal relations will remain problematic in this
area.
Most recently, Onakpoya et al. [1] reanalysed the data
from eight cross sectional studies, selected on strict qual-
ity requirements and including a total of 2433 participants.
Effects considered were annoyance, sleep disturbance and
quality of life. Evidence supports the earlier conclusion that
there is an association between exposure to wind turbine
sound and an increased frequency of annoyance and sleep
problems, after adjustment for key variables as visual aspects,
attitudes and background sound levels. The strength of evi-
dence was the most convincing for annoyance, followed by
sleep disturbance, when comparing participants at exposure
levels below and above 40dB. The findings are in line with
Schmidt and Klokker [24] and Janssen et al. [29]. In con-
trast to these authors, Merlin et al. [19] consider annoyance
a response to wind turbines and not a (health) effect as such.
Personal and contextual factors can influence annoyance.
There is consensus in the literature that visual aspects, atti-
tudes towards wind turbines in the landscape and towards
the people responsible for wind farms, the process around
planning and construction and economic interest can all in
their own way affect levels of annoyance. However, actual
evidence for this is still limited.
The next sections will describe the state of the art in more
detail per health effect. Note that the description is limited to
the effects of wind turbine sound in the ‘normal’ frequency
range. Findings from studies, addressing suggested specific
impacts of the low-frequency component and infrasound
distinct from ‘normal’ sound are summarized separately in
Sect. 4.
3.1.1 Noise Annoyance
In many countries the assessment of the sound of wind tur-
bines is based on average, A-weighted sound levels (see
Sect. 1.2). It is generally accepted that annoyance from wind
turbines occurs at lower levels than is the case for traf-
fic or industrial sound. Based on Dutch and Swedish data,
an exposure–effect relation was derived between calculated
sound exposure levels expressed in Lden (day–evening–night
level) and the percentage highly annoyed, for indoor as well
as outdoor exposures. Later research in Japan and Poland
have confirmed these results and obtained similar results
[30,31]. The relation between wind turbine sound and annoy-
ance can be compared with those for road, rail and aircraft
sound. This comparison is presented in Fig. 2where the ‘air-
craft Europe’ data are from the European HYENA study
[32], the wind turbine data are from Janssen et al. [29], and
the other data are from Miedema and Vos [33] for indus-
trial sound and from Miedema and Oudshoorn [34] for air,
road and rail transportation sound. The more recent HYENA
study has shown that at a number of big European airports
noise annoyance has increased when compared to the older
data from Miedema and Oudshoorn [34]. Figure 2shows
that sound from wind turbines leads to a higher percentage
of highly annoyed people when compared to other sound
sources. The relation resembles that of air traffic sound, but
near airports there are higher sound levels and a correspond-
ingly higher percentage of highly annoyed. The relations for
transport sound in Fig. 2have been derived for large numbers
of persons from many countries, but the actual percentage for
a specific place or situation can be very different, for wind
turbines as well as other sources.
Some think that it is too early to define exposure–effect
relations for wind turbines [20,35]. According to them,
the influence of context (like residential factors, trust in
Fig. 2 Comparison of the percentage highly annoyed residents from
sound of wind turbines, transportation and industry (approach adapted
from Janssen et al. [51]); see text for explanation of legend
123

Acoust Aust
authorities and the planning process, situational factors) and
personal factors (such as noise sensitivity and attitude) is so
strong that the exposure–effect relation can only (or at best)
give an indication of the percentage of highly annoyed at the
local level [22,23].This is not unique to wind turbines, but
is to some degree—also true for other sound sources and in
part explains why in specific places or situations the actual
percentage of annoyed persons can differ from the relations
in Fig. 2. Michaud et al. [36] compared the results from five
studies and found there was a 7.5dB variation in wind tur-
bine sound levels that led to the same percentage of annoyed
persons.
What makes wind turbine sound so annoying?
In a Dutch survey [37] 75% of the respondents indicated
that the terms ‘swishing/lashing’ gave the best description
of wind turbine sound, irrespective of their being annoyed or
not [37]. Laboratory studies have consistently shown that the
periodic variation in the sound of wind turbines adds to the
annoyance. In the study of Persson Waye and Öhrström [38]
it was found that wind turbine sounds described as ‘swish-
ing’, ‘lapping’ or ‘whistling’ were more annoying while the
least annoying sounds were described as ‘grinding’ and ‘low
frequency’ [38]. In the UK research was performed near
three dwellings where people complained about wind tur-
bine sound. Rather than the low-frequency component of the
sound amplitude modulation or the rhythmic character was
the most conspicuous aspect of the sound [39]. In a later
UK study Large and Stigwood [40] concluded that ampli-
tude modulation is an important aspect of the intrusiveness
of wind turbine sound. More recently Yoon et al. [12] stated
that there is a strong possibility that amplitude modulation is
the main reason why wind turbine sound is easily detectable
and relatively annoying.
Whether the type of environment affects the levels of
annoyance is not yet clear. It can be assumed that people
in rural areas are more likely to hear and see wind turbines
than in more built-up urban areas with more buildings and
a less open view. However, Dutch research showed that the
percentage of highly annoyed people was equally high in
rural and urban areas [37] although the correlation with the
wind turbine sound level was less strong in the built-up area
[41]. An important moderator was the existence of a busy
road nearby, reducing the percentage annoyed by wind tur-
bine sound annoyance in rural areas only. In a Swedish study
it was found that residents in rural areas reported more annoy-
ance in rural areas than in urban environments, possibly due
to their expectation that the rural area would be quiet [42].
In a recent study Qu et al. [43] found that the level of annoy-
ance from wind turbine sound in urban and suburban areas
was less than reported in the Swedish, Dutch, Polish and
Canadian studies in rural areas.
3.1.2 Sleep Disturbance
Good sleep is essential for physical and mental health. Sound
is one of the factors that can disturb sleep or affect the quality
of sleep. Several biological reactions to night time sound
from different sources have been described in the literature:
increased heart rate, waking up, difficulty in falling asleep
and more body movements (motility) during sleep [4]. The
night noise guidelines of the WHO are not specifically aimed
at noise from wind turbines, but cover a range of (other)
noise sources. It is conceivable that the relatively small but
frequently occurring sound peaks just above the threshold
for sleep disturbance due to the rhythmic character of wind
turbine sound cause sleep disturbance [44]. A Dutch study
found that wind turbine sound did not affect self-reported
sleep onset latency but did negatively influence the ability
to keep sleeping [37,41]. An increase in sound level above
45 dBA increased the probability of awakening. This was not
the case for people who obtained economic benefit from the
wind turbines, but this might also have been an age effect
(co-owners of the turbines were younger). These findings of
the study in the Netherlands are in line with the conclusions
which the WHO drew from the review of scientific literature
the relation between transport sound and sleep [4]. According
to the WHO, sleep disturbance can occur at an average sound
level at the facade at night (Lnight) of 40dB and higher [4].
A direct association between wind turbine sound and sleep
disturbance can only be determined when there is a measur-
able reaction to the sound. Such an immediate influence is
only plausible when the sound level is sufficiently high and as
yet has not been convincingly shown for wind turbine sound
[23,45]. An indirect effect has been shown between self-
reported sleep disturbance and annoyance from wind turbine
sound, but not between sleep disturbance and the sound lev-
els per se [41]. Research has shown that also for other sound
sources there is a high correlation between self-reported sleep
disturbance and annoyance from noise [46].
Several more recent studies show an association between
quality of life and sleep disturbance and the distance of
a dwelling to a wind turbine [47,48]. Differences in per-
ceived quality of life were associated with annoyance and
self-reported sleep disturbance in residents. These results are
highly comparable with those found for air and road traffic,
e.g. see [49].
3.1.3 Other Health Effects Due to Sound
In an Australian report [50] the number of people living in the
vicinity of wind turbines with serious health complaints was
estimated to be 10–15%. However, according to literature
reviews on the health effects of wind turbines [1,19,20,23–
25,28] there is no evidence for health effects caused by wind
turbines in people living in the vicinity of wind turbines, other
123

Acoust Aust
than annoyance and self-reported sleep disturbance and the
latter is inconclusive. There was, however, a clear correla-
tion between annoyance and self-reported sleep disturbance
in one study [41]. Based on existing field studies, there is
insufficient evidence that living near a wind turbine is the
direct cause of health effects such as mental health prob-
lems, headaches, pain, stiffness or diseases such as diabetes,
cardiovascular disease, tinnitus and hearing damage.
3.1.4 Influence of Situational and Personal Factors
Research in the past decade has shed some light on the ques-
tion why some people are more disturbed by wind turbines
than others. Next to physical aspects, personal and contex-
tual aspects influence the level of annoyance. Often these
aspects are referred to as non-acoustic factors, complemen-
tary to the acoustic factors (the ‘decibels’). Because the term
non-acoustic refers to a broad range of aspects, and as a result
is very unspecific, we prefer the term personal and contex-
tual factors [51]. They can be subdivided in the following
categories (with some exemplary aspects in brackets):
•Situational factors (visual aspects frequency of sound
events, meteorological circumstances, other sound sources,
distance to amenities and attractiveness of the area).
•Demographic and socio-economic factors (age, gender,
income, level of education);
•Personal factors (fear or worry in relation to source, noise
sensitivity, economic benefit from the source);
•Social factors (expectation, attitudes towards producers or
government, media coverage);
There is a lot of variation in the aspects studied and also the
strength of the evidence varies strongly. Without pretending
to be exhaustive, those aspects documented in the reviews on
wind turbine sound up to 2015 are discussed in more detail
below.
3.1.4.1 Visual Aspects
Modern wind turbines are visible from a considerable dis-
tance because they rise high and change the landscape. Due
to the movement of their rotor blades, wind turbines are more
salient in the landscape than objects that do not move. The
rotating blades draw our attention and can cause variations
in light intensity when the blades block or reflect sunlight.
The visual and auditory aspects have been shown to be highly
interrelated [19,36,52] and are therefore hard to unravel with
respect to their effects. Annoyance from visual aspects may
add to or even reinforce annoyance from noise (and vice
versa). Noise and visual annoyance are strongly related as
was also described above. It has been suggested [20] that
people who see the wind turbines from their homes are more
worried about the health effect of continuous exposure and
as a consequence also report more annoyance [20].
3.1.4.2 Economic Aspects
Economic aspects can also affect annoyance from wind tur-
bines. In a study of Pedersen et al. [52] in the Netherlands,
some 14% of the respondents benefited from one or more
wind turbines, in particular enterprising farmers who lived
in general closer to the turbines and were exposed to higher
sound levels than the remaining respondents. The percent-
age of annoyed persons in this group was low to very low,
despite the higher exposure and the use of the same terms
to describe the typical characteristics of wind turbine sound.
In the study this group was described as ‘healthy farmers’:
on average they were younger, more often male and had a
higher level of education when compared to those not hav-
ing economic benefits and reported less problems with health
and sleep. However, it might not only be the benefit, but dif-
ferences in attitude and perception as well as having more
control over the placement of the turbines that might play a
role [37].
3.1.4.3 Noise Sensitivity
Being noise sensitive refers to an internal state determined by
physiological, psychological, attitudinal aspect, lifestyle and
activities of a person that increases the reactivity to sound
in general. Noise sensitivity has a strong genetic component
(i.e. hereditary), but can also be a consequence of a disease
(e.g. migraine) or trauma. Also, serious anxiety disorders
can go together with an increased sensitivity to sound and
possibly lead to a feeling of panic [53]. Only a few studies
have addressed this issue in relation to wind turbine sound.
An early example is the study of Shepherd et al. [47]in
New Zealand, in which two groups were compared (a ‘tur-
bine group’ versus a control group). Noise sensitivity was
measured with a single question informing whether people
considered themselves as noise sensitive. In the turbine group
a strong association was found between noise sensitivity and
annoyance and a weak association in the control group. This
is indicative of an interaction effect of exposure and sensitiv-
ity on annoyance. This has also been documented for other
sound sources [54]. According to a case report from Thorne
[50], a relatively high proportion of residents near two wind
farms in Australia were noise sensitive. Self-selection into
a ‘quiet area’ by noise sensitive people can be a plausible
explanation.
3.1.4.4 Social Aspects
For the social acceptance of wind turbine projects by a local
community, the Belgian Superior Health Council [20] stated
it is crucial how the community evaluates the consequences
for their future quality of life. The communication and rela-
tion between the key parties (residents, municipality and
project developer) are very important. Disturbance by wind
123

Acoust Aust
turbines is a complex problem, in which the objective (physi-
cal) exposure and personal factors play a role, but also policy,
psychology, communication and a feeling of justice.
When planning and participation are experienced as unjust
or inadequate, public support will soon deteriorate, also
among people who were originally neutral or in favour of the
wind farm [55]. When residents feel they have been insuffi-
ciently heard, they feel powerless and experience a lack of
control over their own environmental quality and quality of
life. Worry or concern can be reduced by an open and honest
procedure in which residents can contribute to the decisions
in a positive way [56]. Already in the early phase of wind
energy, research from Wolsink [57] and later from Breukers
[58] showed that collaboration with emphasis on local topics
was more successful than a policy aimed at as much wind
energy as possible and a non-participatory approach.
Pedersen et al. [52] found that people who perceive the
wind turbines as intruding and a threat to their privacy
(motion, sound, visual) reported more annoyance. When peo-
ple feel attached to their environment (‘place attachment’),
the wind farm can form a threat to that location and can
create resistance [59]. Also, a feeling of helplessness and
procedural injustice can develop when people feel they have
no real say in the planning process. Potentially, this plays
a role especially in rural areas where people choose to live
because of tranquillity; for them the wind park can form an
important threat (visual and auditory). Based on renewable
energy projects in the UK, Walker and Devine-Wright [60]
concluded that the more people participated in project devel-
opment, the higher was the public support for renewable
energy in general.
3.2 Evidence Since 2015 Based on New Studies
In the period between January 2015 and 2017, 22 rele-
vant publications were identified in peer-reviewed literature.
These are 10 on field studies [36,61–69], 7 on experiments
[12,70–75], 3 on a prospective cohort study [76–78], 1
panel study [79] and 1 qualitative analysis of interviews and
discourse [80]. After the systematic literature search, two rel-
evant papers from the most recent International Wind Turbine
Noise Conference (Rotterdam 2017) were included [43,81].
Two major studies were (partly) reported in this period
and not included in the reviews, one in Canada [16,61–65]
and one in Japan [66,67]. The study from Health Canada
[36,61–65] was performed with 1238 adult residents living
at varying distances from wind turbines. A-weighted sound
levels outdoors were calculated as well as C-weighted levels,
and additional measurements were made at a number of loca-
tions. A strong point of the study is the high response rate of
79%. The results were presented in six publications, address-
ing effects on sleep, stress, quality of life, noise annoyance
and health effects and a separate paper on the effect of
shadow flicker on annoyance. Also, two papers were pub-
lished describing the assessment of sound levels near wind
turbines and near receivers [82,83]. The Japanese study by
Kakeyama et al. [66,67] pertains a field study with structured
face-to-face interviews at 34 study sites and 16 control sites.
Wind turbine sound levels were estimated based on previous
measurements at some sites and expressed in LAeq. Out-
comes studied were sleep deprivation, sleep disturbance and
physical and mental health symptoms (Table 3).
The next sections describe the state of the art in more
detail per health effect as in 3.1. Note again that the descrip-
tion is limited to the effects of wind turbine sound in the
‘normal’ frequency range. Findings from studies addressing
suggested specific impacts of the low-frequency component
and infrasound distinct from ‘normal’ sound are summarized
separately in Sect. 4.
3.2.1 Noise Annoyance
In one of his papers about the Health Canada study, Michaud
et al. [61] describe the findings on annoyance, self-reported
health and medication use. In line with earlier findings
the study confirms that the percentage of highly annoyed
increased significantly with increasing wind turbine sound
levels. The effect was highest for annoyance with visual
aspects of wind turbines, followed by blinking lights, shadow
flicker, sound and vibrations.
An Iranian study of Abasssi et al. [68] included 53 work-
ers divided in three job groups with repairing, security and
administration tasks. The exposure level to wind turbine
sound of employees at each job group was measured as an
8-h equivalent sound level as is usual in working conditions.
Outcome measures included annoyance, sleep, psychologi-
cal distress and health complaints. Noise sensitivity, age, job
stress and shift work were accounted for. Annoyance was
associated with measured sound levels but lower than found
in residential studies. The other health outcomes did not show
a significant association. It is not clear how this relates to
residential conditions as the situations are quite different and
different factors are involved.
In the period 2015–2017 several laboratory studies have
addressed the effects of wind turbine sound and annoyance.
In a listening test among 60 people, after a pilot in 12 people,
an association was found by Schäffer et al. [70] between
road traffic and wind turbine sound level or variations in
sound level due to amplitude modulation and annoyance.
Attitude towards wind turbines and noise sensitivity were
important confounders, and the frequency of the amplitude
modulation (higher for the wind turbine sound) seemed to
play an important role.
The relative contribution of the typical characteristics of
wind turbine sound, and particularly the rhythmic character
or amplitude modulation (AM) was studied in several exper-
123

Acoust Aust
Tabl e 3 Overview of the studies published after January 2015 and selected for this review
First author,
year and
reference
Studies included
Country Number of
participants
Design Quality Exposure Outcomes Effect
Michaud,
(2016a)
[61]
Canada 1238 Survey objective and
subjective
measures
A waited SPL outdoors
estimated +
C-weighted
Annoyance, sleep
disturbance, stress or
psychological
The prevalence of self-reporting to
be either ‘very’ or ‘extremely’
(i.e. highly) annoyed with several
wind turbine, features increased
significantly with increasing
A-weighted levels
Michaud,
(2016b)
[62]
Canada 1238 Mixed Objective and
subjective
measures
SPL 31–48dB estimated
+measurements on
location
Sleep (actimeter),
subjective sleep indicators
No effect on any of the sleep
indicators
Michaud,
(2016c)
[63]
Canada 1238 Survey Objective and
subjective
measures
A waited SPL outdoors
estimated +
C-weighted
Perceived stress scale (PSS)
scores, hair cortisol
concentrations, resting
blood pressure and heart
rate
The findings do not support an
association between exposure to
WTNupto46dBAandelevated
self-reported and objectively
defined measures of stress
Michaud,
(2016d)
[36]
Canada 1238 Survey Objective and
subjective
measures
A waited SPL outdoors
estimated +
C-weighted
Noise annoyance, wind
turbine perceptions,
(including concern for
physical safety) and a
whole range of personal
and situational aspects
Annoyance determined by other
wind turbine-related,
annoyances, personal benefit,
noise sensitivity, physical safety
concerns, property ownership
and province: the community
tolerance level (CTL) to WTN is
11 and 26dB less than to other
sources
Jalali,
(2016a)
[76]
Canada T1-43, T2-31 Prospective
cohort
Before after
Objective and
subjective
measures
Annoyance, Qol subjective
health, mental health
Significant effect on mental health
and annoyance and symptoms.
Interaction with negative attitude,
worry about housing prize and
visual complaints
Jalali,
(2016b)
[77]
Canada 16/2 nights Prospective
cohort
Before after
Objective and
subjective
measures
Distance only Sleep indicators with
polysomnographic
No major change in sleep after
placement of WT’s
Jalali,
(2016c)
[78]
Canada Prospective
cohort
Before after
Objective and
subjective
measures
Distance only Pittsburg sleep quality,
Epworth Sleepiness Scale
and the Insomnia Severity
Index
WT placement was associated with
increased poor sleep quality,
daytime sleepiness and rates of
insomnia (expressed in th score
on the PSQI and the ESS and the
ISI. There was a strong
association with negative
attitude, worry about property
values and WT visibility
123

Acoust Aust
Tabl e 3 continued
First author,
year and
reference
Studies included
Country Number of
participants
Design Quality Exposure Outcomes Effect
Schäffer,
(2016) [70]
Germany and
Switzerland
60 Laboratory
study
Testinj12ppof
noise stimuli
WT <55 versus traffic
outdoor levels >40
normal fluctuations
due to weather
conditions
Annoyance (short term)
modifying effect of noise
characteristics
Difference found but (much)
smaller than Janssen and
Michaud), AM next to noise level
Feder, (2015)
[64]
Canada 1238 Field study Objective and
subjective
measures
22–11 km and estimates
based on ISO9613-1
and ISO9613-for each
dwelling, dBA and
dBC
WHO Qol annoyance,
symptoms, sleep quality,
perceived stress, life, style
behaviours and prevalent
chronic disease
No effects on Qol subscales below
46dB
Chrichton,
(2015) [71]
New Zealand 60 Laboratory
study
Students/no control
group
Up to 43 dB NZ standard
for WT infra sound
Annoyance Effect only in negative expectation
group, interaction with NS
Blanes-Vidal,
(2016) [69]
Denmark/USA 454 Cross
sectional
Na Distance to WT and
number of turbines
Ideopathic symptoms Effects on fatigue, difficulty
concentrating, headache all
disappeared after adjustment for
noise exposure and odour from
other sources
Ionannnidou,
(2016) [72]
Denmark 19 Laboratory
study
Na Amplitude modulation
elements 60dBA 30s
M (approach van den
Berg)
Annoyance Check
Abassi,
(2015) [68]
Iran 53 Field study Na 8-h equivalent sound
level (LAeq, 8 h)
basedonISO
9612:2009
Annoyance, sleep
psychological distress,
health complaints
Annoyance associated with
measured levels but lower than
found in residential studies
possibly due to economic benefits
Tonin, (2016)
[74]
Australia 72 Laboratory
study
More men Infrasound exposure
double blind (sham
noise)
Annoyance, symptoms Effects mediated by high/low
expectancy
Hafke-Dys,
(2016) [73]
Poland 21 Laboratory
study
Control condition
without
modulation
Broadband and
narrowband noise.
With modulations
typical, for WT (3, 6
and 9dB) based on
Renteghem
Annoyance Interaction between noise type
(broadband) and AM on
annoyance. WT noise is
perceived as less annoying when
AM freq. is <4Hz
Yoon, (2016)
[12]
Korea 24 Laboratory
study
Control group Amplitude modulation Perceived loudness Combined effect of noise levels
andAMonnoiseperception
123

Acoust Aust
Tabl e 3 continued
First author,
year and
reference
Studies included
Country Number of
participants
Design Quality Exposure Outcomes Effect
Botterill,
(2016) [80]
Australia Na Interviews
and
discourse
analysis
Na Na Topics mentioned most
often in the discourse
Health and property values came
forward as main topics
Kageyama,
(2016)
[66,67]
Japan 1079 Face-to-face
structured
interviews
Control sites! (16)
versus 34 exp. sites
LAeq estimated based
on some measurement
sites, median 36–40
and35atcontrolsites
Insomnia, physical and
mental health, sensitivity
to noise and visual
annoyance
Odds ratio (OR) of insomnia was
significantly higher when the
noise exposure level exceeded
40dB, self-reported sensitivity
and visual annoyance
independently associated with
insomnia. OR of poor health only
significant for, noise sensitivity
and visual annoyance
Maffei,
(2015) [75]
Italy 40 Listening,
experiments
Exp versus control Sound recordings of
about 5min were
made at five distances
Noise recognition Recognition is congruent with the
increase of the distance and the
decrease of the values of sound,
equivalent levels and loudness
Krekel,
(2016) [79]
France/Germany 30 Panel data Na (i) The exact
geographical
coordinates, (ii) the
exact construction,
dates and (iii)
information on the
size of the installation
Satisfaction with life Geographical distribution of
well-being merged with WT
locations. Well-being data
merged with
Voicescu,
(2016) [65]
Canada 1238 Survey Objective and
subjective
measures
Shadow flicker (SF)
combined with noise
estimates expressed in
maximum minutes per
day (SFm), modelled
and based on distance
Annoyance, health
complaints including
dizziness
Annoyance associated with SF
annoyance to other wind
turbine-related features, concern
for physical safety and noise
sensitivity. Reported dizziness
wasalsoretainedinthefinal
model (all significant)
123

Acoust Aust
Tabl e 3 continued
First author,
year and
reference
Studies included
Country Number of
participants
Design Quality Exposure Outcomes Effect
Yano, (2015)
[30]
Japan 1079 Face-to-face
interview
Control group (332)
in areas with no
wind turbines
Extra/interpolated from
measured night time
noise level (LAeq,n);
distance for visual
exposure
Noise annoyance, visual
disturbance, perception of
shadow flicker (SF)
LAeq,nand distance significantly
related to noise annoyance;
distance more strongly
associated with noise annoyance
than level. Most annoyance
reported at night-time. Visual
annoyance not significantly
related to distance, SF indoor and
SF outdoor significantly related
to distance. SF outdoor more
prominent in mountainous area
(compared to flat). Interaction
between noise annoyance and
visual annoyance/SF outdoor, not
with visibility and SF indoors
Qu, (2017)
[43]
England +
Scotland
357 Survey in
(sub)urban
areas
No attribution to
wind turbines in
control group (96)
Calculated (maximum?)
A-weighted wind
turbine sound pressure
level (SPL) on most
exposed facade
Awareness of and
annoyance with wind
turbine noise,
self-reported sleep
disturbance, prevalence of
specific health problems,
general health, subjective
well-being
SPL positively associated with
noise annoyance. SPL not
associated with sleep, but degree
of noise annoyance significantly
increased possibility of sleep
disturbance. Visibility of wind
turbine from both window and
garden significantly increased
odds of less deep sleep. In case
group, annoyance with wind
turbine noise significantly
influenced prevalence of health
problems: psychological
problems significantly and
positively associated with being
annoyed by wind turbine noise,
but not with SPL itself. Positive
associations were found between
SPL and adverse health
problems, including nausea and
dizziness. Dizziness and ear
discomfort related to SPL in
control group
123

Acoust Aust
iments. Ionannidou et al. [72] report on a study among 19
volunteers in which the effect of changes over time in the
amplitude modulation of wind turbine sound on annoyance
was investigated. The changes could either be the frequency
of the modulation, the depth (or strength) of the modulation
or a change in depth over time. The study confirms earlier
results that AM leads to a higher annoyance rating. A higher
modulation frequency (from 0.5 to 2Hz) also resulted in a
higher rating, but the effect was not significant. There was
also a higher annoyance rating when the modulation depth
increased intermittently, but again this was not significant.
Because of the limited statistical power of these tests (because
of the low number of participants and the limited time), it was
recommended to investigate the variations in AM for a longer
period and in a field setting.
A study from Hafke-Dys et al. [73] among 21 volun-
teers again concerned the effect of amplitude modulation on
annoyance. In this study sounds with several modulation con-
ditions were compared to a non-modulation condition. The
test sounds used were (1) sound from moving cars, passing
at a rate of 1–4 per second; (2) broadband sound with the
same spectrum as wind turbines and (3) narrowband sound
that could be modulated at 1, 2 and 4Hz. All three types
of sound had modulation depths typical for wind turbines
at 3, 6 and 9 dB similar to Van Renterghem et al. [84], or
zero (no modulation). Results showed that AM did increase
annoyance in the case of broadband sound and passing cars,
but not for the narrow band sound. The modulated sound
was more annoying with increasing modulation frequency,
in agreement with an expected highest sensitivity for modu-
lated sounds at 4Hz. Large, modern wind turbines modulate
their sound at a frequency close to 1Hz. The effect of AM on
annoyance was less for the broadband sound than for passing
cars. The main difference between these two sounds was the
spectral content, with the broadband sound having more low-
frequency sound than the passing cars. The authors conclude
that this result supports the Japanese study [13] in which
it was demonstrated ‘that low frequency components are not
the most significant problem when it comes to the annoyance
perception of wind turbine noise’.
Yoon et al. [12] studied the reaction to modulation of wind
turbine sound in 12 people. Findings show again that there
is an association between AM and level of annoyance. The
authors conclude that there is a strong possibility that ampli-
tude modulation is the main cause of two typical properties
of wind turbine sound: that it is easily detectable and highly
annoying at relatively lower sound levels than other noise
sources. They add that this does not mean that these proper-
ties can be fully explained by the amplitude modulation.
Crichton and Petrie [71] studied 60 volunteers at expo-
sure levels up to 43dBA (the New Zealand standard limit)
in combination with infrasound (9Hz, 50 dB). In one group,
the participants were shown a video about the health risk of
wind turbine infrasound, and in the second group a video
on health benefits was shown. An effect on annoyance was
found only in the group expecting to be negatively affected,
and in this group noise sensitivity increased the likelihood
of being annoyed. In the group expecting a positive effect,
there was far less annoyance and almost no influence from
noise sensitivity.
In a later publication from the Japanese study, it was found
that within 860m from a wind farm 10% of the residents
were annoyed by shadow flicker while within 780m 10%
of the residents were highly annoyed by wind turbine sound
[81]. The authors concluded that a minimum distance (or
‘setback’) between residences and wind farms should be con-
sidered from an aural and visual point of view.
3.2.2 Sleep Disturbance
Michaud et al. [62] reported on sleep disturbance from a field
study involving 742 of the 1238 respondents (as described
under 3.2) wearing an actimeter, to measure relevant sleep
indicators during 3–7 consecutive nights after the interviews.
Outdoor wind turbine sound levels were calculated following
international standards. Neither self-reported sleep quality,
diagnosed sleep disorders nor objective measures such as
sleep onset latency, awakenings and sleep efficiency showed
an immediate association with exposure levels up to 46dB
after adjustment for relevant confounders such as age, caf-
feine use, body mass index (BMI) and health condition. This
partly contrasts with earlier findings on subjective sleep mea-
sures [47]. No study addressed objective sleep measures
in relation to wind turbines before. However, it should be
mentioned that the method of actigraphy is limited as com-
pared to more elaborate polysomnographic measures as were
employed by Jalali et al. [76] and described below. In the
Health Canada study having to close the window in order
to guarantee an undisturbed sleep had by far the strongest
influence on annoyance [61]. This could be a reason that
no relation between wind turbine sound level and sleep dis-
turbance was found: if persons disturbed at night by wind
turbine sound would close their bedroom window, the result
could be that they are less disturbed at night by the sound
as such, although they could be annoyed because they had
to close the window. The results do not directly support or
negate this explanation. However, those closing their bed-
room windows was eight times more likely to be annoyed.
At higher wind turbine sound levels, people more often gave
wind turbines as a reason for closing the bedroom window
[61].
Kakeyama et al. [66,67] showed a significant association
between sound levels above 40dB and sleeping problems
(insomnia). These findings are in contrast with those reported
by Michaud et al. [62] who did not observe an immedi-
ate association between sound exposure levels up to 46dBA
123

Acoust Aust
and subjective and objective indicators for sleep. The earlier
findings of Bakker [41] regarding subjective sleep indica-
tors showed that sleep disturbance seemed to be related
to sound level only when no others factors were included.
When annoyance with wind turbine sound was included, then
sleep disturbance was related to that annoyance and not any-
more to sound level. Earlier, Pedersen and Persson [42]also
concluded on an association between annoyance and sleep
disturbance rather than a direct effect of sound level.
Jalali et al. [77] measured sleep disturbance in a group
of 16 people for 2 consecutive nights using a polysomno-
graphic method including a range of sleep and physiological
parameters such as sleep onset, duration, movement dur-
ing sleep, awakening, EEG activity. Sound measurements
over the whole frequency range (0.5–20,000Hz) were per-
formed in the bedroom as well as outdoor, while accounting
for weather conditions, wind speed and temperature. Factors
that were taken into account were attitude, sensitivity, visibil-
ity, distance within 1000m and windows open versus closed.
Results showed no major changes in the sleep of participants
who had new wind turbines in their community. There were
no significant changes in the average indoor (31dBA) and
outdoor sound levels (40–45dBA before, 38–42dBA after)
before and after the wind turbines became operational. None
of the participants reported waking up to close their windows
because of the outside noise. The lack of an effect might be
explained by the limited measurements (two nights) or the
low indoor sound levels that almost equalled the threshold
value for sleep disturbance of 30dBA.
In another paper Jalali et al. [78] report on the association
between measured wind turbine sound levels and subjective
sleep quality as measured with the Pittsburgh sleep quality
index. Results show only an indirect association with attitude
towards the wind turbines and concern about reduced housing
values and the visibility of the turbine from the properties.
The results confirm the strong psychological component and
individual differences in sleep disturbance from wind turbine
sound.
3.2.3 Other Health Effects Due to Sound
From the Canadian study Michaud et al. [61] concluded that,
except for annoyance, the results do not support an associa-
tion between exposure to wind turbine sound up to 46dBA
and the evaluated health-related end points, such as mental
health problems, headaches, pain, stiffness, or diseases such
as diabetes, cardiovascular disease, tinnitus and hearing dam-
age. Michaud et al. [63] also studied the association between
wind turbine sound level and objective stress indicators (cor-
tisol, heart rate) and perceived stress (PPS index). These
stress indicators were weakly associated with each other, but
analysis showed no significant association between expo-
sure to wind turbine sound (up to 46dBA) and self-reported
or objective measures of stress. The authors remarked that
there was also no association between stress indicators and
noise annoyance, which does not support the hypothesis that
stress can be a consequence of chronic annoyance. The only
wind turbine-related variable that had an influence on stress
was high annoyance with the blinking lights on top of the
wind turbines [63]. McCunney et al. [25] found an expla-
nation for a lack of significant associations in the fact that
sound levels from wind turbines do not reach levels which
could cause such direct effects.
Results for quality of life (Qol) [64], measured using
the WHO Qol index and including physical, environmen-
tal, social quality and satisfaction with health, showed no
relation with sound levels (at levels up to 46dB). This is
in contrast with findings reported earlier by Shepherd et al.
[47] and Nissenbaum et al. [48]. However, the results of these
studies are hard to compare because the exposure levels are
not the same and because different instruments were used to
measure perceived quality of life
Tonin et al. [74] studied 72 volunteers in a laboratory
setting for a double-blind test similar to that of Crichton
et al. [71] but used infrasound at a higher level (91dB).
Before the listening test, participants were influenced to a
high expectancy of negative effects from infrasound with a
video of a wind farm affected couple, or a low expectancy
of negative effects with a video of an academic explaining
why infrasound is not a problem. Then normal wind turbine
sound was presented via a headset to all participants with the
inclusion of the infrasound or no infrasound for a period of
23min. The infrasound had no statistically significant effect
on the symptoms reported by participants, but the concern
they had about the effect of infrasound had a statistically
significant influence on the symptoms reported.
A survey in Denmark [69] among 454 citizens living in
rural areas at different distances to wind turbine farms with a
varying numbers of wind turbines studied the effect on non-
specific symptoms. The study included idiopathic symptoms
(i.e. not related to a specific disease) as effects and distance
to the wind farm and the number of turbines as a measure
of exposure. The originally positive association of distance
with fatigue, headaches and concentration problems all dis-
appeared after adjustment for exposure to sound and odour
from other sources.
Jalali et al. [76] report on a prospective cohort (i.e.
before–after) study with 43 participants who completed a
questionnaire in spring 2014 and again a year later. Exposure
to a wind farm was only measured in terms of distance. Resi-
dents who were annoyed by the sound or sight of turbines, or
who had a negative attitude towards them or were concerned
about property devaluation, after 1year experienced lower
mental health and life quality and reported more symptoms
than residents who were not annoyed and had positive atti-
tudes towards turbines. The response rate for this study was
123

Acoust Aust
low (only 22%), and 12 people (of 43 that is approximately
25%) were not in the second round. Another weak point is
the lack of a control group.
Against the background of the increasing number of wind
farms in Germany, Krekel et al. [79] investigated the effect
of the presence of wind turbines on residential well-being
by combining household data from the German Socio-
Economic Panel with a dataset on more than 20,000 wind
turbines for the time period between 2000 and 2012. The key
effect studied was life satisfaction. Results showed that the
construction of one or more wind turbines in the neighbour-
hood of households had a significant negative effect on life
satisfaction. This effect was limited in both distance and time.
More recent the first results were published of a new
British study that was held near wind turbines in densely
populated, suburban areas [43]. In this study part of the
participants received a questionnaire that included explicit
questions on the impacts of the local wind turbines on well-
being, and the remaining part received a variant with no such
questions. When including all participants, there was less
annoyance from wind turbine sound in this study compared
to what was found in earlier (Swedish, Dutch, Polish and
Canadian) studies in rural areas. For the first group (with
questions concerning local wind turbines), the sound lev-
els were not significantly related to health problems and this
group reported less health problems and better general health;
this was opposite to the relationship found in the other, vari-
ant group.
3.2.4 Influence of Situational and Personal Factors
3.2.4.1 Visual Aspects
The paper of Voicescu et al. [65] on the Canadian data set
(see Sect. 3.2) studied the effect of shadow flicker, expressed
as the maximum duration in minutes per day, in combina-
tion with sound levels and distance, on annoyance and health
complaints including dizziness. As shadow flicker exposure
increased, the percentage of highly annoyed increased from
4% at short duration of shadow flicker (<10min) to 21%
at 30min of shadow flicker. Variables associated with the
percentage highly annoyed due to shadow flicker included
concern for physical safety and noise sensitivity. Reported
dizziness was also found to be significantly associated with
shadow flicker.
3.2.4.2 Economic Aspects
In the study of Michaud et al. [16] personal (economic) ben-
efit was associated with less annoyance, in a significant but
modest way, when excluding factors that were likely to be a
reaction (such as annoyance) to the wind turbine operation.
The association between personal benefit from a wind tur-
bine was also found in the Netherlands [85]. In the Japanese
study from Kageyama et al. [66,67], this relationship was
not found to be significant. However, it might not only be the
benefit, but differences in attitude and perception as well as
having more control over the placement of the turbines that
might play a role [37].
3.2.4.3 Noise Sensitivity
Recent studies of Michaud et al. [36] and Kageyama et
al. [66,67], both from 2016, confirm the independent role
noise sensitivity has on reaction to wind turbines (see also
Sect. 3.1.4.3). The influence of noise sensitivity on noise
annoyance was reported earlier by many other researchers
[42,59,86–88]. In all these studies, being highly noise sen-
sitive was related to more annoyance. Similarly, the odds
of reporting poor QoL and dissatisfaction with health were
higher among those who were highly noise sensitive. How-
ever, after adjustment for current health status and work
situation (unemployment) the influence of noise sensitivity
became marginal. Fear and concern about the potential harm
of wind turbines was an important predictor of annoyance as
has been reported earlier for other noise sources [89–92].
In the Canadian study length of exposure seemed to be an
important situational factor and led to up to 4 times higher
levels of annoyance for people living more than 1year in
the vicinity of a wind turbine. This indicates sensitization to
the sound rather than adaptation or habituation as is often
assumed. The moderate effect of wind turbine sound level
on annoyance and the range of (other) factors that predict
the level of annoyance imply that efforts aimed at mitigating
the community response to WTN will profit from consider-
ing other factors associated with annoyance. In the Japanese
study [66,67] poor subjective health was not related to wind
turbine sound levels, but again noise sensitivity and visual
annoyance were significant predictors for the effects studied.
Both noise sensitivity and visual annoyance seem, according
to them, to be indicators of a certain vulnerability to environ-
mental stimuli or changes in environmental factors.
Maffei et al. [75] studied 40 people subdivided in an exper-
imental and control group (familiar for a long time with wind
turbine sound versus not familiar). The study included a lis-
tening test to sound recorded at a wind farm of 34 wind
turbines including background sound (wind in vegetation),
or only background sound. Sound recordings of about 5-min
duration were made at five distances (150, 200, 250, 300 and
1500m) from the wind farm. For each distance 65 sound-
tracks were used. The aim was to detect wind turbine sound
at varying distances. For both groups of participants, famil-
iar and unfamiliar, there was no difference in recognition of
wind turbine sound at distances of 300m or less and detec-
tion was easiest at distances up to 250m. At 1500m those
familiar with wind turbine sound could detect the sound bet-
ter, but they also reported more often ‘false alarms’. Noise
sensitivity was an important factor.
123

Acoust Aust
3.2.4.4 Social Aspects
According to Chapman et al. [93] and Crichton et al. [94],
there is a strong psychogenic component in the relation
between wind turbine sound and health complaints. This is
not unique for wind turbine sound but has been documented
for other sources as well, see e.g. [89,95,96]. In both studies
[93,94] attention was given to expectations on the level of
annoyance and the level of awareness (‘notice’) of the char-
acteristics and prominent sounds of wind turbines [84]. The
influence of these factors has been found in many studies
regarding the effects of other sound sources [97]. In more
recent years many researchers have investigated the social
acceptance of wind projects in a number of countries by
local communities and many stress the relevance of a fair
planning process and local involvement [98–101]. The influ-
ence of injustice and fair planning process are confirmed in
the most recent studies. Jalali [76] e.g. showed that concern
about decreases in property values was associated with men-
tal health problems.
Finally, Botterill and Cockfield [80] studied the discourse
about wind turbines in submissions to public inquiries and in
a small number of detailed interviews, and topics addressed in
the discourse. Health and property values were found to be the
most prominent topics discussed in the inquiries with regard
to wind turbines in the submissions (and aesthetics/landscape
arguments less often), but in the interviews these were never
mentioned.
4 Health Effects of Low-Frequency Sound and
Infrasound
In the non-scientific literature, which can be found on the
internet, a range of health effects is attributed to the presence
of wind turbines. Infrasound is described as an important
cause of these effects, also when the infrasound levels must
be very low or are unknown. In this section the ques-
tion is whether infrasound or low-frequency sound deserves
special consideration with respect to the effects of wind tur-
bine sound. There is some discrepancy when comparing
conclusions from the majority of scientific publications to
conclusions in popular publications. Also, some scientific
publications suggest possible impacts that are not generally
supported. The findings regarding low-frequency sound and
infrasound are not easy to interpret. It may be confusing that
the frequency of the rhythmic changes in sound due to ampli-
tude modulation is the same as the frequency of an infrasound
component. Also, some authors conclude that low-frequency
sound and infrasound play a role in the reactions to wind tur-
bine sound that is different from the effects of ‘normal’ sound
[16,102] which is contested by many others. In general, how-
ever, there is little definite evidence on specific health effects
of low-frequency sound when compared to health effects
from ‘normal’ sound [103].
First, we will consider the audibility of infrasound and
low-frequency sound and then possible health effects not
involving audibility. Because we are, in the case of low-
frequency sound and infrasound, dealing with other health
effects, the paragraphs are structured different than was the
case in the previous section.
4.1 Audibility of Infrasound and Low-Frequency Sound
Audible low-frequency sound is all around us, e.g. in road
and air traffic. Audible infrasound is less ubiquitous, but can
be heard from big machines and storms. In most publications
on wind turbine sound, there is agreement that infrasound and
low-frequency sound are both present in wind turbine sound.
Generally, it is acknowledged that wind turbine infrasound is
inaudible as infrasound levels are low with respect to human
sensitivity [16,19,25,104,105].
Even close to a wind turbine, most authors argue that infra-
sound is not a problem with modern wind turbines. This can
be shown from measurement results at 10 and 20Hz. At the
(infrasound) frequency of 10 Hz the A-weighted sound power
level is typically 60dB lower than the total sound level in
dBA [15]. At a receiver with a total sound level of 45 dBA this
means that the 10 Hz sound level is about minus 15 dBA or, in
physical terms (not A-weighted), 55 dB. This is far below the
hearing threshold at that frequency, which for normal-hearing
persons is about 95 dB. A sound of 55dB at 10 Hz would also
be inaudible for the few persons that have been reported with
a much lower hearing threshold (close to 80dB). At 20Hz,
the upper frequency limit of infrasound, the result, again at
a receiver total sound level of 45 dBA, would be a physical
level of wind turbine sound of 50–55dB which is much lower
than the normal hearing threshold at that frequency of 80dB
[106].
As a part of a Japanese study on wind turbine low-
frequency sound, persons in a laboratory were subjected to
wind turbine sound where very low frequencies were filtered
out over different frequency ranges [13]. When infrasound
frequencies were filtered out, the study persons did not note
different sensations. Above about 30 Hz they began to notice
a difference between the filtered and original sound.
Leventhall [107] states that the human body produces
infrasound internally (through blood flow, heartbeat and
breathing, etc.) and this would mask infrasound from out-
side sources when this sound is below the hearing threshold.
In contrast to infrasound, there is general agreement that
low-frequency sound is part of the audible sound of wind tur-
bines and therefore contributes to the effects caused by wind
turbine sound. The loudest part of the sound as radiated by a
turbine is in the mid-frequency range (250–1600 Hz) [15,16].
This shifts to lower frequencies when the sound travels
123

Acoust Aust
through the atmosphere and enters a building because absorp-
tion by the atmosphere and a building facade reduces low
frequencies less than higher frequencies. However, studying
the effects of the low frequencies separately from the higher
frequencies is not easy as both frequency ranges automati-
cally go together: wind turbines all have very much the same
sound composition. In a Canadian study on wind turbines,
the sound levels at the facades of dwellings were calculated
as both A- and C-weighted sound levels, but this proved not
to be an advantage as the two were so closely linked that
there was no added value in using both [82]. A limit in A-
weighted decibels (where the A-weighting mimics human
hearing at moderate sound levels) thus automatically limits
the low-frequency part of the sound [105].
Bolin et al. [108] calculated and compared wind turbine
and road traffic sound over a broad frequency range (0–
2000Hz) at sound levels considered acceptable in planning
guidelines (40dB LAeq for wind turbine sound and 55 dB
LAeq for road traffic sound). Compared to road traffic sound,
wind turbine sound had lower levels at low frequencies. Thus,
at levels often found in urban residential areas, low-frequency
sound from wind turbines is less loud than from road traf-
fic sound. Recent measurements in dwellings and residential
areas show that similar levels of infrasound occur, when
comparing wind turbine sound with sound from traffic or
household appliances [109].
4.2 Effect of Lower Frequencies
McCunney et al. [25] mention that both infrasound and low-
frequency sound have been suggested to pose possibly unique
health hazards associated with wind turbine operations. From
their review of the literature, including results from field
measurements of wind turbine-related sound and experimen-
tal studies in which people have been purposely exposed
to infrasound, they conclude that there is no scientific evi-
dence to support the hypothesis that wind turbine infrasound
and low-frequency sound has effects that other sources of
infra/low-frequency sound do not have.
4.3 Subaudible Effects
Several authors have linked infrasound and low-frequency
sound from wind turbines to health effects experienced by
residents, assuming that infrasound can have physiological
effects at levels below the (normal) hearing threshold [110–
112]. This was supported by Salt and Kaltenbach [113]who
argued that normal hearing is the result of inner hair cells
in the inner ear producing electric signals to the brain in
response to sound received by the ear. However, infrasound
and low-frequency sound (up to 100Hz) can also lead to sig-
nals from the outer hair cells (OHC) and the threshold for
this is lower than for the inner hair cells. This means that
inaudible levels of infrasound and low-frequency sound can
still evoke a response [113]. The OHC threshold is 60dB at
10Hz and 48 dB at 20 Hz. Comparing this to actual sound
levels (see Sect. 4.1) shows that infrasound levels from wind
turbines could just exceed this OHC threshold when their
total outdoor sound level is 45dBA. It is unlikely that the
OHC threshold can be exceeded indoors, where levels are
lower, except at a high sound level that may occur very close
to a wind turbine. Salt and Kaltenbach [113] conclude from
this that it is ‘scientifically possible’ that infrasound from
wind turbines thus could affect people living nearby. How-
ever, it is not clear to what reactions these signals would lead
or if they could be detrimental when just exceeding the OHC
threshold. If such inaudible sound could have effects, it is
not clear why this has never been observed with everyday
sources (other than wind turbines) that produce infrasound
and low-frequency sound such as strong winds, road and air
traffic, or with physiological sounds from heartbeat, blood
flow, etc.
Farboud et al. [114] conclude that physiological effects
from infrasound and low-frequency sound need to be better
understood; it is impossible to state conclusively that expo-
sure to wind turbine sound does not cause the symptoms
described by authors such as Salt and Hullar or Pierpont.
Leventhall [107] argues that infrasound at low level is not
known to have an effect. Normal pressure variations inside
the body (from heart beat and breathing) cause infrasound
levels in the inner ear that are greater than the levels from
wind turbines. From exposure to high levels of infrasound,
such as in rocket launches and associated laboratory studies
or from natural infrasound sources, there is no evidence that
infrasound at levels of 120–130dB causes physical damage
to humans, although the exposure may be unpleasant [107].
Stead et al. [115] come to a similar conclusion when con-
sidering the regular pressure changes at the ear when a person
is walking at a steady pace. The up and down movement of the
head implies a slight change in atmospheric pressure that cor-
responds to pressure ‘sound’ levels in the order of 75dB. The
pressure changes in the rhythm of the walking frequency are
similar in frequency (close to 1Hz), and level to the pressure
changes from infrasound at rotation frequencies measured at
houses near wind farms.
4.4 Vestibular Effects
According to Pierpont the (infra)sound of wind turbines can
cause visceral vibratory vestibular disease (VVVD), affect-
ing the vestibular system from which we derive our sense
of balance. She characterized this new disease with the fol-
lowing symptoms: ‘a feeling of internal pulsation, quivering
or jitteriness, and it is accompanied by nervousness, anxi-
ety, fear, a compulsion to flee or check the environment for
safety, nausea, chest tightness, and tachycardia’ [111], stat-
123

Acoust Aust
ing that infrasound and low-frequency sound were causing
this ‘wind turbine syndrome’. Pierpont’s research was based
on complaints from 38 people from 10 families who lived
within 300–1500m from one or more turbines in the USA
or Great Britain, Italy, Ireland and Canada. In several pub-
lications (e.g. [22,25]), it was pointed out that Pierpont’s
selection procedure was to find people who suffer the most,
and it was not made clear that it was indeed the presence of
the wind turbine(s) that caused these symptoms. Although
the complaints may be genuine, it is possible that very sen-
sitive people were selected and/or media coverage had led
to physical symptoms attributed to environmental exposures
as has been demonstrated for wind turbines [93] and other
environmental exposures [116]. Van den Berg [44] noted that
the symptoms of VVVD are mentioned in the Diagnostic
and Statistical Manual of Mental Disorders (DSM) as stress
symptoms in three disorders: an adjustment disorder, a panic
disorder and a generalized anxiety disorder. The wind tur-
bine syndrome may thus not be a new phenomenon, but an
expression of stress that people have and which could have
a relation to their concern or annoyance with respect to a
(planned) wind farm.
In his examination of the wind turbine syndrome, Harri-
son [27] argued that at a level of 40–50dBA no component of
wind turbine sound approaches levels high enough to activate
the vestibular system. The threshold for this is about 110dB
for people without hearing ailments. In people with a hearing
ailment, particularly the ‘superior (semicircular) canal dehis-
cence syndrome’ (SCDS), this threshold is lower and can be
85dB. Such levels are only reported very close to wind tur-
bines. Reports show that 1–5% of the adult population may
have (possibly undiagnosed) SCDS.
Schomer et al. [117] studied residents of three homes
where residents generally did not hear the wind turbines
in their area, but they did report symptoms comparable to
motion sickness. Schomer et al. suggest that this could result
from sound affecting the vestibular sensory cells and in their
opinion wind turbine infrasound could generate a pressure
that they compare with an acceleration exceeding the U.S.
Navy’s criteria for motion sickness. This has been inves-
tigated by Nussbaum and Reinis much earlier [118]. They
exposed 60 subjects to a tone of 8Hz and 130 dB with high
distortion (high-level harmonics at multiples of 8Hz) or low
distortion (harmonics at lower level). Dizziness and nausea
were primarily associated with the low distortion exposure,
i.e. a relatively high infrasound content. In contrast, headache
and fatigue were primarily associated with the high distortion
exposure, with a relatively low infrasound content. Nuss-
baum and Reinis [118] hypothesized that the effects of the
purer infrasound could be explained as acoustically induced
motion sickness. However, this was concluded from exposure
levels (130dB) much higher than wind turbines can cause.
4.5 Vibroacoustic Disease
According to Alves-Pereira and Castelo Branco [112], the
infrasound and low-frequency sound of a wind turbine can
cause vibroacoustic disease (VAD), an affliction identified
by a thickening of the mitral valve (one of the valves in
the heart) and the pericardium (a sac containing the heart).
The most important data regarding VAD are derived from
a study among aircraft technicians who were profession-
ally exposed to high levels of low-frequency sound [119].
VAD is controversial as a syndrome or disease. Results of
animal studies have only been obtained in studies using low-
frequency sound levels which are found in industrial settings.
No studies are known that use a properly selected control
group. And finally, the way the disease was diagnosed has
been criticized because of a lack of precision [120]
After investigating a family with two wind turbines at 322
and 642 m from their dwelling, Alves-Pereira and Castelo
Branco [112] concluded that VAD occurred and was caused
by low-frequency sound. The measured sound levels were
substantially lower (20 dB or more) than levels at which VAD
was thought to occur by Marciniak et al. [119] and the levels
were below the normal hearing threshold for a considerable
range of frequencies in this range. In their review of evidence
on VAD Chapman et al. [93] concluded that in the scien-
tific community VAD was only supported by the group who
coined the term and there is no evidence that vibroacoustic
disease is associated with or caused by wind turbines.
4.6 Effect of Vibrations
Vibrations from wind turbines can lead to ground vibrations
and these can be measured with sensitive vibrations sensors.
In several studies vibrations have been measured at large
distances, but this was because these vibrations could affect
the performance of seismic stations that detect nuclear tests.
These vibrations are too weak to be detected or to affect
humans, even for people living close to wind turbines [98].
In measurements at three dwellings, Cooper et al. [104]
found surges in ground vibration near wind turbines that
were associated with wind gusts, outside as well as inside
one of the three houses. Vibration levels were weak (less
than from people moving around), but measurable. Accord-
ing to Cooper, two residents were clearly more sensitive than
the other four; the sensations experienced by the residents
seemed to be more related to a reaction to the operation
of the wind turbines than to the sound or vibration of the
wind turbines. This echoes earlier findings from Kelley [121]
who investigated complaints, from two residences, that were
thought to be associated with strong low-frequency sound
pulses from the experimental downwind MOD-1 wind tur-
bine. The low-frequency sound pulses were generated when
a turbine blade passed the wind wake behind the mast. The
123

Acoust Aust
residents perceived ‘audible and other sensations, including
vibration and sensed pressure changes’. Although the wind
turbine sound at frequencies below about 30Hz was below
the normal hearing threshold, this sound was believed to be
causing the annoyance complaints. The sound levels were
within a range of sound levels and frequencies cited in a
report from Stephens et al. [122] for situations where (sub-
audible) industrial sound within this range was believed to
be the source of the complaints. This could be explained by
the response of a building to the sound outside: the distri-
bution of sound pressure in the building can be the result of
structure-borne sound, standing waves and resonances due to
the configuration of a room, closet and/or hallway. The rhyth-
mic character of wind turbine sound could have an added
effect because of the periodic pressure pulses; if these coin-
cide with a structural resonance of the building the indoor
level can be higher than expected from just reduction by
the facade. These structural vibrations can lead to sound at
higher frequencies which are audible. Several authors have
pointed out that the rhythmic character itself (technically,
amplitude modulation) is more relevant to human perception
than low-frequency sound or infrasound (see What makes
wind turbine sound so annoying? in Sect. 3.1.1). However,
the appreciation of the sound may depend on a combina-
tion of the frequency and strength of the modulation and the
balance of low- and higher-frequency components [123].
5 Discussion and Conclusions
5.1 Primary Findings
This review summarizes the findings of ten previous reviews
on the effect of wind turbines on health and the role of per-
sonal, situational and physical factors other than sound. In
addition, the results from 22 papers that were published later
(after early 2015) were reviewed. The results will be pre-
sented here with an indication of a possible change over time
when comparing evidence before and since 2015.
Results confirm the earlier evidence that living in areas
with wind turbines is associated with an increased per-
centage of highly annoyed residents. Earlier findings of a
possible association with perceived and measured sleep dis-
turbances are not confirmed in the latest studies, nor does
recent evidence support the notion of a possibly decreased
quality of life in relation to exposure to wind turbine sound.
Also, the findings of recent studies do not support a rela-
tion between subjective and objective stress indicators and
exposure to wind turbine sound. Earlier findings on personal,
situational and contextual factors (such as visual aspects, atti-
tude, benefits, perceived injustice and fair planning process)
are confirmed in the most recent studies. Available scientific
research does not provide a definite answer about the question
whether wind turbine sound can cause health effects which
are different from those of other sound sources. However,
wind turbines do stand out because of their rhythmic charac-
ter, both visually and aurally. Several new laboratory studies
have in particular addressed the role of amplitude modula-
tion (AM). Results are inconclusive regarding the effect of
amplitude modulation on annoyance. A common conclusion
seems to be that AM appears to aggravate existing annoy-
ance, but does not lead to annoyance in persons who benefit
from or have a positive attitude towards wind turbines. Recent
reviews of McCunney et al. [25] and Harrisson [27] conclude
that there is no scientific evidence to support the hypothesis
that wind turbine infrasound and low-frequency sound have
effects that other sources do not have. In general, evidence
on specific health effects of low-frequency sound is limited.
As the CCA [28] worded it: knowledge gaps remain with
regard to the influence of specific sound characteristics, such
as amplitude modulation, low-frequency content or visual
aspects of wind turbines, which are difficult to study in iso-
lation.
The recent studies largely support earlier scientific find-
ings but have improved the state of the art with thorough
research and adding objective measures to self-reported
effects. Exposure characterization has been improved con-
siderably by including local sound measurements in field
studies, and the recent AM studies have improved the knowl-
edge base considerably.
5.2 Discussion
5.2.1 Physical, Social and Personal Factors Add
There are many models or schemes that show how people
react to sound. However, much of the public debate about
wind turbines and sound is at the planning stage when wind
turbines are not yet present. Michaud et al. [63] proposed a
model that incorporates the influence of (media) information
and expectations as well as actual wind turbine sound expo-
sure. In Fig. 3we present a simplified model based on the
one from Michaud et al. [63]. It shows that plans for wind
turbines or actual wind turbines can lead to disturbances and
concern, but a number of factors can influence the effect of the
(planned) turbines (see ‘Michaud model’ for these factors).
Personal factors include attitude, expectations, noise sensi-
tivity. Situational factors include other possible impacts such
as visibility or shadow flicker, other sound sources, type of
area. Contextual factors include participation, the decision-
making process, the siting procedure, procedural justice.
The model illustrates that next to wind turbine sound
itself, several other features are relevant for residents liv-
ing in the vicinity of wind turbines. These include physical
and personal aspects, and the particular circumstances around
decision-making and siting of a wind farm as well as commu-
123

Acoust Aust
Fig. 3 A graphic summary model for the relationship between exposure to wind turbines and individual response (after Michaud et al. [63])
nication and the relation between different people involved
in the process. There is consensus that visual aspects play a
key role in reactions to wind turbines and this includes the
(mis-)match with the landscape, shadow casting and blink-
ing lights. Shadow casting from wind turbines is described
as annoying for people and also the movement of the rotor
blades themselves can be experienced as disturbing. Light
reflection/flicker from the blades and vibrations play a minor
role in modern turbines as far as the effect on residents is
concerned. It has been shown that people who benefit from
and/or have a positive attitude towards wind turbines in their
environment in general report less annoyance. People who
perceive wind turbines as intruding into their privacy and
detrimental to the quality of their living environment in gen-
eral report more annoyance. Perceived (procedural) injustice
has been found to be related with the feeling of intrusion and
lack of control/helplessness. Most studies confirm the role
of noise sensitivity in the reaction to wind turbines, indepen-
dent of the sound level or sound characteristics. Attitude and
media coverage are just a few elements of the complex pro-
cess of policy and decision-making for siting wind turbines.
Most recent studies conclude that social acceptance of wind
projects is highly dependent on a fair planning process and
local involvement. The latest evidence seems to confirm the
role of these factors described in earlier reviews and studies.
5.2.2 Evidence on Adverse Effects of Wind Turbine Sound
Noise annoyance is the main health effect associated with
the exposure to sound from an operational wind turbine. At
equal sound levels, sound from wind turbines is experienced
as more annoying than that of traffic sources [19,29]. From
epidemiological and laboratory studies, the typical character
of wind turbine sound comes forward as one of the key issues.
Particularly, the rhythmic character of the sound (techni-
cally, amplitude modulation or AM), described as a swishing
or wooshing sound, is experienced as annoying. Residen-
tial wind turbine sound levels themselves are modest when
compared to those from other sources such as road or indus-
trial sound. However, recent laboratory studies [12,71,72]
are inconclusive regarding the effect of amplitude modula-
tion on annoyance. One conclusion is that ‘there is a strong
possibility that amplitude modulation is the main cause of
the properties of wind turbine noise’, in which properties
refer to sounds that are easily detectable and highly annoy-
ing at relatively low sound levels [12]. Another dismisses
amplitude modulation as a negative factor per se because it
is highly related to attitude [72]. A common factor is that AM
appears to aggravate existing annoyance, but does not lead to
annoyance for persons positive about or benefiting from wind
turbines. The general exposure–effect relation for annoyance
from wind turbine sound includes all aspects that influence
annoyance and thus averages over all local situations and
non-acoustic factors. The relation can therefore only form
an indication of the annoyance levels to be expected in a
local situation.
New evidence regarding the effect of night time wind
turbine sound exposure on sleep suggests no direct effect,
but remains inconclusive. The current results do not allow a
definite conclusion regarding both subjective and objective
sleep indicators [62]. However, studies do find a relation-
ship between self-reported sleep disturbance and annoyance
from wind turbines [41] and between self-reported sleep dis-
turbance and perceived quality of life [47,48].
For other health effects, there is insufficient evidence for
a direct relation with wind turbine sound levels.
Based on noise research in general, we can conclude that
chronic annoyance from wind turbines and the feeling that the
quality of the living environment has deteriorated or will do
so in the future, and can have a negative impact on well-being
and health in people living in the vicinity of wind turbines.
This is similar to the effect of other stressors [19]. The mod-
erate effect of the level of wind turbine sound on annoyance
and considering the range of factors that influence the lev-
els of annoyance implies that reducing the impact of wind
turbine sound will profit from considering other factors asso-
ciated with annoyance. The influence of these factors is not
necessarily unique for wind turbines. The fact that residents
can respond very differently to a sound shows that annoyance
from a sound is not inextricably bound up with that sound.
123

Acoust Aust
5.2.3 Evidence on Adverse Effects of Low-Frequency Sound
and Infrasound
There is substantial knowledge about the physical aspects of
low-frequency sound. Low-frequency sound can be heard
daily from road and air traffic and many other sources.
Less is known about infrasound and certainly the percep-
tion of infrasound. Infrasound can sometimes be heard, e.g.
from big machines and storms, but is not as common as
low-frequency or ‘normal’ sound. However, with sensitive
equipment infrasound, as well as vibrations, can be mea-
sured at large distances. Infrasound and low-frequency sound
are present in wind turbine sound. Low-frequency sound is
included in most studies as part of the normal sound range. In
contrast, infrasound is in most studies considered as inaudible
as the level of infrasound is low with respect to human sen-
sitivity. Studies of the perception of wind turbine infrasound
support this. Infrasound and low-frequency sound from wind
turbines have been suggested to pose unique health hazards.
There is little scientific evidence to support this. The levels
of infrasound involved are comparable to the level of internal
body sounds and pressure variations at the ear while walking.
Infrasound from wind turbines is not loud enough to influ-
ence the sense of balance (i.e. activate the vestibular system),
except perhaps for persons with a specific hearing condition
(SCDS). Effects such as dizziness and nausea, or motion
sickness, could be an effect of infrasound, but are expected
at much higher levels than wind turbines produce in residen-
tial situations. Vibroacoustic disease and the wind turbine
syndrome are controversial and scientifically not supported.
At the present levels of wind turbine sound, the alleged occur-
rence of vibroacoustic disease (VAD) or the disease (VVVD)
causing the wind turbine syndrome (WTS) is unproven and
unlikely. However, the symptoms associated with WTS are
symptoms found in relation to stress.
The rhythmic character of wind turbine sound is caused
by a succession of sound pulses produced by the blade rota-
tions. From early research it was concluded that this may
lead to structural vibrations of a house and wind turbines
thus may be perceived indirectly inside a house and hence
lead to annoyance. This possibility needs further investiga-
tion.
5.3 Strengths and Limitations
The strengths of this review are the use of a robust search
strategy to identify relevant studies, its broad approach in
terms of both the range of outcomes and noise characteris-
tics considered and the special consideration of the role of
low-frequency sound and infrasound. We also tried to make
the available knowledge accessible for a broader audience
by avoiding technical terms as much as possible. We added
to earlier reviews by reviewing the latest studies which are
of high quality and have shown how the state of knowledge
developed over time. However, we recognize limitations as
well. Although the literature search was performed system-
atically, the review is primarily a narrative one and in this
sense will repeat in a less rigid manner the conclusions of
previous reviews. Although the studies were systematically
selected and structured, in our wording and interpretation we
follow a ‘story line’ inherent to a narrative review. The text
reflects our view, based on an extensive amount of knowl-
edge of (reactions to) wind turbine sound and environmental
sound in general.
5.4 Methodological Considerations and Implications for
Future Research
Again, or we might say still, we can conclude that the ear-
lier identified lack of methodological and statistical strength
of wind turbine studies by CCA [28] still holds. With a few
exceptions in general, the sample size of most studies is lim-
ited, and with regard to both the exposure and outcomes,
there is room for improvement.
5.5 Final Conclusion
Systematic reviews published since 2009 including some
recent and high quality ones, and new evidence not yet
reviewed suggest that exposure to wind turbine sound is
associated with higher odds for annoyance. The proximity
of a wind turbine or wind farm has not conclusively been
proven to negatively affect stress responses, quality of life,
sleep quality (subjective and objective) nor other health com-
plaints. A reason for this may be that individual traits and
attitudes, visual aspects as well as the process of wind farm
planning and decision-making are highly likely to influence
the response to sound from wind turbines. Larger-scale stud-
ies at locations with varying circumstances and with a before
after component (prospective cohort) are recommended for
the future. Ideally measured sound levels over the whole
frequency range and routinely collected registry health data
should be used in conjunction with more subjective data.
Acknowledgements The basis for this text is a report that was writ-
ten at the request of the Noise and NIR Division of the Swiss Federal
Office for the Environment (Bundesamt für Umwelt). We thank Pro-
fessor Geoff Leventhall and Professor Kerstin Persson Waye as well
as Dr. Mark Brink for their useful comments to earlier versions of this
manuscript.
References
1. Onakpoya, I.J., O’Sullivan, J., Thompson, M.J., Heneghan, C.J.:
The effect of wind turbine noise on sleep and quality of life:
a systematic review and meta-analysis of observational studies.
Environ. Int. 30(82), 1–9 (2015)
123

Acoust Aust
2. WHO: WHO Constitution Adopted by the International Health
Conference held in New York from 19 June to 22 July 1946,
Signed on 22 July 1946 by the Representatives of 61 States (Off.
Rec. Wld Hlth Org., 2, 100), and Entered into Force on 7 April
1948. WHO, (1948)
3. WHO: Burden of disease from environmental noise Quantifica-
tion of healthy life years lost in Europe. In: Lin Fritschi, A., Lex,
B., Rokho, K., Dietrich, S., Stelios, K. (eds) WHO regional office
for Europe. JRC. ISBN:978 92 890 0229 5 (1948)
4. Hurtley, C. (ed.): Night Noise Guidelines for Europe. WHO
Regional Office Europe, Copenhagen (2009)
5. Wagner, S., Bareiss, R., Guidati, G.: Wind Turbine Noise.
Springer, Berlin (2012)
6. Van den Berg, G.P.: The sound of high winds. The effect of atmo-
spheric stability on wind turbine sound and microphone noise.
2006. ACADEMIC thesis, University of Groningen (2006)
7. Leventhall, G., Bowdler, D.: Wind Turbine Noise: How it is
Produced, Propagated Measured and Received. Multi-Science
Publishing, Brentwood (2011)
8. Nobbs, B., Doolan, C.J., Moreau, D.J.: Characterisation of noise in
homes affected by wind turbine noise. In: Proceedings of Acous-
tics (2012)
9. Stigwood, M., Large, S.: Audible amplitude modulation—results
of field measurements and investigations compared to psychoa-
coustical assessment and theoretical research. In: Fifth Interna-
tional Conference on Wind Turbine Noise (2013)
10. Larsson, C., Öhlund, O.: Amplitude modulation of sound from
wind turbines under various meteorological conditions. J. Acoust.
Soc. Am. 135(1), 67–73 (2014)
11. Cand, M., Bullmore, A., Smith, M., Von-Hunerbein, S., Davis, R.:
Wind turbine amplitude modulation: research to improve under-
standing as to its cause and effect. In: Acoustics 2012, 23 (2012)
12. Yoon, K., Gwak, D.Y., Seong, Y., Lee, S., Hong, J., Lee, S.: Effects
of amplitude modulation on perception of wind turbine noise. J.
Mech. Sci. Technol. 30(10), 4503–9 (2016)
13. Yokoyama, S., Sakamoto, S., Tachibana, H.: Perception of low
frequency components in wind turbine noise. Noise Control Eng.
J. 62(5), 295–305 (2014)
14. Van den Berg, F.: Criteria for wind farm noise: Lmax and Lden.
In: Proceedings of the Acoustics’08, Paris (2008)
15. Søndergaard, B.: Low frequency noise from wind turbines: do the
danish regulations have any impact? An analysis of noise mea-
surements. Int. J. Aeroacoust. 14(5–6), 909–915 (2015)
16. Møller, H., Pedersen, C.S.: Low-frequency noise from large wind
turbines. J. Acoust. Soc. Am. 129(6), 3727–44 (2011)
17. Van Kamp, I., Dusseldorp, A., van den Berg, G.P., Hagens, W.I.,
Slob, M.J.: Windturbines: invloed op de beleving en gezondheid
van omwonenden: GGD informatieblad medische milieukunde
Update 2013. RIVM briefrapport 200000001. In: Dutch (2014)
18. Windenergie: Pilot Kennisplatform. “Geluid van windturbines.”
(RIVM, 2015). In: Dutch (2015)
19. Merlin, T., Newton, S., Ellery, B., Milverton, J., Farah, C.: Sys-
tematic review of the human health effectsof wind farms. National
Health & Medical Research Council, Canberra (2013)
20. Public health effects of siting and operating onshore wind tur-
bines. Publication of the Superior Health Council (SHC) no. 8738,
Brussels. www.tinyurl.com/SHC-8738-windturbines
21. Knopper, L.D., Ollson, C.A.: Health effects and wind turbines: a
review of the literature. Environ. Health 10(1), 78 (2011)
22. Ellenbogen, J.M., Grace, S., Heiger-Bernays, W.J., Manwell, J.F.,
Mills, D.A., Sullivan, K.A., Santos, S.L.: Wind Turbine Health
Impact Study. Report of Independent Expert Panel. Prepared for:
Massachusetts Department of Environmental Protection. Mas-
sachusetts Department of Health (2012)
23. MDEP: Massachusetts Department of Environmental Protection
and Massachusetts Department of Public Health. Wind Turbine
Health Impact Study: Report of Independent Expert Panel (2012)
24. Schmidt, J.H., Klokker, M.: Health effects related to wind turbine
noise exposure: a systematic review. PLoS ONE 9(12), e114183
(2014)
25. McCunney, R.J., Mundt, K.A., Colby, W.D., Dobie, R., Kaliski,
K., Blais, M.: Wind turbines and health: a critical review of the sci-
entific literature. J. Occup. Environ. Med. 56(11), e108–30 (2014)
26. Knopper, L.D., Ollson, C.A., McCallum, L.C., Whitfield Aslund,
M.L., Berger, R.G., Souweine, K., McDaniel, M.: Wind turbines
and human health. Front. Public Health 19(2), 63 (2014)
27. Harrison, R.V.: On the biological plausibility of wind turbine syn-
drome. Int. J. Environ. Health Res. 25(5), 463–8 (2015)
28. Council of Canadian Academies, 2015: Understanding the Evi-
dence: Wind Turbine Noise. Ottawa (ON): The Expert Panel on
Wind Turbine Noise and Human Health. Council of Canadian
Academies (2015)
29. Janssen, S.A., Vos, H., Eisses, A.R., Pedersen, E.: A comparison
between exposure-response relationships for wind turbine annoy-
ance and annoyance due to other noise sources. J. Acoust. Soc.
Am. 130(6), 3746–53 (2011)
30. Yano, T., Kuwano, S., Kageyama, T., Sueoka, S., Tachibana, H.:
Dose–response relationships for wind turbine noise in Japan. In:
Proceedings of the Inter-noise (2013)
31. Pawlaczyk-Łuszczy´nska, M., Dudarewicz, A., Zaborowski, K.,
Zamojska-Daniszewska, M., Waszkowska, M.: Evaluation of
annoyance from the wind turbine noise: a pilot study.Int. J. Occup.
Med. Environ. Health 27(3), 364–88 (2014)
32. Babisch, W., Pershagen, G., Selander, J., Houthuijs, D., Breugel-
mans, O., Cadum, E., Vigna-Taglianti, F., Katsouyanni, K., Haral-
abidis, A.S., Dimakopoulou, K., Sourtzi, P.: Noise annoyance—a
modifier of the association between noise level and cardiovascular
health? Sci. Total Environ. 1(452), 50–7 (2013)
33. Miedema, H.M., Vos, H.: Noise annoyance from stationary
sources: relationships with exposure metric day-evening-night
level (DENL) and their confidence intervals. J. Acoust. Soc. Am.
116(1), 334–43 (2004)
34. Miedema, H.M., Oudshoorn, C.G.: Annoyance from transporta-
tion noise: relationships with exposure metrics DNL and DENL
and their confidence intervals. Environ. Health Perspect. 109(4),
409 (2001)
35. Fiumicelli, D.: Windfarm noise dose-response: a literature review.
Acoust. Bull. 64, 26–34 (2011)
36. Michaud, D.S., Keith, S.E., Feder, K., Voicescu, S.A., Marro, L.,
Than, J., Guay, M., Bower, T., Denning, A., Lavigne, E., Whelan,
C.: Personal and situational variables associated with wind turbine
noise annoyance. J. Acoust. Soc. Am. 139(3), 1455–66 (2016)
37. Van den Berg, F., Pedersen, E., Bouma, J., Bakker, R.: Visual and
acoustic impact of wind turbine farms on residents. Final Rep. 3,
63 (2008)
38. Persson Waye, K., Öhrström, E.: Psycho-acoustic characters of
relevance for annoyance of wind turbine noise. J. Sound Vib.
250(1), 65–73 (2002)
39. Hayes, M.: The measurement of low frequency noise at three UK
wind farms. Contract Number W/45/00656/00/00, URN 6, 1412
(2006)
40. Large, S., Stigwood, M.: The noise characteristics of compliant
wind farms that adversely affect its neighbours. In: INTER-
NOISE and NOISE-CON Congress and Conference Proceedings
2014 Oct 14, vol. 249, No. 1, pp. 6269-6288. Institute of Noise
Control Engineering (2014)
41. Bakker, R.H., Pedersen, E., van den Berg, G.P., Stewart, R.E.,
Lok, W., Bouma, J.: Impact of wind turbine sound on annoyance,
self-reported sleep disturbance and psychological distress. Sci.
Total Environ. 15(425), 42–51 (2012)
123

Acoust Aust
42. Pedersen, E., Persson, W.K.: Wind turbine noise, annoyance and
self-reported health and well-being in different living environ-
ments. Occup. Environ. Med. 64(7), 480–6 (2007)
43. Qu, F., Tsuchiya, A., Kang, J.: Impact of noise from suburban wind
turbines on human well-being. In: Proceedings 7th International
Conferences on Wind Turbine Noise, Rotterdam (2017)
44. Van den Berg, F.: Effects of sound on people. In: Leventhall, G.,
Bowdler, D. (eds.) Wind Turbine Noise. Multi-Science Publish-
ing, Brentwood (2011)
45. Canadian Summary. http://www.hc-sc.gc.ca/ewh-semt/
noise-bruit/turbine-eoliennes/summary-resume-eng.php (2014)
46. Van den Berg, F., Verhagen, C., Uitenbroek, D.: The relation
between scores on noise annoyance and noise disturbed sleep in
a public health survey. Int. J. Environ. Res. Public Health 11(2),
2314–27 (2014)
47. Shepherd, D., McBride, D., Welch, D., Dirks, K.N., Hill, E.M.:
Evaluating the impact of wind turbine noise on health-related
quality of life. Noise Health 13(54), 333 (2011)
48. Nissenbaum, M.A., Aramini, J.J., Hanning, C.D.: Effects of indus-
trial wind turbine noise on sleep and health. Noise Health 14(60),
237 (2012)
49. Van Kamp, I., Lam, K.C., Brown, A.L., Wong, T.W., Law, C.W.:
Sleep-disturbance and quality of sleep in Hong Kong in relation
to night time noise exposure. J. Acoust. Soc. Am. 131(4), 3222
(2012)
50. Thorne, B.: the relevance of the precautionary principle to
wind farm noise planning. In: INTER-NOISE and NOISE-CON
Congress and Conference Proceedings 2014 Oct 14, vol. 249, No.
3, pp. 4065–4074. Institute of Noise Control Engineering (2014)
51. Dusseldorp, A., Houthuijs, D., van Overveld, A., van Kamp, I.,
Marra, M.: Handreiking geluidhinder wegverkeer: Berekenen en
meten. RIVM rapport 609300020. 2011 Oct 28. In: Dutch (2011)
52. Pedersen, E., Hallberg, L.M., Persson, W.K.: Livingin the vicinity
of wind turbines—a grounded theory study. Qual. Res. Psychol.
4(1–2), 49–63 (2007)
53. Van Kamp, I., Davies, H.: Noise and health in vulnerable groups:
a review. Noise Health 15(64), 153 (2013)
54. Miedema, H.M., Vos, H.: Noise sensitivity and reactions to noise
and other environmental conditions. J. Acoust. Soc. Am. 113(3),
1492–504 (2003)
55. Gross, C.: Community perspectives of wind energy in Australia:
the application of a justice and community fairness framework to
increase social acceptance. Energy Policy 35(5), 2727–36 (2007)
56. Tyler, T.R.: Social justice: outcome and procedure. Int. J. Psychol.
35(2), 117–25 (2000)
57. Wolsink, M.: Maatschappelijke acceptatie vanwindenergie Thesis
Publishers, Amsterdam (1990)
58. Breukers, S.: Institutional capacity building for wind power. A
geographical comparison. Ph.D. thesis, University of Amsterdam
(2007)
59. Devine-Wright, P., Howes, Y.: Disruption to place attachment and
the protection of restorative environments: a wind energy case
study. J. Environ. Psychol. 30(3), 271–80 (2010)
60. Walker, G., Devine-Wright, P.: Community renewable energy:
what should it mean? Energy Policy 36(2), 497–500 (2008)
61. Michaud, D.S., Feder, K., Keith, S.E., Voicescu, S.A., Marro, L.,
Than, J., Guay, M., Denning, A., McGuire, D.A., Bower, T., Lav-
igne, E.: Exposure to wind turbine noise: perceptual responses
and reported health effects. J. Acoust. Soc. Am. 139(3), 1443–54
(2016)
62. Michaud, D.S., Feder, K., Keith, S.E., Voicescu, S.A., Marro, L.,
Than, J., Guay, M., Denning, A., Murray, B.J., Weiss, S.K., Vil-
leneuve, P.J.: Effects of wind turbine noise on self-reported and
objective measures of sleep. Sleep 39(1), 97 (2016)
63. Michaud, D.S., Feder, K., Keith, S.E., Voicescu, S.A., Marro,
L., Than, J., Guay, M., Denning, A., Bower, T., Villeneuve, P.J.,
Russell, E.: Self-reported and measured stress related responses
associated with exposure to wind turbine noise. J. Acoust. Soc.
Am. 139(3), 1467–79 (2016)
64. Feder, K., Michaud, D.S., Keith, S.E., Voicescu, S.A., Marro, L.,
Than, J., Guay,M., Denning, A., Bower, T.J.,Lavigne, E., Whelan,
C.: An assessment of quality of life using the WHOQOL-BREF
among participants living in the vicinity of wind turbines. Environ.
Res. 31(142), 227–38 (2015)
65. Voicescu, S.A., Michaud, D.S., Feder, K., Marro, L., Than, J.,
Guay, M., Denning, A., Bower, T., van den Berg, F., Broner,
N., Lavigne, E.: Estimating annoyance to calculated wind tur-
bine shadow flicker is improved when variables associated with
wind turbine noise exposure are considered. J. Acoust. Soc. Am.
139(3), 1480–92 (2016)
66. Kageyama, T.: Adverse effects of community noise as a public
health issue. Sleep Biol. Rhythms 14(3), 223–229 (2016)
67. Kageyama, T., Yano, T., Kuwano, S., Sueoka, S., Tachibana, H.:
Exposure-response relationship of wind turbine noise with self-
reported symptoms of sleep and health problems: a nationwide
socio-acoustic survey in Japan. Noise Health 18(81), 53 (2016)
68. Abbasi, M., Monazzam, M.R., Ebrahimi, M.H., Zakerian, S.A.,
Dehghan, S.F., Akbarzadeh, A.: Assessment of noise effects of
wind turbine on the general health of staff at wind farm of Manjil,
Iran. J. Low Freq. Noise Vib. Act. Control 35(1), 91–8 (2016)
69. Blanes-Vidal, V., Schwartz, J.: Wind turbines and idiopathic
symptoms: the confounding effect of concurrent environmental
exposures. Neurotoxicol. Teratol. 55, 50–57 (2016)
70. Schäffer, B., Schlittmeier, S.J., Pieren, R., Heutschi, K., Brink,
M., Graf, R., Hellbrück, J.: Short-term annoyance reactions to
stationary and time-varying wind turbine and road traffic noise: a
laboratory study a. J. Acoust. Soc. Am. 139(5), 2949–63 (2016)
71. Crichton, F., Petrie, K.J.: Health complaints and wind turbines:
the efficacy of explaining the nocebo response to reduce symptom
reporting. Environ. Res. 31(140), 449–55 (2015)
72. Ioannidou, C., Santurette, S., Jeong, C.H.: Effect of modulation
depth, frequency, and intermittence on wind turbine noise annoy-
ance a. J. Acoust. Soc. Am. 139(3), 1241–51 (2016)
73. Hafke-Dys, H., Preis, A., Kaczmarek, T., Biniakowski, A., Kleka,
P.: Noise annoyance caused by amplitude modulated sounds
resembling the main characteristics of temporal wind turbine
noise. Arch. Acoust. 41(2), 221–32 (2016)
74. Tonin, R., Brett, J., Colagiuri, B.: The effect of infrasound and neg-
ative expectations to adverse pathological symptoms from wind
farms. J. Low Freq. Noise Vib. Act. Control 35(1), 77–90 (2016)
75. Maffei, L., Masullo, M., Gabriele, M.D., Votsi, N.E., Pantis, J.D.,
Senese, V.P.: Auditory recognition of familiar and unfamiliar sub-
jects with wind turbine noise. Int. J. Environ. Res. Public Health
12(4), 4306–20 (2015)
76. Jalali, L., Bigelow, P., Nezhad-Ahmadi, M.R., Gohari, M.,
Williams, D., McColl, S.: Before-after field study of effects of
wind turbine noise on polysomnographic sleep parameters. Noise
Health 18(83), 194 (2016)
77. Jalali, L., Bigelow, P., McColl, S., Majowicz, S., Gohari, M.,
Waterhouse, R.: Changes in quality of life and perceptions of gen-
eral health before and after operation of wind turbines. Environ.
Pollut. 30(216), 608–15 (2016)
78. Jalali, L., Nezhad-Ahmadi, M.R., Gohari, M., Bigelow, P.,
McColl, S.: The impact of psychological factors on self-reported
sleep disturbance among people living in the vicinity of wind
turbines. Environ. Res. 31(148), 401–10 (2016)
79. Krekel, C., Zerrahn, A.: Does the presence of wind turbines have
negative externalities for people in their surroundings? Evidence
from well-being data. J. Environ. Econ. Manag. 31(82), 221–38
(2017)
123

Acoust Aust
80. Botterill, L.C., Cockfield, G.: The relative importance of land-
scape amenity and health impacts in the wind farm debate in
Australia. J. Environ. Policy Plan. 18(4), 447–62 (2016)
81. Takashi, Y., Kuwano, S., Tachibana, H.: The visual effects of wind
turbines in Japan. In: Proceedings 7th International Conference
on Wind Turbine Noise, Rotterdam (2017)
82. Keith, S.E., Feder, K., Voicescu, S.A., Soukhovtsev, V., Denning,
A., Tsang, J., Broner, N., Leroux, T., Richarz, W., van den Berg,
F.: Wind turbine sound pressure level calculations at dwellings. J.
Acoust. Soc. Am. 139(3), 1436–42 (2016)
83. Keith, S.E., Feder, K., Voicescu, S.A., Soukhovtsev, V., Denning,
A., Tsang, J., Broner, N., Richarz, W., van den Berg, F.: Wind
turbine sound power measure-ments. J. Acoust. Soc. Am. 139(3),
1431–1435 (2016)
84. Van Renterghem, T., Bockstael, A., De Weirt, V., Botteldooren,
D.: Annoyance, detection and recognition of wind turbine noise.
Sci. Total Environ. 1(456), 333–45 (2013)
85. Pedersen, E., van den Berg, F., Bakker, R., Bouma, J.: Response
to noise from modern wind farms in The Netherlands. J. Acoust.
Soc. Am. 126(2), 634–43 (2009)
86. Blackburn, D., Rodrigue, L., Tardif, I., Chagnon, M., Martel, K.,
Morasse, A., et al.: Éoliennes et santé publique. Synthèse des
connaissances. Québec: Institut National de Santé Publique de
Québec; 2009 Septembre. http://www.inspq.qc.ca/publications/
notice.asp?E=p&NumPublication=1015. Accessed 09 Feb 2013
(2013)
87. Pasqualetti, M.J.: Social barriers to renewable energy landscapes.
Geogr. Rev. 101(2), 201–23 (2011)
88. Pedersen, E., Larsman, P.: The impact of visual factors on noise
annoyance among people living in the vicinity of wind turbines.
J. Environ. Psychol. 28(4), 379–89 (2008)
89. Kroesen, M., Molin, E.J., van Wee, B.: Testing a theory of aircraft
noise annoyance: a structural equation analysis. J. Acoust. Soc.
Am. 123(6), 4250–60 (2008)
90. Bartels, S., Márki, F., Müller, U.: The influence of acoustical and
non-acoustical factors on short-term annoyance due to aircraft
noise in the field—the COSMA study. Sci.Total Environ. 15(538),
834–43 (2015)
91. Fyhri, A., Klæboe, R.: Road traffic noise, sensitivity, annoyance
and self-reported health—a structural equation model exercise.
Environ. Int. 35(1), 91–7 (2009)
92. Park, S.H., Lee, P.J., Yang, K.S., Kim, K.W.: Relationships
between non-acoustic factors and subjective reactions to floor
impact noise in apartment buildings. J. Acoust. Soc. Am. 139(3),
1158–67 (2016)
93. Chapman, S., George, A.S., Waller, K., Cakic, V.: The pattern
of complaints about Australian wind farms does not match the
establishment and distribution of turbines: support for the psy-
chogenic, ‘communicated disease’ hypothesis. PLoS ONE 8(10),
e76584 (2013)
94. Crichton, F., Dodd, G., Schmid, G., Gamble, G., Petrie, K.J.: Can
expectations produce symptoms from infrasound associated with
wind turbines? Health Psychol. 33(4), 360 (2014)
95. Hatfield, J., Job, R.S., Hede, A.J., Carter, N.L., Peploe, P., Taylor,
R., Morrell, S.: Human response to environmental noise: the role
of perceived control. Int. J. Behav. Med. 1(9(4)), 341–359 (2002)
96. White, K., Hofman, W.F., van Kamp, I.: Noise sensitivity in rela-
tion to baseline arousal, physiological response and psychological
features to noise exposure during task performance. In: INTER-
NOISE and NOISE-CON Congress and Conference Proceedings
2010 Jun 13, vol. 2010, No. 9, pp. 2604–2610. Institute of Noise
Control Engineering (2010)
97. Shepherd, D., Welch, D., Dirks, K.N., Mathews, R.: Explor-
ing the relationship between noise sensitivity, annoyance and
health-related quality of life in a sample of adults exposed to envi-
ronmental noise. Int. J. Environ. Res. Public Health 7, 3579–94
(2010)
98. Coleby, A.M., Miller, D.R., Aspinall, P.A.: Public attitudes and
participation in wind turbine development. J. Environ. Assess.
Policy Manag. 11(01), 69–95 (2009)
99. Zaunbrecher, B.S., Ziefle, M.: Integrating acceptance-relevant
factors into wind power planning: a discussion. Sustain. Cities
Soc. 30(27), 307–14 (2016)
100. Enevoldsen, P., Sovacool, B.K.: Examining the social acceptance
of wind energy: practical guidelines for onshore wind project
development in France. Renew. Sustain. Energy Rev. 31(53), 178–
84 (2016)
101. Walker, C., Baxter, J., Ouellette, D.: Adding insult to injury: the
development of psychosocial stress in Ontario wind turbine com-
munities. Soc. Sci. Med. 31(133), 358–65 (2015)
102. Salt, A.N., Hullar, T.E.: Responses of the ear to low frequency
sounds, infrasound and wind turbines. Hear. Res. 268(1), 12–21
(2010)
103. Baliatsas, C., van Kamp, I., van Poll, R., Yzermans, J.: Health
effects from low-frequency noise and infrasound in the general
population: is it time to listen? A systematic review of observa-
tional studies. Sci. Total Environ. 1(557), 163–9 (2016)
104. Cooper, K., Kirkpatrick, P., Stewart, A.: Health effects associated
with working in the wind power generation industry: a compre-
hensive systematic review. JBI Database Syst. Rev. Implement.
Rep. 12(11), 327–73 (2014)
105. Berger, R.G., Ashtiani, P., Ollson, C.A., Aslund, M.W., McCal-
lum, L.C., Leventhall, G., Knopper, L.D.: Health-based audible
noise guidelines account for infrasound and low-frequency noise
produced by wind turbines. Front. Public Health. 3, 31 (2015)
106. Moller, H., Pedersen, C.S.: Hearing at low and infrasonic frequen-
cies. Noise Health 6(23), 37 (2004)
107. Leventhall, G.: Infrasound and the ear. In: Proceedings 5th Inter-
national Conference on Wind Turbine Noise (2013)
108. Bolin, K., Bluhm, G., Eriksson, G., Nilsson, M.E.: Infrasound
and low frequency noise from wind turbines: exposure and health
effects. Environ. Res. Lett. 6(3), 035103 (2011)
109. Herrmann, L., Bayer, O., Krapf, K.G., Hoffmann, M., Blaul, J.,
Mehnert, C.: Low-frequency noise incl. infrasound from wind
turbines and other sources. In: INTER-NOISE and NOISE-CON
Congress and Conference Proceedings 2016 Aug 21, vol. 253, No.
3, pp. 5580–5589. Institute of Noise Control Engineering (2016)
110. Frey, B.J., Hadden, P.J.: Noise radiation from wind turbines
installed near homes: effects on health. With an annotated review
of the research and related issues
111. Pierpont, N.: Wind Turbine Syndrome: A Report on a Natural
Experiment. K-Selected Books, Santa Fe (2009)
112. Alves-Pereira, M., Branco, N.A.: Vibroacoustic disease: biologi-
cal effects of infrasound and low-frequency noise explained by
mechanotransduction cellular signalling. Prog. Biophys. Mol.
Biol. 93(1), 256–79 (2007)
113. Salt, A.N., Kaltenbach, J.A.: Infrasound from wind turbines could
affect humans. Bull. Sci. Technol. Soc. 31(4), 296–302 (2011)
114. Farboud, A., Crunkhorn, R., Trinidade, A.: Wind turbine syn-
drome: fact or fiction? J. Laryngol. Otol. 127(3), 222–6 (2013)
115. Stead, M., Cooper, J., Evans, T.: Comparison of infrasound
measured at peoples ears when walking to that measured near
windfarms. Acoust. Aust. 42(3), 197–203 (2014)
116. Witthöft, M., Rubin, G.J.: Are media warnings about the adverse
health effects of modern life self-fulfilling? An experimental study
on idiopathic environmental intolerance attributed to electromag-
netic fields (IEI-EMF). J. Psychosom. Res. 74(3), 206–12 (2013)
117. Schomer, P.D., Erdreich, J., Pamidighantam, P.K., Boyle, J.H.:
A theory to explain some physiological effects of the infrasonic
emissions at some wind farm sites. J. Acoust. Soc. Am. 137(3),
1356–65 (2015)
123

Acoust Aust
118. Nussbaum, D.S., Reinis, S.: Some Individual Differences in
Human Response to Infrasound. University of Toronto, Toronto
(1985)
119. Marciniak, W., Rodriguez, E., Olszowska, K., Atkov, O., Botvin,
I., Araujo, A., Pais, F., Soares Ribeiro, C., Bordalo, A., Loureiro,
J., Prazeres De Sá, E., Ferreira, D., Castelo Branco, M.S., Castelo
Branco, N.A.: Echocardiographic evaluation in 485 aeronautical
workers exposed to different noise environments. Aviat. Space
Environ. Med. 70(3 Pt 2), 46–53 (1999)
120. ATSDR: Agency for Toxic Substance and Disease Registry:
Expert Review of the Vieques Heart Study. Summary Report
for the Vieques Heart Study Expert Panel Review. Contract No.
200-2000-10039. www.atsdr.cdc.gov/sites/vieques/heart_study_
summary (2001)
121. Kelley, N.D., McKenna, H.E., Hemphill, R.R., Etter, C.L., Gar-
relts, R.L., Linn, N.C.: Acoustic Noise Associated with the
MOD-1 Wind Turbine: Its Source, Impact, and Control. US Gov-
ernment Printing Office, Washington (1985)
122. Stephens, D.G., Shepherd, K.P., Hubbard, H.H., Grosveld, F.W.:
Guide to the Evaluation of Human Exposure to Noise from
Large Wind Turbines. NASA Report TM-83288. NASA Lang-
ley Research Center, Hampton (1982)
123. Bengtsson, J., Persson Waye, K., Kjellberg, A.: Evaluations of
effects due to low-frequency noise in a low demanding work sit-
uation. J. Sound Vib. 278, 83–99 (2004)
123