In the matter of Dundonnell windfarm project Expert ... - Trustpower [PDF]

In the matter of Dundonnell windfarm project Expert Witness Statement of Prof Gary Wittert 1

Introduction This witness statement sets out my opinions about health issues associated with wind farms, and responds to health-related submissions on the environment effects statement (EES) for the Dundonnell wind farm project that have been referred to me by Herbert Smith Freehills. I acknowledge that I have read and complied with the Planning Panels Victoria publication titled ‘Guide to Expert Evidence’ (2015). In accordance with the Guide’s reqirements I set out the following information:

1.1

Name and address Prof Gary Wittert Discipline of Medicine, University of Adelaide Level 6, Eleanor Harrald building, Royal Adelaide Hospital Adelaide, South Australia 5000

1.2

1.3

Area of expertise (a)

I hold the degrees of MBBch (Degree in Medicine, awarded in 1983) and MD (A research degree in medicine awarded 1994. My thesis was on the physiology of the stress response in humans).

(b)

I’m a Fellow of the Royal Australasian College of Physicians (1992) registered with AHPRAH to practice in General Medicine and Endocrinology. I have been elected to the Royal College of Physicians UK

(c)

Following my clinical and research training I have, for the past 21 years, been employed by the University of Adelaide in the Discipline of Medicine, where since 2004 I have held a Personal Chair. I undertake clinical, basic and population health research. I’m a senior consultant in Endocrinology at the Royal Adelaide Hospital, and a Senior Principal Research Fellow at the South Australian Health and Medical Research Institute

(d)

My qualifications and experience are detailed in Annexure A.

Instructions I have been engaged by Herbert Smith Freehills on behalf of Trustpower Australia Holdings (New Zealand) Ltd to provide expert evidence to the Panel Inquiry on health issues in relation to the proposed Dundonnell wind farm project.

1.4

Process and Methodology I prepared and have attached a detailed report (Report: Wind Farms and Human Health, August 2015) in which I review and present my opinions, based on the principles of good epidemiological practice, on the relationships between: 

Noise and health impacts in general;

page 1

1.5



Sleep disturbance and noise in general; and



Sound energy from wind farms and health.

Assumptions I have assumed that noise emissions from the Dundonnell wind farm will comply with the New Zealand standard 6808:2010 as required by clause 52.32 of the Moyne planning scheme and the Policy and Planning Guidelines for the Development of Wind Energy Facilities in Victoria, in June 2015. I understand this Standard requires wind farm levels to not exceed 40dB(A)L90 or background plus 5dB(A)L90, whichever is greater.

1.6

2

Documents and materials considered (a)

My report, Wind Farms and Human Health, August 2015, contains a reference list and a series of appendices containing original studies, reviews, reports. The report can be found at Appendix 1 of this statement.

(b)

DUNDONNELL WIND FARM EES Noise Impact Assessment, Rp001 R03 2012480ML, Marshall Day Acoustics, 2 September 2014. Appendix 2

(c)

Decision of the Environment Resources and Development Court (ERDC) of South Australia in relation to TRU ENERGY RENEWABLE DEVELOPMENTS PTY LTD v REGIONAL COUNCIL OF GOYDER & ORS. [2014] SAERDC 48. 4 November 2014. Appendix 3

(d)

My analysis of affidavits from complainants detailing adverse health effects that they attributed to the operation of wind turbines as presented to the ERDC in the matter referred to above and which was the subject of cross-examination. The court transcript is attached as Appendix 4.

(e)

Submissions to the EES: 6, 61, 66, 99, 104, 108, 109, 118, 120, 127, and associated attachments.

Findings and opinion My report, Wind Farms and Human Health, August 2015, and the analysis of affadavits from complainants reporting adverse health effects from the operation of wind turbines, form the basis for my expert witness statement and evidence. A summary of my findings is set out below.

2.1

Noise and Health (Section 3 of my report) A summary of the effects and threshold levels for effects of noise on sleep where sufficient evidence is available is presented in Table 3 on page 8 of my report. In general, the threshold for any biological effect on sleep structure or awakening as assessed by an electroencephalogram (EEG) is 35 dBA indoors and between 40 and 42 dBA outside at night for impaired sleep quality, self-reported insomnia, or well-being. There is a weak relationship between noise exposure and increased risk of adverse cardiovascular outcomes. It depends on the magnitude (well over 45 dBA for the most part) and consistency of noise exposure and the presence or absence of other cardiovascular risk factors and a range of other confounds. page 2

The weight of opinion suggests annoyance, psychological distress and sleep disturbance may be the factors mediating the relationship between noise and cardiovascular risk. There are no consistent data to suggest that children, the elderly or pregnant women are more susceptible than others in the population. 2.2

The relationship between sleep disturbance and adverse health outcomes (Section 2.2, page 7 and Section 4, page 11) Self-reported insomnia is relatively common in Australian adults (13-33% in various surveys) and is strongly related to the presence of depression. There is only a weak relationship between subjective sleep quality and objective measures of sleep. Sleep durations of between six and eight hours per day are compatible with good health. Sleep durations of less than six hours a day has been associated with an increased risk of obesity, cardiovascular disease, and type 2 diabetes. Excessive sleep, or arguably time in bed (greater than 8.5 hours), is associated with an increased risk of type 2 diabetes and increased risk of events and/or death from cardiovascular disease. Disruption of circadian rhythm, such as occurs in shift workers may be an even more important cause of obesity, type 2 diabetes, and cardiovascular disease is linked to an increased risk of some types of cancer. Obstructive sleep apnoea (OSA) is a condition that occurs during sleep where there is intermittent collapse of the airways such that air cannot reach the lungs despite attempts to breathe. It affects half of men over the age of 40 and is moderate to severe or severe in 25% of these men. OSA is associated with high blood pressure, headaches, depression, fatigue, poor concentration, obesity, diabetes, erectile dysfunction, getting up at night to pass urine and an unstable bladder. Although it is generally been considered that women are rarely affected by OSA it is in fact much more common than had previously been thought. The disease associations that occur in men, with the exception of erectile dysfunction, also occur in women. Obesity is a strong determinant of the presence of OSA. Obesity itself independent of anything else is a cause of poor sleep quality and increased daytime sleepiness. Obesity also has a bidirectional relationship with depression.

page 3

A number of dietary factors, or example a high fat diet at night or the use of MSG can adversely affect sleep. 2.3

Sound energy from wind turbines and health (Section 5, Page 12) The perception of, and response to, environmental sound depends on individual auditory perception and other sensory, attentional, cognitive, and emotional factors (5.1; page 12-15). In relation to the effect of the audible sound from wind farms, I have reviewed information from various surveys and anecdotal reports (5.2.1, page 15); recent reviews and reports from expert bodies (5.2.2, page 17, and Appendix 6) and recent research studies (5.2.3, page 20). I have separately considered the specific effects of low-frequency noise (LFN) and infra-sound (IS) (5.3, page 26). The issue of audibility (5.3.1 page 26), the mechanisms by which the inner ear responds to low-frequency sound (page 2627) and the question of effects on human healtth health effects particularly in relation to wind farms (5.3.2 page 30) of LFN and IS have been considered.

2.4

Mood and negative expectations (Nocebo effect) Negative expectations can create symptoms from wind turbines and recent work has shown that positive expectations can produce the opposite effect (page 24, and section 5.3.3 Page31)

2.5

Opinion Based on this and the aforementioned information, my opinions in relation to wind farm noise and likelihood of adverse health effects are as follows: (a)

There is no evidence that audible noise resulting from the operation of wind turbines constitutes a significant risk to health in the majority of individuals.

(b)

Annoyance is acknowledged to occur in a small number of individuals and the extent to which this is problematic in a compliant wind farm may depend more on non-acoustic than acoustic factors.

(c)

It is acknowledged that there are some particularly noise sensitive individuals, but it would seem to me to be surprising that their first awareness of this as adults would be in the context of exposure to wind turbines. However, I am not aware of any specific enquiry in this regard.

(d)

The weight of evidence is that when adverse health effects occur they relate to annoyance and are mediated by psychological distress and or sleep disturbance.

(e)

The extent to which this occurs and whether it manifests as psychological distress and or sleep disturbance and/or other adverse health effect is dependent on a number of other internal and external factors (attitude, visual amenity, nocebo effects, financial interest, et cetera). page 4

(f)

Any problem with LFN, as with high-frequency noise, were likely relate to annoyance associated with audibility and the same range of moderating non-acoustic factors.

(g)

There is no evidence that adverse health effects can be directly attributable to inaudible low-frequency sound emissions.

(h)

There is no evidence that inaudible infrasound are associated with any significant physiological or pathophysiological consequences.

(i)

There is no evidence that the level of infrasound produced by wind turbines constitutes a problem to health.

5

Responses to Specific Submissions

5.1

Background health problems, cause-and-effect relationships and the Cape Bridgewater report. Submission 61 Paragraph e, Page 6; (also relates to submissions 6, 109; and 122) In relation to subparagraph (iv)  

The health problems described in that paragraph are common in the community; and the attribution of cause-and-effect is circumstantial; I draw attention to section 1 of my report (Page 4) at Appendix and in particular section 1.4 (page 5) of that report, and the transcripts from the ERD in Appendix 4

The submissions also refer to an acoustic testing program at the Cape Bridgewater wind farm, reported by Mr Stephen Cooper, 26 November 2014. I have read that report and make the following observations about it:   

This was not a study of health effects of turbine exposure, and no conclusion or even inference can be made in that regard There were no attributable effects to noise or infrasound The significance of the subjective reports of sensation is unclear.

Given the weight of multiple lines of other evidence referred to in my report, there is no reason or justification to invoke the precautionary principle. There is no information in the submissions presented to alter that fact.

5.2

Dr Iser’s surveys at Toora, anecdotal reports of adverse health effects and the nocebo effect Submission 66, attachment D; submission 104 Para 32; submission 108; This document raises general concerns about health effects of wind farms, refers to apparent decisions made overseas to curtail or cease wind farm operations overseas, and refers to Dr Iser’s surveys at Toora. The substantive health issues raised in this document are covered by my report. Furthermore, I analysed a set of statutory declarations made by people attributing the adverse health effects to living in the vicinity of operating wind turbines in South Australia (Attachment 4). In each case, turbine related audible or infrasound was the least likely explanation for the problems experienced. I draw attention to the evidence that harm can be caused by negative expectations (nocebo effect). This occurs by a real physiological and biochemical process involving page 5

pain and stress pathways in the brain. The first two references below are links to websites that can easily be accessed, and for the third I have included the abstract from the paper (fMRI - stands for functional magnetic resonance imaging which is a technique to look at chemical changes that are occurring in particular brain areas in response to specific stimuli) 1. http://www.bbc.com/future/story/20150210-can-you-think-yourself-to-death 2. http://www.sciencedaily.com/terms/nocebo.htm 3. Freeman S, Yu R, Egorova N, Chen X, Kirsch I, Claggett B, Kaptchuk TJ, Gollub RL, Kong J. Neuroimage. Distinct neural representations of placebo and nocebo effects. 2015 May 15;112:197-207. doi: 10.1016/j.neuroimage.2015.03.015. Epub 2015 Mar 14. Abstract Expectations shape the way we experience the world. In this study, we used fMRI to investigate how positive and negative expectation can change pain experiences in the same cohort of subjects. We first manipulated subjects' treatment expectation of the effectiveness of three inert creams, with one cream labeled "Lidocaine" (positive expectancy), one labeled "Capsaicin" (negative expectancy) and one labeled "Neutral" by surreptitiously decreasing, increasing, or not changing respectively, the intensity of the noxious stimuli administered following cream application. We then used fMRI to investigate the signal changes associated with administration of identical pain stimuli before and after the treatment and control creams. Twenty-four healthy adults completed the study. Results showed that expectancy significantly modulated subjective pain ratings. After controlling for changes in the neutral condition, the subjective pain rating changes evoked by positive and negative expectancies were significantly associated. fMRI results showed that the expectation of an increase in pain induced significant fMRI signal changes in the insula, orbitofrontal cortex, and periaqueductal gray, whereas the expectation of pain relief evoked significant fMRI signal changes in the striatum. No brain regions were identified as common to both "Capsaicin" and "Lidocaine" conditioning. There was also no significant association between the brain response to identical noxious stimuli in the pain matrix evoked by positive and negative expectancies. Our findings suggest that positive and negative expectancies engage different brain networks to modulate our pain experiences, but, overall, these distinct patterns of neural activation result in a correlated placebo and nocebo behavioural response. I have included the abstract for this study because it so elegantly demonstrates that the nocebo (negative expectation) effect and the placebo (positive expectation) effect are accompanied by distinct patterns of change in the brain. This serves to underline the powerful biological basis by which these effects are mediated and their importance in determining health-related outcomes. It is also important to draw a clear distinction between adverse health consequences due to the nocebo effect and those states of ill-health that are not due to a nocebo effect but incorrectly attributed to the presence of turbines .

5.3

Low-frequency sound and infra-sound Submissions 99, 109, 118 and 127 There is no specific information as to the nature of the adverse health effects being attributed to low frequency sound or infrasound, but I consider the concerns likely to be addressed by my report and associated attachments as well as those attached to this witness statement. There is no evidence that either low-frequency sound or infrasound produced by wind turbines has any adverse effect on the nervous systems of human beings. I refer to section 5.3 and in particular page 27 and 28 of my report. page 6

5.4

Earache Submission 120 It is implausible that earache can be attributed to infrasound from a windfarm and like the assertion of barotrauma and glue ear being attributed to the operation of the Pacific hydro wind farm at Cape Bridgewater is without evidence or substantiation. Similarly there is no mechanism or even remote possibility that sound of any sort can be triggering earache and headaches 10 km from a nearby wind farm irrespective of weather conditions or the lie the land.

6

Declaration I, Gary Allen Wittert, have made all the inquiries that I believe are desirable and appropriate and that no matters of significance which I regard as relevant have, to my knowledge, been withheld from the Panel.

Signed .….

.

Dated 22 September 2015

page 7

Expert witness statement of Gary Allen Wittert

-Annexure A - Qualifications My CV is attached.

I

page 1

CURRICULUM VITAE

Gary Allen WITTERT, MBBch, MD, FRACP, FRCP Date of Birth

20 September, 1959

Address - Home

39a Anglesey Avenue St Georges SA 5064, Australia

- Work

Level 6 Eleanor Harrald Building, University of Adelaide, DP 509 Adelaide, SA 5005

Email:

[email protected]

Telephone:

+61-8-8222 5502

Fax:

+61-8-8223 3870

Registered with the Medical Board of Australia: Endocrinology and General Medicine QUALIFICATIONS: 2009

FRCP / Medicine Royal College of Physicians, United Kingdom

1994

MD / Medicine University of Otago, New Zealand

1992

FRACP / General Medicine/Endocrinology Royal Australasian College of Physicians

1983

MBBch (distinction) University of Witwatersrand, South Africa

CURRENT APPOINTMENTS: 2014 –

Senior Principal Research Fellow. South Australian Health and Medical Research Institute (SAHMRI)

2012 -

Director, Freemasons Centre for Men’s Health.

2012 -

Honorary Professor, Clinical Trial Centre, University of Sydney

2010 -

Senior Clinical Scientist, New England Research Institutes, Watertown, MA.

2007 -

Founding Member, Freemasons Centre for Men’s Health

2004 -

Professor of Medicine, University of Adelaide (Personal Chair)

Jan 2014

2004 -

Mortlock Professor, and Head, Discipline of Medicine University of Adelaide

1994 -

Senior Consultant Endocrinologist, Royal Adelaide Hospital

1994 -

Member, Hanson Institute, Institute of Medical & Veterinary Science

1994 -

Coordinator, Endocrine Test Unit, Royal Adelaide Hospital

1994 -

Coordinator Obesity Clinic, Royal Adelaide Hospital

PREVIOUS APPOINTMENTS AND PROFESSIONAL EXPERIENCE 2006-2009

Head, School of Medicine, University of Adelaide

Apr, Sept 2004} Jan, July 2005 } June 2006 } 2000-2004

Acting Dean – Faculty of Health Science University of Adelaide

1994-1999 1993-1994

1989-1990 1988 1987 1986

Senior Lecturer in Medicine, University of Adelaide. Clinical and Research Fellow, Oregon Health Sciences University, and Vollum Institute of Advanced Biomedical Research, Portland Oregon Research Fellow of the Fogarty International Centre, Childrens Hospital of Boston and Harvard Medical School Locum Lecturer in Medicine, University of Otago Christchurch Clinical School, Christchurch, New Zealand Senior Registrar Endocrinology, Princess Margaret Hospital Christchurch, New Zealand Medical Registrar, Christchurch, New Zealand. General Practitioner, Oxford, New Zealand. Medical Registrar, Waikato Hospital, Hamilton, New Zealand

1985 1985 1984

House Officer, Waikato Hospital, Hamilton New Zealand Senior House Officer, Hillbrow Hospital, Johannesburg, South Africa Intern, Johannesburg Hospital, Johannesburg, South Africa

1991-1993 1991

Associate Professor, Department of Medicine, University of Adelaide

AWARDS AND DISTINCTIONS Undergraduate 1983

1982

David Lurie Memorial Medal for Surgery Abelheim Medal and Prize for Obstetrics Medical Association Medal for the most distinguished graduand Kurt Gillis Award for Psychiatry

Postgraduate 2012

International Specialist Certification of Obesity Professional Education (SCOPE) Fellowship.

2009

Elected to Fellowship of the Royal College of Physicians, London

Professor Gary Wittert

Page 2

2008

ARI – Research Accolade Award

2008

Finalist – South Australian Science Award for Public Good.

2004

Florey Lecture, University of Adelaide

1994

RACP Pharmacia Research Fellowship

1991

Fogarty Fellowship, National Institute of Health, USA

REGISTRATIONS / MEMBERSHIP OF PROFESSIONAL ORGANISATIONS 2009 1996 1994 1994 1993 -

Royal College of Physicians, London Australian Society for the Study of Obesity Royal Australasian College of Physicians Medical Board of South Australia American Diabetes Association

1993 -

US Endocrine Society

LEADERSHIP DEVELOPMENT 2008 2005

Heads of Schools Leadership Program – Palm Consulting Harvard Macy Residential Development Program for Academic Leaders

COMMITTEE AND OTHER APPOINTMENTS 2015 - 2017

Member, World Obesity Clinical Care Committee

2013-

Unmet Needs Committee of the ICUD on Men’s Health and Infertility

2013-

Research Executive Committee, South Australian Health & Medical Research Institute (SAHMRI)

2014-2018

Senior Principal Research Fellow, SAHMRI

2012-

Clinical Research and Drug and Device Development Pillar Committee, SAHMRI.

2012-

Bioscience Development Pillas Committee, SAHMRI.

2012

NH&MRC Grant Review Panel 6.

2012

IASO Education and Management Task Force

2011 -

Scientific Advisory Board – Obesity Australia

2010 - 2012

Member, Steering Group, Healthy Weight Guidelines, Obesity & Physical Activity Section, Healthy Living Branch, Population Health Division Department of Health & Ageing

2010

Epidemiology Scientific Advisory Group on Conjugated Linoleic Acid Food Standards Australia New Zealand,

2010 -

Member, Advisory Board of National Diabetes Obesity and Cholesterol Disorders Foundation, India

2010 -

Curriculum Development Working Group Andrology Australia Men’s Health

Professor Gary Wittert

Page 3

2010 -

Member, Scientific Advisory Board, Obesity Prevention and Lifestyle Project South Australian Department of Health

2009 -

Member, Human Research Ethics Committee CSIRO Nutritional Sciences

2009

Member, Scientific Advisory Council International Obesity Task Force

2009

Invited Member, External Review and Advisory Group for Diabetes Centre of Clinical Research Excellence (CCRE)

2009

Healthy Communities Initiative Council of Australian Governments

2009

Expert Review,Guidelines on the management of type 2 diabetes mellitus National Health & Medical Research Council (NHMRC)

2008 - 2010

CCRE Grant Review Panel National Health & Medical Research Council (NHMRC)

2008

Research Reform Implementation Group and Analysis Working Group South Australian Department of Health

2008 -

Independent Chair Weight Management Council of Australia

2008

Member, Grant Review Panel Selector Committee B, National Health & Medical Research Council (NHMRC)

2008

Invited participant, Kevin Rudd’s 2020 Summit

2007 - 2010

Advisor, Obesity in the armed forces and admission criteria relating to weight and body composition that regulate entry to the ADF Centre of Military of Veterans Health, Brisbane

2007 - 2009

Member, Faculty of Health Sciences Level E Promotion Committee,University of Adelaide

2007

Member, Faculty of Health Sciences Level B and C Promotion Committee, University of Adelaide

2007

Chair, Infant and Early Childhood Working Group Childhood Obesity Forum – Senator Guy Barnetts’ Obesity Forum, Canberra

2006 -

Vice President, Asian Oceania Society for the Study of Obesity

2006 - 2010

Chair, Board of Examiners MBBS Course, Year 3, University of Adelaide

2006

Member, Grant Review Panel, National Health & Medical Research Council (NHMRC)

2006

Chair, Men’s Health Task Force Operations Group, South Australian Department of Health

2005 - 2007

Member, Health Ministers Task Froce for Development of a Men’s Health Strategy

2005 - 2006

Member, National Obesity Task Force Scientific Reference Group

2005

Member, Faculty of Health Sciences Level E Promotion Committee, University of Adelaide

2005

Member, Research Strategy Think Tank, Central and Northern Adelaide Health Service

2004 - 2009

Chair, Projects Grants Committee, RAH/IMVS Research Committee

2004 – 2007

Board Member, Centre for Reproduction and Development, University of Adelaide

Professor Gary Wittert

Page 4

2004 – 2007

Co-Leader of Ageing Research Cluster, University of Adelaide

2004 – 2005

Deputy Chair/Chair, Standing Committee to advise on Clinical Trials Management Deputy Vice-Chancellor Research, University of Adelaide

2004

Member, Organising Committee, Cottrell Conference 2004, Royal Australasian College of Physicians

2004

Expert Advisory Group of key investigators conducting longitudinal research relevant to ageing, Australian Institute of health and Welfare (AIHW)

2004-2011

Member Global Lifestyle Advisory Council, McDonalds Corporation

2004

Member, Round Panel for Cooperative Research Centres 2004,Department of Education Science and Training

2003 – 2005

President, Australasian Society for the Study of Obesity

2003 - 2004

Member, Curriculum Resourcing Review Committee, Faculty of Health Sciences, University of Adelaide

2003

Member, Faculty of Health Sciences Level D Promotion Committee, University of Adelaide

2002 - 2006

Member, Program Organising Committee, International Congress on Obesity, Sydney

2002 - 2003

Medical Services Advisory Committee on Laparascopic Adjustable Gastric Banding, Department of Health and Ageing

2002

Member, Project Grants Committee 3C, National Health & Medical Research Council (NHMRC)

2001 – 2003

Medical Advisor, Endocrine Nurses Society of Australia Inc

2000 -

Committee on Androgen Function in Men, Australian Advisory Board on Mens Health

1999 – 2003

Roche Obesity Educational Advisory Board

1999 - 2002

Treasurer, Australian Society for the Study of Obesity

1999 – 2000

Convenor, Internal Medicine Service Bed Structure Committee

1999 – 2000

Member, Medical School Accreditation Task Force, University of Adelaide

1997 -1998

Curriculum Review Committee

1996 – 2001

Curriculum Committee

1996 – 2001

Convenor, clinical Years Management Committee, University of Adelaide

1996 – 1999

Chair, Organising Committee, Postgraduate Seminar, Endocrine Society of Australia

1995 - 1996

Member, Human Ethics Committee, University of South Australia

1995 – 1996

Secretary, General Medical Committee, Royal Adelaide Hospital

EDITORIAL BOARDS AND JOURNAL REVIEWS Editor in Chief 2008- Obesity Research and Clinical Practice International Editorial Board 2012-

Advisory Board, ClinicalKey – Elsevier

2006-2013

Diabetes Obesity and Metabolism.

Professor Gary Wittert

Page 5

International Advisory Boards      

McDonalds International Global Lifestyle council Sanofi-Aventis Pfizer Merck Davidsons Principles and Practice of Medicine 19th Edition. Davidsons Principles and Practice of Medicine 20th Edition.

National Advisory Boards  Abbott  Roche  Eli Lilly  Novartis  Metabolic Pharmaceuticals  Sanofi-Aventis Reviewer  Australian Medicines Handbook  Therapeutic Guidelines in Endocrinology.  International Journal of Obesity  Clinical Endocrinology  Diabetes Research and Clinical Practice  American Journal of Physiology  American Journal of Clinical Nutrition  Australian Medical Journal  Diabetes Obesity and Metabolism  Diabetes Care  Journal of Gerontology  Maturitas PATIENT MANAGEMENT SOFTWARE AND EDUCATIONAL AIDS:  OBEMAN™ - Interactive, Obesity Management Software  HopSCOTCH – Software for the shared management of childhood obesity by hospital specialists and general practitioners. PATENTS:  The use of AOD 9604 to treat depression – International Patent. #WO 03/09272 5 A1  Preventing and or treating atrial fibrillation - #T0765Prov GRANT FUNDING Category 1 (From 2004) Exploiting alterations in lipid metabolism to improve diagnosis, treatment and molecular imaging of prostate cancer LM Butler, WD Tilley, A Scott, AJ Hoy, GA Wittert, JV Swinnen Movember Transformative Research Award Plasticity of gastrointestinal vagal afferents A/Prof A J Page, Prof GA Wittert, Prof TN Dear ARC Discovery Grant DP140102203 Professor Gary Wittert

Year

$ 2015 2016 2017 2014 2015 2016

Total $3.25M

206 000 169 000 176 000 Page 6

Circadian control of peripheral gastric satiety signals Page A, Wittert G, Kennaway D. NH&MRC Project Grant 1046289 Centre of Research Excellence in Translating Nutritional Science to Good Health Horowitz M, Wittert G, Clifton P, Rayner C, Chapman I, Feinle-Bissett C, Jones K, Noakes M, Chapman M, Nguyen N. Centres of Research Excellence 1041687 ‘Testosterone Intervention for the Prevention of Diabetes Mellitus in High Risk Men: A Randomized Trial’ Wittert G, Yeap B, Allan C, McLachlan R, Conway A, Kaye J, Jenkins A, Daniel M NHMRC Project Grant 1030123 ‘The Role of Adipokines in modulation of Gastric Vagal Afferent Safety signals Page AJ, Blackshaw LA, Wittert G, Brierly S NHMRC Project Grant 1023972 ‘Does periodic fasting improve insulin sensitivity and metabolic health in humans’ Heilbronn LK, Wittert GA NHMRC Project Grant 1023401 ‘Multifuge X1R with Bioshield Centriguges (3) and upright (-80 degree) Freezers (2)’. Wittert G NH&MRC Equipment Grant GNT90000031

2013-2015

676,987

2012-2017

2,499,990.

2012-2016

4,822,905

2012-2014

603,375

2012-2014

809,130

2011

25,000

‘Effect of sex steroids, inflammation, environmental and biopsychosocial factors on cardiometabolic disease risk in men’. Wittert GA, Wilson DH, Travison T, Adams RJ, Taylor A, McKinlay J, Jenkins A, Milne R, Hugo G, Atlantis E. NH&MRC Project Grant 627227 ‘Interaction of Gastric hormones with vagal afferent pathways’. Page AJ, Blackshaw L Ashley, Wittert GA. NH&MRC Project Grant 565186

2010-2012

1,763,014

2009-2011

532,500

‘Effects of acute and longer-term dietary changes on gut function and appetite in lean and obese subjects’. Feinle-Bisset C, Clifton PM, Horowitz M, Jones KL, Wittert G. NHMRC Project Grant 565312

2009-2011

714,375

‘Australias Baby boomer generation, obesity and work – patterns, causes and implications’. Hugo GJ, Wittert GA, Adams RJ, Cobiac L, Daniel M, Findlay CC, Taylor AW, Wilson DH, Winefield HR, Woollacott AL, Ruffin R. ARC Linkage project LP0990065

2009-2011

654,049

‘GPCRP: Better outcomes for obese children in general practice: randomised control trial of a new shared-care-model vs usual care’. Wake M, Gunn J, Gibbson K, Wittert G, Gold L NHMRC Project Grant 491212

2008-2011

666,374

‘Limiting weight gain in overweight and obese women during pregnancy to improve health outcomes – a randomised trial’. Dodd J, Turnbull D, McPhee A, Wittert G, Robinson J. et al

2008-2011

1,480,525

Professor Gary Wittert

Page 7

NHMRC Project Grant 519240 ‘Cardiovascular and Inflammatory Effects of Dietary Intervention in Obesity’. Worthley S, Wittert GA, Worthley M, et al National Heart Foundation

2008-2009

120,000

‘Automated image analysis system for the high throughput immunohistochemical analysis of clinical and experimental samples’, Tilley W, Wittert G, et al. NHMRC equipment grant 467207

2008

52,000

‘Healthy Ageing Research Cluster (HARC)’. Wittert G, Mayrhofer G, Ward L, Musgrave I, Gravier S. University of Adelaide Research Committee (URC)

2008

100,000

‘CCRE in Nutritional Physiology, Interventions and Outcomes’. Horowitz M, Clifton PM, Wittert GA, Chapman I, Fraser RJ, Rayner CK, NHMRC Project Grant 453557

2007-2011

2,000,000

‘Inspection time: A marker for less successful ageing’. Nettelbeck TJ, Burns NR, Wittert GA ARC Discovery Grant DP0772346

2007-2009

259,385

‘Equipment for Concurrent impedance, manometry and barostat recordings in nutritional physiology studies’. Rayner C, Fraser R, Horowitz M, Wittert G, Feinle-Bisset C, Jones K, Clifton P. NHMRC Equipment Grant 520946

2007

42,000

‘Obesity, health, social disadvantage an environment in Australia: relations and policy implications’. Hugo GJ, Ruffin R, Wittert G, Taylor AW, Adams RJ. ARC Linkage Grant LP0455737 NHMRC Equipment Grant

2005-2008

1,400,000

2004

63,000

‘The safety and efficacy of rapid weight-loss using a modified very low calorie diet, followed by a weight maintenance strategy, on cardiovascular risk factors, vascular and ventricular structure and function in obesity and obesity related cardiovascular disease – [‘Healthy Weight for Life Project’]’. Wittert G, Worthley S, Piantadosi C, McAinch A MBF Foundation Ltd

2007-2009

146,955

‘Impact of nutrition, including long-chain Omega-3 polyunsaturated fatty acids on cognition and functional ageing’. Danthiir V, Wilson C, Nettelbeck T, Wittert G Brailsford Robertson Award

2007-2008

200,000

2007

1,400,000

GRANT FUNDING – Other 1994-current and Catergory 1 1994-2003

‘Building a fit and healthy Australia’. Premiers Science Research Council

Professor Gary Wittert

Page 8

‘Socio-economic status and overweight/obesity: supply of and access to (un)healthy food’. Strategic Health Research Program, South Australian Dept of Health

2007

200,000

‘Automated image analysis system for the high throughput immunohistochemical analysis of clinical and experimental samples’. Tilley W, Owens J, Norman R, Findlay D, Rodgers R, Roberts C, Wittert G, Ricciardelli C et al. NHMRC Equipment Grant 467207

2007

100,695

2006-2008

300,000

2005

21,000

‘Dietary interventions for overweight/obese women prior to pregnancy – safety and efficacy of low calorie and low carbohydrate diets’. Noakes M, Brinkworth G, McMillen C, Clifton P, Norman R, Wittert G. Brailsford Roberston Grant

2005-2006

200,000

‘The Florey Adelaide Male Ageing Study: promoting health wellbeing and utilisation of health services by middle aged and older men’ Florey Foundation

2003-2004

450,000

University of Adelaide Grant

2003

100,000

University of Adelaide Grant

2003

10,000

Silhouette Medical Grant

2002

120,000

ARC Small Grant

2002

10,000

ARC Small Grant

2001

10,000

2001-2003

204,000

Analytica Grant

2000

20,000

B1 Grant

2000

10,000

ARC Small Grant

2000

10,000

Bayer Pharmaceuticals Grant

2000

40,000

Organon Grant

1999

70,000

Dairy Development Research Corporation Grant

1999

44,000

University of Adelaide Nutrition Trust

1999

20,000

University of Adelaide B3 grant

1999

10,000

1998-2000

240,000

1998

10,000

1997-1999

156,000

RAH special purposes fund grant

1996

20,000

ARC small grant

1996

10,000

ARC small grant

1995

16,000

RAH/IMVS Research Review Committee

1995

20,000

RACP Pharmacia Research Fellowship

1994

40,000

‘The Florey Adelaide Male Ageing Study: promoting health wellbeing and utilisation of health services by middle aged and older men’. Premiers Science Research Council Faculty Small Grant University of Adelaide

NH&MRC Project Grant 158012

Veterans affairs Ramaciotti Foundation ARC large grant

Professor Gary Wittert

Page 9

Ramaciotti Foundation

1994

10,000

University of Adelaide B3 grant

1994

10,000

PUBLICATIONS Peer Reviewed 1.

Wittert GA, Donald RA, Espiner EA, Livesey JH. The hormonal effects of pituitary surgery and irradiation: A review of 59 cases. New Zealand Medical Journal, 98: 93-97, 1985

2.

Wittert GA, Joffe B, Shires R, Panz V, Seftel H. Clonidine has no effect on serum potassium changes during exercise. New England Journal of Medicine, 5: 327, 1985

3.

Wittert GA, Joffe B, Shires R, Panz V, Baker SG, Seftel H. Hypoglycaemic glucose counter-regulation in healthy subjects pre-treated with oral clonidine. Journal of Endocrinological Investigation, 10:621622, 1987

4.

Wittert GA, Espiner EA, Donald RA. Arginine Vasopressin in Cushings Disease. Lancet, 335: 991994, 1990

5.

Wittert GA, Stewart DE, Graves MP, Ellis MJ, Evans MJ, Wells JE., Donald RA, Espiner EA. The plasma vasopressin (AVP) and Corticotrophin Releasing Factor (CRF) responses to intense exercise in athletes. Clinical Endocrinology, 35:311-7, 1991

6.

Richards AM, Wittert GA, Espiner EA, Yandle TG, Frampton C, Ikram H. EC 24.11 Inhibition in man alters clearance and bioactivity of atrial peptide. Journal of Clinical Endocrinology and Metabolism, 71:1317, 1991

7.

Richards AM, Wittert GA, Espiner EA, Yandle TG, Frampton C, Ikram H. Prolonged inhibition of endopeptidase 24.11 in normal man: Renal, Endocrine and Hemodynamic effects. Journal of Hypertension, 91:1-8, 1991

8.

Wittert GA, McKellar K. Thiazide induced hyponatraemia. New Ethicals, Jan 1992

9.

Richards AM, Wittert GA, Espiner EA, Yandle TG, Ikram H, Frampton C. Effect of inhibition of endopeptidase 24.11 on responses to angiotensin II in human volunteers. Circulation Research, 71(6):1501-7, 1992

10.

Wittert GA, Or KH, Livesey JL, Richards AM, Donald RA, Espiner EA. Vasopressin, corticotrophin releasing factor, atrial natriuretic factor, and pituitary adrenal responses to acute cold stress in humans. Journal of Clinical Endocrinology and Metabolism, 75:750-755, 1992

11.

Clyde JW, Wittert GA. Gilchrist NL, Turner JG, Donald RA, Espiner EA. The effect of parathyroidectomy on bone mineral density in primary hyperparathyroidism. New Zealand Medical Journal, 105:71-2, 1992

12.

Wittert GA, Livesey JH, Or HK, Donald RA, Espiner EA. Elevated corticotrophin secretion in Addisons disease is independent of change in plasma arginine vasopressin and corticotrophin releasing factor. Journal of Clinical Endocrinology and Metabolism, 76:192-196, 1993

13.

Wittert GA, Espiner EA, Richards AM, Donald RA, Yandle TG. Atrial natriuretic factor reduces vasopressin and angiotensin II, but not the ACTH response to acute hypoglycaemic stress in normal man. Clinical Endocrinology, 38:183-189, 1993.

14.

Richards AM, Wittert GA, Crozier IG, Espiner EA, Frampton C, Ikram H. Chronic inhibition of endopeptidase 24.11 in essential hypertension: evidence for enhanced atrial natriuretic peptide and angiotensin II. J Hypertension, 11:407-416, 1993

Professor Gary Wittert

Page 10

15.

Donald RA, Perry EG, Wittert GA, Chapman M, Livesey JH, Ellis MJ, Yandle T, Espiner EA. The plasma ACTH, AVP, CRH and catecholamine responses to conventional and laparascopic cholecystectomy. Clinical Endocrinology, 38:609-615, 1993

16.

Majzoub JA, Emanuel RL, Adler GK, Martinez C, Robinson B, Wittert G. Second messenger regulation of mRNA for corticotropin releasing factor. Chadwick DJ, Marsh J, Ackrill (eds), Corticotropin releasing factor, John Wiley & Sons, Ciba Symposium 172:30-43, 1993

17.

Florkowski CM, Wittert GA, Lewis JG, Donald RA, Espiner EA. Glucocorticoid responsive ACTH secreting bronchial carcinoid tumours contain high concentrations of glucocorticoid receptors. Clinical Endocrinology, 40:269-274, 1994

18.

Wittert GA, Loriaux DL. Functioning disorders of the adrenal gland: A symptomatic approach. Comprehensive Therapy, 20:358-362, 1994

19.

Wittert G, Hope P, Pyle D. Tissue distribution of opioid receptor gene expression in the rat. Biochem Biophys Res Commun, 218: 877-881, 1996

20.

Lavin J, Wittert G, Sun W-M, Horowitz M, Morley JE, Read NW. Appetite regulation by carbohydrate: Role of blood glucose and gastrointestinal hormones. Am J Physiol-Endo Metab, 34:E209-214, 1996

21.

Yeap B, Russo A, Fraser RJ, Wittert GA, Horowitz M. Hyperglycaemia affects cardiovascular autonomic nerve function in normal subjects. Diabetes Care, 19:880-882, 1996

22.

Wittert GA, Livesey J, Espiner EA, Donald RA. Adaptation of the hypothalamo-pituitary adrenal axis to chronic exercise stress. Medicine and Science in Sports and Exercise, 28:1015-1019, 1996

23.

Yeap Bu, Burnet RB, Scroop G, Chatterton BE, Gaffney RD, Wittert GA. Chronic fatigue syndrome: is total body potassium important? Med J Aust, 164:384, 1996

24.

Nordin BE, Burnet RB, Wittert G, Fitzgerald S, Drummin L. Which bone to measure Australian Prescriber 20(S3): 74-78, 1997

25.

Hope PJ, Wittert GA, Horowitz M, Morley JE. Feeding patterns of S. crassicaudata (Marsupalia: Dasyuridae): The role of gender, photoperiod and fat stores. Am J Physiol, 272:R78-R83, 1997

26.

Perry III HM, Morley JE, Horowitz MH, Kaiser FE, Miller DK, Wittert GA. Leptin, Body composition and Age in African American Women. Metabolism, 46:1399-1405, 1997

27.

Chapman IM, Wittert GA, Norman R. Circulating plasma leptin concentrations in polycystic ovarian disease. Clinical Endocrinology, 46:175-181, 1997

28.

Hope PJ, Pyle D, Daniels CB, Chapman I, Horowitz M, Morley JE, Trayhurn P, Kumuratilake J, Wittert GA. Identification of brown fat and a novel mechanism for energy conservation in the marsupial Sminthopsis crassicaudata. Am J Physiol - Regulatory, Integrative and Comparative Physiology, 42(1): R161- R 167, 1997

29.

Hope PJ, Morley JE, Chapman IC, Horowitz M, Wittert GA. Food intake and food choice: The role of the endogenous opioid peptides in the marsupial Sminthopsis crassicaudata. Brain Research, 764:3945, 1997

30.

Cook C, Andrews J, Jones K, Wittert G, Chapman I, Morley J, Horowitz M. The effects of small intestinal nutrient infusions on appetite and pyloric motility are modified by age. Am J Physiol Regulatory, Integrative and Comparative Physiology, 42(2) R 755- R 761, 1997

31.

Dummin L, Burnet RB, Wittert G, Fitzgerald SP, Nordin BEC. Bone Densitometry in Clinical Practice: Forearm and Spinal BMD Changes in Untreated and Treated Postmenopausal Women Osteoporosis International, Vol 7 Supp/2, p67, 1997

Professor Gary Wittert

Page 11

32.

Scopacasa F, Horowitz M, Wishart JM, Need AG, Morris HA, Wittert G, Nordin BEC. Calcium supplementation suppresses bone resorption in early postmenopausal women. Calcified Tissue Int, 62:8-12, 1998

33.

Wittert GA, Hope P, Chapman I, Morley J, Horowitz M. Decreased glucose utilization does not increase food intake in the marsupial Sminthopsis crassicaudata. Physiology and Behaviour, 63: 3134, 1998

34.

Chapman IM, Goble E, Wittert GA, Morley JE, Horowitz M. The effect of intravenous glucose and euglycaemic insulin infusions on short term appetite and food intake in healthy adults. Am J Physiol Regulatory, Integrative and Comparative Physiology, 43:R569-603, 1998

35.

Lavin J, Wittert G, Andrews J, Horowitz M, Morley JM, Read NW. Appetite regulation by carbohydrate: The role of insulin and gut peptides. American Journal of Clinical Nutrition, 68:591-8, 1998

36.

Thomas N, Wittert GA, Scott G, Reilly P. Infection of a Rathke’s cleft cyst - a rare cause of pituitary abscess. J Neurosurg, 89(4):682, 1998

37.

Clements F, Hope P, Daniels C, Chapman I, Wittert GA. Thermogenesis in the marsupial Sminthopsis crassicaudata: Effect of catecholamines and diet. Aust J Zool, 46:381-390, 1998

38.

Wittert GA. Obesity: The epidemic, recent advances and future trends. South Australian Science Teachers Journal, 98(3):27-, 1998

39.

Chapman IM, Goble EA, Wittert GA, Horowitz M. Effects of small-intestinal fat and carbohydrate infusions on appetite and food intake in obese and non-obese men American Journal of Clinical Nutrition, 69(1):6-12, 1999

40.

Ng K-L, Vozzo R, Hope PJ, Chapman IM, Morley JE, Horowitz M, Wittert GA. Effect of dietary macronutrients on food intake and body weight and tail width in the marsupial S crassicaudata. Physiology and Behavior, 66:131-136, 1999.

41.

Hope PJ, Chapman I, Morley JE, Horowitz M, Wittert GA. The effect of diet on the response to leptin in the marsupial Sminthopsis crassicaudata. Am J Physiol. 276 (Regulatory Integrative Comp. Physiol), 45: R373-R381, 1999

42.

Vozzo R, Wittert G, Chapman I, Hope P, Horowitz M, Morley J. The effect of the nitric oxide synthase inhibitors L-NAME and L-NMMA on food intake in the marsupial S crassicaudata. Comp Physiol Biochem Part C, 123: 145-151, 1999

43.

Kong M-F, Chapman I, Goble E, Wishart J, Wittert G, Morris H, Horowitz M. Effects of blood glucose and fructose on plasma concentration of GLP-1 and appetite in normal subjects. Peptides, 20(5):545551, 1999

44.

Vozzo R, Wittert GA, Horowitz M, Morley JE, Chapman IM. Endogenous nitric oxide does not affect short-term appetite and food intake in humans. Am J Physiol, 276:R1562-R1568, 1999

45.

Hope PJ, Wittert GA, Turnbull H, Breed W, Morley J, Horowitz M. Ovarian steroids and alterations in photoperiod affect metabolic efficiency in the marsupial Sminthopsis crassicaudata. Physiology and Behaviour, 69:463-470, 2000

46.

Hope PJ, Turnbull H, Farr S, Morley JE, Rice KC, Chrousos GP, Torpy GP, Wittert GA. Peripherally administered urocortin but not CRF is a potent anorectic factor. Peptides, 21(5):669-677, 2000

47.

Hope PJ, Lok S, Webb GC, Hope R, Turnbull H, Wittert GA. Cloning of leptin cDNA and assignment to the long arm of chromosome 5 in the marsupial Sminthopsis crassicaudata. Cytogenetics and Cell Genetics, 90:1-2:22-29. 2000

Professor Gary Wittert

Page 12

48.

Nordin BE, Burnet RB, Fitzgerald S, Wittert GA, Schroeder BJ. Bone densitometry in clinical practice: longitudinal measurements at three sites in postmenopausal women on five treatments. Climacteric. Sep; 4(3):235-42, 2001

49.

Ainslie DA, Morris MJ, Wittert GA, Turnbull H, Proietto J, Thorburn AW. Oestrogen deficiency causes central leptin resistance and increases hypothalamic neuropeptide Y content in the rat. Int J Obes Relat Metab Disord, 25(11):1680-8, 2001

50.

Su Y-C, Doran S, Wittert G, Chapman IM, Jones KL, Smout AJPM, Horowitz M. Effects of exogenous corticotropin releasing factor on antropyloroduodenal motility and appetite in humans. Am J Gastroenterol, 97(1):49-57, 2002

51.

Vozzo R., Su Y-C, Fraser R, Wittert GA, Horowitz M., Malbert CH, Shulkes A, Volombello T, Chapman IM. Antropyloroduodenal, cholecystokinin and feeding responses to pulsatile and nonpulsatile intraduodenal lipid infusion. Neurogastroenterol Motil, 14(1):25-33, 2002

52.

Vozzo R, Baker B, Wittert GA, Wishart J, Morriss H, Horowitz M, Chapman I. Glycaemic, hormones and appetite responses to monosaccharide ingestion in patients with type 2 diabetes. Metabolism, 51(8):949-57, 2002

53.

Haren MT, Morley J, Chapman I, O’Loughlin P, Wittert G. Defining “relative” androgen deficiency in aging men: How should testosterone be measured and what are the relationships between androgen levels and physical, sexual and emotional health? Climacteric, 5(1):15-25, 2002

54.

Barton, C, March S, Wittert GA. The Low Dose Dexamethasone Suppression Test: Effect of Time of Administration and Dose. J Endocrinol Invest, 25(4):RC10-2, 2002

55.

Luscombe ND, Noakes M, Clifton PM, Wittert GA. Effects of energy-restricted diets containing increased protein on weight loss, resting energy expenditure, and adaptive thermogenesis in type 2 diabetes mellitus. Diabetes Care. 25(4):652-7, 2002

56.

Keogh MA, Wittert GA. Effect of cabergoline on thyroid function in hyperprolactinaemia. Clin Endocrinol (Oxf), 57(5):699, 2002

57.

Jesudason DR, Dunstan K, Leong D, Wittert GA. Macrovascular Risk and Diagnostic Criteria for Type 2 Diabetes: Implications for the use of FPG and HbA(1c) for cost-effective screening. Diabetes Care, 26(2):485-90, 2003

58.

Luscombe ND, Noakes M, Farnsworth E, Clifton PM, Wittert G. Effect of a high protein, energy restricted diet on weight loss and energy expenditure after weight stabilisation in hyperinsulinemic subjects. Int J Obesity, 27:582-90. 2003

59.

Farnsworth E, Luscombe ND, Noakes M, Wittert G, Argyriou E, Clifton PM. Effect of a high protein, energy restricted diet on body composition, glycaemic control and lipid levels in hyperinsulinemic subjects. Am J Clinical Nutrition, 78:31-9. 2003

60.

Vozzo R, Wittert G, Cocchiaro C, Tan WC, Mudge J, Fraser R, Chapman I. High protein, high carbohydrate and high fat pre-loads and their effect on food intake in subjects who are free to choose when and how much they eat. Appetite, 40:101-7, 2003

61.

Wittert G, Chapman I, haren M, Mackintosh S, Coates P, Morley. Low dose oral testosterone supplementation increases muscle mass and decreases fat mass in healthy elderly males with lownormal gonadal status. J Gerontol, 58:618-25, 2003

62.

Moran LJ, Noakes M, Clifton PM, Wittert G, Tomlinson L, Galletly C, Luscombe N, Tomlinson L, Norman RJ. Ghrelin and measures of satiety are altered in polycystic ovary syndrome but not differentially affected by diet composition. Asia Pac J Clin Nutr, 12 Suppl:S52, 2003

63.

Greutelaers B, Kullen K, Kollias J, Bochner M, Roberts A, Wittert G, Pasieka J, Malycha P. Pasieka illness questionnaire: its value in primary hyperparathyroidism ANZ J Surgery, 74(3): 112, 2004

Professor Gary Wittert

Page 13

64.

Clements RH, Gonzalez QH, Long CI, Wittert G, Laws HL. Hormonal changes after Roux-en Y gastric bypass for morbid obesity and the control of type-II diabetes mellitus. Am Surg, 70(1):1-5, Jan 2004

65.

Wittert GA, Turnbull H, Hope P, Morley JE, Horowitz M. Leptin prevents obesity induced by a high fat diet after diet-induced weight loss in the marsupial Sminthopsis crassicaudata. Am J Physiol Regul Integr Comp Physiol, 286(4):R734-9, Apr 2004

66.

Brinkworth GD, Noakes M, Keogh JB, Luscombe ND, Wittert GA, Clifton PM. Long-term effects of a high protein, low carbohydrate diet on weight control and cardiovascular risk markers in obese hyperinsulinemic subjects. Int J Obes Relat Metab Disord, 28(5):661-70, May 2004

67.

Moran LJ, Noakes M., Clifton P, Wittert GA, Tomlinson L, Galletly C, Luscombe ND, Norman RJ. Ghrelin and measures of satiety are altered in polycystic ovary syndrome but not differentially affected by diet composition. J Clin Endocrinol Metab, 89(7):3337-44, Jul 2004

68.

Roffey D, Luscombe ND, Byrne N, Hills A, Bellon M, Tsopelas C, Kirkwood I, Wittert GA. Use of [14C]bicarbonate-urea to measure physical activity-induced increases in total energy expenditure in healthy men. Asia Pac J Clin Nutr, 14(1):83-90, 2005

69.

Haren MT, Wittert GA, Chapman IM, Coates P, Morley JE. The effect of 12-months of oral testosterone supplementation on the cognitive function, mood and quality of life of healthy elderly males with low-normal gonadal status: A randomised controlled trial. Maturitas. 50(2):124-133, Feb 2005.

70.

McMahon CG, Stuckey BG, Lording DW, Wittert GA, Murphy A, Shin J, Sutherland PD, Palmer NR, Lowy MP, Jesudason DR, Fredlund P. A 6-month study of the efficacy and safety of tadalafil in the treatment of erectile dysfunction: a randomised, double-blind, parallel-group, placebo-controlled study in Australian men. Int J Clin Pract, 59(2):143-9, Feb 2005

71.

Haren MT, Wittert GA, Chapman IM, Coates P, Morley. Effect of 12-month oral testosterone on testosterone deficiency symptoms in symptomatic elderly males with low-normal gonadal status. Age Ageing, 34(2):125-30, Mar 2005

72.

Luscombe-Marsh ND, Noakes M, Wittert GA, Keogh JB, Foster P, Clifton PM. Carbohydraterestricted diets high in either monounsaturated fat or protein are equally effective at promoting fat loss and improving blood lipids. Am J Clin Nutr, 81(4):762-72, Apr 2005

73.

Holden C, McLachlan R, Pitts M, Cumming R, Wittert G, Handelsman D, de Kretser D. Men in Australia, Telephone Survey (MATeS) I: A National Survey Of The Reproductive Health And Concerns Of Middle Aged and Older Australian Men. Lancet, 16-22 366(9481):218-24, Jul 2005.

74.

Moran L, Luscombe N, Wittert G, Keogh J, Noakes M, Norman R, Clifton P. The satiating effect of dietary protein is unrelated to post-prandial ghrelin secretion, J Clin Endocrinol Metab, [Epub ahead of print], Jul 2005

75.

Wittert GA, Turnbull H, Staikopoluos V, Hope P. Exogenously Administered Leptin Increases Physical Activity in the Marsupial Sminthopsis crassicaudata. Physiology and Behaviour, [Epub ahead of print], Jul 2005

76.

Toplak H, Ziegler O, Keller U, Hamann A, Godin C, Wittert G, Zuñiga Z, Van Gaal L. Efficacy of orlistat in obese subjects receiving a mildly reduced-calorie diet or moderate diet: Improved weight loss with early response to treatment. Diabetes, Obesity and Metabolism, 7(6):699-708, Nov 2005

77.

Holden CA, McLachlan RI, Robert Cumming, Wittert G, Handelsman DJ, de Kretser DM, Pitts M. Sexual activity, fertility and contraceptive use in middle aged and older Australian men: Men in Australia, Telephone Survey (MATeS). Hum Reprod, 20(12):3429-34, Dec 2005

78.

Wittert G, Chapman I. Physiology of gut hormones - An Overview. Current Opinion in Endocrinology & Diabetes, 13(1):36-41, 2006

Professor Gary Wittert

Page 14

79.

Luscombe ND, Tsopelas C, Bellon M, Clifton PM, Kirkwood I, Wittert GA. Use Of [14C]-Sodium Bicarbonate/Urea To Measure Total Energy Expenditure In Overweight Men And Women Before And After Low Calorie Diet Induced Weight Loss. Asia Pac J Clin Nutr, 15(3):307-16, 2006

80.

Chen RYT, Wittert GA, Andrews GR. Relative androgen deficiency in relation to obesity and metabolic status in older men. Diabetes Obesity and Metabolism, 8(4):429-35, Jan 2006

81.

Smith JA, Braunack-Mayer A, Wittert GA. What do we know about men’s help-seeking and health service use? Med J Aust, 184(2):81-3, Jan 2006

82.

Moran LJ, Noakes M, Clifton PM, Wittert GA, Williams G, Norman RJ. Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome. Am J Clin Nutr, 84(1):77-87, Jul 2006

83.

Haren MT, Kim MJ, Tariq SH, Wittert GA, Morley JE. Andropause: A Quality-of-Life Issue in Older Males. Med Clin North Am, 90(5):1005-23, Sep 2006

84.

Holden C, McLachlan R, Pitts M, Cumming R, Wittert G, Handelsman D, de Kretser D. Men in Australia Telephone Survey (MATeS): predictors of men's help-seeking behaviour for reproductive health disorders. Med J Aust, 185(8):418-22, Oct 2006

85.

Anand-Ivell R, Wohlgemuth J, Haren MT, Hope PJ, Hatzinikolas G, Wittert G, Ivell R, and members of the FAMAS consortium. Peripheral INSL3 concentrations decline with age in a large population of Australian men. Int J Androl, 29(6):618-26, Dec 2006

86.

Wittert GA, Finer N, Caterson ID. The Clinical Effectiveness of Weight-Loss Drugs. Journal of Obesity Research and Clinical Practice, 1(1): 1-5, 2007

87.

Smith JA, Braunack-Mayer A, Wittert G, Warin M. “I've been independent for so damn long!” Independence, masculinity and aging in a help seeking context. Journal of Aging Studies, 21:325-335, 2007

88.

Keogh JB, Luscombe-Marsh ND, Noakes M, Wittert GA, Clifton PM. Long-term weight maintenance and cardiovascular risk factors are not different following weight loss on carbohydrate-restricted diets high in either monounsaturated fat or protein in obese hyperinsulinaemic men and women. Br J Nutr, 97(2):405-10, Feb 2007

89.

Martin DM, Wittert G, Burns NR. Gonadal steroids and visuo-spatial abilities in adult males: implications for generalized age-related cognitive decline. Aging Male, 10(1):17-29, Mar 2007

90.

Cavuoto P, McAinch AJ, Hatzinikolas G, Cameron-Smith D, Wittert GA. Effects of Cannabinoid Receptors on Skeletal Muscle Oxidative Pathways. Mol Cell Endocrinol, 267(1-2):63-9, Mar 2007

91.

Martin S, Haren M, Taylor A, Middleton M, Wittert G, and Members of the Florey Adelaide Male Ageing Study (FAMAS). Cohort profile: The Florey Adelaide Male Ageing Study (FAMAS). Int J Epidemiol, 36(2):302-6, Apr 2007

92.

Gagliardi L, Wittert G. Management of obesity in patients with Type 2 Diabetes Mellitus. Curr Diabetes Rev, 3(2):95-101, May 2007

93.

Martin DM, Wittert G, Burns NR, Haren T. Testosterone and cognitive function in Ageing Men: Data from the Florey Adelaide Male Ageing Study (FAMAS). Maturitas, 57(2):182-94, Jun 2007

94.

Martin SA, Haren MT, Middleton SM, Wittert GA. The Florey Adelaide Male Ageing Study (FAMAS): Design, procedures & participants. BMC Public Health, 7(1):126, Jun 2007

95.

Moran LJ, Noakes M, Clifton PM, Wittert GA, Belobrajdic DP, Norman RJ. C-reactive protein before and after weight loss in overweight women with and without polycystic ovary syndrome. J Clin Endocrinol Metab, 92(8):2944-51, Aug 2007

Professor Gary Wittert

Page 15

96.

Mohr P, Wilson C, Dunn K, Brindal E, Wittert G. Personal and lifestyle characteristics predictive of the consumption of fast foods in Australia. Public Health Nutr, 13:1-8, Dec 2007

97.

Moran L, Noakes M, Clifton P, Wittert GA, Le Roux CW, Ghatei MA, Bloom SR, Norman RJ. Postprandial ghrelin, cholecystokinin, peptide YY and appetite before and after weight loss in overweight women with and without polycystic ovary syndrome. Am J Clin Nutr, 86(6):1603-10, Dec 2007

98.

Cavuoto P, McAinch AJ, Hatzinikolas G, Janovská A, Game P, Wittert GA. The expression of receptors for endocannabinoids in human and rodent skeletal muscle. Biochem Biophys Res Commun, 364(1):105-10, Dec 2007

99.

Brindal E. Mohr P, Wilson C, Wittert GA. Obesity and the effects of choice at a fast food restaurant. Obesity Research and Clinical Practice, 2:111-7, 2008

100.

Franzon, J, Hugo, G. Wittert, G. Wilson, D. Overweight and obesity in 4-year-old South Australian children and the stability of IOTF cut points in this age group. Obesity Research and Clinical Practice, 2:247-250, 2008

101.

Martin DM, Wittert G, Burns NR, McPherson J. Endogenous testosterone levels, mental rotation performance, and constituent abilities in middle-to-older aged men. Horm Behav, 53(3):431-41, Mar 2008

102.

Janovská A, Hatzinikolas G, Staikopoulos V, McInerney J, Mano M, Wittert GA. AMPK and ACC phosphorylations: Effect of leptin and muscle fbre type and obesity. Mol Cell Endocrinol, 284(1-2):110, Mar 2008

103.

Smith JA, Braunack-Mayer AJ, Wittert G, Warin MJ. “It's sort of like being a detective": Understanding how Australian men self-monitor their health prior to seeking help. BMC Health Services Research, 8:56, Mar 2008

104.

Byles JE, Carroll M; Cumming B, Flicker L, Wittert G, Dobson A, Banks E, Mishra G, Russell C, Wainer. Mars and Venus: does gender matter in ageing? Med J Aust, 188(5):271-3, Mar 2008

105.

Martin SA, Haren MT, Taylor AW, Middleton SM, Wittert GA, and Members of the Florey Adelaide Male Ageing Study (FAMAS). Chronic disease prevalence and associations in a cohort study of Australian men in the Florey Adelaide Male Ageing Study (FAMAS). BMC Public Health. 30(8):261, Jul 2008

106.

Atlantis E, Martin SA, Haren MT, Taylor AW, Wittert GA, Lifestyle factors associated with age-related differences in body composition: the Florey Adelaide Male Aging Study (FAMAS). Am J Clin Nutr, 88(1):95-104, Jul 2008

107.

Jesudason D, Wittert G. Endocannabinoid system in food intake and metabolic regulation. Curr Opin Lipidol, 19(4):344-8, Aug 2008

108.

Dunn KI, Mohr PB, Wilson CJ, Wittert GA. Beliefs about fast food in Australia: a qualitative analysis. Appetite, 51(2):331-4, Sep 2008

109.

Philp LK, Muhlhausler BS, Janovska A, Wittert GA, Duffield JA, McMillen IC. Maternal overnutrition suppresses the phosphorylation of 5'-AMP activated protein kinase (AMPK) in liver, but not skeletal muscle, in fetal and neonatal sheep. Am J Physiol Regul Integr Comp Physiol, 295(6):R1982-90, Dec 2008

110.

Smith J, Braunack-Meyer A, Warin M, Wittert GA, Qualities men value when communicating with GPs: Implications for primary care settings. Med J Aust, 1-15;189(11-12):618-21, Dec 2008

111.

Cavuoto P, Wittert GA. The role of the endocannabinoid system in the regulation of energy expenditure. Best Practice & Research Clinical Endocrinology & Metabolism. Best Pract Res Clin Endocrinol Metab, 23(1):79-86, Feb 2009

Professor Gary Wittert

Page 16

112.

Martin DM, Burns NR, Wittert G. Free Testosterone Levels, attentional control, and processing speed performance in aging men. Neuropsychology, 23(2):158-67, Mar 2009

113.

Chang J, and Wittert GA. Effects of bariatric surgery on morbidity and mortality in severe obesity. International Journal of Evidence-Based Healthcare, 7(1): 43-48(6), Mar 2009

114.

Nelson AJ, Worthley MI, Psaltis PJ, Carbone A, Dundon BK, Duncan RF, Piantadosi C, Lau DH, Sanders P, Wittert GA, Worthley SG. Validation of Cardiovascular Magnetic Resonance Assessment of Pericardial Adipose Tissue Volume. Journal of Cardiovascular Magnetic Resonance. Cardiovasc Magn Reson, 11(1):15, May 2009

115.

Need EF, Scher HI, Peters AA, Moore NL, Cheong A, Ryan CJ, Wittert GA, Marshall VR, Tilley WD, Buchanan G. A novel androgen receptor amino terminal region reveals two classes of amino/carboxyl interaction-deficient variants with divergent capacity to activate responsive sites in chromatin. Endocrinology, 150(6):2674-82, Jun 2009

116.

Wittert GA, Nelson AJ. Medical Education: Revolution, Devolution and Evolution in Curriculum Philosophy and Design. Med J Aust, 191(1):35-37, 6 Jul 2009

117.

Atlantis E, Martin SA, Haren MT, Taylor AW, Wittert GA, and Members of the Florey Adelaide Male Aging Study. Inverse associations between muscle mass, strength, and the metabolic syndrome. Metabolism, 58(7):1013-22, Jul 2009

118.

Atlantis E, Martin SA, Haren MT, O’Loughlin PD, Taylor AW, Anand-Ivell R, Ivell R, Wittert GA, and Members of the Florey Adelaide Male Aging Study. Demographic, physical and lifestyle factors associated with androgen status: the Florey Adelaide Male Aging Study (FAMAS). Clinical Endocrinol (Oxf), 71(2):261-272, Aug 2009

119.

Atlanis E, Lange K, Wittert GA. Chronic disease trends due to excess body weight in Australia Obesity Reviews, 10(5)543-553, Sep 2009

120.

Smith AE, Ridding MC, Higgins RD, Wittert GA, Pitcher JB. Age-related changes in short-latency motor cortex inhibition. Exp Brain Res, 198(4):489-500, Oct 2009

121.

Atlantis E, Goldney R, Wittert G. Obesity and depression or anxiety (Invited Editorial). BMJ, 339:b3868, 6 Oct 2009

122.

McLachlan R, Wittert GA. The obesity epidemic: Implications for recruitment and retention of defence force personnel. Obesity Reviews, 10(6):693-9, Nov 2009

123.

Need EF, O’Loughlin PD, Armstrong DT, Haren MT, Martin SA, Tilley WD, and the Florey Adelaide Male Aging Study, Wittert GA and Grant Buchanan. Serum testosterone bioassay evaluation in a large male cohort. Clin Endocrin, 72(1):87-88, Jan 2010

124.

Holden CA, McLachlan RI, Pitts M, Cumming R, Wittert G, Ehsani JP, de Kretser DM, Handelsman DJ. Determinants of male reproductive health disorders: The Men in Australia Telephone Survey (MATeS). BMC Public Health, 10:96, 19 Jan 2010

125.

Mah P-M, Wittert GA. Obesity and Testicular Function. Mol Cell Endocrinol, 316(2):180-6, Mar 2010

126.

Janovska A, Hatzinikolas G, Mano M, Wittert GA. The effect of dietary fat content on phospholipid fatty acid profile is muscle fiber-type dependent. Am J Physiol Endocrinol Metab, 298(4):e779-e86, Apr 2010

127.

Wilson DH, Appleton SL, Taylor AW, Tucker G, Ruffin RE, Wittert G, Hugo G, Goldney RD, Findlay C, Adams RJ. Depression and obesity in adults with asthma: multiple comorbidities and management issues. Medical Journal of Australia. Med J Aust, 192(7):381-3, Apr 2010

128.

Khoo J, Piantadosi C, Worthley S, Wittert GA. Effects of a modified low-calorie diet on sexual function and lower urinary tract symptoms in obese men. Int J Obesity Int J Obes (Lond), 34(9):1396-403. Apr 2010

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129.

Shi Z, Taylor A, Wittert G, Goldney R, Gill T. Soft drink consumption and mental health problems among adults in Australia. Public Health Nutr, 13(7):1073-9, Jul 2010

130.

Shi Z, Luscombe-Marsh ND, Wittert GA, Yuan B, Dai Y, Pan X, Taylor AW. Monosodium glutamate is not associated with obesity or a greater prevalence of weight gain over 5 years: findings from the Jiangsu Nutrition Study of Chinese adults. Br J Nutr, 104(3):457-63, Aug 2010

131.

Zimmet P, Campbell L, Toomath R, Twigg S, Wittert G, Proietto J. Bariatric surgery to treat severely obese patients with type 2 diabetes: A consensus statement. Obes Res Clin Pract, 5(1):e71-e78, Jan 2011

132.

Smith AE, Sale MV, Higgins RD, Wittert GA, Pitcher JB. Male human motor cortex stimulus-response characteristics are not altered by ageing, J Appl Physiol, 110(1):206-12, Jan 2011

133.

Lam YY, Janovská A, McAinch AJ, Belobrajdic DP, Hatzinikolas G, Game P, Wittert GA. The use of adipose tissue-conditioned media to demonstrate the differential effects of fat depots on insulinstimulated glucose uptake in a skeletal muscle cell line. Obesity Research and Clinical Practice, 5(1):e43-e54, Jan-Mar 2011

134.

Atlantis E, Lange K, Martin S, Haren MT, Taylor A, O’Loughlin PD, Marshall V, Wittert GA. Testosterone and modifiable risk factors associated with diabetes in men. Maturitas, 68(3):279-85, Mar 2011

135.

Atlantis E, Shi Z, Penninx BJ, Wittert GA, Taylor A, Almeida OP. Chronic medical conditions mediate the association between depression and cardiovascular disease mortality. Soc Psychiatry Psychiatr Epidemiol. 47(4):615-25, Apr 2011

136.

Gregory T, Nettelbek T, Burns NR, Danthiir V, Wilson C, Wittert G. Sex differences in inspection time with age. Personality and Individual Differences, 50(5):593-596, Apr 2011

137.

Araujo A, Wittert G. Endocrinology of the Aging Male. Best Practice & Research: Clinical Endocrinology & Metabolism, 25(2):303-319, Apr 2011

138.

Wong C, Abed H, Molaee P, Nelson AJ, Brooks AG, Leong D, Lau DH, Roberts-Thompson KC, Wittert GA, Abhayaratna W, Worthley S, Sanders P. Pericardial fat is associated with atrial fibrillation severity and ablation outcome. J Am Coll Cardiol, 57(17):1745-51, Apr 2011

139.

Martin SA, Haren MT, Marshall V, Lange K, Wittert G, and Members of the Florey Adelaide Male Ageing Study. Prevalence and factors associated with uncomplicated storage and voiding lower urinary tract symptoms in community-dwelling Australian men. World Journal of Urology 29(2):179-84, Apr 2011

140.

Shi Z, Yuan B, Taylor A, Dai Y, Pan X, Gill TK, Wittert GA. Monosodium glutamate is related to a higher increase in blood pressure over 5 years: findings from the Jiangsu Nutrition Study of Chinese adults. J Hypetens, 29(5):846-53, May 2011

141.

Belobrajdic DP, Lam YY, Mano M, Wittert GA, Bird AR. Cereal based diets modulate some markers of oxidative stress and inflammation in lean and obese Zucker rats. Nutrit & Metab, 8(1):27, May 2011

142.

McFarlane C, Barton CA, Yehuda R, Wittert GA. Cortisol response to acute trauma and risk of

posttraumatic stress disorder. Psychoneuroendocrinology, 36(5):720-7, Jun 2011 143.

Lam YY, Hatzinikolas G, Weir JM, Janovská A, McAinch AJ, Game P, Meikle PJ, Wittert GA. Insulinstimulated glucose uptake and pathways regulating energy metabolism in skeletal muscle cells: the effects of subcutaneous and visceral fat, and long-chain saturated, n-3 and n-6 polyunsaturated fatty acids. Biochim Biophys Acta.;1811(7-8):468-75 Jul-Aug 2011

144.

Brindal E, Wilson C, Mohr P, Wittert G. Does meal duration predict amount consumed in lone diners? An evaluation of the time-extension hypothesis. Appetite, 57(1):77-79, Aug 2011

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145.

Shi Z, Taylor AW, Goldney R, Winefield H, Gill TK, Tuckerman J, Wittert G. The use of a surveillance system to measure changes in mental health in Australian adults during the global financial crisis. Int J Public Health, 56(4):367-72, Aug 2011

146.

Wittert GA. Bariatric Surgery as a Treatment for Type 2 Diabetes. Obes Res & Clin Practice. Editorial, 5:e169-e170 [Online], Aug 2011

147.

Araujo AB, Dixon JM, Suarez EA, Murad MH, Guey LT, Wittert GA. Clinical Review: Endogenous Testosterone and Mortality in Men: A Systematic Review and Meta-Analysis. J Clin Endocrinol Metab. 96(10):3007-19, Aug 2011

148.

Reynolds AC, Dorrian J, Liu PY, Van Dongen HPA, Wittert GA, Harmer, LJ, Banks S. (2011). A pilot study on the relationship between sleep restriction, endogenous testosterone and cognitive performance. In: Kennedy GA, Sargent C (Eds). Little clock, big clock: Molecular to physiological clocks. Australasian Chronobiology Society, Melbourne, Australia, pp. 11‐16, Sep 2011

149.

Dunn KI, Mohr P, Wilson CJ, Wittert GA. Determinants of fast-food consumption. An application of the Theory of Planned Behaviour. Appetite, 57(2):349-357, Oct 2011

150.

Keightly J, Chur-Hansen A, Wittert G. Perceptions of Obesity in Self and Others. Obesity Research and Clinical Practice, 5(4):e341-49, Oct 2011

151.

Khoo J, Piantadosi C, Duncan R, Worthley SG, Jenkins A, Noakes M, Worthley MI, Lange K, Wittert GA. Comparing Effects of a Low-energy Diet and High-protein Low-fat Diet on Sexual and Endothelial Function, Urinary Tract Symptoms, and Inflammation in Obese Diabetic Men. J Sex Med. 8(10):2868-75, Oct 2011

152.

Danthiir V, Burns NR, Nettlebeck T, Wilson C, Wittert G. The Older People, Omega-3, and Cognitive Health (EPOCH) trial design and methodology: A randomised, double-blind, controlled trial investigating the effect of long-chain omega-3 fatty acids on cognitive ageing and wellbeing in cognitively healthy older adults. Nutrition. 10:117, Oct 2011.

153.

Dodd JM, Turnbull DA, McPhee AJ, Wittert G, Crowther CA, Robinson JS. Limiting weight gain in overweight and obese women during pregnancy to improve health outcomes: the LIMIT randomised controlled trial. BMC Pregnancy Childbirth. 2011; 11(1):79, Oct 2011

154.

Smith AS, Ridding MC, Higgins RD, Wittert GA, Pitcher JB. Cutaneous afferent input does not modulate motor intracortical inhibition in ageing men. Eur. J. Neurosci. 34(9): 1461-9., Nov 2011

155.

Kentish S, Li H, Philp LK, O'Donnell TA, Isaacs NJ, Young RL, Wittert GA, Blackshaw LA, Page AJ. Diet induced adaptation of vagal afferent function. J Physiol. 1;590(Pt 1):209-21, Jan 2012

156.

Radathy A and Wittert G. Hypogonadism in men: How to evaluate and when to treat. Modern Medicine. 13(1):47-49, Jan 2012.

157.

Gates MA, Araujo AB, Hall SA, Wittert GA, McKinlay JB. Non-steroidal anti-inflammatory drug use and levels of estrogens and androgens in men. Clinical Endocrinology, 76(2):272-80, Feb 2012

158.

Brindal E, Wilson C, Mohr P, Wittert G. Perceptions of portion size and energy content: Implications for strategies to affect behaviour change. Pub Health Nutr. 15(2):246-53, Feb 2012

159.

Shi Z, Dal Grande E, Taylor AW, Gill T, Adams R, Wittert GA. Association between soft drink consumption and asthma and chronic obstructive pulmonary disease among adults in Australia. Respirology. 17(2):363-9, Feb 2012

160.

Wake M, Lycett K, Sabin MA, Gunn J, Gibbons K, Hutton C, McCallum Z, York E, Stringer M, Wittert G. A shared-care model of obesity treatment for 3-10 year old children: Protocol for the HopSCOTCH randomised controlled trial. BMC Pediatrics. 12(1):39, Mar 2012

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161.

Shi Z, Taylor A, Hu G, Gill T, Wittert GA. Rice intake, weight change and risk of metabolic syndrome development among Chinese adults: the Jiangsu Nutrition Study (JIN). Asia Pacific J Clin Nutr. 21(1):35-43, Mar 2012.

162.

Shi Z, Taylor AW, Atlantis E, Wittert GA. Empirically derived dietary patterns and hypertension. Current Nutrition Reports. 12(2):73-86, PMID22374558, Apr 2012

163.

Klafke N, Eliott JA, Wittert GA, Olver IN. Prevalence and predictors of Complementary and Alternative Medicine (CAM) use by men in Australian cancer outpatient services. Annals of Onclogy. 23(6):15718, PMID 22056972 May 2012

164.

Moran L, Noakes M, Wittert G, Clifton P, Norman R. Weight loss and vascular inflammatory markers in overweight women with and without polycystic ovary syndrome. Reproductive Biomedicine Online. 25(5):500-3, PMID22995747, Nov 2012.

165.

Visvanathan R, Yu S, Field J, Chapman I, Adams R, Wittert G, Visvanathan T. Appendicular Skeletal Muscle Mass: Development and Validation of Anthropometric Prediction Equations. Journal of Frailty and Aging. Volume 1, Number 4, 147-151 2012

166.

Reynolds A, Dorrian J, Liu PY, Van Dongen H, Wittert GA, Harmer L, Banks S. Impact of five nights of sleep restriction on glucose metabolism, leptin and testosterone in young adult men. PLoS-One. 2012;7(7):e41218, PMID22844441, Jul 2012.

167.

Peake JM, Gargett S, Waller M, McLaughlin R, Cosgrove T, Wittert G, Nasveld P, Warfe P. The health and cost implications of high body mass index in Australian Defence Force personnel. BMC Public Health. 19;12:451. doi: 10.1186/1471-2458-12-451, 19 Jun 2012

168.

Hall SA, Chiu GR, Kaufman DW, Wittert GA, Link CL, McKinlay JB. Commonly-used antihypertensives and lower urinary tract symptoms: Results from the Boston Area Community Health (BACH) Survey. Brit J Urology. 109(11):1676-84, Jun 2012

169.

Wittert GA, Martin S, Sutherland P, Hall S, Kupelian VK, Araujo A. Overactive Bladder Syndrome in Men as a Marker of Cardio-Metabolic Risk: Implications for Management in Primary Care". Medical Journal of Australia. 1;197(7):379-80.Oct 2012.

170.

Kelly SJ, Burns N, Bradman G, Wittert G, Daniel M. Does IQ vary systematically with all measures of socioeconomic status in a cohort of middle-aged, and older, men? Sociology Mind. (Accepted Aug 2012)

171.

Martin S, Taylor A, Atlantis E, Haren M, Lange K, Wittert G. Clinical and biopsychsocial determinants of sexual dysfunction in middle-aged and older Australian men. J Sex Med. 9(8):2093-2103, Aug 2012.

172.

Shi Z, Yuan B, Taylor AW, Dal Grande E, Wittert GA. Monosodium glutamate intake increases hemoglobin level over five years among Chinese adults. Amino Acids. 43(3):1389-97, PMID2222258, Sep 2012

173.

Chen M, Macpherson A, Owens J, Wittert G, Heilbronn LK. Obesity alone or with type 2 diabetes is associated with tissue specific alterations in DNA methylation and gene expression of PPARGC1A and IGF2. Journal of Diabetes Research and Clinical Metabolism. 2012(1):1-8, Sep 2012

174.

Grossmann M and Wittert GA. Androgens, Diabetes and Prostate Cancer. Endocrine-Related Cancer. 2012 Sep 5;19(5):F47-62. Oct 2012

175.

Yeap B, Araujo A, Wittert G. Do low testosterone levels contribute to ill-health during male ageing? Critical Reviews in Clinical Laboratory Sciences. 2012 Sep;49(5-6):168-82 Oct 2012

176.

Shi Z, Yuan B, Wittert GA, Pan X, Dai Y, Adams R, Taylor AW. Monosodium glutamate intake, dietary patterns and asthma in chinese adults.PLoSOne.7(12):e51567, Dec 2012

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177.

Moran LJ, Teede JH, Noakes M, Clifton PM, Norman RJ, Wittert GA. SHBG, but not testosterone, is associated with the metabolic syndrome in overweight and obese women with polycystic ovary syndrome. J Endocrinological Investigation. PMID 23812344, 2013

178.

Abed HS, Lau DH, Samuel CS, Kelly DJ, Alasady M, Mahajan R, Kuklik P, Zhang Y, Brooks AG, Nelson AJ, Worthley SG, Abhayaratna WP, Kalman JM, Wittert GA, Sanders P. Obesity results in progressive atrial structure and electrical remodeling: implications for atrial fibrillation. Heart Rhythm. 2013 Jan;10(1):90-100, PMID23063864, Jan 2013.

179.

Buckley J, Adams R, Wittert G, Wilson W, Tucker G, Hugo G. The Australian Baby Boomer Population – Factors Influencing Changes to Health Related Quality of Life Over Time. Journal of Aging and Health. 25(1):29-55, Feb 2013

180.

Eckert K, Shi Z, Taylor A, Wittert G, Price K, Goldney R. Learning from an epidemiological, population-based study on prescribed medicine use in adults. Pharmacoepidemiol Drug Saf. 22(3):271-7, PMID 23335093 Mar 2013.

181.

Shi Z, Wittert GA, Yuan B, Dai Y, Gill T, Hu G, Adams R, Zuo H, Taylor A. Association between monosodium glutamate intake and sleep disordered breathing among Chinese adults with normal body weight. Nutrition. 29(3):508-13, PMID 23274090, Mar 2013

182.

Abed HS, Nelson A, Leong D, Richardson JD, Mahajan R, Brooks A, Abhayaratna W, Worthley S, Kalman J, Wittert GA, Sanders P. Impact of weight reduction on pericardial fat and cardiac structure in patients with atrial fibrilation. J Amer Coll Cardiol. 61(S10), PMID 23063864 Mar 2013

183.

Lovell A, Game P, Wittert G, Thompson C. Estimating Renal Function in Morbidly Obese Patients. Obes Surg. 23(9):1427-1430, PMID 23519631, Mar 2013

184.

Kentish SJ, O’Donnell TA, Isaacs NJ, Young RL, Li H, Harrington AM, Brierly SM, Wittert GA, Blackshaw LA, Page A. Gastric vagal afferent modulation by leptin is influenced by food intake status. J Physiol. J Physiol. 1;591(Pt 7):1921-34, PMID 23266933, Apr 2013.

185.

Luscombe-Marsh N, Seimon R V, Bollmeyer E, Wishart JM, Wittert GA, Horowitz M, Bellon M, FeinleBisset C. Acute effects of oral preloads with increasing energy density on upper gut function, thermogenesis and energy intake, in overweight and obese men. Asia Pacific Journal of Clinical Nutrition. 22(3):380-390, PMID 23945408, April 2013

186.

Radhakutty A, Wittert G. Hypogonadism in Men: How to evaluate and when to treat. Modern Medicine. pp45-70, Jun 2013

187.

Gates M, Mekary R, Chiu G, Ding E, Wittert G, Araujo A. Sex steroid hormone levels and body composition in men. J Clinic Endocrinol Metab. 98(6):2442-50, PMID 23626004 Jun 2013

188.

Sia D, Martin S, Wittert GA Casson R. Age-related change in contrast sensitivity among Australian male adults: Florey Adult Male Ageing Study (FAMAS). Acta Ophthalmol. 91(4):312-7, Jun 2013

189.

Wake M, Lycett K, Clifford SA, Sabin MA, Gunn J, Gibbons K, Hutton C, McCallum Z, Arnup SJ, Wittert G. Shared care obesity management in 3-10 year old children: 12 month outcomes of HOPSCOTCH randomised trial. Brit Med J. 346:f3092, PMID 23751902, Jun 2013

190.

Shi Z, Taylor A, Wittert G. Association between monosodium glutamate intake and sleep disordered breathing among Chinese adults with normal body weight: Emerging opportunities for research on monosodium glutamate intake and health at a population level. Nutrition, 29(10):1276:1277. PMID25800569, Jun 2013

191.

Kentish SJ, O’Donnell TA, Frisby CL, Li H, Wittert GA, Page, AJ. Altered gastric vagal mechanosensitivity in diet-induced obesity persists on return to normal chow and is accompanied by increased food intake, Int J Obes. 38:636–642, PMID 23897220 2013, Aug 2013

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192.

Shi Z, Araujo AB, Martin S, Wittert GA. Longitudinal changes in testosterone over five years in community-dwelling men. J Clin Endo Metab, 201398(8):3289-97 PMID 23775354, Aug 2013

193.

Kentish, S. Wittert GA, Blackshaw LA, Page AJ. A chronic high fat diet alters the homologous and heterologous control of appetite regulating peptide receptor expression. Peptides. 46:150-8, PMID 2379934. Aug 2013

194.

Chen M, Zhao J, Davies MJ, Wittert GA, Norman RJ, Heilbronn LK. Decreased insulin sensitivity in young adults born through in vitro fertilisation (IVF) and higher systolic blood pressure following high fat overfeeding. Fertility and Sterility. 100(3)Suppl: S43, Sep 2013

195.

Chen M, Wu L, Wittert GA, Norman RJ, Robker RL, Heilbronn LK. Distinct adult metabolic consequences following ovarian stimulation versus in vitro culture of mouse embryos. Fertility and Sterility 100(3)Suppl: S94, Sep 2013

196.

Nguyen NQ, Game P, Bessell J, Debreceni T L, Neo M, Burgstad CM, Taylor P, Wittert GA. Outcomes of Roux-en-Y bypass and laparascopic adjustable gastric banding. World J Gastro. 19(36):6035-43. PMID 24106404, Sep 2013

197.

Yu S, Appleton S, Adams R, Chapman I, Wittert G, Visvanathan T, Visvanathan R. Sarcopenia in community dwelling older Australians. European Geriatric Medicine. 4(S1):S94, Sep 2013

198.

Yu S, Visvanathan T, Field J, Ward L, Chapman I, Adams R, Wittert G, Visvanathan R. Lean body mass: The development and validation of prediction equations. BMC Geriatrics BMC Pharmacology and Toxicology. 14(53), Oct 2013

199.

Li H, Kentish SJ, Kritas S, Young RL, Isaacs NJ, O’Donnell A, Blackshaw LA, Wittert GA, Page AJ. Modulation of murine gastric vagal afferent mechanosensitivity by neuropeptide W. Acta Physiol (Oxf) 209(2):179-191, PMID 23927541, Oct 2013

200.

Atlantis E, Fahey P, Cochrane B, Wittert G, Smith S. Endogenous testosterone levels and testosterone supplementation therapy in chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis BMJ Open. 3(8):e003127, PMID 23943774, Nov 2013

201.

Abed HS, Wittert GA. Obesity and atrial fibrillation. Obesity Reviews. 14(11):929-938, PMID 23879190, Nov 2013

202.

Abed HS, Wittert GA, Leong DP, Shirazi MG, Bahrami B, Middeldorp ME, Lorimer MF, Lau DH, Antic NA, Brooks AG, Abhayaratna WP, Kalman JM, Sanders P. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 310(19):2050-60. PMID 24240932, Nov 2013

203.

Scholz B, Crabb S, Wittert G. Development of Men’s Depressive Symptoms: A Systematic Review of Prospective Cohort Studies. J Men’s Health, 10(3):91-103, Nov 2013

204.

de Zeeuw D, Akizawa T, Audhya P, Bakris GL, Chin M, Christ-Schmidt H, Goldsberry A, Houser M, Krauth M, Lambers Heerspink HJ, McMurray JJ, Meyer CJ, Parving HH, Remuzzi G, Toto RD, Vaziri ND, Wanner C, Wittes J, Wrolstad D, Chertow GM; BEACON Trial Investigators. Bardoxolone methyl in type 2 diabetes and stage 4 chronic kidney disease. N Engl J Med. 369(26):2492-503. PMID 24206459, Dec 2013

205.

Kentish SJ, Frisby CL, Kennaway DJ, Wittert GA, Page AJ. Circadian variation in gastric vagal afferent mechanosensitivity. J Neurosci.33(49):19238-42. PMID 24305819 Dec 2013

206.

Caterson I, Wittert G. Shuji Inoue. Obes Res & Clin Prac, 7(6):e431, Dec 2013

207.

Martin S, Lange K, Haren MT, Taylor AW, Wittert GA and Members of the Florey Adelaide Male Ageing Study. Risk factors for progression of lower urinary tract symptoms (LUTS) in a prospective cohort of men. Journal of Urology, 191(1):130-7. PMID 23770136 Jan 2014

Professor Gary Wittert

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208.

Tully PJ, Wittert G, Selkow T, Baumeister H. The Real World Mental Health Needs of Heart Failure Patients Are Not Reflected by the Depression Randomized Controlled Trial Evidence. PLoS ONE. 9(1): e85928. PMID 24475060, Jan 2014

209.

Dodd J, Turnbull D, McPhee AJ, Deussen AR, Yelland LN, Wittert G, Owens JA, Robinson JS. Antenatal lifestyle advice for women who are overweight or obese: the LIMIT randomised trial. BMJ. 348:g1285, PMID 24513442, Feb 2014

210.

Shi, Z, Taylor, A, Wittert G. Inadequate riboflavin intake and anemia risk in a Chinese population: fiveyear follow up of the Jiangsu Nutrition Study PLOS One. 9(2):e88862, PMID 24553156, Feb 2014

211.

Brook E, Cohen L, Hakendorf P, Wittert G, Thompson C. Predictors of attendance at an obesity clinic and subsequent weight change. BMC Health Services Research, 14:78, PMID 24552252, Feb 2014.

212.

Klafke N, Eliott JA, Olver IN, Wittert GA. The varied contribution of significant others to Complementary and Alternative Medicine (CAM) uptake by men with cancer: a qualitative analysis. European Journal of Oncology Nursing. 18(3):329-36, PMID 24680598, Mar 2014.

213.

Pilkington R, Taylor AW, Hugo G and Wittert G. Are Baby Boomers healthier than Generation X? A socio-demographic and health profile of Australia’s working generations using National Health Survey data. PLOS One. 9(3):e93087, PMID 24671114, Mar 2014.

214.

Shi Z, Yuan B, Taylor AW, Zhen S, Zuo H, Dai Y, Wittert GA. Riboflavin intake and 5-year blood pressure change in Chinese adults: interaction with hypertensive medication. Food Nutr Bull. 35(1):3342, PMID 24791577, Mar 2014.

215.

Greene FJ, Hanb L, Martin S, Zhang S and Wittert G. Testosterone is Associated with SelfEmployment among Australian Men. Economics and Human Biology. 13:76-78, PMID 24565038, Mar 2014.

216. Li JJ, Appleton SL, Wittert GA, Vakulin A, McEvoy RD, Antic NA, Adams RJ. The relationship between functional health literacy and obstructive sleep apnea and its related risk factors and comorbidities in a population cohort of men. Sleep, 37(3):571-8, PMID 24587580, Mar 2014 217.

Wittert G. The relationship between sleep disorders and testosterone in men. Asian J Androl. PMID 24435056, 16(2):262-5, Mar-Apr 2014

218.

Maserejian NN, Curto T, Hall SA, Wittert G, McKinlay JB. Reproductive History and Progression of Lower Urinary Tract Symptoms in Women: Results from a Population-Based Cohort Study. Urology. 83(4):788-94, Apr 2014

219.

Atlantis E, Taylor AW, Wittert G, Shi Z. Weight gain and lifestyle risk factors for developing metabolic syndrome. Circ J. 78(5):1066-8, PMID 24694744, [Epub ahead of print] Apr 2014

220.

Martin SA, Atlantis E, Lange K, Taylor AW, O’Loughlin P, Wittert GA, and members of the Florey Adelaide Male Ageing Study (FAMAS). Predictors of sexual dysfunction incidence and remission in men. J Sex Med. 11(5):1136-47, PMID 24548342, May 2014

221.

Hall SA, Ranganathan G, Liane TJ, Lund JL, Kupelian V, Wittert GA, Kantoff PW, Morales A, Araujo AB. Population-based patterns of prescription androgen use, 1976-2008. Pharmacoepidemiology and Drug Safety Journal. 23(3):498-506, PMID 24510484, May 2014

222.

Klafke N, Eliott JA, Olver IN, Wittert GA. The role of complementary and alternative medicine (CAM) routines and rituals in men with cancer and their significant others (SOs): A qualitative investigation. Support Care Cancer. 22(5): 1319-31, PMID 24366225, May 2014

223.

Wittert GA. The Relationship between Sleep Disorders and Plasma Testosterone. Current Opinion in Endocrinology and Diabetes. 21(3):239-43, PMID 2473309, Jun 2014.

Professor Gary Wittert

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224.

Yu S, Appleton SL, Adams RJ, Chapman I, Wittert G, Visvanathan T, Visvanathan R. The impact of Low Muscle Mass definition on the Prevalence of Sarcopenia in older Australians. Biomed Research International. 2014, Article 361790, 7 pages, PMID 25165700, Jul 2014

225.

Lycett K, Wittert G, Gunn J, Hutton C, Clifford SA, Wake, M. The challenges of real-world implementation of web-based shared care software: The HopSCOTCH Shared-Care Obesity Trial in Children. BMC Medical Informatics and Decision Making. 14:61, PMID 25056431, Jul 2014

226.

Grant J, Martin SA, Taylor AW, Wilson DH, Araujo A, Adams RJ, Jenkins A, Milne RW, Hugo GJ, Atlantis E, Wittert GA. Cohort Profile: The Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) Study. Int J Epidemiol. 43(4): 1040-53, PMID 23785097, Aug 2014

227.

Kentish SJ, O’Donnell TA, Wittert GA, Page AJ. Diet-dependent modulation of gastro-oesphageal vagal afferent mechanosensitivity by endogenous nitric oxide. The Journal of physiology. 1:592(Pt 15):3287-301, PMID 24879868, Aug 2014

228.

Brindal E, Wilson C, Mohr, P, Wittert G. Nutritional consequences of a fast food eating occasion are associated with choice of quick-service restaurant chain. Nutrition & Dietetics. 71(3):184-192, Sep 2014

229.

Chen, M; Wu, L; Zhao, J; Wu, F; Davies M; Wittert, G; Norman, R; Robker, R; Heilbronn, L. Altered glucose metabolism in mouse and humans conceived by in-vitro fertilization (IVF). Diabetes. 63(10):589-95, PMID 24760136, Oct 2014.

230.

Nguyen NQ, Debreceni TL, Bambrick JE, Chia B, Deane AM, Wittert G, Rayner CK, Horowitz M, Young RL. Up-regulation of intestinal glucose transporters after Roux-en-Y gastric bypass to prevent carbohydrate malabsorption. Obesity 22(10):2164-71, PMID 24990218, Oct 2014

231.

Tong X, Taylor AW, Giles L, Wittert GA, Shi Z. Tea consumption is inversely related to 5-year blood pressure change among adults in Jiangsu, China: a cross-sectional study. Nutr J. 14;13(1):98. PMID 25311544, Oct 2014

232.

Shi Z, Taylor AW, Yuan B, Zuo H, Wittert GA. Monosodium glutamate intake is inversely related to the risk of hyperglycemia. Clin Nutr. 33(5): 823-8, PMID 24238788, Oct 2014

233.

Dodd JM, Cramp C, Yelland LN, Deussen AR, Grivell RM, Moran LJ, Turnbull D, McPhee AJ, Wittert G, Robinson JS. The effects of antenatal lifestyle advice for women who are overweight or obese on maternal diet and physical activity: the LIMIT randomised trial. BMC Medicine. 12(1):161, PMID 25315237, Oct 2014

234.

Dodd, JM, McPhee AJ, Turnbull D, Yelland LN, Deussen AR, Grivell, RM, Crowther, CA, Wittert G, Owens, JA, Robinson JS. The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial. BMC Medicine. 12(1):161, PMID 25315325, Oct 2014

235.

Chen M, Wu L, Wu F, Wittert GA, Norman RJ, Robker RL, Heilbronn LK. Impaired Glucose Metabolism in Response to High Fat Diet in Female Mice Conceived by In Vitro Fertilization (IVF) or Ovarian Stimulation Alone. PLoS One. 9(11):e113155, PMID 25405530, Nov 2014

236.

Tay J, Luscombe-Marsh N, Thompson C, Noakes M, Buckley J, Wittert G, Yancy W, Brinkworth GD. A very low carbohydrate, low saturated fat diet for Type 2 diabetes management: A randomised trial. Diabetes Care 37(11):2909-18, PMID 25071075, Nov 2014

237.

Klafke N, Eliott JA, Olver IN, Wittert GA. Australian men with cancer practice complementary therapies (CTs) as a coping strategy. Psycho-Oncology. 23(11):1236-42, PMID 24737651, Nov 2014

238.

Scholz B, Crabb S, Wittert G. “We've got to break down the shame”: Portrayals of men’s depression. Qualitative Health Research. 24(12):1648-57, PMID 251212853, Dec 2014

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239.

Grossman M, Hoermann, R, Wittert G, Yeap BB. Effects of testosterone treatment on glucose metabolism and symptoms in men with type 2 diabetes and the metabolic syndrome: a systematic review and meta-analysis of randomized controlled clinical trials. Clin Endocrinol (Oxf). PMID 25557752 [Epub ahead of print] Dec 2014

240.

Li H, Feinle-Bisset C, Frisby C, O’Donnell TA, Kentish S, Wittert GA, Page AJ. Gastric neuropeptide W is regulated by meal-related nutrients. Peptides 62:6-14, PMID 25270269, Dec 2014

241.

Sato K, Samocha-Bonet D, Handelsman D, Fujita S, Wittert GA, Heilbronn LK. Serum sex steroids and steroidogenesis-related enzymes in skeletal muscle during experimental weight gain in men Diabetes & Metabolism. 40(6):439-444, Dec 2014

242.

Tully P, Baumeister H, Bengel J, Jenkins A, Januszewski A, Martin S, Wittert GA. The longitudinal association between inflammation and incident depressive symptoms in men: the effects of hs-CRP are independent of abdominal obesity and metabolic disturbances. Physiology & Behavior. 139:32835, PMID 25460540, Feb 2015

243.

Yu S, Appleton S, Chapman I, Adams R, Wittert G, Visvanathan T, Visvanathan R. An Anthropometric Prediction Equation for Appendicular Skeletal Muscle Mass in Combination With a Measure of Muscle Function to Screen for Sarcopenia in Primary and Aged Care. J Am Med Dir Assoc. 16(1):25-30, PMID 25239016, Jan 2015

244.

Philp LK, Heilbronn LK, Janovska A, Wittert GA. Dietary enrichment with fish oil prevents high fatinduced metabolic dysfunction in skeletal muscle in mice PLOS-One, 10(2):e0117494-19, PMID: 25658742, Feb 2015

245.

Kupelian V, Araujo AB, Wittert GA, McKinlay JB. Association of moderate to severe lower Urinary Tract Symptoms with Incident Type 2 Diabetes and Heart Disease. J Urology. 193(2):581-6, PMID 25171906, Feb 2015

246.

Dodd JM, Ahmed S, Karnon J, Umberger W, Duessen AR, Tran T, Grivell RM, Crowther CA, Turnbull D, McPhee AJ, Wittert G, Owens JA, Robinson JS, For the LIMIT Randomised Trial Group. The costeffectiveness of providing antenatal lifestyle advice for women who are overweight or obese: the LIMIT randomised trial. BMC Obesity; 2(14) PMID: 26217529, Mar 2015

247.

Appleton SL, Vakulin A, McEvoy RD, Vincent A, Martin SA, Grant JF, Taylor AW, Antic NA, Catcheside PG, Wittert GA, Adams RJ. Undiagnosed obstructive sleep apnea is independently associated with reductions in quality of life in middle-aged, but not elderly men of a population cohort. Sleep Breath. [Epub ahead of print]. PMID: 25896898. Apr 2015

248.

Bai PY, Wittert GA, Taylor AW, Martin SA, Milne RW, Shi Z. The association of socio-demographic status, lifestyle factors and dietary patterns with total urinary phthalates in Australian men. PLoS One. 10(4):e0122140.. PMID: 25875472, Apr 2015

249.

Tully PJ, Wittert GA, Turnbull DA, Beltrame JF, Horowitz JD, Cosh S, Baumeister H. Panic disorder and incident coronary heart disease: a systematic review and meta-analysis protocol. Syst Rev. 4:33. doi: PMID: 25875199. Apr 2015

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250.

Tay J, Luscombe-Marsh ND, Thompson CH, Noakes M, Buckley JD, Wittert GA, Yancy WS Jr, Brinkworth GD. Response to comment on Tay et al. A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial. Diabetes Care. 38(4):e65-6. PMID: 25805878, Apr 2015

251.

Tully PJ, Winefield HR, Baker RA, Denollet J, Pedersen SS, Wittert GA, Turnbull DA. Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: a five year longitudinal cohort study. Biopsychosoc Med. 26;9:14. PMID: 26019721, May 2015

252.

Nguyen NQ, Debreceni TL, Burgstad CM, Neo M, Bellon M, Wishart JM, Standfield S, Bartholomeusz D, Rayner CK, Wittert G, Horowitz M. Effects of Fat and Protein Preloads on Pouch Emptying, Intestinal Transit, Glycaemia, Gut Hormones, Glucose Absorption, Blood Pressure and Gastrointestinal Symptoms After Roux-en-Y Gastric Bypass. Obes Surg. [Epub ahead of print]. PMID: 25986427, May 2015

253.

Abed HS, Nelson AJ, Richardson JD, Worthley SG, Vincent A, Wittert GA, Leong DP. Impact of weight reduction on pericardial adipose tissue and cardiac structure in patients with atrial fibrillation. Am Heart J. 169(5):655-662.e2. PMID: 25965713, May 2015

254.

Brindal E, Wilson C, Mohr P, Wittert G. Eating in groups: Do multiple social influences affect intake in a fast-food restaurant? J Health Psychol. 20(5):483-9. PMID: 25903236, May 2015

255.

Kentish SJ, Ratcliff K, Li H, Wittert GA, Page AJ. High fat diet induced changes in gastric vagal afferent response to adiponectin. Physiol Behav. S0031-9384(15)00352-2. doi: 10.1016/j.physbeh.2015.06.016. [Epub ahead of print], PMID: 26074203, Jun 2015

256.

Tully PJ, Turnbull DA, Beltrame J, Horowitz J, Cosh S, Baumeister, Wittert GA. Panic disorder and incident coronary heart disease: a systematic review and meta-regression in 1,131,612 persons and 58,111 cardiac events. Psychological Medicine, 1-12, Jun 2015

257.

Appleton SL, Vakulin A, McEvoy RD, Wittert GA, Martin SA, Grant JF, Taylor AW, Antic NA, Catcheside PG, Adams RJ. Nocturnal Hypoxemia and Severe Obstructive Sleep Apnea are Associated with Incident Type 2 Diabetes in a Population Cohort of Men. J Clin Sleep Med. 11(6):60914. PMID: 25766697, Jun 2015

258.

Li H, Frisby CL, O’Donnell TA, Kentish SJ, Wittert GA, Page AJ. Neuropeptide W modulation of gastric vagal afferent mechanosensitivity: Impact of age and sex. Peptides. 71:141-148 [Epub ahead of print], PMID: 26209028, Jul 2015

259.

Tay J, Luscombe-Marsh ND, Thompson CH, Noakes M, Buckley JD, Wittert GA, Yancy WS Jr, Brinkworth GD. Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial. Am J Clin Nutr. [Epub ahead of print], PMID: 26224300, Jul 2015

260.

Nguyen N, Debrenceni T, Burgstad C, Wishart J, Bellon M, Rayner C, Wittert G, Horowitz M. Effects of posture and meal volume on gastric emptying, intestinal transit, oral glucose tolerance, blood pressure and gastrointestinal symptoms after Roux-en-Y Gastric Bypass". Obesity Surgery. 25(8):1392-400, PMID: 25502436, Aug 2015

261.

Kentish SJ, Frisby CL, Kritas S, Li H, Hatzinikolas G, O’Donnell TA, Wittert GA, Page AJ. TPRV1 Channels and Gastric Vagal Afferent Signalling in Lean and High Fat Diet Induced Obese Mice. PLoS One. 10(8):e0135892. PMID: 26285043, Aug 2015

BOOK CHAPTERS 1.

Donald RA, Wittert GA. Stress and ACTH regulation. In Current Opinion in Endocrinology and Diabetes. Edited by Kohler PO. Ch 1 pp93-99, 1994

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2.

Coates P, Wittert G. Miscellaneous Hormones. In Mylers Side Effects of Drugs Annual. Edited by Dukes MNG. Elsevier Press, Amsterdam.

3.

Wittert GA, Fraser RJ, Morley JE. The Endocrine System of the Gastrointestinal Tract. In Endocrinology: Basic and Clinical Principles. Edited by Conn M & Melmed S. Humana Press Inc., Totowa, N.J. pp321-345, 1996

4.

Wittert GA, Morley JE. Effects of aging on the hormonal response to stress. In Endocrinology of critical disease. Edited by KP Ober. Humana Press Inc., Totowa, N.J.,1997

5.

Wittert GA. The response of the HPA axis to physical activity. In The Endocrinology Of Exercise. Edited by M Warren. Humana Press Inc., Totowa, N.J. 2000.

6.

Wittert GA. Morley JE. Aging and Fat Cell Metabolism. In The Science of Geriatrics. Edited by Morley JE, Armbrecht HJ, Coe RM & Vellas B. Serdi Publisher, Paris, 2000.

7.

Coates P, Wittert GA. Osteoporosis in the Elderly. In A Practical Guide to Geriatric Medicine. Edited by Ratnaike. McGraw-Hill Book Company Australia Pty Ltd. In Press 2001.

8.

Wittert GA. Obesity and the Metabolic Syndrome. In Nutritional Disorders, 18th Edition. Merck Manual. Ch 5, 2003.

9.

Wittert GA. Obesity in the Elderly. In Progress in Obesity Research, 9th Edition. Edited by MedeirosNeto G, Halpern A, Bouchard C. John Libbey Eurotext Limited. 24-46 High St, Esher, Surrey, United Kingdom, KT10 9QY. 2003.

10.

Morley JE, Perry HM, Wittert GA. Testosterone and Aging. In Pathophysiology and Treatment of Male Sexual and Reproductive Dysfunction. Edited by Fouad Kandeel. Marcel Dekker Inc. 270 Madison Avenue, New, York, New York 10016. In press 2004.

11.

Morley JE, Wittert GA. Male hormones and systemic disease. In Pathophysiology and Treatment of Male Sexual and Reproductive Dysfunction. Edited by Fouad Kandeel. Marcel Dekker Inc. 270 Madison Avenue, New, York, New York 10016. In press 2004.

12.

Inder WJ, Wittert GA. Exercise and the Hypothalamo-Pituitary-Adrenal Axis. In The Endocrine System in Sports and Exercise (IOC Encyclopedia). Edited by William J Kraemer and Alan D Rogol. In press 2005.

13.

Wittert GA. Obesity in the elderly. In Principles and Practice of Geriatric Medicine, 4th Edition. In Press 2005.

14.

Wittert GA. Obesity and the Metabolic Syndrome. Merck Manual Professional Edition, 2007

15.

Wittert GA. A 30 year old woman with amenorrhea. In Davidson’s Clinical Cases. Edited by Mark WJ Strachan, Surenra K Sharma, John AA Hunter. Churchill Livingston, Elsevier Ltd, 1600 JFK Boulevard, Philadelphia, PA, 19013, USA. Ch 49, 2008.

16.

Wittert GA. A Middle Aged Man with Muscle Cramps. In Davidson’s Clinical Cases. Edited by Mark WJ Strachan, Surenra K Sharma, John AA Hunter. Churchill Livingston, Elsevier Ltd, 1600 JFK Boulevard, Philadelphia, PA, 19013, USA. Ch 51, 2008.

17.

Khoo J, Rayner CK, Feinle-Bisset C, Wittert G. Role of the gastrointestinal tract in peptide hormone release and appetite.

18.

Wittert GA, Nelson A. A Cost Effective Approach to Problem Based Learning. Radcliffe Publishers, Oxford. Pp72-80.

19.

Dunn KI, Mohr PB, Wilson CJ, Wittert GA. Australian Consumer Perceptions of Fast Food: In A Qualitative Study. In Chocolate, Fast Foods and Sweeteners: Consumption and Health. Edited by Marlene R Bishop. Nova Science Publishers Inc. 400 Oser Ave Suite 1600, Hauppauge NY 117883619, USA. Ch 10, pp199-212, 2010.

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20.

Khoo J, Chen YT, Wittert GA. Chapter 20: Obesity. In Pathy’s Principles and Practice of Geriatric Medicine, 5th Edition. Edited by Alan J Sinclair, John E Morley & Bruno Vellas. John Wiley & Sons Ltd Publishers. Ch 20. ISBN: 978-0-470-68393-4. 2012.

21.

Wittert GA. Sibutramine and Rimonabant: Gone, but is their passing instructive? In Controversies in Obesity, Chapter 28, edited by Drs. David Haslam, Arya Sharma, and Carel le Roux, Springer London, ISBN: 978-1-4471-2833-5, 2014

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BOOKS 22.

Wittert GA. A Practical Approach to Obesity Management. Roche Press. 2004

23.

Haslam D and Wittert GA. Fast Facts:Obesity. Health Press Limited, Elizabeth House, Queen Street,Bingdon, Oxford OX14 3LN, UK. 2010

24.

Haslam D and Wittert GA. Fast Facts:Obesity 2nd edition. Health Press Limited, Elizabeth House, Queen Street,Bingdon, Oxford OX14 3LN, UK. 2014

EXPERT REPORTS AND GUIDELINES 25.

Catford John, Wittert Gary, Newton Rob, Flicker Leon, O`Dea Kerin, Wakerman John, Harris Mark, Shaw Kelly and Truswell, Stewart. Healthy weight for adults and older Australians: a national action agenda to address overweight and obeisity in adults and older Australians: 2006-2010 Dept. of Health and Ageing, Canberra, ACT.

26.

Baur L, Bonfiglioli C, Caterson I, Colagiuri R, Cretikos M, Leeder S, Murray K, Pearson S, Sim K, Torode M, Wake M, Wittert G. Recommendations of the 2007 Healthy Lifestyle Forum to Help Combat Childhood Obesity.Sydney: Sydney University Nutrition Research Foundation, 2007o

27.

Farrell G, Wittert G, Macdonald G, George J, Weltman M, Storman M. Fatty Liver Disease. 1st Edition 2007 © Digestive Health Foundation, 2007

28.

Defence Health Services Division: Obesity, body Mass Index and Health Study, July 2007 Literature Review. Centre for Military and Veterans Health, 3 Jul 2007

29.

Defence Health Services Division: Obesity, Body Mass Index and Health Study. Standardised Screening and monitoring programmes. Centre for Military and Veterans Health, 7 August 2007

30.

The Role of Dietary Protein in Weight Control. Report of a workshop at the Institute of Obesity, Nutrition & Exercise University of Sydney, 9 December, 2008

31.

Wittert GA. Sibutramine and Rimonabant: A Postmortem Forensic Examination, in Controversies in Obesity. Eds: Haslam DW, Sharma AM, le Roux CW, 2014

INVITED LECTURES International: 

International Symposium of Human’s Health & Aging Sciences. “Calorie Restriction for Elderly”. Semarang, Indonesia, 5 June 2015



12th International Congress on Obesity, “Managing Obesity in the elderly – too late and too difficult?”, Kuala Lumpur, Malaysia 17-20 March 2014.



Asia Oceania Congress on Obesity. “Pathways to, and Effects of, Obesity and the Cardio-Metabolic Syndrome: The Case of Sleep”, Bandung Indonesia, November 2013.



ENDO13, 95th Annual Meeting, Invited Symposium “Androgens and Sleep: A Two-Way Street”. San Francisco, California. 15-18 June 2013.



Testoterone and the risk of Type 2 Diabetes. 4th Asia-Pacific Forum on Andrology held in conjunction with the 10th International Congress of Andrology. Melbourne, 25 February 2013.



Bariatric Surgery for the Management of Obesity – ANZOS, Auckland. 19 October 2012



Speakers Tour of Malaysia, Singapore and Hong Kong. iNova. 11-15 October 2012



ENDO12, 94th Annual Meeting & Expo, Houston Texas, 12-29 June 2012

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

Management of Obesity in Patients with Craniopharyngioma. 15th International and 14th European Congress of Endocrinology. Fortessa da Basso, Florence, Italy, 5-9 May 2012.

 

47th (EASD) Conference. Feira Internacional de Lisboa, Lisbon Portugal, 3-16 September 2011 Polycystic Ovary Syndrome and Obstructive Sleep Apnoea. 6th Asia-Oceania Conference on Obesity (AOCO 2011). Sofitel Plaza Manila, 31 August-3 September 2011 Metabolic Syndrome and Prostate Cancer 2010. Australian-Canadian Prostate Cancer Research Alliance Symposium.. Gold Cost, August 8th 2010. Testosterone, Sexual and Lower Urinary Tract Function in Men: Effects of Obesity and Diet-Induced Weight Loss. Boston University Medical Centre, 10 May 2010. Fatty acids and the regulation of energy metabolism. Childhood Nutrition Research Institute, Baylor University. Houston, 15 April 2010. Australasian Conference on Obesity. Management of Obesity: Prioritising the Options in a Patient Centred Approach. Auckland, 4 December 2009. Asia Oceania Association for the Study of Obesity. Sleep restriction, obesity and metabolic syndrome, Mumbai, India, 5-8 February 2009 15th International Congress 2008 on Dietitics, Yokohama, Japan, Inivited Symposium – “Obesity and the Metabolic Syndrome”, 8-10 September 2008. Hypertension, Diabetes and Lipid Symposium, 2008. Shanghai, China, “Metabolic Syndrome and Sexual Dysfunction in Men: Implications for the Cardiovascular System” and “Type II Diabetes Mellitus: Emerging Treatment Strategies and Concepts”, 16-21 July 2008. 6th World Congress of the Ageing Male. Tampa, Florida, “Obesity in the Older Male”. USA, 21-23 February, 2008 6th World Congress of the Ageing Male. Tampa, Florida, USA. “Epidemiology of Ageing Males in Australia”. 21-23 February 2008 International Association for Ageing and Nutrition. Management of Morbid Obesity. Adelaide Convention Centre, 5-8 September 2007. International Academy for Ageing and Nutrition, Body composition, nutrition and activity in older men. Adelaide Convention Centre, 5-8 September 2007. Korean Diabetes Association, 20th Spring Congress. Endocannabinoids for the treatment of Obesity and Metabolic Syndrome, Seoul, 10-12 May 2007. Annual Scientific Meeting of the National Heart Association of Malaysia, Integrating Adiposity As A Target In Global Cardiometabolic Risk Reduction. Hilton KL/ Le-Meridien Sentral, 13–15 April 2007. 10th International Conference on Obesity. Invited Symposium: Clinical Effectiveness of Weight Management Drugs, Sydney Convention Centre, September 3 2006. 5th Congress of Asian Pacific Society of Atherosclerosis and Vascular Diseases, Novel pharmacologic approaches to diabetes management, 12-15 April 2006 Jeju, Korea. Combined Scientific Meeting of Singapore Health and National University of Singapore. Invited Plenary Lecture. Ageing Frail or Ageing Robust – Determinants and Interventions. Raffles City Convention Centre, Sinagpore, 4-6 November 2005. Childhood Nutrition Research Institute. Baylor College of Medicine, Houston, Texas. Dietary approaches for the management of obesity: Is there an optimal macronutrient composition, 9 June 2005. European Obesity Meeting. Effect of Orlistat on Obesity Co-morbidities. Roche Symposium, Athens, 1 June, 2005. 3rd International Academy on Nutrition and Aging. The problem of obesity in the elderly. St. Louis Missouri, 6-8 May 2005. Asia Pacific Heart Network – Obesity, a global problem. Singapore, January 2004.

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  

Indian Obesity Society/Abbott India – Causes and Management of Obesity - Delhi, Mumbai, Chennai, Bangalore, September 2003. Eli Lilly Symposium. Androgens and the Aging Male. Auckland, August 2003. Indonesian Obesity Society/Roche Indonesia – Management of Obesity – Jakarta, June 2003. International Conference on Obesity – Invited symposium participant – Obesity in Aging Adults, Sao Paulo Brazil, August 2002. New Zealand Endocrine Society – Invited Speaker: Androgen Function in Aging Men, Wellington, April 2001. International Congress on Sports Science, Sports Medicine and Physical Education – Invited to present a lecture in a symposium on “Macronutrient Regulation of Food Intake – Lessons From Human and Animal Studies. Brisbane, September 2000. Endocrine Society of India Annual Conference, Plenary speaker: Leptin Physiology in humans. Lucknow 1997. Obesity Reseach Centre, VA Medical Centre, Minneapolis, Minnesota, 1997 Rowett Institute, Aberdeen, Scotland, 1996

National: 

Australian Diabetes Association/ADEA Annual Scientific Meeting. “Testosterone and the prevention of type 2 diabetes mellitus (T4DM)”. Adelaide, 28 August 2015



Festschrift for Professor Joe Proietto. “Polytheism, Monotheism and the Religion of Diets”. Melbourne, 20 April 2015 NHMRC Joint Symposium on Molecular Mechanisms of Obesity and Metabolic Diseases. Sydney, 18 March 2015 Physiology Department Retreat. “Translational Research and the Value of Intergated and Multidisciplinary Resarch Teams”. Monash University, at Peppers, Mornington Peninsula, 7 December 2014.

  

Australian Association for Gerontology. “Obesity on the elderly”. Plenary, Adelaide, 26 November 2014



ISCP State of the Heart Congress. Obesity - A rational basis for a therapeutic approach, “Pharmacology for Obesity: is there any hope?”, Adelaide, 27 November 2014



DAA – National Bariatric Roadshow. “Obesity and the Pathophysiology of disease”, Hindmarsh, Adelaide, 20 September 2014



6th National Symposium on Advances in Gastrointestinal & Urogenital Research. “LUTS: A common but neglected obesity and metabolic syndrome related condition”. Bond University, Gold Coast, 5 September 2014



MJA Cententary Symposium, 3-6 July 2014, University of Sydney



National Eating Disorders Collaborative Workshop, 11-16 April 2014, Rydges Sydney



Australian Society for Medical Research. Is there a role for testosterone supplementation for disease prevention?, “Ageing and obesity and the risk of T2DM in men”, Ballaratt, Nov 20, 2013



Endocine and Diabetes Forum. “Obesity, Testosterone and Type 2 Diabetes in Men?” Sydney, October 2013.



National Natural Science Foundation of China & NHMRC, Type Two Diabetes Scientific Symposium, “The Obesity, Testosterone, Sleep Disorders and Type 2 Diabetes Mellitus in Men”, Canberra, 27-28 June 2013.

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

Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting, “Sarcopenia in community dwelling Australians”, Adelaide, 17-19 June 2013



Diabesity, Dapagliflozin Summit & Diabesity Symposium, “Male Reproduction & Diabesity”, Sydney, 17-18 May 2013



Health Services and the Management of Obesity. Obesity Australia Obesity Summit. John Curtin School of medical research. Australian National University, Canberra, December 3-4 2012



Bariatric Surgery - Medical Treatment of Severe Obesity. Australian Gastroenterology Week, Adelaide Convention Centre, 18 October 2012



Beyond the liver: cardiovascular and metabolic risk in NAFLD patients. Australian Gastroenterology Week, Adelaide Convention Centre, 18 October 2012



ADS/ADEA Annual Meeting, ‘Breakfast with the Rising Stars “Trends in Blood Glucose Monitoring”, sponsored by Sanofi, Gold Coast Convention Centre, 29 August 2012



Army Reserve SA Annual Health Day 2012 - Defence Health Triumvirate. "Causes and effects of Obesity". Air Warfare Destroyer Complex, Osborne South Australia, 28 July 2012



Diabetes Master Class. “Testosterone for prevention of diabetes”, Park Royal Darling Harbour, Sydney, 12-15 July 2012



Australian Diabetes Council, Diabetes & Sustainable Populations Forum. Strategies for Managing the Diabetes Epidemic, “Panel Discussion : Best Treatment Options for People with Significant Obesity and Diabetes Including Children”, Parliament House, Sydney, 9-10 July 2012



Dietitian’s Association of Australia Webinar. Managing Obesity in Men. 24 May 2012



MSD Diabetes Master Class. Testosterone and Type 2 Diabetes Mellitus. Melbourne Cricket Ground. 5 November 2011.



Asia Pacific Conference on Metabolic Syndrome (APCMS) 2011. Epidemiology of Obesity. Sydney Convention Centre, 3-5 November 2011



MSD Diabetes Master Class. Testosterone and Type 2 Diabetes Mellitus. Melbourne Cricket Ground. 5 November 2011.



Asia Pacific Conference on Metabolic Syndrome (APCMS) 2011. Epidemiology of Obesity. Sydney Convention Centre, 3-5 November 2011



Australian Sleep Association Annual Scientific Meeting. Sydney Convention Centre, 29 October 2011



Australia New Zealand Society for the Study of Obesity ANZOS 2011. Effect of Obesity on Reproductive and Lower Urinary Tract Function in Men. National Wine Centre, Adelaide, 20-22 October 2011 The Dietitians Association of Australia, Obesity Roadshow. Next Generation, Adelaide, 19 August 2011 Fertility Society of Australia, Medical and Other Disorders in Klinefelters Syndrome. Adelaide Convention Centre, 10-13 October 2010. ANZ Society for Geriatric Medicine. Key Note Speaker: Management of Obesity In The Elderly: For Whom, When and How or If at all, 11-12 September 2010. Pfizer Cardiovascular Forum. Obesity, Diabetes Mellitus and Cardiovascular Disease in Children, 14 August 14 2010. Uroscience Forum. Obesity Sleep and Androgens. Melbourne, 5 September 2009 Uroscience Forum. Debate: AGAINST: The hypogonadal man – testosterone therapy or not, Melbourne, September 2009. Australian Diabetes Society. Bariatric Surgery for the Management of the Obese Type 2 Diabetic – A Debate. Adelaide, August 2009.

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                          

Building a clinical Research Community. CRX09, MCG, Melbourne, 20 August 2009. Sansom Institute, University of South Australia. Ageing, Sex Steroids and Cardio-Metabolic Risk, 16 July 2009. Healthy Male Forum. Gonadal Steroids, Diabetes and Cardiovascular risk. Gold Coast, 19-21 June 2009. Southern Area Health Research Week. Testosterone and Cardio Metabolic Risk in the Ageing Male, Melbourne 5 May 2009. Cardiovascular Specialist Symposium. Workshop on Obesity Management, 27 February 1 March 2009. Australian Health and Medical Research Conference. Obesity and Sexual Function in Men. Brisbane, 19August 2008. Cardiac Society of Australia and New Zealand. Obesity and Heart Disease, Adelaide, 7-10 August 2008. How to Implement a Lifestyle Management Program. GSK Gold Program for GPs and Specialists, Sydney, 17-18 May 2008. Research Tuesday, University of Adelaide. Obesity, Physical, Psychological and Sexual Well-being: Implications for Ageing Men. University of Adelaide, 11 March 2008. 7th National Men’s Health Conference. Keynote Speaker. Adelaide Convention Centre, Adelaide 3-5 October 2007 Diabetes ACT. Obesity and Men's Health –Opportunities and Challenges, Canberra, August 2 2007. Conference on Gender and Ageing. Plenary lecture. The Florey Adelaide Male Ageing Study. Newcastle, NSW, Australia, 9-10 July 2007. Astra Zeneca Cardiovascular Symposium. Workshops on Obesity Management. Sanctuary Cove, 2-4 March 2007. International Diabetes Institute. A weight based approach for the management of Type 2 diabetes Mellitus. Melbourne 6 Feburary 2007. Friends of the Hebrew University of Jerusalem. Ethics of Embryonic Stem Cells and Related Technologies. Adelaide, 4 February 2007. South Australian Diabetes Educators Refresher Day. Plenary Lecure - Metabolic Syndrome a risk for the Heart. Adelaide, 24 November 2006. Jewish Family and Community Services Annual Lecture. The Obesity Epidemic – An Intergenerational Problem: Causes and Consequences. Adelaide, October 29 2006. Prostate Cancer Foundation of Australia. Public Health Promotion Forum. Preventing Diabetes Mellitus. Melbourne, 12 August 2006. Central and Northern Adelaide Health Service, The Obesity Epidemic, What Should We Do? Adelaide, June 2006. New South Wales Diabetes Summitt. Obesity and Diabetes Mellitus. Sydney, April 2006 Australasian Society for the Study of Obesity Annual Conference, Obesity in the Elderly, Adelaide, October 2005. The National Centre for Functional Foods Symposium. The Value and Benefits of Glycaemic index and Glycaemic Load. Wollongong, June 2005. Endocine Society of Australia Seminar Meeting, Sebel Yarra Valley, April 16-19 2005. Annual Florey Lecturer, University of Adelaide, and Florey Foundation, October, 2004. Royal Australasian College of Physicians. Medical Approaches for The Management of Obesity. Canberra, May 17 2004. SAWA Cardiology Meeting. Obesity and Cardiovascular Risk. Glenelg, May 8 2004 Nutrition Research Foundation University of Sydney. “Will we ever get it right – diet for a new millennium” April 22, 2004.

Professor Gary Wittert

Page 33

                

Pfizer Regional Specialists Meeting, Aging and Hormones in Men. Novotel Barossa, April 14-18, 2004. Australasian College of Sexual Health Medicine. “Androgens and the Aging Male: Myths. Mysteries and Mischief”. Sydney, March 4, 2004. Australasian Society for the Study of Obesity. Dietary fat and the management of Obesity” Newcastle, September 2003. Update for Physicians “Workshop on the Metabolic Syndrome” Sanctuary Cove, February 2003. Australian Gastroenterology Week. “Obesity – the way out”, Adelaide 2002 Post-graduate weekend for Physician Trainees – Astra Zeneca. “The Management of Obesity” – Coolum, 2002. Royal Australasian College of Surgeons. “The Role of Surgery in the Management of Obesity”, Adelaide, 2002. Rheumatological Society of Australia – National Meeting, “glucocorticoids and the cardiovascular system”, Adelaide, 2001. National Workshops on Obesity for GP’s and Physicians – Pfizer and Roche, 1999, 2000, 2001. Royal Australasian College of Physicians – Annual meeting – “Pathogenesis and Management of Obesity”, 2001 Australasian Society for Biological Psychiatry – Plenary lecture “Neurobiology of Obesity, December 2000. 5th Annual General Practitioner Conference, Sydney, May 2000. Australian Endocrine Society – Satellite Symposium, Melbourne 1999 Australian Menopause Society – Hormonal regulation of Leptin Annual Conference, 1999 Hanson Symposium - Adelaide, 1998 Sir John Hunter Hospital, Newcastle, Medical Grand Round, 1998 Florey Centenary - Adelaide, 1998

Local:    

 

      

Marine Surveyors Workshop. “Men’s Health Issues”. Port Adelaide, 19 June 2015 Veterans Health Week, Mt Barker, 18 October 2014 Campbelltown Probus Club Diabetes Presentation, Magill, 22 September 2014 Adelaide Blood Club, Haematology Society of ANZ (SA Branch), “Optimising survival and quality of life after treatment for haematological malignancy in men: Is there a role for testosterone?”, Adelaide, 5 July 2013 4th Enteric Nervous System Meeting, Adelaide, 4 November 2012 Campbelltown City Council 'Live Better' health Expo, "Relationship between obesity and lifestyle factors (diet, exercise, smoking, alcohol, stress and sleep) and abnormalities of sexual function and lower urinary tract symptoms", Adelaide, 1 August 2012 University of Adelaide, Year 1 S2 Lecture, “How is body weight regulated: The mechanisms controlling food intake and energy expenditure”, Adelaide, 14 August 2012 RAH Physician trainee 2012 Endocrinology tutorial, "Male Hypogonadism", Adelaide, 31 July 2012 Dietitian’s Association of Australia, Men’s Health for the DAA Webinar, 24 May 2012 Wind Impact Workshop, Institute for Mineral and Energy Resources, University of Adelaide, 21 May 2012 University of Adelaide, Year 2 S1 MBBS Lecture, “Obesity as a disease”, Adelaide, 16 May 2012 RACP Endocrinology Education Session, Adelaide, 14 May 2012 ETSA, Men’s Health Presentation, 30 April 2012

Professor Gary Wittert

Page 34

             

RAH Physician Training Program, Year 1&2 trainees. Adelaide, 17 November 2011. RAH Physician Training Program, Year 1&2 trainees. Adelaide, 23 September 2011. Royal Australian College of Surgeons, Basic Physician Trainees Lecture Series. North Adelaide, 1 August 2011 Australian Educators Diabetes Association, Continuing Education Program. Repatriation General Hospital, 30 July 2011 Flinders & Far North Division of General Practice, CPD for GPs. Pt Augusta, 7 July 2011 Departments of Zoology, Pharmacology, Medicine, Obstetrics and Gynaecology, Psychiatry, University of Adelaide Modbury Hospital, Royal Adelaide Hospital, Queen Elizabeth Hospital Adelaide Clinical Endocrine Society South Australian Society for Post Graduate Medical Education Institute of Medical and Veterinary Science Royal Adelaide Hospital Hanson Institute Marsupial Biology Group, Numerous talks for Endocrinologists, Cardiologists, Renal Physicians, General Physicians and General Practitioners.

SUPERVISION OF STUDENTS Honours 2005 2003 2000 2000 2000 1998 1997 1997 1996

Mr Paul Cavuoto – Honours IIa. Mr Darren Roffey – Honours I Mr Matthew Haren – Honours I Ms Zoe Holthouse – Honours I Ms Jane Mudge – Honours IIa Ms Clarice Chian - Honours I Ms Fiona Clements - Honours IIa Ms Rosalie Vozzo - Honours IIa Ms R Willis - Honours IIa

Higher Degree 2014201420142013201320132012201220112011-2014 2010-2013 2009-2013 2009-2012

Dr Hannah Newall (Joint with Prof Cherrie Galletly, Prof Robert Adams and Dr Dennis Liu) Mr Emmanuel Bukajumbe (Joint with Dr Sarah Appleton) Ms Pennie Taylor (Joint with Prof Manny Noakes) Ms Yingting Cao (Joint with Dr Zumin Shi and A/Prof Anne Taylor) Ms Melissa Opoloski (Joint with Prof Anna Chur-Hansen) Mr Tom Butler (Joint with A/Prof Leonie Heilbronn) Ms Janet Grant (Joint with A/Prof Anne Taylor) Mr Peter Bai (Joint with Dr Zumin Shi and A/Prof Anne Taylor) Ms Constance Kourbelis (Joint with Prof Graeme Hugo and A/Prof Anne Taylor) Ms Rhiannon Pilkington (Joint with A/Prof Anne Taylor) Ms Nadja Klafka - PhD (Joint with Dr Jaklin Elliott and Prof Ian Olver). Mr Brett Scholz - PhD (Joint with Dr Shona Bass) Mr Hany Abed - PhD (Joint with Prof Prash Sanders) – Ralph Reader Award and Cardiac Society of Australia and New Zealand Meeting 2011. American Heart Association, Young Investigator Award, 2012

Professor Gary Wittert

Page 35

2008-2011 2008-2011 2008-2012 2007-2011 2006-2010 2006-2009 2005-2009 2005-2009 2005-2008 2004-2010 2004-2007 2004-2007 2004-2007 2004-2007 1998-2002

2001-2004 2001 2004 1998-2001 1998-1999 1995-1998

Mr Andrew Trotta - PhD (Joint with Prof V Marshall, Dr Grant Buchanan and Dr Eleanor Need. Ms Eva Pedersen - PhD (Joint with Prof Peter Clifton and A/Prof Manny Noakes) Mr Sean Martin - PhD (Joint with Prof Wayne Tilley and Prof Richard Ivell). Ms Lisa Philip - PhD (Joint with A/Prof Graeme Mayrhofer and Dr Alena Janovska) Mr Paul Cavuoto - PhD (Joint with Dr Andrew McAinch and Dr Alena Janovska) Ms Yan Lam - PhD (Joint with Dr Andrew McAinch and Dr Alena Janovska) Ms Emily Brindal – PhD (joint with Dr Phil Mohr and Dr Carlene Wilson) Ms Julie Franzon – PhD (joint with Prof Graham Hugo) Ms Kirsten Dunn – PhD (joint with Dr Carlene Wilson and Dr Phil Mohr) Mr James Smith – PhD (Joint with Prof Janet Hiller and Dr Megan Warin) Ms Eleanor Need – PhD (joint with Prof Wyne Tilley, Dr Peter O’Loughlin) Dr Cynthia Piantadosi – PhD (joint with Prof Stephen Worthley) Mr Donel Martin – PhD (joint with Dr Nick Burns). Mr Dominik Kaczorowski – PhD with Dr Greg Goodall. Ms Natalie Luscombe - PhD (Joint with Dr P Clifton CSIRO). Award for best poster International Congress on Sports Science, Sports Medicine and Physical Education, Brisbane, 2000; Award for best oral presentation Australasian Society for the Study of Obesity, Gold Coast, September 9-11, 2001; Young investigator of the year, Australasian Society for the Study of Obesity 2003. Mr Matthew Haren - PhD Dr Stephen Nicolls – PhD (Joint with Prof P Barter). Ms Rosalie Vozzo - PhD (Joint with Dr Ian Chapman) Mr Chris Barton - MMsc Ms P Hope - PhD. Awarded prize for best abstract Australian Society for Comparative Physiology and Biochemistry 1998.

Professor Gary Wittert

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Expert witness statement of Gary Allen Wittert

-Appendix 1 – Wind Farms and Human Health, August 2015

I

page 2

1

Wind Farms and Human Health

Prof Gary Wittert MBBch MD FRACP FRCP School of Medicine University of Adelaide

Report for Trustpower Adelaide, August 2015

2 Qualifications and experience I am a Specialist Physician with registration in General Medicine and Endocrinology. I obtained my MBBch at the University of Witwatersrand, Johannesburg in 1983, became a fellow of the Royal Australasian College of Physicians in 1992 and a fellow of the Royal College of Physicians, UK in 2009. I have an MD awarded from the University of Otago in 1994. I am currently a Professor of Medicine (personal chair) at the University of Adelaide and Head of the Discipline of Medicine at that university. I also Head the Freemasons foundation centre for Men’s Health. I practice as a Senior Consultant Endocrinologist at the Royal Adelaide Hospital, and I am the coordinator of the Endocrine Test Unit and the Obesity Clinic at that hospital. I have worked at both institutions continuously since 1994. I also spend half a day in week in private practice. I have particular expertise in the physiology and pathophysiology of stress, pathophysiology and management of obesity, physiology and use of androgens, disorders of sleep and relationship to chronic disease. I have published over 280 peer-reviewed publications, book chapters and expert reports. My CV is attached. Foreword In preparing this report I have begun by considering the important principles that must be adhered to in undertaking an assessment of the potential health impact of a change in the environment, in this case the operation of wind turbines. These principles represent good practice in the assessment of an environmental health risk, and represent the benchmark against which to assess the robustness or otherwise of investigations into whether there is a link between wind farms and health impacts. Because common problems occur commonly, one must be satisfied that they are occurring more frequently than would be expected as a result of exposure to a risk factor. Accordingly I have presented some information relating to the frequency of sleep disorders, anxiety and depression in the community. I have then considered the published literature, reports and data relating to the health effects of noise exposure in general, the relationship between sleep disturbance and adverse health effects, whether exposure to sound energy, including low frequency noise (LFN) and infrasound, audible or otherwise, from wind turbines has a direct role in causing or exacerbating health effects.

Conclusion The report concludes that there is no evidence that either audible noise of any frequency or infrasound resulting from the operation of wind turbines constitutes a significant risk to health provided the development is compliant with current guidelines. The weight of evidence is that when adverse health effects occur they are either circumstantially related or mediated by psychological distress, or both.

3

Table of contents 1. Principles of epidemiology important in a health impact assessment

Page 5

1.1. Risk 1.2. Attributable risk and Population Attributable Risk 1.3. Bias in assessing of relationships between risk and health outcomes 1.4. Establishing cause and effect 1.4.1. The problem of confounding 1.4.2. The problem of anecdotal evidence 2. Population prevalence of insomnia, anxiety, and depression

6

2.1. Anxiety 2.2. Insomnia 3. Noise and Health

7

4. Sleep disturbance and adverse health outcomes

11

5. Wind turbines

12

5.1. Noise, noise perception, annoyance and variations in sensitivity

12

5.2. Evidence of adverse health effects from exposure to wind farm noise?

14

5.2.1. Anecdotal reports 5.2.2. Recent Reviews and Reports from Expert Bodies 5.2.3. Recent research 5.2.3.1. Sleep disturbance and psychological distress 5.2.3.2. Quality-of-life 5.2.3.3. Other health abnormalities 5.3. Low-frequency noise (LFN) and Infrasound (IS)

26

5.3.1. Physiological effects of IS and LFN 5.3.2. Do LFN and or IS from wind farms adversely impact health? 6. Conclusions

32

6.1. Wind farm noise and health effects 6.2. LFN and IS and adverse health effects 7. References

33

8. Appendices

36

4 1. Principles of epidemiology and health impact assessment Relevance: in order to assess the health impact of an environmental exposure such as wind farm noise, sound scientific principles of public health and epidemiology must be applied. Basically, epidemiologists count cases of disease or injury, define the affected population, and then compute rates of disease or injury in that population. They then compare these rates with those found in other populations and make inferences regarding the patterns of disease to determine whether a problem exists. If a problem is identified, then the next task is to determine the cause of the health problem and any factors that are related to susceptibility, exposure, or risk; and any potential environmental determinants (http://www.cdc.gov/excite/classroom/intro_epi.htm). 1.1. Risk Risk is the likelihood, usually quantified as an incidence rate or cumulative incidence proportion, that an individual will develop a given disease in a given time period. A risk factor is a particular behaviour or exposure that is positively or negatively associated with the occurrence of a disease. An attribute is a risk factor that is an intrinsic characteristic of the individual (e.g., genetic susceptibility, age, sex, breed, weight). Exposure refers to a risk factor that is in the environment external to the individual (e.g., noise, infrasound, nutrition, housing, or toxic agent etc.). Competing risks are other sets of risk factors that can cause the condition of interest and which coexist with the set of factors of interest. 1.2. Attributable risk and population attributable risk in assessing health outcomes Attributable risk is the difference in rate of occurrence of a condition between an exposed population and an unexposed population. Attributable risk is mostly calculated in cohort studies, where individuals within the cohort are assembled on exposure status and followed over a period of time. Investigators count the occurrence of the diseases. The cohort is then subdivided by the level of exposure and disease frequency is compared across the groups. One is considered exposed to the risk and another unexposed to the risk. All other things being equal, the difference in the occurrence the disease between exposed and unexposed groups indicates the attributable risk. The population attributable risk (PAR) for a combination of risk factors is the proportion of the disease that can be attributed to any of the risk factors studied. The combined PAR is usually lower than the sum of individual PARs since a diseased case can simultaneously be attributed to more than one risk factor and so be counted twice. The attributable fraction is the proportion of disease incidence that can be attributed to a specific exposure (among those who were exposed). 1.3. Bias in the assessment of relationships between risk and health outcomes

5 Bias occurs when an assessment is made in a non-random selection of the population, for example selfselection. Another form of bias is susceptibility bias. For example, someone with anxiety may attribute sleep disturbance to a new environmental noise. 1.4. Establishing cause and effect There must be a significant difference in the health outcomes between exposed and unexposed individuals in order to infer cause-and-effect. The relationship must not be due to some other factor (i.e. there must be strength of association). The observation of the association must be repeatable in different populations at different times (i.e. there must be consistency). The cause must precede the effect (temporality). The explanation must make sense biologically (plausibility). There must be a dose-response relationship (biological gradient). 1.4.1. The problem of confounding In risk assessments, factors such as age, gender, and education often have an impact on health status, and so should be controlled for. Beyond these factors, researchers may not consider or have access to data on other causal factors. An example is the study of smoking tobacco on human health. Smoking, drinking alcohol, and diet are lifestyle activities that are related. A risk assessment that looks at the effects of smoking but does not control for alcohol consumption or diet may overestimate the risk of smoking. 1.4.2. The problem of anecdotal evidence Anecdotal evidence refers to evidence from anecdotes. Such reports are often cherry-picked or otherwise non-representative samples of typical cases. Anecdotal evidence is therefore considered dubious support of a claim. This is true regardless of the veracity of individual claims. Generally speaking the nature of anecdotal evidence prevents it from being investigated using the scientific method. Anecdotal evidence is also open to misuse in a manner sometimes referred to as the "person who" fallacy ("I know a person who..."; "I know of a case where..." etc). Anecdotal evidence is not necessarily representative of a "typical" experience; in fact, exceptional or confirmatory anecdotes are much more likely to be remembered. Accurate determination of whether an anecdote is "typical" requires statistical evidence. Psychologists have found that people are more likely to remember notable examples than typical examples. Anecdotal evidence is often unscientific or pseudoscientific because various forms of cognitive bias may affect the collection or presentation of evidence. For instance, someone who claims to have had an encounter with a supernatural being or alien may present a very vivid story. This phenomenon can also happen to large groups of people through subjective validation. Anecdotal evidence is also frequently misinterpreted because it is easily obtainable, which leads to an overestimation of prevalence. Where a cause can be easily linked to an effect, people overestimate the likelihood of the cause having that effect (availability). Vivid, emotionally-charged anecdotes seem more plausible, and are given greater weight.

6 A related issue is that it is usually impossible to assess, for every piece of anecdotal evidence, the rate of people not reporting that anecdotal evidence in the population. A common way anecdotal evidence becomes unscientific is through fallacious reasoning such as the post hoc ergo propter hoc fallacy, which is the human tendency to assume that if one event happens after another, then the first must be the cause of the second. Another fallacy involves inductive reasoning. In other words an anecdote illustrates a desired conclusion rather than a logical conclusion, leading to hasty or faulty generalisations. For example, here is anecdotal evidence presented as proof of a desired conclusion: There's abundant proof that drinking water cures cancer. Just last week I read about a girl who was dying of cancer. After drinking water she was cured. In any case, where some factor affects the probability of an outcome, rather than uniquely determining it, selected individual cases prove nothing (e.g. "my grandfather smoked 40 a day until he died at 90" and "my sister never went near anyone who smoked but died of lung cancer"). [http://en.wikipedia.org/wiki/Anecdotal_evidence] In medicine, anecdotal evidence is also subject to placebo effects: it is well-established that a patient's (or doctor's) expectation can genuinely change the outcome of treatment. Only double-blind randomized placebo-controlled clinical trials can confirm a hypothesis about the effectiveness of a treatment independent of expectations. Moreover, placebo effects have been shown to work in the opposite direction (i.e. the nocebo effect whereby expectation or anxiety about an adverse event make it’s occurrence more likely ((Crichton, Dodd et al. 2013). A further point to consider is that, a statistical correlation between things does not in itself prove that one causes the other (a causal link). A study found that television viewing was strongly correlated with sugar consumption, but this does not prove that viewing causes sugar intake (or vice versa). In science and logic, the "relative strength of an explanation" is based upon its ability to be tested, proven to be due to the stated cause, and verified under neutral conditions in a manner that other researchers will agree has been performed competently and can independently verify. 2. Population prevalence of anxiety and depression and insomnia Relevance: common problems occur commonly, and one must be satisfied that they are occurring more frequently than would be expected as a result of exposure to a risk factor 2.1. Anxiety and depression In Australia, the 12-month prevalence of anxiety disorders is 14.4% and of depression is 6.2%. Patients with anxiety and/or depression are particularly likely to present with physical complaints rather than mental health symptoms, and symptomatology may initially seem vague and non-specific. The symptoms that may occur in people with anxiety include one or more of the following (Tiller 2012): 

General: Fatigue and loss of energy, feeling slowed up or agitated and restless

7 

Cognitive: Poor attention and concentration, slow thinking, distractibility, impaired memory, indecisiveness



Psychological: Apprehension, derealisation or depersonalisation, irritability, atypical anger



Somatic: 

Musculoskeletal: Muscle aches and pains, muscle tension, headaches



Gastrointestinal: Dry mouth, choking sensation, “churning stomach”, nausea, vomiting, diarrhoea



Cardiovascular: Palpitations, tachycardia, chest pain, flushing



Respiratory: Shortness of breath, occasionally hyperventilation



Neurological: Dizziness, vertigo, blurred vision, paraesthesia



Genitourinary: Loss of sex drive, difficulties with micturition

Females were more likely than males to have experienced anxiety disorders (17.9% compared with 10.8%) and depression (7.1% compared with 5.3%). There are no differences between rural, regional, and urban dwelling Australian’s once sex, age and employment status or accounted for (AIHW 2008) 2.2. Insomnia Insomnia is defined as difficulty getting to sleep, staying asleep or having non-restorative sleep despite having adequate opportunity for sleep, together with associated impairment of daytime functioning, with symptoms being present for at least 4 weeks. Having a sleep experience that does not meet our expectation, such as with some transient awakenings but with good daytime functioning, does not constitute insomnia. Australian population surveys have shown that 13%–33% of the adult population have regular difficulty either getting to sleep or staying asleep. Insomnia can occur as a primary disorder or, more commonly, occurs together with other physical or mental disorders. Around 50% of patients with depression have concomitant insomnia. Depression and sleep disturbance are, respectively, the first and third most common psychological reasons for patient encounters in general practice. Insomnia doubles the risk of future development of depression, and insomnia symptoms together with shortened sleep are associated with hypertension (Cunnington, Junge et al 2013). 3. Noise and Health This section examines the relationship between noise exposure and adverse health outcomes. The conclusion drawn from studies described below is that while there may be a relationship between noise exposure and adverse cardiovascular outcomes this requires the presence of sound intensity well over 45 dBA on a consistent basis and occurring in circumstances beyond what would be experienced in the vicinity of wind farm A recent report (Jones K, Environmental Research and Consultancy Department. ERCD REPORT 0907. Environmental Noise and Health: A Review. Feb 2010) has examined the effects of environmental noise on health and concluded that there is a robust association between environmental noise and annoyance,

8 albeit with a large number of modifying and moderating factors. It is much more difficult to show that noise has a direct effect on health. A summary of the effects and threshold levels for effects where sufficient evidence is available is presented in WHO NNG, 2009. An extract from this report is set out below:

Since 2010, a number of systematic reviews have addressed the relationships between noise and various health outcomes: 3.1. Sleep A comprehensive report (Jones K, 2010) examines the issue of sleep and noise exposure in some detail. Disturbance of normal sleep can be observed for peak noise levels between 45 and 55dBA. To protect noise-sensitive people, the WHO recommended a maximal level of 45dB inside the bedroom, and a mean level (integrated noise level over the 8 nocturnal hours: Lnight) of 30dB. If it takes longer to get to sleep and people wake prematurely, then total sleep time will be reduced. Frequent nocturnal awakenings may also reduce total sleep time and disturb overall sleep architecture, leading to daytime sleepiness. Intermittent noises with peak noise levels of 45dBA and above can increase the time to fall asleep by up to 20 minutes. Combined with this, sleep pressure (i.e. the physiological drive to sleep) is reduced after the first 5 hours, therefore noise events occurring in the early hours of the morning are more likely to prevent the sleeper from going back to sleep. Sleep disturbance occurring during the early part of the night and early morning prior to the natural time of awakening seem to be the most intrusive. There is very little known about the

9 effect of noise on sleep architecture under various circumstances and in various individuals. An important point made in the WHO report and consistent with my own (unpublished) and other research is that the subjective assessment of sleep quality does not accurately correspond to the objective measurement of sleep (Silva, Goodwin et al 2007). A recent paper (Hume, Brink et al. 2012) summarizes the findings from the past 3 year's research on the effects of environmental noise on sleep and corroborates findings that noise events induce arousals at relatively low exposure levels, and independent of the noise source (air, road, and rail traffic, neighbours, church bells) and the environment (home, laboratory, hospital). 3.2. Cardiovascular disease (CVD) The WHO concludes that while epidemiological studies show that cardiovascular risks increase after longterm exposure to noise (aircraft and road traffic) with values of 65 to 70 dBA Leq, the associations are weak overall, although somewhat stronger for ischaemic heart disease than for hypertension. Jones K et al (2010) reached mixed conclusions based on their assessment of the various reviews and papers on the evidence for cardiovascular effects. Some reviewers consider that there is sufficient evidence that CVD increases after long-term exposure to noise, others consider that the evidence does not convincingly demonstrate an association. Aircraft noise is probably more consistently associated with adverse cardiovascular effects. Newer epidemiological studies support already existing evidence that night-time noise is likely associated with CVD and stroke in the elderly (Hume, Brink et al. 2012). These studies collectively also suggest that nocturnal noise exposure may be more relevant for the genesis of CVD than daytime noise exposure. Another review (Davies and Kamp 2012) describes contributions to literature over the past 3 years in the area of noise and CVD, and points out that while a causal relationship between noise and CVD exists many questions remain, such as the magnitude and threshold level for adverse effects of noise, how noise and other cardio-toxic pollutants (such as particulate matter) may interact in disease causation, identification of vulnerable populations, of exposure modifiers (i.e. location of bedrooms) and of other effect-modifiers (i.e., gender), and how epidemiologic methodology can be improved. Swedish studies on road traffic noise support the hypothesis of an association between long-term noise exposure and CVD. However, the magnitude of effect varies between the studies and has been shown to depend on factors such as sex, number of years at residence, and noise annoyance. Two national studies have been performed on the cardiovascular effects of aircraft noise exposure. The first one, a crosssectional study assessing self-reported hypertension, has shown a 30% risk increase per 5 dB(A) noise increase. The second one, which to my knowledge is the first longitudinal study assessing the cumulative incidence of hypertension, found a relative risk (RR) of 1.10 (95% CI 1.01 - 1.19) per 5 dB(A) noise increase

10 above 40dB(A). No associations have been found between railway noise and CVD (Bluhm and Eriksson 2011). A recent meta-analysis examined the relationship between road traffic noise exposure and hypertension. Papers published between 1970 and 2010 in English, German and Dutch, were evaluated. The results of 24 studies were included into the data aggregation. They concluded that road traffic noise was positively and significantly associated with hypertension: Data aggregation revealed an odds ratio (OR) of 1.034 [95% confidence interval (CI) 1.011-1.056] per 5 dB(A) increase of the average road traffic noise level over 16 hours (LAeq16hr) [range 45-75 dB(A)]. Important sources of heterogeneity were the age and sex of the population under study, the way exposure was ascertained, and the noise reference level used. Also the way noise was treated in the statistical model and the minimum years of residence of the population under study, explained the observed heterogeneity. Therefore at most there is a very small effect, but also large heterogeneity and uncertainty about threshold values above 45 dBA (van Kempen and Babisch 2012). In the United Kingdom (UK), noise from transport is a problem, where more than half of the population is exposed to more than the recommended maximum day-time noise level and about three-quarters of the population live in areas where the recommended night-time noise level is exceeded (Stansfeld and Crombie 2011). There have been a number of large population-based cohort studies running in the United Kingdom for many years and these have been interrogated to determine the relationships between road traffic noise and ischaemic heart disease. There were no significant associations between road traffic noise and incident ischaemic heart disease in the Caerphilly and Speedwell studies, but there was a suggestion of effects when modifying factors such as length of residence, room orientation, and window opening were taken into account. In a sample stratified by pre-existing disease, strongly increased odds of incident ischemic heart disease for the highest annoyance category was found compared to the lowest among men without preexisting disease, but not those with pre-existing disease. In the “Hypertension and Exposure to Noise near Airports” (HYENA) study, night time aircraft noise exposure was associated with an increased risk of hypertension, in fully adjusted analyses. Differences between men and women, time of day and other exposure modifying factors remains to be determined (Stansfeld and Crombie 2011). 3.3. Mental health, stress hormones, and cognitive performance The evidence for mental health effects of noise exposure is inconclusive or limited. There is some evidence for a relationship to symptoms of depression and/or anxiety but not of more severe health problems such as clinically defined psychiatric disorder. The evidence for long-term impact on stress hormone levels is inconclusive or limited. There is a lack of data on the impact of environmental noise on the cognitive performance of adults (Jones K 2010). 3.4. Pregnancy

11 A recent review has shown that chronic noise exposure during pregnancy was not associated with birth weight, preterm birth, congenital anomalies, perinatal and neonatal death based on 6 cohort, 4 casecontrol, and 2 cross-sectional studies (highest evidence level 2+)(Hohmann, Grabenhenrich et al. 2013). 3.5. Children Associations between chronic noise and health in children have been based mainly on cross-sectional studies which showed a high variation in study design, outcome, exposure and confounder assessments, and therefore no definite conclusion could be made (Hohmann, Grabenhenrich et al. 2013). Aircraft noise was not consistently related to raised systolic blood pressure in children in the Road Traffic and Aircraft Noise Exposure and Children's Cognition and Health (RANCH) study (Stansfeld, Crombie 2011). 3.6. Responses to the effects of changing noise situations Most studies on human responses to noise exposure relate to steady state situations. Effects may differ when noise changes rapidly, e.g. after noise mitigation interventions or with changes in road or airport configurations. A systematic review of studies on human reactions to changes in environmental noise exposures published from 1980 to March 2011 revealed 41 papers that satisfied the inclusion criteria (Laszlo, McRobie et al. 2012). The most commonly studied outcomes were annoyance (23 papers) and sleep disturbance (11 papers). Other reactions were well-being, activity disturbance and use of living environment. There were no studies identified with physiological or disease measures. The most commonly used study design was a written survey. Studies were methodologically diverse and it was not possible to conduct a formal meta-analysis. An important finding was that annoyance was not necessarily decreased by reducing noise exposure. Non-acoustical factors influenced annoyance ratings and some of these were not identical to those in steady state conditions. There was insufficient evidence to recommend sleep disturbance as an alternative measure of reactions in changed noise conditions. Conclusion There does appear to be a relationship between noise exposure and increased risk of adverse cardiovascular outcomes, but the effect is weak and dependent on the magnitude (well over 45 dBA for the most part) and consistency of noise exposure and the presence or absence of other cardiovascular risk factors and a range of other confounds. Moreover, we do not know exactly how this effect is mediated; the weight of opinion would suggest annoyance, psychological distress and sleep disturbance may be mediating factors.

4. The relationship between sleep disturbance and adverse health outcomes A detailed review on sleep and its relationship to health is beyond the scope of this report. However, I am aware of a recent meta-analysis which shows that there is no evidence of harm for sleep durations between 6 and 8 hours a day. However, sleep restriction (i.e. 5 hours or less) was associated with a greater

12 risk of developing or dying from coronary artery disease or stroke (Cappuccio, Cooper et al. 2011). In addition to cardiovascular disease, sleep restriction has been linked to obesity, type 2 diabetes and increased inflammation. Interestingly, too much sleep (or at least time in bed) is also associated with an increased risk of type 2 diabetes and adverse cardiovascular outcomes. The mechanisms by which short sleep and long sleep relate to adverse health outcomes are probably very different (Cappuccio, Cooper et al. 2011). Severe sleep restriction (i.e. four hours a night over five nights) markedly increases blood sugar even in young men (Reynolds, Dorrian et al. 2012) although such interventions are confounded by overlap with circadian rhythm disruption which may be the more important mediator. The effects of short sleep may be confounded by comorbid conditions. For example, it has been shown that obstructive sleep apnoea is highly prevalent (affects 52% of men over age 40), but may be completely asymptomatic (i.e. daytime sleepiness is an uncommon association). Irrespective of sleepiness it may lead to the development of, or make worse, high blood pressure, headaches, depression, fatigue, poor concentration, obesity, diabetes, etc. Another example is depression which may coexist with short sleep but be responsible for many of the symptoms attributed to the sleep disturbance. Another factor to consider is that the associations may be bidirectional (i.e. disrupted sleep may lead to anxiety and depression and anxiety and depression may also disrupt sleep). Similarly in the case of obesity, where chronic sleep restriction increases the risk of obesity, but obesity in and of itself disrupts sleep both in terms of duration and quality and is a cause of excessive daytime sleepiness (Resta, Foschino Barbaro 2003). Other confounding factors relate to diet. For example we’ve previously shown that monosodium glutamate (Shi, Wittert et al. 2013) and more recently a high fat diet at night (unpublished observation) are also associated with sleep disruption. The interrelationships between various factors remain to be determined. In addition it is not entirely clear the extent to which disruption of sleep architecture i.e. the amount of slow wave or REM sleep and the transitions between them, relate to changes in health.

5. Wind turbines 5.1. Noise, noise perception, annoyance and variations in sensitivity The perception of, and response to, an environmental sound depends on individual auditory perception and other inter-sensory, attentional, cognitive, and emotional factors. Sound intensity and type of sound A cross-sectional study performed in Sweden in 2000 suggested that wind turbine generated noise was more annoying than noise from road traffic (i.e. a higher proportion of people reporting perception and annoyance from exposure to wind farm noise than would be expected from the established dose-response relationships for transportation noise) (Pedersen and Waye 2004). This appears to occur quite seldom when noise exposure is between 35-40 dB SPL. In a field study conducted in the Netherlands with 725

13 respondents a dose-response relationship between calculated A-weighted sound pressure levels and reported perception and annoyance was found. Wind turbine noise was more annoying than transportation noise or industrial noise at comparable levels, possibly due to specific sound properties such as a "swishing" quality, temporal variability, and lack of night-time abatement (Pedersen, van den Berg et al. 2009). The dose response relationships appear to be generalisable. Adults exposed to levels of A-weighted noise of 4050 dB SPL reported higher levels of annoyance than those exposed to levels below 40 dB SPL. Moreover, 12% of the subjects exposed to noise at 40-45 dB SPL reported feeling “very annoyed” versus only 6% from subjects exposed to 35-40 dB SPL; in these cases, individual psychological distress due to wind turbine noise is evident. A recent study done in the Netherlands shows that the presence of sleep disturbance or psychological stress depends on hearing the sound and feeling disturbed (Bakker, Pedersen et al. 2012). Furthermore, other data indicates that the notion that wind farm noise is more annoying than road traffic noise may be more related to psychogenic factors than the origin of the noise per se (Van Renterghem, Bockstael et al. 2013). This is discussed further below. Surrounding environment The likelihood of perceiving and being annoyed by wind turbine noise increases with increasing intensity of sound. A rural area increases the risk of perception and annoyance in comparison with a suburban area; and in a rural setting, complex ground (hilly or rocky terrain) increases the risk compared with flat ground (Pedersen and Persson Waye 2007). Individual sensitivity In addition to the many studies relating to road traffic and wind farms, detailed comparisons of socioacoustic studies conducted around international airports in Amsterdam, Sydney, and London, showed that noise sensitivity appears to increase annoyance independent of the level of noise exposure after adjustment for relevant confounders (van Kamp, Job et al. 2004). Visual amenity The respondents' attitude to the visual impact of wind turbines on the landscape scenery has been found to influence noise annoyance in a number of studies. High turbine visibility enhances negative response, and having wind turbines visible from the dwelling significantly increases the risk of annoyance. Annoyance is strongly correlated with a negative attitude toward the visual impact of wind turbines on the landscape (Pedersen and Waye 2004) (Pedersen and Persson Waye 2007) (Pedersen, van den Berg et al. 2009) (Janssen, Vos et al. 2011). Recent data have shown that the number of turbines visible has a weak effect on individual reactions, while the colour influences both visual and auditory reactions on an individual basis (Maffei, Iachini et al. 2013). Economic benefit People who benefit economically from wind turbines have a significantly decreased risk of annoyance, despite exposure to similar sound levels. (Pedersen, van den Berg et al. 2009) (Janssen, Vos et al. 2011).

14 Age Curvilinear effects of age on self-reported annoyance from environmental noise were investigated in a pooled international and a Dutch sample of 62,983 individuals aged between 15 and 102 years. All respondents were frequently exposed to varying levels of transportation noise (i.e., aircraft, road traffic, and railway noise). Results reveal an inverted U-shaped pattern, where the largest number of highly annoyed individuals was found in the middle-aged segment of the sample (peaking around 45 years) while the lowest number was found in the youngest and oldest age segments. This pattern was independent of noise exposure level and self-reported noise sensitivity. The inverted U-shape explains the absence of linear age effects in previous studies (Van Gerven, Vos et al. 2009). In the case of wind turbines, age (greater for middle aged than young or elderly) and noise sensitivity had similar effects on annoyance to those found in research on annoyance by other sources (Janssen, Vos et al. 2011). Psychogenic factors In studies relating to airport noise, it has been shown that in addition to noise sensitivity, reactions to environmental sound and people's perceptions can be influenced by their expectations about future exposures and source related attitudes (Schreckenberg, Griefahn et al. 2010). In the case of wind farms, annoyance has been found to be associated with lowered sleep quality and negative emotions (Pedersen and Persson Waye 2007). A recent experiment showed, as others have done previously, that annoyance for wind turbine noise is higher than that for highway noise at the same equivalent noise level. However, it also showed that this difference is grounded in higher level appraisal, emotional, and/or cognitive processes and in particular awareness of the source. In this study annoyance, recognition and detection of noise from a single wind turbine was assessed by means of a two-stage listening experiment with 50 participants with normal hearing abilities. In-situ recordings made at close distance from a 1.8-MW wind turbine operating at 22 rpm were mixed with road traffic noise, and processed to simulate indoor sound pressure levels at L Aeq 40 dBA. In a first part, where people were unaware of the true purpose of the experiment, samples were played during a quiet leisure activity. Under these conditions, pure wind turbine noise gave very similar annoyance ratings as unmixed highway noise at the same equivalent level, while annoyance by local road traffic noise was significantly higher. In a second experiment, listeners were asked to identify the sample containing wind turbine noise in a paired comparison test. The detection limit of wind turbine noise in presence of highway noise was estimated to be as low as a signal-to-noise ratio of - 23 dBA. When mixed with local road traffic, such a detection limit could not be determined. The study authors concluded that the difference in noise annoyance between highway traffic and less dense traffic at the same L Aeq is significantly larger than the difference between noise annoyance caused by highway traffic and wind turbine noise when the sound source is unknown beforehand. Therefore, focusing, triggered by more generic appraisal of the presence of wind turbines, could increase annoyance considerably. It was also shown that there are probably inter-

15 individual differences allowing some people to detect and recognize wind turbine noise more easily even if its presence is not revealed (Van Renterghem, Bockstael et al. 2013). 5.2. Evidence of adverse health effects from exposure to noise from wind farms? 5.2.1. Surveys and Anecdotal reports Dr Amanda Harry studied 42 residents of Cornwell, all of whom apart from one were living within 1 km of turbines. The most common reported symptoms include tiredness and lack of sleep, headache, stress, anxiety, and depression, ringing in the years, hearing loss, and palpitations and only three respondents mentioned nausea. Surveys done in Australia: 

A Survey was undertaken in 2004 by Dr Iser, Medical Officer of Health in South Gippsland, in which 20 of 25 surveys were returned. No health problems whatsoever were reported by 60% of respondents and 25% reported mild health problems including disturbed sleep anxiety, stress and concern about property values. Significant problems related to sleep, stress, and dizziness requiring investigation treatment and medication were reported by 15% (Appendix 1).

Comment: Based on the data presented in Section 2, that is approximately the background rate one might expect for such problems. 

In July 2011 surveys were administered to residents in the vicinity of the Waterloo wind farm, by Zhenhua Wang as part of a University of Adelaide honours project. This was nine months after the commencement of the operation of the turbines. Seventy five questionnaires were delivered to households within 5 km of the Waterloo wind farm and 48 were returned (64% response rate). A series of in-depth semi-structured interviews were conducted and attended by 6 local residents (Appendix 2). The result are reported as showing that 70% of respondents were negatively affected (35% ‘moderately’ and 19% ‘very’) by wind farm noise. Wang also reported that 38% of the affected residents claimed to be experiencing health issues that they felt were caused by the wind turbines, but these health issues were not specified. The top two expectations were for the turbines to be turned off at night and that affected residents obtain appropriate financial compensation.

Comment on methodological issues: I was not able to find a copy of the questionnaire to determine what specific questions were asked and how they were asked. It is not stated by what selection process the 6 residents came to be interviewed and how representative or otherwise they were. This is important to understand whether there was a potential for bias. Comment on the results: I estimate 12 to 13 of the surveys (16% of the total) identified health issues that were being attributed to the wind turbines. But this applies to the households and we do not know how many individuals in each household were or were not affected. Nevertheless it is similar to the data from Dr Iser and approximates the background rate of health problems of the sort described.

16 

A further Waterloo wind farm survey was conducted in April 2012 by Mary Morris. The survey aimed to determine the percentage of people disturbed by noise, shadow flicker, or TV/radio interference. Surveys were delivered to 230 households within a radius of 10 km of turbines and 93 households (respondents) returned completed surveys (40% response rate). Overall, 49% of respondents stated that they were disturbed by noise, visual flicker or television reception. Daytime noise bothered 39% of households and night-time noise bothered 40% of households. Sleep disturbance was reported by 29% of households (27 households in total). I do not know whether this applies to all or some occupants of the households who reported sleep disturbance. Within 5 km of the turbines, 56% of households were disturbed by daytime noise, 56% by nighttime noise, and 39% experienced sleep disturbance. Of households within 2 km of the turbines 5 indicated sleep disturbance and 11 did not (45%); at 3 to 4 km 47% (8 affected 9 not); 37% at 4-5 kilometres (3 affected and 5 not); 30% at 5 to 10 km and 10% (1 affected 10 not) at over 10 km (Appendix 3)

Comment: While I am not an acoustician, it does not seem plausible that sound (irrespective of frequency) originating from the turbines can be causing sleep disturbance in the numbers of people at the distances indicated. Of more concern however is that the study has not applied epidemiological methodology to identify and eliminate potential bias (such as through self-selection) or confounders. 

Ms Morris subsequently presents a series of case reports collected from individuals at 16 residences, up to 8 km away from the turbines, documenting how they were pre-October 2010, between October 2010 and 19 July 2013, during the week 19 July 2013 to 26 July 2013 when the turbines were not operating (or they were asked to indicate how they felt when they were away), and then again after 26 July 2013 (Waterloo Case Series Preliminary Report September 2013 Appendix 4).

Comment: It is not possible to attribute cause-and-effect from this sort of series of case reports where the proper use of the epidemiological methodology has not been applied. One approach is the careful correlation of acoustic factors with annoyance and/or symptoms. Where this has been done, at the Waterloo wind farm, it is clear there are other factors apart from those related to acoustics that associate with the problems experienced (Zajamsek, Moreau et al 2013). 

A survey was undertaken at the Cullerin Range Windfarm between July and August 2013 (Appendix 5) that was a follow-up from a survey conducted in August 2012 which found that a large percentage of residents out to 7.5 km were being adversely impacted by noise and vibration from the turbines. In the 2013 survey, questionnaires were delivered to 35 households up to 10 km from the turbines, and 24 (68.5%) returned them. Of these, 83% (91% - 20 households and 49/50 residents out to 8 km) were impacted and had lodged complaints with various authorities and

17 health care providers. No residents were impacted beyond 8 km from the turbines. Of the households affected, 20% (eight people) were within 0-2 km, 30% (18 people) were within 2-5 km, and 50% (23 people) within 5 to 8 km. Put another way, 100% of those resident 0-2km, 90% of those resident 2 to 5 km, and 92% of those resident 5 to 8 km were affected. Daytime noise was complained about by 87.7% and 100% were affected by night-time noise. It is instructive to look at the absolute numbers of households completing the surveys and where they lived in relation to the turbines: 0-2 km-4 households; 2- 5 km 7 households (most in the 4-5 km range); 5 to 10 km, 13 households of which nine were in the 7 to 8 km range; and one household over 10 km. Comment: It does not seem plausible that sound (irrespective of frequency) originating from the turbines can be causing sleep disturbance in the numbers of people at the distances indicated. Of more concern however is that the study has not applied epidemiological methodology to identify and eliminate potential bias (such as through self-selection) or confounders. In the report of Wang in relation to the Waterloo wind farm, 38% of respondents had raised complaints about noise to the developer, 25% to the local council, and 19% to the EPA, indicating, as the data from the Cullerin Range survey did, that where there is concern, people do complain. In this context, a recent study (Chapman, St George et al. 2013) was conducted across all Australian wind farms (51 with 1634 turbines) operating 1993-2012. Records of complaints about noise or health from residents living near the wind farms were obtained from all wind farm companies, and corroborated with complaints in submissions to 3 government public enquiries, news media records and court affidavits. These are expressed as proportions of estimated populations residing within 5 km of wind farms. The results of this study show large historical and geographical variations in wind farm complaints. Of Australian wind farms, 33/51 (64.7%) including 18/34 (52.9%) with turbine size >1 MW have never been subject to noise or health complaints. These 33 wind farms have an estimated 21,633 residents within 5 km and have operated complaint-free for a cumulative 267 years. Western Australia and Tasmania have seen no complaints. Across Australia only 1 in 254 residents appear to have ever complained, with 94 (73%) being residents near 6 wind farms targeted by anti-wind farm groups. The large majority 116/129(90%) of complainants made their first complaint after 2009 when anti wind farm groups began to add health concerns to their wider opposition. In the preceding years, health or noise complaints were rare despite large and small-turbine wind farms having operated for many years. It is considered that the reported historical and geographical variations in complaints are consistent with psychogenic hypotheses that expressed health problems are "communicated diseases" with nocebo effects likely to play an important role in the aetiology of complaints.

5.2.2. Recent Reviews, and Reports from Expert Bodies

18 A comprehensive report (dated 27 September 2013) compiled by Prof Simon Chapman, School of Public Health, University of Sydney, and Theresa Simonetti, Sydney University Medical School, documents 19 reviews of the research literature on wind farms and health and summarises the main conclusions of each in relation to the effects of noise, infrasound, shadow flicker and community and social response (http://tobacco.health.usyd.edu.au/assets/pdfs/publications/WindHealthReviews.pdf). This report is attached as Appendix 6. The information from other reviews that I have located is described below. American Wind Energy Association and Canadian Wind Energy Association December 2009 Following review, analysis, and discussion of current knowledge, the panel reached consensus on the following conclusions: 

There is no evidence that the audible or sub-audible sounds emitted by wind turbines have any direct adverse physiological effects.



The ground-borne vibrations from wind turbines are too weak to be detected by, or to affect, humans.



The sounds emitted by wind turbines are not unique. There is no reason to believe, based on the levels and frequencies of the sounds and the panel’s experience with sound exposures in occupational settings, that the sounds from wind turbines could plausibly have direct adverse health consequences.



There is a small body of literature, much of it not peer reviewed, and generally using methodology that encourages reporting bias, describing self-reported health outcomes related to distance from turbines. It is frequently claimed in these reports that infrasound is the causative factor for the reported effects, even though sound pressure levels are not measured.



In peer reviewed studies, wind turbine annoyance has been statistically associated with wind turbine noise, but found to be more strongly related to visual impact, attitude to wind turbines and sensitivity to noise. To date, no peer reviewed articles demonstrate a direct causal link between people living in proximity to modern wind turbines, the noise they emit and resulting physiological health effects. If anything, reported health effects are likely attributed to a number of environmental stressors that result in an annoyed/stressed state in a segment of the population.

Reviews by Knopper and Ollson (2011) and Kurpas, Mroczek et al. (2013) generally agree that wind turbines can be a source of annoyance for a small group of people. They also generally acknowledged that noise from wind turbines can be annoying and be a cause of sleep disturbance, especially when found at sound pressure levels greater than 40 db(A) or where specific topographic and environmental conditions exist. That aside, annoyance appears to be more strongly related to visual cues and attitude than to noise itself. Self-reported health effects of people living near wind turbines are more likely attributed to physical manifestation from an annoyed state or a nocebo effect (i.e. psychogenic influences) rather than from the wind turbines themselves. In other words, it appears that it is the change in the environment that is associated with reported health effects and not a turbine-specific variable like audible noise or infrasound.

19 Two recent reviews (Hanning and Evans 2012) (Jeffery, Krogh et al 2013) concluded that there is sufficient evidence to support the conclusion that noise from audible industrial wind turbines is a potential cause of health effects. The authors of the latter manuscript are members of the Society for Wind Vigilance, a vocal anti-wind farm lobby group. These authors also favour their own prior work using self-reporting surveys (Krogh, Gillis et al 2011). Like the paper by Hanning and Evans, the 17 reviews that dealt with properly conducted peer reviewed studies were not included. Both of these papers have been vigorously criticised by experienced and credible scientists (Barnard 2013a) (Chapman 2012) Systematic review by Adelaide Health Technology Assessment An extremely comprehensive systematic review of the human health effects of wind farms was undertaken by Adelaide Health Technology Assessment, School of Population Health, University of Adelaide, Adelaide South Australia. This work was commissioned by the National Health and Medical Research Council of Australia. The conclusions reached can be found on page 17 of the report but in summary this extensive and very detailed review finds that: “The evidence considered does not support the conclusion that wind turbines have direct adverse effects on human health, as the criteria for causation have not been fulfilled. Indirect effects of wind farms on human health through sleep disturbance, reduced sleep quality, quality of life and perhaps annoyance are possible. Bias and confounding could, however, be possible explanations for the reported associations upon which this conclusion is based (Merlin, T, Newton, S, Ellery, B, Milverton, J & Farah, C 2013, Systematic review of the human health effects of wind farms, National Health and Medical Research Council, Canberra Appendix 7). National Health and Medical Research Council (NH&MRC) report February 2014 (Appendix 8) A detailed, rigorous and quality controlled report by the NHMRC concluded that there is no reliable or consistent evidence that proximity to wind farms or wind farm noise either audible or in audible and irrespective of frequency directly cause adverse health effects in humans. There is also no evidence that shadow flicker or electromagnetic radiation produced by wind turbines are associated with adverse health effects. A more recent review (Knopper, Ollson et al. 2014) provides a bibliographic-like summary and analysis of the science relating to wind farms and health in terms of noise (including audible, low-frequency noise, and infrasound), EMF, and shadow flicker. There are roughly 60 scientific peer-reviewed articles on this issue. The available scientific evidence suggests that EMF, shadow flicker, low-frequency noise, and infrasound from wind turbines are not likely to affect human health; some studies have found that audible noise from wind turbines can be annoying to some. Annoyance may be associated with some self-reported health effects (e.g., sleep disturbance) especially at sound pressure levels >40 dB(A). Because environmental noise above certain levels is a recognized factor in a number of health issues, siting restrictions, and maximum noise levels have been implemented in many jurisdictions to limit noise exposure. These setbacks should

20 help alleviate annoyance from noise. Subjective variables (attitudes and expectations) are also linked to annoyance and have the potential to facilitate other health complaints via the nocebo effect. Therefore, it is possible that a segment of the population may remain annoyed (or report other health impacts) even when noise limits are enforced. Based on the findings and scientific merit of the available studies, the weight of evidence suggests that when sited properly, wind turbines are not related to adverse health (Knopper, Ollson et al. 2014). The most recent review (Mroczek, Banas et al. 2015) of the literature related to sound measurements near turbines, epidemiological and experimental studies, and factors associated with annoyance that I can locate reports the following:(1) Infrasound sound near wind turbines does not exceed audibility thresholds. (2) Epidemiological studies have shown associations between living near wind turbines and annoyance. (3) Infrasound and low-frequency sound do not present unique health risks. (4) Annoyance seems more strongly related to individual characteristics than noise from turbines (Mroczek, Banas et al. 2015).

5.2.3. Recent research studies 5.2.3.1.

Sleep disturbance and psychological distress

A recent study (Bakker, Pedersen et al. 2012) has addressed the issue of wind turbine noise and sleep disturbance in an elegant way. The main points are summarised below, but a key observation, in this study, was that people who do not notice the sound were not adversely affected by non-audible sound. Role of annoyance: The relationship between sound exposure and sleep disturbance and psychological distress was limited to those who reported that they could hear the sound. This was not, however, a direct relationship, but rather noise annoyance acted as a mediator for both. The hypothesis that sleep quality would be an intermediate factor between sound exposure and psychological distress was not confirmed. Those who are not annoyed by the noise will not be affected. Only those who are annoyed by the noise are at risk of being disturbed in their sleep and/or of being distressed. This risk is more pronounced in quiet areas compared to noisy areas, as the link between the sound levels and annoyance is stronger in these areas. Role of sound intensity: Recent data have shown, as previously, a dose-response relationship between emission levels of wind turbine sound and self-reported noise annoyance, but that annoyance mediates the effect of sound on sleep disturbance and the effect of sound is only significant at 40 dB or more. At levels over 45 dB(A), 48% of the respondents reported sleep disturbance. When respondents exposed to sound levels from wind turbines below 30 dB(A) were chosen as controls in a binary logistic regression, while adjusting for age, gender and economic benefit, being disturbed in sleep was statistically higher among respondents exposed to sound pressure levels above 45 dB(A). Among people who were not noticing the sound of wind turbines, no significant pathways between sound exposure and psychological distress can be distinguished in the SEM analyses. However, there seems to be a relationship between sleep disturbance

21 and psychological distress irrespective of exposure to wind turbine noise, but sleep disturbance only explains 5% of the variation of psychological distress. Benefit: Among respondents that benefited economically from wind turbines the proportion of people who were “rather” or “very” annoyed was significantly lower, as if wind turbine sound was differently valued by them compared to non-benefiting respondents. This is despite the fact that benefiting respondents were generally exposed to higher sound levels than non-benefitting respondents. Environment and effects relative to other sounds: Respondents living in areas with other background sounds were less affected than respondents in quiet areas. Wind turbines are less frequently reported as a sleep disturbing sound source than these other environmental sounds, irrespective of the area type. The Structural Equation Models show that among respondents who notice the sound of wind turbines, annoyance is the only factor in the equation that predicts sleep disturbance. This holds for all area types, i.e. quiet, noisy and total (both combined). A possible explanation might be that being annoyed contributes to a person's sensibility for any environmental sound, and the reaction may be caused by the combination of all sounds present.

5.2.3.2.

Quality-of-life

Quality of life is a multidimensional concept: (i) it always refers to the living conditions of an individual; (ii) it can be assessed by subjective and objective indicators; and (iii) there are important interactions between subjective and objective indicators that must be interrogated in order to adequately address complex research issues. There are two published studies (one in New Zealand and one in the USA) that have indicated a decreased quality of life in individuals residing in the proximity of wind turbines. There is one published study undertaken in Poland which shows that people living closer to the wind farms in fact had better quality of life. None of these studies are methodologically robust. A cross-sectional study undertaken in semirural areas of New Zealand compared the health-related quality of life (HRQOL) of individuals residing in the proximity of a wind farm to those residing in a demographically matched area sufficiently displaced from wind turbines. Self-administered questionnaires, which included the brief version of the World Health Organization quality of life scale, were delivered to residents in two adjacent areas in semirural New Zealand. Participants were also asked to identify annoying noises, indicate their degree of noise sensitivity, and rate amenity. Statistically significant differences were noted in some HRQOL domain scores, with residents living within 2 km of a turbine installation reporting lower overall quality of life, physical quality of life, and environmental quality of life. Those exposed to turbine noise also reported significantly lower sleep quality, and rated their environment as less restful (Shepherd, McBride et al. 2011).

22 The USA study examined the effects of noise emissions on residents living within 1.4 km of wind turbines in comparison to a group of residents living much further away. They attributed disturbed sleep and day-time sleepiness and impaired mental-health to noise emissions from those turbines (Nissenbaum, Aramini et al. 2012). This work, which is severely flawed in a number of respects, has been severely criticised in the literature (Ollson, Knopper et al. 2013). The authors own statistical analyses suggest that although scores may be statistically different between near and far groups for sleep quality and sleepiness, they are no different than those reported in the general population, and the claims of causation by the authors (i.e. wind turbine noise) for negative “mental component symptom scores” on the SF 36 questionnaire are not supported by their data. Another study was undertaken in a group of Polish adults that consisted of 703 women and 574 men, living in places located near wind farms. The mean age was 45.5 +/- 16.10. Some 33.2% of participants lived more than 1,500 m from wind farms and 17% within 700 m. The tools used to assess quality of life were the Norwegian version of the SF-36, General Health Questionnaire, the Visual Analogue Scale (VAS) for health assessment, and original questions. Irrespective of the distance between a place of residence and a wind farm, the highest quality of life was noted within the physical functioning subscale (mean 76+/-27.97), and the lowest within the general health (mean 55.3+/-24.06). Within all scales, the quality of life was assessed highest by residents of areas located closest to wind farms, and the lowest by those living more than 1,500m from wind farms (Mroczek, Kurpas et al. 2012). I have concerns with all of the studies, and place limited weight on them. The Shepherd, McBride et al study (2011) is flawed in my opinion, because the authors deployed a non-equivalent comparison group post-test only design. This means there is no way to compare pre and post wind farm HRQOL scores, and hence no way to verify whether the scores are attributable to the wind farm or not. The other studies are also flawed because they failed to use robust epidemiological methodology with appropriate consideration of confounds. Nissenbaum et al (2012) make conclusions that are not, in my view, supported by their data. The relationship between the presence of wind farms at different stages of development and HRQoL of people living in their vicinity in Poland was established using the SF-36v2 questionnaire among 1277 people who lived within 2 km from a wind turbine. The mental health, role emotional, and social functioning scores were significantly higher among respondents living near wind farms and wind-farm construction sites than among those living close to locations where wind farms were planned but where construction had not yet begun. Significant differences in physical and mental component scores were observed between residents who reacted calmly and those who responded with apprehension. Residents who expected the improvement of their financial standing as a result of the wind farm assessed their general health higher than those who did not expect to receive any economic benefits. The lowest QoL scores corresponded to frequent headaches, stomach aches, and back pain over the

23 previous three months, as well as recurrent problems with falling asleep, anxiety, and a lack of acceptance of the project (McCunney, Mundt et al. 2014). Most recently the World Health Organization QOL-BREF (WHOQOL-BREF) questionnaire was used to evaluate quality of life in relation to wind turbine noise levels among randomly selected participants aged 18-79 (606 males, 632 females) living between 0.25 and 11.22km from wind turbines (response rate 78.9%). Collectively the results indicated that there was no association between exposure to wind turbine noise up to 46dBA and evaluate quality of life assessed using the WHOQOL-BREF questionnaire (Feder, Michaud et al. 2015).

Vibroacoustic disease (VAD) Assuming that such an entity exists, and there is considerable doubt such an entity does exist , there is no evidence of even rudimentary quality that VAD is associated with or caused by wind turbines (Chapman and St George 2013). 5.2.3.3.

Other health abnormalities and the modifying effects of psychogenic influences

Most physiological responses to noise habituate rapidly, but in some people physiological responses persist. It is not clear whether this sub-sample is also subjectively sensitive to noise and whether failure to habituate to environmental noise may also represent a biological indicator of vulnerability to psychiatric disorder. A number of studies have shown that noise sensitivity is moderately stable and associated with current psychiatric disorder and a disposition to negative affectivity. Noise sensitivity levels fall with recovery from depression but still remain high compared to never depressed people, suggesting an underlying high level of noise sensitivity. Noise sensitivity was related to higher tonic skin conductance and heart rate and greater defence/startle responses during noise exposure in the laboratory. Noise sensitive people attend more to noises, discriminate more between noises, find noises more threatening and out of their control, and react to, and adapt to noises more slowly than less noise sensitive people (Stansfeld 1992). Non-specific symptoms and negatively orientated personality traits All households (N = 1270) near 10 small and micro wind turbines in two UK cities were sent questionnaires by mail which any member of the household over the age of 18 could anonymously complete and return or could complete over the Internet. A total of 138 completed surveys were returned (i.e. a response rate of 10.86%). Of the respondents, 54.4% were male and the overall demographic profile was representative of the relevant wider population. Information gathered by questionnaire related to perceived turbine noise, neuroticism, negative aspect, frustration intolerance, attitude to wind turbines and non-specific symptoms. Actual turbine noise level for each household was calculated. There was no relationship between calculated actual noise and non-specific symptoms. The relationship between perceived noise and non-specific

24 symptoms was found in only 4 individuals with high negatively orientated personality traits (Taylor J et al. 2013). Mood and negative expectations Negative expectations can create symptoms from wind turbines and recent work has shown that positive expectations can produce the opposite effect, in terms of a reduction in symptoms and improvements in reported health. In one study, 60 participants were randomized to either positive or negative expectation groups and subsequently exposed to audible wind farm sound and infrasound. Prior to exposure, negative expectation participants watched a DVD incorporating TV footage about health effects said to be caused by infrasound produced by wind turbines. In contrast, positive expectation participants viewed a DVD that outlined the possible therapeutic effects of infrasound exposure. Negative expectation participants experienced a significant increase in symptoms and a significant deterioration in mood, while positive expectation participants reported a significant decrease in symptoms and a significant improvement in mood (Crichton, Dodd et al. 2013). Noise annoyance is considered to be the (long-term) negative evaluation of living conditions with respect to noise. Acoustic factors are a limited part of the problem. Past disturbances attitudes and expectations are all important as are a rage of other factors (Guski 1999): 

The personal factors influencing the evaluation are: Sensitivity to noise, fear of harm connected with the source, personal evaluation of the source, and coping capacity with respect to noise.



The social factors are: General (social) evaluation of the source, trust or misfeasance with source authorities, history of noise exposure, and expectations of residents. It is considered that significant decrease in a negatively moderating variable is as effective in reducing noise annoyance, as is a significant decrease in noise level.

Factors affecting hearing Age People’s hearing tends to worsen slowly with age, this is called presbyacusis. Hearing generally deteriorates faster at the high and mid frequencies than at the low frequencies. This means that older people’s hearing tends to be relatively better at low frequencies, meaning they hear these sounds well, even if they have hearing loss. Thresholds of hearing for unselected 50 to 60-year-old adults are shown in the table below and compared with those for normal young adults. One column shows the 50% (median) level and the second (for each of the young and old) a lower threshold below which the most sensitive 10% of the population fall (most sensitive decile). It is evident that older people are 7 dB less sensitive at the median level than the younger ones, but only 3 dB less sensitive the most sensitive decile. In the infrasound region the difference between the 10% most sensitive young and older people is only 3 dB’s. Therefore, the wellknown differences in hearing sensitivity between old and young people which occur at high frequencies do

25 not result in a particularly disproportionate difference in sensitivity at low frequencies (Health effects of exposure to ultrasound and infrasound. Report of the Independent Advisory Group on non-ionising radiation. Health Protection Agency, United Kingdom, February 2010). Table: low-frequency hearing levels of old and young people (Van Den Berg and Passchier-Vermeer)

It is consistent with this that there is no evidence that older people are disproportionately affected by exposure to wind farms or by LFN or infrasound at the SPL’s that would be expected to occur at a wind farm. Individual sensitivity For some very sensitive people LFN can be so loud that it sounds like ‘an aeroplane engine roaring in the room’. One possible explanation for the enhanced ability of some people to process information at low frequencies is the presence of dead or defective regions for detecting high-frequency. These effects may reflect cortical plasticity induced by the dead regions (Moore and Vinay 2009). However, generally when someone is aware of LFN, they are usually sensitive to lower noise in general – even at levels that don’t normally bother other people. Sensitive people may only notice LFN when it is quiet and they are on their own. The problem is that it becomes more perceptible if attention is focused on it, or if attitudes are negative. This makes people more aware of the sound during everyday activities resulting in irritability,

26 problems concentrating, and difficulty falling asleep. When people are under stress it is found that LFN becomes more annoying. Research has also shown that there is a link between sensitivity to LFN and noise (in general) and depression. 5.3. Low-frequency sound and infra-sound Sound at 20-200 Hz is often called low-frequency sound, while sound below 20 Hz is generally described as infrasound. Humans can perceive infrasound down to frequencies as low as 2 Hz, if the intensity or sound pressure level (SPL) is sufficiently high (Moller and Pedersen 2004). Low-frequency sound is attenuated less with distance and across facades, and may travel further under certain climatic conditions. There are many sources of low-frequency sound and infrasound in the environment. 5.3.1. Effects of infrasound and low-frequency sound. Audibility Below 1000 Hz, the dynamic range of the auditory system decreases with decreasing frequency. This means that a relatively small increase in SPL at 20 Hz would change the perception of this tone from barely audible to very loud. On the other hand, perceivable changes in loudness level at 1 kHz would require larger changes in SPL. Most people live with low frequency noise on an everyday basis and hardly notice it. Because of inter individual differences in hearing sensitivity a sound which is inaudible to some people may be audible to others (Moller and Pedersen 2004). Mechanisms by which the inner ear responds to low frequency sound Cochlea The first step in the auditory processing of sound occurs in the cochlea, a series of fluid-filled cylindrical spaces that spiral around the auditory nerve and are sensitive to differential pressures changes. The membrane between the spaces, the organ of Corti, contains a row of inner hair cells and three rows of outer hair cells. The outer hair cells (OHCs) have stereocilia with variable lengths, some of which are embedded in the overlaying gelatinous membrane. At low frequencies, the inner cells respond to the velocity of the displacement of the basilar membrane while the OHCs respond to the actual displacement. The two types of cells contact different types of afferent nerve fibres. Approximately 95 % of the fibres that transmit impulses that will be experienced as ‘‘hearing’’ are myelinated with one fibre contacting one inner hair cell. There are also unmyelinated fibres, each of which synapse with up to 15-20 OHCs, and which themselves also receive descending input from a part of the brain on the opposite side. This pathway is known as the crossed olivo-cochlear bundle. There is compelling data that OHCs are the instrument of amplification within the cochlear. The OHCs display electro-motility, as result of a protein called “Prestin” that allows them to rapidly change their length. If an OHC is stretched or compressed axially, then a transient whole cell current is generated.

27 Although theoretically the amplification system may be considered to be most important in the highfrequency range of hearing where the quality factors of the tuning curves are greatest (Ashmore 2008), in experimental systems the maximum effect is seen between 1 and 10 Hz. Also OHCs have been observed to oscillate spontaneously and at low-frequency (Nin 2012). The OHCs are important for sharp tuning and high sensitivity, and most hearing loss is due to loss of the outer hair cells. It has been reported that at 5 Hz the OHCs can be stimulated at sound pressures 40 db below those that stimulate the inner hair cells associated with ‘‘conscious hearing.’’ Stated alternatively, at 10 Hz, the sound pressure level required to evoke responses in inner hair cells to experience ‘‘sound’’ is about 100 db (Salt and Hullar 2010). A response of OHCs to 5 Hz at 60 db does not result in activation of the inner hair cells. As Salt points out it would be ‘‘unconscious.’ It is clearly below the threshold required to activate the auditory cortex. Experimentally it has been clearly shown that in humans 12 and 48 Hz tone bursts, delivered directly to the ear at 100 dB, but not 90db activate the primary auditory cortex (Dommes and Bauknecht 2009). A tone of 6 Hz at 130 dB SPL clearly affects the auditory processing in the human cochlea but without any experience of annoyance at least over a brief time frame (Hensel, Günther et al 2007). Therefore, the functional significance and consequences of the activation of OHCs as demonstrated by Salt are unclear. Moreover there is clear evidence that the efferent innervation to OHC afferents can gate unnecessary signals (Peng and Ricci 2011), and the large endolymphatic potentials measured in the guinea pig in response to 5Hz are suppressed by higher frequency tones (Salt and Lichtenhan et al 2013).

Vestibular apparatus Another part of the ear, the vestibular system, controls balance. In terrestrial vertebrates, the otolith organs, part of the vestibular system in the inner ear, have conserved a particular sensitivity to substrateor bone-conducted sound. A study looking at ocular vestibular evoked myogenic potentials (OVEMPs) in humans shows that OVEMPs are highly tuned with a best frequency of about 100 Hz and with a band-pass characteristic between about 25 and 200 Hz. The lowest intensity that a reliable OVEMP could be recorded in the averaged response was 70.2 dB re 1 g and therefore vestibular activation in response to low frequency vibration is evident in normal volunteers (Todd, Rosengren et al. 2008). Salt considers that at certain SPLs infrasound could be associated with unfamiliar sensations or subtle changes in physiology within the ear (Salt and Hullar 2010), but there is no evidence that this is of significance.

Effects of infrasound and LFN A recent study has produced data showing some increase in activity at frequencies as low as 8 Hz in the auditory cortex (Appendix 10) in the absence of hearing the sound and without either evidence or

28 inference that this may be associated with adverse effects. Despite the elegant methodology in the aforementioned study auditory cortical responses and cochlear modulations to infrasound exposure have been observed previously in the absence of an individual’s lack of tonal perception (Chen and Narins 2012). But there is no reliable evidence to suggest that below the hearing threshold any significant adverse results occur unless the SPL is extremely high. The biological effects observed in animal studies have occurred after exposures to infrasound at levels above 100 dB (Health effects of exposure to ultrasound and infrasound. Report of the Independent advisory group on non-ionising radiation. Health Protection Agency, United Kingdom, February 2010). As another example the effect of infrasound to decrease the expression of cannabinoid receptors in rat hippocampi requires exposure to 16 Hz and 130 dB for 7 to 14 days (Ma, He et al. 2015). This is way in excess of what would be experienced other than in extreme and unregulated industrial situations. In contrast to the notion that infrasound is of necessity a harmful phenomenon, a recent study showed that exposure of bone marrow stem cells (BMSCs) to infrasound promoted proliferation and inhibited programmed cell death of BMSC’s (He and Fan 2014). Effects of the Vestibular (balance) system Prior research has shown that overall it is unlikely that external low frequency noise at levels below the threshold of audibility will have an effect on the vestibular system, which is a less sensitive detector of sound than by bone or air conduction. High levels of low frequency noise and infrasound do produce vestibular excitation, but the sound levels required are greatly in excess of hearing threshold levels (Parker, Tubbs et al. 1978) The 1986 study by the USA Navy reported that physical vibration of pilots in flight simulators induced motion sickness when the vibration frequency was in the range of 0.05 to 0.9Hz with the maximum (worst) effect being at about 0.2 Hz. This study cannot be extrapolated to the situation of wind turbines. Even the amplitude at source of the turbine is unlikely to be sufficient. So that by the time attenuation has occurred, even if there is some augmentation indoors, it is implausible that there can be an analogy between what the U.S. Navy reported in pilots in flight simulators and what occurs in dwellings more than a kilometre from a wind turbine. Annoyance A study was carried out to investigate the annoyance due to low frequency noise (LFN) at levels normally prevailing at workplaces, particularly in control rooms and office-like areas. One experiment included 55 young volunteers and a second experiment comprised 70 older volunteers, categorized in terms of sensitivity to noise. The subjects listened to noise samples with different spectra, including LFNs at sound pressure level (SPL) of 45-67 dBA, and evaluated annoyance using a 100-score graphical rating scale. The

29 subjective ratings of annoyance were compared to different noise metrics (Pawlaczyk-Luszczynska, Dudarewicz et al. 2010). In both experiments: 

There were no differences in annoyance assessments between females and males.



A significant influence of individual sensitivity to noise on annoyance rating was observed for some LFNs.



Annoyance of LFN was not rated higher than annoyance from broadband noises without or with less prominent low frequencies at similar A-weighted SPLs.



Median annoyance rating of LFN highly correlated with A-weighted SPL (L(Aeq,T)), low frequency Aweighted SPL (L(LFAeq,T)) and C-weighted SPL (L(Ceq,T)). However, it is only the two latter noise metrics (i.e. L(LFAeq,T) and L(Ceq,T)) which seem to be reliable predictors of annoyance exclusively from LFN.



The young and older participants assessed similar annoyance from LFN at similar L(LFAeq,T) or L(Ceq,T) levels.



Generally, over half of the subjects were predicted to be highly annoyed by LFN at the low frequency Aweighted SPL or C-weighted SPL above 62 and 83 dB, respectively.

Human cognitive performance A group of Polish investigators have conducted a series of studies to examine whether exposure to LFN at levels normally occurring in industrial control rooms can influence human cognitive performance (e.g. visual functions, concentration, continuous and selective attention) and subjective well-being. They concluded there might be an adverse effect in some individuals very sensitive to LFN delivered at high SPL’s (Pawlaczyk-Luszczynska, Dudarewicz et al. 2004). In work done by other investigators, the cognitive performance of 40 subjects was measured during exposure to infrasound and noise in three experiments. In the first experiment, 12 subjects were exposed for 15 min to each of four experimental conditions while performing a Serial Search Task. The conditions were: (i) 65 dB ambient noise (AN), (ii) a low-frequency background noise (BN) at 110 dB, (iii) a 7-Hz tone at 125 dB + AN, and (iv) the 125 dB tone + BN. The second experiment was the same as the first except a Complex Counting Task was used and the exposure duration was increased from 15 min to 30 min. In the third experiment, the Complex Counting Task was used and the subjects were exposed for 15 min to each of the following four conditions: BN, 125 dB at 7 Hz plus BN, 132 dB at 7 Hz plus BN, and 142 dB at 7 Hz plus BN. No decrements in performance were obtained in any of the three experiments, and there were no subjective reports of dizziness or disorientation as suggested in some of the previous literature. The authors conclude that adverse effects of infrasound have been exaggerated and the current levels of infrasound components as produced by “modern” jet aircraft are not considered in themselves a practical problem (Harris and Johnson 1978).

30 5.3.2. Do LFN and or IS in relation to wind farms adversely impact health? Pedersen et al. (2008a and 2008b) describes an investigation of a randomly selected sample of 21 cases of low frequency noise complaints from a pool of 203 cases. The study involved making recordings of sound in the homes of the complainants, and the subjects were exposed to the sounds in blind listening tests at a low - frequency test facility. The study concluded that some of the complainants were annoyed by physical sounds, and others were suffering from low frequency tinnitus (tinnitus is defined as a phantom auditory perception-it is a perception of sound without corresponding acoustic or mechanical correlates in the cochlea (Han, Lee et al. 2009)). Physical sounds in the infrasonic range were not found to be responsible for the annoyance in any of the cases (Pedersen, Møller et al 2008), (Pedersen, Møller et al 2008a). Two papers prepared by academics at the University of Adelaide have examined whether there is a link between infrasound measurements and resident annoyance in the vicinity of Waterloo Wind Farm in the mid-north of South Australia. In the first of these papers (Nobbs et al (2012)), the authors conducted a pilot study to correlate the home occupant’s annoyance levels with measured noise (Z, C and A-weighted) within the dwelling. The dwelling was located about 2.5km from the wind farm. The authors’ preliminary conclusion was that there was a relationship between increased annoyance levels and mean Z and C weighted sound levels, but not A-weighted sound. Significant amplitude modulation was also detected, though no trend in annoyance was observed. The authors acknowledged the preliminary nature of this study, and that future measurements should (among other things) include wind farm operational data to correlate annoyance and sound level data with power production, and meteorological data. These acknowledgements are important because they highlight the key limitation of this study, which is that it did not identify the source of the SPLs measured inside the dwelling. In a subsequent paper presented at a conference in Victor Harbour in November 2013 (Zajansek, Moreau et al 2013), indoor noise monitoring was conducted in a room of a house near a wind farm whose resident claims to be annoyed by wind farm noise. The testing used low-frequency microphones that can resolve noise below 0.5 Hz. The aim of the study was to examine the relationship(s) between the sound pressure levels, weather conditions, resident rated annoyance to sound and wind farm output power data. The study concentrated on sound in the low and infrasonic frequency ranges. Additionally, the methodology records two-minutes of audio data at the same time a resident claim to be annoyed by noise from wind turbines. The final two paragraphs of the discussion bear repeating: “If the wind farm were the source of annoying noise, then we would expect the strongest annoyance to be reported when local wind speed was low (minimising masking noise) and when the wind farm output was high. However, for these results, it appears that annoyance is most likely related to local wind speed rather than another factor. High annoyance was recorded when the local wind speed was high, when local masking noise would be at its greatest. Indeed, when interesting features of the narrowband spectrum are

31 recorded that are quite likely attributable to the wind farm, the local wind speed is low and the resident rates themselves as not annoyed. The authors do not doubt the sincerity of the resident; therefore there must be significant non-acoustical moderating factors (Doolan, 2013) influencing the perception and selfreported annoyance of noise in this case” This study was an improvement on the study presented in the 2012 paper, because the authors were able to correlate recorded SPLs, meteorological information, and the wind farm output. On this basis, I find the methodology applied in the 2013 study, and the conclusions derived from it, more convincing than the 2012 study. 5.3.3. Biology or Psychology Although adverse effects are attributed to infrasound, there is no plausible biological mechanism by which, or evidence that, low intensity infrasound can cause adverse effects to human health. This does not throw into doubt the reports by individuals who feel genuinely affected. Rather, it requires an alternative explanation, and there is evidence to suggest the importance of psychogenic factors in mediating adverse effects. For example in an experiment that provided exposure to both audible and infrasound the provision of an explanation of the nocebo response, followed by exposure to infrasound, abrogates adverse symptoms attributed to windfarm generated infrasound (Crichton and Petrie 2015). Similarly, the delivery of positive expectations might reduce or reverse symptoms triggered by negative expectations formed from such misinformation. Accessing positively framed health information may reverse or dilute the effect of negative expectations formed from exposure to media warnings about health risks posed by new technologies, such as wind turbines. (Crichton and Petrie 2015) 5.3.4. Appropriateness of current guidelines in relation to infrasound A recent study investigated whether current audible noise-based guidelines for wind turbines account for the protection of human health, given the levels of infrasound and low-frequency noise typically produced by wind turbines. New field measurements of indoor infrasound and outdoor low-frequency noise at locations between 400 and 900 m from the nearest turbine, which were previously underrepresented in the scientific literature, are reported and put into context with existing published works. The analysis showed that indoor infrasound levels were below auditory threshold levels while low-frequency noise levels at distances >500 m were similar to background low-frequency noise levels. A clear contribution to low-frequency noise due to wind turbine operation (i.e. measured with turbines on in comparison to with turbines off) was noted at a distance of 480 m. However, this corresponded to an increase in overall audible sound measures as reported in dB(A), supporting the hypothesis that controlling audible sound produced by normally operating wind turbines will also control for low-frequency noise. Overall, the available data from this and other studies suggest that health-based audible noise wind turbine siting guidelines provide

32 an effective means to evaluate, monitor, and protect potential receptors from audible noise as well as infrasound and low-frequency noise. (Berger, Ashtiani et al. 2015) 6. Conclusions 6.1. Wind farm Noise and adverse health effects 

There is no evidence that audible noise resulting from the operation of wind turbines constitutes a significant risk to health provided the development is compliant with current guidelines (Appendix 6).



Annoyance is acknowledged to occur in a generally small, but probably variable number of individuals and the extent to which this is problematic in a compliant wind farm may depend more on non-acoustic than acoustic factors.



There are undoubtedly some particularly noise sensitive individuals, but it would be surprising if their first awareness of this as adults occurred in the context of exposure to wind turbines. However, I am not aware of any specific enquiry in this regard.



The weight of evidence is that when adverse health effects occur they are either circumstantially related or mediated by psychological distress, or both.



The extent to which psychological distress and or sleep disturbance and/or other adverse health effects occur is dependent on a number of other internal and external factors (attitude, visual amenity, nocebo effects, financial interest, et cetera). 6.2. Low-frequency noise and Infrasound and adverse health effects. 6.2.1. Low-frequency noise 

The problem with low-frequency noise, as with high-frequency noise, relates to annoyance associated with audibility and the same range of moderating non-acoustic factors. There is no evidence that adverse health effects can be directly attributable to inaudible low-frequency sound emissions. 6.2.2. Infrasound



There is no evidence that inaudible infrasound are associated with any significant physiological or pathophysiological consequences.



There is no evidence that the level of infrasound produced by wind turbines constitutes a problem to health.

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34 Janssen, S. A., H. Vos, et al. (2011). "A comparison between exposure-response relationships for wind turbine annoyance and annoyance due to other noise sources." J Acoust Soc Am 130(6): 3746-3753. Knopper, L. D. and C. A. Ollson (2011). "Health effects and wind turbines: a review of the literature." Environ Health 10: 78. Knopper, L. D., C. A. Ollson, et al. (2014). "Wind turbines and human health." Front Public Health 2: 63. Krogh, C.M.E., Gillis, L., et al. (2011) WindVOiCe, a self-reporting survey: adverse health effects, industrial wind turbines, and the need for vigilance monitoring. Bull Sci Technol Soc 31(4):334-45. Kurpas, D., B. Mroczek, et al. (2013). "Health impact of wind farms." Ann Agric Environ Med 20(3): 595-604. Laszlo, H. E., E. S. McRobie, et al. (2012). "Annoyance and other reaction measures to changes in noise exposure - a review." Sci Total Environ 435-436: 551-562. Leventhall, G. (2007). "What is infrasound?" Prog Biophys Mol Biol 93(1-3): 130-137. Ma, L., H. He, et al. (2015). "Involvement of cannabinoid receptors in infrasonic noise-induced neuronal impairment." Acta Biochim Biophys Sin (Shanghai) 47(8): 647-653. Maffei, L., T. Iachini, et al. (2013). "The effects of vision-related aspects on noise perception of wind turbines in quiet areas." Int J Environ Res Public Health 10(5): 1681-1697. McCunney, R. J., K. A. Mundt, et al. (2014). "Wind turbines and health: a critical review of the scientific literature." J Occup Environ Med 56(11): e108-130. Moller, H. and C. S. Pedersen (2004). "Hearing at low and infrasonic frequencies." Noise Health 6(23): 3757. Moller, H. and C. S. Pedersen (2011). "Low-frequency noise from large wind turbines." J Acoust Soc Am 129(6): 3727-3744. Moore, B. C. and S. N. Vinay (2009). "Enhanced discrimination of low-frequency sounds for subjects with high-frequency dead regions." Brain 132(Pt 2): 524-536. Mroczek, B., D. Kurpas, et al. (2012). "Influence of distances between places of residence and wind farms on the quality of life in nearby areas." Ann Agric Environ Med 19(4): 692-696. Mroczek, B., J. Banas, et al. (2015). "Evaluation of Quality of Life of Those Living near a Wind Farm." Int J Environ Res Public Health 12(6): 6066-6083. Nin, F., Reichenbach, T., Fisher, J.A.N., et al. (2012) Contribution of active hair-bundle motility to nonlinear amplification in the mammalian cochlea PNAS 109: 21076-21080. Nissenbaum MA, Aramini JJ, Hanning CD. (2012). Effects of industrial wind turbine noise on sleep and health. Noise Health 14:237-43. Ollson, C. A., L. D. Knopper, et al. (2013). "Are the findings of "Effects of industrial wind turbine noise on sleep and health" supported?" Noise Health 15(63): 148-150. Parker, D. E., R. L. Tubbs, et al. (1978). "Visual-field displacements in human beings evoked by accoustical transients." J Acoust Soc Am 63(6): 1912-1918. Pawlaczyk-Luszczynska, M., A. Dudarewicz, et al. (2010). "Evaluation of annoyance from low frequency noise under laboratory conditions." Noise Health 12(48): 166-181. Pawlaczyk-Luszczynska, M., A. Dudarewicz, et al. (2004). "[The effect of low frequency noise on human mental performance]." Med Pr 55(1): 63-74. Pawlaczyk-Luszczynska, M., W. Szymczak, et al. (2006). "Proposed criteria for assessing low frequency noise annoyance in occupational settings." Int J Occup Med Environ Health 19(3): 185-197. Pedersen, C.S., Møller, H. and Persson Waye, K. (2008). "A detailed study of low-frequency noise complaints." Journal of Low Frequency Noise, Vibration and Active Control 27(1):1-33, Pedersen, C.S., Møller, H., Persson Waye, K. (2008a). "A detailed investigation of low frequency noise complaints." Joint Baltic Nordic Acoustic Meeting Reykjavik, Iceland. Pedersen, E. and K. Persson Waye (2007). "Wind turbine noise, annoyance and self-reported health and well-being in different living environments." Occup Environ Med 64(7): 480-486. Pedersen, E., F. van den Berg, et al. (2009). "Response to noise from modern wind farms in The Netherlands." J Acoust Soc Am 126(2): 634-643. Pedersen, E. and K. P. Waye (2004). "Perception and annoyance due to wind turbine noise--a doseresponse relationship." J Acoust Soc Am 116(6): 3460-3470. Peng, A.W. Ricci, A.J. (2011) Somatic motility and hair bundle mechanics, are both necessary for cochlear amplification. Hearing Research. 273 (1–2): 109-122.

35 Resta O, Foschino Barbaro MP, Bonfitto P, et al. (2003) Low sleep quality and daytime sleepiness in obese patients without obstructive sleep apnoea syndrome. J Intern Med. 253:536-43 Reynolds, A. C., J. Dorrian, et al. (2012). "Impact of five nights of sleep restriction on glucose metabolism, leptin and testosterone in young adult men." PLoS One 7(7): e41218. Salt, A. N. and T. E. Hullar (2010). "Responses of the ear to low frequency sounds, infrasound and wind turbines." Hear Res 268(1-2): 12-21. Salt A.N., Lichtenhan, J.T. et al. (2013) Large endolymphatic potentials from low-frequency and infrasonic tones in the guinea pig. Acoust Soc Am. 133(3):1561-71. Šaliūnas, D. and Volkovas, V. (2013). Analysis of Assessments of Low Frequency Noise from Wind Turbines. Calculations of Impact Range According to HN 30:2009 Environmental Research, Engineering and Management. 1(63): 48-59 Schreckenberg, D., B. Griefahn, et al. (2010). "The associations between noise sensitivity, reported physical and mental health, perceived environmental quality, and noise annoyance." Noise Health 12(46): 716. Schust M. (2004) “Effects of low frequency noise up to 100 Hz.” Noise & health.6(23):73-85. Shepherd, D., D. McBride, et al. (2011). "Evaluating the impact of wind turbine noise on health-related quality of life." Noise Health 13(54): 333-339. Shi, Z., G. A. Wittert, et al. (2013). "Association between monosodium glutamate intake and sleepdisordered breathing among Chinese adults with normal body weight." Nutrition 29(3): 508-513. Silva, G.E., Goodwin JL, Sherrill, D.L., et al. (2007) “Relationship between reported and measured sleep times: the sleep heart health study (SHHS).” J Clin Sleep Med. 15(6):622-30. Stansfeld, S. A. (1992). "Noise, noise sensitivity and psychiatric disorder: epidemiological and psychophysiological studies." Psychol Med Monogr Suppl 22: 1-44. Stansfeld S, Crombie R. (2011) Cardiovascular effects of environmental noise: research in the United Kingdom. Noise Health 13(52):229-33 Taylor J et al. (2013). The influence of negative orientated personality trays on the effect of wind turbine noise. Personality and Individual Differences 54:338-343 Tiller, J.W.G. (2012) Depression and anxiety. MJA Open 1 Suppl 4: 28-31 Todd, N.P.M., Rosengren, S.M., Colebatch, J.G. (2008) Tuning and sensitivity of the human vestibular system to low-frequency vibration Neuroscience Letters 444(1):36–41 Van Gerven, P. W., H. Vos, et al. (2009). "Annoyance from environmental noise across the lifespan." J Acoust Soc Am 126(1): 187-194. van Kamp, I., R. F. Job, et al. (2004). "The role of noise sensitivity in the noise-response relation: a comparison of three international airport studies." J Acoust Soc Am 116(6): 3471-3479. van Kempen, E. and W. Babisch (2012). "The quantitative relationship between road traffic noise and hypertension: a meta-analysis." J Hypertens 30(6): 1075-1086. Van Renterghem, T., A. Bockstael, et al. (2013). "Annoyance, detection and recognition of wind turbine noise." Sci Total Environ 456-457: 333-345. Zajamsek, B., Moreau, D. et al. (2013) Indoor Infrasound and low-frequency noise monitoring in a rural environment. Proceedings of Acoustics. Victor Harbor 17-20 November 2013

36 8. Appendices 8.1 Dr Iser survey on wind power station affects 8.2 Evaluation of wind farm noise policies in South Australia-a case study of Waterloo wind farm 8.3 Waterloo wind farm survey April 2012 - M Morris 8.4 Waterloo case series preliminary report September 2013 M Morris 8.5 Cullerin Range wind farm survey 8.6 Summary of main conclusions reached in 19 reviews of the research literature on wind farms and health. 8.7 Systematic review of the human health effects of wind farms 8.8 NHMRC draft information paper-evidence on wind farms and human health February 2014 8.9 Wind farms environmental noise guidelines - EPA South Australia 8.10 Investigation of perception of infrasound frequencies by functional magnetic resonance and magnetoencephalography.

Expert witness statement of Gary Allen Wittert

-Appendix 2 – Dundonnell Wind Farm Noise Report

I

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DUNDONNELL WIND FARM EES Noise Impact Assessment Rp001 R03 2012480ML

2 September 2014

6 Gipps Street Collingwood 3066 Victoria Australia T: +613 9416 1855 F: +613 9416 1231 A.C.N. 006 675 403 www.marshallday.com

Project:

DUNDONNELL WIND FARM

Prepared for:

Trustpower Australia Level 6, 52 Collins St Melbourne VIC 3000

Attention:

Mr Chris Righetti

Report No.:

001 R03 2012480ML

Disclaimer Reports produced by Marshall Day Acoustics Pty Ltd are prepared based on the Client’s objective and are based on a specific scope, conditions and limitations, as agreed between Marshall Day Acoustics and the Client. Information and/or report(s) prepared by Marshall Day Acoustics may not be suitable for uses other than the original intended objective. No parties other than the Client should use any information and/or report(s) without first conferring with Marshall Day Acoustics. Copyright The concepts and information contained in this document are the property of Marshall Day Acoustics Pty Ltd. Use or copying of this document in whole or in part without the written permission of Marshall Day Acoustics constitutes an infringement of copyright. Information shall not be assigned to a third party without prior consent.

Document control Status:

Rev:

Comments

Final Final

01

Final

02

Respond to comments from legal review Minor changes

Final

03

Minor correction

Date:

Author:

Reviewer:

25 Jun 2014

C. Delaire

J. Adcock

26 Aug. 2014

C. Delaire

J. Adcock

2 Sept. 2014

C. Delaire

J. Adcock

2 Sept. 2014

C. Delaire

J. Adcock

TABLE OF CONTENTS 1.0

INTRODUCTION ........................................................................................................................ 5

2.0

ESS SCOPING REQUIREMENTS ................................................................................................ 5

3.0 3.1 3.2 3.3

OPERATIONAL NOISE CRITERIA ............................................................................................... 6 Victorian Guidelines ................................................................................................................. 7 New Zealand Standard 6808:2010.......................................................................................... 7 EPA Publication 1411 – NIRV ................................................................................................. 11

4.0 4.1 4.2 4.3 4.4

CONSTRUCTION NOISE CRITERIA .......................................................................................... 12 EPA Publication 1254 ............................................................................................................. 12 Construction Vibration Guidelines ........................................................................................ 13 Construction Traffic Noise Guidelines .................................................................................. 14 Airblast criteria ....................................................................................................................... 15

5.0 5.1 5.2 5.3

PROJECT DESCRIPTION .......................................................................................................... 16 Wind turbines ......................................................................................................................... 16 Substation ............................................................................................................................... 20 Assessed receivers.................................................................................................................. 21

6.0 6.1 6.2

BACKGROUND NOISE MONITORING .................................................................................... 22 Initial noise predictions .......................................................................................................... 22 Measurements ....................................................................................................................... 23

7.0 7.1 7.2 7.3

NZS 6808:2010 NOISE LIMITS ................................................................................................ 26 Properties with noise agreement.......................................................................................... 26 Base noise levels ..................................................................................................................... 26 Applicable noise limits ........................................................................................................... 27

8.0 8.1 8.2 8.3 8.4 8.5 8.6

ASSESSMENT OF WIND FARM OPERATIONAL NOISE.......................................................... 30 Noise predictions .................................................................................................................... 30 Tonality.................................................................................................................................... 32 Effects of Wind Farm Noise ................................................................................................... 32 Low frequency noise, infrasound and ground vibration ..................................................... 34 Amplitude modulation ........................................................................................................... 38 Operational considerations ................................................................................................... 39

9.0

ASSESSMENT OF SUBSTATION OPERATIONAL NOISE ......................................................... 39

10.0

ASSESSMENT OF OPERATIONAL TRANSMISSION LINE NOISE ............................................ 40

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11.0 11.1 11.2 11.3 11.4 11.5

ASSESSMENT OF CONSTRUCTION NOISE ............................................................................. 42 Construction equipment noise data ..................................................................................... 42 Predicted construction noise levels ...................................................................................... 44 Construction Vibration Assessment...................................................................................... 46 Construction Traffic Noise ..................................................................................................... 48 Airblast Assessment ............................................................................................................... 49

12.0

CONCLUSION .......................................................................................................................... 50

13.0

SUMMARY OF PARAMETERS................................................................................................. 51

APPENDIX A

ACOUSTIC TERMINOLOGY......................................................................................... 52

APPENDIX B

QUALIFICATIONS OF AUTHOR AND REVIEWER ....................................................... 53

APPENDIX C MAPS AND COORDINATES ........................................................................................ 54 C1 Wind farm site plan ................................................................................................................ 54 C2 Turbine locations .................................................................................................................... 55 C3 Receiver locations identified within 5km of the proposed turbines .................................. 56 C4 Zoning map ............................................................................................................................. 57 APPENDIX D

EPA PUBLICATION 1254............................................................................................. 58

APPENDIX E BACKGROUND NOISE MONITORING ........................................................................ 60 E1 Photographs............................................................................................................................ 60 E2 Background noise levels and wind speed vs. time............................................................... 66 E3 Background noise levels vs. wind speed............................................................................... 69 E4 Regression analysis................................................................................................................. 74 E5 Derived NZS 6808:2010 noise limits ..................................................................................... 75 E6 One-third octave band sensitivity analysis ........................................................................... 78 APPENDIX F

A-WEIGHTED NOISE PREDICTION MODEL ............................................................... 85

APPENDIX G

NOISE CONTOUR MAP............................................................................................... 88

APPENDIX H SUMMARY OF MODELING PARAMETERS ................................................................ 89 H1 Predictions .............................................................................................................................. 89

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1.0

INTRODUCTION Dundonnell Wind Farm Pty Ltd (DWFPL), a wholly owned subsidiary of Trustpower Australia Holdings, is proposing to develop a wind farm known as the Dundonnell Wind Farm (DDWF). This report details a noise impact assessment of the Dundonnell Wind Farm in response to the Environmental Effects Statement (ESS) scoping requirements. The Dundonnell Wind Farm is proposed to be located approximately 23km northeast of the Victorian township of Mortlake and consists of up to one hundred and four (104) turbines. The assessment of operational noise has been undertaken in accordance with the New Zealand Standard 6808:2010 Acoustics – Wind farm noise as required by the Victorian Government's Policy and planning guidelines for development of wind energy facilities in Victoria dated July 2012. Noise associated with construction of the wind farm has been assessed against the requirements of EPA Publication 1254 Noise Control Guidelines. The potential noise impact from ancillary power infrastructure, such as the substations, has been assessed in accordance with EPA Publication 1411 Noise from industry in regional Victoria. Acoustic terminology used throughout this report is presented in Appendix A. Note that wind speeds are referenced to hub height unless otherwise noted. Qualifications of the author and reviewer of this report are presented in Appendix B.

2.0

ESS SCOPING REQUIREMENTS In January 2013, the Victorian Minister for Planning determined that an Environment Effects Statement (EES) for the proposed Dundonnell Wind Farm would be required under the Environment Effects Act 1978. In September 2013, the Department of Transport, Planning and Local Infrastructure (DTPLI) specified the potential environmental impact to be investigated as part of the EES in a document titled Dundonnell Wind Farm Project Environment Effects Statement - Scoping Requirements (the Scoping Requirements). Section 4.5 Amenity of the Scoping Requirements states the following evaluation objective: To avoid or minimise adverse noise, visual and other amenity effects on nearby residents and local communities, to the extent practicable.

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The noise related items detailed in the Scoping Requirements are reproduced below: Key Issues • Increase in noise levels from the project for nearby sensitive receptors (including traffic noise and vibration during construction). Priorities for characterising the existing environment • Identify sensitive receptors that may be subject to the various amenity effects from the project including, but not limited to, all dwellings within 2 km of wind turbines. •

Characterise the ambient noise environment.

Design and mitigation measures • Outline and evaluate potential design and siting options that could mitigate effects on visual amenity from adjoining residences. • Describe and evaluate both potential and proposed design responses and/or other mitigation measures (construction equipment, staging and scheduling of works), which could minimise noise and vibration effects on sensitive receptors. Assessment of likely effects • Assess the potential for construction and operation of the project to increase noise levels and/or vibration at sensitive receptors. The assessment should include an estimation of noise (including tonal and infra-sound) from all project-related sources at different times over a 24-hour cycle to establish the likely conditions to be experienced at sensitive receptors. • Assess the potential effects from the proposed on-site quarry activities on sensitive receptors (including air blast, vibration, fly rock). Approach to manage performance • Outline and evaluate proposed additional measures to monitor and manage noise and vibration levels to minimise residual effects and ensure compliance with standards, where necessary.

3.0

OPERATIONAL NOISE CRITERIA In the State of Victoria, the relevant operational noise assessment methodology for wind farms is provided in the Victorian Government's Policy and planning guidelines for development of wind energy facilities in Victoria dated July 2012 (the Victorian Guidelines). Outside of the Melbourne metropolitan area, noise from commercial and industrial premises, such as the substation associated with the proposed wind farm, are assessed in accordance with the Victorian EPA publication 1411 titled Noise from Industry in Regional Victoria – Recommended maximum noise levels from commerce, industry and trace premises in regional Victoria (NIRV).

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3.1

Victorian Guidelines Section 4.3.b of the Victorian Guidelines requires the following: […] an assessment of the noise impact of the proposal prepared in accordance with the New Zealand Standard NZS 6808:2010, Acoustics – Wind Farm Noise (the Standard), including an assessment of whether a high amenity noise limit is applicable, as assessed under Section 5.3 of the Standard.

Furthermore, the Victorian Guidelines also states the following: […] no plans will be endorsed by the responsible authority, and no variation to the endorsed plans will be approved by the responsible authority, which allow a turbine to be located within 2kms of an existing dwelling (measured from closest point of the turbine to closest point of the dwelling) unless evidence has been provided to the satisfaction of the responsible authority that the owner of the dwelling has consented in writing to the location of the turbine.

3.2

New Zealand Standard 6808:2010 New Zealand Standard 6808:2010 Acoustics – Wind farm noise (NZS 6808:2010) is used to assess wind farm noise as required by the Victorian Government's Policy and planning guidelines for development of wind energy facilities in Victoria dated July 2012 (the Victorian Guidelines). In Section 3.5 Applicable Legislation, Policies and Strategies of the scoping Requirements, both NZS 6808:2010 and the Victorian Guidelines are listed as relevant policy documents for the assessment of the proposed wind farm.

3.2.1 Objectives Section C1.1 of NZS 6808:2010 discusses the intent of the standard, which is: [...] to avoid adverse noise effects on people caused by the operation of wind farms while enabling sustainable management of natural wind resources.

The Outcome Statement of NZS 6808:2010 expresses this intention in a planning context as follows: This Standard provides suitable methods for the prediction, measurement, and assessment of sound from wind turbines. In the context of the [New Zealand] Resource Management Act, application of this Standard will provide reasonable protection of health and amenity at noise sensitive locations.

The standard seeks to address health and amenity at noise sensitive locations by specifying noise criteria which are used to assess wind farm noise, as outlined below.

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3.2.2 Protected Premises The provisions of NZS 6808:2010 are intended to protect noise sensitive locations that existed before the development of a wind farm. Noise sensitive locations are defined by the Standard as: The location of a noise sensitive activity, associated with a habitable space or education space in a building not on the wind farm site. Noise sensitive locations include: (a) Any part of land zoned predominantly for residential use in a district plan; (b) Any point within the notional boundary of buildings containing spaces defined in (c) to (f); (c) Any habitable space in a residential building including rest homes or groups of buildings for the elderly or people with disabilities … (d) Teaching areas and sleeping rooms in educational institutions … (e) Teaching areas and sleeping rooms in buildings for licensed kindergartens, childcare, and day-care centres; and (f) Temporary accommodation including in hotels, motels, hostels, halls of residence, boarding houses, and guest houses. In some instances holiday cabins and camping grounds might be considered as noise sensitive locations. Matters to be considered include whether it is an established activity with existing rights.

For the purposes of an assessment according to the Standard, the notional boundary is defined as: A line 20 metres from any side of a dwelling or other building used for a noise sensitive activity or the legal boundary where this is closer to such a building.

NZS 6808:2010 was prepared to provide methods of assessment in the statutory context of New Zealand. Specifically, the Standard notes that in the context of the New Zealand Resource Management Act, application of the standard will provide reasonable protection of health and amenity at noise sensitive locations. This is an important point of context, as the New Zealand Resource Act states: (3)(a)(ii): A consent authority must not, when considering an application, have regard to any effect on a person who has given written approval to the application.

Based on the above definitions and statutory context, noise predictions are normally prepared for receptor locations that are either within the site boundary, or where the occupants have entered into a noise agreement with the proponent of the wind farm. However, the noise limits specified in the Standard are not applied to these locations on account of their participation with the project. Separate consideration is given to alternative guidance values for these locations, having regard to participating land owners both within and outside the site boundary, and participating neighbours outside the site boundary. In addition to consistency with NSZ 6808:2010 and its statutory context, this approach is also consistent with the policy and guidance applied in other jurisdictions in South Australia.

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3.2.3 Noise limit Section 5.2 Noise limit of NZS 6808:2010 defines acceptable noise limits as follows: As a guide to the limits of acceptability at a noise sensitive location, at any wind speed wind farm sound levels (LA90(10 min)) should not exceed the background sound level by more than 5dB, or a level of 40dB LA90(10 min), whichever is the greater.

This arrangement of noise limits requires the noise associated with wind farms to be restricted to a permissible level above background noise, except in instances when both the background and source noise levels are low. In this respect, the criteria indicate that it is not necessary to continue to adhere to a margin above background when the background noise levels are below the range of 30-35dB. It should be noted that compliance with the NZS 6808:6808:2010 criteria may result in wind turbine noise being audible at some locations for some of the time. The applicable operational noise limits derived in accordance with NZS 6808:2010 are detailed in Section 7.1. 3.2.4 High amenity areas Section 5.3.1 of NZS 6808:2010 states that the baseline noise limit of 40dB LA90 detailed in Section 3.2.2 above is “appropriate for protection of sleep, health, and amenity of residents at most noise sensitive locations.” It goes on to note that high amenity areas may require additional consideration: […] In special circumstances at some noise sensitive locations a more stringent noise limit may be justified to afford a greater degree of protection of amenity during evening and night-time. A high amenity noise limit should be considered where a plan promotes a higher degree of protection of amenity related to the sound environment of a particular area, for example where evening and night-time noise limits in the plan for general sound sources are more stringent than 40 dB LAeq(15 min) or 40 dBA L10. A high amenity noise limit should not be applied in any location where background sound levels, assessed in accordance with section 7, are already affected by other specific sources, such as road traffic sound.

The definition of a high amenity area provided in NZS 6808:2010 is specific to New Zealand planning legislation and guidelines. A degree of interpretation is therefore required when determining how to apply the concept of high amenity in Victoria. Section 5.3 of NZS 6808:2010 provides details of high amenity noise limits, requiring that where a residential property is deemed to be located within a high amenity area as defined in Sections 5.3.1 and 5.3.2 of NZS 6808:2010, wind farm noise levels (LA90) during evening and nigh-time periods should not exceed the background noise level (LA90) by more than 5dB or 35dB LA90, whichever is the greater. It is recommended that this reduced noise limit typically apply for wind speeds below 6m/s at hub height. High amenity noise limits are not applicable during the daytime period.

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3.2.5 Special audible characteristics Section 5.4.2 of NZS 6808:2010 requires the following: Wind turbine sound levels with special audible characteristics (such as tonality, impulsiveness and amplitude modulation) shall be adjusted by arithmetically adding up to +6dB to the measured level at the noise sensitive location.

Notwithstanding this, the standard requires that wind farms be designed with no special audible characteristics at nearby residential properties while concurrently noting in Section 5.4.1 that: […] as special audible characteristics cannot always be predicted, consideration shall be given to whether there are any special audible characteristics of the wind farm sound when comparing measured levels with noise limits.

The assessment of potential special audible characteristics is undertaken during the post-construction commissioning noise monitoring to determine whether a penalty is deemed be applicable. Tonality NZS 6808:2010 emphasises assessment of special audible characteristics during the post-construction measurement phase of a project. However, an indication of the potential for tonality to be a characteristic of the noise emission from the assessed turbine model can be determined based on the results of tonality audibility assessment commonly provided by manufacturers with their IEC 61400-111 sound power level specifications. It should be noted that the tonality assessment in accordance with IEC 61400-11 is undertaken in close proximity of a single tested turbine (generally within 150m) whereas the assessment of potential characteristics is performed during postconstruction noise monitoring at receiver locations. Low frequency noise and infrasound Section 5.5 of NZS 6808:2010 provides the following comments regarding low frequency noise and infrasound. 5.5.1

Although wind turbines may produce some sound at (ultrasound and infrasound) frequencies considered to be outside the normal range of human hearing these components will be well below the threshold of human perception.

5.5.2

Claims have been made that low frequency sound and vibration from wind turbines have caused illness and other adverse physiological effects among a very few people worldwide living near wind farms. The paucity of evidence does not justify at this stage, any attempt to set a precautionary limit more stringent than those recommended in 5.2 and 5.3.

Notwithstanding these comments, further consideration of low frequency noise and infrasound from wind turbines is considered as part of the assessment as required by the Scoping Requirements.

1

Wind Turbine Generator Systems – Part 11: Acoustic Noise Measurement Techniques (IEC61400-11)

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3.3

EPA Publication 1411 – NIRV Noise from ancillary equipment such as the substation must be assessed in accordance with the Victorian EPA publication 1411 titled Noise from Industry in Regional Victoria – Recommended maximum noise levels from commerce, industry and trace premises in regional Victoria (NIRV), applicable in rural Victoria. Under NIRV, when either the noise emitter or noise receiver is located within a major urban area, noise limits are determined in accordance with the State Environment Protection Policy (Control of Noise from Commerce, Industry and Trade) No. N-1 (SEPP N-1). According to the maps of the urban centres available on the EPA website neither the subject site nor the nearby residential receivers fall within any of these areas, thus the NIRV guidelines apply. The NIRV criteria for this site have been calculated by determining the zone levels as per NIRV. The zone levels are dependent on the zone the noise source is in and the zone the residence is in. Based on the zoning map of the area surrounding the proposed transformer station (provided in Section C4 of Appendix C), the proposed substation location and surrounding residential properties are located in a Farming Zone (FZ). When substations, defined as utilities in the Victorian Planning Provisions, are located within a Farming Zone, the recommended maximum noise levels detailed in Table 1 apply for each applicable time period. Table 1: NIRV time periods and recommended maximum noise levels, Leff2 dB Period

Day of week

Day

Evening

Night

Start time

End time

Recommended maximum levels

Monday-Friday

0700hrs

1800hrs

45

Saturday

0700hrs

1300hrs

Monday-Friday

1800hrs

2200hrs

Saturday

1300hrs

2200hrs

Sunday, Public holidays

0700hrs

2200hrs

Monday-Sunday

2200hrs

0700hrs

39

34

The noise limits detailed in Table 1 are not dependent on background noise levels. NIRV

allows for a background noise level adjustment in the event that affected residential properties are located in an area where background noise levels may be higher than usual for a rural area. The area where the substation is proposed is not expected to be such an area. As the substation is proposed to operate 24hr a day and 7 days a week, compliance with the NIRV night noise limit of 34dB Leff would allow compliance during all other time periods.

2

Leff is the effective noise level of commercial or industrial noise determined in accordance with SEPP N-1. This is LAeq noise level over a half-hour period, adjusted for the character of the noise. Adjustments are made for tonality, intermittency and impulsiveness.

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4.0

CONSTRUCTION NOISE CRITERIA

4.1

EPA Publication 1254 Section 2 Construction and Demolition Site Noise of EPA Publication 1254 Noise Control Guidelines recommends noise limits and controls for construction noise. This section is reproduced in Appendix D. The noise requirements are summarised in Table 2. Table 2: Construction noise requirements Period

Day of the week

Time Period

Noise requirements depending on construction duration, LAeq Up to 18 months

Day

Evening

Night

Monday-Friday

0700-1800hrs

Saturday

0700-1300hrs

Monday-Friday

1800-2200hrs

Saturday

1300-2200hrs

Sunday, Public Holidays

0700-2200hrs

Monday-Sunday

2200-0700hrs

After 18 months

No requirement

10dB above background (LA90), outside residential dwelling

5dB above background (LA90), outside residential dwelling

Noise from construction activities must be inaudible inside a habitable room with windows open

While there is no noise requirement specified for daytime activities, the EPA states that the following: This guideline does not limit the general ability of a local government or police official to assess the unreasonableness of noise at any time.

This implies that construction noise levels must still be controlled to avoid unreasonable impact. During the night period, noise is required to be inaudible within a habitable room of any residential premises. Publication 1254 allows for flexibility where it is not possible to avoid construction activities during the night stating the following: Noise from the site needs to comply with the requirements of the schedule, except for: 

unavoidable works



night period low-noise or managed-impact works approved by the local authority.

Unavoidable works are defined as “works that cannot practicably meet the schedule requirements because the work involves continuous work — such as a concrete pour — or would otherwise pose an unacceptable risk to life or property, or risk a major traffic hazard.”

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Unavoidable works include, but are not limited, to the following construction activities:  Delivery of large size items such as wind turbine blades due to the risk of traffic hazard  Turbine erection and assembly is dependent on appropriate wind conditions to minimise safety risks For such works, the guidelines require that “affected premises should be notified of the intended work, its duration and times of occurrence.” Low-noise works would include manual painting, cabling, cleaning works and similar tasks. 4.2

Construction Vibration Guidelines There is no standard or regulation that specifies criteria for the control of construction vibration levels in Victoria. However, in New South Wales, the DECC document Assessing Vibration: A Technical Guideline dated February 2006 (the NSW Vibration Guideline) presents preferred and maximum vibration criteria for use in assessing human response to vibration. The acceptable values of human exposure to vibration are dependent on, amongst other things, the time of day. This assessment only considers the period in which construction is expected to normally occur (i.e. 0700-1800hrs Monday to Friday and 0800-1300hrs on Saturday). The vibration criteria are separately specified for the following types of vibration characteristics:  Continuous – vibration that continues uninterrupted for a defined period such as the duration of a day  Impulsive – vibration that comprises a rapid build up to a peak followed by several cycles of progressively reducing vibration  Intermittent – vibration that comprises interrupted periods of continuous (e.g. a drill) or repeated periods of impulsive vibration (e.g. a pile driver), or continuous vibration that varies significantly The types of activities associated with the construction of a wind farm may include both continuous and impulsive vibration sources operating over interrupted periods of a working day. It is therefore expected that vibration would be typically classified as intermittent according to the NSW Vibration Guideline, but may be continuous or impulsive on occasion. Table 3 summarises the preferred and maximum values for acceptable human exposure to continuous and impulsive vibration. It is noted that the NSW Vibration Guideline provides criteria for the assessment of continuous and impulsive vibration in the form of the weighted acceleration values. Given that empirical vibration data is more readily available in the form peak particle velocity (PPV) data, the criteria are reproduced here in the form of equivalent PPV values sourced from Appendix C of the NSW Vibration Guideline.

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Table 3: Preferred and maximum values for vibration during daytime (mm/s) 1-80Hz (PPV) Location

Preferred Values

Maximum Values

0.28

0.56

8.6

17

Continuous Residences Impulsive Residences

Table 4 summarises the preferred and maximum values for acceptable human exposure to intermittent vibration. The NSW Vibration Guideline recommends the assessment of intermittent vibration on the basis of a more complex parameter referred to as the vibration dose value (VDV) which relates vibration magnitude to the duration of exposure. Table 4: Vibration dose values for intermittent vibration during daytime (m/s1.75) 1-80Hz Location Residences

Preferred Values

Maximum Values

0.2

0.4

The NSW Vibration Guideline does not address vibration induced damage to buildings or structures. However, the thresholds for human exposure to vibration are generally well below accepted thresholds for minor cosmetic damage to lightweight structures. Accordingly, vibration which complies with the criteria for human exposure does not pose a risk in terms of structure damage. 4.3

Construction Traffic Noise Guidelines There is no Victorian guidance document in relation to the assessment of construction traffic noise levels on public roads. We therefore propose to assess the significance of changes in traffic volumes associated with construction having regard to the guidance contained in the NSW Road Noise Policy dated 2011 (RNP). The RNP does not specifically preclude direct application to temporary changes in noise levels associated with construction traffic, however the document is predominantly focussed on longer term or permanent impacts associated with completed road projects. Table 5 presents the proposed traffic noise thresholds for this development, however given these could be equally applied to permanent changes associated with a completed development, they can be considered as very conservative when assessing the effects of temporary and intermittent traffic noise level changes associated with construction. The noise thresholds apply outside sensitive receptor locations such as residential dwellings or schools.

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Table 5: Road traffic noise threshold - Existing residences affected by additional traffic Type of road

Assessment criteria Day 0700-2200hrs

Night 2200-0700hrs

Existing freeways, arterial and sub arterial roads

60dB LAeq(15hr)

55dB LAeq(15hr)

Existing local roads

55dB LAeq(1hr)

50dB LAeq(1hr)

The RNP also recommends that traffic arising from the development should not increase existing noise levels by more than 12dB LAeq averaged over the relevant time period (day or night). This does not apply to local roads. 4.4

Airblast criteria The Scoping Requirement specifies that airblast from quarry operations should be assessed. Guidance for assessing the environmental effects of blasting in Victoria are provided in Environmental guidelines – Ground Vibration and Airblast Limits for Blasting in Mines and Quarries, prepared by the Department of Natural Resources and Environment (now the Department of State Development Business and Innovation). These guidelines will be referred to throughout this document as the DSDBI Guidelines. Additional guidance is provided by AS 2187-2:20063 however it should be noted that the reference criteria presented in the standard are less stringent than those recommended by the DSDBI Guidelines. The DSDBI Guidelines recommends that airblast should not exceed 133dB LZpeak for 95% of all blasts. The DSDBI Guidelines also recognises that in situations where it is not possible to achieve, due to the location and nature of the blasting operations, it may be possible to increase the limit subject to approval by DSDBI and all affected residents being informed. From Australian and overseas research, damage (even of a cosmetic nature) has not been found to occur at airblast levels below 133dB LZpeak. The probability of damage increases as the airblast levels increase above this level. Windows are the building element currently regarded as most sensitive to airblast, and damage to windows is considered as improbable below 140dB LZpeak. A limit of 133dB LZpeak is therefore recommended as a safe level that will prevent structural or architectural damage to typical residential constructions from airblast.

3

Australian Standard 2187-2:2006 Explosives—Storage, transport and use, Part 2: Use of explosives

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5.0

PROJECT DESCRIPTION The Dundonnell Wind Farm is proposed to be located approximately 23 km north east of Mortlake and 21 km west of Derrinallum and will comprise up to 104 wind turbines with a maximum planned tip height of 165 m above ground level (AGL). The wind farm site covers an area of around 4200 hectares and comprises of eleven (11) host landholders. The project is proposed to connect to the 500kV network approximately 33km south west at the Mortlake Gas Power Station. Two substations, including two (2) transformers each, are also proposed to be associated with the wind farm. A plan of the proposed layout is presented in Appendix C along with the geographic coordinates for the wind turbines.

5.1

Wind turbines

5.1.1 Turbine type The actual turbine selection would not be determined until the project planning application has been completed, and would be the subject of a commercial tendering process for the supply of turbines from a range of manufacturers. It is therefore necessary to consider a turbine type which can be considered representative of the size, power rating and noise emissions of turbines which may be considered for this site. This assessment has been based on the Vestas V-117 with a hub-height of 106.5m. This turbine model is characterised by sound power levels that are typical of the class of machine being considered. An important element of this assessment is to determine whether the proposed Dundonnell wind farm can viably operate with relevant environmental noise criteria, based on a range of commercial options. An assessment based on the proposed turbine model satisfies this requirement.

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Details of the proposed turbine model are summarised in Table 6 below. Table 6: WTG manufacturer specifications Details Make

Vestas

Model

V117

Rated electrical power (MW)

3.3

Rotor Diameter (m)

117

Wind Class

2A

Hub Height (m) Rotor orientation

Up to 106.5 Upwind

Cut-in Wind Speed (hub height, m/s)

3

Rated Wind Speed (hub height, m/s)

13

Cut-out Wind Speed (hub height, m/s)

25

Sound Power LWA at 12m/s (hub height, dB)

107

Tonality audibility (La,k>0dB) *

not available*

Refer to Section 5.1.3 for further details

5.1.2 Sound power levels Sound power data for the assessed turbine model has been sourced from the Vestas document No. 0038-6455-V00 titled V117-3.3MW-IEC2A Third Octaves according to General Specification and dated 7 June 2013. Section 2.3 Procedure of the Vestas document No. 0038-6455-V00 states that octave band levels provided have been estimated based on measured sound power levels for a similar turbine (Vestas V112-3MW). Table 7 concurrently references wind speeds to non-integer hub height wind speeds4. As suggested by NZS 6808:2010, hub height referenced sound power level data for integer hub height wind speeds is used for this noise assessment, as presented in Table 7.

4

Based on a standardised roughness length of z0 = 0.05, according to IEC 61400-11.

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Table 7: Sound power levels vs wind speed Wind speed (m/s)

10m AGL*

4

5

6

7

8

9

10

11

Hub height

5.8

7.2

8.7

10.1

11.6

13.0

14.5

15.9

97.9

101.6

104.8

106.5

107

107

107

107

Sound power level, LWA dB *

Above Ground Level

Table 8: Sound power levels vs extrapolated integer hub height wind speeds Hub height Wind speed (m/s) Sound power level, LWA dB

6

7

8

9

10

11

12

>12

98.4

101.0

103.4

105.3

106.4

106.9

107.0

107.0

Figure 1 present the reported sound power level data for the assessed turbine referenced to hub height wind speeds.

Figure 1: Sound power level vs. hub height wind speed

Predicted wind farm noise levels incorporate octave band sound power level data for the Vestas V117-3MW. The A-weighted octave band sound power spectrum for the assessed turbine at 8m/s at 10m above ground level (AGL) (approximately 11.6m/s at hub height) is presented in Figure 2.

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Figure 2: A-weighted octave band sound power level spectrum, dB, at 8m/s @10m AGL

Tabular octave band values are presented in Table 9. Table 9: A-weighted octave band sound power levels, dB, at 8m/s @10m AGL Octave Band Centre Frequency (Hz)

LWA

63

125

250

500

1000

2000

4000

8000

Overall

89.0

95.2

97.6

100.5

101.9

100.3

94.5

82.9

107.0

The spectral data presented in Table 9 has been scaled across the wind speed range to match the sound power levels as detailed in Table 7. 5.1.3 Tonality Tonal audibility (La,k) levels determined in accordance with IEC 61400-11 are not provided in the technical information provided by Vestas for the assessed turbine. The IEC 61400-11 tonality assessment is performed in close proximity of a single tested turbine. The results therefore provide an indication of the potential for tonality to be a characteristic of the noise emission from the assessed turbine model. This information can be used to determine whether tonality could be audible at receiver locations, as assessed in accordance with the method provided in Appendix B of NZS 6808:2010. For the purposes of this assessment it is assumed that the considered turbine model will have similar tonal audibility levels (La,k) as the Vestas V112-3MW. Tonality is not a common feature of modern variable speed turbine of this class as evidenced by the tonal audibility levels reported below -1dB for the Vestas V112-3MW5. 5

Report GLGH-4286 12 09255 258-A-0001-B Results of acoustic noise measurements according to IEC 61400-11 on a Vestas V112 – 3.0 MW (mode 0) near Lem / Denmark, dated 20 August 2012

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A tonal audibility assessment would however be required for the final turbine selected as part of the procurement process before proceeding with any site works. 5.2

Substation Two substations are proposed within the Dundonnell Wind Farm site as shown in Figure 3.

Figure 3: Substation proposed locations (extract from Landscape and Visual Assessment report by ERM)

The on-site substation will comprise two transformers of approximately 160MVA which will be used to step-up the 33kV power supply from the wind farm to achieve the 220kV design level of the transmission line. The off-site substation located at the Mortlake Gas Power Station (MOPS) will comprise two transformers of approximately 160MVA each. Measured sound power level data for the transformers will not be available until a transformer type is finalised for the site. In lieu of measured data, Australian Standard AS 60076-10:2009 Power transformers – Part 10: Determination of sound levels (AS 60076-10:2009) provides a method for estimating transformer sound power levels. With reference to Figure ZA1 from AS 60076-10:2009, the estimated standard maximum sound power level is 97dB LWA for each 160MVA transformer.

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5.3

Assessed receivers Trustpower has identified twenty-seven (27) residential properties within 5km of the proposed turbines. These properties are detailed in Table 10 and geographic coordinates are presented in Section C3 of Appendix C. Table 10: Residential properties within 5km of the proposed turbines House

Distance to the nearest turbine (m)

Direction to the nearest o turbine ( )

Nearest turbine

1 (PN)

628

140

T079

2 (PL)

988

223

T097

3

2,501

78

T089

6

4,931

355

T102

7

5,015

332

T097

8

3,953

341

T087

9

4,661

319

T087

16

4,868

312

T043

17

3,618

322

T043

18

2,819

276

T031

19

3,398

254

T002

20

2,789

249

T002

21

2,301

163

T002

22

4,430

176

T002

39 (PL)

3,715

60

T089

40 (PN)

2,691

70

T102

41 (PL)

1,214

67

T079

42

2,100

320

T103

43

2,786

325

T103

44

2,406

335

T097

46 (PN)

1,780

296

T097

47 (PN)

1,003

34

T087

49 (PL)

1,011

261

T013

50 (PL)

1,132

149

T004

51 (PL)

1,727

145

T005

52 (PN)

1,887

144

T005

53

2,995

165

T004

(PL) Participating Landholder

(PN) Participating Neighbour

It can be seen from Table 10 that all nine (9) residential properties within 2km of the proposed turbines are either participating landholders (within the wind farm site under an agreement with Trustpower) or participating neighbours (outside the wind farm site under an agreement with Trustpower).

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There are four (4) houses currently within 2km of proposed turbine locations which have not been considered in this assessment. MDA has been advised that the owners of these houses have each entered into agreements with the proponent on mutually acceptable terms such that if the wind farm proceeds to construction, these houses will either be acquired by the Proponent, removed or modified and uninhabited for the duration of the wind farm's operation. There is an additional house currently owned by the Proponent just outside the wind farm site boundary which has also not been considered in this assessment. One house located within 2km of the proposed turbines is currently owned by the proponent and will therefore not be included in this assessment. 6.0

BACKGROUND NOISE MONITORING

6.1

Initial noise predictions In accordance with NZS 6808:2010, initial noise modelling was carried out for a preliminary site layout to identify noise sensitive locations where the predicted noise level may be higher than 35dB LA90. Locations identified within the 35dB LA90 contour were then reviewed to determine the need for background monitoring. As detailed in Section 3.2.2, participating landholders and neighbours with an agreement with the Proponent are not considered noise sensitive locations. However, for completeness, properties where predicted wind farm noise levels exceed 35dB LA90 have been included in this assessment. Table 11 below presents the predictions for the current design layout and proposed configuration. Note however that since the initial modelling was undertaken, ongoing design development of the wind farm resulted in a modified layout. Accordingly, some locations that were originally identified within the 35dB LA90 contour are now identified with levels below 35dB. Table 11: Current design noise predictions, LA90 (dB) House

Distance to nearest turbine (m)

Predicted noise level

1 (PN)

628

42.8

2 (PL)

988

42.6

3

2,501

32.8

6

4,931

24.0

7

5,015

27.9

8

3,953

28.6

9

4,661

27.0

16

4,868

27.8

17

3,618

30.1

18

2,819

31.8

19

3,398

29.5

20

2,789

30.8

21

2,301

33.3

22

4,430

28.3

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House

Distance to nearest turbine (m)

Predicted noise level

39 (PL)

3,715

29.7

40 (PN)

2,691

30.7

41 (PL)

1,214

38.3

42

2,100

34.7

43

2,786

31.6

44

2,406

33.0

46 (PN)

1,780

36.0

47 (PN)

1,003

40.5

49 (PL)

1,011

43.6

50 (PL)

1,132

38.9

51 (PL)

1,727

36.5

52 (PN)

1,887

35.9

53

2,995

30.4

+

(PL) Participating Landholder (PN) Participating Neighbour + at a hub height wind speed of 11.6m/s (8m/s at 10m AGL)

It can be seen from Table 11 that all nine (9) properties where wind farm noise levels were predicted over 35dB LA90 are either participating landholders or participating neighbours. Specifically:  One (1) of the nine (9) locations is a participating landholder within the site boundary (House 2)  Four (4) of the nine (9) locations are participating landholders outside the site boundary (Houses 41, 49, 50 and 51)  Four (4) of the nine (9) locations are participating neighbours located outside the site boundary (House 1, 46, 47 and 52). 6.2

Measurements

6.2.1 Selected sites Background noise monitoring was undertaken between 25 January and 27 February 2013, before the proposed wind farm layout was finalised. Six (6) properties were selected for background noise monitoring based on their proximity to the proposed turbines at the time. Table 12 below outlines the properties where monitoring was undertaken along with the monitoring duration. The noise monitoring locations are also indicated in the site layout provided in Section C1 of Appendix C.

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Table 12: Background noise monitoring locations House

Easting (m)

Northing (m)

Nearest receiver

2 (PL)

672662

5804740

46 (PN) at 1.7km south east

41 (PL)

668344

5805447

1 (PN) at 1.2km north east

48 (PL)*

675832

5806829

-

49 (PL)

675505

5809139

50 (PL) at 1.8km north

52 (PN)

671501

5811109

51 (PL) at 160m south east

60 (PL)*

673735

5805482

47 (PN) at 1km south

Note: UTM WGS84 Zone 54 MGA 94 (PL) Participating Landholder (PN) Participating Neighbour * House will be removed if the project is approved

6.2.2 Noise monitoring Background noise monitoring has been carried out for a period of approximately four (4) weeks at each location, so as to provide more than the minimum 1,440 data points for analysis. 01dB DUO Class 1 noise loggers have been used to measure the background noise levels, recording measured sound levels in continuous 10 minute intervals. Table 13 details the serial number and last laboratory calibration date prior to the monitoring. Table 13: Noise logger serial numbers and calibration date House

Serial number

Calibration date

2 (PL)

10499

2 April 2012

41 (PL)

10194

5 December 2012

48 (PL)*

10497

27 June 2012

49 (PL)

10496

28 March 2012

52 (PN)

10495

28 March 2012

60 (PL)

10498

8 June 2012

(PL) Participating Landholder (PN) Participating Neighbour * House will be removed if the project is approved

The noise loggers were calibrated before and after placement at site, with no significant drift observed at the end of the monitoring periods. The noise loggers were placed at least 5m from the nearest dwelling in positions that were representative of the general ambient noise environment, in accordance with Section 7.1.6 of NZS 6808:2010. Photographs of the logger positions are presented in Section E1 of Appendix E.

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6.2.3 Wind data Wind speed and direction data has been collected throughout the noise monitoring period at the met mast located within the proposed wind farm site. Details of the met mast are presented in Table 14 below. Table 14: Met mast details GPS Coordinates (GDA94)

Sensor height AGL (m)

Easting

Northing

Wind direction

Wind speed

754300

6171498

82

20.8, 40.8, 60.3 and 84.5

Wind speed has been extrapolated by Garrad Hassan Pacific Pty Ltd to 110m AGL as detailed in their correspondence (Ref. 45622/PL/01-A) dated 13 March 2013. The method used by Garrad Hassan to extrapolate the hub height wind speeds is in accordance with method detailed in the supplementary guidance Note 4: Wind Shear (currently available as a consultation draft) of the IOA Good Practice Guide6. Given the small difference between the provided wind speed height of 110m and the proposed maximum hub height of 106.5m AGL, and the uncertainties that would be introduced in an adjustment to the hub height, the 110m data has been taken as representative of hub height data without further adjustment. Wind data collected at the met masts has been provided to us by the proponent. 6.2.4 Rainfall data Where it is considered likely that rainfall has occurred at the monitoring locations, associated noise and wind speed data points must be removed from regression analysis. Rain intensity during the survey was measured at House 60 using a Vaisala WXT520 weather station connected to the 01dB DUO noise logger. Where rainfall was detected that period has been removed from regression analysis. Photographs of the weather station position are presented in Section E1 of Appendix E. 6.2.5 Daylight savings time All data presented within this report are referenced to Australian Eastern Daylight Time. 6.2.6 Background noise monitoring results The measured background noise levels have been plotted against the 110m AGL wind speeds as presented in Sections E2 and E3 of Appendix E. These plots provide a characterisation of the ambient noise environment in the vicinity of the proposed wind farm as required by the Scoping Requirements.

6

UK Institute of Acoustics A good practice guide to the application of ETSU-R-97 for the assessment and rating of wind turbine noise (IOA GPG) dated May 2013

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7.0

NZS 6808:2010 NOISE LIMITS

7.1

Properties with noise agreement The definition given in NZS 6808:2010 of noise sensitive locations specifically excludes dwellings within the wind farm site boundary. Section 3.2.2 also provides details of the statutory context of NZS 6808:2010 which indicates the method is not intended to be applied to noise sensitive locations outside the site boundary where a noise agreement exists between the occupants and the proponent of the development. For these properties, it is current practice to use the recommendations outlined in the final report by The European Working Group on Noise from Wind Turbines (ETSU-R-97) which allows for an increased baseline noise limit of 45dB LA90 in lieu of the 40dB LA90 minimum noise limit. It is our understanding that a noise agreement has been signed with four (4) participating landholders (Houses 2, 41, 49 and 50) and two (2) participating neighbour (Houses 1 and 47). The baseline noise limit of 45dB LA90 has been used for these six (6) participating properties.

7.2

Base noise levels As noted in Section 3.2.4 above, NZS 6808:2010 states that a “high amenity noise limit should be considered where a plan promotes a higher degree of protection of amenity related to the sound environment of a particular area […]. The area surrounding the proposed wind farm is designated as a Farming Zone as in the planning map shown in Section C4 of Appendix C. The Victoria Planning Provisions Practice Note prepared by the Department of Sustainability and Environment titled Applying the rural zones and dated March 2007 states the following: The Farming Zone is designed to encourage diverse farming practices, some of which can have significant off-site impacts. For this reason, the level of amenity that can be expected in this zone will usually not be compatible with sensitive uses, particularly housing.

Based on the above, it is our understanding that the high amenity noise limit is not applicable for residential properties located within a Farming Zone. On this basis, the high amenity noise limit has not been applied in this assessment and therefore the lowest possible noise limit applicable for this project is 40dB LA90, unless a noise agreement has been reached. Table 15 lists the assessed residential properties and their respective applicable base noise level.

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Table 15: Applicable base noise levels, LA90 dB House

Distance to nearest turbine (m)

Applicable base noise level

1 (PN)

628

45

2 (PL)

1,007

45

41 (PL)

1,214

45

46 (PN)

1,765

40

47 (PN)

1,003

45

49 (PL)

1,011

45

50 (PL)

1,132

45

51 (PL)

1,727

40

52 (PN)

1,887

40

(PL) Participating Landholder

(PN) Participating Neighbour

Other assessed residential properties not listed in Table 15 are located more than 2km away from the nearest proposed turbines. The applicable base noise level for all residential properties located more than 2km away from the nearest proposed turbines is 40dB LA90. 7.3

Applicable noise limits Wind speed dependent noise limits have been derived at each of the noise monitoring locations in accordance with NZS 6808:2010, as detailed in Section 3.2.2 above. Background noise monitoring results and derived noise limits for House 48 are provided for information only as this house is proposed to be removed if the project is approved. Results of the regression analysis undertaken in accordance with NZS 6808:2010 by correlating the measured background noise levels and the 110m AGL wind speeds is provided in Appendix E together with graphical plots of the derived noise limits. Table 16 and Table 17 summarises the background noise levels at integer wind speeds up to 15m/s for both the 24 hour and night-time periods in a tabular format for each monitored location.

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Table 16: NZS 6808:2010 background noise levels – 24 hour Hub height wind speed, m/s House

5

6

7

8

9

10

11

12

13

14

15

2 (PL)

28

29

30

31

32

33

35

36

38

40

42

41 (PL)

26*

27*

29*

30*

32*

35*

37*

40*

43*

-

-

48 (PL)

26

28

29

31

32

33

35

36

38

39

41

49 (PL)

28

30

31

32

33

34

36

37

38

40

41

52 (PN)

28

29

30

31

33

34

36

38

39

41

43

60 (PL)

26

27

28

29

31

32

34

35

37

38

40

(PL) Participating Landholder (PN) Participating Neighbour * based on filtered dataset as detailed in Section E6 of Appendix E Insufficient number of data points at these wind speeds

Table 17: NZS 6808:2010 background noise levels – night-time Hub height wind speed, m/s House

5

6

7

8

9

10

11

12

13

14

15

2 (PL)

25

25

25

25

26

27

27

28

29

31

32

41 (PL)

20*

20*

21*

22*

23*

25*

27*

29*

32*

-

-

48 (PL)

22

22

23

24

25

25

26

26

26

27

27

49 (PL)

23

24

24

25

26

27

27

28

29

29

30

52 (PN)

26

26

27

28

29

30

31

33

35

36

38

60 (PL)

22

22

23

24

24

25

26

27

28

29

30

(PL) Participating Landholder (PN) Participating Neighbour * based on filtered dataset as detailed in Section E6 of Appendix E Insufficient number of data points at these wind speeds

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Table 18 and Table 19 summarises the derived NZS 6808:2010 noise limits at integer wind speeds up to 15m/s for both the 24 hour and night-time periods in a tabular format for each monitored location. Table 18: NZS 6808:2010 noise limits – 24 hour Hub height wind speed, m/s House

12

Applicable noise limit

51 (PL)

27.9

30.5

32.9

34.8

35.9

36.4

36.5

36.5

40



52 (PN)

27.3

29.9

32.3

34.2

35.3

35.8

35.9

35.9

40



(PL) Participating Landholder

Compliance with noise limits?

(PN) Participating Neighbour

It can be seen from Table 21 that predicted noise levels from the proposed wind farm comply with the relevant base noise levels within the range of assessed wind speeds at each of the assessed residential properties. Wind farm noise at all other identified residential properties are predicted to be 5dB or more below the 40dB LA90 base noise level and therefore also demonstrate compliance with NZS 6808:2010 across the range of assessed wind speeds. A representative noise level contour map relating to this turbine model is provided in Appendix G. 8.2

Tonality Based on the information detailed in Section 5.1.3, no special audible characteristics’ penalty for tonality has been applied to the predicted wind farm noise levels detailed above. A tonal audibility test report should be provided for the final turbine model selected prior to commencing any site works, to confirm the significance of any potential tones from the assessed turbine model.

8.3

Effects of Wind Farm Noise Sound is an important feature of the environment in which we live; it provides information about our surroundings and is a key influence on our overall perception of amenity and environmental quality. Sound is therefore an environmental quality that must be considered as part of any proposal to develop new infrastructure that could influence the sound environment of neighbouring communities. Excessive or unwanted sound is commonly referred to as noise and can have a range of effects on people, depending on a range of physical and contextual factors. The Guidelines for Community Noise 1999 prepared by the World Health Organisation (WHO) provides a health-based framework of guideline limits and values to address the broad definition of health given as: A state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity

This broad definition means that effects ranging from community annoyance, sleep disturbance and speech interference, through to direct physiological impacts such as hearing damage, are all identified as potential health considerations. An important aspect of this range of considerations is that some effects will be highly dependent on the listener’s perception and attitude to the noise in question, such as annoyance, while other effects are primarily related to the level of sound and the direct physiological risks these may represent, such as hearing damage.

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Environmental noise policies, including those applied to wind farms, establish objective noise criteria to address these health considerations. In particular, environmental noise policies define criteria which are chosen to prevent direct physiological risks of sound, and minimise as far as practically possible adverse health considerations such as annoyance and sleep disturbance. Practically minimising the risks of noise effects related to annoyance and sleep disturbance requires the potential range of responses to sound to be considered. In this respect, it is important to note that individual attitudes and reactions to sound are highly variable, and will depend on a complex set of acoustic and non-acoustic factors. These include the level and character of the sound in question, the time of day the sound occurs, the regularity of the sound, the environment in which the sound is heard, the individuals hearing acuity, and an individual’s personal opinion and perception of the sound source or development in question. The latter will in turn depend on other complicating factors such as visual impressions of the source in question and the perceived community benefit, or otherwise, of the source in question. Due to the complexity and range of potential responses to sound, it is not possible to define limits that will guarantee an audible sound will be acceptable to all individuals; this will always be a matter of personal judgement for each individual. Further, it is usually not feasible or practical to design new development or infrastructure to inaudible noise levels. As a result, minimising the risks of noise effects involves setting criteria which prevents the majority of people from being disturbed. This requires regulatory authorities to strike a balance between amenity and development, setting noise limits which are as stringent as can be practically achieved without preventing new development. This type of approach to noise policy was outlined by the Victorian Department of Health in their 2013 publication on wind farm sound and health which states: Noise standards are used not only for environmental noise (such as wind farms and traffic noise) but also for industry and even household appliances. Noise standards are set to protect the majority of people from annoyance. The wide individual variation in response to noise makes it unrealistic to set standards that will protect everyone from annoyance. A minority of people may still experience annoyance even at sound levels that meet the standard. This is the case not only for wind farms, but for all sources of noise.

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The subject of health effects related to operational wind farms in Australia has been extensively considered by the Commonwealth Government’s National Health and Medical Research Council (NHMRC) and the Australian Medical Association; in particular, the NHMRC has undertaken and coordinated a systematic review of evidence related to wind farms and health. The research reviews9 and public statements10, 11 produced by these peak health bodies support that, as with any audible sound, wind farm noise can represent a potential source of annoyance or sleep disturbance for some individuals. Their findings did however indicate that there was no reliable evidence to support a relationship between wind farm noise and direct adverse effects on human health. These findings lend support to the suitability of the wind farm noise controls applied in Victoria, which are intended to provide reasonable protection of health and amenity at noise sensitive locations. This is consistent with the objectives of NZS 6808:2010 discussed earlier in Section 3.2. Importantly, the Standard notes that the consensus view of the committee responsible for the development of NZS 6808:2010, including New Zealand representatives from the Ministry of Health and Institute of Environmental Health, was that the Standard provides a reasonable way of protecting health and amenity at nearby noise sensitive locations, without unreasonable restricting the development of wind farm. Further discussions of specific noise considerations related low-frequency sound and infrasound are provided in the following section. 8.4

Low frequency noise, infrasound and ground vibration The limits adopted for the assessment of operational noise from wind farms represent relatively low levels which have been specified in recognition of the quieter rural environments in which wind farms are normally located. However, consistent with noise policies applied to other forms of development, the criteria are not intended to restrict wind farm noise to inaudible levels. Accordingly, a wind farm which achieves compliance with the criteria may still be audible at surrounding receiver locations on some occasions; this will depend on a range of factors such as the time of day, the speed and direction of the wind, the proximity to turbines, the extent of vegetation around the dwelling, and the degree to which the dwelling is sheltered from prevailing wind conditions. Irrespective of the relatively low levels which operational wind farm noise is restricted to, an individual’s judgement of the audible noise from a wind farm is highly subjective and will be influenced by a range of contextual factors.

9

10

11

Systematic review of the human health effects of wind farms 2013, Adelaide University, commissioned by the NMRC NHMRC Draft Information Paper: Evidence on Wind Farms and Human Health 2014, National Health and Medical Research Council AMA Position Statement – Wind Farms and Health 2014, Australian Medical Association

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The subject of wind farm noise and its characteristics has attracted considerable attention recently. Specific attention has been directed to alleged matters relating to low frequency sound as well as infrasound and vibration. Low frequency sounds are generally regarded as sounds above 20Hz and extending upwards into the range of 100-200Hz. The definition of infrasound often varies in different jurisdictions, but is generally accepted to refer to frequencies of sound which lie below 20Hz. While 20Hz is commonly cited as the lower bound of audibility, frequencies below 20Hz can still be audible, provided that the level of the sound is sufficiently high to exceed the threshold of audibility at those frequencies. Common with many other sources of noise, wind turbines emit infrasound, low frequency sound and ground vibrations. However, what is often overlooked is that these types of sound and vibration are a feature of the everyday environment in which we live and arise from a wide range of natural sources such as the wind and the ocean to man-made sources such as domestic appliances, transportation and agricultural equipment. The important point in relation to wind turbines is that the levels of these types of emissions are low and therefore, in many cases, cannot generally be reliably measured amidst normal background levels. NZS 6808:2010 provides specific advice concerning infrasound at Section 5.5 noting: Although wind turbines may produce some sound at (ultrasound and infrasound) frequencies outside the normal range of human hearing these components will be well below the threshold of human perception. Claims have been made that low frequency sound and vibration from wind turbines have cause illness and other adverse physiological effects among a very few people worldwide living near wind farms. The paucity of evidence does not justify at this stage, any attempt to set a precautionary limit more stringent than those recommend [in the Standard].

These types of emissions have been the subject of considerable misrepresentation in media commentary. Notably, the work of Dr Geoff Leventhall, a prominent UK consultant in the field of acoustics and vibration, and researcher in the field of low frequency noise is often cited in some documents which continue to claim concerns about infrasound and low frequency noise from wind turbines. However, Dr Leventhall has regularly made clear statements to assert that there is no significant infrasound from current designs of wind turbines and very little low frequency sound, neither of which are anywhere near the sorts of levels which would represent a direct health risk for neighbouring residents of modern wind farms. An example such publication, co-authored by Dr Leventhall, was published in the UK Institute of Acoustics Bulletin in March 200912. This publication was prepared as an agreement between acoustic consultants regularly employed on behalf of wind farm developers, and conversely acoustic consultants regularly employed by local councils and community groups campaigning against wind farm developments. The intent of the article was to promote consistent assessment practices, and to assist in restricting wind farm noise disputes to legitimate matters of concern.

12

Institute of Acoustics Bulletin – Bowdler, Bullmore, Davis, Hayes, Jiggins, Leventhall, McKenzie - Prediction and Assessment of Wind Turbine Noise –March 2009

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On the subject of infrasound and low frequency noise, the article notes: Infrasound is the term generally used to describe sound at frequencies below 20Hz. At separation distances from wind turbines which are typical of residential locations the levels of infrasound from wind turbines are well below the human perception level. Infrasound from wind turbines is often at levels below that of the noise generated by wind around buildings and other obstacles. Sounds at frequencies from about 20Hz to 200Hz are conventionally referred to as low frequency sounds. A report for the DTI in 2006 by Hayes McKenzie concluded that neither infrasound nor low frequency noise was a significant factor at the separation distances at which people lived. This was confirmed by a peer review by a number of consultants working in this field. We concur with this view. A Portuguese group has been researching ‘Vibro-acoustic Disease’ (VAD) for about 25 years. Their research initially focussed on aircraft technicians who were exposed to very high overall noise levels, typically over 120dB. A range of health problems has been described for the technicians, which the researchers linked to high levels of low frequency noise exposure. However other research has not confirmed this. Wind farms expose people to sound pressure levels orders of magnitude less than the noise levels to which the aircraft technicians were exposed. The Portuguese VAD group has not produced evidence to support their new hypothesis that infrasound and low frequency noise from wind turbines causes similar health effects to those experienced by the aircraft technicians.

Another example of the misrepresentations made in relation to the environmental effects of wind turbines centred around work carried out by Keele University in the UK on ground vibration. Professor Peter Styles and his team at Keele University undertook a study of the effects of wind turbines on the seismic detection array at Eskdalemuir, Scotland. The results of this work were widely misinterpreted and resulted in a statement13 from Professor Styles: We are writing to clarify some misconceptions [...] about wind farm noise. Whilst it is technically correct that ‘vibrations can be picked up as far away as 10km’, to give the impression that they can be felt at this distance is highly misleading. The levels of vibration from wind turbines are so small that only the most sophisticated instrumentation and data processing can reveal their presence, and they are almost impossible to detect. The Dunlaw study was designed to measure effects of extremely low level vibration on one of the quietest sites (Eskdalemuir) in the world, and one which houses one of the most sensitive seismic installations in the world. Vibrations at this level and in this frequency range will be available from all kinds of sources such as traffic and background noise – they are not confined to wind turbines. To put the level of vibration into context, they are ground vibrations with amplitudes of about one millionth of a millimetre. There is no possibility of humans sensing the vibration and absolutely no risk to human health. It is, however, an issue for the Eskdalemuir seismic array, as it can detect this level of vibration. It is designed to detect explosions and earthquakes of a low magnitude from all over the world. The infrasound generated by wind turbines can only be detected by the most sensitive equipment, and again this is at levels far below that at which humans will detect the low frequency sound. There is no scientific evidence to suggest that infrasound has an impact on human health.

13

Keele University Rejects Renewable Energy Foundation’s Low Frequency Noise Research Claims. http://www.bwea.com/ref/lfn_keele.html

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More recent measurements14, 15 have demonstrated that infrasound and low frequency sound produced by regularly encountered natural and man-made sources, such as the infrasound produced by the wind or distant traffic, is comparable to that of modern wind turbines, noting that: Infrasound levels in the rural environment appear to be controlled by localised wind conditions. During low wind periods, levels as low as 40dB(G) were measured at locations both near to and away from wind turbines. At higher wind speeds, infrasound levels of 50 to 70dB(G) were common at both wind farm and non-wind farm sites. Organised shutdowns of the wind farms adjacent to [sic: measurement locations] indicate that there did not appear to be any noticeable contribution from the wind farm to the Gweighted infrasound level measured at either house. This suggests that wind turbines are not a significant source of infrasound at houses located approximately 1.5 kilometres away from wind farm sites

In 2010, the UK Health Protection Agency published a report16 on the health effects of exposure to ultrasound and infrasound. The exposures considered in the report related to medical applications and general environmental exposure. The report notes: Infrasound is widespread in modern society, being generated by cars, trains and aircraft, and by industrial machinery, pumps, compressors and low speed fans. Under these circumstances, infrasound is usually accompanied by the generation of audible, low frequency noise. Natural sources of infrasound include thunderstorms and fluctuations in atmospheric pressure, wind and waves, and volcanoes; running and swimming also generate changes in air pressure at infrasonic frequencies. [...] For infrasound, aural pain and damage can occur at exposures above about 140 dB, the threshold depending on the frequency. The best-established responses occur following acute exposures at intensities great enough to be heard and may possibly lead to a decrease in wakefulness. The available evidence is inadequate to draw firm conclusions about potential health effects associated with exposure at the levels normally experienced in the environment, especially the effects of long-term exposures. The available data do not suggest that exposure to infrasound below the hearing threshold levels is capable of causing adverse effects.

Also, a recent State Government of Victorian Department of Health document17 concludes the following in relation to infrasound from wind farms: Infrasound is audible when the sound levels are high enough. The hearing threshold for infrasound is much higher than other frequencies. Infrasound from wind farms is at levels well below the hearing threshold and is therefore inaudible to neighbouring residents.

These studies all indicate that infrasound levels from the proposed Dundonnell Wind Farm are anticipated to be comparable with existing ambient levels. 14

15

16

17

Sonus report for Pacific Hydro - Infrasound measurements from wind farms and other sources – November 2010 - see http://www.pacifichydro.com.au/media/192017/infrasound_report.pdf Evans, T., Cooper, J. & Lenchine, V., Infrasound levels near wind farms and in other environments, South Australian Environment Protection Authority, Adelaide, 2013 Health Protection Agency UK – Health Effects of Exposure to Ultrasound and Infrasound – Report of the independent Advisory Group on Non-ionising Radiation - 2010 Public Statement: Wind Turbines and Health - July 2010

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In February 2014, the National Health and Medical Research Council (NHMRC) released a draft report18 for public comment addressing human health effects of wind farms which includes consideration of noise. From well over 2,500 articles which were identified during the review, eleven (11) studies across Europe, North America and Australia satisfied a set of pre-specified eligibility criteria for detailed review and therefore form the basis of the report, which concludes: There is no consistent evidence that noise from wind turbines―whether estimated in models or using distance as a proxy―is associated with self-reported human health effects. Isolated associations may be due to confounding, bias or chance. There is consistent evidence that noise from wind turbines―whether estimated in models or using distance as a proxy―is associated with annoyance, and reasonable consistency that it is associated with sleep disturbance and poorer sleep quality and quality of life. However, it is unclear whether the observed associations are due to wind turbine noise or plausible confounders.

8.5

Amplitude modulation Amplitude modulation is a normal feature of a correctly functioning wind turbine, described as the rise and fall in broadband noise level corresponding to the rotation of the blades. This characteristic is typically most evident in close proximity to the turbine. Other reported effects of modern wind farm noise relate to an effect known as atypical amplitude modulation which relates to the rhythmic rise and fall in the level of noise associated with a wind farm, over and above the normal variation in noise associated with a wind farm. A study19 released by Renewable UK in December 2013 presents the findings of a detailed research programme by an international consortium into atypical amplitude modulation of wind farm noise which, if present, could attract a special audible characteristics’ penalty to compliance testing results. The study found that situations can arise where the modulation of the noise is sufficient to give rise to increased annoyance from wind farm noise, however the factors which give rise to the effect are complicated and cannot be predicted. An important outcome of the study is a new method proposed for objectively measuring and assessing atypical amplitude modulation during post-construction monitoring. In recognition of the limited apparent extent of this reported matter, the subject of enhanced amplitude modulation has not altered the current approach in Australia. Specifically, current noise policies continue to represent a suitable basis for designing and assessing new wind farm developments.

18 19

Systematic review of the human health effects of wind farms - 2014 Wind Turbine Amplitude Modulation: Research to Improve Understanding as to its Cause and Effects (http://tinyurl.com/RUK-OAM-Report - 12.6MB)

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8.6

Operational considerations The Scoping Requirements request that the operation of the wind farm be controlled and monitored by a site specific management plan which is to include turbine noise. Methods for monitoring noise at an operational wind farm are provided in NZS 6808:2010. These methods could be incorporated into the Dundonnell Wind Farm operational management plan to facilitate the measurement of operational noise as may be required. Additionally, while wind farm noise levels are predicted to comply with the applicable noise limits, as detailed in Section 8.1, consideration has been given to available contingency strategies to reduce noise levels if required. The following two key measures are available to manage noise from the wind farm:  Sound power level testing: the procurement contract for the supply of turbines to the site will typically include specifications concerning the allowable sound power levels from the turbine, and the permissible characteristics of the turbine. Sound power level testing will inform whether the contracted values are exceeded and assess the potential presence of audible tones. The supplier will generally be required to implement measures to reduce the noise to the contracted value. This can include measures to rectify manufacturing defects or appropriate control settings.  Noise reduction management strategy: modern wind farms include control systems which enable the operation of the turbines to be varied according to environmental constraints. Specifically, variable speed and variable pitch turbines as proposed for this site include control functions which enable the sound power levels of the turbines to be selectively controlled; by adjusting the pitch and rotational speed of blade, the noise level of the turbine can be reduced. In addition, where required, the turbines can be selectively shut down under relevant wind speeds and directions. These types of control measures can be used separately, or in combination, to achieve noise reductions for predetermined wind speed ranges and directions.

9.0

ASSESSMENT OF SUBSTATION OPERATIONAL NOISE The proposed substations associated with the Dundonnell Wind Farm are located within the site boundary and at the Mortlake Gas Power Station (MOPS). It is noted that transformers typically display tonality at 100Hz, therefore a correction of +2dB has been applied to the predicted LAeq noise levels to obtain the effective noise levels (Leff). Using the ISO 9613-2:1996 methodology, the operational noise levels from the on-site substation is predicted to be 16dB Leff at House 2 (participating landholder) which is the nearest affected assessed residential property. The operational noise level from the off-site substation is predicted to be 24dB Leff at the nearest affected residential property located approximately 1.1km to the south east.

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Noise from both proposed substations associated with the Dundonnell Wind Farm is predicted to comply with the night-time NIRV noise limit of 34dB Leff at all assessed residential properties. 10.0

ASSESSMENT OF OPERATIONAL TRANSMISSION LINE NOISE Corona and Aeolian noise can be generated by the interaction of high voltage overhead power lines in specific atmospheric conditions. Sound generated by wind passing across power lines (cables or wires) produces Aeolian tones, which are highly tonal in character. When a steady flow (wind) in air passes a cable, a vortex wake is formed. The vortices are shed alternatively and periodically from opposite sides of the cable, radiating sound (Aeolian tones). The fundamental frequency of the sound generated is equal to the vortex shedding frequency. Aeolian tones can be produced with or without vibration of the cable. The effect of cable vibration will be significant only when the vortex shedding frequency coincides with the natural frequencies of the cable. In such cases, the sound radiation will be greatly enhanced by the cable resonance. Corona discharge noise consists of broadband noise (hiss, crackle, etc.) and is generally only audible under conditions of high humidity, such as during rain or fog. Corona (and the associated discharge noise) is due to ionisation of the air surrounding the conductor and occurs along the length of the conductor. The ionisation is caused by a voltage difference applied across a volume of air. It is the voltage difference and not the actual voltage itself that causes ionisation. For a round conductor, the voltage difference per unit volume of air reduces away from the conductor surface, creating a gradient, with the highest voltage difference being at the surface of the conductor. When this voltage gradient reaches a certain critical value, electrical discharges occur and produce corona. The larger the conductor diameter, the lower the surface voltage gradient, and hence the lower the ionisation effects including corona discharge noise. Ionisation effects are largely determined by the conductor surface conditions. A rough conductor surface (with nicks, broken wire strands, bird droppings, etc.) will create a higher surface-voltage-gradient and hence more ionisation and noise. Under wet conditions, such as very light rain or fog, water drops form on the surface of the conductor and create localised high voltage gradients, causing increased ionisation and corona discharge noise. Corona discharge noise is more prominent during heavy rain, but the duration of heavy rain periods is generally shorter than periods of light rain and in any case the corona noise tends to be obscured by the noise of the rain. Corona discharge noise effects are most appropriately considered under light rain conditions. The corridor of the proposed power transmission line for the Dundonnell Wind Farm has been reviewed to establish the risk of noise considerations associated with Aeolian tones or Corona noise. The proposed corridor is depicted below in Figure 4.

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Figure 4: Proposed transmission line corridor

The proposed corridor depicted above is at least 500m away from the nearest noise sensitive location (House 40). Based on past experience of modelling studies in close proximity to these types of transmission lines, considerations relating to Aeolian tones or Corona noise represent a low risk at the proposed separating distances, particularly at the low to moderate wind speeds that are most relevant to this type of noise source. The occurrence of these types of effects during the operation of the project can also be reduced during the detailed design phase of the project through the selection of appropriate cable characteristics to avoid inherent resonant frequencies that are most important to Aeolian noise.

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11.0

ASSESSMENT OF CONSTRUCTION NOISE Construction tasks associated with the project include the following:  Access road and turbine hardstand construction  Associated Infrastructure construction, such as: substation & site facilities  Concrete batch plant operation  On-site quarry operation  Turbine tower foundation construction  Trench digging to accommodate underground cabling  Assembly of turbine tower, nacelle and rotor blades. Equipment required to complete the tasks outlined above include:  Bulldozers, graders, excavators, dump trucks, rollers, concrete trucks, front end loaders, cranes, pneumatic jack hammers etc  All wheel drive vehicles and flat-bed delivery trucks. Construction works may need to occur outside of standard working hours on some occasions. Examples of activities where this may be required include delivery of oversize plant or structures, including turbine nacelle, blades, tower and transformers in addition to erection of these structures based on weather constraints. The construction phase of the project will be controlled by a construction management plan which will include details of working methods and times, including any requirements for work outside of the day period defined in EPA Publication 1254, as detailed in Table 2 of Section 4.1.

11.1

Construction equipment noise data It is anticipated that a variety of construction equipment would be used for this project. Sound power levels for the proposed construction equipment have been determined based on guidance and data sources including Australian Standard AS 2436:2010 Guide to noise and vibration control on construction, demolition and maintenance sites (AS 2436:2010), and noise level data from previous projects of a similar nature. Table 22 summarises noise emissions used to represent key items of plant associated with construction.

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Table 22: Construction noise sources sound power data, LWA dB Noise source

Sound Power Level

Excavator fitted with pneumatic breaker

118

Excavator (100 to 200kW)

107

Tracked loaders

115

Crane (200t)

105

Crane (500t)

110

Crane (1200t)

115

Delivery Trucks

107

Concrete trucks

108

Dump truck

117

Concrete pump

108

Generator

99

Grader

110

Bulldozer

108

Front end loader

113

Rock crusher

120

Batching Plant

110

Overall sound power levels for equipment items that are likely to operate simultaneously have been estimated for each of the major construction phases have been used to predict construction noise levels at the nearest affected residential properties, as detailed in Table 23.

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Table 23: Overall sound power levels of major construction phases, LWA dB

11.2

Construction phase

Plant/Equipment

Overall sound Power Level

Access road construction

2x Excavator (100 to 200kW), 1x Tracked loaders, 2x Dump truck, 1x Grader, 1x Bulldozer

120

Substation

1x Excavator (100 to 200kW), 1x Crane (500t), 1x Delivery Trucks, 1x Concrete trucks, 1x Concrete pump, 1x Generator, 1x Bulldozer

115

Site Compound

1x Excavator (100 to 200kW), 1x Crane (200t), 1x Delivery Trucks, 1x Concrete trucks, 1x Concrete pump, 1x Generator, 1x Bulldozer

115

Turbine foundations

1x Excavator fitted with pneumatic breaker, 1x Excavator (100 to 200kW), 1x Crane (200t), 1x Delivery Trucks, 1x Concrete trucks, 1x Concrete pump, 1x Generator, 1x Bulldozer

120

Cable trench digging

1x Excavator (100 to 200kW), 1x Dump truck, 1x Generator, 1x Bulldozer

120

Turbine assembly

2x Crane (200t), 2x Crane (500t), 1x Crane (1200t), 1x Generator

120

Concrete Batching

1x Concrete trucks, 1x Concrete pump, 1x Batching Plant

115

Quarry

1x Excavator fitted with pneumatic breaker, 1x Excavator (100 to 200kW), 1x Dump truck, 1x Bulldozer, 1x Front end loader, 1x Rock crusher

125

Predicted construction noise levels Noise levels during construction have been predicted at the nearest noise sensitive locations during the construction phase to provide an indication of potential noise associated with regular working areas. Our assessment of construction noise has been divided up into the eight (8) main components during this phase of the development, namely:  Site compound construction  On-site substation construction  Off-site substation construction  Quarry operation  Access road construction  Concrete batching plant  Turbine foundation preparation  Cable trench digging  Turbine delivery and assembly

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It should be noted that predicted noise levels are for those receivers closest to the respective construction activities. To be conservative, it has been assumed that cable trench digging could occur anywhere along the proposed tracks within the site. Furthermore, predicted noise levels are based on equipment being operational simultaneously for a full 30 minute assessment period. Table 24 details the predicted noise levels at a sample of key receptor locations based on the construction activities outlined above. Given that the precise equipment selections and methods of working would be determined during the development of a construction plan, and that the noise associated with construction plant and activity varies significantly, the predicted noise levels are provided as an indicative range of levels which may occur in practice. Table 24: Indicative range of construction noise predictions, LAeq dB Participating properties Construction phase

Local landholders

Nearest property

Predicted level range

Nearest property

Predicted level range

Access road construction

2 (PL)

60-65

57

50-55

On-site substation

2 (PL)

30-35

3

25-30

Site Compound

1 (PN)

35-40

3

30-35

Turbine foundations

1 (PN)

50-55

42

40-45

Cable trench digging

2 (PL)

60-65

57

50-55

Turbine assembly

2 (PL)

45-50

42

40-45

Concrete Batching

1 (PN)

40-45

3

25-30

Quarry

2 (PL)

50-55

8

35-40

(PL) Participating Landholder

Noise levels from construction activities at the proposed off-site substation is predicted to be 25-30dB LAeq at the nearest affected residential property located approximately 1.1km to the south east. As detailed in Table 2 of Section 4.1, there is no noise requirement specified for daytime activities and therefore the range of predicted noise levels are presented above as an indication of potential worse case levels from construction activities at residential properties in the vicinity of the proposed site. During the evening period, the construction noise limit is defined as an allowable increase over background noise levels. Background noise levels have been measured below 20dB LA90 during the survey period detailed in Section 6.2 and therefore the applicable construction noise limits could be below 25dB LAeq, if construction activities lasted for more than 18 months. It can be seen from Table 24 that all considered construction activities would not be able to operate during the evening period without additional noise control measures.

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Providing that the potentially affected residents are notified in advance, unavoidable works such as turbine erection and delivery of large size items and low noise works (as detailed in Section 4.1) may be undertaken during the evening and night periods. It is recommended for a Construction Noise Management Plan to be prepared subsequent to the determination of this project by the Relevant Authority. 11.2.1 Quarry operations During selected construction phases, it is proposed to operate the quarry during both the day and evening periods (Monday to Sunday 0700-2200hrs). As detailed above, without noise control treatment, noise levels from the quarry are predicted to exceed the estimated evening time noise limit. It is recommended that the quarry operations be restricted to the daytime period (Monday to Friday 0700-1800hrs and Saturday 0700-1300hrs) until a detailed noise assessment is submitted to the relevant authority detailing the noise control treatments required to achieve compliance with the evening time noise limit. 11.3

Construction Vibration Assessment Ground vibration from construction activity is inherently variable, and is influenced by a range of factors related to the construction plant, ground conditions and the separating distance between the plant and the receptor location. Due to the complexity of the factors influencing ground vibration propagation, the prediction of ground vibration is subject to considerable uncertainty. The NSW Vibration Guideline referenced earlier in Section 4.2 provides guideline criteria for assessing vibration levels, but does not provide specific information about vibration emission values or prediction methodologies. In the absence of ratified empirical vibration data or prediction methodologies in Victoria or Australian guidelines, the prediction methodology detailed in the UK Transport Research Laboratory’s (TRL) Groundborne vibration caused by mechanised construction works (Hiller & Crabb, 2000) has been used together with indicative empirical vibration data for common types of construction plant provided in the superseded NSW Roads and Traffic Authority’s Environmental Noise Control Manual (ENCM) dated 2001. The TRL document presents a detailed account of ground vibration sources and mechanisms and proposes a prediction method which is noted to be valid to distances of approximately 100m. It also notes that 100m encompasses the distances in which ground vibration is likely to be perceptible at most sites, but notes that the effects of some larger items of plants and piling may be perceptible at greater distances. It further states that the use of the prediction method is not recommended beyond 100m, and the predictions at increased distances are likely to overestimate the level of vibration. Given that the nearest receiver (participation landholder) is approximately 220m from proposed road works and approximately 1km from longer term areas of working, ground vibration levels are expected to be low and detailed predictions are subject to considerable uncertainty. However, an estimated range of potential vibration levels has been determined on the basis of the indicative data and extrapolation method of the superseded ENCM document.

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Table 25 summarises empirical vibration data for common construction plant, the range of extrapolated values at 220m and 1km, and the PPV criteria for continuous and impulsive vibration sourced from the NSW vibration guidelines. Note that the range of predicted values accounts for the range of vibration source values as well as the range of vibration propagation conditions (minimal propagation through to worst case propagation). Table 25: Typical construction plant vibration levels, PPV (mm/s) Equipment

Typical PPV (mm/s) at 10m

at 220m

at 1km

Continuous

Impulsive

12-30