Medical Observer on 5th Sep 2011 Dr George Crisp.
Air pollution has been recognised as a major contributor to ill health for centuries.
While some of the acute effects of "smogs", wood and coal burning have been obvious even prior to modern medicine, it is only recently we have started to realise the far greater and more insidious consequences of chronic exposure.
(see rest of post by clicking "Links to post")
Worldwide, more than 800,000 deaths are now attributed to outdoor air pollution, with annual mortality in the US and the UK 100,000 and 30,000, respectively.
When the consequences of morbidity, lost productivity and lost years of life are considered, the global cost runs into trillions of dollars.
It is a largely silent but truly massive economic and public health issue.
Large epidemiological studies, supported by toxicological and clinical data, have confirmed a wide range of diseases are related to air quality.
There is strong evidence for a causal relationship between air pollutants and respiratory conditions such as COPD, asthma and lung cancer, and cardiovascular diseases, acute myocardial infarctions (AMI) and arrhythmias.
This is occurring even with exposure to low concentrations well below current guideline levels.
Air pollution refers to the introduced chemical, biological or particulate matter in the atmosphere that harms human health and other organisms, or damages the natural or built environment, with SO2, NO2, CO, volatile organic compounds and particulate matter (PM) the major primary pollutants.
Regulation and technological advances have reduced air pollutants, most notably SO2 and lead, but increasing traffic congestion and energy consumption result in a rise in pollutant emissions, and greater urban density and growth lead to greater human exposure.
Living near a busy road is a serious health hazard, with more than twice the number of Australians killed by traffic fumes than motor vehicle accidents. Research shows 15% of all asthma cases are linked to residential proximity to major roads1.
A recent meta-analysis found traffic related pollution was the largest single population attributable factor for AMI. Exposure for just a few hours a week can trigger cardiovascular events, but longer term exposure can reduce life expectancy by years2.
Particulates are liquid/solid droplets composed of nitrates, sulphates, organic compounds and heavy metals, and cause up to 80% of adverse health effects.
It is the very size of these particles that predominantly determines their damaging effects. Large particles are mostly filtered out in the airway, while the very smallest particles deposit deep within the lungs. Diesel-powered engines are the largest source of very fine particles, and produce up to 100 times the emissions of petrol engines.
A recent study in the European Heart Journal3 found the adverse vascular effects of diesel exhaust inhalation are mediated through combustion derived nano-particulates. A single urban diesel four-wheel drive car may result in $3000 per annum in community health costs, it said.
There are compelling health and cost benefits to be gained by reducing pollution. Studies have repeatedly documented that even small reductions in fine particulate pollution can improve health outcomes.
The US Environmental Protection Agency calculates the 1990 Clean Air Act is currently saving 160,000 early deaths, 130,000 heart attacks, 1.7 million asthma attacks and 13 million working days. By 2020, the Act will be saving the US economy over $2 trillion every year, it says. Similarly, significant health co-benefits occur from reducing air pollution. This includes increased physical activity, reduced water use and pollution – and, of course, reducing greenhouse gas emissions.
One solution to all of these interlinked problems would be to include health in all policy decisions particularly in energy, transport and urban planning.
References
(1) A breath of fresh air please. The Lancet (Editorial)
(2) Public health importance of triggers of myocardial infarction: a comparative risk assessment. ( Nawrot et al )
(3) Combustion-derived nanoparticlate induces the adverse vascular effects of diesel exhaust inhalation ( Mills et al )
Tuesday, September 20, 2011
The mining and burning of coal: effects on health and the environment
Sunday, July 3, 2011
Letter to the editor
The "handful" of 3,000 people who attended the "Say Yes to climate
actions" event in Perth on a long weekend, mirrored the 45,000 who
rallied across Australia on June 5th.
Of course, whilst not a mandate, it is a powerful reflection of the
broad and deep community call for action.
Claims ( in your paper ) that there is no "scientific documentation" that a tax
will work, is an absurd argument, because taxes are economic
measures, not scientific constructs.
Science tells us what will happen if we do nothing, and what the likely
consequences will be. Science does not tell us what action to take.
From an economic perspective, global warming can be viewed as a "market
failure", the result of not capturing the externalized costs of
greenhouse gas emissions ( and other pollution ).
Rather than accept the evidence presented by the world's scientists,
those who seem fundamentally committed to free market ideology, have
instead chosen to put their faith in markets and the paradigm of
indefinite growth, refusing the logical and inescapable conclusion that
we must account for the negative costs of our actions.
As a carbon price rises, it will initially favor gas, then renewable
energy, over coal.
Last weeks letter to the editor raises another popular contradiction of the
economically conservative; the favoring of nuclear energy. Even though it
cannot possibly compete without large taxpayers subsidies, government
regulation, insurance and decommissioning.
This would seem anathema to free market thinking. Or does it say more
about more about privatizing benefits and socializing costs?
Our emissions trajectory means we will now likely pass the relatively
safe threshold of a 2 degree global temperature rise. Heralding a
future, where our health and well being, and the state of our
environment on which we are entirely reliant, will be seriously if not
immeasurably compromised.
The questions really should be; what makes your recent commentator and his ilk so
blithely certain they are right and the scientists with expertise in
these area are wrong? So certain it seems, that they believe we should
willfully ignore the science and the risks and do precisely nothing. How
in fact, is it even possible to entertain such a diabolical dereliction
of responsibility.
actions" event in Perth on a long weekend, mirrored the 45,000 who
rallied across Australia on June 5th.
Of course, whilst not a mandate, it is a powerful reflection of the
broad and deep community call for action.
Claims ( in your paper ) that there is no "scientific documentation" that a tax
will work, is an absurd argument, because taxes are economic
measures, not scientific constructs.
Science tells us what will happen if we do nothing, and what the likely
consequences will be. Science does not tell us what action to take.
From an economic perspective, global warming can be viewed as a "market
failure", the result of not capturing the externalized costs of
greenhouse gas emissions ( and other pollution ).
Rather than accept the evidence presented by the world's scientists,
those who seem fundamentally committed to free market ideology, have
instead chosen to put their faith in markets and the paradigm of
indefinite growth, refusing the logical and inescapable conclusion that
we must account for the negative costs of our actions.
As a carbon price rises, it will initially favor gas, then renewable
energy, over coal.
Last weeks letter to the editor raises another popular contradiction of the
economically conservative; the favoring of nuclear energy. Even though it
cannot possibly compete without large taxpayers subsidies, government
regulation, insurance and decommissioning.
This would seem anathema to free market thinking. Or does it say more
about more about privatizing benefits and socializing costs?
Our emissions trajectory means we will now likely pass the relatively
safe threshold of a 2 degree global temperature rise. Heralding a
future, where our health and well being, and the state of our
environment on which we are entirely reliant, will be seriously if not
immeasurably compromised.
The questions really should be; what makes your recent commentator and his ilk so
blithely certain they are right and the scientists with expertise in
these area are wrong? So certain it seems, that they believe we should
willfully ignore the science and the risks and do precisely nothing. How
in fact, is it even possible to entertain such a diabolical dereliction
of responsibility.
Friday, July 1, 2011
Thursday, June 2, 2011
Peak health - Medical Observer 2 June 2011
Are we in danger of passing peak health?
Medical Observer magazine 30th May 2011 Dr George Crisp MBBS, MRCGP
http://dea.org.au/news/article/are_we_in_danger_of_passing_peak_health
ACCORDING to conventional wisdom, we will keep living longer and enjoying ever healthier lives. After all, public health advances and technological progress over the past 150 years have delivered these improvements. So why shouldn’t this continue indefinitely?
Our perspective has been largely restricted to diagnosed illness and number of years lived, ignoring more meaningful measures of health and wellbeing.
Our time-poor, overstressed lives and iniquitous, fragmented communities have not made us any happier or healthier.
Modern living, with its material focus, over-consumption, poor dietary choice and inactivity, has become a major contributor to chronic disease while eroding traditional, spiritual and cultural values necessary for our non-material well being.
Rates of diabetes and obesity are escalating, worsening health outcomes, diminishing quality of life, and stretching health and welfare services and budgets.
Alcohol and drug use are compromising physical and mental health, damaging our social fabric. But rather than address the causes of societal ill health, we are instead focusing on increasingly expensive, technology-based, hospital-oriented and, inevitably, unsustainable solutions. Antibiotic resistance is a prime example of why this type of exploitative thinking is so short-sighted.
It is, however, our collective impacts that create the most challenging health risks.
In just 150 years, humanity’s environmental footprint has grown 150-fold. This has come at the expense of the other inhabitants of this planet. Through loss of habitat, over-harvesting, pollution and waste, we are driving a new mass extinction event.
Food, shelter, medicines, clean air and fresh water are all natural services we take for granted. At every level our health, and civilisation, is underpinned by the myriad, interdependent, mostly unidentified species that collectively constitute natural ecosystems.
The complex relationships between potential infectious organisms, vectors and hosts are also shifting, making unpredictable the patterns of known diseases – even producing entirely novel ones, such as SARS.
Agriculture is dependent on intact healthy ecosystems and soils. Additionally, the increased yields now required to provide adequate nutrition for billions of people have resulted in unsustainable use of resources, particularly fresh water, oil and phosphate, all of which are now diminishing.
We are approaching ‘peak oil’, with its volatile, rising prices which compromise food production and availability, disproportionately affecting the poorest and most vulnerable.
Our economy and health infrastructure are also highly energy-intensive. We cannot afford to keep repeating the 20th-century mistake of chasing ever more polluting and diminishing resources. We need instead to strive for clean, renewable energy, with the health and social benefits that it brings.
Overuse of fossil fuels and land clearance has produced atmosphere-altering quantities of greenhouse gasses. The ensuing climatic disruption and ocean acidification will have profound health effects, prompting the (Nov 2009) Lancet series “Climate change is the greatest threat to human health in the 21st century”.
Impacts may include heatwaves, heavy precipitation and droughts, more favourable conditions for many microbes, pests and vectors, rising sea levels, fresh water depletion and food insecurity, plus, ultimately, large-scale population displacement and mass migration of refugees.
The timing and magnitude of these interrelated impacts may be uncertain, but the risks to human health at local, regional and global levels are at a scale not seen in human history.
All the more surprising, then, that they have been largely absent from our health expectations and planning. We are in danger of passing ‘peak health’, a time in human history where the best health outcomes recede into the past.
We cannot escape the finite planetary boundaries that define the optimal and safe conditions for humanity, but we can choose a fairer and a healthier future by living within our ecological means.
But only when we have recognised where we are going.
For more information, please contact Doctors for the Environment Australia at: www.dea.org.au
Medical Observer magazine 30th May 2011 Dr George Crisp MBBS, MRCGP
http://dea.org.au/news/article/are_we_in_danger_of_passing_peak_health
ACCORDING to conventional wisdom, we will keep living longer and enjoying ever healthier lives. After all, public health advances and technological progress over the past 150 years have delivered these improvements. So why shouldn’t this continue indefinitely?
Our perspective has been largely restricted to diagnosed illness and number of years lived, ignoring more meaningful measures of health and wellbeing.
Our time-poor, overstressed lives and iniquitous, fragmented communities have not made us any happier or healthier.
Modern living, with its material focus, over-consumption, poor dietary choice and inactivity, has become a major contributor to chronic disease while eroding traditional, spiritual and cultural values necessary for our non-material well being.
Rates of diabetes and obesity are escalating, worsening health outcomes, diminishing quality of life, and stretching health and welfare services and budgets.
Alcohol and drug use are compromising physical and mental health, damaging our social fabric. But rather than address the causes of societal ill health, we are instead focusing on increasingly expensive, technology-based, hospital-oriented and, inevitably, unsustainable solutions. Antibiotic resistance is a prime example of why this type of exploitative thinking is so short-sighted.
It is, however, our collective impacts that create the most challenging health risks.
In just 150 years, humanity’s environmental footprint has grown 150-fold. This has come at the expense of the other inhabitants of this planet. Through loss of habitat, over-harvesting, pollution and waste, we are driving a new mass extinction event.
Food, shelter, medicines, clean air and fresh water are all natural services we take for granted. At every level our health, and civilisation, is underpinned by the myriad, interdependent, mostly unidentified species that collectively constitute natural ecosystems.
The complex relationships between potential infectious organisms, vectors and hosts are also shifting, making unpredictable the patterns of known diseases – even producing entirely novel ones, such as SARS.
Agriculture is dependent on intact healthy ecosystems and soils. Additionally, the increased yields now required to provide adequate nutrition for billions of people have resulted in unsustainable use of resources, particularly fresh water, oil and phosphate, all of which are now diminishing.
We are approaching ‘peak oil’, with its volatile, rising prices which compromise food production and availability, disproportionately affecting the poorest and most vulnerable.
Our economy and health infrastructure are also highly energy-intensive. We cannot afford to keep repeating the 20th-century mistake of chasing ever more polluting and diminishing resources. We need instead to strive for clean, renewable energy, with the health and social benefits that it brings.
Overuse of fossil fuels and land clearance has produced atmosphere-altering quantities of greenhouse gasses. The ensuing climatic disruption and ocean acidification will have profound health effects, prompting the (Nov 2009) Lancet series “Climate change is the greatest threat to human health in the 21st century”.
Impacts may include heatwaves, heavy precipitation and droughts, more favourable conditions for many microbes, pests and vectors, rising sea levels, fresh water depletion and food insecurity, plus, ultimately, large-scale population displacement and mass migration of refugees.
The timing and magnitude of these interrelated impacts may be uncertain, but the risks to human health at local, regional and global levels are at a scale not seen in human history.
All the more surprising, then, that they have been largely absent from our health expectations and planning. We are in danger of passing ‘peak health’, a time in human history where the best health outcomes recede into the past.
We cannot escape the finite planetary boundaries that define the optimal and safe conditions for humanity, but we can choose a fairer and a healthier future by living within our ecological means.
But only when we have recognised where we are going.
For more information, please contact Doctors for the Environment Australia at: www.dea.org.au
Friday, May 20, 2011
Climate changed is a health issue and the medical colleges must pay more attention
"Why Doctors should give climate change the right treatment"
by David Shearman, George Crisp and David King
Leading public health organisations and the peer-reviewed health literature have increasingly recognised the serious impacts for our health and quality of life should we fail to tackle climate change.
This has been reflected in the increasing number and urgency of advisories from peak health authorities and prestigious medical journals over the past decade.
The prestigious journal, The Lancet, has published a series under the overarching statement “climate change is the greatest threat to human health in the 21st century”. The World Health Organisation has attributed more than 140,000 excess deaths annually from climate change since 2004 and noted that many of the major killers — such as diarrhoeal diseases, malnutrition, malaria and Dengue fever — are highly climate-sensitive, therefore expected to worsen with further climate change.
Australia is not immune and has already experienced increased morbidity and mortality from additional heat-related deaths, increased health problems from extreme weather events and increased mental health burden in rural areas from financial stress from failed crop harvests.
In effect, a challenge has been thrown down to all doctors to educate themselves, their patients and governments about the many serious health impacts that will befall humanity if we do not aggressively tackle climate change.
It is the role of our professional medical colleges to first and foremost examine and evaluate the relevant evidence as it applies to their area of health, and then use their expertise to advise accordingly.
Like governments, the colleges have recognised that climate change is a current and growing health problem, but have failed to recognise its urgency and magnitude, and the scale of the response required. The chair of the Royal Australasian College of Physicians’ (RACP) climate committee resigned, presumably over the College’s performance.
A recent press release from RACP, while acknowledging climate change and its impacts, was contentious to many doctors — as Crikey reported on Wednesday. Its main focus appeared to warn of the adverse health impacts of a carbon tax in disadvantaged groups.
Since the government had already promised a compensation package for disadvantaged groups, some doctors saw this as an unnecessary distraction from the main issue of getting a mechanism for reduced emissions to benefit the health of the entire population.
In contrast to our colleges, our peers overseas have been far more decisive and forthright. The Royal College of Physicians in London established the Climate and Health Council, with international committee members including one of this article’s authors.
The American Medical Association has hosted three state-based professional medical education courses on climate change with more to follow, and has been emphasising the public health benefits of reducing greenhouse gas emissions.
The emergence of Doctors for the Environment Australia (DEA), with its main agenda being health and climate change, can be seen as a reflection of inadequate advocacy elsewhere in Australian medical organisations. Recently DEA used the words: “A price on carbon is a public health measure.”
This is not a (party) political statement; rather, it is based on the fact that, in a market economy, pricing carbon is one key component in driving decarbonisation, and that climate change is an established public health problem.
It is now vital to recognise that global environmental changes such as climate change, biodiversity loss, and degradation of ecosystems on land and in the oceans are the major determinants of sustainability and of future population health and survival. In medical terms these are the life support systems for humanity and are therefore an integral part of medical teaching and action.
However, climate change is not a simple problem, such as smoking causing lung cancer. It is more complex and goes to the core of our modern high-consumption and energy intensive lifestyles; it demands fundamental re-evaluation of our values and our way of life, which we all, doctors included, find confronting.
Many political statements from elected representatives indicate a profound lack of understanding of the global and medical impacts of climate change.
The RACP has the knowledge, wisdom and financial resources to offer scientific and medical acumen to all governments in carrying forward the necessary national reforms.
To those doctors who have read the climate change literature, the health risks appear greater than arise from most of the conditions for which we currently treat our patients. Thus it is imperative that our medical colleges convey this health risk to governments.
The present public difficulty in climate change policy does not seem to arise from the integrity of the science; rather, it indicates divergent views on advocacy. As a goal, several Royal Colleges working together and producing clear advice to governments could be a powerful force in protecting the health of future generations.
The face of public health in Australia should include the illness and mortality caused by the coal industries and the potential health impacts from coal seam gas developments. These are some of the climate-related issues that the medical profession is neglecting in its advocacy.
Nevertheless these topics are at the fore in the advocacy of Doctors for the Environment Australia, with programs to visit members of parliament, develop environment and health policies, contribute submissions to Parliaments regarding potential health impacts of major developments and develop educational material for the public.
*David Shearman is FRACP Emeritus Professor of Medicine and honorary secretary of DEA. George Crisp is MRCGP general practitioner and WA representative on the management committee of DEA. David King is FRACGP, general practitioner, senior lecturer in discipline of general practice and school of population health, University of Queensland, and Queensland representative on the management committee of DEA. This article published in Crikey and Climate Spectator.
by David Shearman, George Crisp and David King
Leading public health organisations and the peer-reviewed health literature have increasingly recognised the serious impacts for our health and quality of life should we fail to tackle climate change.
This has been reflected in the increasing number and urgency of advisories from peak health authorities and prestigious medical journals over the past decade.
The prestigious journal, The Lancet, has published a series under the overarching statement “climate change is the greatest threat to human health in the 21st century”. The World Health Organisation has attributed more than 140,000 excess deaths annually from climate change since 2004 and noted that many of the major killers — such as diarrhoeal diseases, malnutrition, malaria and Dengue fever — are highly climate-sensitive, therefore expected to worsen with further climate change.
Australia is not immune and has already experienced increased morbidity and mortality from additional heat-related deaths, increased health problems from extreme weather events and increased mental health burden in rural areas from financial stress from failed crop harvests.
In effect, a challenge has been thrown down to all doctors to educate themselves, their patients and governments about the many serious health impacts that will befall humanity if we do not aggressively tackle climate change.
It is the role of our professional medical colleges to first and foremost examine and evaluate the relevant evidence as it applies to their area of health, and then use their expertise to advise accordingly.
Like governments, the colleges have recognised that climate change is a current and growing health problem, but have failed to recognise its urgency and magnitude, and the scale of the response required. The chair of the Royal Australasian College of Physicians’ (RACP) climate committee resigned, presumably over the College’s performance.
A recent press release from RACP, while acknowledging climate change and its impacts, was contentious to many doctors — as Crikey reported on Wednesday. Its main focus appeared to warn of the adverse health impacts of a carbon tax in disadvantaged groups.
Since the government had already promised a compensation package for disadvantaged groups, some doctors saw this as an unnecessary distraction from the main issue of getting a mechanism for reduced emissions to benefit the health of the entire population.
In contrast to our colleges, our peers overseas have been far more decisive and forthright. The Royal College of Physicians in London established the Climate and Health Council, with international committee members including one of this article’s authors.
The American Medical Association has hosted three state-based professional medical education courses on climate change with more to follow, and has been emphasising the public health benefits of reducing greenhouse gas emissions.
The emergence of Doctors for the Environment Australia (DEA), with its main agenda being health and climate change, can be seen as a reflection of inadequate advocacy elsewhere in Australian medical organisations. Recently DEA used the words: “A price on carbon is a public health measure.”
This is not a (party) political statement; rather, it is based on the fact that, in a market economy, pricing carbon is one key component in driving decarbonisation, and that climate change is an established public health problem.
It is now vital to recognise that global environmental changes such as climate change, biodiversity loss, and degradation of ecosystems on land and in the oceans are the major determinants of sustainability and of future population health and survival. In medical terms these are the life support systems for humanity and are therefore an integral part of medical teaching and action.
However, climate change is not a simple problem, such as smoking causing lung cancer. It is more complex and goes to the core of our modern high-consumption and energy intensive lifestyles; it demands fundamental re-evaluation of our values and our way of life, which we all, doctors included, find confronting.
Many political statements from elected representatives indicate a profound lack of understanding of the global and medical impacts of climate change.
The RACP has the knowledge, wisdom and financial resources to offer scientific and medical acumen to all governments in carrying forward the necessary national reforms.
To those doctors who have read the climate change literature, the health risks appear greater than arise from most of the conditions for which we currently treat our patients. Thus it is imperative that our medical colleges convey this health risk to governments.
The present public difficulty in climate change policy does not seem to arise from the integrity of the science; rather, it indicates divergent views on advocacy. As a goal, several Royal Colleges working together and producing clear advice to governments could be a powerful force in protecting the health of future generations.
The face of public health in Australia should include the illness and mortality caused by the coal industries and the potential health impacts from coal seam gas developments. These are some of the climate-related issues that the medical profession is neglecting in its advocacy.
Nevertheless these topics are at the fore in the advocacy of Doctors for the Environment Australia, with programs to visit members of parliament, develop environment and health policies, contribute submissions to Parliaments regarding potential health impacts of major developments and develop educational material for the public.
*David Shearman is FRACP Emeritus Professor of Medicine and honorary secretary of DEA. George Crisp is MRCGP general practitioner and WA representative on the management committee of DEA. David King is FRACGP, general practitioner, senior lecturer in discipline of general practice and school of population health, University of Queensland, and Queensland representative on the management committee of DEA. This article published in Crikey and Climate Spectator.
Wednesday, May 18, 2011
Unhealthy Claims Blowing in the Wind
Climate Spectator
George Crisp
Published 7:48 AM, 13 May 2011
Updated 7:51 AM, 13 May 2011
Health concerns have been raised in some rural Australian communities that are situated near wind farms. These claims of adverse health effects – as well as economic and social – from wind turbine installations generated a level of speculative discussion that eventually led to a Senate Inquiry, a move initiated by Family First Senator Steve Fielding, to investigate the issue. Recently, health concerns have been raised in some rural Australian communities that are situated near wind farms. These claims of adverse health effects – as well as economic and social – from wind turbine installations generated a level of speculative discussion that eventually led to a Senate Inquiry, a move initiated by Family First Senator Steve Fielding, to investigate the issue.
This seems anachronistic, considering the enormous burden of ill health and premature deaths borne by those communities who live near coal mines and power stations, which has been serially ignored by successive governments.
The impact of air pollution from burning fossil fuels on climate change, and the ensuing health effects, are both long term and cumulative. A recent study from Harvard Medical School has found that the costs to US residents of burning coal amounts to between $US300-$US500 billion dollars annually. Or around $US1000 for every citizen. Previous studies, such as ExterneE (2005) in Europe, have arrived at similar conclusions. The figures in Australia are likely to be broadly similar.
There are many contributing factors, but the single largest is that of illness and mortality arising from air pollution. Health effects, mediated primarily by airborne small particulates (PM2.5), SO2, NOx, volatile organic compounds and Ozone, include asthma, bronchitis and emphysema, heart attacks, arrhythmias and disproportionally affect children and those with pre-existing illness. The US study's “best estimate” for damages due to air quality adds 9.3 c/kWh.
Nevertheless, if there are health concerns related to wind power they should indeed be thoroughly examined. Doctors for the Environment Australia (DEA) has assessed all the evidence and literature surrounding these claims in its submission to the Senate Inquiry and, as the three previous comprehensive recent reviews* concluded, did not find any evidence of adverse health effects.
Proponents of “wind turbine syndrome” list a collection of non-specific symptoms that include; dizziness, headaches, ear and eye pain, nausea, sleep disturbance, palpitations nocturnal urination, anxiety and panic. They have postulated that infrasound or vibration causes disturbance of inner ear function producing illness.
This hypothesis is currently unsupported, as there is no demonstrated physical mechanism by which these effects are mediated. Although it is theoretically possible that low frequencies could be detected in the inner ear, or elsewhere, without an awareness of sound, it is not clear how they might invoke the clinical effects described. Moreover, why would the infrasound from wind turbines cause symptoms when other environmental sources, some of which occur at greater intensities, do not?
Secondly, many of the symptoms are not typical of inner ear disease. They are in fact more suggestive of a psychological origin. Anxiety and panic disorder, for example, fit this picture.
In addition, many areas of Northern Europe, where residents tend to be very socially and health conscious, have far greater densities of wind turbines, but there has been little evidence of related ill health. This absence of evidence is probably more significant than the recent anecdotal reports from the US and Australia.
Much of the recent concern of adverse health effects has been supported by the work of American paediatrician Dr Nina Pierpont. And so it is worth scrutinising her study, conducted by recruiting 38 individuals from 10 families, collecting information by telephone interview without examination or reference to medical notes.
This type of “case-series study” is intrinsically limited and even in good quality studies can be confounded by selection bias. Using this research method, it is not possible to make the claims of causality or increased frequency, or prevalence, made by Pierpont, particularly when the study design is flawed.
The further claims that this is a “crossover study” and is “peer reviewed” are similarly misplaced. A crossover design determines in advance the balanced exposure of subjects, whereas this study has been conceived retrospectively, with no determined exposure; “people came and went and figured it out for themselves”. It appears some subjects had pre-existing complaints, further confounding any results.
It is important that Dr Pierpont allows public scrutiny of her work through appropriate peer review process. Selected testimonies do not count. As it stands, this work is anecdotal, and anecdotes do not constitute evidence.
The current case for the existence of health effects from wind turbines is flimsy. One way of resolving this, and allaying any fears of local residents, would be to conduct an appropriate, well-designed study. This would very likely highlight the disparity and health benefits of wind turbine energy when compared with coal and gas energy sources.
For now, the wind industry and its investors should not be concerned or distracted by the noise made by vocal opponents of wind farms. On the contrary, the reassuring and common themes in the submissions and testimonies from a range of medical and scientific bodies to the senate inquiry highlight the current endorsement of the safety of wind energy generation.
Meanwhile, governments should focus their attention and resources back on the problem of the unhealthy, fossil-fuelled pollution and emissions that are still blowing in the wind.
Dr George Crisp, medical practitioner, is the WA representative of Doctors for the Environment Australia and presented evidence to the Senate Committee on behalf of DEA
*NHMRC Wind Turbines and Health, July 2010, The Health Impact of Wind Turbines: A Review of the Current White, Grey, and Published Literature Chatham-Kent Public Health Unit, June 2008 , Wind Turbine Sound and Health Effects. An Expert Panel Review, 2009. rest
George Crisp
Published 7:48 AM, 13 May 2011
Updated 7:51 AM, 13 May 2011
Health concerns have been raised in some rural Australian communities that are situated near wind farms. These claims of adverse health effects – as well as economic and social – from wind turbine installations generated a level of speculative discussion that eventually led to a Senate Inquiry, a move initiated by Family First Senator Steve Fielding, to investigate the issue. Recently, health concerns have been raised in some rural Australian communities that are situated near wind farms. These claims of adverse health effects – as well as economic and social – from wind turbine installations generated a level of speculative discussion that eventually led to a Senate Inquiry, a move initiated by Family First Senator Steve Fielding, to investigate the issue.
This seems anachronistic, considering the enormous burden of ill health and premature deaths borne by those communities who live near coal mines and power stations, which has been serially ignored by successive governments.
The impact of air pollution from burning fossil fuels on climate change, and the ensuing health effects, are both long term and cumulative. A recent study from Harvard Medical School has found that the costs to US residents of burning coal amounts to between $US300-$US500 billion dollars annually. Or around $US1000 for every citizen. Previous studies, such as ExterneE (2005) in Europe, have arrived at similar conclusions. The figures in Australia are likely to be broadly similar.
There are many contributing factors, but the single largest is that of illness and mortality arising from air pollution. Health effects, mediated primarily by airborne small particulates (PM2.5), SO2, NOx, volatile organic compounds and Ozone, include asthma, bronchitis and emphysema, heart attacks, arrhythmias and disproportionally affect children and those with pre-existing illness. The US study's “best estimate” for damages due to air quality adds 9.3 c/kWh.
Nevertheless, if there are health concerns related to wind power they should indeed be thoroughly examined. Doctors for the Environment Australia (DEA) has assessed all the evidence and literature surrounding these claims in its submission to the Senate Inquiry and, as the three previous comprehensive recent reviews* concluded, did not find any evidence of adverse health effects.
Proponents of “wind turbine syndrome” list a collection of non-specific symptoms that include; dizziness, headaches, ear and eye pain, nausea, sleep disturbance, palpitations nocturnal urination, anxiety and panic. They have postulated that infrasound or vibration causes disturbance of inner ear function producing illness.
This hypothesis is currently unsupported, as there is no demonstrated physical mechanism by which these effects are mediated. Although it is theoretically possible that low frequencies could be detected in the inner ear, or elsewhere, without an awareness of sound, it is not clear how they might invoke the clinical effects described. Moreover, why would the infrasound from wind turbines cause symptoms when other environmental sources, some of which occur at greater intensities, do not?
Secondly, many of the symptoms are not typical of inner ear disease. They are in fact more suggestive of a psychological origin. Anxiety and panic disorder, for example, fit this picture.
In addition, many areas of Northern Europe, where residents tend to be very socially and health conscious, have far greater densities of wind turbines, but there has been little evidence of related ill health. This absence of evidence is probably more significant than the recent anecdotal reports from the US and Australia.
Much of the recent concern of adverse health effects has been supported by the work of American paediatrician Dr Nina Pierpont. And so it is worth scrutinising her study, conducted by recruiting 38 individuals from 10 families, collecting information by telephone interview without examination or reference to medical notes.
This type of “case-series study” is intrinsically limited and even in good quality studies can be confounded by selection bias. Using this research method, it is not possible to make the claims of causality or increased frequency, or prevalence, made by Pierpont, particularly when the study design is flawed.
The further claims that this is a “crossover study” and is “peer reviewed” are similarly misplaced. A crossover design determines in advance the balanced exposure of subjects, whereas this study has been conceived retrospectively, with no determined exposure; “people came and went and figured it out for themselves”. It appears some subjects had pre-existing complaints, further confounding any results.
It is important that Dr Pierpont allows public scrutiny of her work through appropriate peer review process. Selected testimonies do not count. As it stands, this work is anecdotal, and anecdotes do not constitute evidence.
The current case for the existence of health effects from wind turbines is flimsy. One way of resolving this, and allaying any fears of local residents, would be to conduct an appropriate, well-designed study. This would very likely highlight the disparity and health benefits of wind turbine energy when compared with coal and gas energy sources.
For now, the wind industry and its investors should not be concerned or distracted by the noise made by vocal opponents of wind farms. On the contrary, the reassuring and common themes in the submissions and testimonies from a range of medical and scientific bodies to the senate inquiry highlight the current endorsement of the safety of wind energy generation.
Meanwhile, governments should focus their attention and resources back on the problem of the unhealthy, fossil-fuelled pollution and emissions that are still blowing in the wind.
Dr George Crisp, medical practitioner, is the WA representative of Doctors for the Environment Australia and presented evidence to the Senate Committee on behalf of DEA
*NHMRC Wind Turbines and Health, July 2010, The Health Impact of Wind Turbines: A Review of the Current White, Grey, and Published Literature Chatham-Kent Public Health Unit, June 2008 , Wind Turbine Sound and Health Effects. An Expert Panel Review, 2009. rest
Friday, April 29, 2011
Letter: Living within our means...
In her article " Will your kids live as long as you ?", Dr Sadler highlights the fact that our increasingly sedentary, car dependent lifestyles come at a great cost to society.
Here as elsewhere, the prevalence of diabetes and obesity continues to rise. An illness confined of the elderly until 4 decades ago, diabetes is now sweeping through every demographic of society, affecting even the youngest. The gains made in cardiovascular health are starting to be undone.
But, the over-consumption and inactivity that drives these conditions is symptomatic of a far wider problem.
Air pollution, from our fossil fuelled cars, coal burning power stations and other polluting industries, kills thousands of us annually in every large city and causes widespread ill health.
We are depleting oil reserves at 1 million times the rate of their formation. This concentrated form of energy is the basis for our current economy and food security, yet we have no plan for its succession.
In the process, we are returning carbon, locked up for hundreds of millions of years, to our atmosphere where it will reside for centuries.
The resulting climate change has been recognised by the medical profession as the biggest health threat of the 21st century. Through direct affects such as heat, local weather extremes, to far greater problems arising from altered disease propagation and transmission, food and water security, air quality and mass movement of populations.
Overuse and misuse of antibiotics is rendering once life saving drugs impotent against the ravages of infectious diseases.
Our short sighted and excessive actions really are compromising the health and well being of our children.
But we don’t have to be bad ancestors. We can design healthy cities and healthy lifestyles and live within our ecological means, and in the process we can protect the future health of our children.
Here as elsewhere, the prevalence of diabetes and obesity continues to rise. An illness confined of the elderly until 4 decades ago, diabetes is now sweeping through every demographic of society, affecting even the youngest. The gains made in cardiovascular health are starting to be undone.
But, the over-consumption and inactivity that drives these conditions is symptomatic of a far wider problem.
Air pollution, from our fossil fuelled cars, coal burning power stations and other polluting industries, kills thousands of us annually in every large city and causes widespread ill health.
We are depleting oil reserves at 1 million times the rate of their formation. This concentrated form of energy is the basis for our current economy and food security, yet we have no plan for its succession.
In the process, we are returning carbon, locked up for hundreds of millions of years, to our atmosphere where it will reside for centuries.
The resulting climate change has been recognised by the medical profession as the biggest health threat of the 21st century. Through direct affects such as heat, local weather extremes, to far greater problems arising from altered disease propagation and transmission, food and water security, air quality and mass movement of populations.
Overuse and misuse of antibiotics is rendering once life saving drugs impotent against the ravages of infectious diseases.
Our short sighted and excessive actions really are compromising the health and well being of our children.
But we don’t have to be bad ancestors. We can design healthy cities and healthy lifestyles and live within our ecological means, and in the process we can protect the future health of our children.
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