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potential related to muscle contraction (EMG). Earlier research has shown that the vestibular system can be activated by a loud mid- to high-frequency sound. In response to this a muscle in the neck and a muscle attached to the eye contract and this can be measured by EMG. In clinical practice loud clicks are used, either from 6 millisecond sound bursts every 0.2 second (= a repetition rate of 5 Hz) or a continuous loud tone modulated at 40 Hz. To these clinically used stimuli three lowfrequency stimuli were added: a continuous sound over 120 seconds with a frequency of either 5, 16 or 40 Hz. All these sounds were presented to 15 normal-hearing participants and to each ear separately, all at levels corresponding to loud sounds. Only the electromyogenic (EMG) reaction to vertical acceleration of the head was measured, not a reaction to horizontal acceleration or rotation of the head. The results showed that the 500 Hz sounds (as used in clinical tests) were significantly related to an EMG response for most participants. There was no significant response in one of both ears for five participants when using sound bursts, for four participants using modulated sound and in both ears for one participant (modulated sound). In contrast, at the low frequencies the response was predominantly not significant.

At 4 Hz there was no significant response at all, at 16 and 40 Hz only in four of the 15 participants (of which one with both ears). The authors doubt that that infrasound can produce accelerations of the head at lower sound levels, such as occurring near wind turbines. Lubner et al (2020) searched the scientific literature for audio-vestibular symptoms after exposure to sound (and electromagnetic energy) and concluded that symptoms were largely reported in small studies, but either not found in larger studies or not studied at all. They also conclude that symptoms were mostly studied after self-reported exposure, and data on the situation before exposure was not available. In the report of Krahé et al (2020), mentioned in 4.1 and 4.2, participants were also submitted to several neurological tests during exposure. All tests concerned the sense of balance and included keeping balance, performing targeted movements, the occurrence of nystagmus (repetitive, uncontrolled eye movement) and eye fixation. Tests showed no differences between the different sound exposure scenarios and no differences between predisposed participants and others. 4.4

Effect of Vibrations In our 2017 review there was little information about the perception of vibrations from wind turbines; the only post-2000 study then available (Cooper, 2014) suggested that some residents appeared to experience sensations in relation to the wind turbine operation that could be related to vibrations. We speculated that perhaps the rhythmic character of wind turbine sound could lead to vibrations of a house and thus wind turbine operation could be perceived indirectly inside a house. Takahashi (2017) investigated if very low-frequency/infrasound could be experienced as a vibration of the head or body. He exposed four normalhearing participants to six infrasound and low-frequency tones from 16 to 50 Hz in an office type setting. By varying the sound level for each frequency, the hearing threshold was determined, as well as the levels where the sound started to be ‘slightly annoying’, ‘very annoying’ or ‘too Page 50 of 73

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loud to work’. Apart from this, the levels were determined where the sound became unpleasant (unpleasant threshold) and where the participants felt a ‘vibration in the head’ (vibration threshold). The results show that the level where participants felt a vibration in the head was on average about 6 dB (at 16 Hz) to 15 dB (40 Hz) above their average hearing threshold. This vibration threshold almost coincided with levels at which the sound started to be slightly annoying. The threshold above which the sound was rated as unpleasant was still higher and was close to levels at which the sound started to be ‘too loud to work’. Takahashi investigated the perception of vibration in the body and head when exposed to low-frequency sound in earlier studies. In a study with 14 participants (Takahashi, 2013) he also found that the threshold for vibration in the head was higher than the threshold of hearing when participants were exposed to low-frequency sounds of 16 to 50 Hz. Because the threshold was the same as the threshold for ‘vibration in the body’, he concluded that the head was the most sensitive part of the body to feel vibrations from infrasound. In the 2013 study he also determined the threshold for perceived vibration when participants wore ear mufflers that reduced the sound level at the ear by 15 dB at 16 Hz, increasing to 25 dB at 80 Hz.

There was no difference in vibration threshold at the lowest frequency of 16 Hz between wearing ear mufflers or not. At higher frequencies the threshold for vibration perception was up to about 10 dB higher when ear mufflers were worn. Based on his experiments Takahashi hypothesizes that it is the sound pressure on the eardrum and the resulting signal in the hearing system that leads to the sensation of vibration. He states that the effect of ear mufflers does not contradict this, although it is not a matter of simply reducing the sound pressure in the ear canal. Krahé et al (2020) asked participants to rate their perception of vibration, pressure and unease when exposed to each one of four infrasounds or silence (see description in section 4.1). All were perceived mainly in the head area (head, brain, ears), much less in other body parts. This applied to every sound scenario, including silence. Due to a sometimes low response and unequal numbers of participants, no conclusion could be drawn about the significance of differences between exposure scenarios (including silence). Nguyen et al (2020) performed measurements of vibrations in three houses at relatively large distances (houses 1, 2 and 3 at 2.4, 3.3 and 5 km) from a wind farm. Vibrations of the floor (in house 2) and the bed frame (house 1) were weak and related to the wind around the house.

In contrast, vibrations on the window (house 3) included the amplitude modulation of the wind farm sound and were correlated to the wind farm. The wind turbine related sound levels inside these houses was below the average hearing threshold for all frequencies below about 50 Hz, infrasound levels with at least 30 dB.

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5

Conclusions

5.1

Conclusions from chapter 3 Conclusions about the health effects of wind turbine sound have not fundamentally changed since our 2017 review. In general, an association is found between the sound level due to wind turbines and annoyance. Also, an association with sleep disturbance is considered plausible, even though a direct relation is still uncertain because of the limited number of studies and the sometimes contradictory results. In general, the evidence is stronger for self-reported sleep effects than objective sleep indicators. The evidence reviews on annoyance, sleep, cardiovascular and metabolic effects and cognition and mental health for the WHO (Guski et al, 2017) (Basner and McGuire, 2018) (van Kempen et al, 2018) (Clark and Paunovic, 2018) included wind turbine sound. Together with some highquality reviews and updates, the earlier conclusions have now a more solid base. The number, study size and quality of the evidence on annoyance and sleep disturbance do justify the carrying-out of a metaanalysis. It is recommended to distinguish hereby between objective and subjective sleep indicators. Also, for a range of clinical outcomes and outcomes on mental health, evidence is increasing, but the number of studies is still too limited to perform such a meta-analysis.

Since 2017 several studies have been published on the association between WT sound and cardiovascular effects such as ischaemic heart disease, stroke, and medication use for hypertension. No significant effects were found. An exception is the so-called Danish Nurse cohort study, which reports, as worded by the authors “suggestive evidence” for an association between long-term exposure to WT sound and atrial fibrillation amongst female nurses. Possibly the fibrillation is a consequence of (chronic) annoyance, although in the same cohort no association with stroke or ischemic heart disease was found. The review on annoyance, sleep disturbance, cardiovascular and metabolic health outcomes (van Kamp et al, 2020a) yielded two studies investigating the association between wind turbine sound and the incidence of diabetes. Neither study found an association between WT sound and self-reported or diagnosed diabetes. There is also no evidence of an association between WT sound and obesity. For mental health and quality of life there is insufficient evidence for a direct relation with wind turbine sound level. Cognitive effects have not been studied in relation to WT sound. For neither low birth weight nor cancer significant associations were found with WT sound.

Despite limited evidence, an exposure-effect relation was developed for WT sound in the WHO Guidelines (WHO, 2018), and the related limit values were conditional. The current “Environmental Noise Guidelines for the European Region” recommends that wind turbine noise levels should be limited to 45 dB (Lden), based on a 10% prevalence of being highly Page 53 van 73

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annoyed (WHO, 2018). The World Health Organization further notes that noise exposure from an environmental source like a wind turbine may be reduced through simple measures like insulating windows or building barriers (WHO, 2018). Meta-analysis based on the evidence since 2014 allows for deriving a more solid EER for annoyance and for sleep. The general exposure-effect relation for annoyance from wind turbine sound includes all aspects that influence annoyance and thus averages over all local situations. The relation can therefore form an indication only of the annoyance levels to be expected in a local situation. One study shows that this relation can also be used for the more recent larger (3 to 5 MW) turbines. In an endeavour to develop a composite annoyance measures which includes annoyance with factors other than noise Michaud et al (2018b) have shown the complexity of annoyance due to wind turbines. Freiberg et al (2019) recommend that studies should account for these complex pathways of annoyance as an outcome parameter – that is influenced by different moderator variables – or as a mediator variable for other health outcomes. A composite measure of multiple WT related exposures is a promising way to go ahead.

Without pretending to be exhaustive, noise sensitivity, attitude towards wind turbines, visual aspects and economic benefit come again forward as the most important mediators and moderators. From epidemiological studies and experiments the typical character of wind turbine sound again came forward as one of the key issues. Especially the rhythmic character of the sound (technically: Amplitude Modulation or AM) is experienced as annoying and described as a swishing or whooshing sound. Residential wind turbine sound levels themselves are modest when compared to those from other sources such as road traffic or industrial noise. But at equal sound levels, sound from wind turbines is experienced as more annoying than that of other sources. This is confirmed again in recent studies(e.g. Klaeboe, 2016). Acoustic analysis in one new study identified amplitude-modulated noise as a major cause of the complaints. In general, the conclusion is still supported that annoyance increases with amplitude modulation, but AM is not an unequivocal causal factor. Several new experiments showed that AM was a strong predictor of response (in terms of annoyance) in combination with visual aspects. The combined effect of the two is worthwhile studying further in larger groups and outside the laboratory. Some studies investigated the effect of landscape evaluation and other visual aspects.

Chronic annoyance from these physical factors, and from noise, is assumed to be related to stress, and there is enough evidence that stress can negatively affect people’s health and well-being. However, there is no evidence for a direct association between visual aspects of WTs and health effects. Several studies have more extensively evaluated the determining factors of acceptance. Participation in the decision-making process, co-ownership (literal and symbolic), consumption of local energy come forward as important pull factors.

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Overall it is concluded that people are more willing to accept new turbines in their vicinity if they can participate in decision making, the turbines are owned by a group of citizens, and if the generated electricity is consumed in the region instead of being exported and in general experience a sense of control. This is in line with conclusions about the role of these factors in mitigating the aversive effects of other sources such as aircraft sound (Ansensio et al, 2017) (Lercher et al 2017) (Haubrich, 2020). Health is often used in the debates around WT farms, but facts brought forward about health effects are often contradictory. 5.2

Conclusions from chapter 4 Recent studies largely confirm the results of our earlier review: the perception of infrasound and low frequency sound is generally in agreement with what we know from literature and there is no indication that infrasound well below the hearing threshold can have any effect on humans. Except for one study, the studies published since 2017 show that infrasound and low frequency sound is processed in the auditory cortex where also normal sound is processed. Moreover, hearing thresholds based on brain activity agree with those based on ‘classical’ psychoacoustics. The brain studies also show that infrasound and very low frequency sound increase very steeply in loudness when compared with normal sound, which again is known from ‘classical’ psycho-acoustics. A new insight is that individually perceived loudness correlates better with brain activity than with the level of the sound. Perhaps this is related to noise sensitivity, where a highly sensitive person perceives a certain sound level as louder than a less sensitive person does. One study (Weichenberger et al, 2017) suggests that a sub-audible infrasound of 12 Hz is associated with brain activity. It is unclear what effect this brain activity can have elsewhere in the brain or body.

The authors take a big leap when speculating that this could be linked to physiological as well as psychological health effects. In our opinion we first need to be sure this is a true effect of an inaudible sound. The stimulus was just 2 dB below the hearing threshold and perhaps it was, during the prolonged exposure, so close to audibility that it could stimulate the brain. The authors suggest that participants were “constantly left guessing, whether stimulation actually occurred or not when near-threshold infrasound was presented” (Weichenberger et al, 2017). This ‘guessing’ did not occur (no concurring brain activity) when no sound was presented. They suggest that if the outer hair cells indeed react to sub-audible sound, as mentioned by Salt and Hullar (2010), this could explain the concurring brain activity. An alternative explanation may be that the brain activity was there because the near-threshold infrasound was just, perhaps intermittently, audible. If so, it may be hard for the brain to recognize or evaluate the sound due to the very low audibility, which may explain the activity in the amygdala and anterior cingulate cortex (ACC) reported by Weichenberger et al (2017). These brain areas are known to be involved in auditory processing (superior temporal gyrus) and tinnitus perception (ACC) (Vanneste and De Ridder, 2012).

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processing, such as the amygdala (Stevens et al, 2011). Whatever the explanation, the brain activity occurred near the audibility threshold and not at lower levels further away from the threshold. This would be necessary for wind farm infrasound to have an effect. Our conclusion is that it is necessary to study brain activation from infrasound at levels comparable to those near wind turbines/farms and with more realistic sounds before concluding that inaudible infrasound can have an effect on residents. If normal sound is present, it may be harder to detect soft infrasound compared to situations where only the soft infrasound is present. In contrast, the presence of infrasound appears not to have an effect on the detection threshold of normal sound. However, infrasound may influence the perception of normal sound: a tone of 63 or 125 Hz together with 8 Hz infrasound is similar to our ears to a 63/125 Hz tone with a variation in strength at a rate of 8 Hz. We need more research to find out if these interactions between infrasound and normal sound occur over a wider frequency range and not just the artificial sounds used in laboratory settings.

If that would be the case, the implications are 1) that the threshold at which the human ear can detect wind turbine infrasound may be raised because of the presence of the normal WT sound and 2) that the infrasound peak at the blade passing frequency (and its harmonics) may in principle be perceived as a modulation of the normal sound coming from a wind turbine or the environment. In practice the perceived ‘added modulation’ is probably less pronounced than the modulation of the wind turbine sound that is already present in conditions where the infrasound peak is present. The recent studies of possible effects of audible infrasound and low frequency sound confirm earlier results. When persons, including those complaining about WT infrasound, are exposed to WT sound including infrasound, the total WT sound level and amplitude modulation may be a cause for increased annoyance, not infrasound. Also, WT infrasound had no effect on physiological measures of stress, such as changes in heart rate or heart rate variability, or skin conductance. Soft or inaudible infrasound or very low frequency sound does not lead to a reaction of the vestibular system, at least not the part that detects vertical acceleration. When exposed to infrasound or very low frequency sound, a vibration in the body or head is felt at sound levels close to or higher than the hearing threshold.

At similar or higher levels, the sound is rated as less pleasant, either because of its loudness or the added vibration or both. A low frequency sound was also found to be less pleasant when the sound at one ear differs somewhat from the sound at the other ear. This is, for low frequency sound, more likely to occur indoors than outdoors. Finally, vibrations measured in dwellings at relatively large distances from a wind farm (2.4 to 5 km) were of low level and unlikely to cause adverse effects. The vibration of a window pane was related to the airborne sound of the wind farm, the vibrations of a floor and bed frame were more likely to be caused by wind around the house. This leads to the conclusion that low-frequency sound is part of the total sound of wind turbines and has the same effects audio sound has: it can be annoying and may have effects on (getting to) sleep and, if chronic, Page 56 of 73

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this may lead to further health effects. This is also true for other sound sources such as road, rail or air traffic. Because of the low attenuation, low-frequency sound becomes relatively more important at larger distances and inside dwellings. Infrasound is attenuated even less, but coming from wind turbines and at typical distances to residences it is too weak for human perception. 5.3

End conclusion The level of wind turbine sound is modest when compared to other sources such as transportation (road, rail and air traffic) or industry. Studies show that in practice sound levels are usually less than 45 dBA. Nevertheless, at equal sound levels, sound from wind turbines is experienced as more annoying than that of many other sources. Based on current knowledge about the effect of WT sound on health we can conclude that living near a WT or hearing sound of wind turbines can lead to chronic annoyance among residents. For other health effects such as sleep disturbance, insomnia, mental health effects there is no consistent evidence. The new evidence confirms earlier conclusions about the influence of the low-frequency component of WT sound and infrasound from wind turbines: there is no indication that it has other effects on residents than normal sound has or that infrasound well below the hearing threshold can have any effect. When people are exposed to WT sound (over all frequencies), the level and amplitude modulation of all WT sound are the main cause for increased annoyance, rather than low frequency sound or infrasound. There is evidence that sleep disturbance is associated with annoyance rather than to WT sound above a certain level.

Also, new evidence shows an association between total annoyance and health complaints, but we cannot draw conclusions about the direction of this relationship: do people highly annoyed by WT sound have more health complaints or are people with health complaints more annoyed by WT sound. Nevertheless, chronic annoyance itself can lead to a feeling that the quality of the living environment has deteriorated or will do so in the future. This can have a negative impact on well-being and health of people living in the vicinity of wind turbines. The moderate effect of wind turbine sound on annoyance and the range of factors predicting the levels of annoyance implies that reducing the impact of wind turbine sound will profit from considering other aspects associated with annoyance as well. The influence of these factors is not necessarily unique for wind turbines. Important factors include noise sensitivity, attitudes towards WTs, health concerns, visual aspects and aspects related to the procedure preceding the building of a wind park. The role of factors such as participation in the planning process, procedural justice, feelings of fairness and balance of costs and benefits from wind turbines are even more strongly supported by current evidence. In summary: the health complaints are primarily associated with a range of non-acoustic factors rather than the actual exposure levels.

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Acknowledgements

This review was financed by the Noise and NIR Division of the Swiss Federal Office for the Environment (Bundesamt für Umwelt). We gratefully acknowledge the contributions of Floor Boekelman, Rob van Spronsen and Sietske Staatsen, Joost Gorter and Kim White to the preparation of this review. We also would like to thank Judith Hin and Marjolein ‘t Hoen for reviewing this manuscript.

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References

Ansensio, César, Gasco Sanchez, Luis, Arcas, G.(2017) A Review of NonAcoustic Measures to Handle Community Response to Noise around Airports, Current Pollution Reports 3(3):230–244. Bakker, R. H., Pedersen, E., van den Berg, G. P., Stewart, R. E., Lok, W., & Bouma, J. (2012). Impact of wind turbine sound on annoyance, selfreported sleep disturbance and psychological distress. Science of the total environment, 425, 42-51. Baliatsas, C., Kamp, I. van, Bolte, J., Schipper, M., Yzermans, J., Lebret, E.(2012) Non-specific physical symptoms and electromagnetic field exposure in the general population: can we get more specific? A systematic review. Environment International: 2012, 41(1), 15-28 Basner, M. and S. McGuire (2018). "WHO environmental noise guidelines for the european region: A systematic review on environmental noise and effects on sleep." International Journal of Environmental Research and Public Health 15(3). Behler and Uhlenkamp (2020): Behler, O. and S. Uppenkamp (2020). "Activation in human auditory cortex in relation to the loudness and unpleasantness of low-frequency and infrasound stimuli." PLoS ONE 15(2). Beuret, JE. (2016). Is trust negotiable? Building a place-based general interest for the acceptance of the Saint Brieuc and Saint Nazaire offshore wind farms. Geographie Economie Societe, 2016; 18(3):33558.

Botelho A, Arezes P, Bernardo C, Dias H, Pinto LMC (2017) Effect of Wind Farm Noise on Local Residents' Decision to Adopt Mitigation Measures Int J Environ Res Public Health. 2017 Jul 11;14(7). Bräuner, E. V., Jørgensen, J. T., Duun-Henriksen, A. K., Backalarz, C., Laursen, J. E., Pedersen, T. H., ... & Andersen, Z. J. (2018). Long-term wind turbine noise exposure and incidence of myocardial infarction in the Danish nurse cohort. Environment international, 121, 794-802. Bräuner, E. V., Jørgensen, J. T., Duun-Henriksen, A. K., Backalarz, C., Laursen, J. E., Pedersen, T. H., ... & Andersen, Z. J. (2019a). Long-term wind turbine noise exposure and the risk of incident atrial fibrillation in the Danish Nurse cohort. Environment international, 130, 104915. Bräuner, E. V., Jørgensen, J. T., Duun‐Henriksen, A. K., Backalarz, C., Laursen, J. E., Pedersen, T. H., ... & Andersen, Z. J. (2019b). Association Between Long‐Term Exposure to Wind Turbine Noise and the Risk of Stroke: Data From the Danish Nurse Cohort. Journal of the American Heart Association, 8(14), e013157. Brennan, N., Van Rensburg, T.M. & Morris, C. (2017). Public acceptance of large-scale wind energy generation for export from Ireland to the UK: evidence from Ireland. Journal of Environmental Planning and Management, 60:11, 1967-1992. Burke, E., Hensel, J., Fedtke, T., Uppenkamp, S., & Koch, C. (2019).

Detection Thresholds for Combined Infrasound and Audio-Frequency Stimuli. Acta Acustica united with Acustica, 105(6), 1173-1182. Carlile S., Davy J.L., Hillman D., Burgemeister K. (2018). A Review of the Possible Perceptual and Physiological Effects of Wind Turbine Noise. Trends in Hearing, 23. Page 61 van 73

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Clark C., Crumpler C., Notley H (2020) Evidence for environmental noise effects on health for the United Kingdom policy context: A systematic review of the effects of environmental noise on mental health, wellbeing, quality of life, cancer, dementia, birth, reproductive outcomes, and cognition International Journal of Environmental Research and Public Health (2020) 17:2 Article Number: 393. Clark, C. and K. Paunovic (2018). "Who environmental noise guidelines for the European region: A systematic review on environmental noise and quality of life, wellbeing and mental health." International Journal of Environmental Research and Public Health 15(11). Clark, S. and L. C. Botterill (2018). "Contesting facts about wind farms in Australia and the legitimacy of adverse health effects." Health (London, England : 1997) 22(4): 337-355. Cooper, S (2014): The results of an acoustic testing program Cape Bridgewater wind farm. The Acoustic Group, report 44.5100.R7:MSC, 2014 Delicado, A., Truninger, M., Figueiredo, E., Silva, L. & Horta, A. (2017). A Blot on the landscape: Consensus and Controversies on Wind Farms in Rural Portugal. Emerald Publishing Limited, 2017; 179-195. EARS Communiqué (2015). Ears Project Communiqué: Assessment and safety of non-audible sound. June 2015 Frantál, B., Van Der Horst, D., Kunc, J., Jaňurová, M. (2017).

Landscape disruption or just a lack of economic benefits? Exploring factors behind the negative perceptions of wind turbines. Journal of Landscape Ecology, 15(2):139-47. Freiberg, A., Schefter, C., Girbig, M., Murta, V. C., & Seidler, A. (2019). Health effects of wind turbines on humans in residential settings: Results of a scoping review. Environmental research, 169, 446-463. Freiberg, A., Schefter, C., Hegewald, J. & Seidler, A. (2019). The influence of wind turbine visibility on the health of local residents: a systematic review. Int Arch Occup Environ Health 92, 609–628. Gölz, S. & Wedderhoff, O. (2018). Explaining regional acceptance of the German energy transition by including trust in stakeholders and perception of fairness as socio-institutional factors. Energy Research and Social Science, 43: 96-108. Grima Murcia, M.D., Sanchez Ferrer, F., Sorinas, J., Ferrandez, J.M. & Fernandez, E. J. (2017). Application of electroencephalographic techniques to the study of visual impact of renewable energies. Journal of Environmental Management, 2017 Sep 15;200:484-9. Guski, Rainer Dirk Schreckenberg and Rudolf Schuemer (2017) WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Annoyance Int. J. Environ. Res. Public Health 2017, 14(12), 1539; https://doi.org/10.3390/ijerph14121539 - 08 Dec 2017 Haac, T.

R., Kaliski, K., Landis, M., Hoen, B., Rand, J., Firestone, J., ... & Pohl, J. (2019). Wind turbine audibility and noise annoyance in a national US survey: individual perception and influencing factors. The Journal of the Acoustical Society of America, 146(2), 1124-1141.. Haubrich, Julia Narcisa E. Burtea Paul Hooper Rebecca Hudson Dan Radulescu Fiona Raje Dirk Schreckenberg (2020) Foundations for a comprehensive approach of acoustic and non-acoustic measures of aircraft noise annoyance mitigation Aerospace Europe conference, Bordeaux, France.

Page 62 of 73

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Hongisto V, Oliva D, Keranen J (2017) Indoor noise annoyance due to 3-5 megawatt wind turbines-An exposure-response relationship. J Acoust Soc Am. 2017 Oct;142(4):2185. Hübner, G., Pohl, J., Hoen, B., Firestone, J., Rand, J., Elliott, D., & Haac, R. (2019). Monitoring annoyance and stress effects of wind turbines on nearby residents: A comparison of US and European samples. Environment international, 132, 105090.ISO/TS 15666:2003(en) Acoustics — Assessment of noise annoyance by means of social and socio-acoustic surveys https://www.iso.org/standard/28630.html. Janhunen, S., Hujala, M. & Pätäri, S. (2018). The acceptability of wind farms: the impact of public participation. Journal of Environmental Policy & Planning, 20:2, 214-235. Janssen, S.A., Vos, H , Eisser AR, Pedersen E. (2011) A comparison between exposure-response relationships for wind turbine annoyance and annoyance due to other noise sources. J Acoust Soc Am 130(6): 37463753. Jurado C, D Gordillo, BCJ Moore (2019): On the loudness of low-frequency sounds with fluctuating amplitudes. Journal of the Acoustical Society of America, v146 n2 1142-1149. Jurado and Marquardt (2020b): On the Effectiveness of airborne infrasound in eliciting vestibular-evoked myogenic responses. Jurado C, T Marquardt. Journal of Low Frequency Noise, Vibration and Active Control, v39 n1 316. Jurado, C., & Marquardt, T. (2020a).

Brain’s Frequency Following Responses to Low-Frequency and Infrasound. Archives of Acoustics, 45(2), 313319. Kageyama, T., Yano, T., Kuwano, S., Sueoka, S., & Tachibana, H. (2016). Exposure-response relationship of wind turbine noise with self-reported symptoms of sleep and health problems: A nationwide socioacoustic survey in Japan. Noise & health, 18(81), 53. Keith, S. E., Feder, K., Voicescu, S. A., Soukhovtsev, V., Denning, A., Tsang, J., ... & van den Berg, F. (2016). Wind turbine sound pressure level calculations at dwellings. The Journal of the Acoustical Society of America, 139(3), 1436-1442. Kim, H., Cho, S.H. & Song, S. (2018). Wind, power, and the situatedness of community engagement. Public Underst Sci, 28(1):38-52. Klaeboe R, Sundfor HB. Windmill Noise Annoyance, Visual Aesthetics, and Attitudes towards Renewable Energy Sources. International journal of environmental research and public health. 2016; Koch (2017): Hearing beyond the limit: Measurement, perception and impact of infrasound and ultrasonic noise. Koch C, M Brink. 12th ICBEN Congress on noise as a public health problem, 2017 Kongprasit, S., Waewsak, J., Chaichana, T. In: Waewsak J, S OT, Gagnon Y, Sangkharak K, editors. (2017). Wind Turbine and Local Acceptance in Southern Thailand C3 - Energy Procedia. Elsevier Ltd, 138: p. 380-5.

Krahe (2019): Proposal of a procedure assessing the annoyance of lowfrequency noise and infranoise C3 - INTER-NOISE 2019 MADRID - 48th International Congress and Exhibition on Noise Control Engineering

Page 63 van 73

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Krahé D, Alaimo Di Loro A, Müller U, Elmenhorst E, De Gioannis R, Schmitt S, Belke C, Benz S, Großarth S, Schreckenberg D, Eulitz C, Wiercinski B, Möhler U. Lärmwirkungen von Infraschallimmissionen (Noise effects from infrasound immissions). Report Umweltbundesamt (German Environmental Agency), 2020, available at https://www.umweltbundesamt.de/publikationen/laermwirkungen-voninfraschallimmissionen (report in German with English summary) Krogh, C. M., McMurtry, R. Y., Dumbrille, A., Hughes, D., & Gillis, L. (2020). Preliminary Results: Exploring Why Some Families Living in Proximity to Wind Turbine Facilities Contemplate Vacating Their Homes—A Community-Based Study. Open Access Library Journal, 7, e6118.Lamy, J., Azevedo, I.M.L., de Bruine, W., Morgan, M.G. Perceptions of wind energy projects in two coastal Massachusetts communities. Electricity Journal. 2017;30(7):31-42. Landeta-Manzano, B., Arana-Landín, G., Calvo, P.M. & Heras-Saizarbitoria, I. (2018). Wind energy and local communities: A manufacturer's efforts to gain acceptance. Energy Policy, 121:314-24. Lane JD, Bigelow PL, Majowicz SE, McColl RS (2016) Impacts of Industrial Wind Turbine Noise on Sleep Quality: Results From a Field Study of Rural Residents in Ontario, Canada. J Environ Health. 2016 Jul;79(1):812. Langer, K., Decker, T. & Menrad, K. (2017).

Public participation in wind energy projects located in Germany: Which form of participation is the key to acceptance? Renewable Energy, 2017;112:63-73. Langer, K., Decker, T., Roosen, J. & Menrad, K. (2018). Factors influencing citizens’ acceptance and non-acceptance of wind energy in Germany. Journal of Cleaner Production, 175:133-44. Lercher, Peter, Bert De Coensel, Luc Dekonink, and Dick Botteldooren Community Response to Multiple Sound Sources: Integrating Acoustic and Contextual Approaches in the Analysis Int J Environ Res Public Health. 2017 Jun; 14(6): 663. Published online 2017 Jun 20. doi: 10.3390/ijerph14060663 PMID: 28632198 Liebe, U., Bartczak, A.& Meyerhoff, J. (2017). A turbine is not only a turbine: The role of social context and fairness characteristics for the local acceptance of wind power. Energy Policy, 107:300-8. Lubner RJ , Kondamuri NS , Knoll RM , Ward BK , Littlefield PD , Rodgers D , Abdullah KG , Remenschneider AK , Kozin ED. (2020) Review of Audio vestibular Symptoms Following Exposure to Acoustic and Electromagnetic Energy Outside Conventional Human Hearing. Frontiers in neurology, 11: 234. Macdonald, C., Glass, J. & Creamer, E. (2017). What Is the Benefit of Community Benefits? Exploring Local Perceptions of the Provision of Community Benefits from a Commercial Wind Energy Project. Scottish Geographical Journal, 2017;133(3-4):172-91.

Maijala P, A Turunen, I Kurki, L Vainio,S Pakarinen, C Kaukinen, K Lukander, P Tiittanen, T Yli-Tuomi, P Taimisto, T Lanki,,K Tiippana, J Virkkala, E Stickler, M Sainio. Infrasound does not explain symptoms related to wind turbines.Report of the Prime Minister’s Office, Helsinki 2020 Marquardt and Jurado (2018): Amplitude Modulation May Be Confused with Infrasound. Marquardt T, C Jurado. Acta Acustica united with Acustica, Vol. 104 (2018) 825 – 829

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Michaud DS, Keith SE, Feder K, Voicescu SA, Marro L, Than J, et al (2016a) Personal and situational variables associated with wind turbine noise annoyance. The Journal of the Acoustical Society of America. 139:145566. Michaud, D. S., Feder, K., Keith, S. E., Voicescu, S. A., Marro, L., Than, J., ... & Lavigne, E. (2016b). Exposure to wind turbine noise: perceptual responses and reported health effects. The Journal of the Acoustical Society of America, 139(3), 1443-1454. Michaud DS, Feder K, Keith SE, Voicescu SA, Marro L, Than J, Guay M, Denning A, Murray BJ, Weiss SK, Villeneuve PJ. (2016c) Effects of wind turbine noise on self-reported and objective measures of sleep. Sleep. J1;39(1):97 Michaud, D. S., Feder, K., Voicescu, S. A., Marro, L., Than, J., Guay, M., ... & Villeneuve, P. (2018a). Clarifications on the design and interpretation of conclusions from health Canada’s study on wind turbine noise and health. Acoustics Australia, 46(1), 99-110. Michaud, D. S., Leonora Marro and James McNamee (2018b). "Derivation and application of a composite annoyance reaction construct based on multiple wind turbine features." Canadian journal of public health = Revue canadienne de sante publique 109(2): 242-251. Michaud, D. S., Leonora Marro and James McNamee (2018c).

"The association between self-reported and objective measures of health and aggregate annoyance scores toward wind turbine installations." Canadian journal of public health = Revue canadienne de sante publique 109(2): 252-260. Micic, G., Zajamsek, B., Lack, L., Hansen, K., Doolan, C., Hansen, C., ... & Mercer, J. (2018). A review of the potential impacts of wind farm noise on sleep. Acoustics Australia, 46(1), 87-97. Morsing, Ageborg J., Smith, M. G., Ögren, M., Thorsson, P., Pedersen, E., Forssén, J., & Persson Waye, K. (2018). Wind turbine noise and sleep: Pilot studies on the influence of noise characteristics. International journal of environmental research and public health, 15(11), 2573. Nguyen, D. P., Hansen, K., & Zajamsek, B. (2020). Human perception of wind farm vibration. Journal of Low Frequency Noise, Vibration and Active Control, 39(1), 17-27. Pawlaczyk-Łuszczyńska, M., Zaborowski, K., Dudarewicz, A., ZamojskaDaniszewska, M., & Waszkowska, M. (2018). Response to noise emitted by wind farms in people living in nearby areas. International journal of environmental research and public health, 15(8), 1575. Pedersen, E. (2011) Health aspects associated with wind turbine noise: Results from three field studies. Noise Control Eng. J. 2011, 59, 47–53. Pohl, J., Gabriel, J., & Hübner, G. (2018). Understanding stress effects of wind turbine noise–The integrated approach.

Energy Policy, 112, 119-128. Poulsen, A. H., Raaschou-Nielsen, O., Peña, A., Hahmann, A. N., Nordsborg, R. B., Ketzel, M., ... & Sørensen, M. (2018a). Long-term exposure to wind turbine noise and redemption of antihypertensive medication: a nationwide cohort study. Environment international, 121, 207-215. Poulsen, A. H., Raaschou-Nielsen, O., Peña, A., Hahmann, A. N., Nordsborg, R. B., Ketzel, M., ... & Sørensen, M. (2018b). Long-term exposure to wind turbine noise at night and risk for diabetes: a nationwide cohort study. Environmental research, 165, 40-45. Poulsen, A. H., Raaschou-Nielsen, O., Peña, A., Hahmann, A. N., Nordsborg, R. B., Ketzel, M., ... & Sørensen, M. (2018c). Pregnancy exposure to wind turbine noise and adverse birth outcomes: a nationwide cohort study. Environmental research, 167, 770-775. Page 65 van 73

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Poulsen, A. H., Raaschou-Nielsen, O., Peña, A., Hahmann, A. N., Nordsborg, R. B., Ketzel, M., ... & Sørensen, M. (2019a). Impact of long-term exposure to wind turbine noise on redemption of sleep medication and antidepressants: a nationwide cohort study. Environmental health perspectives, 127(3), 037005. Poulsen, A. H., Raaschou-Nielsen, O., Peña, A., Hahmann, A. N., Nordsborg, R. B., Ketzel, M., ... & Sørensen, M. (2019b). Long-term exposure to wind turbine noise and risk for myocardial infarction and stroke: a nationwide cohort study. Environmental health perspectives, 2019(3), 037004. Radun J, Hongisto V, Suokas M. (2019) Variables associated with wind turbine noise annoyance and sleep disturbance. Building and Environment. 150:339-48. Sæþórsdóttir, A.D., Ólafsdóttir, R., Smith, D. (2018). Turbulent times: tourists’ attitudes towards wind turbines in the Southern Highlands in Iceland. International Journal of Sustainable Energy. 2018;37 (9):886901. Salt A.N., Hullar T.E., Responses of the ear to low frequency sounds, infrasound and wind turbines. Hearing research. 2010 Sep 1;268(1):1221. Schäffer, B., Pieren, R., Schlittmeier, S. J., & Brink, M. (2018). Effects of different spectral shapes and amplitude modulation of broadband noise on annoyance reactions in a controlled listening experiment. International journal of environmental research and public health, 15(5), 1029.

Schäffer, B., Pieren, R., Hayek, U. W., Biver, N., & Grêt-Regamey, A. (2019). Influence of visibility of wind farms on noise annoyance–A laboratory experiment with audio-visual simulations. Landscape and Urban Planning, 186, 67-78. Scherhaufer, P., Höltinger, S., Salak, B., Schauppenlehner, T. & Schmidt, J. (2018). A participatory integrated assessment of the social acceptance of wind energy. Energy Research and Social Science, 45:164-172. Scherhaufer, P., Höltinger, S., Salak, B., Schauppenlehner, T. & Schmidt, J. (2017). Patterns of acceptance and non-acceptance within energy landscapes: Acase study on wind energy expansion in Austria. Energy Policy, 109:863-70. Simos, J., Cantoreggi, N., Christie, D. &Forbat, J. (2018). Wind turbines and health: a review with suggested recommendations. Environnement Risques & Santé, 2018; 18: 1-11 Sklenicka, P. & Zouhar, J. (2018). Predicting the visual impact of onshore wind farms via landscape indices: A method for objectivizing planning and decision processes. Applied Energy, 209:445-54. Smith M.G., Ögren M., Thorsson P., Hussain-Alkhateeb L., Pedersen E., Forssén J., Ageborg Morsing J., Persson Waye K (2020) A laboratory study on the effects of wind turbine noise on sleep: Results of the polysomnographic WiTNES study. Sleep (2020). Song K, Di G, Xu Y, Chen X. Community survey on noise impacts induced by 2MW wind turbines in China.

Journal of Low Frequency Noise Vibration and Active Control. 2016; 35:279-90. Sonnberger, M. & Ruddat, M. (2017). Local and socio-political acceptance of wind farms in Germany. Technology in Society, 2017;51:56-65. Stevens FL , Hurley RA , Taber KH. Stevens et al, 2011: Anterior cingulate cortex: unique role in cognition and emotion. Journal of neuropsychiatry and clinical neurosciences. Spring; 23(2): 121-5. Page 66 of 73

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Stevens and Martens (2018): Stevens, M. and W. L. Martens (2019). The influence of binaural incoherence on annoyance reported for unpleasant low frequency sound C3 - Australian Acoustical Society Annual Conference, AAS 2018, Australian Acoustical Society. Takahashi, Y. (2013) Vibratory sensation induced by low-frequency noise: The threshold for ``vibration perceived in the head'' in normal-hearing subjects. Journal of Low Frequency Noise Vibration and Active Control 32, no. 1/2, (2013): 1-10, 2013. Takahashi, Y. (2017): Study on the relationship between unpleasantness and perception of vibration in the head of subjects exposed to low-frequency noise C3 - Takahashi Y. INTER-NOISE 2017 - 46th International Congress and Exposition on Noise Control Engineering Thomson, H. & Kempton, W. (2018). Perceptions and attitudes of residents living near a wind turbine compared with those living near a coal power plant. Renewable Energy, 123:301-11. Tonin (2017): A Review of Wind Turbine-Generated Infrasound: Source, Measurement and Effect on Health. Tonin R Acoustics Australia. 2018;46(1):69-86. van den Berg, F., & van Kamp, I. (2017). Health effects related to wind turbine sound. Commissioned by the Swiss Federal Office for the Environment (FOEN) Van Den Berg, F., Pedersen, E., Bouma, J., & Bakker, R. (2008). Visual and acoustic impact of wind turbine farms on residents..

Final report.https://www.rug.nl/research/ Van Kamp I, Breugelmans O, Van Poll R, Baliatsas C, Van Kempen E. (2017): Determinants of annoyance from humming sound as indicator of low frequency noise C3 - In: McMinn T, Duncan A, editors. Proceedings of ACOUSTICS 2017 Perth: Sound, Science and Society - 2017 van Kamp, I., & van den Berg, F. (2018). Health effects related to wind turbine sound, including low-frequency sound and infrasound. Acoustics Australia, 46(1), 31-57. van Kamp, I., Simon, S., Notley, H., Baliatsas, C., & van Kempen, E. (2020a). Evidence Relating to Environmental Noise Exposure and Annoyance, Sleep Disturbance, Cardio-Vascular and Metabolic Health Outcomes in the Context of IGCB (N): A Scoping Review of New Evidence. International journal of environmental research and public health, 17(9), 3016. van Kamp, I., van Kempen, E. E. M. M., Simon, S. N., & Baliatsas, C. (2020b). Review of Evidence Relating to Environmental Noise Exposure and Annoyance, Sleep Disturbance, Cardio-Vascular and Metabolic Health Outcomes in the Context of the Interdepartmental Group on Costs and Benefits Noise Subject Group (IGCB (N)). RIVM Report 2019-0088; Netherlands. Van Kempen, E., Casas, M., Pershagen, G., & Foraster, M. (2018). WHO environmental noise guidelines for the European region: a systematic review on environmental noise and cardiovascular and metabolic effects: a summary.

International journal of environmental research and public health, 15(2), 379. Vanneste and De Ridder, 2012: The auditory and non-auditory brain areas involved in tinnitus. An emergent property of multiple parallel overlapping subnetworks. Vanneste S, D De Ridder. Frontiers in Systems Neuroscience, v6 (20120508)

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Weichenberger, M., Kühler, R., Bauer, M., Hensel, J., Brühl, R., Ihlenfeld, A., ... & Kühn, S. (2015). Brief bursts of infrasound may improve cognitive function–An fMRI study. Hearing Research, 328, 87-93. Weichenberger M, Bauer M, Kühler R, Hensel J, Forlim CG, Ihlenfeld A, et (2017): Altered cortical and subcortical connectivity due to infrasound administered near the hearing threshold- Evidence from fMRI. al (2017). PLoS ONE 12(4): e0174420 Wen, C., Dallimer,M., Carver, S. & Ziv, G. (2018). Valuing the visual impact of wind farms: A calculus method for synthesizing choice experiments studies. Total Environ, 1;637-638:58-68. WHO, 1946. Constitution of the World Health Organization: principles. World Health Organization. 〈http://www.who.int/about/mission/en/〉 (accessed 12 September 018). WHO, Environmental Noise Guidelines for the European Region (2018) WHO, Bonn. Wüstenhagen, R., M. Wolsink, M.J. Bürer. Social acceptance of renewable energy innovation: An introduction to the concept. Energy policy 35 (5), 2683-2691, 2013 Zaunbrecher, B.S. and M. Ziefle, Integrating acceptance-relevant factors into wind power planning: A discussion. Sustainable Cities and Society, 2016. 27: p. 307-314

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Annex 1

Search strategy

Our previous review was based on a systematic literature search over the period 2000 to early 2017. Three databases were searched: Scopus, Medline and Embase. This updated review uses publications from the period 2017 through June 2020. The results of our 2017 review were updated in July 2018, using the exact same search strategy and databases as in 2017. For the second update until 2020 the Medline and Embase databases were not anymore available, or not available in the same form. The platform and search syntax has been changed, so a new search strategy had to be applied. Also, we added the database PsycINFO; it showed that this hardly expanded the references from the other databases. Because the possible effects of inaudible sound at very low frequencies is an important topic in public wind farm discussions, this topic was added to the literature search. Again, observational as well as experimental studies described in the peer review literature was performed. Language was restricted to German, English, French and Dutch. The search strategy is described below. For the main topic, health effects of wind turbine sound, only studies which in the title, abstract or summary mention that the association between the noise of wind turbines and reaction, health or wellbeing was studied were included.

Also studies addressing participation during the building process were accepted for review. This implied that the association between exposure to wind turbine (low frequency) noise an annoyance, health, wellbeing or activity disturbance in the adult population was studied. For the low frequency topic, studies mentioning low frequency sound or noise or infrasound in the title together with a reaction, health effect or wellbeing in the title were included. For a first selection the following criteria were used. Inclusion: papers addressing human health effects, perception, opinion, concern in relation to wind turbines. Exclusion: papers addressing non-human effects such as ecosystem effects, animals, papers about solely technical aspects of the wind turbines, papers regarding health effects of noise but not specific for wind turbines. The papers were grouped in 7 categories: review, health effects, offshore, low frequency noise, visual aspects, social aspects and not relevant. All reviews and health effects studies were included for full paper examination, offshore studies were a-priori excluded, papers from the other categories were reconsidered after reading the abstracts. Lastly, after full examination of the review and health effect papers by the two authors, a final decision was made about inclusion in this review.

As a result 76 new publications were included in the report. In the context of this report the main results are summarized per outcome. For the key studies, the study design, outcome etc. are discussed in more detail. For this review primarily scientific publications are used, both from peer reviewed journals and conference proceedings. Page 69 van 73

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As usual all material from the selected literature has been read and analysed, but not necessarily included as reference, e.g. because the study was less relevant than originally thought or in case of doubling with other references. (e.g. a conference paper and article from same authors/study). A.1

Search strategy in Scopus, Medline and Embase databases,

until July 2018 This is the same as in our previous review (van den Berg & van Kamp, 2017; Van Kamp&van den Berg, 2018) A.2

Search strategy in Scopus, July 2018-July 2020

Topic: health effects of wind turbine sound TITLE ( "wind turbine*" OR "windmill*" OR "windmill*" OR "windfarm*" OR "wind farm*" OR "windpark*" OR "wind park*" OR "windenerg*" OR "wind energ*" ) ) AND ( TITLE ( "health effect*" OR "health risk*" OR "stress" OR "annoy*" OR "health impact*" OR "sleep" OR "noise avoid*" OR "noise abat*" OR "preval*" OR "inciden*" OR "adverse" OR "human health*" OR "avers*" OR "attitud*" OR "percept*" OR "perceiv*" OR "quality of life" OR "well being" OR "wellbeing" OR "concern*" OR "emot*" OR "accept*" ) ) AND PUBYEAR > 2017 Topic: low frequency effects TITLE( "infrasound*" OR "low frequency nois*" OR "low frequency sound*" OR "infrasonic*" OR "low frequency thresh*" OR “audibi*”) AND (TITLE("health effect*" OR "risk*" OR "stress" OR "annoy*" OR "health impact*" OR "sleep" OR "noise avoid*" OR "noise abat*" OR "preval*" OR "inciden*" OR "adverse" OR "human health*" OR "avers*" OR "attitud*" OR "percept*" OR "perceiv*" OR "quality of life" OR "well being" OR "wellbeing" OR "concern*" OR "emot*" OR "accept*")) AND PUBYEAR > 2017 A.3

Search strategy in Embase, July 2018-July 2020

Topics: health effects of wind turbine sound and low frequency effects #1. 'wind turbine'/exp OR 'wind farm'/exp OR 'wind turbine*':ti,ab OR 'wind farm*':ti,ab OR 'wind power'/exp #2. 'low frequency noise'/exp OR (low:ti AND frequency:ti AND ('noise*':ti OR 'signal*':ti OR ‘noise':ti,ab OR 'low frequency sound':ti,ab OR 'low frequency ultrasound':ti,ab OR 'low frequency signal*':ti,ab OR 'low frequency thresh*':ti,ab OR 'infrasound'/exp OR 'infraso*':ti OR 'audability':ti,ab OR 'audibl*':ti #3. 'noise'/exp/mj OR 'nois*':ti OR 'noise pollution'/exp/mj #4. 'hearing'/exp/mj #5. 'sound'/exp/mj OR 'sound*':ti #6. 'annoyance'/exp OR 'annoy*':ti #7. 'wellbeing'/exp OR 'health*':ti OR 'health'/exp OR 'health status'/exp OR 'wellbeing*':ti #8. 'aversion*':ti OR 'stress*':ti OR 'complain*':ti OR 'distress*':ti OR 'disturb*':ti OR 'worries':ti OR (('sensiti*' NEAR/3 noise):ti) OR 'sound pressure level*':ti OR 'sleep disturbance*':ti OR 'sleep quality':ti OR 'stress'/exp OR 'cognitive*':ti OR 'aversion'/exp OR 'distress Page 70 of 73

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syndrome'/exp OR 'sleep quality'/exp OR 'perception*':ti OR 'unpleasant*':ti #9. 'quality of life'/exp OR ('quality':ti AND ('life':ti OR living:ti)) #10. #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 #11. #6 OR #7 OR #8 OR #9 #12. #1 AND #10 #13. #1 AND #10 AND [2017-2020]/py #14. #1 AND #10 AND [2017-2020]/py AND ([dutch]/lim OR [english]/lim OR [french]/lim OR [german]/lim) #15. #2 AND #11 NOT #1 #16. #2 AND #11 NOT #1 AND [2017-2020]/py ##17. #2 AND #11 NOT #1 AND [2017-2020]/py AND ([dutch]/lim OR [english]/lim OR [french]/lim OR [german]/lim) A.4

Search strategy in Psycinfo, Januari 2017-July 2020

Topic: health effects of wind turbine sound (("health effect*" or "risk*" or "stress*" or "annoy*" or "health impact*" or "sleep*" or "noise avoid*" or "noise abat*" or "preval*" or "inciden*" or "adverse" or "human health*" or "avers*" or "attitud*" or "percept*" or "perceiv*" or "quality of life" or "well being" or "wellbeing" or "concern*" or "emot*" or "accept*" or "commun*" or "engag*" or "activis*" or "prefer*").m_titl.) and (("wind turbine*" or "wind farm*" or "wind park*" or "windfarm*" or "windpark*" or "windmill*" or "wind mill*" or "wind energ*" or "windenerg*").m_titl.) Topic: low frequency effects ("health effect*" or "risk*" or "stress" or "annoy*" or "health impact*" or "sleep*" or "noise avoid*" or "noise abat*" or "preval*" or "inciden*" or "adverse" or "human health*" or "avers*" or "attitud*" or "percept*" or "perceiv*" or "quality of life" or "well being" or "wellbeing" or "concern*" or "emot*" or "accept*" or "commun*" or "engag*" or "activis*" or "prefer*").m_titl. and ("infrasound*" or "low frequency nois*" or "low frequency sound*" or "infrasonic*" or "low frequency thresh*" or "audibi").m_titl.

A.5 Inclusion and exclusion criteria Include when: • paper concerns (all aspects of ) sound from wind turbines; • and: paper concerns a (qualitative or quantitative) study; no restriction regarding study design • and: at least some link is made with health effects and/or (social) wellbeing (including annoyance, community response); • and: language is English, French, German or Dutch. Exclude when: • paper concerns occupational health and safety; offshore; effects on others than residents; • or: paper is a commentary, editorial or opinion, letter to editor; errata or discussion between people. With respect to non-acoustic effects: Page 71 van 73

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Include when one or more of the following issues are addressed: • Visual aspects: o impact on landscape, movement horizon pollution, etc o light effects; shadow flicker • Safety • Vibration • Electromagnetic fields • Contextual and personal factors (noise sensitivity, attitude , effect of participation, co-ownership) A.6 Search results As the diagram below shows, the literature searches yielded 324 (374 – 50) publications of which 76 are included in the review and reference list.

374 Scientific publications: Jan.2017-Jul.2018 in Medline, Scopus and Embase (N=89); and Jan.2017-Jun.2020 in Scopus, Embase and Psycinfo (N= 285)

2 additional publications

50 doubles

241 excluded:

abstract only, opinion/discussion, exposure, offshore, occupational, animals, technical aspects WTs

relevant for review:

LF sound: 19

69 original papers

Non-acoustic: 24

83 articles included

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Health: 40

14 reviews

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Annex 2:

Glossary

ACC AM Atrial fibrillation BMI CI CNHS Cross-sectional CTL DALY dB dBA DEFRA EEG EER EMG Et al EU FFR (%)HA (%)HSD IHD Incidence Lden LAeq Lnight MW NAS NS OR Polysomnography Prevalence PRISMA REM SD SPL VAD VVVD WHO WT WTA WTP

Anterior cingulate cortex Amplitude Modulation Irregular and often rapid heart rate Body Mass Index Confidence interval Canadian Noise and Health study A study at one specific point in time Community Tolerance Level Disability-adjusted life year deciBel, a measure for the level of sound A-weighted deciBel, corrected for human hearing U.K. Department for Environment, Food & Rural Affairs Electroencephalography Exposure Effect Relation Electromyography denotes the co-authors of a publication European Union Frequency Following Response (percentage) Highly annoyed people (percentage) Highly Sleep Disturbed people Ischeamic Heart Disease Measure of the probability of occurrence of a given (medical) condition in a population within a specific period of time Day-evening-night equivalent sound level A-weighted equivalent sound pressure level averaged over a period of time Nighttime equivalent sound level MegaWatt (million Watt) Noise Annoyance Stress Noise sensitivity Odds ratio A test used to diagnose sleep disorders.

Actual number of cases of disease or injury present in a population at any particular moment in time Preferred Reporting Items for Systematic reviews and Meta-Analyses Rapid eye movement (sleep stage) Standard deviation Sound Pressure Level: the actual sound level in certain conditions or at a certain time Vibroacoustic disease Visceral vibratory vestibular disease World Health Organization Wind Turbine Willingness to Accept Willingness to pay

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RIVM Committed to health and sustainability ­