HEALTH CONSIDERATIONS OF INDUSTRIAL WIND TURBINES ISSUES OF SLEEP DEPRIVATION AND CARDIAC RISK PRESENTED BY DR. STANLEY SHAPIRO, MD F.A.C.C.

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1 HEALTH CONSIDERATIONS OF INDUSTRIAL WIND TURBINES ISSUES OF SLEEP DEPRIVATION AND CARDIAC RISK PRESENTED BY DR. STANLEY SHAPIRO, MD F.A.C.C. April 24, 2013

2 Stanley M. Shapiro MD, F.A.C.C. Champlain Valley Cardiovascular Associates Clinical Assistant Professor of Cardiology, University of Vermont College of Medicine Director of Progressive Care Unit, Rutland Regional Medical Center, Rutland, VT Board Certified in Internal Medicine, Cardiovascular Diseases, and Nuclear Cardiology Fellow of the American College of Cardiology Not speaking on behalf of any affiliated organization or hospital

3 A Brief History of Emotions and Heart Disease Plato All bodily ills proceed from the spirit. Middle ages to Renaissance - Ascribe cardiac diseases to emotional disorder. Heberden - Angina is precipitated by disturbances of the mind. John Hunter My life is at the mercy of any scoundrel who chooses to put in a passion.

5 INTERHEART Study These recently published results of the INTERHEART study make a huge contribution to our knowledge on this topic. The study not only has addressed the association of several psychosocial stressors with the risk of acute MI, but it also has done so among a diverse group of 11,119 patients and 13,648 age- and sex-matched control subjects from 262 centers in 52 countries around the globe. This enormous effort yielded findings that self-reported psychosocial factors (perceived stress at work or home, financial stress, stressful life events, depression, and perceived disempowerment) are associated with the risk of the first acute MI; that the effect of stress is independent of socioeconomic status and smoking; and that the effect is generally consistent across geographic regions, in different age and ethnic groups, and in both men and women.

6 Atherosclerosis Timeline

7 Nocturnal Angina Source: Sleep Medicine, Harold Smith, Cynthinia Comella, Birgit Hogl 2008 Cambridge University Press

11 Mars Hill Project Health Effects & Sleep Deprivation Results 82% of study subjects reported new onset or worsened sleep disturbances, versus 3% in the (control) group. 36% reported new onset headaches (3% in the control group). 55% reported stress (0%), 82% anger (0%), 36% worsened depression (0%). 95% of the study subjects perceived reduced quality of life, versus 0% in the control group. Underlining these findings, there were 25 new prescription medications offered to the study subjects, of which 15 were accepted, compared to 4 new or increased prescriptions in the control group.

12 Mars Hill Project Health Effects & Sleep Deprivation Conclusions Adults living within 1100 meters of industrial wind turbines suffer high incidences of chronic sleep disturbances and headaches, among other somatic complaints, and high incidences of dysphoric psychiatric symptomatology, compared to a control group living meters away. They additionally require increased prescription medications to deal with these symptoms compared. Most symptomatology appears attributable to the quality and persistence of the noise generated by the turbine installations. Additional investigation of the children living in close proximity to industrial wind turbines is urgently needed. Improvements in pre-construction sound modeling and siting ordinances are required to prevent the negative health effects observed in our study population.

13 Heart Disease and Sleep Disturbance Autonomic dysregulation Increase CRP Elevation of blood pressure Sympathetic activation Increase in inflammatory mediators Increase in arrhythmias Increase in stress hormones Increase in heart attacks

14 Where Should We Go From Here Brand new area of intersection of public health and renewable energy When improperly sited, industrial wind turbines have a high likelihood of causing sleep deprivation Any publically sanctioned activity that resulted in causing sleep deprivation would be an unacceptable health risk to the effected population For industrial wind to succeed as a renewable energy source health considerations must be given the highest priority in siting decisions There is still much to learn; closing off further research is unconscionable

Cardiac Patients Psychosocial Needs. Cardiac Patients Psychosocial Needs

Cardiac Patients Psychosocial Needs Implications for Rehabilitation Programs and CACR Guidelines Jaan Reitav and Paul Oh Cardiac Rehabilitation & Secondary Prevention Program Cardiac Patients Psychosocial