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            "bbox": {
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            "text": "5. Long-term aircraft-noise study — reading and memory",
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            "bbox": {
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            "text": "Stansfeld et al., 2010. Chronic aircraft-noise exposure in children was associated with impairment in reading and long-term memory. The researchers proposed sleep disturbance as one mechanism connecting chronic noise exposure with cognitive impairment."
        },
        {
            "id": "p29.3",
            "order": 3,
            "type": "text",
            "bbox": {
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            "text": "Source: https://pubmed.ncbi.nlm.nih.gov/20871180/"
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            "text": "6. Landmark study — chronic environmental noise and cognitive development",
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        {
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            "text": "Stansfeld et al., 2005 — RANCH study. Chronic aircraft noise was associated with poorer cognitive development, particularly reading comprehension. The authors characterized chronic aircraft noise as an environmental stressor capable of affecting cognitive development. Aircraft noise cannot be equated with a data-center hum, but the study provides evidence that chronic environmental acoustic exposure can have consequences beyond hearing damage."
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            "text": "Source: https://pubmed.ncbi.nlm.nih.gov/15936421/"
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            "text": "7. Children, noise, stress and behavioral effects",
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            "text": "Stansfeld, Clark et al. Reviews of pediatric environmental noise found associations with annoyance, reduced well-being, physiological stress responses, increased adrenaline/noradrenaline, and hyperactivity symptoms. The literature does not establish that environmental noise causes serious psychiatric disease; the more defensible conclusion is that chronic noise can act as an environmental stressor in children."
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            "text": "Source: https://pubmed.ncbi.nlm.nih.gov/26231366/"
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            "text": "8. Sleep is particularly important in infants and children",
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            "text": "Environmental-noise research demonstrates effects on sleep architecture, sleep continuity, physiological arousal, and daytime functioning. Nighttime noise can produce measurable biological changes and disturb sleep architecture. This is particularly relevant to a continuously operating facility because sleep is a plausible pathway through which chronic environmental noise could affect developing children."
        },
        {
            "id": "p29.12",
            "order": 12,
            "type": "text",
            "bbox": {
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            "text": "Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC4608916/"
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            "text": "9. Infants are a particularly sensitive population",
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            "text": "A 2024 systematic review of noise in neonatal intensive-care units found that all NICUs evaluated exceeded recommended cumulative sound levels. Reviews note that continuous noise from life-support equipment can be a significant acoustic exposure for premature infants. The American Academy of Pediatrics has recommended keeping NICU sound levels below approximately 45 dBA to promote optimal growth and development."
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            "text": "Sources: https://pubmed.ncbi.nlm.nih.gov/39363441/ ; https://pmc.ncbi.nlm.nih.gov/articles/PMC11137833/ ; https://pubmed.ncbi.nlm.nih.gov/28398915/"
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            "text": "10. Newborn auditory exposure research",
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            "text": "Pineda et al., 2017 — Auditory Exposure in the Neonatal Intensive Care Unit. The study quantified auditory exposure in NICU environments and evaluated environmental and medical factors affecting infant exposure. The significance is that researchers consider duration, intensity, developmental stage, acoustic characteristics, and physiological consequences rather than simply whether sound is loud enough to damage hearing."
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            "text": "Source: https://pubmed.ncbi.nlm.nih.gov/28189301/"
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            "text": "11. WHO's broader environmental-noise evidence",
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            "text": "Chronic Environmental Noise — Infants and Children",
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            "text": "Page 2",
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            "text": "Page 29 of 113",
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