[ { "page": 1, "items": [ { "page": 1, "type": "TITLE", "location": { "l": 76.8, "t": 459.36, "r": 643.44, "b": 293.04 }, "text": "Data Center Health\nImpact: NOISE Pollution", "reading_order": 0, "level": 4 }, { "page": 1, "type": "TEXT", "location": { "l": 149.04, "t": 249.6, "r": 572.4, "b": 149.04 }, "text": "Dubuque County Health Department\nData Center Working Group\nSeptember, 2026", "reading_order": 1 } ] }, { "page": 2, "items": [ { "page": 2, "type": "TITLE", "location": { "l": 32.4, "t": 502.8, "r": 514.32, "b": 437.52 }, "text": "Data Center Health Impact: NOISE Pollution", "reading_order": 0, "level": 1 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 22.32, "t": 417.36, "r": 564.48, "b": 393.84 }, "text": "Question Asked: Does NOISE Pollution Impact Health?", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 1 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 22.56, "t": 389.52, "r": 177.36, "b": 367.68 }, "text": "Health Impact", "marker": "•", "list_id": "L1", "level": 0, "items": [ { "page": 2, "type": "LIST_ITEM", "location": { "l": 57.84, "t": 362.16, "r": 377.76, "b": 342.96 }, "text": "Noise, Low Frequency Noise, Vibration", "marker": "•", "list_id": "L1", "level": 1, "reading_order": 0 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 57.36, "t": 337.92, "r": 617.28, "b": 300.24 }, "text": "Noise → Stress Response, Circadian Rhythm Disruption, Inflammation Associated Disorders", "marker": "•", "list_id": "L1", "level": 1, "reading_order": 1 } ], "reading_order": 2 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 22.08, "t": 295.68, "r": 600.72, "b": 272.88 }, "text": "Question Answered: Does NOISE Pollution Impact Health?", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 3 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 22.56, "t": 268.32, "r": 353.28, "b": 246.96 }, "text": "National/Other NOISE Standards", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 4 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 22.32, "t": 241.68, "r": 310.56, "b": 219.36 }, "text": "NOISE Ordinance Examples", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 5 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 22.32, "t": 214.8, "r": 448.8, "b": 192.72 }, "text": "Proposed NOISE Ordinance Requirements", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 6 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 22.56, "t": 187.92, "r": 461.28, "b": 167.04 }, "text": "Recommended NOISE Ordinance Checklist:", "marker": "•", "list_id": "L1", "level": 0, "items": [ { "page": 2, "type": "LIST_ITEM", "location": { "l": 58.08, "t": 165.6, "r": 439.2, "b": 147.6 }, "text": "NOISE Pollution Prevention Included In Ordinance", "marker": "•", "list_id": "L1", "level": 1, "reading_order": 0 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 58.32, "t": 146.64, "r": 253.68, "b": 129.36 }, "text": "Monitoring Requirement", "marker": "•", "list_id": "L1", "level": 1, "reading_order": 1 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 58.32, "t": 128.4, "r": 309.12, "b": 109.92 }, "text": "Sanction(s) for Non-Compliance", "marker": "•", "list_id": "L1", "level": 1, "reading_order": 2 } ], "reading_order": 7 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 22.8, "t": 106.08, "r": 214.8, "b": 83.52 }, "text": "Polling/Questions", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 8 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 22.32, "t": 78.72, "r": 153.6, "b": 57.6 }, "text": "References", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 9 } ] }, { "page": 3, "items": [ { "page": 3, "type": "TITLE", "location": { "l": 30.24, "t": 503.52, "r": 515.76, "b": 436.32 }, "text": "Data Center Health Impact: NOISE Pollution", "reading_order": 0, "level": 5 }, { "page": 3, "type": "LIST_ITEM", "location": { "l": 42.45, "t": 405.0399, "r": 313.1595, "b": 369.2452 }, "text": "Question Asked:", "marker": "•", "list_id": "L2", "level": 0, "items": [ { "page": 3, "type": "LIST_ITEM", "location": { "l": 78.45, "t": 371.6473, "r": 666.8985, "b": 332.2193 }, "text": "Does Noise Pollution Impact Health?", "marker": "•", "list_id": "L2", "level": 1, "reading_order": 0 } ], "reading_order": 1 } ] }, { "page": 4, "items": [ { "page": 4, "type": "TITLE", "location": { "l": 4.08, "t": 524.16, "r": 675.84, "b": 426.48 }, "text": "Reminder: Health →\nA Result of Many Factors + Exposures\nExample Cardiovascular Disease", "reading_order": 0, "level": 6 }, { "page": 4, "type": "FIGURE", "location": { "l": 7.68, "t": 378.24, "r": 713.28, "b": 64.8 }, "text": "", "reading_order": 1 }, { "page": 4, "type": "TITLE", "location": { "l": 14.64, "t": 370.08, "r": 92.88, "b": 346.56 }, "text": "Major exposome\nrisk factors", "reading_order": 2, "level": 6 }, { "page": 4, "type": "TEXT", "location": { "l": 134.4, "t": 370.08, "r": 202.8, "b": 345.36 }, "text": "Genetic predisposition", "reading_order": 3 }, { "page": 4, "type": "TEXT", "location": { "l": 223.44, "t": 369.84, "r": 292.32, "b": 335.28 }, "text": "Pre-existing cardiovascular disease", "reading_order": 4 }, { "page": 4, "type": "TITLE", "location": { "l": 591.6, "t": 370.32, "r": 706.08, "b": 345.36 }, "text": "Increased cardiovascular\nrisk and morbidity", "reading_order": 5, "level": 6 }, { "page": 4, "type": "TEXT", "location": { "l": 329.28, "t": 335.76, "r": 421.68, "b": 311.76 }, "text": "Central biochemical pathways", "reading_order": 6 }, { "page": 4, "type": "TEXT", "location": { "l": 15.12, "t": 322.08, "r": 55.44, "b": 308.64 }, "text": "Smoking", "reading_order": 7 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 332.16, "t": 311.76, "r": 409.68, "b": 306.53999999999996 }, "text": "Circadian clock dysregulation", "marker": "-", "list_id": "L3", "level": 0, "reading_order": 8 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 332.16, "t": 306.53999999999996, "r": 409.68, "b": 301.32 }, "text": "Stress hormone responses", "marker": "-", "list_id": "L3", "level": 0, "reading_order": 9 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 332.16, "t": 301.32, "r": 409.68, "b": 296.1 }, "text": "Inflammation", "marker": "-", "list_id": "L3", "level": 0, "reading_order": 10 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 332.16, "t": 296.1, "r": 409.68, "b": 290.88 }, "text": "Oxidative stress", "marker": "-", "list_id": "L3", "level": 0, "reading_order": 11 }, { "page": 4, "type": "TITLE", "location": { "l": 134.16, "t": 284.16, "r": 269.28, "b": 270.96 }, "text": "Specific external environment", "reading_order": 12, "level": 6 }, { "page": 4, "type": "TEXT", "location": { "l": 332.4, "t": 290.88, "r": 411.36, "b": 270.48 }, "text": "- Stress hormone responses", "reading_order": 13 }, { "page": 4, "type": "TEXT", "location": { "l": 616.08, "t": 281.04, "r": 647.76, "b": 269.04 }, "text": "Plaque", "reading_order": 14 }, { "page": 4, "type": "TEXT", "location": { "l": 658.08, "t": 277.44, "r": 702.48, "b": 266.88 }, "text": "Thrombus", "reading_order": 15 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 332.16, "t": 270.24, "r": 402.48, "b": 260.16 }, "text": "Inflammation", "marker": "-", "list_id": "L4", "level": 0, "reading_order": 16 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 19.92, "t": 270, "r": 96, "b": 247.68 }, "text": "Mental health and societal factors", "list_id": "L4", "level": 0, "items": [ { "page": 4, "type": "LIST_ITEM", "location": { "l": 137.52, "t": 269.04, "r": 168.24, "b": 258.96 }, "text": "Diet", "list_id": "L4", "level": 1, "reading_order": 0 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 137.76, "t": 258.24, "r": 231.6, "b": 255.72 }, "text": "Consumer products", "marker": "-", "list_id": "L4", "level": 1, "reading_order": 1 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 137.76, "t": 255.72, "r": 231.6, "b": 253.2 }, "text": "Physical activity", "marker": "-", "list_id": "L4", "level": 1, "reading_order": 2 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 137.76, "t": 253.2, "r": 231.6, "b": 250.68 }, "text": "Tobacco", "marker": "-", "list_id": "L4", "level": 1, "reading_order": 3 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 137.76, "t": 250.68, "r": 231.6, "b": 248.16 }, "text": "Water", "marker": "-", "list_id": "L4", "level": 1, "reading_order": 4 } ], "reading_order": 17 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 332.16, "t": 259.92, "r": 411.84, "b": 249.12 }, "text": "Oxidative stress", "marker": "•", "list_id": "L4", "level": 0, "reading_order": 18 }, { "page": 4, "type": "TEXT", "location": { "l": 27.12, "t": 237.6, "r": 187.2, "b": 227.04 }, "text": "Psychosocial stress • Tobacco", "reading_order": 19 }, { "page": 4, "type": "TEXT", "location": { "l": 27.84, "t": 227.04, "r": 81.84, "b": 217.44 }, "text": "Lonliness", "reading_order": 20 }, { "page": 4, "type": "TEXT", "location": { "l": 138, "t": 227.04, "r": 176.64, "b": 216.72 }, "text": "Water", "reading_order": 21 }, { "page": 4, "type": "TITLE", "location": { "l": 331.2, "t": 224.4, "r": 426, "b": 212.4 }, "text": "Internal environment", "reading_order": 22, "level": 6 }, { "page": 4, "type": "TITLE", "location": { "l": 468.72, "t": 220.56, "r": 554.16, "b": 196.08 }, "text": "Health effects and risk assessments", "reading_order": 23, "level": 6 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 27.84, "t": 216.72, "r": 103.92, "b": 206.64 }, "text": "Social isolation", "marker": "•", "list_id": "L5", "level": 0, "reading_order": 24 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 657.12, "t": 212.64, "r": 705.6, "b": 189.12 }, "text": "Myocardial infarction", "list_id": "L5", "level": 0, "reading_order": 25 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 331.92, "t": 210.96, "r": 413.04, "b": 207.44 }, "text": "Transcriptomics", "marker": "•", "list_id": "L5", "level": 0, "reading_order": 26 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 331.92, "t": 207.44, "r": 413.04, "b": 203.92000000000002 }, "text": "Proteomics", "marker": "•", "list_id": "L5", "level": 0, "reading_order": 27 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 331.92, "t": 203.92000000000002, "r": 413.04, "b": 200.4 }, "text": "Metabolomics", "marker": "•", "list_id": "L5", "level": 0, "reading_order": 28 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 332.64, "t": 200.4, "r": 394.56, "b": 190.32 }, "text": "Proteomics", "marker": "•", "list_id": "L5", "level": 0, "reading_order": 29 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 332.88, "t": 190.08, "r": 406.32, "b": 179.52 }, "text": "Metabolomics", "marker": "•", "list_id": "L5", "level": 0, "reading_order": 30 }, { "page": 4, "type": "TITLE", "location": { "l": 134.4, "t": 178.56, "r": 267.36, "b": 166.56 }, "text": "General external environment", "reading_order": 31, "level": 6 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 134.64, "t": 173.52, "r": 225.36, "b": 160.9714285714286 }, "text": "General external env", "list_id": "L6", "level": 0, "reading_order": 32 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 134.64, "t": 160.9714285714286, "r": 225.36, "b": 148.42285714285714 }, "text": "Climate", "marker": "-", "list_id": "L6", "level": 0, "reading_order": 33 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 134.64, "t": 148.42285714285714, "r": 225.36, "b": 135.87428571428572 }, "text": "Traffic", "marker": "-", "list_id": "L6", "level": 0, "reading_order": 34 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 134.64, "t": 135.87428571428572, "r": 225.36, "b": 123.3257142857143 }, "text": "Urban environment", "marker": "-", "list_id": "L6", "level": 0, "reading_order": 35 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 134.64, "t": 123.3257142857143, "r": 225.36, "b": 110.77714285714286 }, "text": "Green spaces", "marker": "-", "list_id": "L6", "level": 0, "reading_order": 36 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 134.64, "t": 110.77714285714286, "r": 225.36, "b": 85.68 }, "text": "Social capital\nNoise", "marker": "-", "list_id": "L6", "level": 0, "reading_order": 37 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 14.16, "t": 155.76, "r": 98.4, "b": 131.76 }, "text": "Chemical pollution\n• Air", "list_id": "L6", "level": 0, "reading_order": 38 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 673.44, "t": 138.24, "r": 702.24, "b": 127.2 }, "text": "Stroke", "list_id": "L6", "level": 0, "reading_order": 39 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 22.56, "t": 133.44, "r": 61.44, "b": 128.51999999999998 }, "text": "Water", "marker": "-", "list_id": "L6", "level": 0, "reading_order": 40 }, { "page": 4, "type": "LIST_ITEM", "location": { "l": 22.56, "t": 128.51999999999998, "r": 61.44, "b": 123.6 }, "text": "Soil", "marker": "-", "list_id": "L6", "level": 0, "reading_order": 41 }, { "page": 4, "type": "TEXT", "location": { "l": 329.52, "t": 80.4, "r": 430.8, "b": 68.16 }, "text": "Life course dimension", "reading_order": 42 } ] }, { "page": 5, "items": [ { "page": 5, "type": "TITLE", "location": { "l": 45.12, "t": 536.16, "r": 688.8, "b": 475.2 }, "text": "Reminder: Many Environmental Stressors Driving Cardiovascular Disease", "reading_order": 0, "level": 6 }, { "page": 5, "type": "TITLE", "location": { "l": 184.08, "t": 442.8, "r": 535.92, "b": 427.44 }, "text": "Environmental risk factors and cardiovascular disease", "reading_order": 1, "level": 6 }, { "page": 5, "type": "TITLE", "location": { "l": 109.92, "t": 414.72, "r": 198.24, "b": 401.52 }, "text": "Climate change", "reading_order": 2, "level": 6 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 86.16, "t": 386.4, "r": 207.12, "b": 375.12 }, "text": "Temperature extremes", "marker": "•", "list_id": "L7", "level": 0, "reading_order": 3 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 86.64, "t": 374.4, "r": 175.2, "b": 361.2 }, "text": "Wildfires (PM2.5)", "marker": "•", "list_id": "L7", "level": 0, "reading_order": 4 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 86.64, "t": 361.68, "r": 150.48, "b": 349.92 }, "text": "Hurricanes", "marker": "•", "list_id": "L7", "level": 0, "reading_order": 5 }, { "page": 5, "type": "FIGURE", "location": { "l": 212.88, "t": 417.6, "r": 307.2, "b": 335.52 }, "text": "", "reading_order": 6 }, { "page": 5, "type": "FIGURE", "location": { "l": 410.64, "t": 418.08, "r": 507.36, "b": 336.48 }, "text": "", "reading_order": 7 }, { "page": 5, "type": "TITLE", "location": { "l": 520.56, "t": 415.2, "r": 612.48, "b": 401.52 }, "text": "Water pollution", "reading_order": 8, "level": 6 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 521.04, "t": 392.64, "r": 627.84, "b": 380.64 }, "text": "Arsenic and copper", "marker": "•", "list_id": "L8", "level": 0, "reading_order": 9 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 521.28, "t": 379.92, "r": 620.88, "b": 368.4 }, "text": "Lead and mercury", "list_id": "L8", "level": 0, "reading_order": 10 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 521.28, "t": 367.68, "r": 615.12, "b": 355.92 }, "text": "Nitrogen loading", "marker": "•", "list_id": "L8", "level": 0, "reading_order": 11 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 521.28, "t": 355.68, "r": 618.24, "b": 343.44 }, "text": "Micro/nanoplastic", "marker": "•", "list_id": "L8", "level": 0, "reading_order": 12 }, { "page": 5, "type": "TITLE", "location": { "l": 44.16, "t": 312.24, "r": 150.48, "b": 299.04 }, "text": "Chemical pollution", "reading_order": 13, "level": 6 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 47.52, "t": 291.12, "r": 146.4, "b": 279.36 }, "text": ">16 000 chemicals", "marker": "•", "list_id": "L9", "level": 0, "reading_order": 14 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 47.76, "t": 281.52, "r": 145.92, "b": 253.92 }, "text": "BPA, PCBs, PFAS, phthalates", "marker": "•", "list_id": "L9", "level": 0, "reading_order": 15 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 48, "t": 252.48, "r": 88.8, "b": 240.96 }, "text": "Metals", "marker": "•", "list_id": "L9", "level": 0, "reading_order": 16 }, { "page": 5, "type": "FIGURE", "location": { "l": 155.76, "t": 309.36, "r": 263.28, "b": 232.56 }, "text": "", "reading_order": 17 }, { "page": 5, "type": "FIGURE", "location": { "l": 253.2, "t": 288.24, "r": 268.08, "b": 259.68 }, "text": "", "reading_order": 18 }, { "page": 5, "type": "TEXT", "location": { "l": 275.28, "t": 305.28, "r": 445.44, "b": 292.56 }, "text": "Oxidative stress, inflammation", "reading_order": 19 }, { "page": 5, "type": "TEXT", "location": { "l": 294.96, "t": 279.84, "r": 426.72, "b": 267.12 }, "text": "Endothelial dysfunction", "reading_order": 20 }, { "page": 5, "type": "TEXT", "location": { "l": 296.64, "t": 254.4, "r": 424.32, "b": 241.92 }, "text": "Cardiovascular disease", "reading_order": 21 }, { "page": 5, "type": "FIGURE", "location": { "l": 457.68, "t": 316.08, "r": 565.68, "b": 243.84 }, "text": "", "reading_order": 22 }, { "page": 5, "type": "TITLE", "location": { "l": 585.6, "t": 312, "r": 659.28, "b": 299.28 }, "text": "Air pollution", "reading_order": 23, "level": 6 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 582, "t": 295.92, "r": 679.2, "b": 284.88 }, "text": "Particulate matter", "marker": "•", "list_id": "L10", "level": 0, "reading_order": 24 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 581.76, "t": 283.2, "r": 626.16, "b": 272.88 }, "text": "Ozone", "marker": "•", "list_id": "L10", "level": 0, "reading_order": 25 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 581.76, "t": 271.44, "r": 671.04, "b": 260.16 }, "text": "Volatile organics", "marker": "•", "list_id": "L10", "level": 0, "reading_order": 26 }, { "page": 5, "type": "FORMULA", "location": { "l": 583.92, "t": 259.44, "r": 672, "b": 246.48 }, "text": "· CO x, SO x, NO x", "latex": "\\cdot\\mathrm{CO}_{x},\\mathrm{SO}_{x},\\mathrm{NO}_{x}", "reading_order": 27 }, { "page": 5, "type": "TEXT", "location": { "l": 581.04, "t": 246.48, "r": 673.92, "b": 236.64 }, "text": "• Nitrogen loading", "reading_order": 28 }, { "page": 5, "type": "TITLE", "location": { "l": 115.44, "t": 210.48, "r": 192, "b": 197.52 }, "text": "Soil pollution", "reading_order": 29, "level": 6 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 86.4, "t": 193.92, "r": 207.6, "b": 182.4 }, "text": "Poor microbial content", "marker": "•", "list_id": "L11", "level": 0, "reading_order": 30 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 85.44, "t": 180.96, "r": 202.08, "b": 170.16 }, "text": "Low nitrogen content", "list_id": "L11", "level": 0, "reading_order": 31 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 85.68, "t": 169.2, "r": 145.68, "b": 158.4 }, "text": "Chemicals", "marker": "•", "list_id": "L11", "level": 0, "reading_order": 32 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 86.16, "t": 156.96, "r": 156.48, "b": 145.92 }, "text": "Toxic metals", "marker": "·", "list_id": "L11", "level": 0, "reading_order": 33 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 85.68, "t": 144.96, "r": 180.24, "b": 132.96 }, "text": "Micro/nanoplastic", "list_id": "L11", "level": 0, "reading_order": 34 }, { "page": 5, "type": "FIGURE", "location": { "l": 213.12, "t": 208.56, "r": 294.96, "b": 131.04 }, "text": "", "reading_order": 35 }, { "page": 5, "type": "FIGURE", "location": { "l": 345.6, "t": 163.2, "r": 373.2, "b": 104.16 }, "text": "", "reading_order": 36 }, { "page": 5, "type": "FIGURE", "location": { "l": 413.04, "t": 213.6, "r": 504.72, "b": 133.68 }, "text": "", "reading_order": 37 }, { "page": 5, "type": "TITLE", "location": { "l": 508.56, "t": 210.48, "r": 624, "b": 196.8 }, "text": "Noise/light pollution", "reading_order": 38, "level": 6 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 507.12, "t": 189.36, "r": 617.76, "b": 164.88 }, "text": "Traffic, construction, and industrial noise", "marker": "•", "list_id": "L12", "level": 0, "reading_order": 39 }, { "page": 5, "type": "LIST_ITEM", "location": { "l": 506.16, "t": 162.24, "r": 638.64, "b": 137.76 }, "text": "Street and building lights, advertisement signs", "marker": "•", "list_id": "L12", "level": 0, "reading_order": 40 }, { "page": 5, "type": "TITLE", "location": { "l": 100.08, "t": 99.12, "r": 620.4, "b": 85.2 }, "text": "Coronary syndrome, stroke, peripheral artery disease, heart failure, arrhythmias, hypertension", "reading_order": 41, "level": 6 }, { "page": 5, "type": "TEXT", "location": { "l": 17.76, "t": 72.72, "r": 697.68, "b": 45.84 }, "text": "BPA, bisphenol A; COx, carbon oxide; NOx, nitrogen oxide; PCB, polychlorinated biphenyls; PFAS, per- and polyfluoroalkyl substances; PM, particulate matter; SOx, sulphur oxide; Piepoli M, et al. European Heart Journal.", "reading_order": 42 }, { "page": 5, "type": "TEXT", "location": { "l": 12.24, "t": 30, "r": 309.36, "b": 20.16 }, "text": "The content of this slide may be subject to copyright: please see the slide notes for details.", "reading_order": 43 } ] }, { "page": 6, "items": [ { "page": 6, "type": "TITLE", "location": { "l": 22.56, "t": 509.76, "r": 642.48, "b": 473.52 }, "text": "Health Impact: NOISE Pollution", "reading_order": 0, "level": 6 }, { "page": 6, "type": "TITLE", "location": { "l": 30.72, "t": 456.96, "r": 236.88, "b": 432 }, "text": "• Noise Pollution", "reading_order": 1, "level": 6 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 66, "t": 427.92, "r": 700.32, "b": 378.96 }, "text": "Search: PubMed (National Library of Medicine), Past 5 Years, Full Text", "marker": "•", "list_id": "L13", "level": 0, "reading_order": 2 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 66.72, "t": 375.12, "r": 323.04, "b": 350.64 }, "text": "Observational Studies", "marker": "•", "list_id": "L13", "level": 0, "reading_order": 3 }, { "page": 6, "type": "TITLE", "location": { "l": 32.4, "t": 344.16, "r": 448.08, "b": 312 }, "text": "• Associated With Increased", "reading_order": 4, "level": 6 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 66.72, "t": 306.24, "r": 262.32, "b": 282.72 }, "text": "Noise Annoyance", "marker": "•", "list_id": "L14", "level": 0, "reading_order": 5 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 66.48, "t": 279.84, "r": 248.4, "b": 257.04 }, "text": "Sleep Disorders", "marker": "•", "list_id": "L14", "level": 0, "reading_order": 6 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 65.76, "t": 254.4, "r": 390, "b": 229.68 }, "text": "Cardiovascular Disease (CVD)", "marker": "•", "list_id": "L14", "level": 0, "reading_order": 7 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 66.24, "t": 227.28, "r": 286.8, "b": 204.24 }, "text": "Metabolic Disorders", "marker": "•", "list_id": "L14", "level": 0, "reading_order": 8 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 66.24, "t": 200.88, "r": 283.92, "b": 177.6 }, "text": "Cognitive Disorders", "marker": "•", "list_id": "L14", "level": 0, "reading_order": 9 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 66.24, "t": 174.72, "r": 326.88, "b": 151.44 }, "text": "Mental Health Disorders", "marker": "•", "list_id": "L14", "level": 0, "reading_order": 10 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 66.24, "t": 148.32, "r": 202.56, "b": 124.32 }, "text": "Emerging/?", "marker": "•", "list_id": "L14", "level": 0, "items": [ { "page": 6, "type": "LIST_ITEM", "location": { "l": 102.24, "t": 121.68, "r": 189.84, "b": 102.72 }, "text": "Cancer", "marker": "•", "list_id": "L14", "level": 1, "reading_order": 0 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 101.76, "t": 99.6, "r": 331.92, "b": 79.2 }, "text": "Children's Health Issues", "marker": "•", "list_id": "L14", "level": 1, "reading_order": 1 }, { "page": 6, "type": "LIST_ITEM", "location": { "l": 102.24, "t": 76.32, "r": 323.04, "b": 56.64 }, "text": "Maternal Health Issues", "marker": "•", "list_id": "L14", "level": 1, "reading_order": 2 } ], "reading_order": 11 }, { "page": 6, "type": "TITLE", "location": { "l": 30, "t": 53.04, "r": 625.2, "b": 25.2 }, "text": "• Additive Effects of Combined Types of Pollution", "reading_order": 12, "level": 6 } ] }, { "page": 7, "items": [ { "page": 7, "type": "TITLE", "location": { "l": 46.8, "t": 495.12, "r": 381.12, "b": 462 }, "text": "Noise: Research", "reading_order": 0, "level": 6 }, { "page": 7, "type": "TITLE", "location": { "l": 45.6, "t": 425.52, "r": 301.92, "b": 402 }, "text": "• Literature Review", "reading_order": 1, "level": 6 }, { "page": 7, "type": "LIST_ITEM", "location": { "l": 80.88, "t": 399.6, "r": 689.76, "b": 361.68 }, "text": "Review using a more informal or subjective methods to collect and interpret studies", "marker": "•", "list_id": "L15", "level": 0, "reading_order": 2 }, { "page": 7, "type": "TITLE", "location": { "l": 44.88, "t": 356.4, "r": 318.72, "b": 332.4 }, "text": "• Systematic Review", "reading_order": 3, "level": 6 }, { "page": 7, "type": "LIST_ITEM", "location": { "l": 80.4, "t": 330.96, "r": 661.2, "b": 293.04 }, "text": "A systematic review is an overview of primary studies that uses explicit and reproducible methods.", "marker": "•", "list_id": "L16", "level": 0, "items": [ { "page": 7, "type": "LIST_ITEM", "location": { "l": 188.4, "t": 292.08, "r": 599.52, "b": 274.32 }, "text": "(https://libguides.rutgers.edu/Systematic_Reviews/ma_sr)", "marker": "•", "links": [ { "uri": "https://libguides.rutgers.edu/Systematic_Reviews/ma_sr", "dest": null, "action_type": "/URI", "bbox": [ 192.48, 281.88, 196.32, 285.72 ] }, { "uri": "https://libguides.rutgers.edu/Systematic_Reviews/ma_sr", "dest": null, "action_type": "/URI", "bbox": [ 210.6, 275.4, 588.24, 289.56 ] } ], "list_id": "L16", "level": 1, "reading_order": 0 } ], "reading_order": 4 }, { "page": 7, "type": "TITLE", "location": { "l": 45.36, "t": 270, "r": 252, "b": 246 }, "text": "• Meta-Analysis", "reading_order": 5, "level": 6 }, { "page": 7, "type": "LIST_ITEM", "location": { "l": 79.92, "t": 242.88, "r": 668.64, "b": 198.48 }, "text": "Meta-analysis is the use of statistical methods to summarize the results of independent studies.", "marker": "•", "list_id": "L17", "level": 0, "items": [ { "page": 7, "type": "LIST_ITEM", "location": { "l": 188.16, "t": 196.32, "r": 599.52, "b": 178.56 }, "text": "(https://libguides.rutgers.edu/Systematic Reviews/ma sr)", "marker": "•", "links": [ { "uri": "https://libguides.rutgers.edu/Systematic_Reviews/ma_sr", "dest": null, "action_type": "/URI", "bbox": [ 192.48, 186, 196.32, 189.84 ] }, { "uri": "https://libguides.rutgers.edu/Systematic_Reviews/ma_sr", "dest": null, "action_type": "/URI", "bbox": [ 210.6, 179.52, 588.24, 193.68 ] } ], "list_id": "L17", "level": 1, "reading_order": 0 } ], "reading_order": 6 }, { "page": 7, "type": "TITLE", "location": { "l": 45.36, "t": 176.64, "r": 289.92, "b": 152.88 }, "text": "• Umbrella Review", "reading_order": 7, "level": 6 }, { "page": 7, "type": "LIST_ITEM", "location": { "l": 77.76, "t": 148.8, "r": 669.36, "b": 54.72 }, "text": "An Umbrella Review is essentially a review of reviews. Umbrella Reviews are designed to synthesize evidence from other published systematic reviews and/or meta-analyses on a broad topic.", "marker": "•", "list_id": "L18", "level": 0, "items": [ { "page": 7, "type": "LIST_ITEM", "location": { "l": 188.64, "t": 53.52, "r": 593.28, "b": 35.76 }, "text": "https://laneguides.stanford.edu/types-of-reviews/umbrella", "marker": "•", "links": [ { "uri": "https://laneguides.stanford.edu/types-of-reviews/umbrella", "dest": null, "action_type": "/URI", "bbox": [ 192.48, 43.2, 196.32, 47.04 ] }, { "uri": "https://laneguides.stanford.edu/types-of-reviews/umbrella", "dest": null, "action_type": "/URI", "bbox": [ 210.6, 36.72, 454.8, 50.88 ] }, { "uri": "https://laneguides.stanford.edu/types-of-reviews/umbrella", "dest": null, "action_type": "/URI", "bbox": [ 455.76, 43.08, 459.96, 44.52 ] }, { "uri": "https://laneguides.stanford.edu/types-of-reviews/umbrella", "dest": null, "action_type": "/URI", "bbox": [ 460.8, 39.6, 473.52, 50.88 ] }, { "uri": "https://laneguides.stanford.edu/types-of-reviews/umbrella", "dest": null, "action_type": "/URI", "bbox": [ 473.4, 43.08, 477.6, 44.52 ] }, { "uri": "https://laneguides.stanford.edu/types-of-reviews/umbrella", "dest": null, "action_type": "/URI", "bbox": [ 478.8, 39.6, 590.04, 50.88 ] } ], "list_id": "L18", "level": 1, "reading_order": 0 } ], "reading_order": 8 } ] }, { "page": 8, "items": [ { "page": 8, "type": "TITLE", "location": { "l": 8.16, "t": 514.56, "r": 632.64, "b": 481.2 }, "text": "Noise: Research Evidence Pyramid", "reading_order": 0, "level": 6 }, { "page": 8, "type": "TITLE", "location": { "l": 7.2, "t": 428.16, "r": 200.16, "b": 395.76 }, "text": "Best Quality", "reading_order": 1, "level": 6 }, { "page": 8, "type": "FIGURE", "location": { "l": 33.6, "t": 384.72, "r": 152.64, "b": 70.8 }, "text": "", "reading_order": 2 }, { "page": 8, "type": "TEXT", "location": { "l": 35.04, "t": 138.48, "r": 154.56, "b": 72.72 }, "text": "Lowest Quality", "reading_order": 3 }, { "page": 8, "type": "FIGURE", "location": { "l": 201.12, "t": 478.08, "r": 719.52, "b": 70.56 }, "text": "", "reading_order": 4 }, { "page": 8, "type": "TEXT", "location": { "l": 221.76, "t": 68.4, "r": 392.88, "b": 55.2 }, "text": "Copyright © 2008 Lippincott, Williams & Wilkins.", "reading_order": 5 }, { "page": 8, "type": "TEXT", "location": { "l": 219.84, "t": 54, "r": 720, "b": 4.56 }, "text": "FIGURE 6-1 Quick Guide to an Evidence Hierarchy of Designs for Cause-Probing Questions.\nPolit DE, Beck TC: Nursing research: Generating and assessing evidence for nursing practice.\nPhiladelphia, 2011, Lippincott Williams & Wilkins.", "reading_order": 6 } ] }, { "page": 9, "items": [ { "page": 9, "type": "TITLE", "location": { "l": 47.04, "t": 495.12, "r": 381.12, "b": 462.48 }, "text": "Noise: Research", "reading_order": 0, "level": 6 }, { "page": 9, "type": "TITLE", "location": { "l": 45.6, "t": 430.8, "r": 225.12, "b": 409.2 }, "text": "• Relative Risk", "reading_order": 1, "level": 6 }, { "page": 9, "type": "LIST_ITEM", "location": { "l": 80.4, "t": 407.76, "r": 668.64, "b": 346.8 }, "text": "“Ratio of the probability of an event occurring in the exposed group versus the probability of the event occurring in the non-exposed group.”", "marker": "•", "list_id": "L19", "level": 0, "items": [ { "page": 9, "type": "LIST_ITEM", "location": { "l": 117.36, "t": 346.56, "r": 312.24, "b": 329.76 }, "text": "Hypothetical EXAMPLE:", "marker": "•", "list_id": "L19", "level": 1, "items": [ { "page": 9, "type": "LIST_ITEM", "location": { "l": 152.4, "t": 329.28, "r": 405.6, "b": 313.92 }, "text": "17% of smokers develop lung cancer", "marker": "•", "list_id": "L19", "level": 2, "reading_order": 0 }, { "page": 9, "type": "LIST_ITEM", "location": { "l": 152.16, "t": 313.2, "r": 423.36, "b": 299.04 }, "text": "1% of nonsmokers develop lung cancer,", "marker": "•", "list_id": "L19", "level": 2, "reading_order": 1 }, { "page": 9, "type": "LIST_ITEM", "location": { "l": 151.68, "t": 298.8, "r": 619.68, "b": 269.76 }, "text": "Then we can calculate the relative risk of lung cancer in smokers versus nonsmokers as:", "marker": "•", "list_id": "L19", "level": 2, "items": [ { "page": 9, "type": "LIST_ITEM", "location": { "l": 188.88, "t": 269.04, "r": 405.36, "b": 254.4 }, "text": "Relative risk = 17% / 1% = 17.", "marker": "•", "list_id": "L19", "level": 3, "reading_order": 0 } ], "reading_order": 2 }, { "page": 9, "type": "LIST_ITEM", "location": { "l": 155.6999, "t": 254.0602, "r": 676.5424, "b": 238.3748 }, "text": "Thus, smokers are 17 times more likely to develop lung cancer than nonsmokers”", "marker": "•", "list_id": "L19", "level": 2, "reading_order": 3 } ], "reading_order": 0 } ], "reading_order": 2 }, { "page": 9, "type": "LIST_ITEM", "location": { "l": 335.6934, "t": 239.4164, "r": 641.4485, "b": 223.1964 }, "text": "https://www.ncbi.nlm.nih.gov/books/NBK430824/", "marker": "•", "list_id": "L19", "level": 0, "reading_order": 3 }, { "page": 9, "type": "TITLE", "location": { "l": 45.12, "t": 217.92, "r": 185.76, "b": 195.84 }, "text": "Odd Ratio", "reading_order": 4, "level": 6 }, { "page": 9, "type": "LIST_ITEM", "location": { "l": 79.92, "t": 192.24, "r": 516.24, "b": 172.56 }, "text": "OR=1 Exposure does not affect odds of outcome", "marker": "•", "list_id": "L20", "level": 0, "reading_order": 5 }, { "page": 9, "type": "LIST_ITEM", "location": { "l": 79.68, "t": 169.68, "r": 579.84, "b": 149.52 }, "text": "OR>1 Exposure associated with higher odds of outcome", "marker": "•", "list_id": "L20", "level": 0, "reading_order": 6 }, { "page": 9, "type": "LIST_ITEM", "location": { "l": 79.92, "t": 146.88, "r": 573.6, "b": 126.72 }, "text": "OR<1 Exposure associated with lower odds of outcome", "marker": "•", "list_id": "L20", "level": 0, "reading_order": 7 }, { "page": 9, "type": "LIST_ITEM", "location": { "l": 80.4, "t": 123.84, "r": 678.24, "b": 56.88 }, "text": "In practice, the 95% CI is often used as a proxy for the presence of statistical significance if it does not overlap the null value (e.g. OR=1)", "marker": "•", "list_id": "L20", "level": 0, "reading_order": 8 }, { "page": 9, "type": "LIST_ITEM", "location": { "l": 332.88, "t": 57.12, "r": 655.68, "b": 40.32 }, "text": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2938757/", "marker": "•", "links": [ { "uri": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2938757/", "dest": null, "action_type": "/URI", "bbox": [ 336.36, 47.64, 339.96, 51.24 ] }, { "uri": "https://pmc.ncbi.nlm.nih.gov/articles/PMC2938757/", "dest": null, "action_type": "/URI", "bbox": [ 354.72, 42, 653.04, 54.72 ] } ], "list_id": "L20", "level": 0, "reading_order": 9 } ] }, { "page": 10, "items": [ { "page": 10, "type": "TEXT", "location": { "l": 519.84, "t": 505.2, "r": 679.2, "b": 484.56 }, "text": "Decibel Scale (dB(A))", "reading_order": 0 }, { "page": 10, "type": "FIGURE", "location": { "l": 247.2, "t": 500.16, "r": 684.72, "b": 35.04 }, "text": "", "reading_order": 1 }, { "page": 10, "type": "TITLE", "location": { "l": 34.32, "t": 491.28, "r": 363.12, "b": 455.76 }, "text": "Noise: Definition", "reading_order": 2, "level": 6 }, { "page": 10, "type": "TEXT", "location": { "l": 532.32, "t": 469.68, "r": 676.32, "b": 449.52 }, "text": "Threshold of pain — 130", "reading_order": 3 }, { "page": 10, "type": "TEXT", "location": { "l": 523.68, "t": 438, "r": 673.68, "b": 418.32 }, "text": "Aircraft on take off — 120", "reading_order": 4 }, { "page": 10, "type": "LIST_ITEM", "location": { "l": 41.76, "t": 405.6, "r": 409.44, "b": 342.96 }, "text": "“Unwanted and/or harmful sound” (Fink, 2019)\n• A ubiquitous environmental pollutant, including:", "marker": "•", "list_id": "L21", "level": 0, "reading_order": 5 }, { "page": 10, "type": "LIST_ITEM", "location": { "l": 41.52, "t": 334.32, "r": 431.28, "b": 273.12 }, "text": "A ubiquitous environmental pollutant, including:", "marker": "•", "list_id": "L21", "level": 0, "items": [ { "page": 10, "type": "LIST_ITEM", "location": { "l": 77.04, "t": 269.04, "r": 253.2, "b": 243.6 }, "text": "Transportation\n• Occupational\n• Entertainment\n• Recreational\n• Neighborhood\n• Industrial noise.", "marker": "•", "list_id": "L21", "level": 1, "reading_order": 0 }, { "page": 10, "type": "LIST_ITEM", "location": { "l": 77.04, "t": 238.08, "r": 240.48, "b": 212.88 }, "text": "Occupational", "marker": "•", "list_id": "L21", "level": 1, "reading_order": 1 }, { "page": 10, "type": "LIST_ITEM", "location": { "l": 77.28, "t": 207.12, "r": 249.6, "b": 182.64 }, "text": "Entertainment", "marker": "•", "list_id": "L21", "level": 1, "reading_order": 2 } ], "reading_order": 6 }, { "page": 10, "type": "TEXT", "location": { "l": 296.88, "t": 204.48, "r": 467.52, "b": 174.96 }, "text": "< 45 dB Lnight for road traffic noise (WHO)", "reading_order": 7 }, { "page": 10, "type": "TEXT", "location": { "l": 534.24, "t": 187.68, "r": 666.48, "b": 168.48 }, "text": "Quiet living room — 4", "reading_order": 8 }, { "page": 10, "type": "LIST_ITEM", "location": { "l": 77.52, "t": 176.16, "r": 234.24, "b": 151.92 }, "text": "Recreational", "marker": "•", "list_id": "L22", "level": 0, "reading_order": 9 }, { "page": 10, "type": "LIST_ITEM", "location": { "l": 77.52, "t": 145.68, "r": 249.84, "b": 119.76 }, "text": "Neighborhood", "marker": "•", "list_id": "L22", "level": 0, "reading_order": 10 }, { "page": 10, "type": "LIST_ITEM", "location": { "l": 77.28, "t": 114.72, "r": 275.04, "b": 89.52 }, "text": "Industrial noise.\"", "marker": "•", "list_id": "L22", "level": 0, "reading_order": 11 }, { "page": 10, "type": "TEXT", "location": { "l": 83.04, "t": 63.84, "r": 236.16, "b": 42.72 }, "text": "(Basner, et al., 2026)", "reading_order": 12 } ] }, { "page": 11, "items": [ { "page": 11, "type": "TITLE", "location": { "l": 43.44, "t": 518.88, "r": 614.64, "b": 486.72 }, "text": "NOISE Pollution: Decibel Levels", "reading_order": 0, "level": 6 }, { "page": 11, "type": "TEXT", "location": { "l": 179.52, "t": 479.04, "r": 324.96, "b": 460.08 }, "text": "Decibel scale [dBA]", "reading_order": 1 }, { "page": 11, "type": "TEXT", "location": { "l": 69.6, "t": 476.4, "r": 92.64, "b": 455.04 }, "text": "A", "reading_order": 2 }, { "page": 11, "type": "FIGURE", "location": { "l": 90.72, "t": 476.16, "r": 689.04, "b": 37.92 }, "text": "", "reading_order": 3 } ] }, { "page": 12, "items": [ { "page": 12, "type": "TITLE", "location": { "l": 54.96, "t": 478.8, "r": 605.76, "b": 438.72 }, "text": "Noise: Measurement → Lden", "reading_order": 0, "level": 6 }, { "page": 12, "type": "TEXT", "location": { "l": 44.16, "t": 409.44, "r": 647.04, "b": 324.72 }, "text": "The Lden indicator is an average sound pressure level over all days, evenings and nights in a year (EEA, 2010). This compound indicator was adopted by the EU in the END (EC, 2002a). The Lden in decibels (dB) is defined by a specific formula, where:", "reading_order": 1 }, { "page": 12, "type": "LIST_ITEM", "location": { "l": 51.12, "t": 323.04, "r": 632.4, "b": 281.28 }, "text": "Lday is the A-weighted long-term average sound level as defined in ISO 1996-1: 2016, determined over all the day periods of a year;", "marker": "•", "list_id": "L23", "level": 0, "reading_order": 2 }, { "page": 12, "type": "LIST_ITEM", "location": { "l": 44.88, "t": 279.6, "r": 655.2, "b": 237.6 }, "text": "L evening is the A-weighted long-term average sound level as defined in ISO 1996-1: 2016, determined over all the evening periods of a year; and", "marker": "•", "list_id": "L23", "level": 0, "reading_order": 3 }, { "page": 12, "type": "LIST_ITEM", "location": { "l": 44.88, "t": 236.4, "r": 650.4, "b": 172.8 }, "text": "L_{night} is the A-weighted long-term average sound level as defined in ISO 1996-1: 2016, determined over all the night periods of a year (ISO, 2016).", "marker": "•", "list_id": "L23", "level": 0, "reading_order": 4 }, { "page": 12, "type": "LIST_ITEM", "location": { "l": 42.72, "t": 150.72, "r": 633.84, "b": 42 }, "text": "The Lnight according to the definition in the END, is an equivalent outdoor sound pressure level, measured at the most exposed façade, associated with a particular type of noise source during night time (at least eight hours), calculated over a period of a year (WHO Regional Office for Europe, 2009)", "marker": "•", "list_id": "L23", "level": 0, "reading_order": 5 }, { "page": 12, "type": "TEXT", "location": { "l": 421.2, "t": 39.12, "r": 683.76, "b": 17.52 }, "text": "(World Health Organization, 2024).", "reading_order": 6 } ] }, { "page": 13, "items": [ { "page": 13, "type": "TITLE", "location": { "l": 54.72, "t": 478.8, "r": 456.72, "b": 444.24 }, "text": "Noise: Other Issues", "reading_order": 0, "level": 6 }, { "page": 13, "type": "TITLE", "location": { "l": 41.04, "t": 408.72, "r": 391.44, "b": 379.44 }, "text": "Low Frequency Noise", "reading_order": 1, "level": 6 }, { "page": 13, "type": "LIST_ITEM", "location": { "l": 76.08, "t": 375.84, "r": 321.12, "b": 351.84 }, "text": "Sound at 20-200 Hz", "marker": "•", "list_id": "L24", "level": 0, "reading_order": 2 }, { "page": 13, "type": "LIST_ITEM", "location": { "l": 76.56, "t": 348, "r": 319.2, "b": 323.52 }, "text": "Health Impact Noted", "marker": "•", "list_id": "L24", "level": 0, "reading_order": 3 }, { "page": 13, "type": "LIST_ITEM", "location": { "l": 76.08, "t": 320.16, "r": 412.8, "b": 295.44 }, "text": "Not Addressed in this Review", "marker": "•", "list_id": "L24", "level": 0, "reading_order": 4 }, { "page": 13, "type": "TITLE", "location": { "l": 41.52, "t": 287.28, "r": 225.6, "b": 259.44 }, "text": "Infrasound", "reading_order": 5, "level": 6 }, { "page": 13, "type": "LIST_ITEM", "location": { "l": 76.08, "t": 254.64, "r": 318.96, "b": 230.64 }, "text": "Sound below 20 Hz", "marker": "•", "list_id": "L25", "level": 0, "reading_order": 6 }, { "page": 13, "type": "LIST_ITEM", "location": { "l": 76.32, "t": 227.04, "r": 318.48, "b": 202.56 }, "text": "Health Impact Noted", "marker": "•", "list_id": "L25", "level": 0, "reading_order": 7 }, { "page": 13, "type": "LIST_ITEM", "location": { "l": 76.08, "t": 199.44, "r": 412.8, "b": 174.48 }, "text": "Not Addressed in this Review", "marker": "•", "list_id": "L25", "level": 0, "reading_order": 8 }, { "page": 13, "type": "TITLE", "location": { "l": 41.04, "t": 166.56, "r": 203.28, "b": 138.48 }, "text": "• Vibration", "reading_order": 9, "level": 6 }, { "page": 13, "type": "LIST_ITEM", "location": { "l": 75.84, "t": 134.16, "r": 319.2, "b": 108.96 }, "text": "Health Impact Noted", "marker": "•", "list_id": "L26", "level": 0, "reading_order": 10 }, { "page": 13, "type": "LIST_ITEM", "location": { "l": 76.32, "t": 106.32, "r": 413.04, "b": 80.88 }, "text": "Not Addressed in this Review", "marker": "•", "list_id": "L26", "level": 0, "reading_order": 11 }, { "page": 13, "type": "TEXT", "location": { "l": 276, "t": 61.68, "r": 476.64, "b": 40.32 }, "text": "(Møller & Pedersen, 2004)", "reading_order": 12 } ] }, { "page": 14, "items": [ { "page": 14, "type": "TITLE", "location": { "l": 27.36, "t": 514.08, "r": 589.44, "b": 476.64 }, "text": "Noise: Low Frequency Noise", "reading_order": 0, "level": 6 }, { "page": 14, "type": "LIST_ITEM", "location": { "l": 36, "t": 449.28, "r": 620.4, "b": 399.36 }, "text": "“Type of environmental noise characterized by sound waves 20 - 200 Hz.", "marker": "•", "list_id": "L27", "level": 0, "reading_order": 1 }, { "page": 14, "type": "LIST_ITEM", "location": { "l": 36.48, "t": 395.52, "r": 641.76, "b": 346.8 }, "text": "Distinctive environmental noise issue that affects many households", "marker": "•", "list_id": "L27", "level": 0, "reading_order": 2 }, { "page": 14, "type": "LIST_ITEM", "location": { "l": 37.2, "t": 342.96, "r": 307.68, "b": 319.68 }, "text": "Natural sources of LFN:", "marker": "•", "list_id": "L27", "level": 0, "items": [ { "page": 14, "type": "LIST_ITEM", "location": { "l": 71.52, "t": 316.8, "r": 591.84, "b": 274.08 }, "text": "Wind, thunder, lightning, waves, earthquakes, and volcanic eruptions,", "marker": "•", "list_id": "L27", "level": 1, "reading_order": 0 } ], "reading_order": 3 }, { "page": 14, "type": "TITLE", "location": { "l": 36.96, "t": 270.96, "r": 320.64, "b": 247.68 }, "text": "• Artificial sources of LFN:", "reading_order": 4, "level": 6 }, { "page": 14, "type": "LIST_ITEM", "location": { "l": 72.72, "t": 244.56, "r": 250.08, "b": 225.36 }, "text": "Life-related noise", "marker": "•", "list_id": "L28", "level": 0, "items": [ { "page": 14, "type": "LIST_ITEM", "location": { "l": 107.28, "t": 223.2, "r": 642.96, "b": 204 }, "text": "(e.g., air conditioning, power distribution equipment, elevators, and fans)", "marker": "•", "list_id": "L28", "level": 1, "reading_order": 0 } ], "reading_order": 5 }, { "page": 14, "type": "LIST_ITEM", "location": { "l": 72.48, "t": 202.8, "r": 208.56, "b": 183.36 }, "text": "Traffic noise", "marker": "•", "list_id": "L28", "level": 0, "items": [ { "page": 14, "type": "LIST_ITEM", "location": { "l": 108.48, "t": 180.72, "r": 326.88, "b": 162 }, "text": "(e.g., railways and aviation)", "marker": "•", "list_id": "L28", "level": 1, "reading_order": 0 } ], "reading_order": 6 }, { "page": 14, "type": "LIST_ITEM", "location": { "l": 72.48, "t": 160.56, "r": 333.84, "b": 141.12 }, "text": "Industrial enterprise noise", "marker": "•", "list_id": "L28", "level": 0, "items": [ { "page": 14, "type": "LIST_ITEM", "location": { "l": 107.76, "t": 139.2, "r": 509.28, "b": 120 }, "text": "(e.g., substations, wind farms, and converter stations) (Liang, et al., 2023)", "marker": "•", "list_id": "L28", "level": 1, "reading_order": 0 } ], "reading_order": 7 }, { "page": 14, "type": "TEXT", "location": { "l": 590.4, "t": 140.88, "r": 690.24, "b": 125.28 }, "text": "(Liang, et al., 2023)", "reading_order": 8 }, { "page": 14, "type": "LIST_ITEM", "location": { "l": 75.45, "t": 119.5839, "r": 266.8459, "b": 98.402 }, "text": "Construction noise", "marker": "•", "list_id": "L29", "level": 0, "items": [ { "page": 14, "type": "LIST_ITEM", "location": { "l": 111.45, "t": 96.9481, "r": 327.5811, "b": 79.1178 }, "text": "(e.g., piling and decoration).", "marker": "•", "list_id": "L29", "level": 1, "reading_order": 0 } ], "reading_order": 9 }, { "page": 14, "type": "TITLE", "location": { "l": 36, "t": 76.32, "r": 650.64, "b": 24.96 }, "text": "• As LFN becomes more prominent, its effects on humans intensify\"", "reading_order": 10, "level": 6 } ] }, { "page": 15, "items": [ { "page": 15, "type": "TITLE", "location": { "l": 54.72, "t": 479.04, "r": 403.68, "b": 443.76 }, "text": "Noise: Infrasound", "reading_order": 0, "level": 6 }, { "page": 15, "type": "LIST_ITEM", "location": { "l": 52.32, "t": 393.84, "r": 649.92, "b": 208.8 }, "text": "\"Research on health impact of infrasound is challenging given the ubiquitous nature of infrasound (e.g., from wind, ocean waves, and earth vibrations), and the difficulty in differentiating the actual effects of infrasound from just sensing its presence.\"", "marker": "•", "list_id": "L30", "level": 0, "reading_order": 1 } ] }, { "page": 16, "items": [ { "page": 16, "type": "TITLE", "location": { "l": 43.68, "t": 518.88, "r": 654.24, "b": 485.52 }, "text": "NOISE Pollution: Stress Response", "reading_order": 0, "level": 6 }, { "page": 16, "type": "TEXT", "location": { "l": 30, "t": 473.04, "r": 42.48, "b": 459.36 }, "text": "B", "reading_order": 1 }, { "page": 16, "type": "FIGURE", "location": { "l": 32.16, "t": 474.48, "r": 680.64, "b": 0.96 }, "text": "", "reading_order": 2 }, { "page": 16, "type": "TEXT", "location": { "l": 348, "t": 472.32, "r": 363.84, "b": 455.76 }, "text": "C", "reading_order": 3 } ] }, { "page": 17, "items": [ { "page": 17, "type": "FIGURE", "location": { "l": 66, "t": 496.8, "r": 560.88, "b": 68.88 }, "text": "", "reading_order": 0 } ] }, { "page": 18, "items": [ { "page": 18, "type": "TITLE", "location": { "l": 26.88, "t": 522.72, "r": 586.08, "b": 488.4 }, "text": "Noise: Road Noise & Health", "reading_order": 0, "level": 6 }, { "page": 18, "type": "TITLE", "location": { "l": 5.28, "t": 456.72, "r": 275.76, "b": 387.36 }, "text": "Chen, et al, 2023 Umbrella Review of Systematic Reviews and Meta-analysis", "reading_order": 1, "level": 5 }, { "page": 18, "type": "LIST_ITEM", "location": { "l": 5.76, "t": 383.76, "r": 178.08, "b": 364.08 }, "text": "Associations with:", "marker": "•", "list_id": "L31", "level": 0, "items": [ { "page": 18, "type": "LIST_ITEM", "location": { "l": 41.28, "t": 359.76, "r": 141.84, "b": 339.84 }, "text": "Mortality", "marker": "•", "list_id": "L31", "level": 1, "items": [ { "page": 18, "type": "LIST_ITEM", "location": { "l": 76.32, "t": 337.2, "r": 280.32, "b": 305.52 }, "text": "Stroke, Ischemic Heart Disease, Cardiovascular Disease", "marker": "•", "list_id": "L31", "level": 2, "reading_order": 0 } ], "reading_order": 0 } ], "reading_order": 2 }, { "page": 18, "type": "TITLE", "location": { "l": 41.04, "t": 301.92, "r": 274.08, "b": 282.96 }, "text": "• Cardiovascular Outcomes", "reading_order": 3, "level": 6 }, { "page": 18, "type": "LIST_ITEM", "location": { "l": 76.8, "t": 279.36, "r": 251.28, "b": 247.92 }, "text": "Angina, MI, Hypertension,\nStroke", "marker": "•", "list_id": "L32", "level": 0, "reading_order": 4 }, { "page": 18, "type": "LIST_ITEM", "location": { "l": 76.56, "t": 245.76, "r": 235.92, "b": 214.08 }, "text": "Cardiovascular Disease, Ischemic Heart Disease", "marker": "•", "list_id": "L32", "level": 0, "reading_order": 5 }, { "page": 18, "type": "LIST_ITEM", "location": { "l": 43.2, "t": 213.276, "r": 228.3181, "b": 190.1243 }, "text": "Metabolic Disorders", "marker": "•", "list_id": "L32", "level": 0, "items": [ { "page": 18, "type": "LIST_ITEM", "location": { "l": 79.2, "t": 189.3025, "r": 155.2868, "b": 170.8643 }, "text": "Diabetes", "marker": "•", "list_id": "L32", "level": 1, "reading_order": 0 } ], "reading_order": 6 }, { "page": 18, "type": "LIST_ITEM", "location": { "l": 43.2, "t": 170.076, "r": 254.8571, "b": 146.9243 }, "text": "Neurological Outcomes", "marker": "•", "list_id": "L32", "level": 0, "items": [ { "page": 18, "type": "LIST_ITEM", "location": { "l": 79.2, "t": 146.1024, "r": 229.5712, "b": 127.6643 }, "text": "Depression, Anxiety", "marker": "•", "list_id": "L32", "level": 1, "reading_order": 0 } ], "reading_order": 7 }, { "page": 18, "type": "TITLE", "location": { "l": 41.52, "t": 124.8, "r": 270.96, "b": 104.64 }, "text": "• Maternal/Child Outcome", "reading_order": 8, "level": 6 }, { "page": 18, "type": "LIST_ITEM", "location": { "l": 75.6, "t": 101.52, "r": 264.72, "b": 45.84 }, "text": "Low Birth Weight, Smale for Gestational Age, Preterm Birth", "marker": "•", "list_id": "L33", "level": 0, "reading_order": 9 }, { "page": 18, "type": "TEXT", "location": { "l": 346.08, "t": 456.96, "r": 444.24, "b": 442.32 }, "text": "(Chen, et al., 2023)", "reading_order": 10 }, { "page": 18, "type": "TABLE", "location": { "l": 295.44, "t": 429.36, "r": 720, "b": 125.52 }, "text": "
OutcomeStudyNo. of Cases/TotalExposureRisk Estimates (95% CI)
Mortality
Stroke mortalityCai, 202133528/9126223Dose-response (10dB increase)
Ischemic heart disease mortalityCai, 2021102947/13539101Dose-response (10dB increase)
Non-accidental mortalityCai, 2021512615/9801344Dose-response (10dB increase)
Cardiovascular mortalityCai, 2021170207/916223Dose-response (10dB increase)
Cardiovascular outcomes
Angina pectorisBanerjee, 2014NP/6845Highest vs Lowest
Myocardial infarctionKhosravipour, 202027404/1093405Highest vs Lowest
Blood pressureDzhambov, 201884824/5514555Dose-response (10dB increase)
StrokeDzhambov, 201665855/8790671Dose-response (10dB increase)
Cardiovascular diseaseBanerjee, 2014NP/17707Highest vs Lowest
Ischemic heart diseaseBanerjee, 2014NP/5689Highest vs Lowest
Metabolic disorders
DiabetesSakhvidi, 2018NP/55566Dose-response (5dB increase)
Neurological outcomes
DepressionHegewald, 2020NP/1446218Dose-response (10dB increase)
AnxietyHegewald, 2020NP/576226Dose-response (10dB increase)
Neonatal/infant/child related outcomes
Low birth weightDzhambov, 2019NP/582803Dose-response (10dB increase)
Small-for-gestational ageDzhambov, 2019NP/546256Dose-response (10dB increase)
Preterm birthDzhambov, 2019NP/74609Dose-response (10dB increase)
", "rows": [ { "row_index": 0, "location": [ 295.44, 415.5491, 720, 429.36 ], "cells": [ { "location": [ 295.44, 415.5491, 380.352, 429.36 ], "text": "Outcome", "html_text": "Outcome", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 415.5491, 465.264, 429.36 ], "text": "Study", "html_text": "Study", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 415.5491, 550.176, 429.36 ], "text": "No. of Cases/Total", "html_text": "No. of Cases/Total", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 415.5491, 635.088, 429.36 ], "text": "Exposure", "html_text": "Exposure", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 415.5491, 720, 429.36 ], "text": "Risk Estimates (95% CI)", "html_text": "Risk Estimates (95% CI)", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 1, "location": [ 295.44, 401.7382, 720, 415.5491 ], "cells": [ { "location": [ 295.44, 401.7382, 380.352, 415.5491 ], "text": "Mortality", "html_text": "Mortality", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 401.7382, 465.264, 415.5491 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 401.7382, 550.176, 415.5491 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 401.7382, 635.088, 415.5491 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 401.7382, 720, 415.5491 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 2, "location": [ 295.44, 387.9273, 720, 401.7382 ], "cells": [ { "location": [ 295.44, 387.9273, 380.352, 401.7382 ], "text": "Stroke mortality", "html_text": "Stroke mortality", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 387.9273, 465.264, 401.7382 ], "text": "Cai, 2021", "html_text": "Cai, 2021", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 387.9273, 550.176, 401.7382 ], "text": "33528/9126223", "html_text": "33528/9126223", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 387.9273, 635.088, 401.7382 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 387.9273, 720, 401.7382 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 3, "location": [ 295.44, 374.1164, 720, 387.9273 ], "cells": [ { "location": [ 295.44, 374.1164, 380.352, 387.9273 ], "text": "Ischemic heart disease mortality", "html_text": "Ischemic heart disease mortality", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 374.1164, 465.264, 387.9273 ], "text": "Cai, 2021", "html_text": "Cai, 2021", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 374.1164, 550.176, 387.9273 ], "text": "102947/13539101", "html_text": "102947/13539101", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 374.1164, 635.088, 387.9273 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 374.1164, 720, 387.9273 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 4, "location": [ 295.44, 360.3055, 720, 374.1164 ], "cells": [ { "location": [ 295.44, 360.3055, 380.352, 374.1164 ], "text": "Non-accidental mortality", "html_text": "Non-accidental mortality", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 360.3055, 465.264, 374.1164 ], "text": "Cai, 2021", "html_text": "Cai, 2021", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 360.3055, 550.176, 374.1164 ], "text": "512615/9801344", "html_text": "512615/9801344", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 360.3055, 635.088, 374.1164 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 360.3055, 720, 374.1164 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 5, "location": [ 295.44, 346.4945, 720, 360.3055 ], "cells": [ { "location": [ 295.44, 346.4945, 380.352, 360.3055 ], "text": "Cardiovascular mortality", "html_text": "Cardiovascular mortality", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 346.4945, 465.264, 360.3055 ], "text": "Cai, 2021", "html_text": "Cai, 2021", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 346.4945, 550.176, 360.3055 ], "text": "170207/916223", "html_text": "170207/916223", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 346.4945, 635.088, 360.3055 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 346.4945, 720, 360.3055 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 6, "location": [ 295.44, 332.6836, 720, 346.4945 ], "cells": [ { "location": [ 295.44, 332.6836, 380.352, 346.4945 ], "text": "Cardiovascular outcomes", "html_text": "Cardiovascular outcomes", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 332.6836, 465.264, 346.4945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 332.6836, 550.176, 346.4945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 332.6836, 635.088, 346.4945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 332.6836, 720, 346.4945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 7, "location": [ 295.44, 318.8727, 720, 332.6836 ], "cells": [ { "location": [ 295.44, 318.8727, 380.352, 332.6836 ], "text": "Angina pectoris", "html_text": "Angina pectoris", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 318.8727, 465.264, 332.6836 ], "text": "Banerjee, 2014", "html_text": "Banerjee, 2014", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 318.8727, 550.176, 332.6836 ], "text": "NP/6845", "html_text": "NP/6845", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 318.8727, 635.088, 332.6836 ], "text": "Highest vs Lowest", "html_text": "Highest vs Lowest", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 318.8727, 720, 332.6836 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 8, "location": [ 295.44, 305.0618, 720, 318.8727 ], "cells": [ { "location": [ 295.44, 305.0618, 380.352, 318.8727 ], "text": "Myocardial infarction", "html_text": "Myocardial infarction", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 305.0618, 465.264, 318.8727 ], "text": "Khosravipour, 2020", "html_text": "Khosravipour, 2020", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 305.0618, 550.176, 318.8727 ], "text": "27404/1093405", "html_text": "27404/1093405", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 305.0618, 635.088, 318.8727 ], "text": "Highest vs Lowest", "html_text": "Highest vs Lowest", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 305.0618, 720, 318.8727 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 9, "location": [ 295.44, 291.2509, 720, 305.0618 ], "cells": [ { "location": [ 295.44, 291.2509, 380.352, 305.0618 ], "text": "Blood pressure", "html_text": "Blood pressure", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 291.2509, 465.264, 305.0618 ], "text": "Dzhambov, 2018", "html_text": "Dzhambov, 2018", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 291.2509, 550.176, 305.0618 ], "text": "84824/5514555", "html_text": "84824/5514555", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 291.2509, 635.088, 305.0618 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 291.2509, 720, 305.0618 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 10, "location": [ 295.44, 277.44, 720, 291.2509 ], "cells": [ { "location": [ 295.44, 277.44, 380.352, 291.2509 ], "text": "Stroke", "html_text": "Stroke", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 277.44, 465.264, 291.2509 ], "text": "Dzhambov, 2016", "html_text": "Dzhambov, 2016", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 277.44, 550.176, 291.2509 ], "text": "65855/8790671", "html_text": "65855/8790671", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 277.44, 635.088, 291.2509 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 277.44, 720, 291.2509 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 11, "location": [ 295.44, 263.6291, 720, 277.44 ], "cells": [ { "location": [ 295.44, 263.6291, 380.352, 277.44 ], "text": "Cardiovascular disease", "html_text": "Cardiovascular disease", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 263.6291, 465.264, 277.44 ], "text": "Banerjee, 2014", "html_text": "Banerjee, 2014", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 263.6291, 550.176, 277.44 ], "text": "NP/17707", "html_text": "NP/17707", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 263.6291, 635.088, 277.44 ], "text": "Highest vs Lowest", "html_text": "Highest vs Lowest", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 263.6291, 720, 277.44 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 12, "location": [ 295.44, 249.8182, 720, 263.6291 ], "cells": [ { "location": [ 295.44, 249.8182, 380.352, 263.6291 ], "text": "Ischemic heart disease", "html_text": "Ischemic heart disease", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 249.8182, 465.264, 263.6291 ], "text": "Banerjee, 2014", "html_text": "Banerjee, 2014", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 249.8182, 550.176, 263.6291 ], "text": "NP/5689", "html_text": "NP/5689", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 249.8182, 635.088, 263.6291 ], "text": "Highest vs Lowest", "html_text": "Highest vs Lowest", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 249.8182, 720, 263.6291 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 13, "location": [ 295.44, 236.0073, 720, 249.8182 ], "cells": [ { "location": [ 295.44, 236.0073, 380.352, 249.8182 ], "text": "Metabolic disorders", "html_text": "Metabolic disorders", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 236.0073, 465.264, 249.8182 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 236.0073, 550.176, 249.8182 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 236.0073, 635.088, 249.8182 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 236.0073, 720, 249.8182 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 14, "location": [ 295.44, 222.1964, 720, 236.0073 ], "cells": [ { "location": [ 295.44, 222.1964, 380.352, 236.0073 ], "text": "Diabetes", "html_text": "Diabetes", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 222.1964, 465.264, 236.0073 ], "text": "Sakhvidi, 2018", "html_text": "Sakhvidi, 2018", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 222.1964, 550.176, 236.0073 ], "text": "NP/55566", "html_text": "NP/55566", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 222.1964, 635.088, 236.0073 ], "text": "Dose-response (5dB increase)", "html_text": "Dose-response (5dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 222.1964, 720, 236.0073 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 15, "location": [ 295.44, 208.3855, 720, 222.1964 ], "cells": [ { "location": [ 295.44, 208.3855, 380.352, 222.1964 ], "text": "Neurological outcomes", "html_text": "Neurological outcomes", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 208.3855, 465.264, 222.1964 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 208.3855, 550.176, 222.1964 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 208.3855, 635.088, 222.1964 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 208.3855, 720, 222.1964 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 16, "location": [ 295.44, 194.5745, 720, 208.3855 ], "cells": [ { "location": [ 295.44, 194.5745, 380.352, 208.3855 ], "text": "Depression", "html_text": "Depression", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 194.5745, 465.264, 208.3855 ], "text": "Hegewald, 2020", "html_text": "Hegewald, 2020", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 194.5745, 550.176, 208.3855 ], "text": "NP/1446218", "html_text": "NP/1446218", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 194.5745, 635.088, 208.3855 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 194.5745, 720, 208.3855 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 17, "location": [ 295.44, 180.7636, 720, 194.5745 ], "cells": [ { "location": [ 295.44, 180.7636, 380.352, 194.5745 ], "text": "Anxiety", "html_text": "Anxiety", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 180.7636, 465.264, 194.5745 ], "text": "Hegewald, 2020", "html_text": "Hegewald, 2020", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 180.7636, 550.176, 194.5745 ], "text": "NP/576226", "html_text": "NP/576226", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 180.7636, 635.088, 194.5745 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 180.7636, 720, 194.5745 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 18, "location": [ 295.44, 166.9527, 720, 180.7636 ], "cells": [ { "location": [ 295.44, 166.9527, 380.352, 180.7636 ], "text": "Neonatal/infant/child related outcomes", "html_text": "Neonatal/infant/child related outcomes", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 166.9527, 465.264, 180.7636 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 166.9527, 550.176, 180.7636 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 166.9527, 635.088, 180.7636 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 166.9527, 720, 180.7636 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 19, "location": [ 295.44, 153.1418, 720, 166.9527 ], "cells": [ { "location": [ 295.44, 153.1418, 380.352, 166.9527 ], "text": "Low birth weight", "html_text": "Low birth weight", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 153.1418, 465.264, 166.9527 ], "text": "Dzhambov, 2019", "html_text": "Dzhambov, 2019", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 153.1418, 550.176, 166.9527 ], "text": "NP/582803", "html_text": "NP/582803", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 153.1418, 635.088, 166.9527 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 153.1418, 720, 166.9527 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 20, "location": [ 295.44, 139.3309, 720, 153.1418 ], "cells": [ { "location": [ 295.44, 139.3309, 380.352, 153.1418 ], "text": "Small-for-gestational age", "html_text": "Small-for-gestational age", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 139.3309, 465.264, 153.1418 ], "text": "Dzhambov, 2019", "html_text": "Dzhambov, 2019", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 139.3309, 550.176, 153.1418 ], "text": "NP/546256", "html_text": "NP/546256", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 139.3309, 635.088, 153.1418 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 139.3309, 720, 153.1418 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 21, "location": [ 295.44, 125.52, 720, 139.3309 ], "cells": [ { "location": [ 295.44, 125.52, 380.352, 139.3309 ], "text": "Preterm birth", "html_text": "Preterm birth", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 380.352, 125.52, 465.264, 139.3309 ], "text": "Dzhambov, 2019", "html_text": "Dzhambov, 2019", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 465.264, 125.52, 550.176, 139.3309 ], "text": "NP/74609", "html_text": "NP/74609", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 550.176, 125.52, 635.088, 139.3309 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 635.088, 125.52, 720, 139.3309 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 22, "n_cols": 5, "ref": "#/tables/0", "reading_order": 11 }, { "page": 18, "type": "TEXT", "location": { "l": 695.04, "t": 125.28, "r": 719.04, "b": 116.4 }, "text": "0.8112", "reading_order": 12 } ] }, { "page": 19, "items": [ { "page": 19, "type": "TEXT", "location": { "l": 21.36, "t": 518.64, "r": 682.08, "b": 471.6 }, "text": "Chen, et al, 2023 Umbrella Review of Systematic Reviews and Meta-analysis\nNOTE: Varying Levels of Study Quality and Very Low to Low Quality of Evidence", "reading_order": 0 }, { "page": 19, "type": "TEXT", "location": { "l": 374.88, "t": 458.16, "r": 415.59, "b": 440.8376 }, "text": "Risk sites (95%CI)", "reading_order": 1 }, { "page": 19, "type": "FIGURE", "location": { "l": 0, "t": 457.92, "r": 701.04, "b": 165.36 }, "text": "", "reading_order": 2 }, { "page": 19, "type": "TABLE", "location": { "l": 0, "t": 456.48, "r": 369.84, "b": 172.8 }, "text": "
OutcomeStudyNo. of Cases/TotalExposureEstim
Mortality
Stroke mortalityCai, 202133528/9126223Dose-response (10dB increase)
Ischemic heart disease mortalityCai, 2021102947/13539101Dose-response (10dB increase)
Non-accidental mortalityCai, 2021512615/9801344Dose-response (10dB increase)
Cardiovascular mortalityCai, 2021170207/916223Dose-response (10dB increase)
Cardiovascular outcomes
Angina pectorisBanerjee, 2014NP/6845Highest vs Lowest
Myocardial infarctionKhosravipour, 202027404/1093405Highest vs Lowest
Blood pressureDzhambov, 201884824/5514555Dose-response (10dB increase)
StrokeDzhambov, 201665855/8790671Dose-response (10dB increase)
Cardiovascular diseaseBanerjee, 2014NP/17707Highest vs Lowest
Ischemic heart diseaseBanerjee, 2014NP/5689Highest vs Lowest
Metabolic disorders
DiabetesSakhvidi, 2018NP/55566Dose-response (5dB increase)
Neurological outcomes
DepressionHegewald, 2020NP/1446218Dose-response (10dB increase)
AnxietyHegewald, 2020NP/576226Dose-response (10dB increase)
Neonatal/infant/child related outcomes
Low birth weightDzhambov, 2019NP/582803Dose-response (10dB increase)
Small-for-gestational-ageDzhambov, 2019NP/546256Dose-response (10dB increase)
Preterm birthDzhambov, 2019NP/74609Dose-response (10dB increase)
", "rows": [ { "row_index": 0, "location": [ 0, 443.5855, 369.84, 456.48 ], "cells": [ { "location": [ 0, 443.5855, 73.968, 456.48 ], "text": "Outcome", "html_text": "Outcome", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 443.5855, 147.936, 456.48 ], "text": "Study", "html_text": "Study", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 443.5855, 221.904, 456.48 ], "text": "No. of Cases/Total", "html_text": "No. of Cases/Total", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 443.5855, 295.872, 456.48 ], "text": "Exposure", "html_text": "Exposure", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 443.5855, 369.84, 456.48 ], "text": "Estim", "html_text": "Estim", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 1, "location": [ 0, 430.6909, 369.84, 443.5855 ], "cells": [ { "location": [ 0, 430.6909, 73.968, 443.5855 ], "text": "Mortality", "html_text": "Mortality", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 430.6909, 147.936, 443.5855 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 430.6909, 221.904, 443.5855 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 430.6909, 295.872, 443.5855 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 430.6909, 369.84, 443.5855 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 2, "location": [ 0, 417.7964, 369.84, 430.6909 ], "cells": [ { "location": [ 0, 417.7964, 73.968, 430.6909 ], "text": "Stroke mortality", "html_text": "Stroke mortality", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 417.7964, 147.936, 430.6909 ], "text": "Cai, 2021", "html_text": "Cai, 2021", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 417.7964, 221.904, 430.6909 ], "text": "33528/9126223", "html_text": "33528/9126223", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 417.7964, 295.872, 430.6909 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 417.7964, 369.84, 430.6909 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 3, "location": [ 0, 404.9018, 369.84, 417.7964 ], "cells": [ { "location": [ 0, 404.9018, 73.968, 417.7964 ], "text": "Ischemic heart disease mortality", "html_text": "Ischemic heart disease mortality", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 404.9018, 147.936, 417.7964 ], "text": "Cai, 2021", "html_text": "Cai, 2021", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 404.9018, 221.904, 417.7964 ], "text": "102947/13539101", "html_text": "102947/13539101", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 404.9018, 295.872, 417.7964 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 404.9018, 369.84, 417.7964 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 4, "location": [ 0, 392.0073, 369.84, 404.9018 ], "cells": [ { "location": [ 0, 392.0073, 73.968, 404.9018 ], "text": "Non-accidental mortality", "html_text": "Non-accidental mortality", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 392.0073, 147.936, 404.9018 ], "text": "Cai, 2021", "html_text": "Cai, 2021", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 392.0073, 221.904, 404.9018 ], "text": "512615/9801344", "html_text": "512615/9801344", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 392.0073, 295.872, 404.9018 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 392.0073, 369.84, 404.9018 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 5, "location": [ 0, 379.1127, 369.84, 392.0073 ], "cells": [ { "location": [ 0, 379.1127, 73.968, 392.0073 ], "text": "Cardiovascular mortality", "html_text": "Cardiovascular mortality", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 379.1127, 147.936, 392.0073 ], "text": "Cai, 2021", "html_text": "Cai, 2021", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 379.1127, 221.904, 392.0073 ], "text": "170207/916223", "html_text": "170207/916223", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 379.1127, 295.872, 392.0073 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 379.1127, 369.84, 392.0073 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 6, "location": [ 0, 366.2182, 369.84, 379.1127 ], "cells": [ { "location": [ 0, 366.2182, 73.968, 379.1127 ], "text": "Cardiovascular outcomes", "html_text": "Cardiovascular outcomes", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 366.2182, 147.936, 379.1127 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 366.2182, 221.904, 379.1127 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 366.2182, 295.872, 379.1127 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 366.2182, 369.84, 379.1127 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 7, "location": [ 0, 353.3236, 369.84, 366.2182 ], "cells": [ { "location": [ 0, 353.3236, 73.968, 366.2182 ], "text": "Angina pectoris", "html_text": "Angina pectoris", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 353.3236, 147.936, 366.2182 ], "text": "Banerjee, 2014", "html_text": "Banerjee, 2014", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 353.3236, 221.904, 366.2182 ], "text": "NP/6845", "html_text": "NP/6845", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 353.3236, 295.872, 366.2182 ], "text": "Highest vs Lowest", "html_text": "Highest vs Lowest", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 353.3236, 369.84, 366.2182 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 8, "location": [ 0, 340.4291, 369.84, 353.3236 ], "cells": [ { "location": [ 0, 340.4291, 73.968, 353.3236 ], "text": "Myocardial infarction", "html_text": "Myocardial infarction", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 340.4291, 147.936, 353.3236 ], "text": "Khosravipour, 2020", "html_text": "Khosravipour, 2020", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 340.4291, 221.904, 353.3236 ], "text": "27404/1093405", "html_text": "27404/1093405", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 340.4291, 295.872, 353.3236 ], "text": "Highest vs Lowest", "html_text": "Highest vs Lowest", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 340.4291, 369.84, 353.3236 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 9, "location": [ 0, 327.5345, 369.84, 340.4291 ], "cells": [ { "location": [ 0, 327.5345, 73.968, 340.4291 ], "text": "Blood pressure", "html_text": "Blood pressure", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 327.5345, 147.936, 340.4291 ], "text": "Dzhambov, 2018", "html_text": "Dzhambov, 2018", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 327.5345, 221.904, 340.4291 ], "text": "84824/5514555", "html_text": "84824/5514555", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 327.5345, 295.872, 340.4291 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 327.5345, 369.84, 340.4291 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 10, "location": [ 0, 314.64, 369.84, 327.5345 ], "cells": [ { "location": [ 0, 314.64, 73.968, 327.5345 ], "text": "Stroke", "html_text": "Stroke", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 314.64, 147.936, 327.5345 ], "text": "Dzhambov, 2016", "html_text": "Dzhambov, 2016", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 314.64, 221.904, 327.5345 ], "text": "65855/8790671", "html_text": "65855/8790671", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 314.64, 295.872, 327.5345 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 314.64, 369.84, 327.5345 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 11, "location": [ 0, 301.7455, 369.84, 314.64 ], "cells": [ { "location": [ 0, 301.7455, 73.968, 314.64 ], "text": "Cardiovascular disease", "html_text": "Cardiovascular disease", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 301.7455, 147.936, 314.64 ], "text": "Banerjee, 2014", "html_text": "Banerjee, 2014", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 301.7455, 221.904, 314.64 ], "text": "NP/17707", "html_text": "NP/17707", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 301.7455, 295.872, 314.64 ], "text": "Highest vs Lowest", "html_text": "Highest vs Lowest", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 301.7455, 369.84, 314.64 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 12, "location": [ 0, 288.8509, 369.84, 301.7455 ], "cells": [ { "location": [ 0, 288.8509, 73.968, 301.7455 ], "text": "Ischemic heart disease", "html_text": "Ischemic heart disease", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 288.8509, 147.936, 301.7455 ], "text": "Banerjee, 2014", "html_text": "Banerjee, 2014", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 288.8509, 221.904, 301.7455 ], "text": "NP/5689", "html_text": "NP/5689", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 288.8509, 295.872, 301.7455 ], "text": "Highest vs Lowest", "html_text": "Highest vs Lowest", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 288.8509, 369.84, 301.7455 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 13, "location": [ 0, 275.9564, 369.84, 288.8509 ], "cells": [ { "location": [ 0, 275.9564, 73.968, 288.8509 ], "text": "Metabolic disorders", "html_text": "Metabolic disorders", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 275.9564, 147.936, 288.8509 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 275.9564, 221.904, 288.8509 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 275.9564, 295.872, 288.8509 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 275.9564, 369.84, 288.8509 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 14, "location": [ 0, 263.0618, 369.84, 275.9564 ], "cells": [ { "location": [ 0, 263.0618, 73.968, 275.9564 ], "text": "Diabetes", "html_text": "Diabetes", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 263.0618, 147.936, 275.9564 ], "text": "Sakhvidi, 2018", "html_text": "Sakhvidi, 2018", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 263.0618, 221.904, 275.9564 ], "text": "NP/55566", "html_text": "NP/55566", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 263.0618, 295.872, 275.9564 ], "text": "Dose-response (5dB increase)", "html_text": "Dose-response (5dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 263.0618, 369.84, 275.9564 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 15, "location": [ 0, 250.1673, 369.84, 263.0618 ], "cells": [ { "location": [ 0, 250.1673, 73.968, 263.0618 ], "text": "Neurological outcomes", "html_text": "Neurological outcomes", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 250.1673, 147.936, 263.0618 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 250.1673, 221.904, 263.0618 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 250.1673, 295.872, 263.0618 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 250.1673, 369.84, 263.0618 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 16, "location": [ 0, 237.2727, 369.84, 250.1673 ], "cells": [ { "location": [ 0, 237.2727, 73.968, 250.1673 ], "text": "Depression", "html_text": "Depression", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 237.2727, 147.936, 250.1673 ], "text": "Hegewald, 2020", "html_text": "Hegewald, 2020", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 237.2727, 221.904, 250.1673 ], "text": "NP/1446218", "html_text": "NP/1446218", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 237.2727, 295.872, 250.1673 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 237.2727, 369.84, 250.1673 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 17, "location": [ 0, 224.3782, 369.84, 237.2727 ], "cells": [ { "location": [ 0, 224.3782, 73.968, 237.2727 ], "text": "Anxiety", "html_text": "Anxiety", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 224.3782, 147.936, 237.2727 ], "text": "Hegewald, 2020", "html_text": "Hegewald, 2020", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 224.3782, 221.904, 237.2727 ], "text": "NP/576226", "html_text": "NP/576226", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 224.3782, 295.872, 237.2727 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 224.3782, 369.84, 237.2727 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 18, "location": [ 0, 211.4836, 369.84, 224.3782 ], "cells": [ { "location": [ 0, 211.4836, 73.968, 224.3782 ], "text": "Neonatal/infant/child related outcomes", "html_text": "Neonatal/infant/child related outcomes", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 211.4836, 147.936, 224.3782 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 211.4836, 221.904, 224.3782 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 211.4836, 295.872, 224.3782 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 211.4836, 369.84, 224.3782 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 19, "location": [ 0, 198.5891, 369.84, 211.4836 ], "cells": [ { "location": [ 0, 198.5891, 73.968, 211.4836 ], "text": "Low birth weight", "html_text": "Low birth weight", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 198.5891, 147.936, 211.4836 ], "text": "Dzhambov, 2019", "html_text": "Dzhambov, 2019", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 198.5891, 221.904, 211.4836 ], "text": "NP/582803", "html_text": "NP/582803", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 198.5891, 295.872, 211.4836 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 198.5891, 369.84, 211.4836 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 20, "location": [ 0, 185.6945, 369.84, 198.5891 ], "cells": [ { "location": [ 0, 185.6945, 73.968, 198.5891 ], "text": "Small-for-gestational-age", "html_text": "Small-for-gestational-age", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 185.6945, 147.936, 198.5891 ], "text": "Dzhambov, 2019", "html_text": "Dzhambov, 2019", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 185.6945, 221.904, 198.5891 ], "text": "NP/546256", "html_text": "NP/546256", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 185.6945, 295.872, 198.5891 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 185.6945, 369.84, 198.5891 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 21, "location": [ 0, 172.8, 369.84, 185.6945 ], "cells": [ { "location": [ 0, 172.8, 73.968, 185.6945 ], "text": "Preterm birth", "html_text": "Preterm birth", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 73.968, 172.8, 147.936, 185.6945 ], "text": "Dzhambov, 2019", "html_text": "Dzhambov, 2019", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 147.936, 172.8, 221.904, 185.6945 ], "text": "NP/74609", "html_text": "NP/74609", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 221.904, 172.8, 295.872, 185.6945 ], "text": "Dose-response (10dB increase)", "html_text": "Dose-response (10dB increase)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 295.872, 172.8, 369.84, 185.6945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" } ], "n_rows": 22, "n_cols": 5, "ref": "#/tables/1", "reading_order": 3 }, { "page": 19, "type": "TABLE", "location": { "l": 415.59, "t": 458.16, "r": 700.56, "b": 163.68 }, "text": "
Risk sites (95%CI)Estimates (95%CI)Co/CC/CS/ Total studiesτ2β2Egger test valueAMSTAR 2GRADE
1.05 (0.97,1.13)4/0/1/50.00462.4%0.223ModerateVery low
1.03 (0.99,1.06)5/1/1/70.00145.0%0.975ModerateLow
1.01 (0.98,1.05)4/0/1/50.00177.8%0.480ModerateVery low
1.02 (0.98,1.06)4/0/1/50.00141.0%0.781ModerateLow
1.23 (0.80,1.89)0/0/3/30.09768.3%0.483Very lowVery low
1.06 (0.96,1.16)4/6/0/100.00313.0%0.954ModerateLow
1.02 (1.00,1.05)11/3/0/140.00149.1%0.577ModerateModerate
1.02 (0.98,1.06)3/0/3/60.00185.5%0.904ModerateVery low
1.06 (0.96,1.18)0/16/160.00410.3%0.740Very lowVery low
1.00 (0.79,1.27)0/0/3/30.01739.2%0.104Very lowVery low
1.07 (1.02,1.13)3/0/0/30.00137.0%0.708ModerateVery low
1.02 (0.99,1.06)1/1/9/110.00158.8%0.915HighVery low
1.02 (0.98,1.06)3/0/5/80.00262.6%0.384HighVery low
1.08 (0.96,1.21)5/0/2/70.00848.0%0.351ModerateLow
1.07 (0.95,1.20)3/0/2/50.01089.5%0.491ModerateVery low
0.96 (0.82,1.12)2/1/2/50.02068.9%0.562ModerateVery low
", "rows": [ { "row_index": 0, "location": [ 374.88, 440.8376, 700.56, 458.16 ], "cells": [ { "location": [ 415.59, 440.8376, 456.3, 458.16 ], "text": "Estimates (95%CI)", "html_text": "Estimates (95%CI)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 440.8376, 497.01, 458.16 ], "text": "Co/CC/CS/ Total studies", "html_text": "Co/CC/CS/ Total studies", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 440.8376, 537.72, 458.16 ], "text": "τ2", "html_text": "τ2", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 440.8376, 578.43, 458.16 ], "text": "β2", "html_text": "β2", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 440.8376, 619.14, 458.16 ], "text": "Egger test value", "html_text": "Egger test value", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 440.8376, 659.85, 458.16 ], "text": "AMSTAR 2", "html_text": "AMSTAR 2", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 440.8376, 700.56, 458.16 ], "text": "GRADE", "html_text": "GRADE", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 1, "location": [ 374.88, 423.5153, 700.56, 440.8376 ], "cells": [ { "location": [ 415.59, 423.5153, 456.3, 440.8376 ], "text": "1.05 (0.97,1.13)", "html_text": "1.05 (0.97,1.13)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 423.5153, 497.01, 440.8376 ], "text": "4/0/1/5", "html_text": "4/0/1/5", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 423.5153, 537.72, 440.8376 ], "text": "0.004", "html_text": "0.004", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 423.5153, 578.43, 440.8376 ], "text": "62.4%", "html_text": "62.4%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 423.5153, 619.14, 440.8376 ], "text": "0.223", "html_text": "0.223", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 423.5153, 659.85, 440.8376 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 423.5153, 700.56, 440.8376 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 2, "location": [ 374.88, 406.1929, 700.56, 423.5153 ], "cells": [ { "location": [ 415.59, 406.1929, 456.3, 423.5153 ], "text": "1.03 (0.99,1.06)", "html_text": "1.03 (0.99,1.06)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 406.1929, 497.01, 423.5153 ], "text": "5/1/1/7", "html_text": "5/1/1/7", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 406.1929, 537.72, 423.5153 ], "text": "0.001", "html_text": "0.001", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 406.1929, 578.43, 423.5153 ], "text": "45.0%", "html_text": "45.0%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 406.1929, 619.14, 423.5153 ], "text": "0.975", "html_text": "0.975", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 406.1929, 659.85, 423.5153 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 406.1929, 700.56, 423.5153 ], "text": "Low", "html_text": "Low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 3, "location": [ 374.88, 388.8706, 700.56, 406.1929 ], "cells": [ { "location": [ 415.59, 388.8706, 456.3, 406.1929 ], "text": "1.01 (0.98,1.05)", "html_text": "1.01 (0.98,1.05)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 388.8706, 497.01, 406.1929 ], "text": "4/0/1/5", "html_text": "4/0/1/5", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 388.8706, 537.72, 406.1929 ], "text": "0.001", "html_text": "0.001", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 388.8706, 578.43, 406.1929 ], "text": "77.8%", "html_text": "77.8%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 388.8706, 619.14, 406.1929 ], "text": "0.480", "html_text": "0.480", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 388.8706, 659.85, 406.1929 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 388.8706, 700.56, 406.1929 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 4, "location": [ 374.88, 371.5482, 700.56, 388.8706 ], "cells": [ { "location": [ 415.59, 371.5482, 456.3, 388.8706 ], "text": "1.02 (0.98,1.06)", "html_text": "1.02 (0.98,1.06)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 371.5482, 497.01, 388.8706 ], "text": "4/0/1/5", "html_text": "4/0/1/5", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 371.5482, 537.72, 388.8706 ], "text": "0.001", "html_text": "0.001", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 371.5482, 578.43, 388.8706 ], "text": "41.0%", "html_text": "41.0%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 371.5482, 619.14, 388.8706 ], "text": "0.781", "html_text": "0.781", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 371.5482, 659.85, 388.8706 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 371.5482, 700.56, 388.8706 ], "text": "Low", "html_text": "Low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 5, "location": [ 374.88, 354.2259, 700.56, 371.5482 ], "cells": [ { "location": [ 415.59, 354.2259, 456.3, 371.5482 ], "text": "1.23 (0.80,1.89)", "html_text": "1.23 (0.80,1.89)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 354.2259, 497.01, 371.5482 ], "text": "0/0/3/3", "html_text": "0/0/3/3", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 354.2259, 537.72, 371.5482 ], "text": "0.097", "html_text": "0.097", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 354.2259, 578.43, 371.5482 ], "text": "68.3%", "html_text": "68.3%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 354.2259, 619.14, 371.5482 ], "text": "0.483", "html_text": "0.483", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 354.2259, 659.85, 371.5482 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 354.2259, 700.56, 371.5482 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 6, "location": [ 374.88, 336.9035, 700.56, 354.2259 ], "cells": [ { "location": [ 415.59, 336.9035, 456.3, 354.2259 ], "text": "1.06 (0.96,1.16)", "html_text": "1.06 (0.96,1.16)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 336.9035, 497.01, 354.2259 ], "text": "4/6/0/10", "html_text": "4/6/0/10", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 336.9035, 537.72, 354.2259 ], "text": "0.003", "html_text": "0.003", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 336.9035, 578.43, 354.2259 ], "text": "13.0%", "html_text": "13.0%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 336.9035, 619.14, 354.2259 ], "text": "0.954", "html_text": "0.954", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 336.9035, 659.85, 354.2259 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 336.9035, 700.56, 354.2259 ], "text": "Low", "html_text": "Low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 7, "location": [ 374.88, 319.5812, 700.56, 336.9035 ], "cells": [ { "location": [ 415.59, 319.5812, 456.3, 336.9035 ], "text": "1.02 (1.00,1.05)", "html_text": "1.02 (1.00,1.05)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 319.5812, 497.01, 336.9035 ], "text": "11/3/0/14", "html_text": "11/3/0/14", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 319.5812, 537.72, 336.9035 ], "text": "0.001", "html_text": "0.001", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 319.5812, 578.43, 336.9035 ], "text": "49.1%", "html_text": "49.1%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 319.5812, 619.14, 336.9035 ], "text": "0.577", "html_text": "0.577", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 319.5812, 659.85, 336.9035 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 319.5812, 700.56, 336.9035 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 8, "location": [ 374.88, 302.2588, 700.56, 319.5812 ], "cells": [ { "location": [ 415.59, 302.2588, 456.3, 319.5812 ], "text": "1.02 (0.98,1.06)", "html_text": "1.02 (0.98,1.06)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 302.2588, 497.01, 319.5812 ], "text": "3/0/3/6", "html_text": "3/0/3/6", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 302.2588, 537.72, 319.5812 ], "text": "0.001", "html_text": "0.001", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 302.2588, 578.43, 319.5812 ], "text": "85.5%", "html_text": "85.5%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 302.2588, 619.14, 319.5812 ], "text": "0.904", "html_text": "0.904", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 302.2588, 659.85, 319.5812 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 302.2588, 700.56, 319.5812 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 9, "location": [ 374.88, 284.9365, 700.56, 302.2588 ], "cells": [ { "location": [ 415.59, 284.9365, 456.3, 302.2588 ], "text": "1.06 (0.96,1.18)", "html_text": "1.06 (0.96,1.18)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 284.9365, 497.01, 302.2588 ], "text": "0/16/16", "html_text": "0/16/16", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 284.9365, 537.72, 302.2588 ], "text": "0.004", "html_text": "0.004", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 284.9365, 578.43, 302.2588 ], "text": "10.3%", "html_text": "10.3%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 284.9365, 619.14, 302.2588 ], "text": "0.740", "html_text": "0.740", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 284.9365, 659.85, 302.2588 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 284.9365, 700.56, 302.2588 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 10, "location": [ 374.88, 267.6141, 700.56, 284.9365 ], "cells": [ { "location": [ 415.59, 267.6141, 456.3, 284.9365 ], "text": "1.00 (0.79,1.27)", "html_text": "1.00 (0.79,1.27)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 267.6141, 497.01, 284.9365 ], "text": "0/0/3/3", "html_text": "0/0/3/3", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 267.6141, 537.72, 284.9365 ], "text": "0.017", "html_text": "0.017", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 267.6141, 578.43, 284.9365 ], "text": "39.2%", "html_text": "39.2%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 267.6141, 619.14, 284.9365 ], "text": "0.104", "html_text": "0.104", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 267.6141, 659.85, 284.9365 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 267.6141, 700.56, 284.9365 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 11, "location": [ 374.88, 250.2918, 700.56, 267.6141 ], "cells": [ { "location": [ 415.59, 250.2918, 456.3, 267.6141 ], "text": "1.07 (1.02,1.13)", "html_text": "1.07 (1.02,1.13)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 250.2918, 497.01, 267.6141 ], "text": "3/0/0/3", "html_text": "3/0/0/3", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 250.2918, 537.72, 267.6141 ], "text": "0.001", "html_text": "0.001", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 250.2918, 578.43, 267.6141 ], "text": "37.0%", "html_text": "37.0%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 250.2918, 619.14, 267.6141 ], "text": "0.708", "html_text": "0.708", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 250.2918, 659.85, 267.6141 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 250.2918, 700.56, 267.6141 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 12, "location": [ 374.88, 232.9694, 700.56, 250.2918 ], "cells": [ { "location": [ 415.59, 232.9694, 456.3, 250.2918 ], "text": "1.02 (0.99,1.06)", "html_text": "1.02 (0.99,1.06)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 232.9694, 497.01, 250.2918 ], "text": "1/1/9/11", "html_text": "1/1/9/11", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 232.9694, 537.72, 250.2918 ], "text": "0.001", "html_text": "0.001", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 232.9694, 578.43, 250.2918 ], "text": "58.8%", "html_text": "58.8%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 232.9694, 619.14, 250.2918 ], "text": "0.915", "html_text": "0.915", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 232.9694, 659.85, 250.2918 ], "text": "High", "html_text": "High", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 232.9694, 700.56, 250.2918 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 13, "location": [ 374.88, 215.6471, 700.56, 232.9694 ], "cells": [ { "location": [ 415.59, 215.6471, 456.3, 232.9694 ], "text": "1.02 (0.98,1.06)", "html_text": "1.02 (0.98,1.06)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 215.6471, 497.01, 232.9694 ], "text": "3/0/5/8", "html_text": "3/0/5/8", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 215.6471, 537.72, 232.9694 ], "text": "0.002", "html_text": "0.002", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 215.6471, 578.43, 232.9694 ], "text": "62.6%", "html_text": "62.6%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 215.6471, 619.14, 232.9694 ], "text": "0.384", "html_text": "0.384", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 215.6471, 659.85, 232.9694 ], "text": "High", "html_text": "High", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 215.6471, 700.56, 232.9694 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 14, "location": [ 374.88, 198.3247, 700.56, 215.6471 ], "cells": [ { "location": [ 415.59, 198.3247, 456.3, 215.6471 ], "text": "1.08 (0.96,1.21)", "html_text": "1.08 (0.96,1.21)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 198.3247, 497.01, 215.6471 ], "text": "5/0/2/7", "html_text": "5/0/2/7", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 198.3247, 537.72, 215.6471 ], "text": "0.008", "html_text": "0.008", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 198.3247, 578.43, 215.6471 ], "text": "48.0%", "html_text": "48.0%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 198.3247, 619.14, 215.6471 ], "text": "0.351", "html_text": "0.351", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 198.3247, 659.85, 215.6471 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 198.3247, 700.56, 215.6471 ], "text": "Low", "html_text": "Low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 15, "location": [ 374.88, 181.0024, 700.56, 198.3247 ], "cells": [ { "location": [ 415.59, 181.0024, 456.3, 198.3247 ], "text": "1.07 (0.95,1.20)", "html_text": "1.07 (0.95,1.20)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 181.0024, 497.01, 198.3247 ], "text": "3/0/2/5", "html_text": "3/0/2/5", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 181.0024, 537.72, 198.3247 ], "text": "0.010", "html_text": "0.010", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 181.0024, 578.43, 198.3247 ], "text": "89.5%", "html_text": "89.5%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 181.0024, 619.14, 198.3247 ], "text": "0.491", "html_text": "0.491", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 181.0024, 659.85, 198.3247 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 181.0024, 700.56, 198.3247 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 16, "location": [ 374.88, 163.68, 700.56, 181.0024 ], "cells": [ { "location": [ 415.59, 163.68, 456.3, 181.0024 ], "text": "0.96 (0.82,1.12)", "html_text": "0.96 (0.82,1.12)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 456.3, 163.68, 497.01, 181.0024 ], "text": "2/1/2/5", "html_text": "2/1/2/5", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 497.01, 163.68, 537.72, 181.0024 ], "text": "0.020", "html_text": "0.020", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 537.72, 163.68, 578.43, 181.0024 ], "text": "68.9%", "html_text": "68.9%", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 578.43, 163.68, 619.14, 181.0024 ], "text": "0.562", "html_text": "0.562", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.14, 163.68, 659.85, 181.0024 ], "text": "Moderate", "html_text": "Moderate", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 659.85, 163.68, 700.56, 181.0024 ], "text": "Very low", "html_text": "Very low", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 17, "n_cols": 7, "ref": "#/tables/0", "reading_order": 4 }, { "page": 19, "type": "LIST_ITEM", "location": { "l": 180.72, "t": 144, "r": 555.36, "b": 116.16 }, "text": "AMSTAR 2 as a measurement tool to assess the methodological quality of systematic reviews", "marker": "•", "list_id": "L34", "level": 0, "reading_order": 5 }, { "page": 19, "type": "LIST_ITEM", "location": { "l": 180.96, "t": 114.96, "r": 440.16, "b": 101.04 }, "text": "GRADE tool to evaluate the quality of evidence.", "marker": "•", "list_id": "L34", "level": 0, "reading_order": 6 }, { "page": 19, "type": "TEXT", "location": { "l": 165.12, "t": 76.8, "r": 564, "b": 57.36 }, "text": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11314258/", "links": [ { "uri": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11314258/", "dest": null, "action_type": "/URI", "bbox": [ 169.44, 58.08, 562.2, 74.28 ] } ], "reading_order": 7 }, { "page": 19, "type": "TEXT", "location": { "l": 324.24, "t": 44.16, "r": 421.68, "b": 29.04 }, "text": "(Chen, et al., 2023)", "reading_order": 8 } ] }, { "page": 20, "items": [ { "page": 20, "type": "TITLE", "location": { "l": 29.28, "t": 500.4, "r": 586.56, "b": 464.88 }, "text": "Noise: Road Noise & Health", "reading_order": 0, "level": 6 }, { "page": 20, "type": "TITLE", "location": { "l": 33.84, "t": 440.4, "r": 266.88, "b": 415.44 }, "text": "• Associations with:", "reading_order": 1, "level": 6 }, { "page": 20, "type": "LIST_ITEM", "location": { "l": 69.84, "t": 414, "r": 166.8, "b": 391.92 }, "text": "Stroke", "marker": "•", "list_id": "L35", "level": 0, "reading_order": 2 }, { "page": 20, "type": "LIST_ITEM", "location": { "l": 69.6, "t": 389.28, "r": 371.76, "b": 365.28 }, "text": "Coronary Artery Disease", "marker": "•", "list_id": "L35", "level": 0, "reading_order": 3 }, { "page": 20, "type": "LIST_ITEM", "location": { "l": 69.6, "t": 363.6, "r": 222.24, "b": 340.08 }, "text": "Depression", "marker": "•", "list_id": "L35", "level": 0, "reading_order": 4 }, { "page": 20, "type": "LIST_ITEM", "location": { "l": 69.6, "t": 338.64, "r": 178.32, "b": 313.44 }, "text": "Anxiety", "marker": "•", "list_id": "L35", "level": 0, "reading_order": 5 }, { "page": 20, "type": "TEXT", "location": { "l": 250.8, "t": 313.44, "r": 379.44, "b": 297.12 }, "text": "(Munzel, et al., 2023)", "reading_order": 6 }, { "page": 20, "type": "TEXT", "location": { "l": 589.68, "t": 294.72, "r": 679.92, "b": 248.208 }, "text": "C 2018 WHO Environmental noise guidelines", "reading_order": 7 }, { "page": 20, "type": "TEXT", "location": { "l": 589.68, "t": 248.208, "r": 679.92, "b": 201.696 }, "text": "Chronic noise exposure", "reading_order": 8 }, { "page": 20, "type": "TEXT", "location": { "l": 589.68, "t": 201.696, "r": 679.92, "b": 155.184 }, "text": "Lden >45 dB(A) for aircraft noise", "reading_order": 9 }, { "page": 20, "type": "TEXT", "location": { "l": 589.68, "t": 155.184, "r": 679.92, "b": 108.672 }, "text": "Lden >54 dB(A) for road and railway noise", "reading_order": 10 }, { "page": 20, "type": "TEXT", "location": { "l": 589.68, "t": 108.672, "r": 679.92, "b": 62.16 }, "text": "Lnight >40–42 dB(A)", "reading_order": 11 }, { "page": 20, "type": "TEXT", "location": { "l": 31.68, "t": 292.8, "r": 124.08, "b": 279.6 }, "text": "A Decibel scale [dBA]", "reading_order": 12 }, { "page": 20, "type": "TEXT", "location": { "l": 237.84, "t": 293.28, "r": 409.92, "b": 279.12 }, "text": "B Adverse health effects of noise exposure", "reading_order": 13 }, { "page": 20, "type": "TABLE", "location": { "l": 128.16, "t": 272.4, "r": 586.08, "b": 23.04 }, "text": "
Adverse health effectsNoise sourceAssociationParticipants (n)Events (n)Quality level of evidence
StrokeRoadIncidence-Mortality[F2]51,48551,4851,881+++
581,517581,5172,634+++
AircraftIncidence-Mortality>9 million>9 million97,949+
>4 million25,23125,231+++
Coronary artery diseaseRoadIncidence-Mortality[F2]67,22467,2247,033++++
532,268532,2686,884+++
AircraftIncidence-Mortality>9 million>9 million158,977+
>4 million15,53215,532++
DepressionRoadIncidence-Mortality[F2]>1.2 million--+++
AnxietyRoadIncidence-Mortality[F2]372,079372,079-+++
Sleep disturbanceEstimated RR per 10 dB(A) (95% CI)
", "rows": [ { "row_index": 0, "location": [ 128.16, 251.62, 586.08, 272.4 ], "cells": [ { "location": [ 128.16, 251.62, 185.4, 272.4 ], "text": "Adverse health effects", "html_text": "Adverse health effects", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 185.4, 251.62, 242.64, 272.4 ], "text": "Noise source", "html_text": "Noise source", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 242.64, 251.62, 414.36, 272.4 ], "text": "Association", "html_text": "Association", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 3, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 251.62, 471.6, 272.4 ], "text": "Participants (n)", "html_text": "Participants (n)", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 251.62, 528.84, 272.4 ], "text": "Events (n)", "html_text": "Events (n)", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 251.62, 586.08, 272.4 ], "text": "Quality level of evidence", "html_text": "Quality level of evidence", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 1, "location": [ 128.16, 168.5, 586.08, 251.62 ], "cells": [ { "location": [ 128.16, 168.5, 185.4, 251.62 ], "text": "Stroke", "html_text": "Stroke", "links": [], "cell_header_index": 0, "rowspan": 4, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 185.4, 210.06, 242.64, 251.62 ], "text": "Road", "html_text": "Road", "links": [], "cell_header_index": 1, "rowspan": 2, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 242.64, 210.06, 299.88, 251.62 ], "text": "Incidence-Mortality", "html_text": "Incidence-Mortality", "links": [], "cell_header_index": 2, "rowspan": 2, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 299.88, 168.5, 357.12, 251.62 ], "text": "[F2]", "html_text": "[F2]", "links": [], "cell_header_index": 3, "rowspan": 4, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 357.12, 230.84, 414.36, 251.62 ], "text": "51,485", "html_text": "51,485", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 230.84, 471.6, 251.62 ], "text": "51,485", "html_text": "51,485", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 230.84, 528.84, 251.62 ], "text": "1,881", "html_text": "1,881", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 230.84, 586.08, 251.62 ], "text": "+++", "html_text": "+++", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 2, "location": [ 357.12, 210.06, 586.08, 230.84 ], "cells": [ { "location": [ 357.12, 210.06, 414.36, 230.84 ], "text": "581,517", "html_text": "581,517", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 210.06, 471.6, 230.84 ], "text": "581,517", "html_text": "581,517", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 210.06, 528.84, 230.84 ], "text": "2,634", "html_text": "2,634", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 210.06, 586.08, 230.84 ], "text": "+++", "html_text": "+++", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 3, "location": [ 185.4, 168.5, 586.08, 210.06 ], "cells": [ { "location": [ 185.4, 168.5, 242.64, 210.06 ], "text": "Aircraft", "html_text": "Aircraft", "links": [], "cell_header_index": 1, "rowspan": 2, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 242.64, 168.5, 299.88, 210.06 ], "text": "Incidence-Mortality", "html_text": "Incidence-Mortality", "links": [], "cell_header_index": 2, "rowspan": 2, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 357.12, 189.28, 414.36, 210.06 ], "text": ">9 million", "html_text": ">9 million", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 189.28, 471.6, 210.06 ], "text": ">9 million", "html_text": ">9 million", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 189.28, 528.84, 210.06 ], "text": "97,949", "html_text": "97,949", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 189.28, 586.08, 210.06 ], "text": "+", "html_text": "+", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 4, "location": [ 357.12, 168.5, 586.08, 189.28 ], "cells": [ { "location": [ 357.12, 168.5, 414.36, 189.28 ], "text": ">4 million", "html_text": ">4 million", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 168.5, 471.6, 189.28 ], "text": "25,231", "html_text": "25,231", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 168.5, 528.84, 189.28 ], "text": "25,231", "html_text": "25,231", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 168.5, 586.08, 189.28 ], "text": "+++", "html_text": "+++", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 5, "location": [ 128.16, 85.38, 586.08, 168.5 ], "cells": [ { "location": [ 128.16, 85.38, 185.4, 168.5 ], "text": "Coronary artery disease", "html_text": "Coronary artery disease", "links": [], "cell_header_index": 0, "rowspan": 4, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 185.4, 126.94, 242.64, 168.5 ], "text": "Road", "html_text": "Road", "links": [], "cell_header_index": 1, "rowspan": 2, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 242.64, 126.94, 299.88, 168.5 ], "text": "Incidence-Mortality", "html_text": "Incidence-Mortality", "links": [], "cell_header_index": 2, "rowspan": 2, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 299.88, 85.38, 357.12, 168.5 ], "text": "[F2]", "html_text": "[F2]", "links": [], "cell_header_index": 3, "rowspan": 4, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 357.12, 147.72, 414.36, 168.5 ], "text": "67,224", "html_text": "67,224", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 147.72, 471.6, 168.5 ], "text": "67,224", "html_text": "67,224", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 147.72, 528.84, 168.5 ], "text": "7,033", "html_text": "7,033", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 147.72, 586.08, 168.5 ], "text": "++++", "html_text": "++++", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 6, "location": [ 357.12, 126.94, 586.08, 147.72 ], "cells": [ { "location": [ 357.12, 126.94, 414.36, 147.72 ], "text": "532,268", "html_text": "532,268", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 126.94, 471.6, 147.72 ], "text": "532,268", "html_text": "532,268", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 126.94, 528.84, 147.72 ], "text": "6,884", "html_text": "6,884", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 126.94, 586.08, 147.72 ], "text": "+++", "html_text": "+++", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 7, "location": [ 185.4, 85.38, 586.08, 126.94 ], "cells": [ { "location": [ 185.4, 85.38, 242.64, 126.94 ], "text": "Aircraft", "html_text": "Aircraft", "links": [], "cell_header_index": 1, "rowspan": 2, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 242.64, 85.38, 299.88, 126.94 ], "text": "Incidence-Mortality", "html_text": "Incidence-Mortality", "links": [], "cell_header_index": 2, "rowspan": 2, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 357.12, 106.16, 414.36, 126.94 ], "text": ">9 million", "html_text": ">9 million", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 106.16, 471.6, 126.94 ], "text": ">9 million", "html_text": ">9 million", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 106.16, 528.84, 126.94 ], "text": "158,977", "html_text": "158,977", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 106.16, 586.08, 126.94 ], "text": "+", "html_text": "+", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 8, "location": [ 357.12, 85.38, 586.08, 106.16 ], "cells": [ { "location": [ 357.12, 85.38, 414.36, 106.16 ], "text": ">4 million", "html_text": ">4 million", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 85.38, 471.6, 106.16 ], "text": "15,532", "html_text": "15,532", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 85.38, 528.84, 106.16 ], "text": "15,532", "html_text": "15,532", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 85.38, 586.08, 106.16 ], "text": "++", "html_text": "++", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 9, "location": [ 128.16, 64.6, 586.08, 85.38 ], "cells": [ { "location": [ 128.16, 64.6, 185.4, 85.38 ], "text": "Depression", "html_text": "Depression", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 185.4, 64.6, 242.64, 85.38 ], "text": "Road", "html_text": "Road", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 242.64, 64.6, 299.88, 85.38 ], "text": "Incidence-Mortality", "html_text": "Incidence-Mortality", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 299.88, 64.6, 357.12, 85.38 ], "text": "[F2]", "html_text": "[F2]", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 357.12, 64.6, 414.36, 85.38 ], "text": ">1.2 million", "html_text": ">1.2 million", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 64.6, 471.6, 85.38 ], "text": "-", "html_text": "-", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 64.6, 528.84, 85.38 ], "text": "-", "html_text": "-", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 64.6, 586.08, 85.38 ], "text": "+++", "html_text": "+++", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 10, "location": [ 128.16, 43.82, 586.08, 64.6 ], "cells": [ { "location": [ 128.16, 43.82, 185.4, 64.6 ], "text": "Anxiety", "html_text": "Anxiety", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 185.4, 43.82, 242.64, 64.6 ], "text": "Road", "html_text": "Road", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 242.64, 43.82, 299.88, 64.6 ], "text": "Incidence-Mortality", "html_text": "Incidence-Mortality", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 299.88, 43.82, 357.12, 64.6 ], "text": "[F2]", "html_text": "[F2]", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 357.12, 43.82, 414.36, 64.6 ], "text": "372,079", "html_text": "372,079", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 414.36, 43.82, 471.6, 64.6 ], "text": "372,079", "html_text": "372,079", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 471.6, 43.82, 528.84, 64.6 ], "text": "-", "html_text": "-", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 528.84, 43.82, 586.08, 64.6 ], "text": "+++", "html_text": "+++", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 11, "location": [ 128.16, 23.04, 586.08, 43.82 ], "cells": [ { "location": [ 128.16, 23.04, 299.88, 43.82 ], "text": "Sleep disturbance", "html_text": "Sleep disturbance", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 3, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 299.88, 23.04, 586.08, 43.82 ], "text": "Estimated RR per 10 dB(A) (95% CI)", "html_text": "Estimated RR per 10 dB(A) (95% CI)", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 5, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 12, "n_cols": 8, "ref": "#/tables/0", "reading_order": 14 }, { "page": 20, "type": "TEXT", "location": { "l": 570.48, "t": 39.6, "r": 678.48, "b": 25.44 }, "text": "(Munzel, et al., 2023)", "reading_order": 15 } ] }, { "page": 21, "items": [ { "page": 21, "type": "TITLE", "location": { "l": 54.96, "t": 478.56, "r": 534.96, "b": 441.84 }, "text": "Noise: Noise Annoyance", "reading_order": 0, "level": 6 }, { "page": 21, "type": "LIST_ITEM", "location": { "l": 45.12, "t": 411.84, "r": 599.52, "b": 368.88 }, "text": "“Psychological response to unwanted or disturbing sounds, encompassing cognitive, emotional, and behavioral reactions.”", "marker": "•", "list_id": "L36", "level": 0, "reading_order": 1 }, { "page": 21, "type": "LIST_ITEM", "location": { "l": 45.36, "t": 356.88, "r": 582.48, "b": 293.04 }, "text": "Globally, road traffic noise is the primary source of noise annoyance, while neighborhood noise is another substantial but understudied contributor.", "marker": "•", "list_id": "L36", "level": 0, "reading_order": 2 }, { "page": 21, "type": "LIST_ITEM", "location": { "l": 44.64, "t": 279.84, "r": 625.2, "b": 216.72 }, "text": "ISO standards provide a framework for assessing noise annoyance through population surveys, utilizing the percentage of highly annoyed metric.", "marker": "•", "list_id": "L36", "level": 0, "reading_order": 3 }, { "page": 21, "type": "LIST_ITEM", "location": { "l": 44.88, "t": 203.28, "r": 636.48, "b": 140.4 }, "text": "Acoustic characteristics of noise exposure, such as intensity, frequency, complexity, and duration, do not solely determine noise annoyance reactions.", "marker": "•", "list_id": "L36", "level": 0, "reading_order": 4 }, { "page": 21, "type": "LIST_ITEM", "location": { "l": 45.36, "t": 126, "r": 635.76, "b": 39.84 }, "text": "Influenced by personal, social, and situational factors, encompassing age, sex, health status, noise sensitivity, attitude toward noise, socioeconomic status, public perception, perceived stress, and coping abilities.\" (Münzel, et al., 2020)", "marker": "•", "list_id": "L36", "level": 0, "reading_order": 5 } ] }, { "page": 22, "items": [ { "page": 22, "type": "TITLE", "location": { "l": 32.64, "t": 501.12, "r": 543.12, "b": 467.52 }, "text": "Noise: Sleep Disturbance", "reading_order": 0, "level": 6 }, { "page": 22, "type": "LIST_ITEM", "location": { "l": 3.6, "t": 442.8, "r": 348.48, "b": 359.52 }, "text": "Moderate quality of evidence for the probability of being highly sleep disturbed per 10-dB increase in Lnight for aircraft, road, and railway noise. (Smith, et al., 2022)", "marker": "•", "list_id": "L37", "level": 0, "reading_order": 1 }, { "page": 22, "type": "LIST_ITEM", "location": { "l": 4.56, "t": 356.16, "r": 350.64, "b": 273.6 }, "text": "Meta-analysis demonstrates a positive and statistically significant association between traffic noise exposure (aircraft, railway and road traffic)", "marker": "•", "list_id": "L37", "level": 0, "reading_order": 2 }, { "page": 22, "type": "LIST_ITEM", "location": { "l": 40.08, "t": 270, "r": 342.96, "b": 229.44 }, "text": "Overall sleep disturbance/poor sleep quality", "marker": "•", "list_id": "L37", "level": 0, "reading_order": 3 }, { "page": 22, "type": "LIST_ITEM", "location": { "l": 40.56, "t": 226.8, "r": 238.08, "b": 208.32 }, "text": "Difficulty falling asleep", "marker": "•", "list_id": "L37", "level": 0, "reading_order": 4 }, { "page": 22, "type": "LIST_ITEM", "location": { "l": 40.08, "t": 205.2, "r": 351.6, "b": 149.52 }, "text": "Difficulty maintaining sleep/night awakenings and three sleep outcomes: (Li., 2026)", "marker": "•", "list_id": "L37", "level": 0, "reading_order": 5 }, { "page": 22, "type": "LIST_ITEM", "location": { "l": 1.92, "t": 147.84, "r": 341.76, "b": 19.92 }, "text": "This review demonstrates effects of traffic noise on objectively measured sleep physiology and on subjectively assessed sleep disturbance (including sleep quality, problems falling asleep, and awakenings during the night). (Basner, et al., 2018)", "marker": "•", "list_id": "L37", "level": 0, "reading_order": 6 }, { "page": 22, "type": "FIGURE", "location": { "l": 358.8, "t": 460.32, "r": 707.76, "b": 20.16 }, "text": "", "reading_order": 7 }, { "page": 22, "type": "TEXT", "location": { "l": 502.08, "t": 32.88, "r": 563.76, "b": 24.24 }, "text": "Premature deaths", "reading_order": 8 } ] }, { "page": 23, "items": [ { "page": 23, "type": "FIGURE", "location": { "l": 6.24, "t": 514.8, "r": 719.28, "b": 10.08 }, "text": "", "alt": "Flow chart and schematic showing how noise exposure drives stress responses and cardiovascular disease, from Münzel et al. 2…", "long_description": "The slide is titled \"Noise: Heart Diseae\" (the word \"Disease\" is misspelled as \"Diseae\" on the slide). It carries the credit \"(Münzel, et al., 2023)\" at the bottom left. The page has two panels, A and B.\n\nPanel A is a top-down flow chart. A red bar at the top reads \"high Noise exposure (sound level) low\", with high on the left and low on the right. Two connectors run down from it to two yellow pills: \"Direct pathway\" on the left and \"Indirect pathway\" on the right. A red box labelled \"Hearing loss\" sits off to the left and connects by a horizontal line into the vertical line from the Direct pathway, so hearing loss is a side branch of the direct pathway. The Direct pathway leads down to a dark blue box containing \"Sleep disturbance\". The Indirect pathway leads down to a dark blue box containing two stacked entries, \"Disturbance of activities, sleep, communication\" and \"Cognitive and emotional response\". A red box labelled \"Annoyance\" connects by a short horizontal line to this indirect box. Both the Sleep disturbance box and the indirect box lead down into a grey-blue pill \"Stress responses\". From Stress responses, a thick black arrow runs right to a small angry-man photograph and then up to an arrow pointing at \"Noise perception & stress response\" in Panel B. Below Stress responses, a line leads to a dark blue box \"Activation of autonomic and endocrine systems\", which splits into two boxes: \"Autonomic nervous system (sympathetic nerve)\" and \"Endocrine system (pituitary gland, adrenal gland)\". Next, a grey-blue pill \"Chronic stress generates risk factors\" and then a dark blue box with six entries in two rows of three: \"Blood pressure\", \"Blood lipids\", \"Blood viscosity\", \"Cardiac output\", \"Blood glucose\", \"Blood clotting factors\". A grey-blue pill \"Cardiovascular diseases\" follows. At the bottom, a red bar holds four boxes side by side: \"Arterial hypertension\", \"Ischemic heart disease\", \"Stroke\", \"Heart failure\". Each step connects to the next by a single vertical line, so the flow runs strictly top to bottom.\n\nPanel B is a schematic. It shows a brain with labels \"Amygdala\", \"Hypothalamus\", \"Pituitary\", \"BRAIN\", and a magnified inset. Blue labelled arrows read \"CRH\" (hypothalamus to pituitary), \"ACTH\" (pituitary down to the adrenal cortex), and \"Sympathetic nerves\" (from brain to adrenal medulla). The adrenal gland is labelled \"Adrenal gland\", with \"Cortex\" and \"Medulla\" marked. A kidney labelled \"KIDNEY\" sits on the adrenal gland. The cortex releases \"cortisol (humans), corticosterone (mice), glucocorticoids\", and the medulla releases \"epinephrine, norepinephrine (catecholamines)\". Arrows from both carry hormones down to a red tube labelled \"BLOOD VESSEL\".\n\nBelow Panel B, a red band reads \"RAAS activation → vasoconstriction → (vascular) oxidative stress and inflammation → insulin resistance, obesity, hypertension, atherosclerosis → cardiovascular disease → MAC\" and is cut off at the right edge of the page, so the end of the final word is not legible. A black connector runs from the blood vessel down to this band.", "description_nodes": [ "Noise: Heart Diseae", "high Noise exposure (sound level) low", "Direct pathway", "Indirect pathway", "Hearing loss", "Sleep disturbance", "Disturbance of activities, sleep, communication", "Cognitive and emotional response", "Annoyance", "Stress responses", "Noise perception & stress response", "Activation of autonomic and endocrine systems", "Autonomic nervous system (sympathetic nerve)", "Endocrine system (pituitary gland, adrenal gland)", "Chronic stress generates risk factors", "Blood pressure", "Blood lipids", "Blood viscosity", "Cardiac output", "Blood glucose", "Blood clotting factors", "Cardiovascular diseases", "Arterial hypertension", "Ischemic heart disease", "Stroke", "Heart failure", "BRAIN", "Amygdala", "Hypothalamus", "Pituitary", "CRH", "ACTH", "Sympathetic nerves", "Adrenal gland", "Cortex", "Medulla", "KIDNEY", "Cortex: cortisol (humans) corticosterone (mice) glucocorticoids", "Medulla: epinephrine, norepinephrine (catecholamines)", "BLOOD VESSEL", "RAAS activation → vasoconstriction → (vascular) oxidative stress and inflammation → insulin resistance, obesity, hypertension, atherosclerosis → cardiovascular disease → MAC" ], "description_source": "claude-haiku-5-5", "description_kind": "flow chart with anatomical schematic, process diagram showing how noise leads to cardiovascular disease", "has_long_description": true, "reading_order": 0 } ] }, { "page": 24, "items": [ { "page": 24, "type": "TITLE", "location": { "l": 54.96, "t": 501.6, "r": 486, "b": 468 }, "text": "Noise: Heart Disease", "reading_order": 0, "level": 6 }, { "page": 24, "type": "TEXT", "location": { "l": 20.88, "t": 453.12, "r": 698.4, "b": 413.04 }, "text": "Association between transportation noise and heart disease: A systematic review and meta-analysis", "reading_order": 1 }, { "page": 24, "type": "FIGURE", "location": { "l": 11.76, "t": 408, "r": 707.28, "b": 103.68 }, "text": "", "reading_order": 2 }, { "page": 24, "type": "LIST_ITEM", "location": { "l": 24.96, "t": 168, "r": 234.72, "b": 152.76 }, "text": "Heart disease: ICD-10: I20-I25, I48, I50", "marker": "•", "list_id": "L38", "level": 0, "reading_order": 3 }, { "page": 24, "type": "LIST_ITEM", "location": { "l": 24.96, "t": 152.76, "r": 234.72, "b": 137.52 }, "text": "Incidence, mortality or prevalence", "marker": "•", "list_id": "L38", "level": 0, "reading_order": 4 }, { "page": 24, "type": "LIST_ITEM", "location": { "l": 24.96, "t": 137.52, "r": 234.72, "b": 107.04 }, "text": "Transport noise sources: road, rail & air traffic\n53 studies: 85% road, 23% rail, 30% air", "marker": "•", "list_id": "L38", "level": 0, "reading_order": 5 }, { "page": 24, "type": "TITLE", "location": { "l": 287.04, "t": 398.4, "r": 414.72, "b": 381.36 }, "text": "Study characteristics", "reading_order": 6, "level": 6 }, { "page": 24, "type": "TITLE", "location": { "l": 512.4, "t": 397.92, "r": 651.12, "b": 381.36 }, "text": "Meta-analysis findings", "reading_order": 7, "level": 6 }, { "page": 24, "type": "TABLE", "location": { "l": 459.84, "t": 384.72, "r": 697.2, "b": 248.88 }, "text": "
IncidenceMortality
Road2% increased risk3% increased risk
Rail0% increased risk2% increased risk
Air3% increased risk7% increased risk
", "rows": [ { "row_index": 0, "location": [ 459.84, 350.76, 697.2, 384.72 ], "cells": [ { "location": [ 459.84, 350.76, 538.96, 384.72 ], "text": "", "html_text": "", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 538.96, 350.76, 618.08, 384.72 ], "text": "Incidence", "html_text": "Incidence", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 618.08, 350.76, 697.2, 384.72 ], "text": "Mortality", "html_text": "Mortality", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 1, "location": [ 459.84, 316.8, 697.2, 350.76 ], "cells": [ { "location": [ 459.84, 316.8, 538.96, 350.76 ], "text": "Road", "html_text": "Road", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 538.96, 316.8, 618.08, 350.76 ], "text": "2% increased risk", "html_text": "2% increased risk", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 618.08, 316.8, 697.2, 350.76 ], "text": "3% increased risk", "html_text": "3% increased risk", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 2, "location": [ 459.84, 282.84, 697.2, 316.8 ], "cells": [ { "location": [ 459.84, 282.84, 538.96, 316.8 ], "text": "Rail", "html_text": "Rail", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 538.96, 282.84, 618.08, 316.8 ], "text": "0% increased risk", "html_text": "0% increased risk", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 618.08, 282.84, 697.2, 316.8 ], "text": "2% increased risk", "html_text": "2% increased risk", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 3, "location": [ 459.84, 248.88, 697.2, 282.84 ], "cells": [ { "location": [ 459.84, 248.88, 538.96, 282.84 ], "text": "Air", "html_text": "Air", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 538.96, 248.88, 618.08, 282.84 ], "text": "3% increased risk", "html_text": "3% increased risk", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 618.08, 248.88, 697.2, 282.84 ], "text": "7% increased risk", "html_text": "7% increased risk", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 4, "n_cols": 3, "ref": "#/tables/0", "reading_order": 8 }, { "page": 24, "type": "TEXT", "location": { "l": 258.96, "t": 374.16, "r": 439.92, "b": 355.2 }, "text": "53 studies: 85% road, 23% rail, 30% air", "reading_order": 9 }, { "page": 24, "type": "TEXT", "location": { "l": 260.16, "t": 329.76, "r": 344.4, "b": 296.4 }, "text": "87% studies of\nwithin Europe", "reading_order": 10 }, { "page": 24, "type": "TEXT", "location": { "l": 315.12, "t": 284.88, "r": 441.6, "b": 253.2 }, "text": "5 noise exposure assignment categories", "reading_order": 11 }, { "page": 24, "type": "TEXT", "location": { "l": 458.88, "t": 250.08, "r": 562.56, "b": 238.32 }, "text": "Risk per 10 dB increase in Lden", "reading_order": 12 }, { "page": 24, "type": "TEXT", "location": { "l": 307.92, "t": 246, "r": 402.24, "b": 180.24 }, "text": "83% Mixed sex studies\n70% adjusted for air pollutants", "reading_order": 13 }, { "page": 24, "type": "TEXT", "location": { "l": 469.92, "t": 230.16, "r": 542.16, "b": 183.6 }, "text": "Potential confounding variables", "reading_order": 14 }, { "page": 24, "type": "TEXT", "location": { "l": 551.76, "t": 195.36, "r": 574.56, "b": 182.16 }, "text": "Age", "reading_order": 15 }, { "page": 24, "type": "TEXT", "location": { "l": 594.24, "t": 195.6, "r": 697.2, "b": 182.16 }, "text": "Exposure assignment", "reading_order": 16 }, { "page": 24, "type": "TEXT", "location": { "l": 263.52, "t": 164.88, "r": 687.36, "b": 100.8 }, "text": "Conclusion: road and aircraft noise are associated with increased incidence of heart disease. All transport sources are associated with increased heart disease mortality. Risk of heart disease begins at lower exposure levels than previously reported.", "reading_order": 17 } ] }, { "page": 25, "items": [ { "page": 25, "type": "TITLE", "location": { "l": 55.44, "t": 478.08, "r": 474, "b": 444.96 }, "text": "Noise: Heart Disease", "reading_order": 0, "level": 6 }, { "page": 25, "type": "LIST_ITEM", "location": { "l": 35.04, "t": 410.64, "r": 680.88, "b": 259.2 }, "text": "“ Large meta-analyses and umbrella reviews indicate that the risk of cardiovascular disease typically increases by approximately 2–8% per 10 dB increase in transportation noise exposure, depending on the outcome and the source of noise (Münzel et al., 2021; Engelmann et al., 2023; Sørensen et al., 2024) … Consequently, transportation noise is now widely regarded as a preventable environmental contributor to the global burden of cardiovascular disease. (Basner, et al., 2026)", "marker": "•", "list_id": "L39", "level": 0, "reading_order": 1 }, { "page": 25, "type": "LIST_ITEM", "location": { "l": 33.6, "t": 247.2, "r": 665.28, "b": 182.64 }, "text": "Recent studies highlight the impact of road traffic noise on an elevated risk of stroke and increased mortality in the course of coronary artery disease (CAD). (Jemielita, et al., 2025)", "marker": "•", "list_id": "L39", "level": 0, "reading_order": 2 }, { "page": 25, "type": "LIST_ITEM", "location": { "l": 33.36, "t": 170.88, "r": 682.8, "b": 61.92 }, "text": "The World Health Organization has reported that the most significant association between noise and cardiovascular disease is for ischemic heart disease, with the quality of evidence from the analyzed longitudinal studies rated as high. Moderate quality evidence has also been reported for both heart failure and stroke. (Miller, et al., 2024)", "marker": "•", "list_id": "L39", "level": 0, "reading_order": 3 } ] }, { "page": 26, "items": [ { "page": 26, "type": "TITLE", "location": { "l": 47.76, "t": 484.32, "r": 466.32, "b": 451.2 }, "text": "Noise: Heart Disease", "reading_order": 0, "level": 6 }, { "page": 26, "type": "LIST_ITEM", "location": { "l": 35.28, "t": 418.32, "r": 637.68, "b": 221.76 }, "text": "\"Transportation noise is a significant and modifiable environmental risk factor for cardiovascular disease. The evidence from epidemiological studies, human exposure experiments, and mechanistic animal models is robust and biologically plausible. Chronic noise exposure induces oxidative stress, inflammation, endothelial dysfunction, and circadian disruption, which are all hallmarks of cardiovascular pathophysiology.....The full recognition of environmental noise as a cardiovascular risk factor, on par with hypertension, hyperlipidemia, diabetes, and smoking, is advocated.\" (Munzel, et al., 2025)", "marker": "•", "list_id": "L40", "level": 0, "reading_order": 1 }, { "page": 26, "type": "LIST_ITEM", "location": { "l": 32.88, "t": 214.32, "r": 619.92, "b": 75.12 }, "text": "The comprehensive compilation of preclinical, clinical, and epidemiological evidence strongly reinforces the notion that transportation noise serves as a significant environmental factor contributing to the development of various cardiovascular and cerebrovascular conditions, including chronic coronary artery disease, acute coronary syndrome, arterial hypertension, stroke, and heart failure. (Munzel, et al., 2024)", "marker": "•", "list_id": "L40", "level": 0, "reading_order": 2 } ] }, { "page": 27, "items": [ { "page": 27, "type": "TITLE", "location": { "l": 25.2, "t": 526.8, "r": 454.56, "b": 495.36 }, "text": "Noise: Atrial Fibrillation", "reading_order": 0, "level": 6 }, { "page": 27, "type": "TITLE", "location": { "l": 32.88, "t": 463.2, "r": 142.08, "b": 449.04 }, "text": "The Personal Exposome", "reading_order": 1, "level": 6 }, { "page": 27, "type": "FIGURE", "location": { "l": 31.2, "t": 461.28, "r": 645.84, "b": 210.72 }, "text": "", "reading_order": 2 }, { "page": 27, "type": "TITLE", "location": { "l": 209.52, "t": 414.72, "r": 314.64, "b": 389.52 }, "text": "Biological Responses & Internal Environment", "reading_order": 3, "level": 6 }, { "page": 27, "type": "TITLE", "location": { "l": 32.64, "t": 319.44, "r": 139.68, "b": 305.28 }, "text": "The External Exposome", "reading_order": 4, "level": 6 }, { "page": 27, "type": "LIST_ITEM", "location": { "l": 40.8, "t": 288.24, "r": 119.28, "b": 284.56 }, "text": "Urban Environment", "marker": "·", "list_id": "L41", "level": 0, "reading_order": 5 }, { "page": 27, "type": "LIST_ITEM", "location": { "l": 40.8, "t": 284.56, "r": 119.28, "b": 280.88 }, "text": "Green Spaces", "marker": "·", "list_id": "L41", "level": 0, "reading_order": 6 }, { "page": 27, "type": "LIST_ITEM", "location": { "l": 40.8, "t": 280.88, "r": 119.28, "b": 277.2 }, "text": "Air Pollution", "marker": "·", "list_id": "L41", "level": 0, "reading_order": 7 }, { "page": 27, "type": "LIST_ITEM", "location": { "l": 41.76, "t": 275.76, "r": 103.2, "b": 264.72 }, "text": "Green Space", "marker": "·", "list_id": "L41", "level": 0, "reading_order": 8 }, { "page": 27, "type": "TEXT", "location": { "l": 40.8, "t": 263.04, "r": 94.08, "b": 252 }, "text": "Air Pollution", "reading_order": 9 }, { "page": 27, "type": "TEXT", "location": { "l": 528.24, "t": 239.52, "r": 627.84, "b": 223.44 }, "text": "(Wass, et al., 2024)", "reading_order": 10 }, { "page": 27, "type": "LIST_ITEM", "location": { "l": 19.2, "t": 192.48, "r": 675.12, "b": 129.12 }, "text": "\"In summary, our study found that noise exposure was associated with a higher risk of AF. More high-quality studies are needed in the future to confirm these conclusions given the limitations of study.\" (Song et al., 2022)", "marker": "•", "list_id": "L42", "level": 0, "reading_order": 11 }, { "page": 27, "type": "LIST_ITEM", "location": { "l": 17.04, "t": 127.92, "r": 674.16, "b": 42.24 }, "text": "“Studies suggest a potential association between noise pollution, including traffic-related noise, and increased risk of AF but these links are currently weak and require better designed experiments that also focus on the noise exposure, which undoubtedly reflects other exposures including air pollution and psychological stress.”", "marker": "•", "list_id": "L42", "level": 0, "reading_order": 12 }, { "page": 27, "type": "TEXT", "location": { "l": 522, "t": 41.52, "r": 667.68, "b": 21.12 }, "text": "(Wass, et al., 2024)", "reading_order": 13 } ] }, { "page": 28, "items": [ { "page": 28, "type": "TITLE", "location": { "l": 55.2, "t": 500.88, "r": 468.96, "b": 464.88 }, "text": "Noise: Hypertension", "reading_order": 0, "level": 6 }, { "page": 28, "type": "LIST_ITEM", "location": { "l": 23.76, "t": 408.72, "r": 270, "b": 349.2 }, "text": "Association between Noise and Hypertension is inconsistent across studies", "marker": "•", "list_id": "L43", "level": 0, "reading_order": 1 }, { "page": 28, "type": "LIST_ITEM", "location": { "l": 18.48, "t": 347.52, "r": 268.08, "b": 81.6 }, "text": "“...Inconsistent results about hypertension have been reported... The time of day appears to be critical to this association, where night-time noise exposure leads to more severe hypertension, increased arterial stiffness, and endothelial dysfunction, collectively highlighting that sleep disruption is a critical component of the stress effects.” (Miller, et al., 2026)", "marker": "•", "list_id": "L43", "level": 0, "reading_order": 2 }, { "page": 28, "type": "TEXT", "location": { "l": 305.52, "t": 439.2, "r": 315.6, "b": 427.68 }, "text": "A", "reading_order": 3 }, { "page": 28, "type": "FIGURE", "location": { "l": 299.52, "t": 435.12, "r": 547.92, "b": 44.16 }, "text": "", "reading_order": 4 }, { "page": 28, "type": "TEXT", "location": { "l": 549.12, "t": 438.72, "r": 557.28, "b": 429.12 }, "text": "B", "reading_order": 5 }, { "page": 28, "type": "TITLE", "location": { "l": 551.04, "t": 437.76, "r": 657.6, "b": 409.2 }, "text": "B Relative risk for hypertension per 10 dB increase in Lden", "reading_order": 6, "level": 6 }, { "page": 28, "type": "TEXT", "location": { "l": 557.28, "t": 403.44, "r": 674.64, "b": 393.6 }, "text": "HR curves for road noise and hypertension incidence", "reading_order": 7 }, { "page": 28, "type": "FIGURE", "location": { "l": 554.4, "t": 393.6, "r": 686.64, "b": 218.16 }, "text": "", "reading_order": 8 }, { "page": 28, "type": "TEXT", "location": { "l": 549.36, "t": 209.28, "r": 680.88, "b": 188.4 }, "text": "C Recommended sound pressure limits and mitigation measures", "reading_order": 9 }, { "page": 28, "type": "FIGURE", "location": { "l": 555.84, "t": 390.72, "r": 685.44, "b": 306.96 }, "text": "", "reading_order": 10 }, { "page": 28, "type": "FIGURE", "location": { "l": 556.08, "t": 304.32, "r": 686.16, "b": 218.88 }, "text": "", "reading_order": 11 }, { "page": 28, "type": "TABLE", "location": { "l": 558, "t": 185.04, "r": 681.6, "b": 143.76 }, "text": "
Average SPLoldnew outdoornew indoor
Lden53-55dB45dB35dB
Lnight45dB40dB30dB
", "rows": [ { "row_index": 0, "location": [ 558, 171.28, 681.6, 185.04 ], "cells": [ { "location": [ 558, 171.28, 588.9, 185.04 ], "text": "Average SPL", "html_text": "Average SPL", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 588.9, 171.28, 619.8, 185.04 ], "text": "old", "html_text": "old", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.8, 171.28, 650.7, 185.04 ], "text": "new outdoor", "html_text": "new outdoor", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 650.7, 171.28, 681.6, 185.04 ], "text": "new indoor", "html_text": "new indoor", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 1, "location": [ 558, 157.52, 681.6, 171.28 ], "cells": [ { "location": [ 558, 157.52, 588.9, 171.28 ], "text": "Lden", "html_text": "Lden", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 588.9, 157.52, 619.8, 171.28 ], "text": "53-55dB", "html_text": "53-55dB", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.8, 157.52, 650.7, 171.28 ], "text": "45dB", "html_text": "45dB", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 650.7, 157.52, 681.6, 171.28 ], "text": "35dB", "html_text": "35dB", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 2, "location": [ 558, 143.76, 681.6, 157.52 ], "cells": [ { "location": [ 558, 143.76, 588.9, 157.52 ], "text": "Lnight", "html_text": "Lnight", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 588.9, 143.76, 619.8, 157.52 ], "text": "45dB", "html_text": "45dB", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 619.8, 143.76, 650.7, 157.52 ], "text": "40dB", "html_text": "40dB", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 650.7, 143.76, 681.6, 157.52 ], "text": "30dB", "html_text": "30dB", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 3, "n_cols": 4, "ref": "#/tables/0", "reading_order": 12 }, { "page": 28, "type": "TEXT", "location": { "l": 558, "t": 139.92, "r": 600.72, "b": 132 }, "text": "To be achieved by", "reading_order": 13 }, { "page": 28, "type": "TEXT", "location": { "l": 557.52, "t": 131.76, "r": 682.08, "b": 109.68 }, "text": "General: \"Heart healthy city design\", better management of traffic, sound isolation, night's rest must be protected (e.g. 10pm to 6am)", "reading_order": 14 }, { "page": 28, "type": "TEXT", "location": { "l": 557.76, "t": 109.68, "r": 680.16, "b": 95.04 }, "text": "Aircraft: Optimized starting and landing protocols, no housing in protection zones around airports", "reading_order": 15 }, { "page": 28, "type": "TEXT", "location": { "l": 557.52, "t": 94.8, "r": 673.2, "b": 80.16 }, "text": "Road and railway: Speed limits, sound barriers, whisper road surface, quiet tires and breaks", "reading_order": 16 }, { "page": 28, "type": "TEXT", "location": { "l": 557.28, "t": 79.68, "r": 653.04, "b": 64.8 }, "text": "→ Recognizing noise as a significant environmental health risk factor", "reading_order": 17 } ] }, { "page": 29, "items": [ { "page": 29, "type": "TITLE", "location": { "l": 16.56, "t": 452.4, "r": 149.52, "b": 375.12 }, "text": "Noise: Stroke", "reading_order": 0, "level": 5 }, { "page": 29, "type": "FIGURE", "location": { "l": 194.64, "t": 528.48, "r": 687.12, "b": 255.84 }, "text": "", "reading_order": 1 }, { "page": 29, "type": "TEXT", "location": { "l": 517.92, "t": 245.28, "r": 639.84, "b": 224.88 }, "text": "(Ji & Hou, 2025)", "reading_order": 2 }, { "page": 29, "type": "LIST_ITEM", "location": { "l": 28.32, "t": 212.4, "r": 643.68, "b": 106.8 }, "text": "A recent systematic review and meta-analysis of longitudinal studies found that long-term road-traffic noise exposure was associated with a modest increase in incident stroke risk per 10 dB increase. However, evidence differs by noise source and exposure context.\n....Taken together, these findings support a cautious interpretation that chronic noise exposure may contribute to stroke risk, but the evidence is less consistent than for major particulate or thermal exposures (Ali, et al., 2026)", "marker": "•", "list_id": "L44", "level": 0, "reading_order": 3 }, { "page": 29, "type": "LIST_ITEM", "location": { "l": 26.4, "t": 98.64, "r": 632.16, "b": 46.8 }, "text": "“chronic exposure to traffic-related nitrogen oxides, residential proximity to major roadways, and incremental increases in household or community noise levels have each been linked to higher ICH incidence or fatality in multicentre investigations”", "marker": "•", "list_id": "L44", "level": 0, "reading_order": 4 }, { "page": 29, "type": "TEXT", "location": { "l": 459.12, "t": 47.04, "r": 568.32, "b": 29.28 }, "text": "(Ji & Hou, 2025)", "reading_order": 5 } ] }, { "page": 30, "items": [ { "page": 30, "type": "TITLE", "location": { "l": 24.48, "t": 507.6, "r": 183.12, "b": 441.36 }, "text": "Noise: Diabetes", "reading_order": 0, "level": 5 }, { "page": 30, "type": "TEXT", "location": { "l": 536.16, "t": 522.96, "r": 646.32, "b": 508.56 }, "text": "(Münzel, et al., 2025)", "links": [ { "uri": "https://pubmed.ncbi.nlm.nih.gov/?term=M%C3%BCnzel+T&cauthor_id=40055082", "dest": null, "action_type": "/URI", "bbox": [ 539.52, 510.12, 542.16, 520.68 ] } ], "reading_order": 1 }, { "page": 30, "type": "FIGURE", "location": { "l": 231.84, "t": 522.24, "r": 679.44, "b": 253.44 }, "text": "", "links": [ { "uri": "https://pubmed.ncbi.nlm.nih.gov/?term=M%C3%BCnzel+T&cauthor_id=40055082", "dest": null, "action_type": "/URI", "bbox": [ 539.52, 510.12, 542.16, 520.68 ] } ], "reading_order": 2 }, { "page": 30, "type": "LIST_ITEM", "location": { "l": 42, "t": 229.68, "r": 644.4, "b": 156.24 }, "text": "“Several recent cohort studies have consistently linked transportation noise, especially from road traffic, with a higher risk of diabetes. 34,54-60 . 64”", "marker": "•", "links": [ { "uri": "https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.123.323584?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#core-collateral-R34", "dest": null, "action_type": "/URI", "bbox": [ 331.68, 169.56, 348.12, 181.32 ] }, { "uri": "https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.123.323584?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#core-collateral-R54", "dest": null, "action_type": "/URI", "bbox": [ 353.88, 169.56, 370.32, 181.32 ] }, { "uri": "https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.123.323584?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#core-collateral-R54", "dest": null, "action_type": "/URI", "bbox": [ 370.92, 173.28, 379.92, 174.6 ] }, { "uri": "https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.123.323584?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#core-collateral-R54", "dest": null, "action_type": "/URI", "bbox": [ 380.52, 169.56, 396.96, 181.32 ] }, { "uri": "https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.123.323584?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#core-collateral-R64", "dest": null, "action_type": "/URI", "bbox": [ 411.6, 169.56, 428.04, 181.32 ] } ], "list_id": "L45", "level": 0, "reading_order": 3 }, { "page": 30, "type": "LIST_ITEM", "location": { "l": 41.04, "t": 150.96, "r": 628.32, "b": 75.84 }, "text": "\"Few prospective cohort studies have investigated the effects of exposure to transportation noise on the risk of developing adiposity.65-70 (Münzel e", "marker": "•", "links": [ { "uri": "https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.123.323584?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#core-collateral-R65", "dest": null, "action_type": "/URI", "bbox": [ 386.16, 90.48, 402.72, 102.24 ] }, { "uri": "https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.123.323584?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#core-collateral-R65", "dest": null, "action_type": "/URI", "bbox": [ 403.2, 94.2, 412.2, 95.52 ] }, { "uri": "https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.123.323584?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#core-collateral-R65", "dest": null, "action_type": "/URI", "bbox": [ 412.92, 90.48, 429.24, 102.24 ] } ], "list_id": "L45", "level": 0, "reading_order": 4 }, { "page": 30, "type": "TEXT", "location": { "l": 545.52, "t": 88.8, "r": 638.16, "b": 68.16 }, "text": "(Münzel, et", "reading_order": 5 }, { "page": 30, "type": "TEXT", "location": { "l": 58.56, "t": 68.4, "r": 142.32, "b": 46.8 }, "text": "al., 2024)", "reading_order": 6 } ] }, { "page": 31, "items": [ { "page": 31, "type": "TITLE", "location": { "l": 26.88, "t": 522.72, "r": 194.64, "b": 454.8 }, "text": "Noise: Cognitive", "reading_order": 0, "level": 5 }, { "page": 31, "type": "TITLE", "location": { "l": 295.68, "t": 496.32, "r": 640.8, "b": 467.28 }, "text": "Overview on health risk associate with road traffic, railway, and aircraft noise", "reading_order": 1, "level": 6 }, { "page": 31, "type": "TITLE", "location": { "l": 298.08, "t": 459.6, "r": 355.44, "b": 448.8 }, "text": "Mental illness", "reading_order": 2, "level": 6 }, { "page": 31, "type": "TITLE", "location": { "l": 253.2, "t": 446.88, "r": 294.72, "b": 437.52 }, "text": "Depression", "reading_order": 3, "level": 6 }, { "page": 31, "type": "TEXT", "location": { "l": 253.44, "t": 439.68, "r": 385.44, "b": 382.32 }, "text": "OR 1.23, 1.19-1.28 at 50-55dB(A)c\n4% (OR 1.04, 1.03-1.11 per 10dB(A) increase in Lden)a\nOR 1.17, 95% CI 1.10-1.25 for LpAeq,24h ≥ 70 dBc\nOR 1.15, 1.08-1.22 at 60-65 dB(A)c", "reading_order": 4 }, { "page": 31, "type": "TITLE", "location": { "l": 253.68, "t": 378.48, "r": 282.72, "b": 369.12 }, "text": "Anxiety", "reading_order": 5, "level": 6 }, { "page": 31, "type": "TEXT", "location": { "l": 253.44, "t": 369.36, "r": 378.24, "b": 340.8 }, "text": "12% (effect size 1.12, 1.02-1.23 per 10dB(A)) increase in Ldenb\n12% (OR 1.12, 1.04-1.30 per 10dB(A))", "reading_order": 6 }, { "page": 31, "type": "TITLE", "location": { "l": 253.68, "t": 332.64, "r": 294, "b": 323.04 }, "text": "Annoyance", "reading_order": 7, "level": 6 }, { "page": 31, "type": "TEXT", "location": { "l": 253.44, "t": 323.28, "r": 309.12, "b": 304.56 }, "text": "RR 1.19, 0.93-1.53d\nRR 1.06, 0.93-1.22d", "reading_order": 8 }, { "page": 31, "type": "TITLE", "location": { "l": 253.92, "t": 293.52, "r": 363.84, "b": 283.2 }, "text": "Suicide and night noise exposure", "reading_order": 9, "level": 6 }, { "page": 31, "type": "TEXT", "location": { "l": 251.52, "t": 285.36, "r": 386.4, "b": 253.92 }, "text": "Younger adults (HR 1.32, 1.02-1.70)⁶\nOlder adults (HR 1.43, 1.01-2.02)⁶\nAdults with mental illness (HR 1.55, 1.10-2.19)⁶\nStroke\nOR 1.07, 1.02-1.13 < 40dB/24h⁷\nHR 1.12, 0.99-1.27 for 40-50 vs. ≤40dB⁹\nOR 1.017, 1.003-1.032ᵐ\nHR 1.06, 1.03-1.08 per 10dB increase⁹\nOR 1.018, 1.001-1.033ᵐ", "reading_order": 10 }, { "page": 31, "type": "FIGURE", "location": { "l": 393.12, "t": 455.04, "r": 517.44, "b": 282 }, "text": "", "reading_order": 11 }, { "page": 31, "type": "TEXT", "location": { "l": 396.96, "t": 278.4, "r": 505.92, "b": 222.96 }, "text": "
Stroke
OR 1.07, 1.02-1.13 < 40dB/24hf
HR 1.12, 0.99-1.27 for 40-50 vs. ≤40dBg
OR 1.017, 1.003-1.032m
HR 1.06, 1.03-1.08 per 10dB increaseg
OR 1.018, 1.001-1.033m
", "reading_order": 12 }, { "page": 31, "type": "TITLE", "location": { "l": 528.72, "t": 459.6, "r": 651.36, "b": 448.32 }, "text": "Neurodevelopmental disorders", "reading_order": 13, "level": 6 }, { "page": 31, "type": "TITLE", "location": { "l": 524.88, "t": 445.44, "r": 650.16, "b": 434.88 }, "text": "Hyperactivity/inattention in children", "reading_order": 14, "level": 6 }, { "page": 31, "type": "TEXT", "location": { "l": 524.64, "t": 432.96, "r": 654.24, "b": 404.88 }, "text": "1dB increase associated with an unit increase of 0.017, 0.007-0.028k\nOR 1.11, 1.04-1.19 per 10dB increasej", "reading_order": 15 }, { "page": 31, "type": "TITLE", "location": { "l": 524.64, "t": 394.56, "r": 645.6, "b": 383.04 }, "text": "Reading comprehension in children", "reading_order": 16, "level": 6 }, { "page": 31, "type": "TEXT", "location": { "l": 524.64, "t": 378.96, "r": 655.68, "b": 349.92 }, "text": "1dB increase associated with an unit decrease of -0.007, -0.012 to -0.001k\nTotal difficulties in children\nAircraft nois", "reading_order": 17 }, { "page": 31, "type": "TEXT", "location": { "l": 525.12, "t": 346.8, "r": 579.6, "b": 336.72 }, "text": "OR 1.09, 1.02-1.16", "reading_order": 18 }, { "page": 31, "type": "FIGURE", "location": { "l": 663.36, "t": 465.12, "r": 720, "b": 399.12 }, "text": "", "reading_order": 19 }, { "page": 31, "type": "TEXT", "location": { "l": 693.6, "t": 440.64, "r": 720, "b": 427.2 }, "text": "Road traffic noise", "reading_order": 20 }, { "page": 31, "type": "TEXT", "location": { "l": 664.8, "t": 423.36, "r": 714, "b": 399.6 }, "text": "Railway noise", "reading_order": 21 }, { "page": 31, "type": "TITLE", "location": { "l": 524.88, "t": 313.44, "r": 647.52, "b": 302.64 }, "text": "Dementia and cognitive decline", "reading_order": 22, "level": 6 }, { "page": 31, "type": "TEXT", "location": { "l": 530.88, "t": 290.64, "r": 586.32, "b": 272.64 }, "text": "Residential noise\nexposure", "reading_order": 23 }, { "page": 31, "type": "TEXT", "location": { "l": 601.68, "t": 294.96, "r": 696.96, "b": 257.04 }, "text": "Cognitive impairment\nOR 1.36, 1.15-1.162 per 10dB(A)h\nAlzheimer's disease\nOR 1.29, 1.08-1.55h", "reading_order": 24 }, { "page": 31, "type": "TEXT", "location": { "l": 529.92, "t": 244.56, "r": 646.56, "b": 234.72 }, "text": "Death from dementia HR 1.12, 0.90-1.38", "reading_order": 25 }, { "page": 31, "type": "LIST_ITEM", "location": { "l": 37.2, "t": 210.72, "r": 645.6, "b": 56.16 }, "text": "“Despite being a relatively new area of investigation, indeed, mounting research and conclusive evidence demonstrate that exposure to noise, primarily from traffic sources, may affect the central nervous system and brain, thereby contributing to an increased risk of neuropsychiatric disorders such as stroke, dementia and cognitive decline, neurodevelopmental disorders, depression, and anxiety disorder... The presented values are based on selected representative studies with different quality levels of evidence highlighting the need for more research.” (Habad, et al., 2022)", "marker": "•", "list_id": "L46", "level": 0, "reading_order": 26 } ] }, { "page": 32, "items": [ { "page": 32, "type": "TITLE", "location": { "l": 33.6, "t": 520.08, "r": 459.6, "b": 485.52 }, "text": "Noise: Mental Health", "reading_order": 0, "level": 6 }, { "page": 32, "type": "FIGURE", "location": { "l": 83.04, "t": 474.48, "r": 662.4, "b": 230.88 }, "text": "", "reading_order": 1 }, { "page": 32, "type": "LIST_ITEM", "location": { "l": 33.12, "t": 203.52, "r": 689.76, "b": 139.68 }, "text": "Studies over the last decade have shown that noise annoyance is significantly associated with negative mental health outcomes, and for many noise sources, there is a clear dose-response relationship between noise exposure and noise annoyance.", "marker": "•", "list_id": "L47", "level": 0, "reading_order": 2 }, { "page": 32, "type": "LIST_ITEM", "location": { "l": 31.44, "t": 129.12, "r": 670.8, "b": 46.08 }, "text": "“Noise annoyance and sleep disturbance are likely mediators of the relationship between exposure to environmental noise at home and poor mental health....However, higher quality and longitudinal researches are needed to clarify these and other potential mediating pathways.”", "marker": "•", "list_id": "L47", "level": 0, "reading_order": 3 }, { "page": 32, "type": "TEXT", "location": { "l": 428.4, "t": 44.64, "r": 592.32, "b": 23.52 }, "text": "(Grocott, et al., 2025)", "reading_order": 4 } ] }, { "page": 33, "items": [ { "page": 33, "type": "TITLE", "location": { "l": 30, "t": 523.92, "r": 456, "b": 489.84 }, "text": "Noise: Mental Health", "reading_order": 0, "level": 6 }, { "page": 33, "type": "LIST_ITEM", "location": { "l": 12.48, "t": 453.36, "r": 258.48, "b": 102.72 }, "text": "“Despite being a ...(new) research area, an increasing body of compelling research and conclusive findings confirms that exposure to noise, particularly from sources such as traffic, can potentially impact the central nervous system. These harms of noise increase the susceptibility to mental health conditions such as depression, anxiety, suicide, and behavioral problems in children and adolescents.”", "marker": "•", "list_id": "L48", "level": 0, "reading_order": 1 }, { "page": 33, "type": "TEXT", "location": { "l": 82.56, "t": 103.68, "r": 255.84, "b": 81.84 }, "text": "(Hahad, et al., 2025)", "reading_order": 2 }, { "page": 33, "type": "TEXT", "location": { "l": 546.72, "t": 463.92, "r": 648.24, "b": 448.8 }, "text": "(Habad, et al, 2025)", "reading_order": 3 }, { "page": 33, "type": "FIGURE", "location": { "l": 267.84, "t": 444.48, "r": 712.56, "b": 58.32 }, "text": "", "reading_order": 4 } ] }, { "page": 34, "items": [ { "page": 34, "type": "TITLE", "location": { "l": 29.04, "t": 497.76, "r": 456.24, "b": 462.24 }, "text": "Noise: Mental Health", "reading_order": 0, "level": 6 }, { "page": 34, "type": "TEXT", "location": { "l": 156.24, "t": 344.88, "r": 257.76, "b": 327.36 }, "text": "Depression (adults)", "reading_order": 1 }, { "page": 34, "type": "TEXT", "location": { "l": 175.2, "t": 315.6, "r": 257.52, "b": 299.28 }, "text": "Anxiety (adults)", "reading_order": 2 }, { "page": 34, "type": "TEXT", "location": { "l": 37.68, "t": 286.8, "r": 257.28, "b": 270.48 }, "text": "Behavioral problems (children, adolescents)", "reading_order": 3 }, { "page": 34, "type": "TEXT", "location": { "l": 20.64, "t": 258.24, "r": 257.28, "b": 241.44 }, "text": "Mental health problems (children, adolescents)", "reading_order": 4 }, { "page": 34, "type": "TEXT", "location": { "l": 55.44, "t": 229.2, "r": 258, "b": 199.92 }, "text": "Mental health and behavioural problems (children, adolescents)", "reading_order": 5 }, { "page": 34, "type": "FIGURE", "location": { "l": 280.8, "t": 392.4, "r": 710.64, "b": 196.8 }, "text": "", "reading_order": 6 }, { "page": 34, "type": "FIGURE", "location": { "l": 48.72, "t": 145.2, "r": 109.44, "b": 81.36 }, "text": "", "reading_order": 7 }, { "page": 34, "type": "TEXT", "location": { "l": 287.28, "t": 147.36, "r": 500.16, "b": 70.08 }, "text": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "links": [ { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 290.28, 130.08, 498.96, 144.48 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 292.32, 110.88, 490.44, 125.28 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 492.12, 117.12, 495.96, 118.32 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 305.4, 94.32, 328.08, 105.48 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 329.76, 97.92, 333.6, 99.12 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 335.28, 94.32, 378.48, 105.48 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 380.16, 97.92, 384, 99.12 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 385.68, 94.32, 424.92, 105.48 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 426.6, 97.92, 430.44, 99.12 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 431.52, 94.32, 477.96, 103.92 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 478.92, 97.92, 482.76, 99.12 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 334.44, 75.12, 390.84, 86.28 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 391.8, 78.72, 395.64, 79.92 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/pollution-and-mental-health-current-scientific-evidence", "dest": null, "action_type": "/URI", "bbox": [ 396.84, 75.12, 453.6, 86.28 ] } ], "reading_order": 8 } ] }, { "page": 35, "items": [ { "page": 35, "type": "TITLE", "location": { "l": 27.12, "t": 466.32, "r": 148.8, "b": 365.04 }, "text": "Noise: Mental Health", "reading_order": 0, "level": 4 }, { "page": 35, "type": "FIGURE", "location": { "l": 177.84, "t": 528.24, "r": 701.04, "b": 215.04 }, "text": "", "reading_order": 1 }, { "page": 35, "type": "TITLE", "location": { "l": 57.12, "t": 183.36, "r": 443.04, "b": 160.56 }, "text": "• In a review of “61 high-quality studies”", "reading_order": 2, "level": 6 }, { "page": 35, "type": "LIST_ITEM", "location": { "l": 89.28, "t": 158.64, "r": 667.2, "b": 38.16 }, "text": "“Air, noise, and combined pollution most strongly affected emotional and behavioral outcomes, including depression, anxiety, stress, and sleep disturbances, while chemical pollutants were more closely associated with physical and social dimensions of health.”", "marker": "•", "list_id": "L49", "level": 0, "reading_order": 3 }, { "page": 35, "type": "TEXT", "location": { "l": 345.6, "t": 39.84, "r": 598.32, "b": 14.88 }, "text": "(Chadalavada, et al., 2026)", "reading_order": 4 } ] }, { "page": 36, "items": [ { "page": 36, "type": "TEXT", "location": { "l": 326.4, "t": 513.12, "r": 616.32, "b": 488.16 }, "text": "Conceptual Overview of Environmental Noise, Socio-environmental Determinants and Mental Health in Children and Adolescents", "reading_order": 0 }, { "page": 36, "type": "TITLE", "location": { "l": 18.72, "t": 511.92, "r": 307.92, "b": 392.16 }, "text": "Noise:\nChild/Teen\nMental Health\nVariables affecting age-specific vulnerability\nVariables directly related to health inequalities", "reading_order": 1, "level": 6 }, { "page": 36, "type": "FIGURE", "location": { "l": 249.12, "t": 512.88, "r": 700.32, "b": 184.8 }, "text": "", "reading_order": 2 }, { "page": 36, "type": "TEXT", "location": { "l": 582, "t": 213.84, "r": 692.88, "b": 199.68 }, "text": "(Hussain, et al., 2026)", "reading_order": 3 }, { "page": 36, "type": "LIST_ITEM", "location": { "l": 43.44, "t": 168.96, "r": 617.76, "b": 150.24 }, "text": "In a systematic umbrella review with 8 Systematic Reviews and 1 Report", "marker": "•", "list_id": "L50", "level": 0, "items": [ { "page": 36, "type": "LIST_ITEM", "location": { "l": 80.16, "t": 149.04, "r": 613.2, "b": 111.6 }, "text": "“...\\underline{existing systematic reviews} suggest that road traffic noise has a harmful association with anxiety but no association with depression.", "marker": "•", "list_id": "L50", "level": 1, "reading_order": 0 }, { "page": 36, "type": "LIST_ITEM", "location": { "l": 79.92, "t": 110.88, "r": 649.2, "b": 74.16 }, "text": "The overall quality of the evidence varied widely, ranging from very low to moderate.", "marker": "•", "list_id": "L50", "level": 1, "reading_order": 1 }, { "page": 36, "type": "LIST_ITEM", "location": { "l": 79.2, "t": 72.24, "r": 640.08, "b": 14.4 }, "text": "Key findings are the indication of road noise having a harmful association with anxiety and hyperactivity but no association with depression.\" (Hussain, et al., 2026)", "marker": "•", "list_id": "L50", "level": 1, "reading_order": 2 } ], "reading_order": 4 } ] }, { "page": 37, "items": [ { "page": 37, "type": "TITLE", "location": { "l": 19.2, "t": 506.88, "r": 228.96, "b": 406.08 }, "text": "Noise: Dementia & Alzheimer's", "reading_order": 0, "level": 4 }, { "page": 37, "type": "FIGURE", "location": { "l": 230.16, "t": 503.28, "r": 719.52, "b": 283.92 }, "text": "", "reading_order": 1 }, { "page": 37, "type": "LIST_ITEM", "location": { "l": 33.6, "t": 267.12, "r": 642.48, "b": 226.8 }, "text": "Umbrella Review and Meta – Analysis containing 19 Reviews and 37 meta-analyses (2 Related to Noise)", "marker": "•", "list_id": "L51", "level": 0, "items": [ { "page": 37, "type": "LIST_ITEM", "location": { "l": 68.16, "t": 222.72, "r": 669.12, "b": 104.16 }, "text": "“We found 9 factors where exposure was associated with higher risks of all-cause dementia: fine particulate matter, particulate matter, nitrogen dioxide, nitrogen oxides, carbon monoxide, shift work, night shift work, chronic noise, and extremely-low frequency magnetic fields. ...\nFine particulate matter, particulate matter, and chronic noise were related to vascular dementia.” (Jones, et al., 2025)", "marker": "•", "list_id": "L51", "level": 1, "reading_order": 0 } ], "reading_order": 2 }, { "page": 37, "type": "LIST_ITEM", "location": { "l": 33.84, "t": 96, "r": 668.16, "b": 36 }, "text": "Emerging evidence from large cohort studies has demonstrated links between chronic environmental noise exposure and incident ADRD and mild cognitive impairment (MCI). (Bozigar, et al., 2026)", "marker": "•", "list_id": "L51", "level": 0, "reading_order": 3 } ] }, { "page": 38, "items": [ { "page": 38, "type": "TITLE", "location": { "l": 12.24, "t": 516, "r": 672.72, "b": 486.48 }, "text": "NOISE + Other Pollution: Heart Disease", "reading_order": 0, "level": 6 }, { "page": 38, "type": "LIST_ITEM", "location": { "l": 33.6, "t": 460.8, "r": 404.64, "b": 437.76 }, "text": "Non-communicable diseases (NCDs)", "marker": "•", "list_id": "L52", "level": 0, "items": [ { "page": 38, "type": "LIST_ITEM", "location": { "l": 69.12, "t": 431.76, "r": 313.44, "b": 409.44 }, "text": "70% of Global Mortality", "marker": "•", "list_id": "L52", "level": 1, "reading_order": 0 }, { "page": 38, "type": "LIST_ITEM", "location": { "l": 69.36, "t": 402.72, "r": 346.08, "b": 380.88 }, "text": "38 million Deaths Annually", "marker": "•", "list_id": "L52", "level": 1, "items": [ { "page": 38, "type": "LIST_ITEM", "location": { "l": 105.12, "t": 374.16, "r": 669.12, "b": 351.84 }, "text": "Cardiovascular disease (CVD) majority of these fatalities.", "marker": "•", "list_id": "L52", "level": 2, "reading_order": 0 } ], "reading_order": 1 } ], "reading_order": 1 }, { "page": 38, "type": "LIST_ITEM", "location": { "l": 33.6, "t": 344.88, "r": 677.04, "b": 292.8 }, "text": "Increasing evidence that Environmental Risk Factors (ERFs) may play an increasingly significant role in rising prevalence of NCDs.", "marker": "•", "list_id": "L52", "level": 0, "reading_order": 2 }, { "page": 38, "type": "LIST_ITEM", "location": { "l": 33.6, "t": 287.76, "r": 618.96, "b": 235.44 }, "text": "ERFs are interconnected with cumulative compound health impacts, including", "marker": "•", "list_id": "L52", "level": 0, "items": [ { "page": 38, "type": "LIST_ITEM", "location": { "l": 69.36, "t": 229.68, "r": 210.72, "b": 209.04 }, "text": "Air Pollution", "marker": "•", "list_id": "L52", "level": 1, "reading_order": 0 } ], "reading_order": 3 }, { "page": 38, "type": "TEXT", "location": { "l": 406.8, "t": 216.96, "r": 547.44, "b": 200.64 }, "text": "(Münzel, et al., 2026)", "reading_order": 4 }, { "page": 38, "type": "LIST_ITEM", "location": { "l": 69.84, "t": 198, "r": 303.12, "b": 169.68 }, "text": "Noise Exposure", "marker": "•", "list_id": "L53", "level": 0, "reading_order": 5 }, { "page": 38, "type": "LIST_ITEM", "location": { "l": 69.12, "t": 161.28, "r": 314.88, "b": 138.72 }, "text": "Artificial Noise At Night", "marker": "•", "list_id": "L53", "level": 0, "reading_order": 6 }, { "page": 38, "type": "LIST_ITEM", "location": { "l": 69.36, "t": 131.76, "r": 252.48, "b": 109.92 }, "text": "Plastic Pollution,", "marker": "•", "list_id": "L53", "level": 0, "reading_order": 7 }, { "page": 38, "type": "LIST_ITEM", "location": { "l": 69.36, "t": 103.44, "r": 272.16, "b": 81.84 }, "text": "Chemical Pollution", "marker": "•", "list_id": "L53", "level": 0, "reading_order": 8 }, { "page": 38, "type": "LIST_ITEM", "location": { "l": 69.12, "t": 74.64, "r": 420.72, "b": 52.32 }, "text": "Various Effects Of Climate Change", "marker": "•", "list_id": "L53", "level": 0, "items": [ { "page": 38, "type": "LIST_ITEM", "location": { "l": 104.88, "t": 45.36, "r": 606.24, "b": 23.52 }, "text": "Heat extremes, desert storms, floods and wildfires", "marker": "•", "list_id": "L53", "level": 1, "reading_order": 0 } ], "reading_order": 9 } ] }, { "page": 39, "items": [ { "page": 39, "type": "TITLE", "location": { "l": 11.52, "t": 516.24, "r": 672.72, "b": 486 }, "text": "NOISE + Other Pollution: Heart Disease", "reading_order": 0, "level": 6 }, { "page": 39, "type": "TITLE", "location": { "l": 173.28, "t": 454.08, "r": 472.56, "b": 436.8 }, "text": "Environmental stressors and cardiovascular health", "reading_order": 1, "level": 6 }, { "page": 39, "type": "FIGURE", "location": { "l": 27.6, "t": 416.64, "r": 621.84, "b": 56.88 }, "text": "", "reading_order": 2 }, { "page": 39, "type": "LIST_ITEM", "location": { "l": 69.6, "t": 401.04, "r": 178.56, "b": 395.52000000000004 }, "text": "Noise/light pollution", "list_id": "L54", "level": 0, "reading_order": 3 }, { "page": 39, "type": "LIST_ITEM", "location": { "l": 69.6, "t": 395.52000000000004, "r": 178.56, "b": 390 }, "text": "Traffic, aircraft, construction and industrial noise", "marker": "•", "list_id": "L54", "level": 0, "reading_order": 4 }, { "page": 39, "type": "LIST_ITEM", "location": { "l": 69.6, "t": 390, "r": 178.56, "b": 384.48 }, "text": "Street lights, building lights, advertising signs", "marker": "•", "list_id": "L54", "level": 0, "reading_order": 5 }, { "page": 39, "type": "LIST_ITEM", "location": { "l": 69.6, "t": 382.32, "r": 192, "b": 358.08 }, "text": "Traffic, aircraft, construction and industrial noise", "list_id": "L54", "level": 0, "reading_order": 6 }, { "page": 39, "type": "LIST_ITEM", "location": { "l": 67.68, "t": 358.08, "r": 191.28, "b": 332.88 }, "text": "Street lights, building lights, advertising signs", "list_id": "L54", "level": 0, "reading_order": 7 }, { "page": 39, "type": "LIST_ITEM", "location": { "l": 30.48, "t": 254.4, "r": 114.48, "b": 250.48 }, "text": "Particulate matter", "marker": "•", "list_id": "L54", "level": 0, "reading_order": 8 }, { "page": 39, "type": "LIST_ITEM", "location": { "l": 30.48, "t": 250.48, "r": 114.48, "b": 246.56 }, "text": "Ozone", "marker": "•", "list_id": "L54", "level": 0, "reading_order": 9 }, { "page": 39, "type": "LIST_ITEM", "location": { "l": 30.48, "t": 246.56, "r": 114.48, "b": 242.64 }, "text": "Volatile organics", "marker": "•", "list_id": "L54", "level": 0, "reading_order": 10 }, { "page": 39, "type": "LIST_ITEM", "location": { "l": 30.96, "t": 241.2, "r": 72, "b": 230.4 }, "text": "Ozone", "list_id": "L54", "level": 0, "reading_order": 11 }, { "page": 39, "type": "LIST_ITEM", "location": { "l": 31.44, "t": 229.92, "r": 108.72, "b": 217.2 }, "text": "Volatile organics", "marker": "•", "list_id": "L54", "level": 0, "reading_order": 12 }, { "page": 39, "type": "TEXT", "location": { "l": 69.12, "t": 75.36, "r": 149.04, "b": 61.92 }, "text": "Nitrogen loading", "reading_order": 13 }, { "page": 39, "type": "TEXT", "location": { "l": 16.08, "t": 37.68, "r": 623.52, "b": 12.24 }, "text": "As, arsenic; BPA, bisphenol A; Cd, cadmium; CO, carbon monoxide; Hg, mercury; NOx, nitrogen oxide; Pb, lead; PCBs, polychlorinated biphenyls; PFAS, per- and polyfluoroalkyl substances; PM2.5, particulate matter with an aerodynamic diameter of <2.5 μm; SOx, sulfur oxide", "reading_order": 14 }, { "page": 39, "type": "TEXT", "location": { "l": 18, "t": 9.6, "r": 153.36, "b": 0 }, "text": "Münzel T. et al. European Heart Journal.", "reading_order": 15 } ] }, { "page": 40, "items": [ { "page": 40, "type": "TITLE", "location": { "l": 11.52, "t": 514.56, "r": 704.88, "b": 481.92 }, "text": "Additive Effects: NOISE & Light Pollution", "reading_order": 0, "level": 6 }, { "page": 40, "type": "FIGURE", "location": { "l": 39.84, "t": 449.04, "r": 651.84, "b": 17.76 }, "text": "", "reading_order": 1 } ] }, { "page": 41, "items": [ { "page": 41, "type": "TITLE", "location": { "l": 54.96, "t": 479.04, "r": 444, "b": 444.48 }, "text": "Combined Air/Noise", "reading_order": 0, "level": 1 }, { "page": 41, "type": "TEXT", "location": { "l": 55.92, "t": 422.4, "r": 651.84, "b": 403.92 }, "text": "Impact of Air Pollution and Noise Exposure on Cardiovascular Disease Incidence and Mortality", "reading_order": 1 }, { "page": 41, "type": "TEXT", "location": { "l": 80.88, "t": 390.72, "r": 626.16, "b": 354.96 }, "text": "Main Takeaway and Future Recommendation: Exposure to air pollution increases CVD risk, but interaction with noise needs more study; future research should include residential and occupational exposures and use time-updated confounders.", "reading_order": 2 }, { "page": 41, "type": "FIGURE", "location": { "l": 56.4, "t": 348.24, "r": 665.28, "b": 72.72 }, "text": "", "reading_order": 3 }, { "page": 41, "type": "TEXT", "location": { "l": 62.64, "t": 326.16, "r": 244.56, "b": 123.12 }, "text": "BACKGROUND\nProblem: Combined effects of air pollution and noise on CVD are underexplored. Objective: Review evidence on their correlation with CVD incidence and mortality.\nSystematic Review (PRISMA 2020). Studies from 2003-2024 sourced from PubMed, Embase, Web of Science, Global Health, and CINAHL. Framework: PEOS. Evaluation tool: ROBINS-E.", "reading_order": 4 }, { "page": 41, "type": "TEXT", "location": { "l": 265.44, "t": 227.04, "r": 442.8, "b": 138 }, "text": "Systematic Review (PRISMA 2020). Studies from 2003-2024 sourced from PubMed, Embase, Web of Science, Global Health, and CINAHL. Framework: PEOS. Evaluation tool: ROBINS-E.", "reading_order": 5 }, { "page": 41, "type": "TEXT", "location": { "l": 464.4, "t": 248.16, "r": 659.28, "b": 139.2 }, "text": "Long-term exposure to air pollution increases CVD risk. Combined effects of air pollution and noise need more research. Most studies are Western-based, lack time-updated confounders, and lack combined residential and occupational exposure assessments.", "reading_order": 6 }, { "page": 41, "type": "TEXT", "location": { "l": 297.12, "t": 101.52, "r": 409.44, "b": 84.24 }, "text": "Mayntz SP et al. 2024\nLong-term exposure to air pollution increases\nCVD risk. Combined effects of air pollution\nand noise need more research. Most studies are\nWestern-based, lack time-updated confounders,\nand lack combined residential and occupational\nexposure assessments.", "reading_order": 7 } ] }, { "page": 42, "items": [ { "page": 42, "type": "TITLE", "location": { "l": 52.32, "t": 493.92, "r": 639.12, "b": 419.28 }, "text": "Disability Adjusted Life Years\nDALYs", "reading_order": 0, "level": 6 }, { "page": 42, "type": "LIST_ITEM", "location": { "l": 53.28, "t": 357.84, "r": 616.8, "b": 263.76 }, "text": "One DALY equals to the loss of 1 year of healthy life attributed to morbidity, mortality, or both.", "marker": "•", "list_id": "L55", "level": 0, "reading_order": 1 } ] }, { "page": 43, "items": [ { "page": 43, "type": "TITLE", "location": { "l": 5.04, "t": 478.56, "r": 516.48, "b": 443.28 }, "text": "Noise in Context: Context", "reading_order": 0, "level": 6 }, { "page": 43, "type": "TEXT", "location": { "l": 57.6, "t": 378.72, "r": 270.24, "b": 362.64 }, "text": "a Environmental factors (DALY rates)", "reading_order": 1 }, { "page": 43, "type": "FIGURE", "location": { "l": 14.64, "t": 364.56, "r": 688.56, "b": 4.08 }, "text": "", "reading_order": 2 } ] }, { "page": 44, "items": [ { "page": 44, "type": "TITLE", "location": { "l": 6, "t": 515.28, "r": 516.24, "b": 480.48 }, "text": "Noise in Context: Context", "reading_order": 0, "level": 6 }, { "page": 44, "type": "TEXT", "location": { "l": 489.6, "t": 460.32, "r": 633.84, "b": 438.96 }, "text": "(Clark, et al., 2025)", "reading_order": 1 }, { "page": 44, "type": "TEXT", "location": { "l": 57.36, "t": 426.72, "r": 292.08, "b": 408.96 }, "text": "b Environmental factors (mortality rates)", "reading_order": 2 }, { "page": 44, "type": "FIGURE", "location": { "l": 24.96, "t": 409.92, "r": 690.72, "b": 37.2 }, "text": "", "reading_order": 3 } ] }, { "page": 45, "items": [ { "page": 45, "type": "TEXT", "location": { "l": 10.8, "t": 535.44, "r": 395.04, "b": 510 }, "text": "Figure 3.8 Annual DALYs per 100,000 people attributable to selected environmental risk factors, EEA-32 (excluding Türkiye)", "reading_order": 0 }, { "page": 45, "type": "FIGURE", "location": { "l": 0, "t": 504.72, "r": 707.76, "b": 119.04 }, "text": "", "links": [ { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 368.52, 127.08, 711.36, 143.28 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 367.92, 106.2, 523.92, 121.68 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 531.96, 108.48, 568.92, 120.36 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 576.36, 108.6, 587.52, 120.36 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 653.28, 108.48, 687.84, 120.24 ] } ], "reading_order": 1 }, { "page": 45, "type": "TEXT", "location": { "l": 363.84, "t": 146.64, "r": 713.04, "b": 104.88 }, "text": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "links": [ { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 368.52, 127.08, 711.36, 143.28 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 367.92, 106.2, 523.92, 121.68 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 525.72, 112.44, 530.04, 113.76 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 531.96, 108.48, 568.92, 120.36 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 570.36, 112.44, 574.68, 113.76 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 576.36, 108.6, 587.52, 120.36 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 589.44, 112.44, 593.76, 113.76 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 595.08, 105.48, 645.96, 117.24 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 647.4, 112.44, 651.72, 113.76 ] }, { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 653.28, 108.48, 687.84, 120.24 ] } ], "reading_order": 2 }, { "page": 45, "type": "TEXT", "location": { "l": 12.24, "t": 110.4, "r": 398.4, "b": 98.88 }, "text": "Notes: DALYs for air pollution include all-cause mortality, IHD, asthma, stroke, diabetes, lung cancer and COPD.", "links": [ { "uri": "https://www.eea.europa.eu/en/analysis/publications/environmental-noise-in-europe-2025", "dest": null, "action_type": "/URI", "bbox": [ 367.92, 106.2, 523.92, 121.68 ] } ], "reading_order": 3 }, { "page": 45, "type": "TEXT", "location": { "l": 51.84, "t": 95.04, "r": 402.72, "b": 74.4 }, "text": "DALYs, daily-adjusted life years. IHD, ischaemic heart disease. COPD, chronic obstructive pulmonary disease.", "reading_order": 4 }, { "page": 45, "type": "TEXT", "location": { "l": 11.28, "t": 69.84, "r": 402.72, "b": 29.04 }, "text": "Sources: Values for non-optimal temperature, lead, second-hand smoke, radon and unsafe water, sanitation and handwashing are based on data from the GBD Study 2021 (IHME, 2021); values for transport noise pollution are derived from data presented in Sections 3.2 and 3.3 of this report; and estimates for ambient air pollution are based on 2021 data from the EEA (EEA, 2024a).", "reading_order": 5 } ] }, { "page": 46, "items": [ { "page": 46, "type": "TITLE", "location": { "l": 30.48, "t": 503.52, "r": 514.8, "b": 436.32 }, "text": "Data Center Health Impact: NOISE Pollution", "reading_order": 0, "level": 5 }, { "page": 46, "type": "LIST_ITEM", "location": { "l": 39.6, "t": 403.68, "r": 405.36, "b": 369.36 }, "text": "Question ANSWERED:", "marker": "•", "list_id": "L56", "level": 0, "reading_order": 1 }, { "page": 46, "type": "LIST_ITEM", "location": { "l": 73.44, "t": 364.32, "r": 663.6, "b": 286.08 }, "text": "Does Noise Pollution Impact Health?\nYES", "marker": "•", "list_id": "L56", "level": 0, "reading_order": 2 } ] }, { "page": 47, "items": [ { "page": 47, "type": "TITLE", "location": { "l": 26.88, "t": 517.92, "r": 598.8, "b": 446.64 }, "text": "NOISE Pollution: Recommended\nInclusion", "reading_order": 0, "level": 6 }, { "page": 47, "type": "LIST_ITEM", "location": { "l": 28.32, "t": 409.2, "r": 561.12, "b": 349.2 }, "text": "Recommend Including Noise Pollution Prevention in Data Center Ordinance", "marker": "•", "list_id": "L57", "level": 0, "reading_order": 1 }, { "page": 47, "type": "LIST_ITEM", "location": { "l": 27.36, "t": 337.92, "r": 565.92, "b": 246.48 }, "text": "Recommend Including Noise Pollution Prevention in County Ordinance for All Industries/Other", "marker": "•", "list_id": "L57", "level": 0, "reading_order": 2 } ] }, { "page": 48, "items": [ { "page": 48, "type": "TITLE", "location": { "l": 18, "t": 514.08, "r": 588.96, "b": 440.4 }, "text": "NOISE Pollution: Recommended Monitoring", "reading_order": 0, "level": 5 }, { "page": 48, "type": "LIST_ITEM", "location": { "l": 18, "t": 402, "r": 509.52, "b": 371.28 }, "text": "Noise Level Study With Application", "marker": "•", "list_id": "L58", "level": 0, "reading_order": 1 }, { "page": 48, "type": "LIST_ITEM", "location": { "l": 17.28, "t": 361.44, "r": 636, "b": 302.64 }, "text": "Stipulation of Maximum Day and Night Noise Levels", "marker": "•", "list_id": "L58", "level": 0, "reading_order": 2 }, { "page": 48, "type": "LIST_ITEM", "location": { "l": 18.48, "t": 291.6, "r": 698.16, "b": 260.64 }, "text": "? Stipulation of Vibration, LFN, Infrasound Levels", "marker": "•", "list_id": "L58", "level": 0, "reading_order": 3 }, { "page": 48, "type": "LIST_ITEM", "location": { "l": 18.24, "t": 251.04, "r": 570.72, "b": 219.84 }, "text": "Noise Level Monitoring at Property Line", "marker": "•", "list_id": "L58", "level": 0, "reading_order": 4 }, { "page": 48, "type": "LIST_ITEM", "location": { "l": 17.52, "t": 210.72, "r": 348.72, "b": 180 }, "text": "Continuous Monitoring", "marker": "•", "list_id": "L58", "level": 0, "reading_order": 5 }, { "page": 48, "type": "LIST_ITEM", "location": { "l": 16.8, "t": 170.64, "r": 672.96, "b": 109.68 }, "text": "On-line Noise Pollution Dashboard on Dubuque County Website", "marker": "•", "list_id": "L58", "level": 0, "reading_order": 6 }, { "page": 48, "type": "LIST_ITEM", "location": { "l": 17.76, "t": 100.08, "r": 351.6, "b": 69.84 }, "text": "Paid for by Data Center", "marker": "•", "list_id": "L58", "level": 0, "reading_order": 7 } ] }, { "page": 49, "items": [ { "page": 49, "type": "TITLE", "location": { "l": 29.28, "t": 505.2, "r": 589.44, "b": 437.04 }, "text": "NOISE Pollution: Recommended\nSanctions for Non-Compliance", "reading_order": 0, "level": 6 }, { "page": 49, "type": "LIST_ITEM", "location": { "l": 54.72, "t": 392.64, "r": 597.12, "b": 333.6 }, "text": "Shut Down of Facility Until Compliance Issues Addressed", "marker": "•", "list_id": "L59", "level": 0, "reading_order": 1 } ] }, { "page": 50, "items": [ { "page": 50, "type": "TITLE", "location": { "l": 49.68, "t": 461.76, "r": 285.84, "b": 439.44 }, "text": "What is Noise Pollution?", "reading_order": 0, "level": 6 }, { "page": 50, "type": "TEXT", "location": { "l": 49.2, "t": 426.24, "r": 632.88, "b": 336.48 }, "text": "The traditional definition of noise is “unwanted or disturbing sound”. Sound becomes unwanted when it either interferes with normal activities such as sleeping, conversation, or disrupts or diminishes one's quality of life. The fact that you can't see, taste or smell it may help explain why it has not received as much attention as other types of pollution, such as air pollution, or water pollution. The air around us is constantly filled with sounds, yet most of us would probably not say we are surrounded by noise. Though for some, the persistent and escalating sources of sound can often be considered an annoyance. This “annoyance” can have major consequences, primarily to one's overall health.", "reading_order": 1 }, { "page": 50, "type": "TITLE", "location": { "l": 50.4, "t": 318.48, "r": 187.44, "b": 297.12 }, "text": "Health Effects", "reading_order": 2, "level": 6 }, { "page": 50, "type": "TEXT", "location": { "l": 49.2, "t": 284.16, "r": 632.4, "b": 224.88 }, "text": "Noise pollution adversely affects the lives of millions of people. Studies have shown that there are direct links between noise and health. Problems related to noise include stress related illnesses, high blood pressure, speech interference, hearing loss, sleep disruption, and lost productivity. Noise Induced Hearing Loss (NIHL) is the most common and often discussed health effect, but research has shown that exposure to constant or high levels of noise can cause countless adverse health effects.", "reading_order": 3 }, { "page": 50, "type": "TEXT", "location": { "l": 50.16, "t": 213.6, "r": 208.08, "b": 201.36 }, "text": "Learn more about the health effects:", "reading_order": 4 }, { "page": 50, "type": "TEXT", "location": { "l": 48.96, "t": 202.08, "r": 514.32, "b": 168.24 }, "text": "The Noise Effects Handbook ☑, Office of Noise Abatement and Control, US EPA 1981\nNoise and Its Effects, ☑ by Dr. Alice H. Suter, Administrative Conference of the United States, November 1991", "reading_order": 5 }, { "page": 50, "type": "TITLE", "location": { "l": 50.64, "t": 150.96, "r": 263.76, "b": 129.84 }, "text": "Protection from Noise", "reading_order": 6, "level": 6 }, { "page": 50, "type": "TEXT", "location": { "l": 49.92, "t": 116.88, "r": 630.96, "b": 73.2 }, "text": "Individuals can take many steps to protect themselves from the harmful effects of noise pollution. If people must be around loud sounds, they can protect their ears with hearing protection (e.g., ear plugs or ear muffs). There are various strategies for combating noise in your home, school, workplace, and the community.", "reading_order": 7 }, { "page": 50, "type": "TEXT", "location": { "l": 50.16, "t": 61.44, "r": 246.48, "b": 33.6 }, "text": "Learn more about noise pollution prevention:\nNoise Pollution Clearinghouse", "reading_order": 8 } ] }, { "page": 51, "items": [ { "page": 51, "type": "TITLE", "location": { "l": 177.84, "t": 526.08, "r": 540.24, "b": 465.84 }, "text": "American Academy of Nursing\nConsensus Statement on Noise", "reading_order": 0, "level": 6 }, { "page": 51, "type": "LIST_ITEM", "location": { "l": 18.96, "t": 441.6, "r": 694.56, "b": 397.92 }, "text": "Omission of environmental noise exposure in clinical health assessments (United States Preventive Services Taskforce, 2021);", "marker": "1)", "list_id": "L60", "level": 0, "reading_order": 1 }, { "page": 51, "type": "LIST_ITEM", "location": { "l": 17.52, "t": 391.92, "r": 629.76, "b": 348.72 }, "text": "Failure to protect neighborhoods, especially those housing people disadvantaged from environmental noise (Joan A. Casey et al., 2017a);", "marker": "2)", "list_id": "L60", "level": 0, "reading_order": 2 }, { "page": 51, "type": "LIST_ITEM", "location": { "l": 16.8, "t": 342.96, "r": 697.44, "b": 256.8 }, "text": "Little to no guidance and assistance to state and local governments with surveillance and policies from federal agencies since the defunding of the U.S. Environmental Protection Agency's Office of Noise Abatement and Control (American Public Health Association, 2021); (Defunded in 1982).", "marker": "3)", "list_id": "L60", "level": 0, "reading_order": 3 }, { "page": 51, "type": "LIST_ITEM", "location": { "l": 16.56, "t": 250.32, "r": 693.36, "b": 185.76 }, "text": "Lack of attention by U.S. Congress and state legislatures on the health effects of environmental noise resulting in little regulation (National Academy of Engineering, 2010);", "marker": "4)", "list_id": "L60", "level": 0, "reading_order": 4 }, { "page": 51, "type": "LIST_ITEM", "location": { "l": 18, "t": 179.76, "r": 683.04, "b": 137.28 }, "text": "Noise guidelines that have not been updated for decades (Eichwald et al., 2021);", "marker": "5)", "list_id": "L60", "level": 0, "reading_order": 5 }, { "page": 51, "type": "LIST_ITEM", "location": { "l": 18, "t": 130.08, "r": 671.28, "b": 87.36 }, "text": "Lack of coordination of noise-related activities between localities, states, and the federal government (National Academies of Sciences, 2010);", "marker": "6)", "list_id": "L60", "level": 0, "reading_order": 6 }, { "page": 51, "type": "LIST_ITEM", "location": { "l": 18.48, "t": 81.36, "r": 689.76, "b": 39.12 }, "text": "Absence of federal recommendations, guidelines, and standards for non-occupational noise exposure (Fink, 2021)...", "marker": "7)", "list_id": "L60", "level": 0, "reading_order": 7 }, { "page": 51, "type": "TEXT", "location": { "l": 489.6, "t": 38.16, "r": 675.6, "b": 16.32 }, "text": "(McCollagh, et al., 2026)", "reading_order": 8 } ] }, { "page": 52, "items": [ { "page": 52, "type": "TITLE", "location": { "l": 16.32, "t": 440.4, "r": 240.24, "b": 414.72 }, "text": "Extent of the problem", "reading_order": 0, "level": 6 }, { "page": 52, "type": "FIGURE", "location": { "l": 5.76, "t": 402, "r": 709.44, "b": 70.56 }, "text": "", "reading_order": 1 }, { "page": 52, "type": "TITLE", "location": { "l": 16.08, "t": 374.16, "r": 315.84, "b": 235.2 }, "text": "222", "reading_order": 2, "level": 3 }, { "page": 52, "type": "TEXT", "location": { "l": 14.16, "t": 220.08, "r": 308.88, "b": 148.56 }, "text": "at least 20% population affected by unhealthy levels of noise due to road, rail and air traffic\n30% according to WHO recommendations", "reading_order": 3 }, { "page": 52, "type": "TEXT", "location": { "l": 14.64, "t": 132, "r": 217.2, "b": 84 }, "text": "30% according to WHO recommendations", "reading_order": 4 } ] }, { "page": 53, "items": [ { "page": 53, "type": "TITLE", "location": { "l": 39.12, "t": 437.52, "r": 190.56, "b": 412.56 }, "text": "Health impacts", "reading_order": 0, "level": 6 }, { "page": 53, "type": "FIGURE", "location": { "l": 31.68, "t": 436.08, "r": 392.16, "b": 89.28 }, "text": "", "reading_order": 1 }, { "page": 53, "type": "TEXT", "location": { "l": 41.76, "t": 224.16, "r": 156.96, "b": 91.44 }, "text": "almost\n17 million\nEuropeans\nexperience\nlong-term high\nannoyance\napproximately\n4.6 million\nsuffer from severe\nsleep disturbances\ndue to transport\nnoise", "reading_order": 2 }, { "page": 53, "type": "TEXT", "location": { "l": 181.2, "t": 221.04, "r": 331.2, "b": 92.64 }, "text": "approximately\n4.6 million\nsuffer from severe\nsleep disturbances\ndue to transport\nnoise", "reading_order": 3 }, { "page": 53, "type": "TITLE", "location": { "l": 431.76, "t": 404.16, "r": 579.12, "b": 382.32 }, "text": "New cases in 2021", "reading_order": 4, "level": 6 }, { "page": 53, "type": "FIGURE", "location": { "l": 431.04, "t": 353.04, "r": 506.4, "b": 285.84 }, "text": "", "reading_order": 5 }, { "page": 53, "type": "FIGURE", "location": { "l": 444.24, "t": 269.28, "r": 509.28, "b": 192.72 }, "text": "", "reading_order": 6 }, { "page": 53, "type": "TEXT", "location": { "l": 524.64, "t": 344.4, "r": 608.4, "b": 277.92 }, "text": "73,000 premature deaths", "reading_order": 7 }, { "page": 53, "type": "TEXT", "location": { "l": 524.88, "t": 259.68, "r": 640.32, "b": 193.44 }, "text": "49,000\ncardiovascular\ndisease cases", "reading_order": 8 }, { "page": 53, "type": "FIGURE", "location": { "l": 432.48, "t": 162.96, "r": 515.52, "b": 105.6 }, "text": "", "reading_order": 9 }, { "page": 53, "type": "TEXT", "location": { "l": 524.64, "t": 157.44, "r": 644.64, "b": 91.68 }, "text": "23,000 type 2 diabetes cases", "reading_order": 10 } ] }, { "page": 54, "items": [ { "page": 54, "type": "TEXT", "location": { "l": 364.8, "t": 537.12, "r": 406.56, "b": 525.84 }, "text": "Air pollution", "reading_order": 0 }, { "page": 54, "type": "TEXT", "location": { "l": 443.76, "t": 537.36, "r": 467.04, "b": 526.56 }, "text": "WASH", "reading_order": 1 }, { "page": 54, "type": "TEXT", "location": { "l": 506.16, "t": 537.12, "r": 546.24, "b": 525.84 }, "text": "Solid waste", "reading_order": 2 }, { "page": 54, "type": "TITLE", "location": { "l": 22.08, "t": 536.16, "r": 282.72, "b": 445.92 }, "text": "Compendium of WHO\nand other UN guidance on\nhealth and environment", "reading_order": 3, "level": 6 }, { "page": 54, "type": "FIGURE", "location": { "l": 367.44, "t": 524.4, "r": 403.92, "b": 490.56 }, "text": "", "reading_order": 4 }, { "page": 54, "type": "FIGURE", "location": { "l": 438, "t": 525.36, "r": 472.8, "b": 490.32 }, "text": "", "reading_order": 5 }, { "page": 54, "type": "FIGURE", "location": { "l": 507.84, "t": 524.16, "r": 544.08, "b": 490.32 }, "text": "", "reading_order": 6 }, { "page": 54, "type": "FIGURE", "location": { "l": 367.68, "t": 484.32, "r": 402.24, "b": 450.24 }, "text": "", "reading_order": 7 }, { "page": 54, "type": "FIGURE", "location": { "l": 438, "t": 484.56, "r": 472.8, "b": 449.28 }, "text": "", "reading_order": 8 }, { "page": 54, "type": "TEXT", "location": { "l": 436.56, "t": 446.4, "r": 474.48, "b": 425.52 }, "text": "Nature and health", "reading_order": 9 }, { "page": 54, "type": "FIGURE", "location": { "l": 508.32, "t": 484.8, "r": 544.32, "b": 450.24 }, "text": "", "reading_order": 10 }, { "page": 54, "type": "TEXT", "location": { "l": 359.28, "t": 446.64, "r": 411.36, "b": 435.12 }, "text": "Climate change", "reading_order": 11 }, { "page": 54, "type": "TEXT", "location": { "l": 24.48, "t": 444, "r": 107.52, "b": 426.24 }, "text": "2024 update", "reading_order": 12 }, { "page": 54, "type": "TEXT", "location": { "l": 494.4, "t": 446.4, "r": 558.24, "b": 424.32 }, "text": "Safe environments and mobility", "reading_order": 13 }, { "page": 54, "type": "TEXT", "location": { "l": 286.56, "t": 428.4, "r": 378.48, "b": 413.76 }, "text": "Environmental risk factor", "reading_order": 14 }, { "page": 54, "type": "TABLE", "location": { "l": 7.92, "t": 423.12, "r": 557.52, "b": 14.4 }, "text": "
Environmental risk factor
Disease or injuryWASHIndoor fuel combustionSecond-hand tobacco smokeAmbient air pollutionNoiseChemicalsbHousingRecreational environmentWater resources managementLand use and built environmentOther community risksRadiationOccupationClimate changec
Noncommunicable diseases
Cancers●●●●●●●
Neuropsychiatric disorders●●●●●
Cataracts●●●
Hearing loss●●●
Cardiovascular diseases●●●●●●●●
COPD●●●●
Diabetes●●●
Asthma●●●●●●○
Other respiratory diseases●○
Chronic kidney diseases●●○
Skin diseases●●●
Musculoskeletal diseases●●
Congenital anomalies●●●●●
", "rows": [ { "row_index": 0, "location": [ 7.92, 397.575, 557.52, 423.12 ], "cells": [ { "location": [ 7.92, 397.575, 557.52, 423.12 ], "text": "Environmental risk factor", "html_text": "Environmental risk factor", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 15, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 1, "location": [ 7.92, 372.03, 557.52, 397.575 ], "cells": [ { "location": [ 7.92, 372.03, 44.56, 397.575 ], "text": "Disease or injury", "html_text": "Disease or injury", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 372.03, 81.2, 397.575 ], "text": "WASH", "html_text": "WASH", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 372.03, 117.84, 397.575 ], "text": "Indoor fuel combustion", "html_text": "Indoor fuel combustion", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 372.03, 154.48, 397.575 ], "text": "Second-hand tobacco smoke", "html_text": "Second-hand tobacco smoke", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 372.03, 191.12, 397.575 ], "text": "Ambient air pollution", "html_text": "Ambient air pollution", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 372.03, 227.76, 397.575 ], "text": "Noise", "html_text": "Noise", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 372.03, 264.4, 397.575 ], "text": "Chemicalsb", "html_text": "Chemicalsb", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 372.03, 301.04, 397.575 ], "text": "Housing", "html_text": "Housing", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 372.03, 337.68, 397.575 ], "text": "Recreational environment", "html_text": "Recreational environment", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 372.03, 374.32, 397.575 ], "text": "Water resources management", "html_text": "Water resources management", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 372.03, 410.96, 397.575 ], "text": "Land use and built environment", "html_text": "Land use and built environment", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 372.03, 447.6, 397.575 ], "text": "Other community risks", "html_text": "Other community risks", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 372.03, 484.24, 397.575 ], "text": "Radiation", "html_text": "Radiation", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 372.03, 520.88, 397.575 ], "text": "Occupation", "html_text": "Occupation", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 372.03, 557.52, 397.575 ], "text": "Climate changec", "html_text": "Climate changec", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 2, "location": [ 7.92, 346.485, 557.52, 372.03 ], "cells": [ { "location": [ 7.92, 346.485, 191.12, 372.03 ], "text": "Noncommunicable diseases", "html_text": "Noncommunicable diseases", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 5, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 346.485, 227.76, 372.03 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 346.485, 557.52, 372.03 ], "text": "", "html_text": "", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 9, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 3, "location": [ 7.92, 320.94, 557.52, 346.485 ], "cells": [ { "location": [ 7.92, 320.94, 44.56, 346.485 ], "text": "Cancers", "html_text": "Cancers", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 320.94, 81.2, 346.485 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 320.94, 117.84, 346.485 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 320.94, 154.48, 346.485 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 320.94, 191.12, 346.485 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 320.94, 227.76, 346.485 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 320.94, 264.4, 346.485 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 320.94, 301.04, 346.485 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 320.94, 337.68, 346.485 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 320.94, 374.32, 346.485 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 320.94, 410.96, 346.485 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 320.94, 447.6, 346.485 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 320.94, 484.24, 346.485 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 320.94, 520.88, 346.485 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 320.94, 557.52, 346.485 ], "text": "", "html_text": "", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 4, "location": [ 7.92, 295.395, 557.52, 320.94 ], "cells": [ { "location": [ 7.92, 295.395, 44.56, 320.94 ], "text": "Neuropsychiatric disorders", "html_text": "Neuropsychiatric disorders", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 295.395, 81.2, 320.94 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 295.395, 117.84, 320.94 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 295.395, 154.48, 320.94 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 295.395, 191.12, 320.94 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 295.395, 227.76, 320.94 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 295.395, 264.4, 320.94 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 295.395, 301.04, 320.94 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 295.395, 337.68, 320.94 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 295.395, 374.32, 320.94 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 295.395, 410.96, 320.94 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 295.395, 447.6, 320.94 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 295.395, 484.24, 320.94 ], "text": "", "html_text": "", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 295.395, 520.88, 320.94 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 295.395, 557.52, 320.94 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 5, "location": [ 7.92, 269.85, 557.52, 295.395 ], "cells": [ { "location": [ 7.92, 269.85, 44.56, 295.395 ], "text": "Cataracts", "html_text": "Cataracts", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 269.85, 81.2, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 269.85, 117.84, 295.395 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 269.85, 154.48, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 269.85, 191.12, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 269.85, 227.76, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 269.85, 264.4, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 269.85, 301.04, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 269.85, 337.68, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 269.85, 374.32, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 269.85, 410.96, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 269.85, 447.6, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 269.85, 484.24, 295.395 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 269.85, 520.88, 295.395 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 269.85, 557.52, 295.395 ], "text": "", "html_text": "", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 6, "location": [ 7.92, 244.305, 557.52, 269.85 ], "cells": [ { "location": [ 7.92, 244.305, 44.56, 269.85 ], "text": "Hearing loss", "html_text": "Hearing loss", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 244.305, 81.2, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 244.305, 117.84, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 244.305, 154.48, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 244.305, 191.12, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 244.305, 227.76, 269.85 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 244.305, 264.4, 269.85 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 244.305, 301.04, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 244.305, 337.68, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 244.305, 374.32, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 244.305, 410.96, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 244.305, 447.6, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 244.305, 484.24, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 244.305, 520.88, 269.85 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 244.305, 557.52, 269.85 ], "text": "", "html_text": "", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 7, "location": [ 7.92, 218.76, 557.52, 244.305 ], "cells": [ { "location": [ 7.92, 218.76, 44.56, 244.305 ], "text": "Cardiovascular diseases", "html_text": "Cardiovascular diseases", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 218.76, 81.2, 244.305 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 218.76, 117.84, 244.305 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 218.76, 154.48, 244.305 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 218.76, 191.12, 244.305 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 218.76, 227.76, 244.305 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 218.76, 264.4, 244.305 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 218.76, 301.04, 244.305 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 218.76, 337.68, 244.305 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 218.76, 374.32, 244.305 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 218.76, 410.96, 244.305 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 218.76, 447.6, 244.305 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 218.76, 484.24, 244.305 ], "text": "", "html_text": "", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 218.76, 520.88, 244.305 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 218.76, 557.52, 244.305 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 8, "location": [ 7.92, 193.215, 557.52, 218.76 ], "cells": [ { "location": [ 7.92, 193.215, 44.56, 218.76 ], "text": "COPD", "html_text": "COPD", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 193.215, 81.2, 218.76 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 193.215, 117.84, 218.76 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 193.215, 154.48, 218.76 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 193.215, 191.12, 218.76 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 193.215, 227.76, 218.76 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 193.215, 264.4, 218.76 ], "text": "", "html_text": "", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 193.215, 301.04, 218.76 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 193.215, 337.68, 218.76 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 193.215, 374.32, 218.76 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 193.215, 410.96, 218.76 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 193.215, 447.6, 218.76 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 193.215, 484.24, 218.76 ], "text": "", "html_text": "", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 193.215, 520.88, 218.76 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 193.215, 557.52, 218.76 ], "text": "", "html_text": "", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 9, "location": [ 7.92, 167.67, 557.52, 193.215 ], "cells": [ { "location": [ 7.92, 167.67, 44.56, 193.215 ], "text": "Diabetes", "html_text": "Diabetes", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 167.67, 81.2, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 167.67, 117.84, 193.215 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 167.67, 154.48, 193.215 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 167.67, 191.12, 193.215 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 167.67, 227.76, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 167.67, 264.4, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 167.67, 301.04, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 167.67, 337.68, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 167.67, 374.32, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 167.67, 410.96, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 167.67, 447.6, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 167.67, 484.24, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 167.67, 520.88, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 167.67, 557.52, 193.215 ], "text": "", "html_text": "", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 10, "location": [ 7.92, 142.125, 557.52, 167.67 ], "cells": [ { "location": [ 7.92, 142.125, 44.56, 167.67 ], "text": "Asthma", "html_text": "Asthma", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 142.125, 81.2, 167.67 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 142.125, 117.84, 167.67 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 142.125, 154.48, 167.67 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 142.125, 191.12, 167.67 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 142.125, 227.76, 167.67 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 142.125, 264.4, 167.67 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 142.125, 301.04, 167.67 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 142.125, 337.68, 167.67 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 142.125, 374.32, 167.67 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 142.125, 410.96, 167.67 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 142.125, 447.6, 167.67 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 142.125, 484.24, 167.67 ], "text": "", "html_text": "", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 142.125, 520.88, 167.67 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 142.125, 557.52, 167.67 ], "text": "○", "html_text": "○", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 11, "location": [ 7.92, 116.58, 557.52, 142.125 ], "cells": [ { "location": [ 7.92, 116.58, 44.56, 142.125 ], "text": "Other respiratory diseases", "html_text": "Other respiratory diseases", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 116.58, 81.2, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 116.58, 117.84, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 116.58, 154.48, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 116.58, 191.12, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 116.58, 227.76, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 116.58, 264.4, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 116.58, 301.04, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 116.58, 337.68, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 116.58, 374.32, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 116.58, 410.96, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 116.58, 447.6, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 116.58, 484.24, 142.125 ], "text": "", "html_text": "", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 116.58, 520.88, 142.125 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 116.58, 557.52, 142.125 ], "text": "○", "html_text": "○", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 12, "location": [ 7.92, 91.035, 557.52, 116.58 ], "cells": [ { "location": [ 7.92, 91.035, 44.56, 116.58 ], "text": "Chronic kidney diseases", "html_text": "Chronic kidney diseases", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 91.035, 81.2, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 91.035, 117.84, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 91.035, 154.48, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 91.035, 191.12, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 91.035, 227.76, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 91.035, 264.4, 116.58 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 91.035, 301.04, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 91.035, 337.68, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 91.035, 374.32, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 91.035, 410.96, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 91.035, 447.6, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 91.035, 484.24, 116.58 ], "text": "", "html_text": "", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 91.035, 520.88, 116.58 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 91.035, 557.52, 116.58 ], "text": "○", "html_text": "○", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 13, "location": [ 7.92, 65.49, 557.52, 91.035 ], "cells": [ { "location": [ 7.92, 65.49, 44.56, 91.035 ], "text": "Skin diseases", "html_text": "Skin diseases", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 65.49, 81.2, 91.035 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 65.49, 117.84, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 65.49, 154.48, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 65.49, 191.12, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 65.49, 227.76, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 65.49, 264.4, 91.035 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 65.49, 301.04, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 65.49, 337.68, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 65.49, 374.32, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 65.49, 410.96, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 65.49, 447.6, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 65.49, 484.24, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 65.49, 520.88, 91.035 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 65.49, 557.52, 91.035 ], "text": "", "html_text": "", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 14, "location": [ 7.92, 39.945, 557.52, 65.49 ], "cells": [ { "location": [ 7.92, 39.945, 44.56, 65.49 ], "text": "Musculoskeletal diseases", "html_text": "Musculoskeletal diseases", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 39.945, 81.2, 65.49 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 39.945, 117.84, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 39.945, 154.48, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 39.945, 191.12, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 39.945, 227.76, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 39.945, 264.4, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 39.945, 301.04, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 39.945, 337.68, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 39.945, 374.32, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 39.945, 410.96, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 39.945, 447.6, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 39.945, 484.24, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 39.945, 520.88, 65.49 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 39.945, 557.52, 65.49 ], "text": "", "html_text": "", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 15, "location": [ 7.92, 14.4, 557.52, 39.945 ], "cells": [ { "location": [ 7.92, 14.4, 44.56, 39.945 ], "text": "Congenital anomalies", "html_text": "Congenital anomalies", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 44.56, 14.4, 81.2, 39.945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 81.2, 14.4, 117.84, 39.945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 117.84, 14.4, 154.48, 39.945 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 154.48, 14.4, 191.12, 39.945 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 191.12, 14.4, 227.76, 39.945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 227.76, 14.4, 264.4, 39.945 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 6, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 264.4, 14.4, 301.04, 39.945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 7, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 301.04, 14.4, 337.68, 39.945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 8, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 337.68, 14.4, 374.32, 39.945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 9, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 374.32, 14.4, 410.96, 39.945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 10, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 410.96, 14.4, 447.6, 39.945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 11, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 447.6, 14.4, 484.24, 39.945 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 12, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 484.24, 14.4, 520.88, 39.945 ], "text": "●", "html_text": "●", "links": [], "cell_header_index": 13, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 520.88, 14.4, 557.52, 39.945 ], "text": "", "html_text": "", "links": [], "cell_header_index": 14, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 16, "n_cols": 15, "ref": "#/tables/0", "reading_order": 15 }, { "page": 54, "type": "TEXT", "location": { "l": 579.12, "t": 536.88, "r": 614.4, "b": 526.08 }, "text": "Chemicals", "reading_order": 16 }, { "page": 54, "type": "FIGURE", "location": { "l": 579.6, "t": 523.92, "r": 613.44, "b": 490.56 }, "text": "", "reading_order": 17 }, { "page": 54, "type": "FIGURE", "location": { "l": 578.88, "t": 484.56, "r": 613.92, "b": 449.76 }, "text": "", "reading_order": 18 }, { "page": 54, "type": "TEXT", "location": { "l": 574.8, "t": 446.16, "r": 618.48, "b": 424.32 }, "text": "Safe and healthy food", "reading_order": 19 }, { "page": 54, "type": "TEXT", "location": { "l": 650.4, "t": 537.12, "r": 683.76, "b": 526.32 }, "text": "Radiation", "reading_order": 20 }, { "page": 54, "type": "FIGURE", "location": { "l": 648, "t": 535.92, "r": 684.72, "b": 448.56 }, "text": "", "reading_order": 21 }, { "page": 54, "type": "TEXT", "location": { "l": 656.4, "t": 446.16, "r": 676.56, "b": 435.84 }, "text": "Noise", "reading_order": 22 } ] }, { "page": 55, "items": [ { "page": 55, "type": "TITLE", "location": { "l": 11.52, "t": 518.64, "r": 704.88, "b": 459.12 }, "text": "Noise Pollution\nQuality Guidelines World Health Organization", "reading_order": 0, "level": 6 }, { "page": 55, "type": "LIST_ITEM", "location": { "l": 37.44, "t": 423.12, "r": 617.28, "b": 354.96 }, "text": "The report, based on a limited set of data, estimated that DALYs lost from environmental noise in western European countries are equivalent to", "marker": "•", "list_id": "L61", "level": 0, "items": [ { "page": 55, "type": "LIST_ITEM", "location": { "l": 72.96, "t": 352.08, "r": 473.52, "b": 333.12 }, "text": "61,000 years for Ischaemic Heart Disease (IHD),", "marker": "•", "list_id": "L61", "level": 1, "reading_order": 0 }, { "page": 55, "type": "LIST_ITEM", "location": { "l": 73.2, "t": 331.2, "r": 482.4, "b": 312.96 }, "text": "45,000 years for cognitive impairment in children,", "marker": "•", "list_id": "L61", "level": 1, "reading_order": 1 }, { "page": 55, "type": "LIST_ITEM", "location": { "l": 73.44, "t": 310.8, "r": 385.92, "b": 292.56 }, "text": "903,000 years for sleep disturbance,", "marker": "•", "list_id": "L61", "level": 1, "reading_order": 2 }, { "page": 55, "type": "LIST_ITEM", "location": { "l": 73.68, "t": 290.64, "r": 319.44, "b": 272.4 }, "text": "22,000 years for tinnitus and", "marker": "•", "list_id": "L61", "level": 1, "reading_order": 3 }, { "page": 55, "type": "LIST_ITEM", "location": { "l": 72.48, "t": 270.72, "r": 637.2, "b": 231.84 }, "text": "654,000 years for annoyance (WHO Regional Office for Europe & JRC, 2011).", "marker": "•", "list_id": "L61", "level": 1, "reading_order": 4 } ], "reading_order": 1 }, { "page": 55, "type": "LIST_ITEM", "location": { "l": 36.72, "t": 228.48, "r": 630.24, "b": 159.84 }, "text": "These results indicate that at least one million healthy years of life are lost every year from traffic-related environmental noise in western Europe.", "marker": "•", "list_id": "L61", "level": 0, "reading_order": 2 }, { "page": 55, "type": "LIST_ITEM", "location": { "l": 36.96, "t": 156.72, "r": 640.56, "b": 111.12 }, "text": "Sleep disturbance and annoyance, mostly related to road traffic noise, constitute the bulk of this burden.", "marker": "•", "list_id": "L61", "level": 0, "reading_order": 3 } ] }, { "page": 56, "items": [ { "page": 56, "type": "TITLE", "location": { "l": 11.28, "t": 519.6, "r": 705.6, "b": 457.92 }, "text": "Noise Pollution\nQuality Guidelines World Health Organization", "reading_order": 0, "level": 6 }, { "page": 56, "type": "FIGURE", "location": { "l": 42.24, "t": 395.52, "r": 89.52, "b": 356.16 }, "text": "", "reading_order": 1 }, { "page": 56, "type": "TEXT", "location": { "l": 95.76, "t": 389.52, "r": 231.6, "b": 368.4 }, "text": "Road traffic noise", "reading_order": 2 }, { "page": 56, "type": "FIGURE", "location": { "l": 354.96, "t": 419.04, "r": 398.16, "b": 379.2 }, "text": "", "reading_order": 3 }, { "page": 56, "type": "TEXT", "location": { "l": 579.6, "t": 345.12, "r": 719.28, "b": 265.62 }, "text": "Strength", "reading_order": 4 }, { "page": 56, "type": "TEXT", "location": { "l": 579.6, "t": 265.62, "r": 719.28, "b": 186.12 }, "text": "Strong", "reading_order": 5 }, { "page": 56, "type": "TEXT", "location": { "l": 579.6, "t": 186.12, "r": 719.28, "b": 106.62 }, "text": "Strong", "reading_order": 6 }, { "page": 56, "type": "TEXT", "location": { "l": 579.6, "t": 106.62, "r": 719.28, "b": 27.12 }, "text": "Strong", "reading_order": 7 }, { "page": 56, "type": "TABLE", "location": { "l": 63.12, "t": 344.4, "r": 656.16, "b": 25.2 }, "text": "
recommendationStrength
For average noise exposure, the GDG strongly recommends reducing noise levels produced by road traffic below 53 decibels (dB) Lden, as road traffic noise above this level is associated with adverse health effects.Strong
For night noise exposure, the GDG strongly recommends reducing noise levels produced by road traffic during night time below 45 dB Lnight, as night-time road traffic noise above this level is associated with adverse effects on sleep.Strong
To reduce health effects, the GDG strongly recommends that policy-makers implement suitable measures to reduce noise exposure from road traffic in the population exposed to levels above the guideline values for average and night noise exposure. For specific interventions, the GDG recommends reducing noise both at the source and on the route between the source and the affected population by changes in infrastructure.Strong
", "rows": [ { "row_index": 0, "location": [ 63.12, 264.6, 656.16, 344.4 ], "cells": [ { "location": [ 63.12, 264.6, 359.64, 344.4 ], "text": "recommendation", "html_text": "recommendation", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 359.64, 264.6, 656.16, 344.4 ], "text": "Strength", "html_text": "Strength", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 1, "location": [ 63.12, 184.8, 656.16, 264.6 ], "cells": [ { "location": [ 63.12, 184.8, 359.64, 264.6 ], "text": "For average noise exposure, the GDG strongly recommends reducing noise levels produced by road traffic below 53 decibels (dB) Lden, as road traffic noise above this level is associated with adverse health effects.", "html_text": "For average noise exposure, the GDG strongly recommends reducing noise levels produced by road traffic below 53 decibels (dB) Lden, as road traffic noise above this level is associated with adverse health effects.", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 359.64, 184.8, 656.16, 264.6 ], "text": "Strong", "html_text": "Strong", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 2, "location": [ 63.12, 105, 656.16, 184.8 ], "cells": [ { "location": [ 63.12, 105, 359.64, 184.8 ], "text": "For night noise exposure, the GDG strongly recommends reducing noise levels produced by road traffic during night time below 45 dB Lnight, as night-time road traffic noise above this level is associated with adverse effects on sleep.", "html_text": "For night noise exposure, the GDG strongly recommends reducing noise levels produced by road traffic during night time below 45 dB Lnight, as night-time road traffic noise above this level is associated with adverse effects on sleep.", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 359.64, 105, 656.16, 184.8 ], "text": "Strong", "html_text": "Strong", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 3, "location": [ 63.12, 25.2, 656.16, 105 ], "cells": [ { "location": [ 63.12, 25.2, 359.64, 105 ], "text": "To reduce health effects, the GDG strongly recommends that policy-makers implement suitable measures to reduce noise exposure from road traffic in the population exposed to levels above the guideline values for average and night noise exposure. For specific interventions, the GDG recommends reducing noise both at the source and on the route between the source and the affected population by changes in infrastructure.", "html_text": "To reduce health effects, the GDG strongly recommends that policy-makers implement suitable measures to reduce noise exposure from road traffic in the population exposed to levels above the guideline values for average and night noise exposure. For specific interventions, the GDG recommends reducing noise both at the source and on the route between the source and the affected population by changes in infrastructure.", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 359.64, 25.2, 656.16, 105 ], "text": "Strong", "html_text": "Strong", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 4, "n_cols": 2, "ref": "#/tables/0", "reading_order": 8 } ] }, { "page": 57, "items": [ { "page": 57, "type": "TEXT", "location": { "l": 213.36, "t": 531.12, "r": 691.92, "b": 516.48 }, "text": "Table 8. PICOS/PECCOS scheme of critical health outcomes for exposure to road traffic noise", "reading_order": 0 }, { "page": 57, "type": "TEXT", "location": { "l": 209.52, "t": 511.68, "r": 691.2, "b": 497.66 }, "text": "PECO Description", "reading_order": 1 }, { "page": 57, "type": "TEXT", "location": { "l": 209.52, "t": 497.66, "r": 691.2, "b": 483.64 }, "text": "Population General population", "reading_order": 2 }, { "page": 57, "type": "TEXT", "location": { "l": 209.52, "t": 483.64, "r": 691.2, "b": 469.62 }, "text": "Exposure Exposure to high levels of noise produced by road traffic (average/night time)", "reading_order": 3 }, { "page": 57, "type": "TEXT", "location": { "l": 209.52, "t": 469.62, "r": 691.2, "b": 455.6 }, "text": "Comparison Exposure to lower levels of noise produced by road traffic (average/night time)", "reading_order": 4 }, { "page": 57, "type": "TEXT", "location": { "l": 209.52, "t": 455.6, "r": 691.2, "b": 343.44 }, "text": "Outcome(s) For average noise exposure: For night noise exposure:", "reading_order": 5 }, { "page": 57, "type": "LIST_ITEM", "location": { "l": 370.08, "t": 441.58, "r": 691.2, "b": 427.56 }, "text": "cardiovascular disease 1. effects on sleep", "marker": "1.", "list_id": "L62", "level": 0, "reading_order": 6 }, { "page": 57, "type": "LIST_ITEM", "location": { "l": 370.08, "t": 427.56, "r": 691.2, "b": 413.54 }, "text": "annoyance", "marker": "2.", "list_id": "L62", "level": 0, "reading_order": 7 }, { "page": 57, "type": "LIST_ITEM", "location": { "l": 370.08, "t": 413.54, "r": 691.2, "b": 399.52 }, "text": "cognitive impairment", "marker": "3.", "list_id": "L62", "level": 0, "reading_order": 8 }, { "page": 57, "type": "LIST_ITEM", "location": { "l": 370.08, "t": 399.52, "r": 691.2, "b": 385.5 }, "text": "hearing impairment and tinnitus", "marker": "4.", "list_id": "L62", "level": 0, "reading_order": 9 }, { "page": 57, "type": "LIST_ITEM", "location": { "l": 370.08, "t": 385.5, "r": 691.2, "b": 371.48 }, "text": "adverse birth outcomes", "marker": "5.", "list_id": "L62", "level": 0, "reading_order": 10 }, { "page": 57, "type": "LIST_ITEM", "location": { "l": 370.08, "t": 371.48, "r": 691.2, "b": 357.46 }, "text": "quality of life, well-being and mental health", "marker": "6.", "list_id": "L62", "level": 0, "reading_order": 11 }, { "page": 57, "type": "LIST_ITEM", "location": { "l": 370.08, "t": 357.46, "r": 691.2, "b": 343.44 }, "text": "metabolic outcomes", "marker": "7.", "list_id": "L62", "level": 0, "reading_order": 12 }, { "page": 57, "type": "TITLE", "location": { "l": 6.72, "t": 436.8, "r": 239.52, "b": 383.76 }, "text": "Noise Pollution\nQuality Guidelines\nWorld Health Organization", "reading_order": 13, "level": 6 }, { "page": 57, "type": "FIGURE", "location": { "l": 35.52, "t": 319.92, "r": 79.2, "b": 280.56 }, "text": "", "reading_order": 14 }, { "page": 57, "type": "TEXT", "location": { "l": 213.84, "t": 332.16, "r": 668.88, "b": 317.28 }, "text": "Table 9. Summary of findings for health effects from exposure to road traffic noise (Lden)", "reading_order": 15 }, { "page": 57, "type": "TABLE", "location": { "l": 213.6, "t": 312.96, "r": 693.6, "b": 17.04 }, "text": "
Noise metricPriority health outcome measureQuantitative risk for adverse healthLowest level of exposure across studiesNumber of participants (studies)Quality of evidence
Cardiovascular disease
LdenIncidence of IHDRR = 1.08 (95% confidence interval (CI): 1.01–1.15) per 10 dB increase53 dB67 224 (7)High (upgraded for dose-response)
LdenIncidence of hypertensionRR = 0.97 (95% CI: 0.90–1.05) per 10 dB increaseN/A32 635 (1)Low (downgraded for risk of bias and because only one study was available)
Annoyance
Lden%HAOdds ratio (OR) = 3.03 (95% CI: 2.59–3.55) per 10 dB increase40 dB34 112 (25)Moderate (downgraded for inconsistency)
Cognitive impairment
LdenReading and oral comprehensionNot estimatedN/AOver 2844 (1)Very low (downgraded for inconsistency)
Hearing impairment and tinnitus
LdenPermanent hearing impairment----
", "rows": [ { "row_index": 0, "location": [ 213.6, 283.368, 693.6, 312.96 ], "cells": [ { "location": [ 213.6, 283.368, 293.6, 312.96 ], "text": "Noise metric", "html_text": "Noise metric", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 293.6, 283.368, 373.6, 312.96 ], "text": "Priority health outcome measure", "html_text": "Priority health outcome measure", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 373.6, 283.368, 453.6, 312.96 ], "text": "Quantitative risk for adverse health", "html_text": "Quantitative risk for adverse health", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 453.6, 283.368, 533.6, 312.96 ], "text": "Lowest level of exposure across studies", "html_text": "Lowest level of exposure across studies", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 533.6, 283.368, 613.6, 312.96 ], "text": "Number of participants (studies)", "html_text": "Number of participants (studies)", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 613.6, 283.368, 693.6, 312.96 ], "text": "Quality of evidence", "html_text": "Quality of evidence", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 1, "location": [ 213.6, 253.776, 693.6, 283.368 ], "cells": [ { "location": [ 213.6, 253.776, 693.6, 283.368 ], "text": "Cardiovascular disease", "html_text": "Cardiovascular disease", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 2, "location": [ 213.6, 224.184, 693.6, 253.776 ], "cells": [ { "location": [ 213.6, 224.184, 293.6, 253.776 ], "text": "Lden", "html_text": "Lden", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 293.6, 224.184, 373.6, 253.776 ], "text": "Incidence of IHD", "html_text": "Incidence of IHD", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 373.6, 224.184, 453.6, 253.776 ], "text": "RR = 1.08 (95% confidence interval (CI): 1.01–1.15) per 10 dB increase", "html_text": "RR = 1.08 (95% confidence interval (CI): 1.01–1.15) per 10 dB increase", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 453.6, 224.184, 533.6, 253.776 ], "text": "53 dB", "html_text": "53 dB", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 533.6, 224.184, 613.6, 253.776 ], "text": "67 224 (7)", "html_text": "67 224 (7)", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 613.6, 224.184, 693.6, 253.776 ], "text": "High (upgraded for dose-response)", "html_text": "High (upgraded for dose-response)", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 3, "location": [ 213.6, 194.592, 693.6, 224.184 ], "cells": [ { "location": [ 213.6, 194.592, 293.6, 224.184 ], "text": "Lden", "html_text": "Lden", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 293.6, 194.592, 373.6, 224.184 ], "text": "Incidence of hypertension", "html_text": "Incidence of hypertension", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 373.6, 194.592, 453.6, 224.184 ], "text": "RR = 0.97 (95% CI: 0.90–1.05) per 10 dB increase", "html_text": "RR = 0.97 (95% CI: 0.90–1.05) per 10 dB increase", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 453.6, 194.592, 533.6, 224.184 ], "text": "N/A", "html_text": "N/A", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 533.6, 194.592, 613.6, 224.184 ], "text": "32 635 (1)", "html_text": "32 635 (1)", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 613.6, 194.592, 693.6, 224.184 ], "text": "Low (downgraded for risk of bias and because only one study was available)", "html_text": "Low (downgraded for risk of bias and because only one study was available)", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 4, "location": [ 213.6, 165, 693.6, 194.592 ], "cells": [ { "location": [ 213.6, 165, 693.6, 194.592 ], "text": "Annoyance", "html_text": "Annoyance", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 5, "location": [ 213.6, 135.408, 693.6, 165 ], "cells": [ { "location": [ 213.6, 135.408, 293.6, 165 ], "text": "Lden", "html_text": "Lden", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 293.6, 135.408, 373.6, 165 ], "text": "%HA", "html_text": "%HA", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 373.6, 135.408, 453.6, 165 ], "text": "Odds ratio (OR) = 3.03 (95% CI: 2.59–3.55) per 10 dB increase", "html_text": "Odds ratio (OR) = 3.03 (95% CI: 2.59–3.55) per 10 dB increase", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 453.6, 135.408, 533.6, 165 ], "text": "40 dB", "html_text": "40 dB", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 533.6, 135.408, 613.6, 165 ], "text": "34 112 (25)", "html_text": "34 112 (25)", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 613.6, 135.408, 693.6, 165 ], "text": "Moderate (downgraded for inconsistency)", "html_text": "Moderate (downgraded for inconsistency)", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 6, "location": [ 213.6, 105.816, 693.6, 135.408 ], "cells": [ { "location": [ 213.6, 105.816, 693.6, 135.408 ], "text": "Cognitive impairment", "html_text": "Cognitive impairment", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 7, "location": [ 213.6, 76.224, 693.6, 105.816 ], "cells": [ { "location": [ 213.6, 76.224, 293.6, 105.816 ], "text": "Lden", "html_text": "Lden", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 293.6, 76.224, 373.6, 105.816 ], "text": "Reading and oral comprehension", "html_text": "Reading and oral comprehension", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 373.6, 76.224, 453.6, 105.816 ], "text": "Not estimated", "html_text": "Not estimated", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 453.6, 76.224, 533.6, 105.816 ], "text": "N/A", "html_text": "N/A", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 533.6, 76.224, 613.6, 105.816 ], "text": "Over 2844 (1)", "html_text": "Over 2844 (1)", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 613.6, 76.224, 693.6, 105.816 ], "text": "Very low (downgraded for inconsistency)", "html_text": "Very low (downgraded for inconsistency)", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 8, "location": [ 213.6, 46.632, 693.6, 76.224 ], "cells": [ { "location": [ 213.6, 46.632, 693.6, 76.224 ], "text": "Hearing impairment and tinnitus", "html_text": "Hearing impairment and tinnitus", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" }, { "row_index": 9, "location": [ 213.6, 17.04, 693.6, 46.632 ], "cells": [ { "location": [ 213.6, 17.04, 293.6, 46.632 ], "text": "Lden", "html_text": "Lden", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 293.6, 17.04, 373.6, 46.632 ], "text": "Permanent hearing impairment", "html_text": "Permanent hearing impairment", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 373.6, 17.04, 453.6, 46.632 ], "text": "-", "html_text": "-", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 453.6, 17.04, 533.6, 46.632 ], "text": "-", "html_text": "-", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 533.6, 17.04, 613.6, 46.632 ], "text": "-", "html_text": "-", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" }, { "location": [ 613.6, 17.04, 693.6, 46.632 ], "text": "-", "html_text": "-", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/1" } ], "ref": "#/tables/1" } ], "n_rows": 10, "n_cols": 6, "ref": "#/tables/1", "reading_order": 16 } ] }, { "page": 58, "items": [ { "page": 58, "type": "TEXT", "location": { "l": 174, "t": 531.12, "r": 654.72, "b": 517.2 }, "text": "Table 15. Summary of the assessment of the strength of the road traffic noise recommendation", "reading_order": 0 }, { "page": 58, "type": "TABLE", "location": { "l": 28.08, "t": 513.36, "r": 653.28, "b": 24.48 }, "text": "
Factors influencing the strength of recommendationDecision
Quality of evidenceAverage exposure (Lden)\\nHealth effects\\n• Evidence for a relevant RR increase for incidence of IHD at 59 dB Lden was rated high quality.\\n• Evidence for the incidence of hypertension was rated low quality.\\n• Evidence for a relevant absolute risk of annoyance at 53 dB Lden was rated moderate quality.\\n• Evidence for a relevant RR increase for reading and oral comprehension was rated very low quality.
World Health OrganizationInterventions\\n• Evidence on effectiveness of interventions to reduce noise exposure and/or health outcomes from road traffic noise is of varying quality.
Regional Office for EuropeNight-time exposure (Lnight)\\nHealth effects\\n• Evidence for a relevant absolute risk of sleep disturbance related to night noise exposure from road traffic at 45 dB Lnight was rated moderate quality.
Interventions\\n• Evidence on effectiveness of interventions to reduce noise exposure and/or sleep disturbance from road traffic noise is of varying quality.
Balance of benefits versus harms and burdensHealth benefits can be gained from markedly reducing exposure of the population to road traffic noise; benefits outweigh the harms of interventions to reduce continuous road traffic noise.
Values and preferencesQuiet areas are valued by the population, especially by those affected by continuous noise exposure. Some variability is possible between those who benefit from interventions to reduce road traffic noise and those who finance the interventions.
EquityRisk of exposure to road traffic noise is not equally distributed.
Resource use and implicationsNo comprehensive cost–effectiveness analysis data are available; nevertheless, a wide range of solutions exists and several are being implemented, showing that effective interventions are both feasible and economically reasonable.
Decisions on recommendation strength• Strong for guideline level for average noise exposure (Lden)\\n• Strong for guideline value for average night noise exposure (Lnight)\\n• Strong for specific interventions to reduce noise exposure
", "rows": [ { "row_index": 0, "location": [ 28.08, 464.472, 653.28, 513.36 ], "cells": [ { "location": [ 28.08, 464.472, 340.68, 513.36 ], "text": "Factors influencing the strength of recommendation", "html_text": "Factors influencing the strength of recommendation", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 340.68, 464.472, 653.28, 513.36 ], "text": "Decision", "html_text": "Decision", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 1, "location": [ 28.08, 415.584, 653.28, 464.472 ], "cells": [ { "location": [ 28.08, 415.584, 340.68, 464.472 ], "text": "Quality of evidence", "html_text": "Quality of evidence", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 340.68, 415.584, 653.28, 464.472 ], "text": "Average exposure (Lden)\\nHealth effects\\n• Evidence for a relevant RR increase for incidence of IHD at 59 dB Lden was rated high quality.\\n• Evidence for the incidence of hypertension was rated low quality.\\n• Evidence for a relevant absolute risk of annoyance at 53 dB Lden was rated moderate quality.\\n• Evidence for a relevant RR increase for reading and oral comprehension was rated very low quality.", "html_text": "Average exposure (Lden)\\nHealth effects\\n• Evidence for a relevant RR increase for incidence of IHD at 59 dB Lden was rated high quality.\\n• Evidence for the incidence of hypertension was rated low quality.\\n• Evidence for a relevant absolute risk of annoyance at 53 dB Lden was rated moderate quality.\\n• Evidence for a relevant RR increase for reading and oral comprehension was rated very low quality.", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 2, "location": [ 28.08, 366.696, 653.28, 415.584 ], "cells": [ { "location": [ 28.08, 366.696, 340.68, 415.584 ], "text": "World Health Organization", "html_text": "World Health Organization", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 340.68, 366.696, 653.28, 415.584 ], "text": "Interventions\n• Evidence on effectiveness of interventions to reduce noise exposure and/or health outcomes from road traffic noise is of varying quality.", "html_text": "Interventions\n• Evidence on effectiveness of interventions to reduce noise exposure and/or health outcomes from road traffic noise is of varying quality.", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 3, "location": [ 28.08, 317.808, 653.28, 366.696 ], "cells": [ { "location": [ 28.08, 317.808, 340.68, 366.696 ], "text": "Regional Office for Europe", "html_text": "Regional Office for Europe", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 340.68, 317.808, 653.28, 366.696 ], "text": "Night-time exposure (Lnight)\\nHealth effects\\n• Evidence for a relevant absolute risk of sleep disturbance related to night noise exposure from road traffic at 45 dB Lnight was rated moderate quality.", "html_text": "Night-time exposure (Lnight)\\nHealth effects\\n• Evidence for a relevant absolute risk of sleep disturbance related to night noise exposure from road traffic at 45 dB Lnight was rated moderate quality.", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 4, "location": [ 28.08, 268.92, 653.28, 317.808 ], "cells": [ { "location": [ 28.08, 268.92, 340.68, 317.808 ], "text": "", "html_text": "", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 340.68, 268.92, 653.28, 317.808 ], "text": "Interventions\n• Evidence on effectiveness of interventions to reduce noise exposure and/or sleep disturbance from road traffic noise is of varying quality.", "html_text": "Interventions\n• Evidence on effectiveness of interventions to reduce noise exposure and/or sleep disturbance from road traffic noise is of varying quality.", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 5, "location": [ 28.08, 220.032, 653.28, 268.92 ], "cells": [ { "location": [ 28.08, 220.032, 340.68, 268.92 ], "text": "Balance of benefits versus harms and burdens", "html_text": "Balance of benefits versus harms and burdens", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 340.68, 220.032, 653.28, 268.92 ], "text": "Health benefits can be gained from markedly reducing exposure of the population to road traffic noise; benefits outweigh the harms of interventions to reduce continuous road traffic noise.", "html_text": "Health benefits can be gained from markedly reducing exposure of the population to road traffic noise; benefits outweigh the harms of interventions to reduce continuous road traffic noise.", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 6, "location": [ 28.08, 171.144, 653.28, 220.032 ], "cells": [ { "location": [ 28.08, 171.144, 340.68, 220.032 ], "text": "Values and preferences", "html_text": "Values and preferences", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 340.68, 171.144, 653.28, 220.032 ], "text": "Quiet areas are valued by the population, especially by those affected by continuous noise exposure. Some variability is possible between those who benefit from interventions to reduce road traffic noise and those who finance the interventions.", "html_text": "Quiet areas are valued by the population, especially by those affected by continuous noise exposure. Some variability is possible between those who benefit from interventions to reduce road traffic noise and those who finance the interventions.", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 7, "location": [ 28.08, 122.256, 653.28, 171.144 ], "cells": [ { "location": [ 28.08, 122.256, 340.68, 171.144 ], "text": "Equity", "html_text": "Equity", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 340.68, 122.256, 653.28, 171.144 ], "text": "Risk of exposure to road traffic noise is not equally distributed.", "html_text": "Risk of exposure to road traffic noise is not equally distributed.", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 8, "location": [ 28.08, 73.368, 653.28, 122.256 ], "cells": [ { "location": [ 28.08, 73.368, 340.68, 122.256 ], "text": "Resource use and implications", "html_text": "Resource use and implications", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 340.68, 73.368, 653.28, 122.256 ], "text": "No comprehensive cost–effectiveness analysis data are available; nevertheless, a wide range of solutions exists and several are being implemented, showing that effective interventions are both feasible and economically reasonable.", "html_text": "No comprehensive cost–effectiveness analysis data are available; nevertheless, a wide range of solutions exists and several are being implemented, showing that effective interventions are both feasible and economically reasonable.", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 9, "location": [ 28.08, 24.48, 653.28, 73.368 ], "cells": [ { "location": [ 28.08, 24.48, 340.68, 73.368 ], "text": "Decisions on recommendation strength", "html_text": "Decisions on recommendation strength", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 340.68, 24.48, 653.28, 73.368 ], "text": "• Strong for guideline level for average noise exposure (Lden)\\n• Strong for guideline value for average night noise exposure (Lnight)\\n• Strong for specific interventions to reduce noise exposure", "html_text": "• Strong for guideline level for average noise exposure (Lden)\\n• Strong for guideline value for average night noise exposure (Lnight)\\n• Strong for specific interventions to reduce noise exposure", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 10, "n_cols": 2, "ref": "#/tables/0", "reading_order": 1 } ] }, { "page": 59, "items": [ { "page": 59, "type": "TEXT", "location": { "l": 33.12, "t": 495.12, "r": 267.12, "b": 443.04 }, "text": "Noise Pollution\nQuality Guidelines\nWorld Health Organization", "reading_order": 0 }, { "page": 59, "type": "TEXT", "location": { "l": 429.36, "t": 518.16, "r": 654.48, "b": 422.16 }, "text": "Compendium of WHO\nand other UN guidance on\nhealth and environment\n2024 update", "reading_order": 1 }, { "page": 59, "type": "LIST_ITEM", "location": { "l": 44.64, "t": 403.92, "r": 645.84, "b": 310.8 }, "text": "Based on the systematic review of evidence available at the time of the development of the environmental noise guidelines (2), the following recommended levels for specific noise sources can be defined.", "marker": "•", "list_id": "L63", "level": 0, "reading_order": 2 }, { "page": 59, "type": "LIST_ITEM", "location": { "l": 43.68, "t": 307.68, "r": 652.08, "b": 263.04 }, "text": "For average noise exposure, the following sound pressure levels are recommended (2, 6):", "marker": "•", "list_id": "L63", "level": 0, "items": [ { "page": 59, "type": "LIST_ITEM", "location": { "l": 79.68, "t": 260.64, "r": 364.8, "b": 241.68 }, "text": "< 53 dB Lden for road traffic noise", "marker": "•", "list_id": "L63", "level": 1, "reading_order": 0 }, { "page": 59, "type": "LIST_ITEM", "location": { "l": 79.68, "t": 240, "r": 332.88, "b": 221.04 }, "text": "< 54 dB L_{den} for railway noise", "marker": "•", "list_id": "L63", "level": 1, "reading_order": 1 }, { "page": 59, "type": "LIST_ITEM", "location": { "l": 79.68, "t": 220.08, "r": 338.4, "b": 201.12 }, "text": "< 45 dB Lden for aircraft noise", "marker": "•", "list_id": "L63", "level": 1, "reading_order": 2 }, { "page": 59, "type": "LIST_ITEM", "location": { "l": 79.92, "t": 199.92, "r": 376.08, "b": 180 }, "text": "< 45 dB L_{den} for wind turbine noise", "marker": "•", "list_id": "L63", "level": 1, "reading_order": 3 } ], "reading_order": 3 }, { "page": 59, "type": "LIST_ITEM", "location": { "l": 43.44, "t": 178.08, "r": 626.16, "b": 133.68 }, "text": "For night noise exposure, the following sound pressure levels are recommended (2):", "marker": "•", "list_id": "L63", "level": 0, "items": [ { "page": 59, "type": "LIST_ITEM", "location": { "l": 80.16, "t": 131.04, "r": 377.04, "b": 112.08 }, "text": "< 45 dB Lnight for road traffic noise", "marker": "•", "list_id": "L63", "level": 1, "reading_order": 0 }, { "page": 59, "type": "LIST_ITEM", "location": { "l": 79.68, "t": 110.64, "r": 344.88, "b": 91.2 }, "text": "< 44 dB L_{night} for railway noise", "marker": "•", "list_id": "L63", "level": 1, "reading_order": 1 }, { "page": 59, "type": "LIST_ITEM", "location": { "l": 79.44, "t": 90.48, "r": 352.08, "b": 69.84 }, "text": "< 40 dB L_{night} for aircraft noise.", "marker": "•", "list_id": "L63", "level": 1, "reading_order": 2 } ], "reading_order": 4 } ] }, { "page": 60, "items": [ { "page": 60, "type": "TITLE", "location": { "l": 55.2, "t": 498.96, "r": 354.96, "b": 425.52 }, "text": "Noise Pollution\nOrdinances", "reading_order": 0, "level": 6 }, { "page": 60, "type": "TITLE", "location": { "l": 55.2, "t": 412.32, "r": 278.64, "b": 386.88 }, "text": "• Allamakee, Iowa", "reading_order": 1, "level": 6 }, { "page": 60, "type": "LIST_ITEM", "location": { "l": 89.52, "t": 383.52, "r": 200.64, "b": 370.56 }, "text": "Version: (4/17/26)", "marker": "•", "list_id": "L64", "level": 0, "reading_order": 2 }, { "page": 60, "type": "LIST_ITEM", "location": { "l": 89.76, "t": 369.12, "r": 613.44, "b": 355.68 }, "text": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "marker": "•", "links": [ { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 93.24, 361.44, 96.12, 364.32 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 111.36, 356.64, 289.32, 367.08 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 290.04, 361.32, 293.16, 362.4 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 293.88, 356.76, 434.64, 367.08 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 435.6, 361.32, 438.72, 362.4 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 439.68, 358.92, 444.72, 366.96 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 445.32, 361.32, 448.44, 362.4 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 448.68, 358.8, 507.96, 366.96 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 508.2, 361.32, 511.32, 362.4 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 511.92, 358.8, 523.44, 366.96 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 524.16, 361.32, 527.28, 362.4 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 528.24, 358.8, 550.32, 366.96 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 551.04, 361.32, 554.16, 362.4 ] }, { "uri": "https://allamakeecounty.iowa.gov/wp-content/uploads/2026/04/Ord-L-Amendment-20-Data-Centers.pdf", "dest": null, "action_type": "/URI", "bbox": [ 554.88, 356.76, 611.52, 367.08 ] } ], "list_id": "L64", "level": 0, "reading_order": 3 }, { "page": 60, "type": "LIST_ITEM", "location": { "l": 90.24, "t": 323.28, "r": 203.52, "b": 309.84 }, "text": "Version: (8/17/26)", "marker": "•", "list_id": "L64", "level": 0, "reading_order": 4 }, { "page": 60, "type": "LIST_ITEM", "location": { "l": 90, "t": 308.64, "r": 481.68, "b": 286.56 }, "text": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "marker": "•", "links": [ { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 93.24, 301.08, 96.12, 303.96 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 111.36, 296.4, 391.44, 306.72 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 392.16, 300.96, 395.28, 302.04 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 395.88, 298.44, 418.92, 306.6 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 419.64, 300.96, 422.76, 302.04 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 423, 298.44, 447, 306.6 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 447.72, 300.96, 450.84, 302.04 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 451.32, 298.44, 473.52, 306.6 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 475.8, 300.96, 478.92, 302.04 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 111, 287.04, 328.68, 297.48 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 329.4, 291.72, 332.52, 292.8 ] }, { "uri": "https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:f128cbc6-76ca-421a-a011-d151c23259a3?viewer%21megaVerb=group-discove", "dest": null, "action_type": "/URI", "bbox": [ 333.12, 289.2, 369.6, 297.36 ] } ], "list_id": "L64", "level": 0, "reading_order": 5 }, { "page": 60, "type": "TITLE", "location": { "l": 55.2, "t": 351.6, "r": 348.24, "b": 325.68 }, "text": "• Jackson County, Iowa", "reading_order": 6, "level": 6 }, { "page": 60, "type": "LIST_ITEM", "location": { "l": 56.7, "t": 284.2934, "r": 350.5796, "b": 255.2018 }, "text": "Johnson County, Iowa", "marker": "•", "list_id": "L65", "level": 0, "items": [ { "page": 60, "type": "LIST_ITEM", "location": { "l": 92.7, "t": 253.3143, "r": 521.6553, "b": 231.7401 }, "text": "https://www.johnsoncountyiowa.gov/sites/default/files/2025- 11/Omnibus%20UDO%20Amendment_10.13.25_PZC%26BOS%20PH%20Draft.pdf", "marker": "•", "list_id": "L65", "level": 1, "reading_order": 0 } ], "reading_order": 7 }, { "page": 60, "type": "TEXT", "location": { "l": 57.6, "t": 231.7401, "r": 524.88, "b": 230.4 }, "text": "• https://www.johnsoncountyiowa.gov/sites/default/files/2025-11/Omnibus%20UDO%20Amendment 10.13.25 PZC%26BOS%20PH%20Draft.pdf", "links": [ { "uri": "https://www.johnsoncountyiowa.gov/sites/default/files/2025-11/Omnibus%20UDO%20Amendment_10.13.25_PZC%26BOS%20PH%20Draft.pdf", "dest": null, "action_type": "/URI", "bbox": [ 93.24, 245.76, 96.12, 248.64 ] }, { "uri": "https://www.johnsoncountyiowa.gov/sites/default/files/2025-11/Omnibus%20UDO%20Amendment_10.13.25_PZC%26BOS%20PH%20Draft.pdf", "dest": null, "action_type": "/URI", "bbox": [ 111.36, 240.96, 396.6, 251.4 ] }, { "uri": "https://www.johnsoncountyiowa.gov/sites/default/files/2025-11/Omnibus%20UDO%20Amendment_10.13.25_PZC%26BOS%20PH%20Draft.pdf", "dest": null, "action_type": "/URI", "bbox": [ 397.32, 245.64, 400.44, 246.72 ] }, { "uri": "https://www.johnsoncountyiowa.gov/sites/default/files/2025-11/Omnibus%20UDO%20Amendment_10.13.25_PZC%26BOS%20PH%20Draft.pdf", "dest": null, "action_type": "/URI", "bbox": [ 111.84, 231.84, 522.24, 242.16 ] } ], "reading_order": 8 }, { "page": 60, "type": "LIST_ITEM", "location": { "l": 56.7, "t": 228.9734, "r": 297.0465, "b": 199.8818 }, "text": "Linn County, Iowa", "marker": "•", "list_id": "L66", "level": 0, "items": [ { "page": 60, "type": "LIST_ITEM", "location": { "l": 92.7, "t": 197.9944, "r": 207.8946, "b": 185.6606 }, "text": "As of Date: 8/25/26", "marker": "•", "list_id": "L66", "level": 1, "reading_order": 0 }, { "page": 60, "type": "LIST_ITEM", "location": { "l": 92.7, "t": 183.8343, "r": 548.5999, "b": 171.5005 }, "text": "https://www.linncountyiowa.gov/DocumentCenter/View/27695/PA26-0001-Ordinance-PDF", "marker": "•", "list_id": "L66", "level": 1, "reading_order": 1 }, { "page": 60, "type": "LIST_ITEM", "location": { "l": 90.48, "t": 138.24, "r": 173.52, "b": 124.56 }, "text": "Version 7.3", "marker": "•", "list_id": "L66", "level": 1, "reading_order": 2 }, { "page": 60, "type": "LIST_ITEM", "location": { "l": 90, "t": 123.12, "r": 509.28, "b": 108.48 }, "text": "https://drive.google.com/file/d/1la4dtnUZnulhk5-Bs2w_O6UAAcl2tp3c/view", "marker": "•", "list_id": "L66", "level": 1, "reading_order": 3 } ], "reading_order": 9 }, { "page": 60, "type": "TITLE", "location": { "l": 55.44, "t": 166.56, "r": 215.04, "b": 142.08 }, "text": "• Sierra Club", "reading_order": 10, "level": 6 }, { "page": 60, "type": "TITLE", "location": { "l": 54.48, "t": 105.12, "r": 636, "b": 54.24 }, "text": "• Data Center Accountability for the Citizens of Dubuque County", "reading_order": 11, "level": 6 } ] }, { "page": 61, "items": [ { "page": 61, "type": "TITLE", "location": { "l": 28.8, "t": 522.72, "r": 444.72, "b": 419.76 }, "text": "NOISE Pollution\nOrdinance Language\nAllamakee County Iowa", "reading_order": 0, "level": 1 }, { "page": 61, "type": "LIST_ITEM", "location": { "l": 40.8, "t": 392.88, "r": 653.28, "b": 276.48 }, "text": "Noise. The 1-hour average noise generated from the MDC or LDC, or any of its components, or associated ancillary equipment shall not exceed a noise level of fifty- five (55) dBA or sixty (60) dBC as measured outside of any non-participating dwelling, cabin, mobile home, or occupied community building or the property line, whichever is closer. Applicants shall submit equipment and component manufacturer noise ratings at the time of application to demonstrate compliance.", "marker": "8.", "list_id": "L67", "level": 0, "reading_order": 1 }, { "page": 61, "type": "LIST_ITEM", "location": { "l": 62.16, "t": 277.2, "r": 644.64, "b": 193.92 }, "text": "At the discretion of the Zoning Administrator, the applicant may be required to provide Operating Sound Pressure Level measurements before and after construction from a few sampled locations, to be determined by the Zoning Administrator, at the perimeter of a comparable MDC or LDC to demonstrate compliance with this standard.", "marker": "a.", "list_id": "L67", "level": 0, "reading_order": 2 }, { "page": 61, "type": "LIST_ITEM", "location": { "l": 63.36, "t": 193.2, "r": 657.6, "b": 77.04 }, "text": "The applicant may be required to document the decibel level if there is a complaint on an operational system. At the discretion of the Zoning Administrator, the owner shall commission a report providing Sound Pressure Level measurements from a reasonable number of sampled locations, to be determined by the Zoning Administrator, at the outside wall of any non-participating dwellings, cabins, mobile homes, occupied community building, or the property line to demonstrate compliance with this standard.", "marker": "b.", "list_id": "L67", "level": 0, "reading_order": 3 }, { "page": 61, "type": "LIST_ITEM", "location": { "l": 63.84, "t": 78, "r": 655.44, "b": 38.16 }, "text": "The average hourly decibel level of both dBA and dBC may be exceeded during short-term events such as severe windstorms.", "marker": "c.", "list_id": "L67", "level": 0, "reading_order": 4 }, { "page": 61, "type": "TITLE", "location": { "l": 3.6, "t": 27.84, "r": 708.96, "b": 8.16 }, "text": "NOTE: Mistakenly reported that Allamakee did NOT address “Lighting” even though it did (Light Meeting).", "reading_order": 5, "level": 6 } ] }, { "page": 62, "items": [ { "page": 62, "type": "TITLE", "location": { "l": 24.72, "t": 533.28, "r": 377.28, "b": 446.88 }, "text": "NOISE Pollution\nOrdinance Language\nJACKSON County Iowa", "reading_order": 0, "level": 1 }, { "page": 62, "type": "TITLE", "location": { "l": 34.32, "t": 442.08, "r": 273.6, "b": 428.16 }, "text": "Section 6. Noise and Vibration Standards", "reading_order": 1, "level": 6 }, { "page": 62, "type": "TEXT", "location": { "l": 34.08, "t": 423.6, "r": 637.2, "b": 388.8 }, "text": "The purpose of this section is to protect the health, comfort, and welfare of Jackson County residents from excessive noise and vibration associated with High-Density Computing Facilities.", "reading_order": 2 }, { "page": 62, "type": "TITLE", "location": { "l": 35.04, "t": 384.24, "r": 124.32, "b": 370.8 }, "text": "A. Noise Limits", "reading_order": 3, "level": 6 }, { "page": 62, "type": "LIST_ITEM", "location": { "l": 33.84, "t": 366, "r": 640.32, "b": 328.8 }, "text": "Noise from any High-Density Computing Facility shall not exceed fifty decibels (50 dBA), measured at the property line of a nonparticipating parcel.", "marker": "1.", "list_id": "L68", "level": 0, "reading_order": 4 }, { "page": 62, "type": "LIST_ITEM", "location": { "l": 33.6, "t": 315.12, "r": 636.48, "b": 279.12 }, "text": "If testing identifies a distinct hum, tone, or other prominent low-frequency characteristic, the measured sound level shall be adjusted by plus five decibels (+5 dBA) for compliance evaluation purposes.", "marker": "2.", "list_id": "L68", "level": 0, "reading_order": 5 }, { "page": 62, "type": "TITLE", "location": { "l": 34.08, "t": 264.72, "r": 234, "b": 249.84 }, "text": "B. Noise Measurement Standards.", "reading_order": 6, "level": 6 }, { "page": 62, "type": "LIST_ITEM", "location": { "l": 32.88, "t": 245.52, "r": 655.68, "b": 190.32 }, "text": "Noise measurements shall be conducted in accordance with the most current version of ANSI S12.9 (Parts 1 and 3) and IEC 61672-1, or approved successor or equivalent standards providing equal or greater rigor, accuracy, and public protection.", "marker": "1.", "list_id": "L69", "level": 0, "reading_order": 7 }, { "page": 62, "type": "LIST_ITEM", "location": { "l": 33.12, "t": 187.2, "r": 658.56, "b": 131.76 }, "text": "Instrumentation and Method. Testing shall be performed using a Class 1 / Type 1 sound level meter capable of one-third-octave band analysis, or equivalent instrumentation under an approved successor or equivalent standard.", "list_id": "L69", "level": 0, "reading_order": 8 }, { "page": 62, "type": "LIST_ITEM", "location": { "l": 33.36, "t": 117.36, "r": 659.28, "b": 61.68 }, "text": "Measurements shall be taken over a representative operating period sufficient to capture typical facility conditions, including cyclical equipment operation, as determined by the qualified professional conducting the test.", "marker": "2.", "list_id": "L69", "level": 0, "reading_order": 9 }, { "page": 62, "type": "LIST_ITEM", "location": { "l": 33.6, "t": 47.76, "r": 658.56, "b": 11.28 }, "text": "If a successor or equivalent standard is used, the testing professional shall provide a brief written statement explaining why the alternative standard is equivalent to or more conservative than the standards listed above.", "marker": "3.", "list_id": "L69", "level": 0, "reading_order": 10 } ] }, { "page": 63, "items": [ { "page": 63, "type": "TITLE", "location": { "l": 24.72, "t": 533.52, "r": 377.04, "b": 445.68 }, "text": "NOISE Pollution\nOrdinance Language\nJACKSON County Iowa", "reading_order": 0, "level": 1 }, { "page": 63, "type": "TITLE", "location": { "l": 17.28, "t": 431.28, "r": 331.92, "b": 416.16 }, "text": "C. Noise Testing, Reporting, and Corrective Action.", "reading_order": 1, "level": 6 }, { "page": 63, "type": "LIST_ITEM", "location": { "l": 17.52, "t": 414.24, "r": 448.32, "b": 398.16 }, "text": "The facility owner and operator shall, at their sole expense, provide:", "marker": "1.", "list_id": "L70", "level": 0, "reading_order": 2 }, { "page": 63, "type": "LIST_ITEM", "location": { "l": 17.76, "t": 395.52, "r": 673.2, "b": 361.68 }, "text": "a baseline ambient noise study completed prior to commencement of construction, documenting existing background sound conditions at representative locations; and", "marker": "a.", "list_id": "L70", "level": 0, "reading_order": 3 }, { "page": 63, "type": "LIST_ITEM", "location": { "l": 16.08, "t": 359.76, "r": 671.52, "b": 306.24 }, "text": "a post-startup noise compliance test completed within sixty (60) days after commencement of full facility operations, or within such additional time approved by the Zoning Administrator for good cause, demonstrating compliance with this ordinance under representative operating conditions.", "marker": "b.", "list_id": "L70", "level": 0, "reading_order": 4 }, { "page": 63, "type": "LIST_ITEM", "location": { "l": 16.56, "t": 290.4, "r": 671.04, "b": 236.4 }, "text": "Additional noise testing may be required by Jackson County in response to a complaint, following any Expansion or Modification, following a documented violation, or when the Zoning Administrator reasonably determines that additional testing is necessary to investigate potential noncompliance.", "marker": "2.", "list_id": "L70", "level": 0, "reading_order": 5 }, { "page": 63, "type": "LIST_ITEM", "location": { "l": 15.84, "t": 218.16, "r": 675.84, "b": 165.36 }, "text": "Beginning on the third anniversary of commencement of full facility operations, and every three (3) years thereafter for so long as the facility operates, the facility owner and operator shall provide an updated noise compliance test at their sole expense.", "marker": "3.", "list_id": "L70", "level": 0, "reading_order": 6 }, { "page": 63, "type": "LIST_ITEM", "location": { "l": 15.84, "t": 150.24, "r": 683.76, "b": 115.44 }, "text": "All noise testing shall be conducted by an independent qualified professional experienced in environmental noise measurement.", "marker": "4.", "list_id": "L70", "level": 0, "reading_order": 7 } ] }, { "page": 64, "items": [ { "page": 64, "type": "TITLE", "location": { "l": 23.76, "t": 534.72, "r": 377.28, "b": 444.96 }, "text": "NOISE Pollution\nOrdinance Language\nJACKSON County Iowa", "reading_order": 0, "level": 6 }, { "page": 64, "type": "LIST_ITEM", "location": { "l": 23.28, "t": 350.4, "r": 690.72, "b": 315.12 }, "text": "All noise testing and reporting required under this section shall be at the sole expense of the facility owner and operator and shall not be borne by Jackson County.", "marker": "5.", "list_id": "L70", "level": 0, "reading_order": 1 }, { "page": 64, "type": "LIST_ITEM", "location": { "l": 22.8, "t": 299.04, "r": 697.68, "b": 226.56 }, "text": "Any noise study or sound test required under this ordinance shall be submitted to the Zoning Administrator within ten (10) business days after testing. The report shall include, at a minimum, testing locations, dates and times, equipment and calibration information, standards used, facility operating conditions, and results sufficient to demonstrate compliance.", "marker": "6.", "list_id": "L70", "level": 0, "reading_order": 2 }, { "page": 64, "type": "LIST_ITEM", "location": { "l": 24.48, "t": 211.2, "r": 696.48, "b": 156.24 }, "text": "If noise exceeds the allowable limits, the facility owner and operator shall promptly implement corrective measures and, if necessary, suspend the offending equipment or operations until compliance is demonstrated by follow-up testing. Any follow-up report shall also be submitted to the Zoning Administrator.", "marker": "7.", "list_id": "L70", "level": 0, "reading_order": 3 } ] }, { "page": 65, "items": [ { "page": 65, "type": "TITLE", "location": { "l": 23.52, "t": 534.72, "r": 377.76, "b": 444.48 }, "text": "NOISE Pollution\nOrdinance Language\nJACKSON County Iowa", "reading_order": 0, "level": 6 }, { "page": 65, "type": "TITLE", "location": { "l": 12.24, "t": 392.64, "r": 135.84, "b": 375.6 }, "text": "D. Vibration Limits.", "reading_order": 1, "level": 6 }, { "page": 65, "type": "TEXT", "location": { "l": 12.24, "t": 372.96, "r": 660.24, "b": 288.48 }, "text": "Maximum Vibration Level. Ground vibration from any High-Density Computing Facility shall not exceed the following Peak Particle Velocity (PPV), measured at any property line: 0.30 mm/s PPV during daytime hours (7:00 a.m. to 10:00 p.m.); 0.14 mm/s PPV during nighttime hours (10:00 p.m. to 7:00 a.m.).", "reading_order": 2 } ] }, { "page": 66, "items": [ { "page": 66, "type": "TITLE", "location": { "l": 24.48, "t": 534.24, "r": 376.8, "b": 445.44 }, "text": "NOISE Pollution\nOrdinance Language\nJACKSON County Iowa", "reading_order": 0, "level": 1 }, { "page": 66, "type": "TITLE", "location": { "l": 28.32, "t": 400.8, "r": 253.68, "b": 386.16 }, "text": "E. Vibration Measurement Standards", "reading_order": 1, "level": 6 }, { "page": 66, "type": "LIST_ITEM", "location": { "l": 28.08, "t": 380.88, "r": 667.2, "b": 324.48 }, "text": "Vibration measurements shall be conducted in accordance with the most current versions of DIN 4150-3 and BS 7385-2, or approved successor or equivalent standards providing equal or greater rigor, accuracy, and public protection.", "marker": "1.", "list_id": "L71", "level": 0, "reading_order": 2 }, { "page": 66, "type": "LIST_ITEM", "location": { "l": 29.04, "t": 320.4, "r": 666, "b": 283.68 }, "text": "Instrumentation and Method. Testing shall be performed using a tri-axial vibration monitor or accelerometer capable of recording Peak Particle Velocity in three directions.", "list_id": "L71", "level": 0, "reading_order": 3 }, { "page": 66, "type": "LIST_ITEM", "location": { "l": 26.88, "t": 268.32, "r": 675.84, "b": 212.16 }, "text": "Measurements shall be taken over a representative operating period sufficient to capture typical facility conditions, including cyclical equipment operation, as determined by the qualified professional conducting the test.", "marker": "2.", "list_id": "L71", "level": 0, "reading_order": 4 }, { "page": 66, "type": "LIST_ITEM", "location": { "l": 27.12, "t": 196.08, "r": 660.72, "b": 140.16 }, "text": "If a successor or equivalent standard is used, the testing professional shall provide a brief written statement explaining why the alternative standard is equivalent to or more conservative than the standards listed above.", "marker": "3.", "list_id": "L71", "level": 0, "reading_order": 5 } ] }, { "page": 67, "items": [ { "page": 67, "type": "TITLE", "location": { "l": 24.48, "t": 534, "r": 377.04, "b": 445.2 }, "text": "NOISE Pollution\nOrdinance Language\nJACKSON County Iowa", "reading_order": 0, "level": 1 }, { "page": 67, "type": "TITLE", "location": { "l": 31.68, "t": 411.84, "r": 352.32, "b": 397.2 }, "text": "F. Vibration Testing, Reporting, and Corrective Action.", "reading_order": 1, "level": 6 }, { "page": 67, "type": "LIST_ITEM", "location": { "l": 31.44, "t": 392.4, "r": 442.32, "b": 376.56 }, "text": "The facility owner and operator shall, at their sole expense, provide:", "marker": "1.", "list_id": "L72", "level": 0, "reading_order": 2 }, { "page": 67, "type": "LIST_ITEM", "location": { "l": 31.68, "t": 372.96, "r": 631.68, "b": 336.96 }, "text": "a baseline ambient vibration study completed prior to commencement of construction, documenting existing background vibration conditions at representative locations; and", "marker": "a.", "list_id": "L72", "level": 0, "reading_order": 3 }, { "page": 67, "type": "LIST_ITEM", "location": { "l": 30.72, "t": 332.88, "r": 635.04, "b": 276.24 }, "text": "a post-startup vibration compliance test completed within sixty (60) days after commencement of full facility operations, or within such additional time approved by the Zoning Administrator for good cause, demonstrating compliance with this ordinance under representative operating conditions.", "marker": "b.", "list_id": "L72", "level": 0, "reading_order": 4 }, { "page": 67, "type": "LIST_ITEM", "location": { "l": 30.24, "t": 261.6, "r": 654.96, "b": 204.72 }, "text": "Additional vibration testing may be required by Jackson County in response to a complaint, following any Expansion or Modification, following a documented violation, or when the Zoning Administrator reasonably determines that additional testing is necessary to investigate potential noncompliance.", "marker": "2.", "list_id": "L72", "level": 0, "reading_order": 5 } ] }, { "page": 68, "items": [ { "page": 68, "type": "TITLE", "location": { "l": 24.72, "t": 534.24, "r": 377.04, "b": 445.44 }, "text": "NOISE Pollution\nOrdinance Language\nJACKSON County Iowa", "reading_order": 0, "level": 1 }, { "page": 68, "type": "LIST_ITEM", "location": { "l": 36.24, "t": 387.36, "r": 643.68, "b": 333.12 }, "text": "Beginning on the third anniversary of commencement of full facility operations, and every three (3) years thereafter for so long as the facility operates, the facility owner and operator shall provide an updated vibration compliance test at their sole expense.", "marker": "3.", "list_id": "L72", "level": 0, "reading_order": 1 }, { "page": 68, "type": "LIST_ITEM", "location": { "l": 36.24, "t": 318, "r": 591.12, "b": 283.2 }, "text": "All vibration testing shall be conducted by an independent qualified professional experienced in environmental or structural vibration measurement.", "marker": "4.", "list_id": "L72", "level": 0, "reading_order": 2 }, { "page": 68, "type": "LIST_ITEM", "location": { "l": 36.48, "t": 267.6, "r": 633.36, "b": 232.08 }, "text": "All vibration testing and reporting required under this section shall be at the sole expense of the facility owner and operator and shall not be borne by Jackson County.", "marker": "5.", "list_id": "L72", "level": 0, "reading_order": 3 }, { "page": 68, "type": "LIST_ITEM", "location": { "l": 36.24, "t": 217.2, "r": 656.4, "b": 143.04 }, "text": "Any vibration study or test required under this ordinance shall be submitted to the Zoning Administration within ten (10) business days after testing. The report shall include, at a minimum, test locations and measurement points, dates and times, measurement duration, equipment and calibration information, standards used, facility operating conditions during testing, and results sufficient to demonstrate compliance.", "marker": "6.", "list_id": "L72", "level": 0, "reading_order": 4 }, { "page": 68, "type": "LIST_ITEM", "location": { "l": 36, "t": 128.16, "r": 655.92, "b": 72.24 }, "text": "If vibration exceeds the allowable limits, the facility owner and operator shall promptly implement corrective measures and, if necessary, suspend the offending equipment or operations until compliance is demonstrated by follow-up testing. Any follow-up report shall also be submitted to the Zoning Administrator.", "marker": "7.", "list_id": "L72", "level": 0, "reading_order": 5 } ] }, { "page": 69, "items": [ { "page": 69, "type": "TITLE", "location": { "l": 29.28, "t": 522.48, "r": 405.84, "b": 420.48 }, "text": "NOISE Pollution\nOrdinance Language\nJohnson County Iowa", "reading_order": 0, "level": 1 }, { "page": 69, "type": "TEXT", "location": { "l": 40.56, "t": 373.68, "r": 642.96, "b": 316.32 }, "text": "7. Noise. The one- (1) hour average noise generated from Data Center operations, including, but not limited to, computing, cooling, and energy storage equipment, shall not exceed the following noise levels as measured at the property line:", "reading_order": 1 }, { "page": 69, "type": "TABLE", "location": { "l": 62.4, "t": 313.44, "r": 640.8, "b": 199.2 }, "text": "
Zoning District of Receiving Property7:00 am - 9:59 pm10:00 pm - 6:59 am
A, AR, SF, R, RM, RC, RMH60 dBA50 dBA
C, CH, Ag-T, C-Ag65 dBA65 dBA
ML, MH, RR, SWDRR, RE, ERP, P70 dBA70 dBA
", "rows": [ { "row_index": 0, "location": [ 62.4, 284.88, 640.8, 313.44 ], "cells": [ { "location": [ 62.4, 284.88, 255.2, 313.44 ], "text": "Zoning District of Receiving Property", "html_text": "Zoning District of Receiving Property", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 255.2, 284.88, 448, 313.44 ], "text": "7:00 am - 9:59 pm", "html_text": "7:00 am - 9:59 pm", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 448, 284.88, 640.8, 313.44 ], "text": "10:00 pm - 6:59 am", "html_text": "10:00 pm - 6:59 am", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 1, "location": [ 62.4, 256.32, 640.8, 284.88 ], "cells": [ { "location": [ 62.4, 256.32, 255.2, 284.88 ], "text": "A, AR, SF, R, RM, RC, RMH", "html_text": "A, AR, SF, R, RM, RC, RMH", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 255.2, 256.32, 448, 284.88 ], "text": "60 dBA", "html_text": "60 dBA", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 448, 256.32, 640.8, 284.88 ], "text": "50 dBA", "html_text": "50 dBA", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 2, "location": [ 62.4, 227.76, 640.8, 256.32 ], "cells": [ { "location": [ 62.4, 227.76, 255.2, 256.32 ], "text": "C, CH, Ag-T, C-Ag", "html_text": "C, CH, Ag-T, C-Ag", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 255.2, 227.76, 448, 256.32 ], "text": "65 dBA", "html_text": "65 dBA", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 448, 227.76, 640.8, 256.32 ], "text": "65 dBA", "html_text": "65 dBA", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 3, "location": [ 62.4, 199.2, 640.8, 227.76 ], "cells": [ { "location": [ 62.4, 199.2, 255.2, 227.76 ], "text": "ML, MH, RR, SWDRR, RE, ERP, P", "html_text": "ML, MH, RR, SWDRR, RE, ERP, P", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 255.2, 199.2, 448, 227.76 ], "text": "70 dBA", "html_text": "70 dBA", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 448, 199.2, 640.8, 227.76 ], "text": "70 dBA", "html_text": "70 dBA", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 4, "n_cols": 3, "ref": "#/tables/0", "reading_order": 2 }, { "page": 69, "type": "LIST_ITEM", "location": { "l": 62.88, "t": 196.56, "r": 620.4, "b": 138.24 }, "text": "The applicant shall provide Operating Sound Pressure Level measurements from a reasonable number of sampled locations at the perimeter of comparable data center operations to demonstrate compliance with this standard at the time of permitting.", "marker": "a.", "list_id": "L73", "level": 0, "reading_order": 3 }, { "page": 69, "type": "LIST_ITEM", "location": { "l": 62.88, "t": 130.08, "r": 644.16, "b": 52.08 }, "text": "To document decibel level if there is a complaint on an operational system, at the discretion of the Zoning Administrator, the owner shall commission a report providing Operating Sound Pressure Level measurements from a reasonable number of sampled locations at the property line to demonstrate compliance with this standard.", "marker": "b.", "list_id": "L73", "level": 0, "reading_order": 4 } ] }, { "page": 70, "items": [ { "page": 70, "type": "TITLE", "location": { "l": 5.04, "t": 509.52, "r": 259.44, "b": 437.76 }, "text": "NOISE Pollution\nOrdinance Language\nLINN County Iowa", "reading_order": 0, "level": 6 }, { "page": 70, "type": "LIST_ITEM", "location": { "l": 275.28, "t": 518.64, "r": 694.32, "b": 469.68 }, "text": "Noise Analysis. No operating data center equipment shall produce decibel levels exceeding any of the following limitations, with the exception of initial construction and routine maintenance. Adequate setbacks and effective sound mitigating equipment shall be used to comply with these limitations:", "marker": "(1)", "list_id": "L74", "level": 0, "reading_order": 1 }, { "page": 70, "type": "LIST_ITEM", "location": { "l": 292.08, "t": 464.4, "r": 689.52, "b": 363.36 }, "text": "The average hourly noise level shall not exceed fifty-five (55) dBA or sixty-five (65) dBC as measured from the outer wall of any occupied structure within residentially zoned property adjacent to the proposed development. For property adjacent to the proposed development that is not residentially zoned, the average hourly noise level shall not exceed sixty-five (65) dBA or seventy-five (75) dBC as measured from the outer wall of any occupied structure. The average decibel limit is specific to source of the sound and does not count against cumulative ambient decibel levels as established in a baseline acoustic evaluation.", "marker": "(1)", "list_id": "L74", "level": 0, "reading_order": 2 }, { "page": 70, "type": "LIST_ITEM", "location": { "l": 292.8, "t": 359.52, "r": 685.44, "b": 296.64 }, "text": "Equipment testing, maintenance activities, and construction activities that generate elevated noise, including generator testing, shall be limited to the hours of 8:00 a.m. to 6:00 p.m., Monday through Friday, unless otherwise approved by the Zoning Administrator. County approval for excessive noise generation shall not be unreasonably withheld.", "marker": "(2)", "list_id": "L74", "level": 0, "reading_order": 3 }, { "page": 70, "type": "LIST_ITEM", "location": { "l": 293.04, "t": 292.56, "r": 687.36, "b": 266.88 }, "text": "The average hourly decibel level may be exceeded during short-term events such as severe windstorms.", "marker": "(3)", "list_id": "L74", "level": 0, "reading_order": 4 }, { "page": 70, "type": "LIST_ITEM", "location": { "l": 293.28, "t": 261.84, "r": 692.16, "b": 198.96 }, "text": "A pre- and post-construction noise evaluation shall be completed by a certified professional by the Institute of Noise Control Engineering (INCE), or a licensed Professional Engineer (PE) to verify compliance with the County's standards. The post-construction nose evaluation shall be completed after completion of all planned data center buildings at the end of construction (as defined in section 107-151(I)(5)).", "marker": "(4)", "list_id": "L74", "level": 0, "reading_order": 5 }, { "page": 70, "type": "LIST_ITEM", "location": { "l": 293.04, "t": 195.12, "r": 692.88, "b": 32.88 }, "text": "Commencing on the fifth anniversary of the end of construction, as defined hereafter, and continuing every five years thereafter, for so long as the data center operates, a noise evaluation shall be completed at the operators' expense by a certified professional by the Institute of Noise Control Engineering (INCE), or a licensed professional engineer (PE) to verify compliance with the county's standards in section 107-151(I)(1). Completion of all data center buildings, or end of construction, means the date on which all of the following have occurred: completion of construction of the data center or, in the case of a phased or multi-building campus, all buildings of the multi-building data center campus, and issuance of a certificate of occupancy for all related buildings; and the data center operator has communicated, in writing, to the Zoning Administrator that it has completed the data center campus; provided, that, if all construction has stopped on the property for more than six (6) consecutive calendar months, other than due to delays by the", "marker": "(5)", "list_id": "L74", "level": 0, "reading_order": 6 } ] }, { "page": 71, "items": [ { "page": 71, "type": "TITLE", "location": { "l": 29.52, "t": 521.28, "r": 397.92, "b": 420.48 }, "text": "NOISE Pollution\nOrdinance Language\nSierra Club", "reading_order": 0, "level": 1 }, { "page": 71, "type": "TEXT", "location": { "l": 17.04, "t": 400.08, "r": 683.76, "b": 269.28 }, "text": "1. Cumulative noise standard Noise compliance shall be evaluated at the receiving Sensitive Receptor and receiving property-line locations based on the combined modeled and measured contribution of the proposed LLDC and other existing, approved, pending, concurrently filed, or reasonably foreseeable data-center, generation, cooling, substation, transformer, BESS, fuel, and Associated Infrastructure sources within the Cumulative Impact Review Area. No approval shall be granted unless the applicant demonstrates that cumulative sound, tonal noise, low-frequency noise, infrasound where relevant, vibration, and testing/maintenance scenarios will comply with the applicable daytime, nighttime, tonal, low-frequency, and vibration standards.", "reading_order": 1 }, { "page": 71, "type": "TEXT", "location": { "l": 458.64, "t": 170.88, "r": 624.24, "b": 129.36 }, "text": "SIERRA CLUB\nSOUTHEASTERN PA GROUP", "reading_order": 2 }, { "page": 71, "type": "TEXT", "location": { "l": 370.8, "t": 111.12, "r": 658.08, "b": 94.32 }, "text": "Model Large-Load Data Center Ordinance", "reading_order": 3 }, { "page": 71, "type": "TEXT", "location": { "l": 426, "t": 87.6, "r": 603.6, "b": 75.84 }, "text": "Public Education / Municipal Review Draft", "reading_order": 4 }, { "page": 71, "type": "TEXT", "location": { "l": 493.44, "t": 70.08, "r": 536.88, "b": 59.76 }, "text": "Version 7.2", "reading_order": 5 } ] }, { "page": 72, "items": [ { "page": 72, "type": "TITLE", "location": { "l": 4.32, "t": 524.4, "r": 259.92, "b": 454.56 }, "text": "NOISE Pollution\nOrdinance Language\nSierra Club SECTION", "reading_order": 0, "level": 6 }, { "page": 72, "type": "TITLE", "location": { "l": 202.08, "t": 469.92, "r": 582.72, "b": 455.52 }, "text": "SECTION 13. Noise, Acoustic, and Vibration Performance Standards", "reading_order": 1, "level": 6 }, { "page": 72, "type": "LIST_ITEM", "location": { "l": 201.84, "t": 447.12, "r": 690.72, "b": 387.36 }, "text": "Applicability. This Section applies to all LLDC buildings, cooling equipment, generators, generator testing, primary generation, Stationary Combustion Turbines, turbine inlets, exhaust stacks, bypass stacks, HRSGs, duct burners, gas compressors, black-start equipment, bridge-power units, temporary/mobile/rental generation, substations, transformers, switchgear, BESS, ventilation, construction equipment, fuel/gas infrastructure, and related sources.", "marker": "A.", "list_id": "L75", "level": 0, "reading_order": 2 }, { "page": 72, "type": "LIST_ITEM", "location": { "l": 201.12, "t": 381.12, "r": 684.72, "b": 320.64 }, "text": "Maximum sound limits. Unless the existing zoning ordinance is more protective, sound from the LLDC and associated sources shall not exceed 45 dBA daytime and 40 dBA nighttime at any Sensitive Receptor property line or receiving property line designated by the governing body. The governing body may impose lower limits based on existing ambient conditions, zoning district purpose, or proximity to Sensitive Receptors.", "marker": "B.", "list_id": "L75", "level": 0, "reading_order": 3 }, { "page": 72, "type": "LIST_ITEM", "location": { "l": 201.84, "t": 313.44, "r": 689.76, "b": 264.48 }, "text": "Tonal, impulsive, and low-frequency penalties. A 5 dBA penalty shall be applied to measured or modeled sound containing prominent tonal, impulsive, or low-frequency characteristics, including transformer hum, fan tones, engine tones, exhaust tones, or discrete-frequency noise demonstrated through one-third octave band analysis or other accepted method.", "marker": "C.", "list_id": "L75", "level": 0, "reading_order": 4 }, { "page": 72, "type": "LIST_ITEM", "location": { "l": 201.36, "t": 258.24, "r": 694.56, "b": 174.24 }, "text": "Facility-wide cumulative modeling. Compliance shall be demonstrated on a facility-wide cumulative basis and not through per-unit manufacturer data alone. Modeling shall include all normal operating sources, maximum routine operation, primary generation, emergency generation, redundant units, N+1/N+2/2N scenarios, black-start operation, bridge-power operation, testing, commissioning, startup/shutdown, temporary/mobile/rental generation, turbine inlets, exhaust stacks, bypass stacks, HRSGs, duct burners, gas compressors, cooling systems, transformers, substations, fuel/gas equipment, roof equipment, and foreseeable phase buildout.", "marker": "D.", "list_id": "L75", "level": 0, "reading_order": 5 }, { "page": 72, "type": "LIST_ITEM", "location": { "l": 200.16, "t": 168.24, "r": 690.24, "b": 130.56 }, "text": "Baseline study. The applicant shall fund a baseline ambient sound survey before major construction, including weekday/weekend, daytime/nighttime, and representative weather conditions at property lines and Sensitive Receptors.", "marker": "E.", "list_id": "L75", "level": 0, "reading_order": 6 }, { "page": 72, "type": "LIST_ITEM", "location": { "l": 199.2, "t": 123.84, "r": 651.6, "b": 86.16 }, "text": "Predictive study The applicant shall submit predictive acoustic modeling prepared by a Qualified Acoustical Professional, including one-third octave band analysis, tonal assessment, low-frequency assessment, topography, buildings, barriers, meteorology, phasing, and mitigation.", "marker": "F.", "list_id": "L75", "level": 0, "reading_order": 7 }, { "page": 72, "type": "LIST_ITEM", "location": { "l": 202.08, "t": 79.92, "r": 678.48, "b": 18.96 }, "text": "Testing, emergency, turbine, and redundancy scenarios. Modeling shall separately evaluate generator testing/exercising windows, simultaneous testing caps, commissioning, emergency operation, turbine startup/shutdown and ramping, N+1/N+2/2N redundancy, black-start sequences, bridge-power operation, temporary/mobile/rental generation, and primary generation operation. No operating scenario may be approved unless it complies with the sound limits after penalties.", "marker": "G.", "list_id": "L75", "level": 0, "reading_order": 8 } ] }, { "page": 73, "items": [ { "page": 73, "type": "TITLE", "location": { "l": 29.28, "t": 521.28, "r": 397.92, "b": 420.24 }, "text": "NOISE Pollution\nOrdinance Language\nSierra Club", "reading_order": 0, "level": 1 }, { "page": 73, "type": "LIST_ITEM", "location": { "l": 37.92, "t": 402, "r": 648, "b": 337.92 }, "text": "Mitigation. Mitigation may include larger setbacks, indoor equipment placement, acoustic enclosures, critical-grade silencers, turbine inlet silencers, stack silencers, bypass-stack silencers, gas-compressor enclosures, barriers, berms, building orientation, reduced concurrency, startup/shutdown restrictions, testing-window restrictions, fan selection, transformer selection, speed controls, and operational limits.", "marker": "H.", "list_id": "L75", "level": 0, "reading_order": 1 }, { "page": 73, "type": "LIST_ITEM", "location": { "l": 41.52, "t": 330, "r": 658.56, "b": 267.12 }, "text": "Post-construction verification. The operator shall fund post-construction sound verification after initial energization, after full operation, after Material Changes, and upon credible complaints. If sound limits are exceeded, the operator shall implement corrective action and may be required to curtail or suspend offending operations until compliance is demonstrated.", "marker": "I.", "list_id": "L75", "level": 0, "reading_order": 2 }, { "page": 73, "type": "LIST_ITEM", "location": { "l": 42.96, "t": 258, "r": 674.64, "b": 209.52 }, "text": "Continuous monitoring. Continuous sound monitoring shall be required where any generator yard, primary generation facility, cooling yard, or major electrical infrastructure is within 1,000 feet of a Sensitive Receptor, or where required by the governing body based on the record.", "marker": "J.", "list_id": "L75", "level": 0, "reading_order": 3 }, { "page": 73, "type": "LIST_ITEM", "location": { "l": 44.16, "t": 201.6, "r": 669.12, "b": 153.36 }, "text": "Vibration. The applicant shall evaluate vibration from generators, turbines, transformers, chillers, pumps, and construction. The municipality may impose vibration limits, setbacks, isolation, or monitoring necessary to protect neighboring properties and structures.", "marker": "K.", "list_id": "L75", "level": 0, "reading_order": 4 }, { "page": 73, "type": "TEXT", "location": { "l": 458.64, "t": 114.48, "r": 623.52, "b": 71.28 }, "text": "SIERRA CLUB\nSOUTHEASTERN PA GROUP", "reading_order": 5 }, { "page": 73, "type": "TEXT", "location": { "l": 371.04, "t": 54.24, "r": 657.84, "b": 37.2 }, "text": "Model Large-Load Data Center Ordinance", "reading_order": 6 }, { "page": 73, "type": "TEXT", "location": { "l": 426, "t": 30.72, "r": 603.6, "b": 18.48 }, "text": "Public Education / Municipal Review Draft", "reading_order": 7 }, { "page": 73, "type": "TEXT", "location": { "l": 493.68, "t": 12.96, "r": 536.64, "b": 3.12 }, "text": "Version 7.2", "reading_order": 8 } ] }, { "page": 74, "items": [ { "page": 74, "type": "TITLE", "location": { "l": 44.88, "t": 412.56, "r": 651.12, "b": 300.48 }, "text": "Steve Peake\nData Center Accountability for the\nCitizens of Dubuque County", "reading_order": 0, "level": 1 }, { "page": 74, "type": "TEXT", "location": { "l": 238.8, "t": 251.76, "r": 429.84, "b": 195.84 }, "text": "Noise - Health Perspective", "reading_order": 1 }, { "page": 74, "type": "TEXT", "location": { "l": 212.4, "t": 194.4, "r": 446.88, "b": 177.6 }, "text": "Data Centers and Power Sources", "reading_order": 2 }, { "page": 74, "type": "TEXT", "location": { "l": 213.84, "t": 167.28, "r": 445.44, "b": 114.24 }, "text": "This summary is primarily focused on infrasound Frequencies below hearing range - 1 to 20 Hz Infrasound is less understood and documented than audible sound health effects", "reading_order": 3 } ] }, { "page": 75, "items": [ { "page": 75, "type": "TITLE", "location": { "l": 54.96, "t": 504.72, "r": 576.48, "b": 441.36 }, "text": "Examples of Measured Sound Levels", "reading_order": 0, "level": 1 }, { "page": 75, "type": "TITLE", "location": { "l": 54.48, "t": 435.84, "r": 629.52, "b": 414.72 }, "text": "Natural Gas Power Source and Cooling Tower Excerpts", "reading_order": 1, "level": 1 }, { "page": 75, "type": "TEXT", "location": { "l": 50.16, "t": 368.4, "r": 470.88, "b": 335.76 }, "text": "https://noisenewsinternational.net/data-centers-and-measurement-of-low-frequency-and-infrasound/", "reading_order": 2 }, { "page": 75, "type": "TEXT", "location": { "l": 60.48, "t": 314.64, "r": 287.52, "b": 305.04 }, "text": "Natural Gas Power Sources Serving Data Centers at receiving properties", "reading_order": 3 }, { "page": 75, "type": "FIGURE", "location": { "l": 5.76, "t": 308.4, "r": 342, "b": 162 }, "text": "", "reading_order": 4 }, { "page": 75, "type": "TEXT", "location": { "l": 104.16, "t": 167.76, "r": 139.92, "b": 161.04 }, "text": "Frequency (Hz)", "reading_order": 5 }, { "page": 75, "type": "TEXT", "location": { "l": 424.08, "t": 313.92, "r": 632.4, "b": 304.32 }, "text": "Data Center Cooling Tower Samples vs. Standard Environments", "reading_order": 6 }, { "page": 75, "type": "FIGURE", "location": { "l": 355.68, "t": 303.12, "r": 701.76, "b": 166.32 }, "text": "", "reading_order": 7 }, { "page": 75, "type": "TEXT", "location": { "l": 453.84, "t": 165.36, "r": 490.8, "b": 157.92 }, "text": "Frequency (Hz)", "reading_order": 8 } ] }, { "page": 76, "items": [ { "page": 76, "type": "TITLE", "location": { "l": 54.48, "t": 498.48, "r": 620.16, "b": 426.48 }, "text": "Likely infra-sound at Various Distances", "reading_order": 0, "level": 1 }, { "page": 76, "type": "LIST_ITEM", "location": { "l": 54.48, "t": 378.72, "r": 616.08, "b": 328.8 }, "text": "Sound below 20 Hz (infrasound) receives little attenuation traveling through air, barriers or any other means that may be used to reduce audible noise", "marker": "•", "list_id": "L76", "level": 0, "reading_order": 1 }, { "page": 76, "type": "LIST_ITEM", "location": { "l": 54.48, "t": 323.28, "r": 476.16, "b": 303.12 }, "text": "78 dB at 0.5 mile (from previous chart gas turbine)", "marker": "•", "list_id": "L76", "level": 0, "items": [ { "page": 76, "type": "LIST_ITEM", "location": { "l": 90.24, "t": 301.92, "r": 461.04, "b": 285.6 }, "text": "Decreases approximately 6 dB for every 2x distance", "marker": "•", "list_id": "L76", "level": 1, "items": [ { "page": 76, "type": "LIST_ITEM", "location": { "l": 125.04, "t": 284.4, "r": 322.56, "b": 270 }, "text": "At 1 mile from source – 72 dB", "marker": "•", "list_id": "L76", "level": 2, "reading_order": 0 }, { "page": 76, "type": "LIST_ITEM", "location": { "l": 125.28, "t": 268.56, "r": 327.6, "b": 254.4 }, "text": "At 2 miles from source – 66 dB", "marker": "•", "list_id": "L76", "level": 2, "reading_order": 1 }, { "page": 76, "type": "LIST_ITEM", "location": { "l": 125.04, "t": 252.72, "r": 327.6, "b": 237.84 }, "text": "At 4 miles from source – 60 dB", "marker": "•", "list_id": "L76", "level": 2, "reading_order": 2 } ], "reading_order": 0 } ], "reading_order": 2 }, { "page": 76, "type": "LIST_ITEM", "location": { "l": 54.24, "t": 216.72, "r": 537.6, "b": 196.8 }, "text": "85 dB at 0.25 mile (Siemens SGT-800 45 MW gas turbine with “best available” damping)", "marker": "•", "list_id": "L76", "level": 0, "items": [ { "page": 76, "type": "LIST_ITEM", "location": { "l": 90, "t": 195.6, "r": 460.8, "b": 179.28 }, "text": "Decreases approximately 6 dB for every 2x distance", "marker": "•", "list_id": "L76", "level": 1, "items": [ { "page": 76, "type": "LIST_ITEM", "location": { "l": 125.04, "t": 177.84, "r": 332.16, "b": 163.92 }, "text": "At 0.5 mile from source – 79 dB", "marker": "•", "list_id": "L76", "level": 2, "reading_order": 0 }, { "page": 76, "type": "LIST_ITEM", "location": { "l": 125.28, "t": 162.24, "r": 328.08, "b": 147.84 }, "text": "At 1 miles from source – 73 dB", "marker": "•", "list_id": "L76", "level": 2, "reading_order": 1 }, { "page": 76, "type": "LIST_ITEM", "location": { "l": 125.52, "t": 145.92, "r": 327.36, "b": 132 }, "text": "At 2 miles from source – 66 dB", "marker": "•", "list_id": "L76", "level": 2, "reading_order": 2 }, { "page": 76, "type": "LIST_ITEM", "location": { "l": 125.52, "t": 130.08, "r": 327.36, "b": 116.4 }, "text": "At 4 miles from source – 60 dB", "marker": "•", "list_id": "L76", "level": 2, "reading_order": 3 } ], "reading_order": 0 }, { "page": 76, "type": "LIST_ITEM", "location": { "l": 79.92, "t": 114.24, "r": 588.72, "b": 103.2 }, "text": "Undamped sound from SGT-800 gas turbine 45 MW electric generator is 130-150 dB, Siemens data indicates damping to 85 dB is possible.", "marker": "*", "list_id": "L76", "level": 1, "reading_order": 1 } ], "reading_order": 3 } ] }, { "page": 77, "items": [ { "page": 77, "type": "TITLE", "location": { "l": 53.76, "t": 495.12, "r": 647.52, "b": 427.2 }, "text": "Effect on humans – 2026 placebo-controlled study highlights", "reading_order": 0, "level": 1 }, { "page": 77, "type": "TEXT", "location": { "l": 420.48, "t": 398.88, "r": 560.4, "b": 385.44 }, "text": "ORIGINAL RESEARCH article", "reading_order": 1 }, { "page": 77, "type": "TEXT", "location": { "l": 420.48, "t": 380.16, "r": 563.52, "b": 368.4 }, "text": "Front. Behav. Neurosci., 26 April 2026", "reading_order": 2 }, { "page": 77, "type": "TEXT", "location": { "l": 420.72, "t": 366.24, "r": 556.56, "b": 354.96 }, "text": "Sec. Individual and Social Behaviors", "reading_order": 3 }, { "page": 77, "type": "TEXT", "location": { "l": 420.72, "t": 353.04, "r": 625.44, "b": 342.24 }, "text": "Volume 20 - 2026 | https://doi.org/10.3389/fnbeh.2026.1729876", "reading_order": 4 }, { "page": 77, "type": "TEXT", "location": { "l": 48.24, "t": 328.56, "r": 601.68, "b": 297.12 }, "text": "36 people (university students) were exposed to inaudible low frequency sound or no low frequency sound overlaid over both soothing and unsettling music in controlled lab", "reading_order": 5 }, { "page": 77, "type": "LIST_ITEM", "location": { "l": 48.72, "t": 295.92, "r": 264.72, "b": 280.56 }, "text": "Infrasound was applied at 75-78 dB", "marker": "•", "list_id": "L77", "level": 0, "reading_order": 6 }, { "page": 77, "type": "TEXT", "location": { "l": 48, "t": 263.76, "r": 590.4, "b": 232.56 }, "text": "Regardless of type of music – subjects were unable to determine when infrasound (low frequency below 20 Hz)", "reading_order": 7 }, { "page": 77, "type": "LIST_ITEM", "location": { "l": 48, "t": 230.88, "r": 420.24, "b": 216 }, "text": "When infrasound was overlaid on music – within 1 hour session", "marker": "•", "list_id": "L78", "level": 0, "items": [ { "page": 77, "type": "LIST_ITEM", "location": { "l": 73.68, "t": 214.32, "r": 424.32, "b": 199.68 }, "text": "Salivary cortisol (stress hormone) was statistically Increased", "marker": "•", "list_id": "L78", "level": 1, "reading_order": 0 }, { "page": 77, "type": "LIST_ITEM", "location": { "l": 73.92, "t": 198.24, "r": 306.24, "b": 183.6 }, "text": "Agitation score was statistically higher", "marker": "•", "list_id": "L78", "level": 1, "reading_order": 1 } ], "reading_order": 8 }, { "page": 77, "type": "LIST_ITEM", "location": { "l": 48, "t": 182.4, "r": 422.88, "b": 167.04 }, "text": "During control – soothing or unsettling music without infrasound", "marker": "•", "list_id": "L78", "level": 0, "items": [ { "page": 77, "type": "LIST_ITEM", "location": { "l": 74.64, "t": 165.6, "r": 288.96, "b": 151.44 }, "text": "No cortisol increase was measured", "marker": "•", "list_id": "L78", "level": 1, "reading_order": 0 } ], "reading_order": 9 }, { "page": 77, "type": "TEXT", "location": { "l": 375.6, "t": 156.48, "r": 645.84, "b": 92.16 }, "text": "Cortisol peaks in the morning and decreases through the day reaching minimum around bedtime – even small increases at night cause sleep disturbance", "reading_order": 10 }, { "page": 77, "type": "LIST_ITEM", "location": { "l": 74.16, "t": 149.76, "r": 276, "b": 134.64 }, "text": "Agitation score was not elevated", "marker": "•", "list_id": "L79", "level": 0, "reading_order": 11 } ] }, { "page": 78, "items": [ { "page": 78, "type": "TITLE", "location": { "l": 54.96, "t": 478.32, "r": 582, "b": 442.08 }, "text": "Proposed Infrasound Level", "reading_order": 0, "level": 6 }, { "page": 78, "type": "LIST_ITEM", "location": { "l": 56.7, "t": 373.9511, "r": 594.2628, "b": 353.8417 }, "text": "Draft ordinance requires 65 dB(z) maximum at property boundary", "marker": "•", "list_id": "L80", "level": 0, "items": [ { "page": 78, "type": "LIST_ITEM", "location": { "l": 92.7, "t": 353.1153, "r": 618.2452, "b": 323.7575 }, "text": "dB(z) does not reduce the measurement sensitivity at lower frequencies, like typical dB(A) or lesser degree dB(C)", "marker": "•", "list_id": "L80", "level": 1, "reading_order": 0 } ], "reading_order": 1 }, { "page": 78, "type": "LIST_ITEM", "location": { "l": 54.48, "t": 317.76, "r": 561.36, "b": 298.56 }, "text": "Assuming the noise source is 1/4 mile from property perimeter", "marker": "•", "list_id": "L80", "level": 0, "items": [ { "page": 78, "type": "LIST_ITEM", "location": { "l": 90.24, "t": 297.36, "r": 404.16, "b": 281.28 }, "text": "At 1/2 mile the sound would be around 59 dB", "marker": "•", "list_id": "L80", "level": 1, "reading_order": 0 }, { "page": 78, "type": "LIST_ITEM", "location": { "l": 89.76, "t": 279.6, "r": 401.04, "b": 264 }, "text": "At 1 mile the sound would be around 53 dB", "marker": "•", "list_id": "L80", "level": 1, "reading_order": 1 }, { "page": 78, "type": "LIST_ITEM", "location": { "l": 90, "t": 262.08, "r": 407.28, "b": 246 }, "text": "At 2 miles the sound would be around 46 dB", "marker": "•", "list_id": "L80", "level": 1, "reading_order": 2 } ], "reading_order": 2 }, { "page": 78, "type": "LIST_ITEM", "location": { "l": 54.24, "t": 240.24, "r": 570.96, "b": 204.24 }, "text": "So at 2 miles the level (if compliant with draft ordinance) is still significantly above their ‘rural level’ from the study presented", "marker": "•", "list_id": "L80", "level": 0, "items": [ { "page": 78, "type": "LIST_ITEM", "location": { "l": 126, "t": 194.4, "r": 468.48, "b": 180.24 }, "text": "(approximately at the NASA perception criteria 'window' also from first study)", "marker": "•", "list_id": "L80", "level": 1, "reading_order": 0 } ], "reading_order": 3 }, { "page": 78, "type": "TEXT", "location": { "l": 54.24, "t": 174.96, "r": 653.28, "b": 138.48 }, "text": "—This level is defensible based on human effect but is likely a challenge for data center to comply and unlikely a gas turbine generator(s) can comply", "reading_order": 4 } ] }, { "page": 79, "items": [ { "page": 79, "type": "TITLE", "location": { "l": 54.24, "t": 498.96, "r": 521.28, "b": 425.76 }, "text": "Effect of Sound on Cardiovascular Disease", "reading_order": 0, "level": 1 }, { "page": 79, "type": "TEXT", "location": { "l": 318, "t": 386.64, "r": 561.84, "b": 376.56 }, "text": "Review > J Am Coll Cardiol. 2018 Feb 13;71(6):688-697. doi: 10.1016/j.jacc.2017.12.015.", "reading_order": 1 }, { "page": 79, "type": "TITLE", "location": { "l": 314.88, "t": 370.32, "r": 584.88, "b": 357.12 }, "text": "Environmental Noise and the Cardiovascular System", "reading_order": 2, "level": 6 }, { "page": 79, "type": "TEXT", "location": { "l": 313.92, "t": 352.56, "r": 577.68, "b": 335.04 }, "text": "Thomas Münzel1, Frank P Schmidt2, Sebastian Steven2, Johannes Herzog2, Andreas Daiber2, Mette Sørensen3", "reading_order": 3 }, { "page": 79, "type": "TEXT", "location": { "l": 314.88, "t": 331.44, "r": 378.96, "b": 322.8 }, "text": "Affiliations + expand", "reading_order": 4 }, { "page": 79, "type": "TEXT", "location": { "l": 314.4, "t": 322.32, "r": 457.44, "b": 313.2 }, "text": "PMID: 29420965 DOI: 10.1016/j.jacc.2017.12.015", "reading_order": 5 }, { "page": 79, "type": "TEXT", "location": { "l": 315.12, "t": 311.76, "r": 350.88, "b": 303.12 }, "text": "Free article", "reading_order": 6 }, { "page": 79, "type": "TEXT", "location": { "l": 57.12, "t": 292.56, "r": 148.32, "b": 277.92 }, "text": "Article excerpt:", "reading_order": 7 }, { "page": 79, "type": "TITLE", "location": { "l": 57.36, "t": 276.24, "r": 146.4, "b": 261.84 }, "text": "Noise and CVD", "reading_order": 8, "level": 6 }, { "page": 79, "type": "TEXT", "location": { "l": 55.44, "t": 260.4, "r": 654.48, "b": 162.24 }, "text": "Since publishing of the first study in the late 1980s, the association between traffic noise and coronary heart disease has been studied extensively. Recent meta-analyses consistently conclude that traffic noise is associated with increased risk of coronary heart disease (25,36). The most recent meta-analysis from 2015 included studies on road traffic and aircraft noise, and found a 6% significant increase in risk for every 10 dB(A) increase in traffic noise (day-evening-night equivalent noise level A-weighted), starting as low as 50 dB(A) (25).", "links": [ { "uri": "https://www.jacc.org/doi/10.1016/j.jacc.2017.12.015#bib25", "dest": null, "action_type": "/URI", "bbox": [ 370.08, 213.6, 407.28, 225.36 ] }, { "uri": "https://www.jacc.org/doi/10.1016/j.jacc.2017.12.015#bib25", "dest": null, "action_type": "/URI", "bbox": [ 94.8, 165, 114.96, 176.76 ] } ], "reading_order": 9 }, { "page": 79, "type": "TEXT", "location": { "l": 57.36, "t": 147.12, "r": 640.56, "b": 114.48 }, "text": "Data center noise may be considered similar to road traffic or aircraft noise except that it is continuous 24 hours a day and 7 days a week.", "reading_order": 10 } ] }, { "page": 80, "items": [ { "page": 80, "type": "TITLE", "location": { "l": 6.24, "t": 515.28, "r": 671.04, "b": 440.88 }, "text": "Ordinance Language\nData Center Accountability for the Citizens of Dubuque\nCounty", "reading_order": 0, "level": 1 }, { "page": 80, "type": "TITLE", "location": { "l": 209.76, "t": 440.4, "r": 541.44, "b": 423.6 }, "text": "ARTICLE VII — PERFORMANCE STANDARDS", "reading_order": 1, "level": 6 }, { "page": 80, "type": "TEXT", "location": { "l": 104.16, "t": 411.6, "r": 287.28, "b": 397.2 }, "text": "Sec. 16-701. Noise and Vibration.", "reading_order": 2 }, { "page": 80, "type": "TEXT", "location": { "l": 104.16, "t": 391.2, "r": 641.52, "b": 347.04 }, "text": "Consistent with the Dubuque County Regional Comprehensive Plan, Chapter 10, which directs sustained action to reduce or eliminate the long-term risks to people and property from hazards, the following noise and vibration standards apply:", "reading_order": 3 }, { "page": 80, "type": "LIST_ITEM", "location": { "l": 123.36, "t": 342.24, "r": 644.64, "b": 123.36 }, "text": "Baseline Study. Before the application is complete, and before any site disturbance, a pre-construction noise study prepared by a professional engineer with expertise in acoustics, including low-frequency analysis, shall establish Baseline Ambient Sound at representative monitoring locations along all Property Lines, selected by the County's independent expert to capture the points most susceptible to noise, across all operational times of day and night and across representative seasonal conditions, expressly including harvest-season agricultural operations, with compliance comparisons made against season-matched baseline data. Seasonal baseline data are used solely for season-matched comparison under subsection (B) and shall never increase the limits of subsection (C). Field measurements for the baseline study shall be performed by, or in the physical presence of, the County-selected acoustic expert, with full-spectrum octave-band and narrow-band analysis, expressly including all proposed cooling systems, electrical substations, on-site power generation, and Data Center Accessory Uses, and with special consideration for infrasound (below 20 Hz) beyond standard dB(C) measurement. The applicant shall fund, at submission, the County's retention of an independent acoustic expert with infrasound expertise to review the study and report to the County.", "marker": "A.", "list_id": "L81", "level": 0, "reading_order": 4 }, { "page": 80, "type": "LIST_ITEM", "location": { "l": 124.32, "t": 119.28, "r": 618.72, "b": 75.6 }, "text": "Primary Operating Standard. Operations shall not cause sound levels at any Property Line to exceed Baseline Ambient Sound by more than three (3) dB, in dB(A) or dB(C), at any hour. Any exceedance is a violation unless expressly authorized as a condition of approval.", "marker": "B.", "list_id": "L81", "level": 0, "reading_order": 5 }, { "page": 80, "type": "LIST_ITEM", "location": { "l": 124.32, "t": 70.32, "r": 629.04, "b": 24.96 }, "text": "Numeric Backstop. Sound attributable to the facility, measured at every Property Line, shall not exceed forty (40) dB(A) and fifty (50) dB(C) at any hour of any day, determined by comparison of facility-on and facility-off conditions using the baseline methodology. Where Baseline Ambient", "marker": "C.", "list_id": "L81", "level": 0, "reading_order": 6 } ] }, { "page": 81, "items": [ { "page": 81, "type": "TITLE", "location": { "l": 5.28, "t": 462.72, "r": 94.08, "b": 441.36 }, "text": "County", "reading_order": 0, "level": 6 }, { "page": 81, "type": "LIST_ITEM", "location": { "l": 120.96, "t": 455.04, "r": 621.84, "b": 425.76 }, "text": "Sound already exceeds these values at a given location and time, subsection B governs at that location. In all other circumstances the more restrictive of this subsection or subsection B governs.", "list_id": "L82", "level": 0, "reading_order": 1 }, { "page": 81, "type": "LIST_ITEM", "location": { "l": 121.68, "t": 420.24, "r": 633.84, "b": 347.28 }, "text": "Infrasound. Infrasound (1 Hz to 20 Hz) shall not exceed sixty-five (65) dB(Z) at any Property Line, measured per ANSI S2.7 with instrumentation appropriate to infrasound; microphone-only measurement is not valid. Operations shall not generate vibration, oscillation, or infrasound causing perceptible resonance within any building or adverse effects on the human body, determined per ISO 2631 and ANSI standards for human exposure.", "marker": "D.", "list_id": "L82", "level": 0, "reading_order": 2 }, { "page": 81, "type": "LIST_ITEM", "location": { "l": 122.16, "t": 343.2, "r": 642, "b": 297.84 }, "text": "Tonal Penalty. Every sound study shall include narrow-band analysis per ISO/TS 20065. For sound above 20 Hz, where the decisive audibility of any narrow-band averaged spectrum is 10 dB or more, a 6 dB penalty shall be added to the measured A-weighted level for compliance purposes.", "marker": "E.", "list_id": "L82", "level": 0, "reading_order": 3 }, { "page": 81, "type": "LIST_ITEM", "location": { "l": 122.4, "t": 294.24, "r": 603.84, "b": 249.12 }, "text": "Vibration. Ground-borne vibration attributable to the facility shall not exceed a peak particle velocity of [0.02] inches per second at any Property Line, and shall not be perceptible without instruments at any Property Line.", "marker": "F.", "list_id": "L82", "level": 0, "reading_order": 4 }, { "page": 81, "type": "LIST_ITEM", "location": { "l": 121.92, "t": 244.56, "r": 636.96, "b": 156.96 }, "text": "Measurement. Measurements shall use sound level meters per ANSI S1.4 and Class 1/Type 1 instrumentation per IEC 61672-1 with one-third-octave capability per ANSI S12.9, at microphone heights of four (4) to five (5) feet, under suitable meteorological conditions (no precipitation; sustained wind at the microphone not exceeding 12 mph), at monitoring locations shown on the site plan at the points most susceptible to noise. Compliance is evaluated cumulatively for the facility, not source-by-source. Infrasound shall be measured in accordance with subsection (D).", "marker": "G.", "list_id": "L82", "level": 0, "reading_order": 5 }, { "page": 81, "type": "LIST_ITEM", "location": { "l": 121.68, "t": 151.92, "r": 634.8, "b": 108 }, "text": "Outages; Testing. The limits of this Section apply at all times, including during outages, Emergencies, equipment failures, testing, and maintenance. No allowance above subsections (B) and (C) is available, and the more protective standard governs.", "marker": "H.", "list_id": "L82", "level": 0, "reading_order": 6 }, { "page": 81, "type": "LIST_ITEM", "location": { "l": 121.44, "t": 102.96, "r": 637.68, "b": 0.96 }, "text": "Verification and Enforcement. Post-construction compliance testing of all levels, including infrasound, using the baseline methodology, shall occur within three (3) months of commencement of operation. The County may test at any time. Continuous monitoring shall stream to the Public Dashboard under Article XI, and third-party daytime and nighttime noise reports shall be filed publicly each year. Upon any verified exceedance, the automatic curtailment of Article XI applies; a sustained exceedance allows a cure period not exceeding one (1) month, after which the County may revoke the Conditional Use Permit and operations shall cease until compliance is demonstrated.", "marker": "I.", "list_id": "L82", "level": 0, "reading_order": 7 } ] }, { "page": 82, "items": [ { "page": 82, "type": "TITLE", "location": { "l": 51.36, "t": 512.16, "r": 651.12, "b": 412.32 }, "text": "Audible Noise Limit\nfrom Draft Ordinance- section 16-\n701", "reading_order": 0, "level": 6 }, { "page": 82, "type": "LIST_ITEM", "location": { "l": 55.68, "t": 398.64, "r": 664.8, "b": 291.36 }, "text": "“Numeric Backstop. Sound attributable to the facility, measured at every Property Line, shall not exceed forty (40) dB(A) and fifty (50) dB(C) at any hour of any day, determined by comparison of facility-on and facility-off conditions using the baseline methodology.”", "marker": "•", "list_id": "L83", "level": 0, "reading_order": 1 }, { "page": 82, "type": "LIST_ITEM", "location": { "l": 54.72, "t": 287.28, "r": 649.68, "b": 180.96 }, "text": "This requirement may be challenging to justify, as these levels are the same as ‘quiet suburban levels’ according to the sound study presented. Most other ordinances that we have reviewed have a higher limit, easier for data centers to meet.", "marker": "•", "list_id": "L83", "level": 0, "reading_order": 2 }, { "page": 82, "type": "LIST_ITEM", "location": { "l": 53.28, "t": 175.2, "r": 639.84, "b": 81.6 }, "text": "Current justification is based loosely on the County Regional Comprehensive plan, Objective 1, Item 7\n“Discourage non-farm uses from locating outside of urban areas, or limit such uses to areas that are appropriate for the development and least disruptive of the natural character, and which are designed to blend with the natural character as much as possible, in order to preserve the natural character of the land or community.”", "marker": "•", "list_id": "L83", "level": 0, "reading_order": 3 } ] }, { "page": 83, "items": [ { "page": 83, "type": "TEXT", "location": { "l": 8.4, "t": 534.96, "r": 383.52, "b": 410.64 }, "text": "NOISE\nPollution:\nMEDICAL\nResearch\nReferences\nPENDING", "reading_order": 0 } ] }, { "page": 84, "items": [ { "page": 84, "type": "TITLE", "location": { "l": 32.4, "t": 502.8, "r": 514.32, "b": 437.52 }, "text": "Data Center Health Impact: NOISE Pollution", "reading_order": 0, "level": 1 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 22.32, "t": 417.36, "r": 564.48, "b": 393.84 }, "text": "Question Asked: Does NOISE Pollution Impact Health?", "marker": "•", "list_id": "L84", "level": 0, "reading_order": 1 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 22.56, "t": 389.52, "r": 177.36, "b": 367.68 }, "text": "Health Impact", "marker": "•", "list_id": "L84", "level": 0, "items": [ { "page": 84, "type": "LIST_ITEM", "location": { "l": 57.84, "t": 362.16, "r": 377.76, "b": 342.96 }, "text": "Noise, Low Frequency Noise, Vibration", "marker": "•", "list_id": "L84", "level": 1, "reading_order": 0 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 57.36, "t": 337.92, "r": 617.28, "b": 300.24 }, "text": "Noise → Stress Response, Circadian Rhythm Disruption, Inflammation Associated Disorders", "marker": "•", "list_id": "L84", "level": 1, "reading_order": 1 } ], "reading_order": 2 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 22.08, "t": 295.68, "r": 600.72, "b": 272.88 }, "text": "Question Answered: Does NOISE Pollution Impact Health?", "marker": "•", "list_id": "L84", "level": 0, "reading_order": 3 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 22.56, "t": 268.32, "r": 353.28, "b": 246.96 }, "text": "National/Other NOISE Standards", "marker": "•", "list_id": "L84", "level": 0, "reading_order": 4 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 22.32, "t": 241.68, "r": 310.56, "b": 219.36 }, "text": "NOISE Ordinance Examples", "marker": "•", "list_id": "L84", "level": 0, "reading_order": 5 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 22.32, "t": 214.8, "r": 448.8, "b": 192.72 }, "text": "Proposed NOISE Ordinance Requirements", "marker": "•", "list_id": "L84", "level": 0, "reading_order": 6 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 22.56, "t": 187.92, "r": 461.28, "b": 167.04 }, "text": "Recommended NOISE Ordinance Checklist:", "marker": "•", "list_id": "L84", "level": 0, "items": [ { "page": 84, "type": "LIST_ITEM", "location": { "l": 58.08, "t": 165.6, "r": 439.2, "b": 147.6 }, "text": "NOISE Pollution Prevention Included In Ordinance", "marker": "•", "list_id": "L84", "level": 1, "reading_order": 0 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 58.32, "t": 146.64, "r": 253.68, "b": 129.36 }, "text": "Monitoring Requirement", "marker": "•", "list_id": "L84", "level": 1, "reading_order": 1 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 58.32, "t": 128.4, "r": 309.12, "b": 109.92 }, "text": "Sanction(s) for Non-Compliance", "marker": "•", "list_id": "L84", "level": 1, "reading_order": 2 } ], "reading_order": 7 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 22.8, "t": 106.08, "r": 214.8, "b": 83.52 }, "text": "Polling/Questions", "marker": "•", "list_id": "L84", "level": 0, "reading_order": 8 }, { "page": 84, "type": "LIST_ITEM", "location": { "l": 22.32, "t": 78.72, "r": 153.6, "b": 57.6 }, "text": "References", "marker": "•", "list_id": "L84", "level": 0, "reading_order": 9 } ] }, { "page": 85, "items": [ { "page": 85, "type": "TITLE", "location": { "l": 51.6, "t": 490.08, "r": 645.12, "b": 81.84 }, "text": "What is your greatest concern about the impact of NOISE pollution on you/your family's health?", "reading_order": 0, "level": 2 } ] }, { "page": 86, "items": [ { "page": 86, "type": "TITLE", "location": { "l": 64.8, "t": 488.4, "r": 662.4, "b": 79.2 }, "text": "How strongly do you feel that the Dubuque County should include NOISE pollution limits in its zoning ordinances?", "reading_order": 0, "level": 2 } ] } ]