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Administrative Draft Environmental Impact Report Gill Medical Center Project microgram in diameter and therefore is a subset of particulate matter under 2.5 microns in diameter(i.e., PM2.5). Most PM2.5 derives from combustion, such as use of gasoline and diesel fuels by motor vehicles.). As with 03 and NO,the Project would not generate emissions of PM,o or PM2.5 that would exceed the SJVAPCD's thresholds.Additionally, the Project would be required to comply with Regulation VIII, Rules 8021-8071- Fugitive PM,o Prohibitions and Rule 9510- Indirect Source Review, as described above, which limit the amount of fugitive dust generated during construction. Accordingly, the Project's PM10 and PM2.5 emissions are not expected to cause any increase in related regional health effects for these pollutants. In summary, the Project would not result in a potentially significant contribution to regional or localized concentrations of nonattainment pollutants and would not result in a significant contribution to the adverse health impacts associated with those pollutants. Related impacts are less than significant. Valley Fever Coccidioidomycosis (CM), often referred to as San Joaquin Valley Fever or Valley Fever, is one of the most studied and oldest known fungal infections.Valley Fever most commonly affects people who live in hot dry areas with alkaline soil and varies with the season.This disease, which affects both humans and animals, is caused by inhalation of arthroconidia (spores) of the fungus Coccidioides immitis (CI). Cl spores are found in the top few inches of soil and the existence of the fungus in most soil areas is temporary.The cocci fungus lives as a saprophyte in dry, alkaline soil. When weather and moisture conditions are favorable, the fungus "blooms" and forms many tiny spores that lie dormant in the soil until they are stirred up by wind, vehicles, excavation, or other ground-moving activities and become airborne. Agricultural workers, construction workers, and other people who work outdoors and who are exposed to wind and dust are more likely to contract Valley Fever. Children and adults whose hobbies or sports activities expose them to wind and dust are also more likely to contract Valley Fever.After the fungal spores have settled in the lungs, they change into a multicellular structure called a spherule. Fungal growth in the lungs occurs as the spherule grows and bursts, releasing endospores, which then develop into more spherules. Valley fever (Coccidioidomycosis) is found in California, including San Joaquin County. In about 50 to 75 percent of people, valley fever causes either no symptoms or mild symptoms and those infected never seek medical care;when symptoms are more pronounced, they usually present as lung problems (cough, shortness of breath, sputum production, fever, and chest pains).The disease can progress to chronic or progressive lung disease and may even become disseminated to the skin, lining tissue of the brain (meninges), skeleton, and other body areas. San Joaquin County is considered a highly endemic area for valley fever.When soil containing this fungus is disturbed by ground-disturbing activities such as digging or grading, by vehicles raising dust, or by the wind, the fungal spores get into the air. When people breathe the spores into their lungs, they may get valley fever. Fungal spores are small particles that can grow and reproduce in the body.The highest infection period for valley fever occurs during the driest months in California, between June and November. Infection from valley fever during ground-disturbing activities can be partially mitigated through the control of Project-generated dust.As noted, Project-generated dust would be controlled by adhering to SJVAPCD dust-reducing measures (Regulation VIII), which includes the preparation of a Air Quality 4.5-22 October 2021