In a rule published July 2, 2002, EPA found the Arizona Department of Environmental Quality’s "Plan for Attainment of the 24-Hour PM10 Standard – Maricopa County PM10 Nonattainment Area" (May 1997), inadequate to achieve attainment of the 24-hour National Ambient Air Quality Standards for particulate matter 10 microns or fewer in aerodynamic diameter (PM10) at the Salt River monitoring site. The 1997 ADEQ SIP revision included attainment and Reasonable Further Progress demonstrations for the 24-hour NAAQS at the Salt River air quality monitoring site of the Maricopa County PM10 Serious Nonattainment Area, as well as at three other monitoring sites in the Phoenix area, - the Maryvale, Gilbert, and West Chandler sites. On August 4, 1997, EPA approved ADEQ’s attainment and RFP demonstrations for the Salt River monitoring area, which showed that the 24-hour PM10 NAAQS would reach attainment in the area by May 1998. Due to continuing violations of the 24-hour PM10 NAAQS at the Salt River air quality monitoring site since May 1998, EPA subsequently required Arizona to submit a revision to correct SIP inadequacies. This document consists of Arizona’s revisions to the state implementation plan for the Maricopa County PM10 Serious Nonattainment Area as described by EPA in its Federal Register notice of disapproval.

The Arizona Department of Health Services (ADHS) has prepared this report on the health status of Arizona women to highlight its commitment to the health and wellness of all Arizonans throughout the lifespan and its focus on prevention. It is the intention that the data contained in this report will serve as a baseline and that, in future reports, we will see progress toward creating a healthier Arizona.

This brief includes mortality data with an underlying cause of death coded to ICD-10 codes X20-X29, and hospital discharge data coded to ICD-9 codes 905.0-905.9. The hospital discharge data only include information from private, acute-care facilities. Data from rehabilitation hospitals, urgent care centers, or federal facilities, including Indian Health Services or Veteran’s Administration facilities, are not available.

The data presented in this report show that poisoning is a public health problem that impacts the lives of thousands of Arizona residents each year. These injuries can occur throughout the life span, and like so many injuries, poisonings are predictable and preventable. Understanding the circumstances of poisonings is an important step towards educating and empowering communities and implementing prevention strategies.

As one of the largest Federal block grant programs, Title V is the key source of support for promoting and improving the health of all the nation‘s mothers and children. Each year, all states are required to submit an Application and Annual Report for Federal funds for their Maternal and Child Health Services Title V Block Grant to States Program to the Maternal and Child Health Bureau in the Health Resources and Services Administration.

Abusive head injury fatalities were identified in Arizona’s Child Fatality Review annual reports. Non-fatal hospitalizations and emergency department visits due to abusive head injuries (shaken infant or shaken impact syndrome) were identified using methods from a study conducted in 2005. Infants and children under the age of two years with a code for shaken infant syndrome in any diagnostic fields were included. Additionally, cases with a diagnostic code for skull fracture or intracranial injury, retinal hemorrhage, or intracranial hemorrhage with an external cause of injury code for known or suspected homicide/assault were included.

The Clean Air Act states that an area can be redesignated to attainment if specific conditions are met. This document demonstrates that all CAA requirements for attainment have been met, summarizes the progress of the area in attaining the PM10 standard, demonstrates that the Bullhead City area qualifies for EPA’s Clean Data Policy and Limited Maintenance Plan option, and includes a maintenance plan to assure continued attainment for ten years after the redesignation. This document includes a formal request to the U.S. Environmental Protection Agency to redesignate the Bullhead City, Arizona PM10 nonattainment area to attainment for the health-based 24-hour average and annual average PM10 National Ambient Air Quality Standard.

In addition, this document includes a formal request to revise the nonattainment area boundary, as currently defined in 40 CFR 81.303, to exclude three townships (108 square miles) in the east and south of the nonattainment area. The rationale for eliminating the three townships is that the land contains undisturbed desert terrain. The majority of the three townships is federal land managed by the Bureau of Land Management and state land managed by the Arizona State Land Department. Analyses included in this document show that ambient air quality measurements have remained below the NAAQS for PM10, and both the 24-hour average design value and annual average PM10 design value are below EPA’s LMP allowable limits. This document also demonstrates that the emission reduction control measures responsible for the air quality improvement are both permanent and enforceable.