American Lung Association's 2004 State of the Air report ranks cities and counties with dirty air


American Lung Association fights roll-backs of Clean Air Act that would increase pollution - Quarter of all Americans threatened by dangerous particle pollution levels

April 29, 2004 – NEW YORK, N.Y. – High levels of microscopic, soot-like particles are increasing the risk of premature death for millions of people, including those with heart or lung disease, according to the American Lung Association State of the Air: 2004 report released today. The report, which provides county-by-county grades of ozone pollution and the first-ever county-by-county analysis of particle pollution, can be found by visiting

"Americans need to know about unhealthy air pollution in their communities," said John L. Kirkwood, American Lung Association President and Chief Executive Officer. "The threat may be invisible to the human eye, but it is real – and it can kill. This is why the American Lung Association is fighting hard to protect tools in the Clean Air Act that can clean up the pollution – a tool that the Administration has taken steps to roll back," said Kirkwood.

For the first time, the American Lung Association's annual State of the Air report uses data from a new, national air-quality surveillance network to go beyond its traditional analysis of smog, or ozone air pollution, to include particle pollution. Produced by power plant emissions, diesel exhaust and wood burning, among other sources, particle pollution can be dangerous when it reaches unhealthy levels over a few hours or a few days, as well as with constant daily exposure over a long period of time. The complex and dangerous health effects of particle pollution were confirmed in a National Research Council report released in March 2004.

Both Particle Pollution and Ozone Threaten Air Quality

While particle pollution emerges as a widespread problem affecting a quarter of all Americans, ozone levels continue to endanger nearly half the nation (136 million Americans). Here are some of the cities and counties most affected by the poorest air quality:

  • Northeast – New York City, Philadelphia, Harrisburg, Pittsburgh, Washington, DC, , Newark, Bridgeport and Baltimore
  • Southeast – Atlanta, Birmingham, Knoxville, Louisville, Charleston, Raleigh-Durham and Winston-Salem
  • Midwest – Chicago, Cleveland, Cincinnati, St. Louis and Detroit
  • Southwest: - Dallas-Ft. Worth, Houston and Phoenix
  • West– Los Angeles, San Diego, San Francisco, Sacramento, Fresno, Eugene, Seattle, Provo and Salt Lake City

Report Highlights: Public Health Implications

Particle pollution, complex microscopic bits that are one-thirtieth the width of a human hair, can cause serious health problems even at relatively low concentrations and are responsible for tens of thousands of premature deaths in the U.S. each year, according to the report.

"The dangerous thing about these fine particles is that they are tiny enough to penetrate the body's natural defense systems," said Norman H. Edelman, MD, the American Lung Association's consultant for scientific affairs. "This means when you inhale these particles, they embed themselves deep in the lungs. Some may even pass through the lungs to the blood."

"Particle pollution is like an invisible army, wreaking havoc on your body through complicated mechanisms we're still sorting out," said Edelman. "Studies link particle pollution to increased risk of asthma attacks, heart attacks and strokes, lung cancer, and premature death, to name just a few of the ways this tiny army attacks."

People with cardiovascular diseases, children and the elderly are most vulnerable to the health risks associated with particle pollution, as are tens of millions of people who suffer from chronic lung disease such as asthma and chronic obstructive pulmonary disease. Specifically at risk are:

  • The 16.7 million people with cardiovascular disease living in areas with unhealthy short-term particle pollution levels. Even short-term exposure – several hours to several days – has been linked to premature death, heart attacks and stroke.
  • The 3.6 million adults and a 1.4 million children with asthma exposed to unhealthy year-round particle levels; and
  • The 2.6 million with chronic bronchitis and 888,000 with emphysema living in areas with dangerous short-term particle pollution.

According to the report:

  • Twenty-eight percent (more than 81 million) of the U.S. population lives in areas with unhealthy short-term levels of particle pollution;
  • Nearly one-quarter of Americans (66 million) live in areas with unhealthy year-round levels of particle pollution; and
  • Nearly half of all Americans (136 million) live in counties with unhealthy levels of ozone, despite substantial reductions in ozone in the thirty-four years spent fighting the problem.
  • All totaled, some 159 million Americans live in counties with unhealthy levels of either ozone or short-term levels or year-round levels of particle pollution.
  • Most alarmingly, 46 million Americans live in counties where all three levels are unhealthy.

How Air Quality is Measured

American Lung Association State of the Air: 2004 uses air quality measurements made by state and local agencies and reported to EPA for the years 2000 through 2002 to assign grades A through F and Pass/Fail to counties in three categories: 1) daily particle pollution levels 2) year-round particle pollution levels and 3) daily ozone levels. Grades are based on how often air quality levels reach "unhealthful" amounts under EPA's Air Quality Index for short-term levels of particle pollution and ozone. Pass/Fail grades for the year-round levels of particle pollution are based on EPA's own analysis.

Administration Proposals Jeopardize Clean Air Act

Despite progress toward cleaner air over the past 30 years, the American Lung Association is greatly concerned about roadblocks including the Administration's actions to roll back key provisions of the Clean Air Act and persistent delays in carrying out the existing provisions. Last year, the EPA reversed a provision of the Clean Air Act that would have required the nation's oldest, dirtiest power plants and oil refineries to meet clean air standards. The American Lung Association sued to stop that rollback, and in a December 2003 Court of Appeals ruling blocked EPA's efforts until the court can hear the full case. The American Lung Association has successfully sued EPA to set schedules for ending the delays on other key provisions.

What Americans Can Do

To help Americans protect their health and reduce air pollution, the American Lung Association is issuing a "top 10 list" of "What You Can Do To Protect Yourself From Ozone and Particle Air Pollution," with special guidelines for seniors and parents of small children. These simple and concrete action steps include avoiding exercising outside on high pollution days and not burning wood or trash. The American Lung Association also urges taking steps to help clean up the air, including carpooling and filling gas tanks after sundown, as well as supporting strong national, state, and local pollution control programs. For the full lists or to contact members of Congress to oppose revisions to the Clean Air Act, including loopholes for polluting power plants that would weaken existing laws, individuals can log onto

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Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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