Seven cities with America’s worst air


The Golden State gets far from a gold medal when it comes to air pollution, according to the State of the Air 2022 study by the American Lung Association.

California is home to 14 of the top 25 air polluted counties in America which failed across three measures of air pollution. States east of the Mississippi made big strides in recent years cleaning up their acts though.

The 23rd annual air pollution study measured what authors considered “the most dangerous and widespread air pollutants;” annual particle pollution levels, short-term (24- hour) particle pollution levels and ozone levels. 

Fresno, California had the greatest number of “unhealthy” or worse particle pollution days. Bakersfield, California tops the list for greatest annual particulate pollution levels. Los Angeles tallied up the most number of ozone polluting days. The study analyzed data from 2018, 2019 and 2020.

Much of America breathes unhealthy air

Over 137 million Americans, 40% are living in places that scored failing grades for air pollution. The study stated that 2.1 million more Americans were breathing unhealthy air over the 2021 data. Over 9 million more people suffered through daily unhealthy, even deadly, daily spikes in particle pollution over last year’s data.

The Environmental Protection Agency sets safe levels of particle and ground ozone levels and measures them daily from official recoding sites across the U.S. You can check your daily Air Quality Index from your FOX Weather city forecasts on our app. The EPA also offers daily numbers

The study stated that 2.1 million more Americans were breathing unhealthy air over the 2021 data.
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Annual Particle Pollution

These seven cities/areas scored the worst for annual, average particle air pollution:

  1. Bakersfield, California
  2. Fresno-Madera-Hanford and Visalia, California (tie)
  3. San Jose-San Francisco-Oakland
  4. Los Angeles–Long Beach
  5. Medford-Grants Pass, Oregon
  6. Fairbanks, Alaska
  7. Phoenix-Mesa

The study analyzed air samples from 202 metro areas and determined that 20.9 million people or 6.4% of the nation lived in areas that exceeded the national air quality limit annually. Of the 25 worst counties nationwide, 17 are in California. All 21 counties receiving a failing grade for annual particle pollution were in five western states. 

Study authors feel that the increased number, severity, and duration of recent wildfires have taken a toll on western year-round pollution.

In 2007, 21 areas across eastern and industrialized states like New Jersey, New York and Ohio were on the worst 25 list.  The 2022 report only lists eight areas east of the Mississippi in the top 25 worst for annual pollution.

Fairbanks, Alaska
Fairbanks, Alaska also ranked high for air pollution.
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Short term particle air pollution

These seven cities had the most number of days of unhealthy air for particle pollution out of 221 metro areas:

  1. Fresno-Madera-Hanford, California
  2. Bakersfield, California
  3. Fairbanks, Alaska
  4. San Jose-San Francisco-Oakland
  5. Redding-Red Bluff, California
  6. Chico, California
  7. Sacramento-Roseville, California

The American Lung Association states that 63.2 million people live in the 96 areas across the nation that had unhealthy spikes of particle air pollution. All failing states are in the Western U.S. And 23 of the 35 failing areas are in California.

Particles from exhaust, smoke, dust storms and construction just a twenty-fourth of the width of a human hair, can not only be inhaled but get trapped in the lungs. The finest particles can pass through the lungs into the bloodstream, according to the American Lung Association

Ozone layer
Los Angeles tallied up the most number of ozone polluting days. The study analyzed data from 2018, 2019 and 2020.
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Ozone pollution

These seven areas had the worst ground ozone pollution out of 226 around the nation:

  1. Los Angeles-Long Beach
  2. Bakersfield, California
  3. Visalia, California
  4. Fresno-Madera-Hanford, California
  5. Phoenix-Mesa
  6. San Diego-Chula Vista-Carlsbad
  7. Denver-Aurora

Ozone at the Earth’s surface mixes with other pollutants (nitrogen oxides emitted by cars, power plants and other high-heat combustion) and VOCs (volatile organic compounds – emitted by cars, factories, refineries and paint) to create smog. Ozone is harmful to inhale in high concentrations, even deadly.

Ozone, composed of three oxygen molecules, attacks lung tissue. Most at risk are kids, seniors, people who work or exercise outdoors and those with an existing lung disease. The more a person breathes in, the more at risk they are of damage.

The most likely area to experience smog is downwind of the source which can be miles away.

Fifteen of the 25 worst ozone-polluted areas were in California. Only Chicago, Houston and Fairfield County, Connecticut scored flagging grades but not in the west.

Pregnant woman
Another study linked low birth weight in newborns and preterm labor for moms to air pollution.
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Pollution dangers

Inhaling fine particulate matter/pollution and/or ozone at high levels can cause lung irritation that may take days to recover from.  Research published by the National Institutes of Health indicates that short and long-term air pollution exposure is linked to premature death. 

Researchers found a ‘significant’ increase in deaths within two days of high air pollution levels for people over 65 years old. The number of deaths rose as the ozone and particulate levels increased.

“We found that the mortality rate increases almost linearly as air pollution increases,” wrote Dr. Francesca Domenici, author of the study. “Any level of air pollution, no matter how low, is harmful to human health.” 

Another study linked low birth weight in newborns and preterm labor for moms to air pollution.

Besides premature death, ozone can cause shortness of breath, asthma attacks and lead to an increased risk of respiratory infections for all ages. The EPA also reported that Ozone pollution may cause cardiovascular harm (heart attacks, strokes) and damage the central Nervous system. 

Cleanest air

Let’s get to the clean news — the American Lung Association ranked the cleanest cities for year-round particle pollution – here are the top 7.

  1. Cheyenne, Wyoming
  2. Wilmington, North Carolina
  3. Honolulu (urban)
  4. Kahului–Wailuku–Lahaina, Hawaii
  5. Bangor, Maine
  6. Casper, Wyoming
  7. Bellingham, Washington



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