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Lung Disease & Respiratory Health Center

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Odds Are, You're Breathing Bad Air

WebMD Health News
Reviewed by Gary D. Vogin, MD

Welcome, sulphur dioxide,
Hello, carbon monoxide,
The air, the air is ev'rywhere.

- from the 1968 musical "Hair," lyrics by James Rado & Gerome Ragni

May 1, 2002 -- If you're an American, you're probably breathing bad air. For the third straight year, more than half of U.S. residents live in areas with dangerous smog.

The finding comes from the 2002 edition of the American Lung Association's annual State of the Air report. The bottom line: of the 678 U.S. counties monitoring air, nearly 400 get an "F" grade from the ALA. The failing grade means that these areas had levels of ozone -- a major ingredient in smog -- that made the air unhealthy to breathe for at least nine days.

Part of every year's State of the Air message is a ranking of the best and worst air in the nation. Here are the 10 most polluted urban areas:

  1. Los Angeles (Riverside/Orange counties)
  2. Bakersfield, Calif.
  3. Fresno, Calif.
  4. Visalia-Tulare-Porterville, Calif.
  5. Houston-Galveston-Brazoria, Texas.
  6. Atlanta
  7. Merced, Calif.
  8. Knoxville, Tenn.
  9. Charlotte-Gastonia-Rock Hill, NC-SC
  10. Sacramento, Calif.

And, in alphabetical order, here are the 11 urban areas with the least air pollution:

  • Bellingham, Wash.
  • Colorado Springs, Co.
  • Duluth-Superior, Minn.-Wisc.
  • Fargo-Moorhead, N.D.-Minn.
  • Flagstaff, Ariz.
  • Honolulu, Hawaii.
  • Laredo, Texas.
  • Lincoln, Neb.
  • McAllen-Edinburg-Mission, Texas
  • Salinas, Calif.
  • Spokane, Wash.

So which people are most at risk? Children, of course, and people with chronic lung diseases. But you're not off the hook if you're healthy. Athletes and people who work outdoors are also at increased risk of lung damage from air pollution, says Norman H. Edelman, MD. Edelman is the ALA's scientific consultant and is vice-president and dean of the SUNY-Stony Brook School of Medicine.

"We've still got a big problem. I get very frustrated," Edelman tells WebMD. "It is personal for me. I take care of a lot of asthma patients. They tell me when they can breathe and when they cannot. And very often they cannot."

This year, Edelman and the ALA want you to help. The public-health organization is asking people to write to their elected representatives and to President Bush to demand enforcement of existing clean-air regulations. For the first time, the ALA is providing an easy way to write these letters at their web site,

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