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Worst U.S. Air: Bakersfield, Calif.; Best: Honolulu, Santa Fe

Lung Association Says Air Pollution Kills, Ranks Best/Worst U.S. Cities, Counties
WebMD Health News
Reviewed by Laura J. Martin, MD

April 27, 2011 -- Bakersfield, Calif., has wrested the "dirtiest U.S. air" title from Los Angeles, the American Lung Association (ALA) finds in its annual ranking of U.S. areas with the most and least air pollution.

The ALA ranks cities on three separate lists: most bouts of short-term particle pollution, most year-round particle pollution, and ozone pollution.

Honolulu and Santa Fe, N.M., are the only two U.S. cities to rank among the top 10 cleanest cities on all three lists. Bakersfield tops both the short- and long-term particle pollution list, while L.A. remains the worst city for ozone.

There's some good news. All the cities most polluted by ozone did better than they did last year, as did all but two of the 25 cities with the worst all-year particle pollution.

Improvements in the nation's air quality since 1980 have added five months to U.S. life expectancy, says Normal H. Edelman, MD, the ALA's chief medical officer.

But that's no cause for celebration, Edelman warns.

"Vast portions of our population are at risk of bad health or even death from unhealthy air," Edelman said at a news conference. "Over half of Americans continue to live in areas with bad air pollution -- in air dirty enough to shorten their lives."

It's not an abstract health threat. Particle pollution damages the lungs of healthy people -- the effect may be worse in the growing lungs of children, the fragile lungs of the elderly, and the already weakened lungs of people with asthma and COPD.

It doesn't take years for bad air to kill.  The effects of air pollution are felt immediately. The effects are toxic not only to the lungs but to the heart as well.

The ALA report notes that an estimated 9,200 Californians die annually from breathing particle pollution.

"Deaths can occur on the very day that particle levels are high, or within one to two months afterward," the report states. "These are deaths that would not have occurred if the air were cleaner."

The ALA strongly supports toughening the Clean Air Act. People can protect themselves by:

  • Paying attention to forecasts for high-pollution days and taking precautions
  • Avoiding exercise near high-traffic areas
  • Avoiding outdoor exercise when pollution levels are high
  • Avoiding indoor smoking
  • Reducing the use of fireplaces and wood-burning stoves


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