Air pollution is getting worse.
Nearly 134 million Americans, (41%) live in counties that got at least one "F" for unhealthy air, and have unhealthful levels of either ozone or particle pollution, according to the American Lung Association.
With record-setting heat in 2016, many cities across the U.S. experienced more days when ground-level ozone, (smog) reached unhealthy levels, the ALA reports in its annual State of the Air 2018 report.
Most at risk to the dangers of air pollution are children and adults over 65, and people with asthma or other chronic lung disease, cardiovascular disease or diabetes. Ozone and particle pollution are also both linked to increased risk of lower birth weight in newborns, the report says.
Despite the increase in ozone, the report indicates that actions taken under the Clean Air Act continue to clean up pollution in much of the nation since it was enacted in 1970. The best progress came in the continued reduction of year-round particle pollution, due to cleaner power plants and increased use of cleaner vehicles and engines. Continued progress to cleaner air remains crucial to reduce the risk of premature death, asthma attacks and lung cancer, the report states, and as climate change continues, cleaning up these pollutants will become more challenging.
According to the American Lung Association, these are the cities with the worst air pollution.
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1. Los Angeles-Long Beach, Calif.
Los Angeles remains the city with the worst ozone pollution, as it has for nearly the entire history of the American Lung Association's report. It was the fourth worst for annual particle pollution, and seventh worst city for short-term (24-hours) particle pollution.
2. Bakersfield, Calif.
Bakersfield was the worst for 24-hour particle pollution out of 201 metropolitan areas and the third worst for year-round particle pollution out of 187 metropolitan areas.
Photo: Richard Thornton / Shutterstock
3. Visalia-Porterville-Hanford, Calif.
The community in California's central valley also ranked No. 2 for both short-term and year-round particle pollution.
4. Fresno-Madera, Calif.
Another city in the state's central valley, Fresno ranked third for short-term particle pollution and fifth for year-round particle pollution.
Pohto: Nagel Photography / Shutterstock
5. Sacramento-Roseville, Calif.
California's capital city was also 19th on the short-term particle pollution list.
6. San Diego-Carlsbad, Calif.
7. Modesto-Merced, Calif.
Another city in California's central valley, Modesto was also in the six worst for both short- and long-term particle pollution.
8. Phoenix-Mesa-Scottsdale, Ariz.
Phoenix was also No. 20 for short-term particle pollution.
9. Redding-Red Bluff, Calif.
Above, Sundial Bridge at Turtle Bay in Redding, Calif.
Photo: Stephen B. Goodwin / Shutterstock
10. New York-Newark, N.Y.-N.J.-Conn.-Pa.
11. Houston-The Woodlands, Texas
Houston also ranked No. 15 for year-round particle pollution.
12. Las Vegas-Henderson, Nev.-Ariz.
Vegas also suffers from year-round particle pollution, ranking No. 24 on that list.
13. San Jose-San Francisco-Oakland, Calif.
The Bay Area recorded high levels of all three types of pollution: not only was it the 13th worst for ozone, it was No. 10 for year-round particle pollution and No. 6 for short-term particle pollution.
14. Denver-Aurora, Colo.
Denver also recorded high short-term particle pollution.
15. El Centro, Calif.
The city of 180,883 near the Mexico border is one of the worst for overall air pollution, ranking in the top 10 for both year-round and short-term particle pollution, as well as No. 15 for ozone.
16. Dallas-Fort Worth, Texas-Okla.
17. Washington-Baltimore-Arlington, D.C.-Md.-Va.-W.V.-Pa.
18. Salt Lake City-Provo-Orem, Utah
The city ranked No. 8 for short-term particle pollution.
19. Fort Collins, Colo.
Photo: Wusel007 Wikipedia
20. Hartford-West Hartford, Conn.
Photo: Zak G / Shutterstock
21. Chico, Calif.
22. Chicago-Naperville, Ill.-Ind.-Wis.
23. Atlanta-Athens-Clarke County-Sandy Springs, Ga.
Atlanta was also No. 22 for year-round particle pollution.
24. Sheboygan, Wis.
24. (tie) Philadelphia-Reading-Camden, Penn.-N.J.-Del.-Md.
Photo: Marco Rubino / Shutterstock
These are the cities with the worst year-round particle pollution that have not already been listed on the ozone list:
1. Fairbanks, Alaska
Fairbanks had both the worst year-round particle pollution and the fourth-worst short-term particle pollution.
8. Pittsburgh-New Castle-Weirton, Penn.-Ohio-W.V.
Following the central California cities, Pittsburgh was eighth-worst for year-round particle pollution, and 10th worst for short-term.
8. (tie) Lancaster, Penn.
Photo: Felix Lipov / Shutterstock
10. Cleveland-Akron-Canton, Ohio
Photo: Tupungato / Shutterstock
13. Indianapolis-Carmel-Muncie, Ind.
To see how your town ranked, go to StateoftheAir.org.