AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 2

Acknowledgments
e American Lung Association State of the Air® 2013 is the
result of the hard work of many people:
In the American Lung Association National Headquarters:
Paul G. Billings, who supervised the work; Janice E. Nolen,
MS, who directed the project, analyzed data, wrote the text,
and coordinated print and web presentations; Nick Su-
kachevin, who analyzed data and coordinated eld outreach
and e-advocacy; Peter Iwanowicz and Lyndsay Moseley, who
helped integrate the Healthy Air Campaign with this report;
Zach Jump, MA, and Elizabeth Lancet, MPH, who converted
the raw data into meaningful tables and comparisons and
calculated all the population data; Susan Rappaport, MPH,
who supervised the data analysis; Norman Edelman, MD, who
reviewed the science and health discussions; Jean Haldorsen,
who supervised production and creative for the print edi-
tion; Todd Nimirowski, who directed the online presentation;
Joe Landol who managed content production online; Laura
Lavelle, who developed social sharing and digital engage-
ment strategy; Mary Havell McGinty, Gregg Tubbs and Mike
Townsend who coordinated internal and external communica-
tions and media outreach.
In the nationwide American Lung Association: All Lung
Association eld oces reviewed and commented on the data
for their states. Hard-working sta across the nation went out
of their way to ensure that their state and local air directors
were in the loop.
Outside the American Lung Association: Allen S. Lefohn
of A.S.L. & Associates, who compiled the data; Deborah
Shprentz, who assisted with the research and review of the
science; Beaconre Consulting, who made enhancements to
the website features; Randy Tibbott of Our Designs, Inc., who
designed the print version.
Great appreciation goes to the National Association of Clean
Air Agencies who along with their Executive Director Bill
Becker, strove to make this report better through their com-
ments, review and concerns. Many of their members reviewed
and commented on the individual state data presented and the
methodology to make this report more accurate. We appreci-
ate them as our partners in the ght against air pollution. is
report should in no way be construed as a comment on the
work they do.
A key partner in this work is the U.S. Environmental Protec-
tion Agency. e professional sta of the Agency has long been
dedicated to the ght for clean air.
e American Lung Association assumes sole responsibility
for the content of the American Lung Association State of the
Air 2013.
American Lung Association
National Headquarters
1301 Pennsylvania Ave., NW, Suite 800
Washington, DC 20004-1725
Phone: (202) 785-3355
Fax: (202) 452-1805
www.stateoheair.org
www.Lung.org
Copyright © 2013 by the American Lung Association
American Lung Association, State of the Air, and
Fighting for Air are registered trademarks of the American
Lung Association.
Fighting for Air®
Designed by Our Designs, Inc., Nashville, TN
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 3
Contents
The State of the Air 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Rankings
People at Risk in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Most Polluted Cities in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Most Polluted Counties in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Cleanest Cities in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Cleanest Counties in the U.S.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Health Eíects of Ozone and Particle Pollution . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
State Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 4
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 5
The State of the Air 2013
State of the Air 2013
shows that
cleaning up
air pollution
produces
healthier air
across the nation.
13 of the most
polluted cities had
their fewest unhealthy
ozone days.
Gross Domestic Product
Vehicle Miles Traveled
Population
Energy Consumption
CO
2
Emissions
Aggregate Emissions
(Six Common Pollutants)
220%
200%
180%
160%
140%
120%
100%
80%
60%
40%
20%
0%
–20%
–40%
–60%
–80%
70 80 90 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11
212%
167%
52%
45%
32%
-68%
Figure 1 Air emissions have dropped steadily since 1970 thanks to the Clean Air Act. Even as the economy continues
to recover from the recession, emissions that contribute to the most widespread pollutants continue to drop.
(Source: U.S. EPA, Air Trends, 2012)
T
hanks to the Clean Air Act, the United States continues
to make progress providing healthier air. e State of
the Air 2013 shows that the nation’s air quality is over-
all much cleaner, especially compared to just a decade ago.
Still, over 131.8 million people—42 percent of the nation—
live where pollution levels are too oen dangerous to breathe.
Despite that risk, some seek to weaken the Clean Air Act,
the public health law that has driven the cuts in pollution
since 1970.
e State of the Air 2013 report looks at levels of ozone and
particle pollution found in ocial monitoring sites across the
United States in 2009, 2010, and 2011. e report uses the
most current quality-assured nationwide data available for
these analyses.
e report examines
particle pollution
(PM
2.5
) in two dierent
ways: averaged year-
round (annual average)
and over short-term lev-
els (24-hour). For both
ozone and short-term
particle pollution, the
analysis uses a weighted
average number of days
that allows recognition
of places with higher
levels of pollution. For
the year-round particle
pollution rankings, the
report uses averages cal-
culated and reported by
the U.S. Environmental
Protection Agency (EPA). For comparison, the State of the Air
2012 report covered data from 2008, 2009 and 2010.
1

Overall
Trends
anks to stronger standards for pollut-
ants and for the sources of pollution, the
United States has seen continued reduc-
tion in ozone and particle pollution as
well as other pollutants for decades. Figure 1 from the EPA
shows that since 1970, the air has gotten cleaner while the
population, the economy, energy use and miles driven in-
creased greatly. Even as the economy continues to recover aer
1 A complete discussion of the sources of data and the methodology is
included in Methodology.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 6 THE STATE OF THE AI R 2013
the recession, overall air emissions that create the six most
widespread pollutants continue to drop.
In 2009-2011, many places made strong progress over 2008-
2010, particularly in lower year-round levels of particle
pollution. anks to reductions in emissions from coal-red
power plants and the transition to cleaner diesel fuels and
engines, cleaner air shows up repeatedly in the monitoring
data, especially in the eastern U.S. Still, the science shows that
annual particle levels need to be much lower, as shown in the
EPA’s decision in December 2012 to strengthen the national
air quality standards for ne particles for the rst time in
een years.
Most cities also continued the long-term trend for fewer high
ozone days, but not all. Many places recorded slightly more
unhealthy days on average than in 2008-2010, which had been
the best period to date. Warmer weather may have contributed
to the increase. e most common pollutant, ozone has already
proven to be one of the hardest to reduce. ese ndings add
to the evidence that the nation needs more aggressive tools to
secure continued reductions.
One disturbing trend is the increase in the number of days of
unhealthy particle levels in many cities. Although year-round
average levels for particles are steadily dropping, the reverse
is true for short-term spikes in days with high particle counts.
ese periods oen occur in the winter, as has happened in
Fairbanks (AK) and Salt Lake City in recent winters. In some
cities, the increase comes from increased burning of wood
and other fuels in the winter for heat, oen in highly polluting
indoor wood stoves or outdoor wood boilers.
Ozone
Fifteen of the 27 cities with the most
ozone pollution improved their air quality
over the past year’s report. Thirteen of the
country’s most smog-polluted cities experienced their best
year yet. Unfortunately, even with the improvements, people
living there are still forced to breathe air that reaches
dangerously unhealthy levels.
Los Angeles remained the city with the worst ozone pollution
problem, but reported its fewest unhealthy ozone days since
the State of the Air reports began. Los Angeles has one-third
fewer days of unhealthy air than in the rst report. Of the 27
metropolitan areas most polluted by ozone, twelve others also
reported their fewest unhealthy ozone days
2
: Visalia (CA);
Bakerseld (CA); Fresno; Sacramento; San Diego; Merced
(CA); Modesto (CA); New York City; Charlotte; Philadelphia;
Phoenix; and Pittsburgh. Two others also improved: Hanford
(CA); and San Luis Obispo (CA).
However, twelve cities suered more unhealthy days, includ-
ing three that moved for the rst time to the most polluted list:
Beaumont-Port Arthur (TX); Oklahoma City; and Tulsa (OK).
Other cities reporting more or worse days during 2009-2011
included Houston; Dallas; Washington, DC-Baltimore; El
Centro (CA); Cincinnati; Birmingham; Las Vegas; Louisville;
and St. Louis.
Year-round
Particle Pollution
Eighteen cities had
lower year-round levels
of particle pollution in
2009-2011, including
16 with their lowest levels recorded.
Bakerseld (CA) recorded its lowest levels ever in 2009-
2011, but tied with Merced (CA) as cities with the worst
year-round levels of particle pollution in the nation. Also on
this list are een other cities that reported their lowest levels
of year-round particle pollution: Hanford (CA); Los Angeles;
Visalia (CA); Pittsburgh; Cincinnati; Philadelphia; St. Louis;
Louisville; Canton (OH); Cleveland; Indianapolis; Steubenville
2 Complete names for all these metropolitan areas can be found in the tables
showing the most polluted and cleanest cities. The full metropolitan areas
often include multiple counties, incorporated cities and counties in adjacent
states, as the Oíce of Management and Budget defines them.
Nearly
24.8 million
people in the US live
in counties where the
outdoor air failed all
three tests.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 7 THE STATE OF THE AI R 2013
(OH); Wheeling (WV); Birmingham; and Dayton (OH). Fair-
banks (AK) and Phoenix improved over the previous levels,
but had reported cleaner air in the past.
Unfortunately, seven cities saw their year-round levels in-
crease from previous reports.
3
Top of that list is Merced, where
year-round levels of particle pollution increased to their worst
reading ever to tie Bakerseld for most polluted city. Other
cities with worse annual levels were Fresno, Modesto (CA), El
Centro (CA), Macon (GA), Allentown (PA), and Atlanta.
anks in part to legal action taken by the American Lung
Association, the EPA strengthened the long-outdated limits on
year-round particle pollution in December, 2012. at crucial
step will drive more protection from deadly particles.
Short-term
Particle Pollution
Of the 25 cities with the
worst problem with spikes in
particle pollution, fourteen
had more days or worse
problems in 2009-2011 than in the previous report. For six
cities, this period held their worst record for short-term days
since the data started to be collected: Hanford (CA); Modesto
(CA); Merced (CA); Fairbanks (AK); Stockton (CA); and Las
Cruces (NM). Other cities with more days of unhealthy
particle pollution levels include: Los Angeles, Salt Lake City,
Chicago, Seattle, Indianapolis, Phoenix, Allentown (PA), and
Portland (OR).
Nine cities on the most polluted list continued to improve in
2009-2011. Five cities reported their best records yet: Fresno;
Pittsburgh; Visalia (CA); Eugene (OR); and San Diego. Other
cities improving include: Bakerseld (CA); Logan (UT); Provo
(UT); and Green Bay (WI). Two cities had the same number of
days as in the last report: Harrisburg (PA) and South Bend (IN).
3 These trends are based on prior available data. Not all cities had counties
with complete annual averages posted for all prior years.
Cleanest
Cities

Four cities ranked on all three
lists of the cleanest cities in
2009-2011. That means they had
no days in the unhealthy level for
ozone or short-term particle pollution and were on the list of
the cleanest cities for year-round particle pollution. Listed
alphabetically, the four cities are:

• Bismarck (ND)
• Cape Coral-Fort Myers (FL)
• Palm Bay-Melbourne-Titusville (FL)
• Rapid City (SD)
Sixteen cities ranked as the cleanest for both year-round and
short-term particle pollution, listed alphabetically:
• Bangor (ME)
• Bismarck (ND)
• Cape Coral-Fort Myers (FL)
• Colorado Springs (CO)
• Farmington (NM)
• Flagsta (AZ)
• Fort Collins-Loveland (CO)
• Lakeland-Winter Haven (FL)
• Palm Bay-Melbourne-Titusville
(FL)
• Prescott (AZ)
• Rapid City (SD)
• Redding (CA)
• Salinas (CA)
• Sarasota (FL)
• St. George (UT)
• Tucson (AZ)
Seven cities were on both the cleanest cities lists for ozone and
for year-round particle pollution, listed alphabetically:
• Bismarck (ND)
• Burlington (VT)
• Cape Coral-Fort Myers (FL)
• Duluth (MN)
• Palm Bay-Melbourne-Titusville
(FL)
• Rapid City (SD)
• Santa Fe-Espanola (NM)
Ten cities made both the cleanest cities lists for ozone and for
short-term particle pollution, listed alphabetically:
• Bismarck (ND)
• Brownsville (TX)
• Cape Coral-Fort Myers (FL)
• Claremont-Lebanon (NH)
• Gainesville (FL)
• McAllen-Edinburg-Pharr (TX)
• Monroe (LA)
• Muscle Shoals (AL)
• Palm Bay-Melbourne-Titusville (FL)
• Rapid City (SD)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 8
People At Risk
Looking at the nation as a whole,
the American Lung Association
State of the Air 2013 nds—
More than 4 in 10 people (42%) in the United States live
in counties that have unhealthful levels of either ozone
or particle pollution.
Over 131.8 million Americans live in the 254 counties
where they are exposed to unhealthful levels of air pollu-
tion in the form of either ozone or short-term or year-round
levels of particles.
Nearly 4 in 10 people in the United States (38%) live in
areas with unhealthful levels of ozone.
Counties that were graded F for ozone levels have a com-
bined population of over 119.3 million. ese people live
in the 191 counties where the monitored air quality places
them at risk for premature death, aggravated asthma, dif-
culty breathing, cardiovascular harm and lower birth
weight. e actual number who breathe unhealthy levels of
ozone is likely much larger, since this number does not in-
clude people who live in adjacent counties in metropolitan
areas where no monitors exist.
Fifteen percent (15%) of people in the United States live
in an area with too many days of unhealthful levels of
particle pollution.
Over 47.7 million Americans live in 58 counties that ex-
perienced too many days with unhealthy spikes in particle
pollution, a decrease from the last report. Short-term spikes
in particle pollution can last from hours to several days and
can increase the risk of heart attacks, strokes and emergency
room visits for asthma and cardiovascular disease, and most
importantly, can increase the risk of early death.
Over 44.3 million people (14%) in the United States live
in an area with unhealthful year-round levels of particle
pollution.
ese people live in areas where chronic levels are regularly
a threat to their health. Even when levels are fairly low,
exposure to particles over time can increase risk of hospi-
talization for asthma, damage to the lungs and, signicantly,
increase the risk of premature death.
Nearly 24.8 million people (8%) in the United States live
in 14 counties with unhealthful levels of all three: ozone
and short-term and year-round particle pollution.
With the risks from airborne pollution so great, the Ameri-
can Lung Association seeks to inform people who may be in
danger. Many people are at greater risk because of their age
or because they have asthma or other chronic lung disease, car-
diovascular disease or diabetes. e following list identies the
numbers of people in each at-risk group.
Older and Younger—Over 15.8 million adults age 65 and
over and nearly 32.3 million children under 18 years old
live in counties that received an F for at least one pollutant.
Over 2.8 million seniors and over 6.2 million children live
in counties failing all three tests.
People with Asthma—Nearly 2.7 million children and over
8.7 million adults with asthma live in counties of the United
States that received an F for at least one pollutant. Over
460,000 children and over 1.5 million adults with asthma
live in counties failing all three tests.
Chronic Obstructive Pulmonary Disease (COPD)—Over
5.8 million people with COPD live in counties that received
an F for at least one pollutant. Over 910,000 people with
COPD live in counties failing all three tests.
Cardiovascular Disease—Over 32.5 million people with
cardiovascular diseases live in counties that received an F
for at least one pollutant; over 5.6 million live in counties
failing all three tests.
Diabetes—Over 4.2million people with diabetes live in
counties that received an F for either short-term or year
round particle pollution; over 1.7 million live in counties
failing both tests. Having diabetes increases the risk of harm
from particle pollution.
THE STATE OF THE AI R 2013
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 9 THE STATE OF THE AI R 2013
Poverty—Over 20.2 million people with incomes meeting
the federal poverty denition live in counties that received
an F for at least one pollutant. Over 4.5 million people in
poverty live in counties failing all three tests. Evidence
shows that people who have low incomes may face higher
risk from air pollution.
What Needs
To Be Done
Many major challenges require
the Administration, working
through the EPA, and Congress to
take steps to protect the health of
the public. Here are a few that the American Lung Association
calls for to improve the air we all breathe, starting with
cleaning up smokestacks and tailpipes.
Clean up harmful emissions from smokestacks
Toxic pollution. Coal-red power plants remain among the
largest contributors to particulate pollution, ozone, mer-
cury, and climate change. eir pollution blows across state
lines into states hundreds of miles away. ey produce 84
known hazardous air pollutants, including arsenic, mercury,
dioxins, formaldehyde and hydrogen chloride, as shown in
the Lung Association report Toxic Air: e Case for Cleaning
Up Coal-red Power Plants. ese smokestacks need clean-
ing up.
Carbon pollution. Power plants are the largest stationary
source of greenhouse gases in the United States. Energy pro-
duction accounts for 86 percent of total 2009 greenhouse gas
emissions, and the electric sector represents 39 percent of all
energy-related carbon dioxide (CO
2
) emissions.
4
In 2012, the
EPA proposed the rst ever limits on carbon pollution from
new power plants. Now the EPA needs to nish the job and
issue strong nal standards for carbon pollution from new and
existing plants.
4 U.S. Environmental Protection Agency. Inventory of Greenhouse Gas
Emissions and Sinks: 1990-2009. Washington, DC: U.S. EPA, 2011. EPA 430-
R-11-005.
Transported ozone and particle pollution. In 2011, the EPA
set tough new limits on ozone and particle pollution that could
blow across state lines and add unhealthy air downwind. at
same year the EPA also, for the rst time, set national limits
on the toxic pollutants these power plants can emit. However,
these standards have been blocked in court. e Lung Associa-
tion has taken legal steps to defend the EPA’s eorts. e EPA
and the states must move forward with actions to clean these
plants up.
Clean up harmful emissions from tailpipes
Gasoline, cars, light trucks and SUVs. e EPA needs to
set new pollution standards for cars, light trucks, SUVs and
reduced sulfur in gasoline to reduce nitrogen oxides, hydro-
carbons, and particle pollution emissions. People who live or
work near highways or busy roads bear a disproportionate
health burden from air pollution. Cleaner gasoline will reduce
pollution from every car on the road, reducing emissions as if
we suddenly removed 33 million cars from the road. Cleaner
vehicles will help reduce this impact for all, but especially those
who live closest to the trac.
Dirty diesel vehicles and heavy equipment. Rules the EPA
put in eect over the past several years mean that new diesel
vehicles and equipment must be much cleaner. Still, the vast
majority of diesel trucks, buses, and heavy equipment (such
as bulldozers) will likely be in use for thousands more miles,
spewing dangerous diesel exhaust into communities and
neighborhoods. e good news is that aordable technology
exists to cut emissions by 90 percent. Congress needs to fund
the EPA’s diesel cleanup (“retrot”) program. Congress should
also require that clean diesel equipment be used in federally-
funded construction programs.
Reduce emissions of wood smoke
Residential wood-burning devices, including outdoor wood
boilers and stoves, are the largest residential source of particle
pollution. Emissions of harmful air pollutants from wood-
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 10
burning devices have worsened air quality and public health in
many cities, such as Fairbanks and Salt Lake City. ese devices
could have signicant impacts on their owners and immedi-
ate neighbors. e U.S. Census reports that nearly two percent
of all U.S. households use wood as a primary heat source.
5
In
2006, one study estimated that approximately 14 to 17 million
such devices were then in use in the United States.
6

Besides particle pollution, wood burning also produces
carbon monoxide, nitrogen oxides, sulfur dioxide, and even
toxic air pollution. Studies have found that wood smoke
leads to coughing and shortness of breath, decreases in
lung function, and aggravated asthma and may even cause
cancer.
7

e EPA has not updated national standards for these devices
since 1988. Improved technologies in use today can limit
harmful emissions from wood-burning devices. e EPA
needs to update the standards to reect this new technology.
All wood-burning devices can burn cleaner to reduce impacts
on public health.
Emissions from outdoor wood boilers used to heat resi-
dences also need to be cleaned up. As their use increases,
the EPA is considering its options to regulate outdoor wood
boiler emissions. However, the agency has yet to issue a pro-
posal, originally scheduled for summer 2011 with nal rules
set for summer 2012. e EPA needs to adopt a standard to
limit emissions from these devices to avoid the patchwork of
state regulations currently in place.
5 U.S. Census Bureau. American Housing Survey for the United States. 2011.
Available at www.census.gov/housing/ahs11/national2011.xls
6 Johnson PRS. In-Field Ambient Fine Particle Monitoring of an Outdoor
Wood Boiler: Public Health Concerns. Human and Ecological Risk
Assessment. 2006; 12: 1153-1170.
7 Naeher LP, Brauer M, Lipsett M, Zelikoí JT, Simpson CD, Koenig JQ,
Smith KR. Woodsmoke Health Eíects: A Review. Inhalation Toxicology.
2007; 19:67-106. Bølling AK, Pagels J, Yttri KE, Barregard L, Sallsten G,
Schwarze PE, Boman C. Health eíects of residential wood smoke particles:
the importance of combustion conditions and physicochemical particle
properties. Particle and Fibre Toxicology. 2009; 6:29.
Improve the air pollution monitoring network.
e grades in this report come from information from the
nationwide air pollution monitoring network. at network
forms the public health infrastructure for air pollution. States
and local governments use monitors to accurately measure the
amount of air pollution in the community.
Less than one-third of all counties have ozone or particle
pollution monitors, seriously limiting the ability to ad-
equately detect and track the levels of harmful air pollution.
Coverage is especially limited near major highways, where
people likely breathe higher levels of air pollution. e EPA
needs to expand the monitoring network to include com-
prehensive coverage in areas near major roads and high-
ways. ese monitors are needed to measure the highest
levels of exposures to air pollution related to trac.
Unfortunately, funds for existing air pollution monitors
have been cut across the nation. ese resources may be
cut further unless Congress and the White House resolve to
protect the health of the nation from air pollution.
Adopt an ozone standard that follows the law
and protects health
National air quality standards are the ocial limits that
drive the cleanup of air pollution around the nation. e
Clean Air Act requires that the EPA set national air qual-
ity standards based on the need to protect public health
“with an adequate margin of safety.” In 2001, the Supreme
Court unanimously ruled that protecting health was
the only basis for the standards. e Clean Air Act also
requires that the EPA review the standards every ve years
to make sure that the standards are based on the most
current science.
A federal court ruled in March, 2013 that the existing
standards for ozone, set in 2008, are out-of-date and fail to
adequately protect public health. e American Lung
THE STATE OF THE AI R 2013
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 11
Association led an action challenging the standards set
by the Bush Administration in 2008, and resumed the legal
battle following the Obama Administration’s decision in
2011 to ignore the overwhelming scientic research and
the opinions of experts that much stronger standards were
needed. Now, the EPA has a second chance in December
2013, when it must propose a new standard under the regu-
lar review cycle.
e EPA estimated that setting the standard for ozone to
60 ppb would save 4,000 to 12,000 lives and prevent 21,000
hospitalizations, 58,000 asthma attacks, 5,300 heart attacks,
and result in 2.5 million fewer school and work days lost
each year. e lower ozone levels would yield $35 billion to
$100 billion in health and economic benets by 2020.
8
Protect the Clean Air Act
e continued improvement shown in the State of the Air
report is possible because of the Clean Air Act, the nation’s
strong public health law that the U.S. Congress passed over 40
years ago. e Act requires that the EPA and each state take
steps to clean up the air. Some members of Congress are pro-
posing changes to the Clean Air Act that could dismantle prog-
ress made in the last 40 years. We must keep that law strong to
continue to protect public health.
What You
Can Do
Individual citizens can do a great
deal to help reduce air pollution
outdoors as well. Simple but
eective ways include—
Send a message to Congress. Urge them to support
cleaner, healthier air and oppose measures to block or delay
the cleanup of air pollution. ey should support and pro-
tect the Clean Air Act.
8 U.S. EPA. 2010. Summary of the updated Regulatory Impact Analysis (RIA)
for the Reconsideration of the 2008 Ozone National Ambient Air Quality
Standard (NAAQS). Available at http://www.epa.gov/ttn/ecas/regdata/
RIAs/s1-supplemental_analysis_summary11-5-09.pdf .
Tell the EPA to set tighter standards for gasoline and
stricter tailpipe pollution standards for cars, trucks and
SUVs. e EPA also needs to set tighter standards for ozone.
Share your story. Do you or any member of your family
have a personal reason to want healthier, cleaner air? Go
to www.Fightingforair.org to let us know how healthy air
aects you.
Drive less. Combine trips, walk, bike, carpool or vanpool, and
use buses, subways or other alternatives to driving. Vehicle
emissions are a major source of air pollution. Support commu-
nity plans that provide ways to get around that don’t require a
car, such as more sidewalks, bike trails and transit systems.
Use less electricity. Turn out the lights and use energy-
ecient appliances. Generating electricity is one of the big-
gest sources of pollution, particularly in the eastern United
States.
Don’t burn wood or trash. Burning rewood and trash
are among the largest sources of particles in many parts of
the country. If you must use a replace or stove for heat,
convert your woodstoves to natural gas, which has far
fewer polluting emissions. Compost and recycle as much as
possible and dispose of other waste properly; don’t burn it.
Support eorts in your community to ban outdoor burning
of construction and yard wastes. Avoid the use of outdoor
hydronic heaters, also called outdoor wood boilers, which
are frequently much more polluting than woodstoves.
Make sure your local school system requires clean
school buses, which includes replacing or retrotting old
school buses with lters and other equipment to reduce
emissions. Make sure your local schools don’t idle their
buses, a step that can immediately reduce emissions.
Get involved. Participate in your community’s review of
its air pollution plans and support state and local eorts to
clean up air pollution. To nd your local air pollution con-
trol agency, go to www.4cleanair.org.
THE STATE OF THE AI R 2013
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 12
People at Risk from Short-term Particle Pollution (24-Hour PM
2.5
)
Chronic Diseases Age Groups
In Counties where Adult Pediatric 65 and Total Number of
the Grades were: Asthma Asthma COPD CV Disease Diabetes Poverty Under l8 Over Population Counties
Grade A 4,271,383 1,324,082 3,168,182 16,749,582 4,753,083 9,600,406 15,065,427 8,331,612 63,537,368 267
Grade B 3,949,841 1,198,390 2,881,297 15,128,605 4,361,373 9,028,395 13,667,408 7,292,889 58,495,022 157
Grade C 2,142,208 631,485 1,468,960 7,787,328 2,177,131 4,854,753 6,975,980 4,000,052 30,461,550 80
Grade D 884,316 268,886 582,075 3,234,039 875,069 2,099,432 3,146,380 1,650,498 13,236,246 24
Grade F 3,105,828 907,767 1,779,500 10,884,831 2,984,165 8,023,636 11,988,163 5,558,535 47,738,436 58
National Population in
Counties with PM
2.5
Monitors 14,741,185 4,451,110 10,167,066 55,355,985 15,600,324 34,495,754 52,281,912 27,671,082 219,488,047 646
People at Risk from Year-Round Particle Pollution (Annual PM
2.5
)
Chronic Diseases Age Groups
In Counties where Adult Pediatric 65 and Total Number of
the Grades were: Asthma Asthma COPD CV Disease Diabetes Poverty Under l8 Over Population Counties
Pass 10,708,057 3,224,435 7,370,266 40,101,181 11,332,003 24,020,903 37,279,392 20,137,572 158,279,511 454
Fail 2,892,959 887,896 1,968,049 10,827,051 3,008,200 7,949,646 10,992,232 5,243,648 44,356,304 66
National Population in
Counties with PM
2.5
Monitors 14,741,185 4,451,087 10,167,066 55,355,985 15,600,324 34,495,754 52,281,912 27,671,082 219,488,047 646
People at Risk from Ozone
Chronic Diseases Age Groups
In Counties where Adult Pediatric 65 and Total Number of
the Grades were: Asthma Asthma COPD CV Disease Poverty Under l8 Over Population Counties
Grade A 1,674,517 473,870 1,210,271 6,627,736 4,056,386 5,765,125 3,621,817 25,246,204 165
Grade B 1,534,021 450,751 1,161,667 6,068,321 3,271,922 5,373,524 3,254,787 22,996,964 120
Grade C 2,398,118 707,232 1,751,640 8,918,128 5,008,249 7,733,240 4,550,085 33,740,902 162
Grade D 1,716,079 538,739 1,240,685 6,456,945 4,028,544 5,871,258 3,096,380 24,947,995 87
Grade F 7,835,299 2,435,810 5,228,948 29,397,912 18,270,182 29,247,851 14,241,694 119,364,365 191
National Population in
Counties with Ozone Monitors 15,474,129 4,696,454 10,842,162 58,756,136 35,305,333 55,032,330 29,469,590 230,948,107 811
Note: The State of the Air 2C1¯ covers the period 2CC9-2C11. The Appendix provides a full discussion of the methodology.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 13
People at Risk In 25 U.S. Cities Most Polluted by Short-term Particle Pollution (24-hour PM
2.5
)
20l3 Total 65 and Pediatric Adult CV
Rank
l
Metropolitan Statistical Areas Population
2
Under l8
3
Over
3
Asthma.
4,6
Asthma
5,6
COPD
7
Disease
8
Diabetes
9
Poverty
l0
1 Bakersfield-Delano, CA 851,710 254,658 77,793 18,232 50,187 25,296 167,656 44,022 200,571
2 Fresno-Madera, CA 1,095,829 321,487 114,718 23,016 65,120 33,800 224,505 59,435 272,942
3 Hanford-Corcoran, CA 153,765 42,382 12,366 3,034 9,354 4,504 29,646 7,656 27,949
4 Los Angeles-Long Beach-Riverside, CA 18,081,569 4,542,151 2,021,451 325,187 1,139,030 597,808 3,983,369 1,059,886 3,038,607
5 Modesto, CA 518,522 146,498 56,563 10,488 31,303 16,547 110,394 29,447 119,325
6 Salt Lake City-Ogden-Clearfield, UT 1,776,528 540,098 159,329 36,476 108,788 50,041 317,657 84,494 222,300
7 Pittsburgh-New Castle, PA 2,450,281 487,427 424,058 48,891 175,676 134,681 705,328 194,442 304,860
8 Merced, CA 259,898 80,991 25,034 5,798 15,039 7,658 50,722 13,340 68,371
9 Fairbanks, AK 99,192 25,056 6,759 2,143 6,027 3,659 22,166 5,466 9,045
10 Logan, UT-ID 127,549 39,974 10,727 2,780 7,751 3,467 21,185 5,592 19,977
11 Provo-Orem, UT 540,834 188,312 36,206 12,718 31,034 13,052 78,928 20,237 75,340
12 Stockton, CA 696,214 201,446 73,891 14,422 41,628 21,911 146,134 38,937 124,573
13 Las Cruces, NM 213,598 56,503 26,936 5,681 15,816 9,408 47,038 15,117 61,023
14 Eugene-Springfield, OR 353,416 68,420 54,567 6,475 29,763 16,874 91,147 26,384 73,046
14 Visalia-Porterville, CA 449,253 145,232 43,101 10,398 25,559 13,075 86,663 22,830 113,766
16 Chicago-Naperville-Michigan City, IL-IN-WI 9,729,825 2,409,527 1,137,848 178,564 606,154 450,627 2,427,061 695,509 1,406,443
17 Green Bay, WI 309,469 75,014 39,345 5,720 21,574 12,487 72,064 19,336 32,227
17 Seattle-Tacoma-Olympia, WA 4,269,349 956,101 505,469 67,682 322,196 133,881 1,058,057 289,663 506,278
19 Harrisburg-Carlisle-Lebanon, PA 687,222 150,880 104,875 15,134 48,425 35,784 186,263 50,760 70,738
19 Indianapolis-Anderson-Columbus, IN 2,103,574 538,477 245,760 50,965 150,174 127,524 543,297 156,272 304,431
21 Phoenix-Mesa-Glendale, AZ 4,263,236 1,107,303 540,544 93,175 302,805 166,853 963,671 297,791 727,056
22 Allentown-Bethlehem-Easton, PA-NJ 824,916 184,267 127,180 18,156 57,703 41,844 223,884 60,999 93,243
23 San Diego-Carlsbad-San Marcos, CA 3,140,069 726,602 362,928 52,020 203,011 106,254 707,051 187,806 462,997
24 Portland-Vancouver-Hillsboro, OR-WA 2,262,605 528,336 264,695 47,250 179,204 91,968 529,364 150,599 330,960
25 South Bend-Elkhart-Mishawaka, IN-MI 564,679 145,837 75,670 13,868 40,240 34,946 150,972 43,341 98,292
Notes:
1. Cities are ranked using the highest weighted average for any county within that Combined or Metropolitan Statistical Area.
2. Total Population represents the at-risk populations for all counties within the respective Combined or Metropolitan Statistical Area.
¯. Those under l8 and 65 and over are vulnerable to PM2.o and are, therefore, included. They should not be used as population denominators for disease estimates.
4. Pediatric asthma estimates are for those under 1o years of age and represent the estimated number of people who had asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adult asthma estimates are for those 1o years and older and represent the estimated number of people who had asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma.
7. COPD estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. CV disease is cardiovascular disease and estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
9. Diabetes estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
1C. Poverty estimates come from the U.S. Census Bureau and are for all ages.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 14
People at Risk In 25 U.S. Cities Most Polluted by Year-Round Particle Pollution (Annual PM
2.5
)
20l3 Total 65 and Pediatric Adult CV
Rank
l
Metropolitan Statistical Areas Population
2
Under l8
3
Over
3
Asthma.
4,6
Asthma
5,6
COPD
7
Disease
8
Diabetes
9
Poverty
l0
1 Bakersfield-Delano, CA 851,710 254,658 77,793 18,232 50,187 25,296 167,656 44,022 200,571
1 Merced, CA 259,898 80,991 25,034 5,798 15,039 7,658 50,722 13,340 68,371
3 Fresno-Madera, CA 1,095,829 321,487 114,718 23,016 65,120 33,800 224,505 59,435 272,942
4 Hanford-Corcoran, CA 153,765 42,382 12,366 3,034 9,354 4,504 29,646 7,656 27,949
4 Los Angeles-Long Beach-Riverside, CA 18,081,569 4,542,151 2,021,451 325,187 1,139,030 597,808 3,983,369 1,059,886 3,038,607
6 Modesto, CA 518,522 146,498 56,563 10,488 31,303 16,547 110,394 29,447 119,325
7 Visalia-Porterville, CA 449,253 145,232 43,101 10,398 25,559 13,075 86,663 22,830 113,766
8 Pittsburgh-New Castle, PA 2,450,281 487,427 424,058 48,891 175,676 134,681 705,328 194,442 304,860
9 El Centro, CA 177,057 50,986 18,749 3,650 10,603 5,513 36,633 9,705 43,259
10 Cincinnati-Middletown-Wilmington, OH-KY-IN 2,179,965 537,575 270,708 52,080 163,904 132,373 590,680 164,231 307,286
11 Philadelphia-Camden-Vineland, PA-NJ-DE-MD 6,562,287 1,513,270 886,837 145,153 461,724 305,296 1,699,047 454,024 867,174
12 Louisville-Jeíerson County-Elizabethtown-Scottsburg, KY-IN 1,440,607 343,686 185,720 29,991 113,046 105,848 438,810 118,056 215,950
12 St. Louis-St. Charles-Farmington, MO-IL 2,907,732 682,579 395,222 52,616 198,808 171,525 814,289 227,989 394,418
14 Allentown-Bethlehem-Easton, PA-NJ 824,916 184,267 127,180 18,156 57,703 41,844 223,884 60,999 93,243
14 Canton-Massillon, OH 403,869 91,028 66,842 9,105 30,467 25,305 117,992 33,758 64,237
14 Fairbanks, AK 99,192 25,056 6,759 2,143 6,027 3,659 22,166 5,466 9,045
14 Macon-Warner Robins-Fort Valley, GA 404,668 102,123 49,198 8,733 28,926 21,949 109,457 32,710 77,932
18 Atlanta-Sandy Springs-Gainesville, GA-AL 5,712,148 1,493,455 544,561 127,857 404,213 290,752 1,437,977 419,154 943,886
18 Phoenix-Mesa-Glendale, AZ 4,263,236 1,107,303 540,544 93,175 302,805 166,853 963,671 297,791 727,056
20 Cleveland-Akron-Elyria, OH 2,871,084 647,740 435,316 64,789 217,731 176,025 816,118 232,415 455,857
20 Indianapolis-Anderson-Columbus, IN 2,103,574 538,477 245,760 50,965 150,174 127,524 543,297 156,272 304,431
22 Steubenville-Weirton, OH-WV 123,243 24,279 22,932 2,179 9,359 8,650 40,374 11,831 19,643
22 Wheeling, WV-OH 147,197 28,860 26,232 2,530 11,164 10,287 47,863 14,016 22,359
24 Birmingham-Hoover-Cullman, AL 1,212,800 287,870 162,832 30,184 73,803 89,406 393,595 108,720 200,725
24 Dayton-Springfield-Greenville, OH 1,075,683 245,833 167,819 24,589 81,195 65,402 303,924 86,413 176,793
Notes:
1. Cities are ranked using the highest weighted average for any county within that Combined or Metropolitan Statistical Area.
2. Total Population represents the at-risk populations for all counties within the respective Combined or Metropolitan Statistical Area.
¯. Those under l8 and 65 and over are vulnerable to PM2.o and are, therefore, included. They should not be used as population denominators for disease estimates.
4. Pediatric asthma estimates are for those under 1o years of age and represent the estimated number of people who had asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adult asthma estimates are for those 1o years and older and represent the estimated number of people who had asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma.
7. COPD estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. CV disease is cardiovascular disease and estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
9. Diabetes estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
1C. Poverty estimates come from the U.S. Census Bureau and are for all ages.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 15
People at Risk In 25 Most Ozone-Polluted Cities
20l3 Total 65 and Pediatric Adult CV
Rank
l
Metropolitan Statistical Areas Population
2
Under l8
3
Over
3
Asthma.
4,6
Asthma
5,6
COPD
7
Disease
8
Poverty
9
1 Los Angeles-Long Beach-Riverside, CA 18,081,569 4,542,151 2,021,451 325,187 1,139,030 597,808 3,983,369 3,038,607
2 Visalia-Porterville, CA 449,253 145,232 43,101 10,398 25,559 13,075 86,663 113,766
3 Bakersfield-Delano, CA 851,710 254,658 77,793 18,232 50,187 25,296 167,656 200,571
4 Fresno-Madera, CA 1,095,829 321,487 114,718 23,016 65,120 33,800 224,505 272,942
5 Hanford-Corcoran, CA 153,765 42,382 12,366 3,034 9,354 4,504 29,646 27,949
6 Sacramento—Arden-Arcade—Yuba City, CA-NV 2,489,230 606,325 319,042 43,295 158,254 88,544 586,151 386,342
7 Houston-Baytown-Huntsville, TX 6,191,434 1,708,164 552,120 137,217 333,104 237,213 1,462,793 1,056,710
8 Dallas-Fort Worth, TX 6,853,425 1,881,791 648,640 151,163 369,858 266,821 1,640,113 1,052,759
9 Washington-Baltimore-Northern Virginia, DC-MD-VA-WV 8,670,607 2,025,927 964,445 191,397 577,502 385,948 2,191,845 808,337
10 El Centro, CA 177,057 50,986 18,749 3,650 10,603 5,513 36,633 43,259
11 Merced, CA 259,898 80,991 25,034 5,798 15,039 7,658 50,722 68,371
11 San Diego-Carlsbad-San Marcos, CA 3,140,069 726,602 362,928 52,020 203,011 106,254 707,051 462,997
13 Modesto, CA 518,522 146,498 56,563 10,488 31,303 16,547 110,394 119,325
14 Birmingham-Hoover-Cullman, AL 1,212,800 287,870 162,832 30,184 73,803 89,406 393,595 200,725
14 Cincinnati-Middletown-Wilmington, OH-KY-IN 2,179,965 537,575 270,708 52,080 163,904 132,373 590,680 307,286
16 Las Vegas-Paradise-Pahrump, NV 2,013,326 497,829 241,449 29,400 122,240 109,798 497,456 333,690
17 Louisville-Jeíerson County-Elizabethtown-Scottsburg, KY-IN 1,440,607 343,686 185,720 29,991 113,046 105,848 438,810 215,950
17 New York-Newark-Bridgeport, NY-NJ-CT-PA 22,214,083 5,027,088 2,963,886 472,117 1,634,531 973,420 5,601,883 3,056,701
19 Charlotte-Gastonia-Salisbury, NC-SC 2,442,564 614,338 280,468 52,534 160,312 124,668 630,498 388,999
20 Beaumont-Port Arthur, TX 390,535 95,311 51,293 7,656 22,226 17,372 105,287 67,523
20 Oklahoma City-Shawnee, OK 1,348,333 335,791 162,124 31,610 97,487 84,284 374,335 216,926
20 Philadelphia-Camden-Vineland, PA-NJ-DE-MD 6,562,287 1,513,270 886,837 145,153 461,724 305,296 1,699,047 867,174
23 Phoenix-Mesa-Glendale, AZ 4,263,236 1,107,303 540,544 93,175 302,805 166,853 963,671 727,056
24 Pittsburgh-New Castle, PA 2,450,281 487,427 424,058 48,891 175,676 134,681 705,328 304,860
25 San Luis Obispo-Paso Robles, CA 271,969 49,943 42,541 3,576 18,706 10,595 71,152 38,626
25 St. Louis-St. Charles-Farmington, MO-IL 2,907,732 682,579 395,222 52,616 198,808 171,525 814,289 394,418
25 Tulsa-Bartlesville, OK 998,438 251,983 133,087 23,720 71,733 64,452 286,681 147,999
Notes:
1. Cities are ranked using the highest weighted average for any county within that Combined or Metropolitan Statistical Area.
2. Total Population represents the at-risk populations for all counties within the respective Combined or Metropolitan Statistical Area.
¯. Those under l8 and 65 and over are vulnerable to PM2.o and are, therefore, included. They should not be used as population denominators for disease estimates.
4. Pediatric asthma estimates are for those under 1o years of age and represent the estimated number of people who had asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adult asthma estimates are for those 1o years and older and represent the estimated number of people who had asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma.
7. COPD estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. CV disease is cardiovascular disease and estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
9. Poverty estimates come from the U.S. Census Bureau and are for all ages.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 16
People at Risk in 25 Counties Most Polluted by Short-term Particle Pollution (24-hour PM
2.5
) High PM
2.5
Days in
Unhealthy Ranges,
At-Risk Groups 2009–20ll
20l3 Total 65 and Pediatric Adult CV Weighted
Rank
l
County ST Population
2
Under l8
3
Over
3
Asthma
4,6
Asthma
5,6
COPD
7
Disease
8
Diabetes
9
Poverty
l0
Avg.
ll
Grade
l2
1 Kern CA 851,710 254,658 77,793 18,232 50,187 25,296 167,656 44,022 200,571 46.5 F
2 Fresno CA 942,904 278,349 96,955 19,928 55,881 28,859 191,544 50,623 238,977 40.3 F
3 Kings CA 153,765 42,382 12,366 3,034 9,354 4,504 29,646 7,656 27,949 40.2 F
4 Riverside CA 2,239,620 623,094 268,723 44,609 136,046 73,244 488,747 130,878 371,930 36.8 F
5 Stanislaus CA 518,522 146,498 56,563 10,488 31,303 16,547 110,394 29,447 119,325 33.5 F
6 Los Angeles CA 9,889,056 2,378,370 1,099,904 170,275 631,724 328,847 2,187,906 580,411 1,788,681 25.0 F
7 Salt Lake UT 1,048,985 303,918 92,845 20,525 65,553 29,865 188,795 50,044 149,852 21.0 F
8 Allegheny PA 1,227,066 239,182 203,896 23,991 89,052 66,386 346,036 94,750 159,663 20.7 F
9 Merced CA 259,898 80,991 25,034 5,798 15,039 7,658 50,722 13,340 68,371 16.0 F
10 Shoshone ID 12,672 2,619 2,555 224 934 633 3,786 1,153 2,449 15.7 F
11 Fairbanks North
Star Borough AK 99,192 25,056 6,759 2,143 6,027 3,659 22,166 5,466 9,045 14.7 F
12 Cache UT 114,699 35,495 9,054 2,397 6,974 3,008 18,402 4,770 18,567 14.3 F
13 Hawaii HI 186,738 42,115 28,273 4,601 13,767 6,663 47,413 12,952 37,428 12.5 F
14 Utah UT 530,499 184,519 35,144 12,462 30,458 12,772 77,117 19,746 73,997 11.8 F
15 San Joaquin CA 696,214 201,446 73,891 14,422 41,628 21,911 146,134 38,937 124,573 11.5 F
16 Weber UT 234,420 70,002 23,991 4,728 14,473 6,835 43,758 11,743 30,614 11.3 F
17 Lemhi ID 7,967 1,548 1,821 132 598 428 2,545 783 1,484 11.0 F
18 Muscatine IA 42,815 11,153 5,937 642 2,619 1,621 10,249 2,629 5,644 8.3 F
19 Inyo CA 18,478 3,890 3,597 278 1,233 782 5,333 1,496 2,304 8.2 F
20 Doña Ana NM 213,598 56,503 26,936 5,681 15,816 9,408 47,038 15,117 61,023 7.7 F
21 Tulare CA 449,253 145,232 43,101 10,398 25,559 13,075 86,663 22,830 113,766 7.5 F
21 Lane OR 353,416 68,420 54,567 6,475 29,763 16,874 91,147 26,384 73,046 7.5 F
23 Orange CA 3,055,745 737,120 363,752 52,773 195,151 104,466 698,405 187,107 391,460 6.8 F
23 Lewis and Clark MT 64,318 14,414 9,094 975 4,545 3,014 16,458 4,001 6,781 6.8 F
25 Lake IN 495,558 125,473 66,423 11,875 35,502 31,331 134,320 38,931 94,261 6.3 F
25 Silver Bow MT 34,383 7,159 5,630 484 2,470 1,673 9,127 2,238 5,759 6.3 F
Notes:
1 Counties are ranked by weighted average. See note 12 below.
2. Total Population represents the at-risk populations in counties with PM2.o monitors.
¯. Those under l8 and 65 and over are vulnerable to PM2.o and are, therefore, included. They should not be used as
population denominators for disease estimates.
4. Pediatric asthma estimates are for those under 1o years of age and represent the estimated number of people who had
asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adult asthma estimates are for those 1o years and older and represent the estimated number of people who had
asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma.
7. COPD estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS)
applied to population estimates (U.S. Census).
o. CV disease is cardiovascular disease and estimates are for adults 1o and over who have been diagnosed within their
lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
9. Diabetes estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates
(BRFSS) applied to population estimates (U.S. Census).
1C. Poverty estimates come from the U.S. Census Bureau and are for all ages.
11. The Weighted Average was derived by counting the number of days in each unhealthful range (orange, red, purple,
maroon) in each year (2CC9-2C11), multiplying the total in each range by the assigned standard weights (i.e., 1 for
orange, 1.o for red, 2.C for purple, 2.o for maroon), and calculating the average.
12. Grade is assigned by weighted average as follows: A=C.C, B=C.¯-C.9, C=1.C-2.C, D=2.1-¯.2, F=¯.¯+.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 17
People at Risk in 25 Counties Most Polluted by Year-round Particle Pollution (Annual PM
2.5
)
PM
2.5
Annual,
At-Risk Groups 2009–20ll
20l3 Total 65 and Pediatric Adult CV Weighted
Rank
l
County ST Population
2
Under l8
3
Over
3
Asthma
4,6
Asthma
5,6
COPD
7
Disease
8
Diabetes
9
Poverty
l0
Avg.
ll
Grade
l2
1 Merced CA 259,898 80,991 25,034 5,798 15,039 7,658 50,722 13,340 68,371 18.2 Fail
1 Kern CA 851,710 254,658 77,793 18,232 50,187 25,296 167,656 44,022 200,571 18.2 Fail
3 Fresno CA 942,904 278,349 96,955 19,928 55,881 28,859 191,544 50,623 238,977 17.0 Fail
4 Riverside CA 2,239,620 623,094 268,723 44,609 136,046 73,244 488,747 130,878 371,930 16.2 Fail
4 Kings CA 153,765 42,382 12,366 3,034 9,354 4,504 29,646 7,656 27,949 16.2 Fail
6 Hawaii HI 186,738 42,115 28,273 4,601 13,767 6,663 47,413 12,952 37,428 15.5 Fail
7 Stanislaus CA 518,522 146,498 56,563 10,488 31,303 16,547 110,394 29,447 119,325 15.3 Fail
8 Tulare CA 449,253 145,232 43,101 10,398 25,559 13,075 86,663 22,830 113,766 15.2 Fail
9 Allegheny PA 1,227,066 239,182 203,896 23,991 89,052 66,386 346,036 94,750 159,663 15.0 Fail
10 Imperial CA 177,057 50,986 18,749 3,650 10,603 5,513 36,633 9,705 43,259 14.0 Fail
11 Los Angeles CA 9,889,056 2,378,370 1,099,904 170,275 631,724 328,847 2,187,906 580,411 1,788,681 13.9 Fail
12 Hamilton OH 800,362 187,735 106,776 18,778 60,469 46,564 214,359 60,440 144,388 13.8 Fail
13 San Bernardino CA 2,065,377 593,206 188,958 42,470 123,780 62,735 416,898 109,855 391,911 13.7 Fail
13 Chester PA 503,897 122,975 66,195 12,335 34,515 25,021 129,838 35,031 34,765 13.7 Fail
13 Westmoreland PA 364,471 71,196 69,087 7,141 25,925 20,851 110,034 30,691 37,877 13.7 Fail
16 Clark IN 111,570 26,371 14,384 2,496 8,176 7,101 30,351 8,771 14,322 13.5 Fail
16 Madison IL 268,459 60,495 38,869 4,365 16,994 12,964 73,098 21,199 37,085 13.5 Fail
18 Bibb GA 156,433 40,112 20,072 3,430 11,122 8,486 42,364 12,713 38,253 13.4 Fail
18 Stark OH 375,087 84,543 61,972 8,456 28,303 23,453 109,350 31,269 59,598 13.4 Fail
18 Northampton PA 298,476 63,991 47,529 6,419 21,110 15,794 82,380 22,541 28,873 13.4 Fail
18 Fairbanks North
Star Borough AK 99,192 25,056 6,759 2,143 6,027 3,659 22,166 5,466 9,045 13.4 Fail
22 Fulton GA 949,599 224,779 87,146 19,222 69,694 48,286 238,129 68,614 183,931 13.3 Fail
22 Pinal AZ 382,992 99,877 56,529 8,404 27,145 15,708 90,026 27,883 61,863 13.3 Fail
24 Cuyahoga OH 1,270,294 283,168 198,263 28,323 96,576 78,103 362,751 103,256 233,438 13.1 Fail
24 Wilkinson GA 9,444 2,284 1,525 195 681 566 2,849 880 1,702 13.1 Fail
24 St. Louis City MO 318,069 67,547 34,548 5,313 22,980 18,693 84,398 22,670 83,819 13.1 Fail
24 Marion IN 911,296 228,998 97,604 21,673 65,410 53,638 227,597 64,921 189,843 13.1 Fail
Notes:
1 Counties are ranked by weighted average. See note 12 below.
2. Total Population represents the at-risk populations in counties with PM2.o monitors.
¯. Those under l8 and 65 and over are vulnerable to PM2.o and are, therefore, included. They should not be used as
population denominators for disease estimates.
4. Pediatric asthma estimates are for those under 1o years of age and represent the estimated number of people who had
asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adult asthma estimates are for those 1o years and older and represent the estimated number of people who had
asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma.
7. COPD estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS)
applied to population estimates (U.S. Census).
o. CV disease is cardiovascular disease and estimates are for adults 1o and over who have been diagnosed within their
lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
9. Diabetes estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates
(BRFSS) applied to population estimates (U.S. Census).
1C. Poverty estimates come from the U.S. Census Bureau and are for all ages.
11. The Design Value is the calculated concentration of a pollutant based on the form of the National Ambient Air Quality
Standard, and is used by EPA to determine whether the air quality in a meets the standard.
12. Grade is assigned by weighted average as follows: A=C.C, B=C.¯-C.9, C=1.C-2.C, D=2.1-¯.2, F=¯.¯+.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 18
People at Risk in 25 Most Ozone-Polluted Counties
High Ozone Days in
Unhealthy Ranges,
At-Risk Groups 2009–20ll
20l3 Total 65 and Pediatric Adult CV Weighted
Rank
l
County ST Population
2
Under l8
3
Over
3
Asthma
4,6
Asthma
5,6
COPD
7
Disease
8
Poverty
9
Avg.
l0
Grade
ll
1 San Bernardino CA 2,065,377 593,206 188,958 42,470 123,780 62,735 416,898 391,911 121.5 F
2 Riverside CA 2,239,620 623,094 268,723 44,609 136,046 73,244 488,747 371,930 102.2 F
3 Tulare CA 449,253 145,232 43,101 10,398 25,559 13,075 86,663 113,766 87.5 F
4 Los Angeles CA 9,889,056 2,378,370 1,099,904 170,275 631,724 328,847 2,187,906 1,788,681 81.8 F
5 Kern CA 851,710 254,658 77,793 18,232 50,187 25,296 167,656 200,571 78.3 F
6 Fresno CA 942,904 278,349 96,955 19,928 55,881 28,859 191,544 238,977 58.3 F
7 Kings CA 153,765 42,382 12,366 3,034 9,354 4,504 29,646 27,949 36.2 F
8 Sacramento CA 1,436,105 362,155 164,643 25,928 90,380 48,063 321,109 250,842 35.3 F
9 Uintah UT 33,163 11,005 3,021 743 1,950 905 5,755 3,845 27.8 F
10 Harris TX 4,180,894 1,165,484 350,212 93,623 222,920 155,592 959,756 803,895 27.3 F
11 Tarrant TX 1,849,815 515,168 169,223 41,383 99,250 71,169 438,244 307,362 23.7 F
12 El Dorado CA 180,938 40,081 27,785 2,870 11,895 7,173 49,004 18,496 21.0 F
13 Harford MD 246,489 59,086 31,665 5,444 15,763 11,356 65,860 20,309 20.3 F
14 Placer CA 357,138 85,632 56,457 6,131 22,901 13,526 91,482 29,985 19.7 F
15 Madera CA 152,925 43,138 17,763 3,088 9,239 4,941 32,961 33,965 18.0 F
16 Denton TX 686,406 187,155 50,520 15,034 36,863 25,093 156,026 63,240 17.3 F
17 Imperial CA 177,057 50,986 18,749 3,650 10,603 5,513 36,633 43,259 16.3 F
18 San Diego CA 3,140,069 726,602 362,928 52,020 203,011 106,254 707,051 462,997 16.2 F
18 Merced CA 259,898 80,991 25,034 5,798 15,039 7,658 50,722 68,371 16.2 F
20 Ventura CA 831,771 210,361 100,114 15,060 52,329 28,516 191,413 94,625 15.3 F
20 Stanislaus CA 518,522 146,498 56,563 10,488 31,303 16,547 110,394 119,325 15.3 F
20 Brazoria TX 319,973 88,132 31,569 7,080 17,332 12,720 78,226 37,492 15.3 F
23 Dallas TX 2,416,014 666,960 215,670 53,577 129,337 91,285 560,864 475,446 13.3 F
24 Jeíerson AL 658,931 154,664 87,341 16,217 40,237 48,459 213,021 120,760 12.8 F
24 Hamilton OH 800,362 187,735 106,776 18,778 60,469 46,564 214,359 144,388 12.8 F
Notes:
1. Counties are ranked by weighted average. See note 1C below.
2. Total Population represents the at-risk populations in counties with PM2.o monitors.
¯. Those under l8 and 65 and over are vulnerable to PM2.o and are, therefore, included. They should not be used as population denominators for disease estimates.
4. Pediatric asthma estimates are for those under 1o years of age and represent the estimated number of people who had asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adult asthma estimates are for those 1o years and older and represent the estimated number of people who had asthma in 2C11 based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma.
7. COPD estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. CV disease is cardiovascular disease and estimates are for adults 1o and over who have been diagnosed within their lifetime, based on state rates (BRFSS) applied to population estimates (U.S. Census).
9. Poverty estimates come from the U.S. Census Bureau and are for all ages.
1C. The Weighted Average was derived by counting the number of days in each unhealthful range (orange, red, purple) in each year (2CC9-2C11), multiplying the total in each range by the assigned standard weights (i.e., 1 for orange, 1.o for red, 2.C
for purple), and calculating the average.
11. Grade is assigned by weighted average as follows: A=C.C, B=C.¯-C.9, C=1.C-2.C, D=2.1-¯.2, F=¯.¯+.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 19
Cleanest U.S. Cities for Short-term Particle Pollution (24-hour PM
2.5
)
l
Note:
1. This list represents cities with the lowest levels of short term PM2.o air pollution. Monitors in these cities reported no days with unhealthful PM2.o levels.
Metropolitan Statistical Area Population
Asheville-Brevard, NC 461,837
Athens-Clarke County, GA 193,317
Atlantic City-Hammonton, NJ 274,338
Austin-Round Rock-Marble Falls, TX 1,783,519
Bangor, ME 153,786
Beckley-Oak Hill, WV 124,826
Bismarck, ND 110,879
Bloomington, IN 194,193
Bowling Green, KY 127,607
Brownsville-Harlingen-Raymondville, TX 436,218
Cape Coral-Fort Myers, FL 631,330
Casper, WY 76,366
Champaign-Urbana, IL 232,336
Charleston, WV 303,674
Charlotte-Gastonia-Salisbury, NC-SC 2,442,564
Claremont-Lebanon, NH-VT 218,057
Clarksville, TN-KY 277,701
Colorado Springs, CO 660,319
Columbia-Newberry, SC 814,837
Corpus Christi-Kingsville, TX 464,014
Decatur, IL 110,730
Dover, DE 164,834
Eau Claire-Menomonie, WI 206,628
Farmington, NM 128,200
Fayetteville, NC 374,157
Fayetteville-Springdale-Rogers, AR-MO 473,830
Flagstaí, AZ 134,511
Metropolitan Statistical Area Population
Florence, SC 206,161
Florence-Muscle Shoals, AL 147,293
Fort Collins-Loveland, CO 305,525
Fort Smith, AR-OK 300,087
Gainesville, FL 266,369
Goldsboro, NC 123,697
Greenville, NC 192,690
Gulfport-Biloxi-Pascagoula, MS 416,301
Hattiesburg, MS 145,428
Hickory-Lenoir-Morganton, NC 364,567
Hot Springs, AR 97,124
Houma-Bayou Cane-Thibodaux, LA 208,583
Huntsville-Decatur, AL 579,550
Jackson-Humboldt, TN 165,331
Lake Charles-Jennings, LA 232,516
Lakeland-Winter Haven, FL 609,492
Lansing-East Lansing-Owosso, MI 534,979
Lumberton-Laurinburg, NC 171,378
Lynchburg, VA 254,171
McAllen-Edinburg-Pharr, TX 797,810
Mobile-Daphne-Fairhope, AL 599,294
Monroe-Bastrop, LA 205,259
Montgomery-Alexander City, AL 430,944
Morgantown, WV 132,251
Nashville-Davidson—Murfreesboro—Columbia, TN 1,698,651
Niles-Benton Harbor, MI 156,941
Oklahoma City-Shawnee, OK 1,348,333
Metropolitan Statistical Area Population
Owensboro, KY 115,333
Paducah-Mayfield, KY-IL 136,609
Palm Bay-Melbourne-Titusville, FL 543,566
Pensacola-Ferry Pass-Brent, FL 453,218
Peoria-Canton, IL 416,518
Prescott, AZ 211,888
Pueblo, CO 160,545
Rapid City, SD 128,361
Redding, CA 177,774
Richmond, VA 1,269,380
Roanoke, VA 308,861
Rocky Mount, NC 152,157
Salinas, CA 421,898
San Antonio-New Braunfels, TX 2,194,927
Santa Barbara-Santa Maria-Goleta, CA 426,878
Sarasota-Bradenton-Punta Gorda, FL 869,866
Shreveport-Bossier City-Minden, LA 444,883
Springfield, IL 211,547
St. George, UT 141,666
Syracuse-Auburn, NY 742,291
Tampa-St. Petersburg-Clearwater, FL 2,824,724
Texarkana, TX-Texarkana, AR 136,552
Tucson, AZ 989,569
Tulsa-Bartlesville, OK 998,438
Wichita-Winfield, KS 661,798
Yuma, AZ 200,870
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 20
Cleanest U.S. Cities for
Ozone Air Pollution
l
Note:
1. This list represents cities with no monitored ozone air pollution in unhealthful ranges using the
Air Quality Index based on the 2CCo ozone NAAQS.
Metropolitan Statistical Area Population
Ames-Boone, IA 115,918
Bellingham, WA 203,663
Bend-Prineville, OR 181,177
Bismarck, ND 110,879
Brownsville-Harlingen-Raymondville, TX 436,218
Brunswick, GA 112,923
Burlington-South Burlington, VT 212,535
Cape Coral-Fort Myers, FL 631,330
Cedar Rapids, IA 260,575
Charleston-North Charleston-
Summerville, SC 682,121
Claremont-Lebanon, NH-VT 218,057
Coeur d’Alene, ID 141,132
Columbia, MO 175,831
Davenport-Moline-Rock Island, IA-IL 381,342
Des Moines-Newton-Pella, IA 650,137
Dothan-Enterprise-Ozark, AL 247,132
Duluth, MN-WI 279,815
Eugene-Springfield, OR 353,416
Fargo-Wahpeton, ND-MN 235,008
Florence-Muscle Shoals, AL 147,293
Gadsden, AL 104,303
Gainesville, FL 266,369
Grand Junction, CO 147,083
Honolulu, HI 963,607
Janesville, WI 160,092
Metropolitan Statistical Area Population
La Crosse, WI-MN 134,488
Laredo, TX 256,496
Lincoln, NE 306,503
Logan, UT-ID 127,549
Madison-Baraboo, WI 638,757
McAllen-Edinburg-Pharr, TX 797,810
Medford, OR 204,822
Monroe-Bastrop, LA 205,259
Muncie, IN 117,660
Naples-Marco Island, FL 328,134
Palm Bay-Melbourne-Titusville, FL 543,566
Port St. Lucie-Sebastian-Vero Beach, FL 566,768
Rapid City, SD 128,361
Rochester, MN 187,612
Rochester-Batavia-Seneca Falls, NY 1,150,469
Rockford-Freeport-Rochelle, IL 449,038
Santa Fe-Espanola, NM 186,094
Savannah-Hinesville-Fort Stewart, GA 436,163
Sioux City-Vermillion, IA-NE-SD 158,113
Sioux Falls, SD 232,433
Spokane, WA 473,761
Tuscaloosa, AL 221,553
Utica-Rome, NY 298,447
Waterloo-Cedar Falls, IA 168,289
Wausau-Merrill, WI 163,002
Top 25 Cleanest U.S. Cities for Year-round
Particle Pollution (Annual PM
2.5
)
l

Design
Rank
2
Value
3
Metropolitan Statistical Area Population
1 4.1 Cheyenne, WY 92,680
2 4.2 Santa Fe-Espanola, NM 186,094
2 4.2 St. George, UT 141,666
4 4.3 Prescott, AZ 211,888
5 4.5 Farmington, NM 128,200
6 5.2 Pocatello, ID 91,457
7 5.3 Redding, CA 177,774
8 5.4 Tucson, AZ 989,569
9 5.9 Albuquerque, NM 898,642
9 5.9 Colorado Springs, CO 660,319
9 5.9 Flagstaí, AZ 134,511
9 5.9 Rapid City, SD 128,361
13 6.1 Salinas, CA 421,898
14 6.2 Anchorage, AK 387,516
15 6.3 Fort Collins-Loveland, CO 305,525
16 6.6 Duluth, MN-WI 279,815
16 6.6 Palm Bay-Melbourne-Titusville, FL 543,566
18 6.8 Reno-Sparks-Fernley, NV 481,477
18 6.8 Sarasota-Bradenton-Punta Gorda, FL 869,866
20 6.9 Bismarck, ND 110,879
20 6.9 Cape Coral-Fort Myers, FL 631,330
22 7.3 Bangor, ME 153,786
22 7.3 Burlington-South Burlington, VT 212,535
24 7.4 Boise City-Nampa, ID 627,664
25 7.5 Lakeland-Winter Haven, FL 609,492
25 7.5 Miami-Fort Lauderdale-Pompano Beach, FL 5,670,125
25 7.5 Orlando-Deltona-Daytona Beach, FL 2,861,296
Notes:
1. This list represents cities with the lowest levels of annual PM2.o air pollution.
2. Cities are ranked by using the highest design value for any within that metropolitan area.
¯. The Design Value is the calculated concentration of a pollutant based on the form of the
National Ambient Air Quality Standard, and is used by the EPA to determine whether the
air quality in a county meets the standard.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 21
Cleanest Counties for Short-term Particle Pollution (24-hour PM
2.5
)
l
Notes:
1. This list represents counties with the lowest levels of short term PM2.o air pollution. Monitors in these counties reported no days with unhealthful PM2.o levels
using the AQI adopted December 14, 2C12.
2. MSA and CSA are terms used by the U.S. Oíce of Management and Budget for statistical purposes. MSA stands for Metropolitan Statistical Area. CSA stands
for Combined Statistical Area, which may include multiples and individual counties.
County State MSAs and Respective CSA
2
Anchorage Municipality AK Anchorage, AK
Baldwin AL Mobile-Daphne-Fairhope, AL
Clay AL
Colbert AL Florence-Muscle Shoals, AL
DeKalb AL
Madison AL Huntsville-Decatur, AL
Mobile AL Mobile-Daphne-Fairhope, AL
Montgomery AL Montgomery-Alexander City, AL
Morgan AL Huntsville-Decatur, AL
Russell AL Columbus-Auburn-Opelika, GA-AL
Shelby AL Birmingham-Hoover-Cullman, AL
Talladega AL
Walker AL Birmingham-Hoover-Cullman, AL
Arkansas AR
Ashley AR
Crittenden AR Memphis, TN-MS-AR
Faulkner AR Little Rock-North Little Rock-Pine Bluí, AR
Garland AR Hot Springs, AR
Jackson AR
Phillips AR
Polk AR
Pope AR
Sebastian AR Fort Smith, AR-OK
Union AR
Washington AR Fayetteville-Springdale-Rogers, AR-MO
White AR Little Rock-North Little Rock-Pine Bluí, AR
Apache AZ
Cochise AZ
Coconino AZ Flagstaí, AZ
Pima AZ Tucson, AZ
Yavapai AZ Prescott, AZ
Yuma AZ Yuma, AZ
Calaveras CA
Colusa CA
Humboldt CA
Lake CA
County State MSAs and Respective CSA
2
Mendocino CA
Monterey CA Salinas, CA
Nevada CA Sacramento—Arden-Arcade—Yuba City, CA-NV
San Benito CA San Jose-San Francisco-Oakland, CA
Santa Barbara CA Santa Barbara-Santa Maria-Goleta, CA
Santa Cruz CA San Jose-San Francisco-Oakland, CA
Shasta CA Redding, CA
Siskiyou CA
Sonoma CA San Jose-San Francisco-Oakland, CA
Ventura CA Los Angeles-Long Beach-Riverside, CA
Arapahoe CO Denver-Aurora-Boulder, CO
Denver CO Denver-Aurora-Boulder, CO
Douglas CO Denver-Aurora-Boulder, CO
El Paso CO Colorado Springs, CO
Elbert CO Denver-Aurora-Boulder, CO
La Plata CO
Larimer CO Fort Collins-Loveland, CO
Montezuma CO
Pueblo CO Pueblo, CO
Litchfield CT New York-Newark-Bridgeport, NY-NJ-CT-PA
Kent DE Dover, DE
Sussex DE
Alachua FL Gainesville, FL
Brevard FL Palm Bay-Melbourne-Titusville, FL
Citrus FL
Escambia FL Pensacola-Ferry Pass-Brent, FL
Hillsborough FL Tampa-St. Petersburg-Clearwater, FL
Lee FL Cape Coral-Fort Myers, FL
Orange FL Orlando-Deltona-Daytona Beach, FL
Pinellas FL Tampa-St. Petersburg-Clearwater, FL
Polk FL Lakeland-Winter Haven, FL
Sarasota FL Sarasota-Bradenton-Punta Gorda, FL
Seminole FL Orlando-Deltona-Daytona Beach, FL
Clarke GA Athens-Clarke County, GA
Clayton GA Atlanta-Sandy Springs-Gainesville, GA-AL
Gwinnett GA Atlanta-Sandy Springs-Gainesville, GA-AL
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 22
County State MSAs and Respective CSA
2
Hall GA Atlanta-Sandy Springs-Gainesville, GA-AL
Houston GA Macon-Warner Robins-Fort Valley, GA
Paulding GA Atlanta-Sandy Springs-Gainesville, GA-AL
Walker GA Chattanooga-Cleveland-Athens, TN-GA
Maui HI
Adams IL
Champaign IL Champaign-Urbana, IL
DuPage IL Chicago-Naperville-Michigan City, IL-IN-WI
Hamilton IL
Jersey IL St. Louis-St. Charles-Farmington, MO-IL
Kane IL Chicago-Naperville-Michigan City, IL-IN-WI
Macon IL Decatur, IL
McHenry IL Chicago-Naperville-Michigan City, IL-IN-WI
Peoria IL Peoria-Canton, IL
Randolph IL
Rock Island IL Davenport-Moline-Rock Island, IA-IL
Sangamon IL Springfield, IL
Gibson IN Evansville, IN-KY
Knox IN
LaPorte IN Chicago-Naperville-Michigan City, IL-IN-WI
Monroe IN Bloomington, IN
Spencer IN
Johnson KS Kansas City-Overland Park-Kansas City, MO-KS
Linn KS Kansas City-Overland Park-Kansas City, MO-KS
Sedgwick KS Wichita-Winfield, KS
Sumner KS Wichita-Winfield, KS
Wyandotte KS Kansas City-Overland Park-Kansas City, MO-KS
Boyd KY Huntington-Ashland, WV-KY-OH
Campbell KY Cincinnati-Middletown-Wilmington, OH-KY-IN
Carter KY
Christian KY Clarksville, TN-KY
Daviess KY Owensboro, KY
Franklin KY Lexington-Fayette—Frankfort—Richmond, KY
Hardin KY Louisville-Jeíerson County-Elizabethtown-
Scottsburg, KY-IN
County State MSAs and Respective CSA
2
Henderson KY Evansville, IN-KY
Madison KY Lexington-Fayette—Frankfort—Richmond, KY
McCracken KY Paducah-Mayfield, KY-IL
Warren KY Bowling Green, KY
Caddo Parish LA Shreveport-Bossier City-Minden, LA
Calcasieu Parish LA Lake Charles-Jennings, LA
Iberville Parish LA Baton Rouge-Pierre Part, LA
Ouachita Parish LA Monroe-Bastrop, LA
Tangipahoa Parish LA
Terrebonne Parish LA Houma-Bayou Cane-Thibodaux, LA
Bristol MA Boston-Worcester-Manchester, MA-RI-NH
Essex MA Boston-Worcester-Manchester, MA-RI-NH
Middlesex MA Boston-Worcester-Manchester, MA-RI-NH
Plymouth MA Boston-Worcester-Manchester, MA-RI-NH
Worcester MA Boston-Worcester-Manchester, MA-RI-NH
Harford MD Washington-Baltimore-Northern Virginia,
DC-MD-VA-WV
Hancock ME
Kennebec ME
Penobscot ME Bangor, ME
Allegan MI Grand Rapids-Muskegon-Holland, MI
Berrien MI Niles-Benton Harbor, MI
Genesee MI Detroit-Warren-Flint, MI
Ingham MI Lansing-East Lansing-Owosso, MI
Lenawee MI
Macomb MI Detroit-Warren-Flint, MI
Manistee MI
Missaukee MI
Muskegon MI Grand Rapids-Muskegon-Holland, MI
Oakland MI Detroit-Warren-Flint, MI
Ottawa MI Grand Rapids-Muskegon-Holland, MI
Washtenaw MI Detroit-Warren-Flint, MI
Cedar MO
DeSoto MS Memphis, TN-MS-AR
Forrest MS Hattiesburg, MS
Cleanest Counties for Short-term Particle Pollution (24-hour PM
2.5
)
l
(cont.)
Notes:
1. This list represents counties with the lowest levels of short term PM2.o air pollution. Monitors in these counties reported no days with unhealthful PM2.o levels
using the AQI adopted December 14, 2C12.
2. MSA and CSA are terms used by the U.S. Oíce of Management and Budget for statistical purposes. MSA stands for Metropolitan Statistical Area. CSA stands
for Combined Statistical Area, which may include multiples and individual counties.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 23
County State MSAs and Respective CSA
2
Grenada MS
Hancock MS Gulfport-Biloxi-Pascagoula, MS
Harrison MS Gulfport-Biloxi-Pascagoula, MS
Jackson MS Gulfport-Biloxi-Pascagoula, MS
Jones MS
Lauderdale MS
Lee MS
Flathead MT
Richland MT
Sanders MT
Buncombe NC Asheville-Brevard, NC
Caswell NC
Catawba NC Hickory-Lenoir-Morganton, NC
Chatham NC Raleigh-Durham-Cary, NC
Cumberland NC Fayetteville, NC
Davidson NC Greensboro—Winston-Salem—High Point, NC
Durham NC Raleigh-Durham-Cary, NC
Edgecombe NC Rocky Mount, NC
Forsyth NC Greensboro—Winston-Salem—High Point, NC
Gaston NC Charlotte-Gastonia-Salisbury, NC-SC
Guilford NC Greensboro—Winston-Salem—High Point, NC
Haywood NC Asheville-Brevard, NC
Jackson NC
Martin NC
McDowell NC
Mecklenburg NC Charlotte-Gastonia-Salisbury, NC-SC
Mitchell NC
Montgomery NC
Pitt NC Greenville, NC
Robeson NC Lumberton-Laurinburg, NC
Rowan NC Charlotte-Gastonia-Salisbury, NC-SC
Swain NC
Watauga NC
Wayne NC Goldsboro, NC
Billings ND
County State MSAs and Respective CSA
2
Burleigh ND Bismarck, ND
Mercer ND
Hall NE
Scotts Bluí NE
Belknap NH Boston-Worcester-Manchester, MA-RI-NH
Grafton NH Claremont-Lebanon, NH-VT
Hillsborough NH Boston-Worcester-Manchester, MA-RI-NH
Atlantic NJ Atlantic City-Hammonton, NJ
Camden NJ Philadelphia-Camden-Vineland, PA-NJ-DE-MD
Essex NJ New York-Newark-Bridgeport, NY-NJ-CT-PA
Gloucester NJ Philadelphia-Camden-Vineland, PA-NJ-DE-MD
Middlesex NJ New York-Newark-Bridgeport, NY-NJ-CT-PA
Ocean NJ New York-Newark-Bridgeport, NY-NJ-CT-PA
Chaves NM
Grant NM
San Juan NM Farmington, NM
Chautauqua NY
Essex NY
Nassau NY New York-Newark-Bridgeport, NY-NJ-CT-PA
Niagara NY Buíalo-Niagara-Cattaraugus, NY
Onondaga NY Syracuse-Auburn, NY
Steuben NY
Suíolk NY New York-Newark-Bridgeport, NY-NJ-CT-PA
Athens OH
Clermont OH Cincinnati-Middletown-Wilmington, OH-KY-IN
Greene OH Dayton-Springfield-Greenville, OH
Lake OH Cleveland-Akron-Elyria, OH
Lawrence OH Huntington-Ashland, WV-KY-OH
Medina OH Cleveland-Akron-Elyria, OH
Portage OH Cleveland-Akron-Elyria, OH
Scioto OH
Caddo OK
Mayes OK
Muskogee OK
Oklahoma OK Oklahoma City-Shawnee, OK
Cleanest Counties for Short-term Particle Pollution (24-hour PM
2.5
)
l
(cont.)
Notes:
1. This list represents counties with the lowest levels of short term PM2.o air pollution. Monitors in these counties reported no days with unhealthful PM2.o levels
using the AQI adopted December 14, 2C12.
2. MSA and CSA are terms used by the U.S. Oíce of Management and Budget for statistical purposes. MSA stands for Metropolitan Statistical Area. CSA stands
for Combined Statistical Area, which may include multiples and individual counties.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 24
County State MSAs and Respective CSA
2
Sequoyah OK Fort Smith, AR-OK
Tulsa OK Tulsa-Bartlesville, OK
Umatilla OR
Kent RI Boston-Worcester-Manchester, MA-RI-NH
Chesterfield SC
Florence SC Florence, SC
Lexington SC Columbia-Newberry, SC
Richland SC Columbia-Newberry, SC
Spartanburg SC Greenville-Spartanburg-Anderson, SC
Brown SD
Jackson SD
Pennington SD Rapid City, SD
Blount TN Knoxville-Sevierville-La Follette, TN
Davidson TN Nashville-Davidson—Murfreesboro—Columbia, TN
Lawrence TN
Madison TN Jackson-Humboldt, TN
Maury TN Nashville-Davidson—Murfreesboro—Columbia, TN
McMinn TN Chattanooga-Cleveland-Athens, TN-GA
Montgomery TN Clarksville, TN-KY
Putnam TN
Sumner TN Nashville-Davidson—Murfreesboro—Columbia, TN
Bexar TX San Antonio-New Braunfels, TX
Bowie TX Texarkana, TX-Texarkana, AR
Cameron TX Brownsville-Harlingen-Raymondville, TX
Ellis TX Dallas-Fort Worth, TX
Hidalgo TX McAllen-Edinburg-Pharr, TX
Nueces TX Corpus Christi-Kingsville, TX
Tarrant TX Dallas-Fort Worth, TX
Travis TX Austin-Round Rock-Marble Falls, TX
Washington UT St. George, UT
Bristol city VA Johnson City-Kingsport-Bristol (Tri-Cities), TN-VA
Charles City VA Richmond, VA
Chesterfield VA Richmond, VA
Frederick VA Washington-Baltimore-Northern Virginia,
DC-MD-VA-WV
County State MSAs and Respective CSA
2
Henrico VA Richmond, VA
Lynchburg city VA Lynchburg, VA
Page VA
Roanoke city VA Roanoke, VA
Salem city VA Roanoke, VA
Bennington VT
King WA Seattle-Tacoma-Olympia, WA
Ashland WI
Eau Claire WI Eau Claire-Menomonie, WI
Forest WI
Vilas WI
Hancock WV Steubenville-Weirton, OH-WV
Kanawha WV Charleston, WV
Marion WV Fairmont-Clarksburg, WV
Monongalia WV Morgantown, WV
Ohio WV Wheeling, WV-OH
Raleigh WV Beckley-Oak Hill, WV
Albany WY
Converse WY
Natrona WY Casper, WY
Park WY
Sublette WY
Teton WY
Cleanest Counties for Short-term Particle Pollution (24-hour PM
2.5
)
l
(cont.)
Notes:
1. This list represents counties with the lowest levels of short term PM2.o air pollution. Monitors in these counties reported no days with unhealthful PM2.o levels
using the AQI adopted December 14, 2C12.
2. MSA and CSA are terms used by the U.S. Oíce of Management and Budget for statistical purposes. MSA stands for Metropolitan Statistical Area. CSA stands
for Combined Statistical Area, which may include multiples and individual counties.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 25
Top 25 Cleanest Counties for Year-round
Particle Pollution (Annual PM
2.5
)
l

20l3
Rank
2
County ST Design Value
3
1 Lake CA 3.3
2 Jackson SD 3.8
3 Laramie WY 4.1
4 Washington UT 4.2
4 Santa Fe NM 4.2
6 Billings ND 4.3
6 Yavapai AZ 4.3
8 Essex NY 4.4
8 Park WY 4.4
10 Teton WY 4.5
10 San Juan NM 4.5
10 Hancock ME 4.5
10 Custer SD 4.5
14 Maui HI 4.9
15 Siskiyou CA 5.1
16 Bannock ID 5.2
17 Shasta CA 5.3
18 Pima AZ 5.4
19 Ashland WI 5.5
20 San Benito CA 5.6
20 Sweetwater WY 5.6
22 Litchfield CT 5.7
22 Douglas CO 5.7
24 Belknap NH 5.8
25 Coconino AZ 5.9
25 El Paso CO 5.9
25 Pennington SD 5.9
25 Bernalillo NM 5.9
Notes:
1. This list represents counties with the lowest levels of monitored long term PM2.o air
pollution.
2. Counties are ranked by design value.
¯. The Design Value is the calculated concentration of a pollutant based on the form
of the National Ambient Air Quality Standard, and is used by the EPA to determine
whether the air quality in a county meets the standard.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 26
Cleanest Counties for Ozone Air Pollution
l
Note:
1. This list represents counties with no monitored ozone air pollution in unhealthful ranges using the Air Quality Index based on 2CCo NAAQS.
Yukon-Koyukuk AK
Census Area
Colbert AL Florence-Muscle Shoals, AL
Elmore AL Montgomery-Alexander City, AL
Etowah AL Gadsden, AL
Houston AL Dothan-Enterprise-Ozark, AL
Morgan AL Huntsville-Decatur, AL
Tuscaloosa AL Tuscaloosa, AL
Newton AR
Navajo AZ
Glenn CA
Humboldt CA
Lake CA
Marin CA San Jose-San Francisco-
Oakland, CA
Mendocino CA
San Francisco CA San Jose-San Francisco-
Oakland, CA
Santa Cruz CA San Jose-San Francisco-
Oakland, CA
Siskiyou CA
Sonoma CA San Jose-San Francisco-
Oakland, CA
Garfield CO
Mesa CO Grand Junction, CO
Alachua FL Gainesville, FL
Baker FL Jacksonville, FL
Brevard FL Palm Bay-Melbourne-Titusville, FL
Broward FL Miami-Fort Lauderdale-
Pompano Beach, FL
Collier FL Naples-Marco Island, FL
Columbia FL
Highlands FL
Holmes FL
Lee FL Cape Coral-Fort Myers, FL
Leon FL Tallahassee, FL
Pasco FL Tampa-St. Petersburg-
Clearwater, FL
St. Lucie FL Port St. Lucie-Sebastian-
Vero Beach, FL
Volusia FL Orlando-Deltona-Daytona
Beach, FL
Chatham GA Savannah-Hinesville-
Fort Stewart, GA
Chattooga GA
Coweta GA Atlanta-Sandy Springs-
Gainesville, GA-AL
Glynn GA Brunswick, GA
Sumter GA
Honolulu HI Honolulu, HI
Bremer IA Waterloo-Cedar Falls, IA
Clinton IA
Linn IA Cedar Rapids, IA
Montgomery IA
Palo Alto IA
Polk IA Des Moines-Newton-Pella, IA
Scott IA Davenport-Moline-
Rock Island, IA-IL
Story IA Ames-Boone, IA
Van Buren IA
Warren IA Des Moines-Newton-Pella, IA
Butte ID
Kootenai ID Coeur d’Alene, ID
Clark IL
Eíngham IL
Randolph IL
Rock Island IL Davenport-Moline-
Rock Island, IA-IL
Winnebago IL Rockford-Freeport-Rochelle, IL
Delaware IN Muncie, IN
Huntington IN Fort Wayne-Huntington-
Auburn, IN
Madison IN Indianapolis-Anderson-
Columbus, IN
Wyandotte KS Kansas City-Overland Park-
Kansas City, MO-KS
Bell KY
Carter KY
Hardin KY Louisville-Jeíerson County-
Elizabethtown-Scottsburg, KY-IN
Perry KY
Pike KY
Pulaski KY
Warren KY Bowling Green, KY
Ouachita Parish LA Monroe-Bastrop, LA
Androscoggin ME Portland-Lewiston-
South Portland, ME
Aroostook ME
Oxford ME
Sagadahoc ME Portland-Lewiston-
South Portland, ME
Becker MN
Carlton MN Duluth, MN-WI
Goodhue MN Minneapolis-St. Paul-
St. Cloud, MN-WI
Lake MN
Lyon MN
Mille Lacs MN
Olmsted MN Rochester, MN
Scott MN Minneapolis-St. Paul-
St. Cloud, MN-WI
St. Louis MN Duluth, MN-WI
County State Metropolitan Statistical Area County State Metropolitan Statistical Area County State Metropolitan Statistical Area
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 27
Cleanest Counties for Ozone Air Pollution
l
(cont.)
Note:
1. This list represents counties with no monitored ozone air pollution in unhealthful ranges using the Air Quality Index based on 2CCo NAAQS.
Stearns MN Minneapolis-St. Paul-
St. Cloud, MN-WI
Wright MN Minneapolis-St. Paul-
St. Cloud, MN-WI
Boone MO Columbia, MO
Lauderdale MS
Lee MS
Flathead MT
Richland MT
Avery NC
Chatham NC Raleigh-Durham-Cary, NC
Swain NC
Billings ND
Burke ND
Burleigh ND Bismarck, ND
Cass ND Fargo-Wahpeton, ND-MN
Dunn ND
McKenzie ND
Mercer ND
Oliver ND
Douglas NE Omaha-Council Bluís-
Fremont, NE-IA
Lancaster NE Lincoln, NE
Cheshire NH
Grafton NH Claremont-Lebanon, NH-VT
Lea NM
Luna NM
Sandoval NM Albuquerque, NM
Santa Fe NM Santa Fe-Espanola, NM
Churchill NV
Hamilton NY
Herkimer NY Utica-Rome, NY
Monroe NY Rochester-Batavia-Seneca Falls, NY
Oneida NY Utica-Rome, NY
Steuben NY
Wayne NY Rochester-Batavia-
Seneca Falls, NY
Columbia OR Portland-Vancouver-
Hillsboro, OR-WA
Deschutes OR Bend-Prineville, OR
Jackson OR Medford, OR
Lane OR Eugene-Springfield, OR
Umatilla OR
Washington OR Portland-Vancouver-
Hillsboro, OR-WA
Abbeville SC
Aiken SC Augusta-Richmond County,
GA-SC
Berkeley SC Charleston-North Charleston-
Summerville, SC
Charleston SC Charleston-North Charleston-
Summerville, SC
Colleton SC
Edgefield SC Augusta-Richmond County,
GA-SC
York SC Charlotte-Gastonia-Salisbury,
NC-SC
Brookings SD
Custer SD
Jackson SD
Meade SD Rapid City, SD
Minnehaha SD Sioux Falls, SD
Union SD Sioux City-Vermillion, IA-NE-SD
Cameron TX Brownsville-Harlingen-
Raymondville, TX
Hidalgo TX McAllen-Edinburg-Pharr, TX
Webb TX Laredo, TX
Cache UT Logan, UT-ID
Fauquier VA Washington-Baltimore-
Northern Virginia, DC-MD-VA-WV
Page VA
Rockbridge VA
Wythe VA
Chittenden VT Burlington-South Burlington, VT
Clallam WA
Pierce WA Seattle-Tacoma-Olympia, WA
Skagit WA Seattle-Tacoma-Olympia, WA
Spokane WA Spokane, WA
Whatcom WA Bellingham, WA
Ashland WI
Columbia WI Madison-Baraboo, WI
Dane WI Madison-Baraboo, WI
Dodge WI Fond du Lac-Beaver Dam, WI
Forest WI
Jeíerson WI
La Crosse WI La Crosse, WI-MN
Marathon WI Wausau-Merrill, WI
Oneida WI
Rock WI Janesville, WI
Sauk WI Madison-Baraboo, WI
Vilas WI
Waukesha WI Milwaukee-Racine-Waukesha, WI
Greenbrier WV
Campbell WY
Carbon WY
Crook WY
Sweetwater WY
Uinta WY
County State Metropolitan Statistical Area County State Metropolitan Statistical Area County State Metropolitan Statistical Area
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 28
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 29
Health Eects of Ozone and Particle Pollution
T
wo types of air pollution dominate in the U.S.: ozone
and particle pollution.
1
ese two pollutants threaten the
health and the lives of millions of Americans. anks to
the Clean Air Act, the U.S. has far less of both pollutants now
than in the past. Still, nearly 132 million people live in counties
where monitors show unhealthy levels of one or both.
So what are ozone and particle pollution?
Ozone
Pollution
It may be hard to imagine that pollution
could be invisible, but ozone is. e most
widespread pollutant in the U.S. is also one
of the most dangerous.
Scientists have studied the eects of ozone on
health for decades. Hundreds of research stud-
ies have conrmed that ozone harms people at
levels currently found in the United States. In
the last few years, we’ve learned that it can also
be deadly.
What Is Ozone?
Ozone (O
3
) is a gas molecule composed of
three oxygen atoms. Oen called “smog,”
ozone is harmful to breathe. Ozone aggres-
sively attacks lung tissue by reacting chemi-
cally with it.
e ozone layer found high in the upper
atmosphere (the stratosphere) shields us from
much of the sun’s ultraviolet radiation. How-
ever, ozone air pollution at ground level where
we can breathe it (in the troposphere) causes
serious health problems.
Where Does Ozone Come From?
Ozone develops in the atmosphere from
gases that come out of tailpipes, smokestacks and many other
sources. When these gases come in contact with sunlight, they
react and form ozone smog.
e essential raw ingredients for ozone come from nitro-
gen oxides (NO
X
), hydrocarbons, also called volatile organic
compounds (VOCs) and carbon monoxide (CO). ey are
produced primarily when fossil fuels like gasoline, oil or coal
are burned or when some chemicals, like solvents, evaporate.
NO
X
is emitted from power plants, motor vehicles and other
sources of high-heat combustion. VOCs are emitted from mo-
tor vehicles, chemical plants, reneries, factories, gas stations,
oxygen
oxygen oxygen
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 30
paint and other sources. CO is also primarily emitted from
motor vehicles.
2

If the ingredients are present under the right conditions, they
react to form ozone. And because the reaction takes place in
the atmosphere, the ozone oen shows up downwind of the
sources of the original gases. In addition, winds can carry
ozone far from where it began.
VOCs,
NO
x
, CO
Ozone
You may have wondered why “ozone action day” warnings are
sometimes followed by recommendations to avoid activities
such as mowing your lawn or driving your car. Lawn mower
exhaust and gasoline vapors are VOCs that could turn into
ozone in the heat and sun.
Who is at risk from breathing ozone?
Anyone who spends time outdoors where ozone pollution lev-
els are high may be at risk. Five groups of people are especially
vulnerable to the eects of breathing ozone:
children and teens;
3

anyone 65 and older;
4
people who work or exercise outdoors;
5
people with existing lung diseases, such as asthma and
chronic obstructive pulmonary disease (also known as
COPD, which includes emphysema and chronic bronchi-
tis);
6
and
people with cardiovascular disease.
7

In addition, newer evidence suggests that other groups—in-
cluding women, people who suer from obesity and people
with low incomes—may also face higher risk from ozone.
8

More research is needed to conrm these ndings.
e impact on your health can depend on many factors,
however. For example, the risks would be greater if ozone lev-
els are higher, if you are breathing faster because you’re work-
ing outdoors or if you spend more time outdoors.
Lifeguards in Galveston, Texas, provided evidence of the im-
pact of even short-term exposure to ozone on healthy, active
adults in a study published in 2008. Testing the breathing ca-
pacity of these outdoor workers several times a day, researchers
found that many lifeguards had greater obstruction in their
airways when ozone levels were high. Because of this research,
Galveston became the rst city in the nation to install an air
quality warning ag system on the beach.
9

How Ozone Pollution Harms Your Health
Premature death. Breathing ozone can shorten your life.
Strong evidence exists of the deadly impact of ozone in large
studies conducted in cities across the U.S., in Europe and in
Asia. Researchers repeatedly found that the risk of premature
death increased with higher levels of ozone.
10,11,12
Newer re-
search has conrmed that ozone increased the risk of prema-
ture death even when other pollutants also exist.
13

Even low levels of ozone may be deadly. A large study of 48
U.S. cities looked at the association between ozone and all-
cause mortality during the summer months. Ozone concentra-
tions by city in the summer months ranged from 16 percent
to 80 percent lower than the U.S. Environmental Protection
Agency (EPA) currently considers safe. Researchers found that
ozone at those lower levels was associated with deaths from
cardiovascular disease, strokes, and respiratory causes.
14

Immediate breathing problems. Many areas in the United
States produce enough ozone during the summer months to
cause health problems that can be felt right away. Immediate
problems—in addition to increased risk of premature death—
include:
shortness of breath, wheezing and coughing;
asthma attacks;
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 31 HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
increased risk of respiratory infections;
increased susceptibility to pulmonary inammation; and
increased need for people with lung diseases, like asthma or
chronic obstructive pulmonary disease (COPD), to receive
medical treatment and to go to the hospital.
15
Cardiovascular ehects. Inhaling ozone may aect the heart as
well as the lungs. A 2006 study linked exposures to high ozone
levels for as little as one hour to a particular type of cardiac
arrhythmia that itself increases the risk of premature death
and stroke.
16
A French study found that exposure to elevated
ozone levels for one to two days increased the risk of heart
attacks for middle-aged adults without heart disease.
17
Several
studies around the world have found increased risk of hospital
admissions or emergency department visits for cardiovascular
disease.
18
Long-term exposure risks. New studies warn of serious eects
from breathing ozone over longer periods. With more long-
term data, scientists are nding that long-term exposure—that
is, for periods longer than eight hours, including days, months
or years—may increase the risk of early death.
Examining the records from a long-term national database,
researchers found a higher risk of death from respiratory
diseases associated with increases in ozone.
19

New York researchers looking at hospital records for chil-
dren’s asthma found that the risk of admission to hospitals
for asthma increased with chronic exposure to ozone.
Younger children and children from low-income families
were more likely to need hospital admissions even during
the same time periods than other children.
20

California researchers analyzing data from their long-term
Southern California Children’s Health Study found that
some children with certain genes were more likely to de-
velop asthma as adolescents in response to the variations in
ozone levels in their communities.
21
Studies link lower birth weight and decreased lung func-
tion in newborns to ozone levels in their community.
22
is
research provides increasing evidence that ozone may harm
newborns.
Breathing other pollutants in the air may make your lungs
more responsive to ozone—and breathing ozone may increase
your body’s response to other pollutants. For example, research
warns that breathing sulfur dioxide and nitrogen oxide—two
pollutants common in the eastern U.S.—can make the lungs
react more strongly than to just breathing ozone alone. Breath-
ing ozone may also increase the response to allergens in people
with allergies. A large study published in 2009 found that chil-
dren were more likely to suer from hay fever and respiratory
allergies when ozone and PM
2.5
levels were high.
23

EPA finds ozone causes harm. e EPA released their most
recent review of the current research on ozone pollution
in February 2013.
24
e EPA had engaged a panel of expert
scientists, the Clean Air Scientic Advisory Committee, to
help them assess the evidence, in particular research published
between 2006 and 2012. e EPA concluded that ozone pol-
lution posed multiple, serious threats to health. eir ndings
are highlighted in the box below.
EPA Concludes Ozone Pollution Poses Serious
Health Threats
Causes respiratory harm (e.g. worsened asthma, wors-
ened COPD, inflammation)
Likely to cause early death (both short-term and long-
term exposure)
Likely to cause cardiovascular harm (e.g. heart attacks,
strokes, heart disease, congestive heart failure)
May cause harm to the central nervous system
May cause reproductive and developmental harm
—U.S. Environmental Protection Agency, Integrated Science Assessment for
Ozone and Related Photochemical Oxidants, 2013. EPA/600/R-10/076F.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 32
Particle
Pollution
Ever look at dirty truck exhaust?
e dirty, smoky part of that stream of
exhaust is made of particle pollution.
Overwhelming evidence shows that particle pollution—like that
coming from that exhaust smoke—can kill. Particle pollution
can increase the risk of heart disease, lung cancer and asthma
attacks and can interfere with the growth and work of the lungs.
What Is Particle Pollution?
Particle pollution refers to a mix of very tiny solid and liquid
particles that are in the air we breathe. But nothing about par-
ticle pollution is simple. And it is so dangerous it can shorten
your life.
Size matters. Particles themselves are dierent sizes. Some
are one-tenth the diameter of a strand of hair. Many are even
tinier; some are so small they can only be seen with an electron
microscope. Because of their size, you can’t see the individual
particles. You can only see the haze that forms when millions
of particles blur the spread of sunlight.
e dierences in size make a big dierence in how they aect
us. Our natural defenses help us to cough or sneeze larger
particles out of our bodies. But those defenses don’t keep out
smaller particles, those that are smaller than 10 microns (or
micrometers) in diameter, or about one-seventh the diameter
of a single human hair. ese particles get trapped in the lungs,
while the smallest are so minute that they can pass through
the lungs into the blood stream, just like the essential oxygen
molecules we need to survive.
Researchers categorize particles according to size, grouping them
as coarse, ne and ultrane. Coarse particles fall between 2.5
microns and 10 microns in diameter and are called PM
10-2.5
. Fine
particles are 2.5 microns in diameter or smaller and are called
PM
2.5
. Ultrane particles are smaller than 0.1 micron in diam-
eter
25
and are small enough to pass through the lung tissue into
the blood stream, circulating like the oxygen molecules them-
selves. No matter what the size, particles can harm your health.
“A mixture of mixtures.” Because particles are formed in so
many dierent ways, they can be composed of many dierent
compounds. Although we oen think of particles as solids, not
all are. Some are completely liquid; some are solids suspended
in liquids. As the EPA puts it, particles are really “a mixture of
mixtures.”
26

e mixtures dier between the eastern and western United
States and in dierent times of the year. For example, the Mid-
west, Southeast and Northeast states have more sulfate particles
than the West on average, largely due to the high levels of sulfur
dioxide emitted by large, coal-red power plants. By contrast,
nitrate particles from motor vehicle exhaust form a larger pro-
portion of the unhealthful mix in the winter in the Northeast,
Southern California, the Northwest, and North Central U.S.
27
Who Is at Risk?
Anyone who lives where particle pollution levels are high is
at risk. Some people face higher risk, however. People at the
greatest risk from particle pollution exposure include:
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
HUMAN HAIR
50-70μm
(microns) in diameter
PM2.5
Combustion particles, organic
compounds, metals, etc.
< 2.5μm (microns) in diameter
PM10
Dust, pollen, mold, etc.
< 10μm (microns) in diameter
90μm (microns) in diameter
FINE BEACH SAND
Image courtesy of the U.S. EPA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 33
Infants, children and teens;
People over 65 years of age;
People with lung disease such as asthma and chronic
obstructive pulmonary disease (COPD), which includes
chronic bronchitis and emphysema;
People with heart disease or diabetes;
28

People with low incomes; and
People who work or are active outdoors.
29

Diabetics face increased risk at least in part because of their
higher risk for cardiovascular disease. A 2010 study examined
prevalence of diagnosed diabetes in relation to ne particle
pollution in 2004-2005. e evidence suggested that air pollu-
tion is a risk factor for diabetes.
30

What Can Particles Do to Your Health?
Particle pollution can be very dangerous to breathe. Breath-
ing particle pollution may trigger illness, hospitalization and
premature death, risks showing up in new studies that validate
earlier research.
anks to steps taken to reduce particle pollution, good news
is growing from researchers who study the drop in year-round
levels of particle pollution.
Looking at air quality in 545 counties in the U.S. between
2000 and 2007, researchers found that people had ap-
proximately four months added to their life expectancy on
average due to cleaner air. Women and people who lived in
urban and densely populated counties beneted the most.
31

Another long-term study of six U.S. cities tracked from 1974 to
2009 added more evidence of the benets. eir ndings sug-
gest that cleaning up particle pollution had almost immediate
health benets. ey estimated that the U.S. could prevent ap-
proximately 34,000 premature deaths a year if the nation could
lower annual levels of particle pollution by 1 µg/m
3
.
32
ese studies add to the growing research that cleaning up air
pollution improves life and health.
33
Other researchers estimated
that reductions in air pollution can be expected to produce
rapid improvements in public health, with fewer deaths occur-
ring within the rst two years aer reductions.
34
Researchers are exploring possible dierences in health eects
of the three sizes of particles and particles from dierent sources,
such as diesel particles from trucks and buses or sulfates from
coal-red power plants. So far, the evidence remains clear that
particles of all sizes from all sources can be dangerous.
35

Short-Term Exposure Can Be Deadly
First and foremost, short-term exposure to particle pollution
can kill. Peaks or spikes in particle pollution can last for hours
to days. Deaths can occur on the very day that particle levels
are high, or within one to two months aerward. Particle pol-
lution does not just make people die a few days earlier than
they might otherwise—these are deaths that would not have
occurred if the air were cleaner.
36

Particle pollution also diminishes lung function, causes greater
use of asthma medications and increased rates of school absen-
teeism, emergency room visits and hospital admissions. Other
adverse eects can be coughing, wheezing, cardiac arrhythmias
and heart attacks. According to the ndings from some of the
latest studies, short-term increases in particle pollution have
been linked to:
death from respiratory and cardiovascular causes, including
strokes;
37,38,39,40
increased mortality in infants and young children;
41
increased numbers of heart attacks, especially among the
elderly and in people with heart conditions;
42
inammation of lung tissue in young, healthy adults;
43
increased hospitalization for cardiovascular disease, includ-
ing strokes and congestive heart failure;
44,45,46
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 34
increased emergency room visits for patients suering from
acute respiratory ailments;
47
increased hospitalization for asthma among children;
48,49,50

and
increased severity of asthma attacks in children.
51
Again, the impact of even short-term exposure to particle pol-
lution on healthy adults showed up in the Galveston lifeguard
study, in addition to the harmful eects of ozone pollution.
Lifeguards had reduced lung volume at the end of the day
when ne particle levels were high.
52
Year-Round Exposure
Breathing high levels of particle pollution day in and day out
also can be deadly, as landmark studies in the 1990s conclu-
sively showed.
53
Chronic exposure to particle pollution can
shorten life by one to three years.
54
Other impacts range from
premature births to serious respiratory disorders, even when
the particle levels are very low.
Year-round exposure to particle pollution has also been linked to:
increased hospitalization for asthma attacks for children
living near roads with heavy truck or trailer trac;
55,56
slowed lung function growth in children and teenagers;
57,58
signicant damage to the small airways of the lungs;
59
increased risk of dying from lung cancer;
60
increased risk of death from cardiovascular disease;
61
and
increased risk of lower birthweight and infant mortality.
62
Research into the health risks of 65,000 women over age 50
found that those who lived in areas with higher levels of par-
ticle pollution faced a much greater risk of dying from heart
disease than had been previously estimated. Even women who
lived within the same city faced diering risks depending on
the annual levels of pollution in their neighborhood.
63
e EPA released their most recent review of the current
research on particle pollution in December 2009.
64
e Agency
had engaged a panel of expert scientists, the Clean Air Scien-
tic Advisory Committee, to help them assess the evidence, in
particular research published between 2002 and May 2009. e
EPA concluded that particle pollution caused multiple, seri-
ous threats to health. eir ndings are highlighted in the box
below.
EPA Concludes Fine Particle Pollution Poses
Serious Health Threats
Causes early death (both short-term and long-term
exposure)
Causes cardiovascular harm (e.g. heart attacks, strokes,
heart disease, congestive heart failure)
Likely to cause respiratory harm (e.g. worsened asthma,
worsened COPD, inflammation)
May cause cancer
May cause reproductive and developmental harm
—U.S. Environmental Protection Agency, Integrated Science Assessment for
Particulate Matter, December 2009. EPA 600/R-08/139F.
Where Does Particle Pollution Come From?
Particle pollution is produced through two separate process-
es—mechanical and chemical.
Mechanical processes break down bigger bits into smaller bits
with the material remaining essentially the same, only becom-
ing smaller. Mechanical processes primarily create coarse
particles.
65
Dust storms, construction and demolition, mining
operations, and agriculture are among the activities that pro-
duce coarse particles. Tire, brake pad and road wear can also
create coarse particles. Bacteria, pollen, mold, and plant and
animal debris are also included as coarse particles.
66
By contrast, chemical processes in the atmosphere create most of
the tiniest ne and ultrane particles. Combustion sources burn
fuels and emit gases. ese gases can vaporize and then condense
to become a particle of the same chemical compound. Or, they
can react with other gases or particles in the atmosphere to form
a particle of a dierent chemical compound. Particles formed by
this latter process come from the reaction of elemental carbon
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 35
(soot), heavy metals, sulfur dioxide (SO
2
), nitrogen oxides (NO
x
)
and volatile organic compounds with water and other compounds
in the atmosphere.
67
Burning fossil fuels in factories, power plants,
steel mills, smelters, diesel- and gasoline-powered motor vehicles
(cars and trucks) and equipment generate a large part of the raw
materials for ne particles. So does burning wood in residential
replaces and wood stoves or burning agricultural elds or forests.
Focusing on
Children’s Health
Children face special risks
from air pollution because
their lungs are growing and
because they are so active.
Just like the arms and legs, the largest portion of a child’s lungs
will grow long aer he or she is born. Eighty percent of their
tiny air sacs develop aer birth. ose sacs, called the alveoli, are
where the life-sustaining transfer of oxygen to the blood takes
place. e lungs and their alveoli aren’t fully grown until chil-
dren become adults.
68
In addition, the body’s defenses that help
adults ght o infections are still developing in young bodies.
69

Children have more respiratory infections than adults, which
also seems to increase their susceptibility to air pollution.
70
Furthermore, children don’t behave like adults, and their
behavior also aects their vulnerability. ey are outside for
longer periods and are usually more active when outdoors.
Consequently, they inhale more polluted outdoor air than
adults typically do.
71

Air Pollution Increases Risk of
Underdeveloped Lungs
Another nding from the Southern California Children’s
Health study looked at the long-term eects of particle pollu-
tion on teenagers. Tracking 1,759 children between ages 10 and
18, researchers found that those who grew up in more polluted
areas face the increased risk of having underdeveloped lungs,
which may never recover to their full capacity. e average
drop in lung function was 20 percent below what was expected
for the child’s age, similar to the impact of growing up in a
home with parents who smoked.
72
Community health studies are pointing to less obvious, but
serious eects from year-round exposure to ozone, especially
for children. Scientists followed 500 Yale University students
and determined that living just four years in a region with high
levels of ozone and related co-pollutants was associated with
diminished lung function and frequent reports of respiratory
symptoms.
73
A much larger study of 3,300 school children in
Southern California found reduced lung function in girls with
asthma and boys who spent more time outdoors in areas with
high levels of ozone.
74
Cleaning Up Pollution Can Reduce
Risk to Children
ere is also real-world evidence that reducing air pollution
can help protect children.
In Switzerland, particle pollution dropped during a period in the
1990s. Researchers there tracked 9,000 children over a nine-year
period, following their respiratory symptoms. Aer taking other
factors such as family characteristics and indoor air pollution
into account, the researchers noted that during the years with
less pollution, the children had fewer episodes of chronic cough,
bronchitis, common cold, and conjunctivitis symptoms.
75
Disparities in
the Impact of
Air Pollution
e burden of air pollution is not
evenly shared. Poorer people and
some racial and ethnic groups are
among those who oen face
higher exposure to pollutants and
who may experience greater
responses to such pollution. Many studies have explored the
dierences in harm from air pollution to racial or ethnic
groups and people who are in a low socioeconomic position,
have less education, or live nearer to major sources,
76
including
a workshop the American Lung Association held in 2001 that
focused on urban air pollution and health inequities.
77

HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 36
Many studies have looked at dierences in the impact on pre-
mature death. Results have varied widely, particularly for eects
between racial groups. Some studies have found no dierences
among races,
78
while others found greater responsiveness for
Whites and Hispanics, but not African Americans,
79
or for
African Americans but not other races or ethnic groups.
80

Other researchers have found greater risk for African Americans
from air toxics, including those pollutants that also come from
trac sources.
81

Socioeconomic position has been more consistently associated
with greater harm from air pollution. Recent studies show evi-
dence of that link. Low socioeconomic status consistently in-
creased the risk of premature death from ne particle pollution
among 13.2 million Medicare recipients studied in the largest
examination of particle pollution mortality nationwide.
82
In
the 2008 study that found greater risk for premature death
for African Americans, researchers also found greater risk for
people living in areas with higher unemployment or higher use
of public transportation.
83
A 2008 study of Washington, DC
found that while poor air quality and worsened asthma went
hand-in-hand in areas where Medicaid enrollment was high,
the areas with the highest Medicaid enrollment did not always
have the strongest association of high air pollution and asthma
attacks.
84
However, two other recent studies in France have
found no association with lower income and asthma attacks.
85

Scientists have speculated that there are three broad reasons
why disparities may exist. First, groups may face greater
exposure to pollution because of factors ranging from racism
to class bias to housing market dynamics and land costs. For
example, pollution sources may be located near disadvantaged
communities, increasing exposure to harmful pollutants. Sec-
ond, low social position may make some groups more suscep-
tible to health threats because of factors related to their disad-
vantage. Lack of access to health care, grocery stores and good
jobs, poorer job opportunities, dirtier workplaces or higher
trac exposure are among the factors that could handicap
groups and increase the risk of harm. Finally, existing health
conditions, behaviors, or traits may predispose some groups to
greater risk. For example, diabetics are among the groups most
at risk from air pollutants, and the elderly, African Americans,
Mexican Americans and people living near a central city have
higher incidence of diabetes.
86
Communities of color also may be more likely to live in coun-
ties with higher levels of pollution. In a 2011 analysis of the
population and air quality reported in the American Lung
Association’s State of the Air 2009 report, researchers found that
non-Hispanic Blacks and Hispanics were more likely to live in
counties that had worse problems with particle pollution. Non-
Hispanic Blacks were also more likely to live in counties with
worse ozone pollution. Income groups, by contrast, diered
little in these exposures. However, since few rural counties
have monitors, the primarily older, non-Hispanic white resi-
dents of those counties lack information about the air quality
in their communities.
87

Unemployed people, those with low income or low education
and non-Hispanic Blacks were found to be more likely to live
in areas with higher exposures to particle pollution in a 2012
study. However, the dierent racial/ethnic and income groups
were breathing oen very dierent kinds of particles; the dif-
ferent composition and structure of these particles may have
dierent health impacts.
88
Highways May Be Especially
Dangerous for Breathing
Being in heavy trac, or living near a road, may be even more
dangerous than being in other places in a community. Grow-
ing evidence shows that the vehicle emissions coming directly
from those highways may be higher than in the community as
a whole, increasing the risk of harm to people who live or work
near busy roads.
e number of people living “next to a busy road” may include
30 to 45 percent of the population in North America, accord-
ing to the most recent review of the evidence. In January 2010,
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 37
the Health Eects Institute published a major review of the
evidence by a panel of expert scientists. e panel looked at
over 700 studies from around the world, examining the health
eects. ey concluded that trac pollution causes asthma
attacks in children, and may cause a wide range of other ef-
fects including: the onset of childhood asthma, impaired lung
function, premature death and death from cardiovascular
diseases, and cardiovascular morbidity. e area most aected,
they concluded, was roughly 0.2 mile to 0.3 mile (300 to 500
meters) from the highway.
89

Children and teenagers are among the most vulnerable—
though not the only ones at risk. A Danish study found that
long-term exposure to trac air pollution may increase the risk
of developing chronic obstructive pulmonary disease (COPD).
ey found that those most at risk were people who already
had asthma or diabetes.
90
Studies have found increased risk of
premature death from living near a major highway or an urban
road.
91
Another study found an increase in risk of heart attacks
from being in trac, whether driving or taking public transpor-
tation.
92
Urban women in a Boston study experienced de-
creased lung function associated with trac-related pollution.
93
How to Protect Yourself from Ozone and
Particle Pollution
To minimize your exposure to ozone and particle pollution:
Pay attention to forecasts for high air pollution days to know
when to take precautions;
Avoid exercising near high-trac areas;
Avoid exercising outdoors when pollution levels are high, or
substitute an activity that requires less exertion;
Do not let anyone smoke indoors and support measures to
make all places smokefree; and
Reduce the use of replaces and wood-burning stoves.
Bottom line: Help yourself and everyone else breathe easier.
Support national, state and local eorts to clean up sources
of pollution. Your life and the life of someone you love may
depend on it.
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
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54 Pope CA III. Epidemiology of Fine Particulate Air Pollution and Human Health:
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55 Lin S, Munsie JP, Hwang SA, Fitzgerald E, Cayo MR. Childhood Asthma
Hospitalization and Residential Exposure to State Route Traíc. Environ Res.
2002; 88:73-81.
56 Gauderman WJ, Vora H, McConnell R, Berhane K, Gilliland GF, Thomas D,
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59 Churg, A Brauer, M, Avila-Casado, MdC, Fortoul TI, Wright JL. Chronic Exposure
to High Levels of Particulate Air Pollution and Small Airway Remodeling.
Environ Health Perspect. 2003; 111: 714-718.
60 Lepeule et al, 2012; Pope CA III, Burnett RT, Thun MJ, Calle EE, Krewski D,
Ito K, Thurston GD. Lung Cancer, Cardiopulmonary Mortality, and Long-Term
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Exposure to Fine Particulate Air Pollution. JAMA. 2002; 287(9):1132-1141.
61 Pope CA III, Burnett RT, Thurston GD, Thun MJ, Calle EE, Krewski D, Godleski JJ.
Cardiovascular Mortality and Year-round Exposure to Particulate Air Pollution:
epidemiological evidence of general pathophysiological pathways of disease.
Circulation. 2004; 109:71-77.
62 Bell ML, Ebisu K, Belanger K. Ambient Air Pollution and low birth weight in
Connecticut and Massachusetts. Environ Health Perspect. 2007; 115: 118-24;
Ritz B, Wilhelm M, Zhao Y. Air pollution and infant death in southern California,
2989-2000. Pediatrics. 2006; 118: 493-502; Woodruí TJ, parker JD, Schoendorf
KC. Fine particulate matter (PM
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63 Miller KA, Siscovick DS, Shepard L, Shepherd K, Sullivan JH, Anderson
GL, Kaufman JD. Long-Term Exposure to Air Pollution and Incidence of
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70 WHO, 2005.
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72 Gauderman et al., 2004.
73 Galizia A, Kinney PL. Year-round Residence in Areas of High Ozone: association
with respiratory health in a nationwide sample of nonsmoking young adults.
Environ Health Perspect. 1999; 107:675-679.
74 Peters JM, Avol E, Gauderman WJ, Linn WS, Navidi W, London SJ, Margolis
H, Rappaport E, Vora H, Gong H, Thomas DC. A Study of Twelve Southern
California Communities with Diíering Levels and Types of Air Pollution. II.
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75 Bayer-Oglesby L, Grize L, Gassner M, Takken-Sahli K, Sennhauser FH, Neu U,
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Improved Respiratory Health in Swiss Children. Environ Health Perspect. 2005;
113:1632-1637.
76 Institute of Medicine. Toward Environmental Justice: Research, Education, and
Health Policy Needs. Washington, DC: National Academy Press, 1999; O’Neill
MS, Jerrett M, Kawachi I, Levy JI, Cohen AJ, Gouveia N, Wilkinson P, Fletcher
T, Cifuentes L, Schwartz J et al. Health, Wealth, and Air Pollution: Advancing
Theory and Methods. Environ Health Perspect. 2003: 111: 1861-1870; Finkelstein
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Relation Between Income, Air Pollution And Mortality: A Cohort Study. CMAJ.
2003; 169: 397-402; Ostro B, Broadwin R, Green S, Feng W, Lipsett M. Fine
Particulate Air Pollution and Mortality in Nine California Counties: Results from
CALFINE. Environ Health Perspect. 2005: 114: 29-33; Zeka A, Zanobetti A,
Schwartz J. Short term eíects of particulate matter on cause specific mortality:
eíects of lags and modification by city characteristics. Occup Environ Med.
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77 American Lung Association. Urban Air Pollution and Health Inequities: A
Workshop Report. Environ Health Perspect. 2001: 109(suppl 3): 357-374.
78 Zeka A, Zanobetti A, Schwartz J. Individual-Level Modifiers of the Eíects of
Particulate Matter on Daily Mortality. Am J Epidemiol. 2006: 163: 849-859.
79 Ostro B, Broadwin R, Green S, Feng WY, Lipsett M. Fine particulate air pollution
and mortality in nine California counties: results from CALFINE. Environ
Health Perspect. 2006: 114: 29-33; Ostro B, Feng WY, Broadwin R, Malig B,
Green S, Lipsett M. The Impact of Components of Fine Particulate Matter on
Cardiovascular Mortality in Susceptible Subpopulations. Occup Environ Med.
2008; 65(11):750-6.
80 Bell ML, Dominici F. Eíect Modification by Community Characteristics on the
Short-term Eíects of Ozone Exposure and Mortality in 98 US Communities. Am
J Epidemiol. 2008; 167:986-997.
81 Apelberg BJ, Buckley TJ, White RH. Socioeconomic and Racial Disparities
in Cancer Risk from Air Toxics in Maryland. Environ Health Perspect. 2005:
113:693-699.
82 Zeger SL, Dominici F, McDermott A, Samet J. Mortality in the Medicare
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83 Bell and Dominici, 2008.
84 Babin S, Burkom H, Holtry R, Tabernero N, Davies-Cole J, Stokes L, Dehaan
K, Lee D. Medicaid Patient Asthma-Related Acute Care Visits And Their
Associations with Ozone and Particulates in Washington, DC, from 1994-2005.
Int J Environ Health Res. 2008; 18(3)209-221.
85 Laurent O, Pedrono G, Segala C, Filleul L, Havard S, Deguen S, Schillinger C,
Rivière E, Bard D. Air pollution, asthma attacks, and socioeconomic deprivation:
a small-area case-crossover study. Am J Epidemiol. 2008; 168:58-65; Laurent
O, Pedrono G, Filleul L, Segala C, Lefranc A, Schillinger C, Riviere E, Bard D.
Influence of Socioeconomic Deprivation on the Relation Between Air Pollution
and Beta-Agonist Sales for Asthma. Chest. 2009; 135(3):717-716.
86 O’Neill et al., 2003.
87 Miranda ML, Edwards SE, Keating MH, Paul CJ. Making the Environmental
Justice Grade: The Relative Burden of Air Pollution Exposure in the United
States. Int J Environ Res Public Health. 2011; 8: 1755-1771.
88 Bell ML, Ebisu K. Environmental Inequality in Exposures to Airborne Particulate
Matter Component in the United States. Environ Health Perspect. 2012;
120:1699–1704.
89 Health Eíects Institute Panel on the Health Eíects of Traíc-Related Air
Pollution, Traíc-Related Air Pollution: A Critical Review of the Literature on
Emissions, Exposure, and Health Eíects. Health Eíects Institute: Boston, 2010.
Available at www.healtheíects.org.
90 Andersen ZJ, Hvidberg M, Jensen SS, Ketzel M, Loft S, Sørensen M, Tjønneland
A, Overvad K, and Raaschou-Nielsen O. Chronic Obstructive Pulmonary Disease
and Long-Term Exposure to Traíc-related Air Pollution: A Cohort Study. Am J
Respir Crit Care Med. 2011: 183:455-461.
91 Finklestein MM, Jerrett M., Sears M.R. Traíc Air Pollution and Mortality Rate
Advancement Periods. Am J Epidemiol. 2004; 160:173-177; Hoek G, Brunkreef
B, Goldbohn S, Fischer P, van den Brandt. Associations between mortality and
indicators of traíc-related air pollution in the Netherlands: a cohort study.
Lancet. 2002; 360:1203-1209.
92 Peters A, von Klot S, Heier M, Trentinaglia I, Cyrys J, Hormann A, Hauptmann
M, Wichmann HE, Lowel H. Exposure to Traíc and the Onset of Myocardial
Infarction. N Engl J Med. 2004; 351:1721-1730.
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Related Black Carbon Exposure and Lung Function among Urban Women.
Environ Health Perspect. 2008; 116(10)1333-1337.
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 41 METHODOLOGY
Methodology
Statistical
Methodology:
The Air
Quality Data
Data Sources
e data on air quality through-
out the United States were
obtained from the U.S. Environ-
mental Protection Agency’s Air
Quality System (AQS), formerly
called Aerometric Information Retrieval System (AIRS)
database. e American Lung Association contracted with
Dr. Allen S. Lefohn, A.S.L. & Associates, Helena, Montana, to
characterize the hourly averaged ozone concentration informa-
tion and the 24-hour averaged PM
2.5
concentration information
for the 3-year period for 2009-2011 for each monitoring site.
Design values for the annual PM
2.5
concentrations by county
for the period 2009-2011 were downloaded on October 3, 2012
from the EPA’s website at http://www.epa.gov/air/airtrends/
values.html. ey were updated with the revised design values
posted on December 14, 2012 at http://www.epa.gov/airqual-
ity/particlepollution/2012/20092011table.pdf.
Ozone Data Analysis
e 2009, 2010, and 2011 AQS hourly ozone data were used
to calculate the daily 8-hour maximum concentration for each
ozone-monitoring site. e hourly averaged ozone data were
downloaded on June 29, 2012. e data were considered for
a 3-year period for the same reason that the EPA uses three
years of data to determine compliance with the ozone stan-
dard: to prevent a situation in any single year, where anoma-
lies of weather or other factors create air pollution levels,
which inaccurately reect the normal conditions. e high-
est 8-hour daily maximum concentration in each county for
2009, 2010, and 2011, based on the EPA-dened ozone season,
was identied.
e current national ambient air quality standard for ozone is
0.075 ppm measured over eight hours. e EPA’s Air Quality
Index reects the 0.075 ppm standard. A.S.L. & Associates pre-
pared a table by county that summarized, for each of the three
years, the number of days the ozone level was within the ranges
identied by the EPA based on the EPA Air Quality Index:
8-hour Ozone
Concentration Air Quality Index Levels
0.000 – 0.059 ppm Good (Green)
0.060 – 0.075 ppm Moderate (Yellow)
0.076 – 0.095 ppm Unhealthy for Sensitive Groups
(Orange)
0.096 – 0.115 ppm Unhealthy (Red)
0.116 – 0.374 ppm Very Unhealthy (Purple)
>0.374 ppm Hazardous (Maroon)
e goal of this report was to identify the number of days that
8-hour daily maximum concentrations occurred within the
dened ranges, not just those days that would fall under the
requirements for attaining the national ambient air quality
standards. erefore, no data capture criteria were applied to
eliminate monitoring sites or to require a number of valid days
for the ozone season. All valid days of data within the ozone
season were used in the analysis. However, for computing an
8-hour average, at least 75 percent of the hourly concentra-
tions (i.e., 6-8 hours) had to be available for the 8-hour period.
In addition, an 8-hour daily maximum average was identied
if valid 8-hour averages were available for at least 75 percent
of possible hours in the day (i.e., at least 18 of the possible 24
8-hour averages). Because the EPA includes days with inad-
equate data if the standard value is exceeded, our data capture
methodology may result at times in underestimations of the
number of 8-hour averages within the higher concentration
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 42
ranges. However, our experience is that underestimates are
infrequent.
Following receipt of the above information, the American
Lung Association identied the number of days each county,
with at least one ozone monitor, experienced air quality desig-
nated as orange (Unhealthy for Sensitive Groups), red (Un-
healthy), or purple (Very Unhealthy).
Short-term Particle Pollution Data Analysis
A.S.L. & Associates identied the maximum daily 24-hour AQS
PM
2.5
concentration for each county in 2009, 2010, and 2011
with monitoring information. e 24-hour PM
2.5
data were
downloaded on August 13, 2012. In addition, hourly averaged
PM
2.5
concentration data were characterized into 24-hour aver-
age PM
2.5
values by the EPA and provided to A.S.L. & Associ-
ates. Using these results, A.S.L. & Associates prepared a table by
county that summarized, for each of the 3 years, the number of
days the maximum of the daily PM
2.5
concentration was within
the ranges identied by the EPA based on the EPA Air Quality
Index, as adopted by the EPA on December14, 2012:
24-hour PM
2.5
Air Quality
Concentration Index Levels
0.0 g/m
3
to 15.4 g/m
3
Good (Green)
15.5 g/m
3
to 35.0 g/m
3
Moderate (Yellow)
35.1 g/m
3
to 65.4 g/m
3
Unhealthy for
Sensitive Groups
(Orange)
65.5 g/m
3
to 150.4 g/m
3
Unhealthy (Red)
150.5 g/m
3
to 250.4 g/m
3
Very Unhealthy
(Purple)
greater than or equal to 250.5 g/m
3
Hazardous (Maroon)
All previous data collected for 24-hour average PM
2.5
were
reassessed using these AQI thresholds, above.
e goal of this report was to identify the number of days that
the maximum in each county of the daily PM
2.5
concentration
occurred within the dened ranges, not just those days that
would fall under the requirements for attaining the national
ambient air quality standards. erefore, no data capture
criteria were used to eliminate monitoring sites. Both 24-hour
averaged PM data as well as hourly averaged PM data aver-
aged over 24 hours were used. Included in the analysis are data
collected using only FRM and FEM methods, which reported
hourly and 24-hour averaged data. As instructed by the Lung
Association, A.S.L. & Associates included the exceptional and
natural events that were identied in the database and identi-
ed for the Lung Association the dates and monitoring sites
that experienced such events. Some data have been agged by
the state or local air pollution control agency to indicate that
they had raised issues with the EPA about those data.
Following receipt of the above information, the American
Lung Association identied the number of days each county,
with at least one PM
2.5
monitor, experienced air quality desig-
nated as orange (Unhealthy for Sensitive Groups), red (Un-
healthy), purple (Very Unhealthy) or maroon (Hazardous).
Description
of County
Grading System
Ozone and
short-term
particle pollution
(24-hour PM
2.5
)
e grades for ozone and
short-term particle pollution (24-hour PM
2.5
) were based on a
weighted average for each county. To determine the weighted
average, the Lung Association followed these steps:
1. First, assigned weighting factors to each category of the Air
Quality Index. e number of orange days experienced by
each county received a factor of 1; red days, a factor of 1.5;
purple days, a factor of 2; and maroon days, a factor of 2.5.
is allowed days where the air pollution levels were higher
to receive greater weight.
2. Next, multiplied the total number of days within each cat-
egory by their assigned factor, then summed all the catego-
ries to calculate a total.
METHODOLOGY
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 43 METHODOLOGY
3. Finally, divided the total by three to determine the weighted
average, since the monitoring data were collected over a
three-year period.
e weighted average determined each county’s grades for
ozone and 24-hour PM
2.5
.
All counties with a weighted average of zero (correspond-
ing to no exceedances of the standard over the three-year
period) were given a grade of “A.”
For ozone, an “F” grade was set to generally correlate with
the number of unhealthy air days that would place a county
in nonattainment for the ozone standard.
For short-term particle pollution, fewer unhealthy air days
are required for an F than for nonattainment under the
PM
2.5
standard. e national air quality standard is set to al-
low two percent of the days during the three years to exceed
35 µg/m
3
(called a “98th percentile” form) before violating
the standard. at would be roughly 21 unhealthy days in
three years. e grading used in this report would allow only
about one percent of the days to be over 35 µg/m
3
(called a
“99th percentile” form) of the PM
2.5
. e American Lung
Association supports using the tighter limits in a 99th per-
centile form as a more appropriate standard that is intended
to protect the public from short-term spikes in pollution.
Grading System

Grade
Weighted
Average
Approximate Number of Allowable
Orange/Red/Purple/Maroon days
A 0.0 None
B 0.3 to 0.9 1 to 2 orange days with no red
C 1.0 to 2.0 3 to 6 days over the standard: 3 to 5
orange with no more than 1 red OR
6 orange with no red
D 2.1 to 3.2 7 to 9 days over the standard: 7
total (including up to 2 red) to 9
orange with no red
F 3.3 or higher 9 days or more over the standard: 10
orange days or 9 total including at
least 1 or more red, purple or maroon
Weighted averages allow comparisons to be drawn based on
severity of air pollution. For example, if one county had nine
orange days and no red days, it would earn a weighted aver-
age of 3.0 and a D grade. However, another county which had
only eight orange days but also two red days, which signify
days with more serious air pollution, would receive an F. at
second county would have a weighted average of 3.7.
Note that this system diers signicantly from the methodolo-
gy the EPA uses to determine violations of both the ozone and
the 24-hour PM
2.5
standards. e EPA determines whether a
county violates the standard based on the 4th maximum daily
8-hour ozone reading each year averaged over three years.
Multiple days of unhealthy air beyond the highest four in each
year are not considered. By contrast, the system used in this
report recognizes when a community’s air quality repeatedly
results in unhealthy air throughout the three years. Conse-
quently, some counties will receive grades of “F” in this report,
showing repeated instances of unhealthy air, while still meeting
the EPA’s 2008 ozone standard. e American Lung Associa-
tion’s position is that the evidence shows that the 2008 ozone
standard fails to protect public health.
Counties were ranked by weighted average. Metropolitan areas
were ranked by the highest weighted average among the coun-
ties within a given Metropolitan Statistical Area as of 2009 as
dened by the White House Oce of Management and Budget
(OMB).
Year-round particle pollution (Annual PM
2.5
)
Since no comparable Air Quality Index exists for year-round
particle pollution (annual PM
2.5
), the grading was based on
EPA’s determination of the national ambient air quality stan-
dard for annual PM
2.5
of 12 μg/m
3
. Counties that EPA listed
as being at or below 12 μg/m
3
were given grades of “Pass.”
Counties EPA listed as being at or above 12.1 μg/m
3
were given
grades of “Fail.” Where insucient data existed for EPA to
determine a design value, those counties received a grade of
“Incomplete.”
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 44 METHODOLOGY
Design value is the calculated concentration of a pollutant
based on the form of the national ambient air quality standard
and is used by EPA to determine whether or not the air qual-
ity in a county meets the standard. Counties were ranked by
design value. Metropolitan areas were ranked by the highest
design value among the counties within a given Metropolitan
Statistical Area as of 2010 as dened by the OMB.
e Lung Association received critical assistance from mem-
bers of the National Association of Clean Air Administrators,
formerly known as the State and Territorial Air Pollution Con-
trol Administrators and the Association of Local Air Pollution
Control Administrators. With their assistance, all state and lo-
cal agencies were provided the opportunity to review and com-
ment on the data in dra tabular form. e Lung Association
reviewed all discrepancies with the agencies and, if needed,
with Dr. Lefohn at A.S.L. & Associates. Questions about the
annual PM design values were referred to Mr. Mark Schmidt
of EPA, who reviewed and had nal decision on those deter-
minations. e American Lung Association wishes to express
its continued appreciation to the state and local air directors
for their willingness to assist in ensuring that the characterized
data used in this report are correct.
Calculations
of Populations-
at-Risk
Presently, county-specic
measurements of the number of
persons with chronic conditions
are not generally available. In
order to assess the magnitude
of chronic conditions at the state and county levels, we have
employed a synthetic estimation technique originally
developed by the U.S. Census Bureau. is method uses
age-specic national and state estimates of self-reported
conditions to project disease prevalence to the county level.
e exception to this is poverty, for which estimates are
available at the county level.
Population Estimates
Total population for each county was obtained from U.S. Cen-
sus Bureau summary les of the 2011 decennial census data,
which included age- and gender-specic breakdowns.
Poverty estimates came from the Census Bureau’s Small Area
Income and Poverty Estimates (SAIPE) program. e program
does not use direct counts or estimates from sample surveys, as
these methods would not provide sucient data for all coun-
ties. Instead, a model based on estimates of income or poverty
from the Annual Social and Economic Supplement (ASEC) to
the Current Population Survey (CPS) is used to develop esti-
mates for all states and counties.
Prevalence Estimates
Chronic Obstructive Pulmonary Disease, Cardiovascular
Disease, Asthma and Diabetes. In 2011, the Behavioral Risk
Factor Surveillance System (BRFSS) survey found that approxi-
mately 20.5 million (8.8 percent) of adults residing in the United
States and 8.6 percent of children from thirty-four states and
Washington, D.C. reported currently having asthma. Among
adults in the United States in 2011, the survey found that 14.7
million (6.4 percent) had ever been diagnosed with chronic ob-
structive pulmonary disease (COPD), 79.5 million (34.0 percent)
had ever been diagnosed with cardiovascular disease, and 22.6
million (9.6 percent) had ever been diagnosed with diabetes.
e prevalence estimate for pediatric asthma is calculated for
those younger than 18 years. Local area prevalence of pediatric
asthma is estimated by applying 2011 state prevalence rates,
or if not available, the national rate from the BRFSS to pedi-
atric county-level resident populations obtained from the U.S.
Census Bureau web site. Pediatric asthma data from the 2011
BRFSS were available for thirty-four states and Washington
D.C., and national data were used for the sixteen states
1
that
1 Alaska, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Kentucky,
Maine, Minnesota, New Hampshire, North Carolina, South Carolina, South
Dakota, Virginia, and Wyoming.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 45 METHODOLOGY
had no data available. Data from earlier years were not used
due to changes in the 2011 survey methodology.
e prevalence estimate for COPD, cardiovascular disease,
adult asthma and diabetes is calculated for those aged 18-44
years, 45-64 years and 65 years and older. Local area preva-
lence for these diseases is estimated by applying age-specic
state prevalence rates from the 2011 BRFSS to age-specic
county-level resident populations obtained from the U.S.
Census Bureau web site. Cardiovascular disease included ever
having been diagnosed with a heart attack, angina or coronary
heart disease, stroke, or high blood pressure (excluding bor-
derline or pre-hypertensive and women only when pregnant).
Limitations of Estimates. Since the statistics presented by the
BRFSS and SAIPE are based on a sample, they will dier (due
to random sampling variability) from gures that would be de-
rived from a complete census or case registry of people in the
U.S. with these diseases. e results are also subject to report-
ing, non-response and processing errors. ese types of errors
are kept to a minimum by methods built into the survey.
Additionally, a major limitation of the BRFSS is that the infor-
mation collected represents self-reports of medically diagnosed
conditions, which may underestimate disease prevalence since
not all individuals with these conditions have been properly
diagnosed. However, the BRFSS is the best available source for
information on the magnitude of chronic disease at the state
level. e conditions covered in the survey may vary consid-
erably in the accuracy and completeness with which they are
reported.
Local estimates of chronic diseases are scaled in direct propor-
tion to the base population of the county and its age distribu-
tion. No adjustments are made for other factors that may aect
local prevalence (e.g. local prevalence of cigarette smokers or
occupational exposures) since the health surveys that obtain
such data are rarely conducted on the county level. Because
the estimates do not account for geographic dierences in
the prevalence of chronic and acute diseases, the sum of the
estimates for each of the counties in the United States may not
exactly reect the national or state estimates derived from the
BRFSS.
References
Irwin, R. Guide to Local Area Populations. U.S. Bureau of the Census, Technical
Paper Number 39 (1972).
Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance
System, 2011.
Population Estimates Branch, U.S. Census Bureau. Annual Estimates of the Resident
Population by Selected Age Groups and Sex for Counties: April 1, 2010 to July 1,
2011.
Oíce of Management and Budget. Update of Statistical Areas Definitions and
Guidance on Their Uses. OMB Bulletin 10-02 December 1, 2009.
U.S. Census Bureau. Small Area Income and Poverty Estimates. State and County
Data, 2011.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 46
Alabama . . . . . . . . . . . . . . . 48
Alaska . . . . . . . . . . . . . . . . . . 50
Arizona . . . . . . . . . . . . . . . . 52
Arkansas . . . . . . . . . . . . . . . 54
California . . . . . . . . . . . . . . . 56
Colorado . . . . . . . . . . . . . . . 60
Connecticut . . . . . . . . . . . . 62
Delaware . . . . . . . . . . . . . . . 64
District of Columbia . . . . . 66
Florida . . . . . . . . . . . . . . . . . 68
Georgia . . . . . . . . . . . . . . . . 72
Hawaii . . . . . . . . . . . . . . . . . . 76
Idaho . . . . . . . . . . . . . . . . . . 78
Illinois . . . . . . . . . . . . . . . . . . 80
Indiana . . . . . . . . . . . . . . . . . 82
Iowa . . . . . . . . . . . . . . . . . . . 86
Kansas . . . . . . . . . . . . . . . . . 88
Kentucky . . . . . . . . . . . . . . . 90
Louisiana . . . . . . . . . . . . . . . 94
Maine . . . . . . . . . . . . . . . . . . 96
Maryland . . . . . . . . . . . . . . . 98
Massachusetts . . . . . . . . . 100
Michigan . . . . . . . . . . . . . . 102
Minnesota . . . . . . . . . . . . . 106
Mississippi . . . . . . . . . . . . . 108
Missouri . . . . . . . . . . . . . . . 110
Montana . . . . . . . . . . . . . . . 112
Nebraska . . . . . . . . . . . . . . 114
Nevada . . . . . . . . . . . . . . . . 116
New Hampshire . . . . . . . . 118
New Jersey . . . . . . . . . . . . 120
New Mexico . . . . . . . . . . . . 122
New York . . . . . . . . . . . . . . 124
North Carolina . . . . . . . . . 128
North Dakota . . . . . . . . . . 132
Ohio . . . . . . . . . . . . . . . . . . 134
Oklahoma . . . . . . . . . . . . . 138
Oregon . . . . . . . . . . . . . . . . 140
Pennsylvania . . . . . . . . . . . 142
Rhode Island . . . . . . . . . . . 146
South Carolina . . . . . . . . . 148
South Dakota . . . . . . . . . . 150
Tennessee . . . . . . . . . . . . . 152
Texas . . . . . . . . . . . . . . . . . . 154
Utah . . . . . . . . . . . . . . . . . . 158
Vermont . . . . . . . . . . . . . . . 160
Virginia . . . . . . . . . . . . . . . . 162
Washington . . . . . . . . . . . . 166
West Virginia . . . . . . . . . . 168
Wisconsin . . . . . . . . . . . . . 170
Wyoming . . . . . . . . . . . . . . 174
State Tables
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 47
Notes for all state data tables
1. Total Population is based on 2011 US Census and represents
the at-risk populations in counties with ozone or PM
2.5
pollution
monitors; it does not represent the entire state’s sensitive
populations.
2. Those under 18 and 65 & over are vulnerable to ozone and
PM
2.5
. Do not use them as population denominators for disease
estimates—that will lead to incorrect estimates.
3. Pediatric asthma estimates are for those under 18 years of age
and represent the estimated number of people who had asthma
in 2011 based on the state rates when available or national
rates when not (Behavioral Risk Factor Surveillance System, or
BRFSS), applied to county population estimates (U.S. Census).
4. Adult asthma estimates are for those 18 years and older and
represent the estimated number of people who had asthma
during 2011 based on state rates (BRFSS) applied to county
population estimates (U.S. Census).
5. COPD estimates are for adults 18 and over who had ever been
diagnosed with chronic obstructive pulmonary disease, which
includes chronic bronchitis and emphysema, based on state rates
(BRFSS) applied to county population estimates (U.S. Census).
6. Cardiovascular disease estimates are for adults 18 and over who
have been diagnosed within their lifetime, based on state rates
(BRFSS) applied to county population estimates (U.S. Census).
CV disease includes coronary heart disease, hypertension, stroke,
and heart attack.
7. Diabetes estimates are for adults 18 and over who have been
diagnosed within their lifetime based on state rates (BRFSS)
applied to county population estimates (U.S. Census).
8. Poverty estimates include all ages and come from the U.S.
Census Bureau’s Small Area Income and Poverty Estimates
program. The estimates are derived from a model using estimates
of income or poverty from the Annual Social and Economic
Supplement and the Current Population Survey, 2011.
9. Adding across rows does not produce valid estimates. Adding
the disease categories (asthma, COPD, etc.) will double-count
people who have been diagnosed with more than one disease.
Notes for all state grades tables.
1. Not all counties have monitors for either ozone or particle
pollution. If a county does not have a monitor, that county’s name
is not on the list in these tables. The decision about monitors
in the county is made by the state and the U.S. Environmental
Protection Agency, not by the American Lung Association.
2. INC (Incomplete) indicates that monitoring is underway for that
pollutant in that county, but that the data are incomplete for
all three years. Those counties are not graded or received an
Incomplete.
3. DNC (Data Not Collected) indicates that data on that particular
pollutant is not collected in that county.
4. The Weighted Average (Wgt. Avg.) was derived by adding
the three years of individual level data (2009-2011), multiplying
the sums of each level by the assigned standard weights (i.e.
1=orange, 1.5=red, 2.0=purple and 2.5=maroon) and calculating
the average. Grades are assigned based on the weighted
averages as follows: A=0.0, B=0.3-0.9, C=1.0-2.0, D=2.1-3.2,
F=3.3+.
5. The Design Value is the calculated concentration of a pollutant
based on the form of the National Ambient Air Quality Standard,
and is used by EPA to determine whether the air quality in a
county meets the standard. The Design Values are those released
with the December 14, 2012 announcement of the revised
NAAQS at http://www.epa.gov/pm/2012/20092011table.pdf and
incorporates select design values downloaded at http://www.epa.
gov/airtrends/pdfs/PM25_DesignValues_20092011_Final_%20
07_30_12.xlsx. The numbers refer to micrograms per cubic meter,
or g/m
3
.
6. The annual average National Ambient Air Quality Standard for
PM
2.5
is 12 g/m
3
as of December 14, 2012. Counties with design
values of 12 g/m
3
or lower received a grade of “Pass.” Counties
with design values of 12.1 g/m
3
or higher received a grade of
“Fail.”
State Table Notes
A full explanation of the sources of data and methodology is in Methodology.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 48
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Baldwin 1oo,717 42,oo9 ¯1,o77 4,4o¯ 11,447 14,oo¯ oo,292 1o,¯oo 24,72o
Clay 1¯,oo2 ¯,Co7 2,ooo ¯24 oo¯ 1,1Co 4,97o 1,4C7 2,o4o
Colbert o4,o12 11,922 9,o7o 1,2oC ¯,¯oC 4,¯19 19,¯oC o,449 1C,C9o
DeKalb 71,¯7o 1o,¯Co 1C,C¯o 1,919 4,22o o,1o2 22,o2¯ o,¯24 14,¯¯1
Elmore oC,1o2 1o,472 9,oo1 1,9¯7 4,9¯2 o,oo1 2o,7¯2 7,Coo 1C,299
Etowah 1C4,¯C¯ 2¯,oo9 1o,oo1 2,oC¯ o,¯9o o,C14 ¯o,oo1 9,97o 21,42o
Houston 1C2,¯o9 24,914 1o,1oo 2,o12 o,1oo 7,o19 ¯¯,7o7 9,4CC 17,o97
Jeíerson ooo,9¯1 1o4,oo4 o7,¯41 1o,217 4C,2¯7 4o,4o9 21¯,C21 oo,71o 12C,7oC
Madison ¯4C,111 79,¯99 42,¯2o o,¯2o 2C,o4o 2o,C2o 1C9,ooo ¯C,1o7 4o,7¯2
Mobile 412,o77 1C2,o42 o4,474 1C,7o2 24,7¯9 29,9o4 1¯1,o44 ¯o,411 oC,C7C
Montgomery 2¯2,C¯2 o7,o¯C 27,ooo o,C¯2 1¯,924 1o,29o 71,114 19,¯oo o1,7oo
Morgan 119,9o¯ 2o,oo4 17,2C9 2,99o 7,2oo o,9oC ¯9,7¯9 11,C4o 19,79C
Russell o4,o72 1¯,o2o o,ooo 1,41o ¯,27o ¯,9C¯ 17,1C7 4,o9o 1C,oo7
Shelby 197,9¯o 49,9oo 21,94C o,241 11,oo2 14,C¯9 o1,1o2 1o,7o4 1o,74¯
Sumter 1¯,47o 2,oo9 2,Co2 ¯C1 o44 1,C¯C 4,oo1 1,2o4 4,997
Talladega o1,oo4 1o,9C¯ 11,7oo 1,9o2 o,CCo o,17o 27,¯2o 7,o9o 2C,oo9
Tuscaloosa 197,211 41,7o4 21,o¯9 4,¯79 12,4C2 1¯,o4¯ o9,o7¯ 1o,9o7 ¯7,71o
Walker oo,oo1 14,o97 11,117 1,oo2 4,11o o,22o 2¯,¯o2 o,ooo 14,o11
Totals 2,988,426 707,784 400,l48 74,2l2 l8l,930 2l9,6l5 966,235 266,552 523,646
ALABAMA
American Lung Association in Alabama
P.O. Box 661465
Birmingham, AL 35226
(205) 968-2266
www.lung.org/alabama
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 49
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Baldwin o C C 1.7 C C C C C.C A INC INC
Clay DNC DNC DNC DNC DNC C C C C.C A 1C.1 PASS
Colbert C C C C.C A C C C C.C A 1C.C PASS
DeKalb INC INC INC INC INC C C C C.C A 1C.o PASS
Elmore C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Etowah C C C C.C A 1 C C C.¯ B 11.1 PASS
Houston C C C C.C A 2 C C C.7 B 1C.C PASS
Jeíerson ¯7 1 C 12.o F 2 C C C.7 B 12.9 FAIL
Madison 4 C C 1.¯ C C C C C.C A 11.C PASS
Mobile o C C 2.7 D C C C C.C A 9.o PASS
Montgomery 2 C C C.7 B C C C C.C A 1C.9 PASS
Morgan C C C C.C A C C C C.C A 1C.o PASS
Russell 1 C C C.¯ B C C C C.C A 12.2 FAIL
Shelby 7 C C 2.¯ D C C C C.C A INC INC
Sumter 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Talladega DNC DNC DNC DNC DNC C C C C.C A INC INC
Tuscaloosa C C C C.C A 2 C C C.7 B 1C.o PASS
Walker DNC DNC DNC DNC DNC C C C C.C A 1C.o PASS
ALABAMA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 50
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Anchorage
Municipality 29o,o7C 7o,oo¯ 22,¯9o o,4o7 17,97o 11,¯1o oo,44o 1o,9oo 24,4C9
Fairbanks North Star
Borough 99,192 2o,Coo o,7o9 2,14¯ o,C27 ¯,oo9 22,1oo o,4oo 9,C4o
Juneau City and
Borough ¯2,1o4 7,4oo 2,7o9 o¯o 2,C41 1,¯o1 o,2C¯ 2,C4o 2,¯o¯
Kenai Peninsula
Borough oo,29¯ 1¯,1o2 o,o¯C 1,12o ¯,o1o 2,oC1 1o,o27 ¯,92o o,o12
Matanuska-Susitna
Borough 91,94o 2o,1C9 7,oCC 2,2¯¯ o,4¯4 ¯,oo7 21,o9o o,412 1C,491
Yukon-Koyukuk
Census Area o,ooo 1,oo7 oCC 1¯4 ¯42 241 1,4¯o ¯o¯ 1,24o
Totals 580,82l l49,203 46,774 l2,76l 35,438 22,755 l37,475 34,l79 53,365
ALASKA
American Lung Association in Alaska
500 West International Airport Road, #A
Anchorage, AK 99518-1105
(907) 276-5864
www.lung.org/alaska
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 51
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Anchorage
Municipality INC INC INC INC INC C C C C.C A o.2 PASS
Fairbanks North Star
Borough INC INC INC INC INC 27 1C 1 14.7 F 1¯.4 FAIL
Juneau City and
Borough DNC DNC DNC DNC DNC ¯ C C 1.C C 7.o PASS
Kenai Peninsula
Borough DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Matanuska-Susitna
Borough DNC DNC DNC DNC DNC 4 C C 1.¯ C INC INC
Yukon-Koyukuk
Census Area C C C C.C A DNC DNC DNC DNC DNC DNC DNC
ALASKA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 52
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Apache 72,4C1 22,oC1 o,oo¯ 1,919 4,77¯ 2,712 1o,oo¯ 4,oo1 2o,C9o
Cochise 1¯¯,2o9 ¯C,¯C7 2¯,471 2,ooC 9,o9¯ o,114 ¯4,oo7 1C,o2o 24,72¯
Coconino 1¯4,o11 ¯1,C¯o 12,oo2 2,o12 9,929 4,9¯7 29,C1o o,o99 27,¯1o
Gila o¯,144 11,¯o4 12,¯7C 9oo 4,C2o 2,o4o 1o,o¯o o,CC7 1¯,¯74
La Paz 2C,419 ¯,7C9 o,o2¯ ¯12 1,o9o 1,272 o,9o¯ 2,2CC 4,oo1
Maricopa ¯,ooC,244 1,CC7,42o 4o4,C1o o4,771 27o,ooC 1o1,14o o7¯,o4o 2o9,9Co ooo,19¯
Mohave 2C2,¯o1 4C,9C7 4o,o14 ¯,442 1o,o4o 11,CC2 o1,2¯o 19,¯¯o 42,9oo
Navajo 1C7,¯9o ¯1,¯9o 14,o2o 2,o42 7,¯1o 4,¯¯o 24,7o7 7,7¯o ¯4,C11
Pima 9o9,oo9 224,2oo 1oo,9¯o 1o,o7¯ 7¯,4oo 4¯,4o2 24o,2C9 77,1o9 197,C7o
Pinal ¯o2,992 99,o77 oo,o29 o,4C4 27,14o 1o,7Co 9C,C2o 27,oo¯ o1,oo¯
Santa Cruz 47,o7o 14,¯19 o,ooo 1,2Co ¯,212 1,912 1C,9C¯ ¯,4C7 12,44o
Yavapai 211,ooo ¯9,2o1 o¯,¯oC ¯,¯C4 1o,o¯4 11,9oo oo,47C 21,C2o ¯o,4oC
Yuma 2CC,o7C oo,oC4 ¯1,o47 4,o7C 1¯,o92 o,1¯2 4o,o44 14,¯oC 4¯,1C9
Totals 6,436,752 l,6l2,2l4 9l6,5l5 l35,662 463,ll5 265,547 l,523,899 472,6l8 l,l9l,535
ARIZONA
American Lung Association in Arizona
102 West McDowell Road
Phoenix, AZ 85003-1213
(602) 258-7505
www.lung.org/arizona
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 53
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Apache DNC DNC DNC DNC DNC C C C C.C A INC INC
Cochise 2 C C C.7 B C C C C.C A 7.C PASS
Coconino 4 C C 1.¯ C C C C C.C A o.9 PASS
Gila o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
La Paz 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Maricopa ¯1 C C 1C.¯ F 7 o C o.¯ F 9.9 PASS
Mohave DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Navajo C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Pima 4 C C 1.¯ C C C C C.C A o.4 PASS
Pinal 1C C C ¯.¯ F ¯ 2 C 2.C C 1¯.¯ FAIL
Santa Cruz DNC DNC DNC DNC DNC 1 1 C C.o B 11.1 PASS
Yavapai 2 C C C.7 B C C C C.C A 4.¯ PASS
Yuma 9 C C ¯.C D C C C C.C A INC INC
ARIZONA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 54
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Arkansas 1o,o92 4,419 ¯,11o ¯7o 1,¯9C 1,247 o,CCo 1,74C ¯,4¯9
Ashley 21,o92 o,2oo ¯,ooo 4oC 1,o74 1,412 o,oC7 1,97C 4,2o¯
Clark 22,ooo 4,¯7¯ ¯,4oo ¯74 1,7¯o 1,¯91 o,o22 1,94o 4,o7o
Crittenden oC,o2o 14,41o o,o29 1,2¯¯ ¯,4o9 2,79o 1¯,oo9 ¯,91¯ 1¯,27C
Faulkner 11o,¯42 2o,C74 11,oC9 2,4C1 o,¯o2 o,1o7 ¯C,¯9o o,oo1 1o,424
Garland 97,124 2C,2oC 2C,4o¯ 1,7¯2 7,¯21 7,C1o ¯¯,712 9,77¯ 19,o97
Jackson 17,ooo ¯,o9o 2,ooo ¯1o 1,¯o4 1,177 o,o9¯ 1,o4¯ ¯,79C
Newton o,2o4 1,ooo 1,7oo 144 o¯2 o19 2,9o2 oo2 1,742
Phillips 21,442 o,971 ¯,271 o11 1,4o¯ 1,¯1o o,¯o2 1,o¯o 7,21o
Polk 2C,o1C 4,79o 4,1Co 41C 1,o12 1,44o o,941 2,C14 4,o14
Pope o2,¯¯1 14,2oo o,¯9o 1,222 4,oo7 ¯,7C2 1o,Coo o,1o2 1¯,C2o
Pulaski ¯oo,299 92,o22 4o,9o2 7,912 2o,141 22,o4o 11C,2¯o ¯1,7C9 o¯,CCC
Sebastian 127,127 ¯1,9o1 1o,91o 2,7¯¯ 9,1C9 7,oo9 ¯o,74o 1C,ooo 2o,o1C
Union 41,427 9,o74 o,oC4 o44 ¯,C¯1 2,o7o 12,91o ¯,7¯o o,79C
Van Buren 17,Co¯ ¯,4C4 ¯,942 291 1,¯Co 1,¯C¯ o,2¯o 1,o1¯ ¯,719
Washington 2C7,o21 o2,o7¯ 2C,o21 4,49o 14,o¯o 1C,oo7 o2,ooC 14,97o 4C,19C
White 7o,1o7 1o,o4o 11,179 1,o9o o,ooo 4,o9o 22,oo2 o,ooo 1¯,4o4
Totals l,3l5,570 3l6,2l9 l74,506 27,042 95,278 77,837 378,982 l08,934 247,952
ARKANSAS
American Lung Association in Arkansas
217 W 2
nd
Street, Suite 105
Little Rock, AR 72201
(501) 975-0758
www.lung.org/arkansas
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 55
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Arkansas DNC DNC DNC DNC DNC C C C C.C A 1C.7 PASS
Ashley DNC DNC DNC DNC DNC C C C C.C A 1C.o PASS
Clark INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Crittenden 1o C C o.¯ F C C C C.C A 11.1 PASS
Faulkner DNC DNC DNC DNC DNC C C C C.C A 1C.o PASS
Garland DNC DNC DNC DNC DNC C C C C.C A 1C.o PASS
Jackson DNC DNC DNC DNC DNC C C C C.C A 1C.2 PASS
Newton C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Phillips DNC DNC DNC DNC DNC C C C C.C A 1C.7 PASS
Polk 7 C C 2.¯ D C C C C.C A 1C.o PASS
Pope DNC DNC DNC DNC DNC C C C C.C A 11.¯ PASS
Pulaski 1o C C o.C F 1 C C C.¯ B 12.1 FAIL
Sebastian DNC DNC DNC DNC DNC C C C C.C A INC INC
Union DNC DNC DNC DNC DNC C C C C.C A 11.1 PASS
Van Buren INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Washington o C C 1.7 C C C C C.C A 11.C PASS
White DNC DNC DNC DNC DNC C C C C.C A 11.¯ PASS
ARKANSAS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 56
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Alameda 1,o29,o7o ¯41,229 17o,29o 24,4¯C 1CC,C19 o2,7¯4 ¯o2,1oo 9¯,97C 19o,¯o2
Amador ¯7,9o¯ o,229 o,17C 44o 2,oo2 1,7¯o 11,oo9 ¯,¯47 4,o7C
Butte 22C,2oo 4o,14o ¯4,¯7¯ ¯,2¯2 14,7o1 o,¯4C oo,o7o 1o,1oo 4o,7o4
Calaveras 4o,Co2 o,oC2 9,o¯o o1o ¯,Co4 2,Co4 14,1Co 4,CCo o,oo¯
Colusa 21,o49 o,¯91 2,o74 4oo 1,27o o99 4,oo1 1,2o2 2,o2o
Contra Costa 1,Coo,C9o 2oC,2o4 1¯o,4o7 1o,o¯¯ o7,9C1 ¯7,oo2 2oo,179 o9,¯71 12o,4o7
El Dorado 1oC,9¯o 4C,Co1 27,7oo 2,o7C 11,o9o 7,17¯ 49,CC4 1¯,ooo 1o,49o
Fresno 942,9C4 27o,¯49 9o,9oo 19,92o oo,oo1 2o,oo9 191,o44 oC,o2¯ 2¯o,977
Glenn 2o,12o 7,791 ¯,7oo ooo 1,714 9o7 o,oCo 1,77C o,¯2o
Humboldt 1¯4,7o1 2o,4¯2 1o,22C 1,o92 9,12¯ o,CC2 ¯¯,o4o 9,Co4 27,7oC
Imperial 177,Co7 oC,9oo 1o,749 ¯,ooC 1C,oC¯ o,o1¯ ¯o,o¯¯ 9,7Co 4¯,2o9
Inyo 1o,47o ¯,o9C ¯,o97 27o 1,2¯¯ 7o2 o,¯¯¯ 1,49o 2,¯C4
Kern oo1,71C 2o4,ooo 77,79¯ 1o,2¯2 oC,1o7 2o,29o 1o7,ooo 44,C22 2CC,o71
Kings 1o¯,7oo 42,¯o2 12,¯oo ¯,C¯4 9,¯o4 4,oC4 29,o4o 7,ooo 27,949
Lake o4,¯2¯ 1¯,¯41 11,77C 9oo 4,¯C7 2,o91 1o,¯o1 o,142 14,oo7
Los Angeles 9,oo9,Coo 2,¯7o,¯7C 1,C99,9C4 17C,27o o¯1,724 ¯2o,o47 2,1o7,9Co ooC,411 1,7oo,oo1
Madera 1o2,92o 4¯,1¯o 17,7o¯ ¯,Coo 9,2¯9 4,941 ¯2,9o1 o,o12 ¯¯,9oo
Marin 2oo,C¯1 o2,4CC 44,29¯ ¯,7o1 17,11¯ 1C,oC9 71,ooo 19,99o 2¯,2¯o
Mariposa 1o,191 ¯,19o ¯,922 229 1,2oo o¯4 o,71o 1,o2C 2,o1o
Mendocino o7,oo¯ 19,¯oo 1¯,9o2 1,¯oo o,7o2 ¯,42¯ 2¯,2¯4 o,427 17,¯o7
Merced 2o9,o9o oC,991 2o,C¯4 o,79o 1o,C¯9 7,ooo oC,722 1¯,¯4C oo,¯71
Monterey 421,o9o 11¯,1C¯ 4o,ooo o,C97 2o,97C 1¯,497 o9,o99 2¯,7o4 o9,11¯
Napa 1¯o,Coo ¯1,o7o 21,147 2,2o1 o,979 o,19o ¯o,CoC 9,oC¯ 1o,C9¯
Nevada 9o,o12 1o,49o 19,oo2 1,¯24 o,77¯ 4,¯oo 29,oC9 o,4C4 11,ooC
Orange ¯,Coo,74o 7¯7,12C ¯o¯,7o2 o2,77¯ 19o,1o1 1C4,4oo o9o,4Co 1o7,1C7 ¯91,4oC
CALIFORNIA
American Lung Association in California
424 Pendleton Way
Oakland, CA 94621
(510)638-5864
www.lung.org/california
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 57
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Placer ¯o7,1¯o oo,o¯2 oo,4o7 o,1¯1 22,9C1 1¯,o2o 91,4o2 2o,2C1 29,9oo
Plumas 19,7oo ¯,oC¯ 4,279 2o1 1,¯7o 9Co o,2¯C 1,7o7 2,o7o
Riverside 2,2¯9,o2C o2¯,C94 2oo,72¯ 44,oC9 1¯o,C4o 7¯,244 4oo,747 1¯C,o7o ¯71,9¯C
Sacramento 1,4¯o,1Co ¯o2,1oo 1o4,o4¯ 2o,92o 9C,¯oC 4o,Co¯ ¯21,1C9 oo,oo4 2oC,o42
San Benito oo,C72 1o,94¯ o,o¯2 1,141 ¯,¯7o 1,7o9 11,99o ¯,21o o,9C9
San Bernardino 2,Coo,¯77 o9¯,2Co 1oo,9oo 42,47C 12¯,7oC o2,7¯o 41o,o9o 1C9,ooo ¯91,911
San Diego ¯,14C,Co9 72o,oC2 ¯o2,92o o2,C2C 2C¯,C11 1Co,2o4 7C7,Co1 1o7,oCo 4o2,997
San Francisco o12,o2o 1C9,429 111,9Co 7,o¯4 o9,1o¯ ¯C,99¯ 2Co,ooo o4,4o1 11C,2oC
San Joaquin o9o,214 2C1,44o 7¯,o91 14,422 41,o2o 21,911 14o,1¯4 ¯o,9¯7 124,o7¯
San Luis Obispo 271,9o9 49,94¯ 42,o41 ¯,o7o 1o,7Co 1C,o9o 71,1o2 19,¯4¯ ¯o,o2o
San Mateo 727,2C9 1oC,4o2 99,C11 11,4o7 47,749 2o,o¯9 179,19o 4o,o44 oo,o7o
Santa Barbara 42o,o7o 9o,7¯o oo,o4o o,92o 27,772 14,7o9 9o,2o2 2o,1o4 o¯,212
Santa Clara 1,oC9,¯7o 4¯2,¯oo 2C4,92o ¯C,9o4 11o,oo1 o1,C1o 4C7,122 1Co,o2o 19C,CCo
Santa Cruz 2o4,29o o4,ooo ¯C,o4C ¯,92o 17,o29 9,¯7¯ o2,794 1o,o¯C ¯7,9o2
Shasta 177,774 ¯9,1oo ¯C,7o4 2,oCo 11,o97 7,Coo 4o,Co¯ 1¯,¯2o ¯4,C¯1
Siskiyou 44,oC7 9,12o o,942 oo¯ 2,991 1,929 1¯,19C ¯,71o 1C,7¯C
Solano 41o,471 1CC,1oC 4o,7o7 7,17C 2o,o4C 14,472 97,¯C9 2o,272 o4,912
Sonoma 4oo,11o 1Co,C¯1 7C,¯C4 7,o91 ¯2,212 1o,429 124,oCo ¯4,C7o oo,¯94
Stanislaus o1o,o22 14o,49o oo,oo¯ 1C,4oo ¯1,¯C¯ 1o,o47 11C,¯94 29,447 119,¯2o
Sutter 94,919 2o,7o1 12,¯o9 1,o44 o,o2o ¯,22C 21,oo1 o,o21 14,o¯1
Tehama o¯,oC1 1o,ooC 1C,¯o9 1,1¯o 4,C2o 2,414 1o,¯4o 4,o1o 12,244
Trinity 1¯,72¯ 2,47o 2,o¯2 177 9o2 o22 4,27o 1,212 2,oo1
Tulare 449,2o¯ 14o,2¯2 4¯,1C1 1C,¯9o 2o,oo9 1¯,C7o oo,oo¯ 22,o¯C 11¯,7oo
Tuolumne o4,9o¯ 9,¯oC 11,oCo o72 ¯,oo1 2,4o9 1o,7oo 4,7C¯ o,42C
Ventura o¯1,771 21C,¯o1 1CC,114 1o,CoC o2,¯29 2o,o1o 191,41¯ o1,o¯o 94,o2o
Yolo 2C2,Co4 44,19o 2C,oCo ¯,1o4 1¯,2oo o,o24 42,oo4 11,117 41,7oo
Totals 37,528,434 9,233,l66 4,379,485 66l,030 2,38l,033 l,265,070 8,444,352 2,255,875 6,092,592
CALIFORNIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 58
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Alameda 11 1 C 4.2 F 7 C C 2.¯ D 9.C PASS
Amador o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Butte 2¯ C C 7.7 F o C C 2.C C 1C.1 PASS
Calaveras 19 C C o.¯ F C C C C.C A 7.¯ PASS
Colusa 1 C C C.¯ B C C C C.C A o.¯ PASS
Contra Costa 1C C C ¯.¯ F o C C 1.7 C 7.o PASS
El Dorado oC 2 C 21.C F DNC DNC DNC DNC DNC DNC DNC
Fresno 1¯o 2o C oo.¯ F 79 2o C 4C.¯ F 17.C FAIL
Glenn C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Humboldt C C C C.C A C C C C.C A o.4 PASS
Imperial 49 C C 1o.¯ F 9 1 C ¯.o F 14.C FAIL
Inyo o C C 2.C C 12 7 1 o.2 F 7.¯ PASS
Kern 199 24 C 7o.¯ F 74 41 2 4o.o F 1o.2 FAIL
Kings 9o 7 C ¯o.2 F o9 21 C 4C.2 F 1o.2 FAIL
Lake C C C C.C A C C C C.C A ¯.¯ PASS
Los Angeles 2Co 2¯ ¯ o1.o F oC 1C C 2o.C F 1¯.9 FAIL
Madera 4o 4 C 1o.C F INC INC INC INC INC INC INC
Marin C C C C.C A o C C 1.7 C INC INC
Mariposa 2o 1 C o.o F DNC DNC DNC DNC DNC DNC DNC
Mendocino C C C C.C A C C C C.C A o.o PASS
Merced 47 1 C 1o.2 F 4o 2 C 1o.C F 1o.2 FAIL
Monterey 1 C C C.¯ B C C C C.C A o.1 PASS
Napa ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Nevada ¯o C C 12.C F C C C C.C A o.C PASS
Orange 1o 1 C o.o F 19 1 C o.o F 11.2 PASS
Placer oo 2 C 19.7 F 1 C C C.¯ B 7.9 PASS
CALIFORNIA
American Lung Association in California
424 Pendleton Way
Oakland, CA 94621
(510)638-5864
www.lung.org/california
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 59
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Plumas DNC DNC DNC DNC DNC 1C 1 C ¯.o F 1C.¯ PASS
Riverside 2¯¯ 49 C 1C2.2 F 1C¯ o C ¯o.o F 1o.2 FAIL
Sacramento oo 14 C ¯o.¯ F 11 C C ¯.7 F 1C.C PASS
San Benito 2 C C C.7 B C C C C.C A o.o PASS
San Bernardino 227 oo o 121.o F 9 1 C ¯.o F 1¯.7 FAIL
San Diego 47 1 C 1o.2 F o 4 C 4.7 F 11.o PASS
San Francisco C C C C.C A o C C 2.C C 9.9 PASS
San Joaquin 19 1 C o.o F 27 o C 11.o F 11.1 PASS
San Luis Obispo ¯C C C 1C.C F 2 C C C.7 B 7.7 PASS
San Mateo 1 C C C.¯ B 2 C C C.7 B INC INC
Santa Barbara 12 C C 4.C F C C C C.C A 9.9 PASS
Santa Clara 1o C C o.C F o C C 2.7 D 9.o PASS
Santa Cruz C C C C.C A C C C C.C A o.2 PASS
Shasta 4 C C 1.¯ C C C C C.C A o.¯ PASS
Siskiyou C C C C.C A C C C C.C A o.1 PASS
Solano 7 C C 2.¯ D 11 C C ¯.7 F 9.1 PASS
Sonoma C C C C.C A C C C C.C A o.C PASS
Stanislaus 4¯ 2 C 1o.¯ F 7o 17 C ¯¯.o F 1o.¯ FAIL
Sutter o C C 2.C C 9 2 C 4.C F 7.¯ PASS
Tehama 17 C C o.7 F INC INC INC INC INC INC INC
Trinity DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Tulare 2¯4 19 C o7.o F 1o o C 7.o F 1o.2 FAIL
Tuolumne 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Ventura 4o C C 1o.¯ F C C C C.C A 9.¯ PASS
Yolo 4 C C 1.¯ C 1 C C C.¯ B o.9 PASS
CALIFORNIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 60
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Adams 4o1,44¯ 12o,4¯C ¯o,49C 1C,9o¯ 2o,777 1¯,o1o oC,2oC 19,o79 71,o1¯
Arapahoe oo4,94o 147,979 oC,oo7 12,ooo ¯o,2o2 19,oCC 11o,419 2o,o2¯ o9,4¯o
Boulder 299,¯7o o2,¯4o ¯1,429 o,¯¯2 19,ooo 1C,o2o o1,o7¯ 1o,19o 4C,C2o
Denver o19,9oo 1¯4,471 o¯,7oC 11,499 4C,21o 2C,o¯2 119,oC2 29,¯94 11¯,71¯
Douglas 292,1o7 oo,972 22,oo1 7,4¯7 17,C¯7 9,C1C o¯,o¯C 1¯,1oo 12,4oo
Elbert 2¯,174 o,o¯2 2,41o 4o2 1,4oC ooC o,279 1,¯17 1,o2o
El Paso o¯o,9o¯ 1o¯,7o4 o4,9o1 14,CCo ¯9,247 21,2o4 124,o14 ¯C,o17 o1,ooo
Garfield oo,27C 1o,1¯C o,C12 1,294 ¯,414 1,o1¯ 1C,oo¯ 2,o29 o,921
Gunnison 1o,4Co 2,7o4 1,419 2¯o 1,C49 o¯2 ¯,Coo 7o4 2,oC9
Jackson 1,¯7C 242 2o9 21 94 o2 ¯72 9o 221
Jeíerson o¯9,oo4 117,o9o 7C,9o4 1C,Coo ¯o,Coo 2C,o94 122,4o9 ¯C,oo2 47,ooo
La Plata o1,917 1C,¯79 o,¯4o ooo ¯,447 1,947 11,49o 2,oo2 o,oo4
Larimer ¯Co,o2o o¯,77¯ ¯7,o7o o,4o4 2C,C4o 11,1oC oo,C71 1o,1oo 41,1oo
Logan 22,o19 4,42C ¯,¯oo ¯7o 1,oC9 ooo o,1o4 1,¯C2 ¯,¯o1
Mesa 147,Co¯ ¯4,¯o2 22,¯o9 2,94C 9,¯oC o,oo7 ¯¯,29o o,4Co 17,o21
Moíat 1¯,4o1 ¯,ooo 1,49C ¯Co o21 4oo 2,7o4 o94 1,o9¯
Montezuma 2o,442 o,o¯1 4,¯4o 499 1,o29 1,C4o o,2¯4 1,ooo 4,1¯1
Morgan 2o,17o 7,921 4,CoC o77 1,ooC 1,C1o o,9o7 1,oC7 4,247
Pitkin 17,1C2 2,9¯7 2,1o7 2o1 1,17o o7o 4,C2o 1,CCo 1,274
Pueblo 1oC,o4o ¯o,o4C 2o,CCo ¯,¯21 1C,C97 o,197 ¯o,4¯1 9,21o 29,o74
Rio Blanco o,7o2 1,ooo o49 144 42¯ 24o 1,44o ¯o2 ooC
Weld 2oo,o¯o 71,121 2o,o7C o,Co2 1o,o49 o,¯oo 4o,o4¯ 12,Co9 ¯o,¯¯1
Totals 4,558,252 l,ll0,296 495,l77 94,949 285,987 l56,778 9l8,780 227,748 593,062
COLORADO
American Lung Association in Colorado
5600 Greenwood Plaza Blvd., Suite 100
Greenwood Village, CO 80111-2316
(303) 388-4327
www.lung.org/colorado
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 61
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Adams o C C 1.7 C 1 C C C.¯ B o.1 PASS
Arapahoe 14 C C 4.7 F C C C C.C A o.¯ PASS
Boulder 7 C C 2.¯ D 2 C C C.7 B o.9 PASS
Denver 2 C C C.7 B C C C C.C A 7.o PASS
Douglas 19 1 C o.o F C C C C.C A o.7 PASS
Elbert DNC DNC DNC DNC DNC C C C C.C A INC INC
El Paso o C C 1.7 C C C C C.C A o.9 PASS
Garfield C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Gunnison INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Jackson INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Jeíerson 2¯ 1 C o.2 F DNC DNC DNC DNC DNC DNC DNC
La Plata o C C 2.7 D C C C C.C A INC INC
Larimer 2C C C o.7 F C C C C.C A o.¯ PASS
Logan INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Mesa C C C C.C A o 1 C ¯.2 D o.o PASS
Moíat INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Montezuma 2 C C C.7 B C C C C.C A o.¯ PASS
Morgan INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Pitkin INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Pueblo INC INC INC INC INC C C C C.C A INC INC
Rio Blanco INC INC INC INC INC INC INC INC INC INC INC INC
Weld o C C 2.7 D 1 C C C.¯ B 7.o PASS
COLORADO
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 62
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Fairfield 92o,o99 22o,71o 12o,ooo 2o,414 o9,411 42,o71 227,C24 oo,7o2 oo,24C
Hartford o94,7Co 2CC,7oo 1¯1,7o7 22,oC7 oo,o7o 42,o¯C 227,C1o oo,929 1C7,9o4
Litchfield 1oo,7o9 ¯9,oo2 ¯C,992 4,4oo 14,47o 9,o¯o o2,242 1o,¯o9 14,o¯¯
Middlesex 1oo,C4¯ ¯4,414 2o,¯¯7 ¯,o7o 12,oo4 o,¯2C 44,o2¯ 1¯,127 1C,ooo
New Haven oo1,11¯ 1oo,922 12o,ooo 21,271 oo,729 4C,o¯o 217,¯9¯ o2,974 1Co,C¯o
New London 27¯,oC2 oo,C¯o ¯9,o7o o,o¯o 21,¯2o 1¯,191 7C,¯2C 2C,4C1 2¯,oo4
Tolland 1o2,oC7 29,9oo 1o,722 ¯,¯7o 12,¯11 7,1o1 ¯7,4oo 1C,oo9 1C,9oo
Windham 11o,1o1 2o,771 1o,o4o 2,9C2 9,2CC o,o49 29,¯4C o,4o1 12,C21
Totals 3,580,709 803,3l4 5l5,459 90,448 275,0l4 l69,895 905,626 262,7l2 373,284
CONNECTICUT
American Lung Association in Connecticut
45 Ash Street
East Hartford, CT 06108-3272
(860) 838-4376
www.lung.org/connecticut
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 63
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Fairfield ¯2 2 C 11.7 F 2 1 C 1.2 C 9.4 PASS
Hartford 7 C C 2.¯ D 2 C C C.7 B 9.C PASS
Litchfield ¯ C C 1.C C C C C C.C A o.7 PASS
Middlesex 1¯ C C 4.¯ F DNC DNC DNC DNC DNC DNC DNC
New Haven 14 4 C o.7 F 4 C C 1.¯ C 9.o PASS
New London 1¯ C C 4.¯ F 1 C C C.¯ B o.4 PASS
Tolland o 1 C ¯.2 D DNC DNC DNC DNC DNC DNC DNC
Windham INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
CONNECTICUT
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 64
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Kent 1o4,o¯4 4C,¯4¯ 22,o91 ¯,4oC 12,2oC o,44o 4o,94o 11,oo9 2¯,941
New Castle o41,971 12¯,79o o7,o49 1C,oo7 41,¯9o 2C,9o¯ 1oC,o22 ¯o,oC1 o2,o74
Sussex 2CC,¯¯C 4C,o27 42,724 ¯,4oo 1o,C¯o 9,o27 o7,2o7 1o,1oo 24,¯o1
Totals 907,l35 204,668 l33,464 l7,503 68,69l 36,938 263,835 68,675 lll,l76
DELAWARE
American Lung Association in Delaware
630 Churchmans Road, Suite 202
Newark, DE 19702
(302) 737-6414
www.lung.org/delaware
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 65
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Kent o C C 2.7 D C C C C.C A 9.4 PASS
New Castle 2o 2 C 9.7 F o 1 C ¯.2 D 1C.7 PASS
Sussex 1¯ 2 C o.¯ F C C C C.C A 9.4 PASS
DELAWARE
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 66
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
District of Columbia o17,99o 1Co,¯¯4 7C,179 19,¯¯C o1,oo¯ 22,o41 1oo,o97 44,o1o 111,9Co
Totals 6l7,996 l05,334 70,l79 l9,330 5l,553 22,84l l56,697 44,5l6 lll,906
DISTRICT OF COLUMBIA
American Lung Association in the District of Columbia
1301 Pennsylvania Ave. NW #800
Washington, DC, DC 20004
1-800-LUNG USA
www.lung.org/districtofcolumbia
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 67
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
District of Columbia ¯C 1 C 1C.o F ¯ 1 C 1.o C 1C.o PASS
DISTRICT OF COLUMBIA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 68
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Alachua 249,¯oo 4¯,41o 27,7¯9 ¯,71¯ 1o,o¯4 1¯,9¯9 o¯,o¯7 1o,o1o oo,o79
Baker 27,1o4 o,971 ¯,12o o9o 1,oo2 1,491 o,9¯C 1,o7o 4,oC2
Bay 1o9,ooo ¯o,oo1 2o,19o ¯,1o2 1C,2Co 1C,¯C9 4o,¯Co 1¯,¯4o 2¯,927
Brevard o4¯,ooo 1Co,29o 11¯,C41 9,CC4 ¯¯,o1C ¯7,2¯o 177,C47 oC,ooo 7o,oo9
Broward 1,7oC,172 ¯91,7¯¯ 2o4,724 ¯¯,499 1Co,o4o 1Co,oCo 49o,711 1¯7,2o7 2o¯,4¯o
Citrus 14C,C¯1 21,o¯9 4o,9o2 1,ooC o,o92 11,¯7o o4,99o 1o,2o¯ 2¯,7oo
Collier ¯2o,1¯4 o¯,C9o o9,¯C¯ o,¯9o 19,oo¯ 2¯,o9¯ 11¯,¯o9 ¯2,ooo o2,oo¯
Columbia o7,4oo 14,9oo 1C,72C 1,2oC 4,C24 4,14o 19,4oC o,41o 1¯,o44
Duval o7C,7C9 2C¯,17o 99,4¯o 17,¯7o o1,29o 4o,ooC 22o,oo7 oC,7oC 1oC,o91
Escambia 299,114 o¯,99o 4¯,ooo o,47¯ 17,9o9 17,94o o¯,o4o 2¯,C11 o2,Co1
Flagler 97,¯7o 1o,oo7 24,oo9 1,o1o o,942 o,9oo ¯¯,44¯ 9,oo7 14,21o
Highlands 9o,o¯C 17,o99 ¯2,Co9 1,o¯1 o,CC4 7,o2o ¯o,77o 1C,o2o 1o,2o2
Hillsborough 1,2o7,77o 29o,o79 1oC,o44 2o,2oo 74,o91 71,21C ¯¯C,¯oC o9,147 219,9oC
Holmes 19,o7¯ 4,2oo ¯,494 ¯o4 1,192 1,2o¯ o,9C¯ 1,oo2 4,722
Indian River 1¯o,o94 2o,791 ¯o,¯11 2,2Co o,o2¯ 1C,27o 49,¯19 14,¯7C 19,CCo
Lake ¯C1,C19 o1,ooo 74,2o7 o,291 1o,C4C 2C,9o7 1CC,Coo 2o,o¯7 41,2o7
Lee o¯1,¯¯C 122,¯14 1o2,¯7o 1C,4oC ¯o,4o1 44,1oo 21C,4oo oC,442 9o,422
Leon 277,971 o2,412 27,¯¯7 4,4o2 17,174 1o,CoC oo,o9C 17,72o o9,o¯o
Liberty o,¯14 1,7o4 92¯ 1o1 oC¯ 471 2,179 oo¯ 1,o17
Manatee ¯27,142 oo,72¯ 77,44C o,7Co 19,71C 22,o4o 1Co,CC4 ¯1,C4o o1,221
Marion ¯¯2,o29 o¯,¯4¯ o7,¯4o o,417 2C,279 2¯,9o4 114,o4o ¯¯,19C o7,1C4
Martin 147,49o 2o,o¯9 4C,oo4 2,19¯ 9,2C7 11,11¯ o¯,¯o1 1o,oo9 1o,2o1
Miami-Dade 2,oo4,7oo o4o,¯o9 ¯o¯,o99 4o,722 1o¯,411 1oC,997 7C¯,o¯9 191,o47 o27,CCC
Okaloosa 1o¯,4o2 4C,o¯4 2o,C¯o ¯,47o 1C,9oo 1C,921 o1,C49 14,C2o 24,477
Orange 1,1o9,1C7 27¯,117 11o,14¯ 2¯,¯oo oo,o¯9 o2,¯o4 2oo,oC9 7o,o4o 21C,ooo
FLORIDA
American Lung Association in Florida
6852 Belfort Oaks Place
Jacksonville, FL 32216
(904) 743-2933
www.lung.org/florida
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 69 FLORIDA
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Osceola 27o,1o¯ 71,o21 ¯1,2o9 o,12o 1o,o94 14,92¯ o9,177 1o,o¯o 4¯,oC7
Palm Beach 1,¯¯o,1o7 27C,o¯C 29C,9o4 2¯,14¯ oC,oo2 o9,4oo 424,¯o¯ 12C,ooo 2C7,441
Pasco 4oo,4o7 97,¯o4 97,9oo o,¯2o 2o,C42 ¯1,C¯o 147,27¯ 41,o77 72,121
Pinellas 917,¯9o 1oC,7o1 19o,oC7 1¯,749 o7,7o4 o4,2C1 ¯Co,1o7 o7,1C2 1¯4,72o
Polk oC9,492 141,472 111,o92 12,C9o ¯o,ooC ¯7,oCC 17o,224 49,9o¯ 114,o1o
St. Lucie 2oC,¯79 o1,o4¯ o7,21C o,2o¯ 1o,o2C 1o,272 oo,oC9 24,ooo oo,¯o7
Santa Rosa 1o4,1C4 ¯o,122 2C,274 ¯,Co9 9,C9o 9,C44 42,¯C9 11,o44 1o,o4o
Sarasota ¯o2,21¯ o9,2oo 121,C7o o,Coo 24,2¯1 ¯C,4C2 14o,o72 4¯,141 44,C1C
Seminole 42o,C71 9o,17o o2,oo9 o,1¯9 2o,4C9 24,o91 11o,C2¯ ¯1,¯4¯ 4o,o94
Volusia 494,oC4 91,947 1Co,oC¯ 7,oo¯ ¯C,o77 ¯4,Co4 1o1,92C 4o,1o2 o4,C21
Wakulla ¯C,97o o,7o¯ ¯,oCC ooC 1,o71 1,794 o,¯44 2,2oo 4,C2o
Totals l7,403,535 3,660,527 3,0l8,569 3l3,034 l,047,730 l,09l,l57 5,l3l,3l0 l,429,632 2,905,632
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 70
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Alachua C C C C.C A C C C C.C A 7.7 PASS
Baker C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Bay ¯ C C 1.C C INC INC INC INC INC INC INC
Brevard C C C C.C A C C C C.C A o.o PASS
Broward C C C C.C A 1 C C C.¯ B o.o PASS
Citrus DNC DNC DNC DNC DNC C C C C.C A 7.¯ PASS
Collier C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Columbia C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Duval ¯ C C 1.C C 4 2 C 2.¯ D o.4 PASS
Escambia 7 C C 2.¯ D C C C C.C A 9.C PASS
Flagler INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Highlands C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Hillsborough 12 C C 4.C F C C C C.C A 7.o PASS
Holmes C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Indian River INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Lake ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Lee C C C C.C A C C C C.C A o.9 PASS
Leon C C C C.C A 1 C C C.¯ B 9.9 PASS
Liberty INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Manatee 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Marion 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Martin INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Miami-Dade ¯ C C 1.C C 1 C C C.¯ B 7.o PASS
Okaloosa ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Orange o C C 2.7 D C C C C.C A 7.¯ PASS
Osceola 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
FLORIDA
American Lung Association in Florida
6852 Belfort Oaks Place
Jacksonville, FL 32216
(904) 743-2933
www.lung.org/florida
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 71
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Palm Beach 2 C C C.7 B 2 1 C 1.2 C o.¯ PASS
Pasco C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Pinellas 1 C C C.¯ B C C C C.C A 7.7 PASS
Polk 2 C C C.7 B C C C C.C A 7.o PASS
St. Lucie C C C C.C A INC INC INC INC INC INC INC
Santa Rosa o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Sarasota o C C 1.7 C C C C C.C A o.o PASS
Seminole 2 C C C.7 B C C C C.C A 7.o PASS
Volusia C C C C.C A 1 C C C.¯ B INC INC
Wakulla 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
FLORIDA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 72
GEORGIA
American Lung Association in Georgia
2452 Spring Road
Smyrna, GA 30080-3862
(770) 434-5864
www.lung.org/georgia
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Bibb 1oo,4¯¯ 4C,112 2C,C72 ¯,4¯C 11,122 o,4oo 42,¯o4 12,71¯ ¯o,2o¯
Chatham 271,o44 o1,2CC ¯¯,oo7 o,2¯4 2C,1o1 14,7¯4 7¯,222 21,o7¯ oo,¯o4
Chattooga 2o,7¯o o,74o ¯,ooC 491 1,9C7 1,oCo 7,oo7 2,29o o,¯¯o
Clarke 117,¯44 2C,¯Co 1C,¯C4 1,7¯o 9,42o o,o94 27,o47 7,oo7 42,¯o7
Clayton 2o1,o¯2 7o,912 1o,CC4 o,492 17,oo7 12,C29 o9,Co¯ 1o,7¯o o4,o91
Cobb o97,oo¯ 17o,2o4 o¯,277 1o,C7o 49,992 ¯o,o9o 17o,oo9 o1,¯17 9C,o2C
Columbia 12o,112 ¯4,C99 1¯,4¯o 2,91o o,9oo o,7o4 ¯¯,o1C 9,9o¯ 1C,¯97
Coweta 129,o29 ¯4,o44 1¯,9oo 2,9o¯ 9,Coo o,794 ¯¯,oC1 1C,C21 17,9C9
Dawson 22,4o9 4,91o ¯,¯o9 42C 1,o7C 1,¯oC o,7o2 2,C72 2,o9o
DeKalb o99,o9¯ 1o7,CCC oo,4o1 14,2o1 o1,21¯ ¯o,7o9 17o,o14 o1,C1o 1¯o,92o
Dougherty 94,7oo 24,417 11,71C 2,Coo o,742 o,C1o 24,97o 7,4¯9 2o,1o9
Douglas 1¯¯,¯oo ¯7,C71 12,CC7 ¯,17C 9,2¯2 o,o2¯ ¯2,7oC 9,ooC 21,2o1
Floyd 9o,9o9 2¯,C14 1¯,o77 1,9oo o,97C o,4¯7 27,221 o,249 1o,99o
Fulton 949,o99 224,779 o7,14o 19,222 o9,o94 4o,2oo 2¯o,129 oo,o14 1o¯,9¯1
Glynn oC,¯oo 19,194 12,o17 1,o41 o,o29 4,711 2¯,o72 7,2o4 1o,o42
Gwinnett o24,941 2¯o,7¯7 o9,17C 2C,24o oo,oCC ¯9,C7o 192,¯99 oo,C42 12o,o92
Hall 1o¯,Co2 oC,o1o 21,C21 4,¯4o 12,oo9 9,¯7o 4o,ooo 1¯,o4o ¯1,9¯1
Henry 2C7,¯oC oo,7o9 1o,1oo o,C2o 14,242 1C,24¯ oC,7C1 14,7o9 2o,7¯9
Houston 14¯,92o ¯7,92C 1o,Coo ¯,24¯ 1C,1o4 7,4o1 ¯o,997 1C,9CC 2C,29o
Lowndes 111,ooo 27,1o1 1C,99o 2,¯22 o,1oo o,oo¯ 27,¯o2 7,ooo 2o,oCo
Murray ¯9,oo7 1C,4o1 4,o19 o9o 2,7o2 2,Coo 1C,¯97 ¯,C9¯ 9,o94
Muscogee 194,1C7 49,11¯ 22,41o 4,2CC 1¯,9Co 1C,1¯¯ oC,¯2o 14,ooo ¯7,Co¯
Paulding 14¯,o42 42,2o¯ 1C,o9C ¯,o14 9,7¯2 o,7¯2 ¯¯,1o4 9,o11 1o,o7C
Pike 17,7o1 4,o7o 2,27o 4CC 1,247 97o 4,o9o 1,479 2,44C
Richmond 2C1,217 49,oo¯ 2¯,29o 4,24o 14,o¯C 1C,o47 o2,9CC 1o,o¯o 4o,Coo
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 73 GEORGIA
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Rockdale oo,7oo 22,o22 9,ooo 1,92o o,C41 4,o9¯ 22,o9¯ o,o22 1¯,1oC
Sumter ¯2,o11 o,121 4,2o¯ o94 2,¯¯o 1,7o2 o,7o7 2,o¯2 o,79¯
Walker oo,o4o 1o,o2¯ 1C,o97 1,¯o¯ o,Co¯ 4,Coo 2C,41o o,24o 12,4o¯
Washington 21,111 4,9C7 2,94o 42C 1,o4o 1,219 o,1Co 1,oo1 o,CC4
Wilkinson 9,444 2,2o4 1,o2o 19o oo1 ooo 2,o49 ooC 1,7C2
Totals 6,l49,368 l,569,929 599,788 l34,252 439,502 3l3,360 l,550,727 45l,933 l,l25,729
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 74
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Bibb 1C C C ¯.¯ F 1 1 C C.o B 1¯.4 FAIL
Chatham C C C C.C A o C C 1.7 C 1C.7 PASS
Chattooga C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Clarke o C C 1.7 C C C C C.C A 1C.o PASS
Clayton DNC DNC DNC DNC DNC C C C C.C A 12.o FAIL
Cobb 2o C C o.7 F 1 C C C.¯ B 11.¯ PASS
Columbia 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Coweta C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Dawson 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
DeKalb 1o 1 C o.o F 2 1 C 1.2 C 11.9 PASS
Dougherty DNC DNC DNC DNC DNC 4 1 C 1.o C 12.1 FAIL
Douglas 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Floyd DNC DNC DNC DNC DNC 2 ¯ C 2.2 D 12.4 FAIL
Fulton 29 C C 9.7 F 2 C C C.7 B 1¯.¯ FAIL
Glynn C C C C.C A ¯ C C 1.C C INC INC
Gwinnett 12 C C 4.C F C C C C.C A INC INC
Hall DNC DNC DNC DNC DNC C C C C.C A 1C.7 PASS
Henry 1o C C o.C F DNC DNC DNC DNC DNC DNC DNC
Houston DNC DNC DNC DNC DNC C C C C.C A 11.¯ PASS
Lowndes DNC DNC DNC DNC DNC 2 1 C 1.2 C 1C.4 PASS
Murray o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Muscogee 1 C C C.¯ B ¯ C 1 1.7 C 12.7 FAIL
Paulding o C C 1.7 C C C C C.C A INC INC
Pike INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Richmond 4 C C 1.¯ C 1 1 C C.o B INC INC
Rockdale 22 C C 7.¯ F DNC DNC DNC DNC DNC DNC DNC
GEORGIA
American Lung Association in Georgia
2452 Spring Road
Smyrna, GA 30080-3862
(770) 434-5864
www.lung.org/georgia
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 75
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Sumter C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Walker DNC DNC DNC DNC DNC C C C C.C A 1C.1 PASS
Washington DNC DNC DNC DNC DNC 2 C C C.7 B INC INC
Wilkinson DNC DNC DNC DNC DNC 1 1 1 1.o C 1¯.1 FAIL
GEORGIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 76
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Hawaii 1oo,7¯o 42,11o 2o,27¯ 4,oC1 1¯,7o7 o,oo¯ 47,41¯ 12,9o2 ¯7,42o
Honolulu 9o¯,oC7 211,oo¯ 142,o¯C 2¯,11¯ 71,ooC ¯¯,Co4 2¯1,oCo o¯,C2o 9o,7o9
Kauai o7,7C1 1o,179 1C,o12 1,ooo 4,99¯ 2,42o 17,29C 4,72o o,o¯7
Maui 1oo,o74 ¯o,7o7 2C,9C2 ¯,9C7 11,o9o o,4Co ¯7,9oo 1C,¯11 19,77¯
Totals l,374,720 304,604 202,5l7 33,279 l02,2l5 47,58l 334,l73 9l,0l9 l6l,607
HAWAII
American Lung Association in Hawaii
650 Iwilei Rd., Suite 208
Honolulu, HI 96817
(808) 537 5966
www.lung.org/hawaii
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 77
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Hawaii DNC DNC DNC DNC DNC ¯C o C 12.o F 1o.o FAIL
Honolulu C C C C.C A 1 1 C C.o B o.o PASS
Kauai DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Maui DNC DNC DNC DNC DNC C C C C.C A 4.9 PASS
HAWAII
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 78
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Ada 4CC,o42 1C4,¯o¯ 4¯,497 o,92o 27,¯C1 14,921 91,o1o 2o,o41 o2,¯7o
Bannock o¯,o91 22,o4o 9,o4C 1,9¯7 o,o42 ¯,Coo 1o,77o o,4o¯ 1o,222
Benewah 9,2C9 2,149 1,77C 1o4 ooo 444 2,oo9 o11 1,4oo
Butte 2,o22 7oo 49o oo 19C 12o 7oo 2¯4 4o4
Canyon 191,o94 o9,721 21,49o o,1C7 12,2C4 o,71¯ 41,1o7 11,997 ¯7,79o
Cassia 2¯,1oo 7,oo4 ¯,CC4 o49 1,44o ooC o,1oo 1,o27 ¯,797
Franklin 12,ooC 4,479 1,o7¯ ¯o¯ 777 4o9 2,7o¯ o22 1,41C
Kootenai 141,1¯2 ¯4,42o 2C,979 2,944 9,o7C o,9o4 ¯o,2o9 1C,o29 22,¯7C
Lemhi 7,9o7 1,o4o 1,o21 1¯2 o9o 42o 2,o4o 7o¯ 1,4o4
Power 7,7oo 2,¯9o 9oo 2Co 49o 291 1,771 o2o 1,¯2C
Shoshone 12,o72 2,o19 2,ooo 224 9¯4 o¯¯ ¯,7oo 1,1o¯ 2,449
Totals 893,83l 242,72l l07,795 20,757 60,ll3 33,906 207,526 60,975 l40,l63
IDAHO
American Lung Association in Idaho
1412 W. Idaho St. Suite 100
Boise, ID 83702
(208) 345-5864
www.lung.org/idaho
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 79 IDAHO
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Ada 2 C C C.7 B 4 C C 1.¯ C o.1 PASS
Bannock DNC DNC DNC DNC DNC 1 C C C.¯ B o.2 PASS
Benewah DNC DNC DNC DNC DNC 1C C C ¯.¯ F 9.C PASS
Butte C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Canyon DNC DNC DNC DNC DNC 1 C C C.¯ B 7.4 PASS
Cassia INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Franklin DNC DNC DNC DNC DNC 11 o C o.2 F INC INC
Kootenai C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Lemhi DNC DNC DNC DNC DNC ¯C 2 C 11.C F 1C.9 PASS
Power DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Shoshone DNC DNC DNC DNC DNC 44 2 C 1o.7 F 12.C PASS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 80
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Adams o7,1o9 1o,¯¯9 11,7oC 1,1C7 4,244 ¯,¯77 19,¯C4 o,oo2 1C,¯22
Champaign 2C1,ooo ¯o,¯9o 2C,o1C 2,771 1¯,12o 9,Coo 47,4o1 1¯,¯47 4¯,4o4
Clark 1o,1o1 ¯,o44 2,9C2 2o¯ 1,C2o o2o 4,7o2 1,¯9o 1,9oo
Cook o,217,CoC 1,224,o1¯ o¯C,o14 oo,¯7o ¯24,¯4¯ 2¯7,4¯C 1,¯Co,o27 ¯74,19o 912,Co7
DuPage 92¯,222 22o,¯1o 11C,CoC 1o,2oo o7,Coo 42,441 2¯o,79o oo,72o 71,C4C
Eíngham ¯4,2oC o,¯2C o,22o oCC 2,12o 1,oo¯ 9,414 2,744 ¯,o1o
Hamilton o,42o 1,o97 1,oo4 1¯7 o¯o 441 2,oo1 7o4 1,2o7
Jersey 22,91o o,117 ¯,7C¯ ¯o9 1,4o9 1,142 o,o22 1,9C4 2,17o
Jo Daviess 22,712 4,o41 4,ooo ¯¯o 1,492 1,2o¯ 7,¯oo 2,1oo 2,17o
Kane o2C,271 149,Co4 o1,oCo 1C,7oo ¯C,227 21,o4¯ 12C,o91 ¯4,419 o4,ooC
Lake 7Co,222 1o9,497 7o,1C1 1¯,o7¯ 42,244 ¯1,C47 174,C2¯ 49,91o 7o,¯7o
LaSalle 11¯,o1o 2o,9CC 1o,74¯ 1,oo9 7,1o4 o,ooC ¯2,¯9¯ 9,47o 12,oo7
McHenry ¯Co,944 o2,47o ¯2,719 o,9o1 1o,o4o 1¯,o4o 7o,o7o 22,Coo 24,ooo
McLean 17C,ooo ¯o,C4o 17,ooo 2,74o 1C,72C 7,o77 4C,79o 11,ooo 24,14o
Macon 11C,7¯C 2o,11o 1o,2o4 1,o12 7,C1o o,o17 ¯1,oC1 9,21C 1o,o42
Macoupin 47,oo7 1C,o2o o,1¯o 7o7 ¯,C41 2,411 1¯,o41 4,Coo o,o¯o
Madison 2oo,4o9 oC,49o ¯o,oo9 4,¯oo 1o,994 12,9o4 7¯,C9o 21,199 ¯7,Coo
Peoria 1oo,o¯4 4o,CC7 2o,1oo ¯,24o 11,oo7 o,7oo 49,C92 14,21¯ ¯¯,14¯
Randolph ¯¯,¯o1 o,o4o o,44C 472 2,194 1,7C¯ 9,ooo 2,o1o 4,9o9
Rock Island 147,ooo ¯¯,C¯2 24,224 2,¯o¯ 9,¯74 7,¯42 41,7o1 12,2C4 2C,C9o
St. Clair 27C,2o9 o7,o79 ¯4,191 4,oo¯ 1o,o4o 12,¯9C o9,oC4 2C,C49 oC,o9o
Sangamon 19o,o44 4o,ooo 27,oo¯ ¯,¯o7 12,4oC 9,o1C o¯,91o 1o,o¯o ¯1,¯1o
Will oo1,o4o 19¯,7¯7 oo,C7o 1¯,979 ¯9,7o9 2o,o74 1oo,o77 4o,2o9 oo,¯o2
Winnebago 29¯,99¯ 72,¯9¯ 41,722 o,224 1o,124 1¯,o7C 7o,4¯¯ 22,7o4 oo,¯o¯
Totals l0,572,4l9 2,573,756 l,279,370 l85,7l2 65l,436 480,540 2,665,88l 765,753 l,56l,252
ILLINOIS
American Lung Association in Illinois
55 W. Wacker Drive, Suite 800
Chicago, IL 60601
(312) 781-1100
www.lung.org/illinois
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 81
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Adams 1 C C C.¯ B C C C C.C A 9.7 PASS
Champaign 4 C C 1.¯ C C C C C.C A 1C.4 PASS
Clark C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Cook 24 1 C o.o F 1o C C o.C F 12.7 FAIL
DuPage 1 C C C.¯ B C C C C.C A 1C.7 PASS
Eíngham C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Hamilton o C C 1.7 C C C C C.C A 1C.o PASS
Jersey 4 C C 1.¯ C C C C C.C A 1C.o PASS
Jo Daviess INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Kane 2 C C C.7 B C C C C.C A 1C.o PASS
Lake 1C C C ¯.¯ F INC INC INC INC INC INC INC
LaSalle DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
McHenry 1 C C C.¯ B C C C C.C A 1C.C PASS
McLean 1 C C C.¯ B 1 C C C.¯ B 1C.o PASS
Macon 2 C C C.7 B C C C C.C A 11.o PASS
Macoupin 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Madison ¯C C C 1C.C F 4 C C 1.¯ C 1¯.o FAIL
Peoria 1 C C C.¯ B C C C C.C A 11.¯ PASS
Randolph C C C C.C A C C C C.C A 9.o PASS
Rock Island C C C C.C A C C C C.C A 9.o PASS
St. Clair o 1 C 2.o D 2 C C C.7 B 12.o FAIL
Sangamon 4 C C 1.¯ C C C C C.C A 1C.9 PASS
Will 1 C C C.¯ B 1 C C C.¯ B 1C.o PASS
Winnebago C C C C.C A ¯ C C 1.C C 9.9 PASS
ILLINOIS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 82
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Allen ¯oo,¯27 9o,o2o 4¯,C14 9,Co9 2o,17o 21,oo9 92,C¯o 2o,oCo oC,o99
Boone o7,4o1 1o,9¯C o,ooo 1,oCo 4,CC1 ¯,o22 1o,CC1 4,¯oC 4,ooo
Carroll 2C,C¯1 4,oCC ¯,2¯2 4o4 1,4o1 1,¯o4 o,o9o 1,727 2,291
Clark 111,o7C 2o,¯71 14,¯o4 2,49o o,17o 7,1C1 ¯C,¯o1 o,771 14,¯22
Delaware 117,ooC 2¯,1o9 17,o41 2,19o 9,C11 7,o¯1 ¯2,o29 9,¯oo 2o,C79
Dubois 42,199 1C,o7o o,22o 1,CC1 ¯,C¯o 2,772 11,9¯o ¯,4o4 ¯,4¯2
Elkhart 19o,941 oo,¯1o 24,oC¯ o,¯¯C 1¯,ooo 11,7oo oC,¯o4 14,oCo ¯o,o41
Floyd 74,9o9 17,o4¯ 9,o94 1,o7C o,o11 4,oo2 2C,oo2 o,Coo 9,41o
Gibson ¯¯,oCo 7,971 o,19¯ 7o4 2,44o 2,2¯7 9,ooC 2,o14 ¯,7oo
Greene ¯2,o9o 7,72C o,2oo 7¯1 2,414 2,2¯7 9,ooo 2,o27 4,oo9
Hamilton 2o2,o1C o¯,o¯¯ 2o,1oo 7,9¯4 19,149 1o,o12 oo,717 19,129 12,9C9
Hancock 7C,o29 1o,Coo 9,2¯9 1,71C o,C4¯ 4,oC7 19,29o o,o1o o,229
Hendricks 147,979 ¯9,7oC 1o,¯C9 ¯,7oo 1C,¯9o o,o41 ¯7,oo9 1C,o29 o,1Co
Henry 49,2o4 1C,91¯ o,1C1 1,C¯¯ ¯,o7o ¯,¯91 14,oo7 4,2oC o,49o
Howard o2,oCC 19,274 1¯,o4C 1,o24 o,Co4 o,oo¯ 24,47o 7,1oo 14,Coo
Huntington ¯7,211 o,oo¯ o,o27 o2C 2,7¯7 2,4oC 1C,oo7 ¯,C7o 4,2C¯
Jackson 42,9oo 1C,o1C o,2Co 99o ¯,11C 2,77¯ 11,927 ¯,4oC o,9¯1
Johnson 141,ooo ¯o,o¯¯ 17,77¯ ¯,4oo 1C,Co¯ o,o9o ¯7,1o4 1C,7¯2 12,o94
Knox ¯o,oCC o,1oo o,117 772 2,9C2 2,o92 11,1oo ¯,241 7,C¯o
Lake 49o,ooo 12o,47¯ oo,42¯ 11,o7o ¯o,oC2 ¯1,¯¯1 1¯4,¯2C ¯o,9¯1 94,2o1
LaPorte 111,¯74 24,9oo 1o,1¯o 2,¯o¯ o,2o9 7,4C7 ¯1,o1o 9,24¯ 1o,11¯
Madison 1¯1,2¯o 29,o¯4 2C,o77 2,o24 9,7Co o,7¯o ¯7,o99 1C,94o 2¯,oo¯
Marion 911,29o 22o,99o 97,oC4 21,o7¯ oo,41C o¯,o¯o 227,o97 o4,921 1o9,o4¯
Monroe 1¯9,799 22,4¯o 14,4o7 2,12¯ 11,1o¯ o,2o4 ¯4,o2C 9,o21 ¯C,oCo
Morgan o9,4o4 17,C7o 9,¯9o 1,o1o o,C¯7 4,o¯o 19,442 o,oo9 7,o29
INDIANA
American Lung Association in Indiana
115 W. Washington Street, Suite 1180 South
Indianapolis, IN 46204
(317) 819-1181
www.lung.org/indiana
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 83
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Perry 19,¯o4 4,C71 2,9o¯ ¯oo 1,4oo 1,¯2o o,7C9 1,oo2 2,4C1
Porter 1oo,o¯7 ¯9,¯¯o 21,Co4 ¯,72¯ 12,124 1C,oCo 4o,¯C1 1¯,124 17,4¯o
Posey 2o,72C o,9o9 ¯,792 oo4 1,9C1 1,7oC 7,oo4 2,21o ¯,1oo
St. Joseph 2oo,7CC oo,C74 ¯o,727 o,1o9 19,¯12 1o,7¯1 71,712 2C,o79 49,oo4
Shelby 44,¯¯7 1C,oo2 o,2oC 1,CC9 ¯,2¯o 2,92o 12,oo1 ¯,oo¯ o,o¯C
Spencer 2C,9o1 4,9o2 ¯,219 472 1,o¯o 1,4¯1 o,1oo 1,oCo 2,22¯
Tippecanoe 174,724 ¯o,oo1 1o,7¯7 ¯,¯7o 1¯,2o4 9,o4o 41,4o¯ 11,492 ¯4,2¯9
Vanderburgh 1oC,¯Co ¯9,oC1 2o,C¯C ¯,7o7 1¯,4o4 11,799 oC,oo¯ 14,o4o 2o,79o
Vigo 1Co,1o2 22,777 14,oo¯ 2,1oo o,1o9 o,o97 29,o1o o,4oo 1o,92o
Wabash ¯2,oCo 7,¯CC o,C12 o91 2,41o 2,27o 9,9C7 2,o97 4,92o
Warrick oC,27o 1o,¯CC o,¯7¯ 1,44o 4,¯22 ¯,92o 1o,o4o 4,91o o,1o9
Whitley ¯¯,¯92 o,Co4 4,o2C 7oo 2,4¯2 2,219 9,o¯o 2,7oo ¯,Co2
Totals 4,932,l34 l,2l0,l60 6l8,5l6 ll4,535 356,806 305,440 l,304,9l0 375,653 780,739
INDIANA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 84
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Allen ¯ C C 1.C C 9 C C ¯.C D 11.C PASS
Boone 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Carroll 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Clark 9 C C ¯.C D 1 C C C.¯ B 1¯.o FAIL
Delaware C C C C.C A 1 C C C.¯ B 11.7 PASS
Dubois DNC DNC DNC DNC DNC 1 C C C.¯ B 12.9 FAIL
Elkhart ¯ C C 1.C C 4 C C 1.¯ C 11.7 PASS
Floyd 7 C C 2.¯ D o 1 C 2.o D 12.¯ FAIL
Gibson DNC DNC DNC DNC DNC C C C C.C A 11.4 PASS
Greene 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Hamilton 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Hancock 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Hendricks 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Henry DNC DNC DNC DNC DNC 1 C C C.¯ B 11.1 PASS
Howard DNC DNC DNC DNC DNC 1 C C C.¯ B 11.o PASS
Huntington C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Jackson 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Johnson 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Knox INC INC INC INC INC C C C C.C A 11.7 PASS
Lake ¯ C C 1.C C 1o 2 C o.¯ F 12.4 FAIL
LaPorte 11 C C ¯.7 F C C C C.C A 1C.2 PASS
Madison C C C C.C A 2 C C C.7 B INC INC
Marion 9 C C ¯.C D 17 C C o.7 F 1¯.1 FAIL
Monroe DNC DNC DNC DNC DNC C C C C.C A INC INC
Morgan 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
INDIANA
American Lung Association in Indiana
115 W. Washington Street, Suite 1180 South
Indianapolis, IN 46204
(317) 819-1181
www.lung.org/indiana
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 85
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Perry o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Porter 4 C C 1.¯ C 4 1 C 1.o C 11.1 PASS
Posey o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
St. Joseph 2 C C C.7 B 1¯ C C 4.¯ F 11.C PASS
Shelby o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Spencer DNC DNC DNC DNC DNC C C C C.C A 12.4 FAIL
Tippecanoe DNC DNC DNC DNC DNC ¯ C C 1.C C 11.C PASS
Vanderburgh 7 C C 2.¯ D 2 C C C.7 B 12.7 FAIL
Vigo 1 C C C.¯ B o C C 2.C C 12.4 FAIL
Wabash INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Warrick o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Whitley DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
INDIANA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 86
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Black Hawk 1¯1,o49 2o,CC7 1o,2o1 1,o12 o,o97 4,97¯ ¯1,47C 7,oCo 2C,o¯4
Bremer 24,2o1 o,4C1 4,2o4 ¯11 1,ooo 991 o,¯1¯ 1,o1o 1,7C9
Clinton 49,C1o 11,444 o,244 oo9 ¯,C74 2,C21 12,o4C ¯,¯44 o,o4C
Delaware 17,ooo 4,¯7o 2,9oo 2o2 1,C79 7¯¯ 4,ooo 1,227 1,o27
Harrison 14,o2o ¯,4oC 2,o¯2 2CC 922 o2o ¯,99o 1,Co2 1,477
Johnson 1¯¯,C¯o 2o,o21 11,oo4 1,4oo 9,27o 4,414 27,o14 o,¯oo 21,9oo
Lee ¯o,o21 7,7o1 o,12o 44o 2,27o 1,oC9 9,oo¯ 2,oC4 o,2oo
Linn 21¯,o7o o2,Co4 2o,1o4 2,99o 1¯,o1¯ 7,9o9 oC,2o1 12,oo¯ 22,C7o
Montgomery 1C,o4C 2,4o2 2,114 142 ooC 4oo 2,97o 7o7 1,49o
Muscatine 42,o1o 11,1o¯ o,9¯7 o42 2,o19 1,o21 1C,249 2,o29 o,o44
Palo Alto 9,419 2,Co7 2,C1o 119 o94 417 2,o7o 7C¯ 1,C27
Polk 4¯7,¯99 111,192 47,9o4 o,4CC 27,o12 1o,2o4 9o,C74 2¯,77C o¯,o7C
Pottawattamie 9¯,o1o 22,4oC 1¯,oo7 1,292 o,o79 ¯,o4¯ 2¯,Co4 o,91C 1¯,2Co
Scott 1o7,C9o 4C,o17 22,C9o 2,¯¯o 1C,o21 o,¯1o ¯9,ooo 1C,1¯4 22,o1o
Story o9,oo¯ 1o,o99 9,111 o9o o,417 ¯,C4C 19,1Co 4,¯oo 17,¯94
Tama 17,o9o 4,47o ¯,271 2oo 1,C74 7¯4 4,oo4 1,22o 1,oo7
Van Buren 7,o1C 1,77o 1,474 1C2 4o4 ¯24 2,C72 o47 1,211
Warren 4o,7¯2 11,91o o,¯99 ooo 2,ooo 1,7oo 11,17o 2,ooo 2,9Co
Woodbury 1C2,oC9 27,Coo 1¯,19C 1,oo9 o,29o ¯,71o 2¯,4oo o,91o 1o,ooo
Wright 1¯,Coo ¯,C24 2,749 174 oC9 o77 ¯,o9o 97o 1,o1¯
Totals l,657,928 392,l54 2l2,246 22,572 l06,l23 6l,l35 385,829 96,408 220,529
IOWA
American Lung Association in Iowa
2530 73rd Street
Des Moines, IA 50322
(515) 309-9507
www.lung.org/iowa
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 87
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Black Hawk DNC DNC DNC DNC DNC o C C 1.7 C 1C.o PASS
Bremer C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Clinton C C C C.C A 1C C C ¯.¯ F 11.7 PASS
Delaware DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Harrison 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Johnson DNC DNC DNC DNC DNC 4 C C 1.¯ C 1C.o PASS
Lee DNC DNC DNC DNC DNC 2 C C C.7 B 11.1 PASS
Linn C C C C.C A 9 C C ¯.C D 1C.o PASS
Montgomery C C C C.C A 1 C C C.¯ B 9.4 PASS
Muscatine DNC DNC DNC DNC DNC 19 4 C o.¯ F 12.o FAIL
Palo Alto C C C C.C A 1 C C C.¯ B 9.C PASS
Polk C C C C.C A 4 C C 1.¯ C 9.7 PASS
Pottawattamie DNC DNC DNC DNC DNC 2 C C C.7 B 1C.9 PASS
Scott C C C C.C A 7 C C 2.¯ D 12.2 FAIL
Story C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Tama DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Van Buren C C C C.C A 1 C C C.¯ B 9.o PASS
Warren C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Woodbury DNC DNC DNC DNC DNC 2 C C C.7 B 9.7 PASS
Wright DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
IOWA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 88
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Johnson oo2,991 14¯,oC1 o2,C¯o 11,72o ¯o,9oo 2o,o¯7 1¯4,447 ¯o,C2o ¯o,471
Leavenworth 77,17o 1o,9¯o o,7oC 1,o44 o,11o ¯,799 19,17¯ o,427 o,Co¯
Linn 9,o12 2,21¯ 1,ooo 1oC o2¯ oo9 2,ooo o4¯ 1,¯94
Riley 72,997 1¯,219 o,¯o4 1,C7o o,ooC 2,9o¯ 14,oo1 ¯,7o2 1¯,222
Sedgwick oC1,C7o 1¯o,14C oo,o¯9 11,C19 ¯2,17o 2¯,7o9 12C,29¯ ¯¯,9o7 7o,Coo
Shawnee 17o,941 44,Coo 2o,11o ¯,o9o 11,o7o 9,271 47,2o1 1¯,o¯1 2o,419
Sumner 2¯,7o7 o,1¯o ¯,77o oCC 1,oCo 1,27C o,oC9 1,oo4 ¯,1oo
Trego 2,9¯C ooC o7¯ 4o 19o 1oo 979 2o9 ¯Co
Wyandotte 1oo,224 44,722 1o,94o ¯,o47 1C,C4o 7,197 ¯o,27o 1C,17¯ 4C,ooo
Totals l,577,734 408,8l4 l84,l09 33,334 l02,887 75,693 382,497 l07,90l 203,753
KANSAS
American Lung Association in Kansas
6701 W 64th Street Suite 110
Cloverleaf Oíce Park Building #5
Overland Park, Kansas 66202
(913) 912-7190
www.lung.org/kansas
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 89
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Johnson 4 C C 1.¯ C C C C C.C A o.1 PASS
Leavenworth 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Linn ¯ C C 1.C C C C C C.C A 9.4 PASS
Riley INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Sedgwick 1¯ C C 4.¯ F C C C C.C A 9.1 PASS
Shawnee o C C 2.C C 2 C C C.7 B 9.2 PASS
Sumner 9 C C ¯.C D C C C C.C A o.o PASS
Trego o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Wyandotte C C C C.C A C C C C.C A 1C.4 PASS
KANSAS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 90
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Bell 2o,72o o,2o4 4,ooC o¯7 2,¯7o 2,¯C2 9,o9¯ 2,ooo 11,o24
Boone 121,7¯7 ¯4,C1o 12,CC¯ 2,9C9 9,11C o,47o ¯4,o1o o,9o1 1C,o1¯
Boyd 49,4oo 1C,oo4 o,¯27 9C¯ 4,1¯¯ 4,C¯2 1o,oo4 4,ooo 9,ooo
Bullitt 7o,1C9 1o,44o o,7Co 1,o7o o,9¯9 o,o¯1 2¯,C4o o,C92 o,C71
Campbell 9C,94C 2C,o72 11,ooo 1,7o9 7,¯44 o,91o 2o,4o9 7,4o7 11,o49
Carter 27,ooo o,¯¯9 4,221 o42 2,241 2,1oo o,97o 2,4Co o,ooo
Christian 7¯,o91 2C,7o4 7,7o2 1,777 o,¯o¯ 4,7o2 19,o7o 4,94o 1o,11o
Daviess 97,2¯4 2¯,o29 14,¯21 2,C21 7,7oo 7,47o ¯1,Co2 o,¯2o 1o,11o
Edmonson 12,C9C 2,o¯2 2,C1o 22o 1,CC4 97o 4,Coo 1,1Co 2,2oC
Fayette ¯C1,oo9 o¯,¯71 ¯1,999 o,419 24,¯2¯ 21,9C2 o9,44C 22,o4C o1,191
Franklin 49,¯9¯ 1C,o¯2 7,Coo 9C1 4,C9o ¯,92o 1o,247 4,¯4C 7,221
Greenup ¯o,ooo o,142 o,4Co o9o ¯,Co1 ¯,CCo 12,o9o ¯,4¯C o,¯¯¯
Hancock o,o72 2,19o 1,2Co 1oo o7o ooo 2,712 7¯C 1,C91
Hardin 1C7,4oo 27,oCo 11,9¯¯ 2,¯o2 o,¯11 7,7oo ¯1,744 o,2oo 1o,11¯
Henderson 4o,4Co 1C,oo2 o,o¯7 92o ¯,7o7 ¯,o24 1o,CCo 4,C2o 7,ooo
Jeíerson 74o,9Co 172,C¯o 1CC,oo¯ 14,712 oC,21¯ o7,1Co 2¯o,91¯ o2,4o1 12o,oC¯
Jessamine 49,C4o 12,o¯C o,7o7 1,C72 ¯,oC2 ¯,oo1 14,o29 ¯,o¯2 o,11C
Kenton 1oC,4Co ¯9,o4o 1o,C7o ¯,4C7 12,ooC 11,74o 4o,C71 12,o7o 2o,¯Co
Livingston 9,o¯1 1,9o7 1,749 1o7 o1o o14 ¯,411 94C 1,4o4
McCracken oo,oo4 14,oCo 11,142 1,249 o,4o7 o,¯44 22,¯oo o,C74 11,C9o
Madison o4,1oo 17,o99 9,o7o 1,o¯1 o,794 o,1o7 2o,294 o,4o¯ 1o,¯17
Morgan 1¯,94¯ 2,oC¯ 1,o41 24C 1,1o1 1,C9C 4,491 1,179 ¯,797
Ohio 24,1C¯ o,C27 ¯,oC9 o1o 1,91o 1,oo7 7,7o1 2,C94 o,¯o4
Oldham oC,o42 1o,4C1 o,oo4 1,4C¯ 4,oo9 4,449 1o,C2¯ 4,7o4 ¯,oC4
Perry 2o,7o1 o,27o ¯,9Co o¯7 2,¯o7 2,2o7 9,¯4o 2,49¯ 7,C1o
KENTUCKY
American Lung Association in Kentucky
4100 Churchman Avenue
Louisville, KY 40215
(502) 363-2652
www.lung.org/kentucky
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 91
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Pike o4,9C4 14,1¯9 9,19C 1,2C9 o,¯o1 o,1o2 21,¯2o o,714 14,¯Co
Pulaski o¯,oo7 14,4C7 1C,oo9 1,2¯2 o,2¯1 o,1C1 21,¯¯C o,77o 1o,2oC
Simpson 17,¯7o 4,19o 2,o9C ¯o9 1,¯9¯ 1,¯4o o,o94 1,oC¯ 2,79o
Trigg 14,¯Co ¯,1¯4 2,oCo 2oo 1,2C4 1,2Co o,C94 1,4Co 2,¯2o
Warren 11o,o17 2o,Co1 12,94o 2,2¯C 9,1o2 o,¯1C ¯4,C7C o,ooo 2C,o¯4
Washington 11,o4o 2,7¯9 1,927 2¯4 9oo 94o ¯,944 1,Co9 1,9oo
Totals 2,657,726 620,947 34l,560 53,l00 2l2,55l 200,093 824,668 2l6,985 444,888
KENTUCKY
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 92
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Bell C C C C.C A 1 C C C.¯ B 11.¯ PASS
Boone 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Boyd ¯ C C 1.C C C C C C.C A 1C.o PASS
Bullitt 2 1 C 1.2 C 1 C C C.¯ B 12.2 FAIL
Campbell 1¯ C C 4.¯ F C C C C.C A 11.1 PASS
Carter C C C C.C A C C C C.C A 9.1 PASS
Christian ¯ C C 1.C C C C C C.C A INC INC
Daviess o C C 2.C C C C C C.C A 12.¯ FAIL
Edmonson 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Fayette ¯ C C 1.C C 1 C C C.¯ B 11.2 PASS
Franklin DNC DNC DNC DNC DNC C C C C.C A INC INC
Greenup ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Hancock o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Hardin C C C C.C A C C C C.C A 11.1 PASS
Henderson 7 C C 2.¯ D C C C C.C A 11.7 PASS
Jeíerson ¯2 2 C 11.7 F 4 1 C 1.o C 12.o FAIL
Jessamine 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Kenton INC INC INC INC INC INC INC INC INC INC INC INC
Livingston ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
McCracken 4 C C 1.¯ C C C C C.C A 11.1 PASS
Madison DNC DNC DNC DNC DNC C C C C.C A 9.9 PASS
Morgan INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Ohio DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Oldham 19 1 C o.o F DNC DNC DNC DNC DNC DNC DNC
Perry C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Pike C C C C.C A 1 C C C.¯ B 9.7 PASS
KENTUCKY
American Lung Association in Kentucky
4100 Churchman Avenue
Louisville, KY 40215
(502) 363-2652
www.lung.org/kentucky
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 93
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Pulaski C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Simpson 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Trigg ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Warren C C C C.C A C C C C.C A 11.C PASS
Washington INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
KENTUCKY
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 94
LOUISIANA
American Lung Association in Louisiana
2325 Severn Avenue, Suite 8
Metairie, LA 70001-6918
(504) 828-5864
www.lung.org/louisiana
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
Parish Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Ascension Parish 1C9,9oo ¯1,17o 9,9o2 2,4o2 o,Co4 o,194 ¯C,o74 o,774 12,o2o
Bossier Parish 119,7¯2 ¯C,ooC 14,414 2,4¯2 o,719 o,C29 ¯o,7oC 1C,¯2o 1o,ooo
Caddo Parish 2o7,Co1 o¯,11o ¯o,Co1 o,C2o 12,oCC 1¯,oo¯ oC,7oo 2¯,492 o4,Co¯
Calcasieu Parish 194,C92 4o,7oC 24,9o4 ¯,oo2 9,¯o¯ 1C,11o oC,1C¯ 17,441 ¯o,9¯o
East Baton Rouge
Parish 441,4¯o 1C1,o44 49,¯C¯ o,C9¯ 21,o9o 22,2oo 1¯1,oo4 ¯7,oC2 oo,972
Iberville Parish ¯¯,2¯C 7,¯oo 4,C7o ooo 1,o7o 1,7oo 1C,oCo ¯,Coo o,7o9
Jeíerson Parish 4¯2,o4C 9o,o77 o9,942 7,o97 21,74o 2¯,72o 141,C77 41,C¯o 77,7CC
Lafayette Parish 224,¯9C o4,ooo 2¯,424 4,¯4o 1C,o92 11,171 oo,C¯1 1o,9¯1 ¯o,¯27
Lafourche Parish 9o,ooo 2¯,41o 12,¯24 1,oo4 4,72o o,C71 ¯C,1C7 o,72o 1o,227
Livingston Parish 1¯C,2o1 ¯o,¯42 1¯,412 2,o14 o,111 o,¯¯4 ¯7,4o9 1C,7o4 1o,9oC
Orleans Parish ¯oC,74C 77,24o 4C,444 o,1oC 1o,192 1o,774 111,Co2 ¯1,o92 1CC,C7o
Ouachita Parish 1o4,919 4C,oC9 19,¯oC ¯,22o 7,¯¯9 7,o1C 4o,¯o2 1¯,42¯ ¯9,1o¯
Pointe Coupee Parish 22,7C¯ o,47C ¯,ooo 4¯o 1,127 1,2o9 7,o94 2,2oC 4,927
Rapides Parish 1¯2,¯74 ¯4,C¯C 1o,279 2,7C9 o,¯oo o,97o 41,oC9 12,C97 ¯C,C¯o
St. Bernard Parish ¯9,ooo 1C,1o¯ ¯,oo4 o11 1,oo9 1,9C9 11,2o2 ¯,214 7,o9o
St. Charles Parish o2,o17 1¯,o94 o,¯7C 1,1Co 2,o19 2,oo1 1o,7oo 4,o¯7 o,ooo
St. James Parish 21,7o4 o,oC9 2,o74 4¯9 1,Co9 1,1o4 o,922 2,C1o 4,4o7
St. John the Baptist
Parish 4o,221 12,CC9 4,ooo 9oo 2,1o7 2,2o2 1¯,o21 ¯,o99 7,o42
St. Tammany Parish 2¯o,7oo o9,ooo ¯C,9oC 4,7oo 11,ooo 12,742 7o,7o2 22,CoC 27,7oo
Tangipahoa Parish 122,o71 ¯C,o2o 14,¯12 2,4¯o o,9C9 o,2Co ¯o,7o7 1C,o12 27,19o
Terrebonne Parish 111,917 2o,o9o 12,o17 2,¯C1 o,¯o1 o,oo9 ¯¯,oCo 9,7C1 21,271
West Baton Rouge
Parish 24,1C9 o,97o 2,71o 47o 1,17¯ 1,2¯9 7,¯4C 2,117 ¯,ooo
Totals 3,364,673 8l6,876 406,083 65,036 l64,l7l l74,002 l,03l,848 298,l89 642,570
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 95
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
Parish Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Ascension Parish 1o C C o.C F DNC DNC DNC DNC DNC DNC DNC
Bossier Parish 2o 1 C 9.2 F DNC DNC DNC DNC DNC DNC DNC
Caddo Parish 1¯ C C 4.¯ F C C C C.C A 11.1 PASS
Calcasieu Parish 1o 1 C o.o F C C C C.C A 9.1 PASS
East Baton Rouge
Parish 2o C C 9.¯ F 2 C C C.7 B 1C.2 PASS
Iberville Parish 2C C C o.7 F C C C C.C A 1C.C PASS
Jeíerson Parish 12 C C 4.C F 1 C C C.¯ B 9.2 PASS
Lafayette Parish 7 C C 2.¯ D 1 C C C.¯ B 9.1 PASS
Lafourche Parish o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Livingston Parish 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Orleans Parish 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Ouachita Parish C C C C.C A C C C C.C A 9.2 PASS
Pointe Coupee
Parish 12 C C 4.C F DNC DNC DNC DNC DNC DNC DNC
Rapides Parish DNC DNC DNC DNC DNC 1 C C C.¯ B o.7 PASS
St. Bernard Parish 9 C C ¯.C D 1 C C C.¯ B 1C.o PASS
St. Charles Parish 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
St. James Parish 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
St. John the Baptist
Parish o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
St. Tammany Parish 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Tangipahoa Parish DNC DNC DNC DNC DNC C C C C.C A o.9 PASS
Terrebonne Parish DNC DNC DNC DNC DNC C C C C.C A o.o PASS
West Baton Rouge
Parish 2 1 C 1.2 C 2 C C C.7 B 1C.o PASS
LOUISIANA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 96
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Androscoggin 1C7,¯9o 2¯,94¯ 1o,¯oo 2,C4o 1C,1oo o,¯4o 2o,4¯4 7,712 1o,o1o
Aroostook 71,4o2 14,1Co 1¯,9¯1 1,2Co o,77C 4,77C 21,o19 o,94o 12,7¯o
Cumberland 2o2,4C1 o7,o¯o 41,¯¯C 4,929 27,¯Co 17,191 77,C2o 2C,912 ¯¯,22o
Hancock o4,o7o 9,7oo 1C,292 o¯4 o,299 ¯,717 1o,oC1 4,o21 7,¯7o
Kennebec 121,9¯o 24,7o¯ 19,29o 2,119 11,ooo 7,o7C ¯4,4o4 9,4Co 1o,C7o
Knox ¯9,7Co 7,ooo 7,o2o o4o ¯,7o4 2,o9o 12,219 ¯,¯oo 4,97o
Oxford o7,o9o 12,Co4 9,9o7 1,C¯¯ o,41o ¯,742 1o,o7¯ 4,o¯¯ 9,¯o¯
Penobscot 1o¯,7oo 29,9o4 22,o¯2 2,oo2 1o,1C7 9,¯2o 41,79C 11,¯1o 2o,1o1
Piscataquis 17,419 ¯,27C ¯,o7o 2oC 1,o4o 1,22o o,o7C 1,o42 ¯,¯¯2
Sagadahoc ¯o,2C7 7,144 o,Co9 o11 ¯,¯42 2,2o2 1C,2o9 2,o21 4,C71
Washington ¯2,o¯7 o,4Co o,oC2 o4o ¯,Coo 2,2C1 9,9oo 2,7oC o,oo2
York 19o,199 41,442 ¯1,2Co ¯,o44 1o,o2¯ 12,44o oo,9¯C 1o,2oC 19,912
Totals l,l72,445 238,097 l88,075 20,360 ll2,422 73,6l4 33l,000 90,303 l58,908
MAINE
American Lung Association in Maine
122 State Street
Augusta, ME 04330
(207) 624-0308
www.lung.org/maine
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 97
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Androscoggin C C C C.C A 1 C C C.¯ B 7.o PASS
Aroostook C C C C.C A 1 1 C C.o B 7.1 PASS
Cumberland 4 1 C 1.o C 1 C C C.¯ B o.2 PASS
Hancock 9 C C ¯.C D C C C C.C A 4.o PASS
Kennebec 1 C C C.¯ B C C C C.C A 7.¯ PASS
Knox 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Oxford C C C C.C A C 1 C C.o B o.2 PASS
Penobscot 1 C C C.¯ B C C C C.C A 7.¯ PASS
Piscataquis DNC DNC DNC DNC DNC 1 C C C.¯ B INC INC
Sagadahoc C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Washington 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
York 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
MAINE
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 98
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Anne Arundel o44,4C¯ 12o,24o oo,C21 11,o¯9 ¯o,444 24,oC7 142,7oo ¯9,7oo ¯4,¯o4
Baltimore oC9,941 17o,¯1C 11o,7o4 1o,244 o¯,2oo ¯o,79¯ 22¯,CoC o2,oC4 7o,7¯o
Calvert o9,2oo 22,o72 1C,171 2,Co9 o,oC1 4,CC1 2¯,¯9o o,oo¯ o,41o
Carroll 1o7,2oo ¯9,o77 22,o47 ¯,o74 1C,ooo 7,o7o 4o,C2o 1¯,CCo o,9¯7
Cecil 1C1,o94 24,9o9 12,¯24 2,¯CC o,4o7 4,oC2 2o,o74 7,4o4 9,o9C
Charles 149,1¯C ¯o,41o 14,o¯o ¯,o¯9 9,41C o,¯o2 ¯o,o4¯ 1C,C74 11,¯oC
Dorchester ¯2,o4C 7,Coo o,o4C oo1 2,12C 1,o7C 9,741 2,797 o,oCo
Frederick 2¯o,74o oo,o29 27,CoC o,¯9¯ 1o,Co4 1C,o¯1 oC,oo4 1o,94o 1o,¯2o
Garrett ¯C,Co1 o,4oC o,¯¯4 o97 1,9oo 1,o¯4 o,9¯o 2,oo¯ ¯,o29
Harford 24o,4o9 o9,Coo ¯1,ooo o,444 1o,7o¯ 11,¯oo oo,ooC 1o,49C 2C,¯C9
Kent 2C,2C4 ¯,o17 4,o4C ¯24 1,¯74 1,1¯4 o,o79 1,91C 2,o1o
Montgomery 9o9,794 2¯4,924 124,oo2 21,o4o o¯,7¯4 4o,C9C 2o9,o2C 72,oCo oo,o79
Prince George’s o71,2¯¯ 2Co,C72 oo,44o 1o,o94 oo,941 ¯7,¯o9 212,Coo o7,9oo 79,o74
Washington 14o,2C¯ ¯¯,o27 21,414 ¯,Co9 9,o¯o 7,C¯7 4C,oo¯ 11,427 1o,47o
Worcester o1,o14 9,2¯7 12,1oo oo1 ¯,4o2 2,9o7 17,41C o,C9o o,o7o
Baltimore City o19,49¯ 1¯¯,oo2 72,79o 12,¯Co 41,4¯1 27,o¯o 1o7,27¯ 4¯,29C 14o,1C1
Totals 5,l08,078 l,l78,480 635,488 l08,579 332,344 232,956 l,337,239 372,650 507,442
MARYLAND
American Lung Association in Maryland
211 E. Lombard St., #260
Baltimore, MD 21202
(443) 451-4950
www.lung.org/maryland
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 99
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Anne Arundel 19 ¯ C 7.o F 1 C C C.¯ B 1C.9 PASS
Baltimore ¯2 2 C 11.7 F o C C 1.7 C 11.1 PASS
Calvert 1¯ 2 C o.¯ F DNC DNC DNC DNC DNC DNC DNC
Carroll 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Cecil 2C 1 C 7.2 F ¯ C C 1.C C 1C.4 PASS
Charles 1¯ 1 C 4.o F DNC DNC DNC DNC DNC DNC DNC
Dorchester INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Frederick 1¯ C C 4.¯ F DNC DNC DNC DNC DNC DNC DNC
Garrett o C C 2.C C INC INC INC INC INC INC INC
Harford 4o 1C C 2C.¯ F C C C C.C A 9.o PASS
Kent 1¯ 1 C 4.o F INC INC INC INC INC INC INC
Montgomery 1C C C ¯.¯ F 1 C C C.¯ B 1C.2 PASS
Prince George’s ¯7 C C 12.¯ F ¯ 1 C 1.o C 1C.o PASS
Washington o C C 2.7 D 2 C C C.7 B 1C.9 PASS
Worcester INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Baltimore City o 1 C ¯.2 D 11 C C ¯.7 F 1C.9 PASS
MARYLAND
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 100
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Barnstable 21o,7o9 ¯o,¯79 o4,747 4,¯1C 1o,2¯4 12,o72 o9,99¯ 1o,o49 2C,o29
Berkshire 1¯C,4oo 24,911 24,727 2,9o1 11,C11 o,o1o ¯7,294 9,o9o 1o,o4o
Bristol o4o,922 12C,44C 79,442 14,2o9 4o,o¯¯ 2o,2o1 1¯o,7o2 ¯o,¯oo o¯,799
Dukes 1o,7oo ¯,179 2,oC¯ ¯77 1,42¯ ooo 4,71o 1,22¯ 1,o¯o
Essex 74o,9¯C 17C,19o 1C7,o7o 2C,1o4 o1,4o2 ¯4,49o 1o9,721 4o,o¯o o4,o77
Hampden 4o¯,7o¯ 1Co,42o oo,4o2 12,o4o ¯7,oo7 2C,92o 114,979 29,¯Co 7o,o4¯
Hampshire 1o7,o22 2o,o4o 2C,4o9 ¯,C27 14,¯17 7,22¯ ¯9,791 9,9oo 1o,Coo
Middlesex 1,o1o,171 ¯19,274 2C1,27o ¯7,o27 12o,74o o7,9o4 ¯74,Coo 94,o1C 121,o92
Norfolk o7o,4¯o 1oC,¯24 99,2oC 17,o1C oo,7¯7 ¯1,¯o2 172,492 44,14¯ 41,o94
Plymouth 497,o79 117,221 71,o2o 1¯,ooo 4C,2o4 22,97o 12o,¯92 ¯2,4o1 41,4¯¯
Suíolk 7¯C,9¯2 12o,o99 77,¯o4 1o,2¯o oo,o27 29,727 1o¯,oo9 ¯9,7oo 1o4,¯7C
Worcester oC1,227 1o4,ooo 1C¯,ooo 21,oo7 oo,9¯9 ¯o,oo2 19o,o92 49,7oC 9C,11C
Totals 6,505,795 l,389,067 909,354 l64,572 547,l29 296,036 l,627,975 4l3,296 730,9l5
MASSACHUSETTS
American Lung Association in Massachusetts
460 Totten Pond Road, Suite 400
Waltham, MA 02451-1991
(781) 314-9006
www.lung.org/massachusetts
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 101
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Barnstable o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Berkshire 4 C C 1.¯ C 1 C C C.¯ B o.9 PASS
Bristol 1C C C ¯.¯ F C C C C.C A 7.9 PASS
Dukes 9 2 C 4.C F DNC DNC DNC DNC DNC DNC DNC
Essex o C C 2.C C C C C C.C A o.2 PASS
Hampden o C C 2.7 D 1 C C C.¯ B 9.o PASS
Hampshire 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
Middlesex o C C 1.7 C C C C C.C A 7.7 PASS
Norfolk o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Plymouth DNC DNC DNC DNC DNC C C C C.C A o.2 PASS
Suíolk o C C 1.7 C 1 1 C C.o B 1C.2 PASS
Worcester 1C C C ¯.¯ F C C C C.C A 9.C PASS
MASSACHUSETTS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 102
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Allegan 111,2¯4 2o,712 14,7o9 2,o74 o,174 o,7o1 ¯1,1oo o,4o9 1¯,94o
Bay 1C7,11C 2¯,¯1o 17,747 2,¯¯4 o,2o2 7,Co4 ¯2,77C o,979 14,279
Benzie 17,44¯ ¯,o4C ¯,7¯1 ¯o4 1,¯o1 1,274 o,9¯4 1,oo4 2,C94
Berrien 1oo,941 ¯o,21C 2o,1¯1 ¯,o2o 11,o94 1C,22C 47,¯C1 12,9oo 2o,99¯
Cass o1,9oo 11,99o o,¯¯o 1,2C1 ¯,947 ¯,429 1o,ooo 4,¯oo o,o2o
Chippewa ¯o,797 7,717 o,72¯ 772 ¯,C74 2,47o 11,411 ¯,Co7 o,29o
Clinton 7o,4o9 1o,227 1C,C1C 1,o2o o,o71 4,o11 21,22o o,749 7,o7o
Emmet ¯2,o4o 7,24C o,ooo 72o 2,o2¯ 2,222 1C,29o 2,o¯o 4,2¯¯
Genesee 422,CoC 1C¯,729 o9,¯o7 1C,¯o4 ¯1,4o7 2o,ooo 119,22o ¯2,¯74 oo,2CC
Huron ¯2,o7o o,oC2 7,19o oo1 2,o49 2,4CC 11,1o9 ¯,122 4,o4o
Ingham 2o1,o1¯ oo,94o ¯C,419 o,7CC 22,¯¯7 1o,C2C 7¯,C7o 19,229 o9,o77
Kalamazoo 2o2,C74 oo,9C7 ¯1,249 o,o9o 19,4oC 14,727 o7,49o 1o,CC2 47,1o1
Kent oCo,4o¯ 1o7,7oo oo,7o2 1o,79o 44,7oC ¯4,2o7 1o7,141 42,CCo oo,CC2
Lenawee 99,44C 22,o1o 14,9Co 2,2o4 7,o92 o,¯2o 29,19¯ 7,9o1 12,4oC
Macomb o42,14o 19C,7¯o 122,411 19,C9¯ o4,41o o¯,C19 244,4¯o oo,4C¯ 11o,C2¯
Manistee 24,7C9 4,o1C o,21C 4o1 1,97C 1,o2o o,oCC 2,¯o4 ¯,91o
Mason 2o,o7o o,CoC o,o2¯ oC7 2,22C 2,C2¯ 9,4Co 2,oCo o,111
Missaukee 14,911 ¯,oo2 2,o17 ¯oo 1,117 99C 4,o9¯ 1,2o7 2,79¯
Monroe 1o1,ooC ¯o,ooo 2C,9CC ¯,o9C 11,4o9 9,o2o 4¯,9C4 11,94o 1o,14o
Muskegon 171,¯C2 41,772 2¯,77¯ 4,1o1 12,o17 1C,4oo 4o,¯2o 1¯,112 ¯¯,C79
Oakland 1,21C,14o 27o,¯27 1o4,4¯C 27,oo1 92,¯2C 7o,717 ¯4o,71o 94,o2o 1¯4,42C
Ottawa 2oo,¯CC oo,1o¯ ¯2,221 o,o2o 19,o4o 1o,24o o9,97o 1o,7oo 29,471
St. Clair 1o1,o42 ¯7,412 24,2o4 ¯,74o 12,2oC 1C,42¯ 4o,1¯o 1¯,1oo 2o,1Co
Schoolcraft o,49C 1,o7o 1,o2o 1oo oo7 o¯¯ 2,949 o24 1,2¯o
Tuscola oo,422 12,ooo 9,Co1 1,27C 4,214 ¯,o4C 1o,o44 4,o22 7,o7o
MICHIGAN
American Lung Association in Michigan
1475 E 12 Mile Road
Madison Heights, MI 48071
(248) 784-2000
www.lung.org/michigan
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 103
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Washtenaw ¯47,9o2 7C,CoC ¯o,oo7 7,C12 27,oo2 19,92C 9C,ooo 2¯,929 oo,2C2
Wayne 1,oC2,C9o 44o,o41 2¯1,¯49 44,9CC 1¯4,12o 1Co,9o2 491,o2¯ 1¯2,oo1 4o4,oo2
Wexford ¯2,71o 7,7¯2 o,¯24 774 2,4o¯ 2,12C 9,oC7 2,oo9 4,o9o
Totals 7,406,245 l,747,749 989,648 l74,953 560,437 450,236 2,07l,567 559,778 l,284,486
MICHIGAN
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 104
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Allegan 12 1 C 4.o F C C C C.C A o.o PASS
Bay DNC DNC DNC DNC DNC 1 C C C.¯ B o.C PASS
Benzie ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Berrien 11 1 C 4.2 F C C C C.C A o.o PASS
Cass o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Chippewa INC INC INC INC INC o C C 1.7 C INC INC
Clinton 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Emmet DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Genesee ¯ C C 1.C C C C C C.C A o.7 PASS
Huron ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Ingham 1 C C C.¯ B C C C C.C A o.9 PASS
Kalamazoo ¯ C C 1.C C 1 C C C.¯ B 9.4 PASS
Kent o C C 2.C C 1 C C C.¯ B 9.7 PASS
Lenawee o C C 2.C C C C C C.C A 9.4 PASS
Macomb 1o C C o.¯ F C C C C.C A 9.C PASS
Manistee o C C 1.7 C C C C C.C A o.4 PASS
Mason o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Missaukee 1 C C C.¯ B C C C C.C A o.C PASS
Monroe DNC DNC DNC DNC DNC 2 C C C.7 B 9.9 PASS
Muskegon 1C 1 C ¯.o F C C C C.C A o.o PASS
Oakland o C C 2.7 D C C C C.C A 9.4 PASS
Ottawa 9 C C ¯.C D C C C C.C A 9.2 PASS
St. Clair o C C 2.7 D 1 C C C.¯ B 9.¯ PASS
Schoolcraft o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Tuscola INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
MICHIGAN
American Lung Association in Michigan
1475 E 12 Mile Road
Madison Heights, MI 48071
(248) 784-2000
www.lung.org/michigan
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 105
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Washtenaw 4 C C 1.¯ C C C C C.C A 9.o PASS
Wayne 1o C C o.C F o C C 1.7 C 11.o PASS
Wexford INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
MICHIGAN
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 106
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Anoka ¯¯¯,14C o4,o7o ¯¯,9C2 7,2oo 17,27o 9,7¯o o7,94o 17,49¯ 2o,2o7
Becker ¯2,77o 7,97¯ o,7o7 oo2 1,o9o 1,1¯C o,CoC 2,Co1 4,17o
Carlton ¯o,4oo o,1o7 o,¯2o 7CC 1,o79 1,171 o,2o¯ 2,119 4,11o
Cass 2o,¯9C o,99C o,19o o12 1,o17 1,Co7 7,o1o 1,99o o,142
Crow Wing o2,7o¯ 14,19¯ 11,9C7 1,214 ¯,¯22 2,2¯4 1o,o74 4,Coo o,¯C1
Dakota 4C2,CCo 1C4,C1C 41,9oo o,o9o 2C,7¯o 11,742 o1,o94 21,C7C 27,972
Goodhue 4o,217 1C,7o9 7,o19 921 2,429 1,oo4 11,2o2 2,ooo 4,1oo
Hennepin 1,1oo,4¯1 2o¯,o44 1¯4,oo9 22,o¯7 o¯,2oC ¯o,4oo 244,oC¯ o2,714 1oo,¯¯C
Lake 1C,o24 2,C4C 2,4o7 174 o9o 42o ¯,Co¯ 7oo 1,11o
Lyon 2o,o91 o,247 ¯,oo7 o¯4 1,¯o9 oCo o,ooo 1,42¯ ¯,C14
Mille Lacs 2o,979 o,o2¯ 4,2o1 ooo 1,¯¯9 ooo o,C4o 1,o47 ¯,¯¯7
Olmsted 14o,7o9 ¯o,497 1o,o7o ¯,121 7,o92 4,479 ¯1,1oo 7,992 11,429
Ramsey o14,o9o 119,o42 o2,74¯ 1C,22¯ 27,o2C 1o,ooo 1C7,o¯o 27,oCo oo,¯Co
St. Louis 2CC,2oo ¯o,o42 ¯2,C47 ¯,¯22 11,147 o,911 4o,o4o 12,429 ¯¯,oo¯
Scott 1¯2,ooo ¯9,¯o9 1C,ooo ¯,¯oo o,o¯4 ¯,47o 2¯,o9o o,1oC 7,ooC
Stearns 1o1,¯4¯ ¯4,4Co 1o,7o4 2,942 o,1oo 4,o2¯ ¯1,o91 o,1C4 19,¯79
Washington 241,2oC o2,9o4 2o,o77 o,¯o4 12,¯o1 7,17¯ oC,¯9o 12,97¯ 1¯,99¯
Wright 12o,4¯7 ¯7,¯o1 12,o2C ¯,197 o,224 ¯,4o7 2¯,9¯4 o,144 o,ooo
Totals 3,684,2l0 883,373 440,l33 75,542 l95,076 ll2,059 777,89l l99,55l 428,899
MINNESOTA
American Lung Association in Minnesota
490 Concordia Avenue
St. Paul, MN 55103-2441
(651) 227-8014
www.lung.org/minnesota
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 107
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Anoka 1 C C C.¯ B INC INC INC INC INC INC INC
Becker C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Carlton C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Cass DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Crow Wing 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Dakota DNC DNC DNC DNC DNC o C C 1.7 C 9.2 PASS
Goodhue C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Hennepin DNC DNC DNC DNC DNC 4 C C 1.¯ C 9.o PASS
Lake C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Lyon C C C C.C A INC INC INC INC INC INC INC
Mille Lacs C C C C.C A INC INC INC INC INC INC INC
Olmsted C C C C.C A 4 C C 1.¯ C 9.o PASS
Ramsey DNC DNC DNC DNC DNC 7 C C 2.¯ D 1C.C PASS
St. Louis C C C C.C A 1 C C C.¯ B o.o PASS
Scott C C C C.C A ¯ C C 1.C C o.o PASS
Stearns C C C C.C A 4 C C 1.¯ C o.o PASS
Washington 1 C C C.¯ B INC INC INC INC INC INC INC
Wright C C C C.C A DNC DNC DNC DNC DNC DNC DNC
MINNESOTA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 108
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Adams ¯2,Co7 7,Co9 o,Co9 o2C 1,9¯o 2,21o 11,2¯o ¯,41C 1C,192
Bolivar ¯¯,771 o,oC7 4,1oC 7oo 1,94o 2,C7o 1C,4oC ¯,Coo 1C,7o4
DeSoto 1o4,Co¯ 4o,oC1 17,2o4 ¯,99o 9,1oo 9,oo1 4o,2Co 14,Coo 17,CC1
Forrest 7o,o42 17,o1o o,7o9 1,ooo 4,4oo 4,497 22,oo4 o,44¯ 2C,2Co
Grenada 21,7Co o,¯¯o ¯,¯o9 4o9 1,2o7 1,4¯7 7,29C 2,2CC 4,¯1o
Hancock 44,o49 1C,ooo o,919 9¯C 2,o¯7 ¯,C¯1 1o,¯7o 4,o7o 1C,oC9
Harrison 191,C4C 4o,72¯ 22,o¯2 4,1Co 11,1o2 11,o24 o9,oo4 17,o47 ¯7,971
Hinds 24o,1o4 o4,494 2o,9o9 o,oo7 14,2C4 14,7¯9 74,¯C7 21,o¯7 o2,97C
Jackson 1¯9,9C1 ¯o,2Co 17,oo9 ¯,C94 o,1CC o,o21 44,o9o 1¯,2o2 2¯,92o
Jones oo,C7o 17,419 9,o9o 1,o¯1 ¯,92C 4,¯4o 22,C17 o,o7o 1¯,¯9C
Lauderdale oC,47o 19,94o 11,¯¯o 1,7o¯ 4,oo4 o,1¯o 2o,99¯ 7,7¯1 17,o21
Lee o4,1oo 22,2oo 11,C¯C 1,9oo 4,7oo o,2C9 2o,¯4o 7,o2C 1¯,7¯C
Lowndes o9,o71 14,oo1 7,9o4 1,¯Co ¯,4oo ¯,7o7 19,CoC o,oo¯ 14,224
Yalobusha 12,oo2 2,97o 2,1¯¯ 2o2 741 oo9 4,¯o2 1,¯2o 2,94o
Totals l,256,l42 3l8,8l2 l55,ll8 28,0l5 72,503 77,5l6 39l,592 ll5,472 260,057
MISSISSIPPI
American Lung Association in Mississippi
P.O. Box 2178
Ridgeland, MS 39158
(601) 206-5810
www.lung.org/mississippi
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 109
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Adams 1 C C C.¯ B INC INC INC INC INC INC INC
Bolivar o C C 1.7 C INC INC INC INC INC INC INC
DeSoto 9 C C ¯.C D C C C C.C A 9.9 PASS
Forrest DNC DNC DNC DNC DNC C C C C.C A 11.o PASS
Grenada DNC DNC DNC DNC DNC C C C C.C A 9.4 PASS
Hancock 2 C C C.7 B C C C C.C A 9.o PASS
Harrison 7 C C 2.¯ D C C C C.C A 9.o PASS
Hinds 4 C C 1.¯ C 1 C C C.¯ B 11.1 PASS
Jackson 4 C C 1.¯ C C C C C.C A 9.o PASS
Jones DNC DNC DNC DNC DNC C C C C.C A 11.o PASS
Lauderdale C C C C.C A C C C C.C A 1C.9 PASS
Lee C C C C.C A C C C C.C A 1C.9 PASS
Lowndes DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Yalobusha INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
MISSISSIPPI
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 110
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Andrew 17,19o 4,C22 2,72C ¯1o 1,2C9 1,144 o,2C2 1,4o7 1,o99
Boone 1oo,o27 ¯4,279 1o,oCC 2,o9o 12,C¯o 9,1oC 41,¯1¯ 1C,o2C ¯C,ooo
Buchanan o9,ooo 21,C4o 12,o4o 1,ooo o,2o7 o,oo4 2o,2o2 o,97o 1o,14o
Callaway 44,42C 9,o1o o,o17 772 ¯,17o 2,7oC 12,oo9 ¯,4oo o,oo1
Cass 1CC,Co2 2o,Co7 1¯,974 2,CoC o,7oo o,17C 2o,C17 7,oCo 1C,144
Cedar 1¯,94o ¯,2C7 ¯,1o4 2o2 979 1,CC¯ 4,o47 1,¯¯9 ¯,oo1
Clay 22o,1o1 o7,4¯o 2o,o27 4,o1o 1o,4C1 1¯,21o o9,oo2 1o,¯2o 19,¯¯o
Clinton 2C,7o9 o,C4o ¯,¯7o ¯97 1,44¯ 1,¯o9 o,24C 1,7o1 2,4oo
Greene 277,214 oo,11¯ ¯9,4C2 4,o71 2C,C4o 17,192 7o,42¯ 21,4oo 4o,4oC
Jackson o7o,¯oC 1oo,2CC oo,oCC 12,99o 4o,ooo 4C,7o7 1o4,7oo oC,77o 124,o14
Jasper 11o,4¯o ¯C,¯¯¯ 1o,Coo 2,¯oo o,Co7 7,C4¯ ¯2,C77 o,o27 19,411
Jeíerson 219,4oC o4,¯2¯ 2o,¯2o 4,27¯ 1o,191 1¯,¯o4 oC,192 1o,o1C 24,¯oC
Lincoln o¯,C7o 14,o24 o,o94 1,1oC ¯,o¯o ¯,Co4 1¯,ooo ¯,o21 o,9C2
Monroe o,7¯4 1,971 1,7Co 1oo o19 o19 2,o¯o o1¯ 1,¯42
Perry 19,C41 4,7C4 2,99o ¯7C 1,¯1¯ 1,219 o,ooC 1,oo9 2,oCo
St. Charles ¯oo,1o1 92,C4¯ 42,o1C 7,24C 2o,C9o 21,oo1 9o,o42 27,1¯C 21,o2o
Ste. Genevieve 1o,124 4,124 2,9o4 ¯24 1,2oo 1,2¯o o,o1¯ 1,o9C 2,1o1
St. Louis 99o,o92 229,o1o 1o1,o91 1o,C77 7C,oCC oo,C1o 29o,oC4 o2,7¯9 11o,47C
Taney o2,7¯o 11,o¯4 9,o71 91o ¯,7oo ¯,oo1 1o,¯C2 4,o9o 1C,Co7
St. Louis City ¯1o,Co9 o7,o47 ¯4,o4o o,¯1¯ 22,9oC 1o,o9¯ o4,¯9o 22,o7C o¯,o19
Totals 3,80l,97l 895,35l 500,988 70,425 266,59l 234,092 l,06l,l94 292,545 548,526
MISSOURI
American Lung Association in Missouri
1118 Hampton Avenue
St. Louis, MO 63139-3196
(314) 645-5505
www.lung.org/missouri
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 111
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Andrew 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Boone C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Buchanan DNC DNC DNC DNC DNC 1 C C C.¯ B INC INC
Callaway 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Cass ¯ C C 1.C C 1 C C C.¯ B 1C.2 PASS
Cedar 4 C C 1.¯ C C C C C.C A 1C.o PASS
Clay 2C C C o.7 F 1 C C C.¯ B 9.o PASS
Clinton 1o C C o.C F DNC DNC DNC DNC DNC DNC DNC
Greene 2 C C C.7 B 1 C C C.¯ B 1C.1 PASS
Jackson DNC DNC DNC DNC DNC 4 C C 1.¯ C 1C.7 PASS
Jasper 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Jeíerson 1C 1 C ¯.o F 1 C C C.¯ B 1C.4 PASS
Lincoln 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Monroe 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Perry 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
St. Charles 29 C C 9.7 F DNC DNC DNC DNC DNC DNC DNC
Ste. Genevieve 4 C C 1.¯ C INC INC INC INC INC INC INC
St. Louis 1o C C o.C F 2 C C C.7 B INC INC
Taney INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
St. Louis City 12 1 C 4.o F 4 1 C 1.o C 1¯.1 FAIL
MISSOURI
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 112
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Cascade o1,o¯7 1o,oo2 12,oo9 1,2oo o,7oC ¯,o2¯ 2C,o¯2 o,Coo 12,1o4
Flathead 91,¯C1 2C,o99 1¯,7oo 1,414 o,¯o¯ 4,¯4o 2¯,7o4 o,o22 11,1¯4
Gallatin 91,¯77 1o,o22 o,oo2 1,27¯ o,o12 ¯,711 2C,C17 4,ooo 1C,99o
Glacier 1¯,o24 4,2o9 1,4o1 29C oo1 o¯C 2,ooC ooo 4,1o2
Lewis and Clark o4,¯1o 14,414 9,C94 97o 4,o4o ¯,C14 1o,4oo 4,CC1 o,7o1
Lincoln 19,ooo ¯,o1o 4,1o2 2oo 1,¯91 1,C91 o,997 1,o22 4,297
Missoula 11C,1¯o 21,o2o 12,9o¯ 1,4oo o,242 4,7oo 2o,912 o,C72 1o,194
Powder River 1,7¯o ¯19 ¯9¯ 22 12o 1CC ooC 14C 2¯o
Ravalli 4C,4oC o,o2o o,119 oo4 2,o2o 2,14o 11,77C 2,9oo o,1¯¯
Richland 1C,12o 2,¯o2 1,4oo 1o9 7C7 472 2,o79 o2o 9o¯
Rosebud 9,¯79 2,7o4 1,C99 1oo oCo ¯9¯ 2,14o o1o 1,749
Sanders 11,44C 2,274 2,ooo 1o4 oCo o47 ¯,ooo 9Co 2,C41
Silver Bow ¯4,¯o¯ 7,1o9 o,o¯C 4o4 2,47C 1,o7¯ 9,127 2,2¯o o,7o9
Yellowstone 1oC,Co9 ¯o,2oo 21,o22 2,¯o7 1C,4o7 o,o1o ¯7,12C o,997 19,Coo
Totals 729,748 l6l,l00 l04,0l0 l0,898 52,023 33,549 l82,707 44,l74 l03,678
MONTANA
American Lung Association in Montana
3919 Heritage Way
Missoula MT 59802
(406) 728-0368
www.lung.org/montana
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 113
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Cascade DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Flathead C C C C.C A C C C C.C A INC INC
Gallatin DNC DNC DNC DNC DNC ¯ C C 1.C C INC INC
Glacier INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Lewis and Clark INC INC INC INC INC 1o ¯ C o.o F INC INC
Lincoln DNC DNC DNC DNC DNC ¯ C C 1.C C INC INC
Missoula INC INC INC INC INC 7 C C 2.¯ D 7.o PASS
Powder River INC INC INC INC INC INC INC INC INC INC INC INC
Ravalli DNC DNC DNC DNC DNC 1¯ 1 C 4.o F 7.o PASS
Richland C C C C.C A C C C C.C A o.C PASS
Rosebud INC INC INC INC INC INC INC INC INC INC INC INC
Sanders DNC DNC DNC DNC DNC C C C C.C A INC INC
Silver Bow DNC DNC DNC DNC DNC 19 C C o.¯ F 9.o PASS
Yellowstone DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
MONTANA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 114
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Douglas o24,oo1 1¯o,791 oo,9¯o o,2o1 2o,o24 1o,CC9 112,¯¯¯ 29,74o 74,97o
Hall o9,477 1o,21C 7,9o¯ 9o1 ¯,1o9 2,1o¯ 1¯,o4¯ ¯,o71 o,41C
Knox o,o7o 2,C¯o 1,9oo 12¯ 4o9 ¯94 2,o44 7Co 1,2o1
Lancaster 2o9,oCC oo,¯7¯ ¯2,1C9 4,C1o 1o,o29 1C,171 o¯,197 1o,o17 4C,144
Sarpy 1o2,oo1 4o,2o9 14,¯42 2,oCC o,o9¯ o,24o ¯2,o91 o,ooo 1C,o¯2
Scotts Bluí ¯7,C44 9,Coo o,272 ooC 2,C¯o 1,4oo 9,4o1 2,o7o o,1¯2
Sioux 1,¯¯o 292 294 1o 7o o2 4CC 111 229
Washington 2C,29o 4,9oC 2,949 ¯C1 1,11¯ oC7 o,1¯o 1,4C¯ 1,4¯¯
Totals l,l03,949 282,028 l2l,855 l7,072 60,608 38,339 239,305 63,4l6 l43,2l6
NEBRASKA
American Lung Association in Nebraska
8990 W. Dodge Road, Suite 226
Omaha, NE 68114
(402) 502-4250
www.lung.org/nebraska
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 115
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Douglas C C C C.C A o C C 1.7 C 9.o PASS
Hall DNC DNC DNC DNC DNC C C C C.C A 7.1 PASS
Knox INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Lancaster C C C C.C A 1 C C C.¯ B o.o PASS
Sarpy DNC DNC DNC DNC DNC 4 C C 1.¯ C 11.C PASS
Scotts Bluí INC INC INC INC INC C C C C.C A INC INC
Sioux INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Washington DNC DNC DNC DNC DNC 2 C C C.7 B 9.1 PASS
NEBRASKA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 116
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Churchill 24,o¯7 o,12o ¯,oo7 ¯o2 1,4o4 1,491 o,o91 2,1¯2 ¯,127
Clark 1,9o9,97o 4o9,2C7 2¯C,7oo 2o,o91 119,o¯9 1Co,o1o 4o2,o7o 1oC,72¯ ¯2o,o79
Lyon o1,o71 12,o24 o,o7C 74C ¯,Co7 ¯,¯Co 14,772 4,74o o,oCo
Washoe 42o,71C 99,179 o¯,499 o,oo7 2o,17C 24,¯oo 1C9,o99 ¯4,o2o oo,o4¯
White Pine 1C,C9o 2,17C 1,o¯C 12o o2o o27 2,o1o o9o 1,24o
Carson City oo,4¯9 11,741 9,4¯7 o9¯ ¯,42C ¯,o74 1o,C1o o,11o 7,oo1
Totals 2,537,730 620,949 307,958 36,67l l54,366 l39,878 633,073 l98,240 400,653
NEVADA
American Lung Association in Nevada
3552 W. Cheyenne Avenue, Suite 130
North Las Vegas NV 89032
(702) 431-6333
www.lung.org/nevada
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 117
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Churchill C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Clark ¯o C C 12.C F 2 C C C.7 B 7.7 PASS
Lyon 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Washoe ¯ C C 1.C C 4 C C 1.¯ C o.o PASS
White Pine 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Carson City 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
NEVADA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 118
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Belknap oC,22¯ 12,19o 1C,¯oo 1,C4¯ o,17C ¯,2o9 17,1Co 4,o¯7 o,191
Cheshire 7o,91o 14,74C 11,o7C 1,2o1 o,o¯2 ¯,99o 2C,7oC o,4o4 7,o49
Coos ¯2,ooo o,944 o,o¯2 oCo 2,oo2 1,o7o 9,ooC 2,o9C 4,ooo
Grafton oo,92¯ 1o,91o 14,2¯9 1,¯o1 o,CCo 4,72¯ 24,oo1 o,497 9,¯oo
Hillsborough 4C1,o9o 92,1o1 49,C9o 7,oo¯ ¯4,2oC 19,297 99,o44 2o,194 ¯¯,214
Merrimack 14o,o79 ¯1,11C 2C,ooo 2,ooC 12,ooo 7,4¯o ¯o,o¯7 1C,27C 12,¯¯¯
Rockingham 29o,2C7 oo,44o ¯9,2C7 o,o97 2o,2¯2 14,911 77,o29 2C,72o 1o,7¯4
Totals l,l03,234 237,534 l5l,669 20,3l3 95,032 55,506 288,266 76,500 92,042
NEW HAMPSHIRE
American Lung Association in New Hampshire
1800 Elm Street, Unit D
Manchester, NH 03104
(603) 410-5108
www.lung.org/newhampshire
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 119
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Belknap 1 C C C.¯ B C C C C.C A o.o PASS
Cheshire C C C C.C A o C C 2.C C 9.o PASS
Coos 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Grafton C C C C.C A C C C C.C A INC INC
Hillsborough o C C 1.7 C C C C C.C A 7.o PASS
Merrimack 1 C C C.¯ B 1 C C C.¯ B o.o PASS
Rockingham o C C 2.C C C 1 C C.o B INC INC
NEW HAMPSHIRE
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 120
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Atlantic 274,¯¯o o¯,1oo ¯9,o11 o,499 1o,94C 11,1¯C 72,2o9 19,242 ¯o,1Co
Bergen 911,CC4 2C2,¯o2 1¯o,oCC 17,o1o o¯,44o ¯7,797 24o,o9C oo,o¯o o9,2¯o
Camden o1¯,241 12¯,2o1 oo,71o 1C,7¯2 ¯o,12C 19,9CC 12o,o9o ¯¯,9¯4 oo,o¯9
Cumberland 1o7,C9o ¯7,o9o 2C,11¯ ¯,2o2 1C,771 o,97C ¯o,4o7 1C,C7¯ 24,¯CC
Essex 7oo,1¯7 19¯,¯oo 91,oC4 1o,o¯o o¯,o1o 29,14¯ 1o7,ooC 4o,o9o 1¯2,C17
Gloucester 2o9,1C4 o9,C9¯ ¯o,oCC o,C1o 19,o19 11,2o7 72,91C 19,24o 21,C¯o
Hudson o41,224 1¯2,19o o7,1¯1 11,o1C 4o,¯o¯ 2¯,¯2o 14o,¯1o ¯7,o9o 1C2,17¯
Hunterdon 12o,C¯o 29,Coo 17,C9o 2,o¯¯ o,o72 o,¯49 ¯o,CC9 9,¯9o o,¯7C
Mercer ¯o7,Co¯ o2,122 47,4oo 7,1oC 2o,o97 14,¯4o 92,o7o 24,¯Co ¯o,79C
Middlesex o14,217 1o4,¯9C 1C1,oCo 1o,Co4 oo,ooC ¯1,¯27 2C1,o24 o2,7o4 o7,199
Monmouth o¯1,C2C 147,1C9 o9,Coo 12,oCo 4¯,¯79 2o,o1C 1oo,117 44,9¯1 42,9o¯
Morris 494,97o 11o,o1o 7C,242 1C,Co7 ¯4,C21 2C,17C 1¯1,2o¯ ¯o,C4¯ 24,4¯o
Ocean o79,¯o9 1¯4,9oo 122,14C 11,7o1 ¯9,1o¯ 2o,o¯4 1oo,7o2 4o,1C9 o4,4o7
Passaic oC2,CC7 12¯,7C¯ o1,oo1 1C,77C ¯4,1o4 1o,ooo 121,o21 ¯1,oC4 79,7o9
Union o¯9,494 1¯C,o71 oo,o2C 11,¯oo ¯o,oo7 2C,721 1¯¯,oo4 ¯o,22o oo,9o9
Warren 1Co,¯¯9 24,794 1o,o2¯ 2,1o9 7,4oo 4,4oo 29,C91 7,779 o,21o
Totals 7,735,666 l,793,384 l,054,l68 l56,l43 534,502 305,403 l,975,924 522,l02 828,920
NEW JERSEY
American Lung Association in New Jersey
1031 Route 22 West Suite 203
Bridgewater, NJ 08807-2919
(908) 685-8040
www.lung.org/newjersey
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 121
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Atlantic 9 C C ¯.C D C C C C.C A 9.2 PASS
Bergen 1o C C o.C F 2 C C C.7 B 9.2 PASS
Camden 22 2 C o.¯ F C C C C.C A 9.7 PASS
Cumberland o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Essex 17 C C o.7 F C C C C.C A INC INC
Gloucester 24 2 C 9.C F C C C C.C A 9.¯ PASS
Hudson 1C 1 C ¯.o F 4 C C 1.¯ C 11.1 PASS
Hunterdon 17 C C o.7 F DNC DNC DNC DNC DNC DNC DNC
Mercer 24 C C o.C F 2 C C C.7 B 9.7 PASS
Middlesex 2o C C o.7 F C C C C.C A 7.9 PASS
Monmouth 1o 1 C o.o F DNC DNC DNC DNC DNC DNC DNC
Morris 12 C C 4.C F 1 C C C.¯ B o.o PASS
Ocean 27 1 C 9.o F C C C C.C A o.o PASS
Passaic 7 C C 2.¯ D 1 C C C.¯ B 9.¯ PASS
Union DNC DNC DNC DNC DNC o C C 1.7 C 11.4 PASS
Warren INC INC INC INC INC 2 C C C.7 B 9.2 PASS
NEW JERSEY
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 122
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Bernalillo o7C,9oo 1o9,74C o¯,o2¯ 1o,Co1 o1,4¯¯ ¯C,94o 1o4,72C 49,9o1 129,oo2
Chaves oo,o9C 1o,4o4 9,¯oC 1,ooo 4,74o ¯,C24 1o,C7C 4,oo1 14,2o7
Doña Ana 21¯,o9o oo,oC¯ 2o,9¯o o,oo1 1o,o1o 9,4Co 47,C¯o 1o,117 o1,C2¯
Eddy o4,1o2 1¯,9¯7 7,o44 1,4C1 4,C21 2,oo¯ 12,o7¯ 4,1oo o,1¯o
Grant 29,¯oC o,¯Co o,4oC o¯4 2,2oo 1,71o o,49o 2,794 o,924
Lea oo,42¯ 19,¯2¯ 7,Coo 1,94¯ 4,oo4 2,o9¯ 1¯,4oo 4,¯¯C 11,7¯o
Luna 2o,2o1 o,7Co 4,994 o74 1,o¯o 1,¯Co o,47¯ 2,1C7 o,94C
Sandoval 1¯4,2o9 ¯4,o99 17,C¯2 ¯,oC9 9,9o¯ o,291 ¯1,¯99 1C,22¯ 19,o¯C
San Juan 12o,2CC ¯o,7o¯ 14,447 ¯,o9o 9,2Co o,oCo 27,o¯o o,o9¯ 22,oo¯
Santa Fe 14o,o4o ¯C,Co¯ 2¯,¯o¯ ¯,C22 11,49¯ 7,o¯4 ¯o,971 12,7o¯ 2¯,ooo
Valencia 77,C7C 19,9o4 1C,¯C4 2,CC7 o,71¯ ¯,ooo 1o,24¯ o,941 1o,C21
Totals l,609,869 402,640 2ll,43l 40,482 l2l,l36 74,966 374,307 l2l,205 320,0l4
NEW MEXICO
American Lung Association in New Mexico
5911 Jeíerson Street, NE
Albuquerque, NM 87109
(505) 265-0732
www.lung.org/newmexico
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 123
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Bernalillo o C C 1.7 C o C C 1.7 C o.9 PASS
Chaves DNC DNC DNC DNC DNC C C C C.C A INC INC
Doña Ana 4 C C 1.¯ C 2C 2 C 7.7 F 11.9 PASS
Eddy 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Grant ¯ C C 1.C C C C C C.C A INC INC
Lea C C C C.C A 1 C C C.¯ B INC INC
Luna C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Sandoval C C C C.C A INC INC INC INC INC INC INC
San Juan ¯ C C 1.C C C C C C.C A 4.o PASS
Santa Fe C C C C.C A 1 C C C.¯ B 4.2 PASS
Valencia 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
NEW MEXICO
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 124
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Albany ¯C¯,ooo o9,114 42,oo7 o,o9o 2¯,71o 14,o12 oC,129 2o,o¯4 ¯9,1o7
Bronx 1,¯92,CC2 ¯oo,277 149,¯9¯ ¯4,o74 1CC,C¯4 o7,41C ¯12,1¯7 97,99o 41C,o4o
Chautauqua 1¯4,¯oo 2o,oo7 22,oo7 2,7¯o 1C,1o1 o,oo1 ¯7,¯2C 12,Co7 2o,o2o
Chemung oo,o4C 19,o1o 1¯,9oo 1,ooo o,o7C 4,¯24 24,1o1 7,799 1¯,71o
Dutchess 297,999 o4,497 41,¯¯¯ o,1Co 22,o72 14,2C4 79,C¯7 2o,¯71 2o,¯o¯
Erie 91o,C2o 19o,C99 144,799 1o,47o o9,7oC 44,77o 249,oCo oC,¯o1 1¯o,447
Essex ¯9,1o1 7,¯7o 7,241 o99 ¯,C4o 2,Coo 11,o71 ¯,79o o,¯o¯
Franklin o1,oo1 1C,o1¯ 7,CC9 99o ¯,97o 2,44o 1¯,o4o 4,¯2o 9,4C2
Hamilton 4,79¯ 7o1 1,1oo 74 ¯79 2o7 1,oo7 o49 o12
Herkimer o4,1oC 14,C2C 1C,74o 1,¯2o 4,o17 ¯,2CC 17,9o9 o,o29 1C,o9C
Jeíerson 117,91C 29,7o2 1¯,1o4 2,o1o o,o1o 4,942 2o,o49 o,42¯ 19,44o
Kings 2,o¯2,o4o o9o,1o2 291,o94 oo,o4¯ 1oo,991 1Co,7o¯ o91,o7o 1oo,7oC o9¯,1o2
Madison 7¯,¯oo 1o,o4o 1C,477 1,472 o,oo9 ¯,o2C 19,oo¯ o,2o4 o,11o
Monroe 74o,o2o 1oo,oC2 1Co,o44 1o,o72 oo,1o1 ¯o,CC1 194,Coo o2,1C1 11o,2o1
Nassau 1,¯44,4¯o ¯Co,o47 2C7,C49 29,Co7 99,9¯C o4,9o9 ¯o¯,o92 117,49¯ 9¯,Co2
New York 1,oC1,94o 2¯7,292 21o,o44 22,47C 1¯¯,447 7o,419 414,¯¯C 129,72C 2oo,Co1
Niagara 21o,C11 4o,o72 ¯4,7C2 4,¯1o 1o,4C2 1C,7¯9 oC,21C 19,4o4 27,24o
Oneida 2¯4,2o7 oC,4¯¯ ¯o,oCo 4,77o 17,71C 11,o¯2 o4,oCo 2C,oC9 ¯7,79¯
Onondaga 4oo,9oC 1Co,2oo oo,219 9,9oo ¯4,99¯ 21,91o 121,ooo ¯o,9o2 7C,191
Orange ¯74,o72 1CC,C79 42,411 9,477 2o,oo2 1o,14C o9,CoC 2o,¯o¯ oC,494
Oswego 122,22o 27,49o 1o,7¯o 2,oC4 9,179 o,oo9 ¯1,¯o2 1C,C22 22,o92
Putnam 99,9¯¯ 22,944 1¯,C2C 2,17¯ 7,421 4,7o1 2o,oo1 o,oC9 o,o2o
Queens 2,247,o4o 4o¯,ooo 29C,oo9 4¯,o9o 17¯,oo4 1C¯,¯¯1 ooo,7C¯ 179,422 ¯oo,27o
Rensselaer 1o9,¯9o ¯¯,429 21,77o ¯,1oo 12,2C1 7,ooo 41,o74 1¯,¯9C 1o,412
Richmond 47C,4o7 1C7,o7o o1,194 1C,21o ¯o,147 21,o19 119,o44 ¯o,2C9 oo,1C¯
NEW YORK
American Lung Association in New York
418 Broadway, First Floor
Albany, NY 12207
(518) 465-2013
www.lung.org/newyork
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 125
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Rockland ¯1o,1oo o7,oo2 4¯,C94 o,¯C1 21,9o2 1¯,92C 77,4oo 24,o7C 4¯,7o4
St. Lawrence 111,o9C 2¯,¯¯7 1o,747 2,21C o,ooo o,2oo 29,C9¯ 9,277 1o,992
Saratoga 22C,oo2 4o,797 ¯1,C¯7 4,o21 1o,o11 1C,o74 o9,CC1 1o,9o9 1o,4C7
Schenectady 1oo,Coo ¯4,o47 2¯,¯oo ¯,¯CC 11,oCo 7,4Co 41,29o 1¯,27o 21,¯99
Steuben 99,C¯¯ 22,771 1o,911 2,1oo 7,¯¯1 4,o44 27,2C9 o,o11 17,7C2
Suíolk 1,49o,o1o ¯o1,7oo 2C7,o¯1 ¯¯,¯12 11C,o42 7C,CC2 ¯o9,7C¯ 12o,1o1 1C1,¯oo
Tompkins 1C1,72¯ 1o,729 11,24o 1,4o9 o,4o¯ 4,oo7 24,¯21 7,49o 17,7o2
Ulster 1o2,44o ¯o,7oo 27,9oo ¯,¯o7 14,141 9,112 oC,94o 1o,42o 2o,29o
Wayne 9¯,4¯o 21,oo9 1¯,oCo 2,Co1 o,9C7 4,o1C 2o,¯C2 o,1o4 11,77¯
Westchester 9oo,o99 22o,922 141,47o 21,¯94 7C,4o4 4o,C44 2o1,2C4 oC,oC7 9¯,1C7
Totals l7,836,560 3,946,234 2,403,779 373,690 l,348,l5l 822,035 4,535,032 l,443,978 2,8l0,344
NEW YORK
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 126
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Albany 4 C C 1.¯ C 1 C C C.¯ B o.¯ PASS
Bronx 7 C C 2.¯ D o C C 1.7 C 11.9 PASS
Chautauqua 1C C C ¯.¯ F C C C C.C A 7.4 PASS
Chemung 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Dutchess o 1 C 2.o D DNC DNC DNC DNC DNC DNC DNC
Erie 2 C C C.7 B 1 C C C.¯ B 9.7 PASS
Essex o C C 2.C C C C C C.C A 4.4 PASS
Franklin 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Hamilton C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Herkimer C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Jeíerson 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
Kings DNC DNC DNC DNC DNC 2 C C C.7 B 1C.¯ PASS
Madison 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Monroe C C C C.C A 1 C C C.¯ B INC INC
Nassau DNC DNC DNC DNC DNC C C C C.C A o.9 PASS
New York 9 C C ¯.C D 2 C C C.7 B 11.7 PASS
Niagara ¯ C C 1.C C C C C C.C A INC INC
Oneida C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Onondaga o C C 1.7 C C C C C.C A 7.7 PASS
Orange 4 C C 1.¯ C 1 C C C.¯ B o.2 PASS
Oswego 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Putnam 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Queens 9 1 C ¯.o F 2 C C C.7 B 9.4 PASS
Rensselaer 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Richmond 2o 1 C 9.2 F 1 C C C.¯ B 9.o PASS
Rockland o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
NEW YORK
American Lung Association in New York
418 Broadway, First Floor
Albany, NY 12207
(518) 465-2013
www.lung.org/newyork
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 127
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
St. Lawrence DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Saratoga 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Schenectady 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Steuben C C C C.C A C C C C.C A 7.1 PASS
Suíolk 2o ¯ C 1C.o F C C C C.C A o.4 PASS
Tompkins INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Ulster 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Wayne C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Westchester o 1 C ¯.2 D 1 C C C.¯ B 9.1 PASS
NEW YORK
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 128
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Alamance 1o¯,291 ¯o,777 22,7Co ¯,CoC 1C,¯4C o,¯o1 42,497 1¯,¯o4 2o,oo¯
Alexander ¯7,Co7 o,29o o,oo2 7C9 2,o¯C 2,12C 1C,o1o ¯,424 o,o1C
Avery 17,o72 2,99o ¯,Co9 2oo 1,2oC 1,Co¯ o,42o 1,714 ¯,171
Buncombe 241,419 49,CCo ¯9,1o7 4,191 1o,9Co 1¯,949 71,122 22,4¯9 42,7oo
Caldwell o2,¯9o 1o,2oo 1¯,14o 1,oo2 o,o¯4 4,744 24,2Co 7,o71 1o,o91
Carteret o7,¯7¯ 12,o22 1¯,12o 1,C79 4,7oo 4,274 21,9¯¯ 7,C19 11,CoC
Caswell 2¯,4C¯ 4,o41 ¯,9Co ¯97 1,o4o 1,422 7,2o2 2,¯1¯ 4,¯7C
Catawba 1o4,1o1 ¯o,1o4 22,oC¯ ¯,C9¯ 1C,¯o9 o,o1C 4¯,¯C¯ 1¯,oo4 22,CC1
Chatham o4,19o 1¯,ooo 12,14C 1,1oo 4,¯99 ¯,911 2C,C7o o,41o 7,1o2
Cumberland ¯24,ooo oo,C92 ¯1,114 7,¯o2 21,197 14,9o¯ 7o,192 22,9o2 o9,9o7
Davidson 1o2,o97 ¯o,2o9 2¯,97o ¯,27¯ 1C,9o1 9,CoC 4o,12¯ 14,o7¯ 2¯,ooo
Davie 41,oo2 9,o91 7,1¯7 o2C 2,oC1 2,44¯ 12,oC4 ¯,9o7 4,oo2
Duplin o9,o42 1o,Co9 o,o¯C 1,29C ¯,912 ¯,17¯ 1o,14o o,C79 11,o7C
Durham 27¯,¯92 o2,C1o 27,244 o,¯C¯ 1o,7o7 1¯,2C1 oo,21o 2C,21o o1,o91
Edgecombe oo,C41 1¯,47o o,¯oC 1,1o2 ¯,744 ¯,12¯ 1o,91¯ o,C¯o 14,C19
Forsyth ¯o4,9o2 oo,o¯1 4o,974 7,¯4C 2¯,744 1o,7C2 94,o47 29,o77 o4,¯4o
Franklin o1,14C 14,7oo o,1C9 1,2o2 4,C9¯ ¯,¯Co 1o,7o7 o,2o4 9,o97
Gaston 2C7,C¯1 4o,97o 2o,C9¯ 4,1oo 1¯,94C 11,1o7 oo,o¯1 17,7o1 ¯¯,o2C
Graham o,oC2 1,o99 1,7o4 1o2 oC2 o4¯ 2,791 o94 1,919
Granville o9,97o 12,971 7,7oC 1,1C9 4,1o4 ¯,¯CC 1o,71o o,24o o,oCo
Guilford 49o,279 114,911 o2,C¯o 9,o27 ¯¯,o12 2o,724 1¯C,122 4C,472 9C,o99
Haywood oo,ooo 11,1o9 12,7o7 9o7 4,1oC ¯,7oo 19,oCo o,2oo 1C,79o
Jackson 4C,2oo 7,C¯o o,2o1 oC2 2,927 2,2oo 11,o2C ¯,ooo 7,4CC
Johnston 172,o9o 47,ooo 1o,224 4,C7o 11,Coo o,¯92 42,¯2¯ 1¯,1o4 2o,11o
Lenoir o9,¯¯9 14,17o 9,oo1 1,212 ¯,9o¯ ¯,¯o9 17,¯1o o,oC2 14,oo4
NORTH CAROLINA
American Lung Association in North Carolina
514 Daniels Street, #109
Raleigh, NC 27605
(919) 719-9960
www.lung.org/northcarolina
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 129
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Lincoln 7o,9¯2 1o,¯29 1C,7oo 1,oo7 o,¯4o 4,¯74 22,214 7,C1C 11,C9¯
McDowell 4o,1C4 9,o4o 7,o72 o2o ¯,11C 2,o42 1¯,oC4 4,2o4 o,o¯4
Macon ¯4,C74 o,oCo o,4C1 oo7 2,¯o7 2,27o 11,7oC ¯,oC1 o,41C
Martin 24,1oC o,241 4,¯o¯ 44o 1,ooo 1,472 7,o4o 2,41¯ o,944
Mecklenburg 944,¯7¯ 2¯o,4o9 oo,4o7 2C,¯9¯ o2,749 44,217 221,o29 o7,711 1o9,14o
Mitchell 1o,44o 2,9¯7 ¯,¯¯o 2o1 1,Co9 994 o,119 1,o42 2,92o
Montgomery 27,oo7 o,ooo 4,¯¯o oo9 1,o4o 1,oo1 7,917 2,oCo 7,2oo
New Hanover 2Co,1o9 4C,o97 29,¯o7 ¯,472 14,oC2 11,2oo o7,141 17,7o7 ¯4,971
Person ¯9,o¯7 9,11o o,1oo 779 2,oo¯ 2,27o 11,oC7 ¯,ooo 7,C92
Pitt 171,1¯4 ¯7,9oo 17,2¯9 ¯,24o 11,o2C o,227 41,2oo 12,oo9 41,C41
Robeson 1¯o,o17 ¯o,¯99 1o,oo4 ¯,11¯ o,7oo o,ooo ¯¯,792 1C,oC7 4C,o1o
Rockingham 9¯,¯29 2C,¯oo 1o,ooC 1,742 o,4C¯ o,4o9 2o,C47 o,917 1o,¯oo
Rowan 1¯o,C19 ¯2,29o 2C,2o4 2,7o2 9,¯Co 7,oCC ¯o,o7o 12,1oo 2o,¯2¯
Swain 14,C4¯ ¯,2o9 2,41o 2oC 944 oCo 4,1¯4 1,¯12 2,oo9
Union 2Co,4o¯ o1,¯71 2C,oo7 o,24o 12,771 9,7oC 49,1oo 1o,¯C9 21,o41
Wake 929,7oC 2¯9,4oo o2,19¯ 2C,47o o1,¯oo 4¯,o99 21o,94¯ o7,11o 1Co,o29
Watauga o1,¯¯¯ 7,C77 o,o¯o oCo ¯,91o 2,72o 1¯,7C9 4,1oo 11,912
Wayne 12¯,o97 ¯C,49o 1o,492 2,oCo o,22C o,49C ¯2,92o 1C,¯Co 2o,¯o2
Yancey 17,7C1 ¯,o1o ¯,7¯¯ ¯C1 1,2¯o 1,124 o,79C 1,oo7 ¯,ooo
Totals 6,572,896 l,575,325 804,227 l34,7l4 44l,773 338,563 l,7l2,089 532,804 l,lll,973
NORTH CAROLINA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 130
NORTH CAROLINA
American Lung Association in North Carolina
514 Daniels Street, #109
Raleigh, NC 27605
(919) 719-9960
www.lung.org/northcarolina
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Alamance DNC DNC DNC DNC DNC 1 C C C.¯ B 1C.1 PASS
Alexander ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Avery C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Buncombe 1 C C C.¯ B C C C C.C A 9.¯ PASS
Caldwell 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Carteret INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Caswell 2 C C C.7 B C C C C.C A o.9 PASS
Catawba DNC DNC DNC DNC DNC C C C C.C A 1C.o PASS
Chatham C C C C.C A C C C C.C A o.o PASS
Cumberland 7 C C 2.¯ D C C C C.C A 1C.¯ PASS
Davidson DNC DNC DNC DNC DNC C C C C.C A 11.1 PASS
Davie 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Duplin DNC DNC DNC DNC DNC 1 C C C.¯ B o.9 PASS
Durham ¯ C C 1.C C C C C C.C A 9.7 PASS
Edgecombe 2 C C C.7 B C C C C.C A 9.1 PASS
Forsyth 1o C C o.C F C C C C.C A 1C.C PASS
Franklin 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Gaston DNC DNC DNC DNC DNC C C C C.C A 1C.o PASS
Graham 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Granville 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Guilford 9 C C ¯.C D C C C C.C A 9.o PASS
Haywood o C C 1.7 C C C C C.C A 1C.C PASS
Jackson ¯ C C 1.C C C C C C.C A 9.4 PASS
Johnston 2 C C C.7 B 1 C C C.¯ B 9.2 PASS
Lenoir 1 C C C.¯ B 1 1 C C.o B 9.¯ PASS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 131
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Lincoln o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
McDowell DNC DNC DNC DNC DNC C C C C.C A 9.o PASS
Macon INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Martin 1 C C C.¯ B C C C C.C A o.7 PASS
Mecklenburg ¯2 1 C 11.2 F C C C C.C A 11.2 PASS
Mitchell DNC DNC DNC DNC DNC C C C C.C A 9.¯ PASS
Montgomery INC INC INC INC INC C C C C.C A 9.¯ PASS
New Hanover 1 C C C.¯ B INC INC INC INC INC INC INC
Person 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Pitt 4 C C 1.¯ C C C C C.C A o.7 PASS
Robeson DNC DNC DNC DNC DNC C C C C.C A 1C.C PASS
Rockingham o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Rowan 2o C C o.¯ F C C C C.C A 1C.o PASS
Swain C C C C.C A C C C C.C A 9.7 PASS
Union ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Wake 9 C C ¯.C D C 1 C C.o B 9.o PASS
Watauga DNC DNC DNC DNC DNC C C C C.C A o.¯ PASS
Wayne DNC DNC DNC DNC DNC C C C C.C A 9.9 PASS
Yancey ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
NORTH CAROLINA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 132
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Billings o1o 14¯ 12o o o¯ ¯¯ 2¯C o2 7¯
Burke 2,C¯¯ 4¯9 ¯99 2o 12o oo o91 1o¯ 179
Burleigh o¯,14o 1o,o4C 11,¯oo 1,C77 o,1o2 ¯,C1o 2C,¯2o o,¯17 7,¯47
Cass 1o2,¯oo ¯2,727 1o,C7o 1,o9C 9,777 4,9o7 ¯2,o17 o,1Co 1o,¯oo
Dunn ¯,72C oC4 o1o 4o 2¯1 147 1,CC7 272 ¯9o
McKenzie 7,C19 1,o79 911 1C9 41C 24o 1,oo¯ 44C ooo
Mercer o,449 1,o11 1,¯4o 1Co o19 ¯42 2,¯o2 o4o oo¯
Oliver 1,o¯C ¯99 29o 2¯ 111 7o o2C 144 21C
Totals 259,380 56,842 30,l27 3,283 l6,408 8,930 59,5l6 l5,l54 28,079
NORTH DAKOTA
American Lung Association in North Dakota
212 N. 2nd Street
Bismarck, ND 58501
(701) 223-5613
www.lung.org/northdakota
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 133
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Billings C C C C.C A C C C C.C A 4.¯ PASS
Burke C C C C.C A INC INC INC INC INC INC INC
Burleigh C C C C.C A C C C C.C A o.9 PASS
Cass C C C C.C A 2 C C C.7 B o.1 PASS
Dunn C C C C.C A INC INC INC INC INC INC INC
McKenzie C C C C.C A INC INC INC INC INC INC INC
Mercer C C C C.C A C C C C.C A o.¯ PASS
Oliver C C C C.C A INC INC INC INC INC INC INC
NORTH DAKOTA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 134
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Allen 1Co,C94 2o,1o¯ 1o,oo9 2,o1o 7,9¯o o,¯2o 29,¯¯o o,¯2o 19,2C¯
Ashtabula 1C1,¯4o 2¯,o¯o 1o,1¯7 2,¯o4 7,o9C o,272 29,1oo o,¯4o 19,o91
Athens o4,7o9 9,oo7 o,oo¯ 9o7 o,ooC ¯,o1o 1o,o¯o 4,24C 19,¯o¯
Butler ¯o9,999 92,1oC 4¯,ooC 9,21o 27,oo¯ 2C,72o 94,o12 2o,o17 49,749
Clark 1¯7,o91 ¯2,211 22,o42 ¯,222 1C,27o o,47o ¯9,o¯o 11,292 2o,o42
Clermont 199,1¯9 49,9o7 24,4o9 o,CCC 14,7¯¯ 11,oCo o2,7o7 14,949 21,474
Clinton 41,927 1C,2C4 o,749 1,C21 ¯,12C 2,472 11,4C4 ¯,2¯o o,¯7o
Cuyahoga 1,27C,294 2o¯,1oo 19o,2o¯ 2o,¯2¯ 9o,o7o 7o,1C¯ ¯o2,7o1 1C¯,2oo 2¯¯,4¯o
Delaware 17o,¯41 oC,9C4 17,o¯4 o,C92 12,ooo 9,o1o 4¯,2¯C 12,1o¯ 7,94o
Fayette 2o,9oo 7,C74 4,¯o9 7Co 2,144 1,7¯¯ o,C49 2,291 o,C9C
Franklin 1,17o,799 2oC,7o1 11o,oC7 2o,Co1 o9,9o2 o2,9C9 2oo,CCo 7o,o1o 21o,974
Geauga 9¯,22o 2¯,44o 1o,C49 2,¯4o o,7oo o,ooo 27,4¯o 7,9¯2 7,¯o¯
Greene 1o2,o4o ¯4,4o4 22,oo¯ ¯,447 12,o7o 9,oo9 44,o41 12,o2o 2¯,9oC
Hamilton oCC,¯o2 1o7,7¯o 1Co,77o 1o,77o oC,4o9 4o,oo4 214,¯o9 oC,44C 144,¯oo
Jeíerson oo,o2o 1¯,717 12,o¯4 1,¯72 o,¯4C 4,oo¯ 21,¯¯C o,1¯C 11,2CC
Knox o1,27o 14,oo9 9,11o 1,4o7 4,ooC ¯,o4o 1o,91o 4,oCC o,¯o2
Lake 229,ooo oC,C9o ¯7,4oo o,C11 17,o22 14,o91 o7,914 19,4o¯ 2¯,C42
Lawrence o2,4o9 14,4¯4 9,o¯¯ 1,444 4,o97 ¯,o14 17,7¯o o,Co2 11,oo4
Licking 1o7,24o 4C,72o 22,o9o 4,C74 12,44o 9,ooo 4o,491 12,914 21,27¯
Lorain ¯C1,o14 7C,7o7 44,Co7 7,C77 22,o¯2 1o,2oC o4,o1o 24,C7C 44,7oo
Lucas 44C,CCo 1C4,¯1¯ oo,ooo 1C,4¯4 ¯¯,12¯ 2o,oo4 117,oo2 ¯¯,194 1CC,12¯
Madison 4¯,4C1 9,o7o o,471 9oo ¯,¯¯9 2,o4o 11,oo9 ¯,2oo 4,oCo
Mahoning 2¯7,27C oC,¯oo 42,¯1o o,C¯o 1o,1¯C 1o,¯4C 71,oCo 2C,oCo 4C,oo¯
Medina 17¯,2o2 42,o4o 2¯,424 4,2oo 12,o11 1C,¯42 47,o79 1¯,o97 1o,¯Co
Miami 1C2,oo7 24,4o¯ 1o,1oo 2,44o 7,oo2 o,29o 29,29o o,¯71 14,1¯¯
OHIO
American Lung Association in Ohio
1950 Arlingate Lane
Columbus, OH 43228-4102
(614) 279-1700
www.lung.org/ohio
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 135
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Montgomery o¯7,oC2 121,o1C oo,1CC 12,1o4 4C,ooo ¯2,7¯o 1o2,2o7 4¯,272 9o,Co¯
Noble 14,7C2 2,797 ¯,122 2oC 1,1¯9 1,C4o 4,949 1,442 2,172
Portage 1o1,o24 ¯2,o9C 21,¯44 ¯,27C 12,7o7 9,o¯7 44,22o 12,417 24,2CC
Preble 42,Co¯ 1C,C9o o,o21 1,C1C ¯,122 2,oo¯ 12,CCo ¯,4¯o 4,o29
Scioto 79,277 17,ooC 12,¯o2 1,7oo o,C17 4,791 22,2o2 o,¯12 19,o71
Stark ¯7o,Co7 o4,o4¯ o1,972 o,4oo 2o,¯C¯ 2¯,4o¯ 1C9,¯oC ¯1,2o9 o9,o9o
Summit o¯9,o¯2 121,199 79,o47 12,12¯ 41,Co7 ¯2,9¯o 1o2,4C7 4¯,¯44 o7,o4C
Trumbull 2C9,2o4 4o,o92 ¯o,ooC 4,ooC 1o,o7o 1¯,4o9 o¯,C2¯ 1o,C99 ¯¯,94¯
Warren 214,91C o7,9o7 2¯,794 o,79o 1o,ooo 11,ooo o4,1oo 1o,277 14,477
Washington o1,7oo 12,o99 11,C4o 1,27C 4,7oC 4,C21 1o,o1o o,¯9o o,o49
Wood 12o,¯oo 2o,oo4 1o,7o1 2,ooo 9,ooo 7,2o7 ¯¯,2oo 9,2oC 1o,o17
Totals 8,984,444 2,080,7l8 l,257,8l8 208,l2l 679,5l6 532,293 2,457,043 695,237 l,464,204
OHIO
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 136
OHIO
American Lung Association in Ohio
1950 Arlingate Lane
Columbus, OH 43228-4102
(614) 279-1700
www.lung.org/ohio
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Allen 4 C C 1.¯ C INC INC INC INC INC INC INC
Ashtabula 17 C C o.7 F DNC DNC DNC DNC DNC DNC DNC
Athens 1 C C C.¯ B C C C C.C A 9.C PASS
Butler ¯C C C 1C.C F 1 C C C.¯ B 1¯.C FAIL
Clark 12 C C 4.C F 1 C C C.¯ B 12.o FAIL
Clermont 11 1 C 4.2 F C C C C.C A 11.¯ PASS
Clinton 17 C C o.7 F DNC DNC DNC DNC DNC DNC DNC
Cuyahoga 1o C C o.¯ F 4 C C 1.¯ C 1¯.1 FAIL
Delaware ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Fayette INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Franklin 14 C C 4.7 F 2 C C C.7 B 12.2 FAIL
Geauga o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Greene o C C 2.C C C C C C.C A INC INC
Hamilton ¯7 1 C 12.o F 7 C C 2.¯ D 1¯.o FAIL
Jeíerson 1 C C C.¯ B ¯ C C 1.C C 12.o FAIL
Knox 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Lake 2¯ C C 7.7 F C C C C.C A 1C.1 PASS
Lawrence ¯ C C 1.C C C C C C.C A 11.4 PASS
Licking o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Lorain 4 C C 1.¯ C 1 C C C.¯ B 9.9 PASS
Lucas o C C 2.7 D ¯ C C 1.C C 11.4 PASS
Madison 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Mahoning o C C 1.7 C ¯ C C 1.C C 11.o PASS
Medina ¯ C C 1.C C C C C C.C A INC INC
Miami ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Montgomery 1o C C o.C F 1 C C C.¯ B 12.9 FAIL
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 137 OHIO
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Noble INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Portage 2 C C C.7 B C C C C.C A 1C.9 PASS
Preble 4 C C 1.¯ C 1 C C C.¯ B 11.¯ PASS
Scioto DNC DNC DNC DNC DNC C C C C.C A 1C.9 PASS
Stark 1o C C o.¯ F 7 C C 2.¯ D 1¯.4 FAIL
Summit 1C C C ¯.¯ F o C C 2.C C 12.o FAIL
Trumbull o C C 2.7 D INC INC INC INC INC INC INC
Warren 1o C C o.C F 1 C C C.¯ B 11.o PASS
Washington o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Wood 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 138
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Adair 22,o12 o,2o9 2,9oo o9C 1,o7C 1,429 o,¯o7 1,oo1 4,97o
Caddo 29,o¯7 7,42C 4,¯¯7 o9o 2,12C 1,949 o,o9¯ 2,o4o o,oCo
Canadian 119,492 ¯1,9CC 1¯,19o ¯,CC¯ o,4oC 7,¯¯2 ¯2,47C 9,42¯ 9,oo7
Carter 4o,C9o 12,¯oo 7,179 1,1o¯ ¯,42o ¯,19C 14,22o 4,1oC 7,o4¯
Cherokee 47,o4o 11,411 o,o9¯ 1,C74 ¯,49o ¯,Co7 1¯,oo2 ¯,974 11,¯22
Cleveland 2o1,2o1 oo,ooo 27,oC¯ o,o4C 19,o¯o 1o,9o9 7C,744 2C,271 ¯¯,¯o¯
Comanche 12o,o1o ¯1,o44 12,o7o 2,9o9 9,C94 7,¯72 ¯2,7Co 9,¯oo 2C,241
Cotton o,179 1,497 1,C4C 141 44o 4¯1 1,927 oo9 1,1C¯
Creek 7C,4o7 17,¯¯o 1C,79o 1,o¯2 o,C9¯ 4,o29 21,o1¯ o,¯41 11,o1C
Dewey 4,oo7 1,197 1,C2C 11¯ ¯4o ¯oo 1,oC2 477 oCC
Jeíerson o,oCo 1,o42 1,244 14o 47¯ 472 2,117 o29 1,¯72
Kay 4o,1o9 11,o1¯ 7,9oo 1,C9¯ ¯,297 ¯,177 14,2¯C 4,2C2 o,147
Lincoln ¯4,1oo o,o¯¯ o,2o9 o1¯ 2,44o 2,¯4o 1C,4oC ¯,C9C o,C2C
Love 9,¯oo 2,2o4 1,o47 21o o7o oo7 2,944 o7C 1,o2¯
McClain ¯o,2¯o 9,¯9o 4,7¯4 ooo 2,4o4 2,29¯ 1C,1oo 2,991 4,91¯
McCurtain ¯¯,19o o,o¯9 o,171 o1¯ 2,¯oC 2,219 9,9Co 2,917 1C,C9o
Mayes 41,¯o9 1C,ooo o,o21 994 2,9oC 2,o12 12,ooo ¯,7C4 7,ooo
Muskogee 71,CC¯ 17,oo¯ 1C,o4o 1,ooo o,12C 4,7C9 21,CCo o,1o7 1o,2C1
Oklahoma 7¯2,¯71 1oo,CC¯ oo,2o4 17,oC9 o2,oo7 4o,422 2C1,o¯¯ oo,4o4 1¯7,49o
Osage 47,42o 11,¯4C 7,¯C7 1,Co7 ¯,4o2 ¯,¯22 14,7o1 4,¯oo o,¯17
Ottawa ¯1,ooC 7,ooC o,4Co 74C 2,291 2,1o7 9,712 2,oo9 o,¯9o
Pittsburg 4o,o2o 1C,Coo o,C1o 949 ¯,¯94 ¯,2o2 14,ooo 4,29o 7,o1¯
Sequoyah 42,¯41 1C,o92 o,492 1,C2o ¯,C12 2,o¯4 12,o4¯ ¯,721 o,7¯o
Tulsa o1C,o99 1oo,o¯¯ 74,91o 14,oo1 4¯,7o2 ¯o,212 1o9,7o4 49,¯CC 9C,C7o
Totals 2,523,440 63l,848 32l,l38 59,477 l8l,905 l59,8l0 7l0,643 206,586 420,7l6
OKLAHOMA
American Lung Association in Oklahoma
11212 N. May Ave Suite 405
Oklahoma City, OK 73120
(405) 748-4674
www.lung.org/oklahoma
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 139
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Adair o C C 1.7 C 1 C C C.¯ B INC INC
Caddo o C C 2.7 D C C C C.C A INC INC
Canadian 12 C C 4.C F DNC DNC DNC DNC DNC DNC DNC
Carter INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Cherokee o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Cleveland 12 C C 4.C F DNC DNC DNC DNC DNC DNC DNC
Comanche 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Cotton INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Creek 1o C C o.¯ F DNC DNC DNC DNC DNC DNC DNC
Dewey 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Jeíerson INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Kay 1¯ C C 4.¯ F DNC DNC DNC DNC DNC DNC DNC
Lincoln INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Love INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
McClain 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
McCurtain INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Mayes 1C C C ¯.¯ F C C C C.C A INC INC
Muskogee INC INC INC INC INC C C C C.C A INC INC
Oklahoma ¯2 C C 1C.7 F C C C C.C A 9.o PASS
Osage INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Ottawa 7 C C 2.¯ D INC INC INC INC INC INC INC
Pittsburg 7 C C 2.¯ D 1 C C C.¯ B 1C.1 PASS
Sequoyah ¯ C C 1.C C C C C C.C A INC INC
Tulsa ¯C C C 1C.C F C C C C.C A 1C.o PASS
OKLAHOMA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 140
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Clackamas ¯oC,2C7 oo,C9C o4,C19 o,¯¯o ¯C,o44 17,94o 9o,4CC 2o,¯42 41,4o7
Columbia 49,4C2 11,4oo 7,22o 1,Co4 ¯,9oo 2,¯oo 12,71o ¯,7o¯ o,C2C
Crook 2C,o¯9 4,¯oo 4,44C 41o 1,7C9 1,12o o,C99 1,o17 ¯,o4C
Deschutes 1oC,¯¯o ¯o,¯49 2o,C21 ¯,44C 12,944 7,o47 41,219 12,C72 21,999
Harney 7,¯7¯ 1,o¯7 1,4¯1 1oo o97 ¯oo 2,CoC o19 1,¯oC
Jackson 2C4,o22 44,1oo ¯7,C7¯ 4,179 1o,7¯4 1C,291 oo,o9o 1o,¯oo ¯9,o29
Josephine o2,9o7 1o,7C1 19,Co2 1,ooC o,o7o 4,o1o 24,99o 7,44o 17,C21
Klamath oo,299 14,o7¯ 11,oo1 1,¯79 o,¯9C ¯,29o 17,oC7 o,24C 1o,C2¯
Lake 7,9Co 1,444 1,o42 1¯7 o72 4¯9 2,¯oo 7Co 1,o¯o
Lane ¯o¯,41o oo,42C o4,oo7 o,47o 29,7o¯ 1o,o74 91,147 2o,¯o4 7¯,C4o
Linn 11o,122 2o,11o 1o,4o¯ 2,oo1 9,¯9¯ o,o¯C 29,o4¯ o,719 22,¯79
Marion ¯1o,o72 o¯,o4o 41,oCC 7,9¯o 24,oo7 1¯,oo2 7¯,1oC 21,Coo o¯,412
Multnomah 74o,C¯1 1o2,¯o¯ 79,o74 14,417 o2,4oo ¯1,oo7 17C,1oo 4o,122 142,279
Umatilla 7o,72o 2C,¯o¯ 9,7o4 1,927 o,o94 ¯,2oo 17,oo2 o,Co7 12,o4o
Union 2o,791 o,7¯2 4,¯9o o42 2,C91 1,247 o,74¯ 1,97C ¯,9o4
Washington o4C,41C 1¯o,oCo oo,2o4 12,927 42,¯¯¯ 21,9o9 11o,19o ¯¯,7C9 o7,o22
Totals 3,l6l,542 7l4,240 426,702 67,589 255,93l l42,l04 766,l06 22l,393 533,5l5
OREGON
American Lung Association in Oregon
7420 SW Bridgeport Road, Suite 200
Tigard, OR 97224-7711
(503) 924-4094
www.lung.org/oregon
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 141
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Clackamas ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Columbia C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Crook DNC DNC DNC DNC DNC 2 C C C.7 B o.o PASS
Deschutes C C C C.C A INC INC INC INC INC INC INC
Harney DNC DNC DNC DNC DNC ¯ C C 1.C C INC INC
Jackson C C C C.C A o C C 1.7 C o.o PASS
Josephine DNC DNC DNC DNC DNC 2 C C C.7 B 7.o PASS
Klamath DNC DNC DNC DNC DNC 11 1 C 4.2 F 1C.7 PASS
Lake DNC DNC DNC DNC DNC o ¯ C ¯.2 D 9.1 PASS
Lane C C C C.C A 21 1 C 7.o F 1C.C PASS
Linn DNC DNC DNC DNC DNC 1 C C C.¯ B INC INC
Marion 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Multnomah 2 C C C.7 B ¯ C C 1.C C 7.4 PASS
Umatilla C C C C.C A C C C C.C A 7.4 PASS
Union DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Washington C C C C.C A 4 C C 1.¯ C 7.9 PASS
OREGON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 142
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Adams 1C1,4¯4 22,Co7 1o,¯¯1 2,21o 7,12C o,¯9¯ 2o,1o7 7,7¯¯ o,4o1
Allegheny 1,227,Coo 2¯9,1o2 2C¯,o9o 2¯,991 o9,Co2 oo,¯oo ¯4o,C¯o 94,7oC 1o9,oo¯
Armstrong oo,ooo 1¯,o¯C 12,71C 1,¯o7 4,o4o ¯,o7o 2C,441 o,o92 o,9oC
Beaver 17C,414 ¯4,¯7o ¯1,o¯4 ¯,44o 12,Co2 9,o9¯ oC,o¯¯ 14,Co1 2C,o41
Berks 412,77o 9o,oo9 oC,49o 9,719 2o,o99 2C,9C1 1Co,ooo 29,oCo o¯,oo1
Blair 127,C99 2o,oo7 22,oo2 2,o7o o,97o o,929 ¯o,¯2¯ 1C,C49 1o,C74
Bucks o2o,oo4 14C,91C 9¯,7C¯ 14,1¯4 4¯,o22 ¯¯,Coo 172,97¯ 47,2o¯ 4C,oo1
Cambria 14¯,72o 27,749 2o,912 2,7o¯ 1C,¯¯1 o,Coo 42,499 11,oC4 19,4oo
Centre 1o4,722 2¯,729 17,7¯C 2,¯oC 12,42o 7,44o ¯7,191 9,o4C 2o,772
Chester oC¯,o97 122,97o oo,19o 12,¯¯o ¯4,o1o 2o,C21 129,o¯o ¯o,C¯1 ¯4,7oo
Clearfield o1,44o 1o,947 14,2oo 1,oCC o,oo9 4,oC4 2¯,o9o o,o11 11,2o7
Cumberland 2¯7,o92 4o,2¯7 ¯7,o7¯ 4,o¯o 17,1oo 12,o99 oo,oC4 17,oo¯ 17,9o1
Dauphin 2oo,977 o1,ooo ¯7,o¯4 o,177 1o,7o4 1¯,ooo 7C,9o4 19,2CC ¯¯,4Co
Delaware oo9,494 12o,42¯ oC,471 12,oo2 ¯9,C99 2o,¯44 147,Coo ¯9,o47 o4,77o
Elk ¯1,7o1 o,4o9 o,C¯C o49 2,22o 1,o12 9,o77 2,o77 ¯,C7o
Erie 2oC,9oo o2,942 41,1oC o,¯1¯ 19,7o7 14,¯2o 74,¯1o 2C,14o 44,1C¯
Franklin 1oC,o11 ¯o,oCC 2o,¯o9 ¯,o71 1C,¯4C 7,ooC 41,1CC 11,¯¯2 1o,¯oo
Greene ¯o,o2¯ 7,ooo o,947 7oo 2,o1C 2,Co1 1C,71¯ 2,912 o,47o
Indiana o9,29o 1o,4¯o 1¯,9o2 1,o49 o,oo7 4,7Co 24,¯C4 o,o72 1o,1oo
Lackawanna 214,1oo 4¯,o41 ¯7,771 4,¯o7 1o,¯C1 11,oo9 o1,C4o 1o,o4o 2o,¯¯9
Lancaster o2¯,o94 12o,o4o 79,oCo 12,9C4 ¯o,o9o 2o,¯29 1¯o,991 ¯7,4C2 oo,Co1
Lawrence 9C,o¯o 1o,942 17,Co9 1,9CC o,¯oC o,Co2 2o,o1¯ 7,42C 14,1o1
Lebanon 1¯4,¯11 ¯C,o72 2¯,Co4 ¯,Co7 9,2o7 7,12o ¯7,¯21 1C,¯C9 14,4o4
Lehigh ¯o2,947 o2,1oo o2,27o o,244 24,oC4 17,942 9¯,24o 2o,¯o7 4o,4¯o
Luzerne ¯2C,oo1 o4,179 o7,o¯9 o,4¯o 22,9o¯ 17,o41 92,412 2o,o49 47,1¯2
PENNSYLVANIA
American Lung Association in Pennsylvania
3001 Old Gettysburg Road
Camp Hill, PA 17011-7206
(717) 541-5864
www.lung.org/pennsylvania
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 143
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Lycoming 11o,747 24,CoC 19,2o9 2,41¯ o,¯41 o,2oo ¯2,ooo o,9o¯ 1o,941
Mercer 11o,2Co 24,712 21,o2o 2,479 o,14C o,4C7 ¯¯,o91 9,¯7o 1o,o7o
Monroe 1o9,oo2 ¯9,¯27 22,¯C2 ¯,94o 11,79¯ o,o¯7 44,9Co 12,12¯ 22,2o¯
Montgomery oC4,21C 1o1,7Co 122,9oo 1o,22o oo,C7o 41,oC¯ 217,927 o9,oC¯ oC,o2¯
Northampton 29o,47o o¯,991 47,o29 o,419 21,11C 1o,794 o2,¯oC 22,o41 2o,o7¯
Perry 4o,C42 1C,4oo o,o14 1,Co2 ¯,19o 2,¯9¯ 12,4o4 ¯,¯9o 4,917
Philadelphia 1,o¯o,471 ¯4o,974 1oo,Coo ¯4,7C¯ 11C,o41 72,oC¯ ¯o9,11C 97,274 414,o2o
Somerset 77,4Co 14,7¯¯ 14,o2o 1,47o o,oo¯ 4,4C9 2¯,21¯ o,4o9 9,9oo
Tioga 42,419 o,o1C 7,71C oo4 ¯,C19 2,¯41 12,27o ¯,4C2 o,¯2o
Washington 2Co,2o2 42,1oo ¯o,71¯ 4,2¯2 14,7oo 11,oo1 oC,741 1o,o12 21,479
Westmoreland ¯o4,471 71,19o o9,Co7 7,141 2o,92o 2C,oo1 11C,C¯4 ¯C,o91 ¯7,o77
York 4¯o,77C 1CC,o¯o o2,o97 1C,114 ¯C,¯oC 22,¯1o 11o,Coo ¯1,o22 4o,¯oo
Totals ll,l29,420 2,427,470 l,699,25l 243,490 787,203 577,6l4 3,002,864 8l7,438 l,474,755
PENNSYLVANIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 144
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Adams 4 C C 1.¯ C 2 C C C.7 B 11.7 PASS
Allegheny 29 1 C 1C.2 F oC o C 2C.7 F 1o.C FAIL
Armstrong o C C 1.7 C ¯ C C 1.C C INC INC
Beaver o C C 2.C C 2 C C C.7 B 12.4 FAIL
Berks 12 C C 4.C F 7 C C 2.¯ D 1C.7 PASS
Blair o C C 2.C C INC INC INC INC INC INC INC
Bucks 19 2 C 7.¯ F o 1 C 2.o D 1C.9 PASS
Cambria 4 C C 1.¯ C 1C C C ¯.¯ F 12.4 FAIL
Centre o C C 2.C C o C C 1.7 C 9.¯ PASS
Chester 1o C C o.¯ F 11 C C ¯.7 F 1¯.7 FAIL
Clearfield o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Cumberland DNC DNC DNC DNC DNC 17 C C o.7 F 11.C PASS
Dauphin o C C 2.7 D 12 C C 4.C F 12.1 FAIL
Delaware 11 C C ¯.7 F 7 C C 2.¯ D 12.7 FAIL
Elk INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Erie o C C 2.C C 2 C C C.7 B 1C.7 PASS
Franklin 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Greene o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Indiana 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Lackawanna 2 C C C.7 B 2 C C C.7 B 9.4 PASS
Lancaster 24 C C o.C F 9 C C ¯.C D 12.C PASS
Lawrence 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Lebanon INC INC INC INC INC INC INC INC INC INC INC INC
Lehigh 1o C C o.C F DNC DNC DNC DNC DNC DNC DNC
Luzerne 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Lycoming 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
PENNSYLVANIA
American Lung Association in Pennsylvania
3001 Old Gettysburg Road
Camp Hill, PA 17011-7206
(717) 541-5864
www.lung.org/pennsylvania
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 145 PENNSYLVANIA
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Mercer o C C 2.7 D 2 C C C.7 B 1C.o PASS
Monroe o C C 2.C C INC INC INC INC INC INC INC
Montgomery 17 C C o.7 F 4 C C 1.¯ C 1C.1 PASS
Northampton 1¯ C C 4.¯ F 12 2 C o.C F 1¯.4 FAIL
Perry 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Philadelphia ¯2 C C 1C.7 F 9 C C ¯.C D 11.o PASS
Somerset INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Tioga ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Washington 4 C C 1.¯ C o C C 2.C C 12.o FAIL
Westmoreland 7 C C 2.¯ D 1¯ C C 4.¯ F 1¯.7 FAIL
York 1C C C ¯.¯ F 12 C C 4.C F 11.o PASS
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 146
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Kent 1oo,o¯o ¯¯,¯oo 2o,o72 4,¯1¯ 1o,4o4 o,oC2 49,21¯ 11,ooC 1o,4o1
Providence o2o,7C9 1¯o,o1o o4,9o1 17,ooo oo,4o4 29,9o7 1o7,7o¯ ¯9,92o 1C9,4oo
Washington 12o,oo¯ 24,o¯2 19,7¯o ¯,171 11,979 o,7C4 ¯7,o¯¯ 9,C4C 11,1¯9
Totals 9l8,807 l93,7l3 l3l,27l 25,040 85,927 45,463 254,509 60,848 l36,086
RHODE ISLAND
American Lung Association in Rhode Island
260 West Exchange Street, Suite 102-B
Providence, RI 02903
(401) 533-5171
www.lung.org/rhodeisland
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 147
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Kent o C C 1.7 C C C C C.C A o.4 PASS
Providence 7 C C 2.¯ D 2 1 C 1.2 C 9.4 PASS
Washington o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
RHODE ISLAND
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 148
SOUTH CAROLINA
American Lung Association in South Carolina
44-A Markfield Drive
Charleston, SC 29407
(843) 556-8451
www.lung.org/southcarolina
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Abbeville 2o,1o1 o,o11 4,2o9 4oC 1,o¯1 1,oo4 o,1o9 2,oo¯ 4,9oo
Aiken 1oC,oo2 ¯o,oC4 2o,o4C ¯,C4o 1C,¯94 9,9Co oC,922 1o,oo1 ¯1,o92
Anderson 1oo,4oo 44,oCC 29,Co7 ¯,o14 11,94¯ 11,¯29 oo,2C¯ 1o,142 29,142
Berkeley 1o¯,o2o 4o,oo2 1o,oC4 ¯,921 11,247 9,o¯1 oC,C19 1o,¯¯4 27,721
Charleston ¯o7,7C4 74,Co2 4o,ooC o,¯¯¯ 2¯,24C 2C,7¯1 1Co,9Co ¯2,7C1 oo,2oC
Cherokee oo,o4C 1¯,o49 7,72o 1,1o9 ¯,47C ¯,221 1o,oCo o,12¯ 12,¯4o
Chesterfield 4o,oo7 11,2oo o,oC7 9o¯ 2,92o 2,7o1 14,1C¯ 4,¯79 11,ooo
Colleton ¯o,o11 9,222 o,¯4o 7o9 2,4o4 2,¯oo 12,294 ¯,o44 1C,74¯
Darlington oo,299 1o,272 1C,141 1,¯92 4,¯2¯ 4,111 21,1C2 o,ooo 1o,9oo
Edgefield 2o,o7C o,o¯o ¯,o79 47¯ 1,7oC 1,o¯1 o,¯49 2,ooo 4,oo7
Florence 1¯7,oo2 ¯¯,7o4 1o,7o7 2,oo7 o,o97 7,94o 4C,7C2 12,o2¯ 2o,ooo
Greenville 4o1,299 111,o72 o9,9oC 9,o41 2o,7oC 2o,1oC 1¯¯,91¯ 41,4¯4 71,212
Horry 27o,¯4C oo,24C 4o,991 4,724 1o,¯o9 17,ooo 9C,9o¯ 2o,4o1 o1,¯o7
Lexington 2o7,129 o4,oo7 ¯¯,o4o o,o29 1o,o9o 1o,2o9 7o,1o¯ 24,1o9 ¯o,24¯
Oconee 74,41o 1o,4C2 14,o¯2 1,¯17 4,944 4,91C 2o,¯o9 7,9oo 1¯,9o¯
Pickens 119,o74 2¯,o7o 1o,oo9 2,C42 7,o27 o,94o ¯o,o29 1C,991 22,19¯
Richland ¯o9,11o oo,C1o ¯9,CC2 7,o27 24,441 2C,74o 1Co,¯74 ¯2,21¯ oo,o42
Spartanburg 2oo,ooo o9,¯24 ¯9,4oo o,92o 17,9o1 1o,o97 oo,C2o 2o,¯7o o¯,C9o
York 2¯C,o2o oo,2¯o 2o,oo9 4,9oC 14,174 12,o21 oo,449 2C,177 ¯4,22¯
Totals 3,394,37l 78l,639 456,677 66,844 2l5,l87 l96,588 l,006,072 3ll,550 594,806
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 149 SOUTH CAROLINA
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Abbeville C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Aiken C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Anderson o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Berkeley C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Charleston C C C C.C A 4 C C 1.¯ C 9.2 PASS
Cherokee ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Chesterfield 1 C C C.¯ B C C C C.C A 9.7 PASS
Colleton C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Darlington 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Edgefield C C C C.C A 1 C C C.¯ B 1C.1 PASS
Florence DNC DNC DNC DNC DNC C C C C.C A 1C.7 PASS
Greenville ¯ C C 1 C o C C 1.7 C 11.2 PASS
Horry INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Lexington DNC DNC DNC DNC DNC C C C C.C A 11.¯ PASS
Oconee 1 C C C.¯ B 1 C C C.¯ B INC INC
Pickens ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Richland 11 C C ¯.7 F C C C C.C A 11.C PASS
Spartanburg 1C C C ¯.¯ F C C C C.C A 11.C PASS
York C C C C.C A DNC DNC DNC DNC DNC DNC DNC
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 150
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Brookings ¯2,22o o,C2C ¯,249 o1o 1,77o 1,174 7,271 1,9oo 4,¯o9
Brown ¯o,o22 o,oC4 o,o49 727 1,94o 1,oo2 9,o79 2,7o7 ¯,o4o
Codington 27,442 o,7o¯ 4,Co7 o7o 1,417 1,1¯9 7,1¯o 1,99¯ ¯,¯12
Custer o,¯¯o 1,oC2 1,o41 1¯7 4oo 44C 2,7o4 7o9 oo4
Jackson ¯,1o9 1,C¯¯ 422 oo 147 117 7¯C 2C4 1,C¯o
Meade 2o,o4o o,2Co ¯,17o o¯1 1,¯C9 1,C1o o,41o 1,77o ¯,C1o
Minnehaha 171,7o2 42,742 19,491 ¯,ooo o,717 o,o14 41,C¯C 11,2o9 1o,o1¯
Pennington 1C2,o1o 2o,C14 14,2oo 2,1¯9 o,¯C7 4,19o 2o,¯42 7,¯29 1¯,¯2¯
Union 14,oo1 ¯,7¯o 2,11o ¯19 744 o12 ¯,oo1 1,C79 947
Totals 422,76l l0l,6l9 54,464 8,689 2l,833 l6,790 l05,43l 29,l92 49,239
SOUTH DAKOTA
American Lung Association in South Dakota
401 East 8th Street Suite 205
Sioux Falls, SD 57103
(605) 336-7222
www.lung.org/southdakota
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 151
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Brookings C C C C.C A 1 C C C.¯ B o.4 PASS
Brown DNC DNC DNC DNC DNC C C C C.C A o.C PASS
Codington DNC DNC DNC DNC DNC 1 C C C.¯ B o.o PASS
Custer C C C C.C A 2 ¯ C 2.2 D 4.o PASS
Jackson C C C C.C A C C C C.C A ¯.o PASS
Meade C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Minnehaha C C C C.C A 2 C C C.7 B 9.1 PASS
Pennington DNC DNC DNC DNC DNC C C C C.C A o.9 PASS
Union C C C C.C A ¯ C C 1.C C o.o PASS
SOUTH DAKOTA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 152
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Anderson 7o,2¯¯ 1o,124 1¯,2¯o 1,o41 4,¯oC o,o11 2o,¯¯1 7,4C2 12,¯7o
Blount 12¯,9C1 27,CC2 2C,oo7 2,ooC 7,1CC 9,¯91 42,¯oo 11,o11 17,oCC
Claiborne ¯2,172 o,o¯7 o,¯4o o¯4 1,oo4 2,44o 11,C¯7 ¯,Co¯ o,1oC
Davidson o¯o,47o 1¯o,79¯ oo,o74 1¯,2o¯ ¯o,C91 42,ooo 1oo,o2¯ 4o,CoC 11o,71o
DeKalb 1o,oo4 4,279 ¯,C2¯ 4C9 1,Co7 1,4C9 o,¯4o 1,7o¯ ¯,o97
Dyer ¯o,192 9,41o o,o4¯ 9CC 2,C99 2,742 12,¯Co ¯,¯oo 7,279
Hamilton ¯4C,ooo 7¯,1o¯ oC,ooo o,99¯ 19,4C¯ 2o,C4C 112,1o9 ¯C,o2o o¯,o9o
Jeíerson o1,ooo 11,2¯2 o,o2o 1,C7¯ 2,9oo ¯,o9C 17,o74 4,o91 9,749
Knox 4¯o,929 94,C4o o7,o94 o,9o7 24,oCo ¯1,C29 1¯7,97o ¯o,924 o2,o¯1
Lawrence 42,11o 1C,494 o,9Co 1,CC¯ 2,¯1C ¯,C44 1¯,7oC ¯,o4o 7,oo7
Loudon 49,2¯7 9,o4C 11,C¯o 94C 2,9¯¯ 4,C4o 1o,oo¯ o,4¯C o,¯7o
McMinn o2,oCo 11,o14 9,C7C 1,11C ¯,CC1 ¯,9o7 1o,CoC o,Co2 1C,¯44
Madison 9o,2oo 2¯,2oo 1¯,2¯o 2,22¯ o,41¯ o,911 ¯C,oCo o,¯22 1o,724
Maury o1,oC9 19,oo2 1C,94o 1,o71 4,oC2 o,o21 2o,922 7,C41 1¯,¯¯C
Meigs 11,7¯7 2,4oC 2,C42 2¯o oo4 91o 4,141 1,1o¯ 2,o99
Montgomery 17o,o19 4o,949 14,12o 4,o7o o,91C 1C,47o 4o,4o2 11,¯4o 2o,472
Putnam 72,9oo 1o,oC9 1C,o92 1,4o2 4,112 o,1oo 2¯,29C o,¯CC 1o,472
Roane o¯,o¯o 11,C12 1C,¯¯o 1,Co2 ¯,179 4,¯24 19,o9o o,o1¯ 9,oC1
Rutherford 2oo,921 o9,4¯1 22,7oC o,o¯o 14,C¯¯ 1o,777 72,ooo 1o,4Co ¯1,oC¯
Sevier 91,4oo 2C,C4¯ 14,o77 1,91o o,22¯ o,oo9 ¯C,91¯ o,ooo 1o,171
Shelby 9¯o,Coo 24¯,7o4 97,oo¯ 2¯,29¯ 49,4oo o1,o2o 27C,299 7C,o2¯ 19o,779
Sullivan 1o7,419 ¯1,o9o 29,9o7 ¯,C4o 9,2o1 12,4¯4 oo,oo2 1o,CoC 2o,292
Sumner 1o¯,ooo 4C,7C1 21,¯¯7 ¯,oo9 o,92o 11,oC4 o1,17C 1¯,ooo 17,o1o
Williamson 1oo,ooC o4,214 19,Coo o,1o1 9,791 12,oC2 oo,2oo 14,727 11,oCo
Wilson 11o,o17 2o,o¯9 14,74¯ 2,7¯7 o,4C2 o,274 ¯o,o9o 9,922 1¯,oC4
Totals 4,3l3,8l0 l,022,ll4 540,246 97,672 236,664 299,0l2 l,326,459 354,430 732,473
TENNESSEE
American Lung Association in Tennessee
One Vantage Way, Suite D-220
Nashville, TN 37228
(615) 329-1151
www.lung.org/tennessee
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 153
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Anderson 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Blount 24 C C o.C F C C C C.C A 11.C PASS
Claiborne INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Davidson 4 C C 1.¯ C C C C C.C A 1C.9 PASS
DeKalb INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Dyer DNC DNC DNC DNC DNC 1 C C C.¯ B 9.7 PASS
Hamilton 14 C C 4.7 F C 1 C C.o B 11.2 PASS
Jeíerson 12 C C 4.C F DNC DNC DNC DNC DNC DNC DNC
Knox 7 C C 2.¯ D 2 C C C.7 B 12.¯ FAIL
Lawrence INC INC INC INC INC C C C C.C A o.o PASS
Loudon o C C 2.7 D 1 C C C.¯ B 11.7 PASS
McMinn DNC DNC DNC DNC DNC C C C C.C A 1C.9 PASS
Madison DNC DNC DNC DNC DNC C C C C.C A 9.¯ PASS
Maury DNC DNC DNC DNC DNC C C C C.C A 9.2 PASS
Meigs 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Montgomery DNC DNC DNC DNC DNC C C C C.C A 1C.4 PASS
Putnam DNC DNC DNC DNC DNC C C C C.C A 9.o PASS
Roane DNC DNC DNC DNC DNC C 2 C 1.C C 11.2 PASS
Rutherford 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Sevier 2¯ C C 7.7 F DNC DNC DNC DNC DNC DNC DNC
Shelby 22 C C 7.¯ F 1 C C C.¯ B 1C.4 PASS
Sullivan o C C 1.7 C 1 C C C.¯ B 1C.7 PASS
Sumner 1o C C o.C F C C C C.C A 1C.2 PASS
Williamson o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Wilson ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
TENNESSEE
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 154
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Bell ¯1o,19o o9,212 27,9oC 7,1oo 1o,oC1 11,o7¯ 7C,72o 21,12¯ 4o,4¯2
Bexar 1,7oo,1o¯ 472,ooo 1o2,442 ¯7,9oC 9o,¯1o o9,o7o 424,9o2 129,21¯ ¯C7,19o
Bowie 92,79¯ 22,¯7o 1¯,299 1,797 o,¯11 4,24o 2o,oo9 7,94C 1o,o¯1
Brazoria ¯19,97¯ oo,1¯2 ¯1,oo9 7,CoC 17,¯¯2 12,72C 7o,22o 24,Co7 ¯7,492
Brewster 9,¯oo 1,o1¯ 1,o9o 14o o72 471 2,o12 o74 1,o44
Cameron 414,12¯ 1¯o,21o 4o,oo9 1C,oo2 2C,7¯C 1o,719 94,oo¯ 2o,7oo 1¯o,27o
Collin o12,22o 229,94C oo,714 1o,471 4¯,¯¯o ¯C,497 1o9,4C9 o7,9C7 oo,217
Dallas 2,41o,C14 ooo,9oC 21o,o7C o¯,o77 129,¯¯7 91,2oo ooC,oo4 1o9,oC1 47o,44o
Denton ooo,4Co 1o7,1oo oC,o2C 1o,C¯4 ¯o,oo¯ 2o,C9¯ 1oo,C2o 47,Co¯ o¯,24C
Ector 14C,111 4C,7o¯ 14,1C4 ¯,274 7,¯o2 o,4C2 ¯2,9o9 1C,C¯7 21,71o
Ellis 1o2,7o¯ 4¯,ooo 1o,o14 ¯,oC1 o,2C1 o,14o ¯7,741 11,oo7 1o,91o
El Paso o2C,79C 24¯,oo1 o4,o44 19,oo9 42,7o4 ¯1,417 19C,9Co o7,9C¯ 19o,C17
Galveston 29o,747 74,7C2 ¯4,C¯o o,CC1 1o,oo¯ 12,7oo 7o,244 24,¯o¯ 4¯,27C
Gillespie 2o,114 o,CC¯ o,7o7 4C2 1,ooo 1,o4C o,9¯1 2,ooo ¯,C79
Gregg 12¯,Co1 ¯1,¯71 1o,79¯ 2,o2C o,oo2 o,41o ¯2,o9o 1C,Co1 21,Coo
Harris 4,1oC,o94 1,1oo,4o4 ¯oC,212 9¯,o2¯ 222,92C 1oo,o92 9o9,7oo 29C,C2o oC¯,o9o
Harrison oo,29o 17,2¯9 o,7o1 1,¯oo ¯,711 2,944 17,oo7 o,o74 1C,oo4
Hays 1o4,CoC ¯9,oo9 14,4o¯ ¯,2C2 9,127 o,299 ¯o,o7o 11,oo4 2¯,¯7o
Hidalgo 797,o1C 274,4oC 7o,o7o 22,C49 ¯o,472 27,o92 1o7,¯o9 oC,CC2 294,oC4
Hood o1,o7C 1C,797 11,442 oo7 ¯,1o7 2,9C4 17,1C2 o,442 o,oC¯
Hunt oo,o¯1 21,oC1 12,22¯ 1,727 4,91o ¯,94o 2¯,o22 7,42o 1¯,oo2
Jeíerson 2o2,oC2 oC,o11 ¯2,CC¯ 4,oo9 14,419 11,C9o o7,¯¯7 2C,7o1 47,27¯
Johnson 1o2,7¯4 41,12o 1o,2¯4 ¯,¯C4 o,4C9 o,492 ¯9,o77 12,294 19,oo1
Kaufman 1Co,¯oo ¯C,1oC 11,Coo 2,422 o,o47 4,241 2o,CC7 o,C47 12,ooo
Lubbock 2o¯,91C oo,o17 ¯1,¯o9 o,o12 1o,o71 11,oCo o9,o¯o 2C,9Co oo,ooo
TEXAS
American Lung Association in Texas
5926 Balcones Drive, Suite 100
Austin, TX 78731
(512) 467-6753
www.lung.org/texas
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 155
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
McLennan 2¯o,oo4 o9,9o1 29,7o7 4,o1o 1¯,29o 1C,1Co oC,9o¯ 1o,o91 o4,¯o¯
Montgomery 471,7¯4 12o,929 oC,7oo 1C,¯o7 2o,7oo 19,4oC 119,¯7o ¯7,C¯4 o4,1o9
Navarro 4o,Co4 1¯,C42 o,9oo 1,C4o 2,o49 2,1oo 12,9o9 4,C41 9,¯1o
Nueces ¯4¯,2o1 oo,1¯o 42,119 7,CoC 19,1o¯ 14,72o o9,4oo 27,o¯o o7,oo9
Orange o2,4o7 2C,o19 11,o4o 1,o4o 4,o9o ¯,77o 22,o4o 7,144 1¯,11o
Parker 11o,¯7o 29,o11 1o,C47 2,¯71 o,7o1 o,¯24 ¯2,ooC 1C,22o 12,¯27
Polk 4o,72o 9,ooC o,ooo 77o 2,7oo 2,¯9o 14,2o1 4,494 o,294
Potter 122,2oo ¯4,2o4 1¯,29C 2,7o2 o,ooC 4,ooo 29,741 9,C91 2o,2o9
Randall 12¯,¯o1 ¯C,¯oC 1o,¯o¯ 2,4¯o o,9o¯ o,¯¯2 ¯2,¯22 9,94o 11,9oo
Rockwall o1,29C 2¯,o71 o,1oo 1,9C1 4,¯¯2 ¯,2¯o 19,92C o,177 4,o4o
Smith 21¯,¯o1 o4,o12 ¯C,714 4,¯79 11,9¯2 9,o2o o7,C9o 17,o2C ¯o,744
Tarrant 1,o49,o1o o1o,1oo 1o9,22¯ 41,¯o¯ 99,2oC 71,1o9 4¯o,244 1¯¯,o9¯ ¯C7,¯o2
Travis 1,Co¯,1¯C 2o4,1C9 79,¯9¯ 2C,412 o9,171 ¯9,¯C2 24¯,C7o 72,C7C 1oo,Co4
Victoria o7,o4o 2¯,214 11,94o 1,ooo 4,ooo ¯,o7o 2¯,4C9 7,2oo 1o,91o
Webb 2oo,49o o9,¯o1 2C,47o 7,17o 12,2oo o,49o o1,o9o 1o,447 o1,¯11
Totals l9,667,435 5,436,889 l,886,703 436,744 l,055,958 760,436 4,659,884 l,4l5,960 3,648,629
TEXAS
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 156
TEXAS
American Lung Association in Texas
5926 Balcones Drive, Suite 100
Austin, TX 78731
(512) 467-6753
www.lung.org/texas
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Bell 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Bexar 17 C C o.7 F C C C C.C A 9.¯ PASS
Bowie DNC DNC DNC DNC DNC C C C C.C A 11.1 PASS
Brazoria 4C 4 C 1o.¯ F DNC DNC DNC DNC DNC DNC DNC
Brewster 7 C C 2.¯ D INC INC INC INC INC INC INC
Cameron C C C C.C A C C C C.C A INC INC
Collin ¯C C C 1C.C F DNC DNC DNC DNC DNC DNC DNC
Dallas ¯4 4 C 1¯.¯ F 1 C C C.¯ B 1C.7 PASS
Denton 49 2 C 17.¯ F DNC DNC DNC DNC DNC DNC DNC
Ector DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Ellis 9 C C ¯.C D C C C C.C A INC INC
El Paso o C C 2.7 D o 1 C ¯.2 D 9.o PASS
Galveston 1o 1 C o.o F DNC DNC DNC DNC DNC DNC DNC
Gillespie INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Gregg 1o C C o.C F DNC DNC DNC DNC DNC DNC DNC
Harris o7 1C C 27.¯ F 1 C C C.¯ B 12.4 FAIL
Harrison o C C 2.7 D C 1 C C.o B 1C.o PASS
Hays 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Hidalgo C C C C.C A C C C C.C A 1C.o PASS
Hood 1¯ C C 4.¯ F DNC DNC DNC DNC DNC DNC DNC
Hunt 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Jeíerson 29 2 C 1C.7 F INC INC INC INC INC INC INC
Johnson 17 C C o.7 F DNC DNC DNC DNC DNC DNC DNC
Kaufman 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Lubbock DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
McLennan 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 157 TEXAS
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Montgomery 12 C C 4.C F DNC DNC DNC DNC DNC DNC DNC
Navarro ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Nueces 7 C C 2.¯ D C C C C.C A 1C.¯ PASS
Orange 12 C C 4.C F INC INC INC INC INC INC INC
Parker 24 2 C 9.C F DNC DNC DNC DNC DNC DNC DNC
Polk INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Potter DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Randall INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Rockwall 1o 1 C o.o F DNC DNC DNC DNC DNC DNC DNC
Smith 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Tarrant o2 o C 2¯.7 F C C C C.C A 1C.o PASS
Travis 9 C C ¯.C D C C C C.C A 1C.¯ PASS
Victoria ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Webb C C C C.C A DNC DNC DNC DNC DNC DNC DNC
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 158
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Box Elder oC,29C 1o,ooo o,o97 1,14C 2,942 1,449 9,41C 2,oo9 o,C21
Cache 114,o99 ¯o,49o 9,Co4 2,¯97 o,974 ¯,CCo 1o,4C2 4,77C 1o,oo7
Carbon 21,¯1o o,o99 2,o9o ¯oo 1,¯7o o9o 4,o91 1,2oC ¯,C7C
Davis ¯11,o11 1Co,17o 2o,CoC 7,171 1o,C92 o,2o4 o2,4oo 1¯,9¯o 2o,o7¯
Duchesne 1o,ooo o,¯o9 2,Co¯ 4¯C 1,1C¯ o¯o ¯,4o4 9¯9 2,227
Garfield o,144 1,¯7o o¯1 9¯ ¯¯2 1oC 1,212 ¯¯9 72o
Salt Lake 1,C4o,9oo ¯C¯,91o 92,o4o 2C,o2o oo,oo¯ 29,ooo 1oo,79o oC,C44 149,oo2
San Juan 14,o2o 4,927 1,oo2 ¯¯¯ o71 429 2,79C 7o9 4,¯oC
Tooele o9,¯2o 21,2¯1 4,o¯¯ 1,4¯4 ¯,¯o1 1,o21 9,o2C 2,o47 o,oo9
Uintah ¯¯,1o¯ 11,CCo ¯,C21 74¯ 1,9oC 9Co o,7oo 1,o¯o ¯,o4o
Utah o¯C,499 1o4,o19 ¯o,144 12,4o2 ¯C,4oo 12,772 77,117 19,74o 7¯,997
Washington 141,ooo 42,oo7 24,o91 2,o7o o,7o2 4,oo¯ ¯C,oo2 o,oo7 21,972
Weber 2¯4,42C 7C,CC2 2¯,991 4,72o 14,47¯ o,o¯o 4¯,7oo 11,74¯ ¯C,o14
Totals 2,585,034 8l0,l9l 232,687 54,7l7 l56,227 7l,l65 448,262 ll8,766 345,493
UTAH
American Lung Association in Utah
1930 South 1100 East
Salt Lake City, UT 84106-2317
(801) 484-4456
www.lung.org/utah
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 159
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Box Elder ¯ C C 1.C C o 2 C ¯.7 F o.2 PASS
Cache C C C C.C A 2o 1C C 14.¯ F 9.7 PASS
Carbon INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Davis 4 C C 1.¯ C 1C ¯ C 4.o F 9.2 PASS
Duchesne INC INC INC INC INC INC INC INC INC INC INC INC
Garfield INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Salt Lake 1o C C o.C F 42 14 C 21.C F 9.7 PASS
San Juan 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Tooele ¯ C C 1.C C 1 2 C 1.¯ C o.o PASS
Uintah ¯4 21 9 27.o F DNC DNC DNC DNC DNC DNC DNC
Utah 2 C C C.7 B 2o 7 C 11.o F 9.1 PASS
Washington 1 C C C.¯ B C C C C.C A 4.2 PASS
Weber o C C 1.7 C 2o 4 C 11.¯ F 9.o PASS
UTAH
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 160
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Bennington ¯o,97C 7,¯7o 7,1o1 ooo ¯,2C1 1,o42 1C,o4o 2,o2¯ o,1¯C
Chittenden 1o7,491 ¯C,o4¯ 1o,¯9¯ 2,4¯4 14,o7C o,oo¯ ¯7,4C7 o,o7¯ 1o,oo¯
Rutland o1,2o9 11,ooC 1C,oo7 92C o,4¯o 2,o49 17,Co7 4,Co7 7,ooo
Totals 255,750 49,469 36,l3l 3,942 23,206 9,944 65,042 l5,l63 28,249
VERMONT
American Lung Association in Vermont
372 Hurricane Lane, Suite 101
Williston, VT 05495
(802) 876-6862
www.lung.org/vermont
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 161
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Bennington 1 C C C.¯ B C C C C.C A o.9 PASS
Chittenden C C C C.C A 1 C C C.¯ B 7.¯ PASS
Rutland DNC DNC DNC DNC DNC ¯ C C 1.C C 9.o PASS
VERMONT
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 162
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Albemarle 1CC,oo¯ 21,44¯ 14,oo1 1,o¯4 o,92C o,C12 27,419 o,497 9,1¯9
Arlington 21o,CC4 ¯4,49o 1o,7¯o 2,9oC 1o,72o 9,oo¯ o1,Coo 1o,C¯2 1o,o94
Caroline 2o,o74 o,749 ¯,929 o77 1,92o 1,4Co 7,7C1 2,¯9o ¯,422
Charles City 7,241 1,24o 1,2o9 1C7 o¯1 419 2,¯¯1 741 o4¯
Chesterfield ¯2C,277 o1,o2o ¯4,997 o,9oC 21,C1C 14,oo2 oC,94¯ 2o,CC9 22,oo9
Fairfax 1,1CC,o92 2oo,21o 112,19C 22,ooC 7¯,444 oC,oo¯ 274,921 o4,¯o2 7¯,792
Fauquier oo,C71 1o,2oo o,7Co 1,¯9¯ 4,4CC ¯,2oo 1o,C9C o,o7¯ 4,14o
Frederick 79,ooo 19,oo7 1C,4¯o 1,oo2 o,272 ¯,o¯o 21,C2o o,o¯o 7,C2o
Giles 17,124 ¯,oCC ¯,1oo ¯Co 1,1o7 929 o,1oo 1,o29 2,1¯o
Hanover 1CC,¯42 24,¯44 1¯,7oo 2,Co2 o,7C7 o,C19 27,o4¯ o,oo7 o,CC1
Henrico ¯1C,44o 74,C1¯ ¯9,2C1 o,¯29 2C,711 14,71o oC,24o 24,77C ¯¯,12¯
Loudoun ¯2o,4Co 9o,249 22,42C o,4C2 19,9¯o 12,9o2 o9,4C¯ 2C,92o 12,99o
Madison 1¯,1o9 2,o¯9 2,421 24¯ 9C9 721 4,CC9 1,272 1,o49
Page 2¯,9oo o,C4o 4,¯C¯ 4¯1 1,ooC 1,291 7,1oo 2,2oo 4,Coo
Prince Edward 2¯,¯4¯ ¯,992 ¯,¯1o ¯41 1,o7o 1,14¯ o,17o 1,o7o 4,74o
Prince William 419,CCo 119,4Co 29,o¯o 1C,211 2o,271 17,C24 91,1o7 27,4oo 2o,o¯9
Roanoke 92,74C 19,74¯ 1o,¯22 1,ooo o,414 4,9o¯ 27,oC9 o,71¯ 7,274
Rockbridge 22,¯7o 4,2C1 4,7¯1 ¯o9 1,o9o 1,29¯ 7,214 2,29o 2,ooo
Rockingham 7o,oo9 17,ooC 12,1C¯ 1,o27 o,1o¯ ¯,o91 21,4o2 o,72¯ 7,227
Staíord 1¯2,1¯¯ ¯7,214 1C,C7¯ ¯,1o2 o,¯oo o,o72 ¯C,C2o 9,1¯o o,C7C
Wythe 29,2C4 o,977 o,¯¯¯ o11 2,C¯o 1,ooo o,7o9 2,77¯ 4,14o
Alexandria City 144,¯C1 2o,229 1¯,4¯1 2,1o7 1C,¯o7 o,oo¯ ¯o,Co1 1C,4o9 11,o22
Bristol City 17,7oC ¯,o92 ¯,¯4C ¯C7 1,2¯o 949 o,24¯ 1,o4o 4,4oo
Hampton City 1¯o,4C1 ¯C,712 17,2CC 2,o2o 9,24o o,o11 ¯o,4¯o 1C,9Co 2C,1o¯
Lynchburg City 7o,oC4 14,947 1C,7oC 1,27o o,¯2o ¯,o24 19,o7¯ o,9¯o 14,o71
VIRGINIA
American Lung Association in Virginia
9702 Gayton Road, #110
Richmond, VA 23238
(804) 955-4910
www.lung.org/virginia
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 163
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Newport News City 179,o11 4¯,4o1 19,4o9 ¯,71o 11,o7C 7,99o 4¯,12o 1¯,C9o 2o,712
Norfolk City 242,o2o oC,o72 22,o¯o 4,¯¯¯ 1o,o4C 1C,oCo oo,o7C 1o,oo9 42,7C¯
Roanoke City 9o,714 21,Co¯ 1¯,o71 1,oCC o,o21 4,79o 2o,2oo o,14C 1o,ooo
Salem City 24,9o1 4,914 4,¯7o 42C 1,7o1 1,¯2C 7,27o 2,27o 2,o7o
Suíolk City o4,9¯C 21,7oo 1C,C4¯ 1,oo¯ o,o49 ¯,9oo 21,oC4 o,oo4 1C,214
Virginia Beach City 442,7C7 1C4,o1o 4o,12C o,9¯o 29,o7C 2C,1o1 1Co,97o ¯¯,242 ¯o,49o
Totals 4,95l,5l8 l,l84,ll6 535,246 l0l,257 330,008 226,673 l,228,006 375,7l8 449,736
VIRGINIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 164
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Albemarle ¯ C C 1.C C 1 C C C.¯ B o.7 PASS
Arlington 22 1 C 7.o F 1 C C C.¯ B INC INC
Caroline 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Charles City o 1 C ¯.2 D C C C C.C A o.9 PASS
Chesterfield 4 2 C 2.¯ D C C C C.C A 9.o PASS
Fairfax 22 2 C o.¯ F 2 C C C.7 B 9.o PASS
Fauquier C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Frederick 1 C C C.¯ B C C C C.C A 1C.4 PASS
Giles INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Hanover 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Henrico 1¯ C C 4.¯ F C C C C.C A 9.o PASS
Loudoun o C C 2.7 D 1 C C C.¯ B 9.o PASS
Madison o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Page C C C C.C A C C C C.C A 9.¯ PASS
Prince Edward INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Prince William ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Roanoke 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Rockbridge C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Rockingham 1 C C C.¯ B 2 C C C.7 B 1C.2 PASS
Staíord 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Wythe C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Alexandria City 1o 1 C o.o F INC INC INC INC INC INC INC
Bristol City DNC DNC DNC DNC DNC C C C C.C A 9.9 PASS
Hampton City INC INC INC INC INC 1 C C C.¯ B INC INC
Lynchburg City DNC DNC DNC DNC DNC C C C C.C A o.o PASS
VIRGINIA
American Lung Association in Virginia
9702 Gayton Road, #110
Richmond, VA 23238
(804) 955-4910
www.lung.org/virginia
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 165
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Newport News City INC INC INC INC INC INC INC INC INC INC INC INC
Norfolk City DNC DNC DNC DNC DNC ¯ C C 1.C C 1C.C PASS
Roanoke City DNC DNC DNC DNC DNC C C C C.C A 9.9 PASS
Salem City DNC DNC DNC DNC DNC C C C C.C A 1C.C PASS
Suíolk City 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
Virginia Beach City DNC DNC DNC DNC DNC 1 C C C.¯ B 9.o PASS
VIRGINIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 166
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Clallam 71,o¯o 12,7o4 17,oo9 9Co o,7C2 ¯,C¯4 2¯,o4¯ o,o72 9,24o
Clark 4¯¯,41o 112,7o2 o1,o¯9 7,9o2 ¯1,1oC 1¯,¯C1 1C4,o7o 2o,o77 oo,oo4
King 1,9o9,722 417,C42 22C,9C1 29,o22 1o1,C1o o1,C22 4o¯,44o 1¯1,oo4 2¯4,oo7
Okanogan 41,411 9,o7o 7,¯4o ooo ¯,C7o 1,oC7 11,7o7 ¯,¯11 o,o4¯
Pierce oC7,9C4 19o,oC9 91,17C 1¯,91o o9,447 24,4oo 19¯,447 o2,o42 99,9C7
Skagit 11o,1C9 27,ooC 19,oo7 1,9o7 o,771 4,C97 ¯2,CoC o,94C 17,4o1
Snohomish 722,4CC 17¯,Co¯ 77,o22 12,2o¯ o¯,4o1 22,112 174,777 47,9oo 7o,o¯o
Spokane 47¯,7o1 1Co,o9o o2,992 7,ooo ¯o,472 1o,2o¯ 12C,21¯ ¯¯,Co7 o9,94¯
Thurston 2oo,o91 oo,1oC ¯4,¯o1 4,119 19,2o1 o,¯oC oo,9oC 1o,211 ¯2,1o9
Whatcom 2C¯,oo¯ 41,oo9 2o,Co7 2,944 1o,7¯¯ o,oo9 o2,oo2 14,¯7o ¯C,944
Yakima 247,141 7o,Co9 2o,9o¯ o,¯1o 1o,7C¯ o,9oo oo,19o 1o,Co1 oo,oC¯
Totals 5,345,958 l,233,064 640,469 87,289 399,864 l66,806 l,3l7,877 360,878 696,447
WASHINGTON
American Lung Association in Washington
822 John Street
Seattle, WA 98109
(206) 441-5100
www.lung.org/washington
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 167
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Clallam C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Clark 1 C C C.¯ B 12 1 C 4.o F 7.7 PASS
King o C C 1.7 C C C C C.C A o.¯ PASS
Okanogan DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Pierce C C C C.C A 14 1 C o.2 F o.¯ PASS
Skagit C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Snohomish DNC DNC DNC DNC DNC 1o C C o.C F 7.9 PASS
Spokane C C C C.C A 1 C C C.¯ B INC INC
Thurston 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Whatcom C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Yakima DNC DNC DNC DNC DNC 1C 1 C ¯.o F o.9 PASS
WASHINGTON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 168
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Berkeley 1Co,7oC 2o,1o4 12,¯9¯ 1,999 7,¯o2 o,7o4 ¯C,92o 9,C¯9 1o,42o
Brooke 2¯,o44 4,491 4,o22 ¯4¯ 1,77¯ 1,797 o,¯49 2,49¯ ¯,4¯4
Cabell 9o,oo¯ 1o,91o 1o,¯o¯ 1,44o 7,12¯ o,oo2 ¯C,7C9 o,914 2C,ooo
Gilmer o,7Co 1,2oo 1,22C 9o oo4 oC2 2,7o1 7oo 1,o1o
Greenbrier ¯o,oCC 7,1¯o o,9o2 o4o 2,o2¯ 2,ooC 12,471 ¯,72o o,2oo
Hancock ¯C,o71 o,C71 o,77o 4o4 2,24o 2,¯CC 1C,o9o ¯,2Co o,CC9
Harrison o9,4¯o 1o,1o2 11,ooo 1,1oC 4,9oC 4,9C9 22,7¯2 o,74o 11,94C
Kanawha 192,¯1o ¯9,¯71 ¯2,¯o7 ¯,CC9 14,C4¯ 1¯,o¯o o4,C4o 19,CCo ¯2,o¯o
Marion oo,ooo 11,11C 9,o14 o49 4,1oo 4,C1¯ 1o,o77 o,4o¯ 9,CCo
Marshall ¯2,oCC o,74o o,72o o1o 2,¯94 2,414 11,1o9 ¯,¯49 o,C19
Monongalia 9o,o2o 1o,o2C 1C,Co¯ 1,1oo 7,o¯4 o,11o 27,74¯ 7,oCo 17,2o4
Ohio 44,24o o,4C7 o,141 o4¯ ¯,2o¯ ¯,272 1o,1o7 4,oC9 o,922
Raleigh 79,127 1o,o¯C 12,741 1,2o¯ o,74o o,oo9 2o,74C 7,o97 12,7oo
Tucker 7,C21 1,¯41 1,4o7 1C2 o19 o44 2,o¯o 7o¯ 1,1o2
Wood o7,12C 1o,919 14,924 1,44o o,2oo o,2C4 2o,7o9 o,o42 1o,4o2
Totals 968,502 l97,l50 l52,829 l5,067 70,824 67,663 3l2,42l 9l,740 l64,838
WEST VIRGINIA
American Lung Association in West Virginia
2102 Kanawha Blvd., East
Charleston, WV 25311
(304) 342-6600
www.lung.org/westvirginia
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 169
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Berkeley 1 C C C.¯ B 4 C C 1.¯ C 11.o PASS
Brooke DNC DNC DNC DNC DNC o C C 1.7 C 1¯.C FAIL
Cabell 4 C C 1.¯ C 1 C C C.¯ B 12.1 FAIL
Gilmer INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Greenbrier C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Hancock o C C 1.7 C C C C C.C A 11.7 PASS
Harrison DNC DNC DNC DNC DNC 1 C C C.¯ B INC INC
Kanawha o C C 2.7 D C C C C.C A 12.o FAIL
Marion DNC DNC DNC DNC DNC C C C C.C A 12.1 FAIL
Marshall DNC DNC DNC DNC DNC 1 C C C.¯ B 1¯.C FAIL
Monongalia o C C 1.7 C C C C C.C A 1C.9 PASS
Ohio o C C 1.7 C C C C C.C A 11.9 PASS
Raleigh DNC DNC DNC DNC DNC C C C C.C A 9.o PASS
Tucker INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Wood ¯ C C 1.C C 1 C C C.¯ B 12.¯ FAIL
WEST VIRGINIA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 170
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Ashland 1o,142 ¯,71C 2,o94 2o¯ 1,1¯o 7Co 4,121 1,119 2,o14
Brown 2o1,412 o2,C4¯ 29,799 4,7¯1 17,4o¯ 9,oo4 oo,o9C 1o,12C 2o,o7o
Columbia oo,9C9 1¯,C¯o o,oC7 994 4,C1o 2,4o9 14,¯o¯ ¯,9C¯ o,Co2
Dane 49o,9o9 1Co,o¯9 o2,2o9 o,C7C ¯o,19o 19,Co1 1Co,74¯ 2o,44o o1,9Co
Dodge oo,oo1 19,2¯o 1¯,417 1,4o7 o,¯oo ¯,ooo 22,42C o,Coo o,ooo
Door 27,o2C 4,9o7 o,¯79 ¯oC 2,Coo 1,4o¯ o,o7C 2,41C ¯,C¯¯
Eau Claire 99,o79 2C,oC4 12,o4o 1,o71 7,¯47 ¯,99o 2¯,CC7 o,C¯7 1¯,74¯
Florence 4,44C 7o7 9o7 oo ¯¯¯ 2¯o 1,¯9C ¯oo ooo
Fond du Lac 1C2,C79 22,9¯9 1o,o72 1,749 7,2oo 4,41o 2o,o9o o,9o2 9,7o4
Forest 9,2¯o 2,CCo 1,o74 1o¯ oo9 4¯o 2,oo¯ 7C7 1,41C
Grant o1,21C 1C,oo¯ 7,9¯7 o1o ¯,7¯7 2,174 12,o¯o ¯,¯oo 7,721
Jeíerson o¯,94¯ 19,71o 11,2o¯ 1,oC¯ o,9C7 ¯,4o¯ 19,9oo o,¯o4 o,14o
Kenosha 1o7,29¯ 42,¯9o 19,CC4 ¯,2¯¯ 11,o1o o,4oo ¯7,2o2 9,9oC 2¯,1oo
Kewaunee 2C,oo9 4,74¯ ¯,491 ¯o2 1,447 924 o,4C4 1,47o 1,oC7
La Crosse 11o,o72 24,21o 1o,o9o 1,o47 o,44o 4,722 27,2oC 7,21C 1o,241
Manitowoc oC,97o 17,747 1¯,o47 1,¯o¯ o,7o9 ¯,o97 21,o2o o,919 o,oo2
Marathon 1¯4,4CC ¯2,oCo 19,¯oo 2,479 9,¯44 o,o4o ¯2,799 o,o7o 14,oC¯
Milwaukee 9o2,o¯2 2¯7,294 1Co,oo¯ 1o,C94 oo,24o ¯o,91o 2Co,2C7 o4,2¯¯ 2C2,CoC
Oneida ¯o,oC1 o,444 7,o74 491 2,ooC 1,o49 1C,9¯4 ¯,C¯C 4,o71
Outagamie 177,91¯ 4¯,o9o 21,412 ¯,¯47 12,¯4¯ 7,CoC 4C,o9¯ 1C,ooo 14,171
Ozaukee oo,ooo 19,o4o 1¯,o71 1,o1¯ o,Co¯ ¯,o7o 22,oo¯ o,199 4,4oo
Racine 19o,¯oo 47,92o 2o,21C ¯,ooo 1¯,o29 o,C7¯ 4o,724 12,o¯7 2o,C4o
Rock 1oC,C92 ¯9,274 22,1C2 2,99o 11,1Co o,ooo ¯7,9o9 1C,21o 22,94o
St. Croix o4,922 22,791 o,o44 1,7¯o o,724 ¯,219 1o,442 4,9¯9 o,¯o4
Sauk o2,29C 14,719 9,o2C 1,122 4,¯oC 2,ooo 1o,o2C 4,2C4 7,4o¯
WISCONSIN
American Lung Association in Wisconsin
13100 West Lisbon Road, Suite 700
Brookfield, WI 53005-2508
(262) 703-4200
www.lung.org/wisconsin
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 171
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Sheboygan 11o,149 27,11¯ 1o,9o9 2,Co7 o,Co¯ 4,929 2o,o44 7,77o 9,o¯7
Taylor 2C,oo1 o,CCo ¯,¯o¯ ¯o2 1,429 91C o,¯2C 1,4oo 2,4o9
Vernon 29,9o4 7,o1o o,C2o o9o 2,C17 1,¯12 7,ooo 2,1C9 4,oC4
Vilas 21,442 ¯,721 o,o99 2o4 1,o9o 1,1o4 7,C74 1,971 2,7¯o
Walworth 1C2,9¯1 2¯,oo7 1¯,971 1,799 7,¯C1 4,2oo 24,o12 o,oC2 1¯,2oo
Washington 1¯2,¯oo ¯1,792 1o,44o 2,424 9,2C4 o,o¯2 ¯2,o49 o,o94 o,¯C7
Waukesha ¯9C,7¯C 91,o1o o7,oo4 7,CC1 27,29o 17,Co7 99,1o2 27,14¯ 21,¯19
Totals 4,375,279 l,030,2l2 574,240 78,556 307,960 l78,082 l,028,789 275,585 562,283
WISCONSIN
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 172
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Ashland C C C C.C A C C C C.C A o.o PASS
Brown 2 C C C.7 B 1o C C o.C F 1C.4 PASS
Columbia C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Dane C C C C.C A 1C C C ¯.¯ F 1C.o PASS
Dodge C C C C.C A ¯ C C 1.C C INC INC
Door 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Eau Claire INC INC INC INC INC C C C C.C A INC INC
Florence INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Fond du Lac 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Forest C C C C.C A C C C C.C A o.C PASS
Grant DNC DNC DNC DNC DNC ¯ C C 1.C C 1C.7 PASS
Jeíerson C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Kenosha 1o 1 C o.o F ¯ C C 1.C C 9.7 PASS
Kewaunee o 1 C 2.2 D DNC DNC DNC DNC DNC DNC DNC
La Crosse C C C C.C A ¯ C C 1.C C 9.o PASS
Manitowoc 11 1 C 4.2 F INC INC INC INC INC INC INC
Marathon C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Milwaukee 1C 1 C ¯.o F 7 C C 2.¯ D 11.1 PASS
Oneida C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Outagamie 1 C C C.¯ B 9 C C ¯.C D 9.o PASS
Ozaukee 1C 1 C ¯.o F 1 C C C.¯ B 9.o PASS
Racine 12 1 C 4.o F DNC DNC DNC DNC DNC DNC DNC
Rock C C C C.C A DNC DNC DNC DNC DNC DNC DNC
St. Croix INC INC INC INC INC 2 C C C.7 B INC INC
Sauk C C C C.C A 4 C C 1.¯ C 9.C PASS
Sheboygan 17 2 C o.7 F DNC DNC DNC DNC DNC DNC DNC
WISCONSIN
American Lung Association in Wisconsin
13100 West Lisbon Road, Suite 700
Brookfield, WI 53005-2508
(262) 703-4200
www.lung.org/wisconsin
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 173
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Taylor INC INC INC INC INC 1 C C C.¯ B 7.9 PASS
Vernon INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Vilas C C C C.C A C C C C.C A o.1 PASS
Walworth 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Washington INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Waukesha C C C C.C A o C C 1.7 C 11.7 PASS
WISCONSIN
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 174
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult vascular
County Population Under 18 Over Asthma Asthma COPD Disease Diabetes Poverty
Albany ¯o,oo9 o,92o ¯,¯2o oC7 2,94¯ 1,47C 7,oo2 1,9oo 7,o11
Big Horn 11,7o9 2,99o 2,1¯o 2oo 772 o2o ¯,12o o4o 1,¯¯2
Campbell 4o,o1o 1¯,C79 2,7o2 1,11o ¯,1C1 1,7¯C 9,¯¯2 2,¯9¯ ¯,2Co
Carbon 1o,7oo ¯,oo9 2,Co7 ¯1o 1,Co9 7o9 ¯,o9¯ 1,C¯2 2,Co9
Converse 1¯,7oo ¯,41o 1,o2o 292 92o oo¯ ¯,¯o9 9C2 1,4C4
Crook 7,111 1,oo2 1,1oo 141 4oC ¯o2 1,922 o19 ooo
Fremont 4C,o79 1C,2oo o,92¯ ooC 2,71C 1,9oo 1C,C77 2,ooo o,174
Laramie 92,ooC 22,241 11,979 1,9C2 o,¯7C 4,¯o1 22,¯42 o,o9o 9,CCo
Natrona 7o,¯oo 1o,1¯7 9,o¯7 1,oo1 o,277 ¯,o4o 1o,27o 4,o14 o,oo9
Park 2o,o92 o,o94 o,1¯7 oC4 2,CCo 1,oo4 7,9¯2 2,1¯o ¯,1o4
Sheridan 29,2¯9 o,4C7 4,oo7 o4o 2,C27 1,o4o 7,oCo 2,C94 2,o11
Sublette 1C,14o 2,¯9o 1,1C2 2Co 7CC 4oo 2,4¯2 o42 o¯o
Sweetwater 44,17o 11,97o ¯,77o 1,C24 2,9o7 1,77o 9,¯oo 2,4¯¯ 4,¯19
Teton 21,o4o 4,1oo 2,2o¯ ¯oo 1,o9o 972 o,1C¯ 1,¯2¯ 1,7o7
Uinta 2C,9oo o,2o9 1,9oo o¯o 1,¯¯4 oo2 4,oC4 1,1o2 2,C1¯
Totals 496,228 ll8,536 59,600 l0,l36 34,292 22,726 ll7,403 30,859 54,550
WYOMING
American Lung Association in Wyoming
822 John Street
Seattle, WA 98109
(206) 441-4100
www.lung.org/wyoming
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2013 175
HIGH OZONE DAYS 2009–2011 HIGH PARTICLE POLLUTION DAYS 2009–2011
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Albany INC INC INC INC INC C C C C.C A INC INC
Big Horn INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Campbell C C C C.C A 2 C C C.7 B INC INC
Carbon C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Converse DNC DNC DNC DNC DNC C C C C.C A INC INC
Crook C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Fremont o C C 2.7 D 2 C C C.7 B o.o PASS
Laramie INC INC INC INC INC 1 C C C.¯ B 4.1 PASS
Natrona INC INC INC INC INC C C C C.C A INC INC
Park DNC DNC DNC DNC DNC C C C C.C A 4.4 PASS
Sheridan DNC DNC DNC DNC DNC 1 C C C.¯ B o.¯ PASS
Sublette 9 1 ¯ o.o F C C C C.C A INC INC
Sweetwater C C C C.C A 1 C C C.¯ B o.o PASS
Teton 1 C C C.¯ B C C C C.C A 4.o PASS
Uinta C C C C.C A DNC DNC DNC DNC DNC DNC DNC
WYOMING
About the American Lung Association
Now in its second century, the American Lung Association is the leading organization working to
save lives by improving lung health and preventing lung disease. With your generous support, the
American Lung Association is “Fighting for Air” through research, education and advocacy.
For more information about the American Lung Association, a holder of the Better Business
Bureau Wise Giving Guide Seal, or to support the work it does, call 1-800-LUNGUSA
(1-800-586-4872) or visit www.lung.org.
We will breathe easier when the air in every
American community is clean and healthy.
We will breathe easier when people are free from the addictive
grip of tobacco and the debilitating effects of lung disease.
We will breathe easier when the air in our public spaces and
workplaces is clear of secondhand smoke.
We will breathe easier when children no longer
battle airborne poisons or fear an asthma attack.
Until then, we are ghting for air.

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