AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 2

Acknowledgments
e American Lung Association State of the Air® 2012 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
Suka-chevin, who analyzed data and coordinated eld out-
reach and e-advocacy; Kholla Ahmad, who assisted in the data
analysis; Zach Jump, MA, and Elizabeth Lancet, MPH, who
converted the raw data into meaningful tables and compari-
sons 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 edition; Betty Yuan-Cardinal, who supervised the online
production; Todd Nimirowski, who directed the online pre-
sentation; Katherine Barry-Ishibashi who managed content
production online; Laura Lavelle, who developed e-outreach
and the e-cards; and Carrie Martin, Mary Havell, Gregg Tubbs
and Mike Townsend who coordinated internal and external
communications 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. and Associates, who compiled the data; Deborah
Shprentz, who researched and reviewed the science; Beaconre
Consulting, who made enhancements to the website features;
Randy Tibbott of Our Designs, Inc., who designed the print
version; Randy Krum of InfoNewt, LLC, who created the
online infographics; and Cindy Wright of CJW Associates,
who developed marketing and eld materials.
Great appreciation goes to the National Association of Clean
Air Administrators, who along with their Executive Director
Bill Becker, strove to make this report better through their
comments, review and concerns. Many of their members
reviewed and commented on the individual state data presented
and the methodology to help make this report more
accurate. We appreciate them as our partners in the ght
against air pollution. is report should in no way be con-
strued as a comment on the work they do.
A key partner in this work is the U.S. Environmental Protection
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 2012.
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 © 2012 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
Printing and binding by Hard Copy Printing, New York, NY
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 3
Contents
The State of the Air 2012. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Rankings
People at Risk in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Most Polluted Cities in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Most Polluted Counties in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Cleanest Cities in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Cleanest Counties in the U.S.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Health Eíects of Ozone and Particle Pollution . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
State Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 4
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 5
The State of the Air 2012
State of the Air 2012
shows that
cleaning up
air pollution
produces
healthier air
across the nation.
18 cities had their
fewest unhealthy ozone
days in any State of the
Air report.
Gross Domestic Product
Vehicle Miles Traveled
Population
Energy Consumption
CO
2
Emissions
Aggregate Emissions
(Six Common Pollutants)
70%
60%
50%
40%
30%
20%
10%
0%
–10%
–20%
–30%
–40%
–50%
–60%
90
65%
40%
24%
15%
8%
-59%
95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10
Figure 1. Since 1990, the air we breathe has gotten much cleaner, as shown on this chart. That progress comes thanks
to the Clean Air Act. Even as the economy continues to recover from the recession, emissions targeted by the tools
in the Clean Air Act continue to drop. (Source: U.S. EPA, Our Nation’s Air: Status and Trends Through 2010. February
2012. http://www.epa.gov/air/airtrends/2011/index.html.) Data for CO
2
emissions only goes through 2009.
T
hanks to the Clean Air Act, we’ve made great progress
in cleaning up air pollution from across the U.S. e
State of the Air 2012 shows that the air quality in many
places has improved, but that over 127 million people—41
percent of the nation—still suer pollution levels that are too
oen dangerous to breathe. Unhealthy air remains a threat to
the lives and health of millions of people in the United States,
despite great progress. Air pollution lingers as a widespread
and dangerous reality even as some seek to weaken the Clean
Air Act, the public health law that has driven the cuts in pollu-
tion since 1970.
e State of the Air 2012 report looks at levels of ozone and
particle pollution found
in ocial monitoring
sites across the United
States in 2008, 2009,
and 2010. e report
uses the most current
quality-assured nation-
wide data available for
these analyses.
For particle pollution,
the report examines
ne particulate matter
(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 calculated and reported by
the U.S. Environmental Protection Agency (EPA). For compar-
ison, the State of the Air 2011 report covered data from 2007,
2008 and 2009.
1
Overall
Trends
anks to stronger standards for pollutants
and for the sources of pollution, the
United States has seen continued reduc-
tion in ozone and particle pollution as
1 A complete discussion of the sources of data and the methodology is
included in the chapter, Methodology.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 6 THE STATE OF THE AI R 2012
well as other pollutants for decades. e chart from the EPA on
the previous page shows that since 1990, the air has gotten
cleaner while the population, the economy, energy use and
miles driven increased greatly. Even as the economy begins to
improve aer the recession, air emissions continue to drop.
Air quality has improved greatly since 2001. As of 2010
2
:
I Ozone is 13 percent lower;
I Year-round particle pollution is 24 percent lower; and
I Short-term particle pollution is 28 percent lower.
Ozone
Twenty two of the 25 cities with the most
ozone pollution improved their air quality
over the past year’s report. More than half
of the country’s most smog-polluted cities experienced their
best year yet. However, people living there are still forced to
breathe air that reaches dangerous levels.
Los Angeles, CA remained the city with the worst ozone
pollution problem, but reported its fewest unhealthy ozone
days since the State of the Air reports began. Of the 25 met-
ropolitan areas most polluted by ozone, eighteen reported
the fewest unhealthy ozone days
3
: Los Angeles, CA; Visalia,
CA; Bakerseld, CA; Sacramento, CA; San Diego, CA; Hous-
ton, TX; Dallas-Fort Worth, TX; Washington-Baltimore,
DC-MD-VA; El Centro, CA; New York, NY; Charlotte, NC;
Phoenix, AZ; Pittsburgh, PA; Birmingham, AL; Cincinnati,
OH; Baton Rouge, LA; Philadelphia, PA; and Atlanta, GA.
2 U.S. Environmental Protection Agency. Our Nation’s Air: Status and Trends
Through 2010. February 2012. EPA-454/R-12-001. http://www.epa.gov/air/
airtrends/2011/index.html.
3 Full 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.
Year-round
Particle Pollution
e State of the Air 2012
nds continued progress in
cutting year-round particle
pollution, compared to the
2011 report. 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.
All but three cities with the most year-round particle pollution
improved over the previous report.
4
Philadelphia, PA, Fairbanks,
AK, and Columbus, GA each had worse average year-round
levels in 2008-2010 than in 2007–2009. Bakerseld, CA,
remained the city with the highest year-round average levels.
Improving over the previous report were these 24 metropolitan
areas: Bakerseld, CA; Hanford, CA; Los Angeles, CA; Visalia,
CA; Fresno, CA; Phoenix, AZ; Cincinnati, OH; Louisville, KY;
St. Louis, MO; Philadelphia, PA; Birmingham, AL; Weirton-
Steubenville, WV-OH; Indianapolis, IN; Cleveland, OH;
Dayton, OH; Charleston, WV; Huntington, WV; Parkersburg,
WV; Wheeling, WV; Houston, TX; Atlanta, GA; Davenport,
IA; Fairmont, WV; and Hagerstown, MD.
Four cities moved to the list of the most polluted cities this
year despite having improved annual particle average levels
because other cities made greater improvements. ose cities
included Wheeling, WV; Atlanta, GA; Fairmont, WV; and
Davenport, IA.
Six cities that had previously been ranked among the most
polluted improved enough to fall out of the list: Detroit, MI;
New York, NY; Lancaster, PA; York, PA; Modesto, CA; and
Knoxville, TN. is report marks the rst time Detroit and
York have been o this list entirely.
Twenty of these cities actually had average year-round par-
ticle pollution below the ocial “safe” level, the EPA-adopted
4 The usual list of 25 cities with the most year-round particle pollution
actually includes 27 cities because of ties in the rankings values among
many cities.
All but two cities with the
most year-round particle
pollution improved since
the last report.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 7 THE STATE OF THE AI R 2012
national air quality standard. However, that standard is out
of date. e American Lung Association and other public
health and medical groups have long supported a much more
protective national air quality standard for particle pollution.
e Lung Association has taken legal action to require EPA to
update the particle pollution standards.
Short-term
Particle Pollution
Among the 26 cities with the
worst short-term levels of
particle pollution, thirteen
cities improved in 2008-
2010: that is, they had fewer unhealthy days or lower daily
levels. In addition, nine cities that were on this list in previous
reports moved o the list entirely, including one—
Birmingham, AL—that had been on since the list began.
Twelve of the cities on the list had more high particle days in
2008-2010 than in the previous report. Although “short-term”
particle pollution looks at the same type of pollution that the
year-round levels do, this measure focuses on the spikes in
particle levels that can last from hours to days. ose days or
weeks of high levels can be dangerous, even deadly.
In 2008-2010, these thirteen cities improved, cutting their
average number of days with high particle levels: Bakerseld,
CA(still ranked most polluted); Fresno, CA; Pittsburgh, PA;
Salt Lake City, UT; Provo, UT; Visalia, CA; Eugene-Springeld,
OR; Stockton, CA; Chicago, IL; San Diego, CA; Sacramento,
CA; Davenport, IA; Philadelphia, PA. Nine previously ranked
cities had improved enough to drop o the most polluted list
this year: Birmingham, AL; Louisville, KY; Phoenix, AZ; San
Jose-San Francisco-Oakland, CA; Wheeling, WV; Seattle-
Tacoma, WA; Macon, GA; Portland, OR; and Madison, WI.
Four cities had their lowest average yet, despite still being
among the 25 most polluted: Pittsburgh, PA; Visalia, CA;
Philadelphia, PA; and San Diego, CA.
Five cities were never ranked on this list before but moving to
this list because so many other cities had fewer unhealthy air
days: Las Cruces, NM; Harrisburg, PA; Washington, DC-Balti-
more, MD; South Bend, IN; and Yakima, WA. e remaining cities
on the list had more days or higher daily levels than in the last
report: Hanford, CA; Los Angeles, CA; Modesto, CA; Logan, UT;
Milwaukee, WI; Fairbanks, AK; Merced, CA; and Green Bay, WI.
Cleanest
Cities

Only one city emerged as the
cleanest for all three categories:
Santa Fe-Espanola, NM. Five
cities ranked as the cleanest cities
for both ozone and year-round particle pollution:

đƫ Bismarck, ND
đƫ Duluth, MN-WI
đƫ Honolulu, HI
đƫ Port S. Lucie-Sebastian-Vero Beach, FL.
đƫ Rapid City, SD
Seven cities ranked as the cleanest for both ozone and
short-term particle pollution:
đƫ Brownsville-Harlingen-Raymondville, TX
đƫ Champaign-Urbana, IL
đƫ Decatur, IL
đƫ Florence-Muscle Shoals, AL
đƫ Monroe-Bastrop, LA
đƫ Peoria-Canton, IL
đƫ Springfield, IL
Fieen cities ranked as the cleanest for both measures of
particle pollution:
đƫ Albuquerque, NM
đƫ Bangor, ME
đƫ Burlington, VT
đƫ Cape Coral-Fort Myers, FL
đƫ Cheyenne, WY
đƫ Claremont-Lebanon,
NH-VT
đƫ Colorado Springs, CO
đƫ Flagstaí, AZ
đƫ Fort Collins-Loveland, CO
đƫ Gainesville, FL
đƫ Palm Bay-Melbourne-
Titusville, FL
đƫ Prescott, AZ
đƫ Salinas, CA
đƫ Sarasota, FL
đƫ Tucson, AZ
Nine cities dropped oí
the list of the 25 cities
with the worst short-term
levels of particle pollution
in 2008-2010.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 8
People At Risk
Looking at the nation as a whole,
the American Lung Association
State of the Air 2012 nds—
I More than 4 in 10 people (41%) in the United States live
in counties that have unhealthful levels of either ozone
or particle pollution.
Over 127.2 million Americans live in the 235 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.
I Nearly 4 in 10 people in the United States (38.5%) live in
areas with unhealthful levels of ozone.
Counties that were graded F for ozone levels have a com-
bined population of almost 116.7 million. ese people
live in the 195 counties where the monitored air quality
places them at risk for decreased lung function, respiratory
infection, lung inammation and aggravation of respiratory
illness. 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.
I Nearly one in six (16.1%) of people in the United States
live in an area with unhealthful short-term levels of par-
ticle pollution.
Nearly 50 million Americans live in 66 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 emergen-
cy-room visits for asthma and cardiovascular disease, and
most importantly, can increase the risk of early death.
I Nearly 6.4 million people (2.1%) 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.
I Over 5.7 million people (1.9%) in the United States live
in six 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.
I People with Asthma—Nearly 2.5 million children and over
7.4 million adults with asthma live in parts of the United
States with very high levels of ozone. Over 3.1 million adults
and over 940,000 children with asthma live in areas with
high levels of short-term particle pollution. Over 382,000
adults and over 125,000 children with asthma live in coun-
ties with unhealthful levels of year-round particle pollution.
I Older and Younger—Over 13.7 million adults age 65 and
over and nearly 29 million children age 18 and under live
in counties with unhealthful ozone levels. Over 5.6 million
seniors and over 12.5 million children live in counties with
unhealthful short-term levels of particle pollution. Over
765,000 seniors and over 1.7 million children live in coun-
ties with unhealthful levels of year-round particle pollution.
I Chronic Bronchitis and Emphysema—Over 3.7 million
people with chronic bronchitis and nearly 1.6 million with
emphysema live in counties with unhealthful ozone levels.
Over 1.5 million people with chronic bronchitis and over
652,000 with emphysema live in counties with unhealthful
levels of short-term particle pollution. Over 196,000 people
with chronic bronchitis and more than 84,000 with emphy-
sema live in counties with unhealthful year-round levels of
particle pollution.
THE STATE OF THE AI R 2012
Over 5.7 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 2012 9 THE STATE OF THE AI R 2012
I Cardiovascular Disease—Over 11.6 million people with
cardiovascular diseases live in counties with unhealthful lev-
els of short-term particle pollution; nearly 1.5 million live in
counties with unhealthful levels of year-round particle pollu-
tion. Cardiovascular diseases include coronary heart disease,
heart attacks, strokes, hypertension and angina pectoris.
I Diabetes—Over 3.1 million people with diabetes live in
counties with unhealthful levels of short-term particle pol-
lution; over 409,000 live in counties with unhealthful levels
of year-round particle pollution. Research indicates that
because diabetics are already at higher risk of cardiovascular
disease, they may face increased risk due to the impact of
particle pollution on their cardiovascular systems.
I Poverty—Over 16.9 million people with incomes meeting
the federal poverty denition live in counties with unhealth-
ful levels of ozone. Over 7.9 million people in poverty live in
counties with unhealthful levels of short-term particle pol-
lution, and over 1.1 million live in counties with unhealthful
year-round levels of particle pollution. 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 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.
I 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 40 years ago. e Act requires that
the EPA and each state take steps to clean up the air. Some
members of Congress are proposing changes to the Clean
Air Act that could dismantle progress made in the last 40
years. e nation must keep that law strong to continue to
protect public health.
I Clean up dirty power plants. Over 400 coal-red power
plants in over 40 states are among the largest contributors to
particulate pollution, ozone, mercury, and global warming.
eir pollution blows across state lines into states hundreds
of miles away. ey produce 84 known hazardous air pollut-
ants, 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. In 2011, EPA issued the nal rules that will cut the
emissions that create ozone and particle pollution and, for
the rst time, set national limits on the toxic pollutants they
can emit. However, some have challenged these standards in
the courts. e Lung Association has taken legal steps to de-
fend EPA’s eorts. Congress needs to support EPA’s actions
to clean these plants up.
I Clean up industrial, commercial and institutional boilers
and incinerators. Boilers provide power and fuel processes
for industry, commercial facilities and institutions. Similar
to power plants, but smaller, boilers are also more numer-
ous: there are 1.5 million of them. Many produce toxic air
emissions, including the same toxic emissions that power
plants produce. EPA needs to adopt strong nal standards to
limit emissions from these boilers.
I Clean up the existing fleet of dirty diesel vehicles and
heavy equipment. Rules EPA put in eect over the past
several years mean that new diesel vehicles and equip-
ment 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 neighbor-
hoods. e good news is that aordable technology exists to
cut emissions by 90 percent. Congress needs to fund EPA’s
diesel cleanup (“retrot”) program. Congress should also
require that clean diesel equipment be used in federally-
funded construction programs.
I Strengthen the particle pollution standards. In 2006, EPA
failed to strengthen the annual standard for ne particles,
The nation must
keep the
Clean Air
Act strong
to protect public health.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 10
despite the near unanimous recommendation by their of-
cial science advisors. EPA tightened the 24-hour standard,
though not to the level the Lung Association and other
public health groups recommended. Last year, the Lung
Association and its partners issued Sick of Soot, a report
that showed that EPA can save thousands of lives each year
by dramatically strengthening the annual average and the
24-hour standards. However, EPA ignored its own deadlines
to complete the review, failing to complete steps essential to
protecting public health. e Lung Association led legal
action against EPA to require them to follow the law.
I Clean up harmful emissions from tailpipes. 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. Science shows
that 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. Cleaner cars will help reduce this impact for all, but
especially those who live closest to the trac.
What You
Can Do
Individual citizens can do a great
deal to help reduce air pollution
outdoors as well. Simple but
eective ways include—
I Send a message to Congress: Don’t block the power plant
mercury and air toxic standards. Send a message to your
Senators urging them to support cleaner, healthier air and
oppose measures to block or delay the cleanup of hazardous
air pollutants from coal-red power plants.
I Share your story. Do you or any member of your family
have a personal reason to want healthier, cleaner air? Let us
know how healthy air aects you.
I Drive less. Combine trips, walk, bike, carpool or vanpool,
and use buses, subways or other alternatives to driving. Ve-
hicle emissions are a major source of air pollution. Support
community plans that provide ways to get around that don’t
require a car, such as more sidewalks, bike trails and transit
systems.
I 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.
I 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.
I 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.
I 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.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 11
People at Risk from Short-term Particle Pollution (24-Hour PM
2.5
)
Chronic Diseases Age Groups
In Counties where Adult Pediatric Chronic Cardiovascular 65 and Total Number of
the Grades were: Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty Under l8 Over Population Counties
Grade A (0.0) 3,850,344 1,224,778 1,905,610 833,454 14,471,898 4,030,494 8,839,813 13,861,895 7,536,519 58,147,157 243
Grade B (0.3-0.9) 3,568,530 1,186,378 1,762,544 756,566 13,283,796 3,757,038 7,537,702 13,118,052 6,647,407 54,306,512 174
Grade C (1.0-2.0) 2,326,283 715,258 1,107,507 473,125 8,315,275 2,248,692 4,991,486 7,825,896 4,205,037 33,868,423 73
Grade D (2.1-3.2) 1,171,958 378,178 547,168 242,111 4,178,787 1,192,706 2,737,614 3,966,057 2,209,184 16,609,067 34
Grade F (3.3+) 3,109,432 941,537 1,565,247 652,865 11,625,599 3,114,187 7,967,442 12,502,881 5,658,542 49,674,998 66
National Population in
Counties with PM
2.5
Monitors 14,360,662 4,543,611 7,055,175 3,032,982 53,159,909 14,683,567 32,757,753 52,441,719 26,942,976 217,604,676 643
People at Risk from Year-Round Particle Pollution (Annual PM
2.5
)
Chronic Diseases Age Groups
In Counties where Adult Pediatric Chronic Cardiovascular 65 and Total Number of
the Grades were: Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty Under l8 Over Population Counties
Pass 12,905,672 4,082,684 6,318,917 2,710,055 47,563,023 13,124,798 29,160,892 46,770,173 24,005,443 194,829,442 516
Fail 382,438 125,818 196,209 84,375 1,475,571 409,357 1,136,616 1,722,011 765,217 6,339,080 8
National Population in
Counties with PM
2.5
Monitors 14,360,662 4,543,611 7,055,175 3,032,982 53,159,909 14,683,567 32,757,753 52,441,719 26,942,976 217,604,676 643
People at Risk from Ozone
Chronic Diseases Age Groups
In Counties where Adult Pediatric Chronic 65 and Total Number of
the Grades were: Asthma Asthma Bronchitis Emphysema Poverty Under l8 Over Population Counties
Grade A (0.0) 1,454,784 439,754 732,759 323,723 3,076,002 5,210,044 2,955,503 22,162,912 159
Grade B (0.3-0.9) 1,688,567 510,866 837,603 377,760 3,865,120 5,840,390 3,549,351 25,090,373 141
Grade C (1.0-2.0) 2,427,953 769,798 1,156,558 504,780 5,253,405 8,422,366 4,537,246 35,296,806 150
Grade D (2.1-3.2) 1,633,953 474,629 757,376 329,220 3,389,677 5,146,451 2,961,895 22,799,427 72
Grade F (3.3+) 7,415,180 2,464,572 3,726,745 1,577,970 16,902,832 28,997,486 13,716,301 116,672,535 195
National Population in
Counties with Ozone Monitors 14,879,994 4,742,206 7,337,644 3,168,500 33,049,382 54,567,936 28,214,041 225,921,110 761
Note: The StateoftheAir covers the period 2CCo-2C1C. A complete discussion of the methodology begins on page 4C.

AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 12
People at Risk In 25 U.S. Cities Most Polluted by Short-term Particle Pollution (24-hour PM
2.5
)
20l2 Total 65 and Pediatric Adult Chronic CV
Rank
l
Metropolitan Statistical Areas Population
2
Under l8
3
Over
3
Asthma.
4,8
Asthma
5,8
Bronchitis
6,8
Emphysema
7,8
Disease
9
Diabetes
l0
Poverty
ll
1 Bakersfield-Delano, CA 839,631 254,081 75,437 16,855 44,572 24,047 9,398 173,566 47,097 172,531
2 Fresno-Madera, CA 1,081,315 320,356 110,683 21,251 57,991 31,596 12,865 231,750 63,239 276,242
3 Hanford-Corcoran, CA 152,982 42,548 12,030 2,822 8,348 4,423 1,619 31,019 8,299 29,606
4 Los Angeles-Long Beach-Riverside, CA 17,877,006 4,565,478 1,951,619 302,853 1,017,973 557,067 228,858 4,109,426 1,125,917 2,869,935
5 Modesto, CA 514,453 147,158 54,831 9,762 28,134 15,444 6,401 114,432 31,427 100,554
6 Pittsburgh-New Castle, PA 2,447,393 494,323 424,210 47,100 192,733 88,118 42,691 702,228 210,278 292,906
7 Salt Lake City-Ogden-Clearfield, UT 1,744,886 533,826 153,471 36,709 110,172 49,331 19,048 353,672 79,802 210,795
8 Logan, UT-ID 125,442 40,137 10,337 2,658 7,717 3,345 1,228 23,253 5,195 18,653
9 Fairbanks, AK 97,581 25,001 6,375 1,731 7,184 2,919 1,026 20,296 3,491 8,804
10 Merced, CA 255,793 80,698 23,960 5,353 13,302 7,191 2,853 52,121 14,142 58,212
11 Provo-Orem, UT 526,810 185,814 34,500 12,777 30,927 12,976 4,395 87,084 18,883 75,775
12 Visalia-Porterville, CA 442,179 144,124 41,779 9,561 22,675 12,297 4,931 89,570 24,362 108,143
13 Eugene-Springfield, OR 351,715 69,689 52,781 5,256 26,830 12,309 5,587 95,028 20,424 65,849
14 Green Bay, WI 306,241 75,104 38,204 6,671 19,118 10,013 4,367 76,174 16,251 31,524
15 Stockton, CA 685,306 200,724 71,181 13,315 37,106 20,338 8,380 150,333 41,250 128,331
16 Las Cruces, NM 209,233 55,858 25,881 4,456 14,971 6,503 2,806 48,910 12,556 52,262
17 Harrisburg-Carlisle-Lebanon, PA 683,043 152,398 102,609 14,521 52,634 23,488 10,866 183,301 54,575 71,977
18 Chicago-Naperville-Michigan City, IL-IN-WI 9,686,021 2,431,946 1,110,997 236,714 668,440 307,949 129,526 2,300,130 626,492 1,304,822
18 San Diego-Carlsbad-San Marcos, CA 3,095,313 724,168 351,425 48,038 181,080 99,026 40,726 730,127 199,827 445,556
20 Milwaukee-Racine-Waukesha, WI 1,751,316 431,446 221,571 38,324 109,226 57,101 24,984 434,587 92,773 267,038
21 Sacramento—Arden-Arcade—Yuba City, CA-NV 2,461,780 610,637 306,306 40,690 143,119 79,611 34,539 603,037 166,939 361,014
22 Davenport-Moline-Rock Island, IA-IL 379,690 89,568 57,111 7,347 24,569 12,863 5,987 100,626 25,407 49,380
22 Philadelphia-Camden-Vineland, PA-NJ-DE-MD 6,533,683 1,526,723 871,837 149,002 483,714 217,185 96,168 1,660,434 479,061 821,977
22 Washington-Baltimore-Northern Virginia, DC-MD-VA-WV 8,526,282 2,013,794 928,610 219,161 554,909 275,715 113,600 2,045,032 568,526 770,807
25 South Bend-Elkhart-Mishawaka, IN-MI 563,834 146,933 74,786 13,197 39,968 18,121 8,102 139,037 41,734 87,904
25 Yakima, WA 243,231 74,038 28,122 4,453 16,242 7,193 3,096 54,119 12,716 57,612
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 l8 and under 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 2C1C 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 2C1C based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Chronic bronchitis estimates are for adults 1o and over who had been diagnosed in 2C1C, based on national rates (NHIS) applied to population estimates (U.S. Census).
7. Emphysema estimates are for adults 1o and over who have been diagnosed within their lifetime, based on national rates (NHIS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma and,or emphysema and chronic bronchitis.
9. CV disease is cardiovascular disease and estimates are based on National Heart Lung and Blood Institute (NHLBI) estimates of cardiovascular disease applied to population estimates (U.S. Census).
1C. 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).
11. 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 2012 13
People at Risk In 25 U.S. Cities Most Polluted by Year-Round Particle Pollution (Annual PM
2.5
)
20l2 Total 65 and Pediatric Adult Chronic CV
Rank
l
Metropolitan Statistical Areas Population
2
Under l8
3
Over
3
Asthma.
4,8
Asthma
5,8
Bronchitis
6,8
Emphysema
7,8
Disease
9
Diabetes
l0
Poverty
ll
1 Bakersfield-Delano, CA 839,631 254,081 75,437 16,855 44,572 24,047 9,398 173,566 47,097 172,531
2 Hanford-Corcoran, CA 152,982 42,548 12,030 2,822 8,348 4,423 1,619 31,019 8,299 29,606
3 Los Angeles-Long Beach-Riverside, CA 17,877,006 4,565,478 1,951,619 302,853 1,017,973 557,067 228,858 4,109,426 1,125,917 2,869,935
4 Visalia-Porterville, CA 442,179 144,124 41,779 9,561 22,675 12,297 4,931 89,570 24,362 108,143
5 Fresno-Madera, CA 1,081,315 320,356 110,683 21,251 57,991 31,596 12,865 231,750 63,239 276,242
6 Pittsburgh-New Castle, PA 2,447,393 494,323 424,210 47,100 192,733 88,118 42,691 702,228 210,278 292,906
7 Phoenix-Mesa-Glendale, AZ 4,192,887 1,107,561 514,712 103,850 297,158 130,677 56,150 981,249 250,407 676,590
8 Cincinnati-Middletown-Wilmington, OH-KY-IN 2,172,191 541,640 265,863 52,022 159,476 70,437 30,544 534,359 160,761 297,254
9 Louisville-Jeíerson County-Elizabethtown-Scottsburg, KY-IN 1,427,483 344,414 181,225 35,354 110,720 46,992 20,586 358,161 108,671 212,960
10 Philadelphia-Camden-Vineland, PA-NJ-DE-MD 6,533,683 1,526,723 871,837 149,002 483,714 217,185 96,168 1,660,434 479,061 821,977
10 St. Louis-St. Charles-Farmington, MO-IL 2,902,951 691,253 388,478 73,624 197,528 96,454 42,981 740,304 207,624 377,927
12 Birmingham-Hoover-Cullman, AL 1,208,453 288,331 158,949 33,120 72,591 39,865 17,598 304,358 112,760 202,352
12 Steubenville-Weirton, OH-WV 124,454 24,792 23,112 2,020 8,511 4,573 2,282 36,997 11,773 20,060
14 Cleveland-Akron-Elyria, OH 2,881,937 662,604 431,376 62,126 213,261 98,669 45,842 772,244 233,293 432,423
14 Fairbanks, AK 97,581 25,001 6,375 1,731 7,184 2,919 1,026 20,296 3,491 8,804
14 Indianapolis-Anderson-Columbus, IN 2,080,782 537,309 239,468 47,240 147,611 65,880 27,927 494,231 147,661 301,412
17 Charleston, WV 304,284 65,632 48,538 4,292 17,296 10,731 5,088 84,858 28,530 46,065
17 Columbus-Auburn-Opelika, GA-AL 456,564 110,875 50,422 11,202 26,911 14,390 5,876 105,741 36,206 91,276
17 Dayton-Springfield-Greenville, OH 1,072,891 249,314 162,307 23,376 79,087 36,454 16,955 284,970 86,115 169,263
20 Huntington-Ashland, WV-KY-OH 287,702 61,997 46,625 5,241 19,615 10,019 4,736 78,785 25,083 58,538
20 Parkersburg-Marietta, WV-OH 162,056 34,684 27,634 2,635 10,369 5,771 2,802 46,088 14,900 25,008
20 Wheeling, WV-OH 147,950 29,212 26,446 2,303 9,922 5,402 2,650 43,340 13,886 23,309
23 Houston-Baytown-Huntsville, TX 6,051,363 1,683,279 523,789 127,325 322,604 180,163 69,512 1,298,152 411,138 992,603
24 Atlanta-Sandy Springs-Gainesville, GA-AL 5,618,431 1,489,486 515,559 134,057 319,422 171,459 67,219 1,244,401 391,674 851,796
24 Davenport-Moline-Rock Island, IA-IL 379,690 89,568 57,111 7,347 24,569 12,863 5,987 100,626 25,407 49,380
24 Fairmont-Clarksburg, WV 150,614 31,567 25,022 2,064 8,632 5,333 2,547 42,216 14,143 25,906
24 Hagerstown-Martinsburg, MD-WV 269,140 63,595 36,178 5,950 16,130 8,980 4,009 69,007 21,349 31,317
Notes:
1. Cities are ranked using the highest design value 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 l8 and under 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 2C1C 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 2C1C based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Chronic bronchitis estimates are for adults 1o and over who had been diagnosed in 2C1C, based on national rates (NHIS) applied to population estimates (U.S. Census).
7. Emphysema estimates are for adults 1o and over who have been diagnosed within their lifetime, based on national rates (NHIS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma and,or emphysema and chronic bronchitis.
9. CV disease is cardiovascular disease and estimates are based on National Heart Lung and Blood Institute (NHLBI) estimates of cardiovascular disease applied to population estimates (U.S. Census).
1C. 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).
11. 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 2012 14
People at Risk In 25 Most Ozone-Polluted Cities
20l2 Total 65 and Pediatric Adult Chronic
Rank
l
Metropolitan Statistical Areas Population
2
Under l8
3
Over
3
Asthma.
4,8
Asthma
5,8
Bronchitis
6,8
Emphysema
7,8
Poverty
9
1 Los Angeles-Long Beach-Riverside, CA 17,877,006 4,565,478 1,951,619 302,853 1,017,973 557,067 228,858 2,869,935
2 Visalia-Porterville, CA 442,179 144,124 41,779 9,561 22,675 12,297 4,931 108,143
3 Bakersfield-Delano, CA 839,631 254,081 75,437 16,855 44,572 24,047 9,398 172,531
4 Fresno-Madera, CA 1,081,315 320,356 110,683 21,251 57,991 31,596 12,865 276,242
5 Hanford-Corcoran, CA 152,982 42,548 12,030 2,822 8,348 4,423 1,619 29,606
6 Sacramento--Arden-Arcade--Yuba City, CA-NV 2,461,780 610,637 306,306 40,690 143,119 79,611 34,539 361,014
7 San Diego-Carlsbad-San Marcos, CA 3,095,313 724,168 351,425 48,038 181,080 99,026 40,726 445,556
8 Houston-Baytown-Huntsville, TX 6,051,363 1,683,279 523,789 127,325 322,604 180,163 69,512 992,603
9 San Luis Obispo-Paso Robles, CA 269,637 50,841 41,022 3,373 16,916 9,556 4,342 36,179
10 Merced, CA 255,793 80,698 23,960 5,353 13,302 7,191 2,853 58,212
11 Modesto, CA 514,453 147,158 54,831 9,762 28,134 15,444 6,401 100,554
12 Dallas-Fort Worth, TX 6,697,402 1,850,846 617,125 140,000 357,872 200,820 78,933 960,577
13 Washington-Baltimore-Northern Virginia, DC-MD-VA-WV 8,526,282 2,013,794 928,610 219,161 554,909 275,715 113,600 770,807
14 El Centro, CA 174,528 51,098 18,152 3,390 9,415 5,139 2,104 36,666
15 New York-Newark-Bridgeport, NY-NJ-CT-PA 22,085,649 5,059,741 2,906,533 496,081 1,609,241 733,058 321,030 2,893,957
16 Chico, CA 220,000 46,168 33,817 3,063 13,391 7,563 3,464 43,392
16 Philadelphia-Camden-Vineland, PA-NJ-DE-MD 6,533,683 1,526,723 871,837 149,002 483,714 217,185 96,168 821,977
18 Charlotte-Gastonia-Salisbury, NC-SC 2,402,623 610,448 269,005 55,318 136,032 75,955 31,737 367,170
19 Phoenix-Mesa-Glendale, AZ 4,192,887 1,107,561 514,712 103,850 297,158 130,677 56,150 676,590
20 Pittsburgh-New Castle, PA 2,447,393 494,323 424,210 47,100 192,733 88,118 42,691 292,906
21 Birmingham-Hoover-Cullman, AL 1,208,453 288,331 158,949 33,120 72,591 39,865 17,598 202,352
21 Cincinnati-Middletown-Wilmington, OH-KY-IN 2,172,191 541,640 265,863 52,022 159,476 70,437 30,544 297,254
23 Stockton, CA 685,306 200,724 71,181 13,315 37,106 20,338 8,380 128,331
24 Baton Rouge-Pierre Part, LA 825,905 204,083 89,297 16,955 41,518 26,153 10,735 130,090
25 Atlanta-Sandy Springs-Gainesville, GA-AL 5,618,431 1,489,486 515,559 134,057 319,422 171,459 67,219 851,796
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 l8 and under 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 2C1C 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 2C1C based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Chronic bronchitis estimates are for adults 1o and over who had been diagnosed in 2C1C, based on national rates (NHIS) applied to population estimates (U.S. Census).
7. Emphysema estimates are for adults 1o and over who have been diagnosed within their lifetime, based on national rates (NHIS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma and,or emphysema and chronic bronchitis.
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 2012 15
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 2008–20l0
20l2 Total 65 and Pediatric Adult Chronic CV Weighted
Rank
l
County ST Population
2
Under l8
3
Over
3
Asthma
4,8
Asthma
5,8
Bronchitis
6,8
Emphysema
7,8
Disease
9
Diabetes
l0
Poverty
ll
Avg.
l2
Grade
l3
1 Kern CA 839,631 254,081 75,437 16,855 44,572 24,047 9,398 173,566 47,097 172,531 53.8 F
2 Fresno CA 930,450 277,507 93,421 18,409 49,721 27,034 10,932 197,670 53,861 245,330 41.2 F
3 Kings CA 152,982 42,548 12,030 2,822 8,348 4,423 1,619 31,019 8,299 29,606 29.8 F
4 Riverside CA 2,189,641 620,108 258,586 41,135 120,166 66,447 28,441 498,296 137,270 354,768 28.8 F
5 Stanislaus CA 514,453 147,158 54,831 9,762 28,134 15,444 6,401 114,432 31,427 100,554 26.8 F
6 Allegheny PA 1,223,348 241,663 205,059 23,026 96,938 43,705 20,759 344,552 102,934 141,453 26.3 F
7 Hawaii HI 185,079 42,280 26,834 4,662 13,426 6,404 2,964 50,212 12,390 33,285 23.5 F
8 Los Angeles CA 9,818,605 2,402,208 1,065,699 159,352 566,147 308,756 125,611 2,266,565 619,371 1,699,264 20.3 F
9 Salt Lake UT 1,029,655 299,781 89,367 20,614 66,384 29,531 11,231 210,224 47,227 139,675 19.3 F
10 Cache UT 112,656 35,639 8,694 2,451 6,988 2,985 1,062 20,466 4,503 17,323 15.0 F
11 Shoshone ID 12,765 2,660 2,537 122 915 474 245 3,910 985 2,606 12.7 F
12 Fairbanks North
Star Borough AK 97,581 25,001 6,375 1,731 7,184 2,919 1,026 20,296 3,491 8,804 11.8 F
13 Merced CA 255,793 80,698 23,960 5,353 13,302 7,191 2,853 52,121 14,142 58,212 11.7 F
14 Utah UT 516,564 181,977 33,457 12,514 30,344 12,705 4,280 85,060 18,413 74,539 11.5 F
15 Weber UT 231,236 69,311 23,388 4,766 14,730 6,698 2,713 48,982 11,201 31,542 10.0 F
16 Tulare CA 442,179 144,124 41,779 9,561 22,675 12,297 4,931 89,570 24,362 108,143 9.8 F
17 Muscatine IA 42,745 11,164 5,843 695 2,476 1,393 635 10,809 2,403 5,782 9.2 F
18 Lane OR 351,715 69,689 52,781 5,256 26,830 12,309 5,587 95,028 20,424 65,849 8.7 F
19 Brown WI 248,007 61,823 28,789 5,491 15,440 7,963 3,378 59,793 12,676 24,829 7.0 F
20 San Joaquin CA 685,306 200,724 71,181 13,315 37,106 20,338 8,380 150,333 41,250 128,331 6.8 F
21 Lemhi ID 7,936 1,576 1,758 73 582 308 167 2,602 659 1,660 6.7 F
21 Doña Ana NM 209,233 55,858 25,881 4,456 14,971 6,503 2,806 48,910 12,556 52,262 6.7 F
23 Plumas CA 20,007 3,601 4,154 239 1,308 784 410 6,527 1,886 3,012 6.5 F
23 Lewis and Clark MT 63,395 14,376 8,757 990 4,455 2,189 996 17,049 3,474 7,041 6.5 F
25 San Bernardino CA 2,035,210 594,588 181,348 39,442 109,976 59,433 23,199 429,655 116,882 362,099 6.3 F
25 Cumberland PA 235,406 48,712 36,745 4,641 18,484 8,232 3,818 64,210 19,126 16,451 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 l8 and under 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 2C1C 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 2C1C based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Chronic bronchitis estimates are for adults 1o and over who had been diagnosed in 2C1C, based on national rates
(NHIS) applied to population estimates (U.S. Census).
7. Emphysema estimates are for adults 1o and over who have been diagnosed within their lifetime, based on national
rates (NHIS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma and,or emphysema
and chronic bronchitis.
9. CV disease estimates are based on National Heart Lung and Blood Institute (NHLBI) estimates of cardiovascular
disease applied to population estimates (U.S. Census).
1C. 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).
11. Poverty estimates come from the U.S. Census Bureau and are for all ages.
12. The Weighted Average was derived by counting the number of days in each unhealthful range (orange, red, purple,
maroon) in each year (2CCo-2C1C), 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.
1¯. 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 2012 16
People at Risk in 25 Counties Most Polluted by Year-round Particle Pollution (Annual PM
2.5
)
PM
2.5
Annual,
At-Risk Groups 2008–20l0
20l2 Total 65 and Pediatric Adult Chronic CV Design
Rank
l
County ST Population
2
Under l8
3
Over
3
Asthma
4,8
Asthma
5,8
Bronchitis
6,8
Emphysema
7,8
Disease
9
Diabetes
l0
Poverty
ll
Value
l2
Grade
l3
1 Kern CA 839,631 254,081 75,437 16,855 44,572 24,047 9,398 173,566 47,097 172,531 21.2 Fail
2 Hawaii HI 185,079 42,280 26,834 4,662 13,426 6,404 2,964 50,212 12,390 33,285 18.4 Fail
3 Kings CA 152,982 42,548 12,030 2,822 8,348 4,423 1,619 31,019 8,299 29,606 17.1 Fail
4 Riverside CA 2,189,641 620,108 258,586 41,135 120,166 66,447 28,441 498,296 137,270 354,768 17.0 Fail
5 Tulare CA 442,179 144,124 41,779 9,561 22,675 12,297 4,931 89,570 24,362 108,143 16.5 Fail
6 Fresno CA 930,450 277,507 93,421 18,409 49,721 27,034 10,932 197,670 53,861 245,330 16.4 Fail
7 Allegheny PA 1,223,348 241,663 205,059 23,026 96,938 43,705 20,759 344,552 102,934 141,453 16.0 Fail
8 Pinal AZ 375,770 99,700 52,071 9,348 26,593 11,852 5,331 90,685 23,143 51,500 15.4 Fail
9 San Bernardino CA 2,035,210 594,588 181,348 39,442 109,976 59,433 23,199 429,655 116,882 362,099 14.5 Pass
10 Los Angeles CA 9,818,605 2,402,208 1,065,699 159,352 566,147 308,756 125,611 2,266,565 619,371 1,699,264 14.4 Pass
10 Hamilton OH 802,374 189,640 106,863 17,781 58,986 26,553 11,754 202,912 61,013 144,741 14.4 Pass
12 Clark IN 110,232 26,109 14,055 2,295 8,021 3,640 1,591 27,699 8,299 13,632 14.1 Pass
13 Madison IL 269,282 61,246 38,428 6,026 18,844 9,096 4,119 70,216 19,162 38,068 13.8 Pass
13 Chester PA 498,886 124,055 63,875 11,820 37,427 16,456 7,308 126,487 37,464 31,172 13.8 Pass
15 Jeíerson AL 658,466 154,528 86,443 17,750 39,726 21,754 9,558 165,636 61,402 119,809 13.7 Pass
15 Brooke WV 24,069 4,577 4,602 299 1,411 895 449 7,255 2,432 3,402 13.7 Pass
17 Fairbanks North
Star Borough AK 97,581 25,001 6,375 1,731 7,184 2,919 1,026 20,296 3,491 8,804 13.6 Pass
17 Marion IN 903,393 226,505 96,102 19,914 64,968 28,268 11,496 207,757 61,762 184,537 13.6 Pass
17 Cuyahoga OH 1,280,122 290,262 198,541 27,215 95,026 44,014 20,639 345,470 104,479 227,716 13.6 Pass
20 Butler OH 368,130 92,604 42,484 8,683 26,590 11,775 4,989 88,365 26,449 48,197 13.4 Pass
20 Westmoreland PA 365,169 72,611 68,877 6,919 28,801 13,508 6,795 109,780 33,020 37,017 13.4 Pass
22 Summit OH 541,781 123,575 78,968 11,586 40,213 18,517 8,509 144,235 43,524 82,194 13.3 Pass
23 Muscogee GA 189,885 48,598 22,082 4,368 10,973 5,950 2,500 44,288 13,916 36,998 13.2 Pass
23 Jeíerson KY 741,096 171,807 99,095 18,239 59,161 24,702 10,939 188,884 57,395 125,861 13.2 Pass
23 Montgomery OH 535,153 123,279 81,041 11,559 39,549 18,186 8,441 141,939 42,886 93,697 13.2 Pass
23 Kanawha WV 193,063 39,734 32,315 2,598 11,111 6,919 3,322 54,988 18,465 28,101 13.2 Pass
Notes:
1. Counties are ranked by design value. See note 12 below.
2. Total Population represents the at-risk populations in counties with PM2.o monitors.
¯. Those l8 and under 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 2C1C 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 2C1C based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Chronic bronchitis estimates are for adults 1o and over who had been diagnosed in 2C1C, based on national rates
(NHIS) applied to population estimates (U.S. Census).
7. Emphysema estimates are for adults 1o and over who have been diagnosed within their lifetime, based on national
rates (NHIS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma and,or emphysema
and chronic bronchitis.
9. CV disease is cardiovascular disease and estimates are based on National Heart Lung and Blood Institute (NHLBI)
estimates of cardiovascular disease applied to population estimates (U.S. Census).
1C. 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).
11. Poverty estimates come from the U.S. Census Bureau and are for all ages.
12. 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. The source for the Design
Values is http:,,www.epa.gov,air,airtrends,pdfs,PM2o¸DesignValues¸2CCo2C1C¸FinalRevised.xlsx, downloaded
September 24, 2C11.
1¯. Grades are based on EPA’s determination of meeting or failure to meet the NAAQS for annual PM2.o levels during 2CCo-
2C1C. Counties meeting the NAAQS received grades of Pass; counties not meeting the NAAQS received grades of Fail.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 17
People at Risk in 25 Most Ozone-Polluted Counties
High Ozone Days in
Unhealthy Ranges,
At-Risk Groups 2008–20l0
20l2 Total 65 and Pediatric Adult Chronic Weighted
Rank
l
County ST Population
2
Under l8
3
Over
3
Asthma
4,8
Asthma
5,8
Bronchitis
6,8
Emphysema
7,8
Poverty
9
Avg.
l0
Grade
ll
1 San Bernardino CA 2,035,210 594,588 181,348 39,442 109,976 59,433 23,199 362,099 127.8 F
2 Riverside CA 2,189,641 620,108 258,586 41,135 120,166 66,447 28,441 354,768 111.3 F
3 Tulare CA 442,179 144,124 41,779 9,561 22,675 12,297 4,931 108,143 95.7 F
4 Kern CA 839,631 254,081 75,437 16,855 44,572 24,047 9,398 172,531 95.0 F
5 Los Angeles CA 9,818,605 2,402,208 1,065,699 159,352 566,147 308,756 125,611 1,699,264 86.2 F
6 Fresno CA 930,450 277,507 93,421 18,409 49,721 27,034 10,932 245,330 61.5 F
7 Kings CA 152,982 42,548 12,030 2,822 8,348 4,423 1,619 29,606 42.3 F
8 Sacramento CA 1,418,788 363,053 158,551 24,083 81,006 44,570 18,564 234,470 41.5 F
9 El Dorado CA 181,058 41,175 26,524 2,731 11,057 6,392 3,002 16,825 27.2 F
10 San Diego CA 3,095,313 724,168 351,425 48,038 181,080 99,026 40,726 445,556 25.2 F
11 Harris TX 4,092,459 1,147,835 333,487 86,823 217,153 119,788 44,982 758,916 24.3 F
12 Placer CA 348,432 85,085 53,562 5,644 20,512 11,765 5,556 31,489 24.2 F
13 San Luis Obispo CA 269,637 50,841 41,022 3,373 16,916 9,556 4,342 36,179 23.0 F
13 Ventura CA 823,318 211,915 96,309 14,057 47,178 26,210 11,194 89,880 23.0 F
15 Merced CA 255,793 80,698 23,960 5,353 13,302 7,191 2,853 58,212 22.5 F
16 Nevada CA 98,764 19,106 19,174 1,267 6,321 3,754 1,922 11,456 22.0 F
17 Stanislaus CA 514,453 147,158 54,831 9,762 28,134 15,444 6,401 100,554 21.5 F
18 Tarrant TX 1,809,034 507,061 161,385 38,355 96,149 53,843 20,989 258,595 21.2 F
19 Mariposa CA 18,251 3,242 3,821 215 1,196 717 376 2,665 19.8 F
20 Harford MD 244,826 60,410 30,564 7,155 15,428 8,092 3,566 16,715 19.2 F
21 Uintah UT 32,588 10,857 2,997 747 1,977 894 356 4,594 18.0 F
22 Madera CA 150,865 42,849 17,262 2,842 8,270 4,562 1,933 30,912 16.7 F
23 Imperial CA 174,528 51,098 18,152 3,390 9,415 5,139 2,104 36,666 15.7 F
24 Fairfield CT 916,829 227,019 124,075 25,492 63,223 30,325 13,680 84,125 13.7 F
25 Amador CA 38,091 6,393 7,865 424 2,512 1,495 772 4,286 12.7 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 l8 and under 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 2C1C 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 2C1C based on state rates (BRFSS) applied to population estimates (U.S. Census).
o. Chronic bronchitis estimates are for adults 1o and over who had been diagnosed in 2C1C, based on national rates (NHIS) applied to population estimates (U.S. Census).
7. Emphysema estimates are for adults 1o and over who have been diagnosed within their lifetime, based on national rates (NHIS) applied to population estimates (U.S. Census).
o. Adding across rows does not produce valid estimates, e.g., summing pediatric and adult asthma and,or emphysema and chronic bronchitis.
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 (2CCo-2C1C), 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 2012 18
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
Albuquerque, NM 887,077
Alexandria, LA 153,922
Amarillo, TX 249,881
Asheville-Brevard, NC 457,948
Athens-Clarke County, GA 192,541
Atlantic City-Hammonton, NJ 274,549
Austin-Round Rock-Marble Falls, TX 1,716,289
Bangor, ME 153,923
Baton Rouge-Pierre Part, LA 825,905
Beckley-Oak Hill, WV 124,898
Bowling Green, KY 125,953
Brownsville-Harlingen-Raymondville, TX 428,354
Burlington-South Burlington, VT 211,261
Cape Coral-Fort Myers, FL 618,754
Champaign-Urbana, IL 231,891
Charleston-North Charleston-Summerville, SC 664,607
Charlotte-Gastonia-Salisbury, NC-SC 2,402,623
Cheyenne, WY 91,738
Claremont-Lebanon, NH-VT 218,466
Clarksville, TN-KY 273,949
Colorado Springs, CO 645,613
Columbia-Newberry, SC 805,106
Corpus Christi-Kingsville, TX 460,662
Decatur, IL 110,768
Dover, DE 162,310
Farmington, NM 130,044
Metropolitan Statistical Area Population
Fayetteville, NC 366,383
Fayetteville-Springdale-Rogers, AR-MO 463,204
Flagstaí, AZ 134,421
Florence, SC 205,566
Florence-Muscle Shoals, AL 147,137
Fort Collins-Loveland, CO 299,630
Fort Smith, AR-OK 298,592
Gainesville, FL 264,275
Gulfport-Biloxi-Pascagoula, MS 411,066
Hattiesburg, MS 142,842
Hickory-Lenoir-Morganton, NC 365,497
Hot Springs, AR 96,024
Houma-Bayou Cane-Thibodaux, LA 208,178
Jackson-Humboldt, TN 165,108
Jackson-Yazoo City, MS 567,122
Lafayette-Acadiana, LA 550,134
Lake Charles-Jennings, LA 231,201
Lakeland-Winter Haven, FL 602,095
Lansing-East Lansing-Owosso, MI 534,684
Little Rock-North Little Rock-Pine Bluí, AR 877,091
Longview-Marshall, TX 280,000
Lubbock-Levelland, TX 307,825
Lumberton-Laurinburg, NC 170,325
Lynchburg, VA 252,634
McAllen-Edinburg-Pharr, TX 774,769
Mobile-Daphne-Fairhope, AL 595,257
Metropolitan Statistical Area Population
Monroe-Bastrop, LA 204,420
Niles-Benton Harbor, MI 156,813
Oklahoma City-Shawnee, OK 1,322,429
Orlando-Deltona-Daytona Beach, FL 2,818,120
Owensboro, KY 114,752
Paducah-Mayfield, KY-IL 135,883
Palm Bay-Melbourne-Titusville, FL 543,376
Pensacola-Ferry Pass-Brent, FL 448,991
Peoria-Canton, IL 416,255
Pocatello, ID 90,656
Prescott, AZ 211,033
Pueblo, CO 159,063
Rocky Mount, NC 152,392
Salinas, CA 415,057
San Antonio-New Braunfels, TX 2,142,508
Santa Fe-Espanola, NM 184,416
Sarasota-Bradenton-Punta Gorda, FL 862,259
Shreveport-Bossier City-Minden, LA 439,811
Springfield, IL 210,170
Syracuse-Auburn, NY 742,603
Tampa-St. Petersburg-Clearwater, FL 2,783,243
Texarkana, TX-Texarkana, AR 136,027
Tucson, AZ 980,263
Tulsa-Bartlesville, OK 988,454
Wichita-Winfield, KS 659,372
Yuma, AZ 195,751
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 19
Cleanest U.S. Cities for
Ozone Air Pollution
l
Metropolitan Statistical Area Population
Ames-Boone, IA 115,848
Appleton-Oshkosh-Neenah, WI 392,660
Bend-Prineville, OR 178,711
Bismarck, ND 108,779
Bloomington-Normal, IL 169,572
Brownsville-Harlingen-Raymondville, TX 428,354
Brunswick, GA 112,370
Cedar Rapids, IA 257,940
Champaign-Urbana, IL 231,891
Coeur d’Alene, ID 138,494
Davenport-Moline-Rock Island, IA-IL 379,690
Decatur, IL 110,768
Des Moines-Newton-Pella, IA 639,784
Dothan-Enterprise-Ozark, AL 245,838
Duluth, MN-WI 279,771
Eugene-Springfield, OR 351,715
Fargo-Wahpeton, ND-MN 231,674
Florence-Muscle Shoals, AL 147,137
Fond du Lac-Beaver Dam, WI 190,392
Gadsden, AL 104,430
Honolulu, HI 953,207
Janesville, WI 160,331
La Crosse, WI-MN 133,665
Laredo, TX 250,304
Lincoln, NE 302,157
Note:
1. This list represents cities with no monitored ozone air pollution
in unhealthful ranges using the Air Quality Index based on 2CCo
NAAQS.
Metropolitan Statistical Area Population
Logan, UT-ID 125,442
Madison-Baraboo, WI 630,569
Minneapolis-St. Paul-St. Cloud, MN-WI 3,615,902
Monroe-Bastrop, LA 204,420
Muncie, IN 117,671
Naples-Marco Island, FL 321,520
Ocala, FL 331,298
Peoria-Canton, IL 416,255
Port St. Lucie-Sebastian-Vero Beach, FL 562,135
Rapid City, SD 126,382
Rochester, MN 186,011
Rockford-Freeport-Rochelle, IL 450,639
Santa Fe-Espanola, NM 184,416
Savannah-Hinesville-Fort Stewart, GA 425,528
Sioux Falls, SD 228,261
Spokane, WA 471,221
Springfield, IL 210,170
Terre Haute, IN 172,425
Tuscaloosa, AL 219,461
Waterloo-Cedar Falls, IA 167,819
Wausau-Merrill, WI 162,806
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 Santa Fe-Espanola, NM 184,416
2 4.2 Cheyenne, WY 91,738
3 5.0 Prescott, AZ 211,033
4 5.4 Tucson, AZ 980,263
5 5.6 Albuquerque, NM 887,077
6 5.9 Redding, CA 177,223
7 6.0 Colorado Springs, CO 645,613
8 6.1 Flagstaí, AZ 134,421
9 6.3 Anchorage, AK 380,821
9 6.3 Boise City-Nampa, ID 616,561
11 6.4 Salinas, CA 415,057
12 6.6 Fort Collins-Loveland, CO 299,630
12 6.6 Rapid City, SD 126,382
14 6.8 Cape Coral-Fort Myers, FL 618,754
14 6.8 Claremont-Lebanon, NH-VT 218,466
14 6.8 Sarasota-Bradenton-Punta Gorda, FL 862,259
17 6.9 Palm Bay-Melbourne-Titusville, FL 543,376
18 7.1 Bismarck, ND 108,779
18 7.1 Duluth, MN-WI 279,771
20 7.3 Burlington-South Burlington, VT 211,261
21 7.4 Bangor, ME 153,923
21 7.4 Gainesville, FL 264,275
23 7.5 El Centro, CA 174,528
23 7.5 Honolulu, HI 953,207
23 7.5 Port St. Lucie-Sebastian-Vero Beach, FL 562,135
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 EPA to determine whether the
air quality in a county meets the standard. The source for the Values is http:,,www.epa.
gov,air,airtrends,pdfs,PM2o¸DesignValues¸2CCo2C1C¸FinalRevised.xlsx, downloaded
September 24, 2C11.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 20
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.
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 mutiple MSAs and individual counties.
County State MSAs and Respective CSA
2
Baldwin AL Mobile-Daphne-Fairhope, AL
Clay AL
Colbert AL Florence-Muscle Shoals, AL
DeKalb AL
Mobile AL Mobile-Daphne-Fairhope, AL
Morgan AL Huntsville-Decatur, AL
Shelby AL Birmingham-Hoover-Cullman, AL
Talladega AL
Walker AL Birmingham-Hoover-Cullman, AL
Anchorage Municipality AK Anchorage, AK
Cochise AZ
Coconino AZ Flagstaí, AZ
Pima AZ Tucson, AZ
Yavapai AZ Prescott, AZ
Yuma AZ Yuma, AZ
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
Phillips AR
Polk AR
Pope AR
Pulaski AR Little Rock-North Little Rock-Pine Bluí, 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
Humboldt CA
Mendocino CA
Monterey CA Salinas, CA
San Benito 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
Adams CO Denver-Aurora-Boulder, CO
County State MSAs and Respective CSA
2
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
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
Broward FL Miami-Fort Lauderdale-Pompano Beach, 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
Palm Beach FL Miami-Fort Lauderdale-Pompano 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
Volusia FL Orlando-Deltona-Daytona Beach, FL
Clarke GA Athens-Clarke County, GA
Gwinnett GA Atlanta-Sandy Springs-Gainesville, GA-AL
Maui HI
Bannock ID Pocatello, ID
Adams IL
Champaign IL Champaign-Urbana, IL
Jersey IL St. Louis-St. Charles-Farmington, MO-IL
Lake IL Chicago-Naperville-Michigan City, IL-IN-WI
LaSalle IL
Macon IL Decatur, IL
McHenry IL Chicago-Naperville-Michigan City, IL-IN-WI
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 21
County State MSAs and Respective CSA
2
Peoria IL Peoria-Canton, IL
Randolph IL
Rock Island IL Davenport-Moline-Rock Island, IA-IL
Sangamon IL Springfield, IL
Dubois IN
Gibson IN Evansville, IN-KY
Knox IN
LaPorte IN Chicago-Naperville-Michigan City, IL-IN-WI
Madison IN Indianapolis-Anderson-Columbus, 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
Henderson KY Evansville, IN-KY
Kenton KY Cincinnati-Middletown-Wilmington, OH-KY-IN
Madison KY Lexington-Fayette—Frankfort—Richmond, KY
McCracken KY Paducah-Mayfield, KY-IL
Ohio KY
Warren KY Bowling Green, KY
Caddo Parish LA Shreveport-Bossier City-Minden, LA
Calcasieu Parish LA Lake Charles-Jennings, LA
East Baton Rouge Parish LA Baton Rouge-Pierre Part, LA
Iberville Parish LA Baton Rouge-Pierre Part, LA
Lafayette Parish LA Lafayette-Acadiana, LA
Ouachita Parish LA Monroe-Bastrop, LA
County State MSAs and Respective CSA
2
Rapides Parish LA Alexandria, LA
Tangipahoa Parish LA
Terrebonne Parish LA Houma-Bayou Cane-Thibodaux, LA
West Baton Rouge Parish LA Baton Rouge-Pierre Part, LA
Hancock ME
Kennebec ME
Penobscot ME Bangor, ME
Harford MD Washington-Baltimore-Northern Virginia,
DC-MD-VA-WV
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
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
Washtenaw MI Detroit-Warren-Flint, MI
Adams MS
Bolivar MS
DeSoto MS Memphis, TN-MS-AR
Forrest MS Hattiesburg, MS
Grenada MS
Harrison MS Gulfport-Biloxi-Pascagoula, MS
Hinds MS Jackson-Yazoo City, MS
Jackson MS Gulfport-Biloxi-Pascagoula, MS
Jones MS
Lauderdale MS
Lee MS
Cedar MO
Flathead MT
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.
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 mutiple MSAs and individual counties.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 22
County State MSAs and Respective CSA
2
Richland MT
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
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
Bernalillo NM Albuquerque, NM
Chaves NM
Grant NM
Lea NM
San Juan NM Farmington, NM
Santa Fe NM Santa Fe-Espanola, NM
Chautauqua NY
Essex NY
Niagara NY Buíalo-Niagara-Cattaraugus, NY
Onondaga NY Syracuse-Auburn, NY
Alamance NC Greensboro—Winston-Salem—High Point, NC
Buncombe NC Asheville-Brevard, NC
Caswell NC
Catawba NC Hickory-Lenoir-Morganton, NC
Cumberland NC Fayetteville, NC
Davidson NC Greensboro—Winston-Salem—High Point, NC
Duplin NC
Durham NC Raleigh-Durham-Cary, NC
Edgecombe NC Rocky Mount, NC
Gaston NC Charlotte-Gastonia-Salisbury, NC-SC
Haywood NC Asheville-Brevard, NC
Jackson NC
McDowell NC
Mecklenburg NC Charlotte-Gastonia-Salisbury, NC-SC
Mitchell NC
County State MSAs and Respective CSA
2
Montgomery NC
Robeson NC Lumberton-Laurinburg, NC
Rowan NC Charlotte-Gastonia-Salisbury, NC-SC
Swain NC
Watauga NC
Billings ND
Mercer ND
Athens OH
Clermont OH Cincinnati-Middletown-Wilmington, OH-KY-IN
Greene OH Dayton-Springfield-Greenville, OH
Lawrence OH Huntington-Ashland, WV-KY-OH
Medina OH Cleveland-Akron-Elyria, OH
Scioto OH
Caddo OK
Mayes OK
Muskogee OK
Oklahoma OK Oklahoma City-Shawnee, OK
Ottawa OK
Pittsburg OK
Sequoyah OK Fort Smith, AR-OK
Tulsa OK Tulsa-Bartlesville, OK
Multnomah OR Portland-Vancouver-Hillsboro, OR-WA
Umatilla OR
Union OR
Kent RI Boston-Worcester-Manchester, MA-RI-NH
Charleston SC Charleston-North Charleston-Summerville, SC
Chesterfield SC
Florence SC Florence, SC
Lexington SC Columbia-Newberry, SC
Oconee SC Greenville-Spartanburg-Anderson, SC
Richland SC Columbia-Newberry, SC
Spartanburg SC Greenville-Spartanburg-Anderson, SC
Brown SD
Lawrence TN
Madison TN Jackson-Humboldt, TN
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.
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 mutiple MSAs and individual counties.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 23
County State MSAs and Respective CSA
2
Maury TN Nashville-Davidson—Murfreesboro—Columbia, TN
McMinn TN Chattanooga-Cleveland-Athens, TN-GA
Montgomery TN Clarksville, TN-KY
Putnam TN
Bexar TX San Antonio-New Braunfels, TX
Bowie TX Texarkana, TX-Texarkana, AR
Brewster TX
Cameron TX Brownsville-Harlingen-Raymondville, TX
Harrison TX Longview-Marshall, TX
Hidalgo TX McAllen-Edinburg-Pharr, TX
Lubbock TX Lubbock-Levelland, TX
Nueces TX Corpus Christi-Kingsville, TX
Potter TX Amarillo, TX
Tarrant TX Dallas-Fort Worth, TX
Travis TX Austin-Round Rock-Marble Falls, TX
Bennington VT
Chittenden VT Burlington-South Burlington, VT
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
Lynchburg city VA Lynchburg, VA
Page VA
Salem city VA Roanoke, VA
King WA Seattle-Tacoma-Olympia, WA
Marion WV Fairmont-Clarksburg, WV
Ohio WV Wheeling, WV-OH
Raleigh WV Beckley-Oak Hill, WV
Campbell WY
Converse WY
Laramie WY Cheyenne, WY
Sweetwater 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.
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 2012 24
Top 25 Cleanest Counties for Year-round
Particle Pollution (Annual PM
2.5
)
l

20l2
Rank
2
County ST Design Value
3
1 Santa Fe NM 4.1
2 Elbert CO 4.2
2 Laramie WY 4.2
4 Hancock ME 4.4
4 Essex NY 4.4
4 Jackson SD 4.4
7 Billings ND 4.5
8 Lake CA 4.6
8 Maui HI 4.6
10 Teton WY 4.7
11 Grant NM 4.8
12 Custer SD 4.9
13 Yavapai AZ 5.0
14 Piscataquis ME 5.3
15 Pima AZ 5.4
16 Bernalillo NM 5.6
17 Douglas CO 5.8
17 Belknap NH 5.8
17 Ashland WI 5.8
20 Shasta CA 5.9
21 El Paso CO 6.0
21 Litchfield CT 6.0
23 Coconino AZ 6.1
23 San Benito CA 6.1
23 Missaukee MI 6.1
23 Mercer ND 6.1
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 EPA to determine
whether the air quality in a county meets the standard. The source for the Design
Values is http:,,www.epa.gov,air,airtrends,pdfs,PM2o¸DesignValues¸2CCo2C1C¸
FinalRevised.xlsx, downloaded September 24, 2C11
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 25
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.
County State Metropolitan Statistical Area
County ST Metropolitan Statistical 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
Russell AL Columbus-Auburn-Opelika, GA-AL
Tuscaloosa AL Tuscaloosa, AL
Navajo AZ
Newton AR
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
Baker FL Jacksonville, FL
Collier FL Naples-Marco Island, FL
Columbia FL
Holmes FL
Marion FL Ocala, 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
County State Metropolitan Statistical Area
Chattooga GA
Glynn GA Brunswick, GA
Sumter GA
Honolulu HI Honolulu, HI
Butte ID
Kootenai ID Coeur d’Alene, ID
Champaign IL Champaign-Urbana, IL
Clark IL
DuPage IL Chicago-Naperville-
Michigan City, IL-IN-WI
Eíngham IL
Macon IL Decatur, IL
McHenry IL Chicago-Naperville-
Michigan City, IL-IN-WI
McLean IL Bloomington-Normal, IL
Peoria IL Peoria-Canton, IL
Randolph IL
Rock Island IL Davenport-Moline-
Rock Island, IA-IL
Sangamon IL Springfield, IL
Will IL Chicago-Naperville-
Michigan City, IL-IN-WI
Winnebago IL Rockford-Freeport-Rochelle, IL
Delaware IN Muncie, IN
Elkhart IN South Bend-Elkhart-
Mishawaka, IN-MI
Huntington IN Fort Wayne-Huntington-
Auburn, IN
Madison IN Indianapolis-Anderson-
Columbus, IN
St. Joseph IN South Bend-Elkhart-
Mishawaka, IN-MI
Vigo IN Terre Haute, IN
Bremer IA Waterloo-Cedar Falls, IA
Clinton IA
County State Metropolitan Statistical Area
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
Linn KS Kansas City-Overland Park-
Kansas City, MO-KS
Trego KS
Wyandotte KS Kansas City-Overland Park-
Kansas City, MO-KS
Jessamine KY Lexington-Fayette-
Frankfort-Richmond, KY
Perry KY
Pike KY
Pulaski KY
Warren KY Bowling Green, KY
Ouachita Parish LA Monroe-Bastrop, LA
Aroostook ME
Oxford ME
Sagadahoc ME Portland-Lewiston-
South Portland, ME
Ingham MI Lansing-East Lansing-Owosso, MI
Washtenaw MI Detroit-Warren-Flint, MI
Anoka MN Minneapolis-St. Paul-
St. Cloud, MN-WI
Becker MN
Carlton MN Duluth, MN-WI
Goodhue MN Minneapolis-St. Paul-
St. Cloud, MN-WI
Lake MN
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 26
Cleanest Counties for Ozone Air Pollution
l
(cont.)
County State Metropolitan Statistical Area
Lyon MN
Mille Lacs MN
Olmsted MN Rochester, MN
Scott MN Minneapolis-St. Paul-
St. Cloud, MN-WI
St. Louis MN Duluth, MN-WI
Stearns MN Minneapolis-St. Paul-
St. Cloud, MN-WI
Washington MN Minneapolis-St. Paul-
St. Cloud, MN-WI
Wright MN Minneapolis-St. Paul-
St. Cloud, MN-WI
Lauderdale MS
Lee MS
Monroe MO
Flathead MT
Douglas NE Omaha-Council Bluís-
Fremont, NE-IA
Lancaster NE Lincoln, NE
Lyon NV Reno-Sparks-Fernley, NV
Eddy NM
Lea NM
Luna NM
Sandoval NM Albuquerque, NM
Santa Fe NM Santa Fe-Espanola, NM
Swain NC
Billings ND
Burke ND
Burleigh ND Bismarck, ND
Cass ND Fargo-Wahpeton, ND-MN
Dunn ND
McKenzie ND
Mercer ND
Oliver ND
County State Metropolitan Statistical Area
Adair OK
Cleveland OK Oklahoma City-Shawnee, OK
Dewey OK
Lincoln OK Oklahoma City-Shawnee, OK
Mayes OK
Pittsburg OK
Columbia OR Portland-Vancouver-
Hillsboro, OR-WA
Deschutes OR Bend-Prineville, OR
Lane OR Eugene-Springfield, OR
Umatilla OR
Washington OR Portland-Vancouver-
Hillsboro, OR-WA
Charleston SC Charleston-North Charleston-
Summerville, SC
Colleton SC
Brookings SD
Custer SD
Jackson SD
Meade SD Rapid City, SD
Minnehaha SD Sioux Falls, SD
Brewster TX
Cameron TX Brownsville-Harlingen-
Raymondville, TX
Webb TX Laredo, TX
Cache UT Logan, UT-ID
Page VA
Clallam WA
Skagit WA Seattle-Tacoma-Olympia, WA
Spokane WA Spokane, WA
Greenbrier WV
Ashland WI
Brown WI Green Bay, WI
County State Metropolitan Statistical Area
Columbia WI Madison-Baraboo, WI
Dane WI Madison-Baraboo, WI
Dodge WI Fond du Lac-Beaver Dam, WI
Florence WI
Fond du Lac 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
Outagamie WI Appleton-Oshkosh-Neenah, WI
Rock WI Janesville, WI
Sauk WI Madison-Baraboo, WI
St. Croix WI Minneapolis-St. Paul-
St. Cloud, MN-WI
Vernon WI
Vilas WI
Washington WI Milwaukee-Racine-Waukesha, WI
Waukesha WI Milwaukee-Racine-Waukesha, WI
Campbell WY
Crook WY
Uinta WY
Note:
1. This list represents counties with no monitored ozone air pollution in unhealthful ranges using the Air Quality Index based on 2CCo NAAQS.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 27
Health Eects of Ozone and Particle Pollution
O
zone and particle pollution are the most widespread
air pollutants—and among the most dangerous. Re-
cent research has revealed new insights into how they
can harm the body—including taking the lives of infants and
altering the lungs of children. All in all, the evidence shows
that the risks are greater than we once thought.
Recent ndings provide more evidence about the health im-
pacts of these pollutants:
I A major review of particle pollution and other air pollutants
concluded that many cause heart attacks, even when people
inhale elevated levels for as little as one week.
1
is review
looked at evidence from 177 studies and found that particle
pollution (both ne and coarse), carbon monoxide, nitro-
gen oxides, and sulfur dioxide all increased the risk of heart
attack.
I Particle pollution that lasts for just a short while may be
causing strokes, even at levels considered safe, according to
a study of Boston area patients.
2
In particular, researchers
found that breathing levels of trac-related particles were
linked to increased risk of stroke within 12 to 14 hours of
breathing them.
I Up to 35,700 premature deaths can be prevented in the
United States every year if the Environmental Protection
Agency (EPA) strengthens the health standards for particle
pollution—also known as soot—according to a report, Sick
of Soot: How the EPA Can Save Lives by Cleaning Up Fine
Particle Pollution, released in November by the American
Lung Association, Clean Air Task Force and Earthjustice.
at report summarized the ndings of an in-depth look at
how cleaning up the particles could have powerful, life-
saving benets.
3
I Good news: Reducing air pollution has extended life expec-
tancy. anks to a drop in particle pollution between 1980
and 2000, life expectancy in 51 U.S. cities increased by ve
months on average, according to a 2009 analysis.
4

I Growing evidence shows that diabetics face a greater risk
from air pollution than once believed. Several studies found
increased risk of several factors associated with cardiovas-
cular risks in people with diabetes.
5
Some new research with
animals indicates that ne particle pollution may impact
insulin resistance and other factors.
6

I More people may be vulnerable to air pollution than previ-
ously understood. Researchers studying people who had
received kidney transplants found that long-term exposure
to ozone pollution increased their risk of fatal coronary
heart disease.
7

I Lower levels of ozone and particle pollution pose bigger
threats. A Canadian study showed that particle pollution
levels well below those considered safe in the U.S. for these
pollutants caused premature death.
8
An earlier study had
found higher risk of asthma attacks and emergency room
visits and hospital admissions for children with asthma.
9

Another study found that low levels of these pollutants
increased the risk of hospital treatment for pneumonia and
chronic obstructive pulmonary disease (COPD).
10

I Ozone pollution can shorten life, a conclusion conrmed by
a 2008 scientic review by the National Research Council.
11
Evidence warns that some segments of the population may
face higher risks from dying prematurely because of ozone
pollution, including communities with high unemploy-
ment or high public transit use and large African-American
populations.
12
I Could particulate matter cause lung cancer in never-smokers?
at question is getting closer to being answered with a
strong “yes” aer researchers looked at the records of 1.2
million volunteers which found that levels of ne particles
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 28
measured across the nation in the past few decades are
linked to small, but measurable increases in lung cancer in
people who never smoked.
13

I Research is warning that obesity may place people at higher
risk from particle pollution. Some studies link particle pol-
lution to increases in measurable reactions in the body that
signal harm to health.
14
e increase in the prevalence of
obesity in the nation may mean that more people are at risk.
I Busy highways are high risk zones. Not only may they
worsen diseases, but some evidence warns that years of
breathing the pollution near busy roads may increase the
risk of developing chronic diseases.
O A growing body of evidence suggests breathing
pollution from heavy trac may cause new cases of
asthma in children.
15

O Emerging research has found particle pollution
associated with increasing the risk of new cases
of three chronic diseases in adults: adult-onset
asthma,
16
diabetes,
17
and COPD, especially in people
who already have asthma or diabetes.
18

O Research had already connected pollution from
heavy highway trac to higher risks for heart at-
tack, allergies, premature births and the death of
infants around the time they are born.
19
Evidence
of the impact of trac pollution, even in a city with
generally “cleaner” air, expanded the concern over
the health eects of chronic exposure to exhaust
from heavy trac.
20
Two types of air pollution dominate the problem in the U.S.:
ozone and particle pollution. ey aren’t the only serious air
pollutants: others include carbon monoxide, lead, nitrogen
dioxide, and sulfur dioxide, as well as scores of toxins such
as mercury, arsenic, benzene, formaldehyde, and acid gases.
However, ozone and particle pollution are the most widespread
pollutants.
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 de-
cades. Hundreds of research studies 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 an extremely reactive gas molecule composed
of three oxygen atoms. It is the primary ingredient of smog air
pollution and is very harmful to breathe. Ozone attacks lung
tissue by reacting chemically with it.
e ozone layer found high in the upper atmosphere (the
stratosphere) shields us from much of the sun’s ultraviolet ra-
diation. However, ozone air pollution at ground level where we
can breathe it (in the troposphere) is harmful. It causes serious
health problems.
Where Does Ozone Come From?
What you see coming out of the tailpipe on a car or a truck
isn’t ozone, but the raw ingredients for making ozone. Ozone
is formed by chemical reactions in the atmosphere from two
raw gases that do come out of tailpipes, smokestacks and many
other sources. ese essential raw ingredients for ozone are
nitrogen oxides (NO
X
) and hydrocarbons, also called volatile
organic compounds (VOCs). ey are produced primarily
when fossil fuels like gasoline, oil or coal are burned or when
some chemicals, like solvents, evaporate.
When NO
X
and VOCs come in contact with both heat and
sunlight, they combine and form ozone smog. NO
X
is emit-
ted from power plants, motor vehicles and other sources of
high-heat combustion. VOCs are emitted from motor vehicles,
chemical plants, reneries, factories, gas stations, paint and
other sources. e formula for ozone is simple, and like any
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 29 HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
formula, the ingredients must all be present and in the right
proportions to make the nal product.
NO
x
OZONE VOCs
You may have wondered why “ozone action day” warnings are
sometimes followed by recommendations to avoid activities
such as mowing your lawn or relling your gas tank during
daylight hours. Lawn mower exhaust and gasoline vapors are
VOCs that could turn into ozone in the heat and sun. Take
away the sunlight and ozone doesn’t form, so relling your
gas tank aer dark is better on high ozone days. Since we can’t
control sunlight and heat, we must reduce the chemical raw
ingredients if we want to reduce ozone.
Who is at risk from breathing ozone?
Five groups of people are especially vulnerable to the eects of
breathing ozone:
I children and teens;
I anyone 65 and older;
I people who work or exercise outdoors;
I people with existing lung diseases, such as asthma and
chronic obstructive pulmonary disease (also known as
COPD, which includes emphysema and chronic bronchitis);
and
I “responders” who are otherwise healthy but for some reason
react more strongly to ozone.
21
e impact on your health can depend on many factors, how-
ever. For example, the risks would be greater if ozone levels
are higher, if you are breathing faster because you’re working
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.
22

How Ozone Pollution Harms Your Health
Breathing ozone can shorten your life. Two early studies
published in 2004 found strong evidence of the deadly impact
of ozone in cities across the U.S. and in Europe. Even on days
when ozone levels were low, the researchers found that the risk
of premature death increased with higher levels of ozone. ey
estimated that over 3,700 deaths annually in the U.S. could be
attributed to a 10-parts-per-billion increase in ozone levels.
23

Another study, published the same week, looked at 23 Euro-
pean cities and found similar eects on mortality from short-
term exposure to ozone.
24

Conrmation came in the summer of 2005. ree groups of
researchers working independently reviewed and analyzed the
research around deaths associated with short-term exposures
to ozone. e three teams—at Harvard, Johns Hopkins and
New York University—used dierent approaches but all came
to similar conclusions. All three studies reported a small but
robust association between daily ozone levels and increased
deaths.
25
Writing a commentary on these reviews, David Bates,
MD, explained how these premature deaths could occur:
“Ozone is capable of causing inflammation in
the lung at lower concentrations than any other
gas. Such an eíect would be a hazard to anyone
with heart failure and pulmonary congestion,
and would worsen the function of anyone with
advanced lung disease.”
26

In 2008 a committee of the National Research Council, a
division of the National Academy of Sciences, reviewed the
evidence again and concluded that “short-term exposure to
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 30
ambient ozone is likely to contribute to premature deaths.”
ey recommended that preventing early death be included in
any future estimates of the benets of reducing ozone.
27
New research has begun to identify which groups face higher
risk of death from ozone. A study published in 2010 examined
records from ten cities in Italy and found women, diabetics
and older adults to have a higher risk of premature death from
high ozone.
28
Ozone at levels currently in the U.S. causes immediate health
problems. Many areas in the United States produce enough
ground-level 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:
I shortness of breath;
I chest pain when inhaling;
I wheezing and coughing;
I asthma attacks;
I increased susceptibility to respiratory infections;
I increased susceptibility to pulmonary inammation; and
I 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.
29
Breathing ozone for longer periods can alter the lungs’ ability
to function. Two studies published in 2005 explored ozone’s
ability to reduce the lung’s ability to work eciently, a term
called “lung function.” Each study looked at otherwise healthy
groups who were exposed to ozone for long periods: outdoor
postal workers in Taiwan and college freshmen who were
lifelong residents of Los Angeles or the San Francisco Bay area.
Both studies found that the long exposure to elevated ozone
levels had decreased their lung function.
30
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.
31
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.
32

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 lon-
ger 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.
33
New York researchers looking at hospital records for
children’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.
34
California researchers digging
into data from their long-term Southern California Children’s
Health Study found that some children with certain genes were
more likely to develop asthma as adolescents in response to the
variations in ozone levels in their communities.
35
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.
36

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
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 31
80 percent lower than EPA currently considers safe. Research-
ers found that ozone at those lower levels was associated with
deaths from cardiovascular disease, strokes, and respiratory
causes.
37

Particle
Pollution
Ever look at dirty truck exhaust?
e dirty, smoky part of that stream
of exhaust is made of particle pollu-
tion. 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
particle pollution is simple. First of all, the 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.
You may not be able to tell when you’re breathing particle pol-
lution. Yet it is so dangerous it can shorten your life.
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 be-
tween 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 diameter
38
and are small enough to pass through the
lung tissue into the blood stream, circulating like the oxygen
molecules themselves. No matter what the size, particles can be
harmful to your health.
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 com-
pletely liquid; some are solids suspended in liquids. As the U.S.
Environmental Protection Agency puts it, particles are really “a
mixture of mixtures.”
39
e mixtures dier between the eastern
and western United States and in dierent times of the year.
For example, the Midwest, 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 proportion of the unhealthful mix in the
winter in the Northeast, Southern California, the Northwest,
and North Central U.S.
40
Who Is at Risk?
Anyone who lives where particle pollution levels are high is at
risk (you can take a look at levels in your state in this report).
Some people face higher risk, however. People at the greatest
risk from particle pollution exposure include:
I Anyone with lung disease such as asthma and chronic
obstructive pulmonary disease (COPD), which includes
chronic bronchitis and emphysema;
I Anyone with heart disease or diabetes
41
;
I Anyone over 65;
I Infants, children and teens;
I People with low incomes; and
I People who work or are active outdoors.
42

HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 32
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.
43
Trac-related air pollution
was implicated in two studies. A German study of nondiabetic
women found that new cases of diabetes were more likely as
levels of trac-related pollution and particle pollution in-
creased.
44
A similar nding of an increased risk for diabetes
in women who lived near roadways came in a large study of
nurses and health professionals, although that study did not
nd a strong association with levels of particle pollution.
45
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.
46

Good news came in 2009 from researchers who looked at the
impact of the drop in year-round levels of particle pollution
between 1980 and 2000 in 51 U.S. cities. anks to reduc-
tions in particle pollution people living in these cities had ve
months added to their life expectancy on average.
47
is study
adds to the growing research that cleaning up air pollution
improves life and health. Other researchers estimated that
reductions in air pollution can be expected to produce rapid
improvements in public health, with fewer deaths occurring
within the rst two years aer reductions.
48
Researchers are exploring possible dierences in health ef-
fects of the three sizes of particles and particles from dierent
sources, such as diesel particles from trucks and buses or sul-
fates from coal-red power plants. So far, the evidence remains
clear that all particles from all sources are dangerous.
49

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.
50

Researchers from Harvard University recently tripled the esti-
mated risk of premature death following a review of the newer
evidence from ne particle monitors (PM
2.5
) in 27 U.S. cities.
51

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:
I death from respiratory and cardiovascular causes, including
strokes;
52, 53, 54, 55
I increased mortality in infants and young children;
56
I increased numbers of heart attacks, especially among the
elderly and in people with heart conditions;
57
I inammation of lung tissue in young, healthy adults;
58
I increased hospitalization for cardiovascular disease, includ-
ing strokes and congestive heart failure;
59, 60, 61
I increased emergency room visits for patients suering from
acute respiratory ailments;
62
I increased hospitalization for asthma among children;
63, 64, 65
and
I increased severity of asthma attacks in children.
66
Again, the impact of even short-term exposure to particle pol-
lution on healthy adults showed up in the Galveston lifeguard
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 33
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.
67
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.
68
Chronic exposure to particle pollution can
shorten life by one to three years.
69
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:
I increased hospitalization for asthma attacks for children liv-
ing near roads with heavy truck or trailer trac;
70, 71
I slowed lung function growth in children and teenagers;
72, 73
I signicant damage to the small airways of the lungs;
74
I increased risk of dying from lung cancer;
75
and
I increased risk of death from cardiovascular disease.
76
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.
77
e Environmental Protection Agency released the most
thorough review of the current research on particle pollution
in December 2009.
78
e Agency had engaged a panel of expert
scientists, the Clean Air Scientic Advisory Committee, to
help them assess the evidence, in particular research published
between 2002 and May 2009. EPA concluded that particle pol-
lution caused multiple, serious threats to health. eir ndings
are highlighted in the box below.
EPA Concludes Fine Particle Pollution Poses
Serious Health Threats
I Causes early death (both short-term and long-term
exposure)
I Causes cardiovascular harm (e.g. heart attacks, strokes,
heart disease, congestive heart failure)
I Likely to cause respiratory harm (e.g. worsened asthma,
worsened COPD, inflammation)
I May cause cancer
I 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 processes—
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.
79
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.
80
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 chemi-
cal 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 (soot), heavy metals, sulfur
dioxide (SO
2
), nitrogen oxides (NO
X
) and volatile organic com-
pounds with water and other compounds in the atmosphere.
81

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
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 34
materials for ne particles. So does burning wood in residen-
tial 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
children become adults.
82
In addition, the body’s defenses that
help adults ght o infections are still developing in young
bodies.
83
Children have more respiratory infections than
adults, which also seems to increase their susceptibility to air
pollution.
84
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.
85

In 2004, the American Academy of Pediatrics issued a special
statement on the dangers of outdoor air pollution on children’s
health, pointing out the special dierences for children.
86
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.
87
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.
88
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.
89
Cleaning Up Pollution Can Reduce
Risk to Children
ere is also real-world evidence that reducing air pollution
can help protect children. Two studies published in 2005 added
more weight to the argument.
Changes in air pollution from the reunication of Germany
proved a real-life laboratory. Both East and West Germany had
dierent levels and sources of particles. Outdoor particle levels
were much higher in East Germany, where they came from
factories and homes. West Germany had higher concentrations
of trac-generated particles. Aer reunication, emissions
from the factories and homes dropped, but trac increased.
A German study explored the impact on the lungs of six-year
olds from both East and West Germany. Total lung capacity
improved with the lower particle levels. However, for those
children living near busy roads, the increased pollution from
the increased trac kept them from beneting from the overall
cleaner air.
90
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
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 35
the years with less pollution, the children had fewer episodes
of chronic cough, bronchitis, common cold, and conjunctivitis
symptoms.
91
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,
92
including
a workshop the American Lung Association held in 2001 that
focused on urban air pollution and health inequities.
93

Many studies have looked at dierences in the impact on pre-
mature death. Results have varied widely, particularly for ef-
fects between racial groups. Some studies have found no dier-
ences among races,
94
while others found greater responsiveness
for Whites and Hispanics, but not African-Americans,
95
or
for African-Americans but not other races or ethnic groups.
96

Other researchers have found greater risk for African-Ameri-
cans from air toxics, including those pollutants that also come
from trac sources.
97

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.
98
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.
99
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.
100
However, two other recent studies in France have
found no association with lower income and asthma attacks.
101

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.
102
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. Growing
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,
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
HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 36
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.
103

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.
104
Studies have found increased
risk of premature death from living near a major highway or an
urban road.
105
Another study found an increase in risk of heart
attacks from being in trac, whether driving or taking public
transportation.
106
Urban women in a Boston study experienced
decreased lung function associated with trac-related pollu-
tion.
107
How to Protect Yourself from Ozone, Particle
Pollution
To minimize your exposure to ozone and particle pollution:
I Pay attention to forecasts for high air pollution days to know
when to take precautions;
I Avoid exercising near high-trac areas;
I Avoid exercising outdoors when pollution levels are high, or
substitute an activity that requires less exertion;
I Do not let anyone smoke indoors and support measures to
make all places smokefree; and
I 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.
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Function. Circulation 2005; 111:2913-2920. Zanobetti A, and Schwartz J. Are
Diabetics More Susceptible to the Health Eíects of Airborne Particles? Am J
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42 U.S. EPA. Integrated Science Assessment, 2009.
43 Pearson et al., 2010.
44 Krämer et al., 2010.
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AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 38
2011; 119:384-389.
46 Pope CA III, Dockery DW. Health Eíects of Fine Particulate Air Pollution: Lines
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47 Pope, Ezzati, Dockery, 2009.
48 Schwartz J, Coull B, Laden F, Ryan L. The Eíect of Dose and Timing of Dose
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49 Pope, Dockery, 2006.
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51 Franklin M, Zeka A, Schwartz J. Association between PM
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52 Dominici F, McDermott A, Zeger SL, Samet JM. On the Use of Generalized
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53 Hong Y-C, Lee J-T, Kim H, Ha E-H, Schwartz J, Christiani DC. Eíects of Air
Pollutants on Acute Stroke Mortality. Environ Health Perspect 2002; 110:187-191.
54 Tsai SS, Goggins WB, Chiu HF, Yang CY. Evidence for an Association Between
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55 Wellenius GA, Schwartz J, Mittleman MA. Air Pollution and Hospital Admissions
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56 Pope and Dockery, 2006.
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58 Ghio AJ, Kim C, Devlin RB. Concentrated Ambient Air Particles Induce Mild
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60 Tsai et al., 2003.
61 Wellenius GA, Schwartz J, and Mittleman MA. Particulate Air Pollution and
Hospital Admissions for Congestive Heart Failure in Seven United States Cities.
Am J Cardiol 2006; 97(3):404-408. Wellenius GA, Bateson TF, Mittleman
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Pennsylvania. Am J Epidem 2005; 161:1030-1036.
62 Van Den Eeden SK, Quesenberry CP Jr, Shan J, Lurmann F. Particulate Air
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63 Lin M, Chen Y, Burnett RT, Villeneuve PJ, Kerwski D. The Influence of Ambient
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64 Norris G, YoungPong SN, Koenig JQ, Larson TV, Sheppard L, Stout JW. An
Association Between Fine Particles and Asthma Emergency Department Visits
for Children in Seattle. Environ Health Perspect 1999; 107:489-493.
65 Tolbert PE, Mulholland JA, MacIntosh DD, Xu F, Daniels D, Devine OJ, Carlin BP,
Klein M, Dorley J, Butler AJ, Nordenberg DF, Frumkin H, Ryan PB, White MC. Air
Quality and Pediatric Emergency Room Visits for Asthma in Atlanta, Georgia.
Am J Epidemiol 2000; 151:798-810.
66 Slaughter JC, Lumley T, Sheppard L, Koenig JQ, Shapiro, GG. Eíects of
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with Asthma. Ann Allergy Asthma Immunol 2003; 91:346-353.
67 Thaller et al., 2008.
68 Dockery DW, Pope CA III, Xu X, Spengler JD, Ware JH, Fay ME, Ferris BG,
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Predictor of Mortality in a Prospective Study of U.S. Adults. Am J Respir Crit
Care Med 1995; 151:669-674.
69 Pope CA III. Epidemiology of Fine Particulate Air Pollution and Human Health:
biological mechanisms and who’s at risk? Environ Health Perspect 2000; 108:
713-723.
70 Lin S, Munsie JP, Hwang SA, Fitzgerald E, Cayo MR. Childhood Asthma
Hospitalization and Residential Exposure to State Route Traíc. Environ Res
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71 Gauderman WJ, Vora H, McConnell R, Berhane K, Gilliland GF, Thomas D,
Lurmann F, Avol E, Küenzli N, Jarrett M, Peters J. Eíect of Exposure to Traíc
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72 Gauderman WJ, Gilliland GF, Vora H, Avol E, Stram D, McConnell R, Thomas
D, Lurmann F, Margolis HG, Rappaport EB, Berhane K, Peters JM. Association
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73 Gauderman WJ, Avol E, Gilliland F, Vora H, Thomas D, Berhane K, McConnell R,
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74 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.
75 Pope CA III, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K, Thurston GD.
Lung Cancer, Cardiopulmonary Mortality, and Long-Term Exposure to Fine
Particulate Air Pollution, JAMA 2002; 287(9):1132-1141.
76 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.
77 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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78 U.S. Environmental Protection Agency, Integrated Science Assessment for
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79 U.S. EPA. Integrated Science Assessment, 2009.
80 U.S. EPA. Integrated Science Assessment, 2009.
81 U.S. EPA. Integrated Science Assessment, 2009.
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83 World Health Organization: The Eíects of Air Pollution on Children’s Health
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84 WHO, 2005.
85 American Academy of Pediatrics Committee on Environmental Health, Ambient
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86 American Academy of Pediatrics, 2004.
87 Gauderman et al., 2004.
88 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.
89 Peters JM, Avol E, Gauderman WJ, Linn WS, Navidi W, London SJ, Margolis
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90 Sugiri D, Ranft U, Schikowski T, Krämer U. The Influence of Large Scale Airborne
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91 Bayer-Oglesby L, Grize L, Gassner M, Takken-Sahli K, Sennhauser FH, Neu U,
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92 Institute of Medicine. Toward Environmental Justice: Research, Education, and
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93 American Lung Association. Urban Air Pollution and Health Inequities: A
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94 Zeka A, Zanobetti A, Schwartz J. Individual-Level Modifiers of the Eíects of
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96 Bell et al., 2008.
97 Apelberg BJ, Buckley TJ, White RH. Socioeconomic and Racial Disparities in
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99 Bell et al., 2008.
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102 O’Neill et al., 2003.
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HEALTH EFFECTS OF OZONE AND PARTI CLE POLLUTI ON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 40
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
information and the 24-hour averaged PM
2.5
concentration
information for the 3-year period for 2008–2010 for each
monitoring site.
Design values for the annual PM
2.5
concentrations by county
for the period 2008–2010 were downloaded on September 24,
2011 from EPA’s website at http://www.epa.gov/air/airtrends/
values.html.
Ozone Data Analysis
e 2008, 2009, and 2010 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 28, 2011. e data were consid-
ered for a 3-year period for the same reason that EPA uses
three years of data to determine compliance with the ozone
standard: to prevent a situation in any single year, where
anomalies of weather or other factors create air pollution
levels, which inaccurately reect the normal conditions. e
highest 8-hour daily maximum concentration in each county
for 2008, 2009, and 2010, 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. EPA’s Air Quality
Index reects the 0.075 ppm standard. A.S.L. & Associates
prepared 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 EPA based on the EPA Air Quality
Index:
8-hour Ozone
Concentration Air Quality Index Levels
0.000 – 0.059 ppm I Good (Green)
0.060 – 0.075 ppm I Moderate (Yellow)
0.076 – 0.095 ppm I Unhealthy for Sensitive Groups
(Orange)
0.096 – 0.115 ppm I Unhealthy (Red)
0.116 – 0.374 ppm I Very Unhealthy (Purple)
>0.374 ppm I 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
ranges. However, our experience is that underestimates are
infrequent.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 41 METHODOLOGY
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 2008, 2009, and
2010 with monitoring information. e 24-hour PM
2.5
data
were downloaded on August 1, 2011. In addition, hourly aver-
aged PM
2.5
concentration data were characterized into 24-hour
average PM
2.5
values by the EPA and provided to A.S.L. &
Associates. 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 EPA based on the EPA Air
Quality Index, adjusted by the American Lung Association as
discussed below:
24-hour PM
2.5
Air Quality
Concentration Index Levels
0.0 g/m
3
to 15.4 g/m
3
I Good (Green)
15.5 g/m
3
to 35.0 g/m
3
I Moderate (Yellow)
35.1 g/m
3
to 65.4 g/m
3
I Unhealthy for
Sensitive Groups
(Orange)
65.5 g/m
3
to 150.4 g/m
3
I Unhealthy (Red)
150.5 g/m
3
to 250.4 g/m
3
I Very Unhealthy
(Purple)
greater than or equal to 250.5 g/m
3
I Hazardous (Maroon)
In 2006, the EPA revised the 24-hour National Ambient Air
Quality standard for PM2.5, changing the standard to 35 µg/m
3

from 65 µg/m
3
. As of December 2011, the EPA had not
announced changes to the Air Quality Index based on that stan-
dard. e Lung Association adjusted the level of the category
“Unhealthy for Sensitive Groups” to reect the 2006 standard,
making that category range from 35.1 µg/m
3
to 65.4 µg/m
3
.
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 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.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 42 METHODOLOGY
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.
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
.
I 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.”
I 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.
I 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
allow 2 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 1 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 includ-
ing 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 0 red days, it would earn a weighted average
of 3.0 and a D grade. However, another county which had only
8 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 EPA uses to determine violations of both the ozone and the
24-hour PM
2.5
standards. EPA determines whether a county
violates the standard based on the 4
th
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. Consequently,
some counties will receive grades of “F” in this report, showing
repeated instances of unhealthy air, while still meeting EPA’s
2008 ozone standard. e American Lung Association’s posi-
tion is that the evidence shows that the 2008 ozone standard
fails to protect public health.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 43
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 15 µg/m
3
. Counties that EPA listed
as being at or below 15.0 µg/m
3
were given grades of “Pass.”
Counties EPA listed as being at or above 15.1 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.”
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 2009 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. and Associates. Questions about the
annual PM design values were referred to Mr. Schmidt of EPA,
who reviewed and had nal decision on those determinations.
e American Lung Association wishes to express its contin-
ued 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 primary 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 2010 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 Bronchitis, Emphysema and Cardiovascular Dis-
ease Estimates. In 2010, the National Health Interview Survey
(NHIS) estimated the nationwide annual prevalence of diag-
nosed chronic bronchitis at 9.9 million, the nationwide lifetime
prevalence of diagnosed emphysema at 4.3 million, and the
nationwide lifetime prevalence of diagnosed cardiovascular
METHODOLOGY
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 44 METHODOLOGY
disease at 74.7 million. Estimates for chronic bronchitis and
emphysema should not be combined as they represent dif-
ferent types of prevalence estimates. Cardiovascular disease
includes coronary heart disease, hypertension, stroke and heart
failure.
Local area prevalence of chronic bronchitis, emphysema, and
cardiovascular disease are estimated by applying age-specic
national prevalence rates from the 2010 NHIS to age-specic
county-level resident populations obtained from the U.S.
Census Bureau web site. Prevalence estimates for chronic
bronchitis, emphysema, and cardiovascular disease are calcu-
lated for those aged 18-44 years, 45-64 years and 65 years and
older.
Asthma and Diabetes. In 2010, the Behavioral Risk Factor
Surveillance System (BRFSS) survey indicated that approxi-
mately 8.6 percent of adults residing in the United States and
9.1 percent of children from twenty-nine states and Wash-
ington, D.C. reported currently having asthma. e BRFSS
indicated that 9.2 percent of adults in the United States had
ever been diagnosed with diabetes in 2010.
e prevalence estimate for pediatric asthma is calculated
for those younger than 18 years; adult asthma and diabetes is
calculated for those aged 18-44 years, 45-64 years and 65 years
and older. Local area prevalence of pediatric asthma is estimat-
ed by applying the most recent state prevalence rates, or
if none are available, the national rate from the BRFSS to
pediatric county-level resident populations obtained from
the U.S. Census Bureau web site. Pediatric asthma data from
the 2010 BRFSS were available for thirty-two states and
Washington D.C., ve states
1
from 2009, three states
2
from
2008, and one state each
3
for 2007 and 2006. National data was
used for the eight states
4
that had no data available since 2006.
1 California, Delaware, Idaho, New York and Virginia.
2 Maine, New Hampshire, and Ohio.
3 Alaska for 2007 and Minnesota for 2006.
4 Arkansas, Colorado, Florida, Massachusetts, North Carolina, South Carolina,
South Dakota, and Tennessee.
Local area prevalence of adult asthma and diabetes is esti-
mated by applying age-specic state prevalence rates from the
2010 BRFSS to age-specic county-level resident populations
obtained from the U.S. Census Bureau web site.
Limitations of Estimates. Since the statistics presented by
the NHIS, BRFSS and SAIPE are based on a sample, they will
dier (due to random sampling variability) from gures that
would be derived from a complete census or case registry of
people in the U.S. with these diseases. e results are also sub-
ject to reporting, 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 both surveys is that the
information collected represents self-reports of medically di-
agnosed conditions, which may underestimate disease preva-
lence since not all individuals with these conditions have been
properly diagnosed. However, the NHIS is the best available
source that depicts the magnitude of chronic disease on the
national level and the BRFSS is the best available source for
state-specic asthma and diabetes information. e conditions
covered in the survey may vary considerably 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 estimate derived by the NHIS or
state estimates derived by the BRFSS.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 45
References
Irwin, R. Guide to Local Area Populations. U.S. Bureau of the Census, Technical
Paper Number 39 (1972).
National Center for Health Statistics. Raw Data from the National Health Interview
Survey, United States, 2010. Calculations by the American Lung Association
Research and Program Services Division using SPSS and SUDAAN software.
Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance
System, 2010.
U.S. Census Bureau. 2010 Census. Summary File 1, Tables P12, P13, and PCT12.
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, 2010.
METHODOLOGY
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 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 . . . . . . . . . . . . . 107
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 2012 47
Notes for all state data tables
1. Total Population is based on 2010 U.S. 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 18 & under 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 2010 based on the state rates (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 2010 based on state rates (BRFSS) applied to county
population estimates (U.S. Census).
5. Chronic bronchitis estimates are for adults 18 and over who had
been diagnosed within 2010 based on national rates (from the
National Health Interview Survey, or NHIS) applied to county
population estimates (U.S. Census).
6. Emphysema estimates are for adults 18 and over who have been
diagnosed within their lifetime based on national rates in 2010
(NHIS) applied to county population estimates (U.S. Census).
7. Cardiovascular disease estimates are for adults 18 and over who
have been diagnosed within their lifetime, based on national
rates in 2010 (NHIS) applied to county population estimates
(U.S. Census). CV disease includes coronary heart disease,
hypertension, stroke, and heart failure.
8. 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).
9. 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, 2010.
10. Adding across rows does not produce valid estimates. Adding
emphysema and chronic bronchitis will double-count people with
both diseases.
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 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 (2008-2010), 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. Design values for the annual PM
2.5

concentrations by county were collected from data previously
summarized by the EPA and were downloaded on September
24, 2011 from EPA’s website at http://www.epa.gov/air/airtrends/
values.html. 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 15 g/m
3
. Counties with design values of 15 or lower
received a grade of “Pass.” Counties with design values of 15.1 or
higher received a grade of “Fail.”
State Table Notes
A full explanation of the sources of data and methodology is in the Methodology.
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 48
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Baldwin 1o2,2oo 41,o9o ¯C,ooo 4,o1¯ 11,1¯o o,¯2¯ ¯,Co¯ oC,¯o4 1o,4o7 24,Coo
Clay 1¯,9¯2 ¯,144 2,449 ¯o1 oo7 4o9 241 ¯,921 1,4¯7 2,oC2
Colbert o4,42o 12,C¯4 9,4o¯ 1,¯o2 ¯,¯oo 1,91o 9¯7 1o,¯22 o,o19 1C,¯29
DeKalb 71,1C9 1o,¯oo 9,o7o 2,11C 4,1o¯ 2,¯C2 1,C4o 17,7oo o,ooo 14,ooo
Elmore 79,¯C¯ 1o,7C7 9,4¯o 2,149 4,77o 2,o99 1,1C7 19,ooo 7,2o9 9,27o
Etowah 1C4,4¯C 2¯,9oo 1o,oCo 2,7oo o,¯71 ¯,oo1 1,o92 2o,1o7 1C,¯7¯ 19,4o7
Houston 1C1,o47 24,92o 14,o7o 2,oo¯ o,Coo ¯,¯71 1,o49 2o,2C1 9,oo9 1o,C14
Jeíerson ooo,4oo 1o4,o2o oo,44¯ 17,7oC ¯9,72o 21,7o4 9,ooo 1oo,o¯o o1,4C2 119,oC9
Madison ¯¯4,o11 79,49C 4C,o7¯ 9,1¯1 2C,1¯1 1C,9oo 4,72o o¯,C22 ¯C,o¯C 41,o7o
Mobile 412,992 1C¯,oo1 o¯,¯21 11,o9o 24,412 1¯,4Co o,914 1C2,¯¯o ¯7,91o o¯,4o7
Montgomery 229,¯o¯ oo,1o7 27,421 o,4o2 1¯,oC4 7,¯¯1 ¯,1C4 o4,oC1 2C,¯97 4o,972
Morgan 119,49C 2o,o24 1o,o71 ¯,2oo 7,1o4 ¯,99C 1,o1o ¯C,oo9 11,4C9 1o,oo2
Russell o2,947 1¯,499 o,72C 1,oo1 ¯,1Co 1,o99 744 12,911 4,7oo 12,oo4
Shelby 19o,Coo 49,9o2 2C,o27 o,7¯9 11,42o o,172 2,oo1 4o,9CC 17,1C7 1o,94o
Sumter 1¯,7o¯ ¯,Coo 2,Co¯ ¯o2 o4o 4o9 21o ¯,o¯o 1,¯42 4,CoC
Talladega o2,291 19,2oo 11,o91 2,21o 4,9o4 2,771 1,2oo 21,449 7,92¯ 17,912
Tuscaloosa 194,ooo 41,7oo 21,CoC 4,oCC 11,921 o,229 2,4oo 44,9¯¯ 1o,ooo ¯¯,2oo
Walker o7,C2¯ 1o,1C7 1C,o94 1,7¯o 4,119 2,¯¯1 1,11o 1o,47C o,7oo 1o,2oo
Totals 2,967,90l 708,l58 390,848 8l,345 l78,l92 97,7l9 43,092 745,30l 276,l8l 509,l36
ALABAMA
American Lung Association in Alabama
2200 Riverchase Center #604
Birmingham, AL 35244
(205) 987-7432
www.lung.org/alabama
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 49
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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.¯ PASS
DeKalb DNC DNC DNC DNC DNC C C C C.C A 1C.9 PASS
Elmore C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Etowah C C C C.C A 2 C C C.7 B 11.4 PASS
Houston C C C C.C A 2 C C C.7 B 1C.1 PASS
Jeíerson ¯1 C C 1C.¯ F 7 C C 2.¯ D 1¯.7 PASS
Madison 4 C C 1.¯ C 2 C C C.7 B 11.2 PASS
Mobile 1C C C ¯.¯ F C C C C.C A 9.o PASS
Montgomery ¯ C C 1.C C 2 C C C.7 B INC INC
Morgan C C C C.C A C C C C.C A 1C.o PASS
Russell C C C C.C A 2 C C C.7 B 12.4 PASS
Shelby 1C C C ¯.¯ F 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 1 C C C.¯ B 1C.7 PASS
Walker DNC DNC DNC DNC DNC C C C C.C A 11.C PASS
ALABAMA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 50
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Anchorage
Municipality 291,o2o 7o,7oo 21,1¯9 o,24o 21,4oo o,o72 ¯,2o2 o2,9oo 11,Co1 27,¯o1
Fairbanks North Star
Borough 97,oo1 2o,CC1 o,¯7o 1,7¯1 7,1o4 2,919 1,C2o 2C,29o ¯,491 o,oC4
Juneau City and
Borough ¯1,27o 7,¯¯o 2,o¯o oCo 2,¯9C 1,C22 4C1 7,oC¯ 1,¯oo 2,o24
Matanuska-Susitna
Borough oo,99o 2o,719 7,Co9 1,7oC o,¯22 2,ooC 1,C4o 19,o72 ¯,o2o 9,o1o
Yukon-Koyukuk
Census Area o,ooo 1,oo2 oo9 1C7 4Co 177 7o 1,¯¯o 2oC 1,o12
Totals 5l5,265 l35,394 37,787 9,372 37,772 l5,670 5,809 lll,697 l9,686 49,809
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 2012 51
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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.¯ PASS
Fairbanks
North Star Borough DNC DNC DNC DNC DNC 2o o 1 11.o F 1¯.o PASS
Juneau City and
Borough DNC DNC DNC DNC DNC o C C 2.C C 7.o PASS
Matanuska-Susitna
Borough DNC DNC DNC DNC DNC o C C 1.7 C INC INC
Yukon-Koyukuk
Census Area 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
ALASKA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 52
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Cochise 1¯1,¯4o ¯C,2oC 22,ooo 2,o¯o 9,ooC 4,o¯C 2,2Co ¯o,Co7 9,¯¯1 22,199
Coconino 1¯4,421 ¯1,7oo 11,924 2,9o1 9,oo9 4,191 1,oo9 29,9¯2 7,o1o ¯C,121
Gila o¯,o97 11,471 12,4oC 1,C7o 4,17o 2,C21 1,114 17,12o 4,491 1C,4C¯
La Paz 2C,4o9 ¯,o7o o,oo¯ ¯4o 1,oo7 o4¯ o2o 7,o4¯ 1,9o1 4,7o9
Maricopa ¯,o17,117 1,CC7,oo1 4o2,o41 94,oC2 27C,ooo 11o,o2o oC,o19 o9C,oo4 227,2o4 o2o,C9C
Mohave 2CC,1oo 41,2oo 4o,ooo ¯,oo9 1o,72o 7,ooo 4,1oo o4,129 1o,7oo ¯o,o¯1
Navajo 1C7,449 ¯1,97¯ 14,241 2,99o 7,¯7¯ ¯,¯22 1,o2C 2o,7o¯ o,ooo 29,291
Pima 9oC,2o¯ 22o,¯1o 1o1,29¯ 21,127 7¯,24o ¯¯,Co7 1o,¯44 2o7,2¯1 oo,17o 17C,oCo
Pinal ¯7o,77C 99,7CC o2,C71 9,¯4o 2o,o9¯ 11,oo2 o,¯¯1 9C,ooo 2¯,14¯ o1,oCC
Santa Cruz 47,42C 14,ooC o,224 1,¯oo ¯,21o 1,4o1 ooo 11,2o9 2,9¯2 1¯,247
Yavapai 211,C¯¯ 4C,2o9 oC,7o7 ¯,77o 1o,944 o,2Co 4,o¯o o9,o29 1o,2oo ¯7,97o
Yuma 19o,7o1 oo,1oo ¯C,o4o o,174 1¯,4oo o,1C1 2,o91 47,o2o 12,C99 4C,21C
Totals 6,274,842 l,593,3l6 868,286 l49,397 452,704 20l,986 90,708 l,547,625 396,748 l,072,442
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 2012 53
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Cochise 1 C C C.¯ B C C C C.C A 7.1 PASS
Coconino 4 C C 1.¯ C C C C C.C A o.1 PASS
Gila 1¯ C C 4.¯ F DNC DNC DNC DNC DNC DNC DNC
La Paz 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Maricopa ¯4 C C 11.¯ F 2 2 C 1.7 C 1C.2 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 ¯ C C 1.C C C C C C.C A o.4 PASS
Pinal 17 C C o.7 F o C C 2.7 D 1o.4 FAIL
Santa Cruz DNC DNC DNC DNC DNC ¯ 1 C 1.o C 12.2 PASS
Yavapai 1 C C C.¯ B C C C C.C A o.C PASS
Yuma 14 C C 4.7 F C C C C.C A INC INC
ARIZONA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 54
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Arkansas 19,C19 4,42o ¯,11o 4C1 1,14o oo7 ¯17 o,22o 1,o1C ¯,477
Ashley 21,oo¯ o,¯¯C ¯,o44 4o¯ 1,297 742 ¯o7 o,o9o 1,7C2 4,2CC
Crittenden oC,9C2 14,oC9 o,477 1,¯42 2,o2o 1,o44 oo2 11,o7o ¯,¯1o 1o,217
Faulkner 11¯,2¯7 27,742 11,¯1o 2,o14 o,o44 ¯,49C 1,¯oo 2o,1¯9 7,C9¯ 1o,1oo
Garland 9o,C24 2C,C9¯ 2C,C9o 1,o21 o,9oo ¯,o19 1,o41 2o,99o o,¯91 2C,oC2
Jackson 17,997 ¯,7¯4 2,ooo ¯¯o 1,117 o¯1 29o 4,9¯o 1,42C 4,12C
Newton o,¯¯C 1,7¯o 1,7C1 1o7 o2C ¯C9 1o2 2,ooo 744 1,92C
Phillips 21,7o7 o,11¯ ¯,2o4 oo4 1,22o 7C1 ¯¯4 o,o4¯ 1,oCC 7,o97
Polk 2C,oo2 4,921 4,C2o 44o 1,2¯7 7¯C ¯7o o,991 1,7¯o 4,o7C
Pope o1,7o4 14,241 o,11¯ 1,291 ¯,7Co 2,C22 o77 1o,2o2 4,¯4o 1C,¯o7
Pulaski ¯o2,74o 92,1oo 4o,9Co o,¯o4 22,722 12,4Co o,2oo 9¯,24o 2o,oo4 o4,oC2
Sebastian 12o,744 ¯1,oo2 1o,o1o 2,oo9 7,¯44 4,Coo 1,oC¯ ¯1,C77 o,9C7 2o,412
Union 41,o¯9 1C,Co1 o,4o1 912 2,4oC 1,41o o71 11,1oC ¯,22o o,o77
Van Buren 17,29o ¯,o¯7 ¯,92¯ ¯21 1,Co2 oo2 ¯o¯ o,4oo 1,oo9 ¯,o47
Washington 2C¯,Coo o1,4o4 19,o41 4,ooo 11,7o7 o,124 2,¯o9 4¯,719 12,2o7 ¯o,42o
White 77,C7o 1o,4¯¯ 1C,o4o 1,o7C 4,o7o 2,o24 1,1¯1 19,¯C4 o,o12 12,¯o2
Totals l,279,l02 3l0,726 l66,820 28,l58 75,636 4l,533 l8,l84 3l5,l08 90,044 24l,473
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 2012 55
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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.9 PASS
Ashley DNC DNC DNC DNC DNC C C C C.C A 1C.4 PASS
Crittenden 11 C C ¯.7 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.7 PASS
Jackson DNC DNC DNC DNC DNC 1 C C C.¯ B 1C.4 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 2 C C C.7 B C C C C.C A 1C.4 PASS
Pope DNC DNC DNC DNC DNC C C C C.C A 11.1 PASS
Pulaski o C C 2.C C C C C C.C A 12.C PASS
Sebastian DNC DNC DNC DNC DNC C C C C.C A 11.1 PASS
Union DNC DNC DNC DNC DNC C C C C.C A 1C.9 PASS
Van Buren INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Washington 1 C C C.¯ B C C C C.C A 1C.7 PASS
White DNC DNC DNC DNC DNC C C C C.C A 1C.7 PASS
ARKANSAS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 56
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Alameda 1,o1C,271 ¯4C,o21 1o7,74o 22,o9o o9,7Co 49,1o¯ 2C,1oC ¯o¯,11o 99,717 2CC,27¯
Amador ¯o,C91 o,¯9¯ 7,ooo 424 2,o12 1,49o 772 12,¯¯7 ¯,o49 4,2oo
Butte 22C,CCC 4o,1oo ¯¯,o17 ¯,Co¯ 1¯,¯91 7,oo¯ ¯,4o4 oo,474 1o,¯Co 4¯,¯92
Calaveras 4o,o7o o,94¯ 9,ooo o9¯ 2,924 1,7o2 9¯¯ 14,747 4,27C 4,99o
Colusa 21,419 o,41C 2,49o 42o 1,1oo o4¯ 279 4,oo2 1,¯47 ¯,1o1
Contra Costa 1,C49,C2o 2oC,oCo 1¯C,4¯o 17,2o1 o1,1oo ¯4,299 1o,CCo 2o1,oo2 72,99¯ 97,o44
El Dorado 1o1,Coo 41,17o 2o,o24 2,7¯1 11,Co7 o,¯92 ¯,CC2 oC,o72 14,4¯1 1o,o2o
Fresno 9¯C,4oC 277,oC7 9¯,421 1o,4C9 49,721 27,C¯4 1C,9¯2 197,o7C o¯,oo1 24o,¯¯C
Glenn 2o,122 7,ooo ¯,7¯7 o22 1,ooo oo¯ ¯99 o,oCo 1,9CC 4,o9C
Humboldt 1¯4,o2¯ 27,Co1 17,72o 1,79o o,¯Co 4,o¯4 2,C11 ¯o,12o 9,7oo 2¯,7o2
Imperial 174,o2o o1,C9o 1o,1o2 ¯,¯9C 9,41o o,1¯9 2,1C4 ¯7,792 1C,¯27 ¯o,ooo
Inyo 1o,o4o ¯,9CC ¯,o¯o 2o9 1,1oo oo¯ ¯4o o,oo9 1,oC1 2,o¯o
Kern o¯9,o¯1 2o4,Co1 7o,4¯7 1o,ooo 44,o72 24,C47 9,¯9o 17¯,ooo 47,C97 172,o¯1
Kings 1o2,9o2 42,o4o 12,C¯C 2,o22 o,¯4o 4,42¯ 1,o19 ¯1,C19 o,299 29,oCo
Lake o4,ooo 1¯,o72 11,44C 9C7 4,C2¯ 2,¯o9 1,171 19,1C¯ o,4o1 1¯,4¯o
Los Angeles 9,o1o,oCo 2,4C2,2Co 1,Coo,o99 1o9,¯o2 ooo,147 ¯Co,7oo 12o,o11 2,2oo,ooo o19,¯71 1,o99,2o4
Madera 1oC,ooo 42,o49 17,2o2 2,o42 o,27C 4,oo2 1,9¯¯ ¯4,C79 9,¯7o ¯C,912
Marin 2o2,4C9 o2,214 42,192 ¯,4o4 1o,77¯ 9,179 4,449 7¯,ooo 2C,9oo 22,4oo
Mariposa 1o,2o1 ¯,242 ¯,o21 21o 1,19o 717 ¯7o o,974 1,727 2,ooo
Mendocino o7,o41 19,4o1 1¯,49¯ 1,291 o,¯oo ¯,C79 1,44o 24,297 o,o7o 1o,97o
Merced 2oo,79¯ oC,o9o 2¯,9oC o,¯o¯ 1¯,¯C2 7,191 2,oo¯ o2,121 14,142 oo,212
Monterey 41o,Co7 111,C1¯ 44,422 7,¯o4 2¯,192 12,oo¯ o,1oo 92,9oC 2o,4C2 oo,C¯1
Napa 1¯o,4o4 ¯1,4oo 2C,o94 2,Co9 o,149 4,o41 2,1o4 ¯o,2¯o 1C,17o 14,1o9
Nevada 9o,7o4 19,1Co 19,174 1,2o7 o,¯21 ¯,7o4 1,922 ¯C,ooo o,oo7 11,4oo
Orange ¯,C1C,2¯2 7¯o,oo9 ¯49,o77 4o,oo7 174,oCo 9o,221 4C,41¯ 717,o29 197,o79 ¯o¯,924
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 2012 57
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Placer ¯4o,4¯2 oo,Coo o¯,oo2 o,o44 2C,o12 11,7oo o,ooo 92,o94 2o,14¯ ¯1,4o9
Plumas 2C,CC7 ¯,oC1 4,1o4 2¯9 1,¯Co 7o4 41C o,o27 1,ooo ¯,C12
Riverside 2,1o9,o41 o2C,1Co 2oo,ooo 41,1¯o 12C,1oo oo,447 2o,441 49o,29o 1¯7,27C ¯o4,7oo
Sacramento 1,41o,7oo ¯o¯,Co¯ 1oo,oo1 24,Co¯ o1,CCo 44,o7C 1o,oo4 ¯¯1,241 91,1o2 2¯4,47C
San Benito oo,2o9 1o,Coo o,¯oC 1,Coo ¯,C2¯ 1,oo1 o7o 12,2oo ¯,¯oo 7,C1C
San Bernardino 2,C¯o,21C o94,ooo 1o1,¯4o ¯9,442 1C9,97o o9,4¯¯ 2¯,199 429,ooo 11o,oo2 ¯o2,C99
San Diego ¯,C9o,¯1¯ 724,1oo ¯o1,42o 4o,C¯o 1o1,CoC 99,C2o 4C,72o 7¯C,127 199,o27 44o,ooo
San Francisco oCo,2¯o 1C7,o24 1C9,o42 7,1¯¯ o¯,C2o 2o,9o¯ 12,Co1 21¯,9oo oo,¯oo 1CC,91C
San Joaquin ooo,¯Co 2CC,724 71,1o1 1¯,¯1o ¯7,1Co 2C,¯¯o o,¯oC 1oC,¯¯¯ 41,2oC 12o,¯¯1
San Luis Obispo 2o9,o¯7 oC,o41 41,C22 ¯,¯7¯ 1o,91o 9,ooo 4,¯42 7¯,o11 2C,o22 ¯o,179
San Mateo 71o,4o1 1o9,772 9o,2o2 1C,o99 4¯,21o 24,24o 1C,7Co 1oo,247 o1,o27 49,9Co
Santa Barbara 42¯,o9o 9o,C47 o4,¯9o o,oC4 24,o4o 1¯,o97 o,oo1 1C2,¯72 2o,1C1 72,112
Santa Clara 1,7o1,o42 429,o4o 19o,944 2o,494 1C¯,o4o oo,72¯ 2¯,¯1¯ 41o,9C¯ 114,919 1oo,Co1
Santa Cruz 2o2,¯o2 oo,41o 29,1oo ¯,o7o 1o,9o¯ o,791 ¯,o22 oo,2oo 1o,C24 ¯o,174
Shasta 177,22¯ ¯9,oo2 29,9o7 2,o¯C 1C,7oo o,2¯o ¯,C¯¯ 49,o¯9 14,1¯o ¯1,7oo
Siskiyou 44,9CC 9,¯2o o,7o2 o19 2,o1o 1,o7o oo4 1¯,o17 ¯,974 9,ooo
Solano 41¯,¯44 1C1,o¯o 4o,o47 o,7¯o 24,1¯C 1¯,¯9o o,oo4 1CC,o91 27,94o 49,1o9
Sonoma 4o¯,o7o 1Co,471 o7,¯o4 7,Co¯ 29,¯o9 1o,o1o 7,4o9 12o,422 ¯o,C2C oC,9C9
Stanislaus o14,4o¯ 147,1oo o4,o¯1 9,7o2 2o,1¯4 1o,444 o,4C1 114,4¯2 ¯1,427 1CC,oo4
Sutter 94,7¯7 2o,112 11,99C 1,7¯2 o,27o 2,94¯ 1,294 22,¯o9 o,197 1o,7oC
Tehama o¯,4o¯ 1o,1oC 1C,C71 1,C72 ¯,oo9 2,12o 1,C2¯ 1o,o9o 4,77o 12,o1C
Tulare 442,179 144,124 41,779 9,oo1 22,o7o 12,297 4,9¯1 o9,o7C 24,¯o2 1Co,14¯
Tuolumne oo,¯oo 9,oo2 11,294 o42 ¯,oC1 2,1¯2 1,C9o 17,49o o,C1o 7,72C
Ventura o2¯,¯1o 211,91o 9o,¯C9 14,Co7 47,17o 2o,21C 11,194 197,¯o2 o4,71o o9,ooC
Yolo 2CC,o49 4o,o¯1 19,771 ¯,C27 11,72o o,2o7 2,4C2 44,o72 12,CCo ¯1,942
Totals 37,076,207 9,253,l88 4,225,0l9 6l3,8l4 2,l32,257 l,l72,640 489,l68 8,7l3,009 2,395,575 5,753,600
CALIFORNIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 58
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Alameda 14 2 C o.7 F o C C 2.C C 9.C PASS
Amador 29 o C 12.7 F DNC DNC DNC DNC DNC DNC DNC
Butte ¯1 ¯ C 11.o F 4 ¯ C 2.o D 11.o PASS
Calaveras 29 ¯ C 11.2 F 2 C C C.7 B 7.1 PASS
Colusa 2 C C C.7 B 2 C C C.7 B INC INC
Contra Costa 1o C C o.¯ F 7 C C 2.¯ D o.¯ PASS
El Dorado o¯ 11 1 27.2 F DNC DNC DNC DNC DNC DNC DNC
Fresno 1¯4 ¯1 2 o1.o F 11o o C 41.2 F 1o.4 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.o PASS
Imperial 47 C C 1o.7 F 7 C C 2.¯ D 7.o PASS
Inyo o C C 2.7 D 11 2 C 4.7 F 7.C PASS
Kern 2C9 4o 2 9o.C F 12o 21 2 o¯.o F 21.2 FAIL
Kings 1C4 14 1 42.¯ F oo ¯ C 29.o F 17.1 FAIL
Lake C C C C.C A 1 1 C C.o B 4.o PASS
Los Angeles 1oo 41 o oo.2 F oo 4 C 2C.¯ F 14.4 PASS
Madera 44 4 C 1o.7 F INC INC INC INC INC INC INC
Marin C C C C.C A INC INC INC INC INC INC INC
Mariposa oC o 1 19.o F DNC DNC DNC DNC DNC DNC DNC
Mendocino C C C C.C A C C C C.C A o.7 PASS
Merced o2 9 1 22.o F ¯o C C 11.7 F INC INC
Monterey 1 C C C.¯ B C C C C.C A o.4 PASS
Napa o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Nevada oC 4 C 22.C F o 2 C 2.7 D 7.C PASS
Orange 29 2 C 1C.7 F 17 1 C o.2 F 11.9 PASS
Placer oo o C 24.2 F 1 C C C.¯ B o.4 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 2012 59
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 12 o C o.o F 1C.¯ PASS
Riverside 227 oo 4 111.¯ F oo 1 C 2o.o F 17.C FAIL
Sacramento o¯ 2o 2 41.o F 12 1 C 4.o F 1C.9 PASS
San Benito 14 C C 4.7 F C C C C.C A o.1 PASS
San Bernardino 211 1C¯ 9 127.o F 19 C C o.¯ F 14.o PASS
San Diego oo o C 2o.2 F 1o 2 C o.C F 12.1 PASS
San Francisco C C C C.C A 4 C C 1.¯ C 1C.C PASS
San Joaquin 2o ¯ C 9.o F 19 1 C o.o F 12.1 PASS
San Luis Obispo oo 2 C 2¯.C F 2 C C C.7 B 7.9 PASS
San Mateo 1 C C C.¯ B 1 C C C.¯ B INC INC
Santa Barbara 14 C C 4.7 F 1 C C C.¯ B 9.7 PASS
Santa Clara 19 1 C o.o F 1C C C ¯.¯ F 1C.2 PASS
Santa Cruz C C C C.C A C C C C.C A o.¯ PASS
Shasta 17 1 C o.2 F 2 2 1 2.¯ D o.9 PASS
Siskiyou C C C C.C A C C C C.C A INC INC
Solano 12 C C 4.C F 12 C C 4.C F 9.1 PASS
Sonoma C C C C.C A C C C C.C A o.C PASS
Stanislaus oC 7 2 21.o F 7o ¯ C 2o.o F INC INC
Sutter 14 2 C o.7 F o 7 C o.o F o.2 PASS
Tehama ¯4 1 C 11.o F INC INC INC INC INC INC INC
Tulare 229 ¯o 2 9o.7 F 2o 1 C 9.o F 1o.o FAIL
Tuolumne 2o o C 11.2 F DNC DNC DNC DNC DNC DNC DNC
Ventura o9 C C 2¯.C F 1 C C C.¯ B 9.9 PASS
Yolo 9 1 C ¯.o F 1 C C C.¯ B INC INC
CALIFORNIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 60
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Adams 441,oC¯ 12o,12¯ ¯o,oo2 11,429 29,19C 12,o42 4,oo1 91,o41 17,¯77 o7,2C1
Arapahoe o72,CC¯ 147,¯24 o7,ooC 1¯,¯oC ¯9,CCo 17,941 7,2oo 1¯2,429 2o,4o7 oo,17¯
Boulder 294,oo7 o2,7o4 29,o21 o,oo7 21,¯49 9,oo¯ ¯,o19 7C,¯9o 1¯,4oo ¯9,C97
Denver oCC,1oo 12o,7oo o2,1¯2 11,oo9 4¯,o72 19,C44 7,¯o7 1¯o,11o 2o,927 12o,722
Douglas 2oo,4oo o7,C12 2C,¯4¯ 7,ooo 1o,2o¯ o,¯¯o ¯,1oo oC,2oo 11,4oo 9,9oo
Elbert 2¯,Coo o,oo4 2,19¯ o¯C 1,ooo 7oo ¯¯o o,CoC 1,174 1,49C
El Paso o22,2o¯ 1o2,o7o o2,Co1 14,741 42,2o9 19,¯Co 7,79o 141,9¯9 27,2o4 o1,oC7
Garfield oo,¯o9 1o,21o 4,717 1,¯79 ¯,79¯ 1,71o oo1 12,4C¯ 2,¯o¯ o,¯Co
Jeíerson o¯4,o4¯ 119,C9C o7,411 1C,792 ¯7,o¯C 1o,29C o,C¯o 14C,27o 27,¯¯o 4o,ooo
La Plata o1,¯¯4 1C,o12 o,979 9o¯ ¯,7¯o 1,7oo 74C 1¯,2Co 2,oo4 o,7Co
Larimer 299,o¯C o4,Co7 ¯o,o41 o,oCo 21,o¯4 9,9o2 4,1o¯ 74,C19 14,292 ¯9,772
Mesa 14o,72¯ ¯4,o17 21,o72 ¯,12o 1C,212 4,94o 2,2oo ¯o,o21 7,o71 2C,99o
Montezuma 2o,o¯o o,999 4,2o9 o44 1,7o2 o97 44C 7,221 1,4¯4 4,4C2
Pitkin 17,14o 2,999 1,9o4 272 1,292 o1o 2oo 4,o4C o97 1,199
Pueblo 1o9,Co¯ ¯o,91o 24,¯4o ¯,o2o 1C,919 o,¯¯1 2,oC4 41,o¯1 o,244 ¯C,41o
Rio Blanco o,ooo 1,o21 o27 147 4oC 221 97 1,o91 ¯29 ooC
Weld 2o2,o2o 7C,4C1 24,2¯o o,¯oC 1o,oCo 7,ooo ¯,C21 oo,¯2C 1C,o9o ¯o,4o4
Totals 4,389,00l l,083,836 46l,843 98,2l6 303,729 l39,226 56,828 l,027,864 l97,732 570,545
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 2012 61
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Adams o C C 2.C C C C C C.C A o.7 PASS
Arapahoe o C C 2.C C C C C C.C A o.7 PASS
Boulder 7 C C 2.¯ D 2 C C C.7 B 7.4 PASS
Denver 1 C C C.¯ B C C C C.C A 7.9 PASS
Douglas 17 C C o.7 F C C C C.C A o.o PASS
Elbert DNC DNC DNC DNC DNC C C C C.C A 4.2 PASS
El Paso 4 C C 1.¯ C C C C C.C A o.C PASS
Garfield 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Jeíerson 2¯ C C 7.7 F DNC DNC DNC DNC DNC DNC DNC
La Plata 2 C C C.7 B INC INC INC INC INC INC INC
Larimer 14 C C 4.7 F C C C C.C A o.o PASS
Mesa 1 C C C.¯ B 9 C C ¯.C D 9.¯ PASS
Montezuma 1 C C C.¯ B C C C C.C A INC INC
Pitkin INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Pueblo DNC DNC DNC DNC DNC C C C C.C A INC INC
Rio Blanco INC INC INC INC INC INC INC INC INC INC INC INC
Weld 4 C C 1.¯ C 1 C C C.¯ B 7.o PASS
COLORADO
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 62
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Fairfield 91o,o29 227,C19 124,C7o 2o,492 o¯,22¯ ¯C,¯2o 1¯,ooC 2¯4,29C oC,91¯ o4,12o
Hartford o94,C14 2C4,C4¯ 1¯C,119 22,912 o¯,11o ¯C,424 1¯,9¯7 2¯o,4C¯ o1,47C 9o,24¯
Litchfield 1o9,927 4C,9o2 ¯C,¯42 4,o9o 1¯,4o4 o,o¯o ¯,2o4 o4,ooo 11,9¯9 12,ooC
Middlesex 1oo,o7o ¯o,C9o 2o,o21 ¯,941 11,ooC o,o91 2,77C 4o,o1o 1C,144 11,C¯C
New Haven oo2,477 192,974 12¯,972 21,oo9 o1,¯97 29,291 1¯,277 22o,227 49,21o 97,21C
New London 274,Coo o9,o99 ¯o,99o o,o92 19,o42 9,44¯ 4,277 7¯,Coo 1o,o9C 2¯,¯o2
Tolland 1o2,o91 ¯C,oo4 1o,22C ¯,4oo 11,29C o,2C¯ 2,1oo ¯o,94o o,4C2 o,794
Totals 3,455,669 790,569 49l,344 88,772 243,984 ll7,4l5 53,4ll 9l0,l35 l97,974 335,434
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 2012 63
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Fairfield ¯o 4 C 1¯.7 F o C C 1.7 C 1C.C PASS
Hartford o C C 2.7 D 1 C C C.¯ B 9.4 PASS
Litchfield o C C 2.C C C C C C.C A o.C PASS
Middlesex 1o C C o.C F DNC DNC DNC DNC DNC DNC DNC
New Haven 1o 1 C o.o F o C C 2.7 D 1C.¯ PASS
New London 1C C C ¯.¯ F 4 C C 1.¯ C o.o PASS
Tolland 14 1 C o.2 F DNC DNC DNC DNC DNC DNC DNC
CONNECTICUT
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 64
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Kent 1o2,¯1C 4C,¯79 21,9o2 o,4o4 12,22o o,274 2,¯o4 4C,¯7o 1C,4C7 19,14o
New Castle o¯o,479 12o,C79 oo,222 1o,o9o 41,7o1 17,o99 7,ooo 1¯¯,¯oo ¯4,11C oo,¯oo
Sussex 197,14o 4C,¯C7 41,C7¯ o,44o 1o,C¯o 7,¯C9 ¯,o21 oC,¯2o 1o,Coo 2o,924
Totals 897,934 205,765 l29,277 27,795 69,0l2 30,282 l3,760 234,056 60,603 l04,455
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 2012 65
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Kent 1¯ C C 4.¯ F C C C C.C A 1C.1 PASS
New Castle 2o 1 C 9.2 F 12 C C 4.C F 11.7 PASS
Sussex 17 2 C o.7 F C C C C.C A 1C.o PASS
DELAWARE
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 66
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
District of Columbia oC1,72¯ 1CC,o1o oo,oC9 1o,1C¯ o1,9o2 2C,2oo 7,92o 14o,¯11 ¯o,ooo 1C7,279
Totals 60l,723 l00,8l5 68,809 l8,l03 5l,962 20,256 7,928 l45,3ll 38,688 l07,279
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 2012 67
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
District of Columbia 2o ¯ C 9.o F 7 C C 2.¯ D 11.2 PASS
DISTRICT OF COLUMBIA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 68
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Alachua 247,¯¯o 44,2oo 2o,o27 4,C1¯ 17,2oo o,171 ¯,14o oo,222 1o,14¯ o9,¯1o
Baker 27,11o 7,C47 2,9oo o¯9 1,ooo ooo ¯o7 o,¯79 1,7oo 4,¯1o
Bay 1oo,oo2 ¯7,C7o 24,oo9 ¯,¯oC 11,Co7 o,7o4 2,o¯2 44,77o 12,429 24,oo2
Brevard o4¯,¯7o 1C7,ooo 11C,712 9,7oo ¯o,¯4o 2C,2oC 1C,47o 1oo,oCo 4o,¯C9 72,1o7
Broward 1,74o,Coo ¯91,¯49 249,424 ¯o,4o4 11¯,o9o o9,¯4o 2o,o4¯ 4oo,C4o 127,1¯7 2oo,29o
Citrus 141,2¯o 22,¯94 4o,C41 2,C29 9,o7o o,94o ¯,o¯¯ o2,o¯9 14,74o 2¯,oo9
Collier ¯21,o2C o2,o47 o4,9o1 o,o77 21,o7o 12,¯Co 7,C19 1Co,227 29,¯47 oC,21o
Columbia o7,o¯1 1o,19¯ 1C,¯9C 1,¯77 4,¯o7 2,¯22 1,Co4 1o,1oo o,Co1 12,2o¯
Duval oo4,2o¯ 2C¯,o14 9o,1o9 1o,442 oo,ooo 27,92C 11,o44 2C7,1¯o o7,41o 14C,2o4
Escambia 297,o19 o4,1o4 42,929 o,o14 19,o¯o 1C,1¯2 4,oo7 77,o¯o 21,oCo o¯,ooo
Highlands 9o,7oo 17,972 ¯1,o22 1,o29 o,7oo ¯,9o4 2,4o¯ ¯o,41C 9,o92 2C,1¯7
Hillsborough 1,229,22o 294,2Co 14o,2¯7 2o,oo1 7o,o¯o ¯9,oo2 1o,oo7 29o,2C¯ o1,o72 2C2,o27
Holmes 19,927 4,2o2 ¯,42o ¯oo 1,¯12 7CC ¯¯9 o,oo4 1,o4o 4,C72
Lake 297,Co2 o1,741 71,o2o o,o9o 19,o9C 11,C92 o,142 9¯,o¯9 2o,C9o ¯9,711
Lee o1o,7o4 12C,oo9 14o,1Co 1C,9o¯ 41,o77 2¯,27o 12,o¯7 194,o91 o4,2¯o 1C4,7o2
Leon 27o,4o7 o¯,97¯ 2o,9oC 4,o91 1o,o¯C o,oo¯ ¯,29C o2,2o7 17,2o7 oo,7oo
Manatee ¯22,o¯¯ oo,2o¯ 7o,1C9 o,CCo 21,4o1 12,Co¯ o,ooo 1C1,C9o 2o,1oC 4o,119
Marion ¯¯1,29o o4,1o1 oo,¯1o o,o1o 22,¯¯2 12,719 7,1oo 1Co,4¯7 ¯C,2¯C o¯,¯oo
Martin 14o,¯1o 2o,74o ¯9,972 2,¯¯¯ 1C,C4o o,o4o ¯,¯71 oC,4o4 14,C74 1o,1¯C
Miami-Dade 2,49o,4¯o o4o,72o ¯o2,C1¯ 49,4o¯ 1o4,42o o¯,7oo ¯7,194 o¯o,o1o 177,279 oCC,o¯7
Okaloosa 1oC,o22 4C,¯oo 2o,21o ¯,ooC 11,792 o,12o 2,74o 47,C9o 1¯,C7C 21,792
Orange 1,14o,9oo 27C,147 11C,919 24,4oC 74,12o ¯o,o71 1¯,924 2oo,1¯o 71,o22 1o¯,o12
Osceola 2oo,ooo 7C,41o 29,ooo o,¯o1 1o,7C7 o,¯o¯ ¯,49¯ o2,¯49 17,2oo 4¯,¯oo
Palm Beach 1,¯2C,1¯4 2oo,oo4 2oo,1oo 24,¯oo oo,17o 4o,27o 2o,¯o7 ¯97,179 11C,o94 1oo,¯oo
Pasco 4o4,o97 9o,o7¯ 9o,24o o,9¯¯ ¯C,ooo 1o,oo7 o,774 1¯o,¯77 ¯o,o1¯ o9,o7C
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 2012 69 FLORIDA
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Pinellas 91o,o42 1o2,ooo 194,C99 14,7o1 o2,9C1 ¯o,C¯7 1o,197 2oo,¯22 oC,2C¯ 127,oo7
Polk oC2,C9o 141,7¯o 1Co,29o 12,o44 ¯o,oo2 2C,ooo 1C,229 1oo,42o 4o,C1C 1C¯,277
St. Lucie 277,7o9 o2,CCo oo,¯7o o,o19 1o,Co2 9,o72 o,Co2 oC,oo1 22,424 4o,o7o
Santa Rosa 1o1,¯72 ¯o,2C9 19,4oC ¯,2o1 9,o49 o,C¯o 2,22o ¯o,o11 1C,7Co 1o,oC9
Sarasota ¯79,44o o9,7¯o 11o,227 o,41¯ 2o,o4o 1o,77o 9,o1o 1¯9,C4o ¯o,oCo 4o,o9o
Seminole 422,71o 97,1o1 oC,o77 o,oCo 27,¯41 14,CC4 o,979 1Co,o92 29,274 4o,C71
Volusia 494,o9¯ 9¯,27¯ 1C4,2o9 o,4o2 ¯¯,o49 1o,oo¯ 9,o4o 1o2,o¯C 42,44C 79,o1¯
Wakulla ¯C,77o o,92o ¯,¯¯9 o2o 2,CC1 1,C22 424 7,o2o 2,11¯ ¯,ooo
Totals l6,9l8,657 3,6l8,69l 2,870,523 327,92l l,ll7,l38 590,379 282,744 4,66l,355 l,295,558 2,744,975
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 70
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Alachua 1 C C C.¯ B C C C C.C A 7.4 PASS
Baker C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Bay o C C 2.C C INC INC INC INC INC INC INC
Brevard 1 C C C.¯ B C C C C.C A o.9 PASS
Broward 1 C C C.¯ B C C C C.C A 7.C PASS
Citrus DNC DNC DNC DNC DNC C C C C.C A 7.4 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 2 C C C.7 B 1 C C C.¯ B o.o PASS
Escambia 9 C C ¯.C D C C C C.C A 9.C PASS
Highlands 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Hillsborough 11 1 C 4.2 F C C C C.C A o.C PASS
Holmes C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Lake 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Lee 1 C C C.¯ B C C C C.C A o.o PASS
Leon ¯ C C 1.C C 2 C C C.7 B 1C.C PASS
Manatee o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Marion C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Martin INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Miami-Dade o C C 2.C C 2 C C C.7 B 7.o PASS
Okaloosa INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Orange 2 C C C.7 B C C C C.C A 7.¯ PASS
Osceola 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Palm Beach 2 C C C.7 B C C C C.C A o.¯ PASS
Pasco 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Pinellas 2 C C C.7 B C C C C.C A 7.9 PASS
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 2012 71
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Polk 4 C C 1.¯ C C C C C.C A 7.7 PASS
St. Lucie C C C C.C A 1 C C C.¯ B 7.o PASS
Santa Rosa 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
Sarasota 7 C C 2.¯ D C C C C.C A o.o PASS
Seminole 1 C C C.¯ B C C C C.C A 7.o PASS
Volusia C C C C.C A C C C C.C A INC INC
Wakulla o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
FLORIDA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 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 Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Bibb 1oo,o47 4C,119 19,oo9 ¯,oCo o,972 4,974 2,1oC ¯7,o19 11,9Co ¯o,7¯7
Chatham 2oo,12o oC,CC7 ¯2,oo4 o,¯9¯ 1o,94¯ o,o21 ¯,o4C o4,2C7 2C,1o¯ 49,o99
Chattooga 2o,C1o o,ooo ¯,oC1 o2o 1,o7C oo¯ 4C¯ o,o41 2,1oo 4,922
Clarke 11o,714 2C,42¯ 9,9o2 1,o¯o 7,4oo ¯,o19 1,21¯ 24,Co1 7,4o9 ¯o,oC1
Clayton 2o9,424 74,979 17,2¯o o,7¯9 14,227 7,¯94 2,o22 o1,44o 1o,1¯¯ o7,o49
Cobb ooo,C7o 17o,4o7 o9,972 1o,oo1 ¯9,o29 21,21o o,1o7 1o¯,22o 4o,1o7 9o,¯9o
Columbia 124,Co¯ ¯¯,o1C 12,7CC ¯,C¯9 o,9o4 ¯,o72 1,oCo 2o,9¯7 9,124 1C,9o9
Coweta 127,¯17 ¯4,o¯2 1¯,24C ¯,1¯C 7,1o4 ¯,9¯o 1,o¯C 29,294 9,22o 14,C2o
Dawson 22,¯¯C o,Co¯ ¯,1¯2 4o7 1,¯4C 7oo ¯4o o,947 1,o77 ¯,C44
DeKalb o91,o9¯ 1oo,1¯o o2,22o 14,o41 4C,74o 21,49o o,179 1o¯,o2o 4o,2C4 1¯1,94o
Dougherty 94,ooo 24,¯¯4 11,4o7 2,1o7 o,4oo 2,9oC 1,274 22,¯oC 7,C29 ¯1,9¯C
Douglas 1¯2,4C¯ ¯7,o¯¯ 11,244 ¯,¯7¯ 7,¯¯2 ¯,9¯¯ 1,o21 2o,414 o,9¯4 1o,oo1
Fayette 1Co,oo7 2o,C99 1¯,o4o 2,o2o o,CoC ¯,o72 1,o¯¯ 2o,Co7 o,oo9 7,14o
Floyd 9o,¯17 2¯,44o 1¯,7C2 2,1C7 o,o7o ¯,17¯ 1,44C 24,472 7,7Co 17,o¯4
Fulton 92C,oo1 219,ooo o¯,424 19,744 o4,22o 2o,oo9 1C,oo9 2C4,¯C9 o4,C97 1o9,C4o
Glynn 79,o2o 19,2¯1 11,97o 1,72o 4,7Co 2,oo4 1,2o4 21,C41 o,o¯o 14,7oo
Gwinnett oCo,¯21 2¯4,7C7 oo,1Co 21,C94 4¯,99¯ 2¯,2oo o,4o9 1o4,C9¯ o1,ooo 1Co,7o4
Hall 179,oo4 oC,1oo 2C,C1C 4,oC9 1C,Coo o,4o9 2,29o 4C,7¯o 12,oCo ¯1,49o
Henry 2C¯,922 o9,oo7 17,C4o o,¯o2 11,14o o,CCo 2,¯¯C 4¯,oCo 1¯,oo7 2C,o¯9
Houston 1¯9,9CC ¯7,491 14,o71 ¯,¯o9 7,9¯o 4,¯22 1,77o ¯1,99C 1C,Coo 19,oo2
Lowndes 1C9,2¯¯ 2o,97C 1C,o9¯ 2,424 o,¯79 ¯,¯2o 1,2o2 2¯,7o1 7,4¯o 24,C77
Murray ¯9,o2o 1C,o4o 4,2oo 9o7 2,247 1,2¯2 o14 9,192 2,o94 7,491
Muscogee 1o9,ooo 4o,o9o 22,Co2 4,¯oo 1C,97¯ o,9oC 2,oCC 44,2oo 1¯,91o ¯o,99o
Paulding 142,¯24 4¯,C94 1C,22C ¯,o7¯ 7,ooC 4,C27 1,477 2o,42o o,92¯ 12,4oo
Richmond 2CC,o49 49,¯Co 22,712 4,4¯1 11,7¯7 o,¯oo 2,o¯9 47,129 14,o11 49,4oo
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 73 GEORGIA
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Rockdale oo,21o 22,914 9,Coo 2,Co9 4,o2o 2,o77 1,12¯ 2C,C71 o,¯2o 12,o27
Sumter ¯2,o19 o,¯C1 4,14¯ 74o 1,9C7 1,C4¯ 4o1 7,ooC 2,471 9,441
Walker oo,7oo 1o,2oo 1C,¯C2 1,4o1 4,C9C 2,¯2o 1,Co1 1o,1o9 o,7¯o 11,97C
Washington 21,1o7 o,C4o 2,oo1 4o¯ 1,2oo 7C9 ¯19 o,474 1,72o o,o7o
Wilkinson 9,oo¯ 2,¯24 1,oC4 2C9 oo4 ¯2o 1o7 2,oC7 o24 1,9o2
Totals 6,l34,544 l,584,539 584,785 l42,407 352,l83 l88,735 74,423 l,37l,397 430,923 l,042,425
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 74
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 C 1.o C 12.o PASS
Chatham C C C C.C A 2 C C C.7 B 1C.7 PASS
Chattooga C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Clarke 7 C C 2.¯ D C C C C.C A INC INC
Clayton DNC DNC DNC DNC DNC 1 C C C.¯ B 12.9 PASS
Cobb 1o C C o.C F ¯ C C 1.C C 12.¯ PASS
Columbia ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Coweta ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Dawson o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
DeKalb 17 2 C o.7 F 4 1 C 1.o C 12.¯ PASS
Dougherty DNC DNC DNC DNC DNC o C C 2.C C 12.¯ PASS
Douglas 12 C C 4.C F DNC DNC DNC DNC DNC DNC DNC
Fayette INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Floyd DNC DNC DNC DNC DNC 4 C C 1.¯ C 12.o PASS
Fulton 2o 1 C o.o F 4 1 C 1.o C INC INC
Glynn C C C C.C A 2 C C C.7 B 1C.1 PASS
Gwinnett 9 C C ¯.C D C C C C.C A 12.1 PASS
Hall DNC DNC DNC DNC DNC 1 C C C.¯ B 11.2 PASS
Henry 1o 1 C o.o F DNC DNC DNC DNC DNC DNC DNC
Houston DNC DNC DNC DNC DNC 1 C C C.¯ B 11.4 PASS
Lowndes DNC DNC DNC DNC DNC 1 1 C C.o B 1C.1 PASS
Murray 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Muscogee 2 C C C.7 B ¯ C 1 1.7 C 1¯.2 PASS
Paulding 4 C C 1.¯ C 1 C C C.¯ B 11.C PASS
Richmond o C C 2.C C 2 C C C.7 B 12.7 PASS
Rockdale 2C 1 C 7.2 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 2012 75
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 1 C C C.¯ B 1C.7 PASS
Washington DNC DNC DNC DNC DNC 1 C C C.¯ B 11.o PASS
Wilkinson DNC DNC DNC DNC DNC C 1 C C.o B 1¯.C PASS
GEORGIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 76
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Hawaii 1oo,C79 42,2oC 2o,o¯4 4,oo2 1¯,42o o,4C4 2,9o4 oC,212 12,¯9C ¯¯,2oo
Honolulu 9o¯,2C7 21C,oCC 1¯o,49C 2¯,211 o9,772 ¯2,1Co 14,4o2 24o,419 oC,o¯¯ o7,411
Maui 1o4,o¯4 ¯o,o1o 19,oC¯ ¯,949 11,2o2 o,217 2,¯CC ¯9,9o9 9,o22 1o,214
Totals l,293,l20 288,595 l85,l27 3l,823 94,449 43,729 l9,726 336,620 82,846 l38,9l0
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 2012 77
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 oo ¯ C 2¯.o F 1o.4 FAIL
Honolulu C C C C.C A 1 C C C.¯ B 7.o PASS
Maui DNC DNC DNC DNC DNC C C C C.C A 4.o PASS
HAWAII
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 78
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Ada ¯92,¯oo 1C¯,7Co 41,C4o 4,772 2o,¯C7 12,1¯7 4,9oo o9,oCo 22,C24 o¯,1oo
Bannock o2,o¯9 22,714 9,24¯ 1,C4o o,242 2,o1o 1,C4o 1o,oC9 4,o7o 1¯,2¯¯
Benewah 9,2oo 2,2C1 1,o99 1C1 o42 ¯¯1 1o9 2,717 oo4 1,o4¯
Butte 2,o91 o1o oCo ¯o 1oo 97 oC 799 2C1 44o
Canyon 1oo,92¯ o9,492 2C,¯9o 2,7¯o 11,2o7 o,42o 2,27o 4C,29o 9,914 ¯o,o2C
Cassia 22,9o2 7,oo7 2,9o4 ¯49 1,¯o¯ ooo ¯C4 o,1o2 1,279 ¯,o7o
Franklin 12,7oo 4,49o 1,o4¯ 2C7 729 ¯oC 1oo 2,7o7 o92 1,¯¯C
Kootenai 1¯o,494 ¯4,244 2C,C7o 1,o7o 9,2o9 4,o12 2,1¯C ¯o,9o7 o,9o2 2C,Coo
Lemhi 7,9¯o 1,o7o 1,7oo 7¯ oo2 ¯Co 1o7 2,oC2 oo9 1,ooC
Power 7,o17 2,414 947 111 47o 2¯o 1Co 1,oC¯ 447 1,2o¯
Shoshone 12,7oo 2,ooC 2,o¯7 122 91o 474 24o ¯,91C 9oo 2,oCo
Totals 879,053 24l,907 l02,809 ll,l3l 55,99l 27,l63 ll,626 204,250 50,4ll l35,55l
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 2012 79 IDAHO
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Ada ¯ C C 1.C C 4 C C 1.¯ C o.¯ PASS
Bannock DNC DNC DNC DNC DNC C C C C.C A INC INC
Benewah DNC DNC DNC DNC DNC 1C C C ¯.¯ F 9.4 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 INC INC
Cassia INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Franklin DNC DNC DNC DNC DNC o 1 C ¯.2 D INC INC
Kootenai C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Lemhi DNC DNC DNC DNC DNC 2C C C o.7 F 9.9 PASS
Power DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Shoshone DNC DNC DNC DNC DNC ¯o C C 12.7 F 12.C PASS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 80
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Adams o7,1C¯ 1o,4o1 11,747 1,o21 4,oC9 2,¯2o 1,142 1o,oC4 o,117 o,o47
Champaign 2C1,Co1 ¯9,C79 2C,Coo ¯,o4o 1o,¯o¯ o,422 2,¯9o 4o,Coo 12,C49 ¯o,¯4¯
Clark 1o,¯¯o ¯,71o 2,94o ¯oo 1,119 o74 2oo 4,o¯1 1,27o 1,9¯4
Cook o,194,o7o 1,2¯2,2oC o2C,¯29 121,2¯o ¯oo,o72 1oo,9CC 7C,1o7 1,242,o49 ¯¯o,4o¯ ooo,¯92
DuPage 91o,924 227,4¯C 1Co,¯9o 22,¯7o o2,o7C 29,o94 12,o14 22o,¯41 o1,47o o2,4o4
Eíngham ¯4,242 o,442 o,19o o¯1 2,¯1¯ 1,1oC o41 9,C4o 2,47o ¯,¯o¯
Hamilton o,4o7 1,9¯1 1,o71 19C o7o ¯C1 1oo 2,471 oo¯ 1,21o
Jersey 22,9oo o,2¯9 ¯,oCo o1o 1,o9C 792 ¯74 o,2¯o 1,71C 2,2C4
Kane o1o,2o9 149,19C 49,o9C 14,o7o ¯¯,7oo 1o,¯9o o,2¯1 11¯,¯2C ¯C,oo9 oo,2¯¯
Lake 7C¯,4o2 192,o72 7¯,C9¯ 1o,9oo 4o,o27 21,9o1 9,1oo 1o4,4Co 44,o42 o1,o1o
LaSalle 11¯,924 2o,21o 1o,o7o 2,o79 7,o¯1 ¯,94¯ 1,o9o ¯1,¯C7 o,o9o 14,ooo
McHenry ¯Co,7oC o4,17o ¯1,¯2C o,2o1 2C,4o1 9,ooo 4,C¯2 72,ooo 19,ooo 22,¯o1
McLean 1o9,o72 ¯o,412 17,¯4C ¯,779 12,27o o,¯o¯ 2,1C1 ¯o,ooo 1C,¯94 1o,ooo
Macon 11C,7oo 2o,2o4 1o,142 2,4oo 7,o44 ¯,o¯¯ 1,o¯7 ¯C,¯77 o,¯¯7 1o,97¯
Macoupin 47,7oo 1C,77o o,171 1,CoC ¯,291 1,o74 o17 1¯,¯oo ¯,ooC o,C7o
Madison 2o9,2o2 o1,24o ¯o,42o o,C2o 1o,o44 9,C9o 4,119 7C,21o 19,1o2 ¯o,Coo
Peoria 1oo,494 44,o9¯ 2o,9o¯ 4,417 12,o7o o,14o 2,7o4 47,22o 12,o77 2o,o92
Randolph ¯¯,47o o,o¯1 o,¯4C oo2 2,41o 1,1o7 oo¯ 9,2o2 2,o4C ¯,941
Rock Island 147,o4o ¯¯,1o7 2¯,oo1 ¯,2oo 1C,2o9 o,C97 2,422 4C,2Co 11,C24 17,oo1
St. Clair 27C,Coo oo,ooo ¯¯,o1C o,74o 1o,¯¯o o,72¯ ¯,o1o oo,412 1o,Coo 42,224
Sangamon 197,4oo 4o,o1o 27,¯o2 4,oCo 1¯,ooC o,o44 ¯,C12 o1,4oo 14,Co2 2o,o7o
Will o77,ooC 19o,9o4 o2,o14 19,¯77 44,¯¯2 2C,22o o,11o 14o,oo7 4C,C7o o7,2C7
Winnebago 29o,2oo 7¯,ooC 4C,71o 7,2¯9 2C,C41 9,727 4,4Co 7o,197 2C,o2o oC,o17
Totals l0,508,467 2,592,20l l,246,705 255,029 726,530 337,052 l43,l6l 2,527,560 685,360 l,434,588
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 2012 81
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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.¯ PASS
Champaign C C C C.C A C C C C.C A 1C.o PASS
Clark C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Cook 14 1 C o.2 F 1o C C o.C F 12.7 PASS
DuPage C C C C.C A 1 C C C.¯ B 1C.9 PASS
Eíngham C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Hamilton 2 C C C.7 B 1 C C C.¯ B 11.¯ PASS
Jersey 1 C C C.¯ B C C C C.C A 1C.4 PASS
Kane 1 C C C.¯ B 1 C C C.¯ B 1C.o PASS
Lake o C C 2.C C C C C C.C A 9.¯ PASS
LaSalle DNC DNC DNC DNC DNC C C C C.C A INC INC
McHenry C C C C.C A C C C C.C A 1C.C PASS
McLean C C C C.C A 1 C C C.¯ B 1C.o PASS
Macon C C C C.C A C C C C.C A 11.7 PASS
Macoupin 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Madison 2C C C o.7 F o C C 1.7 C 1¯.o PASS
Peoria C C C C.C A C C C C.C A 11.1 PASS
Randolph C C C C.C A C C C C.C A 1C.1 PASS
Rock Island C C C C.C A C C C C.C A 9.7 PASS
St. Clair 2 1 C 1.2 C 1 C C C.¯ B 12.4 PASS
Sangamon C C C C.C A C C C C.C A 11.C PASS
Will C C C C.C A 1 C C C.¯ B 11.¯ PASS
Winnebago C C C C.C A 4 C C 1.¯ C 1C.1 PASS
ILLINOIS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 82
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Allen ¯oo,¯29 9o,9oo 42,1¯7 o,4¯7 24,7o1 11,1¯o 4,oC1 o4,144 2o,1oo 4o,7o4
Boone oo,o4C 1o,917 o,o44 1,¯99 ¯,oo4 1,792 7oo 1¯,7o2 4,1¯7 4,o1o
Carroll 2C,1oo 4,9o7 ¯,1o2 4¯o 1,4¯¯ ooo ¯¯C o,4oo 1,oo2 2,C21
Clark 11C,2¯2 2o,1C9 14,Coo 2,29o o,C21 ¯,o4C 1,o91 27,o99 o,299 1¯,o¯2
Delaware 117,o71 2¯,o7¯ 17,277 2,C7¯ o,94o ¯,99¯ 1,7o7 ¯C,2o9 9,C19 2o,¯¯9
Dubois 41,oo9 1C,oo9 o,C79 9¯o 2,9oo 1,¯94 ooC 1C,941 ¯,29o ¯,4o9
Elkhart 197,oo9 oo,17o 2¯,9o2 4,9¯9 1¯,47o o,C7o 2,oo2 4o,C9C 1¯,7oo ¯¯,27C
Floyd 74,o7o 17,9¯1 9,ooC 1,o7o o,¯94 2,4oo 1,1C4 19,1C2 o,741 9,C92
Gibson ¯¯,oC¯ o,14o o,122 71o 2,¯97 1,1¯¯ o¯4 o,922 2,oo9 ¯,9oC
Greene ¯¯,1oo 7,oo¯ o,¯17 o9¯ 2,¯o4 1,1¯o o4o 9,C29 2,724 4,o79
Hamilton 274,oo9 o2,9¯o 2¯,oo9 7,292 1o,4o1 o,Coo ¯,1o9 oo,9¯7 17,oo7 1¯,oo4
Hancock 7C,CC2 1o,¯¯o o,9¯7 1,o12 4,91o 2,27o 1,C17 17,oo1 o,279 o,oo2
Hendricks 14o,44o ¯9,9Co 1o,oo9 ¯,oC9 1C,1C9 4,o1¯ 1,o92 ¯¯,77¯ 1C,C9o 9,C¯1
Henry 49,4o2 11,C44 o,CC1 971 ¯,o2o 1,72¯ o21 1¯,o¯1 4,11C 7,49¯
Howard o2,7o2 19,ooo 1¯,441 1,722 o,9o4 2,o44 1,¯oo 22,o94 o,o17 12,994
Huntington ¯7,124 o,79o o,4oo 77¯ 2,oo4 1,2o¯ o79 9,7oo 2,9¯o 4,C2¯
Jackson 42,¯7o 1C,41o o,Coo 91o ¯,C¯C 1,4Co o4¯ 1C,9C4 ¯,27o o,¯2o
Johnson 1¯9,oo4 ¯o,9CC 17,174 ¯,244 9,79o 4,4¯4 1,9¯¯ ¯¯,o7o 1C,Co¯ 14,¯o7
Knox ¯o,44C o,192 o,Co2 72C 2,oo2 1,¯29 o1o 1C,¯o¯ ¯,112 o,2oo
Lake 49o,CCo 127,27¯ oo,o7C 11,19C ¯o,Co4 1o,1¯C 7,2¯7 124,1o9 ¯7,2oo oo,o77
LaPorte 111,4o7 2o,¯o2 1o,oo7 2,2¯2 o,172 ¯,79¯ 1,72o 29,4CC o,o¯9 1o,9oo
Madison 1¯1,o¯o ¯C,¯o9 2C,2¯4 2,o72 9,o7o 4,4o¯ 2,C79 ¯4,oo1 1C,472 22,oo7
Marion 9C¯,¯9¯ 22o,oCo 9o,1C2 19,914 o4,9oo 2o,2oo 11,49o 2C7,7o7 o1,7o2 1o4,o¯7
Monroe 1¯7,974 22,471 14,C47 1,97o 11,1oC 4,oC9 1,o4o ¯1,249 9,11o ¯C,C49
Morgan oo,o94 17,¯2o o,919 1,o2¯ 4,9Co 2,2o¯ 1,C24 17,o4o o,¯14 o,C92
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 2012 83
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Perry 19,¯¯o 4,14¯ 2,9¯o ¯o4 1,4¯9 o74 ¯12 o,2o2 1,oo4 2,¯C7
Porter 1o4,¯4¯ ¯9,921 2C,¯o¯ ¯,o1C 11,oo9 o,419 2,¯o7 41,¯2o 12,4C¯ 17,4o4
Posey 2o,91C o,1¯o ¯,7¯1 o4C 1,o7¯ o92 41o 7,C22 2,122 2,o2C
St. Joseph 2oo,9¯1 oo,oo1 ¯o,ooo o,79C 19,1¯2 o,oo9 ¯,oo¯ oo,¯o2 19,oo7 4C,7C9
Shelby 44,4¯o 1C,o4o o,1oo 9o¯ ¯,1oo 1,492 oo¯ 11,o24 ¯,oC1 o,o72
Spencer 2C,9o2 o,Co¯ ¯,14o 44o 1,oC2 72C ¯41 o,7Co 1,72o 2,¯¯o
Tippecanoe 172,7oC ¯o,717 1o,¯79 ¯,14C 1¯,24o o,¯o4 1,972 ¯7,442 1C,94o ¯¯,1o4
Vanderburgh 179,7C¯ ¯9,o9o 2o,o9o ¯,oCo 1¯,27o o,Co¯ 2,747 4o,o2o 14,C¯7 29,19o
Vigo 1C7,o4o 2¯,C49 14,o11 2,C2o o,Co¯ ¯,o1C 1,oo9 27,2o2 o,1¯1 1o,7o2
Warrick o9,oo9 1o,4¯1 7,9oo 1,¯o7 4,2C4 1,971 o97 1o,¯4o 4,o2o 4,¯¯o
Whitley ¯¯,292 o,1o¯ 4,o49 719 2,¯o2 1,121 o1o o,7oo 2,o41 ¯,CoC
Totals 4,865,l39 l,207,0l8 600,20l l06,l20 349,l22 l56,8l2 67,702 l,l84,639 354,l68 736,825
INDIANA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 84
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Allen 1 C C C.¯ B 1C C C ¯.¯ F 11.o PASS
Boone 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Carroll 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Clark o C C 2.C C o C C 2.7 D 14.1 PASS
Delaware C C C C.C A 1 C C C.¯ B 11.9 PASS
Dubois DNC DNC DNC DNC DNC C C C C.C A INC INC
Elkhart C C C C.C A o C C 1.7 C 12.C PASS
Floyd o C C 1.7 C 4 1 C 1.o C 12.o PASS
Gibson DNC DNC DNC DNC DNC C C C C.C A 11.o PASS
Greene 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Hamilton 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Hancock ¯ C C 1.C C 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 11.4 PASS
Howard DNC DNC DNC DNC DNC 2 C C C.7 B 11.7 PASS
Huntington C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Jackson 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Johnson 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Knox DNC DNC DNC DNC DNC C C C C.C A 11.o PASS
Lake ¯ C C 1.C C 1o C C o.¯ F 12.4 PASS
LaPorte 4 C C 1.¯ C C C C C.C A 1C.7 PASS
Madison C C C C.C A C C C C.C A INC INC
Marion o C C 2.C C 12 C C 4.C F 1¯.o PASS
Monroe DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Morgan 2 C C C.7 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 2012 85
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Perry o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Porter 4 C C 1.¯ C o C C 1.7 C 11.2 PASS
Posey 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
St. Joseph C C C C.C A 1¯ C C 4.¯ F 11.¯ PASS
Shelby ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Spencer DNC DNC DNC DNC DNC C C C C.C A 12.¯ PASS
Tippecanoe DNC DNC DNC DNC DNC 2 C C C.7 B 11.4 PASS
Vanderburgh o C C 1.7 C 1 C C C.¯ B 12.o PASS
Vigo C C C C.C A ¯ C C 1.C C 12.4 PASS
Warrick ¯ C C 1.C 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 2012 86
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Black Hawk 1¯1,C9C 2o,49o 1o,1¯1 1,774 o,Co7 4,¯7C 1,917 ¯¯,Coo 7,2¯o 22,o42
Bremer 24,27o o,o1¯ 4,192 ¯4¯ 1,4oo o¯o 4Co o,o24 1,47o 1,722
Clinton 49,11o 11,o9C o,2o7 722 2,9¯1 1,7C1 o¯C 1¯,o1C ¯,Coo o,oCo
Delaware 17,7o4 4,4o¯ 2,944 279 1,C¯7 oC9 ¯CC 4,9C9 1,1Co 1,7o4
Harrison 14,92o ¯,o9o 2,oo9 224 oo4 o2¯ 2o¯ 4,24o 9o9 1,4oo
Johnson 1¯C,oo2 2o,91o 11,211 1,o14 o,¯12 4,117 1,4oo 2o,¯94 o,944 21,C1o
Lee ¯o,oo2 7,9o1 o,C7o 49o 2,179 1,2o9 o1o 1C,1o1 2,2oo o,¯9C
Linn 211,22o o1,o47 27,4oo ¯,22o 12,o19 o,oo1 ¯,C1¯ o2,17¯ 11,47¯ 2C,¯92
Montgomery 1C,74C 2,o11 2,141 1oo o4C ¯oo 2C2 ¯,1oo 724 1,o12
Muscatine 42,74o 11,1o4 o,o4¯ o9o 2,47o 1,¯9¯ o¯o 1C,oC9 2,4C¯ o,7o2
Palo Alto 9,421 2,Coo 2,CC9 129 o71 ¯42 1o1 2,o¯4 o41 1,C2¯
Polk 4¯C,o4C 1C9,92o 4o,o4o o,o44 2o,271 1¯,4oo o,o¯4 99,4o1 21,o¯o 4o,49¯
Pottawattamie 9¯,1oo 22,479 1¯,¯¯¯ 1,4CC o,o4C ¯,11o 1,427 24,2Co o,¯7o 1¯,219
Scott 1oo,224 4C,ooo 21,oCo 2,o2o 9,7o9 o,429 2,4Co 41,ooo 9,19o 24,¯C9
Story o9,o42 1o,9o¯ o,94o 99¯ o,o2C 2,o7C 1,C4o 19,o7o 4,141 1o,Co¯
Tama 17,7o7 4,o4C ¯,274 2o¯ 1,C¯C oCo ¯1C 4,9oC 1,11o 2,11¯
Van Buren 7,o7C 1,o22 1,49o 11¯ 447 2o7 1¯9 2,2C2 49o 1,22o
Warren 4o,22o 12,C1o o,1o9 74o 2,oo4 1,oC1 o7o 11,oo¯ 2,oo9 ¯,271
Woodbury 1C2,172 27,214 1¯,12o 1,o94 o,ooo ¯,2¯¯ 1,42o 24,o4¯ o,42¯ 1o,C49
Wright 1¯,229 ¯,Coo 2,7o9 192 7oo 47o 2o¯ ¯,9o4 o97 1,4o4
Totals l,643,577 392,749 208,2l6 24,452 98,328 53,372 23,052 402,525 88,l58 2ll,3l2
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 2012 87
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 2.7 D 1C.o PASS
Bremer C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Clinton C C C C.C A 1o C C o.C F 12.1 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 7 C C 2.¯ D 1C.9 PASS
Lee DNC DNC DNC DNC DNC 2 C C C.7 B 11.1 PASS
Linn C C C C.C A 11 C C ¯.7 F 1C.o PASS
Montgomery C C C C.C A 1 C C C.¯ B 9.¯ PASS
Muscatine DNC DNC DNC DNC DNC 2o 1 C 9.2 F 1¯.C PASS
Palo Alto C C C C.C A 1 C C C.¯ B o.o PASS
Polk C C C C.C A 7 C C 2.¯ D 9.o PASS
Pottawattamie DNC DNC DNC DNC DNC 2 C C C.7 B 1C.9 PASS
Scott C C C C.C A 14 C C 4.7 F 12.9 PASS
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.¯ PASS
Warren C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Woodbury DNC DNC DNC DNC DNC ¯ C C 1.C C INC INC
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 2012 88
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Johnson o44,179 14¯,¯oo o9,¯22 1C,792 ¯4,oCo 17,1¯1 7,1o2 12o,17C ¯2,o¯1 ¯o,¯oo
Leavenworth 7o,227 19,147 o,42o 1,441 4,91C 2,44o 1,C29 1o,¯o4 4,o7o o,o7o
Linn 9,ooo 2,24C 1,oo7 1o9 o29 ¯47 1oC 2,oo1 74o 1,¯oo
Sedgwick 49o,¯oo 1¯o,¯7o oo,9o9 1C,191 ¯1,292 1o,4o2 o,o79 11o,19C 29,ooo 7o,2oo
Shawnee 177,9¯4 44,171 2o,o12 ¯,¯2o 11,4oo o,9Co 2,719 4o,9oC 11,o1o ¯C,¯o¯
Sumner 24,1¯2 o,¯14 ¯,7oo 47o 1,o1o o11 ¯92 o,479 1,o7o 2,oo1
Trego ¯,CC1 o99 7C¯ 4o 2C2 117 oo 99o 2o2 ¯¯9
Wyandotte 1o7,oCo 44,4¯o 1o,oCo ¯,¯4o 9,77o 4,7o4 1,9oo ¯o,2Co o,919 ¯7,¯oo
Totals l,490,999 395,638 l73,490 29,785 94,300 46,995 20,ll4 354,236 90,295 l89,492
KANSAS
American Lung Association in Kansas
2400 Troost Avenue, #4300
Kansas City, MO 64108
(816) 842-5242
www.lung.org/kansas
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 89
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Johnson 1 C C C.¯ B C C C C.C A o.1 PASS
Leavenworth 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Linn C C C C.C A C C C C.C A 9.¯ PASS
Sedgwick 4 C C 1.¯ C C C C C.C A 9.1 PASS
Shawnee 2 C C C.7 B 1 C C C.¯ B 9.2 PASS
Sumner o C C 1.7 C C C C C.C A o.o PASS
Trego C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Wyandotte C C C C.C A C C C C.C A 1C.¯ PASS
KANSAS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 90
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Bell 2o,o91 o,229 4,oCo oo1 2,¯¯¯ 1,CCC 47C 7,oo9 2,¯99 o,¯7¯
Boone 11o,o11 ¯¯,o79 11,¯1¯ ¯,ooo o,oo1 ¯,oC2 1,4oo 2o,ooC o,Coo 1C,o9o
Boyd 49,o42 1C,o9¯ o,242 1,12o 4,C4o 1,74o o¯o 1¯,oo9 4,2¯¯ 9,C19
Bullitt 74,¯19 1o,7o¯ o,2o7 1,994 o,771 2,¯99 1,C1o 1o,C7¯ o,o14 7,771
Campbell 9C,¯¯o 2C,oCC 11,oo7 2,1o7 7,24o 2,997 1,¯CC 22,7CC o,oo¯ 11,424
Carter 27,72C o,oC4 4,119 o9C 2,2C4 9¯7 4¯¯ 7,¯CC 2,224 o,24C
Christian 7¯,9oo 21,C7o 7,o9¯ 2,2¯7 o,oC¯ 2,14o oo2 1o,472 4,o92 1¯,ooo
Daviess 9o,ooo 2¯,oCo 14,11o 2,oCo 7,oo9 ¯,229 1,492 2o,17o 7,o7o 1o,21o
Edmonson 12,1o1 2,oo7 2,C2¯ 2o2 9o7 427 2Co ¯,¯9C 1,C¯o 2,2o4
Fayette 29o,oC¯ o2,o¯¯ ¯1,1¯o o,o49 24,2o9 9,oo9 ¯,7o¯ o9,C91 2C,oo9 oo,o21
Franklin 49,2oo 1C,ooo o,oo2 1,1¯2 4,C12 1,o94 7o1 1¯,Co4 ¯,9o4 7,o92
Greenup ¯o,91C o,¯2o o,2oo oo4 2,9oo 1,29o o¯2 1C,¯o9 ¯,171 o,29o
Hancock o,ooo 2,22o 1,19o 2¯o ooo 2o2 1¯C 2,2Co o7o 1,2C9
Hardin 1Co,o4¯ 27,41o 11,oCo 2,911 o,12¯ ¯,¯1C 1,¯79 24,o¯¯ 7,4o¯ 1o,2C2
Henderson 4o,2oC 1C,o7C o,oo1 1,1o4 ¯,o7o 1,oo7 717 12,19¯ ¯,72o 7,4oC
Jeíerson 741,C9o 171,oC7 99,C9o 1o,2¯9 o9,1o1 24,7C2 1C,9¯9 1oo,oo4 o7,¯9o 12o,oo1
Jessamine 4o,ooo 12,o49 o,494 1,¯¯2 ¯,74o 1,o¯o o4o 11,oC2 ¯,4o7 7,o49
Kenton 1o9,72C ¯9,94o 17,oo¯ 4,241 12,4o1 o,1Co 2,1¯9 ¯o,14o 11,o72 2C,9Co
Livingston 9,o19 1,9o¯ 1,72o 2C7 7oo ¯49 174 2,o27 o7C 1,¯oC
McCracken oo,ooo 14,7Co 11,CC1 1,oo1 o,2o1 2,¯CC 1,114 1o,¯4¯ o,o14 1C,¯oC
Madison o2,91o 17,ooC 9,¯12 1,o9o o,7o9 2,oo7 1,Co4 19,oC9 o,o72 1o,ooo
Ohio 2¯,o42 o,9¯4 ¯,oo2 o¯C 1,ooC 797 ¯77 o,27o 1,914 4,771
Oldham oC,¯1o 1o,79o o,o7¯ 1,7o¯ 4,o22 1,oo7 774 14,114 4,¯¯o 4,294
Perry 2o,712 o,244 ¯,o4o oo¯ 2,¯¯4 9oo 4¯7 7,oo4 2,¯1C o,Co2
Pike oo,C24 14,2o2 o,922 1,o14 o,27¯ 2,2¯o 1,CC¯ 17,2o7 o,274 17,4C4
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 2012 91
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Pulaski o¯,Co¯ 14,¯oo 1C,241 1,o24 o,Coo 2,1o4 1,C44 17,29¯ o,2o2 1¯,¯¯1
Simpson 17,¯27 4,2oo 2,471 4o¯ 1,¯o7 o77 2oo 4,494 1,¯71 2,7oo
Trigg 14,¯¯9 ¯,22o 2,727 ¯4¯ 1,1o¯ o1o 2o¯ 4,211 1,29¯ 2,14¯
Warren 11¯,792 2o,912 12,44C 2,7o1 9,142 ¯,o2o 1,4oo 2o,4¯C 7,914 22,1oo
Totals 2,608,364 6l5,572 329,804 65,350 207,l30 85,677 37,l63 648,876 l96,797 436,89l
KENTUCKY
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 92
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 1 C C C.¯ B 11.9 PASS
Boone 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Boyd 4 C C 1.¯ C C C C C.C A 11.4 PASS
Bullitt 4 C C 1.¯ C 1 C C C.¯ B 12.7 PASS
Campbell ¯ C C 1.C C C C C C.C A 11.7 PASS
Carter 2 C C C.7 B C C C C.C A 9.o PASS
Christian ¯ C C 1.C C C C C C.C A INC INC
Daviess 2 C C C.7 B C C C C.C A 12.2 PASS
Edmonson 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Fayette 1 C C C.¯ B 1 C C C.¯ B 11.o PASS
Franklin DNC DNC DNC DNC DNC C C C C.C A 11.1 PASS
Greenup ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Hancock 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Hardin 2 C C C.7 B C C C C.C A 11.o PASS
Henderson 4 C C 1.¯ C C C C C.C A 12.C PASS
Jeíerson 24 1 C o.o F o 1 C 2.2 D 1¯.2 PASS
Jessamine C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Kenton ¯ C C 1.C C C C C C.C A INC INC
Livingston 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
McCracken 1 C C C.¯ B C C C C.C A 11.o PASS
Madison DNC DNC DNC DNC DNC C C C C.C A 1C.¯ PASS
Ohio DNC DNC DNC DNC DNC C C C C.C A INC INC
Oldham 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Perry C C C C.C A INC INC INC INC INC INC INC
Pike C C C C.C A 1 C C C.¯ B 1C.1 PASS
Pulaski C C C C.C A INC INC INC INC INC INC INC
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 2012 93
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Simpson 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Trigg 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Warren C C C C.C A C C C C.C A 11.o PASS
KENTUCKY
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 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 Chronic vascular
Parish Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Ascension Parish 1C7,21o ¯C,7oo 9,494 2,ooo o,1C9 ¯,1oo 1,2o1 2¯,1o2 7,2o2 1¯,o22
Bossier Parish 11o,979 ¯C,C¯4 14,C2o 2,49o o,oC1 ¯,o9C 1,o7¯ 27,oo9 o,7oo 1o,C9C
Caddo Parish 2o4,9o9 o2,oo4 ¯4,o4¯ o,2Co 12,o¯¯ o,¯4o ¯,7¯4 o4,C¯o 2C,o2o 4o,oCo
Calcasieu Parish 192,7oo 49,C12 24,¯2o 4,C72 9,o97 o,2C9 2,719 47,2¯4 1o,C9o ¯¯,2o2
East Baton Rouge
Parish 44C,171 1C¯,ooo 4o,C¯C o,o12 22,4oo 1¯,99o o,oo1 1C2,ooo ¯2,1oo 74,41o
Iberville Parish ¯¯,¯o7 7,oC2 4,CC4 o2¯ 1,729 1,114 47o o,¯92 2,o7o o,7C9
Jeíerson Parish 4¯2,oo2 97,¯97 oo,9oo o,C91 22,¯7o 14,oC1 o,oC4 112,CCo ¯o,9o2 o9,42o
Lafayette Parish 221,o7o o4,2o¯ 22,7o7 4,oCo 11,1o9 o,9oo 2,7o9 oC,o42 1o,91o ¯o,ooo
Lafourche Parish 9o,¯1o 2¯,ooo 12,C¯1 1,9oo 4,ooC ¯,119 1,¯o2 2¯,oCo 7,o22 12,ooo
Livingston Parish 12o,C2o ¯o,¯¯C 12,o71 2,9¯o o,191 ¯,ooo 1,o72 2o,ooC o,9oo 1o,9C¯
Orleans Parish ¯4¯,o29 7¯,21o ¯7,o¯9 o,Co¯ 1o,Co7 11,¯C¯ 4,o74 o2,9oC 2o,C¯o 9C,94o
Ouachita Parish 1o¯,72C 4C,¯7¯ 1o,92C ¯,¯o4 7,oo2 4,o2o 2,Co4 ¯o,¯77 11,o4o ¯C,oCo
Pointe Coupee Parish 22,oC2 o,47o ¯,o¯4 4oo 1,1o7 7oo ¯7o o,2¯o 2,C¯9 ¯,97o
Rapides Parish 1¯1,o1¯ ¯4,C14 1o,C12 2,o2o o,o14 4,2oo 1,9¯2 ¯2,949 1C,o99 2o,C4o
St. Bernard Parish ¯o,o97 9,177 ¯,2oo 7o2 1,7oo 1,1C9 4¯¯ o,C¯9 2,o12 o,491
St. Charles Parish o2,7oC 14,2Co o,2¯o 1,1oC 2,ooC 1,oo4 ooC 12,¯21 ¯,917 o,oC4
St. James Parish 22,1C2 o,7C1 2,o41 474 1,C9o 719 ¯21 o,o¯o 1,7o2 ¯,o42
St. John the Baptist
Parish 4o,924 12,¯oo 4,7¯o 1,C27 2,244 1,4¯o o9o 1C,7Co ¯,4C1 o,¯97
St. Tammany Parish 2¯¯,74C oC,1¯o 29,o2o 4,99o 11,oCo 7,o72 ¯,42o o9,2Co 19,12¯ 21,44C
Tangipahoa Parish 121,C97 ¯C,42C 1¯,oC¯ 2,o27 o,Co¯ ¯,o¯¯ 1,oC4 2o,o4¯ 9,C2C 2o,o99
Terrebonne Parish 111,ooC 29,12¯ 12,ooo 2,419 o,o2o ¯,o2¯ 1,4o2 2o,¯4¯ o,¯o4 2C,192
West Baton Rouge
Parish 2¯,7oo o,927 2,o17 492 1,19¯ 7o2 ¯19 o,o9o 1,oCo ¯,oCo
Totals 3,323,ll5 8l4,403 393,8l9 67,658 l67,489 l07,002 45,474 803,095 254,984 575,574
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 95
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
Parish Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Ascension Parish 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
Bossier Parish 11 1 C 4.2 F DNC DNC DNC DNC DNC DNC DNC
Caddo Parish o C C 2.7 D C C C C.C A 1C.9 PASS
Calcasieu Parish 14 1 C o.2 F C C C C.C A 9.2 PASS
East Baton Rouge
Parish 27 C C 9.C F C C C C.C A 1C.o PASS
Iberville Parish 1o C C o.C F C C C C.C A 1C.o PASS
Jeíerson Parish 11 C C ¯.7 F 1 C C C.¯ B 9.2 PASS
Lafayette Parish 7 C C 2.¯ D C C C C.C A 9.2 PASS
Lafourche Parish 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Livingston Parish 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
Orleans Parish ¯ C C 1.C C 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 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
Rapides Parish DNC DNC DNC DNC DNC C C C C.C A o.9 PASS
St. Bernard Parish 4 C C 1.¯ C 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 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
St. John the Baptist
Parish 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
St. Tammany Parish 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
Tangipahoa Parish DNC DNC DNC DNC DNC C C C C.C A 9.1 PASS
Terrebonne Parish DNC DNC DNC DNC DNC C C C C.C A o.o PASS
West Baton Rouge
Parish 2 C C C.7 B C C C C.C A 1C.9 PASS
LOUISIANA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 96
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Androscoggin 1C7,7C2 24,¯Co 1o,1o4 2,274 o,¯¯o ¯,oo7 1,ooC 2o,¯oo o,947 1o,24C
Aroostook 71,o7C 14,¯o4 1¯,oo1 1,¯4o o,71o 2,oo1 1,¯44 21,o7¯ o,¯o7 9,o2o
Cumberland 2o1,o74 oo,o94 4C,1o7 o,o1C 22,27o 9,o27 4,44o 7o,Co9 1o,o4o 2o,17o
Hancock o4,41o 9,977 9,9¯7 9¯¯ 4,42o 2,Coo 1,C21 1o,o74 4,129 7,4o1
Kennebec 122,1o1 2o,¯Co 1o,9oC 2,¯oo 9,o7C 4,¯o9 2,C4o ¯4,¯7o o,4o1 1¯,o9o
Knox ¯9,7¯o 7,71C 7,o94 721 ¯,1oo 1,491 7oo 12,174 ¯,C1o o,2o1
Oxford o7,o¯¯ 12,¯17 9,o4¯ 1,1o2 4,o¯o 2,C9o 1,C2o 1o,o7¯ 4,17¯ o,o11
Penobscot 1o¯,92¯ ¯C,¯oo 22,2o¯ 2,o4C 12,¯o4 o,¯99 2,42o 41,oo7 1C,1oo 2¯,oCo
Piscataquis 17,o¯o ¯,¯oo ¯,oo4 ¯1o 1,4C7 o72 ¯oC o,o7C 1,¯oo 2,oo9
Sagadahoc ¯o,29¯ 7,422 o,7oo o94 2,7oC 1,27o o1o 1C,199 2,o19 ¯,oo2
Washington ¯2,ooo o,oo4 o,42o o14 2,o1¯ 1,22o o2o 1C,Coo 2,494 o,1o2
York 197,1¯1 42,C91 ¯C,¯o¯ ¯,9¯o 1o,4o2 7,CC7 ¯,297 oo,¯7o 1¯,o41 2C,Coo
Totals l,l72,l22 242,695 l83,7l0 22,706 92,78l 4l,738 l9,6l4 328,992 80,944 l44,649
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 2012 97
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Androscoggin 1 C C C.¯ B 2 C C C.7 B 7.o PASS
Aroostook C C C C.C A 1 C C C.¯ B 7.1 PASS
Cumberland 4 1 C 1.o C 1 C C C.¯ B o.4 PASS
Hancock o C C 2.7 D C C C C.C A 4.4 PASS
Kennebec 1 C C C.¯ B C C C C.C A 7.o PASS
Knox 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Oxford C C C C.C A 2 C C C.7 B o.2 PASS
Penobscot 1 C C C.¯ B C C C C.C A 7.4 PASS
Piscataquis DNC DNC DNC DNC DNC 1 C C C.¯ B o.¯ PASS
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 o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
MAINE
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 98
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Anne Arundel o¯7,ooo 12o,Co1 o¯,oo4 14,o12 ¯4,o92 17,7oo 7,o91 1¯4,21o ¯o,¯o¯ ¯4,4o4
Baltimore oCo,C29 17o,7oC 117,47o 2C,9¯¯ o2,2o9 27,oC1 12,oCo 212,o41 o1,2Co o4,494
Calvert oo,7¯7 2¯,2¯1 9,oo¯ 2,7o1 o,oC7 2,oo4 1,2¯o 21,9oo o,2oo o,4¯2
Carroll 1o7,1¯4 41,2¯7 21,oC9 4,oo4 1C,o2C o,oC9 2,o2o 4¯,o¯o 12,o¯2 o,o7¯
Cecil 1C1,1Co 2o,¯oo 11,o7o ¯,CC¯ o,¯oC ¯,¯C1 1,427 2o,1Co 7,1o7 1C,49¯
Charles 14o,oo1 ¯o,oo4 1¯,oo2 4,oCo 9,Co2 4,o74 1,o4o ¯¯,772 9,ooo 9,C77
Frederick 2¯¯,¯oo o9,C44 2o,914 o,99¯ 14,o41 7,o¯o ¯,194 oo,o29 1o,2¯C 12,oo4
Garrett ¯C,C97 o,ooC o,2¯1 7o9 1,9¯o 1,Coo o24 o,o7¯ 2,492 4,4oo
Harford 244,o2o oC,41C ¯C,oo4 7,1oo 1o,42o o,C92 ¯,ooo o2,C47 17,oCo 1o,71o
Kent 2C,197 ¯,o4o 4,¯97 42C 1,¯oC 7o9 4C1 o,¯2o 1,oo1 2,o77
Montgomery 971,777 2¯¯,o¯C 119,7o9 27,ooo o1,7o2 ¯1,99o 1¯,o91 24¯,1¯9 o9,o2C 72,2o9
Prince George’s oo¯,42C 2Co,999 o1,o1¯ 24,¯9o oo,4oC 27,2o7 1C,o7o 197,oo4 oo,927 79,2C¯
Washington 147,4¯C ¯¯,779 21,1C4 4,CC1 9,4o7 4,9o4 2,2oo ¯o,ooC 11,C99 1o,o4o
Worcester o1,4o4 9,42¯ 11,9o1 1,11o ¯,42C 2,CC1 1,Coo 1o,o¯1 4,9oC o,¯o2
Baltimore city o2C,9o1 1¯¯,ooC 72,o12 1o,o1o 4C,ooo 2C,¯7o o,4C4 1oC,4C7 42,7oo 147,ooo
Totals 5,029,762 l,l76,47l 6ll,624 l39,336 322,65l l65,769 7l,l40 l,25l,837 357,882 489,8l0
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 2012 99
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Anne Arundel 21 ¯ C o.o F ¯ C C 1.C C 11.o PASS
Baltimore 2o 4 C 11.¯ F 9 C C ¯.C D 11.7 PASS
Calvert 1¯ 2 C o.¯ F DNC DNC DNC DNC DNC DNC DNC
Carroll 11 1 C 4.2 F DNC DNC DNC DNC DNC DNC DNC
Cecil 22 1 C 7.o F o C C 1.7 C 1C.o PASS
Charles 1o C C o.¯ F DNC DNC DNC DNC DNC DNC DNC
Frederick 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
Garrett o C C 1.7 C INC INC INC INC INC INC INC
Harford 47 7 C 19.2 F C C C C.C A 1C.1 PASS
Kent 1o 1 C o.o F INC INC INC INC INC INC INC
Montgomery 1C C C ¯.¯ F 2 C C C.7 B 1C.¯ PASS
Prince George’s ¯¯ 1 C 11.o F o C C 2.C C 11.o PASS
Washington o C C 2.7 D ¯ C C 1.C C 11.C PASS
Worcester o 1 C 2.2 D DNC DNC DNC DNC DNC DNC DNC
Baltimore city 2 1 C 1.2 C 14 C C 4.7 F 11.o PASS
MARYLAND
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 100
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Barnstable 21o,ooo ¯7,249 o¯,o79 ¯,¯7o 1o,C¯2 o,o29 4,oC¯ 7¯,o19 17,1oo 2¯,1C2
Berkshire 1¯1,219 2o,o24 24,¯oo 2,¯22 1C,79¯ 4,o47 2,41o ¯9,197 o,99o 1o,o42
Bristol o4o,2oo 122,4C9 77,o79 11,C9¯ 4¯,997 1o,ooo o,4¯¯ 144,C29 ¯2,o4o oo,247
Dukes 1o,o¯o ¯,17¯ 2,o99 2oo 1,¯oo o1¯ 29¯ 4,o9¯ 1,112 1,¯oC
Essex 74¯,1o9 172,Co9 1Co,Co¯ 1o,o94 oo,oo9 2o,2oo 11,o¯o 19o,o2¯ 44,42¯ 7o,12o
Hampden 4o¯,49C 1C9,ooo oo,74o 9,9oo ¯o,o27 1o,49o 7,C4C 119,o¯4 27,1Co 7o,7oC
Hampshire 1oo,CoC 2o,7oo 2C,C22 2,42o 1¯,o7o o,o42 2,¯17 41,22o 9,2Co 17,12o
Middlesex 1,oC¯,Coo ¯2C,4¯9 197,C1o 29,C¯o 122,o91 oC,o2o 22,C7o ¯oo,C27 oo,4o2 11o,oo4
Norfolk o7C,ooC 1o2,1¯2 97,¯C4 1¯,7oo o¯,4o2 22,9oo 1C,o¯o 17o,oC¯ 4C,4o9 41,2C7
Plymouth 494,919 119,47o oo,o4o 1C,o27 ¯o,o¯2 1o,7oC 7,o7¯ 1¯C,7C¯ 29,o¯o 4C,Co2
Suíolk 722,C2¯ 12o,27o 7o,72o 11,44¯ o2,oo1 2¯,ooo o,o¯¯ 1oo,¯7o ¯o,477 1o¯,o14
Worcester 79o,oo2 1o7,2¯1 1C2,C¯o 1o,9o7 o¯,24o 2o,o1o 11,oo2 2C¯,24¯ 4o,ooC o4,142
Totals 6,466,085 l,402,747 890,6l9 l27,ll5 524,l43 2l9,784 97,638 l,682,376 379,206 7l5,793
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 2012 101
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Barnstable o 1 C ¯.2 D DNC DNC DNC DNC DNC DNC DNC
Berkshire 4 1 C 1.o C 2 C C C.7 B 9.2 PASS
Bristol 1C C C ¯.¯ F C C C C.C A o.¯ PASS
Dukes o ¯ C 4.2 F DNC DNC DNC DNC DNC DNC DNC
Essex 1C C C ¯.¯ F C C C C.C A o.o PASS
Hampden 12 C C 4.C F 2 C C C.7 B 9.o PASS
Hampshire 1o C C o.¯ F DNC DNC DNC DNC DNC DNC DNC
Middlesex o C C 2.C C C C C C.C A o.2 PASS
Norfolk 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Plymouth DNC DNC DNC DNC DNC C C C C.C A o.o PASS
Suíolk o C C 1.7 C 1 C C C.¯ B 1C.o PASS
Worcester 14 1 C o.2 F C C C C.C A 9.4 PASS
MASSACHUSETTS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 102
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Allegan 111,4Co 29,224 14,4¯o ¯,2¯o o,o12 ¯,o4¯ 1,o42 2o,22¯ o,o¯2 1o,2o¯
Bay 1C7,771 2¯,9o2 17,oC7 2,oo1 o,o41 ¯,777 1,oC7 29,9o7 9,179 1o,92¯
Benzie 17,o2o ¯,o7o ¯,o17 4C7 1,4Co oo2 ¯42 o,4C9 1,oo1 2,171
Berrien 1oo,o1¯ ¯o,o72 2o,o49 4,CoC 12,¯o9 o,412 2,oC¯ 4¯,CC9 1¯,174 2o,o47
Cass o2,29¯ 12,2oo o,¯oo 1,¯o7 4,1C7 1,o2o o79 14,oo7 4,4o4 o,Co9
Chippewa ¯o,o2C 7,7o1 o,o27 ooo ¯,21¯ 1,¯¯o oC2 1C,2oo ¯,144 o,ooC
Clinton 7o,¯o2 1o,o12 9,7Co 2,CoC o,912 2,4o2 1,1CC 19,C¯2 o,o17 7,oo1
Emmet ¯2,o94 7,¯o9 o,4¯7 o1o 2,o9¯ 1,1oo oo4 9,2o¯ 2,o4o ¯,ooo
Genesee 42o,79C 1Co,o79 oo,1o9 11,79o ¯¯,1oo 14,C¯o o,¯oo 1Co,ooo ¯¯,197 o7,9¯1
Huron ¯¯,11o o,o42 7,19o 7o7 2,oo2 1,244 ooo 1C,¯92 ¯,19¯ o,1o4
Ingham 2oC,o9o oo,o99 29,41¯ o,4o7 2¯,7C9 9,C7o ¯,oo2 oo,¯9¯ 19,o92 o¯,C29
Kalamazoo 2oC,¯¯1 oo,92o ¯C,7oC o,¯C2 2C,41o o,1o1 ¯,44¯ oC,7o4 1o,o¯o 4o,¯91
Kent oC2,o22 1oo,1¯4 o7,1C4 17,oCo 4o,799 1o,o¯o 7,oo¯ 14C,411 42,o2o 9o,9¯o
Leelanau 21,7Co 4,24C o,Co2 4o9 1,747 oo¯ 471 7,2o7 2,2¯o 2,CC2
Lenawee 99,o92 2¯,12o 14,ooC 2,ooC 7,9oo ¯,4C¯ 1,ooo 2o,o41 o,12C 1¯,44o
Macomb o4C,97o 19¯,ooo 12C,1oC 21,4¯o o7,2oo 2o,49C 12,97o 22C,o¯o o7,o¯o 1Co,4¯9
Manistee 24,7¯¯ 4,71o o,1Co o22 2,C¯2 941 49C 7,774 2,¯o7 ¯,9o7
Mason 2o,7Co o,24C o,oC9 o91 2,2oo 1,C47 o¯o o,ooo 2,o¯o 4,4o1
Missaukee 14,o49 ¯,o9o 2,oo1 ¯9o 1,1o1 o1o 2oo 4,199 1,2oo 2,¯¯o
Monroe 1o2,C21 ¯o,o77 2C,¯92 4,CoC 11,94C o,121 2,¯1o ¯9,7¯1 12,1o4 1o,2oC
Muskegon 172,1oo 42,7o7 2¯,¯o2 4,7¯o 1¯,4o7 o,oo4 2,ooo 4¯,9C¯ 1¯,424 ¯4,7oC
Oakland 1,2C2,¯o2 2o2,1Co 1o9,124 ¯1,229 9o,4o9 4C,o9o 1o,1oC ¯1¯,24¯ 9o,7o2 122,9¯2
Ottawa 2o¯,oC1 oo,7¯7 ¯1,C2¯ 7,oC9 2C,o17 o,299 ¯,o¯2 o2,2oo 1o,99o 29,17C
St. Clair 1o¯,C4C ¯o,o1¯ 2¯,o71 4,274 12,o41 o,o77 2,oo9 4¯,7oC 1¯,¯9o 24,o99
Schoolcraft o,4oo 1,oo7 1,oC2 1o7 ooo ¯24 172 2,7Co o¯2 1,¯22
MICHIGAN
American Lung Association in Michigan
25900 Greenfield Road, Suite 601
Oak Park, MI 48237
(248) 784-2000
www.lung.org/michigan
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 103
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Washtenaw ¯44,791 71,9o¯ ¯4,9o1 7,9oo 29,C4C 11,19o 4,¯oo oC,7¯o 24,oo4 42,ooo
Wayne 1,o2C,oo4 4o1,79o 2¯C,7C¯ o1,12C 141,972 oo,o9o 2o,oo¯ 449,1¯2 1¯7,2C¯ 429,4Co
Totals 7,343,299 l,766,545 960,977 l95,556 58l,948 242,576 l07,3l9 l,855,995 567,l09 l,2l4,835
MICHIGAN
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 104
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Allegan 7 1 C 2.o D 1 C C C.¯ B o.9 PASS
Bay DNC DNC DNC DNC DNC 1 C C C.¯ B o.4 PASS
Benzie 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Berrien 4 C C 1.¯ C C C C C.C A 9.2 PASS
Cass 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Chippewa INC INC INC INC INC 12 C C 4.C F INC INC
Clinton 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Emmet DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Genesee 2 C C C.7 B C C C C.C A 9.1 PASS
Huron ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Ingham C C C C.C A C C C C.C A 9.¯ PASS
Kalamazoo o C C 1.7 C 1 C C C.¯ B 1C.1 PASS
Kent ¯ C C 1.C C 1 C C C.¯ B 1C.2 PASS
Leelanau INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Lenawee ¯ C C 1.C C C C C C.C A INC INC
Macomb 11 C C ¯.7 F C C C C.C A 9.7 PASS
Manistee 4 C C 1.¯ C C C C C.C A o.o PASS
Mason 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Missaukee 2 C C C.7 B C C C C.C A o.1 PASS
Monroe DNC DNC DNC DNC DNC 2 C C C.7 B 1C.¯ PASS
Muskegon 7 1 C 2.o D 1 C C C.¯ B o.9 PASS
Oakland o C C 1.7 C 1 C C C.¯ B 1C.C PASS
Ottawa 4 C C 1.¯ C 1 C C C.¯ B 9.7 PASS
St. Clair o C C 2.C C 2 C C C.7 B 9.9 PASS
Schoolcraft 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
MICHIGAN
American Lung Association in Michigan
25900 Greenfield Road, Suite 601
Oak Park, MI 48237
(248) 784-2000
www.lung.org/michigan
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 105
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Washtenaw C C C C.C A C C C C.C A 1C.C PASS
Wayne 12 C C 4.C F 7 C C 2.¯ D 12.¯ PASS
MICHIGAN
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 106
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Anoka ¯¯C,o44 oo,C¯1 ¯2,2¯2 o,99o 1o,o7o 1C,4oo 4,2o1 77,o99 1o,¯9o 24,2oo
Becker ¯2,oC4 7,999 o,o¯7 ooo 1,o17 1,12o oo2 9,1¯C 1,927 4,o7¯
Carlton ¯o,¯oo o,¯o4 o,¯17 oo¯ 2,C2o 1,2C7 oo4 9,479 1,9oo ¯,o¯4
Cass 2o,oo7 o,2C¯ o,C29 4¯2 1,o¯7 1,Co2 ooo o,ooo 1,9C7 4,ooo
Crow Wing o2,oCC 14,¯72 11,oo4 1,CC2 ¯,o7C 2,2Co 1,111 17,oo1 ¯,79o 7,o24
Dakota ¯9o,oo2 1Co,CoC ¯9,o1o 7,¯2o 22,¯77 12,ooo o,1o7 9¯,417 1o,o91 27,ooC
Goodhue 4o,1o¯ 1C,9oC 7,o94 7o¯ 2,o24 1,oC2 77o 12,o14 2,oo4 ¯,7o¯
Hennepin 1,1o2,42o 2o1,¯4o 1¯C,o14 1o,221 oo,121 ¯7,o2¯ 1o,ooC 279,1o¯ oo,Co2 1oo,9¯o
Lake 1C,ooo 2,Co7 2,42o 144 o4¯ 419 22o ¯,o1o 7o9 1,191
Lyon 2o,oo7 o,2oo ¯,o19 4¯7 1,4oo o¯9 ¯71 o,¯oo 1,¯1¯ 2,o¯o
Mille Lacs 2o,C97 o,o1o 4,2Co 4o1 1,4oo o72 42C o,917 1,4o1 ¯,¯¯o
Olmsted 144,24o ¯o,44C 1o,1¯¯ 2,o41 o,17o 4,ooo 2,C¯o ¯o,¯9¯ 7,21¯ 12,1o1
Ramsey oCo,o4C 11o,49¯ o1,1o1 o,2o1 29,7oo 1o,oC¯ o,9o4 12¯,2Co 24,9¯C o4,o9o
St. Louis 2CC,22o ¯9,oo9 ¯1,o1o 2,7oo 12,Co4 7,1¯o ¯,¯¯2 oo,91o 11,oCo ¯¯,¯24
Scott 129,92o ¯9,22o 1C,C1o 2,7¯o o,99C ¯,7o¯ 1,42o 2o,9oo o,2o1 o,o1o
Stearns 1oC,o42 ¯4,9CC 1o,22o 2,4¯¯ o,oo¯ 4,oo2 2,C42 ¯o,14o 7,¯21 17,4C4
Washington 2¯o,1¯o o¯,o9o 24,9o4 4,4¯4 1¯,247 7,o7o ¯,191 o7,C9o 11,422 1¯,o97
Wright 124,7CC ¯7,¯o1 11,9¯4 2,oCo o,oo9 ¯,o7¯ 1,4o9 27,C4o o,¯9C 7,21C
Totals 3,646,30l 884,850 425,448 6l,69l 2l0,249 ll8,l28 50,073 886,950 l78,994 4l4,590
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 2012 107
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Anoka C C C C.C A 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 2.C C 9.o PASS
Goodhue C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Hennepin DNC DNC DNC DNC DNC o C C 2.C C 9.7 PASS
Lake C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Lyon C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Mille Lacs C C C C.C A INC INC INC INC INC INC INC
Olmsted C C C C.C A o C C 1.7 C 9.7 PASS
Ramsey DNC DNC DNC DNC DNC 1C C C ¯.¯ F 1C.o PASS
St. Louis C C C C.C A 1 C C C.¯ B 7.1 PASS
Scott C C C C.C A 4 C C 1.¯ C 9.¯ PASS
Stearns C C C C.C A 4 C C 1.¯ C o.o PASS
Washington C C C C.C A 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 2012 108
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Adams ¯2,297 7,19o o,11o o19 1,oo9 1,127 o¯4 o,9Co ¯,4C¯ 9,21¯
Bolivar ¯4,14o o,o4¯ 4,11¯ 744 1,o4o 1,Coo 4oo o,1o9 ¯,11C 11,C2o
DeSoto 1o1,2o2 4o,o2o 1o,¯41 ¯,92o o,¯¯o 4,ooo 1,9o1 ¯o,792 1¯,o94 1o,7¯9
Forrest 74,9¯4 17,7C¯ o,oo4 1,o24 4,Co7 2,¯oo 9o2 17,22o o,4o4 2C,7oC
Grenada 21,9Co o,¯91 ¯,277 4o4 1,21o 7¯2 ¯42 o,7¯o 2,1oo 4,o49
Hancock 4¯,929 1C,49o o,ooo 9C4 2,479 1,oC2 7Co 11,ooC 4,o¯¯ o,2¯o
Harrison 1o7,1Co 4o,oo¯ 21,9o2 ¯,94o 1C,2¯4 o,C12 2,o44 4o,C¯2 17,11o ¯o,79o
Hinds 24o,2oo oo,C4¯ 2o,oo1 o,oCC 12,99o 7,oo7 ¯,1¯7 oo,2C4 21,¯2o o4,44o
Jackson 1¯9,ooo ¯o,oCC 17,¯41 ¯,Coo 7,oC4 4,o1C 1,972 ¯4,¯4C 1¯,C9o 22,9oo
Jones o7,7o1 17,¯4o 9,74o 1,494 ¯,oo2 2,2C4 1,C12 17,Coo o,4o2 1o,o¯o
Lauderdale oC,2o1 2C,CoC 11,¯1o 1,729 4,¯oo 2,o2C 1,1o9 2C,2Co 7,ooo 1o,o29
Lee o2,91C 22,1Co 1C,749 1,9C¯ 4,429 2,o¯1 1,1oo 2C,11o 7,o42 1o,7¯2
Lowndes o9,779 1o,Coo 7,7C4 1,29o ¯,2oo 1,9¯C o49 14,o9o o,ooo 1o,Coo
Webster 1C,2o¯ 2,o79 1,o14 222 oo7 ¯44 1o4 2,722 1,C¯7 2,¯oo
Totals l,24l,485 3l8,7l9 l5l,l73 27,440 66,960 39,497 l7,028 298,l05 ll3,236 252,240
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 2012 109
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 1C.2 PASS
Bolivar 2 C C C.7 B C C C C.C A 1C.7 PASS
DeSoto o C C 2.7 D C C C C.C A 1C.o PASS
Forrest DNC DNC DNC DNC DNC C C C C.C A 12.C PASS
Grenada DNC DNC DNC DNC DNC C C C C.C A 9.o PASS
Hancock INC INC INC INC INC INC INC INC INC INC INC INC
Harrison 11 C C ¯.7 F C C C C.C A 9.o PASS
Hinds 1 C C C.¯ B C C C C.C A 11.4 PASS
Jackson o C C 2.7 D C C C C.C A 9.o PASS
Jones DNC DNC DNC DNC DNC C C C C.C A 12.2 PASS
Lauderdale C C C C.C A C C C C.C A 11.4 PASS
Lee C C C C.C A C C C C.C A 11.¯ PASS
Lowndes DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Webster INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
MISSISSIPPI
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 110
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Andrew 17,291 4,1o4 2,oo1 4o4 1,17¯ o91 2o1 4,o7o 1,¯2o 1,727
Boone 1o2,o42 ¯4,2o1 1o,C72 ¯,7¯7 11,14o o,114 1,o94 ¯o,o91 9,97o 29,C2¯
Buchanan o9,2C1 2C,9o¯ 12,oC1 2,2o7 o,C22 2,9oo 1,¯2o 22,7C2 o,4C1 1¯,449
Callaway 44,¯¯2 1C,CC¯ o,4oC 1,C91 ¯,Co4 1,479 o¯o 11,1o1 ¯,1o2 o,ooC
Cass 99,47o 2o,¯oo 1¯,49C 2,o79 o,499 ¯,212 1,4o9 24,oo7 7,C¯9 o,¯14
Cedar 1¯,9o2 ¯,¯Co ¯,12o ¯o1 942 oCo 27o 4,24o 1,2C¯ 2,7oo
Clay 221,9¯9 o7,2o7 24,9o4 o,24o 14,oC9 7,C1o 2,9o2 o2,4oC 14,o1¯ 2C,9¯2
Clinton 2C,74¯ o,C94 ¯,2oC ooo 1,¯97 7Co ¯¯o o,oC2 1,o9C 2,2¯o
Greene 27o,174 oo,¯7¯ ¯o,o9¯ o,¯o9 1o,992 9,242 4,Coo 7C,C49 19,oo7 oC,¯oo
Jackson o74,1oo 1oo,o¯o o¯,99C 1o,C71 4o,CC7 21,o2¯ 9,44o 1oo,Coo 4o,oo7 111,o1o
Jasper 117,4C4 ¯C,279 1o,714 ¯,¯C4 7,ooC ¯,744 1,oo¯ 2o,o49 o,C¯2 2C,224
Jeíerson 21o,7¯¯ o4,9oo 24,¯94 o,999 14,o7C 7,C79 ¯,CC1 o¯,¯72 1o,141 2o,1oC
Lincoln o2,ooo 14,72o o,71o 1,oC7 ¯,¯7o 1,o2o oo9 12,229 ¯,4o2 o,o¯4
Monroe o,o4C 2,Co1 1,o4o 22o oCo ¯1o 1oC 2,o71 7¯1 1,¯2o
Perry 1o,971 4,7o2 2,9oC o2C 1,2oC o¯4 ¯C1 o,CC1 1,41o 2,o2o
St. Charles ¯oC,4oo 92,ooC 4C,¯7o 1C,1¯1 2¯,ooo 11,4oo 4,oo7 oo,¯C9 24,422 21,7¯o
Ste. Genevieve 1o,14o 4,221 2,911 4o1 1,2o1 o¯o ¯Co o,C71 1,444 2,CC¯
St. Louis 99o,9o4 2¯4,174 149,49¯ 2o,o49 oo,11o ¯4,CCC 1o,o22 2oo,2¯9 7o,4o7 1C2,972
Taney o1,o7o 11,427 9,1oC 1,247 ¯,o49 1,oCo oo4 14,411 4,C71 1C,C2o
St. Louis city ¯19,294 o7,o¯9 ¯o,17o 7,¯o9 22,Co7 1C,41o 4,1o¯ 7o,9oo 21,29o oo,o1o
Totals 3,784,007 902,480 490,675 98,463 255,273 l24,389 54,543 946,50l 267,2l9 524,676
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 2012 111
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Andrew INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Boone INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Buchanan DNC DNC DNC DNC DNC 1 C C C.¯ B 11.4 PASS
Callaway INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Cass 2 C C C.7 B 1 C C C.¯ B 9.9 PASS
Cedar 2 C C C.7 B C C C C.C A INC INC
Clay 9 C C ¯.C D 1 C C C.¯ B 9.o PASS
Clinton 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Greene 1 C C C.¯ B 1 C C C.¯ B 1C.C PASS
Jackson DNC DNC DNC DNC DNC ¯ C C 1.C C 11.1 PASS
Jasper INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Jeíerson 1C C C ¯.¯ F 2 C C C.7 B INC INC
Lincoln o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Monroe C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Perry 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
St. Charles 1o C C o.C F INC INC INC INC INC INC INC
Ste. Genevieve 4 C C 1.¯ C INC INC INC INC INC INC INC
St. Louis 7 C C 2.¯ D 1 C C C.¯ B INC INC
Taney INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
St. Louis city o C C 2.C C 4 1 C 1.o C 1¯.1 PASS
MISSOURI
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 112
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Cascade o1,¯27 1o,o¯C 12,o9C 1,2o¯ o,7¯C 2,77o 1,¯C¯ 21,77o 4,447 1C,oo7
Flathead 9C,92o 21,2o4 1¯,1C¯ 1,4o4 o,¯¯¯ ¯,1¯¯ 1,4o¯ 24,oC7 o,C29 1¯,¯17
Gallatin o9,o1¯ 1o,7¯¯ o,47C 1,29C o,4o1 2,o7C 1,Coo 2C,4¯2 4,C21 11,Coo
Glacier 1¯,¯99 4,2¯o 1,414 292 o¯o ¯9o 1oo 2,97o o99 ¯,7o2
Lewis and Clark o¯,¯9o 14,¯7o o,7o7 99C 4,4oo 2,1o9 99o 17,C49 ¯,474 7,C41
Lincoln 19,oo7 ¯,o9o 4,C4C 2oo 1,4¯4 7o7 ¯9o o,¯17 1,¯1o ¯,o21
Missoula 1C9,299 21,o2o 12,4o7 1,oC4 o,CCC ¯,ooC 1,4o4 2o,o1o o,¯44 1o,oo¯
Powder River 1,74¯ ¯o¯ ¯9o 2o 12o o7 ¯7 o74 12C 24o
Ravalli 4C,212 o,o24 7,72o oCo 2,ooo 1,47o 7oC 12,1oo 2,o2o o,992
Richland 9,74o 2,2o¯ 1,44o 1o7 o7o ¯¯7 1oo 2,ooC o4o 1,1C7
Rosebud 9,2¯¯ 2,7¯2 1,Coo 1oo o9C 2o9 12o 2,2¯C 4o¯ 1,71o
Sanders 11,41¯ 2,¯o4 2,4oo 1o2 o2¯ 4¯9 2¯o ¯,7C¯ 77o 2,1oo
Silver Bow ¯4,2CC 7,1o4 o,o14 49o 2,4oo 1,211 o7o 9,o7¯ 1,9o1 o,oo4
Yellowstone 147,972 ¯o,C4C 2C,ooo 2,414 1C,¯Co 4,9o9 2,2o2 ¯o,¯71 7,oCC 1o,o71
Totals 722,067 l6l,733 l00,499 ll,l40 5l,ll2 24,550 ll,037 l89,240 38,4l2 l02,l49
MONTANA
American Lung Association in Montana
825 Helena Avenue
Helena, MT 59601-3459
(406) 442-6556
www.lung.org/montana
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 113
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 o.o PASS
Gallatin DNC DNC DNC DNC DNC 4 C C 1.¯ C o.1 PASS
Glacier INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Lewis and Clark DNC DNC DNC DNC DNC 1o 1 C o.o F INC INC
Lincoln DNC DNC DNC DNC DNC 4 C C 1.¯ C 11.7 PASS
Missoula INC INC INC INC INC o C C 2.C C 7.9 PASS
Powder River INC INC INC INC INC INC INC INC INC INC INC INC
Ravalli DNC DNC DNC DNC DNC 1C C C ¯.¯ F 7.9 PASS
Richland INC INC INC INC INC C C C C.C A INC INC
Rosebud INC INC INC INC INC INC INC INC INC INC INC INC
Sanders DNC DNC DNC DNC DNC 1 C C C.¯ B o.¯ PASS
Silver Bow DNC DNC DNC DNC DNC 1o C C o.¯ F 9.9 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 2012 114
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Douglas o17,11C 1¯4,719 o4,o7o o,197 ¯C,¯o¯ 1o,99o o,o¯2 117,7oo 2o,o42 74,2o¯
Hall oo,oC7 1o,977 7,ooC 972 ¯,¯¯o 1,oo4 o¯o 14,2o9 ¯,29¯ 7,oo2
Lancaster 2oo,4C7 oo,9C1 ¯1,1C1 4,C1C 17,oCo 9,C71 ¯,oo¯ oo,19o 14,92¯ 4C,4C9
Sarpy 1oo,o4C 4o,722 1¯,o44 2,7o2 9,C1o 4,ooo 1,oC1 ¯¯,o41 7,o2o 9,1oo
Scotts Bluí ¯o,97C 9,1o2 o,21o oo7 2,1oC 1,2o1 o1C 9,977 2,¯41 o,712
Sioux 1,¯11 29¯ 2oC 1o 77 49 2o 41C 9o 219
Washington 2C,2¯4 o,C92 2,o41 ¯1C 1,1o7 oo2 ¯1o o,¯o9 1,24o 1,¯CC
Totals l,078,479 276,856 ll6,706 l6,846 63,606 33,570 l3,773 247,609 56,069 l38,643
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 2012 115
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 9.2 PASS
Hall DNC DNC DNC DNC DNC C C C C.C A 7.4 PASS
Lancaster C C C C.C A 1 C C C.¯ B o.4 PASS
Sarpy DNC DNC DNC DNC DNC ¯ C C 1.C C 1C.2 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 o.o PASS
NEBRASKA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 116
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Churchill 24,o77 o,274 ¯,7o1 o¯7 1,oo4 o29 ¯91 o,o21 1,71o 2,o¯1
Clark 1,9o1,2o9 4oo,o1o 22C,44o 41,oo7 1¯o,¯CC o1,4oC 2o,o22 4oo,o2C 122,o2o 29C,4o1
Lyon o1,9oC 12,92o o,21o 1,1C7 ¯,oC4 1,7oo ooC 14,C79 ¯,oo1 o,o7¯
Washoe 421,4C7 99,¯¯2 oC,o79 o,oC9 29,4o9 1¯,o17 o,9C9 1C4,12¯ 27,749 o¯,o4o
White Pine 1C,C¯C 2,17¯ 1,494 1oo 71C ¯49 1o1 2,72o 717 1,1Co
Carson City oo,274 11,o1o 9,1¯¯ 1,C12 ¯,92o 1,9oC 9¯2 1o,442 4,Co¯ 7,oCo
Totals 2,5l4,837 62l,l40 293,947 53,2l0 l74,58l 80,l73 33,765 598,4l0 l60,442 37l,94l
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 2012 117
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Churchill 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Clark 24 C C o.C F 2 C C C.7 B o.o PASS
Lyon C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Washoe o 1 C 2.o D 7 1 C 2.o D o.1 PASS
White Pine 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Carson City 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
NEVADA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 118
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Belknap oC,Coo 12,4o1 1C,Co7 1,C7¯ 4,o1C 2,1o7 1,Co2 17,oo2 4,1¯9 o,o2o
Cheshire 77,117 1o,112 11,¯42 1,299 o,411 2,729 1,2¯o 21,12¯ 4,9o9 o,19o
Coos ¯¯,Coo o,2o2 o,¯99 o¯o 2,oo4 1,2oC o¯o 1C,221 2,4¯o 4,497
Grafton o9,11o 1o,¯o4 1¯,o11 1,4C9 7,oC7 ¯,211 1,47o 24,9oC o,oo¯ 9,o¯2
Hillsborough 4CC,721 94,Co2 47,o27 o,Co9 ¯1,919 1¯,¯¯¯ o,7¯o 1C1,1o1 2¯,4¯9 29,99o
Merrimack 14o,44o ¯1,94o 2C,CCo 2,747 11,7o9 o,Co¯ 2,29C ¯9,¯94 9,1o7 1¯,2o2
Rockingham 29o,22¯ o7,4¯o ¯7,424 o,79o 2¯,¯o1 1C,179 4,o¯o 7o,o19 1o,24¯ 1o,ooC
Sullivan 4¯,742 9,2C2 7,217 791 ¯,oC1 1,o7o 7o1 12,o1C 2,97o 4,o41
Totals l,l45,509 252,897 l53,785 2l,744 92,002 39,550 l7,73l 305,86l 7l,260 92,530
NEW HAMPSHIRE
American Lung Association in New Hampshire
1800 Elm Street
Manchester, NH 03104
(603) 410-5108
www.lung.org/newhampshire
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 119
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 1 C C C.¯ B ¯ C C 1.C C 9.o PASS
Coos o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Grafton 1 C C C.¯ B C C C C.C A o.o PASS
Hillsborough 9 C C ¯.C D C C C C.C A o.4 PASS
Merrimack 1 C C C.¯ B 2 C C C.7 B o.o PASS
Rockingham 7 C C 2.¯ D 1 C C C.¯ B 7.4 PASS
Sullivan INC INC INC INC INC INC INC INC INC INC INC INC
NEW HAMPSHIRE
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 120
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Atlantic 274,o49 o¯,ooo ¯o,9C2 o,719 1o,¯49 9,¯C¯ 4,241 72,22o 2C,1¯¯ ¯o,o9¯
Bergen 9Co,11o 2C4,4Co 1¯7,1C¯ 1o,299 oC,927 ¯1,19o 14,o¯o 244,o1o oo,4o2 o1,71o
Camden o1¯,oo7 12o,117 oo,72o 11,2C1 ¯¯,9oo 1o,o42 7,¯9o 12o,411 ¯o,441 o2,Co2
Cumberland 1oo,o9o ¯7,7Co 19,79o ¯,¯7o 1C,4oC o,Co1 2,192 ¯o,29o 1C,4o9 24,oo¯
Essex 7o¯,9o9 194,91o 9C,2o7 17,4oC o1,7Co 24,97¯ 1C,49o 1oo,¯oo oC,o12 12o,oC¯
Gloucester 2oo,2oo 7C,2o1 ¯o,o99 o,29C 19,CoC 9,4oo 4,1¯9 72,2o1 19,9o¯ 19,449
Hudson o¯4,2oo 1¯1,1o2 oo,Coo 11,742 44,o2¯ 2C,¯o2 7,oo¯ 14o,ooo ¯o,oo¯ 1C¯,o7o
Hunterdon 12o,¯49 ¯C,217 1o,¯44 2,7Co o,oCo 4,4o7 2,C1o ¯4,o71 9,oC2 o,C1o
Mercer ¯oo,o1¯ o2,9o2 4o,¯47 7,429 24,o¯o 12,1oo o,24¯ 91,o11 2o,197 4C,o¯o
Middlesex oC9,ooo 1oo,4o7 99,4o2 1o,oC¯ o4,7oC 2o,o9o 11,¯¯4 199,oo7 o4,o99 oC,7oo
Monmouth o¯C,¯oC 1oC,299 oo,o91 1¯,4oo 41,7¯¯ 21,4o1 9,79o 1o7,¯1o 4o,o2o 42,¯94
Morris 492,27o 117,o9o oo,1oo 1C,o¯o ¯2,o77 1o,o9C 7,o2¯ 1¯C,Co¯ ¯o,¯oo 27,oo4
Ocean o7o,oo7 1¯4,919 121,1C4 12,C7o ¯o,C7C 2C,¯97 1C,7oo 1oo,4o7 4o,2oo o2,o¯4
Passaic oC1,22o 124,o1¯ oC,¯24 11,1oo ¯¯,C2¯ 1o,Co7 o,oo9 12C,o7o ¯¯,C2C 7o,91C
Union o¯o,499 1¯1,2oo o7,7o1 11,7o1 ¯o,4o1 17,49o 7,o¯4 1¯2,94o ¯o,o19 oo,CC7
Warren 1Co,o92 2o,oCo 1o,292 2,292 7,221 ¯,71¯ 1,7Co 29,C1o o,12o 7,o7¯
Totals 7,707,l03 l,8l0,504 l,035,057 l62,08l 5l5,l5l 256,256 ll3,876 l,962,6l2 542,792 8l5,462
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 2012 121
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Atlantic o C C 2.7 D C C C C.C A 9.o PASS
Bergen 1¯ C C 4.¯ F ¯ C C 1.C C 9.o PASS
Camden ¯2 C C 1C.7 F o C C 1.7 C 1C.¯ PASS
Cumberland 1o C C o.C F DNC DNC DNC DNC DNC DNC DNC
Essex INC INC INC INC INC C C C C.C A INC INC
Gloucester 2o ¯ C 1C.o F C C C C.C A 1C.C PASS
Hudson 12 1 C 4.o F o C C 2.C C 11.o PASS
Hunterdon 2¯ C C 7.7 F DNC DNC DNC DNC DNC DNC DNC
Mercer 2o C C o.¯ F o C C 2.C C 1C.C PASS
Middlesex 2o C C 9.¯ F C C C C.C A o.o PASS
Monmouth 1o C C o.C F DNC DNC DNC DNC DNC DNC DNC
Morris 14 C C 4.7 F 1 C C C.¯ B o.7 PASS
Ocean ¯1 1 C 1C.o F ¯ C C 1.C C 9.C PASS
Passaic o C C 2.7 D 2 C C C.7 B 9.o PASS
Union DNC DNC DNC DNC DNC o C C 2.C C 11.o PASS
Warren DNC DNC DNC DNC DNC 2 C C C.7 B 9.7 PASS
NEW JERSEY
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 122
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Bernalillo oo2,oo4 1o9,1¯C o1,C14 12,o9o 49,1C4 21,oCo 9,212 1o1,oo1 41,oo9 1C7,1oo
Chaves oo,o4o 1o,¯o¯ 9,29¯ 1,4o7 4,ooC 2,Co7 9o4 1o,Co1 4,1o7 14,o2o
Doña Ana 2C9,2¯¯ oo,ooo 2o,oo1 4,4oo 14,971 o,oC¯ 2,oCo 4o,91C 12,ooo o2,2o2
Eddy o¯,o29 14,C¯o 7,o41 1,12C ¯,o¯o 1,7o4 oCo 1¯,o¯4 ¯,o4C o,o2C
Grant 29,o14 o,47¯ o,299 o1o 2,1oo 1,Coo o79 9,Co¯ 2,4Co o,42o
Lea o4,727 19,C2o o,991 1,o1o 4,4oC 1,921 oC1 14,2oo ¯,o42 11,2o¯
Luna 2o,C9o o,o4o 4,9C7 o¯C 1,742 o44 44C o,91o 1,o29 7,o44
Sandoval 1¯1,oo1 ¯o,1o9 1o,ooC 2,oCo 9,¯¯o 4,22o 1,oo7 ¯2,¯o1 o,¯o7 1o,1Co
San Juan 1¯C,C44 ¯7,oo1 14,Co¯ ¯,CC4 9,C27 ¯,9¯9 1,ooC 29,4oo 7,oo4 ¯C,727
Santa Fe 144,17C ¯C,2¯o 21,oC4 2,412 1C,9C9 o,1oC 2,4Co 4C,o27 1C,o99 2¯,421
Valencia 7o,oo9 2C,1o2 9,742 1,o1C o,4o4 2,47o 1,1C¯ 19,C4¯ 4,92o 1o,o7o
Totals l,592,95l 402,780 203,435 32,l35 ll5,578 5l,470 22,625 392,22l l0l,l35 296,260
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 2012 123
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Bernalillo 1 C C C.¯ B C C C C.C A o.o PASS
Chaves DNC DNC DNC DNC DNC C C C C.C A INC INC
Doña Ana 7 C C 2.¯ D 2C C C o.7 F 11.2 PASS
Eddy C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Grant 1 C C C.¯ B C C C C.C A 4.o PASS
Lea C C C C.C A C C C C.C A 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 1 C C C.¯ B C C C C.C A INC INC
Santa Fe C C C C.C A C C C C.C A 4.1 PASS
Valencia INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
NEW MEXICO
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 124
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Albany ¯C4,2C4 oC,o¯1 42,¯14 o,C9C 2¯,99C 1C,o1o 4,o¯7 oC,1oC 21,7oC ¯o,14C
Bronx 1,¯oo,1Co ¯oo,19o 14o,oo2 ¯o,9o2 1CC,ooo 42,1o1 17,C74 ¯Co,497 o2,¯29 4C4,o7o
Chautauqua 1¯4,9Co 29,44o 22,¯o1 2,9oo 1C,¯¯o 4,724 2,2o¯ ¯7,427 1C,2oo 22,¯oo
Chemung oo,o¯C 19,ooC 1¯,94¯ 1,997 o,7oo ¯,Co1 1,4o2 24,2o2 o,ooo 1¯,C¯9
Dutchess 297,4oo oo,9o9 4C,¯C4 o,o2o 22,792 1C,1oo 4,o4C 7o,2o1 21,¯9o 2¯,C22
Erie 919,C4C 19o,944 144,¯o4 19,9o2 7C,o92 ¯1,91¯ 14,9¯1 2oC,C19 oo,4oo 127,4o9
Essex ¯9,¯7C 7,ooo 7,14¯ 7o2 ¯,11C 1,4o¯ 71o 11,o9¯ ¯,2¯o 4,o14
Franklin o1,o99 1C,72C o,ooC 1,C77 4,C2o 1,77C 77o 1¯,4oo ¯,oo7 7,¯1¯
Hamilton 4,o¯o 79o 1,1¯C oC ¯9¯ 197 1C7 1,o72 472 o12
Herkimer o4,o19 14,29o 1C,ooo 1,4¯o 4,92C 2,274 1,1C2 1o,14¯ o,CCo 9,oo¯
Jeíerson 11o,229 29,o¯¯ 12,9o1 2,97o o,oo7 ¯,oC1 1,4oC 2o,oC1 7,CoC 1o,oC9
Kings 2,oC4,7CC o94,¯7o 2o7,o¯¯ o9,7CC 1oo,7oC 79,¯9o ¯2,ooo oo4,277 1oo,C4¯ ooo,2¯9
Madison 7¯,442 1o,CCo 1C,2¯9 1,oCo o,oo2 2,o1o 1,1¯C 19,4C2 o,29o 7,oo4
Monroe 744,¯44 1oo,o99 1C¯,o94 1o,944 oo,o49 2o,Co7 11,249 192,oo¯ o2,o2o 1C9,Co¯
Nassau 1,¯¯9,o¯2 ¯11,ooC 2C4,oo1 ¯1,29o 1CC,9CC 4o,C1o 21,o2¯ ¯o2,2o4 99,o2o o1,¯C1
New York 1,ooo,o7¯ 2¯4,4¯o 214,1o¯ 2¯,o47 1¯¯,4oo oo,oo7 2¯,C¯4 4Co,7o7 1Co,oo9 2o4,74C
Niagara 21o,4o9 4o,49C ¯4,¯oo 4,o7C 1o,o7o 7,o29 ¯,oC7 oC,2¯1 1o,o77 29,9Co
Oneida 2¯4,o7o o1,¯77 ¯o,1oo o,1oC 17,99o o,1oC ¯,oo4 o4,o1C 17,o97 ¯¯,o71
Onondaga 4o7,C2o 1C7,2oo oo,o7o 1C,77¯ ¯o,¯94 1o,72o 7,C91 121,222 ¯¯,Co2 o¯,4Co
Orange ¯72,o1¯ 1C1,o29 4C,9oo 1C,19o 2o,7o1 11,oo¯ 4,9¯9 o7,71¯ 2¯,oCo 41,14o
Oswego 122,1C9 2o,22¯ 1o,4CC 2,o¯o 9,2o4 4,C7o 1,777 ¯1,C¯2 o,4oC 19,o1o
Putnam 99,71C 2¯,ooC 12,417 2,¯7o 7,492 ¯,¯9o 1,o1C 2o,27¯ 7,241 o,Co4
Queens 2,2¯C,722 4o1,9C1 2oo,14o 4o,¯94 174,o1C 74,oo2 ¯1,oo7 ooC,¯oC 1oC,o22 ¯¯¯,299
Rensselaer 1o9,429 ¯¯,9o9 21,oC7 ¯,412 12,¯oo o,4o1 2,417 41,79o 11,¯oo 2C,744
Richmond 4oo,7¯C 1C9,2C1 o9,¯44 1C,9oo ¯o,4¯9 1o,oo1 o,779 11o,¯CC ¯2,1o4 oo,1¯o
NEW YORK
American Lung Association in New York
155 Washington Ave., Suite 210
Albany, NY 12210
(518) 465-2013
www.lung.org/newyork
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 125
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Rockland ¯11,oo7 o7,ooC 41,o41 o,797 22,C¯o 9,ooo 4,49¯ 7o,¯o7 2C,o74 ¯o,o7¯
St. Lawrence 111,944 2¯,oCo 1o,oo¯ 2,¯91 o,o79 ¯,oC1 1,oo2 2o,992 7,oo2 17,o2o
Saratoga 219,oC7 49,ooo 29,994 o,CCo 1o,7C4 7,oC9 ¯,¯oo oo,1¯C 1o,9¯o 1o,C4¯
Schenectady 1o4,727 ¯o,oC9 2¯,Co¯ ¯,oo7 11,712 o,27¯ 2,4¯9 41,1¯4 11,2o1 1o,Co4
Steuben 9o,99C 2¯,19o 1o,71o 2,¯¯C 7,4¯2 ¯,42C 1,o¯4 27,1¯o 7,4o1 14,C12
Suíolk 1,49¯,¯oC ¯o7,o7C 2C1,79¯ ¯o,92o 111,7o¯ 49,o9o 22,421 ¯o4,949 1Co,2¯¯ 9o,Co7
Ulster 1o2,49¯ ¯o,o1o 27,C44 ¯,o9o 14,¯2C o,4o2 2,974 oC,ooo 1¯,ooo 21,o2C
Wayne 9¯,772 22,299 1¯,¯o¯ 2,24C 7,C2¯ ¯,2C9 1,4o4 2o,172 o,9¯9 9,7o¯
Westchester 949,11¯ 22o,CCC 1¯9,122 22,9C1 7C,o47 ¯1,9Co 14,747 24o,9C9 oo,1oC o¯,C41
Totals l7,64l,588 3,959,523 2,350,022 397,702 l,347,988 588,4l4 257,899 4,470,469 l,2ll,254 2,603,277
NEW YORK
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 126
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Albany o C C 2.7 D 2 C C C.7 B o.o PASS
Bronx 9 C C ¯.C D 7 C C 2.¯ D 12.o PASS
Chautauqua 11 C C ¯.7 F C C C C.C A 7.o PASS
Chemung ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Dutchess 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Erie o C C 2.C C ¯ C C 1.C C 1C.1 PASS
Essex 9 C C ¯.C D C C C C.C A 4.4 PASS
Franklin 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Hamilton 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Herkimer 2 C C C.7 B 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 ¯ C C 1.C C 1C.o PASS
Madison 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Monroe 4 C C 1.¯ C 1 C C C.¯ B o.¯ PASS
Nassau DNC DNC DNC DNC DNC 1 C C C.¯ B 9.o PASS
New York o C C 2.7 D 4 C C 1.¯ C 12.1 PASS
Niagara ¯ C C 1.C C C C C C.C A o.9 PASS
Oneida 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Onondaga o C C 2.C C C C C C.C A 7.o PASS
Orange o 1 C 2.o D 2 C C C.7 B o.o PASS
Oswego 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Putnam 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Queens 9 C C ¯.C D ¯ C C 1.C C 1C.C PASS
Rensselaer o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Richmond 1o 1 C o.o F 2 C C C.7 B 1C.o PASS
Rockland INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
NEW YORK
American Lung Association in New York
155 Washington Ave., Suite 210
Albany, NY 12210
(518) 465-2013
www.lung.org/newyork
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 127
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Schenectady ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Steuben 1 C C C.¯ B 1 C C C.¯ B 7.4 PASS
Suíolk ¯¯ 1 C 11.o F 1 C C C.¯ B o.9 PASS
Ulster 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Wayne 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Westchester 14 1 C o.2 F 2 C C C.7 B 9.o PASS
NEW YORK
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 128
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Alamance 1o1,1¯1 ¯o,44¯ 22,Co1 ¯,212 o,oo4 o,Co2 2,¯C7 ¯9,C7o 11,o9¯ 27,217
Alexander ¯7,19o o,4o¯ o,o27 7oo 2,1o¯ 1,279 o9o 1C,C2¯ ¯,C74 o,C7o
Avery 17,797 ¯,Co9 ¯,C97 277 1,1C9 ooo ¯11 o,1oo 1,o7o ¯,o21
Buncombe 2¯o,¯1o 4o,o4C ¯o,C9o 4,42o 14,24o o,¯o4 ¯,922 oo,o4C 2C,C7o ¯9,o¯C
Caldwell o¯,C29 1o,7oo 12,o1o 1,7C2 4,o¯o 2,o7C 1,¯4o 22,o7¯ o,9¯¯ 1o,C4C
Caswell 2¯,719 4,oo9 ¯,7oo 44¯ 1,42C ooo 4Co o,779 2,C9o 4,oo4
Catawba 1o4,¯oo ¯o,79o 21,77¯ ¯,¯¯4 o,o¯2 o,17o 2,¯o7 4C,12¯ 12,2o2 21,9oC
Chatham o¯,oCo 1¯,o41 11,o¯1 1,2o4 ¯,7o¯ 2,2oC 1,142 1o,47C o,71o o,91o
Cumberland ¯19,4¯1 oo,o41 ¯C,2CC 7,7o2 17,4Co 9,ooo ¯,72o oo,oo¯ 2C,4C9 oo,499
Davidson 1o2,o7o ¯o,o72 2¯,¯oo ¯,o2¯ 9,¯2¯ o,49¯ 2,o24 42,794 1¯,1Co 27,o4o
Davie 41,24C 9,7o1 o,o29 oo4 2,¯77 1,4¯o o99 11,497 ¯,ooo o,722
Duplin oo,oCo 14,o7C o,29o 1,¯4o ¯,277 1,91o o7o 14,ooC 4,o¯C 1¯,7o1
Durham 2o7,oo7 oC,¯21 2o,117 o,4oo 1o,411 o,411 ¯,2¯1 oC,11o 17,7o1 47,o99
Edgecombe oo,oo2 1¯,o79 o,1C4 1,2oo ¯,21C 1,9C2 o79 14,o72 4,ooo 1¯,oCo
Forsyth ¯oC,o7C oo,4C1 4o,o11 7,7¯9 19,o77 11,44o o,C29 o7,14o 2o,427 oo,o7C
Franklin oC,o19 14,oo2 7,o7o 1,¯47 ¯,4¯¯ 2,CCC oo2 1o,¯17 4,o74 9,477
Gaston 2Co,Coo 49,241 27,294 4,4o2 11,7oo o,o29 ¯,C¯2 o2,¯22 1o,927 4C,¯¯o
Graham o,oo1 1,91¯ 1,742 17¯ o2o ¯21 1oo 2,o¯2 o1o 1,9oo
Granville o9,91o 1¯,¯¯¯ 7,441 1,2Co ¯,491 2,C2C o7¯ 1o,¯¯2 4,oo4 o,29o
Guilford 4oo,4Co 114,4o¯ oC,12¯ 1C,¯74 27,9o4 1o,o92 o,77o 119,2¯¯ ¯o,9¯o oo,271
Haywood o9,C¯o 11,o¯o 12,41o 1,C4o ¯,o9o 2,212 1,1oo 1o,24o o,oo7 o,491
Jackson 4C,271 7,12¯ o,Co4 o4o 2,4o1 1,41¯ o27 1C,7¯¯ ¯,2¯2 7,1C1
Johnston 1oo,o7o 4o,97C 17,2o9 4,2oo 9,1C7 o,1o4 2,117 ¯o,17o 11,49o 27,C1C
Lenoir o9,49o 14,¯¯2 9,o14 1,299 ¯,4Co 2,C4¯ 9o2 1o,2o7 o,C14 1¯,o21
Lincoln 7o,2oo 1o,4o1 1C,¯o1 1,o7o 4,491 2,o¯7 1,1oC 2C,¯oC o,2¯1 11,o2C
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 2012 129
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
McDowell 44,99o 9,7oo 7,¯77 oo7 2,oo2 1,o79 7o4 12,49o ¯,o4C o,oo2
Martin 24,oCo o,4¯o 4,297 49¯ 1,442 o79 4¯o 7,1Co 2,2Co o,oo7
Mecklenburg 919,o2o 2¯¯,¯¯o o1,11¯ 21,14o o1,C¯¯ 27,9¯C 1C,o9o 199,194 oo,947 141,4¯o
Mitchell 1o,o79 ¯,C¯o ¯,2oC 27o 9oC oo4 ¯C4 4,o11 1,494 2,o4o
Montgomery 27,79o o,74o 4,¯o4 o11 1,ooo 944 449 7,4o1 2,29¯ o,oo9
New Hanover 2C2,oo7 4C,41¯ 2o,C92 ¯,oo2 12,142 o,914 ¯,C1o o2,27C 1o,7oo ¯o,7o¯
Orange 1¯¯,oC1 27,9o9 12,oo9 2,o¯o 7,o7o 4,¯¯o 1,ooo ¯1,12o 9,242 21,7¯o
Person ¯9,4o4 9,114 o,99¯ o2o 2,2oo 1,¯oo o42 1C,7oo ¯,¯1o o,¯9C
Pitt 1oo,14o ¯7,79o 1o,o19 ¯,42o 9,oo9 o,271 2,C24 ¯7,oC9 11,Co1 ¯o,1C9
Robeson 1¯4,1oo ¯o,927 1o,C7o ¯,2oo 7,¯4o 4,17C 1,7oo ¯1,14o 9,¯oo 41,C2C
Rockingham 9¯,o4¯ 2C,7o9 1o,171 1,oo4 o,492 ¯,2o9 1,o74 2o,11¯ o,C4o 17,127
Rowan 1¯o,42o ¯2,942 19,99¯ 2,9oo 7,924 4,o4C 2,12o ¯o,C1o 1C,997 2o,949
Swain 1¯,9o1 ¯,2o9 2,¯21 29o oCo 4o4 2¯4 ¯,oo4 1,1o7 2,o4¯
Union 2C1,292 oC,ooC 19,4oo o,o17 1C,492 o,9o4 2,44C 44,12¯ 1¯,¯1C 1o,4¯2
Wake 9CC,99¯ 2¯4,o1¯ 7o,o49 21,2oC 49,o7o 27,2o2 1C,¯¯C 194,79o o7,o2o 1Co,oo2
Watauga o1,C79 7,C74 o,¯29 o41 ¯,271 1,77C o9o 12,7CC ¯,72o 11,¯7C
Wayne 122,o2¯ ¯C,4o4 1o,C7o 2,7o2 o,9C7 ¯,9oo 1,7o¯ ¯C,4¯o 9,2¯o 2¯,oC9
Yancey 17,o1o ¯,oo2 ¯,o72 ¯2¯ 1,CoC oo¯ ¯4o o,4o2 1,o97 ¯,ooo
Totals 6,506,362 l,574,l87 765,893 l42,65l 368,736 209,26l 88,295 l,564,054 47l,222 l,077,592
NORTH CAROLINA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 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 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 C C C C.C A 1C.9 PASS
Alexander 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Avery 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Buncombe 2 C C C.7 B C C C C.C A 9.2 PASS
Caldwell 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Caswell o C C 2.C C C C C C.C A 9.9 PASS
Catawba DNC DNC DNC DNC DNC C C C C.C A 11.4 PASS
Chatham 1 C C C.¯ B C 1 C C.o B 9.¯ PASS
Cumberland o C C 2.C C C C C C.C A 11.1 PASS
Davidson DNC DNC DNC DNC DNC C C C C.C A 12.1 PASS
Davie 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Duplin DNC DNC DNC DNC DNC C C C C.C A 9.¯ PASS
Durham o C C 2.C C C C C C.C A 1C.4 PASS
Edgecombe 4 C C 1.¯ C C C C C.C A 9.o PASS
Forsyth 2C C C o.7 F 1 C C C.¯ B 1C.9 PASS
Franklin o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Gaston DNC DNC DNC DNC DNC C C C C.C A 11.1 PASS
Graham 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Granville 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Guilford 1C C C ¯.¯ F C 1 C C.o B 1C.o PASS
Haywood 11 C C ¯.7 F C C C C.C A 1C.o PASS
Jackson INC INC INC INC INC C C C C.C A 9.o PASS
Johnston o C C 1.7 C INC INC INC INC INC INC INC
Lenoir 2 C C C.7 B 1 C C C.¯ B 9.4 PASS
Lincoln 9 1 C ¯.o F DNC DNC DNC DNC DNC DNC DNC
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 131
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
McDowell DNC DNC DNC DNC DNC C C C C.C A 1C.¯ PASS
Martin ¯ C C 1.C C C 1 C C.o B 9.2 PASS
Mecklenburg 29 4 C 11.7 F C C C C.C A 11.9 PASS
Mitchell DNC DNC DNC DNC DNC C C C C.C A 9.o PASS
Montgomery DNC DNC DNC DNC DNC C C C C.C A 9.9 PASS
New Hanover 1 C C C.¯ B INC INC INC INC INC INC INC
Orange DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Person o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Pitt 4 C C 1.¯ C C 1 C C.o B INC INC
Robeson DNC DNC DNC DNC DNC C C C C.C A 1C.4 PASS
Rockingham 1¯ C C 4.¯ F DNC DNC DNC DNC DNC DNC DNC
Rowan 2o C C o.7 F C C C C.C A 11.4 PASS
Swain C C C C.C A C C C C.C A 9.9 PASS
Union 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Wake 1C C C ¯.¯ F C 1 C C.o B 1C.2 PASS
Watauga DNC DNC DNC DNC DNC C C C C.C A o.o PASS
Wayne DNC DNC DNC DNC DNC 1 C C C.¯ B 1C.o PASS
Yancey o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
NORTH CAROLINA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 132
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Billings 7o¯ 1¯o 1o1 9 47 ¯1 1o 2o4 oo 9¯
Burke 1,9oo 4C9 412 2o 114 7o 4C o2o 144 19o
Burleigh o1,¯Co 1o,¯4¯ 1C,91¯ 1,174 4,oo4 2,724 1,2C2 2C,7oo 4,oCo 7,¯o¯
Cass 149,77o ¯2,ooC 14,ooC 2,C9C o,o12 4,729 1,oC1 ¯¯,o4o 7,22¯ 17,44o
Dunn ¯,o¯o 777 o1o oC 2C¯ 12o o¯ 1,C¯1 2¯4 42o
McKenzie o,¯oC 1,o91 9C2 1Co ¯4o 2C9 97 1,o¯o ¯o7 o¯o
Mercer o,424 1,799 1,¯2o 11o 4o4 ¯1C 1oC 2,49o oo9 ooo
Oliver 1,o4o 41C ¯Co 2o 1Co o9 ¯4 oo1 129 21o
Totals 254,003 56,227 29,l80 3,598 l4,793 8,275 3,403 6l,039 l3,332 27,25l
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 2012 133
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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.o PASS
Burke C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Burleigh C C C C.C A 1 C C C.¯ B 7.1 PASS
Cass C C C C.C A 2 C C C.7 B o.o PASS
Dunn C C C C.C A DNC DNC DNC DNC DNC DNC DNC
McKenzie C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Mercer C C C C.C A C C C C.C A o.1 PASS
Oliver C C C C.C A DNC DNC DNC DNC DNC DNC DNC
NORTH DAKOTA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 134
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Allen 1Co,¯¯1 2o,44o 1o,o97 2,¯oo 7,7o9 ¯,ooo 1,o47 27,7o9 o,¯oo 1o,7oo
Ashtabula 1C1,497 24,CC7 1o,o77 2,2o1 7,4¯o ¯,4o4 1,ooo 27,oo1 o,¯4o 1o,771
Athens o4,7o7 1C,249 o,o¯o 9o1 o,2oo 2,1¯1 777 14,7o9 4,¯o1 1¯,71C
Butler ¯oo,1¯C 92,oC4 42,4o4 o,oo¯ 2o,o9C 11,77o 4,9o9 oo,¯oo 2o,449 4o,197
Clark 1¯o,¯¯¯ ¯2,o4¯ 22,422 ¯,Co1 1C,1¯2 4,742 2,274 ¯7,oC1 11,¯9o 2o,991
Clermont 197,¯o¯ oC,o9C 2¯,244 4,74¯ 14,17C o,4C4 2,777 4o,7o2 14,o2¯ 1o,79C
Clinton 42,C4C 1C,2o2 o,oo4 9o2 ¯,CoC 1,¯99 o¯1 1C,o1¯ ¯,2oo o,¯92
Cuyahoga 1,2oC,122 29C,2o2 19o,o41 27,21o 9o,C2o 44,C14 2C,o¯9 ¯4o,47C 1C4,479 227,71o
Delaware 174,214 oC,oC4 1o,o17 4,7¯o 11,977 o,2o7 2,1o1 ¯9,27C 11,7Co 1C,C¯7
Franklin 1,1o¯,414 27o,o42 11o,7Co 2o,11o oo,o49 ¯o,41o 14,¯14 2o¯,o2C 7o,¯1¯ 21¯,o99
Geauga 9¯,¯o9 24,2¯7 14,474 2,272 o,o44 ¯,199 1,ooo 2o,74¯ 7,oC7 7,2C7
Greene 1o1,o7¯ ¯o,1¯¯ 21,99o ¯,294 12,171 o,4o¯ 2,411 41,oo4 12,o2o 2C,C¯2
Hamilton oC2,¯74 1o9,o4C 1Co,oo¯ 17,7o1 oo,9oo 2o,oo¯ 11,7o4 2C2,912 o1,C1¯ 144,741
Jeíerson o9,7C9 14,Co4 12,7oo 1,¯1o o,¯27 2,o44 1,2o2 2C,o17 o,24C 12,o¯2
Knox oC,921 14,7C1 o,9o7 1,¯7o 4,4¯9 2,C¯o 94C 1o,oo1 4,7o7 9,49C
Lake 2¯C,C41 o1,C2o ¯o,9oo 4,7o4 17,1o¯ o,Co4 ¯,ooC o4,1oo 19,4¯¯ 21,o2o
Lawrence o2,4oC 14,o49 9,717 1,¯7¯ 4,oo7 2,127 1,CC2 1o,724 o,CoC 1¯,149
Licking 1oo,492 41,12o 22,Co7 ¯,ooo 12,C7o o,o1¯ 2,474 42,o¯4 12,oC2 2C,19C
Lorain ¯C1,¯oo 72,C7o 4¯,1¯1 o,7oo 22,Co2 1C,17o 4,ooC 79,¯oo 2¯,949 41,o12
Lucas 441,o1o 1Co,1¯7 o7,oC9 9,9o1 ¯2,¯2o 14,o¯7 o,4C9 11C,9¯C ¯¯,¯4C oo,2o9
Madison 4¯,4¯o 9,oC7 o,¯o9 92C ¯,244 1,4o1 o2o 1C,9oo ¯,294 o,72o
Mahoning 2¯o,o2¯ o1,¯¯o 42,7C2 4,o1¯ 17,94o o,o44 4,224 oo,7o4 2C,9C4 ¯9,¯oC
Medina 172,¯¯2 4¯,741 22,oC1 4,1C1 12,¯9¯ o,717 2,oo¯ 44,¯o7 1¯,¯o9 12,9o1
Miami 1C2,oCo 24,7oo 1o,7¯1 2,¯22 7,4o4 ¯,4oo 1,o49 27,o¯7 o,¯¯¯ 12,C47
Montgomery o¯o,1o¯ 12¯,279 o1,C41 11,oo9 ¯9,o49 1o,1oo o,441 141,9¯9 42,ooo 9¯,o97
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 2012 135
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Portage 1o1,419 ¯¯,o7o 2C,o19 ¯,1oo 12,¯12 o,47o 2,¯oC 41,¯44 12,¯9o 2¯,14o
Preble 42,27C 1C,2¯o o,42o 9oC ¯,C77 1,44C ooC 11,¯77 ¯,442 o,C22
Scioto 79,499 1o,C9C 12,¯17 1,o9o o,o92 2,7C1 1,2oo 21,C7o o,¯72 1o,7o1
Stark ¯7o,ooo oo,9oo oC,97o o,Co2 27,77o 1¯,C27 o,242 1C¯,¯o2 ¯1,¯22 o¯,oC2
Summit o41,7o1 12¯,o7o 7o,9oo 11,ooo 4C,21¯ 1o,o17 o,oC9 144,2¯o 4¯,o24 o2,194
Trumbull 21C,¯12 4o,o¯2 ¯o,o17 4,¯72 1o,o77 7,4o1 ¯,oo9 o9,9o1 1o,21o ¯7,¯o9
Warren 212,o9¯ oo,47o 22,9¯o o,4o¯ 14,9C2 o,o47 2,o1C oC,C1C 14,9oC 12,¯1o
Washington o1,77o 12,941 1C,794 1,21¯ 4,o79 2,22C 1,Coo 17,79o o,4C4 9,¯99
Wood 12o,4oo 27,27o 1o,¯o9 2,oo7 9,47C 4,1oC 1,7o7 ¯1,C79 9,¯C2 1o,2oo
Totals 8,929,396 2,097,7ll l,230,207 l96,68l 657,355 298,488 l34,l06 2,298,l00 69l,987 l,395,082
OHIO
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 136
OHIO
American Lung Association in Ohio
1950 Arlingate Lane
Columbus, OH 43228-4102
(614) 279-1700
www.lung.org/ohio
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Allen 2 C C C.7 B INC INC INC INC INC INC INC
Ashtabula 1o C C o.¯ F DNC DNC DNC DNC DNC DNC DNC
Athens 1 C C C.¯ B C C C C.C A 9.7 PASS
Butler 2o C C o.¯ F 2 C C C.7 B 1¯.4 PASS
Clark o C C 2.7 D ¯ C C 1.C C 12.o PASS
Clermont ¯ C C 1.C C C C C C.C A 11.o PASS
Clinton o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Cuyahoga 1o C C o.C F 7 C C 2.¯ D 1¯.o PASS
Delaware 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Franklin 1¯ C C 4.¯ F ¯ C C 1.C C 12.o PASS
Geauga 12 C C 4.C F DNC DNC DNC DNC DNC DNC DNC
Greene 4 C C 1.¯ C C C C C.C A INC INC
Hamilton ¯1 C C 1C.¯ F 9 C C ¯.C D 14.4 PASS
Jeíerson ¯ C C 1.C C o C C 2.C C 1¯.C PASS
Knox 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Lake 22 C C 7.¯ F 1 C C C.¯ B INC INC
Lawrence 9 C C ¯.C D C C C C.C A 12.2 PASS
Licking o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Lorain ¯ C C 1.C C 2 C C C.7 B 1C.o PASS
Lucas o C C 2.7 D 4 C C 1.¯ C 11.o PASS
Madison 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Mahoning ¯ C C 1.C C o C C 1.7 C 12.4 PASS
Medina o C C 1.7 C C C C C.C A 11.1 PASS
Miami 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Montgomery 17 C C o.7 F ¯ C C 1.C C 1¯.2 PASS
Portage 1 C C C.¯ B 1 C C C.¯ B 11.o PASS
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 137 OHIO
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Preble 2 C C C.7 B 1 C C C.¯ B 11.7 PASS
Scioto DNC DNC DNC DNC DNC C C C C.C A 11.o PASS
Stark 17 C C o.7 F 9 C C ¯.C D INC INC
Summit 11 C C ¯.7 F 12 C C 4.C F 1¯.¯ PASS
Trumbull 1C C C ¯.¯ F INC INC INC INC INC INC INC
Warren 19 C C o.¯ F 1 C C C.¯ B 11.o PASS
Washington o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Wood 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 138
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Adair 22,oo¯ o,¯o7 2,9¯4 o49 1,oo9 712 ¯19 o,471 1,7¯2 o,971
Caddo 29,oCC 7,4o9 4,¯4¯ 7o4 2,11¯ 974 4o1 7,ooo 2,4C7 o,9o9
Canadian 11o,o41 ¯1,C94 12,o7o ¯,174 o,C4o ¯,oCC 1,oC9 2o,91C o,4oo 1C,o2o
Carter 47,oo7 12,247 7,C7o 1,2oC ¯,¯77 1,ooo 7¯¯ 12,2o7 ¯,o97 o,o19
Cherokee 4o,9o7 11,¯¯¯ o,¯¯o 1,1o7 ¯,¯9¯ 1,o2o o74 11,o17 ¯,ooo 9,99o
Cleveland 2oo,7oo o9,17o 2o,177 o,C4C 1o,o27 o,Co7 ¯,192 oo,o7¯ 1o,2o¯ ¯¯,C7o
Comanche 124,C9o ¯1,1¯4 12,7C2 ¯,17o o,79o ¯,79o 1,499 27,427 o,o2o 2C,CC7
Cotton o,19¯ 1,o24 1,Co1 1oo 44o 212 1C4 1,7CC o4¯ 9oo
Creek o9,9o7 17,42o 1C,47o 1,779 o,C¯o 2,¯o4 1,1C7 1o,o¯9 o,91C 1C,771
Dewey 4,o1C 1,221 9oo 12o ¯4o 1o7 oo 1,¯o¯ 44¯ oo4
Jeíerson o,472 1,ooo 1,2¯9 1oC 471 227 117 1,oo4 o9¯ 1,¯oC
Kay 4o,oo2 11,7o1 7,9¯2 1,2C2 ¯,¯¯2 1,o7C 77¯ 12,o7o 4,CCo 7,9C1
Lincoln ¯4,27¯ o,741 o,2o2 o92 2,4oC 1,1o2 ooC 9,141 2,919 4,oC1
Love 9,42¯ 2,294 1,o1o 2¯4 oo¯ ¯2¯ 1o9 2,o92 o27 1,4o4
McClain ¯4,oCo 9,19o 4,ooo 9¯o 2,422 1,11o oC4 o,o¯2 2,74¯ ¯,oo¯
McCurtain ¯¯,1o1 o,o99 o,14C o7o 2,¯oC 1,C9o o22 o,ooC 2,7oo 7,o12
Mayes 41,2o9 1C,o14 o,471 1,C7¯ 2,94o 1,¯oC ooC 1C,9¯2 ¯,4o¯ 7,¯o1
Muskogee 7C,99C 17,o11 1C,4Co 1,7o7 o,1Co 2,¯o1 1,Coo 1o,2oo o,79o 1¯,oo2
Oklahoma 71o,o¯¯ 1o1,11o oo,¯o7 1o,4oo o1,11o 22,791 9,7CC 17C,7¯4 o¯,ooo 12¯,9o7
Osage 47,472 11,oo¯ 7,27o 1,179 ¯,449 1,o2o 77¯ 12,o9o 4,12¯ 7,oo¯
Ottawa ¯1,o4o 7,ooo o,41o oC2 2,294 1,C7¯ o2¯ o,o¯9 2,71¯ o,¯1o
Pittsburg 4o,o¯7 1C,12C o,C¯o 1,C¯¯ ¯,421 1,o1C 7oo 12,ooo 4,C9o o,1o1
Sequoyah 42,¯91 1C,92o o,¯29 1,11o ¯,C11 1,4CC oo7 1C,994 ¯,49o o,2o4
Tulsa oC¯,4C¯ 1o4,27o 72,ooo 1o,74o 42,74o 19,1¯9 o,2CC 14¯,9¯4 4o,¯14 94,1oo
Totals 2,489,4ll 625,052 3l3,532 63,796 l77,54l 79,850 34,687 604,ll4 l90,402 403,474
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 2012 139
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Adair C C C C.C A 1 C C C.¯ B INC INC
Caddo 1 C C C.¯ B C C C C.C A 9.2 PASS
Canadian 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Carter INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Cherokee 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Cleveland C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Comanche ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Cotton INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Creek 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Dewey C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Jeíerson INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Kay ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Lincoln C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Love INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
McClain 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
McCurtain INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Mayes C C C C.C A C C C C.C A 11.C PASS
Muskogee INC INC INC INC INC C C C C.C A 1C.o PASS
Oklahoma 12 C C 4.C F C C C C.C A 9.7 PASS
Osage INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Ottawa 1 C C C.¯ B C C C C.C A INC INC
Pittsburg C C C C.C A C C C C.C A 1C.¯ PASS
Sequoyah 1 C C C.¯ B C C C C.C A INC INC
Tulsa 14 1 C o.2 F C C C C.C A 1C.9 PASS
OKLAHOMA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 140
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Clackamas ¯7o,992 o9,2¯1 o1,2¯1 o,7¯C 27,4oo 12,7oo o,oCC 99,¯12 21,¯74 ¯o,o¯4
Columbia 49,¯o1 11,o19 o,oo¯ o7o ¯,o14 1,o91 77o 1¯,22o 2,oo4 o,oo4
Crook 2C,97o 4,oCC 4,2C¯ ¯47 1,o47 7oo 4CC o,¯49 1,41C ¯,o1C
Deschutes 1o7,7¯¯ ¯o,221 2¯,491 2,7¯2 11,o7o o,¯9¯ 2,499 42,1oC 9,1Co 2¯,247
Harney 7,422 1,oo4 1,4C2 12o o4o 2o9 1¯o 2,2Co 4o9 1,¯o9
Jackson 2C¯,2Co 44,¯12 ¯o,o¯4 ¯,¯42 1o,Co4 7,21o ¯,ooC o7,91C 12,o91 ¯1,o29
Josephine o2,71¯ 1o,oo¯ 1o,4¯o 1,27¯ o,1oo ¯,12¯ 1,oo¯ 2o,177 o,ooC 1o,¯oo
Klamath oo,¯oC 14,oC¯ 11,¯o1 1,11o 4,o9¯ 2,¯¯7 1,1¯9 1o,oo7 4,Co7 11,¯o4
Lake 7,o9o 1,o2o 1,o12 11o oC¯ ¯CC 1oo 2,4o1 oo1 1,o2C
Lane ¯o1,71o o9,oo9 o2,7o1 o,2oo 2o,o¯C 12,¯C9 o,oo7 9o,C2o 2C,424 oo,o49
Linn 11o,o72 2o,17¯ 17,991 2,12o o,4C9 ¯,9¯9 1,ooo ¯C,9oo o,717 2C,9C1
Marion ¯1o,¯¯o o¯,¯o1 4C,o49 o,2o9 22,Coo 9,97C 4,¯o9 7o,o2o 1o,17o oo,C¯C
Multnomah 7¯o,¯¯4 1oC,oo¯ 77,42¯ 11,¯oo oo,97¯ 24,111 9,o2o 174,ooo ¯o,¯24 1¯C,o2C
Umatilla 7o,oo9 2C,2CC 9,oo7 1,o24 o,¯1C 2,4Co 1,CoC 1o,¯2o ¯,912 11,172
Union 2o,74o o,797 4,¯Co 4¯7 1,o92 o9o 4¯2 7,121 1,oo¯ 4,1o2
Washington o29,71C 1¯o,o¯o o¯,1C9 1C,24o ¯7,7o4 1o,4¯o o,o94 12C,294 2o,C9o oC,o9o
Totals 3,l22,073 7l4,6l9 4l0,263 53,899 229,747 l03,93l 45,583 790,929 l68,622 472,l72
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 2012 141
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Clackamas o C C 2.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 INC INC INC INC INC INC INC
Deschutes C C C C.C A 1 C C C.¯ B INC INC
Harney DNC DNC DNC DNC DNC 2 C C C.7 B INC INC
Jackson 1 C C C.¯ B 11 C C ¯.7 F 9.C PASS
Josephine DNC DNC DNC DNC DNC 2 C C C.7 B o.1 PASS
Klamath DNC DNC DNC DNC DNC 1¯ 1 C 4.o F 11.o PASS
Lake DNC DNC DNC DNC DNC 1C 1 C ¯.o F 9.o PASS
Lane C C C C.C A 2o C C o.7 F 1C.o PASS
Linn DNC DNC DNC DNC DNC 1 C C C.¯ B INC INC
Marion 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Multnomah 1 C C C.¯ B C C C C.C A 7.4 PASS
Umatilla C C C C.C A C C C C.C A 7.7 PASS
Union DNC DNC DNC DNC DNC C C C C.C A o.o PASS
Washington C C C C.C A 2 C C C.7 B o.C PASS
OREGON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 142
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Adams 1C1,4C7 22,4¯o 1o,9o4 2,1¯o 7,o21 ¯,o27 1,oo2 27,77¯ o,2oo 9,oC7
Allegheny 1,22¯,¯4o 241,oo¯ 2Co,Co9 2¯,C2o 9o,9¯o 4¯,7Co 2C,7o9 ¯44,oo2 1C2,9¯4 141,4o¯
Armstrong oo,941 14,1o9 12,oo7 1,¯o2 o,¯94 2,o2C 1,2o9 2C,419 o,1¯7 9,¯4o
Beaver 17C,o¯9 ¯4,o7o ¯1,ooC ¯,¯2¯ 1¯,¯o4 o,2¯o ¯,121 oC,o27 1o,1o9 2o,211
Berks 411,442 9o,1¯o o9,ooo 9,¯o1 ¯1,Co1 1¯,7oo o,¯21 1C7,Coo ¯1,o44 o4,o27
Blair 127,Co9 2o,o7o 22,o27 2,oo1 9,oo4 4,o2o 2,21o ¯o,192 1C,oo¯ 1o,4oo
Bucks o2o,249 14¯,o14 91,219 1¯,o74 47,972 21,o49 1C,Coo 17C,C7¯ oC,o47 ¯9,¯2C
Cambria 14¯,o79 2o,2¯o 27,C71 2,o9C 11,¯4o o,2o9 2,o¯1 42,ooC 12,792 1o,o7¯
Centre 1o¯,99C 24,o12 17,¯oo 2,¯¯o 12,o9C o,147 1,9oo ¯o,412 1C,o97 2o,o47
Chester 49o,ooo 124,Coo o¯,o7o 11,o2C ¯7,427 1o,4oo 7,¯Co 12o,4o7 ¯7,4o4 ¯1,172
Clearfield o1,o42 1o,29o 14,2oo 1,oo¯ o,44o 2,947 1,4¯C 2¯,49o 7,C¯7 12,o¯1
Cumberland 2¯o,4Co 4o,712 ¯o,74o 4,o41 1o,4o4 o,2¯2 ¯,o1o o4,21C 19,12o 1o,4o1
Dauphin 2oo,1CC o2,21o ¯o,o41 o,92o 2C,oC4 9,Co7 4,Co2 o9,9o9 2C,7o¯ ¯o,o19
Delaware ooo,979 1¯C,412 79,72o 12,42o 42,oo1 1o,7o9 o,o4C 14o,¯4o 4¯,1o4 o¯,oo4
Erie 2oC,ooo o¯,oCo 4C,o24 o,CoC 21,oC1 9,49o 4,¯¯C 7¯,o1C 21,ooC 4o,124
Franklin 149,o1o ¯o,74C 24,o79 ¯,4Co 11,22¯ o,C9¯ 2,4o¯ 4C,¯o4 12,Coo 14,C¯7
Greene ¯o,ooo 7,ooC o,9¯1 7¯2 ¯,C77 1,¯7C o¯1 1C,o7o ¯,177 o,4C2
Indiana oo,ooC 1o,o4o 1¯,944 1,oCo 7,121 ¯,12o 1,427 24,121 7,17¯ 1o,o¯7
Lackawanna 214,4¯7 4¯,947 ¯7,o9o 4,1o7 1o,7o2 7,ooo ¯,727 o1,C1o 1o,2oo 2o,C¯o
Lancaster o19,44o 129,C1o 77,7oC 12,29¯ ¯o,o2o 17,224 o,C19 1¯4,o1o 4C,Coo o¯,¯94
Lawrence 91,1Co 19,¯o2 17,12o 1,o44 7,C4o ¯,291 1,oo7 2o,o9o o,C¯2 14,¯o2
Lehigh ¯49,497 o2,ooC o1,oC4 7,o7o 2o,4oC 11,77C o,4¯¯ 91,oo¯ 27,291 4o,C7o
Luzerne ¯2C,91o o4,oCC o7,o9o o,174 2o,2C¯ 11,o47 o,oo2 92,292 27,o7o 49,124
Lycoming 11o,111 24,212 19,112 2,¯C7 9,CoC 4,C9o 1,94o ¯2,¯27 9,oo7 1o,o74
Mercer 11o,o¯o 2o,229 21,ooo 2,4C4 o,97o 4,1o9 2,Coo ¯¯,o7o 1C,12o 1o,241
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 2012 143
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Monroe 1o9,o42 4C,o74 21,7C1 ¯,ooo 12,9¯1 o,7C9 2,o¯o 4¯,97o 1¯,C2o 21,4oo
Montgomery 799,o74 1o¯,499 12C,727 17,4o4 o1,12o 27,¯92 12,7o1 214,4o2 o¯,9C7 44,9Co
Northampton 297,7¯o oo,177 4o,oCo o,21C 2¯,C¯C 1C,¯4o 4,oo1 o1,217 24,222 ¯C,ooC
Perry 4o,9o9 1C,7Co o,294 1,C2C ¯,o2C 1,o71 714 12,219 ¯,o29 4,oo7
Philadelphia 1,o2o,CCo ¯4¯,o¯7 1oo,¯C9 ¯2,7o1 117,o94 49,21o 2C,494 ¯o¯,7CC 1Co,9¯7 ¯9C,oo¯
Tioga 41,9o1 o,o9C 7,oo2 o1o ¯,2oo 1,o1C 742 12,1C¯ ¯,o¯1 o,¯CC
Washington 2C7,o2C 42,oo4 ¯o,¯oo 4,Co7 1o,¯C4 7,o19 ¯,o77 oC,2o2 1o,C7C 21,¯oC
Westmoreland ¯oo,1o9 72,o11 oo,o77 o,919 2o,oC1 1¯,oCo o,79o 1C9,7oC ¯¯,C2C ¯7,C17
York 4¯4,972 1C2,C14 o1,Co7 9,72C ¯¯,129 14,7Co o,o92 114,1C9 ¯¯,9C2 ¯9,4Co
Totals l0,843,969 2,399,l34 l,637,093 228,594 836,880 372,l62 l7l,782 2,897,849 862,633 l,397,074
PENNSYLVANIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 144
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Adams o C C 2.C C o C C 1.7 C 11.4 PASS
Allegheny ¯C 1 C 1C.o F 7¯ 4 C 2o.¯ F 1o.C FAIL
Armstrong 14 C C 4.7 F INC INC INC INC INC INC INC
Beaver 11 C C ¯.7 F 1 C C C.¯ B 1¯.1 PASS
Berks 2¯ C C 7.7 F o C C 2.C C 11.1 PASS
Blair o C C 1.7 C INC INC INC INC INC INC INC
Bucks 24 ¯ C 9.o F o C C 2.7 D 11.¯ PASS
Cambria 2 C C C.7 B 9 C C ¯.C D 12.o PASS
Centre 4 C C 1.¯ C 2 C C C.7 B 9.7 PASS
Chester 1o C C o.C F 12 C C 4.C F 1¯.o PASS
Clearfield o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Cumberland DNC DNC DNC DNC DNC 19 C C o.¯ F 11.o PASS
Dauphin 12 C C 4.C F 14 C C 4.7 F 12.4 PASS
Delaware 1¯ C C 4.¯ F o C C 2.C C 1¯.1 PASS
Erie o C C 2.C C 4 C C 1.¯ C 1C.o PASS
Franklin 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Greene o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Indiana 12 C C 4.C F DNC DNC DNC DNC DNC DNC DNC
Lackawanna o 1 C 2.2 D ¯ C C 1.C C 9.7 PASS
Lancaster 2¯ C C 7.7 F 9 C C ¯.C D 12.o PASS
Lawrence ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Lehigh 2C C C o.7 F DNC DNC DNC DNC DNC DNC DNC
Luzerne 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Lycoming 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Mercer 12 C C 4.C F 2 C C C.7 B 11.C PASS
Monroe 1C C C ¯.¯ F INC INC INC INC INC INC INC
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 2012 145 PENNSYLVANIA
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Montgomery 2¯ 1 C o.2 F 2 C C C.7 B 1C.o PASS
Northampton 14 C C 4.7 F 12 C C 4.C F 12.o PASS
Perry o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Philadelphia ¯4 1 C 11.o F 14 C C 4.7 F 12.C PASS
Tioga o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Washington o C C 2.7 D 7 C C 2.¯ D 12.9 PASS
Westmoreland 9 C C ¯.C D 9 C C ¯.C D 1¯.4 PASS
York 14 1 C o.2 F 7 C C 2.¯ D 12.2 PASS
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 146
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Kent 1oo,1oo ¯4,2o4 2o,Co9 ¯,99o 14,¯C¯ o,924 2,7o4 4o,o92 11,CoC 1o,71o
Providence o2o,oo7 1¯7,o2o o4,¯o9 1o,Co4 o¯,o1¯ 2C,914 9,14C 1oo,421 ¯7,C9o 1Co,124
Washington 12o,979 2o,491 19,C17 2,97o 11,C21 4,o¯¯ 2,C91 ¯o,4o4 o,¯oo 1C,o7o
Totals 9l9,804 l97,370 l29,475 23,038 78,836 3l,37l l4,0l5 240,576 56,56l l32,5l6
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 2012 147
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Kent 4 C C 1.¯ C C C C C.C A o.o PASS
Providence o C C 2.7 D 2 C C C.7 B 9.o PASS
Washington o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
RHODE ISLAND
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 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 Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Abbeville 2o,417 o,7o7 4,2C¯ o24 1,o¯4 oo7 42o 7,Co¯ 2,2oo 4,o94
Aiken 1oC,C99 ¯o,o2o 24,o19 ¯,¯¯7 1C,2o1 o,4oo 2,o72 4¯,Co9 1¯,o¯¯ 27,9oo
Anderson 1o7,12o 44,o2o 2o,¯29 4,Co2 11,o47 o,¯19 2,9o4 49,o¯¯ 1o,9C¯ ¯4,44o
Berkeley 177,o4¯ 44,9o2 17,794 4,C74 11,Co¯ o,ooC 2,2¯2 4C,74¯ 1¯,1Co 2o,217
Charleston ¯oC,2C9 72,ooo 44,721 o,oo4 2¯,11o 11,7o¯ o,CC1 o7,992 2o,29o o¯,oo7
Cherokee oo,¯42 1¯,oo4 7,442 1,2¯7 ¯,47C 1,o1o o14 1¯,971 4,4oo 11,24o
Chesterfield 4o,7¯4 11,oo7 o,¯¯2 1,C47 2,92o 1,oo1 7C1 11,99o ¯,oo¯ 1C,91C
Colleton ¯o,o92 9,492 o,C7o ooC 2,44o 1,¯2o o¯2 1C,oC4 ¯,¯71 o,o77
Darlington oo,oo1 1o,ooo 9,79¯ 1,o1C 4,¯27 2,¯11 1,Co¯ 1o,C¯C o,7oo 1o,o71
Edgefield 2o,9oo o,771 ¯,o24 o2¯ 1,7o¯ 92o 4C9 7,1Co 2,2o¯ 4,9¯9
Florence 1¯o,ooo ¯¯,7CC 1o,C17 ¯,Co4 o,oo7 4,4o9 1,994 ¯4,¯o9 11,C4o 29,Co4
Greenville 4o1,22o 1C9,¯17 o7,oo1 9,9Co 2o,4o4 14,7CC o,4C7 111,4o9 ¯o,o¯4 oo,C7¯
Lexington 2o2,¯91 o4,1o2 ¯2,111 o,o14 1o,4o7 o,o72 ¯,71¯ oo,C¯¯ 2C,o97 ¯¯,oo7
Oconee 74,27¯ 1o,7C7 14,1Co 1,42¯ 4,oo1 2,oo¯ 1,¯o4 21,771 o,9o¯ 1C,C¯7
Pickens 119,224 24,2o7 1o,99¯ 2,2C1 7,914 4,CCo 1,72C ¯C,C19 9,ooo 19,C1o
Richland ¯o4,oC4 o7,oo¯ ¯7,o41 7,9¯4 24,727 12,1¯7 4,7CC o7,2Co 2o,Coo oC,¯C7
Spartanburg 2o4,¯C7 o9,4oC ¯o,227 o,29¯ 17,ooo 9,¯4o 4,171 71,o9C 2¯,C¯¯ 47,ooo
York 22o,C7¯ o7,744 2o,o2o o,2¯¯ 14,CCC 7,2Co ¯,C47 o4,Co¯ 17,¯oo 29,21o
Totals 3,076,2l0 724,ll2 392,037 65,6l8 l95,79l l0l,077 43,9l2 765,7l0 246,ll3 505,48l
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 149 SOUTH CAROLINA
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Abbeville ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Aiken ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Anderson ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Berkeley 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Charleston C C C C.C A C C C C.C A 9.1 PASS
Cherokee o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Chesterfield 2 C C C.7 B C C C C.C A 1C.¯ PASS
Colleton C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Darlington o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Edgefield ¯ C C 1.C C 1 C C C.¯ B 1C.o PASS
Florence DNC DNC DNC DNC DNC C C C C.C A INC INC
Greenville 2 C C C.7 B 2 C C C.7 B 11.¯ PASS
Lexington DNC DNC DNC DNC DNC C C C C.C A 11.o PASS
Oconee ¯ C C 1.C C C C C C.C A o.o PASS
Pickens 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Richland 1C C C ¯.¯ F C C C C.C A 11.2 PASS
Spartanburg 17 C C o.7 F C C C C.C A INC INC
York ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 150
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Brookings ¯1,9oo o,C¯o ¯,17C o47 1,9oo 1,C12 ¯71 7,C1o 1,¯44 4,917
Brown ¯o,o¯1 o,47¯ o,o7¯ 7oo 2,112 1,24¯ oo9 9,774 1,992 ¯,o41
Codington 27,227 o,749 4,Co1 o12 1,o¯9 9C¯ 419 7,C4¯ 1,4¯C 2,994
Custer o,21o 1,o¯C 1,7oo 14o 49¯ ¯21 17¯ 2,711 o7C o97
Jackson ¯,C¯1 997 4C7 9C 1o¯ o9 42 o9o 141 99C
Meade 2o,4¯4 o,41o ¯,C¯o oo1 1,421 o2o ¯o7 o,272 1,2o7 2,o17
Minnehaha 1o9,4oo 42,oo¯ 1o,o4¯ ¯,oo7 9,oCo o,¯o¯ 2,222 ¯9,7¯C 7,o7o 19,199
Pennington 1CC,94o 24,o¯7 1¯,o17 2,2o1 o,7C7 ¯,¯1o 1,4oo 2o,oC1 o,142 1o,1CC
Union 14,¯99 ¯,7o7 2,C22 ¯41 79o 477 222 ¯,74o 7o¯ 1,C1C
Totals 4l7,2l9 l0l,469 52,787 9,l95 23,680 l3,542 5,88l l02,492 20,5l5 5l,365
SOUTH DAKOTA
American Lung Association in South Dakota
108 E. 38th Street, Suite 600
Sioux Falls, SD 57105
(605) 336-7222
www.lung.org/southdakota
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 151
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 2 C C C.7 B o.4 PASS
Brown DNC DNC DNC DNC DNC C C C C.C A o.2 PASS
Codington DNC DNC DNC DNC DNC 2 C C C.7 B 9.C PASS
Custer C C C C.C A ¯ ¯ C 2.o D 4.9 PASS
Jackson C C C C.C A 1 C C C.¯ B 4.4 PASS
Meade C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Minnehaha C C C C.C A ¯ C C 1.C C 9.4 PASS
Pennington DNC DNC DNC DNC DNC 1 C C C.¯ B o.o PASS
Union INC INC INC INC INC INC INC INC INC INC INC INC
SOUTH DAKOTA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 152
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Anderson 7o,129 1o,4o4 1¯,Co4 1,492 ¯,4¯o 2,oo7 1,¯Co 21,¯oo 7,29o 11,9oo
Blount 12¯,C1C 27,¯7o 19,77C 2,4o1 o,o¯¯ 4,2oo 2,C¯7 ¯¯,oo7 11,o4o 1o,oo1
Davidson o2o,oo1 1¯o,¯91 oo,4C¯ 12,¯oC 29,794 2C,1¯2 7,9¯o 14o,oo2 49,¯4¯ 12C,7o7
Dyer ¯o,¯¯o 9,oo2 o,o17 ooo 1,7C¯ 1,27o oo9 9,9o9 ¯,¯97 7,722
Hamilton ¯¯o,4o¯ 72,o11 49,41o o,ooC 1o,o74 11,ooo o,2o9 o9,¯o7 ¯C,4¯2 o1,¯Co
Haywood 1o,7o7 4,o1C 2,oo¯ 4¯o o2o o22 2oo 4,oo1 1,ooo 4,¯7o
Jeíerson o1,4C7 11,¯o9 o,¯¯4 1,C29 2,¯o¯ 1,7oo o4o 14,Coo 4,797 o,¯C7
Knox 4¯2,22o 94,49C oo,491 o,oo¯ 2C,2¯¯ 14,4o1 o,2o¯ 1C9,21o ¯7,122 o4,¯9o
Lawrence 41,oo9 1C,o29 o,7¯o 9o4 1,o47 1,4C1 o7¯ 11,C9o ¯,777 7,o44
Loudon 4o,ooo 9,ooo 1C,4¯4 o94 2,2¯7 1,o14 9oC 1o,Co7 o,1¯2 o,o7¯
McMinn o2,2oo 11,79o o,o1¯ 1,Co9 2,¯7o 1,o2o oo4 14,o¯o 4,9oo 9,o1o
Madison 9o,294 2¯,o¯4 12,9¯2 2,142 4,4oo ¯,2¯C 1,42o 24,o4o o,¯o9 1o,¯2o
Maury oC,9oo 19,oo7 1C,479 1,7o1 ¯,o4¯ 2,ooo 1,192 2C,o2o 7,C41 11,4C7
Meigs 11,7o¯ 2,o2o 1,ooo 229 o42 41o 199 ¯,¯17 1,1¯4 2,oo2
Montgomery 172,¯¯1 4o,214 1¯,791 4,¯o9 7,o17 4,94o 1,oCo ¯4,oCC 11,ooo 2o,oo1
Putnam 72,¯21 1o,oo7 1C,ooo 1,411 ¯,¯9o 2,42o 1,Coo 1o,o21 o,27o 14,9o2
Roane o4,1o1 11,2oo 1C,Coo 1,C2¯ 2,49o 1,9o4 99o 1o,1¯2 o,o12 o,1¯o
Rutherford 2o2,oC4 oo,714 21,ooo o,227 11,oo¯ 7,o27 2,9C¯ oo,2o4 1o,7¯2 ¯7,217
Sevier o9,oo9 19,o92 1¯,917 1,oC¯ 4,1¯2 ¯,12C 1,4o1 24,oC1 o,¯oo 14,ooo
Shelby 927,o44 244,742 9o,224 22,17o 41,149 2o,7oo 11,7o2 212,oC7 72,¯oC 1oo,97o
Sullivan 1oo,o2¯ ¯2,29¯ 29,21o 2,92o 7,277 o,oo9 2,o4¯ 4o,97¯ 1o,o7C 27,779
Sumner 1oC,o4o 4C,o¯C 2C,2o2 ¯,oo2 7,14¯ o,2¯7 2,¯C9 4C,C7o 1¯,o7o 21,17o
Williamson 1o¯,1o2 o¯,o29 17,oC7 4,ooC 7,722 o,o4o 2,¯oo 42,ooo 14,oCC 11,74C
Wilson 11¯,99¯ 2o,oo1 1¯,ooo 2,ooo o,Co2 ¯,7¯o 1,o¯o 2o,oo2 9,7o¯ 11,271
Totals 4,229,345 l,0l4,589 5l8,l28 9l,94l l92,63l l37,552 59,0l6 l,036,505 352,670 69l,4l4
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 2012 153
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Anderson o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Blount 2o C C o.7 F 1 C C C.¯ B 11.7 PASS
Davidson 4 C C 1.¯ C 1 C C C.¯ B 11.2 PASS
Dyer DNC DNC DNC DNC DNC 1 C C C.¯ B 1C.1 PASS
Hamilton 1o 1 C o.o F C 1 C C.o B 11.o PASS
Haywood INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Jeíerson 12 C C 4.C F DNC DNC DNC DNC DNC DNC DNC
Knox 1o C C o.C F o C C 1.7 C 12.4 PASS
Lawrence DNC DNC DNC DNC DNC C C C C.C A o.9 PASS
Loudon 12 C C 4.C F 2 C C C.7 B 12.4 PASS
McMinn DNC DNC DNC DNC DNC C C C C.C A 11.7 PASS
Madison DNC DNC DNC DNC DNC C C C C.C A 9.o PASS
Maury DNC DNC DNC DNC DNC C C C C.C A 9.o PASS
Meigs ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Montgomery DNC DNC DNC DNC DNC C C C C.C A 1C.7 PASS
Putnam DNC DNC DNC DNC DNC C C C C.C A 1C.2 PASS
Roane DNC DNC DNC DNC DNC 1 1 C C.o B 11.9 PASS
Rutherford 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Sevier 2o C C o.7 F DNC DNC DNC DNC DNC DNC DNC
Shelby 14 1 C o.2 F 1 C C C.¯ B 1C.o PASS
Sullivan o C C 1.7 C 1 C C C.¯ B 11.C PASS
Sumner 1o C C o.C F 1 C C C.¯ B 1C.o PASS
Williamson o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
Wilson o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
TENNESSEE
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 154
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Bell ¯1C,2¯o oo,117 27,CC¯ o,ooo 1o,¯27 o,92¯ ¯,¯o¯ o¯,172 19,o72 4C,¯1o
Bexar 1,714,77¯ 4oo,2oo 17o,oo¯ ¯o,19o 92,129 o1,o7o 2C,942 ¯79,oo4 12C,oC1 2oo,o17
Bowie 92,ooo 22,4o2 1¯,1C¯ 1,o9o o,1o4 ¯,CoC 1,¯oo 2¯,o2C 7,o94 1o,2C¯
Brazoria ¯1¯,1oo oo,9oo 29,92¯ o,ooC 1o,7¯1 9,oC2 ¯,o1o o9,7o9 22,2Co ¯o,oC9
Brewster 9,2¯2 1,o77 1,o¯1 142 o4o ¯¯C 1o7 2,oC9 o44 1,¯oo
Cameron 4Co,22C 1¯4,199 44,o91 1C,1o1 2C,C¯C 11,419 4,oo7 oo,1oo 27,1¯7 144,4¯9
Collin 7o2,¯41 224,o77 oC,C4o 1o,99o 41,24C 22,9o7 o,o¯2 1o4,1¯1 o1,9¯2 oC,¯¯7
Dallas 2,¯oo,1¯9 oo4,2o¯ 2C7,972 49,4o9 12o,¯1o o9,927 2o,7o¯ oCC,4o1 1oo,C7C 44o,4oo
Denton oo2,o14 1o2,2oC 4o,C4¯ 1¯,7oo ¯o,4¯o 19,¯1o o,912 1¯4,9¯o 42,411 o¯,4o7
Ector 1¯7,1¯C ¯9,oCo 1¯,9o4 ¯,C11 7,1o1 4,Coo 1,ooo 29,9Co 9,oC9 2o,4oo
Ellis 149,o1C 4¯,¯1o 14,94o ¯,27o 7,o72 4,o24 1,ooo ¯¯,o¯7 1C,741 17,Co2
El Paso oCC,o47 24C,o1¯ o2,22¯ 1o,21o 41,2o9 2¯,29C 9,o2¯ 171,1oo o4,¯7o 19¯,o2o
Galveston 291,¯C9 74,1o7 ¯2,oC4 o,o1C 1o,1CC 9,¯7o ¯,9o4 7C,o92 22,oo¯ ¯7,o21
Gregg 121,7¯C ¯1,C21 1o,47o 2,¯4o o,o9o ¯,91C 1,744 29,ooo 9,oo2 24,124
Harris 4,C92,4o9 1,147,o¯o ¯¯¯,4o7 oo,o2¯ 217,1o¯ 119,7oo 44,9o2 oo1,7oo 2oo,74o 7oo,91o
Harrison oo,o¯1 1o,9o1 o,71o 1,2o4 ¯,oC4 2,1¯o 9o1 1o,4oC o,¯C4 11,1¯1
Hays 1o7,1C7 ¯o,7o1 1¯,2oo 2,9¯2 o,712 4,7o9 1,7o2 ¯¯,o41 1C,o49 21,7oC
Hidalgo 774,7o9 2oo,4o4 72,24o 2C,¯Co ¯7,172 2C,o42 o,149 14o,1¯1 4o,7o2 2oo,Coo
Hood o1,1o2 1C,9C2 1C,o92 o2o 2,9o7 1,o9o 1,CCo 1o,7oo o,1oC o,C14
Hunt oo,129 21,419 12,CC1 1,o2C 4,7o9 2,o¯o 1,2o7 21,912 7,CoC 1o,o7o
Jeíerson 2o2,27¯ oC,¯9o ¯2,CC2 4,oo9 14,17o o,22o ¯,oo7 o2,217 19,91o o¯,4o2
Johnson 1oC,9¯4 41,149 17,¯¯1 ¯,11¯ o,129 4,729 2,C29 ¯o,724 11,444 1o,917
Kaufman 1C¯,¯oC 29,7o4 1C,o22 2,2o1 o,449 ¯,1¯o 1,¯C¯ 2¯,¯7C 7,4oo 12,21o
Kleberg ¯2,Co1 o,CoC ¯,oo1 oC9 1,7o¯ 9o4 4C2 7,1oC 2,27¯ 7,44o
Lubbock 27o,o¯1 o7,oo2 ¯C,o22 o,1¯¯ 1o,o14 o,oo¯ ¯,4o¯ o2,942 19,92o oo,Co7
TEXAS
American Lung Association in Texas
8150 Brookriver Drive, Suite S102
Dallas, TX 75247
(214) 631-5864
www.lung.org/texas
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 155
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
McLennan 2¯4,9Co o9,74o 29,2o9 4,o19 12,9C9 7,¯9o ¯,17¯ oo,4oo 17,o9¯ 4o,2oC
Montgomery 4oo,74o 12o,979 47,4C4 9,o29 24,429 14,C92 o,ooo 1Co,2C9 ¯¯,o¯C o2,47¯
Navarro 47,7¯o 12,92¯ o,oo¯ 97o 2,o7o 1,o¯o 712 11,977 ¯,ooC 1C,C7o
Nueces ¯4C,22¯ oo,2oo 4C,91¯ o,o7o 1o,o¯¯ 1C,o11 4,ooo o1,oo4 2o,1¯9 oo,97o
Orange o1,o¯7 2C,oC7 11,47¯ 1,oo1 4,o4¯ 2,7Co 1,2¯7 21,C1o o,772 12,22¯
Parker 11o,927 29,oo9 14,2o¯ 2,2o9 o,4o¯ ¯,o21 1,ooC 29,2o1 9,42C 1¯,712
Potter 121,C7¯ ¯¯,oo¯ 1¯,142 2,o4o o,4o1 ¯,o72 1,o2¯ 27,199 o,oo1 2o,C4o
Rockwall 7o,¯¯7 2¯,oC7 7,o4C 1,77o 4,Co¯ 2,¯¯o 9oo 17,¯¯7 o,o¯o 4,9o7
Smith 2C9,714 o¯,79o 29,oo1 4,Co9 11,oC4 o,7o1 ¯,Coo o1,977 1o,ooo ¯C,oo4
Tarrant 1,oC9,C¯4 oC7,Co1 1o1,¯oo ¯o,¯oo 9o,149 o¯,o4¯ 2C,9o9 ¯o9,492 12¯,4o7 2oo,o9o
Travis 1,C24,2oo 24o,C¯7 74,7o9 1o,o¯o o7,29o ¯C,719 1C,7¯9 211,¯o2 oo,Co9 1o9,o11
Victoria oo,79¯ 2¯,177 11,oo4 1,7o¯ 4,7C9 2,7o7 1,2o1 21,o19 o,92¯ 1o,o¯7
Webb 2oC,¯C4 oo,1oo 19,oC7 o,ooo 11,912 o,4o4 2,42o 4o,724 14,¯oo 7o,27o
Totals l9,06l,332 5,3l2,502 l,779,729 40l,843 l,0l4,l33 567,lll 222,827 4,l06,978 l,30l,2l6 3,4l4,9l5
TEXAS
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 156
TEXAS
American Lung Association in Texas
8150 Brookriver Drive, Suite S102
Dallas, TX 75247
(214) 631-5864
www.lung.org/texas
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Bell INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Bexar 17 C C o.7 F C C C C.C A 9.1 PASS
Bowie DNC DNC DNC DNC DNC C C C C.C A 11.2 PASS
Brazoria 29 1 C 1C.2 F DNC DNC DNC DNC DNC DNC DNC
Brewster C C C C.C A C C C C.C A INC INC
Cameron C C C C.C A C C C C.C A 11.C PASS
Collin 12 C C 4.C F DNC DNC DNC DNC DNC DNC DNC
Dallas 2¯ 1 C o.2 F 1 C C C.¯ B 1C.7 PASS
Denton ¯2 C C 1C.7 F DNC DNC DNC DNC DNC DNC DNC
Ector DNC DNC DNC DNC DNC 1 C C C.¯ B INC INC
Ellis o C C 1.7 C 1 C C C.¯ B 1C.2 PASS
El Paso 11 C C ¯.7 F o C C 2.7 D 9.o PASS
Galveston 1¯ 1 C 4.o F DNC DNC DNC DNC DNC DNC DNC
Gregg 7 C C 2.¯ D DNC DNC DNC DNC DNC DNC DNC
Harris o1 o C 24.¯ F 1 C C C.¯ B 1¯.C PASS
Harrison 2 C C C.7 B C C C C.C A 1C.C PASS
Hays ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Hidalgo 1 C C C.¯ B C C C C.C A 1C.o PASS
Hood 1C C C ¯.¯ F DNC DNC DNC DNC DNC DNC DNC
Hunt 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Jeíerson 21 C C 7.C F 1 C C C.¯ B INC INC
Johnson 2C C C o.7 F DNC DNC DNC DNC DNC DNC DNC
Kaufman ¯ C C 1.C C DNC DNC DNC DNC DNC DNC DNC
Kleberg INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Lubbock DNC DNC DNC DNC DNC C C C C.C A INC INC
McLennan 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 157 TEXAS
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Montgomery o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Navarro INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Nueces o C C 1.7 C C C C C.C A 1C.4 PASS
Orange o C C 2.7 D 1 C C C.¯ B INC INC
Parker 1o 1 C o.o F DNC DNC DNC DNC DNC DNC DNC
Potter DNC DNC DNC DNC DNC C C C C.C A INC INC
Rockwall o 1 C 2.o D DNC DNC DNC DNC DNC DNC DNC
Smith ¯ 1 C 1.o C DNC DNC DNC DNC DNC DNC DNC
Tarrant o9 ¯ C 21.2 F C C C C.C A 1C.o PASS
Travis o C C 2.7 D C C C C.C A 1C.C PASS
Victoria 1 C C C.¯ B 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 2012 158
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Box Elder 49,97o 1o,97o o,oo¯ 1,1o7 ¯,CC¯ 1,4C1 oCo 1C,oo1 2,4oo 4,oo1
Cache 112,ooo ¯o,o¯9 o,o94 2,4o1 o,9oo 2,9oo 1,Co2 2C,4oo 4,oC¯ 17,¯2¯
Davis ¯Co,479 1Co,¯¯9 24,992 7,244 1o,297 o,1oo ¯,12o oo,¯¯o 1¯,1¯2 24,o77
Salt Lake 1,C29,ooo 299,7o1 o9,¯o7 2C,o14 oo,¯o4 29,o¯1 11,2¯1 21C,224 47,227 1¯9,o7o
San Juan 14,74o o,C17 1,oCC ¯4o ooo 414 17o ¯,114 724 ¯,o74
Tooele oo,21o 21,C1o 4,¯79 1,44o ¯,¯oo 1,oCo ooo 1C,o99 2,¯9o o,2¯C
Uintah ¯2,ooo 1C,oo7 2,997 747 1,977 o94 ¯oo o,491 1,477 4,o94
Utah o1o,oo4 1o1,977 ¯¯,4o7 12,o14 ¯C,¯44 12,7Co 4,2oC oo,CoC 1o,41¯ 74,o¯9
Washington 1¯o,11o 41,ooo 2¯,o2o 2,oo7 o,7oo 4,24o 2,11o ¯¯,o79 o,197 2C,111
Weber 2¯1,2¯o o9,¯11 2¯,¯oo 4,7oo 14,7¯C o,o9o 2,71¯ 4o,9o2 11,2C1 ¯1,o42
Totals 2,490,232 787,603 2l8,263 54,l59 l54,747 68,548 26,239 487,800 l09,728 325,926
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 2012 159
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Box Elder o C C 1.7 C 11 C C ¯.7 F o.¯ PASS
Cache C C C C.C A ¯9 4 C 1o.C F 1C.C PASS
Davis 11 C C ¯.7 F 1¯ C C 4.¯ F 9.o PASS
Salt Lake 1o C C o.C F 4o o C 19.¯ F 1C.9 PASS
San Juan 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Tooele 4 C C 1.¯ C 4 1 C 1.o C o.o PASS
Uintah 2C 1o o 1o.C F DNC DNC DNC DNC DNC DNC DNC
Utah o C C 1.7 C ¯C ¯ C 11.o F 9.o PASS
Washington 2 C C C.7 B INC INC INC INC INC INC INC
Weber 7 C C 2.¯ D ¯C C C 1C.C F 9.o PASS
UTAH
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 160
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Bennington ¯7,12o 7,oC¯ o,99o 7oo ¯,21C 1,¯o7 o9C 11,1¯1 2,2oo 4,o94
Chittenden 1oo,o4o ¯1,¯1¯ 17,ooo ¯,11¯ 14,¯o4 o,2oo 2,1o1 ¯o,ooo 7,4¯7 17,2o9
Rutland o1,o42 11,oo2 1C,2o7 1,1o1 o,4o7 2,2o4 1,Coo 1o,C¯4 ¯,o1o 7,7o9
Totals 255,3l2 50,798 34,937 5,05l 23,04l 8,897 3,926 68,02l l3,32l 29,972
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 2012 161
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Bennington 2 C C C.7 B C C C C.C A o.9 PASS
Chittenden 2 C C C.7 B C C C C.C A 7.¯ PASS
Rutland DNC DNC DNC DNC DNC 2 C C C.7 B 9.9 PASS
VERMONT
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 162
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Albemarle 9o,97C 21,2oo 14,124 1,7o7 o,o2o ¯,¯7¯ 1,o1¯ 2o,o9o 7,C¯o o,419
Arlington 2C7,o27 ¯2,o2o 1o,Co4 2,o92 14,474 o,o29 2,¯97 4o,o2C 11,9o¯ 14,9C¯
Caroline 2o,o4o o,o44 ¯,744 ooo 1,o2o 9oC 422 7,294 1,9o1 ¯,1oC
Charles City 7,2oo 1,¯C1 1,214 1C7 oC7 27o 1¯¯ 2,22C o1o oo4
Chesterfield ¯1o,2¯o o2,o1o ¯2,o7o o,oC9 19,ooo 1C,Co2 4,191 7o,¯o¯ 2C,1oo 21,47o
Fairfax 1,Co1,72o 2o2,o4o 1Co,29C 21,o7o oo,772 ¯4,7oC 14,C2¯ 2oo,4oC oo,1o2 o¯,91o
Fauquier oo,2C¯ 1o,44o o,2o9 1,¯o7 4,129 2,1o4 9o¯ 1o,97¯ 4,o¯o 4,o¯9
Frederick 7o,¯Co 19,o7o 9,9o4 1,o24 4,9¯o 2,oo1 1,1¯2 19,o2C o,¯2¯ o,7oo
Hanover 99,oo¯ 24,99o 1¯,1C4 2,Co¯ o,¯¯o ¯,¯4o 1,o17 2o,Coo 7,122 o,21o
Henrico ¯Co,9¯o 74,¯72 ¯7,924 o,1¯7 19,o2o 9,99o 4,¯17 7o,o9o 2C,¯79 29,9o7
Loudoun ¯12,¯11 9o,4¯4 2C,42o 7,o7o 1o,1Co o,o29 ¯,192 o2,1o9 1o,Co9 11,o2o
Madison 1¯,¯Co 2,97C 2,¯¯C 24o o7o 477 2¯7 ¯,oo2 1,C77 1,o44
Page 24,C42 o,19¯ 4,24o 429 1,o9o ooo 422 o,o9C 1,91o ¯,72o
Prince William 4C2,CC2 11o,17o 27,22C 9,oo7 2¯,oo2 11,o44 4,221 o2,C7C 21,2o2 24,o9o
Roanoke 92,¯7o 2C,11¯ 1o,912 1,ooC o,122 ¯,299 1,o1o 2o,492 7,¯oC o,291
Rockbridge 22,¯C7 4,2o4 4,o2C ¯o2 1,o¯¯ o4o 4¯9 o,9o9 1,9o2 2,7Co
Rockingham 7o,¯14 1o,C72 11,9o4 1,491 4,91o 2,oC4 1,2¯4 2C,o4o o,oo1 o,Co4
Staíord 12o,9o1 ¯7,197 9,4o4 ¯,C7C 7,o91 ¯,o21 1,441 27,4oo 7,19C o,o¯1
Wythe 29,2¯o o,11C o,212 oC4 1,9oo 1,Co1 o17 o,4¯o 2,¯44 4,o7o
Alexandria city 1¯9,9oo 2¯,97C 12,oCo 1,97o 9,o¯¯ 4,o¯¯ 1,o9o ¯2,4o4 o,¯91 12,o9o
Bristol city 17,o¯o ¯,7C7 ¯,¯o1 ¯Co 1,191 o¯o ¯17 o,1C¯ 1,42C ¯,744
Hampton city 1¯7,4¯o ¯1,274 1o,ooo 2,oo1 o,9C¯ 4,o2o 1,9¯C ¯4,C1¯ 9,1¯7 17,4¯9
Lynchburg city 7o,ooo 14,774 1C,ooo 1,219 o,Coo 2,oCo 1,Coo 1o,o91 4,9o9 14,921
Newport News city 1oC,719 4¯,91¯ 19,219 ¯,o24 11,417 o,oo2 2,27o 41,¯¯2 1C,9¯7 2o,Coo
Norfolk city 242,oC¯ oC,o12 22,79o 4,177 1o,92o 7,o2C 2,o1o o¯,¯4o 1¯,792 ¯9,9C¯
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 2012 163
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Roanoke city 97,C¯2 21,12o 1¯,o¯o 1,74¯ o,¯79 ¯,29o 1,4o1 2o,¯41 o,o9C 21,414
Salem city 24,oC2 4,9¯4 4,24C 4C7 1,o7¯ oo1 42C o,947 1,91o 2,247
Suíolk city o4,ooo 22,1¯7 9,727 1,o27 o,2o4 2,7C1 1,1oo 2C,4¯2 o,oCo 9,9oo
Virginia Beach city 4¯7,994 1Co,249 4o,4¯o o,ooo 27,o4C 1¯,9¯o o,oo9 1C2,o12 27,22¯ ¯4,¯C¯
Totals 4,830,262 l,l69,933 506,822 96,547 306,638 l54,l6l 62,769 l,l37,263 302,426 4ll,088
VIRGINIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 164
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Albemarle o C C 2.C C 1 C C C.¯ B INC INC
Arlington 22 1 C 7.o F 1 C C C.¯ B 1C.o PASS
Caroline 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Charles City 1o C C o.C F C C C C.C A 9.o PASS
Chesterfield 7 4 C 4.¯ F C C C C.C A 1C.¯ PASS
Fairfax 2¯ 2 C o.7 F 2 C C C.7 B 1C.¯ PASS
Fauquier 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Frederick ¯ C C 1.C C C C C C.C A 11.1 PASS
Hanover 1¯ C C 4.¯ F DNC DNC DNC DNC DNC DNC DNC
Henrico 1o 1 C o.o F 2 C C C.7 B 1C.C PASS
Loudoun 12 1 C 4.o F 2 C C C.7 B 1C.¯ PASS
Madison o C C 2.7 D DNC DNC DNC DNC DNC DNC DNC
Page C C C C.C A C C C C.C A 9.o PASS
Prince William 4 C C 1.¯ C DNC DNC DNC DNC DNC DNC DNC
Roanoke 2 C C C.7 B DNC DNC DNC DNC DNC DNC DNC
Rockbridge 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Rockingham 1 C C C.¯ B 2 C C C.7 B 1C.o PASS
Staíord o C C 2.C C DNC DNC DNC DNC DNC DNC DNC
Wythe 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Alexandria city 1¯ C C 4.¯ F INC INC INC INC INC INC INC
Bristol city DNC DNC DNC DNC DNC C C C C.C A 1C.2 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 9.4 PASS
Newport News city INC INC INC INC INC INC INC INC INC INC INC INC
Norfolk city DNC DNC DNC DNC DNC o 2 C 2.7 D 11.1 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 2012 165
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Roanoke city DNC DNC DNC DNC DNC 1 C C C.¯ B 1C.4 PASS
Salem city DNC DNC DNC DNC DNC C C C C.C A INC INC
Suíolk city 11 C C ¯.7 F DNC DNC DNC DNC DNC DNC DNC
Virginia Beach city DNC DNC DNC DNC DNC o ¯ C ¯.o F 1C.¯ PASS
VIRGINIA
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 166
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Asotin 21,o2¯ 4,7C4 4,172 2o¯ 1,o2C 779 ¯97 o,¯oo 1,o2o ¯,¯o4
Chelan 72,4o¯ 1o,Co¯ 11,17o 1,Coo o,227 2,4¯o 1,1oo 19,222 4,o71 1C,1o1
Clallam 71,4C4 12,9o9 17,1o9 7o1 o,o77 2,7oo 1,o¯2 2¯,ooo o,7C7 1C,o2o
Clark 42o,¯o¯ 112,o7o 4o,71C o,77C ¯C,1oo 1¯,4oo o,7o¯ 1C1,o7o 2¯,o4o o¯,717
King 1,9¯1,249 41¯,oC2 21C,o79 24,ooo 14o,2¯1 o¯,o9o 2o,o72 4oo,91¯ 1C9,¯o7 2¯2,7C4
Kittitas 4C,91o 7,4o4 o,212 4oC ¯,2C1 1,¯oo o7¯ 1C,19o 2,¯o4 o,C49
Okanogan 41,12C 9,oo7 7,C7C oo1 ¯,C27 1,44o 717 11,o9o 2,79o o,94¯
Pierce 79o,22o 19o,127 o7,7oo 11,91o o7,ooC 2o,¯o7 1C,oo7 1oo,o71 44,19o 9o,ooo
Skagit 11o,9C1 27,7¯7 1o,o7o 1,ooo o,oo1 4,CC1 1,917 ¯1,71o 7,oo2 1o,C12
Snohomish 71¯,¯¯o 174,1o7 7¯,o44 1C,474 o2,1CC 22,927 9,¯oC 17C,C11 ¯9,o99 7C,22o
Spokane 471,221 1C9,oC2 oC,9o9 o,ooo ¯4,797 1o,o97 o,o14 11o,oC2 27,o9o o7,272
Thurston 2o2,2o4 oo,122 ¯2,7o4 ¯,49o 1o,7Co o,44o ¯,71o o4,o4o 1o,2C9 2o,7o7
Whatcom 2C1,14C 42,2Co 2o,o4C 2,o¯o 1o,2oo o,79o 2,94o o1,¯¯o 12,C72 2o,¯2o
Yakima 24¯,2¯1 74,C¯o 2o,122 4,4o¯ 1o,242 7,19¯ ¯,C9o o4,119 12,71o o7,o12
Totals 5,397,444 l,262,882 632,907 75,950 398,274 l76,3l6 74,426 l,320,630 309,554 688,7ll
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 2012 167
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Asotin DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Chelan DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Clallam C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Clark 1 C C C.¯ B o C C 2.7 D 7.o PASS
King o C C 2.7 D C C C C.C A o.o PASS
Kittitas DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Okanogan DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Pierce ¯ C C 1.C C 11 C C ¯.7 F o.9 PASS
Skagit C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Snohomish DNC DNC DNC DNC DNC 12 C C 4.C F o.2 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 INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Yakima DNC DNC DNC DNC DNC 1¯ C C 4.¯ F 9.¯ PASS
WASHINGTON
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 168
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Berkeley 1C4,1o9 2o,21o 11,ooo 1,714 o,oo4 ¯,¯o2 1,422 2o,219 o,491 1¯,14C
Brooke 24,Co9 4,o77 4,oC2 299 1,411 o9o 449 7,2oo 2,4¯2 ¯,4C2
Cabell 9o,¯19 1o,9Co 1o,¯o4 1,2¯o o,o2o ¯,¯o9 1,oo¯ 2o,1C¯ o,ooo 21,o77
Greenbrier ¯o,4oC 7,11o o,o¯o 4oo 2,Co¯ 1,¯1C oo4 1C,o7o ¯,ooC 7,22o
Hancock ¯C,o7o o,1o1 o,7o4 4C¯ 1,774 1,1¯4 o71 9,22o ¯,1C1 4,12o
Harrison o9,C99 1o,172 11,4Co 992 ¯,9Co 2,4¯1 1,1oo 19,¯1o o,4o¯ 11,o19
Kanawha 19¯,Co¯ ¯9,7¯4 ¯2,¯1o 2,o9o 11,111 o,919 ¯,¯22 o4,9oo 1o,4oo 2o,1C1
Marion oo,41o 11,2Co 9,o41 7¯¯ ¯,2o1 2,CCo 9oo 1o,o27 o,2o4 9,2¯7
Marshall ¯¯,1C7 o,o92 o,o14 4o1 1,o97 1,2C¯ o92 9,o91 ¯,2o2 o,o¯o
Monongalia 9o,1o9 1o,2o2 9,o2o 997 o,917 ¯,1o9 1,177 22,2oC 7,¯21 19,o44
Ohio 44,44¯ o,4oo o,21¯ oo4 2,oC7 1,o¯4 oC7 1¯,1¯¯ 4,¯9o o,9o2
Raleigh 7o,oo9 1o,¯oC 12,oo1 1,C71 4,o¯1 2,7o9 1,¯1o 21,9oo 7,¯o4 1¯,49o
Wood oo,9oo 1o,991 14,71o 1,242 4,92o ¯,C72 1,4o9 24,oC4 o,21o 1¯,¯Co
Totals 948,847 l95,069 l48,9l2 l2,756 54,702 33,305 l5,484 260,l52 87,082 l57,77l
WEST VIRGINIA
American Lung Association in West Virginia
415 Dickinson Street
P.O. Box 3980
Charleston, West Virginia 25339-3980
(304) 342-6600
www.lung.org/westvirginia
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 169
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Berkeley 2 C C C.7 B 4 C C 1.¯ C 12.9 PASS
Brooke DNC DNC DNC DNC DNC o C C 2.7 D 1¯.7 PASS
Cabell 2 C C C.7 B 1 C C C.¯ B 1¯.1 PASS
Greenbrier C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Hancock o C C 2.7 D ¯ C C 1.C C 12.4 PASS
Harrison DNC DNC DNC DNC DNC 1 C C C.¯ B 11.o PASS
Kanawha o C C 1.7 C ¯ C C 1.C C 1¯.2 PASS
Marion DNC DNC DNC DNC DNC C C C C.C A 12.9 PASS
Marshall DNC DNC DNC DNC DNC o C C 1.7 C 1¯.1 PASS
Monongalia 4 C C 1.¯ C 1 C C C.¯ B 11.o PASS
Ohio 4 C C 1.¯ C C C C C.C A 12.4 PASS
Raleigh DNC DNC DNC DNC DNC C C C C.C A 1C.1 PASS
Wood ¯ C C 1.C C 2 C C C.7 B 1¯.1 PASS
WEST VIRGINIA
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 170
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Ashland 1o,1o7 ¯,744 2,oo7 ¯¯¯ 1,C2C oo7 2oo 4,4C2 9o7 2,92C
Brown 24o,CC7 o1,o2¯ 2o,7o9 o,491 1o,44C 7,9o¯ ¯,¯7o o9,79¯ 12,o7o 24,o29
Columbia oo,o¯¯ 1¯,2o7 o,294 1,17o ¯,oo1 1,94o 9C1 1o,2¯o ¯,29o o,2¯¯
Dane 4oo,C7¯ 1Co,Co4 oC,144 9,42¯ ¯1,o91 1o,o11 o,2o4 114,o7o 2¯,9o¯ oo,¯7o
Dodge oo,7o9 19,o79 1¯,2o1 1,7¯9 o,o99 ¯,Co2 1,41¯ 2¯,oo1 o,1o9 7,oCo
Door 27,7oo o,C7o o,24o 4o1 1,o¯o 1,C92 ooo 9,1oo 2,Co¯ ¯,C4o
Eau Claire 9o,7¯o 2C,o72 12,4¯o 1,oo4 o,491 ¯,2o7 1,¯7o 24,¯CC o,14C 1o,oo¯
Florence 4,42¯ 774 9¯1 o9 29o 17o 92 1,4o4 ¯2o oo7
Fond du Lac 1C1,o¯¯ 2¯,C44 1o,22o 2,C47 o,47¯ ¯,4o4 1,o14 27,21o o,ooo 11,¯72
Forest 9,¯C4 2,C4¯ 1,ooo 1o1 o9¯ ¯¯7 17o 2,771 o1o 1,o2o
Grant o1,2Co 1C,ooo 7,974 9o7 ¯,¯41 1,7oC oCo 1¯,o¯o 2,92C 7,oo1
Jeíerson o¯,ooo 19,oo7 11,C42 1,7o4 o,27o 2,777 1,2¯C 21,2oo 4,ooC o,7oo
Kenosha 1oo,42o 42,o29 1o,o79 ¯,oC4 1C,2oC o,2oC 2,224 ¯9,ooC o,¯72 21,¯oC
Kewaunee 2C,o74 4,o49 ¯,¯9¯ 4¯1 1,2oo 714 ¯47 o,711 1,24o 2,C¯¯
La Crosse 114,o¯o 24,4o2 1o,2C1 2,17¯ 7,497 ¯,o¯4 1,oo7 2o,ooC o,14o 14,21o
Manitowoc o1,442 1o,21C 1¯,714 1,o1o o,177 2,oo2 1,4C4 2¯,Co7 o,C49 9,2Co
Marathon 1¯4,Co¯ ¯2,oo9 1o,9oo 2,92C o,¯¯o 4,474 2,CoC ¯4,oC1 7,oC7 1o,o91
Milwaukee 947,7¯o 2¯o,¯77 1C9,1¯¯ 2C,99o o9,2o¯ 29,o¯C 12,42o 221,1C7 4o,ooo 2C2,o2o
Oneida ¯o,99o o,o¯9 7,oCC o9C 2,¯o¯ 1,¯9o 7¯9 11,o¯o 2,o92 4,C1o
Outagamie 17o,o9o 44,424 2C,o¯4 ¯,94o 1C,9o¯ o,o94 2,44C 42,9oo 9,1¯4 1o,79o
Ozaukee oo,¯9o 2C,¯72 1¯,2Co 1,o1C o,¯99 ¯,CC9 1,4¯2 2¯,9¯¯ o,2Co 4,o¯4
Racine 19o,4Co 4o,o1C 2o,7¯9 4,¯C9 12,1C9 o,4o¯ 2,o97 49,oo4 1C,7C2 27,o7o
Rock 1oC,¯¯1 4C,1o¯ 21,7o9 ¯,oo9 9,92o o,249 2,¯o2 4C,4¯C o,ooo 21,94¯
St. Croix o4,¯4o 22,oo¯ o,4oo 2,C¯¯ o,C92 2,o27 1,Co2 19,oo7 4,121 o,o4o
Sauk o1,97o 14,7o7 9,2oo 1,¯12 ¯,ooo 2,C99 979 1o,449 ¯,oo2 o,9o2
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 2012 171
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Sheboygan 11o,oC7 27,oo2 1o,o21 2,4oC 7,2¯4 ¯,912 1,o1C ¯C,oo7 o,o1¯ 11,CoC
Taylor 2C,oo9 o,Co9 ¯,¯¯4 4o2 1,27o 7C9 ¯4¯ o,ooo 1,2¯7 2,oC7
Vernon 29,77¯ 7,o7o 4,9o2 7CC 1,7o9 1,CCo oCC o,14o 1,7o9 4,¯2o
Vilas 21,4¯C ¯,oC9 o,ooo ¯¯o 1,42¯ oo¯ 49C 7,4¯2 1,ooC ¯,C4o
Walworth 1C2,22o 24,CCC 1¯,7o7 2,1¯2 o,4o4 ¯,41C 1,o19 2o,1o7 o,oC9 12,o99
Washington 1¯1,oo7 ¯2,¯77 17,oC¯ 2,o7o o,17o 4,4¯o 2,C17 ¯4,o14 7,4¯o o,2oo
Waukesha ¯o9,o91 9¯,o1C oo,ooo o,¯¯¯ 24,2oo 1¯,¯o4 o,21¯ 1Co,179 22,771 2¯,41o
Totals 4,352,035 l,038,968 562,9l0 92,287 274,l43 l43,47l 63,02l l,093,593 233,657 565,366
WISCONSIN
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 172
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
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 1 C C C.¯ B o.o PASS
Brown C C C C.C A 21 C C 7.C F 11.C PASS
Columbia C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Dane C C C C.C A 12 C C 4.C F 11.4 PASS
Dodge C C C C.C A 2 C C C.7 B INC INC
Door 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Eau Claire DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Florence C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Fond du Lac C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Forest C C C C.C A 1 C C C.¯ B o.o PASS
Grant DNC DNC DNC DNC DNC 4 C C 1.¯ C 11.o PASS
Jeíerson C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Kenosha 1C C C ¯.¯ F 2 C C C.7 B 1C.o PASS
Kewaunee o C C 1.7 C DNC DNC DNC DNC DNC DNC DNC
La Crosse C C C C.C A 7 C C 2.C C 1C.o PASS
Manitowoc o C C 2.7 D 2 C C C.7 B 9.7 PASS
Marathon C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Milwaukee o C C 2.7 D 17 1 C o.7 F 11.o PASS
Oneida C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Outagamie C C C C.C A 1C C C ¯.¯ F 1C.4 PASS
Ozaukee 7 C C 2.¯ D o C C 2.C C 1C.2 PASS
Racine 9 C C ¯.C D DNC DNC DNC DNC DNC DNC DNC
Rock C C C C.C A DNC DNC DNC DNC DNC DNC DNC
St. Croix C C C C.C A o C C 2.C C 1C.C PASS
Sauk C C C C.C A o C C 1.7 C 9.o PASS
Sheboygan 12 C C 4.C 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 2012 173
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Taylor DNC DNC DNC DNC DNC 2 C C C.7 B o.7 PASS
Vernon C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Vilas C C C C.C A 1 C C C.¯ B o.2 PASS
Walworth 1 C C C.¯ B DNC DNC DNC DNC DNC DNC DNC
Washington C C C C.C A DNC DNC DNC DNC DNC DNC DNC
Waukesha C C C C.C A 1C C C ¯.¯ F 12.¯ PASS
WISCONSIN
(continued)
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 174
AT-RISK GROUPS
Lung Diseases
Cardio-
Total 65 & Pediatric Adult Chronic vascular
County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty
Albany ¯o,299 o,C¯7 ¯,1oo ¯9o ¯,C2C 1,1oo 4C4 7,92C 1,o¯2 7,C9o
Campbell 4o,1¯¯ 12,9o2 2,o1o ooo ¯,29¯ 1,¯o2 47o 9,4o7 1,9oo ¯,117
Carbon 1o,ooo ¯,7o1 2,C44 247 1,1oo o¯4 2¯7 4,1Co o94 1,oo¯
Converse 1¯,o¯¯ ¯,o12 1,77o 2¯1 1,CC7 4o7 2Co ¯,o¯1 771 1,429
Crook 7,Co¯ 1,oo9 1,1oC 111 o22 249 121 2,CC¯ 44o oo1
Fremont 4C,12¯ 1C,212 o,oCo o7¯ 2,912 1,¯¯2 o19 1C,42o 2,29o o,447
Laramie 91,7¯o 22,4C1 11,oCo 1,47o o,79C ¯,CC4 1,¯11 22,ooo 4,9o1 1C,o49
Natrona 7o,4oC 1o,C2C 9,¯92 1,1o7 o,o2o 2,4oo 1,C79 1o,o7C 4,C91 7,oC1
Park 2o,2Co o,911 4,942 ¯o9 2,1oo 1,C2C oC2 o,2C9 1,o29 ¯,29o
Sheridan 29,11o o,4oo 4,o4o 427 2,197 1,C2o 4oo o,122 1,79o 2,ooo
Sublette 1C,247 2,42o 1,C¯9 1oC 7oo ¯¯o 1¯9 2,o2o o41 oC7
Sweetwater 4¯,oCo 11,oo9 ¯,o4¯ 7o2 ¯,1oo 1,¯¯2 o14 9,o¯9 2,C¯o ¯,914
Teton 21,294 4,C7o 2,C9o 2oo 1,7C1 71¯ 27o o,1o2 1,C92 1,9C2
Uinta 21,11o o,¯71 1,o74 42C 1,4o1 o¯C 2oo 4,ooo 99o 2,¯44
Totals 480,330 ll5,744 55,598 7,623 35,785 l5,637 6,625 ll7,49l 25,333 52,930
WYOMING
American Lung Association in Wyoming
825 Helena Avenue
Helena, MT 59601-3459
(406) 442-6556
www.lung.org/wyoming
AMERI CAN LUNG ASSOCI ATI ON STATE OF THE AI R 2012 175
HIGH OZONE DAYS 2008–2010 HIGH PARTICLE POLLUTION DAYS 2008–2010
24 Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail
Albany DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Campbell C C C C.C A C C C C.C A INC INC
Carbon 1 C C C.¯ B 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 7 C C 2.¯ D 2 C C C.7 B o.o PASS
Laramie DNC DNC DNC DNC DNC C C C C.C A 4.2 PASS
Natrona DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Park DNC DNC DNC DNC DNC 1 C C C.¯ B INC INC
Sheridan DNC DNC DNC DNC DNC 1 C C C.¯ B o.4 PASS
Sublette 9 4 1 o.7 F 1 C C C.¯ B INC INC
Sweetwater 2 C C C.7 B C C C C.C A o.2 PASS
Teton 1 C C C.¯ B C C C C.C A 4.7 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 Charity Navigator Four Star Charity
and holder of the Better Business Bureau Wise Giving Guide Seal, or to support the work it does,
call 1-800-LUNG-USA (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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