AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 2

Acknowledgments

The American Lung Association State of the Air 2011 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 and wrote the 

text; Nick Sukachevin, who analyzed data; Josephine Ceselski, 

who coordinated field outreach and e-advocacy; Zach Jump, 

MA, and Elizabeth Lancet, MPH, who converted the raw data 

into meaningful tables and comparisons and calculated all the 

population data; Susan Rappaport, MPH, who supervised the 

data analysis; Norman Edelman, MD, who reviewed the science and health discussions; Jean Haldorsen, who supervised 

production and creative for print and online editions; Betty 

Yuan-Cardinal, who supervised the online production; Todd 

Nimirowski, who coordinated online materials; 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 field offices reviewed and commented on the data for 

their states. Hard-working staff 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; Beaconfire 

Consulting, who developed the online presentation; and Cindy 

Wright of CJW Associates, who developed marketing and field 

materials.

Great appreciation goes to the National Association of Clean 

Air Administrators, who along with their Executive Director 

Bill Becker and Amy Royden-Bloom, 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 fight against air pollution. This report should in no way 

be construed as a comment on the work they do. 

A key partner in this work is the U.S. Environmental Protection Agency, which celebrated its 40th anniversary in 2010. The 

professional staff of the Agency has long been dedicated to the 

fight for clean air. 

The American Lung Association assumes sole responsibility 

for the content of the American Lung Association State of the 

Air 2011.

American Lung Association

National Headquarters

1301 Pennsylvania Ave., NW, Suite 800

Washington, DC 20004-1725

Phone: (202) 785-3355

Fax: (202) 452-1805

http//:www.stateoftheair.org

http//:www.lungusa.org

Fighting for Air

Copyright © 2011 by the American Lung Association

American Lung Association is a registered trademark.

State of the Air is a registered trademark.

Designed by Our Designs, Inc., Nashville, TN

Printing and binding by Hard Copy Printing, New York, NY
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 3

Contents

The State of the Air 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Rankings

People at Risk in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Most Polluted Cities in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Most Polluted Counties in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Cleanest Cities in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Cleanest Counties in the U.S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Health Effects of Ozone and Particle Pollution . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

State Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 4
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 5

The State of the Air 2011

The State of the Air 2011 shows that the air quality in 

many places has improved, but that over 154 million 

people—just over one half the nation—still suffer pollution levels that are too often 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 pollution since 1970.

The State of the Air 2011 report looks at levels of ozone and 

particle pollution found in official monitoring sites across the 

United States in 2007, 2008, and 2009. The report uses the 

most current quality-assured nationwide data available for 

these analyses. 

For particle pollution, the report examines fine particulate matter 

(PM2.5) in two different ways: averaged year-round (annual average) and over short-term levels (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. For comparison, the State of 

the Air 2010 report covered data from 2006, 2007 and 2008.1

Ozone Each 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—but people living there are still forced to breathe air 

that reaches dangerous levels.

1 A complete discussion of the sources of data and the methodology is 

included in Appendix: Methodology.

Of the 25 metropolitan areas most polluted by ozone, fifteen 

reported the lowest ozone scores since the State of the Air 

reports began2: Los Angeles, CA; Bakersfield, CA; Fresno, CA; 

Sacramento, CA; Houston, TX; Dallas-Fort Worth, TX; El 

Centro, CA; Washington-Baltimore, DC-MD-VA; New York, 

NY; Knoxville, TN; Phoenix, AZ; Philadelphia, PA; Atlanta, 

GA; Pittsburgh, PA; and Las Vegas, NV. 

Year-round

particle pollution

The State of the Air 2011

finds continued progress in 

cutting year-round particle 

pollution, compared to the 

2010 report. Thanks to reductions in emissions from coal-fired 

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 two cities with the most year-round particle pollution improved over the previous report.3

 Bakersfield, CA, and Hanford, 

CA, each had worse average year-round levels in 2007–2009 

than in 2006–2008. Bakersfield, CA, moved into the most polluted city rank. Improving over the previous report were these 

25 metropolitan areas: Los Angeles, CA; Phoenix, AZ; Visalia, 

CA; Pittsburgh, PA; Fresno, CA; Birmingham, AL; Cincinnati, 

OH; Modesto, CA; Louisville, KY; Cleveland, OH; WeirtonSteubenville, WV-OH; Charleston, WV; Huntington, WV; 

Indianapolis, IN; St. Louis, MO; Detroit, MI; Houston, TX; Hagerstown, MD; New York, NY; Dayton, OH; Lancaster, PA; York, 

PA; Philadelphia, PA; Knoxville, TN; and Parkersburg, WV. 

2 Full names for all these metropolitan areas can be found in the lists 

beginning on page 10. The full metropolitan areas often include multiple 

counties, incorporated cities and counties in adjacent states.

3 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.

State of the Air 2011

shows that 

cleaning up 

air pollution 

produces 

healthier air

across the nation.

Each of the 25

cities with the most ozone 

pollution improved.
THE STATE OF THE AIR 2011 AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 6

Only these eight cities averaged levels higher than the official 

national standard: Bakersfield, CA; Los Angeles, CA; Phoenix, 

AZ; Visalia, CA; Hanford, CA; Fresno, CA; Pittsburgh, PA; and 

Birmingham, AL. Nineteen of these cities actually had 

levels of year-round particle pollution that were lower than the 

official national air quality standard. However, that standard is 

currently under review. The American Lung Association and 

other public health and medical groups have long supported a 

much more protective national air quality standard for particle 

pollution.

Short-term

particle pollution

Unlike with year-round 

particle pollution levels, 

fewer cities with the worst 

short-term levels improved 

in 2007–2009. Only 12 cities had fewer unhealthy days or lower 

daily levels, while 16 of the cities on the list did worse than in 

2006–2008. One city stayed the same.2,4 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. Those days or 

weeks of high levels can be dangerous, even deadly.

Twelve cities improved, having cut the average number of days 

with high particle levels: Pittsburgh, PA; Los Angeles, CA; 

Visalia, CA; Birmingham, AL; Sacramento, CA; Modesto, CA; 

Stockton, CA; Philadelphia, PA; Louisville, KY; Phoenix, AZ; 

San Jose-San Francisco-Oakland, CA; and Wheeling, WV. The 

Chicago metropolitan area had the same average number of 

unhealthy days in 2007–2009 as in 2006–2008. 

The remaining sixteen cities had more days or higher daily levels: Bakersfield, CA (ranked most polluted); Fresno, CA; Salt 

Lake City, UT; Provo, UT; Hanford, CA; Logan, UT; Merced, 

CA; Eugene-Springfield, OR; San Diego, CA; Seattle-Tacoma, 

WA; Fairbanks, AK; Macon, GA; Green Bay, WI; Davenport, 

IA; Portland, OR; and Madison, WI.

4 The usual list of the 25 cities with the most short-term particle pollution 

actually includes 29 cities because of ties in the rankings.

Cleanest cities Honolulu, HI and Santa Fe, NM 

were the only metropolitan areas 

landing on all three of the 

cleanest cities lists during 2007–2009.2 Four cities ranked on 

the cleanest for both ozone and short-term particle pollution: 

Brownsville, TX; Lincoln, NE; Monroe, LA; and Spokane, WA. 

Five other cities were on the cleanest cities lists for both ozone 

and year-round particle pollution: Bismarck, ND; Duluth, 

MN-WI; Fargo, ND; Port S. Lucie-Sebastian-Vero Beach, FL; 

and Rapid City, SD. Eleven cities ranked as the cleanest for 

both measures of particle pollution: Amarillo, TX; Bangor, 

ME; Billings, MT; Burlington, VT; Cape Coral-Fort Myers, FL; 

Cheyenne, WY; Fort Collins-Loveland, CO; Palm BayMelbourne-Titusville, FL; Salinas, CA; Sarasota, FL; and 

Tucson, AZ. 

People at risk Looking at the nation as a whole, 

the American Lung Association 

State of the Air 2011 finds—

■ Roughly half the people (50.3%) in the United States 

live in counties that have unhealthful levels of either 

ozone or particle pollution. 

Almost 154.5 million Americans live in the 366 counties 

where they are exposed to unhealthful levels of air pollution in the form of either ozone or short-term or year-round 

levels of particles. 

■ Nearly half the people in the United States (48.2%) live 

in areas with unhealthful levels of ozone.

Counties that were graded F for ozone levels have a combined population of almost 148.1 million. These people live 

in the 338 counties where the monitored air quality places 

them at risk for decreased lung function, respiratory infection, lung inflammation and aggravation of respiratory 

illness. The actual number who breathe unhealthy levels 

of ozone is likely much larger, since this number does not 

include people who live in adjacent counties in metropolitan 

areas where no monitors exist. 

All but two cities with the 

most year-round particle 

pollution improved over 

the previous report.

Fewer cities with the 

worst short-term levels 

of particle pollution 

improved in 2007-2009.

Honolulu, HI and Santa Fe, 

NM were the only cities 

landing on all three of the 

cleanest cities lists during 

2007-2009.
THE STATE OF THE AIR 2011 AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 7

■ Nearly one in five (19.8%) of people in the United States 

live in an area with unhealthful short-term levels of 

particle pollution.

Nearly 61 million Americans live in 76 counties that experienced too many days with unhealthy spikes in particle 

pollution, a decrease from the last report. Short-term spikes 

in particle pollution can last from hours to several days and 

can increase the risk of heart attacks, strokes and emergency-room visits for asthma and cardiovascular disease, and 

most importantly, can increase the risk of early death.

■ Over 18.5 million people (6%) in the United States live 

in an area with unhealthful year-round levels of particle 

pollution.

These 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 hospitalization for asthma, damage to the lungs and, significantly, 

increase the risk of premature death. 

■ Roughly one in 17 people—more than 18.5 million in 

the United States—live in 10 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 American 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, 

cardiovascular disease, or diabetes. The following list identifies 

the numbers of people in each at-risk group.

■ People with Asthma—Approximately 3.2 million children 

and nearly 9.5 million adults with asthma live in parts of 

the United States with very high levels of ozone. Over 3.8 

million adults and over 1.2 million children with asthma 

live in areas with high levels of short-term particle pollution. Nearly 1.1 million adults and over 339,000 children 

with asthma live in counties with unhealthful levels of yearround particle pollution. 

■ Older and Younger—Nearly 17.4 million adults age 65 and 

over and nearly 37 million children age 18 and under live in 

counties with unhealthful ozone levels. Nearly 7 million seniors and nearly 15.5 million children live in counties with 

unhealthful short-term levels of particle pollution. Over 2 

million seniors and nearly 5 million children live in counties 

with unhealthful levels of year-round particle pollution. 

■ Chronic Bronchitis and Emphysema—Nearly 4.8 million 

people with chronic bronchitis and nearly 2.3 million with 

emphysema live in counties with unhealthful ozone levels. 

Over 1.9 million people with chronic bronchitis and over 

917,000 with emphysema live in counties with unhealthful 

levels of short-term particle pollution. Nearly 573,000 million people with chronic bronchitis and more than 268,000 

with emphysema live in counties with unhealthful yearround levels of particle pollution. 

■ Cardiovascular Disease—Over 15.9 million people with 

cardiovascular diseases live in counties with unhealthful 

levels of short-term particle pollution; nearly 4.7 million live 

in counties with unhealthful levels of year-round particle 

pollution. Cardiovascular diseases include coronary heart 

disease, heart attacks, strokes, hypertension and angina 

pectoris. 

■ Diabetes—Over 3.9 million people with diabetes live in 

counties with unhealthful levels of short-term particle pollution; over 1.2 million 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.

■ Poverty—Over 20 million people with incomes meeting the 

federal poverty definition live in counties with unhealthful 

levels of ozone. Over 9.3 million people in poverty live in 

counties with unhealthful levels of short-term particle pollution, and nearly 3 million live in counties with unhealthful 

year-round levels of particle pollution. Evidence shows that 

18.5 million

people in the US live 

in counties where the 

outdoor air failed all three 

tests.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 8

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. 

Protect the Clean Air Act. The continued improvement 

shown in the State of the Air report is possible because of the 

Clean Air Act, the nation’s landmark public health law that the 

U.S. Congress passed 40 years ago. The Act requires that the 

U.S. Environmental Protection Agency (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 

40 years’ progress. We must keep that law strong to continue to 

protect public health.

Clean up dirty power plants. Over 440 coal-fired power 

plants in 46 states are among the largest contributors to 

particulate pollution, ozone, mercury, and global warming. 

Their pollution blows across state lines into states thousands of 

miles away. They produce 84 known hazardous air pollutants, 

including arsenic, mercury, dioxins, formaldehyde and hydrogen chloride. EPA has proposed steps that will cut the emissions that create ozone and particle pollution and, for the first 

time, set national limits on the toxic pollutants they can emit. 

EPA needs to issue the final rules that will start those cleanup 

measures. Congress needs to support EPA’s actions to clean 

these plants up. 

Clean up the existing fleet of dirty diesel vehicles and 

heavy equipment. Rules EPA put in effect over the past 

several years mean that new diesel vehicles and equipment 

must be much cleaner. Still, the vast majority of diesel trucks, 

buses and heavy equipment (such as bulldozers) will likely be 

in use for thousands more miles, spewing dangerous diesel 

exhaust into communities and neighborhoods. The good news 

is that affordable technology exists to cut emissions by 90 

percent. Congress needs to fund EPA’s diesel cleanup (“retrofit”) program. Congress should also require that clean diesel 

equipment should be used in federally-funded construction 

programs. 

Strengthen the ozone standards. The Lung Association urges 

the EPA to adopt a much tighter, more protective national air 

quality standard for ozone, set at 60 parts per billion. The EPA 

is currently considering strengthening the standard adopted in 

March 2008, which they now believe was not strong enough to 

protect health against the widespread harm from ozone smog. 

The 2008 decision set 75 ppb as the standard, despite the unanimous recommendations of EPA’s official science advisors that 

such a level would allow too much ozone to meet the requirements of the Clean Air Act. The American Lung Association 

challenged the 2008 decision in court, along with several states, 

public health and environmental groups. In January 2010, the 

EPA proposed a range for the new standard that met the earlier 

recommendations of the expert panel and the nation’s leading 

public health organizations. EPA will announce the decision 

on the new standard the summer of 2011. 

Strengthen the particle pollution standards. In 2006, EPA 

failed to strengthen the annual standard for fine particles, despite the near unanimous recommendation by their official science advisors. EPA lowered the 24-hour standard, though not 

to the level the Lung Association recommended. EPA can save 

thousands of lives each year by dramatically strengthening the 

annual average and the 24-hour standards. In 2009, the Lung 

Association challenged that 2006 standard in the U.S. Circuit 

Court and won. EPA is expected to issue a new proposal for 

the particle pollution standards in 2011.

Clean up harmful emissions from tailpipes. EPA needs to 

set new pollution standards for cars, light trucks, SUVs and 

gasoline fuels to reduce nitrogen oxides, hydrocarbons, and 

particle pollution emissions. Science shows that people who 

THE STATE OF THE AIR 2011

The strong, continued

improvement

shown in this report is 

possible because of the

Clean Air Act. 
THE STATE OF THE AIR 2011 AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 9

live or work near highways or busy roads bear a disproportionate health burden from air pollution. Cleaner cars will help 

reduce this impact for all, but especially those who live closest 

to the traffic.

What you

can do

Individual citizens can do a great 

deal to help reduce air pollution 

outdoors as well. Simple but 

effective ways include— 

■ Send a message to EPA. Send a message to tell EPA to 

clean up hazardous air pollutants from coal-fired power 

plants. Tell EPA you support stronger standards for ozone 

and particle pollution to limit how much of those pollutants 

can be in the air.

■ Tell the President and Congress that you support the 

Clean Air Act and that they should, too. Send a message

to tell them to keep the safeguards in place in this public 

health law. 

■ Drive less. Combine trips, walk, bike, carpool or vanpool, 

and use buses, subways or other alternatives to driving. Vehicle emissions are a major source of air pollution. Support 

community plans that provide ways to get around that don’t 

require a car, such as more sidewalks, bike trails and transit 

systems.

■ Don’t burn wood or trash. Burning firewood and trash 

are among the largest sources of particles in many parts of 

the country. If you must use a fireplace 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 efforts in your community to ban outdoor burning 

of construction and yard wastes. Avoid the use of outdoor 

hydronic heaters, also called outdoor wood boilers, which 

are frequently much more polluting than woodstoves.

■ Make sure your local school system requires clean 

school buses, which includes replacing or retrofitting old 

school buses with filters and other equipment to reduce 

emissions. Make sure your local schools don’t idle their 

buses, a step that can immediately reduce emissions.

■ Get involved. Participate in your community’s review of 

its air pollution plans and support state and local efforts to 

clean up air pollution. To find your local air pollution control agency, go to www.4cleanair.org.

■ Use less electricity. Turn out the lights and use energyefficient appliances. Generating electricity is one of the biggest sources of pollution, particularly in the eastern United 

States.

Tell the President and 

Congress to support the 

Clean Air Act.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 10

People at Risk from Short-term Particle Pollution (24-Hour PM2.5)

Chronic Diseases Age Groups

In Counties where Adult Pediatric Chronic CV 65 and Total Number of

the Grades were: Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty Under 18 Over Population Counties

Grade A (0.0) 1,971,559 631,469 994,663 498,303 8,390,082 2,056,404 4,212,190 7,189,834 3,977,708 29,964,695 139

Grade B (0.3-0.9) 3,072,492 983,227 1,505,369 734,927 12,557,984 3,027,179 5,907,902 11,417,242 5,629,468 46,216,077 182 

Grade C (1.0-2.0) 3,267,080 1,064,195 1,656,331 818,511 13,887,267 3,330,980 6,423,414 11,701,176 6,435,736 49,887,758 133

Grade D (2.1-3.2) 1,360,920 467,562 720,134 343,264 5,944,250 1,486,651 3,193,153 5,355,664 2,578,742 22,235,806 46

Grade F (3.3+) 3,814,340 1,211,124 1,930,376 917,820 15,912,763 3,944,139 9,339,268 15,491,071 6,950,809 60,921,655 76

National Population in

Counties with PM2.5 Monitors 13,981,412 4,520,949 7,077,034 3,450,294 58,986,094 14,425,846 30,307,311 53,090,799 26,707,334 217,329,744 637

People at Risk from Year-Round Particle Pollution (Annual PM2.5)

Chronic Diseases Age Groups

In Counties where Adult Pediatric Chronic CV 65 and Total Number of

the Grades were: Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty Under 18 Over Population Counties

Pass 11,782,176 3,804,274 5,908,715 2,884,062 49,275,596 11,974,999 24,713,502 43,790,193 22,310,786 180,765,573 516

Fail 1,084,656 339,493 572,689 268,425 4,691,047 1,220,449 2,968,257 4,916,821 2,017,113 18,516,713 10

National Population in

Counties with PM2.5 Monitors 13,978,245 4,520,382 7,075,664 3,449,614 58,974,595 14,422,959 30,301,175 53,083,823 26,701,815 217,291,013 636

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 18 Over Population Counties

Grade A (0.0) 703,128 207,583 381,246 191,369 1,483,375 2,721,182 1,536,254 11,450,818 81

Grade B (0.3-0.9) 952,592 295,991 515,494 265,139 2,186,428 3,659,910 2,196,893 15,336,801 76

Grade C (1.0-2.0) 1,448,582 445,265 724,178 364,081 2,977,882 5,045,020 2,922,055 21,604,100 142

Grade D (2.1-3.2) 1,407,537 442,528 715,047 354,495 2,906,192 4,986,790 2,816,311 21,477,147 64

Grade F (3.3+) 9,498,907 3,171,100 4,769,422 2,296,790 20,025,940 36,939,467 17,393,446 148,069,983 339

National Population in

Counties with Ozone Monitors 14,445,482 4,702,553 7,333,231 3,585,499 30,504,009 54,999,066 27,757,857 224,798,559 755

Note: The State of the Air 2011 covers the period 2007-2009. The Appendix provides a full discussion of the methodology. 
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 11

People at Risk In 25 U.S. Cities Most Polluted by Short-term Particle Pollution (24-hour PM2.5)

2011 Total 65 and Pediatric Adult Chronic CV

Rank1 Metropolitan Statistical Areas Population2 Under 183 Over3 Asthma.

4,8 Asthma5,8 Bronchitis6,8 Emphysema7,8 Disease9 Diabetes10 Poverty11

1 Bakersfield-Delano, CA 807,407 250,561 72,666 16,621 43,747 23,012 10,309 184,959 48,102 170,614

2 Fresno-Madera, CA 1,063,899 319,551 104,947 21,198 58,379 30,977 14,213 251,405 65,433 221,348

3 Pittsburgh-New Castle, PA 2,445,117 495,068 422,943 51,002 174,497 89,288 48,733 783,055 183,922 290,876

4 Los Angeles-Long Beach-Riverside, CA 17,820,893 4,682,410 1,902,902 310,610 1,030,481 552,457 257,170 4,512,759 1,179,719 2,579,016

5 Salt Lake City-Ogden-Clearfield, UT 1,743,364 528,004 154,359 38,413 96,430 49,678 21,913 396,577 75,234 172,338

6 Provo-Orem, UT 555,551 193,164 36,244 14,053 28,686 13,744 5,338 104,030 18,731 77,177

7 Visalia-Porterville, CA 429,668 141,279 40,393 9,372 22,622 11,998 5,494 97,299 25,326 97,542

8 Birmingham-Hoover-Cullman, AL 1,212,848 291,846 160,168 25,030 70,273 40,311 20,201 340,136 107,132 177,638

9 Hanford-Corcoran, CA 148,764 41,081 11,466 2,725 8,468 4,221 1,721 32,615 8,286 24,546

9 Logan, UT-ID 127,945 39,861 10,455 2,783 7,009 3,438 1,431 26,746 5,015 20,081

9 Sacramento—Arden-Arcade—Yuba City, CA-NV 2,436,109 607,251 300,098 40,307 143,692 79,445 39,034 664,653 175,011 320,925

12 Modesto, CA 510,385 149,225 53,538 9,899 28,322 15,287 7,192 125,454 32,878 85,583

13 Merced, CA 245,321 78,461 24,167 5,205 13,076 6,948 3,210 56,540 14,704 59,349

14 Eugene-Springfield, OR 351,109 70,025 50,780 3,931 31,083 12,379 6,290 105,086 23,292 58,935

15 San Diego-Carlsbad-San Marcos, CA 3,053,793 739,625 347,859 49,063 181,385 97,908 46,204 804,440 210,648 372,782

16 Stockton, CA 674,860 202,135 68,180 13,409 37,098 19,982 9,330 163,489 42,864 103,777

17 Chicago-Naperville-Michigan City, IL-IN-WI 9,804,845 2,491,070 1,104,442 231,348 660,705 312,722 148,887 2,580,626 586,411 1,231,739

18 Seattle-Tacoma-Olympia, WA 4,158,293 944,478 468,853 64,582 281,862 137,891 65,277 1,135,710 241,202 421,614

19 Fairbanks, AK 98,660 25,640 6,170 1,775 6,482 2,900 1,146 22,185 3,823 7,420

20 Philadelphia-Camden-Vineland, PA-NJ-DE-MD 6,533,122 1,535,672 869,965 158,452 438,946 219,155 109,986 1,850,540 428,512 760,156

21 Macon-Warner Robins-Fort Valley, GA 394,538 102,473 47,839 10,108 20,164 12,685 6,229 106,099 29,946 67,875

22 Louisville-Jefferson County-Elizabethtown-Scottsburg, KY-IN 1,395,634 335,150 177,354 31,918 105,477 46,544 23,133 391,515 118,443 193,601

23 Green Bay, WI 304,783 72,441 37,275 5,016 22,809 10,116 4,951 84,521 18,546 31,142

24 Davenport-Moline-Rock Island, IA-IL 379,066 89,246 55,929 6,420 23,219 12,981 6,779 111,579 23,842 42,634

24 Madison-Baraboo, WI 628,947 134,274 68,877 9,298 49,319 20,807 9,598 169,365 36,341 74,105

24 Phoenix-Mesa-Glendale, AZ 4,364,094 1,187,246 496,355 96,895 347,250 133,817 63,556 1,101,803 255,571 643,772

24 Portland-Vancouver-Hillsboro, OR-WA 2,241,841 533,526 244,548 31,367 183,150 72,947 34,260 598,721 132,377 265,996

24 San Jose-San Francisco-Oakland, CA 7,427,757 1,679,302 898,351 111,397 450,647 247,427 119,351 2,053,445 541,562 721,023

24 Wheeling, WV-OH 144,637 28,817 25,881 2,564 10,687 5,359 2,965 47,308 13,923 22,162

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.

3. Those 18 and under and 65 and over are vulnerable to PM2.5 and are, therefore, included. They should not be used as population denominators for disease estimates.

4. Pediatric asthma estimates are for those under 18 years of age and represent the estimated number of people who had asthma in 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

5. Adult asthma estimates are for those 18 years and older and represent the estimated number of people who had asthma during 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

6. Chronic bronchitis estimates are for adults 18 and over who had been diagnosed in 2009, based on national rates (NHIS) applied to population estimates (U.S. Census).

7. Emphysema estimates are for adults 18 and over who have been diagnosed within their lifetime, based on national rates (NHIS) applied to population estimates (U.S. Census).

8. 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).

10.Diabetes estimates are for adults 18 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.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 12

People at Risk In 25 U.S. Cities Most Polluted by Year-Round Particle Pollution (Annual PM2.5)

2011 Total 65 and Pediatric Adult Chronic CV

Rank1 Metropolitan Statistical Areas Population2 Under 183 Over3 Asthma.

4,8 Asthma5,8 Bronchitis6,8 Emphysema7,8 Disease9 Diabetes10 Poverty11

1 Bakersfield-Delano, CA 807,407 250,561 72,666 16,621 43,747 23,012 10,309 184,959 48,102 170,614

2 Los Angeles-Long Beach-Riverside, CA 17,820,893 4,682,410 1,902,902 310,610 1,030,481 552,457 257,170 4,512,759 1,179,719 2,579,016

2 Phoenix-Mesa-Glendale, AZ 4,364,094 1,187,246 496,355 96,895 347,250 133,817 63,556 1,101,803 255,571 643,772

2 Visalia-Porterville, CA 429,668 141,279 40,393 9,372 22,622 11,998 5,494 97,299 25,326 97,542

5 Hanford-Corcoran, CA 148,764 41,081 11,466 2,725 8,468 4,221 1,721 32,615 8,286 24,546

6 Fresno-Madera, CA 1,063,899 319,551 104,947 21,198 58,379 30,977 14,213 251,405 65,433 221,348

7 Pittsburgh-New Castle, PA 2,445,117 495,068 422,943 51,002 174,497 89,288 48,733 783,055 183,922 290,876

8 Birmingham-Hoover-Cullman, AL 1,212,848 291,846 160,168 25,030 70,273 40,311 20,201 340,136 107,132 177,638

9 Cincinnati-Middletown-Wilmington, OH-KY-IN 2,214,954 543,893 270,380 51,168 166,495 72,691 35,624 607,603 168,199 272,692

10 Louisville-Jefferson County-Elizabethtown-Scottsburg, KY-IN 1,395,634 335,150 177,354 31,918 105,477 46,544 23,133 391,515 118,443 193,601

10 Modesto, CA 510,385 149,225 53,538 9,899 28,322 15,287 7,192 125,454 32,878 85,583

12 Charleston, WV 304,214 66,646 47,487 5,652 20,945 10,797 5,739 93,597 29,594 46,041

12 Cleveland-Akron-Elyria, OH 2,891,988 667,656 424,508 62,599 218,655 100,087 52,255 860,578 231,353 433,633

12 Steubenville-Weirton, OH-WV 120,929 24,249 22,891 2,179 8,953 4,536 2,568 40,483 11,745 18,861

15 Huntington-Ashland, WV-KY-OH 285,624 60,932 46,146 5,479 21,189 10,055 5,339 87,025 26,468 55,531

15 Indianapolis-Anderson-Columbus, IN 2,064,870 529,363 238,784 51,705 139,825 66,093 31,843 548,249 139,402 276,696

17 Detroit-Warren-Flint, MI 5,327,764 1,280,345 673,872 104,036 404,526 178,165 88,632 1,499,596 378,182 851,246

17 Houston-Baytown-Huntsville, TX 5,968,586 1,693,708 507,966 138,409 275,407 177,262 78,010 1,415,731 385,690 897,732

17 St. Louis-St. Charles-Farmington, MO-IL 2,916,789 696,764 383,974 69,317 208,250 97,816 49,155 826,708 178,048 360,713

20 Hagerstown-Martinsburg, MD-WV 266,149 62,604 35,621 6,461 18,296 8,917 4,479 75,308 21,340 30,121

21 New York-Newark-Bridgeport, NY-NJ-CT-PA 22,232,494 5,171,357 2,905,795 513,309 1,559,643 744,517 370,377 6,262,030 1,456,452 2,721,910

22 Dayton-Springfield-Greenville, OH 1,066,261 244,969 160,192 22,968 80,775 36,765 19,252 316,371 85,080 150,147

22 Lancaster, PA 507,766 125,939 75,950 12,974 34,593 17,080 8,988 147,264 34,405 46,401

24 Knoxville-Sevierville-La Follette, TN 1,053,627 231,414 158,809 19,847 66,813 36,686 19,121 315,000 87,170 162,410

24 Parkersburg-Marietta, WV-OH 160,905 34,240 27,442 3,018 11,589 5,818 3,179 51,054 15,220 24,379

24 Philadelphia-Camden-Vineland, PA-NJ-DE-MD 6,533,122 1,535,672 869,965 158,452 438,946 219,155 109,986 1,850,540 428,512 760,156

24 York-Hanover-Gettysburg, PA 531,260 122,145 75,887 12,583 37,060 18,316 9,464 156,758 36,557 44,431

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.

3. Those 18 and under and 65 and over are vulnerable to PM2.5 and are, therefore, included. They should not be used as population denominators for disease estimates.

4. Pediatric asthma estimates are for those under 18 years of age and represent the estimated number of people who had asthma in 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

5. Adult asthma estimates are for those 18 years and older and represent the estimated number of people who had asthma during 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

6. Chronic bronchitis estimates are for adults 18 and over who had been diagnosed in 2009, based on national rates (NHIS) applied to population estimates (U.S. Census).

7. Emphysema estimates are for adults 18 and over who have been diagnosed within their lifetime, based on national rates (NHIS) applied to population estimates (U.S. Census).

8. 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).

10.Diabetes estimates are for adults 18 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.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 13

People at Risk In 25 Most Ozone-Polluted Cities

2011 Total 65 and Pediatric Adult Chronic

Rank1 Metropolitan Statistical Areas Population2 Under 183 Over3 Asthma.

4,8 Asthma5,8 Bronchitis6,8 Emphysema7,8 Poverty9

1 Los Angeles-Long Beach-Riverside, CA 17,820,893 4,682,410 1,902,902 310,610 1,030,481 552,457 257,170 2,579,016

2 Bakersfield-Delano, CA 807,407 250,561 72,666 16,621 43,747 23,012 10,309 170,614

3 Visalia-Porterville, CA 429,668 141,279 40,393 9,372 22,622 11,998 5,494 97,542

4 Fresno-Madera, CA 1,063,899 319,551 104,947 21,198 58,379 30,977 14,213 221,348

5 Sacramento—Arden-Arcade—Yuba City, CA-NV 2,436,109 607,251 300,098 40,307 143,692 79,445 39,034 320,925

6 Hanford-Corcoran, CA 148,764 41,081 11,466 2,725 8,468 4,221 1,721 24,546

7 San Diego-Carlsbad-San Marcos, CA 3,053,793 739,625 347,859 49,063 181,385 97,908 46,204 372,782

8 Houston-Baytown-Huntsville, TX 5,968,586 1,693,708 507,966 138,409 275,407 177,262 78,010 897,732

9 Merced, CA 245,321 78,461 24,167 5,205 13,076 6,948 3,210 59,349

10 Charlotte-Gastonia-Salisbury, NC-SC 2,389,763 615,854 263,236 52,818 139,028 75,668 35,810 332,654

11 San Luis Obispo-Paso Robles, CA 266,971 49,825 39,636 3,305 16,962 9,572 4,880 33,198

12 Dallas-Fort Worth, TX 6,772,276 1,884,196 607,900 153,975 314,809 202,280 89,746 950,677

13 El Centro, CA 166,874 51,337 17,578 3,405 9,042 4,822 2,259 35,368

14 Modesto, CA 510,385 149,225 53,538 9,899 28,322 15,287 7,192 85,583

14 Washington-Baltimore-Northern Virginia, DC-MD-VA-WV 8,394,115 2,017,092 913,919 217,649 558,279 272,776 128,313 700,129

16 Cincinnati-Middletown-Wilmington, OH-KY-IN 2,214,954 543,893 270,380 51,168 166,495 72,691 35,624 272,692

17 New York-Newark-Bridgeport, NY-NJ-CT-PA 22,232,494 5,171,357 2,905,795 513,309 1,559,643 744,517 370,377 2,721,910

18 Knoxville-Sevierville-La Follette, TN 1,053,627 231,414 158,809 19,847 66,813 36,686 19,121 162,410

19 Phoenix-Mesa-Glendale, AZ 4,364,094 1,187,246 496,355 96,895 347,250 133,817 63,556 643,772

20 Philadelphia-Camden-Vineland, PA-NJ-DE-MD 6,533,122 1,535,672 869,965 158,452 438,946 219,155 109,986 760,156

21 Birmingham-Hoover-Cullman, AL 1,212,848 291,846 160,168 25,030 70,273 40,311 20,201 177,638

22 Chico, CA 220,577 46,201 33,001 3,065 13,594 7,643 3,920 39,717

23 Atlanta-Sandy Springs-Gainesville, GA-AL 5,831,778 1,573,677 513,199 155,122 296,754 177,090 78,367 802,336

24 Pittsburgh-New Castle, PA 2,445,117 495,068 422,943 51,002 174,497 89,288 48,733 290,876

25 Las Vegas-Paradise-Pahrump, NV 1,947,068 510,425 214,427 35,278 127,748 60,786 28,636 240,066

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.

3. Those 18 and under and 65 and over are vulnerable to PM2.5 and are, therefore, included. They should not be used as population denominators for disease estimates.

4. Pediatric asthma estimates are for those under 18 years of age and represent the estimated number of people who had asthma in 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

5. Adult asthma estimates are for those 18 years and older and represent the estimated number of people who had asthma during 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

6. Chronic bronchitis estimates are for adults 18 and over who had been diagnosed in 2009, based on national rates (NHIS) applied to population estimates (U.S. Census).

7. Emphysema estimates are for adults 18 and over who have been diagnosed within their lifetime, based on national rates (NHIS) applied to population estimates (U.S. Census).

8. 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.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 14

People at Risk in 25 Counties Most Polluted by Short-term Particle Pollution (24-hour PM2.5) High PM2.5 Days in 

Unhealthy Ranges, 

At-Risk Groups 2007–2009

2011 Total 65 and Pediatric Adult Chronic CV Weighted

Rank1 County ST Population2 Under 183 Over3 Asthma4,8 Asthma5,8 Bronchitis6,8 Emphysema7,8 Disease9 Diabetes10 Poverty11 Avg.12 Grade13

1 Kern CA 807,407 250,561 72,666 16,621 43,747 23,012 10,309 184,959 48,102 170,614 60.5 F

2 Fresno CA 915,267 275,906 89,528 18,302 50,145 26,546 12,137 215,107 55,930 192,638 53.7 F

3 Allegheny PA 1,218,494 242,202 204,401 24,952 88,010 44,083 23,650 383,427 89,816 153,937 32.5 F

4 Riverside CA 2,125,440 615,621 245,456 40,837 118,086 64,267 31,066 533,297 139,608 290,003 24.5 F

5 Salt Lake UT 1,034,989 301,147 89,962 21,909 58,207 29,771 12,941 236,201 44,562 108,994 22.5 F

6 Los Angeles CA 9,848,011 2,500,804 1,042,989 165,892 576,310 306,992 141,524 2,496,934 651,091 1,552,196 20.0 F

7 San Bernardino CA 2,017,673 601,101 172,905 39,874 111,493 58,546 25,840 467,948 122,008 335,321 17.7 F

8 Utah UT 545,307 189,454 35,179 13,783 28,166 13,467 5,204 101,731 18,281 75,993 14.8 F

9 Tulare CA 429,668 141,279 40,393 9,372 22,622 11,998 5,494 97,299 25,326 97,542 14.7 F

10 Jefferson AL 665,027 158,005 90,242 13,551 38,702 22,191 11,187 187,691 59,012 107,081 14.0 F

11 Sacramento CA 1,400,949 361,552 157,628 23,984 81,493 44,281 21,049 365,071 95,904 210,786 13.2 F

11 Kings CA 148,764 41,081 11,466 2,725 8,468 4,221 1,721 32,615 8,286 24,546 13.2 F

11 Cache UT 115,269 35,491 8,905 2,582 6,320 3,075 1,246 23,661 4,328 18,744 13.2 F

14 Stanislaus CA 510,385 149,225 53,538 9,899 28,322 15,287 7,192 125,454 32,878 85,583 12.8 F

15 Merced CA 245,321 78,461 24,167 5,205 13,076 6,948 3,210 56,540 14,704 59,349 11.5 F

16 Orange CA 3,026,786 755,550 346,897 50,120 178,032 96,766 46,079 798,336 209,664 318,173 11.0 F

16 Lane OR 351,109 70,025 50,780 3,931 31,083 12,379 6,290 105,086 23,292 58,935 11.0 F

18 San Diego CA 3,053,793 739,625 347,859 49,063 181,385 97,908 46,204 804,440 210,648 372,782 9.2 F

19 San Joaquin CA 674,860 202,135 68,180 13,409 37,098 19,982 9,330 163,489 42,864 103,777 8.8 F

19 Plumas CA 20,122 3,615 4,290 240 1,281 814 483 7,441 2,032 2,453 8.8 F

21 Cook IL 5,287,037 1,283,145 621,214 119,167 360,936 169,759 80,867 1,400,158 314,356 828,626 8.7 F

22 Snohomish WA 694,571 171,462 68,364 11,724 45,931 22,398 10,328 182,585 38,690 66,458 8.5 F

23 Fairbanks North 

 Star Borough AK 98,660 25,640 6,170 1,775 6,482 2,900 1,146 22,185 3,823 7,420 8.3 F

24 Muscatine IA 42,934 11,301 5,457 538 2,133 1,406 710 11,916 2,352 5,074 7.2 F

25 Philadelphia PA 1,547,297 362,879 192,683 37,384 110,439 50,004 24,037 413,743 95,348 366,125 7.0 F

25 Sutter CA 92,614 25,610 11,969 1,699 5,231 2,910 1,462 24,562 6,468 13,511 7.0 F

Notes:

1. Counties are ranked by weighted average. See note 12 below.

2. Total Population represents the at-risk populations in counties with PM2.5 monitors.

3. Those 18 and under and 65 and over are vulnerable to PM2.5 and are, therefore, included. They should not be used as 

population denominators for disease estimates.

4. Pediatric asthma estimates are for those under 18 years of age and represent the estimated number of people who had 

asthma in 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

5. Adult asthma estimates are for those 18 years and older and represent the estimated number of people who had 

asthma during 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

6. Chronic bronchitis estimates are for adults 18 and over who had been diagnosed in 2009, based on national rates 

(NHIS) applied to population estimates (U.S. Census).

7. Emphysema estimates are for adults 18 and over who have been diagnosed within their lifetime, based on national 

rates (NHIS) applied to population estimates (U.S. Census).

8. 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).

10.Diabetes estimates are for adults 18 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 (2007-2009), multiplying the total in each range by the assigned standard weights (i.e., 1 for 

orange, 1.5 for red, 2.0 for purple, 2.5 for maroon), and calculating the average.

13.Grade is assigned by weighted average as follows: A=0.0, B=0.3-0.9, C=1.0-2.0, D=2.1-3.2, F=3.3+.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 15

People at Risk in 25 Counties Most Polluted by Year-round Particle Pollution (Annual PM2.5) 

PM2.5 Annual, 

At-Risk Groups 2007–2009

2011 Total 65 and Pediatric Adult Chronic CV Design

Rank1 County ST Population2 Under 183 Over3 Asthma4,8 Asthma5,8 Bronchitis6,8 Emphysema7,8 Disease9 Diabetes10 Poverty11 Value12 Grade13

1 Kern CA 807,407 250,561 72,666 16,621 43,747 23,012 10,309 184,959 48,102 170,614 22.6 FAIL

2 Pinal AZ 340,962 90,261 47,067 7,366 27,072 10,833 5,497 91,770 21,269 44,379 18.8 FAIL

2 Riverside CA 2,125,440 615,621 245,456 40,837 118,086 64,267 31,066 533,297 139,608 290,003 18.8 FAIL

2 Tulare CA 429,668 141,279 40,393 9,372 22,622 11,998 5,494 97,299 25,326 97,542 18.8 FAIL

5 Kings CA 148,764 41,081 11,466 2,725 8,468 4,221 1,721 32,615 8,286 24,546 17.3 FAIL

6 Fresno CA 915,267 275,906 89,528 18,302 50,145 26,546 12,137 215,107 55,930 192,638 17.1 FAIL

7 Allegheny PA 1,218,494 242,202 204,401 24,952 88,010 44,083 23,650 383,427 89,816 153,937 17.0 FAIL

8 San Bernardino CA 2,017,673 601,101 172,905 39,874 111,493 58,546 25,840 467,948 122,008 335,321 16.2 FAIL

9 Los Angeles CA 9,848,011 2,500,804 1,042,989 165,892 576,310 306,992 141,524 2,496,934 651,091 1,552,196 15.8 FAIL

10 Jefferson AL 665,027 158,005 90,242 13,551 38,702 22,191 11,187 187,691 59,012 107,081 15.1 FAIL

11 Hamilton OH 855,062 200,406 115,705 18,790 64,933 28,687 14,447 242,554 65,213 126,872 15.0 PASS

12 Stanislaus CA 510,385 149,225 53,538 9,899 28,322 15,287 7,192 125,454 32,878 85,583 14.7 PASS

12 Clark IN 108,634 25,544 14,060 2,495 7,544 3,636 1,809 30,586 7,852 12,743 14.7 PASS

14 Cuyahoga OH 1,275,709 292,883 194,879 27,461 96,471 44,247 23,347 382,121 102,760 235,014 14.4 PASS

14 Brooke WV 23,509 4,577 4,557 388 1,659 885 503 7,912 2,504 3,075 14.4 PASS

14 Kanawha WV 191,663 40,727 31,882 3,454 13,286 6,903 3,738 60,336 19,080 27,060 14.4 PASS

17 Marion IN 890,879 227,659 96,665 22,236 60,465 27,928 13,035 228,393 57,284 171,860 14.3 PASS

17 Cabell WV 95,214 19,062 15,496 1,617 6,717 3,341 1,750 28,712 9,053 19,182 14.3 PASS

19 Jefferson OH 67,691 13,678 12,743 1,282 5,213 2,530 1,430 22,561 6,070 11,524 14.2 PASS

19 Beaver PA 171,673 34,909 31,392 3,596 12,106 6,388 3,578 56,723 13,375 19,285 14.2 PASS

21 Madison IL 268,457 61,590 38,074 5,720 18,600 9,147 4,681 77,902 17,531 34,532 14.1 PASS

21 Wayne MI 1,925,848 487,257 234,767 39,593 143,904 62,834 30,943 526,404 132,430 458,811 14.1 PASS

21 Harris TX 4,070,989 1,174,860 328,354 96,009 186,211 118,470 51,005 937,343 254,761 686,928 14.1 PASS

24 Butler OH 363,184 89,746 41,603 8,415 27,375 11,732 5,610 97,011 26,067 46,350 14.0 PASS

24 Berkeley WV 103,854 25,871 11,828 2,194 6,925 3,363 1,613 27,848 8,781 10,866 14.0 PASS

Notes:

1. Counties are ranked by Design Value. See note 12 below.

2. Total Population represents the at-risk populations in counties with PM2.5 monitors.

3. Those 18 and under and 65 and over are vulnerable to PM2.5 and are, therefore, included. They should not be used as 

population denominators for disease estimates.

4. Pediatric asthma estimates are for those under 18 years of age and represent the estimated number of people who had 

asthma in 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

5. Adult asthma estimates are for those 18 years and older and represent the estimated number of people who had 

asthma during 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

6. Chronic bronchitis estimates are for adults 18 and over who had been diagnosed in 2009, based on national rates 

(NHIS) applied to population estimates (U.S. Census).

7. Emphysema estimates are for adults 18 and over who have been diagnosed within their lifetime, based on national 

rates (NHIS) applied to population estimates (U.S. Census).

8. 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).

10.Diabetes estimates are for adults 18 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 meets the standard. The source for the Design 

Values is EPA, communication from the Office of Air Quality Planning & Standards, Mark Schmidt, February 15, 

2011.

13.Grades are based on EPA’s determination of meeting or failure to meet the NAAQS for annual PM2.5 levels during 2007-

2009. Counties meeting the NAAQS received grades of Pass; counties not meeting the NAAQS received grades of 

Fail.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 16

People at Risk in 25 Most Ozone-Polluted Counties

High Ozone Days in 

Unhealthy Ranges, 

At-Risk Groups 2007–2009

2011 Total 65 and Pediatric Adult Chronic Weighted

Rank1 County ST Population2 Under 183 Over3 Asthma4,8 Asthma5,8 Bronchitis6,8 Emphysema7,8 Poverty9 Avg.10 Grade11

1 San Bernardino CA 2,017,673 601,101 172,905 39,874 111,493 58,546 25,840 335,321 136.8 F

2 Riverside CA 2,125,440 615,621 245,456 40,837 118,086 64,267 31,066 290,003 126.2 F

3 Kern CA 807,407 250,561 72,666 16,621 43,747 23,012 10,309 170,614 102.8 F

4 Tulare CA 429,668 141,279 40,393 9,372 22,622 11,998 5,494 97,542 101.3 F

5 Los Angeles CA 9,848,011 2,500,804 1,042,989 165,892 576,310 306,992 141,524 1,552,196 91.5 F

6 Fresno CA 915,267 275,906 89,528 18,302 50,145 26,546 12,137 192,638 58.8 F

7 Sacramento CA 1,400,949 361,552 157,628 23,984 81,493 44,281 21,049 210,786 42.3 F

8 Kings CA 148,764 41,081 11,466 2,725 8,468 4,221 1,721 24,546 36.8 F

9 El Dorado CA 178,447 41,818 21,717 2,774 10,768 6,281 3,177 13,492 35.0 F

10 Nevada CA 97,751 18,601 18,170 1,234 6,170 3,810 2,163 9,819 30.5 F

11 San Diego CA 3,053,793 739,625 347,859 49,063 181,385 97,908 46,204 372,782 29.5 F

12 Harris TX 4,070,989 1,174,860 328,354 96,009 186,211 118,470 51,005 686,928 27.0 F

13 Ventura CA 802,983 209,334 94,655 13,886 46,559 25,886 12,661 83,323 26.0 F

14 Mariposa CA 17,792 3,187 3,496 211 1,135 700 401 2,364 24.7 F

15 Placer CA 348,552 83,608 54,762 5,546 20,640 12,020 6,442 25,053 24.2 F

16 Merced CA 245,321 78,461 24,167 5,205 13,076 6,948 3,210 59,349 23.8 F

17 Rowan NC 140,798 33,135 20,938 2,842 8,364 4,817 2,519 22,778 23.7 F

18 San Luis Obispo CA 266,971 49,825 39,636 3,305 16,962 9,572 4,880 33,198 23.3 F

19 Tarrant TX 1,789,900 507,390 155,996 41,464 82,590 53,033 23,400 254,582 22.3 F

20 Imperial CA 166,874 51,337 17,578 3,405 9,042 4,822 2,259 35,368 19.8 F

21 Stanislaus CA 510,385 149,225 53,538 9,899 28,322 15,287 7,192 85,583 19.3 F

21 Harford MD 242,514 59,776 29,902 7,135 16,488 8,095 4,027 14,948 19.3 F

21 Mecklenburg NC 913,639 237,842 78,551 20,398 53,271 27,572 11,905 126,807 19.3 F

24 Hamilton OH 855,062 200,406 115,705 18,790 64,933 28,687 14,447 126,872 18.7 F

25 Fairfield CT 901,208 223,771 119,291 26,823 63,497 30,094 15,271 72,291 17.8 F

Notes:

1. Counties are ranked by weighted average.

2. Total Population represents the at-risk populations in counties with ozone monitors.

3. Those 18 and under and 65 and over are vulnerable to PM2.5 and are, therefore, included. They should not be used as population denominators for disease estimates.

4. Pediatric asthma estimates are for those under 18 years of age and represent the estimated number of people who had asthma in 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

5. Adult asthma estimates are for those 18 years and older and represent the estimated number of people who had asthma during 2009 based on state rates (BRFSS) applied to population estimates (U.S. Census).

6. Chronic bronchitis estimates are for adults 18 and over who had been diagnosed in 2009, based on national rates (NHIS) applied to population estimates (U.S. Census).

7. Emphysema estimates are for adults 18 and over who have been diagnosed within their lifetime, based on national rates (NHIS) applied to population estimates (U.S. Census).

8. 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.

10.The Weighted Average was derived by counting the number of days in each unhealthful range (orange, red, purple) in each year (2007-2009), multiplying the total in each range by the assigned standard weights (i.e., 1 for orange, 1.5 for red, 2.0 

for purple), and calculating the average.

11.Grade is assigned by weighted average as follows: A=0.0, B=0.3-0.9, C=1.0-2.0, D=2.1-3.2, F=3.3+.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 17

Cleanest U.S. Cities for Short-term Particle Pollution (24-hour PM2.5)1

Note:

1. This list represents cities with the lowest levels of short term PM2.5 air pollution. Monitors in these cities reported no days with unhealthful PM2.5 levels.

Metropolitan Statistical Area Population

Alexandria, LA 154,101

Amarillo, TX 246,474

Asheville-Brevard, NC 442,875

Athens-Clarke County, GA 192,222

Austin-Round Rock-Marble Falls, TX 1,705,075

Bangor, ME 149,419

Billings, MT 154,553

Bloomington-Normal, IL 167,699

Brownsville-Harlingen-Raymondville, TX 416,766

Burlington-South Burlington, VT 208,055

Cape Coral-Fort Myers, FL 586,908

Champaign-Urbana, IL 226,132

Cheyenne, WY 88,854

Colorado Springs, CO 626,227

Corpus Christi-Kingsville, TX 447,111

Farmington, NM 124,131

Fayetteville, NC 360,355

Fort Collins-Loveland, CO 298,382

Greenville-Spartanburg-Anderson, SC 1,264,930

Gulfport-Biloxi-Pascagoula, MS 394,375

Hattiesburg, MS 143,093

Honolulu, HI 907,574

Houma-Bayou Cane-Thibodaux, LA 202,973

Jackson-Yazoo City, MS 568,847

Lafayette-Acadiana, LA 546,834

Lake Charles-Jennings, LA 225,235

Metropolitan Statistical Area Population

Lake Havasu City-Kingman, AZ 194,825

Lansing-East Lansing-Owosso, MI 523,609

Lincoln, NE 298,012

Longview-Marshall, TX 271,669

McAllen-Edinburg-Pharr, TX 741,152

Mobile-Daphne-Fairhope, AL 591,599

Monroe-Bastrop, LA 202,309

Oklahoma City-Shawnee, OK 1,297,552

Palm Bay-Melbourne-Titusville, FL 536,357

Pensacola-Ferry Pass-Brent, FL 455,102

Pueblo, CO 157,224

Rocky Mount, NC 146,596

Saginaw-Bay City-Saginaw Township North, MI 307,484

Salinas, CA 410,370

San Luis Obispo-Paso Robles, CA 266,971

Santa Fe-Espanola, NM 188,210

Sarasota-Bradenton-Punta Gorda, FL 845,078

Shreveport-Bossier City-Minden, LA 432,060

Spokane, WA 468,684

Springfield, IL 208,182

Springfield, MO 430,900

St. Joseph, MO-KS 126,644

Syracuse-Auburn, NY 725,610

Texarkana, TX-Texarkana, AR 137,486

Tucson, AZ 1,020,200
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 18

Cleanest U.S. Cities for Ozone Air Pollution1

Metropolitan Statistical Area Population

Bismarck, ND 106,286

Brownsville-Harlingen-Raymondville, TX 416,766

Brunswick, GA 103,841

Coeur d’Alene, ID 139,390

Dothan-Enterprise-Ozark, AL 239,475

Duluth, MN-WI 276,368

Fargo-Wahpeton, ND-MN 222,433

Honolulu, HI 907,574

Laredo, TX 241,438

Lincoln, NE 298,012

Monroe-Bastrop, LA 202,309

Naples-Marco Island, FL 318,537

Port St. Lucie-Sebastian-Vero Beach, FL 541,463

Rapid City, SD 124,766

Rochester, MN 185,618

Santa Fe-Espanola, NM 188,210

Savannah-Hinesville-Fort Stewart, GA 417,512

Sioux Falls, SD 238,122

Spokane, WA 468,684

Topeka, KS 230,824

Note:

1. This list represents cities with no monitored ozone air pollution in unhealthful ranges using the 

Air Quality Index based on 2008 NAAQS.

Top 25 Cleanest U.S. Cities for Year-round

Particle Pollution (Annual PM2.5)1

 Design

Rank2 Value3 Metropolitan Statistical Area Population

1 4.2 Cheyenne, WY 88,854

2 4.4 Santa Fe-Espanola, NM 188,210

3 5.6 Tucson, AZ 1,020,200

4 5.8 Great Falls, MT 82,178

4 5.8 Honolulu, HI 907,574

6 5.9 Anchorage, AK 374,553

7 6.0 Albuquerque, NM 857,903

7 6.0 Amarillo, TX 246,474

9 6.3 Redding, CA 181,099

10 6.7 Salinas, CA 410,370

11 6.8 Bismarck, ND 106,286

12 6.9 Boise City-Nampa, ID 606,376

13 7.0 Billings, MT 154,553

14 7.1 Cape Coral-Fort Myers, FL 586,908

14 7.1 Flagstaff, AZ 129,849

14 7.1 Fort Collins-Loveland, CO 298,382

14 7.1 Palm Bay-Melbourne-Titusville, FL 536,357

14 7.1 Sarasota-Bradenton-Punta Gorda, FL 845,078

19 7.2 Claremont-Lebanon, NH-VT 214,431

20 7.4 Port St. Lucie-Sebastian-Vero Beach, FL 541,463

20 7.4 Rapid City, SD 124,766

22 7.5 Duluth, MN-WI 276,368

23 7.8 Fargo-Wahpeton, ND-MN 222,433

24 7.9 Bangor, ME 149,419

24 7.9 Burlington-South Burlington, VT 208,055

24 7.9 Orlando-Deltona-Daytona Beach, FL 2,747,614

Notes:

1.This list represents cities with the lowest levels of annual PM2.5 air pollution.

2.Cities are ranked by using the highest design value for any county within that metropolitan area.

3.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 meets the standard. The source for 

the Design Values is EPA, communication from the Office of Air Quality Planning & Standards, Mark Schmidt, 

Febraruy 15, 2011. 

 

 
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 19

Cleanest Counties for Short-term Particle Pollution (24-hour PM2.5)1

Notes:

1.This list represents counties with the lowest levels of short term PM2.5 air pollution. Monitors in these counties reported no days with unhealthful PM2.5 levels.

2.MSA and CSA are terms used by the U.S. Office of Management and Budget for statistical purposes. MSA stands for Metropolitan Statistical Area. 

CSA stands for Combined Statistical Area, which may include multiple metropolitan statistical areas and individual counties.

County State MSAs and Respective CSA2

Anchorage Municipality AK Anchorage, AK

Baldwin AL Mobile-Daphne-Fairhope, AL

Mobile AL Mobile-Daphne-Fairhope, AL

Arkansas AR

Ashley AR

Faulkner AR Little Rock-North Little Rock-Pine Bluff, AR

Polk AR

Sebastian AR Fort Smith, AR-OK

Cochise AZ

Mohave AZ Lake Havasu City-Kingman, AZ

Pima AZ Tucson, AZ

Humboldt CA

Monterey CA Salinas, CA

San Benito CA San Jose-San Francisco-Oakland, CA

San Luis Obispo CA San Luis Obispo-Paso Robles, CA

Santa Cruz CA San Jose-San Francisco-Oakland, CA

Sonoma CA San Jose-San Francisco-Oakland, CA

El Paso CO Colorado Springs, CO

Elbert CO Denver-Aurora-Boulder, CO

Larimer CO Fort Collins-Loveland, CO

Pueblo CO Pueblo, CO

Brevard FL Palm Bay-Melbourne-Titusville, FL

Citrus FL

Escambia FL Pensacola-Ferry Pass-Brent, FL

Lee FL Cape Coral-Fort Myers, FL

Sarasota FL Sarasota-Bradenton-Punta Gorda, FL

Clarke GA Athens-Clarke County, GA

Honolulu HI Honolulu, HI

Lee IA

Van Buren IA

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

McLean IL Bloomington-Normal, IL

County State MSAs and Respective CSA2

Sangamon IL Springfield, IL

St. Clair IL St. Louis-St. Charles-Farmington, MO-IL

Johnson KS Kansas City-Overland Park-Kansas City, MO-KS

Linn KS Kansas City-Overland Park-Kansas City, MO-KS

Sumner KS Wichita-Winfield, KS

Wyandotte KS Kansas City-Overland Park-Kansas City, MO-KS

Campbell KY Cincinnati-Middletown-Wilmington, OH-KY-IN

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

Rapides Parish LA Alexandria, LA

St. Bernard Parish LA New Orleans-Metairie-Bogalusa, LA

Tangipahoa Parish LA

Terrebonne Parish LA Houma-Bayou Cane-Thibodaux, LA

Bristol MA Boston-Worcester-Manchester, MA-RI-NH

Essex MA Boston-Worcester-Manchester, MA-RI-NH

Middlesex MA Boston-Worcester-Manchester, MA-RI-NH

Harford MD Washington-Baltimore-Northern Virginia, 

DC-MD-VA-WV

Cumberland ME Portland-Lewiston-South Portland, ME

Hancock ME

Kennebec ME

Penobscot ME Bangor, ME

Piscataquis ME

Bay MI Saginaw-Bay City-Saginaw Township North, MI

Genesee MI Detroit-Warren-Flint, MI

Ingham MI Lansing-East Lansing-Owosso, MI

Macomb MI Detroit-Warren-Flint, MI

Manistee MI

Missaukee MI

Buchanan MO St. Joseph, MO-KS

Clay MO Kansas City-Overland Park-Kansas City, MO-KS

Greene MO Springfield, MO
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 20

County State MSAs and Respective CSA2

Ste. Genevieve MO

Adams MS

Bolivar MS

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

Lee MS

Yellowstone MT Billings, MT

Buncombe NC Asheville-Brevard, NC

Cumberland NC Fayetteville, 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

Mcdowell NC

Rowan NC Charlotte-Gastonia-Salisbury, NC-SC

Watauga NC

Billings ND

Mercer ND

Hall NE

Lancaster NE Lincoln, NE

Scotts Bluff NE

Belknap NH Boston-Worcester-Manchester, MA-RI-NH

Rockingham NH Boston-Worcester-Manchester, MA-RI-NH

Chaves NM

Grant NM

Lea NM

San Juan NM Farmington, NM

Sandoval NM Albuquerque, NM

Santa Fe NM Santa Fe-Espanola, NM

Essex NY

County State MSAs and Respective CSA2

Onondaga NY Syracuse-Auburn, NY

St. Lawrence NY

Suffolk NY New York-Newark-Bridgeport, NY-NJ-CT-PA

Medina OH Cleveland-Akron-Elyria, OH

Caddo OK

Mayes OK

Oklahoma OK Oklahoma City-Shawnee, OK

Ottawa OK

Linn OR

Umatilla OR

Union OR

Greenville SC Greenville-Spartanburg-Anderson, SC

Oconee SC Greenville-Spartanburg-Anderson, SC

Spartanburg SC Greenville-Spartanburg-Anderson, SC

Brown SD

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

Nueces TX Corpus Christi-Kingsville, TX

Orange TX Beaumont-Port Arthur, TX

Potter TX Amarillo, TX

Travis TX Austin-Round Rock-Marble Falls, TX

Bristol City VA Johnson City-Kingsport-Bristol (Tri-Cities), TN-VA

Frederick VA Washington-Baltimore-Northern Virginia, 

DC-MD-VA-WV

Page VA

Bennington VT

Chittenden VT Burlington-South Burlington, VT

Spokane WA Spokane, WA

Campbell WY

Converse WY

Laramie WY Cheyenne, WY

Teton WY

Cleanest Counties for Short-term Particle Pollution (24-hour PM2.5)1 (cont.)

Notes:

1.This list represents counties with the lowest levels of short term PM2.5 air pollution. Monitors in these counties reported no days with unhealthful PM2.5 levels.

2.MSA and CSA are terms used by the U.S. Office of Management and Budget for statistical purposes. MSA stands for Metropolitan Statistical Area. 

CSA stands for Combined Statistical Area, which may include multiple metropolitan statistical areas and individual counties.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 21

Top 25 Cleanest Counties for Year-round

Particle Pollution (Annual PM2.5)1

2010

Rank2 County ST Design Value3

1 Converse WY 3.7

2 Laramie WY 4.2

3 Elbert CO 4.4

3 Santa Fe NM 4.4

5 Billings ND 4.5

6 Lake CA 4.7

6 Maui HI 4.7

8 Hancock ME 4.8

8 Essex NY 4.8

10 Jackson SD 4.9

11 Grant NM 5.0

12 Custer SD 5.5

13 Pima AZ 5.6

13 Piscataquis ME 5.6

13 Campbell WY 5.6

16 Honolulu HI 5.8

16 Cascade MT 5.8

16 St. Lawrence NY 5.8

19 Anchorage Municipality AK 5.9

20 Bernalillo NM 6.0

20 Potter TX 6.0

20 Ashland WI 6.0

23 Douglas CO 6.1

24 Mercer ND 6.2

24 San Benito CA 6.2

Notes:

1.This list represents counties with the lowest levels of monitored long term PM2.5 air 

pollution.

2.Counties are ranked by design value.

3.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 meets the standard. The source for the Design Values is EPA, 

communication from the Office of Air Quality Planning & Standards, Mark Schmidt, 

February 15, 2011.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 22

Cleanest Counties for Ozone Air Pollution1

Note:

1.This list represents counties with no monitored ozone air pollution in unhealthful ranges using the Air Quality Index based on 2008 NAAQS.

County State Metropolitan Statistical Area

Houston AL Dothan-Enterprise-Ozark, AL

Navajo AZ

Humboldt CA

Lake CA

Marin CA San Jose-San Francisco-

 Oakland, CA

Mendocino CA

San Francisco CA San Jose-San Francisco-

 Oakland, CA

San Mateo 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

Montezuma CO

Collier FL Naples-Marco Island, FL

Columbia FL

Holmes FL

St. Lucie FL Port St. Lucie-Sebastian-

 Vero Beach, FL

Chatham GA Savannah-Hinesville-

 Fort Stewart, GA

Glynn GA Brunswick, GA

Honolulu HI Honolulu, HI

Montgomery IA

Palo Alto IA

Polk IA Des Moines-Newton-Pella, IA

Butte ID

Kootenai ID Coeur d’Alene, ID

Will IL Chicago-Naperville-

 Michigan City, IL-IN-WI

Linn KS Kansas City-Overland Park-

 Kansas City, MO-KS

County State Metropolitan Statistical Area

Shawnee KS Topeka, KS

Trego KS

Ouachita Parish LA Monroe-Bastrop, LA

Becker MN

Carlton MN Duluth, MN-WI

Lyon MN

Olmsted MN Rochester, MN

Scott MN Minneapolis-St. Paul-

 St. Cloud, MN-WI

St. Louis MN Duluth, MN-WI

Lauderdale MS

Flathead MT

Swain NC

Billings ND

Burke ND

Burleigh ND Bismarck, ND

Cass ND Fargo-Wahpeton, ND-MN

Dunn ND

McKenzie ND

Mercer ND

Oliver ND

Douglas NE Omaha-Council Bluffs-

 Fremont, NE-IA

Lancaster NE Lincoln, NE

Sioux NE

Eddy NM

Grant NM

Lea NM

Luna NM

Santa Fe NM Santa Fe-Espanola, NM

Lyon NV Reno-Sparks-Fernley, NV

Adair OK

County State Metropolitan Statistical Area

Cherokee OK

Cleveland OK Oklahoma City-Shawnee, OK

Dewey OK

Ottawa OK

Columbia OR Portland-Vancouver-

 Hillsboro, OR-WA

Umatilla OR

Custer SD

Jackson SD

Meade SD Rapid City, SD

Minnehaha SD Sioux Falls, SD

Brewster TX

Cameron TX Brownsville-Harlingen-

 Raymondville, TX

Harrison TX Longview-Marshall, TX

Hunt TX Dallas-Fort Worth, TX

Webb TX Laredo, TX

San Juan UT

Uintah UT

Page VA

Clallam WA

Spokane WA Spokane, WA

Ashland WI

Washington WI Milwaukee-Racine-Waukesha, WI

Waukesha WI Milwaukee-Racine-Waukesha, WI

Sweetwater WY

Uinta WY
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 23

Health Effects of Ozone and Particle Pollution

Ozone and particle pollution are the most widespread 

air pollutants—and among the most dangerous. Recent 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 findings provide more evidence about the health impacts of these pollutants:

■ Ozone pollution can shorten life, a conclusion confirmed 

by a 2008 scientific review by the National Research 

Council.1 Evidence warns that some segments of the population may face higher risks from dying prematurely because 

of ozone pollution, including communities with high unemployment or high public transit use and large Black/AfricanAmerican populations.2

■ Good news: Reducing air pollution has extended life 

expectancy. Thanks to a drop in particle pollution between 

1980 and 2000, life expectancy in 51 U.S. cities increased by 

5 months on average, according to a 2009 analysis.3

■ 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 

cardiovascular risks in people with diabetes.4 Some new 

research with animals indicates that fine particle pollution 

may impact insulin resistance and other factors.5

■ Lower levels of ozone and particle pollution pose bigger 

threat than previously thought. A Canadian study showed 

that levels well below those considered safe for these pollutants triggered asthma attacks and increased the risk of 

emergency room visits and hospital admissions for children 

with asthma.6 Another study found that low levels of these 

pollutants increased the risk of hospital treatment for pneumonia and chronic obstructive pulmonary 

disease (COPD).7

❖ 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. 

❖ A growing body of evidence suggests breathing 

pollution from heavy traffic may cause new cases 

of asthma in children.8

❖ Some emerging research has found particle pollution associated with increasing the risk of new 

cases of three chronic diseases in adults: adult-onset 

asthma,9 diabetes,10 and COPD, especially in people 

who already have asthma or diabetes.11

❖ Research had already connected pollution from 

heavy highway traffic to higher risks for heart attack, allergies, premature births and the death of 

infants around the time they are born.12 Evidence 

of the impact of traffic pollution, even in a city with 

generally “cleaner” air, expanded the concern over 

the health effects of chronic exposure to exhaust 

from heavy traffic.13

Two types of air pollution dominate the problem in the U.S.: 

ozone and particle pollution. They 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. 
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 24

Ozone 

Pollution

It may be hard to imagine that pollution 

could be invisible, but ozone is. The most 

widespread pollutant in the U.S. is also one 

of the most dangerous. 

Scientists have studied the effects of ozone on health for decades. Hundreds of research studies have confirmed 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 (O3) 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. 

News about ozone can be confusing. Some days you hear that 

ozone levels are too high and other days that we need to prevent ozone depletion. Basically, the ozone layer found high in 

the upper atmosphere (the stratosphere) is beneficial because it 

shields us from much of the sun’s ultraviolet radiation. 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. These essential raw ingredients for ozone are 

nitrogen oxides (NOx) and hydrocarbons, also called volatile 

organic compounds (VOCs). They are produced primarily 

when fossil fuels like gasoline, oil or coal are burned or when 

some chemicals, like solvents, evaporate. 

When NOx and VOCs come in contact with both heat and 

sunlight, they react to form ozone smog. NOx is emitted from 

power plants, motor vehicles and other sources of high-heat 

combustion. VOCs are emitted from motor vehicles, chemical plants, refineries, factories, gas stations, paint and other 

sources. The formula for ozone is simple, and like any formula, 

the ingredients must all be present and in the right proportions 

to make the final product.

VOCs NOx OZONE

You may have wondered why “ozone action day” warnings are 

sometimes followed by recommendations to avoid activities 

such as mowing your lawn or refilling your gas tank during 

daylight hours. Lawn mower exhaust and gasoline vapors are 

VOCs that help produce ozone in the heat and sun. Take away 

the sunlight and ozone doesn’t form, so refilling your gas tank 

after 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 effects of 

breathing ozone: 

■ children and teens; 

■ anyone 65 and older;

■ people who work or exercise outdoors;

■ people with existing lung diseases, such as asthma and 

chronic obstructive pulmonary disease (also known as 

COPD, which includes emphysema and chronic bronchitis); 

and

■ “responders” who are otherwise healthy but for some reason 

react more strongly to ozone.14

The impact on your health can depend on many factors, however. 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.

HEALTH EFFECTS OF OZONE AND PARTICLE POLLUTION
HEALTH EFFECTS OF OZONE AND PARTICLE POLLUTION AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 25

Lifeguards in Galveston, Texas, provided evidence of the impact of even short-term exposure to ozone on healthy, active 

adults in a study published in 2008. Testing the breathing capacity 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 first city in the nation to install an air 

quality warning flag system on the beach.15

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. They 

estimated that over 3,700 deaths annually in the U.S. could be 

attributed to a 10-parts-per-billion increase in ozone levels.16

Another study, published the same week, looked at 23 European cities and found similar effects on mortality from shortterm exposure to ozone.17

Confirmation came in the summer of 2005. Three groups of 

researchers working independently reviewed and analyzed the 

research around deaths associated with short-term exposures 

to ozone. The three teams—at Harvard, Johns Hopkins and 

New York University—used different approaches but all came 

to similar conclusions. All three studies reported a small but 

robust association between daily ozone levels and increased 

deaths.18 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 effect would be a hazard to anyone 

with heart failure and pulmonary congestion, 

and would worsen the function of anyone with 

advanced lung disease.”19

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 

ambient ozone is likely to contribute to premature deaths.” 

They recommended that preventing early death be included in 

any future estimates of the benefits of reducing ozone.20

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.21

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:

■ shortness of breath;

■ chest pain when inhaling; 

■ wheezing and coughing;

■ asthma attacks;

■ increased susceptibility to respiratory infections;

■ increased susceptibility to pulmonary inflammation; and

■ increased need for people with lung diseases, like asthma or 

chronic obstructive pulmonary disease (COPD), to receive 

medical treatment and to go to the hospital.22

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 efficiently, 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.23
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 26

Inhaling ozone may affect 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.24 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.25

New studies warn of serious effects from breathing ozone over 

longer periods. With more long-term data, scientists are finding that long-term exposure—that is, for periods longer than 

8-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.26

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.27 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.28

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 to ozone than to just breathing ozone alone. 

Breathing ozone may also increase the response to allergens in 

people with allergies. A large study published in 2009 found 

that children were more likely to suffer from hay fever and 

respiratory allergies when ozone and PM2.5 levels were high.29

Even low levels of ozone may be deadly. A large study of 48 

U.S. cities looked at the association between ozone and allcause mortality during the summer months. Ozone concentrations by city in the summer months ranged from 16 percent to 

80 percent lower than EPA currently considers safe. Researchers found that ozone at those lower levels was associated with 

deaths from cardiovascular disease, strokes, and respiratory 

causes.30

Particle

Pollution

Ever look at dirty truck exhaust?

The dirty, smoky part of that stream 

of exhaust is made of particle pollution. Overwhelming evidence shows 

that particle pollution—like that coming from that exhaust 

smoke—can kill. Particle pollution can increase the risk of 

heart disease, lung cancer and asthma attacks and can interfere 

with the growth and work of the lungs. 

What Is Particle Pollution?

Particle pollution refers to a mix of very tiny solid and liquid 

particles that are in the air we breathe. But nothing about 

particle pollution is simple. First of all, the particles themselves 

are different 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 pollution. Yet it is so dangerous it can shorten your life.

The differences in size make a big difference in how they affect 

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. These particles get trapped in the lungs, 

while the smallest are so minute that they can pass through 

the lungs into the bloodstream, just like the essential oxygen 

molecules we need to survive. 

HEALTH EFFECTS OF OZONE AND PARTICLE POLLUTION
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 27

Researchers categorize particles according to size, grouping 

them as coarse, fine and ultrafine. Coarse particles fall between 2.5 microns and 10 microns in diameter and are called 

PM10-2.5. Fine particles are 2.5 microns in diameter or smaller 

and are called PM2.5. Ultrafine particles are smaller than 0.1 

micron in diameter31 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 different ways, they 

can be composed of many different compounds. Although we 

often think of particles as solids, not all are. Some are completely liquid; some are solids suspended in liquids. As the U.S. 

Environmental Protection Agency puts it, particles are really “a 

mixture of mixtures.”32 The mixtures differ between the eastern 

and western United States and in different 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-fired 

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.33

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 

becoming smaller. Mechanical processes primarily create 

coarse particles.34 Dust storms, construction and demolition, mining operations, and agriculture are among the 

activities that produce 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.35

By contrast, chemical processes in the atmosphere create most 

of the tiniest fine and ultrafine particles. Combustion sources 

burn fuels and emit gases. These gases can vaporize and then 

condense to become a particle of the same chemical compound. Or, they can react with other gases or particles in the atmosphere to form a particle of a different chemical compound. 

Particles formed by this latter process come from the reaction 

of elemental carbon (soot), heavy metals, sulfur dioxide (SO2), 

nitrogen oxides (NOx) and volatile organic compounds with 

water and other compounds in the atmosphere.36 Burning fossil 

fuels in factories, power plants, steel mills, smelters, diesel- and 

gasoline-powered motor vehicles (cars and trucks) and equipment generate a large part of the raw materials for fine particles. So does burning wood in residential fireplaces and wood 

stoves or burning agricultural fields or forests. 

What Can Particles Do to Your Health?

Particle pollution can be very dangerous to breathe. Breathing particle pollution may trigger illness, hospitalization and 

premature death, risks confirmed in new studies that validate 

earlier research.37

Good news came this year from researchers who looked at 

the impact of the drop in year-round levels of particle pollution between 1980 and 2000 in 51 US cities. They found that, 

thanks to reductions in particle pollution, people living in 

these cities had 5 months added to their life expectancy on 

average.38 This 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 first two years after reductions.39

Researchers these days are exploring possible differences in 

health effects of the three sizes of particles and particles from 

different sources, such as diesel particles from trucks and buses 

or sulfates from coal-fired power plants. So far, the evidence 

remains clear that all particles from all sources are dangerous.40

HEALTH EFFECTS OF OZONE AND PARTICLE POLLUTION
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 28

Particle pollution can damage the body in ways similar to 

cigarette smoking. A recent review of the research on how particles cause harm found that the body responds to particles in 

similar ways to its response to cigarette smoke. These findings 

help explain why particle pollution can cause heart attacks and 

strokes.41

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 afterward. Particle pollution 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.42

Researchers from Harvard University recently tripled the estimated risk of premature death following a review of the newer 

evidence from fine particle monitors (PM2.5) in 27 US cities.43

Particle pollution also diminishes lung function, causes greater 

use of asthma medications and increased rates of school absenteeism, emergency room visits and hospital admissions. Other 

adverse effects can be coughing, wheezing, cardiac arrhythmias 

and heart attacks. According to the findings from some of the 

latest studies, short-term increases in particle pollution have 

been linked to:

■ death from respiratory and cardiovascular causes, including 

strokes;44,45,46,47

■ increased mortality in infants and young children;48

■ increased numbers of heart attacks, especially among the 

elderly and in people with heart conditions;49

■ inflammation of lung tissue in young, healthy adults;50

■ increased hospitalization for cardiovascular disease, including strokes and congestive heart failure;51,52,53

■ increased emergency room visits for patients suffering from 

acute respiratory ailments;54

■ increased hospitalization for asthma among children;55,56,57

and

■ increased severity of asthma attacks in children.58

Again, the impact of even short-term exposure to particle pollution on healthy adults showed up in the Galveston lifeguard 

study, in addition to the harmful effects of ozone pollution. 

Lifeguards had reduced lung volume at the end of the day 

when fine particle levels were high.59

Year-Round Exposure

Breathing high levels of particle pollution day in and day out 

also can be deadly, as landmark studies in the 1990s conclusively showed.60 Chronic exposure to particle pollution can 

shorten life by one to three years.61 Other impacts range from 

premature births to serious respiratory disorders, even when 

the particle levels are very low.

Year-round exposure to particle pollution has also been 

linked to:

■ increased hospitalization for asthma attacks for children 

living near roads with heavy truck or trailer traffic;62,63

■ slowed lung function growth in children and teenagers;64,65

■ significant damage to the small airways of the lungs;66

■ increased risk of dying from lung cancer; and67

■ increased risk of death from cardiovascular disease.68

The evidence warns that the death toll is high. Although no 

national tally exists, California just completed an analysis that 

estimates that 9,200 people in California die annually from 

breathing particle pollution.69 An updated computer modeling of deaths from pollution caused by coal-fired power plant 

emissions, exposures which are more predominant outside of 

California, estimates roughly 13,200 deaths from particle pollution in the Midwest, New England and the Southeast.70

HEALTH EFFECTS OF OZONE AND PARTICLE POLLUTION
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 29

Research into the health risks of 65,000 women over age 50 

found that those who lived in areas with higher levels of particle 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 differing risks depending on 

the annual levels of pollution in their neighborhood.71

The Environmental Protection Agency released the most 

thorough review of the current research on particle pollution 

in December 2009.72 The Agency had engaged a panel of expert 

scientists, the Clean Air Scientific Advisory Committee, to 

help them assess the evidence, in particular research published 

between 2002 and May 2009. EPA concluded that particle pollution caused multiple, serious threats to health. Their findings 

are highlighted in the box below.

EPA Concludes Fine Particle Pollution Poses 

Serious Health Threats

■ Causes early death (both short-term and long-term 

exposure)

■ Causes cardiovascular harm (e.g. heart attacks, strokes, 

heart disease, congestive heart failure) 

■ Likely to cause respiratory harm (e.g. worsened asthma, 

worsened COPD, inflammation)

■ May cause cancer 

■ May cause reproductive and developmental harm

—U.S. Environmental Protection Agency, Integrated Science Assessment for 

Particulate Matter, December 2009. EPA 600/R-08/139F.

Who Is at Risk?

Anyone living in an area with a high level of particle pollution is at risk (you can take a look at levels in your state in 

this report). People at the greatest risk from particle pollution exposure include those with lung disease such as asthma 

and chronic obstructive pulmonary disease (COPD), which 

includes chronic bronchitis and emphysema; people with sensitive airways, where exposure to particle pollution can cause 

wheezing, coughing and respiratory irritation; the elderly; 

people with heart disease; and children. New research points to 

ever-larger groups at higher risk, including diabetics, and most 

recently, women over 50.73

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 fine particle 

pollution in 2004-2005. The evidence suggested that air pollution is a risk factor for diabetes.74 Traffic-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 traffic-related pollution and particle pollution increased.75 A similar finding 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 

find a strong association with levels of particle pollution.76

Researchers are identifying increased risk for workers whose 

jobs expose them to heavy diesel exhaust as a routine part of 

their job. The risk of dying from lung cancer and heart disease 

is markedly higher in truck drivers than in the general population in the U.S., according to a study by Harvard University researchers.77 This study of over 50,000 members of the 

Teamsters Union employed from 1985 to 2000 looked at the 

cause of death of workers classified by job category. Truckers 

are exposed to traffic pollution and diesel engine emissions, 

while dockworkers are exposed to exhaust from forklifts and 

trucks in the shipyard. The study found that death rates for 

heart disease were 49 percent higher among truck drivers, and 

32 percent higher among dockworkers than in the general U.S. 

population. Lung cancer death rates were 10 percent higher 

in the both the drivers and the dockworkers. Railroad workers have also faced higher risks of death from lung cancer and 

COPD, according to two studies looking at historical data for 

those workers. Although these studies examined historical 

data, both found that even accounting for smoking among the 

workers, the findings showed the impact of the diesel exposures.78

HEALTH EFFECTS OF OZONE AND PARTICLE POLLUTION
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 30

Focusing on

Children’s Health

Children may look like 

miniature adults, but they’re 

not. Air pollution is especially 

dangerous to them 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 after he or she is born. Eighty percent of their 

tiny air sacs develop after birth. Those sacs, called the alveoli, 

are where the life-sustaining transfer of oxygen to the blood 

takes place. The lungs and their alveoli aren’t fully grown until 

children become adults.79 In addition, the body’s defenses that 

help adults fight off infections are still developing in young 

bodies.80 Children have more respiratory infections than 

adults, which also seems to increase their susceptibility to air 

pollution.81

Furthermore, children don’t behave like adults, and their 

behavior also affects their vulnerability. They are outside for 

longer periods and are usually more active when outdoors. 

Consequently, they inhale more polluted outdoor air than 

adults typically do.82

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 differences for children.83

Air Pollution Increases Risk of Underdeveloped 

Lungs

Another finding from the Southern California Children’s 

Health study looked at the long-term effects of particle pollution 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. The 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.84

Community health studies are pointing to less obvious, but 

serious effects 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.85 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.86

Cleaning Up Pollution Can Reduce Risk to 

Children

There 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 reunification of Germany 

proved a real-life laboratory. Both East and West Germany had 

different 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 traffic-generated particles. After reunification, emissions 

from the factories and homes dropped, but traffic 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 traffic kept them from benefiting from the overall 

cleaner air.87

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. After 

taking other factors such as family characteristics and indoor 

air pollution into account, the researchers noted that during 

the years with less pollution, the children had fewer episodes 

of chronic cough, bronchitis, common cold, and conjunctivitis 

symptoms.88

HEALTH EFFECTS OF OZONE AND PARTICLE POLLUTION
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 31

Disparities in

the Impact of

Air Pollution

The burden of air pollution is not 

evenly shared. Poorer people and 

some racial and ethnic groups are 

among those who often face 

higher exposure to pollutants and 

who may experience greater 

responses to such pollution. Many studies have explored the 

differences 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,89 including 

a workshop the American Lung Association held in 2001 that 

focused on urban air pollution and health inequities.90

Many studies have looked at differences in the impact on premature death. Results have varied widely, particularly for effects between racial groups. Some studies have found no differences among races,91 while others found greater responsiveness 

for Whites and Hispanics, but not Blacks/African-Americans,92

or for Blacks/African-Americans but not other races or ethnic 

groups.93 Other researchers have found greater risk for Blacks/

African-Americans from air toxics, including those pollutants 

that also come from traffic sources.94

Socioeconomic position has been more consistently associated 

with harm from air pollution. Recent studies show evidence of 

that link. Low socioeconomic status consistently increased the 

risk of premature death from fine particle pollution among 13.2 

million Medicare recipients studied in the largest examination 

of particle pollution mortality nationwide.95 In the 2008 study 

that found greater risk for premature death for Blacks/AfricanAmericans, researchers also found greater risk for people living 

in areas with higher unemployment or higher use of public 

transportation.96 A 2008 study of Washington, DC found that 

while poor air quality and worsened asthma went hand-inhand 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.97

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

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. 

Second, low social position may make some groups more 

susceptible to health threats because of factors related to their 

disadvantage. Lack of access to health care, grocery stores 

and good jobs, poorer job opportunities, dirtier workplaces 

or higher traffic 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, Blacks/

African-Americans, Mexican-Americans and people living 

near a central city have higher incidence of diabetes.99

Highways May 

Be Especially 

Dangerous for 

Breathing

Being in heavy traffic, 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. 

The number of people living “next to a busy road” may include 

30 to 45 percent of the population in North America, according to the most recent review of the evidence. In January 2010, 

the Health Effects Institute published a major review of the 

evidence by a panel of expert scientists. The panel looked at 

over 700 studies from around the world, examining the health 

effects. They concluded that traffic pollution causes asthma 

attacks in children, and may cause a wide range of other effects including: the onset of childhood asthma, impaired lung 

function, premature death and death from cardiovascular 

HEALTH EFFECTS OF OZONE AND PARTICLE POLLUTION
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 32

diseases, and cardiovascular morbidity. The area most affected, 

they concluded, was roughly 0.2 mile to 0.3 mile (300 to 500 

meters) from the highway.100

Children and teenagers are among the most vulnerable—

though not the only ones at risk. A Danish study found that 

long-term exposure to traffic air pollution may increase the 

risk of developing chronic obstructive pulmonary disease 

(COPD). They found that those most at risk were people who 

already had asthma or diabetes.101 Studies have found increased 

risk of premature death from living near a major highway or an 

urban road.102 Another study found an increase in risk of heart 

attacks from being in traffic, whether driving or taking public 

transportation.103 Urban women in a Boston study experienced 

decreased lung function associated with traffic-related pollution.104

How to Protect Yourself from Ozone, 

Particle Pollution

To minimize your exposure to ozone and particle pollution:

■ Pay attention to forecasts for high air pollution days to know 

when to take precautions;

■ Avoid exercising near high-traffic areas;

■ Avoid exercising outdoors when pollution levels are high, or 

substitute an activity that requires less exertion;

■ Do not let anyone smoke indoors and support measures to 

make all places smokefree; and

■ Reduce the use of fireplaces and wood-burning stoves.

Bottom line: Help yourself and everyone else breathe easier. 

Support national, state and local efforts to clean up sources 

of pollution. Your life and the life of someone you love may 

depend on it.

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HEALTH EFFECTS OF OZONE AND PARTICLE POLLUTION
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 36 Methodology

Statistical

Methodology:

The Air

Quality Data

Data Sources

The data on air quality throughout 

the United States were obtained 

from the U.S. Environmental 

Protection Agency’s Air Quality 

System (AQS), formerly called 

Aerometric Information Retrieval System (AIRS) database. 

The 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 PM2.5 concentration information for the 

3-year period for 2007-2009 for each monitoring site. 

Design values for the annual PM2.5 concentrations by county 

were collected from data previously summarized by the U.S. 

Environmental Protection Agency (EPA) and were originally 

downloaded on October 25, 2010 from EPA’s website at http://

www.epa.gov/air/airtrends/values.html. However, EPA began 

reviewing these design values in January, 2011 and provided 

a draft of the revised design values to the Lung Association by 

email on February 15, 2011. That set of data became the basis 

for the data included in this report.

Ozone Data Analysis 

The 2007, 2008, and 2009 AQS hourly ozone data were used 

to calculate the daily 8-hour maximum concentration for each 

ozone-monitoring site. The hourly averaged ozone data were 

downloaded on June 29, 2010. The data were considered for a 

3-year period for the same reason that EPA uses 3 years of data 

to determine compliance with the ozone: to prevent a situation in any single year, where anomalies of weather or other 

factors create air pollution levels, which inaccurately reflect 

the normal conditions. The highest 8-hour daily maximum 

concentration in each county for 2007, 2008, and 2009, based 

on the EPA-defined ozone season, was identified.

The current national ambient air quality standard for ozone is 

0.075 ppm measured over 8-hours. Although EPA is reconsidering that standard, the Agency has postponed a final decision 

until July 2011. EPA’s Air Quality Index reflects the 0.075 ppm 

standard. A.S.L. & Associates prepared a table by county that 

summarized, for each of the 3 years, the number of days the 

ozone level was within the ranges identified by EPA based on 

the EPA Air Quality Index:

8-hour Ozone

Concentration Air Quality Index Levels

0.000 – 0.059 ppm n Good (Green)

0.060 – 0.075 ppm n Moderate (Yellow)

0.076 – 0.095 ppm n Unhealthy for Sensitive Groups

 (Orange)

0.096 – 0.115 ppm n Unhealthy (Red)

0.116 – 0.374 ppm n Very Unhealthy (Purple)

>0.374 ppm n Hazardous (Maroon)

The goal of this report was to identify the number of days that 

8-hour daily maximum concentrations occurred within the 

defined ranges, not just those days that would fall under the 

requirements for attaining the national ambient air quality 

standards. Therefore, 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 concentrations (i.e., 6-8 hours) had to be available for the 8-hour period. 

In addition, an 8-hour daily maximum average was identified 

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 inadequate data if the standard value is exceeded, our data capture 

methodology may result at times in underestimations of the 
APPENDIX: DESCRIPTION OF METHODOLOGY AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 37

number of 8-hour averages within the higher concentration 

ranges. However, our experience is that underestimates are 

infrequent.

Following receipt of the above information, the American 

Lung Association identified the number of days each county, 

with at least one ozone monitor, experienced air quality designated as orange (Unhealthy for Sensitive Groups), red (Unhealthy), or purple (Very Unhealthy).

Short-term Particle Pollution Data Analysis

A.S.L. & Associates identified the maximum daily 24-hour 

AQS PM2.5 concentration for each county in 2007, 2008, and 

2009 with monitoring information. The 24-hour PM2.5 data 

were downloaded on August 9, 2010. 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 PM2.5 concentration was within the ranges identified by EPA based on the EPA Air Quality Index, adjusted by 

the American Lung Association as discussed below:

24-hour PM2.5 Air Quality

Concentration Index Levels

0.0 mg/m3 to 15.4 mg/m3 n Good (Green)

15.5 mg/m3 to 35.0 mg/m3 n Moderate (Yellow)

35.1 mg/m3 to 65.4 mg/m3 n Unhealthy for

 Sensitive Groups

 (Orange)

65.5 mg/m3 to 150.4 mg/m3 n Unhealthy (Red)

150.5 mg/m3 to 250.4 mg/m3 n Very Unhealthy

 (Purple)

greater than or equal to 250.5 mg/m3 n Hazardous (Maroon)

In 2006, the EPA revised the 24-hour National Ambient Air 

Quality standard for PM2.5, changing the standard to 35 μg/m3

from 65 μg/m3. As of December 2010, the EPA had not announced changes to the Air Quality Index based on that standard. The Lung Association adjusted the level of the category 

“Unhealthy for Sensitive Groups” to reflect the 2006 standard, 

making that category range from 35.1 μg/m3 to 65.4 μg/m3.

The goal of this report was to identify the number of days that 

the maximum in each county of the daily PM2.5 concentration 

occurred within the defined ranges, not just those days that 

would fall under the requirements for attaining the national 

ambient air quality standards. Therefore, no data capture 

criteria were used to eliminate monitoring sites. Only 24-hour 

averaged PM data were used. Included in the analysis are data 

collected using only FRM and FEM methods, which reported 

24-hour averaged data. As instructed by the Lung Association, A.S.L. & Associates included the exceptional and natural 

events that were identified in the database and identified for 

the Lung Association the dates and monitoring sites that experienced such events. 

Following receipt of the above information, the American 

Lung Association identified the number of days each county, 

with at least one PM2.5 monitor, experienced air quality designated as orange (Unhealthy for Sensitive Groups), red (Unhealthy), purple (Very Unhealthy) or maroon (Hazardous).

Description

of County

Grading System

Ozone and

short-term

particle pollution

(24-hour PM2.5)

The grades for ozone and 

short-term particle pollution (24-hour PM2.5) 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. The 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. 

This allowed days where the air pollution levels were higher 

to receive greater weight. 

2. Next, multiplied the total number of days within each 
DESCRIPTION OF METHODOLOGY AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 38

category by their assigned factor, then summed all the 

categories 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. 

The weighted average determined each county’s grades for 

ozone and 24-hour PM2.5.

■ All counties with a weighted average of zero (corresponding to no exceedances of the standard over the three-year 

period) were given a grade of “A.” 

■ For ozone, an “F” grade was set to generally correlate with 

the number of unhealthy air days that would place a county 

in nonattainment for the ozone standard. 

■ For short-term particle pollution, fewer unhealthy air days 

are required for an F than for nonattainment under the 

PM2.5 standard. The national air quality standard is set to 

allow 2 percent of the days during the 3 years to exceed 35 

μg/m3 (called a “98th percentile” form) before violating 

the standard. That would be roughly 21 unhealthy days in 

3 years. The grading used in this report would allow only 

about 1 percent of the days to be over 35 μg/m3 (called a 

“99th percentile” form) of the PM2.5. The American Lung 

Association supports using the tighter limits in a 99th percentile form as a more appropriate standard that is intended 

to protect the public from short-term spikes in pollution. 

Weighted averages allow comparisons to be drawn based on 

severity of air pollution. For example, if one county had 9 

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 2 red days, which signify days with more 

serious air pollution, would receive a F. That second county 

would have a weighted average of 3.7.

Grading System

Grade

Weighted 

Average

Approximate Number of Allowable 

Orange/Red/Purple/Maroon days

A 0.0 None

B 0.3 to 0.9 1 to 2 orange days with no red

C 1.0 to 2.0 3 to 6 days over the standard: 3 to 5 

orange with no more than 1 red OR 

6 orange with no red

D 2.1 to 3.2 7 to 9 days over the standard: 7 

total (including up to 2 red) to 9 

orange with no red

F 3.3 or higher 9 days or more over the standard: 

10 orange days or 9 total including at least 1 or more red, purple or 

maroon

Note that this system differs significantly from the methodology EPA uses to determine violations of both the ozone and the 

24-hour PM2.5 standards. EPA determines whether a county 

violates the standard based on the 4th maximum daily 8-hour 

ozone reading each year averaged over three years. Multiple 

days of unhealthy air beyond the highest four in each year are 

not considered. By contrast, the system used in this report 

recognizes when a community’s air quality repeatedly results 

in unhealthy air throughout the three years. Consequently, 

some counties will receive grades of “F” in this report, showing 

repeated instances of unhealthy air, while still meeting EPA’s 

2008 or 1997 ozone standard. EPA is currently reconsidering 

the 2008 standard based on evidence that that standard failed 

to protect the health of the public. 

Counties were ranked by weighted average. Metropolitan areas 

were ranked by the highest weighted average among the counties 

within a given Metropolitan Statistical Area as of 2009 as defined 

by the White House Office of Management and Budget (OMB). 

Year-round particle pollution (Annual PM2.5)

Since no comparable Air Quality Index exists for year-round 

particle pollution (annual PM2.5), the grading was based on 
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 39

EPA’s determination of design value for the national ambient 

air quality standard for annual PM2.5 of 15 μg/m3, as described 

earlier. Counties that EPA listed as being at 15.0 μg/m3 or lower 

were given grades of “Pass.” Counties EPA listed at 15.1 μg/m3

or higher were given grades of “Fail.” Where insufficient 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 quality 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 defined by the OMB. In 2003, the 

OMB published revised definitions for the nation’s Metropolitan Statistical Areas. Therefore, comparisons between MSAs 

in the State of the Air reports from 2000 to 2003 and the State 

of the Air reports from 2004 and later should be made with 

caution. 

The Lung Association received critical assistance from members of the National Association of Clean Air Administrators, 

formerly known as the State and Territorial Air Pollution Control Administrators and the Association of Local Air Pollution 

Control Administrators. With their assistance, all state and local agencies were provided the opportunity to review and comment on the data in draft tabular form. The 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 final decision on those determinations. 

The American Lung Association wishes to express its continued appreciation to the state and local air directors for their 

willingness to assist in ensuring that the characterized data 

used in this report are correct. 

Calculations

of Populationsat-Risk

Presently county-specific 

measurements of the number of 

persons with chronic lung 

disease and other chronic 

conditions are not generally 

available. In order to assess the magnitude of lung disease and 

other chronic conditions at the state and county levels, we have 

employed a synthetic estimation technique originally 

developed by the U.S. Census Bureau. This method uses 

age-specific national estimates of self-reported lung disease 

and other conditions to project disease prevalence to the 

county level. The primary exceptions to this are asthma and 

diabetes, as state-specific estimates for asthma and diabetes are 

available through one national survey discussed below, and 

poverty, for which estimates are available at the county level.

Population Estimates 

The U.S. Census Bureau estimated data on the total population of each county in the United States for 2009. The Census 

Bureau also estimated the age-specific breakdown of the population and how many individuals were living in poverty by 

county. These estimates are the best information on population 

demographics available between decennial censuses.

Poverty estimates came from the Census Bureau’s Small Area 

Income and Poverty Estimates (SAIPE) program. SAIPE was 

created to provide accurate income and poverty estimates 

between decennial censuses. The program does not use direct 

counts or estimates from sample surveys, as these methods 

would not provide sufficient data for all counties. 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 estimates for all 

states and counties. 

APPENDIX: DESCRIPTION OF METHODOLOGY
DESCRIPTION OF METHODOLOGY AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 40

Prevalence Estimates 

Chronic Bronchitis and Emphysema. In 2009, the National 

Health Interview Survey (NHIS) estimated the nationwide annual prevalence of diagnosed chronic bronchitis at 9.9 million; 

the nationwide lifetime prevalence of diagnosed emphysema 

was estimated at 4.9 million.

Due to the revision of the NHIS questionnaire, prevalence 

estimates from the American Lung Association State of the Air 

2000 cannot be compared to later publications. Estimates for 

chronic bronchitis and emphysema can be compared to the 

State of the Air reports for 2001 through 2009. Furthermore, 

estimates for chronic bronchitis and emphysema should not 

be combined as they represent different types of prevalence 

estimates. 

Local area prevalence of chronic bronchitis and emphysema 

are estimated by applying age-specific national prevalence 

rates from the 2009 NHIS to age-specific county-level resident 

populations obtained from the U.S. Census Bureau web site. 

Prevalence estimates for chronic bronchitis and emphysema 

are calculated for those aged 18-44 years, 45-64 years and 65 

years and older.

Asthma and Diabetes. In 2009, the Behavioral Risk Factor 

Surveillance System (BRFSS) survey indicated that approximately 8.4 percent of adults residing in the United States and 

15.4 percent of children from twenty-nine states and Washington, D.C. reported currently having asthma. The BRFSS 

indicated that 9.0 percent of adults in the United States had 

ever been diagnosed with diabetes in 2009.

The prevalence estimate for pediatric asthma is calculated for 

those younger than 18 years; adult asthma and diabetes are 

calculated for those aged 18-44 years, 45-64 years and 65 years 

and older. Local area prevalence of pediatric asthma is estimated 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 2009 

BRFSS were available for twenty-nine states and Washington 

D.C., eleven states1 from 2008, and one state each2 for 2007 

and 2006. National data were used for the eight states3 that had 

no data available since 2006. Local area prevalence of adult 

asthma and diabetes is estimated by applying age-specific state 

prevalence rates from the 2009 BRFSS to age-specific countylevel resident populations obtained from the U.S. Census 

Bureau web site.

Cardiovascular Disease Estimates. All cardiovascular 

disease estimates are based on the 2005 National Health and 

Nutrition Examination Survey and were obtained from the 

National Heart Lung and Blood Institute (NHBLI). According to their estimate, 79.8 million Americans suffer from one 

or more types of cardiovascular disease, including coronary 

heart disease, hypertension, stroke and heart failure. Local area 

prevalence of cardiovascular disease is estimated by applying 

age-specific prevalence rates for those aged 18-44 years, 45-64 

years and 65 years and older., provided by NHLBI, to agespecific 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 NHANES are based on a sample, they will 

differ (due to random sampling variability) from figures that 

would be derived from a complete census or case registry of 

people in the U.S. with these diseases. The results are also subject to reporting, non-response and processing errors. These 

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 diagnosed conditions, which may underestimate disease preva1 Arizona, Colorado, Kentucky, Maine, Missouri, New Hampshire, New Mexico, 

Ohio, Oklahoma, Oregon and Wyoming.

2 Alaska for 2007 and Minnesota for 2006.

3 Alabama, Arkansas, Florida, Massachusetts, North Carolina, South Carolina, 

South Dakota, and Tennessee.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 41

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-specific asthma and diabetes information. The 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 proportion to the base population of the county and its age distribution. No adjustments are made for other factors that may affect 

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 differences 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 reflect the national estimate derived by the NHIS or 

state estimates derived by the BRFSS.

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, 2009. 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, 2009.

Population Estimates Branch, U.S. Census Bureau. County Resident Population 

Estimates, by Age, Sex, and Race: July 1, 2009.

Office of Management and Budget. Update of Statistical Areas Definitions and 

Guidance on Their Uses. OMB Bulletin 10-02 December 1, 2009.

National Heart Lung and Blood Institute. Cardiovascular Disease Prevalence 

Estimates from 2005-2006 National Health and Nutrition Examination Survey.

Unpublished data prepared by Dr. Michael Mussolino upon special request to 

NHLBI.

U.S. Census Bureau. Small Area Income and Poverty Estimates. State and County 

Data, 2009.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 42

Alabama . . . . . . . . . . . . . . . 44

Alaska . . . . . . . . . . . . . . . . . . 46

Arizona . . . . . . . . . . . . . . . . 48

Arkansas . . . . . . . . . . . . . . . 50

California . . . . . . . . . . . . . . . 52

Colorado . . . . . . . . . . . . . . . 56

Connecticut . . . . . . . . . . . . 58

Delaware . . . . . . . . . . . . . . . 60

District of Columbia . . . . . 62

Florida . . . . . . . . . . . . . . . . . 64

Georgia . . . . . . . . . . . . . . . . 68

Hawaii . . . . . . . . . . . . . . . . . . 72

Idaho . . . . . . . . . . . . . . . . . . 74

Illinois . . . . . . . . . . . . . . . . . . 76

Indiana . . . . . . . . . . . . . . . . . 78

Iowa . . . . . . . . . . . . . . . . . . . 82

Kansas . . . . . . . . . . . . . . . . . 84

Kentucky . . . . . . . . . . . . . . . 86

Louisiana . . . . . . . . . . . . . . . 90

Maine . . . . . . . . . . . . . . . . . . 92

Maryland . . . . . . . . . . . . . . . 94

Massachusetts . . . . . . . . . . 96

Michigan . . . . . . . . . . . . . . . 98

Minnesota . . . . . . . . . . . . 102

Mississippi . . . . . . . . . . . . 104

Missouri . . . . . . . . . . . . . . 106

Montana . . . . . . . . . . . . . . 108

Nebraska . . . . . . . . . . . . . 110

Nevada . . . . . . . . . . . . . . . 112

New Hampshire . . . . . . . 114

New Jersey . . . . . . . . . . . 116

New Mexico . . . . . . . . . . . 118

New York . . . . . . . . . . . . . 120

North Carolina . . . . . . . . 124

North Dakota . . . . . . . . . 128

Ohio . . . . . . . . . . . . . . . . . 130

Oklahoma . . . . . . . . . . . . 134

Oregon . . . . . . . . . . . . . . . 136

Pennsylvania . . . . . . . . . . 138

Rhode Island . . . . . . . . . . 142

South Carolina . . . . . . . . 144

South Dakota . . . . . . . . . 148

Tennessee . . . . . . . . . . . . 150

Texas . . . . . . . . . . . . . . . . . 152

Utah . . . . . . . . . . . . . . . . . 156

Vermont . . . . . . . . . . . . . . 158

Virginia . . . . . . . . . . . . . . . 160

Washington . . . . . . . . . . . 164

West Virginia . . . . . . . . . 166

Wisconsin . . . . . . . . . . . . 168

Wyoming . . . . . . . . . . . . . 172

State Tables
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 43

Notes for all state data tables 

1. Total Population is based on 2009 US Census and represents 

the at-risk populations in counties with ozone or PM2.5 pollution 

monitors; it does not represent the entire state’s sensitive 

populations.

2. Those 18 & under and 65 & over are vulnerable to ozone and 

PM2.5. They should not be used as population denominators for 

disease estimates.

3. Pediatric asthma estimates are for those under 18 years of 

age and represent the most recent state prevalence rates, or if 

none are available, the national rate (both from the Behavioral 

Risk Factor Surveillance System, or BRFSS) applied to county 

population estimates (US Census).

4. Adult asthma estimates are for those 18 years and older and 

represent the estimated number of people who had asthma 

during 2009 based on state rates (BRFSS) applied to county 

population estimates (US Census).

5. Chronic bronchitis estimates are for adults 18 and over who had 

been diagnosed within 2009 based on national rates (National 

Health Interview System, or NHIS) applied to county population 

estimates (US Census).

6. Emphysema estimates are for adults 18 and over who have been 

diagnosed within their lifetime based on national rates (NHIS) 

applied to county population estimates (US Census).

7. CV disease estimates are for adults 18 and over, based on 

national rates (2005 National Health and Nutrition Examination 

Survey, or NHANES, provided by the National Heart Lung 

and Blood Institute) applied to county population estimates 

(US 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 (US Census).

9. Poverty estimates include all ages and come from the U.S. 

Census Bureau’s Small Area Estimates Branch, 2009.

10. Adding across rows does not produce valid estimates. For 

example, because of differences in the surveys used to gather the 

information, adding pediatric and adult asthma does not produce 

an accurate estimate of total population with asthma. Adding 

emphysema and chronic bronchitis will double-count people with 

both diseases.

Notes for all state grades tables. 

1. The Weighted Average (Wgt. Avg) was derived by adding the 

three years of individual level data (2007-2009), 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.

a. INC indicates incomplete monitoring data for all three years. 

Therefore, those counties are excluded from the grade 

analysis or received an Incomplete.

b. DNC (Data Not Collected) indicates that data on that 

particular pollutant is not collected in that county.

c. Grades are as follows: A=0.0, B=0.3-0.9, C=1.0-2.0, D=2.1-3.2, 

F=3.3+.

2. 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 

EPA, communication from the Office of Air Quality Planning & 

Standards, Mark Schmidt, February 15, 2011.

State Table Notes

A full explanation of the sources of data and methodology is in the Appendix: Methodology.
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 44

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Baldwin 179,878 41,578 30,610 3,566 10,456 6,334 3,478 55,690 17,553 23,590

Clay 13,640 2,908 2,500 249 810 496 278 4,400 1,386 2,555

Colbert 54,639 12,037 9,168 1,032 3,222 1,946 1,058 17,039 5,377 8,648

Dekalb 69,380 17,719 9,903 1,520 3,931 2,296 1,191 19,671 6,192 14,886

Elmore 79,233 19,280 9,576 1,654 4,583 2,595 1,263 21,625 6,818 10,373

Escambia 37,434 8,592 5,678 737 2,196 1,280 669 10,998 3,452 7,761

Etowah 103,645 24,190 16,769 2,075 6,021 3,600 1,939 31,371 9,881 17,467

Houston 100,085 24,528 15,808 2,104 5,739 3,396 1,817 29,491 9,263 17,485

Jefferson 665,027 158,005 90,242 13,551 38,702 22,191 11,187 187,691 59,012 107,081

Lawrence 34,106 7,810 4,598 670 1,996 1,171 594 9,939 3,153 5,497

Madison 327,744 78,451 41,181 6,728 19,034 10,855 5,351 90,951 28,687 32,925

Mobile 411,721 106,494 51,499 9,133 23,309 13,298 6,593 111,683 35,181 75,425

Montgomery 224,119 56,008 27,243 4,803 12,909 7,171 3,469 59,534 18,625 42,293

Morgan 117,293 28,822 16,820 2,472 6,721 3,949 2,050 33,859 10,686 18,397

Russell 50,846 12,515 7,137 1,073 2,929 1,675 854 14,233 4,457 9,975

Shelby 192,503 50,391 17,778 4,322 10,890 6,029 2,735 48,803 15,487 13,085

Sumter 12,853 3,020 1,914 259 749 435 226 3,731 1,171 4,399

Talladega 80,242 18,744 11,439 1,608 4,674 2,737 1,411 23,390 7,385 14,413

Tuscaloosa 184,035 41,523 20,332 3,561 11,019 5,893 2,698 47,760 14,849 34,591

Walker 68,742 15,535 11,479 1,332 4,028 2,422 1,316 21,196 6,678 10,828

Totals 3,007,165 728,150 401,674 62,448 173,920 99,769 50,177 843,055 265,295 471,674

ALABAMA

American Lung Association in Alabama

2200 Riverchase Center #604

Birmingham, AL 35244

(205) 987-7432

www.lungusa.org/alabama
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 45

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Baldwin 10 0 0 3.3 F 0 0 0 0.0 A INC INC

Clay INC INC INC INC INC 3 0 0 1.0 C 10.9 PASS

Colbert 5 0 0 1.7 C 2 0 0 0.7 B 11.1 PASS

Dekalb DNC DNC DNC DNC DNC 1 0 0 0.3 B 11.6 PASS

Elmore 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Escambia DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Etowah 3 0 0 1.0 C 10 0 0 3.3 F 12.6 PASS

Houston 0 0 0 0.0 A 2 1 0 1.2 C 10.8 PASS

Jefferson 38 4 0 14.7 F 42 0 0 14.0 F 15.1 FAIL

Lawrence INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Madison 12 1 0 4.5 F 4 0 0 1.3 C 11.8 PASS

Mobile 17 0 0 5.7 F 0 0 0 0.0 A 10.4 PASS

Montgomery 7 0 0 2.3 D 8 1 0 3.2 D INC INC

Morgan 13 0 0 4.3 F 3 0 0 1.0 C 11.6 PASS

Russell 5 0 0 1.7 C 8 2 0 3.7 F 13.0 PASS

Shelby 20 3 0 8.2 F 5 0 0 1.7 C 11.8 PASS

Sumter 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Talladega DNC DNC DNC DNC DNC 1 0 0 0.3 B INC INC

Tuscaloosa 10 0 0 3.3 F 3 0 0 1.0 C 11.5 PASS

Walker DNC DNC DNC DNC DNC 3 0 0 1.0 C 11.9 PASS

ALABAMA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 46

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Anchorage 

Municipality 286,174 74,045 20,522 5,125 18,902 8,686 3,628 67,975 11,939 21,109

Denali Borough 1,851 417 124 29 132 63 28 505 90 88

Fairbanks 

North Star Borough 98,660 25,640 6,170 1,775 6,482 2,900 1,146 22,185 3,823 7,420

Juneau City and 

Borough 30,796 7,014 2,500 486 2,146 1,022 453 8,205 1,468 1,988

Matanuska-Susitna 

Borough 88,379 24,332 6,780 1,684 5,746 2,712 1,188 21,659 3,864 7,564

Totals 505,860 131,448 36,096 9,099 33,408 15,383 6,443 120,529 21,183 38,169

ALASKA

American Lung Association in Alaska

500 West International Airport Road, #A

Anchorage, AK 99518-1105

(907) 276-5864

www.lungusa.org/alaska
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 47

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Anchorage 

Municipality DNC DNC DNC DNC DNC 0 0 0 0.0 A 5.9 PASS

Denali Borough 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Fairbanks North Star 

Borough DNC DNC DNC DNC DNC 17 4 1 8.3 F 12.8 PASS

Juneau City And 

Borough DNC DNC DNC DNC DNC 6 0 0 2.0 C 6.9 PASS

Matanuska-Susitna 

Borough DNC DNC DNC DNC DNC 2 0 0 0.7 B INC INC

ALASKA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 48

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Cochise 129,518 31,172 23,078 2,544 10,362 4,559 2,561 40,510 9,505 19,982

Coconino 129,849 33,783 10,539 2,757 10,653 3,975 1,717 31,523 7,391 22,789

Gila 52,199 11,883 11,701 970 4,139 1,982 1,215 18,373 4,330 10,555

La Paz 20,012 3,761 6,621 307 1,605 825 573 8,121 1,874 5,003

Maricopa 4,023,132 1,096,985 449,288 89,528 320,178 122,984 58,059 1,010,033 234,302 599,393

Mohave 194,825 42,395 43,579 3,460 15,706 7,399 4,497 68,267 16,038 33,981

Navajo 112,975 34,237 13,995 2,794 8,488 3,486 1,769 29,593 6,953 30,282

Pima 1,020,200 238,950 153,660 19,501 83,840 34,538 17,997 296,314 69,111 189,172

Pinal 340,962 90,261 47,067 7,366 27,072 10,833 5,497 91,770 21,269 44,379

Santa Cruz 43,771 13,873 6,074 1,132 3,188 1,357 724 11,776 2,769 10,903

Yavapai 215,686 42,076 51,339 3,434 17,792 8,545 5,273 79,450 18,705 29,979

Yuma 196,972 57,415 36,969 4,686 14,660 6,305 3,636 56,552 13,002 36,667

Totals 6,480,101 1,696,791 853,910 138,480 517,684 206,788 103,518 1,742,282 405,250 1,033,085

ARIZONA

American Lung Association in Arizona

102 West McDowell Road

Phoenix, AZ 85003-1213

(602) 258-7505

www.lungusa.org/arizona
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 49

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Cochise 1 0 0 0.3 B 0 0 0 0.0 A 7.1 PASS

Coconino 3 0 0 1.0 C 1 0 0 0.3 B 7.1 PASS

Gila 18 0 0 6.0 F INC INC INC INC INC INC INC

La Paz 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

Maricopa 46 0 0 15.3 F 1 1 0 0.8 B 11.4 PASS

Mohave DNC DNC DNC DNC DNC 0 0 0 0.0 A INC INC

Navajo 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Pima 3 0 0 1.0 C 0 0 0 0.0 A 5.6 PASS

Pinal 22 0 0 7.3 F 16 0 0 5.3 F 18.8 FAIL

Santa Cruz DNC DNC DNC DNC DNC 2 1 0 1.2 C 12.8 PASS

Yavapai INC INC INC INC INC INC INC INC INC INC INC INC

Yuma 13 0 0 4.3 F INC INC INC INC INC INC INC

ARIZONA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 50

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Arkansas 18,971 4,615 3,098 396 1,079 662 362 5,817 1,577 3,196

Ashley 21,941 5,444 3,319 467 1,241 747 397 6,477 1,755 4,703

Crittenden 53,022 15,486 5,581 1,328 2,826 1,610 766 13,287 3,607 14,802

Faulkner 109,386 26,478 10,951 2,271 6,272 3,376 1,498 26,998 7,257 14,790

Garland 98,479 20,785 21,382 1,783 5,858 3,698 2,204 33,779 9,077 14,205

Jackson 16,658 3,612 2,292 310 983 571 287 4,826 1,306 4,108

Newton 8,191 1,663 1,552 143 490 310 177 2,775 753 2,073

Phillips 20,921 6,216 3,103 533 1,106 671 363 5,864 1,588 7,151

Polk 20,259 4,811 3,795 413 1,163 724 414 6,488 1,751 4,391

Pope 60,214 14,186 8,525 1,217 3,476 1,998 1,013 16,929 4,554 10,570

Pulaski 381,904 94,976 47,738 8,145 21,614 12,459 6,141 104,365 28,260 62,547

Sebastian 123,597 32,435 16,130 2,782 6,868 3,995 2,012 33,781 9,139 21,305

Union 42,782 10,458 6,831 897 2,433 1,471 795 12,843 3,474 9,734

Washington 200,181 51,661 19,814 4,431 11,238 6,044 2,686 48,366 12,992 35,893

White 76,338 18,464 10,966 1,584 4,372 2,519 1,288 21,417 5,758 11,944

Totals 1,252,844 311,290 165,077 26,697 71,018 40,855 20,403 344,012 92,849 221,412

ARKANSAS

American Lung Association in Arkansas

217 W 2nd Street, Suite 105

Little Rock, AR 72201

(501) 975-0758

www.lungusa.org/arkansas
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 51

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

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 0 0 0 0.0 A 11.2 PASS

Ashley DNC DNC DNC DNC DNC 0 0 0 0.0 A 10.7 PASS

Crittenden 16 1 0 5.8 F 2 0 0 0.7 B 11.7 PASS

Faulkner DNC DNC DNC DNC DNC 0 0 0 0.0 A 11.1 PASS

Garland DNC DNC DNC DNC DNC 1 0 0 0.3 B 11.1 PASS

Jackson DNC DNC DNC DNC DNC 2 0 0 0.7 B 11.0 PASS

Newton 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Phillips DNC DNC DNC DNC DNC 1 0 0 0.3 B 11.1 PASS

Polk 5 0 0 1.7 C 0 0 0 0.0 A 10.7 PASS

Pope DNC DNC DNC DNC DNC 1 0 0 0.3 B 11.6 PASS

Pulaski 15 0 0 5.0 F 2 0 0 0.7 B 12.1 PASS

Sebastian DNC DNC DNC DNC DNC 0 0 0 0.0 A 11.4 PASS

Union DNC DNC DNC DNC DNC 1 0 0 0.3 B 11.2 PASS

Washington 1 0 0 0.3 B INC INC INC INC INC INC INC

White DNC DNC DNC DNC DNC 1 0 0 0.3 B 10.7 PASS

ARKANSAS
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 52

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Alameda 1,491,482 344,679 162,522 22,864 90,064 48,579 22,624 397,146 104,315 158,531

Amador 37,876 6,380 7,373 423 2,449 1,492 846 13,328 3,601 3,762

Butte 220,577 46,201 33,001 3,065 13,594 7,643 3,920 65,106 17,171 39,717

Calaveras 46,731 8,946 8,921 593 2,944 1,836 1,055 16,530 4,512 5,242

Colusa 21,321 6,555 2,566 435 1,154 642 320 5,406 1,426 2,803

Contra Costa 1,041,274 259,082 126,828 17,186 61,367 34,463 17,043 289,409 77,083 97,510

El Dorado 178,447 41,818 21,717 2,774 10,768 6,281 3,177 53,407 14,516 13,492

Fresno 915,267 275,906 89,528 18,302 50,145 26,546 12,137 215,107 55,930 192,638

Glenn 28,299 8,167 3,548 542 1,574 881 443 7,446 1,969 4,412

Humboldt 129,623 26,149 16,832 1,735 8,107 4,493 2,202 37,555 9,931 23,979

Imperial 166,874 51,337 17,578 3,405 9,042 4,822 2,259 39,462 10,254 35,368

Inyo 17,293 3,816 2,759 253 1,054 635 346 5,583 1,516 2,139

Kern 807,407 250,561 72,666 16,621 43,747 23,012 10,309 184,959 48,102 170,614

Kings 148,764 41,081 11,466 2,725 8,468 4,221 1,721 32,615 8,286 24,546

Lake 65,279 14,413 10,929 956 3,968 2,384 1,313 21,025 5,681 14,185

Los Angeles 9,848,011 2,500,804 1,042,989 165,892 576,310 306,992 141,524 2,496,934 651,091 1,552,196

Madera 148,632 43,645 15,419 2,895 8,233 4,431 2,076 36,298 9,503 28,710

Marin 250,750 51,078 40,694 3,388 15,603 9,301 5,035 81,394 21,996 17,647

Mariposa 17,792 3,187 3,496 211 1,135 700 401 6,285 1,704 2,364

Mendocino 86,040 19,263 13,290 1,278 5,217 3,069 1,639 26,682 7,177 14,864

Merced 245,321 78,461 24,167 5,205 13,076 6,948 3,210 56,540 14,704 59,349

Monterey 410,370 112,705 42,286 7,476 23,348 12,439 5,736 101,182 26,385 67,288

Napa 134,650 31,455 19,941 2,087 8,055 4,632 2,423 39,854 10,621 11,187

Nevada 97,751 18,601 18,170 1,234 6,170 3,810 2,163 34,102 9,286 9,819

Orange 3,026,786 755,550 346,897 50,120 178,032 96,766 46,079 798,336 209,664 318,173

Placer 348,552 83,608 54,762 5,546 20,640 12,020 6,442 104,542 27,901 25,053

CALIFORNIA

American Lung Association in California

424 Pendleton Way

Oakland, CA 94621

(510)638-5864

www.lungusa.org/california
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 53

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Plumas 20,122 3,615 4,290 240 1,281 814 483 7,441 2,032 2,453

Riverside 2,125,440 615,621 245,456 40,837 118,086 64,267 31,066 533,297 139,608 290,003

Sacramento 1,400,949 361,552 157,628 23,984 81,493 44,281 21,049 365,071 95,904 210,786

San Benito 55,058 15,906 5,110 1,055 3,083 1,663 762 13,513 3,566 7,573

San Bernardino 2,017,673 601,101 172,905 39,874 111,493 58,546 25,840 467,948 122,008 335,321

San Diego 3,053,793 739,625 347,859 49,063 181,385 97,908 46,204 804,440 210,648 372,782

San Francisco 815,358 117,695 114,294 7,807 54,486 29,283 14,044 241,955 62,853 94,134

San Joaquin 674,860 202,135 68,180 13,409 37,098 19,982 9,330 163,489 42,864 103,777

San Luis Obispo 266,971 49,825 39,636 3,305 16,962 9,572 4,880 81,373 21,560 33,198

San Mateo 718,989 160,428 94,255 10,642 43,738 24,475 12,180 205,956 54,613 54,268

Santa Barbara 407,057 96,810 53,553 6,422 24,219 13,250 6,521 110,771 28,968 58,700

Santa Clara 1,784,642 436,221 194,995 28,937 105,776 56,769 26,441 463,876 121,353 159,677

Santa Cruz 256,218 55,780 28,426 3,700 15,763 8,632 4,071 71,010 18,808 34,268

Shasta 181,099 41,659 28,538 2,763 10,878 6,393 3,436 55,709 14,946 27,614

Siskiyou 44,634 9,365 8,647 621 2,742 1,708 990 15,432 4,197 7,083

Solano 407,234 102,344 46,804 6,789 23,930 13,214 6,377 109,749 29,066 42,135

Sonoma 472,102 104,634 64,482 6,941 28,782 16,416 8,351 139,583 37,288 44,093

Stanislaus 510,385 149,225 53,538 9,899 28,322 15,287 7,192 125,454 32,878 85,583

Sutter 92,614 25,610 11,969 1,699 5,231 2,910 1,462 24,562 6,468 13,511

Tehama 61,138 15,300 9,308 1,015 3,574 2,081 1,110 18,068 4,828 11,360

Tulare 429,668 141,279 40,393 9,372 22,622 11,998 5,494 97,299 25,326 97,542

Tuolumne 55,175 9,548 11,095 633 3,540 2,157 1,235 19,353 5,213 7,196

Ventura 802,983 209,334 94,655 13,886 46,559 25,886 12,661 216,244 57,349 83,323

Yolo 199,407 46,043 19,585 3,054 12,034 6,201 2,713 49,304 12,678 30,043

Totals 36,784,738 9,394,103 4,125,946 623,162 2,147,343 1,162,731 550,335 9,567,130 2,509,345 5,102,011

CALIFORNIA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 54

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Alameda 13 1 0 4.8 F 9 0 0 3.0 D 9.4 PASS

Amador 27 6 0 12.0 F DNC DNC DNC DNC DNC DNC DNC

Butte 39 3 0 14.5 F 8 3 0 4.2 F 12.4 PASS

Calaveras 28 3 0 10.8 F 2 0 0 0.7 B 7.5 PASS

Colusa 1 0 0 0.3 B 2 0 0 0.7 B INC INC

Contra Costa 13 0 0 4.3 F 12 0 0 4.0 F 8.7 PASS

El Dorado 82 14 1 35.0 F DNC DNC DNC DNC DNC DNC DNC

Fresno 132 27 2 58.8 F 140 14 0 53.7 F 17.1 FAIL

Glenn 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Humboldt 0 0 0 0.0 A 0 0 0 0.0 A 7.3 PASS

Imperial 58 1 0 19.8 F 8 1 0 3.2 D 8.2 PASS

Inyo 25 0 0 8.3 F 7 1 0 2.8 D 6.5 PASS

Kern 228 51 2 102.8 F 134 29 2 60.5 F 22.6 FAIL

Kings 95 9 1 36.8 F 38 1 0 13.2 F 17.3 FAIL

Lake 0 0 0 0.0 A 1 1 0 0.8 B 4.7 PASS

Los Angeles 182 51 8 91.5 F 51 6 0 20.0 F 15.8 FAIL

Madera 39 3 0 14.5 F DNC DNC DNC DNC DNC DNC DNC

Marin 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Mariposa 66 4 1 24.7 F DNC DNC DNC DNC DNC DNC DNC

Mendocino 0 0 0 0.0 A INC INC INC INC INC 8.1 PASS

Merced 56 9 1 23.8 F 33 1 0 11.5 F INC INC

Monterey 1 0 0 0.3 B 0 0 0 0.0 A 6.7 PASS

Napa 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Nevada 84 5 0 30.5 F 5 2 0 2.7 D 7.1 PASS

Orange 35 2 0 12.7 F 30 2 0 11.0 F 13.2 PASS

Placer 65 5 0 24.2 F 1 0 0 0.3 B 9.0 PASS

CALIFORNIA

American Lung Association in California

424 Pendleton Way

Oakland, CA 94621

(510)638-5864

www.lungusa.org/california
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 55

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

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 16 7 0 8.8 F 11.3 PASS

Riverside 247 77 8 126.2 F 69 3 0 24.5 F 18.8 FAIL

Sacramento 88 22 3 42.3 F 38 1 0 13.2 F 12.1 PASS

San Benito 15 0 0 5.0 F 0 0 0 0.0 A 6.2 PASS

San Bernardino 201 121 14 136.8 F 44 6 0 17.7 F 16.2 FAIL

San Diego 81 5 0 29.5 F 23 3 0 9.2 F 12.8 PASS

San Francisco 0 0 0 0.0 A 5 0 0 1.7 C 9.4 PASS

San Joaquin 27 3 0 10.5 F 25 1 0 8.8 F 12.9 PASS

San Luis Obispo 67 2 0 23.3 F 0 0 0 0.0 A 8.4 PASS

San Mateo 0 0 0 0.0 A 1 0 0 0.3 B 8.7 PASS

Santa Barbara 19 0 0 6.3 F 1 0 0 0.3 B 9.9 PASS

Santa Clara 12 1 0 4.5 F 15 0 0 5.0 F 10.8 PASS

Santa Cruz 0 0 0 0.0 A 0 0 0 0.0 A 6.3 PASS

Shasta 21 1 0 7.5 F 2 2 1 2.3 D 6.3 PASS

Siskiyou 0 0 0 0.0 A INC INC INC INC INC INC INC

Solano 10 0 0 3.3 F 16 0 0 5.3 F 9.8 PASS

Sonoma 0 0 0 0.0 A 0 0 0 0.0 A 8.2 PASS

Stanislaus 45 6 2 19.3 F 37 1 0 12.8 F 14.7 PASS

Sutter 22 2 0 8.3 F 12 6 0 7.0 F 8.9 PASS

Tehama 38 1 0 13.2 F DNC DNC DNC DNC DNC DNC DNC

Tulare 243 38 2 101.3 F 41 2 0 14.7 F 18.8 FAIL

Tuolumne 42 5 0 16.5 F DNC DNC DNC DNC DNC DNC DNC

Ventura 75 2 0 26.0 F 4 0 0 1.3 C 10.9 PASS

Yolo 12 1 0 4.5 F 5 0 0 1.7 C INC INC

CALIFORNIA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 56

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Adams 440,994 124,557 36,530 13,776 26,049 12,891 5,550 101,955 16,544 58,240

Arapahoe 565,360 145,186 63,674 16,058 34,314 18,101 8,672 149,829 24,853 68,473

Boulder 303,482 64,217 27,667 7,102 19,652 9,982 4,391 79,752 12,998 37,975

Denver 610,345 140,109 61,984 15,496 38,694 18,996 8,367 151,397 24,683 112,871

Douglas 288,225 84,641 18,628 9,361 16,747 8,508 3,588 66,941 10,815 9,477

Elbert 23,287 5,631 2,149 623 1,435 812 390 6,766 1,122 1,252

El Paso 604,542 157,382 59,474 17,406 36,611 19,028 8,765 154,968 25,499 67,373

Garfield 56,298 15,830 4,683 1,751 3,320 1,706 758 13,693 2,236 4,775

Jefferson 536,922 119,688 66,241 13,237 33,944 18,572 9,200 156,197 26,087 43,138

La Plata 51,464 10,231 5,652 1,132 3,370 1,780 834 14,611 2,413 5,749

Larimer 298,382 63,365 33,826 7,008 19,232 9,975 4,669 81,722 13,492 42,850

Mesa 146,093 35,058 20,930 3,877 9,015 4,935 2,550 42,216 7,112 16,909

Montezuma 25,368 6,017 3,974 665 1,562 899 487 7,870 1,339 4,238

Pueblo 157,224 38,848 23,477 4,297 9,595 5,310 2,796 45,809 7,748 25,972

Weld 254,759 70,340 21,241 7,780 15,167 7,590 3,296 60,278 9,798 37,033

Totals 4,362,745 1,081,100 450,130 119,569 268,708 139,085 64,313 1,134,004 186,740 536,325

COLORADO

American Lung Association in Colorado

5600 Greenwood Plaza Blvd., Suite 100

Greenwood Village, CO 80111-2316

(303) 388-4327

www.lungusa.org/colorado
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 57

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Adams 8 0 0 2.7 D 3 0 0 1.0 C 9.4 PASS

Arapahoe 5 0 0 1.7 C 1 0 0 0.3 B 7.2 PASS

Boulder 13 0 0 4.3 F 1 0 0 0.3 B 8.0 PASS

Denver 5 0 0 1.7 C 5 0 0 1.7 C 8.7 PASS

Douglas 18 0 0 6.0 F 1 0 0 0.3 B 6.1 PASS

Elbert DNC DNC DNC DNC DNC 0 0 0 0.0 A 4.4 PASS

El Paso 3 0 0 1.0 C 0 0 0 0.0 A INC INC

Garfield INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Jefferson 32 1 0 11.2 F DNC DNC DNC DNC DNC DNC DNC

La Plata 2 0 0 0.7 B INC INC INC INC INC INC INC

Larimer 26 0 0 8.7 F 0 0 0 0.0 A 7.1 PASS

Mesa 1 0 0 0.3 B 6 0 0 2.0 C 9.4 PASS

Montezuma 0 0 0 0.0 A INC INC INC INC INC INC INC

Pueblo DNC DNC DNC DNC DNC 0 0 0 0.0 A INC INC

Weld 3 0 0 1.0 C 3 0 0 1.0 C 8.7 PASS

COLORADO
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 58

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Fairfield 901,208 223,771 119,291 26,823 63,497 30,094 15,271 255,513 44,816 72,291

Hartford 879,835 201,894 126,148 24,200 63,498 30,199 15,570 258,121 45,441 86,396

Litchfield 188,728 40,811 29,408 4,892 13,725 6,864 3,685 59,845 10,726 12,130

Middlesex 165,702 35,045 24,554 4,201 12,186 5,932 3,101 51,066 9,058 9,149

New Haven 848,006 192,012 118,666 23,016 61,586 28,920 14,708 245,616 43,008 97,672

New London 266,830 58,117 37,391 6,966 19,554 9,289 4,739 79,053 13,887 20,119

Tolland 150,461 30,248 17,944 3,626 11,350 5,172 2,467 42,733 7,341 9,140

Totals 3,400,770 781,898 473,402 93,723 245,395 116,470 59,541 991,947 174,277 306,897

CONNECTICUT

American Lung Association in Connecticut

45 Ash Street

East Hartford, CT 06108-3272

(860) 838-4376

www.lungusa.org/connecticut
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 59

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Fairfield 43 7 0 17.8 F 6 0 0 2.0 C 11.3 PASS

Hartford 9 4 0 5.0 F 3 0 0 1.0 C 9.2 PASS

Litchfield 23 0 1 8.3 F 3 0 0 1.0 C 8.8 PASS

Middlesex 19 3 0 7.8 F DNC DNC DNC DNC DNC DNC DNC

New Haven 22 3 0 8.8 F 12 0 0 4.0 F 11.4 PASS

New London 17 1 0 6.2 F 7 0 0 2.3 D 9.6 PASS

Tolland 25 3 0 9.8 F DNC DNC DNC DNC DNC DNC DNC

CONNECTICUT
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 60

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Kent 157,741 39,820 21,087 5,379 10,174 5,140 2,588 43,437 9,359 20,880

New Castle 534,634 127,014 64,384 17,157 35,428 17,582 8,516 146,173 31,533 52,424

Sussex 192,747 40,159 41,222 5,425 12,494 7,287 4,325 66,459 14,445 23,106

Totals 885,122 206,993 126,693 27,961 58,096 30,009 15,429 256,069 55,338 96,410

DELAWARE

American Lung Association in Delaware

630 Churchmans Road, Suite 202

Newark, DE 19702

(302) 737-6414

www.lungusa.org/delaware
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 61

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Kent 11 0 0 3.7 F 1 0 0 0.3 B 11.0 PASS

New Castle 27 1 1 10.2 F 13 0 0 4.3 F 13.0 PASS

Sussex 25 0 0 8.3 F 1 0 0 0.3 B 11.7 PASS

DELAWARE
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 62

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

District Of Columbia 599,657 114,036 70,184 15,905 47,869 20,119 9,253 163,364 36,054 100,489

Totals 599,657 114,036 70,184 15,905 47,869 20,119 9,253 163,364 36,054 100,489

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.lungusa.org/districtofcolumbia
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 63

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

District Of Columbia 29 2 0 10.7 F 8 0 0 2.7 D 12.1 PASS

DISTRICT OF COLUMBIA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 64

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Alachua 243,574 44,381 26,164 3,806 14,299 7,959 3,469 63,118 15,677 53,221

Baker 26,336 6,774 2,832 581 1,420 832 391 6,830 1,698 4,098

Bay 164,767 37,319 24,313 3,201 9,211 5,664 2,936 48,507 12,074 23,220

Brevard 536,357 107,407 111,885 9,212 30,807 20,287 11,864 183,694 45,782 61,045

Broward 1,766,476 408,191 247,665 35,008 98,263 59,944 30,570 509,713 126,849 227,374

Citrus 140,357 22,661 43,327 1,943 8,338 6,003 4,025 58,109 14,503 21,848

Collier 318,537 64,677 85,470 5,547 17,919 12,345 7,927 116,780 29,130 39,648

Columbia 69,264 15,688 10,602 1,345 3,865 2,385 1,250 20,520 5,108 12,354

Duval 857,040 209,772 94,111 17,991 46,938 27,491 12,907 225,503 56,069 128,651

Escambia 303,343 66,386 45,163 5,693 17,065 10,384 5,337 88,524 22,031 53,032

Highlands 98,704 18,492 31,085 1,586 5,612 4,012 2,729 39,049 9,746 19,374

Hillsborough 1,195,317 292,524 140,604 25,088 65,296 38,461 18,402 317,904 79,056 178,302

Holmes 19,099 4,159 3,155 357 1,071 662 352 5,726 1,425 4,115

Lake 312,119 60,215 94,277 5,164 17,646 12,462 8,348 120,357 30,035 38,764

Lee 586,908 119,851 133,488 10,279 33,300 22,167 13,362 203,460 50,721 74,380

Leon 265,714 52,091 24,329 4,467 15,407 8,497 3,568 66,439 16,496 56,589

Manatee 318,361 66,419 72,588 5,696 17,966 11,998 7,260 110,341 27,509 45,156

Marion 328,547 66,036 80,828 5,663 18,664 12,660 7,864 117,903 29,402 50,861

FLORIDA

American Lung Association in Florida

6852 Belfort Oaks Place

Jacksonville, FL 32216

(904) 743-2933

www.lungusa.org/florida
FLORIDA AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 65

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Miami-Dade 2,500,625 574,690 360,396 49,287 138,647 83,905 42,750 712,438 177,283 433,363

Okaloosa 178,473 41,380 24,449 3,549 9,921 6,028 3,049 51,073 12,709 21,741

Orange 1,086,480 266,722 104,455 22,875 59,329 33,715 14,961 269,906 67,063 151,852

Osceola 270,618 73,517 32,277 6,305 14,230 8,425 4,092 70,065 17,426 42,239

Palm Beach 1,279,950 268,835 275,578 23,056 72,082 47,219 27,858 428,817 106,874 180,884

Pasco 471,709 99,991 97,450 8,576 26,553 17,269 10,042 155,780 38,819 61,380

Pinellas 909,013 166,476 190,756 14,277 53,355 35,015 20,358 316,179 78,797 118,620

Polk 583,403 140,675 102,687 12,065 31,722 20,047 11,096 176,709 44,011 95,938

St. Lucie 266,502 60,176 54,424 5,161 14,737 9,601 5,597 86,716 21,610 41,047

Santa Rosa 151,759 35,826 18,915 3,073 8,429 5,091 2,516 42,730 10,631 16,912

Sarasota 369,765 59,808 112,837 5,129 21,886 15,566 10,359 150,015 37,437 46,001

Seminole 413,204 95,808 48,312 8,217 23,079 13,750 6,620 114,090 28,377 42,537

Volusia 495,890 95,962 104,014 8,230 28,641 18,705 10,880 168,834 42,074 73,142

Wakulla 32,815 7,085 4,469 608 1,860 1,120 559 9,433 2,347 4,186

Totals 16,561,026 3,649,994 2,802,905 313,035 927,557 579,669 313,298 5,055,262 1,258,770 2,421,874
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 66

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Alachua 6 0 0 2.0 C 6 0 0 2.0 C 8.0 PASS

Baker 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Bay 8 0 0 2.7 D 1 0 0 0.3 B 9.7 PASS

Brevard 2 0 0 0.7 B 0 0 0 0.0 A 7.1 PASS

Broward 1 0 0 0.3 B 7 0 0 2.3 D 7.3 PASS

Citrus DNC DNC DNC DNC DNC 0 0 0 0.0 A 7.5 PASS

Collier 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Columbia 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Duval 8 0 0 2.7 D 5 3 0 3.2 D 9.0 PASS

Escambia 19 0 0 6.3 F 0 0 0 0.0 A 9.5 PASS

Highlands 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Hillsborough 19 2 0 7.3 F 1 2 0 1.3 C 8.8 PASS

Holmes 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Lake 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

Lee 2 0 0 0.7 B 0 0 0 0.0 A 7.1 PASS

Leon 5 0 0 1.7 C 4 1 0 1.8 C 10.3 PASS

Manatee 4 0 0 1.3 C INC INC INC INC INC INC INC

Marion 3 0 0 1.0 C INC INC INC INC INC INC INC

FLORIDA

American Lung Association in Florida

6852 Belfort Oaks Place

Jacksonville, FL 32216

(904) 743-2933

www.lungusa.org/florida
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 67

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Miami-Dade 7 0 0 2.3 D 4 0 0 1.3 C 8.0 PASS

Okaloosa INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Orange 8 0 0 2.7 D 2 1 0 1.2 C 7.7 PASS

Osceola 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Palm Beach 1 0 0 0.3 B 3 0 0 1.0 C 6.5 PASS

Pasco 9 0 0 3.0 D DNC DNC DNC DNC DNC DNC DNC

Pinellas 5 0 0 1.7 C 2 1 0 1.2 C 8.2 PASS

Polk 7 0 0 2.3 D 1 0 0 0.3 B 8.0 PASS

St. Lucie 0 0 0 0.0 A 1 0 0 0.3 B 7.4 PASS

Santa Rosa 18 0 0 6.0 F DNC DNC DNC DNC DNC DNC DNC

Sarasota 9 0 0 3.0 D 0 0 0 0.0 A 7.1 PASS

Seminole 3 0 0 1.0 C 0 1 0 0.5 B 7.9 PASS

Volusia 1 0 0 0.3 B 2 1 0 1.2 C INC INC

Wakulla 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

FLORIDA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 68 GEORGIA

American Lung Association in Georgia

2452 Spring Road

Smyrna, GA 30080-3862

(770) 434-5864

www.lungusa.org/georgia

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Bibb 156,060 41,737 20,447 4,117 7,860 4,992 2,516 42,212 11,980 32,633

Chatham 256,992 60,605 32,180 5,978 13,524 8,354 4,045 69,365 19,484 39,999

Chattooga 26,619 6,027 3,887 594 1,412 904 464 7,698 2,193 4,925

Clarke 116,342 21,334 10,161 2,104 6,567 3,542 1,371 26,729 7,069 38,764

Clayton 275,772 82,519 21,408 8,139 13,462 7,833 3,327 61,615 16,784 44,330

Cobb 714,692 187,982 65,913 18,542 36,649 22,006 9,856 177,038 48,895 79,679

Columbia 112,958 31,667 10,484 3,124 5,673 3,519 1,632 28,772 8,030 7,624

Coweta 127,111 34,773 12,418 3,430 6,418 3,922 1,809 31,954 8,891 12,627

Dawson 22,555 5,267 2,906 520 1,195 765 383 6,455 1,832 2,627

Dekalb 747,274 178,925 63,618 17,648 39,607 23,195 9,939 183,160 50,019 123,939

Dougherty 95,859 25,584 12,037 2,524 4,835 3,026 1,495 25,354 7,158 25,759

Douglas 129,703 38,446 9,842 3,792 6,379 3,782 1,631 29,981 8,213 15,698

Fayette 106,788 28,538 12,988 2,815 5,443 3,630 1,864 31,073 8,900 5,820

Floyd 96,250 24,210 13,783 2,388 4,936 3,164 1,630 27,006 7,700 18,170

Fulton 1,033,756 249,981 81,901 24,657 54,726 31,869 13,419 249,966 68,002 176,169

Glynn 76,820 19,268 11,403 1,901 3,949 2,602 1,376 22,498 6,464 12,754
GEORGIA AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 69

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Gwinnett 808,167 244,140 55,288 24,081 39,508 23,163 9,726 181,672 49,457 109,334

Hall 187,743 53,786 19,154 5,305 9,271 5,614 2,599 45,745 12,719 27,941

Henry 195,370 59,894 14,625 5,908 9,471 5,624 2,429 44,609 12,226 14,736

Houston 135,715 36,573 14,809 3,607 6,864 4,242 2,015 34,974 9,794 18,099

Lowndes 106,814 26,513 10,373 2,615 5,557 3,233 1,413 25,680 7,028 23,217

Murray 40,621 11,142 4,082 1,099 2,048 1,258 586 10,298 2,873 8,274

Muscogee 190,414 50,163 22,498 4,948 9,671 5,973 2,879 49,512 13,897 32,062

Paulding 136,655 41,515 9,318 4,095 6,650 3,834 1,580 29,816 8,069 9,673

Richmond 199,768 51,212 24,440 5,051 10,234 6,350 3,088 52,838 14,862 43,225

Rockdale 84,569 24,027 8,464 2,370 4,208 2,608 1,226 21,428 5,993 11,010

Sumter 32,084 8,404 4,175 829 1,628 1,025 512 8,631 2,443 8,949

Walker 64,983 15,434 9,532 1,522 3,401 2,211 1,151 18,974 5,429 11,004

Washington 20,879 4,969 2,758 490 1,097 701 352 5,923 1,681 4,709

Wilkinson 10,076 2,661 1,528 262 508 338 182 2,945 849 2,074

Totals 6,309,409 1,667,296 586,420 164,456 322,748 193,279 86,495 1,553,921 428,933 965,824
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 70

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Bibb 17 2 0 6.7 F 17 2 0 6.7 F 13.5 PASS

Chatham 0 0 0 0.0 A 3 0 1 1.7 C 11.3 PASS

Chattooga 10 1 0 3.8 F DNC DNC DNC DNC DNC DNC DNC

Clarke 14 0 0 4.7 F 0 0 0 0.0 A INC INC

Clayton DNC DNC DNC DNC DNC 4 0 0 1.3 C 13.5 PASS

Cobb 22 0 0 7.3 F 5 1 0 2.2 D 13.4 PASS

Columbia 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

Coweta 14 1 0 5.2 F DNC DNC DNC DNC DNC DNC DNC

Dawson 8 0 0 2.7 D DNC DNC DNC DNC DNC DNC DNC

Dekalb 34 4 1 14.0 F 13 1 0 4.8 F 13.3 PASS

Dougherty DNC DNC DNC DNC DNC 5 1 0 2.2 D 12.8 PASS

Douglas 26 1 0 9.2 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 14 0 0 4.7 F 13.3 PASS

Fulton 32 6 1 14.3 F 12 2 0 5.0 F INC INC

Glynn 0 0 0 0.0 A 4 0 0 1.3 C 10.4 PASS

GEORGIA

American Lung Association in Georgia

2452 Spring Road

Smyrna, GA 30080-3862

(770) 434-5864

www.lungusa.org/georgia
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 71

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Gwinnett 29 1 0 10.2 F 1 0 0 0.3 B 12.7 PASS

Hall DNC DNC DNC DNC DNC 2 0 0 0.7 B 11.8 PASS

Henry 27 7 0 12.5 F DNC DNC DNC DNC DNC DNC DNC

Houston DNC DNC DNC DNC DNC 4 2 0 2.3 D 12.3 PASS

Lowndes DNC DNC DNC DNC DNC 0 1 0 0.5 B 10.5 PASS

Murray 22 0 0 7.3 F DNC DNC DNC DNC DNC DNC DNC

Muscogee 7 0 0 2.3 D 6 1 0 2.5 D 13.0 PASS

Paulding 14 0 0 4.7 F 2 0 0 0.7 B 12.0 PASS

Richmond 9 0 0 3.0 D 4 0 0 1.3 C 13.5 PASS

Rockdale 31 5 0 12.8 F DNC DNC DNC DNC DNC DNC DNC

Sumter 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Walker DNC DNC DNC DNC DNC 3 0 0 1.0 C INC INC

Washington DNC DNC DNC DNC DNC 2 0 0 0.7 B 12.5 PASS

Wilkinson DNC DNC DNC DNC DNC 3 0 0 1.0 C INC INC

GEORGIA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 72

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Honolulu 907,574 201,499 135,661 22,640 65,846 30,693 15,732 261,198 58,800 85,138

Maui 145,157 33,217 17,940 3,732 10,587 4,904 2,409 41,056 9,259 14,724

Totals 1,052,731 234,716 153,601 26,372 76,433 35,597 18,141 302,254 68,059 99,862

HAWAII

American Lung Association in Hawaii

630 Iwilei Road, Suite 575

Honolulu, HI 96817

(808) 537-5966

www.lungusa.org/hawaii
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 73

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Honolulu 0 0 0 0.0 A 0 0 0 0.0 A 5.8 PASS

Maui DNC DNC DNC DNC DNC INC INC INC INC INC 4.7 PASS

HAWAII
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 74

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Ada 384,656 99,742 39,263 4,590 23,696 11,973 5,506 97,343 21,303 44,204

Bannock 82,539 22,308 9,161 1,027 5,010 2,528 1,190 20,734 4,545 11,630

Benewah 9,258 2,238 1,652 103 579 335 191 2,999 684 1,483

Butte 2,764 754 490 35 166 97 56 873 200 395

Canyon 186,615 58,702 19,694 2,701 10,639 5,366 2,532 44,055 9,658 33,409

Franklin 12,676 4,370 1,550 201 689 363 185 3,085 687 1,337

Idaho 15,461 3,270 2,999 150 1,004 592 344 5,358 1,228 3,126

Kootenai 139,390 33,776 20,251 1,554 8,747 4,731 2,467 40,642 9,108 18,958

Lemhi 7,908 1,668 1,627 77 513 308 183 2,813 647 1,457

Shoshone 12,660 2,606 2,431 120 829 480 275 4,313 985 1,836

Totals 853,927 229,434 99,118 10,557 51,872 26,773 12,929 222,215 49,045 117,835

IDAHO

American Lung Association in Idaho

1412 W. Idaho St. Suite 100

Boise, ID 83702

(208) 345-5864

www.lungusa.org/idaho
IDAHO AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 75

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Ada 13 0 0 4.3 F 1 0 0 0.3 B 6.9 PASS

Bannock DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Benewah DNC DNC DNC DNC DNC 1 0 0 0.3 B 9.6 PASS

Butte 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Canyon DNC DNC DNC DNC DNC 1 0 0 0.3 B INC INC

Franklin DNC DNC DNC DNC DNC 7 0 0 2.3 D INC INC

Idaho DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Kootenai 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Lemhi DNC DNC DNC DNC DNC 6 1 1 3.2 D INC INC

Shoshone DNC DNC DNC DNC DNC 16 0 0 5.3 F 11.8 PASS
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 76

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Adams 67,054 15,248 11,897 1,416 4,645 2,369 1,314 20,916 4,727 10,109

Champaign 195,671 38,198 19,723 3,548 14,248 6,220 2,652 48,877 10,952 34,982

Clark 16,657 3,770 2,989 350 1,155 594 331 5,258 1,188 2,193

Cook 5,287,037 1,283,145 621,214 119,167 360,936 169,759 80,867 1,400,158 314,356 828,626

Dupage 932,541 230,375 106,059 21,395 63,220 30,691 14,843 255,301 57,227 61,041

Effingham 34,424 8,519 5,369 791 2,325 1,172 628 10,193 2,298 3,485

Hamilton 8,096 1,758 1,600 163 567 296 171 2,664 603 1,121

Jersey 22,549 5,145 3,515 478 1,563 787 418 6,819 1,537 2,171

Kane 511,892 151,648 46,418 14,084 32,497 15,272 6,966 123,874 27,708 47,635

Lake 712,567 195,892 72,500 18,193 46,548 22,412 10,601 184,703 41,352 53,026

Lasalle 112,498 26,391 17,971 2,451 7,727 3,916 2,107 34,124 7,694 13,680

McHenry 320,961 86,135 34,622 7,999 21,147 10,245 4,921 84,982 19,041 21,119

McLean 167,699 37,988 17,097 3,528 11,718 5,304 2,360 42,481 9,517 22,440

Macon 108,204 24,567 17,619 2,282 7,505 3,802 2,051 33,159 7,478 15,822

Macoupin 47,774 10,628 8,149 987 3,331 1,707 936 15,003 3,386 5,589

Madison 268,457 61,590 38,074 5,720 18,600 9,147 4,681 77,902 17,531 34,532

Peoria 185,816 45,421 25,825 4,218 12,629 6,148 3,128 52,197 11,750 29,997

Randolph 32,686 6,798 5,165 631 2,326 1,151 604 9,913 2,234 3,847

Rock Island 146,826 32,736 23,498 3,040 10,244 5,138 2,740 44,566 10,049 15,862

St. Clair 263,617 66,766 33,215 6,201 17,715 8,609 4,279 72,394 16,265 44,084

Sangamon 195,716 46,126 27,378 4,284 13,442 6,706 3,455 57,333 12,894 25,308

Will 685,251 197,658 59,988 18,357 44,004 20,539 9,228 165,545 37,005 47,438

Winnebago 299,702 74,996 40,039 6,965 20,208 9,925 5,034 84,214 18,938 52,161

Totals 10,623,695 2,651,498 1,239,924 246,248 718,300 341,909 164,315 2,832,576 635,731 1,376,268

ILLINOIS

American Lung Association in Illinois

55 W. Wacker Drive, Suite 800

Chicago, IL 60601

(312) 781-1100

www.lungusa.org/illinois
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 77

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Adams 3 0 0 1.0 C 0 0 0 0.0 A INC INC

Champaign 1 0 0 0.3 B 0 0 0 0.0 A 11.5 PASS

Clark 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Cook 19 3 0 7.8 F 26 0 0 8.7 F 13.5 PASS

Dupage 1 0 0 0.3 B 3 0 0 1.0 C 11.6 PASS

Effingham 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Hamilton 4 0 0 1.3 C 2 0 0 0.7 B 12.0 PASS

Jersey 3 0 0 1.0 C 0 0 0 0.0 A 11.1 PASS

Kane 3 0 0 1.0 C 3 0 0 1.0 C 11.6 PASS

Lake 9 0 0 3.0 D 0 0 0 0.0 A 10.0 PASS

Lasalle DNC DNC DNC DNC DNC 0 0 0 0.0 A INC INC

McHenry 2 0 0 0.7 B 1 0 0 0.3 B 10.4 PASS

McLean 3 0 0 1.0 C 0 0 0 0.0 A 11.1 PASS

Macon 5 0 0 1.7 C 2 0 0 0.7 B 12.3 PASS

Macoupin 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Madison 24 1 0 8.5 F 7 0 0 2.3 D 14.1 PASS

Peoria 7 0 0 2.3 D 1 0 0 0.3 B 11.6 PASS

Randolph 7 0 0 2.3 D 1 0 0 0.3 B 11.4 PASS

Rock Island 1 0 0 0.3 B 1 0 0 0.3 B 10.6 PASS

St. Clair 4 1 0 1.8 C 0 0 0 0.0 A 13.3 PASS

Sangamon 2 0 0 0.7 B 0 0 0 0.0 A 11.5 PASS

Will 0 0 0 0.0 A 3 0 0 1.0 C 12.3 PASS

Winnebago 1 0 0 0.3 B 3 0 0 1.0 C 10.9 PASS

ILLINOIS
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 78

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Allen 353,888 94,334 41,674 9,214 23,611 11,246 5,486 93,796 23,943 51,005

Boone 56,287 15,534 6,549 1,517 3,716 1,813 900 15,259 3,955 4,374

Carroll 19,752 4,808 2,921 470 1,350 680 359 5,878 1,541 1,935

Clark 108,634 25,544 14,060 2,495 7,544 3,636 1,809 30,586 7,852 12,743

Delaware 115,192 23,184 17,118 2,264 8,293 3,939 1,982 33,230 8,421 22,254

Dubois 41,419 10,525 5,897 1,028 2,794 1,398 732 12,038 3,147 2,918

Elkhart 200,502 57,100 23,070 5,577 13,036 6,172 2,998 51,364 13,059 28,473

Floyd 74,426 17,748 9,784 1,734 5,148 2,518 1,271 21,335 5,524 9,041

Gibson 32,750 7,920 4,982 774 2,239 1,124 597 9,736 2,546 3,640

Greene 32,463 7,473 5,123 730 2,252 1,140 612 9,927 2,606 5,277

Hamilton 279,287 80,421 23,749 7,855 18,283 8,380 3,743 67,395 16,910 15,521

Hancock 68,334 18,032 8,847 1,761 4,568 2,256 1,151 19,207 4,999 4,394

Hendricks 140,606 36,778 14,872 3,592 9,489 4,457 2,101 36,651 9,304 6,897

Henry 47,827 10,639 7,623 1,039 3,347 1,677 894 14,547 3,796 6,776

Howard 82,895 20,023 13,148 1,956 5,657 2,865 1,544 24,980 6,553 12,369

Huntington 37,777 8,891 5,915 868 2,601 1,308 698 11,357 2,970 3,796

Jackson 42,362 10,461 6,020 1,022 2,882 1,415 730 12,094 3,128 5,554

INDIANA

American Lung Association in Indiana

115 W. Washington Street, Suite 1180 South

Indianapolis, IN 46204

(317) 819-1181

www.lungusa.org/indiana
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 79

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Johnson 141,501 36,141 17,019 3,530 9,582 4,570 2,234 38,153 9,745 13,521

Knox 37,907 8,025 6,143 784 2,686 1,328 703 11,476 2,971 6,338

Lake 494,211 130,241 64,495 12,721 33,010 16,173 8,221 137,413 35,584 79,923

Laporte 111,063 25,690 15,722 2,509 7,729 3,810 1,961 32,549 8,448 15,114

Madison 131,417 29,943 21,038 2,925 9,123 4,552 2,427 39,473 10,271 18,309

Marion 890,879 227,659 96,665 22,236 60,465 27,928 13,035 228,393 57,284 171,860

Monroe 130,738 21,695 13,685 2,119 9,941 4,252 1,792 33,230 7,886 25,663

Morgan 70,876 17,415 8,790 1,701 4,871 2,391 1,198 20,210 5,254 7,152

Perry 18,812 3,963 2,737 387 1,344 660 339 5,629 1,457 2,062

Porter 163,598 39,282 19,922 3,837 11,325 5,468 2,693 45,836 11,804 12,162

Posey 26,004 5,939 3,521 580 1,826 917 473 7,852 2,064 2,147

St. Joseph 267,613 66,371 35,286 6,483 18,227 8,757 4,381 73,801 18,885 41,682

Shelby 44,503 10,905 5,982 1,065 3,049 1,505 770 12,825 3,336 5,447

Spencer 20,039 4,739 2,997 463 1,383 701 372 6,079 1,600 1,983

Tippecanoe 167,964 35,084 16,294 3,427 12,129 5,202 2,188 40,641 9,674 31,945

Vanderburgh 175,434 38,778 25,834 3,788 12,336 6,014 3,092 51,293 13,209 25,579

Vigo 105,967 22,696 14,276 2,217 7,542 3,574 1,762 29,910 7,592 20,152

Warrick 58,521 14,653 7,502 1,431 3,992 1,978 1,006 16,826 4,393 4,623

Totals 4,791,448 1,188,634 589,260 116,099 327,373 155,804 76,254 1,300,969 331,710 682,629

INDIANA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 80

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Allen 8 0 0 2.7 D 4 0 0 1.3 C 12.0 PASS

Boone 10 0 0 3.3 F DNC DNC DNC DNC DNC DNC DNC

Carroll 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Clark 29 0 0 9.7 F 18 0 0 6.0 F 14.7 PASS

Delaware 9 0 0 3.0 D 3 0 0 1.0 C 12.0 PASS

Dubois DNC DNC DNC DNC DNC 8 0 0 2.7 D INC INC

Elkhart 8 0 0 2.7 D 6 1 0 2.5 D INC INC

Floyd 18 2 0 7.0 F 5 0 0 1.7 C 13.1 PASS

Gibson DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Greene 16 0 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

Hamilton 19 0 0 6.3 F DNC DNC DNC DNC DNC DNC DNC

Hancock 13 0 0 4.3 F DNC DNC DNC DNC DNC DNC DNC

Hendricks 10 0 0 3.3 F DNC DNC DNC DNC DNC DNC DNC

Henry DNC DNC DNC DNC DNC 1 0 0 0.3 B 11.7 PASS

Howard DNC DNC DNC DNC DNC 2 0 0 0.7 B 12.0 PASS

Huntington 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

Jackson 9 0 0 3.0 D 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.lungusa.org/indiana
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 81

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Johnson 16 0 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

Knox DNC DNC DNC DNC DNC 1 0 0 0.3 B 12.3 PASS

Lake 16 0 0 5.3 F 9 0 0 3.0 D 12.9 PASS

Laporte 11 0 0 3.7 F 3 0 0 1.0 C 11.2 PASS

Madison 6 0 0 2.0 C 5 0 0 1.7 C 12.4 PASS

Marion 24 0 0 8.0 F 15 0 0 5.0 F 14.3 PASS

Monroe DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Morgan 18 0 0 6.0 F DNC DNC DNC DNC DNC DNC DNC

Perry 13 0 0 4.3 F DNC DNC DNC DNC DNC DNC DNC

Porter 11 0 0 3.7 F 2 0 0 0.7 B 12.0 PASS

Posey 14 0 0 4.7 F DNC DNC DNC DNC DNC DNC DNC

St. Joseph 6 0 0 2.0 C 6 0 0 2.0 C 11.8 PASS

Shelby 23 0 0 7.7 F DNC DNC DNC DNC DNC DNC DNC

Spencer DNC DNC DNC DNC DNC 2 0 0 0.7 B 12.6 PASS

Tippecanoe DNC DNC DNC DNC DNC 3 0 0 1.0 C 11.9 PASS

Vanderburgh 32 0 0 10.7 F 1 0 0 0.3 B 13.1 PASS

Vigo 9 0 0 3.0 D 4 0 0 1.3 C 12.8 PASS

Warrick 17 0 0 5.7 F DNC DNC DNC DNC DNC DNC DNC

INDIANA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 82

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Black Hawk 129,276 27,996 18,483 1,334 6,873 4,362 2,192 36,797 7,280 21,437

Bremer 23,460 5,331 3,973 254 1,230 823 448 7,205 1,448 1,633

Clinton 48,934 11,584 8,110 552 2,530 1,714 937 15,040 3,022 5,727

Delaware 17,205 4,235 2,860 202 876 608 337 5,376 1,082 1,571

Harrison 15,328 3,610 2,685 172 793 549 308 4,874 984 1,592

Johnson 131,005 25,308 10,923 1,206 7,157 4,097 1,641 31,416 5,933 20,390

Lee 35,447 7,789 6,031 371 1,870 1,284 707 11,317 2,275 5,021

Linn 209,226 50,767 26,536 2,419 10,716 6,845 3,368 57,277 11,263 19,441

Montgomery 10,796 2,549 2,116 121 559 395 231 3,582 730 1,532

Muscatine 42,934 11,301 5,457 538 2,133 1,406 710 11,916 2,352 5,074

Palo Alto 9,279 2,059 1,979 98 493 342 203 3,114 638 973

Polk 429,439 109,037 48,212 5,194 21,647 13,590 6,427 111,776 21,796 45,826

Pottawattamie 90,224 21,453 12,723 1,022 4,646 3,071 1,583 26,252 5,208 11,485

Scott 166,650 41,299 21,122 1,967 8,461 5,495 2,734 46,238 9,104 20,482

Story 87,214 15,399 9,090 734 4,884 2,790 1,175 21,786 4,168 13,285

Van Buren 7,679 1,800 1,499 86 400 277 161 2,502 510 1,347

Warren 45,275 11,229 6,034 535 2,298 1,510 767 12,827 2,536 3,143

Woodbury 102,831 27,862 13,138 1,327 5,069 3,281 1,647 27,703 5,469 14,689

Wright 12,716 2,989 2,640 142 661 469 280 4,294 879 1,274

Totals 1,614,918 383,597 203,611 18,274 83,298 52,908 25,856 441,292 86,677 195,922

IOWA

American Lung Association in Iowa

2530 73rd Street

Des Moines, IA 50322

(515) 309-9507

www.lungusa.org/iowa
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 83

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

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 6 0 0 2.0 C 11.1 PASS

Bremer 2 0 0 0.7 B INC INC INC INC INC INC INC

Clinton 2 0 0 0.7 B 12 0 0 4.0 F 12.7 PASS

Delaware DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Harrison 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Johnson DNC DNC DNC DNC DNC 8 0 0 2.7 D 11.1 PASS

Lee DNC DNC DNC DNC DNC 0 0 0 0.0 A 11.4 PASS

Linn 5 0 0 1.7 C 7 0 0 2.3 D 10.3 PASS

Montgomery 0 0 0 0.0 A 1 0 0 0.3 B 9.3 PASS

Muscatine DNC DNC DNC DNC DNC 20 1 0 7.2 F 13.1 PASS

Palo Alto 0 0 0 0.0 A 2 0 0 0.7 B 9.0 PASS

Polk 0 0 0 0.0 A 3 0 0 1.0 C 10.0 PASS

Pottawattamie DNC DNC DNC DNC DNC 3 0 0 1.0 C 10.6 PASS

Scott 1 0 0 0.3 B 16 0 0 5.3 F 13.6 PASS

Story 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Van Buren 2 0 0 0.7 B 0 0 0 0.0 A 9.6 PASS

Warren 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Woodbury DNC DNC DNC DNC DNC 4 0 0 1.3 C INC INC

Wright DNC DNC DNC DNC DNC 4 0 0 1.3 C 10.0 PASS

IOWA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 84

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Johnson 542,737 137,982 58,284 11,409 34,716 17,336 8,171 142,523 32,752 36,346

Leavenworth 75,227 18,784 7,905 1,553 4,837 2,423 1,137 19,886 4,568 6,521

Linn 9,335 2,179 1,621 180 580 338 190 3,007 707 1,180

Sedgwick 490,864 132,853 56,259 10,985 30,628 15,390 7,427 127,736 29,428 65,212

Shawnee 176,255 43,224 24,841 3,574 11,165 5,923 3,056 50,643 11,770 28,476

Sumner 23,488 6,012 3,529 497 1,438 807 434 7,039 1,646 2,631

Trego 2,920 622 668 51 181 114 70 1,057 251 331

Wyandotte 155,085 43,360 16,463 3,585 9,626 4,737 2,229 38,884 8,928 32,788

Totals 1,475,911 385,016 169,570 31,836 93,170 47,068 22,714 390,775 90,051 173,485

KANSAS

American Lung Association in Kansas

2400 Troost Avenue, #4300

Kansas City, MO 64108

(816) 842-5242

www.lungusa.org/kansas
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 85

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Johnson 3 0 0 1.0 C 0 0 0 0.0 A 9.6 PASS

Leavenworth 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

Linn 0 0 0 0.0 A 0 0 0 0.0 A 9.7 PASS

Sedgwick 2 0 0 0.7 B 1 0 0 0.3 B 9.6 PASS

Shawnee 0 0 0 0.0 A 1 0 0 0.3 B 10.0 PASS

Sumner 4 0 0 1.3 C 0 0 0 0.0 A 9.1 PASS

Trego 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Wyandotte 3 0 0 1.0 C 0 0 0 0.0 A 10.7 PASS

KANSAS
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 86

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Bell 28,972 6,575 4,319 622 2,271 997 519 8,555 2,668 10,118

Boone 118,576 32,414 11,477 3,068 8,771 3,647 1,673 29,643 9,336 9,289

Boyd 48,527 10,537 7,268 997 3,852 1,704 888 14,636 4,572 9,681

Bullitt 75,653 17,731 7,900 1,678 5,895 2,503 1,173 20,551 6,487 8,017

Campbell 88,423 20,026 11,298 1,896 6,947 2,966 1,458 24,821 7,770 9,494

Carter 26,771 6,503 2,936 616 2,062 876 416 7,233 2,277 6,537

Christian 80,938 23,810 8,303 2,254 5,812 2,326 1,056 18,766 5,850 14,157

Daviess 95,394 23,679 14,025 2,241 7,269 3,223 1,692 27,771 8,666 14,147

Edmonson 11,926 2,526 1,769 239 953 424 221 3,638 1,138 2,453

Fayette 296,545 63,248 31,927 5,987 23,746 9,616 4,347 77,537 24,288 49,376

Franklin 48,968 10,646 6,764 1,008 3,889 1,702 864 14,449 4,525 6,631

Greenup 38,020 8,204 7,299 777 3,012 1,389 792 12,423 3,848 5,992

Hancock 8,635 2,298 1,087 218 643 284 144 2,417 759 1,125

Hardin 99,770 25,996 12,070 2,461 7,494 3,221 1,586 26,982 8,460 14,037

Henderson 45,496 10,680 6,589 1,011 3,530 1,568 817 13,475 4,214 7,436

Jefferson 721,594 169,839 96,692 16,076 56,004 24,217 12,181 204,688 64,009 111,718

Jessamine 47,589 11,965 5,125 1,133 3,624 1,515 711 12,426 3,903 6,455

KENTUCKY

American Lung Association in Kentucky

4100 Churchman Avenue

Louisville, KY 40215

(502) 363-2652

www.lungusa.org/kentucky
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 87

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Kenton 158,729 39,121 17,249 3,703 12,167 5,123 2,416 42,123 13,245 20,669

Larue 13,663 3,146 2,245 298 1,065 482 262 4,216 1,313 2,260

Livingston 9,598 1,885 1,660 178 781 358 196 3,150 983 1,392

McCracken 65,880 14,855 10,980 1,406 5,164 2,347 1,281 20,592 6,415 10,022

Madison 83,258 17,741 9,007 1,679 6,668 2,699 1,221 21,769 6,817 14,903

Ohio 23,534 5,691 3,614 539 1,808 806 429 6,990 2,179 4,029

Oldham 58,095 15,346 5,363 1,453 4,354 1,866 866 15,271 4,843 3,164

Perry 29,136 6,914 3,627 654 2,257 975 482 8,185 2,569 7,965

Pike 65,446 14,377 8,751 1,361 5,185 2,269 1,144 19,218 6,028 16,618

Pulaski 60,853 13,744 10,274 1,301 4,767 2,148 1,172 18,827 5,853 11,635

Simpson 17,019 4,050 2,404 383 1,315 577 297 4,927 1,540 2,529

Trigg 13,290 2,792 2,478 264 1,061 494 280 4,415 1,373 2,011

Warren 108,669 25,046 12,138 2,371 8,506 3,485 1,612 28,380 8,882 17,556

Totals 2,588,967 611,385 326,638 57,869 200,872 85,807 42,196 718,074 224,812 401,416

KENTUCKY
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 88

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Bell 19 0 0 6.3 F 1 1 0 0.8 B 12.7 PASS

Boone 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

Boyd 6 0 0 2.0 C 4 0 0 1.3 C 12.4 PASS

Bullitt 10 0 0 3.3 F 4 0 0 1.3 C 13.3 PASS

Campbell 21 0 0 7.0 F 0 0 0 0.0 A INC INC

Carter 2 0 0 0.7 B 1 0 0 0.3 B 10.6 PASS

Christian 24 0 0 8.0 F 4 0 0 1.3 C INC INC

Daviess 19 0 0 6.3 F 2 0 0 0.7 B 12.7 PASS

Edmonson 16 0 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

Fayette 7 0 0 2.3 D 3 0 0 1.0 C 12.5 PASS

Franklin DNC DNC DNC DNC DNC 3 0 0 1.0 C 11.8 PASS

Greenup 12 0 0 4.0 F DNC DNC DNC DNC DNC DNC DNC

Hancock 15 0 0 5.0 F DNC DNC DNC DNC DNC DNC DNC

Hardin 13 0 0 4.3 F 3 0 0 1.0 C 12.5 PASS

Henderson 15 0 0 5.0 F 2 0 0 0.7 B 12.6 PASS

Jefferson 34 1 0 11.8 F 9 0 0 3.0 D 13.6 PASS

Jessamine 17 0 0 5.7 F DNC DNC DNC DNC DNC DNC DNC

KENTUCKY

American Lung Association in Kentucky

4100 Churchman Avenue

Louisville, KY 40215

(502) 363-2652

www.lungusa.org/kentucky
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 89

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Kenton 15 0 0 5.0 F 1 0 0 0.3 B 12.3 PASS

Larue INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Livingston 7 0 0 2.3 D DNC DNC DNC DNC DNC DNC DNC

McCracken 7 0 0 2.3 D 2 0 0 0.7 B 12.4 PASS

Madison DNC DNC DNC DNC DNC 2 0 0 0.7 B 11.2 PASS

Ohio DNC DNC DNC DNC DNC 2 0 0 0.7 B 12.5 PASS

Oldham 22 0 0 7.3 F DNC DNC DNC DNC DNC DNC DNC

Perry 4 0 0 1.3 C INC INC INC INC INC INC INC

Pike 9 0 0 3.0 D 4 0 0 1.3 C 11.3 PASS

Pulaski 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Simpson 16 0 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

Trigg 16 0 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

Warren 6 0 0 2.0 C 6 0 0 2.0 C INC INC

KENTUCKY
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 90 LOUISIANA

American Lung Association in Louisiana

2325 Severn Avenue, Suite 8

Metairie, LA 70001-6918

(504) 828-5864

www.lungusa.org/louisiana

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

Parish Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Ascension Parish 104,822 29,957 8,934 2,814 4,739 3,115 1,376 24,924 7,474 11,624

Bossier Parish 111,492 28,647 13,343 2,691 5,232 3,533 1,706 29,308 8,898 15,618

Caddo Parish 253,623 63,531 34,410 5,968 11,962 8,316 4,210 70,449 21,514 41,924

Calcasieu Parish 187,554 48,353 23,737 4,542 8,761 6,071 3,020 51,055 15,551 30,062

East Baton Rouge 

Parish 434,633 104,315 47,200 9,799 20,919 13,790 6,363 112,195 33,867 73,717

Iberville Parish 32,505 7,500 3,982 705 1,577 1,076 521 8,943 2,715 5,875

Jefferson Parish 443,342 102,048 60,959 9,586 21,423 15,138 7,702 128,647 39,286 60,410

Lafayette Parish 210,954 52,785 22,292 4,959 10,008 6,634 3,062 54,006 16,298 28,188

Lafourche Parish 93,682 22,920 11,527 2,153 4,459 3,059 1,496 25,533 7,760 14,211

Livingston Parish 123,326 33,952 12,239 3,189 5,654 3,750 1,720 30,457 9,182 14,735

Orleans Parish 354,850 76,343 41,687 7,172 17,555 11,977 5,714 98,965 29,973 82,240

Ouachita Parish 151,502 40,117 18,633 3,769 7,033 4,763 2,327 39,704 12,074 30,520

Pointe Coupee Parish 22,447 5,428 3,473 510 1,063 780 419 6,795 2,089 4,074

Rapides Parish 133,937 34,893 18,460 3,278 6,222 4,381 2,251 37,372 11,432 20,090

St. Bernard Parish 40,655 10,889 3,754 1,023 1,875 1,278 586 10,397 3,130 8,619

St. Charles Parish 51,611 13,858 5,100 1,302 2,375 1,637 768 13,447 4,060 6,129

St. James Parish 21,054 5,616 2,647 528 969 684 344 5,789 1,765 3,142

St. John The Baptist 

Parish 47,086 13,034 4,460 1,224 2,148 1,454 669 11,841 3,568 7,405

St. Tammany Parish 231,495 59,772 28,350 5,615 10,765 7,651 3,828 64,605 19,671 23,675

Tangipahoa Parish 118,688 30,378 13,377 2,854 5,580 3,744 1,773 30,803 9,327 23,559

Terrebonne Parish 109,291 29,235 12,535 2,746 5,049 3,439 1,657 28,525 8,653 16,951

West Baton Rouge 

Parish 22,638 5,682 2,443 534 1,069 729 345 6,005 1,816 3,170

Totals 3,301,187 819,253 393,542 76,960 156,435 106,999 51,857 889,765 270,104 525,938
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 91

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

Parish Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Ascension Parish 13 2 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

Bossier Parish 7 1 0 2.8 D DNC DNC DNC DNC DNC DNC DNC

Caddo Parish 5 0 0 1.7 C 0 0 0 0.0 A 11.2 PASS

Calcasieu Parish 14 1 0 5.2 F 0 0 0 0.0 A 9.3 PASS

East Baton Rouge 

Parish 33 1 0 11.5 F 0 0 0 0.0 A 11.0 PASS

Iberville Parish 30 2 0 11.0 F 0 0 0 0.0 A 11.1 PASS

Jefferson Parish 14 1 0 5.2 F 2 0 0 0.7 B 9.4 PASS

Lafayette Parish 9 0 0 3.0 D 0 0 0 0.0 A 9.4 PASS

Lafourche Parish 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

Livingston Parish 15 0 0 5.0 F DNC DNC DNC DNC DNC DNC DNC

Orleans Parish INC INC INC INC INC INC INC INC INC INC INC INC

Ouachita Parish 0 0 0 0.0 A 0 0 0 0.0 A 9.7 PASS

Pointe Coupee Parish 17 0 0 5.7 F DNC DNC DNC DNC DNC DNC DNC

Rapides Parish DNC DNC DNC DNC DNC 0 0 0 0.0 A 9.1 PASS

St. Bernard Parish 6 0 0 2.0 C 0 0 0 0.0 A 10.9 PASS

St. Charles Parish 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

St. James Parish 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

St. John The Baptist 

Parish 16 0 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

St. Tammany Parish INC INC INC INC INC INC INC INC INC INC INC INC

Tangipahoa Parish DNC DNC DNC DNC DNC 0 0 0 0.0 A 9.9 PASS

Terrebonne Parish DNC DNC DNC DNC DNC 0 0 0 0.0 A 8.8 PASS

West Baton Rouge 

Parish 6 0 0 2.0 C 1 1 0 0.8 B 11.5 PASS

LOUISIANA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 92

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Androscoggin 106,539 23,426 15,781 2,192 9,036 3,702 1,919 31,711 6,701 15,427

Aroostook 71,488 14,397 13,161 1,347 6,092 2,684 1,510 23,889 5,138 11,441

Cumberland 278,559 57,847 39,768 5,412 23,997 9,833 5,028 83,762 17,728 25,188

Hancock 53,447 9,921 9,238 928 4,649 2,042 1,121 17,986 3,875 6,162

Kennebec 121,090 25,103 18,749 2,349 10,346 4,388 2,326 38,009 8,120 15,201

Knox 40,801 7,749 7,695 725 3,522 1,559 881 13,906 2,994 5,352

Oxford 56,244 11,913 9,130 1,115 4,740 2,074 1,128 18,192 3,918 7,679

Penobscot 149,419 29,745 21,580 2,783 13,043 5,292 2,694 44,971 9,484 21,854

Piscataquis 16,795 3,318 3,099 310 1,425 651 370 5,830 1,267 2,657

Sagadahoc 36,391 7,611 5,567 712 3,095 1,325 703 11,486 2,462 3,439

Washington 32,107 6,455 6,015 604 2,733 1,211 686 10,816 2,329 6,414

York 201,876 42,452 30,512 3,972 17,177 7,296 3,849 63,083 13,491 16,711

Totals 1,164,756 239,937 180,295 22,448 99,854 42,057 22,215 363,641 77,506 137,525

MAINE

American Lung Association in Maine

122 State Street

Augusta, ME 04330

(207) 624-0308

www.lungusa.org/maine
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 93

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Androscoggin 7 0 0 2.3 D 1 0 0 0.3 B 8.3 PASS

Aroostook 3 0 0 1.0 C 1 0 0 0.3 B 7.3 PASS

Cumberland 7 1 0 2.8 D 0 0 0 0.0 A 9.1 PASS

Hancock 15 1 0 5.5 F 0 0 0 0.0 A 4.8 PASS

Kennebec 6 0 0 2.0 C 0 0 0 0.0 A 8.2 PASS

Knox 7 1 0 2.8 D DNC DNC DNC DNC DNC DNC DNC

Oxford 2 0 0 0.7 B 1 0 0 0.3 B 8.6 PASS

Penobscot 3 0 0 1.0 C 0 0 0 0.0 A 7.9 PASS

Piscataquis DNC DNC DNC DNC DNC 0 0 0 0.0 A 5.6 PASS

Sagadahoc 4 1 0 1.8 C DNC DNC DNC DNC DNC DNC DNC

Washington 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

York 13 1 0 4.8 F DNC DNC DNC DNC DNC DNC DNC

MAINE
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 94

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Anne Arundel 521,209 121,140 60,879 14,459 36,414 17,378 8,383 144,332 36,837 34,650

Baltimore 789,814 173,026 113,391 20,652 55,907 27,230 13,920 231,770 59,819 63,931

Calvert 89,212 22,948 9,284 2,739 5,966 2,930 1,405 24,315 6,208 4,749

Carroll 170,089 41,821 21,874 4,992 11,494 5,766 2,924 48,994 12,646 9,735

Cecil 100,796 24,927 11,978 2,975 6,881 3,323 1,626 27,777 7,112 9,903

Charles 142,226 38,002 13,247 4,536 9,550 4,438 2,026 36,021 9,091 8,966

Frederick 227,980 58,175 24,364 6,944 15,423 7,390 3,521 61,091 15,561 12,674

Garrett 29,555 6,361 5,141 759 2,064 1,069 589 9,418 2,469 3,643

Harford 242,514 59,776 29,902 7,135 16,488 8,095 4,027 68,170 17,518 14,948

Kent 20,247 3,646 4,089 435 1,475 772 441 6,911 1,824 2,708

Montgomery 971,600 237,621 119,511 28,362 66,484 32,270 15,952 270,900 69,497 64,607

Prince George’s 834,560 206,580 79,223 24,657 57,809 26,489 11,979 214,060 53,894 63,748

Washington 145,910 33,346 20,874 3,980 10,229 4,947 2,528 42,087 10,858 17,103

Worcester 49,122 9,236 11,303 1,102 3,474 1,937 1,174 17,846 4,770 5,828

Baltimore City 637,418 142,991 75,292 17,067 45,686 20,844 9,842 171,242 43,434 127,205

Totals 4,972,252 1,179,596 600,352 140,794 345,345 164,878 80,337 1,374,934 351,538 444,398

MARYLAND

American Lung Association in Maryland

211 E. Lombard St., #260 

Baltimore, MD 21202

(443) 451-4950

www.lungusa.org/maryland
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 95

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Anne Arundel 31 1 1 11.5 F 4 0 0 1.3 C 12.4 PASS

Baltimore 24 3 0 9.5 F 14 0 0 4.7 F 12.6 PASS

Calvert 16 0 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

Carroll 28 1 0 9.8 F DNC DNC DNC DNC DNC DNC DNC

Cecil 34 1 1 12.5 F 1 0 0 0.3 B 11.1 PASS

Charles 24 1 0 8.5 F DNC DNC DNC DNC DNC DNC DNC

Frederick 21 0 0 7.0 F DNC DNC DNC DNC DNC DNC DNC

Garrett 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Harford 49 6 0 19.3 F 0 0 0 0.0 A 11.0 PASS

Kent 24 1 0 8.5 F DNC DNC DNC DNC DNC DNC DNC

Montgomery 21 1 0 7.5 F 2 0 0 0.7 B 10.7 PASS

Prince George’s 34 3 0 12.8 F 4 0 0 1.3 C 12.4 PASS

Washington 12 0 0 4.0 F 2 0 0 0.7 B 11.5 PASS

Worcester 5 1 0 2.2 D DNC DNC DNC DNC DNC DNC DNC

Baltimore City 3 0 0 1.0 C 13 0 0 4.3 F 12.9 PASS

MARYLAND
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 96

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Barnstable 221,151 38,601 54,200 3,311 18,648 9,013 5,575 83,915 18,511 17,523

Berkshire 129,288 25,431 23,942 2,181 10,898 4,858 2,726 43,175 9,383 15,715

Bristol 547,433 122,508 76,257 10,507 45,682 18,808 9,569 159,810 34,195 59,101

Dukes 15,974 3,037 2,651 260 1,357 609 332 5,347 1,158 1,302

Essex 742,582 172,076 103,403 14,758 61,003 25,633 13,194 219,095 46,990 78,064

Hampden 471,081 111,135 66,005 9,531 38,668 15,951 8,167 135,901 29,105 78,142

Hampshire 156,044 26,761 19,958 2,295 14,081 5,541 2,656 45,856 9,718 15,471

Middlesex 1,505,006 320,068 193,906 27,450 128,458 51,377 25,194 429,429 91,337 107,851

Norfolk 666,303 150,086 94,682 12,872 55,257 23,113 11,908 197,575 42,372 41,225

Plymouth 498,344 120,510 66,869 10,335 40,352 17,052 8,747 145,601 31,222 37,172

Suffolk 753,580 137,120 79,915 11,760 68,931 24,454 10,556 193,107 40,152 123,939

Worcester 803,701 189,444 101,026 16,247 66,230 27,057 13,425 227,513 48,510 73,188

Totals 6,510,487 1,416,777 882,814 121,507 549,565 223,466 112,049 1,886,324 402,654 648,693

MASSACHUSETTS

American Lung Association in Massachusetts

460 Totten Pond Road, Suite 400

Waltham, MA 02451-1991

(781) 314-9006

www.lungusa.org/massachusetts
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 97

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Barnstable 16 1 0 5.8 F DNC DNC DNC DNC DNC DNC DNC

Berkshire 14 1 0 5.2 F 2 0 0 0.7 B 9.6 PASS

Bristol 8 0 0 2.7 D 0 0 0 0.0 A 8.8 PASS

Dukes 9 2 0 4.0 F DNC DNC DNC DNC DNC DNC DNC

Essex 23 2 0 8.7 F 0 0 0 0.0 A 9.0 PASS

Hampden 24 4 0 10.0 F 2 0 0 0.7 B 10.8 PASS

Hampshire 27 2 0 10.0 F DNC DNC DNC DNC DNC DNC DNC

Middlesex 17 0 0 5.7 F 0 0 0 0.0 A 8.6 PASS

Norfolk 21 0 0 7.0 F DNC DNC DNC DNC DNC DNC DNC

Plymouth DNC DNC DNC DNC DNC 1 0 0 0.3 B 9.2 PASS

Suffolk 9 0 0 3.0 D 4 0 0 1.3 C 11.1 PASS

Worcester 30 2 0 11.0 F 1 0 0 0.3 B 10.3 PASS

MASSACHUSETTS
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 98

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Allegan 113,449 28,965 14,401 2,354 8,436 3,776 1,908 32,021 8,110 12,850

Bay 107,434 23,593 17,390 1,917 8,288 3,836 2,067 33,458 8,558 13,465

Benzie 17,227 3,649 3,458 297 1,325 648 378 5,862 1,520 2,256

Berrien 160,472 38,392 25,377 3,120 12,067 5,586 3,012 48,738 12,467 27,259

Cass 49,925 11,218 7,116 912 3,851 1,773 926 15,270 3,896 7,837

Clinton 69,893 17,379 9,112 1,412 5,239 2,364 1,205 20,127 5,108 5,253

Emmet 33,649 7,268 5,847 591 2,598 1,229 681 10,861 2,793 3,803

Genesee 424,043 105,917 56,823 8,606 31,692 14,136 7,201 120,211 30,434 80,851

Huron 32,236 6,653 6,892 541 2,487 1,242 741 11,365 2,961 4,905

Ingham 277,633 58,542 30,034 4,757 22,063 9,013 4,069 72,627 17,897 49,909

Kalamazoo 248,407 54,936 30,047 4,464 19,390 8,173 3,884 67,329 16,768 46,977

Kent 608,315 157,173 66,257 12,771 45,321 19,167 9,023 157,389 39,211 86,639

Leelanau 21,899 4,239 4,675 344 1,719 871 520 7,977 2,083 2,096

Lenawee 99,837 23,142 14,432 1,880 7,621 3,441 1,787 29,510 7,497 12,606

Macomb 831,427 191,006 117,603 15,520 63,710 28,400 14,553 242,054 61,291 89,772

Manistee 24,439 4,730 4,926 384 1,926 941 546 8,495 2,202 3,214

Mason 28,637 6,053 5,516 492 2,210 1,075 618 9,666 2,503 5,024

MICHIGAN

American Lung Association in Michigan

25900 Greenfield Road, Suite 601

Oak Park, MI 48237

(248) 784-2000

www.lungusa.org/michigan
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 99

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Missaukee 14,838 3,509 2,411 285 1,118 527 289 4,635 1,191 2,202

Monroe 152,721 36,106 19,733 2,934 11,648 5,219 2,635 44,248 11,209 16,239

Muskegon 173,951 42,480 23,181 3,452 13,105 5,815 2,943 49,304 12,465 31,179

Oakland 1,205,508 281,639 155,733 22,885 92,295 41,218 20,745 348,930 88,316 116,380

Ottawa 261,957 67,413 30,329 5,478 19,497 8,340 4,009 69,102 17,281 26,051

St. Clair 167,562 39,837 23,360 3,237 12,711 5,767 2,984 49,417 12,566 22,280

Schoolcraft 8,127 1,611 1,701 131 635 316 187 2,883 751 1,300

Washtenaw 347,563 71,777 33,935 5,832 27,878 11,309 4,967 90,158 22,142 46,533

Wayne 1,925,848 487,257 234,767 39,593 143,904 62,834 30,943 526,404 132,430 458,811

Totals 7,406,997 1,774,484 945,056 144,188 562,734 247,016 122,821 2,078,041 523,651 1,175,691

MICHIGAN
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 100

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Allegan 23 4 0 9.7 F 1 0 0 0.3 B 10.0 PASS

Bay DNC DNC DNC DNC DNC 0 0 0 0.0 A 9.1 PASS

Benzie 12 0 0 4.0 F DNC DNC DNC DNC DNC DNC DNC

Berrien 15 1 0 5.5 F 1 0 0 0.3 B 10.1 PASS

Cass 9 0 0 3.0 D DNC DNC DNC DNC DNC DNC DNC

Clinton 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

Emmet DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Genesee 11 0 0 3.7 F 0 0 0 0.0 A 9.9 PASS

Huron 15 1 0 5.5 F DNC DNC DNC DNC DNC DNC DNC

Ingham 5 0 0 1.7 C 0 0 0 0.0 A 10.1 PASS

Kalamazoo 10 0 0 3.3 F 2 0 0 0.7 B 11.2 PASS

Kent 14 0 0 4.7 F 1 0 0 0.3 B 11.3 PASS

Leelanau INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Lenawee 8 0 0 2.7 D INC INC INC INC INC INC INC

Macomb 23 2 0 8.7 F 0 0 0 0.0 A 10.7 PASS

Manistee 16 0 0 5.3 F 0 0 0 0.0 A 7.4 PASS

Mason 15 1 0 5.5 F 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.lungusa.org/michigan
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 101

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Missaukee 6 0 0 2.0 C 0 0 0 0.0 A 6.8 PASS

Monroe DNC DNC DNC DNC DNC 2 0 0 0.7 B 11.6 PASS

Muskegon 18 1 0 6.5 F 1 0 0 0.3 B 9.6 PASS

Oakland 16 0 0 5.3 F 4 0 0 1.3 C 11.4 PASS

Ottawa 13 0 0 4.3 F 1 0 0 0.3 B 10.6 PASS

St. Clair 13 1 0 4.8 F 4 0 0 1.3 C 11.1 PASS

Schoolcraft 15 0 0 5.0 F DNC DNC DNC DNC DNC DNC DNC

Washtenaw 4 0 0 1.3 C 2 0 0 0.7 B 11.3 PASS

Wayne 20 1 0 7.2 F 13 0 0 4.3 F 14.1 PASS

MICHIGAN
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 102

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Anoka 331,582 84,469 31,043 5,889 16,301 10,582 4,839 85,991 14,730 23,255

Becker 32,076 7,701 5,490 537 1,599 1,142 637 10,129 1,813 4,145

Carlton 34,327 8,122 5,247 566 1,724 1,192 635 10,343 1,831 3,428

Cass 28,534 6,239 5,695 435 1,458 1,080 633 9,805 1,774 3,961

Crow Wing 62,723 14,215 11,713 991 3,191 2,259 1,282 20,171 3,620 8,828

Dakota 396,500 102,580 35,532 7,152 19,389 12,552 5,683 101,590 17,365 24,099

Goodhue 45,836 10,937 7,177 763 2,291 1,609 868 14,050 2,496 3,366

Hennepin 1,156,212 261,191 129,035 18,210 59,227 38,071 17,858 312,221 53,721 134,301

Lake 10,610 1,958 2,240 137 566 418 246 3,807 689 1,186

Lyon 25,074 5,985 3,645 417 1,263 837 431 7,140 1,253 2,780

Mille Lacs 26,383 6,509 4,383 454 1,309 908 497 7,972 1,420 3,450

Olmsted 143,962 35,910 17,810 2,504 7,141 4,690 2,306 39,244 6,823 10,813

Ramsey 506,278 116,740 67,522 8,139 25,790 16,821 8,349 141,224 24,592 80,441

St. Louis 197,767 38,546 31,871 2,687 10,489 7,185 3,806 62,164 10,992 30,773

Scott 131,939 38,409 9,671 2,678 6,197 3,848 1,635 30,319 5,105 6,323

Stearns 148,955 33,880 19,123 2,362 7,628 4,911 2,392 40,882 7,087 17,767

Washington 231,958 61,313 21,835 4,275 11,228 7,426 3,452 60,807 10,461 12,929

Wright 121,907 35,909 11,143 2,504 5,694 3,615 1,639 29,235 4,993 7,487

Totals 3,632,623 870,613 420,175 60,699 182,484 119,146 57,188 987,094 170,766 379,332

MINNESOTA

American Lung Association in Minnesota

490 Concordia Avenue

St. Paul, MN 55103-2441

(651) 227-8014

www.lungusa.org/minnesota
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 103

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Anoka 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Becker 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Carlton 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Cass DNC DNC DNC DNC DNC 1 0 0 0.3 B INC INC

Crow Wing 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Dakota DNC DNC DNC DNC DNC 5 0 0 1.7 C 9.6 PASS

Goodhue 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Hennepin DNC DNC DNC DNC DNC 6 0 0 2.0 C 10.4 PASS

Lake 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Lyon 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Mille Lacs 3 0 0 1.0 C 2 0 0 0.7 B INC INC

Olmsted 0 0 0 0.0 A 5 0 0 1.7 C 10.0 PASS

Ramsey DNC DNC DNC DNC DNC 7 0 0 2.3 D 11.1 PASS

St. Louis 0 0 0 0.0 A 1 0 0 0.3 B 7.5 PASS

Scott 0 0 0 0.0 A 4 0 0 1.3 C 9.5 PASS

Stearns 1 0 0 0.3 B 4 0 0 1.3 C 8.6 PASS

Washington 4 0 0 1.3 C 2 0 0 0.7 B INC INC

Wright 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

MINNESOTA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 104

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Adams 30,722 7,475 5,278 776 1,768 1,083 604 9,594 3,052 8,564

Bolivar 36,766 9,621 4,213 999 2,043 1,154 551 9,525 2,959 12,223

Desoto 158,719 45,326 15,946 4,707 8,524 4,786 2,218 39,041 12,134 14,187

Forrest 81,078 19,380 9,575 2,013 4,632 2,516 1,164 20,442 6,214 17,466

Grenada 23,046 5,910 3,474 614 1,298 765 404 6,610 2,076 5,289

Hancock 40,962 9,569 6,187 994 2,380 1,434 761 12,425 3,948 7,580

Harrison 181,191 45,840 21,936 4,760 10,201 5,832 2,841 48,592 15,169 31,675

Hinds 247,631 67,251 27,413 6,984 13,574 7,659 3,633 63,075 19,602 55,442

Jackson 132,922 34,338 16,580 3,566 7,443 4,334 2,159 36,493 11,482 18,574

Jones 67,776 17,487 9,819 1,816 3,804 2,215 1,150 18,967 5,931 16,259

Lauderdale 79,099 20,450 11,169 2,124 4,433 2,567 1,318 21,873 6,828 17,723

Lee 81,913 22,114 10,487 2,296 4,515 2,611 1,309 22,026 6,895 14,163

Lowndes 59,658 15,716 7,762 1,632 3,318 1,919 964 16,201 5,070 14,824

Webster 9,852 2,416 1,683 251 565 340 188 2,997 946 2,225

Totals 1,231,335 322,893 151,522 33,532 68,497 39,215 19,264 327,861 102,304 236,194

MISSISSIPPI

American Lung Association in Mississippi

P.O. Box 2178

Ridgeland, MS 39158

(601) 206-5810

www.lungusa.org/mississippi
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 105

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Adams 2 0 0 0.7 B 0 0 0 0.0 A 10.4 PASS

Bolivar 6 0 0 2.0 C 0 0 0 0.0 A 11.2 PASS

Desoto 19 1 0 6.8 F 1 0 0 0.3 B 11.3 PASS

Forrest DNC DNC DNC DNC DNC 0 0 0 0.0 A 12.8 PASS

Grenada DNC DNC DNC DNC DNC 0 0 0 0.0 A 10.5 PASS

Hancock INC INC INC INC INC INC INC INC INC INC INC INC

Harrison 19 0 0 6.3 F 0 0 0 0.0 A 10.0 PASS

Hinds 1 0 0 0.3 B 0 0 0 0.0 A 11.8 PASS

Jackson 12 0 0 4.0 F 0 0 0 0.0 A 10.2 PASS

Jones DNC DNC DNC DNC DNC 0 0 0 0.0 A 13.0 PASS

Lauderdale 0 0 0 0.0 A 1 0 0 0.3 B 12.0 PASS

Lee 3 0 0 1.0 C 0 0 0 0.0 A 11.7 PASS

Lowndes DNC DNC DNC DNC DNC 2 0 0 0.7 B 11.5 PASS

Webster INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

MISSISSIPPI
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 106

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Andrew 17,052 4,109 2,385 417 1,224 586 304 5,024 1,081 1,478

Boone 156,377 33,130 14,607 3,364 11,914 4,920 2,091 38,654 7,744 26,229

Buchanan 89,856 21,080 12,799 2,140 6,533 3,006 1,532 25,532 5,418 12,960

Callaway 43,727 9,916 5,039 1,007 3,227 1,461 699 12,091 2,538 4,404

Cass 100,184 26,556 11,957 2,696 7,003 3,233 1,596 27,123 5,747 8,911

Cedar 13,544 3,194 2,943 324 962 497 300 4,568 1,015 2,764

Clay 228,358 57,550 25,431 5,844 16,324 7,303 3,465 60,186 12,572 17,790

Clinton 21,002 5,131 3,133 521 1,497 722 383 6,257 1,352 2,029

Greene 269,630 57,470 37,960 5,835 20,216 9,103 4,537 76,514 16,087 47,009

Jackson 705,708 173,837 87,143 17,651 50,665 23,081 11,329 193,005 40,689 106,038

Jasper 118,179 30,547 15,786 3,102 8,341 3,787 1,900 31,932 6,736 22,818

Jefferson 219,046 54,088 23,982 5,492 15,733 7,172 3,426 59,344 12,485 22,772

Lincoln 53,311 14,559 5,559 1,478 3,703 1,665 786 13,700 2,866 5,795

Monroe 8,993 2,095 1,623 213 646 324 183 2,887 634 1,258

Perry 18,847 4,656 3,015 473 1,338 642 346 5,599 1,210 2,117

St. Charles 355,367 90,399 39,024 9,179 25,286 11,462 5,470 94,767 19,897 18,038

Ste. Genevieve 17,542 4,120 2,654 418 1,264 619 331 5,386 1,170 2,014

St. Louis 992,408 233,595 145,381 23,719 71,730 34,210 17,899 294,448 63,338 93,601

St. Louis City 356,587 79,527 39,516 8,075 26,557 11,630 5,387 94,801 19,605 92,243

Totals 3,785,718 905,559 479,937 91,950 274,164 125,423 61,964 1,051,818 222,184 490,268

MISSOURI

American Lung Association in Missouri

1118 Hampton Avenue

St. Louis, MO 63139-3196

(314) 645-5505

www.lungusa.org/missouri
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 107

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

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 0 0 0 0.0 A 11.4 PASS

Callaway INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Cass 4 0 0 1.3 C 1 0 0 0.3 B 10.1 PASS

Cedar 4 0 0 1.3 C INC INC INC INC INC INC INC

Clay 21 2 0 8.0 F 0 0 0 0.0 A 10.1 PASS

Clinton 15 0 0 5.0 F DNC DNC DNC DNC DNC DNC DNC

Greene 5 0 0 1.7 C 0 0 0 0.0 A 10.7 PASS

Jackson DNC DNC DNC DNC DNC 1 0 0 0.3 B 11.5 PASS

Jasper INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Jefferson 23 0 0 7.7 F 5 0 0 1.7 C INC INC

Lincoln 13 2 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

Monroe 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Perry 22 0 0 7.3 F DNC DNC DNC DNC DNC DNC DNC

St. Charles 31 1 0 10.8 F INC INC INC INC INC INC INC

Ste. Genevieve 17 1 0 6.2 F 0 0 0 0.0 A INC INC

St. Louis 26 4 0 10.7 F 3 0 0 1.0 C INC INC

St. Louis City 22 2 0 8.3 F 9 0 0 3.0 D 12.8 PASS

MISSOURI
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 108

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Cascade 82,178 18,817 13,036 1,202 5,128 2,849 1,518 24,703 4,370 12,020

Flathead 89,624 21,172 12,722 1,353 5,557 3,113 1,624 26,777 4,713 11,906

Gallatin 90,343 18,314 8,188 1,170 5,788 2,877 1,213 22,538 3,762 11,616

Glacier 13,550 4,314 1,378 276 747 399 191 3,303 569 4,057

Lewis And Clark 61,942 13,936 8,177 890 3,898 2,168 1,102 18,449 3,227 6,084

Lincoln 18,717 3,722 3,689 238 1,223 733 427 6,641 1,201 3,755

Missoula 108,623 21,216 12,240 1,356 7,042 3,634 1,663 29,462 5,020 17,714

Ravalli 40,431 8,858 7,485 566 2,569 1,506 859 13,497 2,428 6,229

Richland 9,313 2,240 1,444 143 575 329 178 2,881 512 948

Sanders 11,096 2,240 2,365 143 722 438 262 4,017 731 2,375

Silver Bow 32,949 7,228 5,627 462 2,084 1,178 644 10,338 1,841 4,641

Yellowstone 144,797 34,442 20,325 2,201 8,929 4,888 2,505 41,656 7,299 16,433

Totals 703,563 156,499 96,676 9,999 44,262 24,112 12,186 204,262 35,672 97,778

MONTANA

American Lung Association in Montana

825 Helena Avenue

Helena, MT 59601-3459

(406) 442-6556

www.lungusa.org/montana
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 109

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

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 5 0 0 1.7 C 5.8 PASS

Flathead 0 0 0 0.0 A 1 2 0 1.3 C 9.4 PASS

Gallatin DNC DNC DNC DNC DNC 3 1 0 1.5 C 8.2 PASS

Glacier INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Lewis And Clark DNC DNC DNC DNC DNC 4 0 0 1.3 C INC INC

Lincoln DNC DNC DNC DNC DNC 2 0 0 0.7 B 12.2 PASS

Missoula DNC DNC DNC DNC DNC 7 1 0 2.8 D 9.1 PASS

Ravalli DNC DNC DNC DNC DNC 4 1 0 1.8 C 8.7 PASS

Richland INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Sanders DNC DNC DNC DNC DNC 1 1 0 0.8 B 6.9 PASS

Silver Bow DNC DNC DNC DNC DNC 11 1 0 4.2 F 10.9 PASS

Yellowstone INC INC INC INC INC 0 0 0 0.0 A 7.0 PASS

MONTANA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 110

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Douglas 510,199 134,035 54,719 6,947 28,777 15,838 7,388 129,488 25,412 63,394

Hall 57,487 16,289 7,825 844 3,116 1,826 944 15,622 3,171 6,739

Lancaster 281,531 64,445 29,771 3,340 16,660 8,947 4,046 72,145 14,001 40,594

Sarpy 153,504 42,924 13,239 2,225 8,505 4,569 2,008 36,456 7,020 7,996

Scotts Bluff 36,865 9,241 6,290 479 2,071 1,268 703 11,200 2,324 5,117

Sioux 1,281 239 222 12 78 49 27 429 89 205

Washington 19,718 4,873 2,758 253 1,120 677 354 5,833 1,191 1,278

Totals 1,060,585 272,046 114,824 14,100 60,327 33,174 15,470 271,173 53,208 125,323

NEBRASKA

American Lung Association in Nebraska

8990 W. Dodge Road, Suite 226

Omaha, NE 68114

(402) 502-4250

www.lungusa.org/nebraska
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 111

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Douglas 0 0 0 0.0 A 3 0 0 1.0 C 8.8 PASS

Hall DNC DNC DNC DNC DNC 0 0 0 0.0 A 7.7 PASS

Lancaster 0 0 0 0.0 A 0 0 0 0.0 A 8.1 PASS

Sarpy DNC DNC DNC DNC DNC 3 0 0 1.0 C 9.2 PASS

Scotts Bluff DNC DNC DNC DNC DNC 0 0 0 0.0 A INC INC

Sioux 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Washington DNC DNC DNC DNC DNC 2 0 0 0.7 B 8.4 PASS

NEBRASKA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 112

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Churchill 24,897 6,843 3,739 473 1,613 825 444 7,192 1,619 2,443

Clark 1,902,834 501,150 203,909 34,637 124,627 59,057 27,562 482,976 106,020 233,890

Lyon 52,641 13,259 7,658 916 3,527 1,796 949 15,538 3,485 5,275

Washoe 414,820 101,276 50,628 7,000 27,972 13,626 6,670 113,839 25,195 53,865

White Pine 9,188 1,970 1,374 136 644 322 167 2,756 616 1,052

Carson City 55,176 13,007 9,161 899 3,756 1,919 1,044 16,798 3,789 7,337

Totals 2,459,556 637,505 276,469 44,061 162,139 77,545 36,836 639,099 140,725 303,862

NEVADA

American Lung Association in Nevada

3552 W. Cheyenne Avenue, Suite 130

North Las Vegas NV 89032

(702) 431-6333

www.lungusa.org/nevada
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 113

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Churchill 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Clark 38 0 0 12.7 F 1 0 0 0.3 B 9.4 PASS

Lyon 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Washoe 5 1 0 2.2 D 6 1 0 2.5 D 8.7 PASS

White Pine 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Carson City 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

NEVADA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 114

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Belknap 61,358 12,475 10,016 1,073 4,948 2,273 1,231 19,897 3,815 5,599

Cheshire 77,045 15,122 11,598 1,300 6,336 2,767 1,432 23,690 4,495 6,957

Coos 31,487 6,092 6,212 524 2,536 1,217 702 10,967 2,132 4,477

Grafton 86,291 15,929 13,727 1,370 7,190 3,142 1,643 27,014 5,137 8,156

Hillsborough 405,906 95,703 48,083 8,228 32,056 13,563 6,601 113,105 21,168 34,979

Merrimack 149,071 32,079 20,353 2,758 11,992 5,247 2,670 44,633 8,438 10,871

Rockingham 299,276 68,422 37,652 5,883 23,687 10,414 5,237 88,208 16,635 17,991

Sullivan 42,692 8,996 7,111 773 3,410 1,559 849 13,675 2,625 4,751

Totals 1,153,126 254,818 154,752 21,909 92,156 40,182 20,365 341,189 64,445 93,781

NEW HAMPSHIRE

American Lung Association in New Hampshire

1800 Elm Street

Manchester, NH 03104

(603) 410-5108

www.lungusa.org/newhampshire
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 115

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Belknap 3 0 0 1.0 C 0 0 0 0.0 A 6.3 PASS

Cheshire 3 0 0 1.0 C 1 0 0 0.3 B 10.6 PASS

Coos 12 0 0 4.0 F DNC DNC DNC DNC DNC DNC DNC

Grafton 3 0 0 1.0 C INC INC INC INC INC 7.2 PASS

Hillsborough 19 0 0 6.3 F 1 0 0 0.3 B 9.1 PASS

Merrimack 3 0 0 1.0 C 1 0 0 0.3 B 8.9 PASS

Rockingham 13 1 0 4.8 F 0 0 0 0.0 A 8.0 PASS

Sullivan INC INC INC INC INC INC INC INC INC INC INC INC

NEW HAMPSHIRE
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 116

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Atlantic 271,712 63,321 39,118 5,761 15,988 9,351 4,853 80,186 18,865 28,926

Bergen 895,250 198,585 134,157 18,067 53,395 31,434 16,477 270,777 63,853 58,713

Camden 517,879 125,759 66,235 11,442 30,209 17,147 8,524 144,208 33,606 57,405

Cumberland 157,745 39,208 19,870 3,567 9,144 5,094 2,498 42,545 9,913 23,801

Essex 769,644 193,289 90,090 17,585 44,531 24,720 11,895 204,895 47,420 107,767

Gloucester 289,920 68,703 35,199 6,251 17,064 9,674 4,739 80,884 18,742 21,878

Hudson 597,924 122,659 64,500 11,160 36,933 19,393 8,676 155,616 35,572 86,008

Hunterdon 130,034 30,701 15,921 2,793 7,635 4,565 2,313 38,838 8,995 5,372

Mercer 366,222 83,985 45,749 7,641 21,780 12,191 5,948 101,662 23,605 37,360

Middlesex 790,738 184,267 97,975 16,765 46,814 26,119 12,708 217,511 50,492 61,032

Monmouth 644,105 153,862 86,603 13,998 37,643 22,189 11,398 189,611 44,328 43,974

Morris 488,518 116,662 66,156 10,614 28,557 16,758 8,600 143,096 33,481 18,065

Ocean 573,678 132,162 121,029 12,024 33,378 20,811 12,345 189,570 46,371 46,190

Passaic 491,778 124,538 60,810 11,330 28,323 15,894 7,807 132,916 30,924 79,637

Union 526,426 129,639 66,428 11,795 30,576 17,339 8,596 145,647 33,913 49,365

Warren 109,638 25,652 14,777 2,334 6,451 3,785 1,937 32,281 7,545 7,542

Totals 7,621,211 1,792,992 1,024,617 163,127 448,420 256,464 129,314 2,170,243 507,625 733,035

NEW JERSEY

American Lung Association in New Jersey

1031 Route 22 West Suite 203

Bridgewater, NJ 08807-2919

(908) 685-8040

www.lungusa.org/newjersey
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 117

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Atlantic 9 0 0 3.0 D 1 0 0 0.3 B 9.9 PASS

Bergen INC INC INC INC INC 4 0 0 1.3 C 11.3 PASS

Camden 40 3 0 14.8 F 12 0 0 4.0 F 11.7 PASS

Cumberland 19 0 0 6.3 F DNC DNC DNC DNC DNC DNC DNC

Essex INC INC INC INC INC 2 0 0 0.7 B INC INC

Gloucester 26 3 0 10.2 F 1 0 0 0.3 B 11.4 PASS

Hudson 19 0 0 6.3 F 13 0 0 4.3 F 13.1 PASS

Hunterdon 35 1 0 12.2 F DNC DNC DNC DNC DNC DNC DNC

Mercer 25 2 0 9.3 F 9 0 0 3.0 D 10.8 PASS

Middlesex 35 2 0 12.7 F 1 0 0 0.3 B 10.4 PASS

Monmouth 26 0 0 8.7 F DNC DNC DNC DNC DNC DNC DNC

Morris 27 1 0 9.5 F 1 0 0 0.3 B 9.6 PASS

Ocean 32 1 0 11.2 F 5 0 0 1.7 C 9.5 PASS

Passaic 17 0 0 5.7 F 5 0 0 1.7 C 11.3 PASS

Union DNC DNC DNC DNC DNC 12 0 0 4.0 F 12.6 PASS

Warren DNC DNC DNC DNC DNC 2 0 0 0.7 B 10.9 PASS

NEW JERSEY
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 118

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Bernalillo 642,527 156,186 78,831 11,859 41,781 20,861 10,131 173,539 40,618 98,582

Chaves 63,622 17,568 9,215 1,334 3,977 2,040 1,070 17,551 4,116 12,786

Dona Ana 206,419 56,885 25,265 4,319 12,837 6,318 3,070 52,502 12,261 49,686

Eddy 52,706 14,260 7,297 1,083 3,319 1,713 888 14,678 3,446 7,066

Grant 29,903 6,676 6,068 507 2,027 1,108 650 10,053 2,370 5,703

Lea 60,232 18,366 6,632 1,394 3,593 1,778 852 14,703 3,438 8,861

Luna 27,044 7,473 5,362 567 1,706 911 538 8,273 1,944 8,156

Sandoval 125,988 32,762 13,901 2,488 8,013 4,070 1,961 33,801 7,934 13,819

San Juan 124,131 35,352 13,096 2,684 7,616 3,789 1,791 31,172 7,297 25,222

Santa Fe 147,532 30,566 21,242 2,321 10,107 5,297 2,741 45,403 10,684 18,335

Valencia 72,913 18,930 8,619 1,437 4,643 2,355 1,152 19,674 4,615 14,261

Totals 1,553,017 395,024 195,528 29,993 99,619 50,240 24,844 421,349 98,722 262,477

NEW MEXICO

American Lung Association in New Mexico

5911 Jefferson Street, NE

Albuquerque, NM 87109

(505) 265-0732

www.lungusa.org/newmexico
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 119

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Bernalillo 2 0 0 0.7 B 1 0 0 0.3 B 6.0 PASS

Chaves DNC DNC DNC DNC DNC 0 0 0 0.0 A INC INC

Dona Ana 9 0 0 3.0 D 15 0 0 5.0 F 10.9 PASS

Eddy 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Grant 0 0 0 0.0 A 0 0 0 0.0 A 5.0 PASS

Lea 0 0 0 0.0 A 0 0 0 0.0 A INC INC

Luna 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Sandoval 1 0 0 0.3 B 0 0 0 0.0 A INC INC

San Juan 16 0 0 5.3 F 0 0 0 0.0 A INC INC

Santa Fe 0 0 0 0.0 A 0 0 0 0.0 A 4.4 PASS

Valencia INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

NEW MEXICO
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 120

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Albany 298,284 59,920 40,840 6,018 23,427 10,396 5,178 87,482 21,108 33,382

Bronx 1,397,287 389,306 147,488 39,103 99,171 42,287 19,699 345,450 81,701 383,691

Chautauqua 133,503 28,945 21,737 2,907 10,242 4,753 2,554 41,392 10,185 22,517

Chemung 88,331 19,445 13,744 1,953 6,757 3,118 1,653 26,987 6,625 13,123

Dutchess 293,562 66,143 38,858 6,644 22,403 10,084 5,072 85,302 20,722 24,690

Erie 909,247 195,839 144,021 19,670 69,899 32,148 17,055 278,281 68,215 122,068

Essex 37,686 6,993 6,424 702 3,009 1,408 762 12,304 3,038 4,059

Franklin 50,274 9,532 6,901 957 4,005 1,773 879 14,893 3,589 7,418

Hamilton 4,923 825 1,066 83 401 202 120 1,844 468 523

Herkimer 62,236 13,718 10,265 1,378 4,755 2,229 1,210 19,511 4,821 8,640

Jefferson 118,719 28,812 13,946 2,894 8,841 3,820 1,822 31,532 7,509 18,305

Kings 2,567,098 633,619 300,114 63,642 189,965 81,620 38,762 672,138 159,593 550,617

Madison 69,954 15,015 9,585 1,508 5,407 2,436 1,232 20,648 5,017 7,307

Monroe 733,703 164,582 101,855 16,531 55,935 25,177 12,796 213,825 51,932 94,494

Nassau 1,357,429 313,480 206,727 31,487 102,570 47,679 25,348 413,507 101,846 73,777

New York 1,629,054 259,817 207,637 26,097 134,340 56,776 26,449 463,333 109,048 262,350

Niagara 214,557 46,229 33,290 4,643 16,529 7,651 4,056 66,250 16,288 29,328

Oneida 231,044 49,642 37,603 4,986 17,753 8,186 4,378 71,106 17,447 31,240

NEW YORK

American Lung Association in New York

155 Washington Ave., Suite 210

Albany, NY 12210

(518) 465-2013

www.lungusa.org/newyork
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 121

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Onondaga 454,753 104,132 64,282 10,459 34,437 15,557 7,971 132,590 32,254 60,792

Orange 383,532 104,311 39,975 10,477 27,595 12,059 5,712 99,400 23,813 43,394

Oswego 121,377 27,581 14,920 2,770 9,251 4,109 2,015 34,379 8,301 17,034

Putnam 99,265 23,572 11,835 2,368 7,497 3,404 1,692 28,694 7,001 5,960

Queens 2,306,712 494,057 300,922 49,624 178,096 78,104 38,278 652,332 156,497 293,729

Rensselaer 155,541 33,322 21,142 3,347 12,027 5,399 2,717 45,666 11,078 16,602

Richmond 491,730 113,416 61,394 11,392 37,283 16,567 8,161 138,841 33,527 55,407

Rockland 300,173 83,166 41,203 8,353 21,319 9,761 5,088 83,868 20,523 34,291

St. Lawrence 109,715 22,826 14,824 2,293 8,536 3,774 1,873 31,697 7,634 17,504

Saratoga 220,069 48,324 28,832 4,854 16,938 7,640 3,834 64,583 15,705 13,527

Schenectady 152,169 34,823 23,586 3,498 11,497 5,278 2,794 45,639 11,179 17,191

Steuben 96,552 22,164 15,035 2,226 7,304 3,404 1,822 29,611 7,301 14,342

Suffolk 1,518,475 367,195 204,117 36,882 113,373 51,520 26,306 438,791 107,047 84,755

Ulster 181,440 36,590 26,192 3,675 14,258 6,502 3,343 55,543 13,571 21,578

Wayne 91,291 21,806 12,758 2,190 6,850 3,171 1,652 27,269 6,706 9,939

Westchester 955,962 229,936 135,355 23,095 71,354 32,549 16,853 278,834 68,126 84,810

Totals 17,835,647 4,069,083 2,358,473 408,706 1,353,023 600,541 299,136 5,053,522 1,219,417 2,478,384

NEW YORK
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 122

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Albany 9 0 0 3.0 D 4 0 0 1.3 C 9.3 PASS

Bronx 13 0 0 4.3 F 14 0 0 4.7 F 13.9 PASS

Chautauqua 24 0 0 8.0 F 1 0 0 0.3 B 8.3 PASS

Chemung 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Dutchess 15 0 0 5.0 F DNC DNC DNC DNC DNC DNC DNC

Erie 18 0 0 6.0 F 8 0 0 2.7 D 10.7 PASS

Essex 18 2 0 7.0 F 0 0 0 0.0 A 4.8 PASS

Franklin 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Hamilton 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Herkimer 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Jefferson 11 0 0 3.7 F DNC DNC DNC DNC DNC DNC DNC

Kings DNC DNC DNC DNC DNC 4 0 0 1.3 C 12.2 PASS

Madison 8 0 0 2.7 D DNC DNC DNC DNC DNC DNC DNC

Monroe 13 0 0 4.3 F 1 0 0 0.3 B 8.8 PASS

Nassau DNC DNC DNC DNC DNC 2 0 0 0.7 B 10.3 PASS

New York 12 0 0 4.0 F 7 0 0 2.3 D 12.1 PASS

Niagara 17 0 0 5.7 F 2 0 0 0.7 B 9.8 PASS

Oneida 3 0 0 1.0 C 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.lungusa.org/newyork
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 123

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Onondaga 8 0 0 2.7 D 0 0 0 0.0 A 8.5 PASS

Orange 11 3 0 5.2 F 3 0 0 1.0 C 9.3 PASS

Oswego 8 0 0 2.7 D DNC DNC DNC DNC DNC DNC DNC

Putnam 18 0 0 6.0 F DNC DNC DNC DNC DNC DNC DNC

Queens 8 0 0 2.7 D 6 0 0 2.0 C 10.6 PASS

Rensselaer 11 0 0 3.7 F DNC DNC DNC DNC DNC DNC DNC

Richmond 11 1 0 4.2 F 2 0 0 0.7 B 11.6 PASS

Rockland INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

St. Lawrence DNC DNC DNC DNC DNC 0 0 0 0.0 A 5.8 PASS

Saratoga 19 0 0 6.3 F DNC DNC DNC DNC DNC DNC DNC

Schenectady 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Steuben 4 0 0 1.3 C 1 0 0 0.3 B 7.7 PASS

Suffolk 34 2 0 12.3 F 0 0 0 0.0 A 9.7 PASS

Ulster 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Wayne 9 0 0 3.0 D DNC DNC DNC DNC DNC DNC DNC

Westchester 24 4 0 10.0 F 2 0 0 0.7 B 10.6 PASS

NEW YORK
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 124

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Alamance 150,358 36,647 21,210 3,143 8,849 5,004 2,563 42,610 11,335 22,341

Alexander 36,777 8,223 5,209 705 2,223 1,277 657 10,907 2,920 5,306

Avery 17,932 3,272 3,162 281 1,135 647 346 5,611 1,490 2,896

Buncombe 231,452 48,027 36,899 4,119 14,233 8,239 4,359 71,217 19,057 36,407

Caldwell 79,914 18,124 12,452 1,554 4,793 2,804 1,492 24,314 6,529 13,111

Caswell 23,004 4,854 3,648 416 1,407 836 448 7,283 1,966 4,876

Catawba 159,125 38,391 22,488 3,293 9,393 5,385 2,779 46,050 12,311 22,556

Chatham 64,772 14,254 9,408 1,222 3,929 2,273 1,179 19,490 5,227 7,019

Cumberland 315,207 84,590 29,994 7,255 18,138 9,440 4,192 75,558 19,646 50,582

Davidson 158,582 38,042 21,823 3,263 9,384 5,395 2,769 46,047 12,332 22,833

Davie 41,420 9,851 6,385 845 2,448 1,447 776 12,597 3,395 4,801

Duplin 53,177 13,847 7,031 1,188 3,065 1,727 874 14,634 3,894 12,757

Durham 269,706 63,286 25,277 5,428 16,258 8,373 3,638 66,415 17,214 42,503

Edgecombe 51,853 13,631 5,940 1,169 2,988 1,703 840 14,299 3,834 12,953

Forsyth 359,638 88,322 46,939 7,575 21,162 11,874 5,942 100,134 26,623 57,456

Franklin 60,088 14,557 6,787 1,248 3,565 1,985 955 16,473 4,385 8,018

Gaston 208,958 50,744 27,530 4,352 12,336 6,960 3,499 58,826 15,668 31,956

Graham 8,001 1,724 1,660 148 482 295 173 2,677 723 1,546

Granville 57,639 13,103 6,591 1,124 3,489 1,915 911 15,808 4,186 7,433

Guilford 480,362 114,112 59,680 9,787 28,624 15,745 7,668 131,155 34,672 79,412

Haywood 57,109 11,431 11,816 980 3,507 2,164 1,263 19,580 5,303 8,563

Jackson 36,891 6,929 5,550 594 2,333 1,301 660 11,022 2,918 6,962

Johnston 168,525 46,970 15,880 4,028 9,552 5,139 2,346 41,689 10,987 28,963

Lenoir 56,387 14,025 9,292 1,203 3,275 1,964 1,082 17,305 4,672 11,551

Lincoln 76,043 18,578 9,505 1,593 4,486 2,546 1,270 21,467 5,739 10,701

NORTH CAROLINA

American Lung Association in North Carolina

514 Daniels Street, #109

Raleigh, NC 27605

(919) 719-9960

www.lungusa.org/northcarolina
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 125

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Mcdowell 43,988 9,683 7,106 830 2,659 1,551 830 13,483 3,614 7,579

Martin 23,337 5,454 4,017 468 1,381 838 467 7,423 2,010 4,939

Mecklenburg 913,639 237,842 78,551 20,398 53,271 27,572 11,905 218,335 56,775 126,807

Mitchell 15,634 3,169 3,100 272 959 586 337 5,263 1,423 2,826

Montgomery 27,745 6,850 4,084 587 1,623 939 493 8,088 2,166 5,664

New Hanover 195,085 39,600 26,867 3,396 12,132 6,696 3,315 56,153 14,839 30,416

Onslow 173,064 40,880 12,336 3,506 10,478 4,918 1,840 36,675 9,135 21,659

Orange 129,083 26,871 13,409 2,305 8,036 4,227 1,897 34,003 8,880 19,910

Person 37,667 8,688 5,384 745 2,253 1,320 689 11,356 3,058 5,414

Pitt 159,057 36,950 16,122 3,169 9,602 4,977 2,209 39,813 10,330 38,973

Robeson 129,559 35,980 14,141 3,086 7,329 3,993 1,898 32,923 8,689 38,939

Rockingham 92,252 20,972 14,752 1,799 5,523 3,266 1,760 28,493 7,673 13,557

Rowan 140,798 33,135 20,938 2,842 8,364 4,817 2,519 41,427 11,078 22,778

Swain 13,404 3,143 2,339 270 792 475 264 4,201 1,133 2,316

Union 198,645 59,783 17,682 5,127 10,918 5,873 2,667 47,541 12,535 21,321

Wake 897,214 237,116 74,382 20,336 52,057 27,056 11,654 214,149 55,821 89,217

Watauga 45,479 6,492 5,777 557 3,058 1,581 719 12,762 3,298 8,516

Wayne 113,811 29,354 14,667 2,517 6,587 3,698 1,853 31,206 8,298 22,051

Yancey 18,548 3,744 3,684 321 1,139 697 401 6,264 1,695 3,260

Totals 6,590,929 1,621,240 751,494 139,042 389,215 211,518 100,398 1,742,726 459,476 999,644

NORTH CAROLINA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 126 NORTH CAROLINA

American Lung Association in North Carolina

514 Daniels Street, #109

Raleigh, NC 27605

(919) 719-9960

www.lungusa.org/northcarolina

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Alamance DNC DNC DNC DNC DNC 1 0 0 0.3 B 11.6 PASS

Alexander 19 0 0 6.3 F DNC DNC DNC DNC DNC DNC DNC

Avery 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Buncombe 3 0 0 1.0 C 0 0 0 0.0 A 9.9 PASS

Caldwell 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

Caswell 21 0 0 7.0 F 1 0 0 0.3 B 10.7 PASS

Catawba DNC DNC DNC DNC DNC 1 0 0 0.3 B 12.5 PASS

Chatham 4 0 0 1.3 C 0 1 0 0.5 B 10.2 PASS

Cumberland 13 0 0 4.3 F 0 0 0 0.0 A 11.7 PASS

Davidson DNC DNC DNC DNC DNC 1 0 0 0.3 B 13.0 PASS

Davie 26 0 0 8.7 F DNC DNC DNC DNC DNC DNC DNC

Duplin DNC DNC DNC DNC DNC 0 0 0 0.0 A 9.6 PASS

Durham 15 0 0 5.0 F 0 0 0 0.0 A INC INC

Edgecombe 13 0 0 4.3 F 0 0 0 0.0 A 10.4 PASS

Forsyth 35 1 0 12.2 F 3 0 0 1.0 C 11.8 PASS

Franklin 13 0 0 4.3 F DNC DNC DNC DNC DNC DNC DNC

Gaston DNC DNC DNC DNC DNC 0 0 0 0.0 A 12.0 PASS

Graham 16 0 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

Granville 18 0 0 6.0 F DNC DNC DNC DNC DNC DNC DNC

Guilford 29 1 0 10.2 F 2 1 0 1.2 C 11.3 PASS

Haywood 18 0 0 6.0 F 0 0 0 0.0 A INC INC

Jackson INC INC INC INC INC 1 0 0 0.3 B 10.4 PASS

Johnston 12 0 0 4.0 F INC INC INC INC INC INC INC

Lenoir 6 0 0 2.0 C 1 0 0 0.3 B 9.7 PASS

Lincoln 28 1 0 9.8 F DNC DNC DNC DNC DNC DNC DNC
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 127

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

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 0 0 0 0.0 A 11.5 PASS

Martin 4 0 0 1.3 C 0 1 0 0.5 B 9.5 PASS

Mecklenburg 47 6 1 19.3 F 4 0 0 1.3 C 12.6 PASS

Mitchell DNC DNC DNC DNC DNC 2 0 0 0.7 B 10.8 PASS

Montgomery DNC DNC DNC DNC DNC 1 0 0 0.3 B 10.6 PASS

New Hanover 1 0 0 0.3 B INC INC INC INC INC INC INC

Onslow DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Orange DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Person 13 0 0 4.3 F DNC DNC DNC DNC DNC DNC DNC

Pitt 13 0 0 4.3 F 1 1 0 0.8 B INC INC

Robeson DNC DNC DNC DNC DNC 2 0 0 0.7 B 11.2 PASS

Rockingham 19 0 0 6.3 F DNC DNC DNC DNC DNC DNC DNC

Rowan 62 6 0 23.7 F 0 0 0 0.0 A 12.3 PASS

Swain 0 0 0 0.0 A 1 0 0 0.3 B 11.0 PASS

Union 26 1 0 9.2 F DNC DNC DNC DNC DNC DNC DNC

Wake 29 0 0 9.7 F 3 1 0 1.5 C 11.2 PASS

Watauga DNC DNC DNC DNC DNC 0 0 0 0.0 A 9.6 PASS

Wayne DNC DNC DNC DNC DNC 1 0 0 0.3 B 11.1 PASS

Yancey 12 0 0 4.0 F DNC DNC DNC DNC DNC DNC DNC

NORTH CAROLINA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 128

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Billings 827 154 129 9 57 32 17 280 57 86

Burke 1,839 364 397 21 123 73 44 676 141 176

Burleigh 79,822 17,597 10,652 1,010 5,474 2,695 1,336 22,620 4,492 6,431

Cass 143,339 31,086 14,012 1,784 10,135 4,498 1,942 35,553 6,800 16,051

Dunn 3,365 773 595 44 220 124 70 1,106 228 370

McKenzie 5,799 1,451 839 83 370 203 109 1,770 361 735

Mercer 7,873 1,690 1,254 97 519 297 163 2,622 539 557

Oliver 1,643 347 250 20 108 63 34 550 113 184

Totals 244,507 53,462 28,128 3,069 17,005 7,985 3,715 65,177 12,730 24,590

NORTH DAKOTA

American Lung Association in North Dakota

212 N. 2nd Street

Bismarck, ND 58501

(701) 223-5613

www.lungusa.org/northdakota
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 129

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Billings 0 0 0 0.0 A 0 0 0 0.0 A 4.5 PASS

Burke 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Burleigh 0 0 0 0.0 A 1 0 0 0.3 B 6.8 PASS

Cass 0 0 0 0.0 A 2 0 0 0.7 B 7.8 PASS

Dunn 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

McKenzie 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Mercer 0 0 0 0.0 A 0 0 0 0.0 A 6.2 PASS

Oliver 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

NORTH DAKOTA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 130

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Allen 104,357 25,453 15,446 2,386 7,756 3,539 1,857 30,485 8,198 18,751

Ashtabula 100,767 23,816 15,407 2,233 7,522 3,517 1,876 30,551 8,213 17,245

Athens 63,026 10,246 6,438 961 5,426 2,055 859 16,005 4,306 18,756

Butler 363,184 89,746 41,603 8,415 27,375 11,732 5,610 97,011 26,067 46,350

Clark 139,671 32,717 22,667 3,068 10,443 4,870 2,634 42,529 11,440 22,130

Clermont 196,364 49,973 22,581 4,685 14,577 6,417 3,125 53,536 14,378 20,330

Clinton 43,058 10,562 5,670 990 3,216 1,440 728 12,203 3,280 4,989

Cuyahoga 1,275,709 292,883 194,879 27,461 96,471 44,247 23,347 382,121 102,760 235,014

Delaware 168,708 47,444 14,867 4,448 12,234 5,148 2,326 41,608 11,167 8,433

Franklin 1,150,122 275,763 115,143 25,856 88,661 36,021 16,129 289,384 77,767 207,183

Geauga 99,060 24,926 15,740 2,337 7,170 3,501 1,929 30,903 8,305 7,789

Greene 159,823 34,583 20,595 3,243 12,474 5,442 2,676 45,542 12,240 18,620

Hamilton 855,062 200,406 115,705 18,790 64,933 28,687 14,447 242,554 65,213 126,872

Jefferson 67,691 13,678 12,743 1,282 5,213 2,530 1,430 22,561 6,070 11,524

Knox 59,637 14,206 8,833 1,332 4,471 2,030 1,061 17,456 4,694 7,383

Lake 236,775 52,298 36,828 4,903 18,037 8,429 4,492 73,173 19,671 19,274

Lawrence 62,744 14,248 9,598 1,336 4,767 2,171 1,141 18,714 5,033 12,168

Licking 158,488 38,868 21,372 3,644 11,799 5,356 2,741 45,662 12,271 18,030

OHIO

American Lung Association in Ohio

1950 Arlingate Lane

Columbus, OH 43228-4102

(614) 279-1700

www.lungusa.org/ohio
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 131

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Lorain 305,707 73,108 42,167 6,855 22,931 10,416 5,350 88,931 23,901 42,750

Lucas 463,493 110,036 60,186 10,317 35,130 15,430 7,677 129,788 34,888 84,797

Madison 42,539 9,561 5,321 896 3,290 1,427 696 11,904 3,199 5,280

Mahoning 236,735 51,468 41,320 4,826 17,975 8,580 4,747 75,747 20,376 42,135

Medina 174,035 43,820 22,117 4,109 12,856 5,846 2,959 49,630 13,330 11,432

Miami 101,256 23,878 15,570 2,239 7,565 3,532 1,886 30,687 8,250 11,591

Montgomery 532,562 121,551 80,785 11,397 40,455 18,322 9,591 157,588 42,387 83,595

Portage 157,530 33,175 19,916 3,110 12,404 5,387 2,626 44,917 12,071 21,367

Preble 41,422 9,719 6,354 911 3,098 1,451 775 12,608 3,389 4,190

Scioto 76,334 17,398 11,640 1,631 5,812 2,605 1,359 22,362 6,016 16,987

Stark 379,466 86,481 60,813 8,108 28,615 13,366 7,193 116,495 31,329 54,614

Summit 542,405 123,630 77,454 11,592 41,264 18,744 9,676 160,352 43,103 78,762

Trumbull 210,157 46,075 36,332 4,320 15,924 7,600 4,196 67,034 18,031 32,904

Warren 210,712 55,822 21,762 5,234 15,528 6,665 3,135 54,775 14,709 12,051

Washington 61,048 12,792 10,514 1,199 4,691 2,226 1,221 19,570 5,264 8,204

Wood 125,380 26,856 15,227 2,518 9,871 4,206 2,011 34,762 9,343 16,031

Totals 8,965,027 2,097,186 1,223,593 196,632 679,950 302,935 153,506 2,569,148 690,659 1,347,531

OHIO
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 132 OHIO

American Lung Association in Ohio

1950 Arlingate Lane

Columbus, OH 43228-4102

(614) 279-1700

www.lungusa.org/ohio

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Allen 7 0 0 2.3 D DNC DNC DNC DNC DNC DNC DNC

Ashtabula 22 1 0 7.8 F DNC DNC DNC DNC DNC DNC DNC

Athens INC INC INC INC INC 2 0 0 0.7 B 10.9 PASS

Butler 38 3 0 14.2 F 5 0 0 1.7 C 14.0 PASS

Clark 13 1 0 4.8 F 6 0 0 2.0 C 13.3 PASS

Clermont 17 0 0 5.7 F 1 0 0 0.3 B 12.3 PASS

Clinton 25 0 0 8.3 F DNC DNC DNC DNC DNC DNC DNC

Cuyahoga 19 1 0 6.8 F 10 0 0 3.3 F 14.4 PASS

Delaware 11 0 0 3.7 F DNC DNC DNC DNC DNC DNC DNC

Franklin 31 0 0 10.3 F 5 0 0 1.7 C 13.0 PASS

Geauga 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

Greene 11 0 0 3.7 F 1 0 0 0.3 B 12.1 PASS

Hamilton 53 2 0 18.7 F 12 0 0 4.0 F 15.0 PASS

Jefferson 12 0 0 4.0 F 10 0 0 3.3 F 14.2 PASS

Knox 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

Lake 18 0 0 6.0 F 4 0 0 1.3 C INC INC

Lawrence 13 0 0 4.3 F 3 0 0 1.0 C INC INC

Licking 7 0 0 2.3 D DNC DNC DNC DNC DNC DNC DNC
OHIO AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 133

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Lorain 6 0 0 2.0 C 1 0 0 0.3 B 11.4 PASS

Lucas 12 1 0 4.5 F 5 0 0 1.7 C 12.7 PASS

Madison 16 0 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

Mahoning 8 0 0 2.7 D 5 0 0 1.7 C 13.0 PASS

Medina 3 0 0 1.0 C 0 0 0 0.0 A 11.8 PASS

Miami 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Montgomery 10 0 0 3.3 F 6 0 0 2.0 C 13.8 PASS

Portage 8 0 0 2.7 D 2 0 0 0.7 B 12.3 PASS

Preble 4 0 0 1.3 C 2 0 0 0.7 B 12.2 PASS

Scioto DNC DNC DNC DNC DNC 3 0 0 1.0 C 12.3 PASS

Stark 36 1 0 12.5 F 4 0 0 1.3 C INC INC

Summit 28 1 0 9.8 F 5 0 0 1.7 C 13.7 PASS

Trumbull 25 0 0 8.3 F INC INC INC INC INC INC INC

Warren 46 1 0 15.8 F 2 0 0 0.7 B 12.5 PASS

Washington 20 0 0 6.7 F DNC DNC DNC DNC DNC DNC DNC

Wood 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 134

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Adair 21,857 6,354 2,719 636 1,543 679 341 5,737 1,699 5,464

Caddo 30,393 7,749 4,260 775 2,250 1,000 515 8,539 2,526 6,090

Canadian 109,668 28,385 12,221 2,840 8,108 3,509 1,680 29,045 8,620 8,092

Carter 48,326 12,467 7,266 1,248 3,551 1,615 858 13,987 4,143 7,960

Cherokee 46,029 11,047 5,739 1,105 3,500 1,488 721 12,360 3,646 9,794

Cleveland 244,589 53,967 23,707 5,400 19,180 7,834 3,455 62,567 18,480 27,133

Comanche 113,228 29,970 12,509 2,999 8,355 3,482 1,629 28,484 8,397 15,288

Cotton 6,281 1,517 1,015 152 470 218 118 1,907 565 1,010

Creek 70,244 17,645 10,492 1,766 5,200 2,388 1,268 20,692 6,142 8,953

Dewey 4,404 1,076 946 108 326 160 97 1,472 435 595

Kay 46,110 12,011 7,640 1,202 3,366 1,564 862 13,779 4,079 7,976

Lincoln 32,199 8,096 4,809 810 2,380 1,101 586 9,556 2,840 5,064

Love 9,124 2,219 1,561 222 680 319 177 2,824 837 1,268

McClain 33,168 8,563 4,667 857 2,440 1,100 571 9,433 2,797 3,779

Mayes 40,065 10,091 6,414 1,010 2,964 1,362 738 11,903 3,524 6,401

Muskogee 71,412 18,018 10,817 1,803 5,297 2,384 1,260 20,586 6,087 14,540

Oklahoma 716,704 184,435 89,827 18,456 53,188 22,817 11,191 190,542 56,247 120,900

Ottawa 31,629 7,645 5,243 765 2,374 1,085 590 9,493 2,806 5,709

Pittsburg 45,211 10,136 7,777 1,014 3,472 1,587 866 13,907 4,108 7,230

Sequoyah 41,433 10,610 6,328 1,062 3,051 1,393 743 12,087 3,580 9,035

Tulsa 601,961 156,436 73,033 15,654 44,479 19,178 9,362 159,911 47,294 86,097

Totals 2,364,035 598,437 298,990 59,885 176,171 76,263 37,628 638,811 188,853 358,378

OKLAHOMA

American Lung Association in Oklahoma

11212 N. May Ave Suite 405

Oklahoma City, OK 73120

(405) 748-4674

www.lungusa.org/oklahoma
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 135

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Adair 0 0 0 0.0 A INC INC INC INC INC INC INC

Caddo 1 0 0 0.3 B 0 0 0 0.0 A 8.7 PASS

Canadian 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Carter INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Cherokee 0 0 0 0.0 A INC INC INC INC INC INC INC

Cleveland 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Comanche 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Cotton INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Creek 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Dewey 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Kay 4 0 0 1.3 C INC INC INC INC INC INC INC

Lincoln INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Love INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

McClain 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Mayes 2 0 0 0.7 B 0 0 0 0.0 A 11.3 PASS

Muskogee INC INC INC INC INC 1 0 0 0.3 B 11.5 PASS

Oklahoma 14 0 0 4.7 F 0 0 0 0.0 A 10.4 PASS

Ottawa 0 0 0 0.0 A 0 0 0 0.0 A 10.6 PASS

Pittsburg 2 0 0 0.7 B 1 0 0 0.3 B 11.0 PASS

Sequoyah 2 0 0 0.7 B 1 0 0 0.3 B 11.3 PASS

Tulsa 16 1 0 5.8 F 2 0 0 0.7 B 11.5 PASS

OKLAHOMA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 136

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Clackamas 386,143 90,104 50,736 5,058 32,777 13,307 6,756 113,116 24,985 35,864

Columbia 49,592 11,659 6,178 655 4,207 1,714 862 14,520 3,205 5,846

Crook 22,566 5,161 3,939 290 1,899 811 452 7,179 1,576 3,606

Deschutes 158,629 36,112 22,724 2,027 13,521 5,496 2,843 47,068 10,399 18,625

Harney 6,756 1,496 1,360 84 568 257 151 2,338 510 1,220

Jackson 201,286 44,155 35,081 2,479 17,161 7,264 4,016 64,098 14,091 29,520

Josephine 81,026 16,580 17,570 931 6,938 3,132 1,876 28,716 6,265 16,357

Klamath 66,247 15,331 10,854 861 5,577 2,334 1,268 20,431 4,498 13,098

Lake 7,089 1,462 1,482 82 607 273 162 2,494 544 1,300

Lane 351,109 70,025 50,780 3,931 31,083 12,379 6,290 105,086 23,292 58,935

Linn 116,584 27,856 18,507 1,564 9,734 4,024 2,161 35,026 7,724 17,140

Marion 317,981 84,898 38,839 4,766 25,881 10,083 4,959 84,361 18,760 50,546

Multnomah 726,855 154,032 73,926 8,647 64,286 23,758 10,649 191,057 42,844 107,551

Umatilla 73,347 19,414 9,348 1,090 5,975 2,369 1,189 20,003 4,436 11,381

Union 25,038 5,694 4,070 320 2,121 878 473 7,657 1,688 4,084

Washington 537,318 137,554 51,015 7,722 44,864 16,715 7,523 134,722 30,164 53,333

Totals 3,127,566 721,533 396,409 40,507 267,199 104,794 51,630 877,872 194,983 428,406

OREGON

American Lung Association in Oregon

7420 SW Bridgeport Road, Suite 200

Tigard, OR 97224-7711

(503) 924-4094

www.lungusa.org/oregon
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 137

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Clackamas 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

Columbia 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Crook DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Deschutes INC INC INC INC INC INC INC INC INC INC INC INC

Harney DNC DNC DNC DNC DNC 4 0 0 1.3 C 9.7 PASS

Jackson 1 0 0 0.3 B 12 0 0 4.0 F 10.0 PASS

Josephine DNC DNC DNC DNC DNC 1 0 0 0.3 B 8.7 PASS

Klamath DNC DNC DNC DNC DNC 15 1 0 5.5 F 11.8 PASS

Lake DNC DNC DNC DNC DNC 12 1 0 4.5 F 10.0 PASS

Lane 1 0 0 0.3 B 33 0 0 11.0 F 11.0 PASS

Linn DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Marion 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Multnomah 1 0 0 0.3 B 1 0 0 0.3 B 8.0 PASS

Umatilla 0 0 0 0.0 A 0 0 0 0.0 A 8.0 PASS

Union DNC DNC DNC DNC DNC 0 0 0 0.0 A 7.0 PASS

Washington INC INC INC INC INC 1 0 0 0.3 B 8.6 PASS

OREGON
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 138

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Adams 102,323 22,963 15,257 2,366 7,175 3,565 1,863 30,666 7,162 7,077

Allegheny 1,218,494 242,202 204,401 24,952 88,010 44,083 23,650 383,427 89,816 153,937

Armstrong 67,851 13,924 12,425 1,434 4,760 2,532 1,423 22,520 5,314 8,399

Beaver 171,673 34,909 31,392 3,596 12,106 6,388 3,578 56,723 13,375 19,285

Berks 407,125 97,104 58,492 10,004 28,165 13,798 7,137 118,081 27,529 47,780

Blair 126,122 26,695 22,662 2,750 8,880 4,567 2,533 40,336 9,491 17,824

Bucks 626,015 142,248 90,433 14,654 43,440 22,031 11,519 189,720 44,351 25,903

Cambria 143,998 28,396 27,110 2,925 10,270 5,362 3,011 47,642 11,232 20,991

Centre 146,212 23,442 16,611 2,415 11,793 4,852 2,110 38,404 8,708 23,186

Chester 498,894 122,830 63,063 12,654 34,241 16,678 8,352 140,836 32,717 30,546

Clearfield 82,324 16,143 14,625 1,663 5,924 3,028 1,661 26,613 6,254 10,910

Cumberland 232,483 47,356 36,388 4,879 16,802 8,253 4,320 70,982 16,570 14,672

Dauphin 258,934 59,291 35,928 6,108 18,111 8,914 4,563 75,985 17,700 31,959

Delaware 558,028 129,660 79,758 13,358 38,998 18,988 9,763 162,055 37,746 49,589

Erie 280,291 63,342 40,938 6,526 19,750 9,617 4,962 82,191 19,151 41,724

Franklin 144,994 33,561 24,569 3,457 10,014 5,060 2,763 44,360 10,414 13,162

Greene 39,245 7,763 5,940 800 2,859 1,403 726 12,007 2,800 6,281

Indiana 87,450 16,349 13,966 1,684 6,491 3,132 1,628 26,838 6,255 14,474

PENNSYLVANIA

American Lung Association in Pennsylvania

3001 Old Gettysburg Road

Camp Hill, PA 17011-7206

(717) 541-5864

www.lungusa.org/pennsylvania
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 139

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Lackawanna 208,801 43,339 36,961 4,465 14,824 7,556 4,154 66,455 15,617 28,916

Lancaster 507,766 125,939 75,950 12,974 34,593 17,080 8,988 147,264 34,405 46,401

Lawrence 90,160 19,159 16,918 1,974 6,293 3,307 1,870 29,482 6,957 10,530

Lehigh 343,519 80,483 52,716 8,291 23,808 11,788 6,222 101,784 23,790 41,232

Luzerne 312,845 63,634 56,765 6,556 22,279 11,426 6,329 100,845 23,724 39,328

Lycoming 116,840 24,529 19,508 2,527 8,302 4,187 2,258 36,507 8,559 16,335

Mercer 116,071 24,948 20,817 2,570 8,112 4,211 2,343 37,263 8,775 14,215

Monroe 166,355 39,464 20,861 4,066 11,523 5,659 2,830 47,779 11,102 16,571

Montgomery 782,339 177,415 117,678 18,277 54,617 27,249 14,308 234,867 54,887 41,925

Northampton 298,990 65,602 45,068 6,758 21,108 10,478 5,481 90,146 21,053 24,607

Perry 45,502 10,513 6,072 1,083 3,165 1,571 800 13,370 3,114 3,955

Philadelphia 1,547,297 362,879 192,683 37,384 110,439 50,004 24,037 413,743 95,348 366,125

Tioga 40,875 8,305 7,483 856 2,903 1,502 836 13,286 3,128 6,262

Washington 207,389 42,739 36,360 4,403 14,654 7,615 4,198 67,117 15,791 22,025

Westmoreland 362,251 71,744 68,549 7,391 25,617 13,661 7,736 121,935 28,797 36,754

York 428,937 99,182 60,630 10,218 29,885 14,751 7,601 126,092 29,396 37,354

Totals 10,768,393 2,388,052 1,628,977 246,018 759,912 374,296 195,553 3,217,321 751,028 1,290,234

PENNSYLVANIA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 140

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Adams 14 0 0 4.7 F 6 0 0 2.0 C 11.6 PASS

Allegheny 39 1 0 13.5 F 93 3 0 32.5 F 17.0 FAIL

Armstrong 28 1 0 9.8 F DNC DNC DNC DNC DNC DNC DNC

Beaver 17 0 0 5.7 F 6 0 0 2.0 C 14.2 PASS

Berks 26 0 0 8.7 F 6 0 0 2.0 C 12.6 PASS

Blair 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Bucks 33 3 2 13.8 F 6 0 0 2.0 C 12.2 PASS

Cambria 2 0 0 0.7 B 2 0 0 0.7 B 13.4 PASS

Centre 5 0 0 1.7 C 7 0 0 2.3 D 10.7 PASS

Chester 20 0 1 7.3 F 5 0 0 1.7 C INC INC

Clearfield 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

Cumberland DNC DNC DNC DNC DNC 13 0 0 4.3 F 12.6 PASS

Dauphin 26 0 0 8.7 F INC INC INC INC INC 13.2 PASS

Delaware 19 1 0 6.8 F 4 0 0 1.3 C 13.7 PASS

Erie 15 1 0 5.5 F 9 0 0 3.0 D 10.8 PASS

Franklin 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

Greene 8 0 0 2.7 D DNC DNC DNC DNC DNC DNC DNC

Indiana 14 0 0 4.7 F DNC DNC DNC DNC DNC DNC DNC

PENNSYLVANIA

American Lung Association in Pennsylvania

3001 Old Gettysburg Road

Camp Hill, PA 17011-7206

(717) 541-5864

www.lungusa.org/pennsylvania
PENNSYLVANIA AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 141

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Lackawanna 7 1 0 2.8 D 7 0 0 2.3 D 10.2 PASS

Lancaster 27 0 0 9.0 F 8 0 0 2.7 D 13.8 PASS

Lawrence 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

Lehigh 19 0 0 6.3 F DNC DNC DNC DNC DNC DNC DNC

Luzerne 8 0 0 2.7 D DNC DNC DNC DNC DNC DNC DNC

Lycoming 10 0 0 3.3 F DNC DNC DNC DNC DNC DNC DNC

Mercer 22 0 0 7.3 F 8 0 0 2.7 D 11.7 PASS

Monroe 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

Montgomery 27 1 0 9.5 F 3 0 0 1.0 C 11.7 PASS

Northampton 16 0 0 5.3 F 14 0 0 4.7 F 12.5 PASS

Perry 8 0 0 2.7 D DNC DNC DNC DNC DNC DNC DNC

Philadelphia 34 4 0 13.3 F 21 0 0 7.0 F 13.0 PASS

Tioga 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Washington 12 0 0 4.0 F 15 0 0 5.0 F 13.7 PASS

Westmoreland 9 0 0 3.0 D 6 0 0 2.0 C 13.8 PASS

York 27 1 0 9.5 F 8 0 0 2.7 D 13.7 PASS
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 142

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Kent 168,752 34,784 25,559 3,822 13,473 6,080 3,190 52,417 9,945 13,908

Providence 627,690 140,734 84,119 15,463 49,157 20,995 10,400 176,109 32,487 89,058

Washington 126,925 25,500 18,780 2,802 10,225 4,617 2,408 39,720 7,546 9,585

Totals 923,367 201,018 128,458 22,087 72,855 31,692 15,998 268,246 49,978 112,551

RHODE ISLAND

American Lung Association in Rhode Island

260 West Exchange Street, Suite 102-B

Providence, RI 02903

(401) 533-5171

www.lungusa.org/rhodeisland
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 143

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Kent 12 0 0 4.0 F 1 0 0 0.3 B 7.3 PASS

Providence 15 1 0 5.5 F 2 0 0 0.7 B 10.5 PASS

Washington 12 1 0 4.5 F DNC DNC DNC DNC DNC DNC DNC

RHODE ISLAND
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 144 SOUTH CAROLINA

American Lung Association in South Carolina

 44-A Markfield Drive 

Charleston, SC 29407 

 (843) 556-8451

www.lungusa.org/southcarolina

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Abbeville 25,098 5,595 3,826 480 1,535 886 468 7,661 2,152 4,784

Aiken 156,017 36,315 24,248 3,114 9,431 5,435 2,898 47,168 13,220 28,674

Anderson 184,901 44,824 27,491 3,844 11,023 6,306 3,318 54,399 15,229 30,636

Barnwell 22,688 5,799 3,167 497 1,328 761 396 6,536 1,836 5,593

Beaufort 155,215 33,867 31,640 2,905 9,640 5,593 3,236 50,311 13,936 17,953

Berkeley 173,498 43,374 16,900 3,720 10,116 5,463 2,477 44,171 12,307 25,594

Charleston 355,276 75,457 46,308 6,471 21,872 11,935 5,804 99,296 27,501 56,163

Cherokee 54,714 13,337 7,211 1,144 3,243 1,822 917 15,406 4,307 10,328

Chester 32,410 7,814 4,697 670 1,935 1,112 582 9,577 2,690 6,236

Chesterfield 43,037 10,676 5,851 916 2,541 1,450 745 12,380 3,477 9,993

Colleton 39,246 9,674 5,959 830 2,331 1,352 723 11,757 3,305 8,521

Darlington 66,445 16,167 9,284 1,387 3,951 2,264 1,172 19,398 5,450 14,646

Edgefield 25,752 5,441 2,920 467 1,584 880 418 7,265 2,039 4,897

Florence 134,208 33,951 18,130 2,912 7,866 4,433 2,258 37,680 10,529 23,991

Georgetown 60,703 13,491 10,726 1,157 3,739 2,222 1,245 19,746 5,564 12,434

Greenville 451,428 111,230 55,706 9,539 26,607 14,748 7,233 123,272 34,380 67,337

Greenwood 69,671 16,887 10,619 1,448 4,153 2,339 1,228 20,135 5,595 13,162

Horry 263,868 54,430 47,556 4,668 16,560 9,582 5,297 84,484 23,570 41,191
SOUTH CAROLINA AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 145

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Lexington 255,607 63,678 31,623 5,461 15,023 8,428 4,175 70,803 19,837 26,761

Oconee 71,514 15,354 13,412 1,317 4,452 2,623 1,486 23,404 6,555 13,634

Pickens 118,144 25,077 16,169 2,151 7,284 3,990 1,973 33,429 9,252 19,508

Richland 372,023 88,508 36,761 7,591 22,021 11,683 5,214 93,745 25,922 54,397

Spartanburg 286,822 69,894 39,526 5,994 17,021 9,558 4,869 81,227 22,658 41,480

Union 27,362 6,240 4,549 535 1,668 975 533 8,562 2,405 5,905

Williamsburg 34,445 7,863 5,087 674 2,090 1,196 625 10,290 2,885 10,682

York 227,003 57,383 27,411 4,921 13,263 7,354 3,595 61,389 17,134 27,546

Totals 3,707,095 872,326 506,777 74,813 222,278 124,390 62,885 1,053,491 293,732 582,046
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 146

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Abbeville 13 0 0 4.3 F DNC DNC DNC DNC DNC DNC DNC

Aiken 12 0 0 4.0 F DNC DNC DNC DNC DNC DNC DNC

Anderson INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Barnwell INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Beaufort DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Berkeley 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Charleston 1 0 0 0.3 B 3 1 0 1.5 C 9.9 PASS

Cherokee 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

Chester INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Chesterfield 3 0 0 1.0 C 1 0 0 0.3 B 10.9 PASS

Colleton 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Darlington 7 0 0 2.3 D DNC DNC DNC DNC DNC DNC DNC

Edgefield 4 0 0 1.3 C 2 0 0 0.7 B 11.3 PASS

Florence DNC DNC DNC DNC DNC 1 0 0 0.3 B INC INC

Georgetown DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Greenville INC INC INC INC INC 0 0 0 0.0 A 12.3 PASS

Greenwood DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Horry DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

SOUTH CAROLINA

American Lung Association in South Carolina

 44-A Markfield Drive 

Charleston, SC 29407 

 (843) 556-8451

www.lungusa.org/southcarolina
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 147

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Lexington DNC DNC DNC DNC DNC 1 0 0 0.3 B 12.1 PASS

Oconee 5 0 0 1.7 C 0 0 0 0.0 A 9.3 PASS

Pickens 13 0 0 4.3 F DNC DNC DNC DNC DNC DNC DNC

Richland 19 0 0 6.3 F 3 0 0 1.0 C 12.0 PASS

Spartanburg 22 0 0 7.3 F 0 0 0 0.0 A 11.8 PASS

Union INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Williamsburg INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

York 7 0 0 2.3 D DNC DNC DNC DNC DNC DNC DNC

SOUTH CAROLINA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 148

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Brookings 30,056 5,647 3,195 484 1,947 956 409 7,516 1,352 3,942

Brown 35,204 7,900 5,847 678 2,102 1,226 660 10,678 2,064 3,455

Codington 26,168 6,492 3,884 557 1,511 879 461 7,571 1,455 2,952

Custer 7,924 1,648 1,611 141 466 310 184 2,831 565 830

Jackson 2,658 861 344 74 138 80 42 687 132 947

Meade 23,916 5,639 2,820 484 1,396 801 390 6,687 1,265 3,001

Minnehaha 183,048 44,151 22,596 3,787 10,768 5,940 2,881 49,379 9,282 18,519

Pennington 100,850 25,043 13,999 2,148 5,826 3,352 1,717 28,562 5,458 13,863

Union 14,589 3,643 1,977 312 833 492 253 4,208 807 889

Totals 424,413 101,024 56,273 8,664 24,988 14,036 6,997 118,119 22,380 48,398

SOUTH DAKOTA

American Lung Association in South Dakota

108 E. 38th Street, Suite 600

Sioux Falls, SD 57105

(605) 336-7222

www.lungusa.org/southdakota
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 149

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Brookings DNC DNC DNC DNC DNC 2 0 0 0.7 B 8.4 PASS

Brown DNC DNC DNC DNC DNC 0 0 0 0.0 A 7.9 PASS

Codington DNC DNC DNC DNC DNC 2 0 0 0.7 B 9.0 PASS

Custer 0 0 0 0.0 A 1 1 0 0.8 B 5.5 PASS

Jackson 0 0 0 0.0 A INC INC INC INC INC 4.9 PASS

Meade 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Minnehaha 0 0 0 0.0 A 2 0 0 0.7 B 9.4 PASS

Pennington DNC DNC DNC DNC DNC 1 0 0 0.3 B 7.4 PASS

Union County INC INC INC INC INC INC INC INC INC INC INC INC

SOUTH DAKOTA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 150

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Anderson 74,849 17,054 12,564 1,463 4,728 2,657 1,454 23,334 6,407 12,788

Blount 122,784 27,087 19,221 2,323 7,801 4,334 2,302 37,550 10,367 14,084

Davidson 635,710 141,156 68,368 12,106 39,563 20,509 9,339 165,921 46,893 104,427

Dyer 37,811 9,386 5,498 805 2,311 1,272 665 10,938 3,027 7,746

Hamilton 337,175 73,952 49,939 6,342 21,385 11,737 6,086 100,565 27,868 59,543

Haywood 18,881 4,929 2,564 423 1,136 631 327 5,411 1,504 3,973

Jefferson 51,722 11,302 8,044 969 3,287 1,810 953 15,610 4,311 10,109

Knox 435,725 94,839 57,195 8,134 27,512 14,743 7,263 123,426 34,471 62,028

Lawrence 41,314 10,345 6,822 887 2,526 1,403 765 12,285 3,366 7,341

Loudon 46,725 9,688 9,716 831 3,057 1,766 1,038 16,031 4,340 6,854

McMinn 52,739 12,143 8,425 1,041 3,311 1,841 988 16,017 4,411 9,439

Madison 97,317 24,129 12,390 2,069 5,916 3,190 1,583 26,805 7,483 19,273

Maury 84,302 20,347 10,923 1,745 5,179 2,814 1,408 23,741 6,626 12,235

Meigs 12,108 2,831 1,778 243 756 420 220 3,621 1,003 2,441

Montgomery 160,978 43,670 13,729 3,745 9,319 4,701 2,000 36,961 10,547 21,543

Putnam 72,431 16,110 10,915 1,382 4,551 2,442 1,253 20,781 5,741 14,823

Roane 53,508 11,057 9,509 948 3,483 1,979 1,099 17,507 4,799 7,281

Rutherford 257,048 66,819 21,656 5,731 15,135 7,690 3,278 60,554 17,308 31,121

Sevier 86,243 19,105 13,797 1,639 5,478 3,052 1,635 26,543 7,316 11,907

Shelby 920,232 250,454 93,716 21,480 53,867 28,569 13,336 233,910 66,100 188,373

Sullivan 154,552 32,227 28,112 2,764 10,025 5,663 3,160 50,171 13,716 27,049

Sumner 158,759 40,295 19,629 3,456 9,599 5,231 2,604 44,051 12,323 17,387

Williamson 176,838 49,953 16,570 4,284 10,261 5,577 2,624 45,919 13,037 9,431

Wilson 112,377 28,123 13,186 2,412 6,824 3,718 1,825 31,135 8,743 10,089

Totals 4,202,128 1,017,001 514,266 87,221 257,011 137,749 67,205 1,148,787 321,708 671,285

TENNESSEE

American Lung Association in Tennessee

One Vantage Way, Suite D-220

Nashville, TN 37228

(615) 329-1151

www.lungusa.org/tennessee
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 151

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Anderson 12 0 0 4.0 F DNC DNC DNC DNC DNC DNC DNC

Blount 45 1 0 15.5 F 5 0 0 1.7 C 12.9 PASS

Davidson 13 1 0 4.8 F 8 0 0 2.7 D 11.8 PASS

Dyer DNC DNC DNC DNC DNC 3 0 0 1.0 C 10.7 PASS

Hamilton 32 3 0 12.2 F 6 0 0 2.0 C 12.7 PASS

Haywood INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Jefferson 18 0 0 6.0 F DNC DNC DNC DNC DNC DNC DNC

Knox 39 0 1 13.7 F 14 0 0 4.7 F 13.0 PASS

Lawrence INC INC INC INC INC 3 0 0 1.0 C 10.1 PASS

Loudon 29 1 0 10.2 F 5 0 0 1.7 C 13.7 PASS

McMinn DNC DNC DNC DNC DNC 3 0 0 1.0 C 12.9 PASS

Madison DNC DNC DNC DNC DNC 4 0 0 1.3 C 10.6 PASS

Maury DNC DNC DNC DNC DNC 2 0 0 0.7 B 10.9 PASS

Meigs 12 1 0 4.5 F DNC DNC DNC DNC DNC DNC DNC

Montgomery DNC DNC DNC DNC DNC 9 0 0 3.0 D 11.5 PASS

Putnam INC INC INC INC INC 1 0 0 0.3 B 11.3 PASS

Roane DNC DNC DNC DNC DNC 1 1 0 0.8 B 12.9 PASS

Rutherford 7 1 0 2.8 D DNC DNC DNC DNC DNC DNC DNC

Sevier 53 0 0 17.7 F DNC DNC DNC DNC DNC DNC DNC

Shelby 28 2 0 10.3 F 7 0 0 2.3 D 11.3 PASS

Sullivan 17 2 0 6.7 F 2 0 0 0.7 B 12.0 PASS

Sumner 33 1 0 11.5 F 4 0 0 1.3 C 11.5 PASS

Williamson 23 0 0 7.7 F DNC DNC DNC DNC DNC DNC DNC

Wilson 24 0 0 8.0 F DNC DNC DNC DNC DNC DNC DNC

TENNESSEE
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 152

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Bell 285,787 84,937 26,707 6,941 12,903 8,173 3,630 65,382 17,679 42,158

Bexar 1,651,448 462,341 171,115 37,782 76,691 49,708 22,999 404,882 110,000 285,469

Bowie 93,964 22,940 12,913 1,875 4,612 3,109 1,577 26,361 7,193 17,301

Brazoria 309,208 85,965 29,100 7,025 14,415 9,401 4,276 76,128 20,773 29,764

Brewster 9,481 1,822 1,369 149 496 331 165 2,785 758 1,545

Cameron 396,371 138,667 43,799 11,332 16,654 10,926 5,329 90,959 24,681 132,894

Collin 791,631 221,800 62,987 18,125 36,687 23,520 10,156 186,449 50,818 56,280

Dallas 2,451,730 690,205 211,073 56,403 113,137 71,545 30,972 566,836 153,584 450,082

Denton 658,616 179,866 41,492 14,699 30,676 19,110 7,626 146,787 39,857 56,409

Ector 134,625 40,702 13,763 3,326 6,062 3,947 1,842 32,267 8,774 22,328

Ellis 151,737 43,931 14,931 3,590 6,977 4,609 2,150 37,736 10,319 16,347

El Paso 751,296 236,119 79,541 19,296 33,260 21,688 10,265 178,318 48,436 174,651

Galveston 286,814 74,744 31,538 6,108 13,762 9,231 4,435 76,566 20,985 41,606

Gregg 119,637 32,206 16,450 2,632 5,679 3,831 1,962 32,613 8,890 17,441

Harris 4,070,989 1,174,860 328,354 96,009 186,211 118,470 51,005 937,343 254,761 686,928

Harrison 64,795 16,439 8,294 1,343 3,146 2,140 1,076 18,098 4,959 9,662

Hays 155,545 38,482 12,532 3,145 7,500 4,674 1,943 36,428 9,851 28,162

Hidalgo 741,152 270,620 70,444 22,115 30,255 19,278 8,868 156,390 42,227 258,259

Hood 51,462 11,257 10,133 920 2,645 1,909 1,107 17,226 4,730 5,874

Hunt 82,831 20,720 11,192 1,693 4,039 2,742 1,394 23,291 6,369 15,976

TEXAS

American Lung Association in Texas

8150 Brookriver Drive, Suite S102

Dallas, TX 75247

(214) 631-5864

www.lungusa.org/texas
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 153

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Jefferson 243,237 60,160 31,643 4,916 11,874 7,946 3,954 66,812 18,221 43,356

Johnson 156,997 42,443 17,344 3,468 7,426 4,954 2,379 41,058 11,231 17,614

Kaufman 103,038 30,215 9,539 2,469 4,708 3,094 1,418 25,147 6,875 12,428

Kleberg 30,647 7,762 3,563 634 1,473 944 441 7,703 2,081 6,491

Lubbock 270,550 67,197 30,779 5,491 13,091 8,396 3,897 68,394 18,498 52,273

McLennan 233,378 59,806 28,536 4,887 11,210 7,327 3,531 60,684 16,465 50,871

Montgomery 447,718 124,444 45,430 10,169 20,949 13,943 6,569 114,679 31,411 49,974

Navarro 49,440 13,312 6,763 1,088 2,348 1,589 815 13,539 3,695 8,801

Nueces 323,046 86,795 37,483 7,093 15,313 10,207 4,955 84,947 23,200 63,272

Orange 81,816 20,731 11,258 1,694 3,979 2,726 1,403 23,287 6,379 12,624

Parker 114,919 29,364 13,094 2,400 5,563 3,771 1,840 31,501 8,651 10,990

Potter 121,816 34,009 14,995 2,779 5,673 3,718 1,814 30,957 8,396 26,250

Rockwall 81,391 24,011 7,625 1,962 3,712 2,444 1,127 19,914 5,446 5,314

Smith 204,665 52,774 29,819 4,313 9,869 6,675 3,464 57,142 15,566 32,316

Tarrant 1,789,900 507,390 155,996 41,464 82,590 53,033 23,400 423,856 115,329 254,582

Travis 1,026,158 246,456 70,474 20,140 49,782 30,363 11,890 231,110 62,284 160,747

Victoria 87,790 24,130 11,722 1,972 4,141 2,818 1,444 24,013 6,566 12,041

Webb 241,438 91,018 19,581 7,438 9,658 6,098 2,686 48,619 13,140 73,466

Totals 18,867,063 5,370,640 1,743,371 438,886 869,167 558,388 249,804 4,486,207 1,219,075 3,242,546

TEXAS
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 154 TEXAS

American Lung Association in Texas

8150 Brookriver Drive, Suite S102

Dallas, TX 75247

(214) 631-5864

www.lungusa.org/texas

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

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 16 0 0 5.3 F INC INC INC INC INC INC INC

Bowie DNC DNC DNC DNC DNC 0 0 0 0.0 A 11.3 PASS

Brazoria 24 2 0 9.0 F DNC DNC DNC DNC DNC DNC DNC

Brewster 0 0 0 0.0 A 0 0 0 0.0 A INC INC

Cameron 0 0 0 0.0 A 0 0 0 0.0 A 11.4 PASS

Collin 20 0 0 6.7 F DNC DNC DNC DNC DNC DNC DNC

Dallas 24 2 0 9.0 F 1 0 0 0.3 B 11.3 PASS

Denton 33 3 0 12.5 F DNC DNC DNC DNC DNC DNC DNC

Ector DNC DNC DNC DNC DNC 1 0 0 0.3 B 8.1 PASS

Ellis 9 0 0 3.0 D 1 0 0 0.3 B 10.8 PASS

El Paso 21 0 0 7.0 F 11 0 0 3.7 F 10.6 PASS

Galveston 13 3 0 5.8 F DNC DNC DNC DNC DNC DNC DNC

Gregg 8 0 0 2.7 D DNC DNC DNC DNC DNC DNC DNC

Harris 66 10 0 27.0 F 7 0 0 2.3 D 14.1 PASS

Harrison 0 0 0 0.0 A 0 0 0 0.0 A 10.3 PASS

Hays 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Hidalgo 1 0 0 0.3 B 0 0 0 0.0 A 10.9 PASS

Hood 11 0 0 3.7 F DNC DNC DNC DNC DNC DNC DNC

Hunt 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC
TEXAS AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 155

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Jefferson 25 0 0 8.3 F 1 0 0 0.3 B 11.0 PASS

Johnson 23 0 0 7.7 F DNC DNC DNC DNC DNC DNC DNC

Kaufman 6 0 0 2.0 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 INC INC INC INC INC INC INC

McLennan 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Montgomery 8 0 0 2.7 D DNC DNC DNC DNC DNC DNC DNC

Navarro INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Nueces 4 0 0 1.3 C 0 0 0 0.0 A 10.5 PASS

Orange 6 0 0 2.0 C 0 0 0 0.0 A INC INC

Parker 16 2 0 6.3 F DNC DNC DNC DNC DNC DNC DNC

Potter DNC DNC DNC DNC DNC 0 0 0 0.0 A 6.0 PASS

Rockwall 8 1 0 3.2 D DNC DNC DNC DNC DNC DNC DNC

Smith 8 1 0 3.2 D DNC DNC DNC DNC DNC DNC DNC

Tarrant 59 4 1 22.3 F 1 0 0 0.3 B 10.9 PASS

Travis 10 0 0 3.3 F 0 0 0 0.0 A 9.1 PASS

Victoria 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Webb 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 156

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Box Elder 49,902 16,648 5,376 1,211 2,645 1,425 691 11,847 2,326 4,748

Cache 115,269 35,491 8,905 2,582 6,320 3,075 1,246 23,661 4,328 18,744

Davis 300,827 101,475 24,522 7,382 15,813 8,115 3,541 64,496 12,189 21,001

Salt Lake 1,034,989 301,147 89,962 21,909 58,207 29,771 12,941 236,201 44,562 108,994

San Juan 15,049 5,010 1,542 364 798 424 201 3,494 680 4,181

Tooele 58,335 20,493 4,379 1,491 3,000 1,519 645 11,939 2,233 4,063

Uintah 31,536 10,323 2,873 751 1,684 873 394 7,033 1,344 3,139

Utah 545,307 189,454 35,179 13,783 28,166 13,467 5,204 101,731 18,281 75,993

Washington 137,473 40,470 24,297 2,944 7,751 4,327 2,436 38,370 7,883 19,260

Weber 231,834 68,148 24,145 4,958 13,003 6,814 3,162 55,547 10,722 28,582

Totals 2,520,521 788,659 221,180 57,376 137,387 69,810 30,461 554,319 104,548 288,705

UTAH

American Lung Association in Utah

1930 South 1100 East

Salt Lake City, UT 84106-2317

(801) 484-4456

www.lungusa.org/utah
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 157

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Box Elder 11 0 0 3.7 F 8 0 0 2.7 D 8.4 PASS

Cache 3 0 0 1.0 C 35 3 0 13.2 F 9.8 PASS

Davis 18 0 0 6.0 F 9 2 0 4.0 F 10.6 PASS

Salt Lake 30 1 0 10.5 F 51 11 0 22.5 F 11.4 PASS

San Juan 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Tooele 7 0 0 2.3 D 3 1 0 1.5 C 7.0 PASS

Uintah 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Utah 11 0 0 3.7 F 31 9 0 14.8 F 10.7 PASS

Washington 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Weber 23 0 0 7.7 F 19 1 0 6.8 F 10.6 PASS

UTAH
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 158

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Bennington 36,411 7,313 6,953 741 2,820 1,369 778 12,243 2,039 4,498

Chittenden 152,313 30,597 15,891 3,099 12,224 5,115 2,324 41,394 6,396 15,392

Rutland 63,014 11,955 10,653 1,211 4,973 2,361 1,282 20,675 3,401 8,281

Totals 251,738 49,865 33,497 5,050 20,017 8,845 4,384 74,312 11,836 28,171

VERMONT

American Lung Association in Vermont

372 Hurricane Lane, Suite 101

Williston, VT 05495

(802) 876-6862

www.lungusa.org/vermont
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 159

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Bennington 6 0 0 2.0 C 0 0 0 0.0 A 7.3 PASS

Chittenden 6 0 0 2.0 C 0 0 0 0.0 A 7.9 PASS

Rutland DNC DNC DNC DNC DNC 1 0 0 0.3 B 10.4 PASS

VERMONT
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 160

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Albemarle 94,908 20,366 12,208 1,681 5,836 3,229 1,583 26,984 6,108 7,774

Arlington 217,483 35,785 18,697 2,953 14,237 7,043 2,818 53,986 11,628 13,988

Caroline 27,870 6,550 3,535 541 1,668 931 461 7,815 1,774 2,845

Charles City 7,217 1,324 1,311 109 461 283 159 2,522 591 735

Chesterfield 306,670 81,242 24,493 6,704 17,474 9,649 4,286 77,554 17,427 18,507

Fairfax 1,037,605 258,129 101,289 21,302 60,651 33,532 15,501 273,721 61,696 57,573

Fauquier 68,010 17,083 7,944 1,410 3,964 2,279 1,129 19,174 4,387 4,003

Frederick 74,972 19,213 8,532 1,586 4,352 2,430 1,177 20,222 4,585 6,796

Hanover 99,933 24,971 12,744 2,061 5,846 3,378 1,715 28,718 6,589 4,747

Henrico 296,415 70,539 37,707 5,821 17,691 9,798 4,830 82,070 18,589 29,165

Loudoun 301,171 89,850 19,156 7,415 16,434 8,548 3,486 66,255 14,533 10,069

Madison 13,702 2,937 2,401 242 845 503 280 4,454 1,035 1,456

Page 24,070 5,082 4,229 419 1,494 870 479 7,655 1,769 2,964

Prince William 379,166 110,941 25,325 9,155 20,850 10,962 4,550 85,580 18,861 22,535

Roanoke 91,011 21,199 14,502 1,749 5,468 3,228 1,750 28,248 6,541 5,379

Rockbridge 21,294 4,410 3,847 364 1,325 792 444 7,038 1,638 2,353

Rockingham 75,134 17,282 10,845 1,426 4,533 2,583 1,336 22,108 5,060 7,685

Stafford 124,166 36,249 8,095 2,991 6,818 3,647 1,529 28,619 6,346 5,764

Wythe 28,868 5,964 5,271 492 1,803 1,055 588 9,337 2,162 4,058

VIRGINIA

American Lung Association in Virginia

9702 Gayton Road, #110

Richmond, VA 23238

(804) 955-4910

www.lungusa.org/virginia
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 161

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Alexandria City 150,006 27,447 16,059 2,265 9,616 4,933 2,163 39,239 8,617 13,486

Bristol City 17,690 3,510 4,177 290 1,129 661 400 6,074 1,414 3,458

Hampton City 144,236 32,144 16,926 2,653 8,789 4,696 2,202 38,454 8,593 19,499

Lynchburg City 73,933 14,930 12,369 1,232 4,673 2,509 1,303 21,427 4,831 13,122

Newport News City 193,172 49,502 21,270 4,085 11,260 6,011 2,802 49,103 10,965 25,430

Norfolk City 233,333 54,515 23,197 4,499 14,033 7,169 3,125 56,876 12,468 37,917

Roanoke City 94,482 19,970 16,345 1,648 5,877 3,328 1,800 29,021 6,653 18,382

Salem City 25,462 5,058 4,367 417 1,607 912 489 7,926 1,817 2,240

Suffolk City 83,659 21,634 9,738 1,785 4,847 2,695 1,310 22,453 5,086 10,091

Virginia Beach City 433,575 106,502 46,020 8,789 25,574 13,775 6,376 112,294 25,128 28,889

Totals 4,739,213 1,164,328 492,599 96,085 279,154 151,429 70,071 1,234,927 276,888 380,910

VIRGINIA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 162

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Albemarle INC INC INC INC INC INC INC INC INC INC INC INC

Arlington 28 1 0 9.8 F 3 0 0 1.0 C 11.9 PASS

Caroline 17 0 0 5.7 F DNC DNC DNC DNC DNC DNC DNC

Charles City 19 0 0 6.3 F 2 0 0 0.7 B 10.3 PASS

Chesterfield 10 2 0 4.3 F 1 0 0 0.3 B 11.2 PASS

Fairfax 38 2 0 13.7 F 7 0 0 2.3 D 11.7 PASS

Fauquier 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Frederick 3 0 0 1.0 C 0 0 0 0.0 A INC INC

Hanover 17 1 0 6.2 F DNC DNC DNC DNC DNC DNC DNC

Henrico 22 1 0 7.8 F 6 0 0 2.0 C 10.8 PASS

Loudoun 21 1 0 7.5 F 3 0 0 1.0 C 11.2 PASS

Madison 5 0 0 1.7 C INC INC INC INC INC INC INC

Page 0 0 0 0.0 A 0 0 0 0.0 A 10.6 PASS

Prince William 7 0 0 2.3 D DNC DNC DNC DNC DNC DNC DNC

Roanoke 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC

Rockbridge 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Rockingham 1 0 0 0.3 B 2 0 0 0.7 B 11.7 PASS

Stafford 11 0 0 3.7 F DNC DNC DNC DNC DNC DNC DNC

Wythe 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

VIRGINIA

American Lung Association in Virginia

9702 Gayton Road, #110

Richmond, VA 23238

(804) 955-4910

www.lungusa.org/virginia
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 163

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Alexandria City 14 0 0 4.7 F DNC DNC DNC DNC DNC DNC DNC

Bristol City DNC DNC DNC DNC DNC 0 0 0 0.0 A 11.2 PASS

Hampton City INC INC INC INC INC 2 0 0 0.7 B INC INC

Lynchburg City DNC DNC DNC DNC DNC 1 0 0 0.3 B 10.5 PASS

Newport News City INC INC INC INC INC INC INC INC INC INC INC INC

Norfolk City DNC DNC DNC DNC DNC 6 2 0 3.0 D 11.5 PASS

Roanoke City DNC DNC DNC DNC DNC 3 0 0 1.0 C 11.5 PASS

Salem City DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Suffolk City 14 0 0 4.7 F DNC DNC DNC DNC DNC DNC DNC

Virginia Beach City DNC DNC DNC DNC DNC 8 3 0 4.2 F 10.7 PASS

VIRGINIA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 164

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Asotin 21,432 4,738 4,102 324 1,478 780 446 6,988 1,513 3,189

Chelan 72,372 18,049 11,387 1,234 4,801 2,481 1,340 21,656 4,663 9,309

Clallam 71,413 13,256 16,751 906 5,185 2,846 1,739 26,334 5,744 9,986

Clark 432,002 113,146 48,530 7,737 28,008 13,816 6,653 114,652 24,397 50,559

King 1,916,441 408,363 205,002 27,923 131,958 63,737 29,348 518,698 109,820 184,782

Kittitas 39,532 7,124 4,893 487 2,815 1,334 618 10,856 2,296 7,545

Pierce 796,836 196,488 86,174 13,435 52,578 25,569 11,993 209,703 44,485 95,421

Skagit 119,534 28,477 18,438 1,947 8,035 4,118 2,190 35,692 7,673 13,060

Snohomish 694,571 171,462 68,364 11,724 45,931 22,398 10,328 182,585 38,690 66,458

Spokane 468,684 108,969 60,952 7,451 31,580 15,675 7,781 131,711 28,105 67,264

Thurston 250,979 56,937 31,719 3,893 17,068 8,503 4,198 71,325 15,217 27,352

Whatcom 200,434 41,941 25,982 2,868 13,875 6,804 3,315 56,676 12,066 30,351

Yakima 239,054 74,412 28,027 5,088 14,428 7,119 3,520 59,689 12,727 51,725

Totals 5,323,284 1,243,362 610,321 85,019 357,740 175,180 83,469 1,446,565 307,397 617,001

WASHINGTON

American Lung Association in Washington

2625 Third Avenue

Seattle, WA 98121-1213

(206) 441-5100

www.lungusa.org/washington
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 165

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

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 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Clark 1 0 0 0.3 B 16 0 0 5.3 F INC INC

King 9 0 0 3.0 D 1 0 0 0.3 B 9.3 PASS

Kittitas DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Pierce 4 0 0 1.3 C 16 0 0 5.3 F 9.8 PASS

Skagit 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Snohomish DNC DNC DNC DNC DNC 24 1 0 8.5 F 8.9 PASS

Spokane 0 0 0 0.0 A 0 0 0 0.0 A INC INC

Thurston 1 0 0 0.3 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 12 0 0 4.0 F 9.7 PASS

WASHINGTON
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 166

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Berkeley 103,854 25,871 11,828 2,194 6,925 3,363 1,613 27,848 8,781 10,866

Brooke 23,509 4,577 4,557 388 1,659 885 503 7,912 2,504 3,075

Cabell 95,214 19,062 15,496 1,617 6,717 3,341 1,750 28,712 9,053 19,182

Greenbrier 34,527 7,163 6,403 607 2,401 1,279 721 11,387 3,605 6,361

Hancock 29,729 5,994 5,591 508 2,081 1,121 635 10,010 3,171 4,262

Harrison 68,911 15,401 11,099 1,306 4,713 2,432 1,306 21,169 6,692 12,049

Kanawha 191,663 40,727 31,882 3,454 13,286 6,903 3,738 60,336 19,080 27,060

Marion 56,706 11,268 9,665 956 4,001 2,039 1,096 17,741 5,602 9,461

Marshall 32,556 6,584 5,466 558 2,286 1,203 655 10,552 3,340 5,586

Monongalia 90,080 14,970 9,607 1,269 6,702 2,982 1,284 23,527 7,369 18,083

Ohio 44,015 8,797 8,541 746 3,086 1,642 934 14,674 4,643 5,813

Raleigh 79,187 16,530 12,442 1,402 5,526 2,829 1,495 24,454 7,729 14,258

Wood 86,888 18,768 14,966 1,592 5,990 3,124 1,712 27,448 8,680 14,110

Totals 936,839 195,712 147,543 16,597 65,373 33,143 17,442 285,770 90,248 150,166

WEST VIRGINIA

American Lung Association in West Virginia

415 Dickinson Street

P.O. Box 3980 

Charleston, West Virginia 25339-3980

(304) 342-6600

www.lungusa.org/westvirginia
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 167

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Berkeley 3 0 0 1.0 C 1 0 0 0.3 B 14.0 PASS

Brooke DNC DNC DNC DNC DNC 12 0 0 4.0 F 14.4 PASS

Cabell 28 0 0 9.3 F 5 0 0 1.7 C 14.3 PASS

Greenbrier 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

Hancock 14 0 0 4.7 F 9 0 0 3.0 D 13.4 PASS

Harrison DNC DNC DNC DNC DNC 1 0 0 0.3 B 12.5 PASS

Kanawha 17 0 0 5.7 F 12 0 0 4.0 F 14.4 PASS

Marion DNC DNC DNC DNC DNC 2 0 0 0.7 B 13.6 PASS

Marshall DNC DNC DNC DNC DNC 16 0 0 5.3 F 13.4 PASS

Monongalia 6 0 0 2.0 C 4 0 0 1.3 C 12.7 PASS

Ohio 13 0 0 4.3 F 5 0 0 1.7 C 13.2 PASS

Raleigh DNC DNC DNC DNC DNC 1 0 0 0.3 B 11.0 PASS

Wood 15 0 0 5.0 F 5 0 0 1.7 C 13.7 PASS

WEST VIRGINIA
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 168

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Ashland 16,181 3,764 2,518 261 1,202 561 298 4,862 1,094 2,788

Brown 247,319 59,726 28,167 4,136 18,540 8,045 3,834 66,432 14,436 25,782

Columbia 55,170 12,461 8,289 863 4,110 1,944 1,026 16,800 3,785 4,907

Dane 491,357 102,412 48,449 7,091 39,130 16,007 7,071 127,929 27,017 62,188

Dodge 87,335 18,868 12,335 1,306 6,666 3,042 1,553 25,896 5,760 7,342

Door 27,815 5,023 6,142 348 2,111 1,124 675 10,329 2,425 2,110

Eau Claire 99,409 20,526 12,733 1,421 7,901 3,311 1,582 27,319 5,889 14,672

Florence 4,554 767 919 53 349 187 109 1,698 397 636

Fond Du Lac 100,070 22,607 14,679 1,565 7,522 3,467 1,801 29,740 6,648 9,103

Forest 9,605 2,060 2,078 143 715 360 215 3,290 765 1,505

Grant 48,965 10,352 7,945 717 3,777 1,715 907 14,807 3,310 6,261

Jefferson 80,833 18,566 10,594 1,286 6,098 2,731 1,363 23,005 5,076 8,104

Kenosha 165,382 42,098 18,362 2,915 12,174 5,293 2,519 43,693 9,497 20,693

Kewaunee 20,315 4,635 3,239 321 1,503 720 389 6,289 1,426 1,544

La Crosse 113,679 23,781 14,621 1,647 8,945 3,822 1,846 31,699 6,879 13,864

Manitowoc 80,583 17,834 13,062 1,235 6,003 2,895 1,568 25,322 5,751 7,338

Marathon 131,612 31,686 18,545 2,194 9,689 4,479 2,316 38,347 8,570 13,394

Milwaukee 959,521 241,292 109,505 16,708 71,568 30,360 14,368 249,703 53,900 192,170

Oneida 35,930 6,492 7,968 450 2,743 1,440 863 13,209 3,094 3,808

WISCONSIN

American Lung Association in Wisconsin

13100 West Lisbon Road, Suite 700

Brookfield, WI 53005-2508

(262) 703-4200

www.lungusa.org/wisconsin
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 169

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Outagamie 177,155 43,368 21,675 3,003 13,157 5,810 2,845 48,540 10,641 15,099

Ozaukee 86,311 20,137 12,866 1,394 6,290 3,074 1,641 26,738 6,074 4,361

Racine 200,601 49,688 25,585 3,441 14,673 6,702 3,368 56,677 12,574 24,279

Rock 160,155 39,195 21,606 2,714 11,813 5,344 2,713 45,360 10,060 20,278

St. Croix 83,351 21,576 8,336 1,494 6,096 2,645 1,228 21,617 4,676 5,223

Sauk 58,922 13,751 8,910 952 4,362 2,046 1,081 17,687 3,979 5,050

Sheboygan 114,560 26,893 16,332 1,862 8,489 3,939 2,042 33,766 7,556 10,055

Taylor 19,222 4,503 3,106 312 1,408 680 370 5,955 1,354 2,412

Vernon 29,324 7,650 4,831 530 2,063 1,012 562 8,958 2,049 4,509

Vilas 21,496 3,697 5,598 256 1,641 894 566 8,420 2,000 2,512

Walworth 100,593 22,823 13,446 1,580 7,618 3,412 1,710 28,795 6,358 12,777

Washington 130,681 31,063 17,309 2,151 9,621 4,481 2,283 38,147 8,518 7,355

Waukesha 383,154 89,803 55,072 6,218 28,064 13,458 7,074 116,215 26,237 18,548

Totals 4,341,160 1,019,097 554,822 70,565 326,041 145,000 71,786 1,217,244 267,795 530,667

WISCONSIN
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 170

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Ashland 0 0 0 0.0 A 1 0 0 0.3 B 6.0 PASS

Brown 6 0 0 2.0 C 17 0 0 5.7 F 11.4 PASS

Columbia 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

Dane 5 0 0 1.7 C 16 0 0 5.3 F 12.4 PASS

Dodge 3 0 0 1.0 C 2 0 0 0.7 B 10.6 PASS

Door 23 0 0 7.7 F DNC DNC DNC DNC DNC DNC DNC

Eau Claire DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Florence 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Fond Du Lac 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Forest 1 0 0 0.3 B 1 0 0 0.3 B 6.7 PASS

Grant DNC DNC DNC DNC DNC 7 0 0 2.3 D 12.2 PASS

Jefferson 5 0 0 1.7 C DNC DNC DNC DNC DNC DNC DNC

Kenosha 14 0 0 4.7 F 5 0 0 1.7 C 12.2 PASS

Kewaunee 16 0 0 5.3 F DNC DNC DNC DNC DNC DNC DNC

La Crosse INC INC INC INC INC 6 0 0 2.0 C 11.4 PASS

Manitowoc 19 0 0 6.3 F 2 0 0 0.7 B 10.4 PASS

Marathon 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Milwaukee 11 0 0 3.7 F 12 1 0 4.5 F 13.1 PASS

WISCONSIN

American Lung Association in Wisconsin

13100 West Lisbon Road, Suite 700

Brookfield, WI 53005-2508

(262) 703-4200

www.lungusa.org/wisconsin
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 171

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

24 Hour Annual

 Wgt. Wgt. Design Pass/

County Orange Red Purple Avg Grade Orange Red Purple Avg Grade Value Fail

Oneida 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC

Outagamie 3 0 0 1.0 C 9 0 0 3.0 D 11.0 PASS

Ozaukee 13 0 0 4.3 F 4 0 0 1.3 C 11.4 PASS

Racine 10 0 0 3.3 F DNC DNC DNC DNC DNC DNC DNC

Rock 7 0 0 2.3 D DNC DNC DNC DNC DNC DNC DNC

St. Croix 3 0 0 1.0 C 4 0 0 1.3 C 10.3 PASS

Sauk 2 0 0 0.7 B 5 0 0 1.7 C 10.4 PASS

Sheboygan 24 0 0 8.0 F DNC DNC DNC DNC DNC DNC DNC

Taylor DNC DNC DNC DNC DNC 1 0 0 0.3 B 8.8 PASS

Vernon 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC

Vilas 1 0 0 0.3 B 1 0 0 0.3 B 6.6 PASS

Walworth 4 0 0 1.3 C DNC DNC DNC DNC DNC DNC DNC

Washington 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC

Waukesha 0 0 0 0.0 A 5 0 0 1.7 C 13.2 PASS

WISCONSIN
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 172

AT-RISK GROUPS

Lung Diseases

 CardioTotal 65 & Pediatric Adult Chronic vascular

County Population Under 18 Over Asthma Asthma Bronchitis Emphysema Disease Diabetes Poverty

Albany 33,979 5,576 2,899 334 2,600 1,073 417 8,116 1,439 5,881

Campbell 43,967 12,348 2,446 740 2,858 1,293 519 9,976 1,861 2,817

Carbon 15,720 3,788 1,985 227 1,056 532 267 4,493 854 1,754

Converse 13,578 3,359 1,656 201 903 458 229 3,866 737 1,195

Crook 6,653 1,518 1,175 91 447 244 137 2,171 418 544

Fremont 38,719 10,026 5,633 601 2,528 1,296 683 11,191 2,125 5,551

Laramie 88,854 21,562 11,294 1,293 5,984 2,925 1,446 24,534 4,610 8,927

Natrona 74,508 18,175 9,071 1,090 5,014 2,441 1,192 20,366 3,828 6,905

Park 27,976 5,879 4,798 352 1,933 1,027 565 9,044 1,730 2,803

Sheridan 29,163 6,523 4,501 391 1,989 1,036 552 9,000 1,718 2,673

Sublette 8,792 2,255 771 135 583 284 130 2,311 440 504

Sweetwater 41,226 11,501 3,432 690 2,666 1,253 556 10,054 1,886 2,939

Teton 20,710 3,935 1,838 236 1,515 684 291 5,386 995 1,199

Uinta 20,927 6,431 1,707 386 1,296 621 280 5,019 948 1,853

Totals 464,772 112,876 53,206 6,767 31,372 15,167 7,264 125,527 23,587 45,545

WYOMING

American Lung Association in Wyoming

825 Helena Avenue

Helena, MT 59601-3459

(406) 442-6556

www.lungusa.org/wyoming
AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2011 173

HIGH OZONE DAYS 2007–2009 HIGH PARTICLE POLLUTION DAYS 2007–2009

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 4 0 0 1.3 C 0 0 0 0.0 A 5.6 PASS

Carbon INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Converse DNC DNC DNC DNC DNC 0 0 0 0.0 A 3.7 PASS

Crook INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

Fremont 1 0 0 0.3 B 2 0 0 0.7 B 7.8 PASS

Laramie DNC DNC DNC DNC DNC 0 0 0 0.0 A 4.2 PASS

Natrona DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Park DNC DNC DNC DNC DNC INC INC INC INC INC INC INC

Sheridan DNC DNC DNC DNC DNC 1 0 0 0.3 B 8.6 PASS

Sublette 9 4 1 5.7 F 1 0 0 0.3 B INC INC

Sweetwater 0 0 0 0.0 A INC INC INC INC INC INC INC

Teton 1 0 0 0.3 B 0 0 0 0.0 A INC INC

Uinta 0 0 0 0.0 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.LungUSA.org.