More than 40% of Americans live in areas with unhealthy levels of air pollution, according to the American Lung Association's (ALA) annual "State of the Air" report—and experts say significant policy changes are needed to curtail the problem.

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Report details and key findings

For the report, ALA analyzed data on ozone and particle pollution from the Environmental Protection Agency's Air Quality System. The report covered data between 2018 and 2020.

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Overall, ALA found that more than 40% of the U.S. population—or 137 million people—live in areas with unhealthy levels of ozone or particle pollution. Compared with last year's report, an additional 2.1 million people now live in counties with unhealthy air and are experiencing more days of "very unhealthy" or "hazardous air quality."

In addition, over 63 million Americans are now impacted by daily spikes in deadly particle pollution—an increase of almost 9 million people from last year's report. According to ABC News, particulate pollution, also known as "soot," comes from wildfires, coal-fired power plants, and diesel engines, and can trigger asthma attacks, strokes, heart attacks, and potentially cause lung cancer.

In general, many of the regions most impacted by particle pollution are located in California, according to the report. The top five regions for unhealthy spikes in short-term particle pollution were:

1. Fresno-Madera-Hanford, CA
2. Bakersfield, CA
3. Fairbanks, AK
4. San Jose-San Francisco-Oakland, CA
5. Redding-Red Bluff, CA

In addition, the top five regions where annual particle pollution exceeded national air quality limits were:

1. Bakersfield, CA
2. Fresno-Madera-Hanford, CA
3. Visalia, CA
4. San Jose-San Francisco-Oakland, CA
5. Los Angeles-Long Beach, CA

According to John Balmes, a professor of environmental health sciences at the University of California, Berkeley and a volunteer medical spokesperson for the ALA, all of progress in air quality seen in the Mountain West "has pretty much been undone by wildfires."

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When it comes to ozone, also known as "smog," the report found that more than 122.3 million people live in counties with unhealthy levels of the pollutant, including 27.8 million children and 18.5 million older adults who are at an increased risk of harm. The top five regions for ozone pollution were:

1. Los Angeles-Long Beach, CA
2. Bakersfield, CA
3. Visalia, CA
4. Fresno-Madera-Hanford, CA
5. Phoenix-Mesa, AZ

Ground-level ozone contamination is "a powerful respiratory irritant whose effects have been likened to sunburn of the lung," ALA wrote in the report. Exposure to ozone, which is more likely to form as the climate warms, can lead to coughing, shortness of breath, and asthma attacks, and could ultimately shorten a person's life.

The report also found that people of color were disproportionately affected by air pollution. Compared with white people, people of color were 61% more likely to live in a county with a failing grade for at least one pollutant, and 3.6 times more likely to live in a county that failed on all three (short-term particle pollution, average annual particle pollution, and ozone pollution).

"The burden of living with unhealthy air is not shared equally," ALA wrote.

Comments

According to Paul Billings, SVP of public policy for ALA, the United States has "seen much better air quality in most areas today than when [ALA] started the report," but there has been an increase in air pollution over the last five years due to climate change "creating dry conditions that lead to drought and wildfire."

Going forward, ALA has asked the Biden administration to strengthen national limits on particle pollution. "We've long advocated for much more protective standards," Billings said, adding that "[t]he public has a right to know when air pollution threatens their health and the health of their children, seniors and families."

Ultimately, Franziska Rosser, an assistant professor of pediatrics in the division of pulmonary medicine at the University of Pittsburgh, said policy changes, not individual actions, are needed for real change to be made when it comes to air pollution.

"Personal interventions for air pollution are unfair. Air pollution cannot be controlled by one person," she said. "It is a societal problem and a global problem. The absolute best interventions for air pollution are policy." (Meltzer, ABC News, 4/21; Udasin, The Hill, 4/21; ALA "State of the Air" methodology, accessed 4/22)