The SF Gate lists Allegheny, PA as the city with the worst air quality, followed by Fresno, Kern, Riverside (all in California!) and Jefferson, AL.
This article comes up with different cities, but the rankings by state remain the same. It lists Pittsburgh, PA as the most polluted, with Fresno, Bakersfield, Los Angeles (again, all in California), and Birmingham, AL following it.
Both lists were made according to the 2009 State of the Air report released by the American Lung Association with consideration to ozone, short-term particulates, and long-term particulates. However, the two news articles were written three months apart, which might be due to changes that the ALA made to the report since its initial release. Check out their website for more details.
Here is slightly updated information from the 2010 State of the Air report:
For ozone pollution, the worst five cities are Los Angeles, Bakersfield, Visalia, Fresno and Sacramento–all in California.
For short-term particle pollution, they are Bakersfield, Fresno, Pittsburgh, Los Angeles, and Birmingham.
For year-round particle pollution, the culprits are Phoenix-Mesa-Scottsdale, Bakersfield, Los Angeles, Visalia and Pittsburgh.
Also check out this map of air pollution grades for the entire U.S. Red means worse air quality, while blue is best.
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