ST. LOUIS, MO. - Madison and Jersey counties received low grades in the American Lung Association's latest "State of the Air" report as daily forecasting returns for the 2024 season.

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Madison received an "F" in the grading, while Jersey a "D." Macoupin County was given a "B" mark and St. Clair County a "C."

For the eighth consecutive year, the St. Louis region avoided being ranked among the top 25 most ozone-polluted U.S. cities, coming in at number 30 on the list out of 228 metropolitan areas.

The American Lung Association’s latest “State of the Air” report finds that despite decades of progress cleaning up air pollution, 39% of people living in America – 131.2 million individuals – still live in places with failing grades for unhealthy levels of ozone or particle pollution. This is 11.7 million more people breathing unhealthy air compared to the years covered by the 2023 report (2019-2021), which reinforces the need to protect our local communities from the continued risks to public health resulting from of a combination of factors, including extreme heat, drought, wildfire smoke and more.

The region ranked 33rd on the list for most polluted cities by annual particle pollution, which is back six spots from the previous year.

The “State of the Air” report looks at two of the most widespread and dangerous air pollutants, fine particles and ozone. The air quality data used in the report are collected at official monitoring sites across the United States by the federal, state, local and governments. The Lung Association calculates values reflecting the air pollution problem and assigns grades for daily and long-term measures of particle pollution and daily measures of ozone. Those values are also used to rank cities (metropolitan areas) and counties.

“Even though we’re pleased to see that St. Louis continues to avoid landing back among the nation’s top 25 most ozone-polluted cities, the data still clearly shows that we’re far from a clean bill of health for our region,” said Susannah Fuchs, Director of Clean Air for the American Lung Association in Missouri. “As we prepare to settle into the summer months when we’re at greater risk for poor air quality, the Clean Air Partnership strongly urges area residents to remain steadfast in their efforts to take voluntary steps to reduce emissions because those actions play a critical role in improving air quality conditions and helping people across the region breathe easier. This is particularly important to keep in mind for children, older adults and those who suffer from lung diseases that make them especially vulnerable.”

The most up-to-date report findings have added to the evidence that a changing climate is making the job of cleaning up the air and protecting human health more difficult.

High ozone days and spikes in particle pollution related to extreme heat, drought and wildfires are putting millions of people at risk and adding challenges to the work that states and cities are doing across the nation to clean up air pollution.

Here’s a look at the latest rankings for ozone pollution across the region for counties in the non-attainment area included in the American Lung Association’s report:


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Jefferson County: D
St. Charles County: F
St. Louis County: D
St. Louis City: C


Jersey County: D
Macoupin County: B
Madison County: F
St. Clair County: C

According to the 2024 “State of the Air” report, exposure to unhealthy levels of ozone air pollution continues to make breathing difficult for more people across the country than any other single pollutant. For the three years covered in this year’s report (2020-2022), some 100.6 million people lived in the 125 counties in 26 states that earned an “F” grade for ozone, including St. Charles County in Missouri and Madison County in Illinois. This means that three of every ten people – including 22.5 million infants and children, 15.5 million people age 65 or older and tens of millions in other groups at risk of health harm – are exposed to high levels of ozone on enough days to earn the air they breathe a failing grade.

While ozone air pollution remains a serious threat to public health, one trend continuing in a positive direction for the fourth consecutive report is the number of people living in counties with a failing grade for ozone that actually declined, this year by 2.4 million people. The long-term trend of improvement can be attributed to controls placed on emissions that have increasingly resulted in the replacement of more polluting engines, fuels and industrial processes nationwide.

Fuchs notes that since transportation has long been reported to have the most profound impact on air quality, making the choice to spend less time behind the wheel is an easy way to reduce harmful greenhouse gas emissions. Actions like using transit, carpooling and vanpooling, combining errands into a single trip, telecommuting, and walking and biking more to get around town all help take cars off area roads and keep related emissions out of our air. There are also many other eco-friendly lifestyle changes unrelated to commuting that individuals and businesses can consider to positively impact air quality and improve lung health, including efforts to conserve energy, recycle, reduce waste and reuse items.

During the forecasting season, the Partnership ramps up its efforts to inform area residents about ozone pollution levels in the region and how those levels can affect their health by releasing color-coded, daily air quality forecasts to let people know what the next day’s air quality is forecast to be and if they should alter their outdoor activities to minimize exposure to polluted air. This is especially crucial on orange or red unhealthy air quality days, which we saw an excess of this past year. Individuals can now sign up to receive the daily forecast via their email inboxes or text through the Environmental Protection Agency’s EnviroFlash air quality alert system by visiting There, they can also access a wealth of air quality information and tips to do their share for cleaner air all summer long.

Additional air quality information and the daily forecast can be accessed by liking the Clean Air Partnership on Facebook, or by following the organization on X, formerly known as Twitter, @gatewaycleanair. To access the full American Lung Association 2024 “State of the Air” report, visit

About the American Lung Association

The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease through education, advocacy and research. The work of the American Lung Association is focused on four strategic imperatives: to defeat lung cancer; to champion clean air for all; to improve the quality of life for those with lung disease and their families; and to create a tobacco-free future. For more information about the American Lung Association, which has a 4-star rating from Charity Navigator and is a Platinum-Level GuideStar Member, call 1-800-LUNGUSA (1-800-586-4872) or visit: To support the work of the American Lung Association, find a local event at

About the Clean Air Partnership

The Clean Air Partnership was formed in 1995, led by the American Lung Association, St. Louis Regional Chamber and Growth Association, East-West Gateway Council of Governments, Washington University, and others, to increase awareness of regional air quality issues and to encourage activities to reduce air pollution emissions.

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