Download the 2020 State of the Air full report


Threats and Opportunities for the Nation’s Air Quality

After 50 years under the Clean Air Act, the nation has made significant strides in cleaning up harmful air pollution. However, this year’s report shows that many communities are still waiting for healthy air, and that climate change poses current and growing threats to the nation’s progress. Fully implementing and enforcing the Clean Air Act and addressing climate change requires a strong, coordinated effort on the part of our federal, state, tribal and local leaders, and the need is more urgent than ever.

Unfortunately, in almost every case, the current Administration has continued to attempt to roll back, weaken, or undermine core healthy air protections under the Clean Air Act. Not only has this Administration targeted specific Clean Air Act safeguards for rollbacks, it has also sought to weaken EPA’s ability to set future protections. Many of the rollbacks are not yet final and face challenges in court. However, the impacts of some of this Administration’s actions could be felt for years to come.

At the same time as the Administration is halting progress or even moving backward on addressing climate change, many members of the U.S. Congress have worked to advance policies to reduce greenhouse gas emissions. This critical work presents real opportunities for cleaning up air pollution and improving lung health. However, some climate proposals actually include provisions that would weaken the Clean Air Act, a tradeoff that could lead to more health harm from air pollution.

Below are key threats and opportunities for the nation’s progress toward cleaner, healthier air, plus ways that you can help.

Opportunity: Congressional action on climate change

To protect public health from climate change, the nation needs urgent action in every arena – from the Administration to the U.S. Congress to state, local and tribal governments to the private sector. The Clean Air Act requires EPA to limit greenhouse gases because of the danger they pose to human health. Congressional action is critical too, and climate conversations and ideas have been proliferating on Capitol Hill.

There are many ways Congressional legislation could reduce emissions, like investing further in clean, renewable energy and incentivizing low- and zero-emission cars, buses and trucks. The Lung Association led a Declaration on Climate Change and Health with more than a dozen other leading national health organizations laying out five requirements for climate action. The nation needs climate policies that:

  • Adopt science-based targets to prevent climate change above 1.5o C.
  • Maximize benefits to health, reducing carbon and methane pollution at the same time that they reduce other dangerous emissions from polluting sources.
  • Ensure pollution is cleaned up in all communities, including those near polluting sources that have historically borne a disproportionate burden from air pollution.
  • Leave the Clean Air Act fully in place. Any policy to address climate change must not weaken or delay the Clean Air Act or the authority that it gives EPA to reduce carbon emissions.
  • Ensure communities have the tools and resources to identify, prepare for and adapt to the unique health impacts of climate change in their communities.
    • The nation’s public and environmental health systems must have adequate resources to protect communities by identifying, preparing for and responding to the health impacts of climate change.
    • Community leaders must be able to adequately protect those whose health is most at risk, and provide access to uninterrupted, quality healthcare during and after disasters.

What you can do:

  • Urge your members of Congress to support climate action to protect health, including the Climate Change Health Protection and Promotion Act. Take action now.
Threat 1: Weakening the Clean Air Act

Congress must make certain that the Clean Air Act remains strong, fully implemented and fully enforced.

The Clean Air Act remains a strong public health law put in place by an overwhelming bipartisan majority in Congress 50 years ago. Congress wrote the Clean Air Act to set up science-based, technology-fostering steps to protect public health by reducing pollution. Under the Clean Air Act, Congress directed EPA and each state to take steps to clean up the air to protect public health. For years, the “State of the Air” report chronicled the slow but steady improvement in the nation’s air quality thanks to the Clean Air Act.

Now, that positive trend is threatened. Climate change is making pollution cleanup more difficult, and unfortunately, some in Congress seek changes to the Clean Air Act that would dismantle key provisions of the law and threaten the progress made over five decades.

Undermining the Act itself is one of the fundamental goals of polluters and their allies. They have repeatedly challenged Clean Air Act provisions in court, and have repeatedly lost, so now they seek to weaken the law. Proposed efforts include exempting certain polluting facilities from some emissions controls, delaying science-based updates to air pollution standards, and undermining public health as the core premise of the Act’s key pollution limits.

Another emerging threat is the idea that legislation to address climate change must come at the price of weakening the Clean Air Act. Several bills have been introduced that would put a fee or price on carbon, but would also postpone or permanently restrict EPA’s ability to reduce greenhouse gas emissions. We don’t accept this trade-off. The Clean Air Act can and should work hand-in-hand with new laws in Congress to address climate change. Now is not the time to remove tools from the nation’s toolbox to address this urgent challenge.

To protect the lives and health of millions of Americans, the Lung Association calls on Congress to reject attempts to weaken the Clean Air Act and make certain the law remains strong, fully implemented and fully enforced.

What you can do:

  • Spread the word that some climate change legislation would actually weaken the Clean Air Act. Learn more here.
Threat 2: Considering outdated particle and ozone pollution limits

A fundamental reason for the success of the Clean Air Act is the requirement that EPA base decisions and actions on up-to-date science to protect public health. EPA has to periodically review its national limits on ozone and particle pollution (as well as four other pollutants) based on the current science and update them if necessary to reflect how much of each pollutant is safe to breathe. This requires ensuring that independent expert scientists regularly analyze current, peer-reviewed research and then provide their conclusions and perspectives to the EPA staff scientists and the Administrator. This process is critical. Over the years, research has shown that these pollutants are more dangerous than was known previously. In this way, the Clean Air Act requires EPA to make sure the national ozone and particle pollution standards protect Americans’ health.

However, in 2018, the agency put forward a very aggressive timeline for completing a full review of both the ozone and particulate matter standards before the end of 20201. Such a shortened review has severely limited what has historically been a thorough assessment of the science. The current EPA also removed independent science advisors from key advisory committees, including the Clean Air Scientific Advisory Committee (CASAC), and replaced them with people with far less experience in the research or who were paid by polluting industries2. EPA also dismissed a panel of experts that had been providing advice based on their deep understanding of the complex research on particle pollution. Many former participants and independent health and medical groups, including the Lung Association, urged EPA to reinstitute the panel3. Former chairs and members of CASAC have raised concerns about the lack of scientific expertise in the new members of the committee, as well as the dramatically reduced capacity for scientific reviews4.

With these changes to the process, in 2020, EPA proposed keeping the current limits on particle pollution in place, and is expected to do the same for ozone pollution–despite the fact that science has shown for years that these limits are too weak.

What you can do:

  • Tell EPA today that they need to set strong limits on particle and ozone pollution that protect the public. Take action now.
Threat 3: Dramatically weakening Cleaner Cars Standards

In 2020, EPA and the Department of Transportation finalized rules to weaken limits on greenhouse gas emissions from cars, SUVs and personal trucks for model year 2021-2026 vehicles. Weakening these cleaner cars standards will not only greatly slow progress in cleaning up climate pollution from the transportation sector, but will also cause additional premature deaths from air pollution.

Even more drastically, in 2019, the Administration decided to attack the rights states have to set stronger standards to protect their residents. Under the Clean Air Act, California has the right to establish its own, stronger emissions standards for cars and trucks, and other states have the option of adopting California’s standards. The Administration formally revoked California’s permission to set its own limits on greenhouse gas emissions for cars, SUVs and light trucks, setting off a heated legal battle.

California’s Clean Air Act authority to set more protective emissions standards has helped drive lifesaving reductions in harmful pollution from vehicles nationwide; maintaining this authority is critical. The Lung Association strongly opposed these rollbacks and recruited nearly 100 national, state and local health organizations to join comments to EPA in opposition5.

What you can do:

  • Drive less. Combine trips, walk, bike, carpool or vanpool, and use buses, subways or other alternatives to driving.
  • Support community plans that provide ways to get around that don’t require a car, such as more sidewalks, bike trails and transit systems.
Threat 4: Putting limits on mercury and air toxics at risk

In April 2020, EPA finalized a proposal that could undermine the Mercury and Air Toxics Standards, lifesaving protections that are fully implemented, widely supported, and successful in reducing a long list of dangerous emissions. In its proposal, EPA deliberately undercounted the benefits of these protections.

EPA adopted the Mercury and Air Toxics Standards in 2011 to limit emissions of mercury and other hazardous air pollutants, including carcinogens, like arsenic, acid gases and other dangerous toxins. Reducing these emissions from power plants results in the reduction of other harmful emissions at the same time. Since then, the standards have not only slashed mercury and air toxics emissions but have also reduced particulate matter, preventing thousands of premature deaths and asthma attacks every year. EPA has proposed not to count the benefits stemming from reductions of particulate matter and other pollutants not explicitly covered by the rule, which artificially tips the balance to make the rule appear less cost-effective than it is. This approach to calculating benefits, by design, obscures the enormous positive health impacts resulting from the Mercury and Air Toxics Standards.

What you can do:

  • Call on your members of Congress to oppose EPA’s decision that threatens to undermine the Mercury and Air Toxics Standards. The standards have bipartisan support, and your representative and senators need to hear from you so they speak up about this critical issue.
Threat 5: Censoring the science available for EPA’s decisions

In March 2020, EPA issued a proposal that resurrected a dangerous effort at the agency to suppress sound science, misleadingly labeled “Strengthening Transparency in Regulatory Science.” The proposed rule, which the Lung Association has deemed the “Censoring Science” proposal, would permit EPA to restrict the scientific studies the agency considers when it makes policy.

EPA’s effort is under the guise of transparency because the proposal would undervalue or block studies based on data that, for privacy reasons, can’t be made public. However, this effort is disingenuous. The proposed rule would exclude sound research from informing regulations or important scientific information. The rule would ignore or discount key health studies that show that particle pollution, for example, can cause premature death – because those health studies are based on personal medical data that cannot and should not be released.

Many databases that scientists use today do allow unrestricted access to their information, but others do not because of the need for patient confidentiality for subjects included in the research. The studies are available and transparent, but the private health data they are based on must be protected. Blocking the use of these key studies that have been through multiple independent reviews and show widespread harm from outdoor air pollutants introduces dangerous bias that could limit the evidence, risking weaker air pollution safeguards.

Even in the midst of the COVID-19 crisis, EPA is pushing ahead with the Censoring Science proposal. The Lung Association is leading health, medical, scientific and academic organizations in pushing back.

What you can do:

  • Raise your voice. There’s still time to sign our petition opposing EPA’s efforts to censor science. Join us at
Threat 6: Replacing the Clean Power Plan with dangerously weak standards

Climate change is a public health emergency. To address it, the nation must dramatically cut greenhouse gases, including carbon pollution. Power plants comprise the largest stationary source of carbon pollution in the United States. The electric sector produced 28 percent of all U.S. greenhouse gas emissions in 20176. Unfortunately, the current EPA repealed a sweeping plan to limit carbon pollution from power plants, the Clean Power Plan, and has now finalized a new rule that will not only fail to meaningfully cut carbon, but could actually increase harmful emissions.

“EPA’s replacement for the Clean Power Plan could be worse than doing nothing at all.”

The now-repealed Clean Power Plan was the only nationwide plan to clean up carbon pollution from power plants. Adopted in 2015, it would have delivered a flexible, practical toolkit for states to reduce carbon from power plants approximately 32 percent (below 2005 levels) by 2030. States could have chosen a variety of ways to cut carbon, including requiring cleaner fuels for existing utilities, improving energy efficiency, producing more clean energy or partnering with other states to jointly reduce carbon pollution. This would have not only tackled climate change, but would have also reduced ozone, particle pollution, and other air pollutants and immediately benefited people’s health.

Even though EPA repealed the Clean Power Plan, the Clean Air Act still requires that the agency reduce carbon pollution from power plants. In 2019, EPA finalized into law a dangerous replacement, called the “Affordable Clean Energy” (ACE) Rule. The ACE rule rejects the strong menu of options to reduce emissions that states had under the Clean Power Plan. Instead, it only sets minimal, totally inadequate limits on carbon emissions at power plants themselves. Worse, independent scientists found that this rule could result in dirtier power plants running more often, which would actually increase air pollution emissions and the risk of premature deaths7. In short, EPA’s replacement for the Clean Power Plan could be worse than doing nothing at all.

The Lung Association led national health and medical organizations in speaking out in opposition to the ACE rule8 and is suing the Administration to stop it.9 The Clean Air Act requires that EPA address carbon pollution in a way that protects public health. The nation urgently needs a system-wide reduction in carbon dioxide emissions from power plants and other sources to combat climate change. 

What you can do:

  • Raise your voice. The Lung Association is taking EPA to court to get them to clean up climate pollution from power plants, but they’re not the only ones who can act. Call on your states and local governments to switch to clean, renewable electricity to address climate change and protect public health.
  • Reduce your electricity use. Turn off the lights and unplug appliances when you’re not using them. Switch to more energy-efficient electric appliances. If you have the option in your community, buy power from clean, renewable sources.
Threat 7: Removing limits on methane emissions from the oil and gas industry

Natural gas is far from clean. Oil and gas production wells, processing plants, transmission pipelines and storage units emit harmful gases, including volatile organic compounds and methane, a potent greenhouse gas. For the last few years, “State of the Air” has reported elevated levels of unhealthy ozone in places where oil and gas production has expanded, even in largely rural counties in the West.

Despite this, EPA has taken multiple steps to weaken pollution limits for the industry that were set in 2016.10 Most recently, the agency proposed in 2019 to entirely roll back methane standards for new oil and gas sources, which would also result in other dangerous pollution that could have been prevented. EPA’s proposal would also prevent any limits on existing oil and gas industry sources, despite the fact that they are currently a major source of air pollution, including methane. We led hundreds of health professionals in raising their voices in opposition to EPA’s efforts.11

What you can do:

  • Raise your voice. Producing and burning natural gas for electricity creates air pollution and causes climate change. Call on your state and local governments to switch to clean, renewable electricity to address climate change and protect public health.
  • Reduce your electricity use. Turn off the lights and unplug appliances when you’re not using them. Switch to more energy-efficient electric appliances. If you have the option in your community, buy power from clean, renewable sources.
Threat 8: Cutting funding needed to clean up the air

The Clean Air Act set up smart, open processes for protecting Americans from air pollution, which have enabled the U.S. to reduce some of the most common pollutants by more than 70 percent. Still, these processes only work if EPA and state, local and tribal air agencies have the funding and staffing they need to implement and enforce the law. The Trump Administration has consistently proposed budgets that would greatly reduce the ability of EPA to protect public health, including slashing overall funding for the agency and reducing grants to support the work of state and local agencies and tribes to implement the requirements of the Clean Air Act and other critical laws.

The Trump Administration’s proposed budget would greatly reduce the ability of EPA to protect public health.

The Lung Association calls on Congress to ensure that EPA has sufficient funding to protect public health with the full range of programs, including state, local and tribal grants. In many cases, key EPA and other public health programs need funding increases to keep pace with their role in protecting the public. Investment in clean air and public health protections is critical.

Threat 9: Chipping away at air pollution enforcement

EPA has issued several directives to roll back or undermine steps to implement the Clean Air Act’s requirements for reducing major air pollutants, weakening both current pollution cleanup and likely future air pollution standards, including for ozone and particulate matter.

EPA proposed weakening “New Source Review” requirements, which would allow new polluting sources to add to the burden of unhealthy air in communities in several ways. The proposal would allow emissions to be calculated at an hourly rate as opposed to an annual one. The result would be that emissions could increase dramatically, but facilities would not have to install and operate modern pollution controls as long as their hourly rate of emissions did not increase. A similar bill, HR 172, has also been introduced in Congress.

In 2019, EPA finalized guidance that redefined “ambient air” to allow industries to pollute more at their own facilities. This decision reversed a decades-old policy that narrowed the area that an industry could use, which helped limit public exposure to its emissions.12 The change will allow the industry to produce more emissions.

EPA also announced an end to its decades-old “Once-In, Always-In” policy, allowing facilities to increase toxic air emissions.13 Under the old policy, if a facility emitted toxic air pollution above a certain threshold, it had to install and keep running strong pollution controls in the future. EPA’s reversal weakened the requirements that these facilities keep running their controls, potentially resulting in some of them increasing their pollution to just under the legal threshold.

Finally, amidst the COVID-19 crisis, polluting industries have sought, and EPA has granted, compliance waivers. We strongly oppose a widespread relaxation of Clean Air Act compliance and enforcement. The COVID-19 pandemic and its disproportionate impacts on people with lung disease and other chronic conditions make the continued reduction of air pollution more important, not less.

  1. Memo from Scott Pruitt, EPA Administrator, Re: Back-to-Basics Process for Reviewing National Ambient Air Quality Standards, May 9, 2018.
  2. Memo from EPA Administrator Scott Pruitt. Subject: Strengthening and Improving Membership on EPA Federal Advisory Committees. October 31, 2017.
  3. The testimony took place at the December 12, 2018 meeting of the Chartered Clean Air Scientific Advisory Committee (CASAC) Public Meeting on Particulate Matter. All testimony is posted on that site.
  4. Letter to Tony Cox, Chair Clean Air Scientific Advisory Committee from H. Christopher Frey, Jonathan M. Samet, et al. RE: CASAC Advice on the EPA’s Integrated Review Plan for the Ozone National Ambient Air Quality Standards (External Review Draft). November 26, 2018.
  5. Letter from health and medical organizations opposing EPA’s proposed SAFE rule.
  6. U.S. Environmental Protection Agency. Inventory of Greenhouse Gas Emissions and Sinks: 1990-2016. Washington, DC: U.S. EPA, 2017. Accessed at .
  7. Driscoll C, Buonocore J, Levy J, Lambert K, et al. 2015 US power plant carbon standards and clean air and health co-benefits. Nature Climate Change 5: 525-540. Schwartz J, Buonocore J, Levy J, Driscoll C, Fallon Lambert K, and Reid S. Health Co-Benefits of Carbon Standard for existing Power Plants: Part 2 of the Co-Benefits of Carbon Standards Study. September 30, 2014. Harvard School of Public Health, Syracuse University, Boston University. Available at Health Co-Benefits of Carbon Standards for Existing Power Plants.
  8. These comments are available at
    U.S. Court of Appeals for the District of Columbia. Case # 19-1140. American Lung Association, et al. v. EPA.
  9. U.S. EPA. Proposed Improvements 2016 New Source Performance Standards, September 11, 2018.
  10. Letter from More than 660 Health Professionals in support of Existing Methane Standard.
  11. U.S. EPA. Draft Guidance: Revised Policy on Exclusions from “Ambient Air.” November 2018.
  12. U.S. EPA. News Release: Reducing Regulatory Burdens: EPA withdraws “once in always in” policy for major sources under Clean Air Act. January 25, 2018.

Did You Know?

  1. Nearly 5 out of 10 people live where the air they breathe earned an F in State of the Air 2020.
  2. 150 million people live in counties that received an F for either ozone or particle pollution in State of the Air 2020.
  3. More than 20.8 million people live in counties that got an F for all three air pollution measures in State of the Air 2020.
  4. Breathing ozone irritates the lungs, resulting in something like a bad sunburn within the lungs.
  5. Breathing in particle pollution can increase the risk of lung cancer, according to the World Health Organization.
  6. Particle pollution can also cause early death and heart attacks, strokes and emergency room visits for people with asthma and cardiovascular disease.
  7. Particles are smaller than 1/30th the diameter of a human hair. When you inhale them, they are small enough to get past the body's natural defenses.
  8. Ozone and particle pollution are both linked to increased risk of lower birth weight in newborns.
  9. Do you live near, or work on or near a busy highway? Pollution from the traffic may put you at greater risk of harm.
  10. People who work or exercise outside face increased risk from the effects of air pollution.
  11. Millions of people are especially vulnerable to the effects of air pollution, including infants, older adults and people with lung diseases like asthma.
  12. People of color and those earning lower incomes are often disproportionately affected by air pollution that put them at higher risk for illnesses.
  13. Air pollution is a serious health threat. It can trigger asthma attacks, harm lung development in children, and can even be deadly.
  14. You can protect your family by checking the air quality forecasts in your community and avoiding exercising or working outdoors when the unhealthy air is expected.
  15. Climate change enhances conditions for ozone to form and makes it harder to keep ozone from forming.
  16. Climate change increases the risk of wildfires that spread particle pollution and ozone in the smoke.
  17. This Administration is trying to roll back or create loopholes in core healthy air protections under the Clean Air Act. The Lung Association opposes these actions that will add pollution to the air we breathe.
  18. Cutting air pollution through the Clean Air Act will prevent at least 230,000 deaths and save $2 trillion annually by 2020.
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