Over 400,000 Kids in Tennessee Are Breathing Unhealthy Air; Nashville Metro Area Now Fails for Ozone Smog, but among Cleanest in Nation for Daily Particle Measure

Today, the American Lung Association released its 27th annual “State of the Air” report, which finds that nearly half of the children in the U.S. are breathing unhealthy levels of air pollution—including over 427,343 children in Tennessee—as communities across the state experienced both worsening smog conditions and selective improvements in particle pollution.

The report finds that the Nashville-Davidson–-Murfreesboro metro area worsened to an F grade for ozone smog. Also in that metro area, four counties earned A grades for the daily measure of particle pollution—Davidson, Lawrence, Maury, and Sumner—ranking the area among the nation’s cleanest cities. Meanwhile, Davidson County was worst for the year-round measure of fine particles but improved enough so that now all Tennessee counties graded for this measure earned passing marks.

• Shelby County posted the worst value for ozone smog in Tennessee, earning an F grade, and driving the Memphis metro rank from 32nd worst to 27th worst in the nation.  
• Blount County was worst in the state for the daily (short-term) measure of particle pollution, earning a C grade. 
• Davidson County was worst for the year-round measure of fine particles, but improved enough so that now all Tennessee counties graded for this measure earned passing marks. 
• Three Tennessee counties continued to be listed among the cleanest in the country for ozone smog—DeKalb, Loudon, and Sullivan.
• Four Tennessee counties earned A grades for the daily measure of particle pollution—Davidson, Lawrence, Maury, and Sumner (all in the Nashville metro area, ranking it among the nation’s cleanest cities).

The Lung Association’s “State of the Air” report grades counties’ air quality in terms of unhealthy levels of ground-level ozone air pollution (also known as smog), and year-round and short-term spikes in particle pollution (also known as soot) over a three-year period (2022-2024). The report also ranks counties and metropolitan areas in cleanest and most polluted lists for each pollutant. Both ozone and particle pollution can cause premature death and other serious health effects such as asthma attacks, heart attacks and strokes, preterm births and impaired cognitive functioning later in life. Particle pollution can also cause lung cancer.

Infants, children and teens as a group are more susceptible to the health impacts of air pollution. Their lungs are still developing, they breathe more air for their body size than adults, and they are frequently exposed to outdoor air. Air pollution exposure in childhood can cause long-term harm, including reduced lung growth, new asthma cases and increased risk of respiratory diseases.

“Clean air is essential to the health and wellbeing of families across Tennessee. Children deserve to breathe air that won’t make them sick,” Unfortunately, too many people across the state, particularly in several of our metro areas, are living with unhealthy levels of ozone and/or particle pollution. This air pollution is causing kids to have asthma attacks, contributing to chronic health conditions, and making people who work outdoors sick,” said Shannon Baker, director of advocacy for the American Lung Association.  “To compound the issue further, the U.S. Environmental Protection Agency’s (EPA) rollbacks of critical healthy air rules are impacting our residents. We urge Tennessee policymakers to take action to improve our air quality and we are calling on everyone to tell EPA that our kids’ health counts.”

Speaking from personal experience on the health impacts of air pollution, lung cancer patient, Hendersonville resident and youth athletic coach Aaron Hawkins said: “When I was diagnosed with lung cancer in 2019, I was a ‘healthy’ 47-year-old, non-smoking marathon runner. Doctors said my cancer was caused by environmental factors. I still run and I coach youth track and cross country. I know the effects of poor air quality firsthand. On days when the air is unhealthy, my young athletes with asthma rely heavily on inhalers and are often forced to do their workouts indoors. Poor air quality causes respiratory distress and lung disease. Tennessee’s kids deserve better. They deserve to run their best races fueled by grit and clean air.”

Nationally, the report found that 33.5 million children in the U.S., or 46% of people under 18 years old, live in an area that received a failing grade for at least one measure of air pollution. In total, 44% of people of all ages in the U.S. (152 million people in total) live in a county that received a failing grade for at least one measure of air pollution. 32.9 million people live in counties with failing grades for all three measures.

Key Findings for Nashville metro area:
Ground-level Ozone Pollution: 
Ozone “smog” affects the largest number of people in the U.S. Smog forms when gases from tailpipes, smokestacks, factories and other pollution sources react with sunlight. It is a powerful respiratory irritant with effects that have been likened to a sunburn of the lungs.  

• The Nashville metro area ranked 66th worst in the nation for ozone pollution.
  • The ranking was based on the area’s worst county’s average number of unhealthy days—4 days per year, an F grade, in Sumner County, Tennessee.
  • This was worse than the area's ranking in last year's report of 75th worst, with 3 days per year, a D grade.  

Particle Pollution: 
Fine particle pollution can be extremely dangerous and even deadly. These particles come from wildfires, wood-burning stoves, coal-fired power plants, diesel engines and other sources. The report has two grades for particle pollution: one for “short-term” particle pollution, or daily spikes, and one for the annual average “year-round” level that represents the concentration of particles in each location.

• The Nashville metro area ranked among the nation's cleanest cities for short-term particle pollution.
  • The ranking was based on the area’s worst counties’ average number of unhealthy days—0 days per year, an A grade, in Davidson, Lawrence, Maury and Sumner Counties, Tennessee.
  • This was better than the area's ranking in last year's report of 139th worst, with 1 day per year, a C grade.  
• For the year-round average level of particle pollution, the area’s worst county, Davidson County, Tennessee, received a passing grade for pollution levels at the federal standard. 
  • The Nashville metro area ranked 53rd worst in the nation.
  • This was better than the area's ranking in last year's report of 39th worst in the nation, when a failing grade was reported. 

Other parts of the state showed declines, improvements or continued strong performance for certain pollution measures, highlighting air quality contrasts across Tennessee communities. In particular:

• Shelby County posted the worst value for ozone smog in Tennessee, earning an F grade, and driving the Memphis metro rank from 32nd worst to 27th worst in the nation.  
• Blount County was worst in the state for the daily (short-term) measure of particle pollution, earning a C grade. 
• Three Tennessee counties continued to be listed among the cleanest in the country for ozone smog—DeKalb, Loudon, and Sullivan.

Knoxville-Morristown-Sevierville, TN Metro Area

• The Knoxville metro area improved for all three measures of air pollution compared with last year’s report.
• The metro area ranked 110th worst in the nation for ozone pollution, based on 1.7 unhealthy days per year, earning a C grade in Blount County, TN, with a slightly improved value.
• Short-term particle pollution also improved as Blount County’s C grade for 1.3 unhealthy days improved over Knox County, TN’s 2 days (also a C grade) in last year’s report. The area’s rank improved from 98th to 122nd worst in the nation.
• The worst county in the metro area for year-round particle pollution, Knox County, improved from last year’s failing grade to a passing value, with the area’s rank moving from 66th to 70th worst.

Memphis–Clarksdale–Forrest City, TN-MS-AR Metro Area

• The Memphis metro area ranked 27th worst in the nation for ozone pollution, based on 9.8 unhealthy days per year, earning an F grade in Shelby County, TN, marking the third straight year of worsening ozone conditions.
• For short-term particle pollution, the area slipped to a C grade, with 1.0 unhealthy day per year in DeSoto County, MS, down from a B grade last year.
• For year-round particle pollution, DeSoto County, MS received a failing grade, moving from passing levels last year, and the metro area ranked 49th worst nationally. 

Johnson City–Kingsport–Bristol, TN-VA Metro Area

• The Johnson City–Kingsport–Bristol metro area again ranked among the nation’s cleanest cities for ozone pollution, based on 0 unhealthy days per year and an A grade in Sullivan County, TN, matching the past two years’ strong performance.
• For short-term particle pollution, the area ranked 154th worst nationally, with 0.7 unhealthy days per year and a B grade in Sullivan County, TN, and Bristol City, VA, similar to last year.
• For year-round particle pollution, Bristol City, VA received a passing grade, and the metro area ranked 164th worst nationally, an improvement from last year. 

The Chattanooga-Cleveland-Dalton, TN-GA-AL Metro area:

• The Chattanooga-Cleveland-Dalton metro area ranked 110th worst nationally for ozone pollution, earning a C grade in Hamilton County, TN, slightly worse than last year’s ranking.
• For short-term particle pollution, the area ranked 122nd worst nationally, with 1.3 unhealthy days per year and a C grade in Walker County, GA, a slight improvement from 114th worst and 1.7 days.
• For year-round particle pollution, Walker County, GA, improved significantly, from a value earning a failing grade and ranking the area 26th worst in the nation to a Passing grade and 53rd worst rank.

The Clarksville, TN-KY Metro area:

• The Clarksville Metro area ranked 135th worst nationally for ozone pollution, earning a C grade in Christian County, KY, an improvement from last year’s ranking.
• For short-term  particle pollution, the area earned a B grade, and a slightly better rank than last year.
• For year-round particle pollution, Christian County, KY received a passing grade for it best-ever result, with the area ranking 114th worst nationally, improved from last year. 

The Jackson, TN Metro area:

• The Jackson metro area had no ozone data available in this year’s or last year’s report.
• For short-term particle pollution, the area earned a B grade, with 0.3 unhealthy days per year in Madison County, TN, an improvement from last year.
• For year-round particle pollution, Madison County received a passing grade, and the metro area ranked 132nd worst nationally, better than last year’s ranking.

The Lung Association is calling on everyone to urge EPA to value the health of America’s kids. Historically, EPA has played an essential role in protecting people’s health from air pollution. The current EPA has retreated from its public health foundation by rolling back clean air protections. This EPA has also taken the recent step of eliminating health-related information from its economic analyses, meaning that the costs of pollution to kids, families and communities will not be counted as policies are undone. EPA must not devalue kids’ health.

See the full report results and take action at Lung.org/sota.