ST. LOUIS – Two counties in the St. Louis metro – St. Charles County in Missouri and Madison County in Illinois – received an “F” grade in a newly-released national report on air quality.

The American Lung Association recently released its 2024 “State Of The Air” report, which graded 125 counties across 26 states with an “F” in air quality.

An “F” grade indicates there are unhealthy levels of ozone air pollution that could present health risks. Among U.S. counties with an “F” grade, on average, three out of every 10 residents were at risk health harm due to air pollution.


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According to the ALA, the St. Louis region has avoided a rank within the Top 25 ozone-populated metros over the last eight years, but ranks 30th in this year’s report.

“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.”

Regionally, the report also gave the City of St. Louis and St. Clair County a “C” grade and St. Louis and Jefferson counties a “D” grade for their air quality situations.

The ALA says younger children, older adults and people who suffer from lung diseases are among the most at risk of health issues from air pollution.

Experts say spending less time behind the wheel can have a profound impact on air quality. Actions like using transit, carpooling and vanpooling, combining errands into a single trip, telecommuting, and walking and biking can help with reducing greenhouse gas emissions.

For more information on the ALA’s recent findings, click here.