by Sarah Ladd
For Louisville High School math teacher Lindsay Thurman, air quality isn’t an abstract concept; His body tenses and spasms as he fights the pollutants to breathe.
Thurman lives with the rare Pulmonary arterial hypertension (PAH)which is characterized by “abnormally high” blood pressure in the pulmonary arteries, according to the National Organization for Rare Disorders.
“It was as if my lungs were built wrong, and the blood vessels in my lungs narrowed and thickened, which made it harder for my heart to pump blood to my lungs to get oxygen, which made the heart bigger, which made it harder to breathe,” Thurman explained. “It’s just a mess.”
To boot, he’s breathing some of Kentucky’s worst air, according to a report released Wednesday.
The American Lung Association’s 2026 “State of the Air” report shows that 176,359 children in Kentucky breathe air with unhealthy levels of pollution.
According to the report, the Jefferson County area — which includes Clarksville, Indiana, and Elizabethtown as part of the report — is one of the dirtiest areas in the United States. Ozone haze. Causes include engine exhaust, factory output and wildfire smoke as pollution drifts into the Ohio Valley. Louisville is the most populous city in Kentucky.
This annual report issues grades to cities based on air quality. The Louisville area received an F for ozone smog and year-round particle pollution because it has about 11 days labeled unhealthy each year. The area has received failing grades over the years.
Meanwhile, several eastern Kentucky counties ranked among the cleanest in the nation for ozone smog.
Search in reports
Rural Kentucky scored a few wins in the latest State of the Air report, but the state overall ranks poorly for air quality.
The findings of the report include:
- Eight Kentucky counties are among the cleanest in the nation for ozone smog – Bell, Boyd, Carter, Greenup, Morgan, Perry, Pike and Pulaski. They all earned an A grade in the report based on their low levels of ozone.
- Perry County was worst in the state for daily (short-term) measurements of particulate pollution, earning a D grade.
- Jefferson County posted the worst values for ozone smog in Kentucky, earning the commonwealth’s only F grade, and Louisville moved the metro rank from 29th worst to 22nd.
- Jefferson County was also the worst for the year-round measure of fine particulate matter, but has improved enough that all Kentucky counties graded for this measure now earn a passing mark.
In many ways, the reported trend is no surprise to Shannon Baker, director of advocacy for the Lung Association of Kentucky.
“Our grades tend to be worse in more urban areas and, of course, better in more rural areas, which is perhaps intuitive, because these are the areas – urban areas – areas with higher population density and, generally, therefore higher emissions,” he said. “Louisville is truly the worst place in the state by most measures, constantly struggling with ozone smog, which this year has landed us in the top 25 dirtiest cities in the United States.”
Air pollution can also occur Asthma triggersWhich makes breathing more difficult. About 12% of Kentucky adults and about 7% of children overall have asthma, according to Cabinet for Health and Family Services.
Pockets of the state, like Louisville, where the air is bad, have higher rates of asthma, said Dr. Scott G. Bickel, a pediatric pulmonologist at Norton Children’s.
“It’s multifaceted in nature,” Bickel told The Lantern. “But of course when you overlay a map of areas with high prevalence of asthma, they go with areas that have high levels of air pollution (and) less, say, green space.”
Asthma can be “pretty serious,” Bickel said. This is one of the leading reasons children end up in the emergency room. Chronic but manageable conditions can keep children out of sports and the classroom High rate of absenteeism.
He describes asthma like this: “Think of the airways as an upside-down tree. You have the trachea, or windpipe; that’s the main airway, and then you have multiple generations of small, tiny airways branching out. And these airways have smooth muscle around them, and when they’re inflamed, or very tight, they become very stiff. It’s very difficult to inhale and exhale, and so you’ll often hear people with asthma describe their breathing as ‘it’s so hard, let the air out.’ difficult.’
Medications such as inhalers, when used correctly, can help manage asthma symptoms, Bickel said. Inhaling steroids can “quickly” open those airways and allow breathing to flow more easily.
Poor air quality can also contribute to its severity BronchiolitisBickel said, in addition to chronic obstructive pulmonary disease (COPD) and heart disease.
“Dirty air is dangerous to public health. It exposes people to immediate and potentially fatal medical problems like heart attacks and strokes and asthma attacks,” Baker said. “In the long term, particulate pollution can cause lung cancer, and breathing unhealthy levels of ozone or particulate pollution can shorten your life by months or even years.”
Data Centers and EPA
In February, the Environmental Protection Agency (better known by its acronym EPA) 2009 Greenhouse Gas Endangerment FindingsWhat Harvard University calls “The Basis of greenhouse gas control In the United States.” The EPA said it does not have the statutory authority to “set standards” for greenhouse gas emissions and boasted the move could “save Americans more than $1.3 trillion.”
The State of the Air report criticized this and other EPA decisions, saying, “The effects of this rollback will be felt in the form of air pollution, illness and death.”
Bad air days in Louisville are increasing as EPA alarms public health advocates over Trump cuts
That means Kentucky and other states lack key information around pollution and how it affects health, Baker said.
“As we all know, there is overwhelming clear evidence of this The climate is changing And People are responsibleAnd climate change actually, A health emergency“, Baker said. “So the air pollution data shows that warmer temperatures are increasing the ozone layer and wildfires are causing more frequent and intense spikes in particle pollution, and that’s supported by the experience that people around the country are experiencing the effects of more heat and more intense storms and more wildfires.”
The report also singled out data centers as a growing contributor to air pollution as they consume about 4% of the country’s electricity and are expected to triple by 2028 thanks to artificial intelligence demand.
There is no operational hyperscale data center in Kentucky, although one is in the works and This decline is expected Louisville notwithstanding protest From the locals.
“With the increase in demand and development New data centerEnsuring facilities are powered by clean electricity, and transitioning to clean power and storage resources instead of diesel, for example, can play a role in moving forward on clean air,” Baker said.
the ‘luxury’ of air
Thurman’s PAH developed in his early 20s, but his breathing problems returned. he had Sports-induced asthma Tried running cross country as a child and in middle school but had to stop because his shortness of breath “upset” his mother. He couldn’t get enough air into his lungs.
He still has a rescue inhaler but his asthma is much improved. Thanks to the daily medications she takes — one she takes once a day, one every 12 hours and another every eight hours — Thurman has even been able to start running again.
In 2021, he became First known PAH patient To finish a marathon — and he did it in Louisville, crossing the finish line in five and a half hours.
Still, he has to monitor air quality notices daily. On a bad day, he knows he can’t run as far as he’d like. On the long run, he brings a rescue inhaler. He practices yoga. Keeping his lungs as healthy as possible.
Despite the relative stability he enjoys on his current drug regimen, he feels pollution in the air—like exhaust from a passing car—throughout his body.
“I love running through Cherokee Park. There are times where cars with really bad exhaust will go by, and I can feel it in my lungs,” he said. “It’s not just the smell. I can feel my lungs tighten.”
Not being able to breathe affects more than just the lungs. He went through a period of being “tired all the time,” he said. Other times, “I was in varying degrees of pain depending on how well my breathing was.”
When he can’t get enough oxygen, he says, his body becomes desperate, first cramping “on the edge” and “working its way up” until his head is pounding and his vision is “blurred.” Sometimes, he even passes out.
“It can be extremely painful. Your body doesn’t like not having oxygen. It doesn’t feel good. If anyone has ever had side pain from running, imagine it everywhere,” he said. “It’s horrible that your body reacts in such a way that it’s sucking in air so desperately, desperately, but it doesn’t actually help.”
There are also moments he characterizes as “embarrassing” — having to stop and catch his breath for seemingly “minimal” tasks like walking across a parking lot or walking up two steps.
He wants people to know that “when the air quality is really bad, it can be bad enough that people without lung conditions can even tell a difference,” he said. “But living with a lung condition is already so difficult, and so air is a luxury that you never really feel like you have if you can’t breathe well.”
Ways to contribute to clean air
Several agencies and organizations recommend steps that can help clean the air. They include:
- Burn less coal.
- Run less Minimize toxic emissions by running jobs at once when possible. Carpool and ride bikes or public transport when possible. When you drive, avoid laziness.
- Turn off the lights When not in use and, when possible, choose appliances with high energy efficiency ratings
- Do not burn leaves or trash. Use leaves as compost.
And more.
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kentucky lantern Part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. The Kentucky Lantern maintains editorial independence. For questions contact editor Linda Blackford: (email protected).
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Previously published With kentuckylantern on Creative Commons License
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Photo credit: splash
