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For 2019, the 10 worst cities for air quality are in California and Arizona

AGreenLiving

The American College of Sports Medicine (ACSM) recognizes this, which is why for the 2019 American Fitness Index rankings, the ACSM added air quality as an environmental indicator of a city’s health. But man-made elements — including vehicular use plus industrial emissions — especially affect air quality. with the worst air quality.