For Louisville High School math teacher Lindsey Thurman, air quality is not an abstract concept. Her body tenses and spasms as she fights the pollutants to breathe.
Thurman lives with the rare. Pulmonary arterial hypertension (PAH)According to the National Organization for Rare Diseases, it is characterized by “abnormally high” blood pressure in the pulmonary arteries.
Lindsay Thurman, a high school math teacher, has pulmonary arterial hypertension (PAH), a rare condition that causes difficulty breathing. In 2021, she became the first person with PAH to complete a marathon. (Photo provided)
“It appears that the lungs were built incorrectly, causing the blood vessels in the lungs to constrict and thicken, making it harder for the heart to pump blood to the lungs for oxygen, making the heart larger and making it harder to breathe,” Thurman said. “It’s just a mess.”
What’s more, she breathes the worst air in Kentucky, according to a report released Wednesday.
The American Lung Association’s 2026 State of the Air report shows that 176,359 children in Kentucky are breathing air with unhealthy levels of pollution.
According to the report, the Jefferson County area (which includes areas from Clarksville, Indiana, to Elizabethtown as part of the report) is one of the dirtiest in the United States. ozone smog. Reasons include engine exhaust, factory production, and wildfire smoke as pollutants drift and settle in the Ohio Valley. Louisville is Kentucky’s most populous city.
This annual report rates cities based on air quality. The Louisville area received an F rating for ozone smog and year-round particle pollution, with nearly 11 days each year considered unhealthy. The area has received a failing grade for many years.
Meanwhile, several eastern Kentucky counties rank among the cleanest in the nation for ozone smog.
Report findings
The 2026 State of Aviation Report shows that many Kentuckians are breathing unhealthy air. (Screenshot)
Rural Kentucky scored some wins in the latest air quality report, but the state as a whole continues to rank poorly for air quality.
The report includes findings such as:
- Eight Kentucky counties continue to be named among the cleanest in the country for ozone smog: Bell, Boyd, Carter, Greenup, Morgan, Perry, Pike, and Pulaski. All received an A grade in the report due to low ozone levels.
- Perry County had the worst daily (short-term) particulate pollution measurements in the state, earning a D grade.
- Jefferson County had the worst ozone smog in Kentucky, earning it the only county in the commonwealth to receive an F grade, and moving the Louisville metro from 29th to 22nd worst in the nation.
- Jefferson County also ranked worst in the annual particulate measurement, but it has improved enough that every Kentucky county scored on this measure now receives a passing grade.
In many ways, the report’s trends are not surprising to Shannon Baker, director of advocacy for the Kentucky Lung Association.
Shannon Baker is the advocacy director for the American Lung Association in Kentucky. (Photo provided)
“Our performance tends to be worse in urban areas, and of course it tends to be better in rural areas. This probably makes intuitive sense because these areas, urban areas, are areas with higher population densities and typically higher numbers of sources of emissions,” she said. “Louisville actually ranks among the worst in the state by most metrics, and suffers from persistent ozone smog, which this year ranked it among the 25 dirtiest cities in the nation.”
Air pollution is also possible cause asthmabreathing becomes more difficult. According to , about 12% of adults and nearly 7% of all children in Kentucky have asthma. Health and Family Services Cabinet.
Dr. Scott G. Bickel, a pediatric pulmonologist at Norton Children’s, said some areas of the state, like Louisville, have poor air quality and high rates of asthma.
“It’s multicausal in nature,” Bickel told the Lantern. “But certainly when you overlay maps of areas with high asthma prevalence, those areas sit alongside areas that have higher levels of air pollution (and) have less green space, for example.”
Asthma can be “pretty serious,” Bickel said. That’s one of the main reasons children end up in the emergency room. This incurable but manageable condition can also prevent children from playing sports or staying out of the classroom in an already difficult condition. High absenteeism rate.
Dr. Scott G. Bickel is a pediatric pulmonologist at Norton Children’s Hospital. (Photo provided)
He described asthma as follows: “Think of your airways like an upside-down tree. You have your trachea or trachea, which is your main airway, and it branches out into smaller little airways over the generations. And around those airways, you have smooth muscle that can get inflamed or anything. This irritation causes the smooth muscles to tighten, making it very difficult to breathe in and out, which is why you often hear people with asthma describe their breathing as “so tight that it’s hard to get air in and out.” ”
Bickel said treatments such as inhalers can help manage asthma symptoms when used correctly. Inhaled steroids “rapidly” open these airways, allowing breathing to flow more easily.
Poor air quality can also contribute to the severity of symptoms. bronchiolitisBickel not only has chronic obstructive pulmonary disease;COPD) and heart disease.
“Dirty air is a danger to public health. People can suffer immediate and potentially fatal medical problems such as heart attacks, strokes and asthma attacks,” Baker said. “In the long term, particulate pollution can cause lung cancer, and breathing in unhealthy levels of ozone and particulate pollution can shorten your lifespan by months or even years.”
Data center and EPA
Smoke from a wildfire in Slade, Kentucky, April 21, 2023. (Kentucky Lantern Photo: Sarah Rudd)
February, Environmental Protection Agency (better known by its acronym EPA) 2009 Greenhouse Gas Crisis Survey Results CompletedHarvard University is Basics of greenhouse gas regulation In the US. ” The EPA stated that it “has no legal authority to:”Defining Greenhoe standardsHe boasted that the measure would “save Americans more than $1.3 trillion” using gas emissions.
The State of the Air report criticized this and other EPA decisions, saying, “The effects of these reductions will be felt in increased air pollution, illness, and death.”
Louisville’s bad air days are on the rise as President Trump’s EPA cuts alarm public health advocates
It also means Kentucky and other states will lack critical data about pollution and how it affects health, Baker said.
“As we all know, there is overwhelmingly clear evidence that: the climate is changing and humans are responsibleAnd climate change is actually health emergency“Air pollution data shows that rising temperatures are causing ozone levels to rise, and wildfires are causing more frequent and intense spikes in particle pollution. And this is supported by people across the country experiencing hotter heat, more intense storms, and more wildfire impacts,” Baker said.
The report also highlights that data centers are a growing source of air pollution, as they consume around 4% of the country’s electricity and are expected to triple by 2028 due to demand for artificial intelligence.
There are no hyperscale data centers in operation in Kentucky, but one is currently under construction. expected this fall Despite Louisville protest From locals.
“With the increase and development of demand, new data centerAs an example, ensuring facilities are powered by clean electricity and moving to clean electricity and storage resources instead of diesel could contribute to cleaner air in the future,” Baker said.
Air “luxury”
Lindsay Thurman, a high school math teacher, has pulmonary arterial hypertension (PAH), a rare condition that causes difficulty breathing. In 2021, she became the first person with PAH to complete a marathon. (Photo provided)
Thurman’s PAH developed in her early 20s, but her breathing problems go back much further. she had sports-induced asthma He tried to run cross country as a child, but had to stop because his wheezing “freaked out” his mother. She couldn’t get enough air into her lungs.
She still has an emergency inhaler, but her asthma has improved significantly. Thurman was even able to start running again thanks to a series of medications she takes every day, including some once a day, some every 12 hours, and some every eight hours.
In 2021, she became this. First known patient with PAH And she completed a marathon in Louisville, crossing the finish line in less than five and a half hours.
Still, she has to monitor air quality notifications daily. She knows that on bad days she won’t be able to run as far as she would like. When traveling long distances, bring an emergency inhaler with you. She practices yoga. Anything to keep her lungs as healthy as possible.
Even though she is relatively stable on her current medication, she feels all the pollution in the air, like exhaust fumes from passing cars.
“I love driving through Cherokee Park. Every once in a while, a car passes by with bad exhaust fumes. I can feel it in my lungs,” she said. “It’s not just the smell. I can feel the tension in my lungs.”
Not being able to breathe affects more than just the lungs. She said she was left “tired all the time.” Another said, “The degree of pain varied depending on the state of breathing.”
Lindsay Thurman, a high school math teacher, has pulmonary arterial hypertension (PAH), a rare condition that causes difficulty breathing. In 2021, she became the first person with PAH to complete a marathon. (Photo provided)
When she doesn’t get enough oxygen, her body becomes desperate, first spasming at the “ends” and then “gradually working its way in” until her head starts pounding and her vision becomes “blurry,” she said. In some cases, you may even faint.
“It can be very painful. Your body doesn’t like being without oxygen, and it doesn’t feel good either. If you’ve ever had side pain from running, imagine it happening everywhere,” she said. “It’s scary when you’re desperately trying to get air, and then you react in a way that doesn’t actually help you.”
There are also moments she describes as “embarrassing.” It means having to stop and catch your breath for seemingly “minimal” tasks like walking across a parking lot or climbing two flights of stairs.
She wants people to know that “when the air quality is really bad, it can be so bad that even people without lung disease can tell the difference,” she says. “But living with lung disease is already very difficult, so air is a luxury you don’t have when you can’t breathe properly.”
How to contribute to cleaner air
Several organizations and agencies recommend measures to help clean the air. They include:
- reduce coal combustion.
- drive less If possible, run errands at once to reduce toxic exhaust fumes. Carpool or ride a bicycle Please use public transportation if possible. Avoid idling when driving.
- Please turn off the lights When not in use, choose energy-efficient equipment if possible.
- Do not burn leaves or trash. Leaves are used as compost.
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