Smoke from the Camp Fire wafts across San Francisco's Financial District during November 2018. An American Lung Association report found the Bay Area had one of the nation's highest pollution levels from 2016-18. (Photo by Thomas Hawk/Flickr)

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The San Jose-San Francisco-Oakland region had the fifth-highest annual particle pollution in the country from 2016 to 2018, according to a report released this week by the American Lung Association.

The organization’s annual State of the Air report examines ozone and particulate pollution in cities and major metro areas across the country.

This year’s report found that the San Jose-San Francisco-Oakland area has the country’s third-highest daily particle pollution and the eighth-highest ozone pollution.

No Bay Area city made the report’s list of the top-25 cleanest U.S. cities by yearly particle pollution. Salinas was the only city in the greater Bay Area and Monterey peninsula to make the list of cleanest cities, tied for 23rd with Appleton-Oshkosh-Neenah, Wisconsin, and Gainesville-Lake City, Florida.

“With nearly half of Americans — and almost all Californians — affected by unhealthy air, our ‘State of the Air’ report shows that because of increased heat and wildfires driven by climate change, we have to work harder at protecting public health — especially for our most vulnerable and highly polluted communities,” American Lung Association clean air advocacy director Will Barrett said.

California cities and metro regions occupied six spots on the list of the 10 cities with the most annual pollution, including each of the top five positions. Bakersfield topped the list, followed by Fresno-Madera-Hanford, Visalia, Los Angeles-Long Beach and San Jose-San Francisco-Oakland.

Nationally, the report found that about 150 million Americans live in areas with unhealthy levels of ozone or particle pollution. That figure has increased each of the last four years, from about 141 million in the 2019 report, about 134 million in the 2018 report and 125 million in the 2017 report.

In addition, about 21 million people live in the 14 counties across the country that failed all three measures of air pollution.

“California has clear pathways to healthier air — we know transportation pollution is at the heart of our clean air challenges — we need a widespread transition to zero emission cars, trucks and buses and a shift in our travel choices toward more transit and pedestrian friendly communities that reduce traffic and harmful pollution,” Barrett said.