U.S. Environmental Protection Agency
Office of Air Quality Planning and Standards
Outreach and Information Division
Research Triangle Park, NC

August 2009
EPA-456/F-09-002
                                                AIR  QUALITY  INDEX
                                                   A Guide to Air Quality and
                                                                       Your  Health
   Recycled/recyclable. Printed with vegetable oil-based
   inks on 100% postconsumer process, chlorine-free
   recycled paper.

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              «
                's a code red day
                     for ozone.''
'Particlepollution levels are
forecast to be unhealthy
for sensitive groups.y
         "Local air quality is very
               unhealthy today.''
You may hear these alerts on radio
or TV or read them in the newspaper.
But what do they mean if you:
  > Are active outdoors?
  > Have children who play outdoors?
  > Are an older adult?
  > Have heart or lung disease?
This booklet will help you understand
how to find out about air quality in
your area and protect your health.

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Air Quality Index
   Why is air quality
   important?
                              Air quality directly affects our quality
                              of life.
Local air quality affects how
you live and breathe. Like
the weather, it can change
from day to day or even
hour to hour. The U.S.
Environmental  Protection
Agency (EPA) and your
local air quality agency
have been working to make
information about outdoor
air quality as easy to find
and understand as weather
forecasts. A key tool in this
effort is the Air  Quality Index, or AQI. EPA and local offi-
cials use the AQI to  provide simple information about your
local air quality, how unhealthy air may affect you, and how
you can protect your health.

What is the AQI?
The AQI is an index for reporting daily air quality. It tells
you how clean or unhealthy your air is, and what associ-
ated health effects might be a concern. The AQI focuses on
health effects you may experience within a few hours or days
after breathing unhealthy air. The AQI is calculated for four
major air pollutants  regulated by the Clean Air Act: ground-
level ozone, particle  pollution, carbon monoxide, and sulfur
dioxide. For each of these pollutants, EPA has established
national air quality standards to protect public health.
EPA is currently reviewing the national air quality standard
for nitrogen dioxide.  If the standard is revised, the AQI
will be revised as well.
How does the AQI work?
Think of the AQI as a yardstick that runs from 0 to 500.
The higher the AQI value, the greater the level of air pol-
lution and the greater the health concern. For example, an
AQI value of 50 represents good air quality with little or no
potential to affect public health, while an AQI value over
300 represents air quality so hazardous that everyone may
experience serious effects.
An AQI value of 100 generally corresponds to the national air
quality standard for the pollutant, which is the level EPA has set
to protect public health. AQI values at or below 100 are generally
thought of as satisfactory. When AQI values are above 100, air
quality is considered to be unhealthy—at first for certain sensitive
groups of people, then for everyone as AQI values increase.

What do  the AQI values  mean?
The purpose of the AQI is to help you understand what local
air quality means to your health. To make it easier to under-
stand, the AQI is divided into six levels of health concern:
Air Quality Index
(AQI) Values
When the AQI is in
this range:
OtoSO
51 to 100
101 to 150
151 to 200
201 to 300
301 to 500
Levels of
Health Concern
...air quality
conditions are:
Good
Moderate
Unhealthy for
Sensitive Groups
Unhealthy
Very Unhealthy
Hazardous
Colors
...as symbolized
by this color:
Green
Yellow
Oranse
Red
Purple
Maroon

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Air Quality Index
   Each category corresponds to a different level of health concern:
   •  Good. The AQI value for your community is between
      0 and 50. Air quality is satisfactory and poses little or no
      health risk.
   •  Moderate.  The AQI is between 51 and 100. Air quality
      is acceptable; however, pollution in this range may pose a
      moderate health concern for a very small number of indi-
      viduals. People who are unusually sensitive to ozone or
      particle pollution may experience respiratory symptoms.
   •  Unhealthy for Sensitive Groups. When AQI values
      are between 101 and 150, members of sensitive groups
      may experience health effects, but the general public is
      unlikely to  be affected.
      • Ozone: People with lung disease, children, older adults,
        and people who are active outdoors are considered
        sensitive and therefore at greater risk.
      • Particle pollution: People with heart or lung disease,
        older adults,1  and children are considered sensitive and
        therefore at greater risk.
   •  Unhealthy. Everyone may begin to experience health effects
      when AQI values are between 151 and 200. Members of
      sensitive groups may experience more serious health effects.
   •  Very Unhealthy. AQI values between  201 and 300
      trigger a health alert, meaning everyone may experience
      more serious health effects.
   •  Hazardous. AQI values over 300 trigger health warnings
      of emergency conditions. The entire population is even
      more likely to be affected by serious health effects.

   How  is  a community's AQI calculated
   and reported?
   Each day,  monitors record concentrations of the major pol-
   lutants at  more than a thousand locations across the country.
   1  Due to the normal aging process, older adults may experience increased
     health risks from exposure to unhealthy air. Studies indicate that some
     people become more sensitive in their mid-60s. However, the risk of
     heart attacks, and thus the risk from particle pollution, may begin as
     early as the mid-40s for men and mid-50s for women.
Children active outdoors can be sensitive to air pollutants.
These raw measurements are converted into a separate AQI
value for each pollutant (ground-level ozone, particle pollu-
tion, carbon monoxide, and sulfur dioxide) using standard
formulas developed by EPA. The highest of these AQI values
is reported as the AQI value for that day.2
In large cities (more than 350,000 people), state and local
agencies are required to report the AQI to the public daily.
Many smaller communities also report the AQI as a public
health service.
When the AQI is above 100, agencies must also report
which groups, such as children or people with asthma or
heart disease, may be sensitive to that pollutant. If two or
more pollutants have AQI values above  100 on a given day,
agencies must report all the groups that are sensitive  to those
pollutants. For example, if a community's AQI is 130 for
ozone and  101 for particle pollution, the AQI value for that
day would be announced as 130 for ozone. The announce-
ments would note that particle pollution levels were  also
high and would alert groups sensitive to ozone or particle
pollution about how to protect their health.
Many cities also provide forecasts for the next day's AQI.
These forecasts help local residents protect their health  by
alerting them to plan their strenuous outdoor activities for a
time when air quality is better.
  For more information on how the AQI is calculated, see "Guidelines for
  the Reporting of Daily Air Quality—the Air Quality Index (AQI)" in
  the "Publications" section ofwww.airnow.gov.

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Air Quality Index
   The AQI is a national index, so the values and colors used
   to show local air quality and the levels of health concern are
   the same everywhere in the United States.

   Where can I find the AQI?
   Checking local air quality is as easy as checking the weather.
   You can find the latest AQI values on the Internet, in your
   local media, and on many state and local telephone hotlines.
   You can also sign up to receive AQI forecasts by e-mail:
   • AQI OH the Internet. EPA and its federal, tribal, state, and
     local partners have developed an AIRNow Web site to
     provide the public with easy access to national air quality
     information. At www.airnow.gov,  you will find daily AQI
     forecasts and real-time AQI conditions for over 300 cities
     across the United States, with links to more detailed state
     and local air quality Web sites. AIRNow's reports  are
     displayed as maps you can use to quickly determine if the
     air quality is unhealthy near you.
         (imsmt «jj^ j
   Example of a national AQI map available on the AIRNow Web site.
      AQI Via e-mail. Sign up for EnviroFlash
      (www.enviroflash.info), a free service that will alert
      you via e-mail when air quality is forecast to be a
      concern in your area.
   AQI in the media. Many local media—television, radio,
   and newspapers—and some national media (such as USA
   Today, The Weather Channel, and CNN) provide daily
   air quality reports, often as part of the weather forecast.
   Here's the type of report you might hear:

    Tomorrow will be a code red air quality day for Center
    City. The cold winter air, morning traffic, and wood
   smoke are expected to cause particle pollution to rise to
    unhealthy levels. People with heart or lung disease,
    older adults, and children should avoid prolonged or
    heavy physical activities.
What are typical AQI values in
most communities?
In many U.S. communities, AQI values are usually below
100, with higher values occurring just a few times a year.
Larger cities typically have more air pollution than smaller
cities, so their AQI values may exceed 100 more often. AQI
values higher than 200 are infrequent, and AQI values above
300 are extremely rare—they generally occur only during
events such as forest fires. You can compare the air quality of
U.S. cities and find out about quality trends in your area by
visiting "Air Compare" at www.epa.gov/aircompare/.
AQI values can vary from one season to another.  In winter,
carbon monoxide may be high in some areas because cold
weather makes it difficult for car emission control systems to
operate effectively. Ozone is often higher in warmer months,
because heat and sunlight increase ozone formation. Particle
pollution can be elevated any time of the year.
AQI values also can vary depending on the time of day.
Ozone levels often peak in the afternoon to early evening.
Carbon monoxide may be a problem during morning or
evening rush hours. And particle pollution can be high any
time of day, and is often elevated near busy roadways, espe-
cially during morning or evening rush hours.

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Air Quality Index
   How can  I avoid being exposed to
   unhealthy air?
   You can take simple steps to reduce your exposure to
   unhealthy air. First, you need to find out whether AQI levels
   are a concern in your area. You can do this, as described
   previously, by visiting the AIRNow Web site, signing up for
   EnviroFlash, or checking your local media. If the AQI for
   ozone, particle pollution,  carbon monoxide, or sulfur dioxide
   is a concern in your area, you can learn what steps to take to
   protect your  health by checking the charts on the following
   pages. Two important terms you will need to understand are:
                      OZONE
                        . This means any outdoor activity that
      you'll be doing intermittently for several hours and that
      makes you breathe slightly harder than normal. A good
      example of this is working in the yard for part of a day.
      When air quality is unhealthy, you can protect your health
      by reducing how much time you spend on this type of
      activity.
      Heavy exertion. This means intense outdoor activi-
      ties that cause you to breathe hard. When air quality
      is unhealthy, you can protect your health by reducing
      how much time  you spend on this type of activity, or by
      substituting a less intense activity — for example, go for a
      walk instead of a jog. Be sure to reduce your activity level
      if you experience any unusual coughing, chest discom-
      fort, wheezing, breathing difficulty, or unusual fatigue.
What is ozone?
   Heavy exertion means an intense activity that causes you to breathe hard.
Ozone is a gas found in the air we breathe. Ozone can be
good or bad, depending where it occurs:
•  Good OZOne is present naturally in the Earth's upper
   atmosphere—approximately 6 to 30 miles above the
   Earth's surface. This natural ozone shields us from the
   sun's harmful ultraviolet rays.
•  Bad OZOne forms near the ground when pollutants
   (emitted by sources such as cars, power plants, industrial
   boilers, refineries, and chemical plants) react  chemically
   in sunlight. Ozone pollution is more likely to form dur-
   ing warmer months. This is when the weather conditions
   normally needed to form ground-level ozone—lots of
   sun—occur.

Who is most at risk?
Several groups of people are particularly sensitive  to ozone,
especially when they are active outdoors. This is because ozone
levels are higher outdoors, and physical activity causes faster
and deeper breathing, drawing more ozone into the body.
•  People with lung diseases, such as asthma, chronic
   bronchitis, and emphysema, can be particularly sensitive
   to ozone. They will generally experience more serious
   health effects at lower levels. Ozone can aggravate their
   diseases, leading to increased medication use, doctor and
   emergency room visits, and hospital admissions.
•  Children are at higher risk from ozone exposure because they
   often play outdoors in warmer weather when ozone levels
   are higher, they are more likely to have asthma (which may
   be aggravated by ozone exposure), and their lungs are still
   developing.
•  Older adults may be more affected by ozone exposure,
   possibly because they are more likely to have  pre-existing
   lung disease.

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Air Quality Index
   •  Active people of all ages who exercise or work vigorously
      outdoors are at increased risk.
   •  Some healthy people are more sensitive to ozone. They
      may experience health effects at lower ozone levels than
      the average person even though they have none of the
      risk factors listed above. There may be a genetic basis for
      this increased sensitivity.
   In general, as  concentrations of ground-level ozone increase,
   more people begin to experience more serious health effects.
   When levels are very high, everyone should be concerned
   about ozone exposure.

   What  are  the health effects?
   Ozone affects the lungs and respiratory system in many
   ways. It  can:
   •  Irritate the respiratory system, causing coughing,
      throat soreness, airway irritation, chest tightness, or chest
      pain when taking a deep breath.
   •  Reduce lung function, making it more difficult to
      breathe as  deeply and vigorously as you normally would,
      especially when exercising. Breathing may start to feel
      uncomfortable, and you may notice that you are taking
      more rapid and shallow breaths than normal.
Inflame and damage the cells that line the lungs.
Within a few days, the damaged cells are replaced and
the old cells are shed—much like the way your skin peels
after sunburn. Studies suggest that if this type of inflam-
mation happens repeatedly, lung tissue may become
permanently scarred and lung function may be perma-
nently reduced .
Make the lungs more susceptible to infection. Ozone
reduces the lung's defenses by damaging the cells that
move particles and bacteria out of the airways and by
reducing the number and effectiveness of white blood
cells in the lungs.
Aggravate asthma. When ozone levels are unhealthy,
more people with asthma have symptoms that require a
doctor's attention or the use of medication. Ozone makes
people more sensitive to allergens—the most common
triggers for asthma attacks. Also, asthmatics may be more
severely affected by reduced lung function and airway
inflammation. People with asthma should ask their
doctor for an asthma action plan and follow it carefully
when ozone levels are unhealthy.
Aggravate other chronic lung diseases such as
emphysema and bronchitis. As concentrations of
ground-level ozone increase, more people with lung
disease visit doctors or emergency rooms and are
admitted to the hospital.
Cause permanent lung damage. Repeated short-term
ozone damage to children's developing lungs may lead
to reduced lung function in adulthood. In adults,  ozone
exposure may accelerate the natural decline in lung func-
tion that occurs with age.
   The risk of exposure to unhealthy levels of ground-level ozone is
   greatest during warmer months. Children, who often play outdoors
   in warmer weather, are at higher risk.

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Air Quality Index
   How can I protect my health at different
   AQI values?
    AQI Value

    Good
    (0-50)

    Moderate
    (51-100*)

    Unhealthy
    for
    Sensitive
    Groups
    (101-150)
    Unhealthy
    (151-200)
    Very
    Unhealthy
    (201-300)
Actions to Protect Your Health
From Ozone

None
Unusually sensitive people should consider
reducing prolonged or heavy outdoor
exertion.
The following groups should reduce
prolonged or heavy outdoor exertion:
  • People with lung disease, such as asthma
  • Children and older adults
  • People who are active outdoors
                  The following groups should avoid
                  prolonged or heavy outdoor exertion:
ima
  • People with lung disease, such as asthma
  • Children and older adults
  • People who are active outdoors
Everyone else should limit prolonged
outdoor exertion.
The following groups should avoid all
outdoor exertion:
  • People with lung disease, such as asthma
  • Children and older adults
  • People who are active outdoors
Everyone else should limit outdoor
exertion.
   * An AQI of 100 for ozone corresponds to an ozone level of 0.075 parts per
    million (averaged over 8 hours).
          PARTICLE POLLUTION


What is particle pollution?

Particle pollution (also known as "particulate matter") con-
sists of a mixture of solids and liquid droplets. Some particles
are emitted directly; others form when pollutants emitted
by various sources react in the atmosphere. Particle pollu-
tion levels can be very unhealthy and even hazardous during
events such as forest fires. Particle levels can be elevated
indoors, especially when outdoor particle levels are high.

Particles come in a wide range of sizes. Those less than 10
micrometers in diameter (smaller than the width of a single
human hair) are so small that they can get into the lungs,
where they can cause serious health problems.

•  Fine particles. The smallest particles  (those 2.5
  micrometers or less in diameter) are called "fine" par-
  ticles. These particles are so small they can be detected
  only with an electron microscope. Major sources of fine
  particles include motor vehicles, power plants, residential
  wood burning, forest fires, agricultural burning, some
  industrial processes, and other combustion processes.

• Coarse particles. Particles between 2.5 and 10 microm-
  eters in diameter are referred to as "coarse." Sources of
  coarse particles include crushing or grinding operations,
  and dust stirred up by vehicles traveling on roads.


What are the health effects and who is

most at risk?

Particles smaller than  10 micrometers  in diameter can cause
or aggravate a number of health problems and have been
linked with illnesses and deaths from heart or lung disease.
These effects have been associated with both short-term
exposures (usually over 24 hours, but possibly as short as
one hour) and long-term exposures (years).

Sensitive groups for particle pollution include people with
heart or lung disease (including heart failure and coronary
artery disease, or asthma and chronic obstructive pulmonary

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Air Quality Index
   disease), older adults (who may have undiagnosed heart or
   lung disease), and children. The risk of heart attacks, and
   thus the risk from particle pollution, may begin as early as
   the mid-40s for men and mid-50s for women.
   •  When exposed to particle pollution, people with heart
      or lung diseases and older adults are more likely to visit
      emergency rooms, be admitted to hospitals, or in some
      cases, even die.
   •  Exposure to particle pollution may cause people with
      heart disease to experience chest pain, palpitations,
      shortness of breath, and fatigue.  Particle pollution has
      also been associated with cardiac arrhythmias and heart
      attacks.
   •  When exposed to high levels of particle pollution, people
      with existing lung disease may not be able to breathe as
      deeply or vigorously as they normally would. They may
      experience symptoms  such as coughing and shortness of
      breath. Healthy people also may experience these effects,
      although they are unlikely to experience more serious effects.
   •  Particle pollution also can increase susceptibility to respi-
      ratory infections and can aggravate existing respiratory
   diseases, such as asthma and chronic bronchitis, causing
   more use of medication and more doctor visits.
How can I protect my health at different
AQI values?
 AQI Value

 Good
 (0-50)

 Moderate
 (51-100*)
  Unhealthy
  for Sensitive
  Groups
  (101-150)
                                                                               Unhealthy
                                                                               (151-200)
                                                                               Very Unhealthy
                                                                               (201-300)
Actions To Protect Your Health
From Particle Pollution
Unusually sensitive people should
consider reducing prolonged or heavy
exertion.
The following groups should reduce
prolonged or heavy outdoor exertion:
  • People with heart or lung disease
  • Children and older adults
Everyone else should limit prolonged
or heavy exertion.
                   The following groups should avoid all
                   physical outdoors:
                     • People with heart or lung disease
                     • Children and older adults
                   Everyone else should avoid prolonged
                   or heavy exertion.
                   The following groups should remain
                   indoors and keep activity levels low:
                     • People with heart or lung disease
                     • Children and older adults
                   Everyone else should avoid all
                   physical activity outdoors.
      Smoke from old, uncertified wood stoves is a major source of particle
      pollution in some communities. For information on cleaner-burning wood
      stoves that are more energy efficient, go to www.epa.gov/woodstoves.
* For particles up to 2.5 micrometers in diameter: EPA intends to update the
 AQI rule to reflect the Agency's September 2006 standards for fine particle
 pollution (PM25). In anticipation of this action, AQI forecasts and reports
 on the AIRNow Web site use the new 24-hour fine particle standard—35
 micrograms per cubic meter—as the 100 level of the AQI.
 For particles up to 10 micrometers in diameter: An AQI of 100 corresponds
 to 150 micrograms per cubic meter (averaged over 24 hours).

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Air Quality Index
             CARBON MONOXIDE


   What is carbon monoxide?
   Carbon monoxide is an odorless, colorless gas. It forms
   when the carbon in  fuels does not completely burn. Vehicle
   exhaust contributes  roughly 75 percent of all carbon mon-
   oxide emissions nationwide, and up to 95 percent in cities.
   Other sources include fuel combustion in industrial processes
   and natural sources  such as wildfires. Carbon monoxide
   levels typically are highest during cold weather, because cold
   temperatures make combustion less complete and cause inver-
   sions that trap pollutants close to the ground.

   What are the  health effects and who is
   most at risk?
   Carbon monoxide enters the bloodstream through the lungs
   and binds to hemoglobin,  the substance in blood that carries
   oxygen to cells. It reduces the amount of oxygen reaching
   the body's organs and tissues.
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   About half of all carbon monoxide emissions nationwide come from the exhaust
   of roadway vehicles. Exhaust from all types of vehicles (including marine vessels,
   aircraft, locomotives, and mobile equipment) contributes around three-quarters
   of all carbon monoxide emissions in the United States.
•  People with cardiovascular disease, such as coronary artery
   disease, are most at risk. They may experience chest pain
   and other cardiovascular symptoms if they are exposed to
   carbon monoxide, particularly while exercising.

•  People with marginal or compromised cardiovascular
   and respiratory systems (for example, individuals with
   congestive heart failure, cerebrovascular disease, anemia,
   or chronic obstructive lung disease), and possibly young
   infants and fetuses, also may be at greater risk from car-
   bon monoxide pollution.

•  In healthy individuals, exposure to higher levels of car-
   bon monoxide can affect mental alertness and vision.


How can I protect my health at different

AQI values?

  AQI Value


  Good
  (0-50)

  Moderate
  (51-100*)

  Unhealthy
  for Sensitive
  Groups
  (101-150)
  Unhealthy
  (151-200)
  Very Unhealthy
  (201-300)
Actions To Protect Your Health
From Carbon Monoxide

None

None

People with heart disease, such
as angina, should reduce heavy
exertion and avoid sources of carbon
monoxide, such as heavy traffic.
People with heart disease, such as
angina, should reduce moderate
exertion and avoid sources of carbon
monoxide, such as heavy traffic.
People with heart disease, such as
angina, should avoid exertion and
sources of carbon monoxide, such as
heavy traffic.
                                                                      * An AQI of 100 for carbon monoxide corresponds to a level of 9 parts per
                                                                      million (averaged over 8 hours).

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Air Quality Index
                SULFUR DIOXIDE


   What is sulfur dioxide?
   Sulfur dioxide, a colorless, reactive gas, is produced when
   sulfur-containing fuels such as coal and oil are burned.
   Generally, the highest levels of sulfur dioxide are found near
   large industrial complexes. Major sources include power
   plants, refineries,  and industrial boilers.

   What are the health effects and who is
   most at risk?
   Sulfur dioxide is an irritant gas that is removed by the nasal
   passages. Moderate activity levels that trigger mouth breath-
   ing, such as a brisk walk, are needed for sulfur dioxide to
   cause health effects in most people.
   •   People with asthma who are physically active outdoors
      are most likely to  experience the health effects  of sulfur
      dioxide. The main effect, even with very brief exposure
      (minutes), is a narrowing of the airways (called bron-
      choconstriction). This may be accompanied by wheez-
      ing, chest tightness, and shortness of breath, which
      may require use of medication that opens the airways.
      Symptoms increase as sulfur dioxide levels or breathing
   rate increases. When exposure to sulfur dioxide ceases,
   lung function typically returns to normal within an hour,
   even without medication.
•  At very high levels, sulfur dioxide may cause wheezing,
   chest tightness, and shortness of breath even in healthy
   people who do  not have asthma.
•  Long-term exposure to sulfur dioxide may cause respira-
   tory symptoms and illness, and aggravate asthma. People
   with asthma are the most susceptible to sulfur dioxide.
   However, people with other chronic lung diseases or car-
   diovascular disease,  as well as children and older adults,
   may also be susceptible to these  effects.

How  can  I protect my health at different
AQI values?
  AQI Value

 •j^^^^^^^^^^^^^^^H
  Good
  (0-50)

  Moderate
  (51-100*)

  Unhealthy for
  Sensitive Groups
  (101-150)
                                                                           Unhealthy
                                                                           (151-200)
                                                                          Very Unhealthy
                                                                          (201-300)
Actions To Protect Your Health
From Sulfur Dioxide

None

None

People with asthma should consider
reducing exertion outdoors.
                   Children, asthmatics, and people
                   with heart or lung disease should
                   reduce exertion outdoors.
                   Children, asthmatics, and people
                   with heart or lung disease should
                   avoid outdoor exertion. Everyone
                   else should reduce exertion
                   outdoors.
                                                                         * An AQI of 100 for sulfur dioxide corresponds to a level of 0.14 parts per
                                                                          million (averaged over 24 hours).
                Children and adults with asthma who
                are active outdoors are most vulnerable
                to the health effects of sulfur dioxide.

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Air Quality Index
   Where can I get more information?
   For information and resources about air quality, visit the
   AIRNow Web site at www.airnow.gov. There you can:
   •   Access maps and information on air quality in your area.
      Find out how to protect your health and how to reduce
      air pollution.
   •   Sign Up for EnviroFlash (www.environflash.info),  a free
      service that will alert you via e-mail when air quality in
      your area is forecast to be a concern.
   •   Access brochures, movies, games, and other air quality
      educational resources for adults and kids.
   •   Visit Air Compare (www.epa.gov/aircompare/), where you
      can compare the air quality of U.S. cities and find out
      about air quality trends in your area.
   •   Access Web Cameras that provide real-time pictures of
      visibility at many locations across the United States.
   •   Access training and tools. If you are a health care
      provider, teacher, or weathercaster, you can use these
      resources to help adults and children understand how air
      pollution affects their health and how they can protect
      their health.

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