SACRAMENTO (CBS13) – The City of Trees is one of the most ozone-polluted cities in the US, according to a new report from the American Lung Association.

The American Lung Association released their 2019 “State of the Air” report on Wednesday, revealing that more and more Americans are living with unhealthy air quality.

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According to their numbers, 141.1 million people live in counties with unhealthy ozone or particle pollution – an increase of more than 7.2 million since the association’s last report.

The Sacramento-Roseville area took fifth place on the Top 10 Most Ozone-Polluted Cities list – a ranking that featured almost every major metropolitan area in California. Los Angeles-Long Beach topped the list, while the San Jose-San Francisco-Oakland area came in eighth.

Ozone pollution – also known as smog – triggers such health concerns like shortness of breath, coughing and asthma attacks, the American Lung Association says.

The report was compiled using the number of high ozone and high particle pollution days from 2015-2017.

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Only six cities qualified for Cleanest US Cities: Bangor, Maine; Burlington-South Burlington, Vermont; Honolulu, Hawaii; Lincoln-Beatrice, Nebraska; Palm Bay-Melbourne-Titusville, Florida; and Wilmington, North Carolina.