Dear Editor:

As a pulmonologist practicing in Delaware for three decades, I have seen patients suffering from a variety of lung diseases. I've seen my patients struggle to breathe and struggle to understand why they could not breathe. I've met them in the hospital and in the emergency room, as their struggles to breathe became near impossibility. What I have not seen in all of these years is a decrease in the number of people suffering from lung disease.Lung disease is still the same killer that it was when I first began practicing medicine.And yet, I'm optimistic for the future.The American Lung Association just released its 13th annual State of the Air report. It shows that while the air most Americans breathe is still dirty, still polluted, still filled with too much smog and soot, it's getting better.But better is not safe.More than 127 million people are living in counties with dangerous levels of either ozone or particle pollution. And for those who already have lung diseases like asthma, COPD, or bronchitis, dirty polluted air makes their symptoms much worse.Thanks to the Clean Air Act, we've made great progress in cleaning up air pollution from across the U.S. But there's still a lot of work to be done. I live and work in the mid-Atlantic, where we have some of the worst air and best in the country.• The Philadelphia-Camden-Vineland metro area, which includes five New Jersey counties, was listed in the 2012 State of the Air report was listed as being in the worst 25 city areas for ozone and for daily and year-round particle pollution.• Pennsylvania had two counties among the 25 most polluted in the nation for short-term particle pollution and three counties among the 25 most polluted in the nation for year-round particle pollution.• West Virginia's air has generally improved compared to last year's State of the Air report, and in fact was at its cleanest since the first annual report 12 years ago. However, West Virginia also claimed seven of the 27 metro areas listed as the most polluted cities for year-round particle pollution in the country.• In my home state of Delaware, air quality also was at its cleanest since the annual report began 12 years ago. However, factors such as cross-state pollution played a role ultimately in poor air quality grades; all three Delaware counties received an "F" for ozone pollution.I urge everyone to take the time to visit

www.stateoftheair.org and learn about the air quality in their community. Then, take a moment to think about your friends, your neighbors and your loved ones who have lung disease and need our support to fight for air that's safe for everyone to breathe. Join me in the fight for clean healthy air. Learn how to protect yourself and your family from air pollution by visiting

www.stateoftheair.org.Sincerely,Dr. Albert A. RizzoNational Volunteer Chair of the American Lung AssociationARizzo@christianacare.org