Those that have asthma need to be more aware of environmental factors that can negatively impact their quality of life. Some states have low air quality that can impact those with asthma symptoms. Every state has a different climate, as a result, pollen levels can dramatically vary. States with higher pollen levels can have a negative impact on the quality of life for those with asthma. Here are the six worst states for those with asthma:

1. Virginia

Residents of the state experience more symptoms of asthma than in other parts of the nation. A contributing factor is the pollen level, which remains higher than the national average. The quality of air is much lower than in other states and is a significant factor. Poverty in the state is widespread, often many don’t seek out healthcare due to the inability to afford such services. The numbers of uninsured residents continues to remain higher than the national average.

2. Pennsylvania

The state of Pennsylvania has many large industrial sectors that give off higher levels of pollution. Many children in these areas experience three times the national average of asthma symptoms. The state also has a rich history of depending on coal-powered plants for the state’s electricity. Even today, the lasting effects of the damage to air quality remain with the state’s high rates of residents with asthma. Other asthma effects are a result of high pollen levels.

3. Massachusetts

On average, Massachusetts residents have a much higher rate of having asthma when compared to the country as a whole. Researchers are uncertain what causes asthma triggers to occur in their state, however, there are some causes that may be a result. The air pollution in the state tends to be at much higher levels than in other areas. Mold and dust mites are quite common in the area that can be quite damp during the warm seasons.

4. Ohio

When it comes to pollution, Ohio ranks at the top. The level of ragweed is the highest in the country. Those with allergies and asthma are exposed to some of the worst air they could ever find. Sneezing, and wheezing are the most common symptoms. Many experience itchy, and watery eyes when the pollen levels are at their peak in fall. Ozone pollution levels in the state remain high. Children are more likely to be exposed to the harmful effects because they typically spend more time outside.

5. Kentucky

Seeing the Kentucky bluegrass is considered by many to be the prettiest place in the world to be during the spring. Yet the bluegrass gives off the most pollen of any variety of grass. During the springtime, the pollen is at its peak. Many symptoms consist of congestion, sneezing, and sniffling. Humidity and smog tend to linger in many parts of the state due to the Ohio Valley’s low elevation. More recently, climate change has lengthened the spring and fall pollen seasons as well.

6. Michigan

The industrial strength of Detroit has left the damaging mark of pollution. The refinery near Zug Island has made the state one of the most polluted areas in the nation. Air quality is only expected to get worse, as the refinery is seeking to ramp up production. They are expecting to increase yearly sulfur dioxide emissions. The poor air quality is not the only factor. The quality of housing remains low with higher levels of dust mites, cockroaches, and rodents. These pests can inflame allergies.