Once again, the Louisville area's air has been ranked among the worst in the nation by theAmerican Lung Association. The organization released it's annual State of the Air reporttoday.The Louisville metropolitan area was ranked 12th in the nation for year-round particle pollution (PM2.5); last year, it was ranked 9th. Louisville didn't even make the American Lung Association's list of the 25 cities with the most ozone pollution in 2012, but after a summer beleaguered by high-ozone days, this year the metro area was named the 17th most ozone polluted city in the country. Indianapolis also made the list for particle pollution, and Cincinnati was ranked poorly for both particle pollution and ozone.Louisville Air Pollution Control District spokesman Tom Nord says despite the rankings, the overall air quality in the area is better than it's been in the past."Air quality has steadily been improving in Kentuckiana over the past couple decades thanks to tighter standards and better public awareness," he said in a statement. "Even though ozone has been trending up again, we still see fewer bad air days in the summer now than we did in the late 1990s. At the same time, the particle pollution picture continues to get clearer. The State of the Air report is an important reminder that many major cities continue to grapple with air pollution, and should help motivate our community to keep working together to help the air."But the news wasn't all bad for Kentucky. Campbell, Carter, Christian, Daviess, Franklin, Hardin, Henderson, Madison, McCracken and Warren counties were among the cleanest in the nation for short-term particle pollution. Bell, Carter, Hardin, Perry, Pike Pulaski and Warren counties all had low levels of ozone pollution.In the report, the American Lung Association said that the country's air is improving, but the ozone levels especially are still problematic. High levels of pollution can manifest itself in conditions like wheezing, coughing, asthma attacks, heart attacks and premature death, and the elderly and children are the most vulnerable.The Lung Association used the report to call for policy change.