This list, compiled by The Blacksmith Institute, shows not only the world’s most polluted cities, but also demonstrates the various ways in which cities are polluted. The Institute recognizes that, in terms of air quality, 16 of the 20 most polluted cities are in China (according to The World Bank), but only includes one Chinese city on its list in order to show the different types of pollution plaguing cities around the world.

Dzerzinsk, Russia

This city’s residents are now paying the price for chemical waste that was improperly disposed of in the 1930s. The 300,000 tons of chemical waste discarded between 1930 and 1938 have led to an average life expectancy of only 42 years for men and 47 years for women. The water here contains industrial chemicals such as phenol at 17 million times the safe limit.

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Linfen, China

Located in the Shanxi Province, this city is at the center of China’s coal industry. The air quality is among the worst in the world, and residents claim it is so bad they literally choke on coal dust in the air. The country’s rapid expansion requires huge amounts of coal, meaning there are no plans in sight to improve Linfen.

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Kabwe, Zambia

Once a thriving mining community, this city is now left with the consequences of the mining and smelting of lead that occurred here for almost a century. Safe blood levels of lead are less than 10 micrograms per deciliter and levels higher than 120 mcg/dl often lead to death – concentrations of 200 have been recorded in children in this city.

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Norilsk, Russia

This city, located in the Arctic Circle, is characterized by black snow and air that reeks of sulfur. The world’s largest smelting complex is here, and it emits four million tons of chemicals into the air every year. Foreign visitors are not allowed in Norilsk, following in the Soviet-era tradition of “closing” certain Russian towns for reasons of secrecy.

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Haina, Dominican Republic

Residents of this city, particularly children, suffer from high rates of eye damage, birth deformities, and learning disorders due to lead poisoning from an automobile battery recycling smelter. While the recycling center closed down in 1997, its effects still linger. Such battery re-processing facilities are common in major cities of developing nations, where they often introduce detrimental lead poisoning to the local communities.

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Chernobyl, Ukraine

Chernobyl is now infamous for the 1986 nuclear disaster that killed 30 people, forced 35,000 to evacuate their homes, and left a 19-mile radius around the plant that is still uninhabitable to this day. The tremendous amounts of radiation released during the meltdown led to skyrocketing rates of thyroid cancer in children in the surrounding area.

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La Oroya, Peru

The children of La Oroya suffer from blood lead levels far over the safe limit, which often leads to mental development problems. The city’s plant life has been destroyed by the acid rain that is caused by excessive sulfur dioxide emissions. This small Andes town has been ravaged by the toxic emissions of an American-owned smelting plant.

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Ranipet, India

The soil and groundwater of Ranipet have been left dangerously polluted by decades of solid waste and runoff from a local factory that manufactures chromium salts, sodium chromate, and a powder used in the leather tanning process. Drinking wells have been abandoned and most crops fail to grow in this region where mere contact with the water causes painful skin lacerations.

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Rudnaya Pristan and Dalnegorsk, Russia

The average child in this area has a blood lead level between eight and 20 times the maximum acceptable amount for a child in the U.S. Thanks to an old (now closed) smelter and improperly transported lead from the local mines, everything from the area’s drinking water to the dust inside homes contains unsafe levels of lead.

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Mailuu-Suu, Kyrgystan

A former Soviet uranium plant located in Mailuu-Suu processed more than 10,000 tons of uranium ore between 1946-1968. Some of this material went on the create the Soviet Union’s first atomic bomb. Almost two million cubic meters of radioactive waste now lie in this densely populated and precariously situated region, where residents are twice as likely to suffer from some form of cancer than in the rest of the country. Mudflows, earthquakes, and landslides (all not uncommon occurrences here) constantly threaten to move the toxic waste into rivers and streams, spreading the problem even further throughout the region.

By Elizabeth Wolfe