 such as persistent cough, wheezing, shortness of breath, tightness of the chest and chest pain, and even red eyes. What cities and or states have the most air pollution? What we looked at was the cities that have the most pollution, the dirtiest cities. San Bernardino, California is number one. Detroit is number two. Reading, Pennsylvania, three. Newark, New Jersey, Ontario, California. These are the top five. Phoenix, Arizona, six.