Sumqayit in Azerbaijan gained the dubious distinction this week of being added to Blacksmith Institute's top 10 list of the world's most polluted sites. Yet another heir to the toxic legacy of Soviet industry, the city of 275,000 souls bears heavy metal, oil and chemical contamination from its days as a center of chemical production. As a result, local Azeris suffer cancer rates 22 to 51 percent higher than their countrymen and their children suffer from a host of genetic defects ranging from mental retardation to bone diseases.

"As much as 120,000 tons of harmful emissions were released on an annual basis, including mercury," says Richard Fuller, founder of Blacksmith, an environmental health organization based in New York City. "There are huge untreated dumps of industrial sludge."

Fuller says the list includes "places that are highly polluted in the developing world, where children are dying in droves or living with chronic disease… areas of desolation and disgust at what man has wrought." Joining Sumqayit as the worst polluted:

Chernobyl, Ukraine — The fallout from the world's worst nuclear power accident continues to accumulate, affecting as many as 5.5 million people and leading to a sharp rise in thyroid cancer. The incident has also blighted the economic prospects of surrounding areas and nations. "Belarus is very agricultural," says Stephan Robinson, a director at Green Cross Switzerland, an environmental group that collaborated on the report. "Through Chernobyl, they lost access to world markets for their produce."

Dzerzinsk, Russia — A center of Cold War chemical manufacturing, the city's 300,000 residents have one of the lowest life expectancies in the world thanks to waste injected directly into the ground. "Average life expectancy is roughly 45 years," Robinson says. "Fifteen to 20 years less than the Russian average and about half a Westerner's."

Kabwe, Zambia — The second largest city in this southern African country was home to one of the world's largest lead smelters until 1987. As a result, the entire city is contaminated with the heavy metal, which can cause brain and nerve damage in children and fetuses. "Measurements of children's blood levels of lead average over 50 micrograms per deciliter and some were over 100," Fuller says. "For every 10 points above 10 micrograms per deciliter [(the U.S. Centers for Disease Control standard for treatment)] that your blood level goes up, your IQ drops."

La Oroya, Peru — Although this is one of the smallest communities on the list (population 35,000) it is also one of the most heavily polluted due to lead, copper and zinc mining by U.S.-based Doe Run mining company.

Linfen, China — a city in the heart of China's coal region in Shanxi Province, its three million inhabitants choke on dust and drink arsenic that leaches from the fossil fuel. In addition, "it is difficult to see," Robinson says, "the air is heavily polluted."

Norilsk, Russia — This city above the Arctic Circle contains the world's largest metal smelting complex and, therefore, some of the world's worst smog. "There is so much pollution going into the air from this place that there is no living piece of grass or shrub within 30 kilometers of the city," Fuller says. "Contamination [with heavy metals] has been found as much as 60 kilometers away."

Sukinda, India — Home to one of the world's largest chromite mines—used to make steel stainless, among other things—and 2.6 million people, the waters of this valley contain carcinogenic hexavalent chromium compounds courtesy of 30 million tons of waste rock lining the Brahmani River. "Hexavalent chromium is very toxic and very mobile," notes David Hanrahan, Blacksmith's London-based director of global programs.

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