Transboundary Air Pollution and Respiratory and Cardiovascular Morbidity in Rustavi, Georgia: A Time-Series Analysis

Transboundary air pollution represents a growing environmental health concern, particularly in regions affected by long-range transport of desert dust and other particulate matter sources (WHO, 2021; EEA, 2019). In Georgia, and especially in the city of Rustavi, episodes of elevated particulate matter concentrations are frequently associated with transboundary dust intrusions originating from arid regions to the south and southeast (air.gov.ge). Fine (PM_2.5) and coarse (PM₁₀) particles transported over long distances can penetrate deep into the respiratory system and contribute to both respiratory and cardiovascular morbidity (Lelieveld et al., 2015; Guarnieri & Balmes, 2014).

This study aimed to assess the short-term impact of transboundary PM₁₀ and PM_2.5 pollution on asthma exacerbations and ischemic heart disease (IHD) hospitalizations among residents of Rustavi, Georgia. A time-series analysis was conducted using hourly air quality data obtained from the National Environment Agency of Georgia and hospital admission records from the National Center for Disease Control and Public Health (NCDC) for the period 2019-2023. Transboundary pollution episodes were identified based on elevated PM₁₀ and PM_2.5 concentrations combined with meteorological conditions indicative of long-range transport (Trans_PM₁₀/PM_2.5=1). Hospital admissions for asthma (ICD-10: J45) and ischemic heart disease (ICD-10: I20-I21) occurring during these periods were analyzed.

During the study period, 6,007 hours were classified as transboundary pollution episodes. These events showed clear seasonal patterns, with peaks observed in January, August, and December. Preliminary analyses suggest a possible increase in hospital admissions for asthma and ischemic heart disease during transboundary PM episodes compared to non-episode periods; however, these findings are not yet conclusive.

The study is ongoing, and further statistical analyses are required to clarify the strength and significance of the association between transboundary particulate matter exposure and acute respiratory and cardiovascular health outcomes in Rustavi. The results highlight the importance of incorporating transboundary air pollution into national public health surveillance and air quality management strategies. Strengthening early-warning systems and regional cooperation is essential to reducing the health burden associated with long-range transported particulate matter.