A Comparative Analysis of Air Quality (PM2.5) and Its Health Impact in Central Asia

Air pollution, particularly fine particulate matter (PM2.5), presents a significant environmental health risk in Central Asia, where scientific understanding and monitoring systems remain limited. This study provides a comprehensive analysis of PM2.5 concentrations and their associated health impacts in the capital cities of Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan – Astana, Bishkek, Dushanbe, Ashgabat, and Tashkent – during the period 2010-2019. A fused dataset combining satellite-derived estimates with CAMS reanalysis outputs was developed to produce daily, spatially refined PM2.5 concentrations for the region.All five cities exceeded the WHO annual guideline of 5 µg/m³, with Ashgabat and Tashkent recording the highest annual averages, surpassing 25 µg/m³. Using the AirQ+ model, a Health Impact Assessment (HIA) was performed for chronic obstructive pulmonary disease (COPD) and lung cancer (LC) in adults aged 25 and older. Attributable COPD mortality under the background pollution scenario (2.4 µg/m³) reached up to 34 cases per 100,000 in Bishkek, with attributable proportions ranging from 9% to 21% across cities. LC burdens, although lower in absolute numbers, showed attributable fractions between 9% and 20% in Ashgabat and Tashkent, corresponding to 2 - 3 deaths per 100,000 – values comparable to estimates from studies in similarly polluted urban areas.Scenario analysis revealed that reducing PM2.5 to the WHO guideline of 5 µg/m³ would cut COPD and LC mortality by up to 80% in the most polluted cities. Notably, even moderate reductions, such as reaching the WHO Interim Target-3 of 15 µg/m³, already yielded substantial health benefits. These findings emphasize the urgent need for targeted air quality interventions and stricter regulatory standards across Central Asia.