Abstract

 Iraq's environmental crisis, over the past 20 years, has become incomparable. The explosion of dust affected days — 122 annually in 2000 to 283 by 2022, a rise of 132% — has been recorded by the European Centre for Medium-Range Weather Forecasts. During dust storm events, fine particulate matter (PM2.5) concentrations in the three provinces exceeded WHO air quality guidelines by 14 to 18 times.We obtained hospital admissions spanning three provinces (between January 2000 and December 2024) from 32 governmental hospitals resulting in a total of 864 months for data collection. These clinical reports were cross-referenced with high-resolution satellite data: MODIS-MAIAC at a 1-km level, TROPOMI at a 3.5-km level, and ERA5 reanalysis datasets.The analytical strategy used a negative binomial count model in a Bayesian hierarchical framework with Markov Chain Monte Carlo simulation (50,000 iterations). The results indicate that for every 10 μg/m³ increase in PM2.5, there was a 3.74% increase in admissions of respiratory cases (95% BCI: 2.86-4.63%). The model had a good fit with the performance results: DIC = 8,342.6 and RMSE = 198.3.The peak health effects of exposure were found to be 2 days in the distributed lags models (coefficie nt=0.0142). The highest level of spatial variation was found between geographical areas; Basra, Baghdad, and Karbala were the most sensitive 0.187, 0.134, and 0.089 respectively.