Air Pollution and Public Health: A Multi-City Assessment of PM₂.₅ Exposure in Punjab, Pakistan

Particulate matter, particularly PM₂.₅ continues to be a critical determinant of the global disease burden, underscoring the scale of exposure and the multifaceted processes through which it affects human health. In Pakistan, particularly the Punjab province, fast-growing urbanization and industrialization has dramatically intensified PM₂.₅ load, with many metropolitan cities consistently surpassing WHO air quality guidelines. This study aims to examine the persuasive relationship between PM₂.₅ exposure and associated health impacts across five major cities including Lahore, Faisalabad, Rawalpindi, Multan and Rahim Yar Khan. Integrating NASA MERRA-2 satellite derived PM₂.₅ data (January 2015–July 2025) with hospital health records, this study performed a time series epidemiological analysis to quantify the impact of PM₂.₅ on morbidity and mortality from respiratory, cardiovascular, and allergic diseases across multiple urban centers. Demographic factors including gender and age group have also been considered for evaluating vulnerable populations. Results indicate a positive correlation between escalating PM₂.₅ concentrations and respiratory (r = 0.33), cardiovascular (r = 0.46), and allergies (r = 0.44) diseases, with pediatric and older being more susceptible. Although significance dip in PM₂.₅ levels was observed during COVID-19 period, the disease incidence continued to surge with a little decline during lockdown months displaying just a short-term fluctuation. Findings underscore the pressing need for consolidated, data-driven approaches including strict air quality regulations, healthcare system strengthening and sustainable city development strategies. Ultimately, this study will contribute to the current understanding of environmental and public health, providing a foundation for future research and policy interventions aimed at safeguarding populations from the health impacts of particulate matter.