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Air pollution is emerging as a significant risk factor for human health in developing countries, particularly in Iran where air pollutant concentrations are elevated. Currently, knowledge of health effects of air pollution in developing countries is limited. The objective of this study was to estimate the excess number of hospitalizations for Chronic Obstructive Pulmonary Disease (COPD) and the number of excess cases of Respiratory Mortality (RM) associated with daily averages levels of particulate matter less than 10 mu m in diameter (PM10) in Ilam (Iran) over 1-year period (2015-2016). The excess instances of COPD and RM were estimated based on relative risk (RR) and baseline incidence (BI). The numbers of excess cases for COPD and RM during normal, dusty and Middle Eastern Dust (MED) storm days were 60 and 5, 200 and 15, and 78 and 6 persons, respectively. The results also showed that about 4.9% (95% CI: 3.0-6.8%) of hospital visits for COPD and 7.3% (CI: 4.9-19.5%) of RM could be attributed to 10 mu g/m(3) increase in PM10 concentration, respectively. It was found that a higher number of people were admitted to hospital when PM10 concentrations exceed 200 mu g/m(3) related to the MED events. Significant exposure to air pollutants, particularly during MED event, led to an excess of hospital admissions for COPD and an excess of the respiratory mortality. Several immediate actions such as strategic management of water bodies or planting of tree species in suburbs particularly bare area around the city could be effective to mitigate the impact of desert dust on respiratory illness. (C) 2017 Turkish National Committee for Air Pollution Research and Control. Production and hosting by Elsevier B.V. All rights reserved.