Air pollution control and the occurrence of acute respiratory illness in school children of Quito, Ecuador

J Public Health Policy. 2019 Mar;40(1):17-34. doi: 10.1057/s41271-018-0148-6.


Because of air quality management and control, traffic-related air pollution has declined in Quito, Ecuador. We evaluated the effect of a city-wide 5-year air pollution control program on the occurrence of acute respiratory illness (ARI). We compared two studies conducted at the same location in Quito: in 2000, 2 years before the policy to control vehicle emission was introduced, and in 2007. Each study involved ~ 730 children aged 6-12 years, observed for 15 weeks. We examined associations between carboxyhemoglobin (COHb) serum concentration-an exposure proxy for carbon monoxide (CO)-ambient CO, and ARI in both cohorts. In 2007, we found a 48% reduction in the ARI incidence (RR 0.52; 95% CI 0.45-0.62, p < 0.0001), and 92% decrease in the percentage of children with COHb > 2.5% as compared to the 2000 study. We found no association between COHb concentrations above the safe level of 2.5% and the ARI incidence (p = 0.736). The decline in air pollution due to vehicle emissions control was associated with a lower incidence of respiratory illness in school children.

Keywords: Acute respiratory illness; Carboxyhemoglobin; Policy emission control.

MeSH terms

  • Acute Disease
  • Air Pollution / adverse effects
  • Air Pollution / prevention & control*
  • Carboxyhemoglobin / analysis
  • Child
  • Ecuador / epidemiology
  • Female
  • Health Policy
  • Humans
  • Incidence
  • Male
  • Prevalence
  • Respiratory Tract Diseases / epidemiology*
  • Respiratory Tract Diseases / etiology
  • Urban Population / statistics & numerical data
  • Vehicle Emissions / prevention & control


  • Vehicle Emissions
  • Carboxyhemoglobin