Association of PM2.5 concentration with health center outpatient visits for respiratory diseases of children under 5 years old in Lima, Peru

Environ Health. 2020 Jan 15;19(1):7. doi: 10.1186/s12940-020-0564-5.


Background: Lima is one of the more polluted cities in Latin America. High levels of PM2.5 have been shown to increase health center outpatient visits of respiratory diseases.

Methods: Health center outpatient visits for children < 5 years for childhood respiratory disease (acute lower respiratory infections (ALRI), pneumonia and acute bronchiolitis/asthma) from 498 public clinics in Lima were available on a weekly basis from 2011 to 2015 from Peru's Ministry of Health (MINSA). The association between the average weekly concentrations of PM2.5 was evaluated in relation to the number of weekly health center outpatient visits for children. Weekly PM2.5 values were estimated using a recently developed model that combined data observed from ground monitors, with data from space satellite and meteorology. Ground monitoring data came from 10 fixed stations of the Peruvian National Service of Meteorology and Hydrology (SENAMHI) and from 6 mobile stations located in San Juan de Miraflores by Johns Hopkins University. We conducted a time-series analysis using a negative binomial model.

Results: We found a significant association between exposure to PM2.5 and all three types of respiratory diseases, across all age groups. For an interquartile increase in PM2.5, we found an increase of 6% for acute lower respiratory infections, an increase of 16-19% for pneumonia, and an increase of 10% for acute bronchiolitis / asthma.

Conclusions: Higher emissions of environmental pollutants such as PM2,5 could be a trigger for the increase of health center outpatients visits for respiratory diseases (ALRI, pneumonia and asthma), which are themselves risk factors for mortality for children in Lima province, Peru.

Keywords: Air pollution; Children; Health center outpatient visits; PM2.5; Respiratory diseases.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Air Pollutants / adverse effects*
  • Child, Preschool
  • Cities
  • Environmental Exposure / adverse effects*
  • Humans
  • Infant
  • Infant, Newborn
  • Outpatients / statistics & numerical data*
  • Particulate Matter / adverse effects*
  • Peru / epidemiology
  • Respiration Disorders / chemically induced
  • Respiration Disorders / epidemiology*


  • Air Pollutants
  • Particulate Matter