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Illegal fuel pipeline tapping is a widespread issue in Mexico with significant, yet underexplored, public health impacts. Using data from the Mexican Life and Family Survey, this study examines the localized effects of hydrocarbon theft on respiratory health. Our findings show that municipalities with tapping incidents experience a 7.8% increase in allergy prevalence, particularly within 1,500 meters of pipelines, and predominantly affecting men. Asthma patterns are more complex, with minors under 18 in affected areas having a 1.6% higher probability of reporting symptoms. This study provides the first causal evidence linking illegal fuel extraction to adverse respiratory health outcomes. It suggests that antitheft enforcement strategies should include targeted health interventions, such as enhanced air quality monitoring and respiratory health screening. These insights are critical for public health responses in similar contexts globally.