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A coroner has made legal history by ruling that air pollution was the cause of the death of a nine-year-old girl.
Philip Barlow, the South Central London Coroner, said Ella Kissi-Debrah’s death in February 2013 was caused by acute respiratory failure, severe asthma and exposure to air pollution.
She said she was exposed to nitrogen dioxide and particulate matter (PM) pollution above World Health Organization guidelines, the main source of which was emissions from traffic.
The coroner said failure to reduce pollution levels to legal limits possibly contributed to her death, as did failure to provide her mother with information about the potential for air pollution to exacerbate asthma.
“She died of asthma contributed to by exposure to excessive air pollution,” the coroner said.
He said that during Ella’s lifetime, nitrogen dioxide emissions in Lewisham, where Ella lived, exceeded legal limits, both at the European and national level. The particulate matter levels were above WHO guidelines, he said.
“All of Ella’s life was spent near highly polluting roads. I have no difficulty in concluding that his personal exposure to nitrogen dioxide and PM was very high. “
The coroner said the health effects of air pollution had been known for many years and that children and people with asthma were particularly at risk.
He found that air pollution both induced and exacerbated Ella’s particular form of severe asthma.
The ruling is the first of its kind in the UK and is likely to increase pressure on the government to tackle illegal levels of air pollution across the country.
Ella’s mother, Rosamund Kissi-Debrah, a former teacher, spent years fighting for a second coroner to examine her daughter’s death. Her stamina was rewarded Wednesday when Barlow agreed with expert medical evidence provided by the family that said Ella’s particular form of acute asthma is exacerbated by air pollution.
Kissi-Debrah’s attorneys argued that air pollution was a public health emergency and that there was an urgent need for it to be recorded as a cause of death to ensure that public health programs to combat toxic air were given priority.
As evidence of the two-week investigation, Professor Stephen Holgate, an immunopharmacologist and consultant respiratory physician at the University of Southampton and Southampton General Hospital, said that a biological cause of Ella’s worsening illness in the winter months was seasonal worsening of air pollution.
She said it was the cumulative effects of the toxic air Ella breathed living 30 meters from the South Circular Highway that caused her last acute asthma attack.
Holgate said She was like a canary in a coal mine, indicating the risk to other Londoners from the toxic mix of pollutants like nitrogen oxides in the air.
She had had numerous seizures and was taken to the hospital nearly 30 times in the three years before her death.
A 2014 investigative ruling, which determined that she died of acute respiratory failure, was overturned by the superior court following new evidence about dangerous levels of air pollution near her home.
During the hearing, Holgate, who was a member of the royal commission for environmental pollution until it closed in 2011, harshly criticized the Department of Environment, Food and Rural Affairs and the Department of Health and Social Care, for not working together on toxic air.
The family argued that there was sufficient evidence to conclude that the State did not take measures to protect the public from dangerous levels of air pollution, which amounted to a violation of article 2 of the Human Rights Law, regarding the right to life.
London Mayor Sadiq Khan said the coroner’s conclusion was a “historic moment” and called the contamination a “public health crisis.”
“Today should be a turning point so that other families do not have to suffer the same anguish as Ella’s family. Toxic air pollution is a public health crisis, especially for our children, and the research once again underscored the importance of pushing ahead with bold policies such as the expansion of the Ultra Low Emission Zone into London. “
“Ministers and the previous mayor have been too slow in the past, but now they must learn the lessons of the coroner’s decision and do much more to tackle the deadly scourge of air pollution in London and across the country.”
