Coroner: ‘Excessive air pollution’ caused death of Ella, 9

Published on 17-12-2020 at 09:09

Ella Adoo-Kissi-Debrah who, aged nine, was the first person in the world to have air pollution listed as a cause of death. Image by kind permission of The Ella Roberta Family Foundation

A landmark ruling has found that a nine-year-old girl who died in 2013 after an acute asthma attack is the first person in the UK – and possibly the world – to have ‘excessive air pollution’ from traffic listed as an official cause of death.

The ruling on the death of Ella Kissi-Debrah at Southwark Coroner’s Court in South London is likely to result in calls to governments and city authorities across the globe to do much more to cut the number of deaths every year which are associated with polluted air.

Philip Barlow, assistant coroner for the London Inner South, highlighted how Ella had had severe asthma, resulting in episodes of respiratory and cardiac arrest, requiring frequent hospital admissions.

Significant contributory factor

She lived very close to the South Circular Road in Lewisham, one of London’s busiest roads, and Mr Barlow heard that levels of nitrogen dioxide (NO2) near her home were in excess of both European and world guidelines.

On 15 February 2013 she had a further asthmatic ‘episode’ at home, and was taken to University Hospital Lewisham where she suffered a cardiac arrest from which she could not be resuscitated.

“Air Pollution was a significant contributory factor to both the induction and exacerbations of her asthma,” stated Mr Barlow on the Record of Inquest.

“During the course of her illness between 2010 and 2013 she was exposed to levels of Nitrogen Dioxide and Particulate Matter in excess of World Health Organization Guidelines. The principal source of her exposure was traffic emissions. During this period there was a recognized failure to reduce the level of NO2 to within the limits set by EU and domestic law which possibly contributed to her death.

‘She would have taken steps’

“Ella’s mother was not given information about the risks of air pollution and its potential to exacerbate asthma,” he continued. “If she had been given this information she would have taken steps which might have prevented Ella’s death.”

The medical causes of death were recorded as acute respiratory failure, severe asthma and air pollution exposure. In his conclusion, Mr Barlow said Ella had ‘died of asthma contributed to by exposure to excessive air pollution’.

The World Health Organization says that air pollution kills an estimated seven million people worldwide every year, and that nine out of 10 people breathe air that exceeds WHO guideline limits containing high levels of pollutants.

In a statement after the court’s ruling, Sadiq Khan, the Mayor of London, said: “This is a landmark moment and is thanks to the years of tireless campaigning by Ella’s mother Rosamund, who has shown an extraordinary amount of courage. Today must be a turning point so that other families do not have to suffer the same heartbreak as Ella’s family.

“Toxic air pollution is a public health crisis, especially for our children, and the inquest underlined yet again the importance of pushing ahead with bold policies such as expanding the Ultra Low Emission Zone to inner London. Ministers and the previous Mayor have acted too slowly in the past, but they must now learn the lessons from the Coroner’s ruling and do much more to tackle the deadly scourge of air pollution in London and across the country.”