Global Health And Air Pollution Advocates Hail Landmark UK Court Ruling Recognizing Air Pollution As Factor In Child’s Death Health & Environment 16/12/2020 • Raisa Santos Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Ella Adoo-Kissi-Debrah’s death in February 2013 was initially recorded as being caused by acute respiratory failure. It is now recorded as having been caused by acute respiratory failure, severe asthma and air pollution exposure. Global health and air pollution advocates have hailed a landmark court case which has recognized air pollution as a factor into the 2013 death of a 9 year-old girl – for the first time in history. On Wednesday, a Coroner Court in the United Kingdom ruled that air pollution was one of the causes of death of 9-year old Ella Kissi-Debrah, who lived with her mother near a heavily trafficked road in London, the South Circular. Ella has thus become first person in the UK – and potentially in the world – to have air pollution listed as a cause of death. “Today was a landmark case, a 7 year fight has resulted in air pollution being recognised on Ella’s death certificate,” tweeted the Ella Roberta Family Foundation, that was formed in Ella’s name, and pursued the court battle to win her justice. “ Hopefully this will mean many more children’s lives being saved. Thank you everyone for your continued support.” Professor Stephen Holgate who described Ella’s condition as “a canary in a coal mine”. It seems it was always going to end in a disaster no matter how hard we tried to maintain her. When your triggers are spikes in air pollution, I guess it was always going to end in heartbreak pic.twitter.com/2c41RXpG1E — The Ella Roberta Family Foundation (@rosamund_ElsFdn) December 16, 2020 “Landmark case in UK! Air pollution recognized in Ella’s death certificate. Ella’s light guiding and Rosamund Kissi-Debrah fighting made the miracle. Our heart is full of emotions beating with Ella, Rosamund and the fantastic ‘duo’,” tweeted Maria Neira, WHO Director of Public Health, Environmental and Social Determinants of Health. Ella Kissi-Debrah with her mother Rosamund in a family photo. Ruling from coroner Philip Barlow stated an early 2014 court finding that had only attributed her death to respiratory failure, should be overturned, as Barlow said, “Ella died of asthma contributed to by exposure to excessive air pollution.” “So, for the medical record cause of death, I intended to record 1A acute respiratory failure. 1B, severe asthma. 1C air pollution exposure. That is an agreement with the autopsy findings, and also the evidence of Sir Steven Holgate,” announced the Southwark Coroner’s court on Wednesday, reporting that Ella was exposed to nitrogen dioxide and particulate matter (PM) pollution in excess of WHO guidelines. The initial 2014 inquest into the girl’s death in February 2013 had been recorded as acute respiratory failure, without taking into account any reference to environmental factors that caused the fatal collapse of the girl, who suffered from chronic asthma. Her mother, Rosamund Kissi-Debrah knew nothing about the health impacts of air pollution, notably from particulate matter and nitrogen dioxide, closely associated with increased severity from asthma, while her daughter was still alive. It was only when she launched a charity in her daughter’s name, The Ella Roberta Family Foundation, to improve the lives of children with asthma in south-east London, that she began to stumble across the linkages. The case was taken up by human rights lawyer Jocelyn Cockburn. Professor Sir Stephen Holgate, an immunopharmacologist and consultant respiratory physician of the University of Southampton and Southampton general hospital, heavily researched the case and produced a report linking air pollution levels to Ella’s death, also testifying in the repeated court hearings. This Inquiry Played Out Differently Than the One in 2014 In 2019, the United Kingdom’s High Court granted a request from the family for a new inquest over the girl’s death, in light of the new evidence and research that had been gathered – sending the case back to London’s Southwark Coroner’s Court for another round of hearings. In the 2019 hearing where the new inquest was granted, Judge Mark Lucraft said: “In our judgement, the discovery of new evidence makes it necessary in the interests of justice that a fresh inquest be held.” #AirPollution will be written on the death certificate of Ella Roberta. The Southwark Coroner's Court near London just announced… "So, for the medical cause of death, I intend to record, 1A Acute Respiratory Failure. 1B, Severe Asthma. 1C Air Pollution exposure."@CleanAirLondon — Jeff Smith on Air Pollution (@jksmith34) December 16, 2020 The past two weeks in the Coroner’s Court played out a very different inquiry over what took the 9 year-old’s life. Government departments, officials from the local authority, and even Sadiq Khan, the Mayor of London were questioned about what they did – or did not do – to reduce illegal air pollution levels in the area where Ella lived, where levels of nitrogen dioxide air pollution from traffic constantly exceeded annual limits of 40 µg/m3 between 2006 and 2010. The mayor said the coroner’s conclusion was a “landmark moment” and called pollution a “public health crisis.” “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.” According to the WHO, air pollution kills an estimated seven million people worldwide every year, including 4.2 million deaths from outdoor air pollution generated by industry, road traffic, energy production and building heating, among other sources. The most health-hazardous pollution components include PM 2.5, these fine particles measure 2.5 microns in diameter, meaning that 400 particles can be fit into a single millimetre. These tiny particles can not only enter the lungs but also penetrate into the bloodstream. Excessive levels of nitrogen dioxide, also emitted by vehicles, are closely associated with higher risks of chronic respiratory infections, including asthma. UK scientists estimate that air pollution shortens British lives by an average of six months. The combined effects of outdoor and household air pollution cause about seven million premature deaths every year – with increased mortality from stroke, heart disease, chronic obstructive pulmonary disease, lung cancer, and acute respiratory infections. Evidence is also growing that it can limit the growth of children’s lungs. Rosamund Kissi-Debrah told the coroner that had she known the air her daughter was breathing was killing her, she would have moved them away immediately. “We were desperate for anything to help her. I would have moved straight away, I would have found another hospital for her and moved. I cannot say it enough. I was desperate, she was desperate,” she said. News of the Court Ruling Echos Globally News of the court judgement echoed quickly around the world, sparking hopes that the landmark ruling may create a precedent that could prevent other children in Ella’s situation from suffering as she did. Advocacy groups for air pollution are already working on ensuring that children are saved from this ‘silent killer.” Rosamund Kissi-Debrah appearing on television following the ruling. The NCD Alliance said: “Heartfelt thanks for your tireless work to gain this landmark recognition. You and your family are heroes to so many of us now and to future generations.” Professor Clare Horwell, an air pollution expert at the UK’s Durham University said: “This is a very important result. I want to say congratulations but that doesn’t feel right. Your enormous dedication has paid off. Ella can never be replaced but her legacy will be remarkable.” “We celebrate this judgment with a heavy heart. But also huge admiration for a mum who just wouldn’t give up,” tweeted the Indian air pollution advocacy group Care for Air, based in Delhi, which suffers from some of the highest air pollution levels in the world. Indian groups are already looking at ways to pursue court claims over health damage wrought by air pollution. One India environmental activist told Health Policy Watch. “We are trying to do something around personal compensation, and this would be a great precedent,” she said. “Our research is at a very vey early stage and we hope others will beat us to it. Yes, with strong advocates, we could use Indian courts … although with the current dispensation of the government, and compromised judges I am not sure it wouldn’t be dismissed.” Let Me Breathe, another New Delhi-based platform tweeted: “Ella died because of air pollution. Thank you [Rosamund Kissi-Debrah] for fighting this fight. It is a step to save many more children.” Long Journey Though the Court Process While the journey often seemed quixotic, Ella’s mother did not give up. And along the way the determination of Rosamund snowballed, gathering her support from not only the world’s most famous air pollution and health experts, but also celebrity figures. On Tuesday, just before the court case ruling was issued, former California Governor Arnold Schwarzenegger sent her a letter, saying: “My thoughts are with you and your family tonight, ahead of the release of the coroner’s invest into Ella’s tragic death. I know this is the culmination of years of hard work on your part to have pollution’s terrible impact on your daughter acknowledged. As a father, I cannot think of anything worse than what you have been through… You are a hero.” Thank you Mr S for your warm words, I will pass it onto the twins. I hope you are continuing to recover well . See you next year @Schwarzenegger pic.twitter.com/hP8EZAAldj — The Ella Roberta Family Foundation (@rosamund_ElsFdn) December 16, 2020 In a statement issued just ahead of the court ruling, Rosamund said: “Professor Stephen Holgate who described the nine-year-old girl’s condition as ‘a canary in a coal mine’. It seems it was always going to end in a disaster no matter how hard we tried to maintain her. When your triggers are spikes in air pollution, I guess it was always going to end in heartbreak.” “The past six years of not knowing why my beautiful, bright and bubbly daughter died has been difficult for me and my family, but I hope the new inquest will answer whether air pollution took her away from us,” she said in 2019, just after the new court hearing was granted. “If it is proved that pollution killed Ella then the government will be forced to sit up and take notice that this hidden but deadly killer is cutting short our children’s lives.” Now that proof has become a reality. Image Credits: @rosamund_ElsFdn. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.