Air pollution exposure has been listed as the cause of death in the UK for the first time, with the case of nine-year-old Ella viewed as a historic moment which could increase pressure on the government to address the issue.
Philip Barlow, assistant coroner for inner South London, said in his verdict on Wednesday that air pollution had made a “material contribution” to the death of Ella Adoo-Kissi-Debrah in 2013, following a two-week inquest into the case.
From 2010 to 2013, Ella, who lived in southeast London, had been taken to hospital nearly 30 times with breathing difficulties.
“Ella died of asthma contributed to by exposure to excessive air pollution,” Barlow said, following the ruling, which also recorded acute respiratory failure as a cause of death.
He added that she was exposed to levels of nitrogen dioxide (NO2) and and particulate matter (PM) which exceeded World Health Organization (WHO) guidelines near her London home, which is 30 metres from a major ringroad often clogged with heavy traffic.
“There was a recognised failure to reduce the levels of nitrogen dioxide, which possibly contributed to her death,’ Barlow said.
“There was also a lack of information given to Ella’s mother that possibly contributed to her death.”
Mayor of London Sadiq Khan hailed Wednesday’s ruling as a “landmark moment” and said he was pleased to have supported Ella’s family in their efforts to “secure justice”.
“Today must now be a turning point,” Khan, who was named as an interested party in the inquest, wrote on Twitter.
“Toxic air pollution is a public health crisis. 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.”
An initial inquest in 2014 into Ella’s death found she died of acute respiratory failure.
But that ruling was overturned and a new hearing was ordered after a review of the case, in which pollution expert Stephen Holgate said he found a “striking association” between levels of NO2 and harmful particulate matter when Ella was taken to hospital for treatment.
Holgate said Ella was “living on a knife edge” because of her surroundings and the air quality in her neighbourhood, which exacerbated her condition.
Winter air pollution worsened her asthma in the months leading up to her death, added Holgate, a professor of immunopharmacology at the UK-based University of Southampton.