A court in the UK has made legal history by ruling that air pollution is one of the causes of death of 9 year old Ella Kissi Debrah, who lived near a busy road in London with her mother. Ella has become the first person in the UK – and potentially the world – for whom air pollution is listed as a cause of death.
The Coroner found that air pollution levels near Ella’s home exceeded WHO guidelines EU lawful limits over the three years prior to her death and this materially contributed to Ella’s death. The Coroner said the principal source of Ella’s exposure was traffic emissions.
The Coroner stated that there was a recognised failure to reduce the level of NO2 which possibly contributed to her death. He also recognised the lack of information given to Ella’s mother, which possibly contributed to her death.
It will now be stated in Ella’s death certificate that she died from the following causes:
1a) acute respiratory failure
1b) severe asthma
1c) air pollution exposure.
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The Coroner referred to a picture of Ella taken shortly before her 9th birthday which was in the Coroner’s court during the inquest. “It shows someone with very bright brown eyes and a smile that seems to be even larger than the photograph itself. What is clear from everything I’ve read about Ella, is her absolute determination…we have a great many reasons to thank you [Rosamund] in getting us here.”
Ella’s mother, Rosamund, gave evidence during the inquest and said that Kissi-Debrah, her daughter had been taken to hospital about 28 times during her life after suffering acute asthma attacks and seizures. Hours before she died in February 2013, she said she had read to Ella in bed after the family had eaten a meal together on Valentine’s Day evening. “I had printed off Beethoven’s love letters that day, so that was the last thing I read to her.”
A few hours later her daughter woke and needed her asthma pump. She woke again struggling to breathe and her mother called an ambulance that took her to Lewisham hospital, where her condition deteriorated. “I begged the consultant – I knew we were in trouble,” her mother said. But they were unable to save her daughter, she told the inquest. “Not this time.” Ella was declared dead at 3.27am on 15 February.
93% of the world’s children under the age of 15 breathe bad air and researchers have found that air pollutants can breach a mother’s placenta and potentially reach fetuses in the womb. The World Health organisation estimates that in 2016, 600,000 children died from acute lower respiratory infections caused by bad air. Currently half the world does not have access to the necessary data to address the health threat while countries with air pollution laws regularly breach them.
Earlier Governor Arnold Schwarzenegger has expressed his support for Rosamund and the family calling her a ‘hero’.
Ella Kissi-Debrah died in February 2013 following three years of seizures and 27 visits to hospital for breathing problems. An inquest in 2014, which focused on the nine-year-old’s medical care, ruled she died of acute respiratory failure as a result of a severe asthma attack. After years of campaigning, in December 2019, the family’s legal team were successful in their application to the High Court to reopen the inquest in light of new evidence regarding air pollution levels.
The full inquest, which began on November 30 and ran for 10 days, considered whether air pollution caused or contributed to Ella’s death and how levels were monitored at the time. Other issues addressed at the inquest included the steps taken to reduce air pollution, and the information provided to the public about the levels, its dangers and ways to reduce exposure.
Rosamund, Ella’s mother, has become an important voice in the clean air movement, setting up a foundation (The Ella Roberta Family Foundation) to improve the lives of children suffering from asthma and becoming a World Health Organization advocate for health and air quality. A number of government departments as well as the Mayor of London have been identified as Interested Persons in the case.
The World Health Organisation states that ambient air pollution causes 4.2 million deaths a year globally, while 3.8 million deaths are caused by household exposure to dirty cookstoves and fuels. 91% of the world’s population live in places where air quality exceeds WHO guidelines.