Air pollution contributed to nine-year-old's death - inquest

Ella Kissi-Debrah is believed to be the first person in the UK to have air pollution listed as the cause of death on their death certificate, following the ruling by assistant coroner Philip Barlow at a second inquest into her death.

Mr Barlow also said there was a "recognised failure" to cut levels of pollutant nitrogen dioxide to within limits set by EU and domestic law, which possibly contributed to her death.

It marks the culmination of a long battle by Ella's mother, Rosamund Kissi-Debrah, to have the role of air pollution in her daughter's death recognised.

In the wake of the ruling, she said: "We've got the justice for her which she so deserved."

But with other children still exposed to illegal levels of air pollution, "the matter is far from over", Ms Kissi-Debrah said.

She said she wanted Ella's legacy to be a new Clean Air Act and for governments around the world to take the problem seriously, adding that more detail would be coming in the new year on "Ella's Law".

After the coroner found Ms Kissi-Debrah had not been given information on air pollution that might have helped prevent Ella's death, she also called for more information to be made available and a public awareness campaign to teach people about the damage caused by pollutants.

The family's legal team said the official recognition of the part played in Ella's death by high levels of pollutants in the air around where she lived made it a "landmark ruling".

Family lawyer Jocelyn Cockburn, of Hodge Jones & Allen Solicitors, said there had been a "massive failure" to consider the effect of air pollution on people's lives and that the ruling should prompt "joined-up Government action" to ensure "lives are saved from air pollution".

She said pressure is now likely to build on the Government to adopt World Health Organisation (WHO) guideline levels "so that the population, particularly those in polluted areas like Ella, are not exposed to very high levels of air pollution".

In the wake of the ruling, campaigners called for immediate action to protect people from pollution such as nitrogen dioxide and small particles known as particulate matter (PMs), which are linked to a catalogue of health problems and play a role in the equivalent of 40,000 early deaths a year in the UK.

Much of the country suffers from illegal levels of nitrogen dioxide, which comes from sources such as traffic, as towns and cities continue to breach limits that should have been met a decade ago.

Ella lived 25 metres from the South Circular Road in Lewisham, south-east London - one of the capital's busiest roads.

She died in February 2013, having endured numerous seizures and made almost 30 hospital visits over the previous three years.

A previous inquest ruling from 2014, which concluded Ella died of acute respiratory failure, was quashed by the High Court following new evidence about the dangerous levels of air pollution close to her home.

Giving his narrative conclusion at Southwark Coroner's Court after a two-week inquest, Mr Barlow said: "I will conclude that Ella died of asthma, contributed to by exposure to excessive air pollution."

He included air pollution exposure in the medical cause of death, and said: "Air pollution was a significant contributory factor to both the induction and exacerbations of her asthma.

"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 Organisation (WHO) guidelines.

"The principal source of her exposure was traffic emissions.

"During this period there was a recognised failure to reduce the level of nitrogen dioxide to within the limits set by EU and domestic law, which possibly contributed to her death."

A 2018 report by Professor Stephen Holgate found that air pollution levels at the Catford monitoring station one mile from where Ella lived "consistently" exceeded lawful EU limits over the three years prior to her death.

During the inquest, Sir Stephen described Ella as a "canary in a coalmine", highlighting the risk of pollutants such as nitrogen oxides (NOx) to other Londoners.

The fresh inquest had been listed under Article 2 - the right to life - of the Human Rights Act, which scrutinises the role of public bodies in a person's death.

Sarah Woolnough, chief executive of Asthma UK and the British Lung Foundation, called on the Government to set out a health protection plan, including efforts to make sure people are getting the information they need to protect their health.

"Today's verdict sets the precedent for a seismic shift in the pace and extent to which the Government, local authorities and clinicians must now work together to tackle the country's air pollution health crisis," she said.

Katie Nield, a lawyer for the environmental legal charity ClientEarth which has won three court cases against the Government over its failure to curb pollution in line with the law, said: "The inquest has thrown into sharp relief just how long the Government has known about the harm that air pollution wreaks on people's lives and how slow they have been to react."

She called on the Government to commit to a legally binding target to achieve WHO guideline levels of harmful fine particulate matter pollution by 2030 at the latest.

A Government spokesperson said their thoughts remained with Ella's family and friends.

They said the Government was taking action on the issue, including a £3.8 billion plan to clean up transport and tackle pollution and plans for "ambitious" air quality targets in the new Environment Bill.