British justice questions for the first time pollution in the death of a girl

British justice for the first time recognized the role of air pollution in a death, saying in a long-awaited decision that it had constituted "a material contribution" in the death of a nine-year-old girl in London .

"My conclusion is that air pollution was a material contribution to Ella's death" Adoo-Kissi-Debrah in 2013, said London Borough of Southwark deputy medical examiner Philip Barlow after two weeks of hearings that ended on Friday.

Ella Adoo-Kissi-Debrah died on February 15, 2013 of a serious asthma attack after nearly three years of repeated attacks and around thirty hospitalizations related to this disease.

She lived in Lewisham, less than 30 yards from the South Circular, a busy route in South London. 

A link "striking" between the hospitalizations of the young girl and the peaks of nitrogen dioxide 

In 2014, justice determined that she died of acute respiratory failure caused by severe asthma, not pollution.

But those findings were overturned in 2019, and a new round of hearings ordered due to new scientific evidence, including the report by UK air pollution expert Stephen Holgate in 2018. The latter noted a “striking link” between Ella's emergency hospitalizations and the recorded peaks of nitrogen dioxide (NO2) and suspended particles, the most harmful pollutants, near her home.

In his judgment, the doctor Philip Barlow established the causes of death as being firstly acute respiratory failure, second asthma from which the girl suffered and third exposure to pollution, the level of which exceeded the recommendations of the World Health Organization.

"Air pollution is an important factor contributing to both triggering and exacerbating asthma," he explained.

"Ella's mother was not informed of the health risks. (...). If she had been, she would have taken measures which could have prevented Ella's death."

Nearly 30,000 deaths a year from pollution in the UK 

During the hearings, the defense of the family of the girl had accused the authorities of the district of Lewisham of having delayed in taking action against the pollution which levels were rising.

Once the local council had assessed the borough's air quality, it took three years for an action plan to be designed and four more years for it to be formally adopted.

A representative of this council had recognized the slowness in acting.

Officials from the Ministries of Transport, Environment and Health were also heard in the proceedings.

Ella "lived on a razor's edge. This means that a very small change can have dramatic consequences," Stephen Holgate, professor of immunopharmacology at the University of Southampton, told a hearing on December 8.

He said a "hyper-secretion" of mucus in Ella's lungs caused prolonged coughing fits that got worse in the winter of 2012 "when air pollution worsened in her neighborhood" .

"I believe this is the reason why (Ella's condition) worsened during this time, as during the summer months when air pollution levels were generally decreasing, her airways were able to recover, ”he explained.

Between 28,000 and 36,000 deaths occurring in the UK each year are estimated to be linked to air pollution.