A photograph taken in London on November 30, 2020 shows a mobile phone displaying a photograph of Ella Adoo-Kissi-Debrah who died in February 2013 from a severe asthma attack. (AFP/Hollie Adams)
The mother of a nine-year-old British girl who died after a severe asthma attack called on Wednesday for a public health campaign warning of the dangers of air pollution, after a coroner ruled it contributed to her death.
In a legal first, coroner Philip Barlow said poor air quality from vehicle emissions made a "material contribution" to the death of Ella Adoo-Kissi-Debrah in 2013.
London Mayor Sadiq Khan called the ruling a "landmark moment" and called air pollution a "public health crisis", while campaigners said it should now lead to an overhaul in policy.
Ella's mother, Rosamund, welcomed the coroner's ruling, which she said should contribute to improving the lives of children struggling with asthma because of poor air quality.
"As we walk around our city, there are still illegal levels of air pollution. This matter is far from over," she told reporters.
"There needs to be a whole health campaign about this. This is a very serious health matter... Hopefully this (ruling) will change that."
Ella died of acute respiratory failure in February 2013 after a serious asthma attack. She had been taken to hospital nearly 30 times in the previous three years with breathing difficulties.
The young girl lived in southeast London just 30 meters from a major ringroad in the British capital which is often clogged with heavy traffic.
The coroner's ruling is the first to have poor air quality recorded as a factor on a death certificate.
Barlow said Ella was "exposed to levels of nitrogen dioxide in excess of World Health Organization guidelines. The principal source of her exposure was traffic emissions".
He said it was also important to record a "recognized failure" to reduce those NO2 levels to within UK and EU limits, "which possibly contributed to her death".
Information was not provided to her mother that may have prompted her to take action that might have prevented the girl's death, he added.
A first inquest in 2014 determined that Ella died of acute respiratory failure. But the ruling was overturned and a new hearing ordered after a review of the case.
Air pollution expert Stephen Holgate found a "striking link" between spikes in NO2 and harmful particulate matter and the occasions that she was taken to hospital for treatment.
He told the inquest she was "living on a knife edge" because of her surroundings and the air quality in her neighborhood, 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 University of Southampton.
Public health emergency
The inquest was told that air pollution had been a known factor in worsening asthma, including in children, for at least four decades.
Air pollution readings one mile (1.6 kilometers) from Ella's family home consistently broke lawful EU limits in the three years before her death, the coroner was told.
Rosamund Adoo-Kissi-Debrah said she would have moved from the area had she been aware of the effects of air quality on her daughter's health.
She now wants a new Clean Air Act to be her daughter's legacy.
The British Lung Foundation and Asthma UK said the inquest had laid bare the "invisible dangers of breathing dirty air".
"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 crisis," said co-chair Sarah Woolnough.
Between 28,000 and 36,000 deaths in Britain each year are thought to be linked to air pollution.
According to figures from the London mayor's office, WHO-recommended limits for air pollution are broken in virtually all of the British capital.
Across the world, the global health body says air pollution kills some seven million people every year and nine out of 10 people breathe air that exceeds guideline limits on pollutants.
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