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Explained: In UK, examining the world’s first ‘foul air death’

Ella’s death could become possibly the first in the world to be legally certified as having been caused by “air pollution”.

Ella Adoo Kissi-Debrah (Source: ellaroberta.org)

An important inquest is underway in London to determine whether air pollution caused or contributed to the death in February 2013 of a nine-year-old child, Ella Adoo Kissi-Debrah, who lived with her mother near a busy road in London.

Ella’s death could become possibly the first in the world to be legally certified as having been caused by “air pollution”.

Illness and death

For three years before she died, Ella Adoo Kissi-Debrah had suffered seizures, and had made 27 visits to hospital after having problems breathing. She lived less than 30 metres from the South Circular, a busy and congested arterial road in Lewisham in southeast London.


In 2014, an inquest focused on medical care provided to the child found she died of acute respiratory failure as a result of a severe asthma attack. In December 2019, her family was successful in their application to the High Court to reopen the inquest in the light of new evidence regarding air pollution levels. 📣 Follow Express Explained on Telegram

The second inquest

The full inquest that began on Monday will continue for approximately 10 days, and will consider whether air pollution caused or contributed to Ella’s death, and how pollution levels were monitored at the time. Issues such as steps taken to reduce air pollution, and information provided to the public about the levels, the dangers, and ways to reduce exposure, will also be taken up.

A report by the acclaimed expert Prof Stephen Holgate had said that air pollution levels near Ella’s home “consistently” exceeded lawful EU limits over the three years prior to her death. The inquest will look at potential failings by the authorities to take adequate steps to reduce pollution and provide the public with information about the risks of air pollution, and the extent to which they contributed to Ella’s death.

Significance of case

If the campaign by the family is successful — Ella’s mother Rosamund, an important voice in the clean air movement, has set up The Ella Roberta Family Foundation to help improve the lives of children suffering from asthma — Ella will become the first person in the United Kingdom, and possibly in the world, to have air pollution recorded as the cause of death.

Apart from setting this legal precedent, the hearing could also determine whether Article 2 of the European Convention on Human Rights is engaged — in terms of arguable failures by the UK authorities — such that Ella should have been afforded a ‘right to life’.

Prof (Dr) Arvind Kumar, Founder Trustee of Lung Care Foundation (India), told The Indian Express that the inquest in Ella’s death could ultimately end up saving the lives of millions of children around the world, including in India. “By confirming that the air pollution in Ella’s London neighbourhood caused the asthma attacks that killed her, this inquest would make clear that a government’s obligation to protect our right to life includes ensuring our right to breathe clean air. Toxic air causes 7 million premature deaths every year worldwide, and kills 500,000 children under 5 years old. Clean air is a human right, and it’s time governments did something about it,” Prof Kumar said.

Dr Sundeep Salvi, founder of Pulmocare Research and Education Foundation, said the ongoing proceedings in the UK could have far-reaching implications for Indian courts, as the levels of air pollution in India are several times higher than what is found in the UK.

Killer air pollution

According to the World Health Organisation (WHO), ambient air pollution causes 4.2 million deaths every year globally. Another 3.8 million deaths are caused by household exposure to dirty cookstoves and fuels. Ninety-one per cent of the world’s population lives in places where the air quality is worse than is recommended by WHO guidelines.

Dr Maria Neira, Director of WHO’s Department of Environment, Climate Change and Health, said in a statement: “Air pollution is a silent killer, and more than 90% of the world’s children breathe toxic air every day. This inquiry into the premature death of Ella Kissi-Debrah at 9 years old shines the spotlight on the unhealthy levels of pollution that most of our young ones are exposed to. The inquest could create an important legal precedent, and strengthen the case that everyone has the human right to breathe clean air.”

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