Air pollution factor in girl’s death: UK court ruling can set precedent for India

United Kingdom court December 16 concluded air pollution exposure, along with asthma and acute respiratory failure, was the major cause of death of a 9-year-old girl

By Swagata Dey
Published: Thursday 17 December 2020

A United Kingdom’s court December 16, 2020 judgment concluding air pollution exposure as one of the major causes of death of a nine-year-old girl may serve as a wake-up call for India to deal with its own high levels of pollution.   

In an inquest filed at the London Inner South Coroner’s Court into the death of Ella Roberta Adoo Kissi-Debrah on February 15, 2013, deputy coroner Phillip Barrow ruled that the young girl died of asthma contributed by exposure to excessive air pollution. This is the first time in legal history that air pollution has been formally recognised as cause of death in the death certificate of an individual.

The case

Ella, born on January 24, 2004 in Lewisham in south eastern, London, suffered from hypersecretory asthma, wherein a large quantity of mucus is secreted leading to blockage of intrapulmonary airways.

The quantity and quality of the mucus is also different than routine chest infections. This led to frequent episodes of respiratory and cardiac distress, which required frequent visits to the emergency room. On February 15, 2013, during one such visit to the University Hospital Lewisham, she suffered a fatal cardiac arrest.

For Ella’s mother, Rosamund Kissi-Debrah, the battle has been long and arduous.  The family resided near South Circular Road in Lewisham, one of London’s busiest roads, with very heavy vehicular movement.

She told the court that she had no idea about nitrogen dioxide (NO2) emissions from vehicles and its associated health risks. Monitoring stations in the area have recorded very high levels of pollution, with pollutant concentration exceeding the prescribed standards.

The family along with the doctors who attended Ella, believed that if they had enough information and the financial means to move to a less polluted and congested area, Ella could have been saved.

The inquest had several experts, medical doctors and environmental strategists who served as witnesses and testified on Ella’s medical history, the exact cause and nature of hospitalisations and the deteriorating air quality of the region.

The court ruled that air pollution was indeed a significant contributory factor to both the induction and exacerbation of Ella’s asthma. It said:

“During the course of her illness between 2010 and 2013, she was exposed to excessive high levels of nitrogen dioxide and particulate matter (PM), primarily from traffic emissions.”

The court recognised the failure to reduce the levels of NO2 to below the ones prescribed by the European Union and British environmental laws, all of which contributed to her poor health and untimely death. 

The verdict has been unanimously welcomed by the UK administration and the scientific community. It is further expected to be a watershed moment towards more clean air zones in London, higher number of walking and cycling zones and faster electrification of the vehicular fleet.

Relevant for India

In India, 24 per cent of infant deaths can be attributed to air pollution. Out of a global tally of 6.67 million particulate matter (PM) 2.5-attributable deaths, 980,000 were recorded in India. The number has been steadily increasing despite our attempts to curb air pollution through national-level policies; there has been a whopping 61 per cent increase in such deaths since 2010.

These numbers, however, are put forward by the scientific community, often through esoteric literature, and do not often reach the common man.

In October 2020, Delhi-NCR experienced a another smog episode. According to several studies, bronchial asthma is now way more common in Indian children below 15 years.  Despite air pollution being declared a public health emergency and its links with increased risks of the novel coronavirus disease (COVID-19), very rarely is it listed as a specific cause of death.

Hypertension, cardiac arrests, asthma and chronic obstructive pulmonary disease (COPD) are the usual listed causes.

The courts in India have been very proactive in taking cognisance of the severe health risks of air pollution and have often pushed for “immediate solutions” towards this public health crisis. They have frequently cited Article 21 of Indian Constitution; Right to Life, which extends to the right to a pollution-free environment. With the UK judgement as a precedent, India can perhaps follow suit. 

Listing air pollution as a cause of death would perhaps be a non-cognisable offense, it will certainly help spread awareness among the public regarding the ills of air pollution and galvanize towards faster and decisive steps in curbing it. 

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