The landmark finding made Ella the first person in the United Kingdom to have air pollution listed as a cause of death. Lawyers say it might also be a world-first, with major implications for government policy.
Ella died in the early hours of February 15, 2013 after a massive asthma attack triggered cardiac arrest. In the three years prior she had suffered seizures and was admitted to hospital 27 times.
A 2014 inquest found her death was the result of acute respiratory failure, but the High Court overturned that ruling last year once new evidence emerged about air pollution in London.
Deputy Coroner Philip Barlow presided over a new two-week inquest and on Wednesday ruled Ella’s death was caused by acute respiratory failure, severe asthma and air pollution exposure.
“Air pollution was a significant contributory factor to both the induction and exacerbations of her asthma,” Barlow said.
“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 guidelines. The principal source of her exposure was traffic emissions.”
Barlow said there was a “recognised failure” to reduce pollution within European and domestic law which “possibly contributed to her death”. He also said Ella’s mother was never given information about the health risks of air pollution and its potential to exacerbate her daughter’s asthma.
“If she had been given this information she would have taken steps which might have prevented Ella’s death.”
Air pollution is estimated to cause up to seven million deaths around the globe each year but Ella will be the first victim in Britain to have it listed on a death certificate. Legal experts believe the case will put pressure on governments and councils to do more or risk lawsuits.
Respiratory disease professor Sir Stephen Holgate told the inquest Ella was a “canary in a coalmine” and governments had failed to fix what they have long known was a major problem.
A report he authored in 2018 found levels of pollution at a monitoring station 1.6 kilometres from Ella’s Lewisham home had consistently breached lawful limits in the years before the young girl’s death.
London mayor Sadiq Khan said the ruling “must be a turning point” in clean air policy.
“This is a landmark moment and is thanks to the years of tireless campaigning by Ella’s mother Rosamund, who has shown an extraordinary amount of courage,” he said.
“Toxic air pollution is a public health crisis, especially for our children, and the inquest underlined yet again the importance of pushing ahead with bold policies such as expanding the ultra-low emissions zone to inner London.”
Sarah Woolnough, the chief executive of Asthma UK and the British Lung Foundation, called on the government to craft an urgent plan to protect citizens: “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.”
Rosamund Kissi-Debrah thanked the coroner for his findings: “Seven million people around the world die every year courtesy of air pollution. Yes this was about my daughter getting air pollution on the death certificate, which we finally have and we’ve got the justice for her which she so deserved.
“But this is also about other children still who are walking around our city with high levels of pollution. And I hope you heard what the coroner said – that there are still illegal levels of pollution now as we speak. So this matter is far from over.”
Bevan Shields is the Europe correspondent for The Sydney Morning Herald and The Age.