How anti-Ulez campaigners misused air pollution finding in Ella Adoo-Kissi-Debrah death

Impact of Air Pollution on Children’s Health in London

Rosamund Adoo-Kissi-Debrah reserves a withering eye roll for people who question the impact that air pollution has on the health of children living in London. It helps her to shrug off the increasingly politicised debate over what needs to be done to improve the capital’s air quality.

Landmark Ruling on Air Pollution

Adoo-Kissi-Debrah fought a calm and determined campaign for seven years to make sure air pollution was included on her daughter Ella’s death certificate, and in December 2020 a second inquest ruled that air pollution contributed to Ella’s death from asthma in 2013.

It was a landmark moment, the first time air pollution had been cited as a factor on a death certificate. But recently, as the row about London’s ultra-low emission zone (Ulez) expansion has intensified, some anti-Ulez campaigners have wilfully inverted the unprecedented finding and attempted to minimise the problem, declaring that only one person has died in the UK of air pollution-related causes since 2001.

On GB News earlier this year, Jacob Rees-Mogg questioned the estimate of about 4,000 pollution-related excess deaths regularly cited by the London mayor, Sadiq Khan.

“Our team actually checked the Office for National Statistics figure on deaths caused by pollution between the years 2001 and 2021. One death has been caused by car emissions in London. So there’s a vast disparity here between what Mr Khan claims and what is suggested by the ONS,” he said.

A freedom of information response from the ONS, frequently shared by air pollution sceptics on Facebook and Twitter, states: “One death in England and Wales in the period 2001 to 2021 had exposure to air pollution … recorded on the death certificate.”

The conclusion drawn by those sharing the information is that if only one death has been recorded then the threat from air pollution must have been overstated.

The Complexity of Proving Air Pollution’s Role

A schoolteacher who has given classes in statistics, Adoo-Kissi-Debrah is particularly vexed by the misuse of the figure.

“Politics has got hold and it’s been turned on its head in a bizarre way. People say this to me all the time, trying to tell me that pollution is not a problem, that only one person has died from it. I try not to respond. When people feel they can’t win the argument, they resort to these tactics,” she said.

Rees-Mogg “is playing politics with this. He is manipulating the public. He’s an intelligent man and knows exactly what he’s doing,” she added. “I’m tired. This makes my job of raising awareness more difficult.”

The ONS response also makes clear that epidemiological studies estimating numbers of deaths that can be attributed to poor air quality may be more informative, and notes that it is “unusual for wider contextual factors such as exposure to car emissions, pollution or air quality to be recorded among the causes of death”. But neither Rees-Mogg nor online sceptics quote this part of the response.

The Health Impacts of Air Pollution

There is a growing body of scientific evidence indicating that excessive exposure to air pollution raises the risk of cancer, dementia, strokes and heart attacks as well as respiratory illnesses. A comprehensive global review in 2019 concluded that air pollution may be damaging every organ in the body.

Air pollution has been linked to almost a million stillbirths a year. Official government estimates say between 28,000 to 36,000 deaths in the UK annually are caused by long-term exposure to humanmade air pollution.

Yet no one else has had the words “air pollution” put on their death certificate, and the lack of other individuals for whom it can be incontrovertibly stated that their health has been damaged by poor air quality makes this a largely invisible problem.

The Challenges of Identifying Air Pollution as a Cause of Death

As the fight over the London’s clean air zones becomes more intense, the absence of other cases has created some problems for scientists and campaigners. Why does Ella’s death remain the only time a coroner has highlighted the role of air pollution on a death certificate?

From a distance, the lone instance seems puzzling and open to malicious distortion, but those close to the case know the complexities involved in proving the role played by air pollution.

Prof Frank Kelly, the chair in community health and policy at Imperial College London’s Global Centre of Air Pollution Research, said the medical system was “failing us by not recognising that air quality is a contributing factor” to the earlier deaths of thousands of people a year.

He acknowledged that it was unlikely that the inquest’s recognition that Ella’s death was linked to air pollution would swiftly open the way for other deaths to be similarly classified.

“I don’t see it happening again in the near future,” he said. The unprecedented scientific investigation mounted by Prof Sir Stephen Holgate, one of the UK’s leading experts on air pollution, and Rosamund Adoo-Kissi-Debrah was so exceptional that it would be unrealistic to expect more cases to follow.

In Ella’s case, Holgate was able to link 27 of her asthma-related hospitalisations with precise information about air pollution levels in the exact area where she lived, 25 metres from London’s congested South Circular.

Holgate himself is not optimistic that Ella’s inquest will open the way for air pollution to be highlighted on other people’s death certificates.

“This is exactly what we should be trying to do now, and have failed as a health community – to be able to pin down other cases,” he said.

He set out why her case was so unusual. “She was perfectly well; she went from a normal child, to a child aged nine who died from a disease that is entirely treatable. This was the most severe case of asthma I’ve ever seen in my life, and I’ve spent 45 years researching the causes of asthma; this was by no means routine asthma.”

Crucially, there was sophisticated air quality monitoring close to where she was living.

“It was fortuitous that she lived a mile away from a monitored site. For most people in the country, that isn’t the case because air quality is monitored by about 500 monitored sites, so there are two or three maybe in each city,” he said.

There was also a second set of pollution data that Holgate could draw on because the local council was planning to change the local bus fleet and was monitoring nitrogen dioxide (NO₂) pollution levels.

“We had

SDGs, Targets, and Indicators Analysis

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 11: Sustainable Cities and Communities
• SDG 13: Climate Action

The article discusses the impact of air pollution on health, particularly on children living in London. This connects to SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages. It also relates to SDG 11, which focuses on making cities inclusive, safe, resilient, and sustainable. Additionally, the article mentions the need to address air pollution as part of climate action efforts, aligning with SDG 13.

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 3.9: By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination.
• SDG 11.6: By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality and municipal and other waste management.
• SDG 13.1: Strengthen resilience and adaptive capacity to climate-related hazards and natural disasters in all countries.

The article highlights the need to reduce deaths and illnesses caused by air pollution, aligning with SDG target 3.9. It also emphasizes the importance of addressing air quality in cities, which relates to target 11.6. Furthermore, the article mentions the impact of air pollution on climate-related hazards, connecting to target 13.1.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Number of deaths and illnesses attributed to air pollution
• Air quality index or levels of pollutants in specific areas
• Adoption and implementation of clean air policies and regulations

The article mentions the number of deaths caused by air pollution and highlights the need for more cases to be recognized and recorded. This indicates the importance of tracking the number of deaths and illnesses attributed to air pollution as an indicator of progress towards target 3.9. The article also discusses the need for air quality monitoring and the installation of more air pollution monitors, which can be used as indicators to measure progress in improving air quality in cities. Additionally, the adoption and implementation of clean air policies and regulations can serve as indicators of progress towards targets 11.6 and 13.1.

Table: SDGs, Targets, and Indicators

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Source: theguardian.com

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