Ella Kissi-Debrah died in 2013 at the age of nine. On Wednesday she reportedly became the first person to ever have air pollution given as a cause of death on her death certificate. CNN reports on the landmark coroner's ruling regarding Ella, who lived near one of London's most highly trafficked streets in Lewisham. Her asthma was so severe that she had repeated episodes of respiratory and cardiac arrest. The BBC reports she was hospitalized 27 times over the final three years of her life, and the Guardian adds her lungs partially or fully collapsed five times. Her final cardiac arrest proved fatal. Assistant coroner Philip Barlow told a coroner's court that during those three years she "was exposed to levels of nitrogen dioxide ... in excess of World Health Organization guidelines" and beyond the limits of EU and UK law.
Ella's cause of death was initially given as acute respiratory failure, but her mother, Rosamund Kissi-Debrah, later got a call "from someone who told me [that] in the two days around Ella’s death there were big spikes in air pollution locally." The family had a University of Southampton professor look into the data and produce a report, and Stephen Holgate said he found a pattern: Ella's asthma attacks weren't tied to pollen or respiratory infections, but as air pollution levels worsened in winter, coughing fits would set in that led to secretions in her lungs and then collapses. Kissi-Debrah told the coroner that had she been informed of the pollution issues, "I would have moved straight away, I would have found another hospital for her and moved. I cannot say it enough. I was desperate, she was desperate." (Read more air pollution stories.)