Coroner calls for legally binding targets for particulate matter based on WHO guidelines, urges range of bodies to take action on air quality

Lewisham Council is amongst 14 government, educational and professional organisations being called upon by a coroner to address air pollution after poor air quality led to the death of a nine-year-old girl.

Ella Adoo-Kissi-Debrah, the first person in the UK to have "air pollution exposure" listed as the cause of death on their birth certificate, lived near the South Circular road in Lewisham. In 2013, she died of asthma contributed to by exposure to excessive air pollution.

Coroner Philip Barlow found that 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 Organization Guidelines. The principal source of her exposure was traffic emissions."

Mr Barlow, in his inquest, raised three matters of concern. Firstly, the national limits for particulate matter are set at a level far higher than the WHO guidelines. The evidence at the inquest was that there is no safe level for particulate matter. In light of this, "the WHO guidelines should be seen as minimum requirements," Mr Barlow said.

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He went on to say that legally binding targets based on WHO guidelines would reduce the number of deaths from air pollution in the UK.

Secondly, Mr Barlow said that national and local government have a responsibility to publicise information regarding air pollution and its effects on health, which they are not fulfilling.

"It was clear from the evidence at the inquest that publicising this information is an issue that needs to be addressed by national as well as local government," Mr Barlow said.

"The information must be sufficiently detailed and this is likely to require enlargement of the capacity to monitor air quality, for example by increasing the number of air quality sensors."

Thirdly, Mr Barlow raised concerns that the adverse effects of air pollution on health are not being sufficiently communicated to patients and their carers by medical and nursing professionals.

Mr Barlow found the evidence at the inquest was that this should be addressed at three levels in which medical professionals receive training: Undergraduate, Postgraduate and Professional guidance.

Action should be taken by the recipient organisations sent the report on all three concerns in order to prevent future deaths.

According to Mr Barlow, the first concern should be addressed by the Central Government Departments (Defra, DfT and DHSC); the second concern should be addressed by the Central Government Departments, the Mayor of London and the London Borough of Lewisham; and the third concern should be addressed by the named professional organisations. 

The government departments and institutions that have received the report are under a duty to respond to Mr Barlow's report by 17 June 2021.

Their response must contain details of action taken or proposed to be taken, setting out the timetable for action. Otherwise, they must explain why no action is proposed.

The coroner sent the report to the following institutions:

  • Department for Environment, Food and Rural Affairs, Defra
  • Department for Transport
  • Department of Health and Social Care
  • Mayor of London
  • Transport for London
  • London Borough of Lewisham
  • General Medical Council
  • Health Education England
  • Nursing and Midwifery Council
  • Royal College of Physicians
  • Royal College of Paediatrics and Child Health
  • Royal College of General Practitioners
  • NICE
  • British Thoracic Society

Adam Carey

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