The A205 ducks and dives as it crosses Hither Green in south London, squeezing three lanes of relentless traffic under a low railway bridge before arcing away through interwar parades of small shops and mock-Tudor semis. On an average day, according to the most recent available data, 21,670 motor vehicles pass along this stretch of the South Circular Road, generally in stop-start slow motion.
Ella Adoo-Kissi-Debrah grew up 30 yards from the railway bridge, in the home her mother Rosamund had lived in for more than a decade. In 2010, just before Ella turned seven, Rosamund took her to the GP to assess ‘a peculiar cough’. Within two months she was in intensive care, one of about 30 hospital admissions that would follow over the next two years. The eventual diagnosis was hypersecretory asthma – a rare and dangerous variant that periodically floods the lungs with mucus. This condition almost always affects children, who usually grow out of it. But Ella never had the chance. On 15 February 2013, three weeks after her ninth birthday, Ella suffered a severe asthma attack and passed away. An inquest the following year ascribed her death to acute respiratory failure.
Ella’s grieving mother only considered the influence of airborne pollution later, when a neighbour shared their research into local air-quality measurements. ‘In the evening when she had her last asthma attack,’ Rosamund Adoo-Kissi-Debrah told a reporter from Energy Live News, ‘Lewisham had one of the worst air pollution episodes ever.’ This revelation would catalyse a tireless campaign, which in December 2020 finally won her a second inquest into her daughter’s death.
Professor Sir Stephen Holgate, an authority on air quality, told the Southwark court that Ella was ‘a canary in the coal mine’ on account of her exceptionally sensitive airways. ‘When I had the opportunity to look at her lungs on the microscope,’ he later said, ‘I saw that the lining was largely stripped off [prolonged asthma can erode this lining] and therefore the chemicals in the air would interact with the nerves and the tissues directly.’
Coroner Philip Barlow delivered an historic verdict. ‘Air pollution was a significant contributory factor to both the induction and exacerbation of [Ella’s] asthma,’ he concluded. ‘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.’