London girl could be first to have “air pollution” listed as cause of death

https://www.cbsnews.com/news/ella-kissi-debrah-could-become-first-death-attributed-to-air-pollution-in-united-kingdom/

by DoreenMichele • 7 years ago

166 91 7 years ago

cbsnews.com

tsomctl• 7 years ago

https://en.wikipedia.org/wiki/Great_Smog_of_London

paulddraper4• 7 years ago

I don't know how this normally works.

But isn't "air pollution" an overly ambiguous cause of death?

Could be lung cancer, injury, asphyxiation, etc.

It seems a bit like listing "sugar" as the cause of death.

Funes-• 7 years ago

Well, if it is confirmed that it had a decisive role in this unfortunate event, I guess it would be fair to say that air pollution is one of the primary causes of the development of the subsequent ailments she went through, which ultimately lead her to her death. If removing air pollution from the equation would have saved her life, I think it's reasonable to say that it was, if not the sole cause of her death, one of the causes.

maxk42• 7 years ago

Asthma was her cause of death. It may be due to a genetic disorder, a disease, or some other cause. But air pollution was not definitively shown to be the cause of her death. This is a political move committed by Stephen Holgate, the former chair of the U.K. government's advisory committee on air pollution. The article pretty much spells that out.

briandear2• 7 years ago

So are Pepsi or hamburgers listed as a cause of death when someone dies of a heart attack due to obesity? Calling air pollution a cause of death is a stretch.

eeZah7Ux• 7 years ago

No.

Example: If a person made to ingest something that leads to immediate cardiac or respiratory failure we call it "poisoned to death".

Same for "being stabbed" rather than "cardiac failure due to blood loss"

briandear2• 7 years ago

But she lived in that street for years. Just like someone might have eaten cheeseburgers for years and died of a heart attack. You don’t say that someone died from chronic cheeseburger ingestion.

paulddraper4• 7 years ago

Those are causes of death.

ICD-10 has X85 "Assault by drugs, medicaments and biological substances" and X99 "Assault by sharp object". [1]

But it is unprecedented (AFAIK) to specify an external cause that is so far removed from the point of death.

E.g. assuredly people have died from the long-term effects of tanning, but "sun tan" is not considered to be a cause of a death.

[1] http://apps.who.int/classifications/apps/icd/icd10online2005...

chabes3• 7 years ago

From the article: “Ella lived near a busy street where pollution levels were consistently recorded at above the legal limit between 2010 and her death in 2013.”

It seems there was legislation, enacted to protect people, that was ignored for years. The child’s death was not of their own doing, so I’m not sure why folks are even mentioning sugar or cheeseburgers.

lnsru• 7 years ago

I am just thinking about fireworks during New Year’s celebration. We pollute all major cities all over the world for 2 days just like that and then complain about pollution. Insane!

Edit: I see many people here like fireworks. But if we as humanity can’t handle this crazy stupid pollution source, we also cannot do anything else. Forget handling diesel car pollution or improving public transport.

Al-Khwarizmi• 7 years ago

Not to defend the fireworks, but between pollution one night a year and pollution 24 hours a day, 356 days a year from the diesel cars going through my street and neighboring streets all the time... I know what I should be most worried about, and it's not the fireworks.

ghobs91• 7 years ago

The cause of death is respiratory failure, not "air pollution". I'm getting real tired of even big names like CBS getting in on this clickbait game.

habnds5• 7 years ago

That's like saying someone who bleeds out after being shot died of "circulatory failure". Words have meanings and you don't get to redefine things to make yourself feel better. The court ruled that the girl wouldn't be dead if not for years of illegal air pollution. It's a fact.

matz14• 7 years ago

Both are correct, both are fact, it's up to you to decide which are more important to you.

paulddraper4• 7 years ago

No, it's not like at all.

For death by firearm discharge, the coroner would indicate W34, X74, X94, X95, Y35, or Y36 (depending on the reported circumstances: suicide, homocide, legal action, or war). [1] This cause of death is readily determined by the autopsy and reported immediate circumstances.

Changing the cause of death to air pollution rather than asthma (J45) requires lengthy investigation into years of the deceased's lifetime. It would be infeasible to use that as an actual classification.

---

An actually comparable (and practically relevant) situation is changing cause of death from lung cancer (C34) to smoking. "Smoking" is not a cause of death recognized by the CDC, WHO, or any other health organization; it's a underlying factor. This is why you'll see statistics on smoking-related deaths.

[1] http://apps.who.int/classifications/apps/icd/icd10online2005...

klodolph• 7 years ago

https://en.wikipedia.org/wiki/Between_Planets

[..] he is told that his friend has died of "heart failure." It is only later that he realizes that all deaths can be described that way.

hanniabu• 7 years ago

Cause of death lists the root cause, so while she may have died from respiratory failure, she had respiratory failure due to air pollution.

sjg007• 7 years ago

Maybe now the U.K. will do something about truck, bus and automobile particulates.

reaperducer• 7 years ago

Considering the number of people in this thread defending pollution and blaming the dead girl or her parents, I wouldn't count on it.

Some days HN goes from its usual baseline mechanical callousness to outright horror film.

llamathrowaway• 7 years ago

I don’t think anyone is actually defending pollution. Those who say ‘meh it’s asthma not pollution’ just enjoy being a contrarian, who would point out any perceived ‘error’ in others’ words. They don’t really have any agenda to push nor any opinions of their own that worth posting. Just nitpicking here and there to show how others are ‘wrong’.

Back to the topic, I wish we could ban diesel ASAP. I passed through Oxford Street a few times when it was virtually shut off by the protesters last month, so none of the diesel-burning black cabs not busses were there. It was much, much more pleasant than any other busy London street, almost serene, if there were not that many shoppers...

adventured• 7 years ago

Has the UK begun adopting electric buses? They seem to be getting tested or rolled out gradually everywhere these days.

cardinalfang• 7 years ago

London had the largest trolley bus network in the world until about 1960 when about 2000 electric buses were replaced with diesels.

DanBC• 7 years ago

Yes, but it's a slow process. https://en.wikipedia.org/wiki/Low_emission_buses_in_London

ptaipale• 7 years ago

This tells perhaps more about the politics of naming causes of death than actual historical causes of death, considering the history of air pollution and smogs in London.

pinewurst• 7 years ago

https://en.wikipedia.org/wiki/Great_Smog_of_London

esotericn11• 7 years ago

I'm very familiar with this part of London. I haven't quite lived on the road in question but I know people who have. It's not clear the exact location but I imagine it to be near a busy junction with lots of vehicles idling.

Ultimately in a system where people bid for housing this sort of thing is bound to happen. It's notably cheaper to live on a main road, near a pollution hotspot, etc; there's also commonly social housing in those sorts of locations, which makes moving less about marginal income and more about navigating a bureaucracy (if you're paying below market rent you may need double or triple the amount to move to a nearby privately rented place).

In my view we should heavily tax diesel cars out of existence, at least in busy cities. The alternatives are to either demolish large amounts of housing (the South Circular Road and A2 in London are lined with residential; so too are most major roads in the capital), to basically delete the road network, or to accept these deaths as a way of life.

osrec• 7 years ago

I believe they've started the taxation in some sense. I can no longer drive my old diesel car in London without paying £18 per day for the privilege. That's enough to make me never want to drive it in central London.

esotericn11• 7 years ago

The South Circular Road (where this girl lived) is due to be the boundary of the ULEZ[1] in 2021 when it is expanded.

At the moment it only covers a very small area of the central congestion zone (smaller than Zone 1).

If anything the pollution there is likely to become worse as it forms the official diversion.

We already see this; Marylebone Road, the current northern boundary of the ULEZ and Congestion Charge zone, is one of the most polluted roads in the capital.

I work around there. Me and my team actively avoid walking along the main road for that reason.

[1] Ultra Low Emission Zone https://tfl.gov.uk/modes/driving/ultra-low-emission-zone

7952• 7 years ago

I wish they would just ban these dirty cars completely from the zones. Being able to poison the air is not a privilege that you should be able to buy. It turns a moral issues into a financial one.

mjevans• 7 years ago

The closer to "Caves of steel" (Azimov) for cities, the better.

SlowRobotAhead• 7 years ago

In my view we should heavily tax diesel cars out of existence, at least in busy cities.

Strong opinion you have there. How much do you know about Diesel engines that utilize DEF? And how do you weigh NOX output against that from a petrol engine?

Or do you have strong opinions without knowing the actual science behind this? Because I’d like to see your sources that show modern diesels should be taxed out of existence.

Edit: Nope, turns out I received no support for the argument at all but rather OP really just means for all cars to be banned or at least taxed so only rich people can drive in London. Because when I go to Singapore with its like tax model I see equality, and opportunity!

esotericn11• 7 years ago

This is all band-aid style stuff. The real issue is that personal cars don't need to be driven in Inner London, petrol or diesel. It's simply unnecessary, public transport here is fantastic and more buses could easily pick up the slack.

A blue-badge style disabled exemption, and more frequent inspections for things like emergency services / trade vehicles. Done.

The diehards can use electric cars if they wish.

Lewisham/Hither Green, where this girl lived, has frequent trains into Central London (15-20mins), buses all over the place, and Google Maps' current estimate to cycle in to London is 33 mins (vs 36 mins for driving).

village-idiot4• 7 years ago

Modern diesel cars are not economically viable if you reduce NOx emissions down to acceptable rates. That’s exactly why all the manufacturers cheated, to be able to claim lower emissions while maintaining engine reliability and MPG performance. If you actually reduced emissions properly, the resulting engine wouldn’t be economically viable compared to their gasoline alternatives.

alimw2• 7 years ago

there's also commonly social housing in those sorts of locations

I never noticed this. Is there some reason for it or just your general impression?

esotericn11• 7 years ago

I think you're misinterpreting my comment; I'm not stating that the majority of social housing is located in high pollution areas but rather that some of it is (a decent amount).

These people are effectively in a sort of rent-control style scenario in which moving out and in to privately rented accommodation might mean doubling the rent and moving from a stable long-term tenancy to a yearly thing.

They technically have the ability to move whilst being heavily discouraged from doing so.

This is quite different to, for example, someone who owns or rents a house that costs 25% more than an equivalent one in a side street, say. It's more of a cost benefit analysis for them.

There is however the issue still that eventually, someone is going to end up living there, because housing in London isn't going to be left empty if it exists.

frereubu8• 7 years ago

I live in Brighton (55 miles south of London) and regularly come up by train. But as soon as it's more than me - my wife and daughter joining me to see an exhibition for example - it often costs more to travel by train than it does to drive (in my polluting diesel car I bought quite a while ago when people still thought they were good), including fuel, central London parking and the congestion charge, presuming we don't know three months in advance that we want to do that (when we'd be able to buy cheap super-advance off-peak tickets). The ULEZ will change that calculation a bit. But the thing I hate the very most is the reduction of government subsidies for public transport when the effective subsidies for cars - including things like NHS treatment for this poor girl - is astronomical. I would love my diesel car to be taxed out of existence. But unless there's some kind of provision for public transport (both cost and capacity) to balance that out, it's going to be a real shitshow.

esotericn11• 7 years ago

Would it not work to drive to the edge of the Oyster zone and get the train in? Somewhere around East Croydon or one of the tram stops, say? I agree that you wouldn't do it at the moment because it'd be more hassle, but if the cost went up it'd make sense right? (I'm not that familiar with the drive from Brighton but it feels like there must be a station somewhere you can use; there are tons of stations in SE London that have unrestricted parking 10 mins walk away).

I agree that National Rail pricing is absurd. We should fix that. There's this silly two-tier thing going on whereby getting a journey within the Oyster zone is trivial and getting one outside (i.e. most of the bloody country) is this escapade of finding advance tickets, finding the cheapest time, etc.

Ultimately though, things are going to get more expensive. A poster below commented something along the lines of "so only the rich should drive in London" - and that's what's going to end up happening, unless you ban driving entirely, which would be the nuclear option.

Not all problems, particularly those to do with pollution, have an easy "everyone wins" answer. It might just be the case that things we previously considered normal and standard just won't be possible if we want to preserve health and the climate.

grey-area2• 7 years ago

The congestion charge is used to fund public transport, which has massively improved since.

Please just use the train.

alexandercrohde2• 7 years ago

For anybody who thinks this type of thing is "just asthma," it may help to remember that there's strong and growing evidence that air pollution has all kinds of health effects on everybody.

For example: "Our findings add to the growing body of evidence that air pollution may play a role in autism, as well as in other neurodevelopmental disorders." [1]

1 - https://en.wikipedia.org/wiki/Air_pollution#Health_effects

village-idiot4• 7 years ago

NOx is really nasty stuff. It won’t kill you straight up like CO or CO2 can, but it can mess up a lot of various systems to the point where your lifespan is limited.

imtringued• 7 years ago

If this is related to local air pollution then what is the biggest producer of that pollution? I mean are there any coal plants or blast furnaces near her home? Was there a construction site pouring concrete or demolishing a building and creating toxic dust? Is the traffic especially bad? It is far simpler to move pollution away from locations than it is to reduce them in the first place. Therefore knowing what the source of the pollution is far more important than the pollution itself. If this death really was caused by global air pollution then good luck, nobody can help you when China and India are ramping up their pollution, certain industries might never stop emitting CO2 and capturing CO2 in the air will never be economical without a huge carbon tax.

alexandercrohde2• 7 years ago

Actually, to clarify, I believe this type of pollution is very easily stoppable at the source. There are basic "particulate filters" that could catch almost all of this pollution, and I don't believe there is any reason that they couldn't be standardized on all busses, cars, coal-power plants.

CO2 is something entirely different.

Brakenshire2• 7 years ago

I think lung problems are actually more strongly linked to Nitrogen Dioxide pollution, although particulate pollution is still an issue.

Particulate filters I think are required to be fitted for the last 10 years or so, the problem is they require frequent high speed travel to function properly, and people have routinely removed them.

esotericn11• 7 years ago

The South Circular Road is a major arterial road across Inner London which was not really "designed" as such (for a lot of its' length it is made up of a bunch of minor roads lined by terraced houses glued together).

NeedMoreTea2• 7 years ago

There's very little coal in the UK now. There are fewer than 10 coal power stations left, and the nearest is over 100 miles from London.

The specific London problem is traffic, and maybe added to by the current fashion for log stoves. You get the constant thick taste of the fumes about 10 miles outside the centre, and it's there permanently.

Just about everywhere inside the north and south circular, which is more like 4 or 5 miles outside the centre, is badly polluted, but the south circular exceptionally so - it's almost constantly gridlocked and wasn't built for the volume of traffic it has. South Circular makes it sound like a major road or city motorway - it's used as one, and was probably intended to one day be rebuilt as one. Except it's just a regular one lane each way street for most of it, with lights and junctions, and lined with houses and shops.

So dirt and grit if you leave windows open, or washing out, black gunk in the nostrils and the constant taste.

Locals get used to it to some extent. It strikes us every single time we visit the relatives down there.

village-idiot4• 7 years ago

I find the idea that log stoves are part of the problem interesting. Here in America wood burning stoves have pretty strict emissions requirements, to the point where a portion of wood burning stoves sold today actually have a catalytic converters in them to ensure complete combustion of any particulate!

Does the U.K. not have similar rules, or are all of these just grandfathered in?

dolguldur• 7 years ago

Diesel cars.

Seems like you haven’t been to the UK or Europe. The London busses and cabs are really bad. Plus all the other diesel cars with NOx emissions way past the legal limits.

Brakenshire2• 7 years ago

Categorization of cause of death is an interesting issue, there are a lot of cases like this where there are multiple contributory factors, and how you decide which to list is not clear. For instance, people don’t really die of dementia, they die of medical problems secondary to dementia, malnutrition, lack of exercise, and so on. Lung-related deaths amongst miners are related to exposure to pollution, but also to genetic predispositions which massively increase risk. If you drink enough alcohol to raise your risk of liver failure a hundred times, and die of liver failure, that’s a fairly clear causal link, but what about if you drink a smaller amount, and only increase your risk five-fold, but still die of liver failure? Or if you drink a small amount, raise your risk 20%, but still die of liver failure?

There is no hard line between someone who has rolled the dice on bad odds and come off badly, and someone who has rolled the dice on moderate or good odds but still come out badly.

For this girl, there likely would have been genetic factors or simply bad luck which compounded air pollution, but it’s difficult to say that air pollution didn’t contribute significantly as one of the causes of her death. And that is important to know, to be able to reduce deaths and ongoing poor health in the future.

As electronic medical records become more prevalent, this is going to become more important. For instance, you could look back through patients with a cause of death like this, and pick out the frequency and timing of hospitalization as linked with local episodes of air pollution, that could then be used to inform advice to patients currently suffering from the same symptoms in the same pattern. You could essentially join together medical care, epidemiology and public health in a symbiosis which could be hugely beneficial.

DoreenMichele• 7 years ago

In the US, this is a racial injustice issue.* I can't help but wonder if it is in the UK as well.

* https://ggwash.org/view/71256/why-are-city-planners-so-afrai...

esotericn11• 7 years ago

If we exclude Central London and talk about Zone 2 outwards, anecdotally I'd say it is purely based on knowing the makeup of certain neighbourhoods.

Removed from that though, you only need to make a few assumptions to come to the conclusion it would be anyway.

If we assume, say, that people would prefer to live on a side street over a main road, and then away from a junction rather than on a junction, from that it stems that it's going to be cheaper to own/rent a place in the most polluted areas.

There are differences in income and wealth by race.

crimsonalucard• 7 years ago

If everyone is responsible than no one is.

BurningFrog2• 7 years ago

A quick googling gave this historical graph of London's air pollution index: https://ourworldindata.org/london-air-pollution

The peak is at 623¹ in 1891. After another minipeak at 409 in 1935, it went down fast to 26 in 1994 and is now 16.

That's not to say this isn't a problem today. But it was much worse in the past, and this girl is far from the first to die from it.

¹ suspended particulate matter (SPM), measured in micrograms per cubic metres

inamberclad• 7 years ago

Yep, but the headline says listed as a cause of death. I don't know anyone who doesn't know about the London Fog from the industrial revolution.

BurningFrog2• 7 years ago

I think today people mostly know it from watching The Crown :)

rorykoehler• 7 years ago

Depends on the day that's in it. There have been days you could see the particles, not as a haze but as actual individual particles. I don't have asthma and London air triggered exercise induced asthma on hot calm summer days (this was 10 years ago).

thatoneuser• 7 years ago

What about people who committed suicide by running a car in the garage? What about smoking?

Sensationalism is the biggest threat to people accepting climate change in a wholesome way. Take a stand. End Sensationalism.

tomjakubowski• 7 years ago

Air pollution is, unfortunately, an issue with broader scope than just climate change, and the particular effects of the pollution that slowly killed this girl aren't related to it.

London girl could be first to have “air pollution” listed as cause of death

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