The government knew for years of nitrogen dioxide levels in London exceeding legal limits and the polluter’s associated risk to health, Southwark Coroner’s Court heard on Wednesday.

Central government had been warned of nitrogen dioxide levels since 1999, Richard Hermer QC, representing the family of nine-year-old Ella Roberta Adoo Kissi-Debrah, who died from asthma in 2013, argued at the new hearing into her death. He said: “They had about 20 years to reach the legal levels.”

Dr Bill Parish, deputy director and head of air quality and industrial emissions, said: “It is recognised that NO2 causes health outcomes that in some cases might lead to mortality.”

Ella lived in close proximity to the South Circular Road in Lewisham, one that has high emission levels. Hermer suggests it is likely she was exposed to unlawful levels of NO2 and particle matters – the polluters central to the inquest – for all nine years of her life.

Nine-year-old Ella Roberta Adoo Kissi-Debrah died in February 2013, with a fatal asthma attack listed as the cause of death. She lived within 25 meters from the busy South Circular road in Lewisham, a route she also often walked to school. The road had levels of air pollution exceeding the legal limit. She was admitted to the hospital 27 times between 2010 and 2013.

Ella’s mother, Rosamund Kissi-Debrah, campaigned for an inquest. This was granted after a report by Professor Stephan Holgate, one of the UK’s leading experts on asthma and air, found a ‘striking association’ between Ella’s hospital admissions and spikes of nitrogen dioxide and PM10 levels – the most severe polluters. The inquest takes place under Article 2 of the Human Rights Act, the right to life, which scrutinises the role of public bodies, such as local authorities, in a person’s death

In 2011 an air quality action plan was put in place by central government for Greater London, as the zone exceeded emission limits. Currently, an estimated 99 per cent of Londoners are exposed to exceeding particle matter levels.

Parish said: “The medical and scientific opinion is that there is no safe level of these emissions for people to be exposed to at any time. So it’s a reasonable conclusion that everyone living in areas with particle matter levels above the limit in WHO guidelines [and EU legislation] is at a continuous risk.”

“Frustrated”

On Tuesday, Philip Graham, executive director of the Greater London Authority’s Good Growth fund, told the Court that all three of London’s mayors since the position was created in 2000 had found it “more of a source of frustration than an effective means of change” to appeal for government support to tackle emission levels in the city.

Sadiq Khan, Ken Livingstone and Boris Johnson had all attempted to pursue clean air policies, such as changes to vehicle taxes, a national framework for low emission zones and an electric bus fleet. But all needed government support. Graham said: “In few, if any, cases has the government’s response been positive.”

Ken Livingstone, serving as mayor of London from 2000 to 2008, was already concerned about the lethal potential of nitrogen oxides in 2002. In a strategy published at the time, he warned London would struggle to meet its air quality targets without government funding.

“Going slowly”

Parish said the government is working to make information on air pollution more accessible, but they are struggling: “It’s going slowly. There’s quite a lot to do in terms of training [medical professionals] by explaining the different polluters and how to turn that into specific advice.”

“If you want to offer [information on air pollution] in a package at a GP for example, it has to compete with a lot of other messages on exercise and diet. It will get lost in all other information and not have as much of an impact. Also, behavioural change is difficult to achieve. People who are not vulnerable will get tired of being told not to use their car to lower emissions.”

The inquest that will determine whether air pollution caused or contributed to Ella’s death, and if local authorities or central government can be held responsible, will continue tomorrow.

Read the rest of our coverage here:
– Lewisham failed to treat air pollution as ‘public health emergency’ inquest told
– Inquest to rule on whether air pollution led to Lewisham child’s death
– Calls for new inquest into ‘air pollution’ death