Ella Kissi-Debrah will be the first person in the UK to have air pollution officially listed as a cause of death following a tireless campaign by her mother Rosamund that attracted worldwide attention and unprecedented focus on the links between air quality and child health.

The Association believes this historic ruling will create much needed urgency around efforts to tackle air pollution, including changes to building legislation, and add impetus to its own campaign – backed by Ella’s mother – to turn buildings into ‘safe havens’ that can protect children at home and in school from the worst effects of outdoor pollution.

Ella died in 2013 following multiple severe asthma attacks. She was admitted to hospital 27 times in three years. The coroner ruled that air pollution 'made a material contribution' to her death and that the family were not properly informed about the dangers of air quality near their home and Ella’s school in south east London.

Coroner Philip Barlow said Ella had been exposed to “excessive” levels of air pollution and that levels of nitrogen dioxide (NO2) near her home exceeded World Health Organisation (WHO) guidelines. “There was a recognised failure to reduce the levels of nitrogen dioxide, which possibly contributed to her death,” he said.

“There was also a lack of information given to Ella's mother that possibly contributed to her death.”

Knife edge
A 2018 report by international asthma authority Professor Sir Stephen Holgate revealed that unlawful levels of pollution detected at a monitoring station one mile from Ella's home had contributed to her fatal asthma attack. He said Ella had been “living on a knife edge” in the months leading up to her death.

“By making a direct link between air quality and a child’s death, the coroner has moved the air quality debate up to a whole new level,” said Nathan Wood, chair of BESA’s Health & Wellbeing in Building’s Group. “He has effectively ruled that the government failed in its duty to protect Ella from unlawful levels of pollution – and opened the door for many more similar rulings.

“It also increases the pressure on our industry to deliver on its promises to improve air filtration, ventilation and air quality monitoring inside buildings so that they can act as safe havens while the longer term project to clean up external air continues.”

Rosamund, who is honorary president of the H&WB Group, addressed the last two BESA National Conferences and urged all building professionals to rally behind her call for the protection of children through improved indoor air quality (IAQ).

She pointed to research carried out by Professor Holgate at Southampton University, which showed that IAQ can often be 13 times worse than outside air, but that it can be controlled through a combination of improved building systems and occupant behaviour. She also noted that 80% of people spend an average of 90% of their lives indoors.

“Everyone has a responsibility to do what they can to make our children safer inside and outside buildings, but the building engineering industry has a particularly important role to play because of the nature of your work,” Rosamund told the BESA Conference. “It is, therefore, so crucial that you don’t cut corners and don’t look for loopholes in standards and regulations.”

BESA has been lobbying the government to include the measures needed to turn buildings into safe havens in its proposed new Environment Bill, which goes before Parliament for its second reading in January. It said the bill should include mandatory measuring and monitoring of IAQ with specific focus on airborne particulates PM2.5 and below; along with levels of CO2, NO2 ozone and VOCs, which are linked to heart and lung diseases as well as certain cancers. 

BESA also proposed that energy efficient ventilation systems, clean air technology and the new filtration standard (ISO16890) be adopted as part of revised building regulations. This would allow building engineers to efficiently tackle even the very smallest particulates including PM1 (the smallest easily measurable), which was identified by the WHO as a Group One carcinogen.

“This historic verdict should make everyone involved with designing, managing and maintaining buildings wake up and face their responsibility for tackling this huge human tragedy,” said Wood. “It should also make it harder for policy makers to ignore our advice to enshrine IAQ measures in future legislation.”

BESA has also backed calls from Clean Air in London for a new Clean Air Act that provides new duties and powers for local and central government and for it to be called ‘Ella’s Law’.

www.theBESA.com/iaq