
London girl could be first to have “air pollution” listed as cause of death - DoreenMichele
https://www.cbsnews.com/news/ella-kissi-debrah-could-become-first-death-attributed-to-air-pollution-in-united-kingdom/
======
esotericn
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.

~~~
frereubu
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.

~~~
esotericn
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.

~~~
frereubu
As I've said below, I should have been clearer that I do take the train rather
than drive. My point was more about the calculations that don't make sense,
and until those change in tandem with more investment in public transport (and
yes, sort out those stupidly confusing fare structures on National Rail) we'll
be treading water (literally, in London). I wouldn't really care if only rich
people drove in London, if they paid enough to make a difference to public
transport for everyone else. Even if they didn't the much cleaner air might be
worth it.

There are stations like the ones you're suggesting. Forest Hill has free on-
street parking less than five minutes from the station, but that would
increase journey time significantly with the switch to another mode of
transport with family in tow, and make a day trip much less feasible.

Fair point about some things not being possible though. Better to reduce the
number of people travelling if it means a much cleaner, healthier London. I've
even considered trying to commute to London from Brighton via bike during the
summer, staying a night with a friend and riding back the next afternoon...
That would be much nicer if I didn't feel like I was inhaling exhaust fumes
for half the journey.

~~~
esotericn
Ha. So I'm not the only one that knows about Forest Hill, then.

(Feels like it'd be a bloody pain to drive to from Brighton!)

The last part of your comment is what really hits home for me.

People driving private cars around damage other modes of transport. Cycling
becomes less pleasant (near passes, inhaling shit, etc); buses are caught in
congestion; everything becomes less dense; etc.

~~~
frereubu
Yeah, if pollution can kill that girl just because she lives near that
junction, I just keep thinking what it must be like in my lungs if I'm
pedalling hard and sucking in great gulps of the stuff.

(Sydenham is OK as a backup - a bit further south of the station on the side
roads. Not as convenient as Forest Hill though!)

Edit: I seem to remember a study about health of cyclists (although don't have
the citation so take with a pinch of salt) and it was universally better
except in cities. Either crashes, pollution, or both, meant that cycling
didn't make a difference to cyclists' health overall.

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alexandercrohde
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](https://en.wikipedia.org/wiki/Air_pollution#Health_effects)

~~~
village-idiot
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.

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

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

------
Brakenshire
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.

------
ptaipale
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
[https://en.wikipedia.org/wiki/Great_Smog_of_London](https://en.wikipedia.org/wiki/Great_Smog_of_London)

------
sjg007
Maybe now the U.K. will do something about truck, bus and automobile
particulates.

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

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

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DoreenMichele
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...](https://ggwash.org/view/71256/why-are-city-planners-so-afraid-to-talk-about-race)

~~~
esotericn
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.

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tsomctl
[https://en.wikipedia.org/wiki/Great_Smog_of_London](https://en.wikipedia.org/wiki/Great_Smog_of_London)

------
imtringued
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.

~~~
NeedMoreTea
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-idiot
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?

~~~
NeedMoreTea
I knew it was a bit of an issue, so I looked it up[1]. Turns out it's far
worse than vehicles, and far worse than I thought:

 _"...the burning of solid fuels (such as house coal and wood) in our homes is
the largest contributor of harmful particulate-matter (PM) emissions."_

 _" This makes up 38% of our national PM emissions while, in comparison,
industrial combustion is 16% and road transport 12%."_

Wood stoves appear to have side-stepped much of our clean air legislation
which is woefully out of date anyway. Coal fires have become fairly rare over
the same period, so that's mostly down to wood stoves. Haven't heard of any
requirements for catalytic converters, which seems a sensible idea.

In my lifetime we've gone from almost nowhere selling wood except wood yards,
to everywhere does - mainly in the last 10 years - garages, corner shops,
supermarkets. In neat little single use plastic bags. This government has lost
3 court cases on air pollution, and their current targets kick out real action
well into the long grass: 2030.

It's ridiculous.

[1] [https://www.which.co.uk/reviews/wood-burning-
stoves/article/...](https://www.which.co.uk/reviews/wood-burning-
stoves/article/wood-burning-stoves-what-you-need-to-know/stoves-and-pollution)

~~~
village-idiot
Can you find any references to the actual particulate emissions that’ll be
allowed after 2030? I’m curious if wood burning stoves are inherently
problematic, or if the EPA really is that much more strict than the U.K.
equivalent.

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lnsru
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
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.

------
thatoneuser
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
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.

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ghobs91
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.

~~~
habnds
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.

~~~
paulddraper
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...](http://apps.who.int/classifications/apps/icd/icd10online2005/fr-
icd.htm?gx85.htm+)

~~~
habnds
Right, because everyone knows that smoking is a totally objective, non-
manipulated conversation about the simple facts of a straightforward
situation.

In both cases, powerful parties have a huge incentive to use semantics to
excuse the blame that should rightfully be placed at their feet.

Which is why it's outrageous to use the phrase "respiratory failure" to imply
that this is clickbait and not a real issue.

~~~
paulddraper
> smoking is a totally objective, non-manipulated conversation

Is this irony?

------
crimsonalucard
If everyone is responsible than no one is.

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paulddraper
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-
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
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.

~~~
chabes
Sounds like politicians are trying to cover their asses after an entirely
preventable (under their own legislation) death

