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London girl could be first to have “air pollution” listed as cause of death (cbsnews.com)
166 points by DoreenMichele on May 4, 2019 | hide | past | favorite | 130 comments

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.

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.

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.

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.

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.

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.

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

Please just use the train.

I should probably have been clear - I do use the train. (I was one of the Extinction Rebellion protesters in London recently, so have very firm beliefs about modes of transport). My point was that the vast majority of people just won't give a shit until it hits them in their pocket. I don't see that changing, so the only real way of doing anything about it in any reasonable time frame is to make driving much more expensive and public transport much cheaper.

I disagree with your point about public transport massively improving since the congestion charge though. In what respect? I've been regularly travelling in London since the mid 90s and haven't really noticed much beyond the re-opening of what used to be the East London Line. I get the feeling that things are starting to improve now, after some serious public investment, but it still feels like too little. Until peak-time commuters aren't packed into trains like sausage meat I doubt much will shift in terms of behaviour.

Thanks for the clarification.

Buses have improved, there are far more though I wish they were electric.

Fair enough - I don't use buses regularly. Glad to hear they're better (I might try using them more if that's the case). Agree that it would be much better if they were electric, although I think a reasonable number of new ones are hybrids at least.

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.

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

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.

> 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?

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.

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

>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!

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).

I agree with your premise, but peak-time trains on those lines are horrifically overcrowded. Unless you can somehow magic more capacity on the same lines - which was tried recently by tweaking timetables to add a very small amount of extra capacity, which was an utter disaster - you're getting into trying to add lines and / or longer stations in one of the most crowded parts of the UK, with a NIMBY culture like no other. I don't mean to just talk down your ideas, but I don't see the practical fix here in infrastructure terms.

Sure, but it's definitely not the case that Lewisham only has an issue with people driving at peak time, and trains are not the only answer either (if someone is driving over taking the train, then it can't be impossible to design bus routes that would work for them even if perhaps slightly less optimal).

Basically any hour of the day people will be rattling up and down the South Circular, up and down the rat runs, etc.

I used to live near a long arterial road. I would do things like count the cars whilst waiting for the bus. It had buses every 15 minutes, and between each bus you'd have way more cars than the number of people that would fit on a bus.

Unless we say they just wouldn't make that journey otherwise, increasing taxes on private cars can help with the transition that could make that bus every 7 minutes instead (which would eventually be self fulfilling due to fare intake).

Peak time is when the vast majority of people travel though. If that doesn't change, it feels a bit like tinkering around the edges.

You're right about the buses and passenger number, but I don't think they'll easily replace fast rail routes. I used to live in Forest Hill, which has the south circular running through it. I tried taking buses into the centre of town but it took ages, although I suppose you might be able to run "express" buses with fewer stops if there was more space on the road.

I just hope that whoever the mayor is during the next few administrations uses the ULEV to exponentially ratchet up the pressure on cars, so there's a breathing space that can be filled by public transport before people jump to electric cars and we end up with both cleaner air and less congested roads.

I'd love to know what sorts of reasons are given for driving a private car inside the congestion zone. I've been this close to tapping on a window of some dude in a BMW stuck in traffic in Soho or some place ask them why the hell they're there.

- I've driven in from Leeds and am going to Brighton and it's cheaper than the train?

- I could go by bus but it would be 50 mins as opposed to 20?

- I just want to drive my car and I don't care?

- I've got a case of champagne I need to get to a friend?

- Something else?

It's pretty mysterious. Mind you these days it's hard to tell if a car's a taxi or not with Uber and things but I wonder if the Mayor's office has any data on reasons for vehicle use?

There really doesn't need to be a reason other than "because I want to", because the incremental impact of one car is low enough that no-one really thinks about it. If you think of people who drive cars as some sort of careless demons you've missed the point really - it's purely an economics problem.

I own a car and have used it to drive in on occasion just because I can. It's fun to roll about the streets and do stuff like drive down Shaftesbury Avenue.

This is precisely why taxation is necessary, because people don't realise that what they're doing is an issue in aggregate. If you had to pay the cost of a taxi to get to the local supermarket then people would figure out alternatives like cycling/taking the bus fairly quickly (and the supermarkets would adjust their business models, you'd see smaller ones more dispersed).

I think part of the issue is that people can't seem to juggle the concept of something being fun and good but ultimately damaging. I might enjoy a pint every now and then, but I'm fairly happy about the fact that we tax it.

I don't understand this comment. You've thought up some good reasons, so why the mystery?

"A blue-badge style disabled exemption"

Why? Why not change motability so that it only includes electric vehicles?

Or are you suggesting banning all vehicles? In that case what's wrong with public transport/mobility scooters?

The former would work too. Primarily that's just me recognizing that obviously there are some people that have reason to be driving.

I'm not sure that mobility scooters / wheelchairs would be adequately handled by all public transport at the moment even in London, there would probably be a lot of repressed demand, or people would just stay indoors.

A 60-person bus might have one or two wheelchair spots; a mobility scooter won't go on them at all; I very rarely see either on the trains despite it being technically possible. A lot of tube stations are not step-free.

I'm not suggesting banning vehicles; I'm suggesting taxing them appropriate to the damage they cause so that fewer people see "go for a drive through tons of residential streets" as a normal / accepted thing to do.


People can drive in major cities if they wish, but they should pay for the externalities imposed on residents.

Both petrol and diesel cars pollute above acceptable levels, I'm not willing to accept that a car with "reduced pollution" is clean when alternatives are readily available.

>I'm not willing to accept that a car with "reduced pollution" is clean when alternatives are readily available.

That’s exactly what you just did when you said electric cars would be ‘ok’. In 2015 less than 25% of power was renewable generated in U.K.

So pardon me, but my problem isn’t with your lack of understanding on the topic - it’s that you have strong and seemingly contradictory opinions that directly relate to what should and shouldn’t be “taxed out of existence”.

I might be more forgiving if you say what you mean up front instead of moving goal posts.

In this case, I think your original post you should have said “I think only rich people should be allowed to drive in London”.

I support carbon taxes as well. Crazy how far steelmanning can get you.

So by moving the goal posts, never being able to technically support your opinions, and being generally ignorant on the topic you have strong “everyone needs do as I say” opinions about...

Has someone explained that to you as what a “steelman” argument is?

I don't think that people need do as I say at all.

I think that the externalities of private ICE cars should be priced in.

It is absurd that I can drive an ICE car about in London for an hour for less than the cost of a pint.

The GP was right. There is very little reason for most people to need to drive in central London. In fact most of my London based friends either don’t have a driving licence or do and keep their car in a location outside of London.

Unless your job requires driving, there’s no incentive to drive in central London. It’s slower than public transport (slower than even waking on some streets), more expensive than public transport and more stressful than public transport.

> Unless your job requires driving, there’s no incentive to drive in central London.

Then nobody does it?

That's not quite how these things work.

There's no incentive (other than a bit of ephemeral fun) for a person to drink until they pass out, but people do it anyway.

Humans are not perfectly rational utilitarian beings - and we shouldn't be. There's nothing wrong with a bit of fun here and there.

But when that fun negatively affects others (and tens of thousands of fume belching cars driving through your street as a rat run certainly falls in that camp) we should act.

What does the word “incentive” mean to you?

People do drive in London, so they have their reasons (however unreasonable they may look to you). And probably “fun” is down on the list.

Unless you think, Berra-style (https://quoteinvestigator.com/2014/08/29/too-crowded/), that nobody drives in London because it’s too congested. But in that case there would be no need for congestion zone charges to de-incentivize something that nobody was doing anyway.

I get your point but you’re also missing the fact that there will always be a need for private hire vehicles (taxis, Uber, chauffeurs, etc), buses, delivery drivers and other goods vehicles too. Some of the streets I’ve worked in were congested just with those types of traffic and the incentives there are pretty clear: they’re getting paid to driving in central London.

Clearly there are going to be people who fall outside of that group and still choose to drive. As I said in my other post, you’ll always get statistical outliers. But for the vast majority of people who live and/or work in London, we will use public transport, bike, or walk. Some of us might drive into Greater London and pick up the Tube. But very few of us would contemplate driving into central London as part of our daily commute.

Of course not everyone can take their car to the city center every day. It's physically impossible. We agree that the vast majority of people won't, we agree that there are still enough people doing it (very few, but many nevertheless) to create congestion and other problems.

You can defend that charges, restrictions and other disuasory measures are a good solution to diminish the use of private vehicles and its impact. But it doesn't make sense to say that those people have no reason to drive in central London unless they are paid to do so.

Sure, “little” would have been a better term to use but the context of my post was well established. If your only quibble was the use of that solitary word then you’re being pointlessly pedantic.

Note that I was not replying to you in my first comment, I was replying to esotericn's "interpretation" of your comment as people not acting as rational utilitarian beings when they drive in London.

Most people don’t. However there will always be statistical outliers when talking about human trends.

In a survey from 2015, almost 40% of vehicle commuters in London used a car[1]. That's not "statistical outliers".

[1] https://files.lsecities.net/files/2015/09/New-Urban-Mobility...

We are talking about central London, not Greater London. Greater London is a massive area which has leafy suburbs and wide areas without congestion. Central London is where the worst of the problem is, where we have been discussing, where the congestion charge zone is, and where you (generally) wouldn’t see people commute to by car.

For what it’s worth, part of my commute is via car too. However I do then get the train into central London. So I would still be classed as a driver

Fair enough. If nobody has an incentive to commute to central London by car, why the need for a congestion charge?

The points are mutually inclusive. The congestion charge is one of the reasons why there is little incentive to drive in central London.

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.

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

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.

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

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.

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

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).

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.

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.

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

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.

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...

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

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

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...

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.

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.

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.

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?

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/...

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.

At least wood fuel is carbon neutral.

There are smoke control zones - https://www.gov.uk/smoke-control-area-rules - first put in place after the Great Smog of 1956 - https://en.wikipedia.org/wiki/Clean_Air_Act_1956. Generally only in built-up areas, so not sure whether it applies to this particular situation, and certainly no controls in the countryside.

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.

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.

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).

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.

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.

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.

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.

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.


By that logic, nobody ever died of HIV. It only makes you immuno-deficient, opening the door for any of a zillion diseases (pneumonia, TBC, Kaposi’s sarcoma, cervical cancer, etc)

Also by the same logic, heart attacks do not kill, the resulting oxygen shortage does. Correction, it isn’t the oxygen shortage, it’s some chemical reaction in your brain cells that causes irreversible changes (experts in the field likely can split this in a sequence of multiple events)

If you take this chain to the limit, you end up with “you die because your cells die”, which is almost circular reasoning.

I think what matters is what’s the root or at least primary cause. If a child has asthma, would easily have survived in a normal (already polluted) city environment, but died because of living in an extremely polluted neighborhood, I would agree taking that as the cause of her death.

Back to the cheeseburger example: “died of overeating” (if eating a lot in a short time frame caused the heart attack) or “died of obesity” (if eating too much over a long period stressed the heart too much) could, IMO, be better descriptions than “died of a heart attack”

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.


The negligence was due to the pollution being higher than legally permitted in that area. These regulations are there to protect people, and someone either did not enforce those, or someone blatantly violated them.

If someone illegally dumped radioactive waste next to your home, and you don't move either due to inability or some other reason, the crime does not magically fall on your shoulders.

All events have an infinite number of causes - when we pick just one of them, we're doing some combination of assigning blame and responsibility and calling others to action.

So that's precisely why blaming pollution might be sensible. Can you actually force all parents to move away from a polluted area? Or can you punish a diesel truck driver for driving in a legally designated area? Taken to the extreme, can you change the laws of the universe, or its initial boundary conditions?

Probably not, but you can certainly change pollution limits and enforce them.

This is least sound argument I’ve read all week. Pollution exacerbates asthma, this is well-studied and well-understood, we even know which kinds of pollution do this (ozone and particulates).

Deaths generally have multiple causes and complex chains of events leading to them, and we have a rich history studying the relationship between how an actual event happened (a girl dying) and where we assign the blame (pollution). If you think that the slippery slope will lead us to blame ignorant parents or a random diesel truck, well, that way to assign blame isn’t supported by theory or precedent.

The parents wouldn't be blamed because they didn’t have any particular duty to move somewhere with less pollution, just like you don’t have a legal duty to avoid getting murdered by moving to a lower crime area (the idea that you would assign blame here to the parents is legally ridiculous). The diesel truck wouldn’t be blamed because it did not contribute significantly to the death, you wouldn’t reasonably suppose that whether a particular truck drove down a street would make the difference between someone dying from asthma or not—after all, if that particular truck didn’t, then another truck will, later.

Blaming pollution is well-founded—there are legal limits on pollution which were violated (there existed a legal duty to keep pollution below these limits), the pollution was a significant contribution to the death (without the pollution, the death would be much less likely), and the contribution of pollution to the death was natural and foreseeable. These three things together are key elements in fault.

There are a number of hypothetical (and real) cases which you can use to illustrate all of these factors working together. For example, Alice breaks into Bob’s house to murder Bob, she waits in the closet with a gun ready to jump out and shoot him. When she closes the closet door, it knocks over an umbrella. Bob comes home, trips on the umbrella, hits his head on the floor, and dies. Alice acted with intent to kill Bob, and has in fact succeeded (her actions caused Bob to die), but the chain of causality between her actual actions (knocking over the umbrella, which Bob trips over) is not something that someone would reasonably expect to cause someone to die, so Alice is not in fact guilty of murder (again, even though she acted with intent to kill Bob, and did in fact cause Bob to die).

If pollution was above the legal limits, yes, that changes a lot about the cause of death.

Actually, unlike air, cheeseburgers are not a shared-resource.

Entities abusing shared resources for economic gain is hardly a new concept and most definitely NOT absurd. Even the most conservative of economists will be able to discuss the Tragedy of the commons, a concept dating back to the 1800s. https://en.wikipedia.org/wiki/Tragedy_of_the_commons

Economics aside, she was a 9 year old girl - think on that for a bit. Listen I don't know who you are or where you're from, maybe you have a good reason to hold this point of view... but the only way things are going to get better for everyone is if we all have a little empathy for each other.

It's not more empathetic to say she died of air pollution than an asthma attack, so we can put this one in the empathy shmempathy bucket.

This is a straw man argument. Semantics are not the issue at hand.

It's easy to not eat cheeseburger, it's hard not to breathe


Whenever I see comments like this, I want to remind people to be grateful that they have such luxuries and abilities in their life to relocate at will whenever factors become inconvenient.

The reality is, I think most people don't realize how hard others have it, and how non-trivial such things can be for those in more dire straits or those that are more destitute. These are simply not options for many folks. Where's the money to move, to relocate, the wherewithal? The sheer number of factors that tie people to less-than-ideal places can be daunting, and those not living in that kind of squalor are sometime oblivious...or lacking the empathy, to understand its rarely that simple.

I grew up in extreme poverty and for myself (and others in a similar situation) moving was, perhaps contrary to intuition, a pretty common thing. Whenever a better paying job or cheaper housing popped up, we moved. There are a number of factors that make it somewhat easier to move when you're in poverty. In particular you're always renting and you have negligible items of wealth. For instance you don't need to worry about a place accepts pets when you can't even afford a cat. An extra $50 a month is a pretty big deal when you don't have anything so there's much more of an external drive to move for what otherwise people might just simply accept. There are also extrinsic factors that, more or less, force moving when you're in poverty. Indeed FiveThirtyEight dug up the stats and people who earn < $5000 per year are just about twice as likely to move (13%), in any given year, than those earning > $100,000 (7%). [1]

In some cases there are going to be some extenuating circumstances that prevent things like moving. For instance, extreme disability is one possibility, though that does not seem to be the issue in this case. The mother seems able, younger mid aged, and had 3 children. If she was disabled in any significant way, the media pieces and her crowd funding would also have mentioned that, to further draw at pathos.

Ultimately you cannot discount the fact that there are many negligent parents. In this case the parent is claiming, in her crowd funding page [2], that she only realized pollution might be a trigger for her daughter's asthma, after she died. Quoting her, "Since her death I have become aware of the dangers posed by air pollution and discovered that our home, located approximately 25 metres from the South Circular in London, was a known air pollution ‘hot spot’ and started to put two and two together. ". It's insane and inexcusable that somebody can have a daughter with severe asthma and not realize pollution and fumes can trigger it. That's something any 10 second search on asthma would turn up.

[1] - https://fivethirtyeight.com/features/how-many-times-the-aver...

[2] - https://www.crowdjustice.com/case/airpollution/

> (yes, I realize most people cant just move on a whim)?

> It's easy to live outside of a heavily polluted area if you have severe asthma.

Most people can't just move, but it's easy to just move?

So why isnt the cause of death poverty?

She was nine fucking years old.

I am straining to maintain the notion of civility that HN demands, so I will only ask you this: what bent you to make you think this sort of thing is reasonable or okay or decent?


Please stop posting unsubstantively. You've been doing it a lot, and eventually we ban accounts that won't follow the guidelines by posting thoughtfully and informatively.



This has nothing to do with "differing opinions", only to do with your egregiously breaking the site guidelines. Since you don't seem to want to use HN as intended, I've banned the account. If you don't want to be banned, you're welcome to email hn@ycombinator.com and give us reason to believe that you'll follow the rules in the future.

Thank you, Dan.

Breadth of viewpoint is important, but I reject the notion that HN is somehow closed-minded because "perhaps it's the nine-year-old's fault?" gets a measure of incredulity.

My understanding is that it is not about science, it is about the law.

Her mother noticed that the air pollution levels were above the legal limit and wants to put the blame on someone, maybe even get damage.

There is no single cause of death. The question is which one to choose.

I wonder what cause of death is mentioned when someone allergic to peanuts eat peanuts. Is it "peanuts", "peanuts allergy", or "anaphylactic shock". The first one is the trigger, the second is the underlying condition, the third is the symptom. All the three should be valid.

> we don't claim people who die from a heart attack to have died because of cheeseburger overdose...

We kind of do though, it's not the case for all of them but poor nutrition has always been linked with cardiovascular issues.

It's like if you said, "nah he didn't die because he smoked 5 packs a day, he died of lung cancer"


Because deaths from heart attacks usually have very many factors

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.

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.

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...

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.

> smoking is a totally objective, non-manipulated conversation

Is this irony?

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

no reasonable person would agree that it's correct to call a gunshot wound "circulatory failure" because that's not what society has agreed that those words mean. You can decide personally that they mean something different, but you would be wrong. Language is determined socially not personally.

And how does it become the "society" ? It starts from the individual.

yes sure, you could individually start a movement to redefine the meaning of a word, Frindle-style, but here, today, in our society, the words "respiratory failure" do not mean the same thing as "poisoned by air pollution".

Well at least to me, the author and to some society, both are technically fact and both are technically correct.

In this example, though, we are looking for actionable items. But for the pollution, it appears this girl would have not had respiratory failure. Reducing pollution is the actionable item for addressing the respiratory related illness in this story, and thus the focal point. Writing an article about this person and not mentioning pollution, and writing only about respiratoy failure, would have been utterly pointless.

Edit, to add: just because something is true does not make it relevant. It is true that if this woman never would have been born she would not have had respiratory failure caused by pollution and this article never would have been written... but how is stating that helpful?

I'm just pointing out that it is also correct that the girl die from respiratory failure.

I do not claim to know what is the author true intention or whether its helpful or not.

just trolling


> [..] 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.

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

If everyone is responsible than no one is.

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.

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.

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.

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.

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

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.

Pepsi and hamburgers are not shared resources. Air is.

Asthma is induced by both genetic and environmental factors. [0] So air pollution causing asthma is hardly a stretch. Especially if you've been exposed 1/3 of your life at such a young age. She was 9 years old. Having developed lungs and going into that area is majorly different than developing lungs in that area.

[0] https://www.ncbi.nlm.nih.gov/pubmed/21799018


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"

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...

OK, what about lead poisoning? An environmental hazard, especially effects children, preventable, mostly affects poor folks and developing nations. This seems like it's pretty analogous.

British law is not medical coding. Misadventure isn't a medical code and could cover many of the bizarre ones like whale ingestion.

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.

Not being snarky, but perhaps we should. It wouldn't be untrue. When people drink their livers to death we often say they died of alcohol abuse even if we note they died of liver failure - seems reasonable if someone ate tons of cheeseburgers we could say they died of cheeseburger abuse etc.

It's a bit dramatic, but could also be useful?

I'm definitely in agreement that we should say people died from alcohol overdose at least, maybe then people will take it seriously,

There weren’t legal limits on cheeseburger ingestion, like their was for air pollution. This death was preventable, and not the child’s fault.

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