Introduction

Rapid urbanization and industrialization along with parallel to rampant increase in population have resulted in environmental pollution and natural resources degradation imposing serious risk to public health and environment in general. Environmental forensics, a branch of environmental science was developed during 1980’s with focus on scientific investigations using knowledge/techniques of environmental and allied sciences for the purpose of legal issues. Main objectives of Environmental Forensic include identification of pollution source, history of pollution events, fate and transportation of pollutants in environmental components, identification of potentially responsible parties for pollution, statutory obligations, and suggestive actions for the same [1, 2]. Environmental forensics can be defined as “the systematic and scientific evaluation of physical, chemical, and historical information for the purpose of developing defensible scientific and legal conclusions regarding the source or age of a contaminant release into the environment [3].

Usually, environmental forensics studies are focused on pollution of soil and water rather than air. However, the recent findings and data indicate that air pollution became invisible killer with huge death troll and public health and economic impacts. According to WHO, globally seven million people dies every year due to air pollution (including ambient air pollution and indoor air pollution) [4] and more than 80% people living in urban areas are exposed to ambient air pollution level higher than emission standards [5]. During the last decades, air pollution in the urban areas gain significant focus of scientific community and people in general. Many scientific studies draw strong link between exposure to air pollution resulting in short/long term health implications and increase in mortality due to acute respiratory infections, lung cancer, chronic obstructive pulmonary disease (COPD), cardiovascular disease, stroke etc. [5]. In Indian context air pollution as an invisible killer presents a horrific scenario, air pollution accounted for 1.67 million deaths in India during year 2019 which is 17.8% of the total death in the year [6]. This indicates equal necessity for development of air pollution related environmental forensic for scrutinization air pollution as invisible killer and tackled systematically.

As described above, air pollution become a major reason for health risk resulting in morbidity and mortality which interlinked with other social and physical factors create wide range of adverse effects. To address air pollution problems and minimize the impacts of air pollution on human health, countries all over the world have formulated many policies to improve ambient air quality, implemented ambient air quality standards/ air quality index. Despite which, still huge death troll due to air pollution exists and increasing day by day. Though air pollution related morbidity and mortality well reported in scientific literature [5], the issue is not addressed in legal proceedings to prove high exposure of air pollutants as evident behind a human death. But recently, one case filed to South London Inner Coroner’s Court of London city has gained attention all over the world. The case was related to death of nine-year-old girl named Ella Kissi Debrah, who died due to asthma attack on 15^th February 2013, and in this case the judgment given that her death was causally linked to exposer to severe air pollution at her residential area of London city. The case was first legal proceeding which state that air pollution as contributory factor of a person’s death and she became the fist person in UK and perhaps in the world for whom court order to write air pollution as cause of death in the death certificate [7] [8].

The Case Details

Ella Kissi Debrah, a nine-year-old girl died on 15^th February 2013, after fighting long battle for three years. She lived at Lewisham, Southeast London, her resident was 25 meters away from South Circular Road which is hotspot for high exposure of air pollution. She hence has constant exposer to traffic origin air pollution; between 2006 to 2010 concentration of Nitrogen Dioxide in ambient air found constantly higher than WHO annual limits of 40µg/m³ at south circular road. She was suffering with hypersecretion asthma since 2010 and she been admitted to different hospitals 27times due to her health problems before her  tragic death in February 2013 [7] [8]. Since 2010, her mother Rosamund Kissi constantly asking over reason behind her daughter’s asthma attack. She filed a case in High Court to seek out the reason behind her daughter’s death. The first Inquest held in 2014, which more focused to her medical care and not on role of air pollution. The judgment given in the first inquest that she died due to acute respiratory failure and something in air triggering her asthma attacks not clearly answering role of air pollution. Her mother was not satisfied with the judgment and hence launched campaign as a result of which High Court of London quelled the first inquest in May 2019 and demand for new inquest which brought more powerful evidence [7] [9].

This second inquest lasted for 10 days from 30^th November to 11^th December 2020, which held at Court of Inner South Coroner before Deputy Coroner Philip Barlow. The inquest appraised role and submissions by various departments/authorities of government of UK such as Department for Health and Social Care (DHSC), Department for Environment, Food and Rural Affairs (DEFRA), Department for Transport, and local authorities Lewisham London Borough Council, the Greater London Authority etc. [7]. For the inquest, Barrister Richard Hermer QC and Indian origin Advocate Ravi Mehta acted on behalf of Ella’s Family, Ravi Mehta before the inquest acted for NGO ClientEarth in two legal proceedings related to violation of air quality related law by UK government [10].

The crucial scientific evidence during the second inquest provided by Immunopharmacologist and air quality expert Professor Stephen Holgate from Faculty of Medicine, the University of Southampton [11]. His 2018 study report revealed role of excessive air pollution detected at the Catford Monitoring Station near Ella’s home consistently during the three years prior to her death in 2013, based on which High court ordered for the second inquest [12] [7] [13] [9]. Linking death of Ella with higher level air pollution detected at nearby ambient air quality monitoring station, Prof. Stephen Holgate testified and proved before the court that Ella was suffering from hypersecretion asthma and hence her lungs outpoured with mucus whenever gets irritated by air pollution. Hence, she admitted to hospitals multiple times due air pollution aggravated asthma attack and she tragically died at age of nine due to cumulative effect of particulate matter and nitrogen dioxide she breathed during her life. He further provided evidence to court regarding worst health situation of Ella during winter months due to seasonal increase in air pollution [7] [13] [9] [14]. Other scientific evidence provided by Professor Paul Wilkinson, School of Tropical Disease, London conforming role of traffic origin air pollution at South Circular Road, South London for impaired health of Ella Kissi [13] [12] so court admitted Ella’s death linked with air pollution [7, 8].

Implications and Conclusion

During the second inquest, the lawyer behalf of Ella’s family requested the court that air pollution should be considered as public health emergency and public should be well informed regarding the adverse effect of air pollution on health and resultant mortality. With this context, the court notified in the judgment that Ella’s mother not been informed about health risk of air pollution and its potential to initiate and aggravate asthma [7] [8]. Also, the lawyers contended about pressing need to record air pollution as causative factor for Individual’s death to sensitize the government/government authorities in order to prioritize efforts for the most persuasive need to protect citizens/vulnerable from the invisible killer [14] [9].

In the UK, the biggest environmental threat to public health is air pollution [15] [16], as per data 60% of UK population exposed to air pollution excess than legal limits in year 2019, specifically nitrogen dioxide which can affect 7 million children and 5.5 million elders and 33 million population as whole [17]. In London itself 4,00,000 children and inclusively 2 million London citizens are living at areas with poor ambient air quality [18]. Ella’s Death case imposed clear obligations on government all over the world for protection of citizens/vulnerable from air pollution. In this context, the UK government established historic environmental bill with prime focus on protection of citizens from air pollution with 3.8-billion-pound plan for tackling traffic origin nitrogen dioxide [9].

For London city, ultra-low emission zone scheme (ULEZ) launched by Mayor of London to improve air quality at central London with further expansion to other areas [19]. On 15^th March 2021 Mayor of London declare 1.5-million-pound investment to strengthen the ambient air quality monitoring network with 195 new air quality sensors set across the London city along with 60 sensors allocated to community groups and establishment of sensors at schools, hospitals, and other priority locations. The day-to-day real time monitoring data from the sensors along with data from existing monitoring stations will be available to residents of London city on newly launched website ‘Breath London’ [20].

The Ella’s Death case and the judgment air pollution as causal factor for individual’s death is eye opening for governments all over the world with respect to impacts of air pollution on public health and associated economic burden throughout the world. The case clearly reflected importance of clean air and how poor air quality is detrimental for public health and deaths of vulnerable. However, at global level there are many challenges to deal with management of air pollution such as lack of strong network, harmonized air pollution policies, financial problems, and maintaining authenticity of air quality data etc. also the problems of regional air pollution problem like deterioration of air quality in Delhi due to agricultural field burning in surrounding states. Ella’s Death case opens a new scope for environmental forensics for finding such evidence behind morbidity and mortality due to exposure of air pollution exceeding the legal limits. Development of air pollution related Environmental Forensic prerequisite to assist governments/ administrators and courts in many parameters like, how monitoring of air pollutants is carried out, how to spread awareness, and information is to be shared with public regarding peril levels of pollutants, what measures should be taken by officials and when and where monitoring is done because like Ella’s case, there are many unrevealed cases which are needed to be solved through environmental forensics.

References

1. Toranzos GA, Cano RJ (2018) Definitions and Historical Perspectives in Environmental Forensics. Microbiol Spectr 6:. https://doi.org/10.1128/microbiolspec.EMF-0016-2018
2. Haddad RI (2004) Invited Editorial: What is Environmental Forensics? Environmental Forensics 5:3–3. https://doi.org/10.1080/15275920490424006
3. Environmental Forensics. In: Oxford Biblographies. https://www.oxfordbibliographies.com/view/document/obo-9780199363445/obo-9780199363445-0071.xml. Accessed 2 Feb 2021
4. WHO Air pollution. https://www.who.int/westernpacific/health-topics/air-pollution. Accessed 17 Feb 2021
5. Sofia D, Gioiella F, Lotrecchiano N, Giuliano A (2020) Mitigation strategies for reducing air pollution. Environ Sci Pollut Res 27:19226–19235. https://doi.org/10.1007/s11356-020-08647-x
6. Pandey A, Brauer M, Cropper ML, et al (2021) Health and economic impact of air pollution in the states of India: the Global Burden of Disease Study 2019. The Lancet Planetary Health 5:e25–e38. https://doi.org/10.1016/S2542-5196(20)30298-9
7. Dyer C (2020) Air pollution from road traffic contributed to girl’s death from asthma, coroner concludes. BMJ 371:m4902. https://doi.org/10.1136/bmj.m4902
8. London Inner South Coroner’s Court Inquest touching the death of Ella Roberta Adoo Kissi-Debrah. In: London Inner South Coroner’s Court. https://www.innersouthlondoncoroner.org.uk/news/2020/nov/inquest-touching-the-death-of-ella-roberta-adoo-kissi-debrah. Accessed 5 Apr 2021
9. The Guardian (2020) Air pollution a cause in girl’s death, coroner rules in landmark case. In: the Guardian. http://www.theguardian.com/environment/2020/dec/16/girls-death-contributed-to-by-air-pollution-coroner-rules-in-landmark-case. Accessed 8 Apr 2021
10. Blackstone Chambers Inquest into the Death of Ella Adoo-Kissi-Debrah. In: Blackstone Chambers. https://www.blackstonechambers.com/news/inquest-death-ella-adoo-kissi-debrah/. Accessed 12 Apr 2021
11. University of Southampton Influencing Government Policy On Air Pollution | University of Southampton. https://www.southampton.ac.uk/news/2016/04/health-impact-of-air-pollution.page. Accessed 8 Apr 2021
12. BBC News (2020) Ella Kissi-Debrah “living on knife edge” before death. BBC News
13. Jazrawi HL-W Landmark Air Pollution Decision in the Ella Roberta Adoo Kissi-Debrah Case | Lexology. https://www.lexology.com/library/detail.aspx?g=97992882-c694-47e2-8869-c6ad9da87147. Accessed 8 Apr 2021
14. Sandra Laville Air pollution a cause in London girl’s death, coroner rules in landmark case. In: The Irish Times. https://www.irishtimes.com/news/world/uk/air-pollution-a-cause-in-london-girl-s-death-coroner-rules-in-landmark-case-1.4439447. Accessed 8 Apr 2021
15. GOV.UK Public Health England publishes air pollution evidence review. In: GOV.UK. https://www.gov.uk/government/news/public-health-england-publishes-air-pollution-evidence-review. Accessed 5 Apr 2021
16. Ballinger A, Chowdhury T, Sherrington C, Cole G (2017) AIR POLLUTION: ECONOMIC ANALYSIS. Air pollution: outdoor air quality and health NICE guideline [NG70] by National Institute of Health and Care Excellance:87
17. Cockburn H (2020) 60% of population living with air pollution above legal limits. In: The Independent. https://www.independent.co.uk/climate-change/news/air-pollution-england-defra-labour-who-nitrogen-dioxide-luke-pollard-b404484.html. Accessed 12 Apr 2021
18. Mayor of London (2019) Latest data shows two million Londoners living with illegal toxic air. In: London City Hall. https://www.london.gov.uk//press-releases/mayoral/two-million-londoners-live-with-illegal-toxic-air. Accessed 15 Apr 2021
19. Transport for London Ultra Low Emission Zone. In: Transport for London. https://www.tfl.gov.uk/modes/driving/ultra-low-emission-zone. Accessed 15 Apr 2021
20. Mayor of London (2021) Mayor makes major new investment in air quality monitoring in London. In: London City Hall. https://www.london.gov.uk//press-releases/mayoral/mayor-makes-major-new-investment-in-aq-monitoring-0. Accessed 15 Apr 2021

Author

Vrushali Mohite, Dr. Hemen Dave

National Forensic Sciences University, Gandhinagar, India