Ella Kissi-Debrah was only nine when she died in London in 2013. The cause was respiratory failure, but it’s pollution that killed her.
That is what the coroner determined in a landmark case, which explicitly linked the girl’s death to levels of nitrogen dioxide and particulate matter higher than the World Health Organization (WHO) says are safe. Vehicles were the main cause of such emissions, which were especially high where the Kissi-Debrah family lived.
The coroner established that the exposure to air pollutants exacerbated the victim’s asthma and respiratory problems, hastening her death.
Though the science linking high air pollution rates to negative health outcomes is well established, finding the right legal framing to keep air clean and humans healthy is not straightforward. It’s hard to prove pollution as the primary cause of illness or death, and to establish the exact source of dangerous pollutants inhaled by a specific individual. But legal frameworks that focus only on environmental damage might not be strict enough to protect people’s health.
To solve this, some activists and organizations are pushing for a different approach—one that frames clean air as a human right, and pollution as a public health issue—hoping this will make it easier for governing bodies to impose meaningful clean air standards, and give victims of air pollution an avenue to accountability.
Ella Kissi-Debrah‘s case was the first to officially cite air pollution as a cause of death, but she was not the first to fall victim to harmful air. Pollution levels are above safe levels in many parts of the world; in parts of countries including India, Mongolia, and Chile, the air is consistently hazardous. The University of Chicago’s Air Quality Life Index, a project that assesses the health impacts of air quality around the world, determined that air pollution in Delhi, India shortens residents’ life expectancies by an average of eight years. Air quality in London is better than in Delhi and many other metropolitan areas in developing countries, so if pollution kills in London, you can assume it does in those cities, too.
Fundamentally, air quality is a public health issue. The years lost to polluted air, and the resources that go into treating people who suffer from it, are a burden for society. To prevent such waste and suffering, governments need to intervene.
The pandemic has shown this more strongly than ever: In Italy and Belgium, the areas that had worse air quality were where the biggest and worst outbreaks of Covid-19 occurred. People’s respiratory systems were under strain prior to the pandemic, resulting in worse outcomes for people exposed to the airborne virus.
International governing bodies understand that this is a problem. On March 8, 2021, the United Nations Environment Program, on behalf of 15 UN entities and at least 60 countries, issued a statement asking for “a safe, clean, healthy and sustainable environment” to be recognized as a human right.
“Air pollution on today’s scale clearly violates the rights to life and health, the rights of the child, and the right to live in a safe, clean, healthy and sustainable environment,” wrote David Boyd, a professor of law, policy, and sustainability at the University of British Columbia in a paper published in the journal Annals of Global Health in 2019.
Boyd notes that framing clean air as a human right has the power to promote public policy to protect it. That’s what happened to clean water, which was recognized as a human right by the UN in 2010; since then, the international development community rallied around the cause to ensure everyone had access to it.
But air quality is more complicated to guarantee than water. For one thing, it is harder to identify the origin of pollutants, because sources of pollution mix more easily in air than in water. Further, air is ambient, unlike water that has identifiable sources, making it easier to protect their purity. Even if breathable air were established as a human right, enforcing it wouldn’t be easy. And, as Kissi-Debrah’s death shows, identifying pollution as the main cause of death—which could potentially allow victims to be compensated in lawsuits—can be a challenge. Even in her case, compensation won’t be easy to obtain.
The UK has passed clean air laws before. The Smoke Abatement Acts of the mid-1800s and the Public Health Act of 1891 were intended to reduce smoke in urban areas. After the 1952 Great Smog of London, which covered the city in a thick, polluted fog for five days, killing 4,000 (and up to 8,000 more in the long term), parliament passed the Clean Air Act of 1956.
Ella Kissi-Debrah’s death has been another catalytic moment in the fight for clean air.; activists have made a push for updated laws to protect air quality. The result was the Clean Air bill (pdf), presented in parliament in Jan. 2020, though has not yet been passed. While not solving the entirety of the UK’s air quality problem, the bill is a step toward getting to “zero air emissions,” says Simon Birkett, the director of environmental nonprofit Clean Air in London.
While various bills to protect clean air are being discussed all over the world, the UK’s is the most ambitious in scope, because unlike limiting emissions and compensating for them, it requires a bigger change in living, working, and energy production ways.
“Zero air emissions” is different from the goal of “net zero” emissions presented in most other environmental policies. While “net zero” challenges countries to reach carbon neutrality by offsetting the effects of carbon emissions and other pollutants, “zero air emissions” would cut them entirely. This, Birkett says, has a significantly better impact on health, because while zero net emissions might help the environment, people might still be exposed to pollutants—and suffer the consequences.
The key focus of the bill is to cut the emissions of buildings, caused by everything from heating and cooling systems to electricity use, which in London account for 78% of harmful emissions. To do so, buildings would have to use green energy sources and be optimized to require less energy consumption overall. “We would have to update the entire national building stocks, and we have to do it within 10 to 15 years, or we’ll have burnt through our whole emission budget,” says Birkett (the emission budget was established by the UK government in accordance with the Climate Change Act).
This would be a substantial undertaking by building authorities, but it’s not unprecedented—this is exactly what was done by the government in 1956, when buildings phased out the use of coal for domestic heating over the course of seven years.
Cutting building emissions would improve the air quality dramatically, a boon to the health of those breathing it and the environment.
Establishing priorities and rights does little in absence of strong enforcement mechanisms. If passed, the Clean Air bill would give several public bodies, including mayors and local authorities, the power to demand compliance with the law, including by fining buildings that don’t follow its standards.
If replicated in other countries, the zero-emission approach might provide a path toward making clean air available not purely in a way that preserves the environment, but that keeps people healthy, too.