Public health campaigners applauded a “landmark” ruling by a coroner in London Wednesday, as air pollution was officially recognized as a cause of a person’s death, in what anti-pollution groups said was an international first. 

Philip Barlow, a coroner in the city’s Lewisham neighborhood, found after a two-week inquest that air pollution “made a material contribution” to the asthma attack and respiratory failure which killed nine-year-old Ella Kissi-Debrah in 2013. The pollution was mostly caused by heavy traffic on one of London’s busiest streets, the South Circular.

“We urgently need to see a seismic shift in the pace and extent to which the government, local authorities, and clinicians work together to tackle our air pollution health crisis.”
—British Lung Foundation

The level of exposure Ella was subjected to was illegal according to guidelines set by the World Health Organization (WHO), Barlow found, with particulate matter (PM) and nitrogen oxide emissions reaching excessive levels. 

“Ella died of asthma contributed to by exposure to excessive air pollution,” Barlow said in his report. “The whole of Ella’s life was lived in close proximity to highly polluting roads. I have no difficulty in concluding that her personal exposure to nitrogen dioxide and PM was very high.” 

The inquest came after a seven-year campaign by Rosamund Kissi-Debrah, Ella’s mother, who said Barlow’s ruling secured “justice for her which she so deserved.”

Kissi-Debrah was pleased that Barlow’s conclusion was “so decisive, so comprehensive,” but emphasized to reporters that Ella’s case is now about the health and safety of other children. 

“Still, as we walk around our city where we have high levels of air pollution, there are still illegal levels of air pollution now as we speak, so this matter is far from over,” Kissi-Debra said.

As Kissi-Debrah noted, the WHO has reported that seven million people die each year as the result of air pollution.

Ella’s cause of death on her death certificate was updated following the inquest to say “acute respiratory failure, severe asthma, and air pollution exposure.”

London Mayor Sadiq Khan said Wednesday that the coroner’s report “must be a turning point so that other families do not have to suffer the same heartbreak as Ella’s family.”

“Toxic air pollution is a public health crisis, especially for our children, and the inquest underlined yet again the importance of pushing ahead with bold policies such as expanding the Ultra Low Emission Zone to inner London,” Khan said. “Ministers and the previous mayor have acted too slowly in the past, but they must now learn the lessons from the coroner’s ruling and do much more to tackle the deadly scourge of air pollution in London and across the country.”

Khan plans to expand London’s Ultra Low Emission Zone by October 2021, among other reforms, and a study by Kings College London found that following a “trend of inaction seen between 2010 and 2016,” the city’s air is expected to be within legal limits for nitrogen dioxide by 2025. 

The British Lung Foundation said Wednesday marked “a landmark moment in the fight against toxic air.”

“We urgently need to see a seismic shift in the pace and extent to which the government, local authorities, and clinicians work together to tackle our air pollution health crisis,” the group said. 

This post was originally published on Radio Free.