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If air pollution isn’t a public health issue then what is, asks RSPH chief

Ella Adoo-Kissi-Debrah case will have impact over the months and years.
29 April 2021 , Katie Coyne

Air quality, alongside other environmental and food standards issues, are core public health issues now and for the future, said RSPH chief executive Christina Marriott.

Marriott welcomed recommendations for tougher, legally binding air quality limits made in a report following the death of Ella Adoo-Kissi-Debrah. The nine-year-old is the only person in the UK, and possibly in the world, to have air pollution listed as a cause of her death.

The prevention of future deaths report also recommended raising public awareness of air quality information, and that medical and healthcare professionals inform patients so they can take action.

Marriott questioned this onus on the individual to deal with what are environmental issues. She said: “Of course, if you are treating a child who has asthma to the level where tragically air pollution could lead to that child's death, you are probably honour-bound to say to their parents this is the case.

“But what does that mean if you live in a housing association house and you have no chance of being able to move away, because you can't do a house swap and you can't do a private rental?

“So, again, we're putting the onus on individual parents, individual families to respond to what is an environmental and public health challenge that comes back to [the fact that] we just allow our cities to have this level of noxious substances floating around.

“And is that not the core challenge of public health. I'm going to go all John Snow here, is it not about protecting the population from this? I assure you, that is a role for our government and our mayors to step in and protect the populations they are meant to serve from dangers that you cannot individually control or move away from.

“We protect kids from their parents smoking, but we don't protect them from pollution coming from our roads or pollution coming out of industry.”

She added: “Where [will] government decide they can step in to protect individuals’ health and population health and where we don't? It's going to be a key example to think through in the next few months and years – where does that line fall? Where does it fall for air pollution? Where does it fall for climate change? Where does it fall for food production.”

Marriott paid tribute to Ella’s mother, Rosamund, as an “amazing” woman for pursuing the case and to have got the first recognition, in a coroner's court, of the impact of air pollution.

The public health chief said the sector had achieved a lot over the past 70 years and progress had been made on many individual issues such as seatbelt safety and smoking.

She argued the UK has good regulations around food safety and water safety – where the causal link is obvious. But added: “I think our next challenge is how do we engage with the state and with industry when the causal chain isn't simple.”

Christina Marriott, chief executive of RSPH

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