Cause of Death: Follow-up

Guest News Brief by Kip Hansen – 18 December 2020

The New York Times and The Guardian are both reporting a “landmark ruling” from Britain.  “A 9-year-old girl who suffered a fatal asthma attack in 2013 became the first person in Britain to officially have air pollution listed as a cause of death, a British official said. . . . In the ruling on Wednesday, assistant coroner Philip Barlow in London said air pollution had significantly helped induce and exacerbate Ella’s asthma, adding that she had been exposed to levels of nitrogen dioxide and particulate matter in excess of World Health Organization guidelines.” [ source: NY Times ]   

In a recent essay here, I discussed the problems with the reporting of Cause of Death and some of the details on how this is done in the United States. For the details, read (or re-read)  Cause of Death: A Primer

The fact is that Cause of Death is not simple, not cut-and-dried,  not always obvious and often contentious.  It is important to know that deaths in the UK are handled differently than in the United States.

In the United States, a doctor or coroner simply fills out a Death Certificate listing the chain of events or chain of diseases that led to the death, including any contributing factors.  In England and Wales, there are a long list of cases in which a death must be subject to an inquest.   If you watch British TV shows, you may be familiar with the older version of an inquest, in which some coroner must rule a death a natural death, a suicide, a murder or “death by misadventure”. 

 The Guardian reports the case this way:

A coroner has made legal history by ruling that air pollution was a cause of the death of a nine-year-old girl.

Philip Barlow, the inner south London coroner, said Ella Kissi-Debrah’s death in February 2013 was caused by acute respiratory failure, severe asthma and air pollution exposure.

He said she was exposed to nitrogen dioxide and particulate matter (PM) pollution in excess of World Health Organization guidelines, the principal source of which were traffic emissions.

The coroner said the failure to reduce pollution levels to legal limits possibly contributed to her death, as did the failure to provide her mother with information about the potential for air pollution to exacerbate asthma.

“Ella died of asthma contributed to by exposure to excessive air pollution,” said the coroner on Wednesday.

This young girl’s death had been subject to an inquest in 2014, which found she had died of acute respiratory failure.   But, Cause of Death can be contentious and sometimes, political.  In this case:

Ella’s mother, Rosamund Kissi-Debrah, a former teacher, spent years fighting to have her daughter’s death examined by a second coroner. Her resilience was repaid on Wednesday when Barlow agreed with expert medical evidence provided by the family which said Ella’s particular form of acute asthma was exacerbated by air pollution.

Kissi-Debrah’s lawyers submitted that air pollution was a public health emergency and there was a pressing need for it to be recorded as a cause of death to ensure public health programmes to tackle toxic air were prioritised.

In evidence to the two-week inquest, Prof Stephen Holgate, an immunopharmacologist and consultant respiratory physician of the University of Southampton and Southampton general hospital, said a biological cause of Ella’s disease getting worse in the winter months was the seasonal worsening air pollution.

He said it was the cumulative effect of the toxic air Ella was breathing in living within 30 metres of the South Circular road that caused her final acute asthma attack.

The Guardian

For those not familiar with London, UK, the South Circular Road  is not a multi-lane major highway, but rather: “The South Circular is 20.5 miles (33.0 km) long. The majority of the road is single carriageway, one lane each way, aside from a small section of dual carriageway near the Woolwich Ferry. It is a primary road for its entire length” and “The South Circular has received sustained criticism for congestion and pollution and is one of the least popular roads in Britain.” [source:  Wiki ]  

In this case, we see the sad end of a young girl’s life.  A young girl that had suffered from severe asthma for years and had been repeatedly hospitalized for asthma attacks and seizures.  Somehow, the public health doctors had reportedly failed to inform her mother that asthma sufferers should not live where there are exacerbating circumstances, such as high ozone levels, high dust levels, high levels of roadway auto and truck exhaust.  Her mother, a school teacher, should have known this, with or without public health officials specifically informing her, as all medical web sites on asthma feature this information

In the end, it appears that a second coroners inquest has found, as should have been obvious from the beginning, that, as is common medical knowledge, roadway air pollutants can be a contributing trigger for asthma attacks.  The landmark ruling though is almost entirely political  — the shocking thing being that her family apparently remained ignorant of the basic facts that every parent of a child suffering from asthma would know. 

As for Cause of Death, we see once more that it is not always a matter of simple medical facts and that the medical facts can be confused and conflated with other considerations and popular social movements. 

# # # # #

Author’s Comment:

The area in which I live, the Central Hudson Valley of New York State, is listed as #19 on the Allergy Capitals of America list – one of the worst paces for allergy and asthma sufferers to live.  Everyone with pollen allergies living here knows this and is rudely and painfully reminded of this twice a year (we are lucky enough to have two allergy seasons).  If any parent of a child suffering from severe allergies living here had tried to claim ignorance of this simple fact, they would be laughed out of court. 

As for science, in a greater sense, the concept of cause is a difficult issue, and, in my opinion, is most often mis-assigned based on vague association.

As many medical practitioners have begun to point out, Covid Deaths being reported in the media are more correctly characterized as “Deaths Involving Covid” and in many more cases, “Deaths with some vague association to Covid”.

Cause of Death is simply not simple.

# # # # #

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John McCabe
December 18, 2020 6:08 am

I watched the report on this on the BBC last night, and totally agree with your comments. It’s absolutely fine accepting that air pollution was a contributory factor in this case but, as you rightly say, anyone with half a brain knows, and has known for decades, that this is the case and her parents should have done something tangible about reducing that risk.

Reply to  John McCabe
December 18, 2020 10:03 am

Frankly, I don’t believe in the ’cause of death’ listed on death certificates.
My father’s death certificate reads cause of death as “prostate cancer” but I know for a fact that he died of lung cancer.

Reply to  Neo
December 18, 2020 11:30 am

The lungs are about the first place prostate cancer spreads to.

Hot under the collar
Reply to  John McCabe
December 18, 2020 10:39 am

Another contributory factor was climate change alarmists at the time encouraging diesel over petrol because diesel cars emitted less CO2. Unfortunately, in 2013, diesel cars also emitted higher levels of real pollutants, such as, nitrogen dioxide and particulate matter. The air in London is now cleaner than it has been for centuries, although there is more to do.

Reply to  Hot under the collar
December 18, 2020 12:10 pm

French minister of green and ecoloon stuff (officially “ministre de l’Écologie et du Développement durable”), Roselyne Bachelot (under Sarkozy), was widely mocked when she encouraged diesel cars over gasoline.

But she was right WRT to the anti-CO2 doxa at the time!

Reply to  Hot under the collar
December 18, 2020 12:44 pm

Since humans control fire they have lived in smoke. It is like you say the air is now cleaner than it has ever been. 

Reply to  Hot under the collar
December 18, 2020 5:46 pm

Yes, one has to wonder just how many lives have been lost by the unnecessary promotion of diesel engines with their PM2.5 and other pollutants. The AGW mob will, however, never be held to account for this toll. Would they be the only global warming related deaths?

Mark A Luhman
Reply to  Alastair Brickell
December 19, 2020 10:12 am

PM2.5 does not kill anyone. I as a long time asthmatic I am at greater risk from the cold air than I am from dusty air.

Reply to  Alastair Brickell
December 19, 2020 2:55 pm

Gasoline engines emit particulate matter also. It is so fine and weighs so little that the pm2.5 test doesn’t measure it. However, because the spark ignition pm is so fine, it is more irritating and stays in the air longer. Diesel pm is orders of magnitude larger and settles out faster. Since spark ignition pm effectively isn’t measured diesel is blamed for ALL pm.

It doesn't add up...
Reply to  Alastair Brickell
December 20, 2020 6:08 am

Particulate filters have eliminated the problem. Tyre and road wear now dominate roadside particulates. Heavier EVs will increase that, although they may produce less by way of brake wear.

It doesn't add up...
Reply to  Hot under the collar
December 20, 2020 6:06 am

The reality is that diesel particulate filters had been a legal requirement for new cars since 2009, and the contribution of NO2 from road traffic is generally greatly exaggerated. Trends in pollutants levels since 1970 in this chart
comment image

It is surely remarkable that when pollution levels were of the order of three times higher, no coroner found pollution as a cause of death.

Check out the pollutants map here (set the menu and zoom in)

and you will see that there is only a small section of the A205 South Circular with higher levels of traffic induced NO2 around Catford.

December 18, 2020 6:09 am

Mother should be careful what she wishes for. If air pollution is accepted as a cause in a situation where the area is famous for its car pollution, mother can become liable for parental negligence and be added as a cause of death.

Doug Huffman
December 18, 2020 6:09 am

Meanwhile back at the ranch, Dale and Roy learned that Wildfire Smoke Carries Infectious Agents.

They are doomed, DOOMED I tell ya!

December 18, 2020 6:10 am

As I have said in regards to Covid (or ChiComFlu, as I like to call it), with apologies to George Orwell, “All deaths are equal, but some deaths are more equal than others.”

Gerry, England
December 18, 2020 6:44 am

And yet the medical fraternity still have no explanation for the rise in asthma as the air in cities has never been cleaner.

As for the WHO limits – how do we know they are valid given the political nature of the WHO and its poor performance in relation to Covid? The much-vaunted weekly consumption of units of alcohol has no scientific basis as an admission from one member ‘well, we had to come up with something’ shows.

Reply to  Gerry, England
December 18, 2020 7:34 am

The rise in asthma and some other respiratory diseases seems to be due the the LACK of exposure to allergens during early childhood through puberty.
In particular a Swedish or Danish study(it was years ago) found distinct differences in the same school between children who lived in a small city compared to children from surrounding farms. The major difference was farm children were daily exposed to animals, manure, plants, soil and other allergens. Parents in the city had been taught of the importance of being clean and washing up frequently so they taught their children the same things. The city children only had brief exposures to soil, manure of any kind, animals, etc.

The city children had much higher incidence of allergies, asthma, bronchitis and coughs. The other noted difference was that very young children were much more likely to have had instances of worm infections, which seem to be associated with fewer allergies and respiratory illnesses.

Peta of Newark
Reply to  Philo
December 18, 2020 8:29 am

Two part response to the ‘Farm Children’ remarks

1) I was a Farm Child.
My farm was a classic mixed farm. Primary enterprise was dairy but father ran a mini market garden – about 3 acres of potatoes, cabbage, turnip, parsnip and beetroot
Also reared abot 80 to 100 turkeys for the Christmas market
Veggies were sold to market trader but also swapped with neighbours for ha;ves of lamb and wodges of pork
Also real free-range chickens. father was also a good shot with his hi-velocity hollow point 22 rifle.
I was pretty-well brought up on rabbit casserole and raw cows milks. Cod-liver oil was bought in, in 45 gallon drums as an additive for the baby calves – I got some of that too

I and no-one I *ever* knew from age= 0 to when I went to university age nearly 18 had asthma. Not one case.
Was that because I ate a lot of dirt or simply just my diet – which you figure out from the above

2) A significat role model for me became a guy who had been born on the very farm I was born on, about 15 yrs my senior.
We met at the new large farm our family moved to in ’71 and he became/was our ‘Farm Hand’/worker.
‘Blot’ he answered to – a pet-name his parents gave him because of his chilhood habit of getting very very messy, playing in mud, dirt, grass, up down trees in whatever weather.

Cumbrian farm work (the weather actually, same for me) was not for him so he took off on an old Land Rover to ‘travel the world’
Landy broke down completely halfway to the Dover Ferry terminal and so he joined The Army – Military Police to be exact

They gave him a very tough medical exam in order to find out what vaccinations he should be given, should he be sent overseas. (That WAS the plan – geddit?)

He didn’t need any vaccinations. None. He was immune to almost everything and as strong as a horse

They also told him that the jam-jar bottomed spectacles he’d worn since age 4 were *completely* unnecessary. He had 20/20 vision

Thus, my point eventually….
People are getting ill and dying because of Shit Low Nutrient Plant Derived Food – food that is loaded with irritants, allergens and poisons.
Quackery from our doctors don’t help much either.

Things the plants put there EXACTLY to *deter* critters (that’s us) from eating them

Yet Brain Dead politically Correct Junk Science tells us that eating plants is the route to good health and long life.

The world has gone mad. Stop it. I wanna get off.

Reply to  Peta of Newark
December 18, 2020 9:20 am

Hmmmm…. all that exposure to dirt (garden and field crops), animals (horses, sheep, hogs, cattle, dogs, cats, chickens, pet birds), and cooking starting when I was 6, and running around in the fresh air might explain why I’m generally healthy, and my older sister, who shunned such things – couldn’t stand animals of any kind – and wanted nothing to do with “farm stuff” and has now told me that every time she gets the flu shot, she has a bad reaction to it?

I’m generally healthy, and yet she’s constantly got one complaint or another, and going in to one’s middle years with that is not a good sign. Same parents, same household, and same schools… and she’s always got something happen that I never have happen to me.

If Peta’s experiences and mine mostly match – all sorts of exposure to “bad” stuff, seldom sick at all – and I’m still out hiking around in the bush with a camera, annoying the geese when they start setting up housekeeping – then there may be something to that.

How many other people see this in their own families? I think it’s worth looking into.

Reply to  Sara
December 18, 2020 3:27 pm

Sara (and Peta) – I can’t solve these issues but I often think about them. I had terrible asthma as a child, many years ago, and all ‘they’ could do each time was sit by the bed and hope I recovered. I eventually ‘grew out of it’ – it seems it was better to get asthma early in life (if you survived it, that is) rather than later. Evolution’s ‘rules’ say that survivors pass on their survival factors. If we make a 100% pure environment then no protection gets passed on and one little hiccup wipes out the population. If our medicines cure every disease then we will breed more vulnerability and end up needing even more medicines. Without medicines life is short brutal and miserable. If we make a 100% toxic environment then everyone dies before they can breed. So as in everything a balance is needed.
PS. When it comes to medicines I admit to not having a completely balanced view – my main hope is that the medical profession keep ahead of whatever I have.

John F Hultquist
Reply to  Sara
December 18, 2020 9:34 pm

” <em>every time she gets the flu shot, she has a bad reaction to it? </em>”

Interesting. Small sample size and all, but still interesting.
I’m a dirt and manure kid, and I have never had a reaction to any sort of shot.

Reply to  John F Hultquist
December 19, 2020 6:46 am

Ditto, and it may be something that should be looked into. I don’t think my brother has ever been really ill with anything, either and he played all the school sports from grade school on up. I have a photo of him at about 5 holding his pet chicken in his arms. He was either out in the garden digging stuff up like me, or pulling weeds (we got paid $.01 per weed for that), just being a typical kid.
And I can’t figure out if that lack of illness is due to being outdoor kids or just good genes, but my sister would never get into any of the things my brother and I did as kids. My father was very seldom sick with anything, and ditto my mother.

Reply to  Peta of Newark
December 18, 2020 9:27 am

Peta, you left out the part as a farm kid when you used to secretly dip a finger into the cows’ molasses barrel and suck it like a lollypop.
Ah, what sweet memories!. Literally.
(god knows what else was in that molasses, but didn’t do us an harm)

Reply to  Peta of Newark
December 18, 2020 1:06 pm

Um, there’s no such thing as a medical exam to find out if a person is immune to the things we get vaccinated for. No one would give him a skin scratch test with a harmful virus to see if he already had immunity. If your friend couldn’t remember being vaccinated they would have just vaccinated him. There’s no harm in that.

Fred Dombrose
Reply to  Philo
December 18, 2020 8:41 am

It’s not possible to be microbe free no matter how hard you might try. Washing and disinfecting only temporarily reduces(!) the microbial load that quickly re-establishes. Microbes arrive from human and animal bodies, plants, shoes, clothes, the air, water … you name it, all of the time. Few people live in a sealed container that can be sterilised and remain so. Thus exposure to microbial allergens is inevitable and continual. Yours, a PhD microbiologist with 35 years experience.

Tony Berry
Reply to  Philo
December 18, 2020 9:17 am

It is likely that in individuals with asthma the primary cause is respiratory allergy. In a study at St Thomas’s Hospital (London) some years ago it was shown that at least 80% of asthmatics were allergic to house dust mite. House dust mite are ubiquitous in modern homes with central heating. About 8% of the U.K. population are asthmatic. The main allergens in house dust mites are cysteine protease enzymes which are potent and stable enzymes which have been shown to damage epithelial cells and release the cytokines TSPL with is a potent activator of the immune system and particularly Mast cells. Other common and potent allergens also contain proteases the most potent of which also contain cysteine protease; american ragweed is one example. The ingestion of one of these allergens into the lungs triggers allergic response via the IgE mechanisms but also cause significant cell damage and over time permanent scarring and inflammation making. the lungs sensitive to other inflammatory insults such as fine particles. So although ‘ pollution’ may trigger an asthmatic attack it is not the root cause of the condition. It is still not clear why some individuals become asthmatic and others not. It may be the hygiene hypothesis as you suggest. What ever the cause it is clear that allergy is rising in the U.K. population reaching 25% in the general population. But not all allergy sufferers are asthmatic but it is probable that most asthmatics are allergic. I have spent many years researching and developing anti-allergy treatments and in particular vaccines which do work but are not for the faint hearted!

Reply to  Philo
December 18, 2020 5:32 pm

I’ve been wearing the same mask since March….I get little micro exposures every time I go out….it’s a coronavirus

Reply to  Gerry, England
December 18, 2020 7:37 pm

Did you notice the coronor’s lure-and-switch trick. He started by talking about WHO recommendations and finished talking about them as if they were legal limits.

Nick Schroeder
December 18, 2020 6:45 am

Between 12/9/20 and 12/16/20 CDC logged 14,531 deaths attributed to Covid-19.
There were 74,340 deaths due to all cause. C-19 would represent about 20%.
They were distributed as follows:
 Under 1 year 1         0.01%
1–4 years        1         0.01%
5–14 years      1         0.01%
15–24 years    9         0.06%
25–34 years    60       0.41%
35–44 years    184     1.27%
45–54 years    500     3.44%
55–64 years    1405   9.67%
65–74 years    3071   21.13%
75–84 years    4350   29.94%
85 years +      4949   34.06%
The 65+ demographic was accountable for 85% of those deaths.

If you are 65+ w multiple health issues in a crowded nursing home and the staff brings in C-19 you are screwed, but then you were screwed anyway. In other words: If you are already seriously ill, C-19 will probably finish you off, i.e. no different from the seasonal flu.

C-19 is not a problem for the young and healthy herd. Mother Nature and her buddy Grim Reaper are just doing their jobs, culling the herd of the too many, too old, too sick warehoused too close together as Medicare/Medicaid cash cows in poorly run contagious lethal elder care facilities.

Japan has the highest percentage of 65+, 27%, yet just over 2,700 deaths. (WHO)
What do they know/do the rest of the world does not?

Jeffrey C. Briggs
Reply to  Nick Schroeder
December 18, 2020 7:50 am

Do we have numbers for the ages of those hospitalized? That could skew a little younger, which would support a broader lockdown approach for the sake of hospital resources, but if those numbers also skew heavily to the older crowd the “lockdown” effort should be focused on the elderly and not foisted on the rest of us.

Wayne Townsend
Reply to  Nick Schroeder
December 18, 2020 7:51 am

A partial explanation is that Japan (and all of East Asia) already experienced SARS Covid-1 (aka SARS) and developed a certain amount of immunity off of that exposure and many of the vulnerable were already taken in that outbreak.

Fred Dombrose
Reply to  Nick Schroeder
December 18, 2020 8:44 am

Courtesy Alex.

Screen Shot 2020-12-18 at 16.42.46.jpg
Ed Bo
Reply to  Nick Schroeder
December 18, 2020 9:09 am

Japan has few nursing homes, as they are not willing to admit the immigrants who would do the low-paid work required. I just lost my best Japanese field engineer, who retired at age 60 to take care of his ailing mother full time at home.

Reply to  Nick Schroeder
December 18, 2020 9:36 am

People try to put us d-down
(Talkin’ ’bout my generation)
Just because we get around
(Talkin’ ’bout my generation)
Things they do look awful c-c-cold
(Talkin’ ’bout my generation)
Hope I can die before I get old
The Who
I hope I die before I get o
I hope I die before I ge

Reply to  Nick Schroeder
December 18, 2020 1:44 pm

Maybe in Japan older people are more outside to see the sun stimulating their immune system.

Bill Parsons
Reply to  Nick Schroeder
December 18, 2020 2:03 pm

Yes. “At least 99.95% of people under 70 survive infection; that figure is only 95% for 70 and older.” According to Jay Bhattacharya and Sunetra Gupta of the “Great Barrington Declaration”. Their article in today’s WSJ recommends ending lockdowns and targting only the most vulnerable and elderly > 70 y-o for the initial rounds of vaccinations.

Meanwhile CDC is reporting that public health laboratories in the US have tested 182,414 people for flu. Only 123 cases were positives.

This impossibly low number is being reported as the result of America’s efforts to avoid Covid-19, i.e., our mask-wearing and social distancing. The question I have is why is the virus “raging” to new highs with these precautions but the total number of positive flu cases in the entire country only 123 cases?

Typically influenza “positives” (per total numbers of people tested) have been much higher. They were 14% in 2016, 25% in 2017, 17% in 2018, and 27% last year. This year they represent < .2 % of all tests done.

Once again I think this raises the question of mis-attribution of actual illnesses being reported by CDC – and health clinics. Government money does flow to Covid cases. Not to flu.

 Grants COVID-19 Webpage.

Thomas Gasloli
Reply to  Bill Parsons
December 19, 2020 7:45 am

Flu isn’t the only goofy statistic. Apparently there has been an unreported cure for heart disease because no on has died from it in the US in November. Same for cancer deaths. The two major causes of death have somehow been cured and the AMA has kept it a secret–unlikely. It is also unlikely that everyone who has died from heart disease or cancer in November tested positive for COVID. They are just lying.

Doc Chuck
Reply to  Thomas Gasloli
December 19, 2020 6:42 pm

What! Now we’re not supposed to lie? I never got that memo, I can tell ya. Ain’t lying these days widely regarded to be a freely expressive liberal art displaying clever achievement and so career enhancing? I mean, when is the last time anyone in government was held accountable for lying to the public? Get real!

And just how is anyone supposed get on with making a living with proponents of honest weights and measures peering over our shoulders? Besides, didn’t we scrub that truly burdensome IX commandment off the courthouse years ago.

Reply to  Nick Schroeder
December 18, 2020 9:12 pm

Japan (both culturally and by government financial incentives) does not tend to “warehouse” as many of its elderly in large nursing homes.
As noted by Ed Bo, it is common for a family member to care for an elder – which vastly reduces their exposure to all kinds of pathogens; particularly those to which they have no prior immunity.
Note that the death rate in Red States here is much lower than that in Blue States. There is also a big difference in the proportion of “warehoused” elders between those States.

Ian Magness
December 18, 2020 6:47 am

Very well written article Kip. Whilst this is clearly a very sad case indeed, you are right to infer at least an element of guilt on the parents, for unfathomable ignorance if nothing else.
The “South Circ”, along with its sibling the “North Circ” was a much earlier version of the M25 that now orbits London further out. The idea was to skirt around the central areas of the city. Even by the time I was a young adult in the 80s, both roads were notorious for being congested almost 24/7, and vehicle pollution was far worse then too. Thus, if you had a child with potential problems with this, the last place you would choose to live would be 30 yards from these incredibly busy roads. Further, if you were forced to live there for some reason, you would move heaven and Earth to move as soon as practicable. It is not obvious from the story (as documented at the time) that this family attempted to do so.
All very sad but I cannot see that the British authorities were responsible for this.

Reply to  Ian Magness
December 18, 2020 2:21 pm

I agree – but note that ‘Social housing’ – which I surmise may have housed the unfortunate child and her family – was not easy to exchange, even with a good reason, then as now.
Many [old] London County Council- built estates, especially from the Thirties, had some greenery around them [I don’t know if this was the case for this family’s home]. Some still do.


in The Real World
December 18, 2020 7:02 am

UK Government figures show that air pollution has dropped by 75% in the last 50 years.
And air quality figures from this year prove that traffic is not a major cause of emissions as during the Pandemic Lockdowns , with a massive reduction in traffic , air quality did not alter . Although there has been a large effort to keep the truth hidden.

So this has almost certainly been a political decision to try to blame at least 1 death on air quality so that the insanity of trying to ban fossil fuel vehicles has a bit of ammunition.

Ron Long
December 18, 2020 7:02 am

Not to make light about the death of ant children, but the general theme reminded me of a death in Texas. The Texas Rangers chased after an escaping wanted felon and finally found him. The wanted felon ignored their warnings to stop and raise his hands, whereupon the wanted felon starts running. The Texas Rangers shot him about 20 times. The coroner listed the cause of death as “suicide”. When asked about that the coroner declared “it is suicide to run from the Texas Rangers. Case closed.

December 18, 2020 7:40 am

Excellent job Kip. There is an example closer to your home where the concept of cause is a difficult issue. New York State’s current air quality “crisis” is peaking power plants. Peaker plants are claimed to have an outsized effect on communities and the environment because there are old and inefficient, some run on kerosene, and are disproportionately located in communities of color in New York City. The argument goes that they release harmful pollutants like nitrogen oxides, sulfur oxides, and tiny, easily inhalable particles that contribute to respiratory issues. Environmental justice activists claim that these power plants need to be replaced inferring that once they are replaced that there will be observable changes in the health outcomes in these neighborhoods.

A primary public health reference in their arguments is the Department of Health and Mental Hygiene’s (DOHMH) Air Pollution and the Health of New Yorkers report ( which concludes: “Each year, PM2.5 pollution in [New York City] causes more than 3,000 deaths, 2,000 hospital admissions for lung and heart conditions, and approximately 6,000 emergency department visits for asthma in children and adults.” These conclusions are for average air pollution levels in New York City as a whole over the period 2005-2007. Based on their results the report notes that: “Even a feasible, modest reduction (10%) in PM2.5 concentrations could prevent more than 300 premature deaths, 200 hospital admissions and 600 emergency department visits.” Their conclusions were based on average air pollution levels in New York City as a whole over the period 2005-2007.

In a post entitled PM2.5 Health Impacts in New York City ( and others summarized in New York Peaking Power Plants and Environmental Justice Summary ( I reviewed these claims. I found that the latest available average (2016-2018) to compare to the DOHMOH pollution levels show a 38% decrease since 2005-2007. If someone were to show me the resulting improvements in deaths, hospital admissions, and emergency room visits then I might have more sympathy for these claims. Furthermore, the health impacts rely on not only the PM2.5 impacts but also ozone which are both secondary pollutants. That means that they don’t have local impacts so observable power plant impacts on local neighborhoods from either pollutant are unlikely. In fact, if a local power plant has any effect on a neighborhood it would be to reduce ozone levels because nitrogen oxides scavenge ozone before they react with volatile organic compounds to create ozone.

Reply to  Roger Caiazza
December 18, 2020 8:55 am

Talking about C-19, UK hospitals receive a supplementary payment from government when they issue C-19 death certificate. This is meant to cover the additional costs involved. However many hospitals think the supplementary payment is inadequate so they are tempted to confuse “with C-19” and “of C-19”. One of the results is that the U.K. posts one of the highest C-19 death rates in the world. Many other countries would consider a high death rate shameful.

Paul C
Reply to  Spen
December 18, 2020 12:36 pm

NHS hospitals are also probably the most likely place to get infected with SARS-COV-2. At one stage, it was reported that up to 25% of patients being treated for COVID-19 in some hospitals had healthcare acquired infections. As that figure only counted patients testing negative throughout the first fortnight of their hospital stay before being tested positive, it would exclude the vast majority of patients – all those staying for less than a fortnight, and anyone infected as they are admitted who tested positive before the two week cutoff. Also, the many hospital staff who have been infected at work are not included in that statistic. General Hospitals are not the place to be treating highly infectious diseases – something our ancestors knew. If the money wasted on empty Nightingale Hospitals had been used instead to re-create some permanent Fever Hospitals, the current epidemic would have been handled better, and that infrastructure could be mothballed, ready to be staffed to handle the next pandemic, or even be used in normal winters to isolate the flu hospitalisations from other vulnerable patients.

David Roger Wells
Reply to  Roger Caiazza
December 18, 2020 9:13 am

Environmental Protection Agency Seal (Photo credit: DonkeyHotey)
By John Dale Dunn MD JD (via email)

United States Environmental Protection Agency (EPA) Administrator Lisa Jackson testified before Congress in September of 2011 that small-particle (2.5 microns or less) air pollution is lethal. “Particulate matter causes premature death. It’s directly causal to dying sooner than you should.”

At the hearing, Representative Edward J. Markey (D-MA) asked, “How would you compare [the benefits of reducing airborne PM2.5] to the fight against cancer?” Ms. Jackson replied, “Yeah, I was briefed not long ago. If we could reduce particulate matter to healthy levels, it would have the same impact as finding a cure for cancer in our country.” Cancer kills a half-million Americans a year — 25 percent of all deaths in the U.S. annually.

That same month, September 2011, Environmental Health Perspectives (EHP), a journal sponsored by the National Institutes of Health, reported an experiment that exposed a 58-year-old lady to high levels of small particles in a chamber. After 49 minutes in the chamber, the lady, who was obese with hypertension and a family history of heart disease, who also had premature atrial heartbeats on her pre-experiment electrocardiogram, developed a rapid heart beat irregularity called atrial fibrillation/flutter, which can be life threatening. She was taken out of the chamber, and she recovered, but she was hospitalized for a day. Weeks later, an abnormal electrical heart circuit was fixed by cardiologists, as reported in EHP.

It is illegal, unethical, and immoral to expose experimental subjects to harmful or lethal toxins. The Reference Manual on Scientific Evidence, 3rd Ed. (2011), published by the Federal Judicial Center, on page 555 declares that exposing human subjects to toxic substances is “proscribed” by law and cites case law. The editor of EHP refused a request to withdraw the paper and conduct an investigation.

The EPA’s internal policy guidance on experimental protocols prohibits, under what is called the “Common Rule,” experiments that expose human subjects to lethal or toxic substances. Milloy referenced the “Common Rule” that governs EPA policy on research conduct in human experimentation in his letter to the inspector general of the EPA requesting an investigation of the matter.

A full report on the research study shows that 41 other people were exposed to what the EPA says are harmful or lethal levels of small particles, with some enduring up to 10 times the EPA’s declared safe level of 35 micrograms per cubic meter of air. The EPA human experiments described were conducted from January 2010 to June 2011, according to the information obtained by on a Freedom of Information Act request, and ended three months before Ms. Jackson’s congressional testimony, but she still asserted dramatic claims of PM2.5’s lethality — thousands of deaths at stake and hundreds of billions in economic consequences from the deaths and disabilities caused by small particles.
According to the congressional testimony of Lisa Jackson, these experiments risked the lives of these 42 people. So what could have possessed these EPA researchers to do the experiments? The authors reveal the reason in their case report on the lady:
Although epidemiologic data strongly support a relationship between exposure to air pollutants and cardiovascular disease, this methodology does not permit a description of the clinical presentation in an individual case. To our knowledge, this is the first case report of cardiovascular disease after exposure to elevated concentrations of any air pollutant.

The people at the EPA claim that they must control air pollution to prevent the deaths of thousands. Then they expose human subjects to high levels of air pollution. Is it possible that they are lying, or unethical, or both?

In the experimental protocol, seven subjects were exposed to levels 10 times greater than the 24-hour safe limit for small particles, and all of the other 41 subjects were exposed to more than the 35 micrograms per cubic meter that the EPA says is the 24-hour safety limit. The researchers failed to report that none of the other subjects had any adverse effects, which is unscientific, since researchers are obligated to report results both for and against their hypothesis.

The only way out for the EPA in this episode is to acknowledge the reality that ambient levels or even higher levels of PM2.5 are not toxic or lethal, based on their own research, and to admit that their claims of thousands of lives lost from small particles is nonsense. Or they can stay with their assertions about small particle toxicity and face charges of criminal and civil neglect.

The individuals who were the subjects of this experiment certainly might be concerned if the EPA claim of small particle toxicity and lethality is true. There is good reason to believe that the EPA itself doesn’t believe the claims. However, based on congressional testimony by EPA officials, any death now or later of the subjects of this experiment from heart and lung disease or cancer would be under the cloud of concern about the EPA claims that small particles kill. What were the EPA officials and researchers thinking?
John Dale Dunn MD JD
Consultant Emergency Services/Peer Review
Civilian Faculty, Emergency Medicine Residency
Carl R. Darnall Army Med Center

David Roger Wells
Reply to  Roger Caiazza
December 18, 2020 9:18 am

Tube tunnels in London are 46 times more polluted than above ground but because its public transport and therefore green no one ever comments its those diesels. When levels of emissions are decided in the EU you have automotive on one side of the table and environmentalists on the other. Greenpeace wants X and automotive wants Y and after days of bartering behind closed doors an agreement is struck which has little if anything to do with what level of emission causes what diseases.

This is backed up by this:
Many of the so-called experts are only interested in self-promotion and winning their next research grant, and I think you have hit the nail on the head as regards the symbiosis they have with the media that is only interested in a good “bad news scare stories”!
Apart from not checking on the facts they ignore:
• Particles from tyres/road wear brake linings which will not be reduced by banning diesel engines.
• Natural NOx produced by grassland and microbes.
• NOx produced the photocatalytic action of urban grime
• NOx produced by central heating (condensing boilers especially)
• The very high concentrations of iron oxide in underground stations due to brake/track wear ( that is what causes that characteristic “tube smell”)
• The static air conditions we had a few times this winter with stagnant polluted air from the continent drifting across.
• Indoor particulates and VOCs from upholstery, paint etc…
All in all the media has a lot to answer for and it is sad to see some normally rational people sucked in by their antics!
With best wishes
Professor Peter J Dobson OBE
The Queen’s College,
Oxford OX1 4AW
and this:
Whilst there, I learned of a very interesting bit of research carried out at the end of WW2. Lord Penney (Rector of Imperial College at the time) commissioned some work by my first boss to check to see that the nitrogen and oxygen in the atmosphere would not all be combined by the heat of an atomic bomb. They proved it could not be as catastrophic as feared, but it is part of the reason for the NOx problem….the modern diesel and even modern petrol engines do run much hotter and hence a small amount of the gases in the air combines to form the nitrogen oxides.
Needless to say I am going to fight the media and bad scientist/medics rather robustly.
Diesel engines are not the biggest cause of air pollution they are just another convenient political target like Co2 where the science is inverted and exaggerated because to environmentalists like Client Earth – lawyers not scientists – the ends always justify the means.
Just to get away from environmentalists and environmentalism I might just hook up a diesel to my letter box because it couldn’t be worse.

David Roger Wells
Reply to  Roger Caiazza
December 18, 2020 9:22 am

So what does Professor Frew make of the claim that alarming levels

of toxicity in the air in the UK causes 40,000 deaths each year?

It is not 40,000 people who should have air pollution

on their death certificate, or 40,000 people who

It’s a lot of people who had a little bit of life shortening

To examine these figures further we travelled to Cambridge to visit

I asked him about the data on which these claims

They come from a study on how mortality rates in US cities

First of all, it is important to realise that that 40,000 figure

29,000, which are due to fine particles, and another 11,000

I will just talk about this group for a start.

These are what are known as attributable deaths.

Known as virtual deaths, they come from a complex statistical model.

Quite remarkably it all comes from just one number and this

was based on a study of US cities and they found out that

by monitoring these cities over decades that the cities which had

a higher level of pollution had a higher mortality rate.

They estimated that there was a 6% increased risk of dying

each year for each small increase in pollution.

So this is quite a big figure, but it is important to realise

it is only a best estimate and the committee that advises

the government says that this figure could be between 1% and 12%.

So this 6% figure is used to work out the 29,000

Yes, through a rather complex statistical model.

And a similar analysis gives rise to the 11,000 attributable deaths

Paul C
Reply to  David Roger Wells
December 18, 2020 6:33 pm

I seem to recall that those cities had many other differences too. Heavy industry, poverty levels, regional climate, diet, etc. However, I do not find it credible that data was only available for five cities. Almost like the discredited Ancel Keys seven countries study which had data available for over 20 countries, but selected a small subset which fit a pre-conceived narrative with one country anchoring one end of the plot, and ignoring the smoking data which was also collected.

It doesn't add up...
Reply to  David Roger Wells
December 20, 2020 6:16 am

Professor Frew is now sadly dead. But he did debunk those claims as nonsense in radio interviews and elsewhere.

Reply to  Roger Caiazza
December 18, 2020 9:43 am

All these reports of deaths from air pollutants make a great case for nuclear power generation.

Reply to  Mr.
December 19, 2020 9:39 am

It makes an even greater case for Governor Cuomo to not shut down a nuclear power plant just north of NYC.

Bill Powers
December 18, 2020 7:44 am

As someone recently pointed out, on WUWT, the one immutable fact about this thing called life is that none of us are getting out of it alive. All of this death assignment is akin to assessing blame which is something the political left do with great aplomb to menace the masses with hobgoblins in order to advance collectivist agendas e.g. death by COVID, death by climate change, death by violent weather, death by WOO WOO.

December 18, 2020 8:01 am

“Pointed threats they bluff with scorn
Suicide remarks are torn
From the fools gold mouthpiece the hollow horn
Plays wasted words, proves to warn
That he not busy being born
Is busy dying”

It’s Alright, Ma (I’m Only Bleeding)
Bob Dylan

Reply to  Kip Hansen
December 18, 2020 9:41 am

“NobEL”, Kip
(or were you pulling our legs?)

John Endicott
Reply to  Kip Hansen
December 18, 2020 4:33 pm

Auto-corrupt, as I like think of it, will get you every time. I’m capable of making enough typos on my own, without auto-corrupt adding to the mix.

Bruce Cobb
December 18, 2020 8:03 am

Cause of death: Stupidity. Case closed. One has to wonder, as well, was there no inhaler or epi-pen handy, and if not, why not.

chris moffatt
December 18, 2020 8:04 am

so the thousands who died in the killer smogs of London in the 1950s didn’t die from air pollution? Sadly this girl was far from the first.

December 18, 2020 8:11 am

I wonder what the reason of around 12,000 deaths in 1962 in London was, perhaps airpollution ?
The young girl certainly was not the first, as sad it is for the family

David Roger Wells
December 18, 2020 8:31 am

My Sister in Law Doreen left Leyton in London after she got married at 21 and moved to Ringmer in Sussex to a bungalow surrounded by fields. Doreen had smoked cigarettes a little but stopped when she got married.

Since moving to Ringmer Doreen was bedevilled with repeated chest infections requiring treatment with antibiotics. Then overtime taking antibiotics at home was not sufficient and she needed to be hospitalised to be treated with 3 intravenous antibiotics.

These repeated infections and hospitalisation plagued her life until she died age 68 from chronic bronchiectasis. Doreen also contracted Churg Straus Syndrome.

Where as I drove 50,000 miles a year for 30 years with cars that had no filtration so everything that came into the car went in to my lungs. As far as I know up to age 72 I have not suffered any obvious ill effects. But when I went skiing in Austria I contracted bronchitis in two days. First and last time I contracted bronchitis. My father was invalided out of the army age 16 with chronic bronchitis and chain smoked until the GP said he had six months unless he stopped I think at age 52, he died just before his 80th birthday. My brother smoked 60 a day until he was given the same message and died at 87 because his lungs like my fathers were in an awful state Ron had COPD but it was the scaring on his kidneys which was the final cause death because he could not make red blood cells.

Both of my sisters smoked they both got cancer only one survives but neither my father brother or sisters contracted lung cancer. My Mother did not smoke and neither have I. Mum lived to 91 and eat butter cream saturated fat everything that the greens say we should not eat but had no arterial disease at 91, she decided she had had enough.

I think people don’t care enough about what they eat and those that complain about air pollution and saturated fat and eating meat as life threatening will cheerfully consume many bottles without a care in the world because it is their drug of choice. I don’t eat anything that doesn’t look like food and thus far it has served me well. Lung oxygenation 98/99%, blood pressure when training 115/70. You pays your money and takes your choice genetics is hugely important and food is next, dense nutrition is critical to survival on a hostile planet, having said that last year it was reported a 93 year old solicitors clerk walked 3 miles up and down a hill twice a day, eat one bowl of porridge for breakfast and dinner and a sandwich for lunch the young female reported could not keep up with him walking up the hill. Makes you think?

Fred Dombrose
December 18, 2020 8:46 am

Causative contribution or correlation conspiracy?

David Hartley
December 18, 2020 8:47 am

I Grew up in Bradford in the 50’s/’60’s. Once the wool capital of the World the number of Mills was staggering as was the number of attendant mill chimneys. I well remember trips home where if one could see the next street light one was lucky an eerie experience for an infant. This level of industrial outpourings was repeated across the country especially in the North. To make this claim is so bizarre it creates the danger of Aneurism in any adult capable of thought. Thousands upon thousands, in all likelihood into the millions throughout the Industrial Age in the UK died from air pollution, hence the Clean Air Act. Palpable nonsense.

What about the danger to our mental health hearing or reading bollox like this. The World is truly insane and unfortunately the Asylum is in the hands of the Lunatics.

David Roger Wells
December 18, 2020 9:08 am

I have a large medical dictionary and on the basis of the number of deadly diseases listed I am surprised at anyone gets to live beyond puberty. A mere few hundred thousand have spawned 7.6 billion souls so to a huge extent inbreeding is a fact of life, it is a lottery but isn’t that why we have a health service. Though in the UK the NHS was not put in place to help people get back to health it was put in place after WWII to soak up employment which is were the doctor knows best syndrome came about and most often they did not know better top down bureaucracy was the rule and we just existed to servants to the cause and very little has changed.

December 18, 2020 9:09 am

Why does a mother who lost a child to asthma six years ago need lawyers to make public news statements about the cause of death in 2020? That is the question people should ask themselves.

slow to follow
December 18, 2020 9:15 am

The single page Record of Inquest is here:

The Inquest was held under consideration of the Human Rights Act as specified in Section 5(2) of the Coroners and Justice Act 2009:

“Where necessary in order to avoid a breach of any Convention rights (within the meaning of the Human Rights Act 1998 (c. 42)), the purpose mentioned in subsection (1)(b) is to be read as including the purpose of ascertaining in what circumstances the deceased came by his or her death.”

slow to follow
Reply to  Kip Hansen
December 18, 2020 2:13 pm

Full HJA Press Release here;

As far as I know there are no public records of the Inquest proceedings, so everything that is in the public domain is based on the widely circulated and repeated press releases of the solicitors or yellowjersey pr company.

December 18, 2020 9:56 am

If the coroner can be goaded into this decision, then the cause of death of the poor child really should be listed as “child abuse due to wilful disregard of the pollution or extreme criminal negligence of factors affecting the health of the child.” There should be another inquest to probe the parents for not moving sooner.

December 18, 2020 10:01 am

SARS-COv2 is life imitating the movie “Final Destination”.
Cheat death now, it comes back for you later.

Andy Pattullo
December 18, 2020 10:16 am

With so few details it is difficult to know if this is a valid attribution of risk or a politically convenient claim to be used to advance more punishing but possibly ineffective environmental regulations. If particulates and chemical aerosols are as dangerous as claimed using poorly designed, often non-transparent and highly questionable correlation studies then many natural environments including forests, dry dusty lands, national parks, geothermal formations, volcanos and vigorous sea sprays must be considered hazards. Similarly a wide variety of naturally occurring plants and other allergens are hazards. In this case blaming possible anthropogenic pollution for a winter asthma death and not mentioning the adverse effect of cold temperatures plus/minus seasonal viruses would be a very selective view of things.

Asthma is a chronic disease requiring ongoing medical therapies both for prevention and management of symptoms. Was there good medical supervision and was there compliance with appropriate therapies? I have managed asthmatics early in my career who were resistant to virtually all therapies and in many cases would return with life-threatening exacerbation on a regular basis. Therapies today are much more effective but nothing is foolproof. My suspicion is that no-one can reliably attribute a death such as this to ambient pollution without strong evidence proving cause and effect. This would be especially difficult for a medical practitioner to reach a conclusion long after the tragic event as cause and effect would be largely based on speculation.

December 18, 2020 12:20 pm

Will a rationed health care system ever be found to be responsible for any death in England and Wales?

December 18, 2020 12:23 pm

When does the Pope revamp criteria for climate sainthood?

Paul C
December 18, 2020 1:02 pm

Yet the acute respiratory failure happened at a time of year when exposure to the lower levels of outdoor pollutants was at minimum, and exposure to higher levels of indoor pollutants would be maximised. February is not the time of year to be spending time outside – even down south in balmy London. I am sure the current WHO guidelines could be used to “prove” that pollution levels in the past (and present day China) killed the entire populations of cities – which .simply is not true.

December 18, 2020 4:36 pm

The coroner said…the failure to provide her mother with information about the potential for air pollution to exacerbate asthma (contributed to her death).

Every city has air pollution. It’s a fact of city life. You can minimize it somewhat, but air pollution is a product of normal human behavior and when humans cluster together in high density, there’s more of it. That air pollution exacerbates asthma hasn’t been a mystery for a century or more. People with severe asthma and other respiratory conditions have been moving to cleaner places for decades. Her mother has no excuse for not knowing that, unless she is profoundly, debilitatingly ignorant.

Then there’s this:

Ella’s mother(‘s)…resilience was repaid on Wednesday when Barlow agreed with expert medical evidence provided by the family which said Ella’s particular form of acute asthma was exacerbated by air pollution.

So Ella’s mother’s “resilience” ultimately proved that she is to blame for not doing the smart thing and moving out of the city. I’m not sure any mother would be excited by the guilt that comes with learning that her failure to act resulted in her child’s death.

Last edited 2 years ago by stinkerp
Robert of Texas
December 18, 2020 6:02 pm

Cause of death? Having severe asthma. You cannot adjust the world to everyone’s perfect needs, people have to adjust to the world around them. In this case the girl would have had a better chance living somewhere else, but she still may have succumbed to an asthma attack while young.

This is like blaming the peanut for killing someone allergic to peanuts…it’s the allergic reaction killing them – not the peanut becoming somehow a killer mutant legume. They should have avoided the peanut if they are allergic to it, not removed all peanuts from the face of the Earth.

December 18, 2020 7:28 pm

If you want an allergy capital, it’s hard to go past Canberra, the capital of Australia. I have to use allergy medicine all year round.

John F Hultquist
December 18, 2020 9:52 pm

Recall from Dec. 10th

  • Bombshell finding: Automobile tires, not climate change – is killing west coast salmon

” a chemical called 6PPD-quinone, a biproduct from the 6PPD preservative added on tires to prevent breakdown by ozone ”

Just wondering about all the other things that might be involved.
From my first visit to a big city (Pittsburgh PA) I knew I did not want to live in such a place. Air in the valley did get cleaned up, starting about that time.

December 19, 2020 1:00 am

Cause of Death is simply not simple.”

Oh yes it is – on the front page under a headline…

Laurence Ridyard
December 19, 2020 1:44 am

Huh ! I have no doubt she was not tested for Psittacosis. I was wrongly diagnosed as having asthma, then almost died from ” atypical pneumonia “. I advise anybody diagnosed in the UK with asthma to ensure they are properly tested for Psittacosis, otherwise known as Parrot Fever, which the NHS does not carry out proper tests for.

December 19, 2020 3:52 am

Call me cynical but I’m waiting to see how much compensation she receives.

December 21, 2020 7:49 am

I’ve breathed a lot of South Circular air and I don’t believe a word of it.

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