Richard (“Drew”) Marcantonio is a social and environmental science researcher at the University of Notre Dame’s Kroc Institute for International Peace Studies. He is working on a book about human-produced toxic and nontoxic pollution and the harm it causes.

In December, a British coroner ruled that the cause of 9-year-old Ella Adoo-Kissi-Debrah’s death in 2013 was “toxic air pollution.” On its face this may not seem all that important, given that an estimated 7 million people die annually from air pollution and more than 90 percent of the world’s population breathes in hazardous air every day. And yet Ella’s certificate of death is the first to formally list toxic air pollution as the cause of death.

Ella’s case is part of a growing recognition that human-produced toxic pollution is causing a substantial global health crisis, and it has substantial implications for environmental policymaking and for the legal liabilities that pollution producers may face in the future.

If the recent cases surrounding glyphosate — the herbicide pioneered by Monsanto in its infamous Roundup weedkiller — are any guide, Ella’s case could trigger a potential windfall of cases. After a California court awarded $289 million in damages to Dewayne Johnson, a groundskeeper who used glyphosate for decades, civil cases mounted by the thousands. As a result, Bayer, which acquired Monsanto in 2018, agreed to a $10 billion settlement for all other cases in the U.S..

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In the U.K., Ella’s case has already sparked local action. The British government recently stated that in response to the verdict it would allocate $5.2 billion towards cleaning up vehicle transport emissions in cities and reducing urban nitrogen dioxide levels — the pollutant named as partially responsible for Ella’s death in the coroner’s report. The mayor of London, Sadiq 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.”

Living in London, Ella was like many urban-dwelling children who are more likely to develop asthma or other respiratory illnesses due to early and chronic exposure to air pollution from cars, buses, and industry. The coroner concluded that a complex of different noxious gases and particles in the air she breathed daily caused the asthma attack that led to her death.

While children’s respiratory systems are more vulnerable, adults do not escape the reach of air pollution in cities, where higher rates of dementia and Alzheimer’s are linked to exposure to particulate matter of 2.5 microns or less in size. It’s also one of the strongest correlates of death or hospitalization due to COVID-19. Spikes in particulate matter, along with other air pollutants like nitrogen oxides, are associated with higher death rates in general in the days following exposure.

Here in the United States, there’s been relatively little attention paid to Ella’s case. Given the pandemic, domestic political struggles, and the transition to a new presidential administration, there is certainly an overload of news competing for attention. But with the renewed focus on climate change and environmental justice signaled by the Biden administration and among U.S. policymakers, Ella’s case could be the perfect catalyst for environmental justice, in which poverty, race, and environmental risk exposure intersect. Ella’s case sets a legal precedent to do something about it.

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Death certificates fall under the purview of the Centers for Disease Control and Prevention. Thanks to guidance issued by the Obama administration, environmental exposure may be listed as a contributing factor to a death, but there is currently no code to attribute the immediate cause of death to a toxic pollution exposure. The Biden administration could issue guidance to the CDC to change that, which could shift the way people think about pollution.

There are more than 450,000 toxic sites across the U.S. and more than 20,000 active permitted polluters. We need to amend and bolster current domestic environmental legislation to hold polluters accountable and to make the changes permanent, rather than executive orders and programs that can be rolled back by a future administration.

Biden’s order to build a White House Office of Domestic Climate Policy and an environmental justice interagency council is a formidable start to mitigating and remediating toxic pollution and its unequal distribution. Additionally, the Biden administration needs to put toxic air pollution on the international environmental agenda, for example leading the charge in creating a corollary international agreement to the Paris Climate Agreement.

Doing so would signal a shift from treating the outcomes of climate change to treating the causes. For example, in early 2016, the Department of Housing and Urban Development deemed the Isle de Jean Charles along the Louisiana Gulf Coast too risky to live on and granted $48 million to the community to relocate, for the first time codifying the term “climate refugee.” But what could have been the start to a long process of redistributive environmental justice to communities threatened by climate change was quickly doused by the incoming Trump team.

In that case and in the case of glyphosate, it is the outcomes of pollution that were addressed — either by restitution or relocation — rather than the root cause.

Ella’s tragic death puts a face to a problem that will be responsible for many more deaths in the future if we don’t change our current policies. Let’s not let this opportunity for systemic change pass us by.

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