Advocating for Cleaner Air

I'm Wendy Zuckerman and this is Science verses Before we get into today's episode, I just want to say that We're getting advertising from various companies about AI products, but we are going to be rethinking our policy on all of this For those who have been writing to us, we are reading your comments. We totally hear you We have to take a lot into account to try to keep this show going. and there are some balances we need to strike, but sometimes we make the wrong call So I just wanted to say thank you for getting in touch. And now on with the show Recently, the Trump administration has been rolling back protections that are designed to keep the air clean in the US And he's been making it easier for certain industries to pump potentially dangerous chemicals into the air They want to make pollution great again. So in case you don't know, the EPA just announced that they're doing massive deregulation. It means pollutants from cars, trucks and power plants will no longer be regulated at the federal level Ccel the EPA iss abbserved Just totally absurd emission standards, which was a disaster. Trump says that he's doing this to save money for the automotive and fossil fuel industry and to make cars cheaper for consumers And since he's said that climate change is a scam, He's obviously not worrying about that I'm like us But the thing is even away from climate change, these changes that he's making It made us at science versus want to go back to an episode that we published several years ago. It's one that I find myself thinking about a lot these days and I won't say too much more about it. I've probably said too much already Except that this story unfolds as a medical mystery Let's just jump in So tell us about it is Rosaminda D Kissy Deborah. She's a former teacher in London One second, one second. this is my daughter. Let's see what she dos. Hi bubs Can you know what sharing Yeah, okay. I love you too byye. Rosamond is a single mum, and just as we got on the call, one of her twins phoned, it was about her birthday. Do see what For one day in the year, I allow them to have chocolate cereal. . Oh gosh she went to be sana's such a st' momum. Oh no She did say I love you at the end. so see, D good But our story today isn't about the twins or chocolate cereal. It's about Rosamond and her oldest daughter, Ella She was the big sister to those twins big brown eyes and often wore her hair in braids Rosaman told us that she loved to swim and bike And she was super competitive. L she would play chess conect fall so she was into board games. She was into beating people, you know, like ling you people in, pretending that, you know, like a chess game was equal that when you got comfortable bang bang, bang check, mate. Mom, would you like to play chess? No, thank you very much, Ella. I don't want to play chess with you Hello was smot At nine years old, she was picking up Jane Eyre. And just the other day, Rosaman found this book that Ella had been reading It was called The Observer Book of Genius So who did Ella compare herself to I follow me have a look in there Plato, she was Pythoras So she had a great sense of humor. But a few years before all this, Ella's life had taken a turn It started in October, twenty ten. when she was six years old. Ella and her mum had gone to visit the mononument to the Great Fire of London. It's this tall tower and to get to the top, you have to walk up more than three hundred steps So together, They were climbing this tall tower But weirdly, Ello was struggling She'd been a little sick. a bit of a cough. I wish she was climbing up the stairs. she said, Oh, I can't climb up the stairs. And then I remember typical mum, I I saiding, you've only got a cold Little did I know it was the beginning of the end That night on the way home Ea fell asleep on the train whichich was also strange And from there, Things got bad that Ella had. turned into these terrible coughing fits. It seemed to come out of nowhere Sometimes she'd cough so hard that she couldn't breathe. What used to happen is she used to get so much mucus, herer lungs would collapse and she would stop breathing So we had to resuscitate her to live And because oxygen wasn't getting into her brain Sometimes she'd have a seizure and even pass out By Christmasim, she had been admitted to ICU for the first time She was admitted to hospital twenty eight times. twentywenty eight times Yes Yes. So she had hundreds of attacks And the scariest part of this Rosaman didn't know why any of this was happening How did her kid go from being perfectly healthy too being in the ICU. in just a couple of months Ella would go to some of the best doctors in London, many different hospitals And yet no one could tell them what was going on after the break. The story of Ella's medical mystery and how it made the invisible visible This episode is brought to you by Quaker Oats. The pace of the morning, the rhythm of the commute, the energy for whatever the day throws your way However your day unfolds, it all starts in the morning. So start with Quaker oats. one hundred percent whole grain oats with a good source of fiber to support digestive health and energy to keep you going. Stay in sync throughout the day Quaker, the official sponsor of the FIFA World Cup twenty six, brringing you fuel to start whatever's next. Visit Quakeroats dot com slash FIFA to learn more. Adobe Firefly is the all in one creative studio with AI powered image and video editing for today's creative process. buuilt for creators of every kind Firefly helps you generate, edit, and experiment fast Because the asks aren't getting smaller budgets aren't getting bigger, and the timelines, oh yeah, still tight With all the best creative AI models in one place, Firefly brings your ideas to life. Unlock a better way to make with Adobe Firefly. Welcome back Where we left off Ellab, who had been this Really healthy little kid. was now in and out of hospital And her mom was desperate to figure out what was making her sick What did doctors tell you, you know when you were going into hospital? We didn't know. We were testing her for loads of things, epilepsy, cystic fibrosis, loads of things we were testing her for. Doctors were confused because her symptoms were kind of all over the place, likeike Ella's lungs were producing way too much mucus, which made it harder and harder for her to breathe And that kind of thing can happen in people with cystic fibrosis. So they tested her for that came back negative Doctors also tested her for epilepsy because of the seizures But that didn't pan out either tons of blood tests, EGs and doctors' appointments Hello. Finally got a diagnosis They told her she had asthma That was weird too because she didn't present herself like a normal Asthmatic One of the best medications that we use for asthma, steroids It didn't work for LR And then there was her cough It was just something weird about it Well you know what, I would recognize Ellna's cough anywhere. If you gave me a thousand coughs I could still pick out her cough The medical name for a cough like Ellers, where you cough until you pass out It's called Tough synop pay And one day, while Ella was getting one of her mini tests, Rosammond started Googling it I was looking it's up in hospital. And the research because I'm a bit obsessed with research in my job as a teacher. the research at the time when it came to cic syncy showed me there were mainly men in the fifties and they'd been long distance lorry drivers. And I remember looking at the time game. They are many in their fifties She's nine, I've never smoked, donon't get the connection. And I remember showing it to the doctor didn't get the connection It wasn't a thing that a child got So it didn't make sense she had it Most of the people with cough syncopeay are middle aged men who have been smoking for years It rarely happens to kids One of Ella's doctors said that her case was so odd that they wanted to write about it in a medical journal which Ea was excited about An Ella would go on to be written up in many medical journals making international news and helping Thousands of people breathe easier But in the middle of all this, Rosamond andlla. didnn't know any of that. And then there was this one final but really important mystery here This truly was asthma. Th what was triggering it Most asthmatics, you get an attack because it's triggered by something. cigarette smoke, mold, cleaning products. That stuff gets in your lungs and causes this huge inflammatory reaction and then your airways constrict Doctors tested La for all kinds of stuff, and none of those triggers made sense And the thing is, Ella didn't always have attacks They're comeing clusters, but when she was feeling okay Rosamond would tryry hard to keep things normal Ella loved listening to music, so they'd put on her favorite songs and dance around to them Rosamond remembers this one song that she loved by Justin Timbbleake and JZ It had just come out. this was early twenty thirteen It's called suit and tie Oh my sit and do. See, I can see her dog say else is to like jump on the sofas. You know how justust us to jump. And blama, don't break your neck Seriously, Bama, don't bre We have enough problems, I used to say to her soon after. Ella had another asmer attack Rosamman said that It startted out. justust like a normal night Nella was listening to music. by Adele She was kind of obsessed with that song And I remember that night, she was in the playroom on the computer playing Skyfall again and again. And I remember because it was Valentine's Day and I'd gone and bought food I was cooking. I was like, look, You need to go and have a shower and be ready to come and eat because we needed to eat by a certain time. You know, we had school the following day. And I remember. so my f will say to you, Oh, M shouted at her the night before she I was like look I know what happened was it makes her happen, but we need to eat and I've cooked and there she is on there. And I remember being so upset when Adele won the Oscar And I wasn't alive to see it Ella had a coughing fit that led to a seizure and then a heart attack. She died in the middle of the night Three AM. on february fifteenth, twenty thirteen In the UK, when someone dies of unknown causes, a coroner is called in to do the assessment In twenty fourteen Karna declared that Ella died as a combination of acute respiratory failure and severe asthma But still None of this made sense to Rosamond And she still wanted to understand What had triggered the attacks? killed Ella It was important to know why she died. She has siblings and I knew as they got older You know, what was that going to say? She got asked my why, how? I had no answers. Coroner's report was mostly useless to Rosamond Except There was this one thing. He triger whats to do with something in the air It didn't specifically state what it was And that gave me some hope I thought at least this is a bit further than we've got before To push it even further, she started doing a bunch of media interviews to say, lookook, this is what's happening to my daughter. If anyone's got any ideas out there, if they can help me get to the bottom of this mysterious thing Could they let me know? is how the ball began to roll People got in touch from all over the country, throwing out all kinds of ideas for what might have happened to you And this eventually led her to Stephen Holgate a professor at the University of South Hampton who specializes in asthma and allergies One day in twenty sixteen, he was on the train heading home from London On the long journey back, he picked up the standard and he was reading it. I had to pick up the evening standard and I saw Rosamond Kissy Deborah. I mean it was just a dreadfully sad story Stephven had spent his entire career researching asthma, getting to know the lungs inside and out And here was his life's work sitting in front of him. in the form of a medical mystery Yeah. I mean, I'm a doctor, you know, and there was clearly a an opportunity to try and Unravel what had happened And I know Rosamond couldn't do that. and none of the doctors in all these hospitals could do it either. But because I had spent, you know, my life researching asthma You know, I knew a lot about the dises He got in touch with Rosamond and said, Would you mind if I look through your daughter's medical records And she was like, yes, go for it Added them over And Stehven dove in Mounds and mounds and boxes, hospital notes and GP records and all rest Stephven also went to the hospital where sections of Ella's lungs were being preserved He pulled out these tiny lung scrapings that are about the size of a fingernail. Put them under the microscope And straight away He saw something odd And what I saw in the sections was almost unbelievable, really The lining of her lungs, which should protect them from gunk in the air totally destroyed. It's as if you'd lost your skin and had kind of raw raw areas underneath healthy lung, you should see these lovely cells that look like columns with little hairs But with Ella Those little columns had been replaced by a totally different cell. One that pumps out mucus And this was mucking everything up this lining pe in large areas that peeled off and was rolled up into the airway itself was coming away and was rolling up with mucus, very sticky, viscid mucus So she had these large plugs of Mucus and blocked her airways You are supposed to have some mucus in your lungs, and it's helpful. It captures gunk in the air and helps you to cough it out But Ell's lungs had become it like a mucus factory. Stephven looked for signs of what might have been irritating her lungs so much, like Material of fungal infection But nothing could explain this But then A new clue emerged away from the lab somethingomething clinched it for him We were I suppose I hate to use the term Fortunate, Wendy, but I mean, in a way it was, just so happened There were A monitoring station for air pollution one mile from Alla's house pollution station He was monitoring stuff like nitrogen dioxide, which gets spewed out by London traffic and can damage lung cells Now by this point, Rosamond already had a lawyer to help out with Ella's case. and so her legal team and Stephen got to work Here's what they did They matched up the pollution levels for the days surrounding when Ella would have these really bad attacks And bam You could see the local air pollution levels were astronomically high Illegal. levels of nitrogen dioxide. Oh God. Dame found a patent Ella's attacks would come in these clusters And mostly they hit when pollution levels were particularly high muchuch higher than the World Health Organization sets for maximum safe levels of pollution and higher than the UK government is supposed to allow And in the days before Ella died, poollution levels were bonkers in her neighborhood Through his academic research, Stepven had suspected that air pollution might have played a role here But now Here was the evidence And he was sure Pollution had been triggering Ella's asthma attacks And it all made a lot of sense because it turned out that Ella's family lived near one of the busiest roads in London So all of Ella's life, she'd been breathing in lots of car exhaust and other pollution When Rosaman found out about all this She was shocked Like what the air is what's killing her What I now know is every day she was going out on her bikes, you know, she was really active. She was breathing in the air around ye, even in the garden. It's kind of a bit hard because Pollution is invisible You can't see it with the naked eye We're still not sure why Ella's asthma was so deadly. Like one of her siblings has asthma, but it's not nearly as bad Staven thinks It's perhaps some very unlucky genetic predisposition. But what Stehven did know? was that every time L littleittle Ella breathed in all that pollution irritating her lungs M more and more until it destroyed them Rosamond started researching about pollution. And she realized that in the UK and the US Pollution levels tend to be higher in black and brown communities And that's partly because the government and industry have gotten away with building things like highways through black and brown neighborhoods And the thing is, The neighborhood where Rosamond lives, it has a pretty large black population Rosamond herself is black If we if we didn't live I think that's what blows my mind if we probably didn't live in this house near this road then maybe my daughter will still be alive. So it is as simple as that I If we live somewhere else, then this might not have happened If I think that, then I'll be sad all the time. So I try not to drive myself crazy And once Rosama knew that air pollution had played this big role in killing her daughter The next question was Why didn't any of Ella's doctors know about this? Like why didn't they even suggest that air pollution could have been triggering her asthma There'd been heaps of studies, even at the time showing that air pollution could make asthma worse. But despite that It just wasn't on the radar of some of the best doctors in London How is that possible? And soou. coming out just after the break. Inoring, gasping during sleep Feeling fatigued? askk your doctor about Zepbound, Terzetite, the first and only FDA approved prescription medicine for moderate to severe obstructive sleep apnea,A and adults with obesity. 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You spin some c pop theory and I find the evidence. I solved the mysteries for a living. I think I'm good to go. Murder has met its match. You cannot be here. This is a police investigation. I've wridden you. What does that mean? It was a big city cub with a small jurisdict I sure Boomers are so cute when they flirt. You're killing me. all new episodes. Now on accorn TV. This episode is brought to you by SopFi, the all in one finance app. The sooner you start investing, the more potential you have to build your money. Even for beginners, SopFi makes it simple with an easy to use app. To get you going, SopFi is offering up to one thousand dollars in stock when you open and fund a SopFi's self directed brokerage account. Learn more at soopFi dot com slash spotify Brokerage offered through Sopfi Securities LLC, meber FiNRA slash SIPC Terms apply Welcome back We just heard that pollution was a major trigger for Ellis Aspa. But until Stehven and the team came along, none of her doctors had even suggested it as a possibility So why is that Well, some researchers told us that it could be because These days You often can't see the pollution around us It's a little out of sight, out of mind. That is not how it used to be. In fact, London used to burn so much coal that the air turned to this gross puky color. When that happened, it was known as a pe super Time for a bit of history, and then we'll get back to Rosman's story. One of the worst events where smog took over London was known appropriately as the Great Smog of London If you're a fan of the Crown, you know what I'm talking about It happened in december nineteen fifty two. He's a BBC Ducko about it This was smog on the grand scale There had never been anything like it before, the sky and the light were blotted out, and London coughed and crawled almost to a standstill in murky yellow gloom The smog stuck around for five days and ended up killing thousands of people And while people coughed and choked, the smog got thicker and darker. And nobody could do anything about it. They could do something about it And they did Events like this kicked governments in the butt to get rid of the smog In places like the UK and the U.S, where similar events happened They started passing clean air acts to gunk, power plants, homes and cars could spew into the air And these laws, they made a big difference. Power exhaust is safer than it used to be, and many power plants now have dooby whackers on them, like scrubbers to keep some of the pollution out of the air So yeah For London, no more pea soupers But over the years, scientists have come to realize that the invisible stuff that is still getting pumped into our air can do some dangerous things to our hu One researcher told me It scares the shad of her This pollution can break down into teeny tiny pieces about the same size as bacteria. They float in the air. And when you breathe them in They're so small that they can just sneak inside us You staven again. We know that these pollutants can penetrate the lung and pass through into the bloodstream and circulate parts of the body now. Really all part like all parts of the body? Yeah. brain, the heart, the pancreas And Stehven says air pollution is now being linked to all sorts of diseases. Chronic heart disease, dementia, diabetes, accelerates blindness. Blindness Yeah. Yeah, it's thought that tiny bits of pollution can mess with our retina, increasing our risk of eye disease And some of these bits of pollution are so small that they can actually cross the placenta, potentially affecting fetuses. They can even get into our brains We're still working out exactly what all of this means, but some of the other effects of pollution are more clear Besides fouling up our lungs, we've known for years that crap in the air increases our risk of getting heart disease For example, a study of around half a million older folks found that those living near a highway or busy streets were' thirty percent more likely to die from coronary heart disease than those living further away And that's why for years pllaces like the World Health Organization and the EPA been lowering what a safe level of pollution is. The truth is that almost nowhere in the world actually meets those standards every day. And actually, this big report just came out last month from the American Lung Association. And it says that nearly fifty percent of U.S. kids now live in a place with unhealthy levels of air pollution So Even though it's really rare to get sick like Ella did from pollution To Steven, he says what happened to her as an extreme example of What's happening to all of us Ella really was like the canarary in that was able to sense the pollution and be a warning to others And a warning to Gumman, really that something needs to be done about this And so Rosamond hached a plan She wanted to get air pollution listed on Ella's death certificate And if she could do that, it would be a world first Rosamond wanted the real reason that Ella died to be official. But she also thought that perhaps Ella could put a face to all these awful statistics about what pollution is doing to us Her lawyer also thought that it would open the door to more lawsuits. For other people to force governments around the world Clean out air So can you see, as the journey was going on on, the whole thing then got bigger and bigger. But I am very honest to say in the beginning, it was definitely all about her But getting air pollution on a death certificate, it was going to be tricky Rosamond had to go to a court to convince a coroner that there was a direct link between pollution and Ella's death And even though we have statistics showing that pollution contributes to millions of deaths each year It's actually really hard to point to a person and say air pollution killed them But with Ella, the data was so damning. She was living under illegal levels of pollution And so Rosaman thought She could do this. There would have not been any point knowing all that research and failing in court. That wasn't going to help anything So the most important thing still, was to get that on her death certificate In late twenty twenty, almost eight years after Ella died. The second inquest into her death began Stephven was an expert witness Did you think you'd win? Was it like you thought this was a slam dunk? I had no idea what would happen What I didn't know was that I knew about Estlna I knew about Ela because I've spent the last two and a half years pouring over all this material And as Stephen remembers it The government lawyers really put him to task My evidence was only about Nearly two hours, my go they really tried to put through the menswer. He kept saying you will agree, you know, he pointed to some ent We had a bunch of documents about two feet h. And every time he said that and I said, No, I do not agree. with the answer. And actually that is wrong After all, the evidence was presented, the corona had to decide Did pollution kill Ella I remember the agonizing wh It was really a stressful time in the first ruling of its kind Pollution from busy Roads, a coroner found today, contributed to the nine year old premature death. Ella tragically made history when she became the first person to have air pollution listed as the cause on her death certificate. a victory for her mother Corners inquest found that air pollution made a material contribution my goodness me. apppparently her story was written up two and a half thousand times around the world. India, Australia, everywhere. It was enormous because it had never been done before Ella is the first person in the world to have air pollution. on her death certificate. The new coroner's report listed air pollution, along with asthma and acute respiratory failure, as Ella's official cause of death. And since that happened, Things have been getting better The council where Ella lived has made it way easier for people to find out what's going on with the pollution on any given day And doctors groups in the UK are updating guidelines and training manuals to make sure that doctors know that air pollution can trigger asthma And in London, They already had this program that basically charges a fee for some of the dirtiest cars and trucks But it was only in Central London So after this decision came down They decided to expand it even further to neighborhoods like where Ella lived. And today It now covers all of Greater London And it has worked to make the air cleaner The city reported that since that program started Nitrogen oxide levels have dropped almost thirty percent across all of London Stavven told us that This case, this little girl was able to break through and stir up real change Tons of research. I mean mountains of papers on air pollution and asthma. didn't And I can't tell you what a big impact this has had You can have all any epidemiology in the world Having the story of a single mother and a child You know, with real facts. actually is more influential in many ways than all of the sort of complex statistics and everything else put together We now know the detrimental impacts of air pollution on the public's health So can you see how much things have changed compared to where I was for all of this work twenty twenty one at the United Nations Big Conference on Climate Change The World Health Organization dedicated a special report to Ella there on the cover. it says In memory of Ella Eeborah and all other children who have suffered and died from air pollution and climate change. Oh my gosh. It shows you the enormity And you know what? it's too big to even contemplate it. I don't sit there as you can see, when you first jumped on, you know, I'm trying to organize my twins birthday. I don't sit there and think, o you've achieved this en all. Then it will get too big So I do I continue on my journey and do that. and I try and be a good enough mum as I am for my other. I don't sit there and say, oh, this is no mistake. No Rosaman knows that what they've done so far It's not enough She quit her job as a teacher and became a full time clean air advocate giving speeches, starting a foundation and organizing protests She wants our air to be cleaner She wants us to do the stuff we've been talking about since Captain Planet came out Burning less fossil fuels, having fewer cars on the road. And the vehicles that are on the road need to be electric and run from the power of the wind and the sun. We also need to be thinking about things like preventing wildfires. because scientists say that wildfiire smoke in some places is starting to reverse the decades of progress we've made on improving air quality And you know, Rosaman says that these changes, like getting off fossil fuels We need to do them anyway. Fossil fuels are killing us and they can do it any which way they like Sooner or later, they're going to have to address it. What do you think Ella would make of this work that you've done and all of this The fact I'm talking to you guys in the states now Oh let me think of something I think she'd be very proud seriously, seriously be f. I don't know, it's really difficult because Her aim was to be a pilot. And we had started steps towards that. She was very clever, like I said to you. She was passionate about flying. And ultimately, the air that she loved so much was in effect killing her. So I don't know what she would say about that on a very serious note So she was here She definitely made her her voice h How would she feel I think she'd be quite happy to be talking about her today if you ask me We spoke to Rosamond in twenty twenty two, and since then, she's continued to fight for accountability after Ella's death Rosaman sued three UK government departments in twenty twenty four and later received a settlement from them They wrote in a statement to her, quote Young children like Ella should not have to suffer because of our air Meanwhile, Rosamond and her team have worked towards creating a bill that they call Ella's Law or the Clean air Human rightights Bill requiring the UK to meet clean air targets by twenty thirty and legally enshrine clean air as a human right The bill was published just a couple of months ago and it's making its way through Parliament overver in the US As we mentioned at the start of the show Things are moving in the opposite direction And experts say that There's rollbacks, which make it easier for industry to pollute It's expected that they will make the air dirtier And that could affect the health of millions of people in the US That's science passasses Hello Hey, a Ketdy producer at Science Masses . Hi, Wendy, host of Science Vversus. How many citations in this week's episode? There are I'm wrong. one hundred and twenty eight citations. That's a big one. And if people want to see these citations, where should they go? They can click on the link in our show notes and through reesearching this episode, have you changed anything about how you lived your life? Yeah, I will say at first, I was like pretty freaked out. I remember there was this one time I saw this giant like nasty like twelve wher truck come down And I was literally looking for roads to run away to Oh my God, I'm doing the exact same thing. I'm doing the same thing It's so bad, but it really doesn't have to be like that. I think the biggest thing that I've changed is I've started actually really paying attention to the air quality on my phone on the weather app. Oh, tellell me more about this. It's like a scale between zero and five hundred.