RCP to Review Medical Curriculum Following Air Pollution Linked Death

Priscilla Lynch 

June 17, 2021

The Royal College of Physicians(RCP) has committed to reviewing its medical curriculum to make sure doctors better understand the impacts of air pollution on health, following the death of nine-year-old Ella Adoo-Kissi-Debrah in February 2013.

The commitment is part of the RCP’s response to the Assistant Coroner’s (HM Coroner for the Inner South District of Greater London) Prevention of Future Deaths report.

This followed the landmark ruling at the inquest into Ella’s death that she developed and then died of asthma contributed to by exposure to excessive air pollution.

The coroner was concerned that “the adverse effects of air pollution on health are not being sufficiently communicated to patients and their carers by medical and nursing professionals”.

As well as reviewing the delivery of the internal medicine curriculum, the RCP has pledged to help doctors talk to patients and their families about air pollution, how to avoid it and how to lessen its effects.

Limiting Pollution

The coroner also expressed concern about public awareness of information about national and local air pollution levels. But their chief concern was that the annual average limits for particulate matter (PM2.5) in the UK at 25mg/m3 are much higher than the World Health Organization (WHO) health-related guideline (currently set at 10mg/m3). During the course of her illness, between 2010 and 2013 Ella was exposed to levels of nitrogen dioxide and PM2.5 that exceeded WHO guidelines.

The RCP said it agrees that the national limits for particulate matter are too high, that the WHO health-related guidelines should be seen as minimum requirements, and that legally binding targets based on them would reduce disease incidence, morbidity and deaths from non-communicable diseases in the UK.

There needs to be a particular focus on initiatives that reduce the exposure of those with pre-existing disease, women and children, older people, and people in lower socioeconomic groups, in which ethnic minorities are overrepresented, the RCP said.

Dr Cathryn Edwards, RCP registrar, said: “The RCP accepts the evidence presented at the inquest and thanks the coroner for helping us think about our role with regard to it. There is more we can do to support doctors and other clinicians to talk to patients, their families and carers about avoiding and mitigating the impact of air pollution.

“But the risk of air pollution to public health will only be significantly reduced if government and other policy makers agree to widespread societal measures to regulate and reduce pollution-generating activity.”

This article originally appeared on Univadis, part of the Medscape Professional Network.


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