In a first, a coroner in the United Kingdom ruled that air pollution contributed to the death of a nine-year-old girl with severe asthma, reported AFP.

In February 2013, Ella Adoo-Kissi-Debrah died after a serious asthma attack. She was hospitalised nearly 30 times with breathing difficulties in previous three years.

The young girl lived in southeast London just 30 metres (yards) from a major ringroad in the capital, which is often clogged with heavy traffic.

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Assistant coroner Philip Barlow said air pollution contributed to to Ella’s death.

“She was exposed to levels of nitrogen dioxide in excess of World Health Organisation guidelines,” he said.

He said it was also important to record there were a “recognised failure” to reduce those NO2 levels, “which possibly contributed to her death”.

The first preliminary report suggested that Ella died due to acute respiratory failure. But the ruling was overturned and a new hearing ordered after a review of the case.

Air pollution expert Stephen Holgate found a “striking link” between levels of NO2 and harmful particulate matter at the times she was taken to hospital for treatment.

He told the inquest she was “living on a knife edge” because of her surroundings and the air quality in her neighbourhood, which exacerbated her condition.

Winter air pollution worsened her asthma in the months leading up to her death, added Holgate, a professor of immunopharmacology at the University of Southampton.