'We don't all breathe the same air': How London's pollution gap persists

When her nine-year-old daughter died of an asthma attack in 2013, Rosamund Adoo-Kissi-Debrah had never heard about air pollution being a possible trigger for asthma.

After a medical report suggested a direct link between Ella's illness and illegal air pollution levels near her home, an inquest into her death was opened. Ella became the first person in the UK to have air pollution listed on her death certificate.

The coroner recorded that "there was a recognised failure to reduce the level of nitrogen dioxide to within the limits set by EU and domestic law".

A spokesperson from the Department for Environment, Food and Rural Affairs (Defra) told the BBC that the government was committed to reducing air pollution, which "robs people of their health and costs the NHS millions of pounds every year".

Ella grew up in Lewisham in south-east London, near the South Circular Road, where her family still lives today. Although her mother said things had improved, she said more work was needed.

"The first steps of cleaning up the air in London with Ulez (Ultra Low Emission Zone) have clearly been worth it," Adoo-Kissi-Debrah said. "There is still so much more to do."

New BBC analysis shows London's air has improved substantially over the past decade. Average nitrogen dioxide (NO₂) levels have fallen by almost 38% since 2014 and every neighbourhood now meets the UK's legal limit, an annual average of 40 micrograms per cubic meter (μ g/m³).

But fewer than 1% of neighbourhoods meet the World Health Organization's (WHO) recommended guideline. At 10 μ g/m³, it is a quarter of the UK's legal limit.

More deprived areas and neighbourhoods with larger non-white populations saw some of the biggest reductions in air pollution over the decade. But they also started with much higher levels of NO₂ and remain among the most polluted parts of London.

"We don't all breathe the same air," said Adoo-Kissi-Debrah.

The BBC's analysis used modelled air pollution data produced by Defra, together with census ethnicity data and income deprivation data from the UK government's Index of Multiple Deprivation.

After Ella's death, before the inquest, Sir Stephen Holgate, professor of immunopharmacology at the University of Southampton, examined her medical papers. He concluded that high levels of air pollution in Ella's neighbourhood contributed to the severity of her asthma and, ultimately, her death.

"Air pollution is always talked about as an environmental issue. It's not talked about as a health issue," he said.

Speaking recently to the BBC, Holgate argued reducing pollution was essential, but added that unless the government also tackled interconnected issues like poverty, housing, overcrowding and health inequalities, the burden of air pollution would continue to fall unequally.

The WHO states air pollution can affect almost every organ in the body. A report from the Royal College of Physicians estimated air pollution had contributed to 30,000 deaths in the UK in 2025 and costs the economy more than £27bn annually.

Holgate said communities with poorer underlying health and living conditions were more vulnerable to pollution, which he said explained why inequalities persisted even as pollution fell.

A Defra spokesperson said the government was committed to reducing harmful pollution through measures including cleaner transport, tighter emissions standards and support for local authorities.

Multiple clean-air policies were introduced in the period covered by the BBC's analysis between 2014 and 2024. They include cleaner buses and a shift towards lower-emission vehicles, as well as London's Ulez, which replaced the earlier Toxicity Charge (T-Charge).

Research published this year found the T-Charge and the original central London Ulez were associated with reductions in emergency hospital admissions among adults living in the zone. Another recent study found deaths linked to air pollution fell by an estimated 40% in London over five years from 2019.

Last week, a group of researchers published results from a five-year study following primary school children in London and Luton to determine if young children's lungs begin to recover under air quality improvements. Their findings show children in London whose lung growth had been stunted by pollution improved drastically in the years after the introduction of the Ulez.

A spokesperson for the Mayor of London, Sir Sadiq Khan, said: "London's Ulez, the world's largest clean-air zone, has been a huge success in cleaning up London's air, with harmful roadside NO₂ concentrations now 24% lower in outer London compared to without the Ulez in place.

"All Londoners are now breathing much cleaner air, but there is still more to do and the mayor will continue to take action as we build a greener, fairer London for everyone."

Steve McNamara, general secretary of the Licensed Taxi Drivers' Association, said cab drivers were sceptical when the Ulez was first introduced in central London in April 2019.

But he has since changed his mind.

"When you used to drive a cab around with the windows open, at the end of the day, your hand was black. You were filthy. You don't get that now. You can actually breathe the difference."

Despite the improvements in air quality, the expansion of the Ulez in 2023 remains controversial, with some small business owners and trade unions arguing the financial burden has fallen unfairly.

Maria Melucci, who owns an Italian deli in Bexley village in south-east London, said she had seen first hand how the expansion affected small businesses.

Many of her customers came from Kent, but many of the customers coming from outside the Ulez area now have to pay the daily £12.50 charge to visit her shop.

"If air pollution kills people, if it affects people's lungs, for sure we must do it," she said about the policy. "I'm not against that. But charging poor people is not the solution."

Melucci also questioned the logic behind the Ulez charge: "If that car is polluting and dangerous, then that car should be taken off the street, not pay £12.50 to drive anyway."

Gavin Davies, GMB union senior organiser, said: "We are very supportive of cleaner air in London and welcome improvements to the capital's air quality, but we'd argue that more needs to be done to shield frontline workers from the costs associated with Ulez."

He said NHS workers unable to afford Ulez-compliant vehicles often could not rely on public transport for their commute during unsocial hours or to more remote sites.

He added some staff whose shifts crossed from one day into the next were being forced to pay the Ulez charge twice, creating an unfair burden on night workers.

"We'd like to see discounts to the Ulez charge applied for NHS and other frontline workers, as well as the introduction of schemes to assist them to purchase Ulez-compliant vehicles."

London has cleaned up its air faster than many expected. But while pollution has fallen across every London neighbourhood, the BBC's analysis shows communities which have historically experienced the dirtiest air continue to face higher levels of pollution.

Adoo-Kissi-Debra said she would keep pushing the government on implementing the stricter WHO air quality targets by 2030 through the proposed Clean Air (Human Rights) Bill, known as Ella's Law in memory of her daughter.

"Pollution is still there, it's just different now. Whereas 70 years ago you could see it with the naked eye, it's now hidden. You have to see it underneath a microscope," she said.

"But if people are continuing to breathe dirty air, they're going to continue to get ill."