Categorization of cause of death is an interesting issue, there are a lot of cases like this where there are multiple contributory factors, and how you decide w

Categorization of cause of death is an interesting issue, there are a lot of cases like this where there are multiple contributory factors, and how you decide which to list is not clear. For instance, people don’t really die of dementia, they die of medical problems secondary to dementia, malnutrition, lack of exercise, and so on. Lung-related deaths amongst miners are related to exposure to pollution, but also to genetic predispositions which massively increase risk. If you drink enough alcohol to raise your risk of liver failure a hundred times, and die of liver failure, that’s a fairly clear causal link, but what about if you drink a smaller amount, and only increase your risk five-fold, but still die of liver failure? Or if you drink a small amount, raise your risk 20%, but still die of liver failure? There is no hard line between someone who has rolled the dice on bad odds and come off badly, and someone who has rolled the dice on moderate or good odds but still come out badly. For this girl, there likely would have been genetic factors or simply bad luck which compounded air pollution, but it’s difficult to say that air pollution didn’t contribute significantly as one of the causes of her death. And that is important to know, to be able to reduce deaths and ongoing poor health in the future. As electronic medical records become more prevalent, this is going to become more important. For instance, you could look back through patients with a cause of death like this, and pick out the frequency and timing of hospitalization as linked with local episodes of air pollution, that could then be used to inform advice to patients currently suffering from the same symptoms in the same pattern. You could essentially join together medical care, epidemiology and public health in a symbiosis which could be hugely beneficial.