I was under the impression that death certificates only list the immediate cause of death, and maybe occasionally some immediate biological confounders (e.g. pneumonia caused by Mycobacterium tuberculosis).

Here's one for you though: https://www.mirror.co.uk/news/uk-news/breaking-pollution-rec...

: Pollution has been recorded as a cause of death for the first time in the UK at the inquest of a nine-year-old girl.

: A coroner concluded air pollution made a "material contribution" to the death of Ella Adoo Kissi-Debrah after a severe asthma attack in February 2013, in the landmark ruling.

: The schoolgirl, who lived in Lewisham, South London, was rushed to hospital at 2am before she died.

: Her family has long argued that pollution caused her death, and it has emerged that levels of nitrogen dioxide where she lived were unlawful.

…you’re suggesting pollution is fake news?

Denying that pollution exists is very different from having some skepticism that one in six deaths worldwide is caused thereby.

I believe air pollution can be a contributing factor but rarely the principal cause of death. If it was, everyone in the area would die from air pollution. Stating that an elderly person or someone who is already very sick died from air pollution is disingenuous.

> someone who is already very sick

But what caused this initial sickness?

https://www.epa.gov/sciencematters/links-between-air-polluti...

: In a study funded in part by EPA, researchers from Johns Hopkins University found that children exposed to outdoor coarse particulate matter (PM10-2.5), were more likely to develop asthma

: Coarse PM can come from roadway particles such as brake and tire wear, and mixtures of road dust and metals.

: This finding is significant because while researchers have generally found that exposure to fine particulate matter (PM2.5) is associated with the development of asthma and other respiratory and cardiovascular diseases.

: While researchers do not fully understand how air pollution exposure increases asthma prevalence, evidence suggests air pollutants suppress genes that regulate the immune system’s ability to differentiate an allergen from a dangerous foreign substance, such as a virus or bacteria. The immune system then goes into action, setting up an inflammatory response whether the substance is harmful or not, which leads to asthma.

: In the study, researchers from the Children’s Center at Stanford University examined the impact of air pollution on two genes involved in immune tolerance in children from an area known to have high air pollution levels. Researchers found that short-term and long-term exposures to high levels of carbon monoxide, nitrogen dioxide, and PM 2.5 were associated with alterations to these two genes and those alterations were significantly associated with asthma.