Carbon footprint impact of the choice of inhalers for asthma and COPD

• Published in: Thorax Vol. 75; no. 1; pp. 82 - 84
• Main Authors: Janson, Christer, Henderson, Richard, Löfdahl, Magnus, Hedberg, Martin, Sharma, Raj, Wilkinson, Alexander J K
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Thoracic Society 01.01.2020; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Administration, Inhalation; Adrenergic beta-Agonists - administration & dosage; Asthma; Asthma - drug therapy; asthma pharmacology; Brief Communication; Carbon; Carbon Footprint; Chlorofluorocarbons; Chronic obstructive pulmonary disease; COPD pharmacology; Emissions; England; Environmental impact; Equipment Design; Fluorocarbons; Health services; Humans; inhaler devices; Inhalers; Nebulizers and Vaporizers; Patients; Pulmonary Disease, Chronic Obstructive - drug therapy; Respiratory therapy; Sweden; England; Sweden; United Kingdom > UK; asthma pharmacology; inhaler devices; COPD pharmacology
• ISSN: 0040-6376; 1468-3296; 1468-3296
• DOI: 10.1136/thoraxjnl-2019-213744

In the 1990s, metered dose inhalers (MDIs) containing chlorofluorocarbons were replaced with dry-powder inhalers (DPIs) and MDIs containing hydrofluorocarbons (HFCs). While HFCs are not ozone depleting, they are potent greenhouse gases. Annual carbon footprint (CO2e), per patient were 17 kg for Relvar-Ellipta/Ventolin-Accuhaler; and 439 kg for Seretide-Evohaler/Ventolin-Evohaler. In 2017, 70% of all inhalers sold in England were MDI, versus 13% in Sweden. Applying the Swedish DPI and MDI distribution to England would result in an annual reduction of 550 kt CO2e. The lower carbon footprint of DPIs should be considered alongside other factors when choosing inhalation devices.