Olympic Athlete Backs Call to Cut Inhaler Carbon Footprint 

Peter Russell

June 18, 2019

Olympic swimming gold medallist Rebecca Adlington has said she was "shocked" to hear claims that 5 doses from an asthma inhaler could generate the same amount of carbon as a 9-mile car trip.

It followed new evidence from the National Institute for Health and Care Excellence (NICE) highlighting how some inhalers have a higher carbon footprint than others.

To coincide with the evidence, NICE released an updated patient decision aid last month to help people and health professionals decide which inhalers could control their symptoms and meet their needs.

Four available options were outlined in the aid. These were:

  • Breath-actuated metered dose inhaler (BAI)

  • Dry powder inhaler (DPI)

  • Pressurised metered dose inhaler (pMDI)

  • pMDI plus a spacer

Reducing Carbon Footprint

The NICE aid, partially funded by the Sustainable Development Unit, also highlighted the environmental impact of asthma inhalers.

It said some metered dose inhalers contain propellants known as hydrofluorocarbons (HFCs), which are powerful greenhouse gases.

Pressurised metered dose inhalers have an estimated carbon footprint of 500g CO2eq per dose, compared to 20g in DPIs. While HFCs helped to propel the dose into the patient's respiratory system, many people would be able to achieve the same benefit from dry powder inhalers (DPIs), the aid said.

It is understood to be the first time that NICE has addressed the carbon footprint of a medicine or medical device in one of its publications.

Speaking on Sky News this morning, Ms Adlington, who was diagnosed with asthma aged 12, said: "I never knew that one type of inhaler was worse for the environment over another – it doesn't get explained to you."

Alex Wilkinson, NHS respiratory consultant at the Sustainable Development Unit, said: "The most commonly used inhaler in the UK for instance, Ventolin Evohaler, [GlaxoSmithkline] has a carbon footprint equivalent to 28kg of CO2.

"For some patients, switching inhalers could save as much greenhouse gas as becoming vegetarian."

Inhaler Recycling

Inhalers can be recycled at some local pharmacies.

Used pMDI canisters, even when empty, still contain hydrofluorocarbon propellants that can contribute to global warming, the aid said.

If no recycling scheme was operating, it recommended that inhalers were placed in the pharmacist’s normal pharmaceutical waste bins.

However, spacers cannot currently be recycled.

Approximately 73 million inhalers are used each year in the UK.

According to the website, recyclenow, if every inhaler user in the UK returned all their inhalers for one year, it would lead to 512,330 tonnes of CO2eq being saved – the equivalent of a VW Golf car being driven around the world 88,606 times.

Prof Gillian Leng, deputy chief executive of NICE, said: "This aid will help people make shared decisions on which inhaler is right for them, and help them use that inhaler effectively. This can help them to control their asthma, rather than have their asthma control them.

"People who need to use metered dose inhalers should absolutely continue to do so – but if you have the choice of a green option, do think about the environment.

"Cutting carbon emissions is good news for everyone, especially those with respiratory conditions."

Alex Wilkinson said: "Patients who are concerned about their environmental impact, shouldn't stop their inhalers just to reduce their carbon footprint. Suffering from an asthma attack will greatly increase a patient’s carbon footprint."


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