Reducing the environmental impact of inhalers in primary care

Climate change is the largest public health emergency of the 21st century, threatening humanity's access to food supplies, safe drinking water, clean air and shelter (World Health Organization (WHO), 2023). Since the 1800s, the main driver for climate change has been greenhouse gas emissions (GHGE) produced by human activity (UN, 2023). These emissions blanket the earth, trapping the sun's heat, which results in global warming. It is not too late to alter these effects and governments around the world are tasked with the challenge of reducing emissions to reverse the devastating effect our lifestyles are having on our health and our planet.

In the UK, the government aims to achieve net zero GHGEs by 2050 (Department for Business Energy and Industrial Strategy, 2019). The NHS produces 23 megatons of carbon dioxide equivalent (CO2e) per year, which makes it the largest emitter of all the UK public sectors; and 3.5% of this is produced by pressurized metered-dose inhalers (pMDIs) (Janson et al, 2020). This type of inhaler uses hydrofluorocarbon (HFA) propellant to deliver a measured amount of medication to the lungs in a short sharp burst. While this is an effective delivery method of inhaled medication, HFA propellants omit high levels of CO2e. To put this into perspective, using one inhaler has the same global warming effect as driving a car for 170 miles (National Institute for Health and Care Excellence (NICE, 2019).