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Switching to ‘green’ inhalers could reduce carbon emissions

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Asthma sufferers could reduce their greenhouse gas emissions by switching to ‘green’ inhalers, a new study suggests.

The study conducted by researchers from the University of Cambridge claims that swapping out metered-dose inhalers for the cheapest equivalent dry powder inhaler could reduce carbon emissions equivalent to recycling or cutting out meat.

Metered-dose inhalers contain liquefied, compressed gases that act as a propellant to atomise the drug being delivered and pump it out to the user.

Originally chlorofluorocarbons (CFCs) were used as the propellant but these greenhouse gases and ozone-depleting substances are now banned. Instead, they have been replaced by hydrofluoroalkane (HFA) propellants.

While HFAs are not damaging to the ozone layer, they are still potent greenhouse gases, and currently, metered-dose inhalers contribute an estimated 3.9 per cent of the carbon footprint of the NHS.

Alternatives such as dry-powder inhalers exist, but the researchers said a barrier has been the higher up-front cost of these other drug-delivery products.

However, switching to the more ‘eco-friendly’ inhalers could cut millions from the NHS drugs bill and significantly reduce carbon emissions, the research published in the journal BMJ Open says.

The researchers used prescription data from England in 2017 and estimated the carbon footprint of inhalers commonly used in the country to compare the financial and environmental costs of different inhalers.

They found the carbon footprints of metered-dose inhalers were between 10 and 37 times those of dry powder inhalers.

In 2017, around 50 million inhalers were prescribed in England, of which 70 per cent were metered-dose productions.

At these levels, however, the team found that replacing one in ten metered-dose inhalers in England with the cheapest equivalent dry-powder inhalers could lead to a reduction in drug costs of £8.2m annually.

Furthermore, they estimate that the alternative would reduce carbon dioxide equivalent emissions by 58 kilotonnes, roughly the same as would arise from 180,000 return car journeys from London to Edinburgh.

Dr Alexander Wilkinson, consultant in respiratory medicine from East and North Hertfordshire NHS Trust, said: “Any move towards ‘greener’ inhalers would need to ensure that replacements were cost effective.

“By switching to less expensive brands, we’ve shown that it would still be possible to make a positive impact on carbon emissions while at the same time reducing drug costs.

“It’s important to stress that patients shouldn’t stop using their usual treatments to reduce their carbon footprint.”

The team, however, advises that patients should review conditions and treatments at least annually with healthcare professionals – and could discuss whether environmentally friendly inhalers are available and appropriate for them to use.

People can also ensure they are using their inhalers correctly, return finished ones to pharmacies for proper disposal and avoid throwing away half-full items to help reduce the carbon footprint of their medication, the researchers added.

“Our study shows that switching to inhalers which are better for the environment could help individuals, and the NHS as a whole, reduce their impact on the climate significantly,” said Dr James Smith from the University of Cambridge.

“This is an important step towards creating a zero-carbon healthcare system fit for the 21st century.”

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