Global access and patient safety in the transition to environmentally friendly respiratory inhalers: the Global Initiative for Asthma perspective

Climate change and its impacts on the health of our planet and its people are, deservedly, on centre stage in international discourse, and have prompted critical evaluation of all human activities that could lessen the degree and progression of these effects. Health care, too, is under scrutiny for its contribution to climate change. Among the many issues is the global warming potential of gases in medical devices, including fluorinated gas propellants in pressurised metered-dose inhalers (pMDIs) that are often used for the treatment of airway diseases; these contribute a small but substantial proportion of global greenhouse gas emissions (estimated as <0·1%). 1 Panigone S Sandri F Ferri R Volpato A Nudo E Nicolini G Environmental impact of inhalers for respiratory diseases: decreasing the carbon footprint while preserving patient-tailored treatment. BMJ Open Respir Res. 2020; 7e000571 Crossref PubMed Scopus (34) Google Scholar , 2 Pritchard JN The climate is changing for metered-dose inhalers and action is needed. Drug Des Devel Ther. 2020; 14: 3043-3055 Crossref PubMed Scopus (32) Google Scholar , 3 Pernigotti D Stonham C Panigone S et al. Reducing carbon footprint of inhalers: analysis of climate and clinical implications of different scenarios in five European countries. BMJ Open Respir Res. 2021; 8e001071 Crossref PubMed Scopus (9) Google Scholar , 4 Jeswani H Azapagic A Life cycle environmental impacts of inhalers. J Clean Prod. 2019; 237117733 Crossref Scopus (42) Google Scholar , 5 Janson C Henderson R Löfdahl M Hedberg M Sharma R Wilkinson AJK Carbon footprint impact of the choice of inhalers for asthma and COPD. Thorax. 2020; 75: 82-84 Crossref PubMed Scopus (71) Google Scholar , 6 Carroll WD Gilchrist FJ Horne R Saving our planet one puff at a time. Lancet Respir Med. 2022; 10: e44-e45 Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar , 7 Drew J Christie SD Rainham D Rizan C HealthcareLCA: an open-access living database of health-care environmental impact assessments. Lancet Planet Health. 2022; 6: e1000-e1012 Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar , 8 Wilkinson A Woodcock A The environmental impact of inhalers for asthma: a green challenge and a golden opportunity. Br J Clin Pharmacol. 2022; 88: 3016-3022 Crossref PubMed Scopus (13) Google Scholar , 9 European Respiratory SocietyEuropean Respiratory Society position statement on asthma and the environment. European Respiratory Society, 2021https://www.ersnet.org/wp-content/uploads/2021/04/ERS-position-statement-on-asthma-and-the-environment-5-May-2021.pdfDate accessed: July 14, 2023 Google Scholar