Asthma & COPD Inhalers Contribute Considerably to Carbon Emissions: Equivalent to Half a Million Cars Annually
Inhalers, commonly known as puffers, are a vital treatment for respiratory conditions like asthma and COPD. However, a recent American study reveals these essential devices have a surprisingly large environmental impact. Researchers at the University of California,Los Angeles (UCLA) have determined that inhalers released over 2 million tons of carbon dioxide into the atmosphere over the past decade – a figure comparable to the annual emissions of approximately 530,000 gasoline-powered cars.
The study, published in JAMA, analyzed emissions from three types of inhalers approved for use in the United States between 2014 and 2024. The findings pinpointed metered dose inhalers (MDIs) as the primary source of pollution, accounting for 98% of all inhaler-related emissions over the ten-year period. These MDIs rely on hydrofluoroalkane (HFA) propellants – potent greenhouse gases – to deliver medication.
“Many patients wiht chronic respiratory diseases are thus at extra risk,” explains William Feldman, a pulmonologist and researcher at UCLA. “The upside is that there is a huge possibility to make changes that protect both patients and the planet by using lower-emitting variants.”
Researchers utilized a large US prescription database and estimated emissions based on existing academic research, factoring in drug type, device, and propellant. Feldman emphasizes the importance of understanding the scale of the problem: “An important first step toward change is to understand the true scope of the problem. From there we can find out what causes these emissions and develop targeted strategies to reduce them. this will benefit both patients and the environment.”
The impact isn’t limited to the United States. In the Netherlands, approximately 1.4 million people used inhalers in 2021, with 55% utilizing MDIs. Around 590,000 individuals were prescribed multiple types of inhalers, and 180,000 received both a powder inhaler and an MDI.
Fortunately,efforts are underway to mitigate the environmental impact. Dutch healthcare policy prioritizes prescribing medications based on ease of use, breathing control, strength, and emissions. The Association of Doctors for Pulmonary Diseases and Tuberculosis (NVALT) estimates that 70 to 80 percent of patients could potentially switch to more climate-friendly alternatives, such as powder or mist inhalers which don’t rely on propellants.
A new, more climate-friendly propellant, HFA-152a, is currently under review by the European Medicines Agency (EMA). Expected to have a similar climate impact to powder and mist inhalers, it is indeed anticipated to be available by the end of 2025. However, a complete transition away from propellant-based inhalers is expected to take several years.