For millions of people with asthma and chronic obstructive pulmonary disease (COPD), inhalers are a vital lifeline. But a growing body of research reveals a hidden cost to these essential devices: their impact on the environment. While the medical benefits are undeniable, the propellants used in many inhalers contribute to greenhouse gas emissions, raising concerns about their role in climate change.
The issue centers around metered-dose inhalers (MDIs), the most commonly prescribed type in the United States. These devices deliver medication as a measured spray, powered by hydrofluorocarbons (HFCs). According to a report from NPR, HFCs can be thousands of times more potent greenhouse gases than carbon dioxide. A recent study published in the medical journal JAMA quantified this impact, prompting discussion among healthcare professionals and environmental advocates.
Dr. Jyothi Tirumalasetty of Stanford University, who has prescribed numerous inhalers throughout her career, expressed surprise at the extent of the environmental impact. Everyone who’s involved in asthma treatment, everyone I talked to, they were like, oh, we didn’t know about this. And I certainly had no idea about it,
she stated, as reported by NPR. The climate impact of inhalers hadn’t been thoroughly calculated in the U.S. Until her team’s research.
The Asthma and Allergy Foundation of America (AAFA) acknowledges the findings but emphasizes the importance of perspective. In a press release, the AAFA stated that emissions from inhalers represent only a small portion of the total impact contributing to air pollution and climate change. The organization stresses that individuals with asthma or COPD should not discontinue their current treatment based on these findings, as interruptions can lead to serious health consequences, including asthma attacks and emergency room visits.
The scale of the problem is significant. KFF Health News reported that approximately 144 million MDIs are prescribed annually in the United States, with the cumulative gas released equivalent to driving half a million gas-powered cars for a year. This contribution to climate change, in turn, can exacerbate conditions that trigger asthma and COPD, creating a concerning cycle. Increased wildfire smoke, air pollution, and longer allergy seasons – all consequences of a changing climate – can make breathing more difficult for those with respiratory illnesses, potentially increasing their reliance on inhalers.
Fortunately, alternatives exist. Dry powder inhalers (DPIs) offer a more eco-friendly option. These devices deliver medication in powder form, requiring patients to inhale deeply rather than relying on a propellant gas. As Miguel Divo, a lung specialist at Brigham and Women’s Hospital in Boston, explained to a patient, You have the same medications, two different delivery systems,
according to KFF Health News. Switching to a DPI eliminates the release of greenhouse gases associated with MDIs.
However, the transition isn’t always straightforward. DPIs require a stronger inspiratory effort, which can be challenging for some patients, particularly those with severe asthma or COPD. The effectiveness of a DPI also depends on proper technique, requiring careful instruction from a healthcare provider. Patient preference and familiarity with MDIs can also play a role in treatment adherence.
The AAFA highlights that drug manufacturers are already working on lower-emission alternatives to traditional MDIs. Kenneth Mendez, President and CEO of AAFA, emphasized the need to focus on major sources of air pollution and greenhouse gases while acknowledging the concerns raised by the recent study. He also expressed concern about rollbacks of clean air regulations, which he believes will have a greater and longer-lasting impact on both the climate and public health.
The issue of inhaler emissions underscores the complex interplay between healthcare, environmental sustainability, and public health. While inhalers remain a critical treatment for millions, awareness of their environmental impact is growing. As more research emerges and greener alternatives become available, healthcare providers and patients can work together to make informed decisions that prioritize both respiratory health and the health of the planet. The conversation is shifting towards a more holistic approach, recognizing that addressing climate change is not only an environmental imperative but also a crucial component of protecting and improving public health.
The potential benefits of widespread adoption of DPIs are substantial. By reducing the release of potent greenhouse gases, healthcare systems can contribute to mitigating climate change and improving air quality, ultimately benefiting the very patients who rely on these medications. As Dr. Divo of Brigham and Women’s Hospital stated, There is only one planet and one human race.
This sentiment encapsulates the growing recognition that environmental stewardship and healthcare are inextricably linked.
