Inhaler use is producing millions of metric tonnes of emissions and having a big impact on global warming, a new study has suggested.
The findings, published in journal JAMA, found inhaler-related emissions in the US have increased in the last 10 years.
Inhalers are the main form of treatment for people with asthma and COPD – but they generated 24.9million metric tonnes of carbon dioxide-equivalent emissions in the US between 2014 and 2024.
In 2022, estimated emissions from inhalers used by Medicare and Medicaid patients exceeded 1million metric tonnes of emissions – equivalent to the annual electricity use of more than 200,000 homes.
Researchers behind the study warn the costs of inhaler-related emissions reached around $5.7billion (£4.2billion), and suggest shifting prescribing towards lower-emission inhalers could be the way forward.
Some 98% of inhalers prescribed in the last decade were metered-dose inhalers. They contain hydrofluoroalkane propellants which contribute to ‘substantial’ greenhouse gas emissions.
In comparison, dry powder and soft mist inhalers deliver medicine to the lungs without propellants.
In total there were 1.6billion inhalers dispensed in the US between 2014 and 2024. Actual emissions increased by 24% in that time period, from 1.9million metric tonnes of carbon dioxide-equivalent in 2014 to 2.3million metric tonnes in 2024.
The study concludes: ‘Inhaler-related emissions in the US have increased over the past decade.
‘Policymakers and regulators seeking to reduce emissions should identify targeted solutions aimed at shifting utilization to currently marketed dry powder and soft mist inhalers while facilitating the entry of newer, affordable metered-dose products containing propellants with low global warming potential.’
The study also found that brand-name inhalers produced 72% of total emissions, compared to authorised generics producing 22% and independent generics producing 6%.
GlaxoSmithKline products generated the highest overall emissions (10.1million metric tonnes of carbon dioxide-equivalent emissions), followed by AstraZeneca (5.9million metric tonnes), Teva (5.2million metric tonnes), and Boehringer Ingelheim (0.2million metric tonnes).
While the US plans to phase out the use of hydrofluorocarbons in the next decade, it’s not yet known how and when this will happen.
The federal government pledged to reduce the use of hydrofluorocarbons by 85% by 2036 under the Montreal Protocol – a UN agreement to regulate the use of manmade chemicals which deplete the ozone layer.
The hydrofluoroalkane propellant inhalers are themselves an improvement on chlorofluorocarbon inhalers.
They were phased out between 2009 and 2013 under the Montreal Protocol because not only were they creating emissions, they were also ozone depleting, damaging the ozone layer which protects the planet from the sun’s harmful UV rays.
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