Respiratory care has some of the biggest problems (inhalers) and many good solutions for sustainable healthcare.

Plans underway for a Sustainable Respiratory Inhalers Programme

The continued use of metered-dose inhalers (MDIs) in respiratory care will have a potentially serious effect on global warming if production is not controlled, largely because these inhalers use potent green-house gas hydroflourocarbons (HFCs) as propellants. A cost-effective and safe alternative is available in the form of Dry Powder Inhalers (DPIs), and we propose a programme to change prescribing practices such that DPIs are used in preference to HFC-driven inhalers where not clinically contra-indicated. 

Sustainable Respiratory Inhalers Programme - briefing note

The continued use of metered-dose inhalers in respiratory care will have a potentially catastrophic effect on global warming if production is not controlled, largely because these inhalers use potent green-house gas hydroflourocarbons (HFCs) as propellants.

Centre for Sustainable Healthcare
March, 2013

Cradle to Gate

Greenhouse Gas Accounting Sector Guidance for Pharmaceutical Products and Medical Devices

A consortium of major global companies has been working with the NHS SDU to agree standards for reporting of carbon equivalents emissions for the manufacture of drugs and medical devices. The report was launched on Friday 30th Nov 2012 at St Thomas' Hospital in London and is a real achievement, albeit only the beginning of a lot more work. 

Greener Inhalers for the UK

The Centre's Sustainable Respiratory Care group will lead research on why the UK continues to use inhalers with a much higher carbon footprint than other European countries.

Following the Montreal protocol banning the use of CFC gases in 1987, many countries moved directly to a new technology for inhalers based on Dried Powder (DPIs) while the UK still prescribes a majority of metered dose inhalers (MDIs) which use powerful greenhouse gases.  

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Green Inhaler website

This patient- and clinician-facing website gives guidance on choosing inhalers with lower environmental impact - something which is now included in the BTS asthma guidelines.

Dr Alex Wilkinson
September, 2019

New BTS asthma guidelines encourage use of low-GWP inhalers

Section 8.6 of the new BTS/SIGN Guideline for the management of asthma highlights the environmental impact of metered dose inhalers (pMDI) and recommends that inhalers with low global-warming potential (GWP) should be used when likely to be equally effective.

British Thoracic Society
July, 2019

Asthma UK inhaler videos

Are you confident in teaching patients how to use their inhalers? The first step in improving environmental sustainability of inhaler use is to ensure that people use the correct technique to get the drug to where it is needed. 

Asthma UK
July, 2019

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