As atmospheric carbon dioxide levels top 400 parts per million, an editorial in this week's BMJ from Nick Hopkinson, Toby Hillman and Frances Mortimer draws attention to the impact of respiratory inhalers on global warming.
The editorial points out that propellants in metered-dose inhalers are powerful greenhouse gases, but that alternatives (such as dry-powder inhalers (DPI's)) offer an opportunity to reduce emissions while maintaining patient care.
Evidence to date suggests that in general, DPI’s, which have a carbon footprint 18 times lower than MDI inhalers, are equally effective for the treatment of both asthma and COPD and that DPI’s used for maintenance therapy are not in general less cost effective than MDI’s (although some short-acting bronchodilators are marketed at much lower prices as MDI’s than in DPI form).
Furthermore, an IPSOS MORI poll found that 92% of the public surveyed said it was important for the NHS to work in a more sustainable way, suggesting that patients, properly informed of a way to minimise environmental harm, are likely to prefer a sustainable option.
Link to full article: http://www.bmj.com/content/346/bmj.f3359
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