1 Pressurized metered-dose (pMDI) inhalers are an important contributor to greenhouse gas emissions
Hydrofluorocarbon propellants in pMDIs are responsible for roughly 0.03% of yearly global greenhouse gas emissions. (1) Prescriptions for pMDIs represent about 3% of total health care-related emissions from the United Kingdom's National Health Service. (2) The carbon footprint from 1 pMDI (200 doses) is estimated as equivalent to a 290-km automobile ride. (3) Reducing pMDI prescriptions when appropriate could have a meaningful environmental impact.
2 Alternative inhalers with lower carbon impact are available
Dry powder and soft mist inhalers, both available as rapid reliever and maintenance therapies, are commonly used in the treatment of asthma and chronic obstructive pulmonary disease. Dry powder and soft mist inhalers contribute a lower carbon dioxide equivalency (< 20 g C[O.sub.2]e per inhalation) than pMDIs (about 100 g C[O.sub.2]e per inhalation). (1)
3 Dry powder and soft mist inhalers are effective and can have advantages over pMDI prescription
Compared with pMDIs, alternative inhaler devices show similar efficacy and are often preferred by patients. (4-6) The Canadian Thoracic Society guideline highlights reliever therapy with a budesonideformoterol dry powder inhaler as an appropriate...