Inhalers that offer quick relief for asthma and chronic obstructive pulmonary disease (COPD) may have a surprising downside. Research indicates they could be contributing to climate change, producing emissions equivalent to over 500,000 cars each year.
A study published in JAMA reveals that in the past decade, inhalers have released more than 2 million tons of carbon dioxide annually. This amount roughly mirrors the emissions from around 530,000 gasoline vehicles.
The analysis focused on three categories of inhalers approved for use from 2014 to 2024, noting that metered-dose inhalers were the most environmentally damaging.
Interestingly, it was found that metered-dose inhalers, which rely on hydrofluoroalkane (HFA) propellants—a substantial greenhouse gas used in aerosols—accounted for 98% of the emissions during that period. On the brighter side, other types, like dry powder inhalers and soft mist inhalers, avoid using propellants and have a much smaller environmental impact.
Some companies, like AstraZeneca, are already making efforts to transition away from pressurized metered-dose inhalers (pMDIs) to more eco-friendly alternatives.
Dr. William Feldman, who led the study and works at the UCLA David Geffen School of Medicine, highlighted that these inhalers pose risks to individuals with chronic respiratory issues. However, he acknowledged a significant opportunity to protect both patients and the environment through low-emission alternatives.
The researchers conducted their assessment using a detailed national prescription database at the National Drug Code (NDC) level. They estimated emissions based on validated academic studies, taking into account various factors like drug type, device type, propellant used, and more.
Moving forward, the research team intends to broaden their study. They aim to assess inhaler emissions among specific patient populations, such as Medicaid recipients, and compare the clinical results of low-emission versus high-emission inhalers within the same therapeutic category. Additionally, they plan to explore how pricing and patent strategies could influence the rollout of new low-emission technologies.
Dr. Feldman remarked, “Understanding the true scale of the problem is a critical first step in driving change. Once we grasp the factors contributing to these emissions, we can craft targeted strategies to mitigate them, benefiting both patients and the planet.”
