ArticleBMJ open respiratory research2021
Reducing carbon footprint of inhalers: analysis of climate and clinical implications of different scenarios in five European countries.
Article in BMJ open respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Efficacy and safety of different inhaler types for asthma and chronic obstructive pulmonary disease. a systematic review and meta-analysis.NPJ primary care respiratory medicine · 2026Pooled it
- Pooled it
- Educational Intervention on Environmentally Responsible Inhaler Prescribing Among French General Practitioners: Pilot Pre-Post Study.JMIR formative research · 2026Article
- Recupera e Respira: A sustainable pilot model for disposal of inhalers.Multidisciplinary respiratory medicine · 2026Article
- Climate Change and the Switch from Pressurised Metered-Dose Inhalers to Dry Powder Inhalers: A Proportionate Balancing of Risk and Reward?Pulmonary therapy · 2026Review
- Increasing propellant gas emissions from pressurized metered-dose inhalers in obstructive lung diseases in France over 11 years.Respiratory research · 2026Article
- Climate conscious pharmacy practice: a qualitative interview study with pharmacists in the context of respiratory health care.International journal of clinical pharmacy · 2026Article
- Article
- Estimation of carbon emissions from inhaled respiratory medicines in Ireland: a cross-sectional study from a national pharmacy claims database from 2020 to 2022.International journal of clinical pharmacy · 2026Article
- Air pollution, inhaled therapy and COPD exacerbations in Yunlin, Taiwan: a 2016-2024 single-centre retrospective cohort with environmental and carbon-footprint analyses.BMJ open respiratory research · 2025Observational
- Article
- Article
- Priority Setting in the Context of Planetary Healthcare.Applied health economics and health policy · 2025Review
- Inhaler use and their carbon footprint in Germany: a 10-year analysis (2013-2022).BMJ open respiratory research · 2025Article
- Modelling the climate impact of inhalers and mitigation strategies: a population-based study in British Columbia, Canada (2015-2032).BMJ open respiratory research · 2025Article
- Carbon emissions from the increasing use of inhaled corticosteroid-LABA medications: a primary care used case from Singapore.NPJ primary care respiratory medicine · 2025Article
- Carbon Footprint Impact, of Monoclonal Antibodies for Severe Asthma, Administered in Italy.Biomedicines · 2025Article
- [Community pharmacy and global warming].Farmaceuticos comunitarios · 2025Article
- [Inhaled Respiratory Therapy and Global Warming].Farmaceuticos comunitarios · 2025Observational
- Environmental impact of inhaled medicines: A Thoracic Society of Australia and New Zealand position statement.Respirology (Carlton, Vic.) · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInhaled therapies are key components of asthma and chronic obstructive pulmonary disease (COPD) treatments. Although the use of pressurised metered-dose inhalers (pMDIs) accounts for <0.1% of global greenhouse gas emissions, their contribution to global warming has been debated and efforts are underway to reduce the carbon footprint of pMDIs. Our aim was to establish the extent to which different scenarios led to reductions in greenhouse gas emissions associated with inhaler use, and their clinical implications.
methodsWe conducted a series of scenario analyses using asthma and COPD inhaler usage data from 2019 to model carbon dioxide equivalent (CO
resultsTransition to low-GWP pMDIs and forced switching to DPI/SMIs (excluding SABA inhalers) would reduce annual CO
conclusionsWhile the absolute contribution of pMDIs to global warming is very small, substantial reductions in the carbon footprint of pMDIs can be achieved with transition to low-GWP propellant (HFA-152a) inhalers. This approach outperforms the substitution of pMDIs with DPI/SMIs while preserving patient access and choice, which are essential for optimising treatment and outcomes. These findings require confirmation in independent studies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.