Overuse of asthma reliever inhalers ‘a major contributor’ to CO2 emissions in respiratory care

Overuse of short-acting bronchodilator inhalers in the UK is responsible for 250,000 tonnes of CO2 equivalent annually, according to a new analysis.

Many asthma reliever inhalers contain hydrofluoroalkane propellants, which are known to be potent greenhouse gases. | GETTY IMAGES
Many asthma reliever inhalers contain hydrofluoroalkane propellants, which are known to be potent greenhouse gases. | GETTY IMAGES

Excessive prescribing of short-acting ß2 agonist (SABA) reliever inhalers is responsible for 250,000 tonnes of CO2 equivalent annually, similar to driving an average diesel car for about 900 million miles, a new analysis has shown.

Using data collected from 2007 to 2017, the UK SABINA I study found that 83% of all SABA inhalers for asthma, representing 9.24 million prescriptions, are prescribed to patients who have already received two or more prescriptions in a year. 

Results from the global SABINA programme published to date have shown that prescription or collection of three or more SABA inhalers per year is associated with poor asthma control, approximately twice the number of exacerbations compared with low SABA users and increased asthma-related healthcare utilisation.

Reliever overuse

Dr Alexander J Wilkinson, consultant in respiratory and general medicine at East and North Hertfordshire NHS Trust, and lead author of the study, said: "Overuse of reliever inhalers in asthma is widespread in the UK and associated with an increased risk of exacerbations for patients, highlighting the importance of adopting strategies to improve disease control and reduce short-acting beta-2-agonist overuse.

This new analysis shows that reliever overuse is also a major contributor to greenhouse gas emissions in respiratory care, similar to driving an average diesel car for about 900 million miles. These findings are important for informing clinical guidelines and healthcare policies to support improvements in asthma care while also realising carbon savings."

Further results from the SABINA I analysis showed that SABA inhaler use drives 70% of greenhouse gas emissions from inhalers in the UK. The per capita use of SABA inhalers in the UK was approximately three or more times that seen in other large European countries.

The findings are being presented at the British Thoracic Society Winter Meeting, taking place online from 17th to 19th February.

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