How green is your inhaler?
Are inhalers bad for the environment? The answer is not so straightforward. Our in-house GP, Dr Andy, talks us through all you need to know about greener inhalers.
I get asked a lot about whether inhalers are bad for the environment. The answer is not so straightforward, as there are so many other factors.
Inhaler devices contain plastic, and metered-dose inhaler cannisters contain propellants. Both can have an impact on the environment.
However, poorly controlled asthma creates its own carbon footprint and by using the right inhalers in the right way, we can find a balance that keeps us well, while minimising our own impact on the environment.
Recycling inhalers and the NHS’ carbon footprint
We can recycle our inhalers more than we do now. Take your empty inhalers back to the pharmacy, so they can dispose of them appropriately. Find out what do with used inhalers.
The key points I make to my patients when considering the environmental impact of their medicines, including inhalers, are the following:
1. The best thing that you can do for the environment is to keep your asthma under control.
Repeated appointments with your GP, emergency care and hospital admissions are more likely to increase your carbon footprint. However, don’t miss out on these if you need them! It’s also important not to stop taking your inhalers because your worried about the environment – stopping using your existing aerosol inhalers could be very damaging to your health.
2. The worst thing you can do is not to take your preventer medicines regularly.
By taking them every day, as prescribed, they will do their job by dampening down the inflammation in your airways and helping to prevent symptoms and asthma attacks.
3. Make sure you’re taking your inhalers correctly.
Check your inhaler technique with your asthma nurse, GP, pharmacist and by watching our inhaler technique videos. By not using the best technique possible, you may be wasting medicine and getting less of the benefits of your inhaler. You’re also more likely to get side effects, such as a sore throat and thrush.
4. Act early if you’re getting asthma symptoms.
By delaying help, you are more likely to need even more medicines and support to get back to normal. You’re also putting yourself at risk of an asthma attack and an admission to hospital. Follow your asthma action plan, so you know what action to take and when to seek help.
The NHS has a lot of areas where it can reduce its carbon footprint and is continuing to make changes for the better. One area we are keeping an eye on is a scheme aimed at GPs around the prescribing of inhalers.
We know that some inhalers have a bigger impact on the environment than others. This is based on the gases they contain. GPs are being asked to reduce the number of gas-containing inhalers (you may know these as metered-dose inhalers or MDIs) and increase the number of powder-based inhalers (known as Dry Powder Inhalers or DPIs). They have not been told to stop prescribing certain inhalers, just to get more people on to DPIs.
For most people, this change may be appropriate – it may be an easier inhaler to use, it may allow the medicines to work better and may help to control their asthma better. It’s crucial that any change of inhaler device includes a clear demonstration of how to use the inhaler and a check to see whether they can use it correctly.
If you can’t use your new inhaler
If you are unable to correctly use your new DPI inhaler, or are unhappy with how it is working for you, then speak with your GP, asthma nurse or pharmacist, so they can help you or find a better alternative.
For some people, it may take time to find the right DPI, as there are many different types. However, not every type of inhaler will contain the right medicines at the right doses for them.
For others, the MDI (ideally with a spacer) will be the best inhaler because it suits them, it works well and they are able to take it with the correct inhaler technique. I reassure people that aren’t able to change to a DPI that the key thing is to keep their asthma as well-controlled as possible.
I also point out that in the future, there will be some industry development going on that will massively reduce the environmental impact of MDIs.
Changing inhalers can be difficult
Change can be unnerving for people, especially when it comes to their medicines. I am also seeing increased numbers of people wanting to look at different inhaler types. Personally, I am trying not to change inhalers where their inhaler suits them, works well and controlling their asthma symptoms. However, if people ask at an annual asthma review, then we look at the options.
Whenever I am considering an inhaler for someone, the main things I weigh up are what medicines they need and at what dose. We are increasingly prescribing MART inhalers, depending on the patient’s age and types of medicines they are needing to manage their asthma.
Asthma + Lung UK have put together a webpage for people who are worried about having their inhaler changed, or are considering whether this is the best option for them.
There is also this NICE patient decision aid to help you consider what is important for you when choosing an inhaler.
The future for inhaler switching
Due to the pressures of the pandemic on the NHS, the speed of change from MDIs to DPIs will be more gradual than originally planned. For many people, a DPI can be a good thing, but it is definitely not the end of the world if you cannot switch over. The most important thing is your health and keeping your asthma under good control.
The NHS prescribes millions of inhalers every year and will not be able to get everyone on to DPIs. Focus on the things that you can do, such as:
1. Taking your current preventer inhalers regularly, as prescribed, to keep your asthma under good control
2. Checking your inhaler technique to make sure you are getting the most out of your inhalers
3. Having a look at the NICE Decision Aid and discuss it at your next asthma review
4. Returning empty inhalers to your local pharmacy
5. Considering walking instead of using your car (the exercise is likely to be good for you and you will be cutting down on pollution)
6. Reading up about other ways to improve your carbon footprint
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