PT - JOURNAL ARTICLE AU - Christer Janson AU - Richard Henderson AU - Magnus Löfdahl AU - Martin Hedberg AU - Raj Sharma AU - Alexander J K Wilkinson TI - Carbon footprint impact of the choice of inhalers for asthma and COPD AID - 10.1136/thoraxjnl-2019-213744 DP - 2019 Nov 07 TA - Thorax PG - thoraxjnl-2019-213744 4099 - http://thorax.bmj.com/content/early/2019/11/07/thoraxjnl-2019-213744.short 4100 - http://thorax.bmj.com/content/early/2019/11/07/thoraxjnl-2019-213744.full AB - In the 1990s, metered dose inhalers (MDIs) containing chlorofluorocarbons were replaced with dry-powder inhalers (DPIs) and MDIs containing hydrofluorocarbons (HFCs). While HFCs are not ozone depleting, they are potent greenhouse gases. Annual carbon footprint (CO2e), per patient were 17 kg for Relvar-Ellipta/Ventolin-Accuhaler; and 439 kg for Seretide-Evohaler/Ventolin-Evohaler. In 2017, 70% of all inhalers sold in England were MDI, versus 13% in Sweden. Applying the Swedish DPI and MDI distribution to England would result in an annual reduction of 550 kt CO2e. The lower carbon footprint of DPIs should be considered alongside other factors when choosing inhalation devices.