Sustainable Respiratory Care: Cutting Carbon Without Compromising 2026

Sustainable respiratory care is emerging as a critical frontier in healthcare, where the mission to improve lives must now align with the urgent need to reduce carbon emissions. The climate crisis is also a health crisis, and the respiratory care sector—particularly inhaler production—faces a unique challenge: can it cut its carbon footprint without compromising patient outcomes?

Maria Paola Chiesi, chair of the board for global biopharmaceutical company Chiesi, argues that healthcare’s mission is fundamentally contradicted when pharmaceutical practices contribute to climate change. Research from the University of Michigan Medical School shows that pollution harms not only lung health but also cardiovascular and brain health. This underscores the need for sustainable respiratory care that addresses both patient needs and environmental impact.

The Environmental Impact of Inhalers

Pressurised metered-dose inhalers (pMDIs) are essential for treating chronic lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). However, the propellant used to deliver medication—a pressurised liquefied gas—has significant environmental implications. Until the 1990s, pMDIs used chlorofluorocarbons (CFCs), which deplete the ozone layer. When CFCs were phased out, they were replaced with hydrofluoroalkane (HFA) propellants, which eliminated ozone risk but were later found to contribute to global warming.

Chiesi faced a pivotal choice: switch to a more sustainable propellant or supply only dry powder inhalers (DPIs). The company opted to invest in a novel propellant with a much lower global warming potential, demonstrating that sustainable respiratory care is achievable without sacrificing efficacy.

Comparing Inhaler Options for Sustainability

Understanding the carbon footprint of different inhaler types is crucial for healthcare providers and patients. The table below compares key environmental and clinical factors.

Switching to low-GWP propellants or DPIs can drastically reduce the carbon footprint of respiratory care. However, patient suitability varies; DPIs may not be appropriate for young children or those with severe airflow limitation.

Strategies for Sustainable Respiratory Care

Achieving sustainability without compromising patient care requires a multifaceted approach. Key strategies include:

• Propellant innovation: Investing in low-GWP propellants like HFA-152a, which maintains efficacy while reducing environmental impact.
• Patient education: Training patients on proper inhaler technique to minimize waste and ensure optimal disease control.
• Recycling programs: Implementing inhaler recycling schemes to safely dispose of propellants and plastics.
• Telehealth and remote monitoring: Reducing travel-related emissions through virtual consultations and remote monitoring of lung function.
• Green prescribing: Encouraging healthcare providers to consider environmental impact when selecting inhalers, where clinically appropriate.

These measures can collectively lower the carbon footprint of respiratory care while maintaining or even improving patient outcomes.

Balancing Patient Needs and Environmental Responsibility

The transition to sustainable respiratory care is not without challenges. Some patients rely on pMDIs for immediate relief and cannot switch to DPIs due to technique or flow limitations. Therefore, a personalized approach is essential. Healthcare providers must weigh the clinical benefits against environmental impact, ensuring that no patient is disadvantaged.

Chiesi’s commitment to developing a low-GWP propellant exemplifies how industry can drive change. Regulatory bodies and health systems also play a role by incentivizing green practices and supporting research into sustainable alternatives.

FAQ

Sustainable respiratory care is not just an environmental imperative but also an opportunity to improve patient outcomes through innovation. By embracing low-carbon technologies and smart practices, the healthcare sector can propel change without compromising the quality of care.

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