Why replacing asthma inhalers might be better for you and the planet The current asthma inhalers we use are cheap, but because of the gas they contain, they are one of the biggest contributors to NHS climate change. Other countries think the options are better - and some patients in the UK who have changed say they have better control over their asthma. So, can different inhalers be prescribed for millions of people?
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| Why replacing asthma inhalers might be better for you and the planet |
"It looks like there's a vacuum in your lungs trying to get the air out." That's what nine-year-old Sebastian thinks of his asthma attack.
Some of his attacks required hospital treatment. A recent cross-country race stopped him on the ground as he struggled to breathe through his lungs and narrowed airways. "I fell to the ground and my lungs felt like air couldn't enter, and I felt like there was nothing left in me," he said.
Sebastian was hospitalized with asthma when he was young
He has asthma in his family. Her mother, Caroline Sask, said the disease had "taken a lot of control" of her life since she was three. It will start from the moment he wakes up and he is breathing: "I'm not going anywhere without an inhaler in my hand, it really affected what I was able to do and when I was able to do it."
Both mother and son say they have changed their asthma control by changing their inhaler which is much better for the planet.
Speaking to me on BBC Radio 4's Inside Health program, Caroline said, "I can't believe the impact ... it really changed my life."
He and Sebastian still have 'preventive' medication to reduce the risk of seizures and this should be a 'painkiller' treatment. But the important change for them is how these drugs get into their lungs.
Caroline and Sebastian after the football match
Photo source: Caroline Music
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Caroline and Sebastian are getting better with their new 'green' inhaler
Previously, they used aerosol spray inhalers - also known as nebulizers or pressurized metered-dose inhalers.
"Aerosol nebulizers contain powerful greenhouse gases that are used to push drugs from inhalers into the airways," said Dr. Alex Wilkinson, an NHS consultant in Stevenage who specializes in pulmonology.
The various gases used in these inhalers - known as hydrofluorocarbons - are 1,000 to 3,000 times more powerful for warming the planet than carbon dioxide.
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Inside Health is broadcast on BBC Radio 4 every Tuesday at 2100 GMT and Wednesday at 1530 GMT. It is also available as a podcast on BBC Sound.
Listen to Inside Health: Asthma Inhalers and Antivirals
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You might not think it adds too much, because all inhalers are small and slide inside a coat pocket. But more than five million people in the UK are treated for asthma and most are prescribed spray inhalers. Overall, about 4% of the total NHS carbon footprint comes from asthma medications. Other drugs that come close are anesthetic gas used in surgery.
Now, Caroline and Sebastian have "eco-friendly" inhalers that do not contain propellant. These are called dry powder inhalers and you need to absorb the medicine.
If you only think about climate change when using dry powder inhalers, are they a good option for patients?
The relative carbon footprint of different inhalers
At Sheffield GP Surgery you will find one of the first 'Net Zero' GPs in the country. Dr. Aarti Bansal's goal is to simultaneously improve patient care and reduce carbon emissions.
"As long as you can get the medicine in the right place in your lungs, one inhaler is not necessarily better than the other and most patients can use a dry powder inhaler," he told Inside Health.
He says spray inhalers are "very difficult" to use and that people often misunderstand itstheir technique. So instead of the drug entering the lungs, it will "hit the back of your throat."
Mist nebulizer inhalers require slow, steady breathing as the inhaler is used. A dry powder inhaler requires strong, fast sucking, which is the number of people who use the inhaler instinctively.
An example of a dry powder asthma inhaler
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An example of a dry powder asthma inhaler
Asthma UK: How to use your inhaler
Caroline says it was "really difficult" to adjust her breathing and the inhaler, especially when she was having trouble breathing.
But switching to a dry powder inhaler changed her life and she can now run 10km.
“A year and a half ago it seemed like I could never do it, I could run 3km and my chest was breaking.
"Ever since I started taking [dry powder blocker], I don't need to take inhalers."
Caroline rides a bike through the hills
Photo source: Caroline Music
Dr. Bansal said Caroline's experience was not unique and she changed their inhalers when patients used the wrong technique.
“I see that if I switch them to a dry powder spray that often improves their control,” he says.
Control is key for both the patient and the planet. The fewer people rely on inhalers, the better their standard of living and greenhouse gas emissions. The NHS says one person in the UK has a life-threatening asthma attack every 10 seconds.
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