Not only is too much salbutamol bad for people with asthma, it's also bad for the environment

Widespread poor asthma management, including overuse of salbutamol inhalers and the use of salbutamol inhalers without preventive asthma treatment, is putting the health of thousands of Kiwis at risk. In addition to this, the carbon footprint of these inhalers is significant. Metered dose inhalers (MDIs) contain hydrofluorocarbon propellants, powerful greenhouse gases that contribute to global warming. The estimated carbon footprint of a (200-puff) salbutamol inhaler is 28kg of carbon dioxide equivalents (CO2-e).

EPiC Asthma’s new carbon footprint story shows that nationally, in the last 12 months, there were 91,117 people aged 12 years and over who had potentially problematic dispensings of salbutamol inhalers. This was made up of:

• 58,561 people who had been dispensed salbutamol inhalers without maintenance treatment
• 29,011 people who had been dispensed six or more salbutamol inhalers with maintenance treatment, and
• 3,455 people who had been dispensed six or more salbutamol inhalers without maintenance treatment.

This equates to just under 600,000 inhalers and an estimated carbon footprint of 16,800 tonne CO2-e. As a comparison, one person flying from Auckland to Hong Kong return has an estimated carbon footprint of 1 tonne CO2-e.

Improving the way salbutamol is used has dual benefits – improved patient outcomes and a significant reduction in the carbon footprint of asthma management. To help with this, health providers can consider:

• prescribing dry powder inhalers where possible (carbon footprint ~1kg CO2-e per inhaler)
• reducing the use of salbutamol without maintenance therapy by switching to SMART/AIR therapy in people aged 12 and older
• reducing excessive use of salbutamol by reviewing people who have been dispensed six or more inhalers in the last 12 months.

What do your carbon footprint data look like?

Prescriber, practice, and national data can be viewed at the link below.

If you are not a prescriber but you are associated with a medical practice, and you want to view carbon footprint data for that practice, request a practice account here.