From the Guidelines
To reduce the carbon footprint of medicine, healthcare providers should prioritize the use of low-carbon inhalers, such as dry powder inhalers, over metered-dose inhalers when clinically appropriate, as they have a substantially lower carbon footprint. The carbon footprint of medicine refers to the greenhouse gas emissions produced throughout the lifecycle of healthcare products and services. According to a recent study published in the British Journal of Pharmacology 1, inhalers contribute 13% of the NHS's carbon footprint related to delivery of care, with metered-dose inhalers having a larger carbon footprint than dry powder inhalers due to the propellant gases used.
Key Strategies for Reducing Carbon Footprint
- Using inhalers with lower emissions, such as dry powder inhalers, when clinically appropriate
- Properly disposing of unused medications through take-back programs
- Choosing medications with longer shelf lives to reduce waste
- Implementing sustainable practices in healthcare facilities, such as energy-efficient equipment and telemedicine to reduce travel emissions
- Reducing waste through strategies like recycling and composting
A more recent study published in Anaesthesia 1 highlights the importance of balancing patient needs with environmental impacts in general anesthesia, and provides a narrative review and clinical perspective on best practices. The study notes that inhaled anesthetic gases and metered dose inhalers contribute to greenhouse gas emissions, and that total intravenous anesthesia (TIVA) may be a more environmentally friendly option. However, the study also notes that TIVA components need to be disposed of in special waste containers routed for incineration, which can generate dioxins and furans, carcinogens and endocrine disrupters.
Role of Healthcare Providers
- Prescribing appropriately to avoid overprescribing
- Considering environmental impacts when choosing between equivalent treatments
- Educating patients about proper medication disposal
- Promoting sustainable practices in healthcare facilities
Overall, reducing the carbon footprint of medicine is crucial not only for environmental protection but also for mitigating the health challenges created by climate change, making sustainability in healthcare a form of preventive medicine.
From the Research
Carbon Footprint in Medicine
- The healthcare system is a significant contributor to greenhouse gas emissions, accounting for 4%-5% of global emissions and 8%-10% of emissions in the United States 2, 3.
- Hospital buildings and operating rooms are major contributors to emissions, with operating rooms accounting for 20%-33% of hospital waste 2.
- Primary care's carbon footprint can be classified into clinical and non-clinical sources, with significant impacts from pharmaceuticals and inhaler propellant gases 4.
Factors Contributing to Carbon Footprint
- Limited knowledge of emission sources, lack of awareness of sustainable practices, and low prioritization of sustainability are contributing factors to the carbon footprint of primary care 4.
- The choice of inhaler device for asthma patients is driven by the prescribed medication, rather than patient characteristics, which may reflect a lack of confidence in existing inhaler devices 5.
- Poor adherence to inhaled therapy in asthma is a significant challenge, despite the benefits of inhaled medication, and is linked to substantial morbidity and mortality 6.
Strategies for Reduction
- Implementing a dedicated fellowship program or similar intensive educational experience in healthcare sustainability can help reduce the carbon footprint of healthcare settings 2.
- Decarbonization of patient care, increasing education and awareness, and implementing non-clinical decarbonization efforts are identified strategies to reduce emissions in primary care 4.
- Developing metrics to track progress and securing policy supports are critical to improving adoption and implementation of sustainable initiatives in healthcare settings 4, 3.