2023-12-19 23:00:00
Planetary health is a concept that shows the foundations of sustainable and environmentally friendly healthcare, beneficial for animals, environments and humans. A principle that is the axis of the document of the Spanish Society of Family and Community Medicine (Semfyc) ‘What to do and not to do in Planetary Health?’, in which among its recommendations they call for “do not prescribe PMDI inhalers “If there is a better alternative.”
As indicated by Primary Care doctors Anna Fernández Ortiz and Maria del Campo Gimenez In the document, all drugs have an impact on the environment: with the carbon footprint of production, storage, packaging, transportation and waste management. However, “inhalers have another added factor: the propellant of pressurized pMDI (pressurized Metered Dose Inhaler) systems, hydrofluorocarbon gases (HFC), with a more powerful greenhouse effect than CO2.”
pMDIs contain hydrofluorocarbon gases (HFC) with a very powerful greenhouse effect: between 1,480 and 2,900 times greater than carbon dioxide (CO2)
Currently, in Spain, there are 15 million units of pressurized metered dose inhalers (pMDI, for its acronym in English pressurized metered dose inhaler) aimed at patients with asthma or COPD. The gases that pMDI contain have a very powerful greenhouse effect: between 1,480 and 2,900 greater than carbon dioxide (CO2).
These inhalers are the most used and only one device has a carbon footprint of 28 kg, The same amount of greenhouse gas emissions produced by the exhaust pipe of a car traveling 282 km. In turn, among short-acting beta-agonist drugs, one application of salbutamol in a pMDI device is equivalent to 60.4 g CO2eq; Taking into account that up to 8 applications can be used daily, it would be equivalent to 176.37 kg CO2eq per year, which is the same as a 978.5 km car trip.
According to the platform Green Inhaler, changing the type of inhalers might reduce your carbon footprint as much as going vegetarian. Family Medicine specialists estimate that a change from a pMDI system to a dry powder (DPI) and fine mist (SMI) system would reduce the carbon footprint by 95-98% per inhaler.
DRY POWDER AND FINE MIST DEVICE
As stated in the report ‘What to do and not to do in Planetary Health?’, the prescription of the type of devices must always be carried out taking into account the characteristics of the patient and their preferences regarding the type of inhaler. However, if the patient’s situation allows it, “it is recommended to prescribe DPI and SMI, with a smaller carbon footprint (up to 18 times, in the case of DPI). These devices are just as effective and cost-effective as pMDIs,” the document states.
“It is recommended to prescribe DPI and SMI, with a lower carbon footprint (up to 18 times, in the case of DPI). “These devices are just as effective and cost-effective as pMDIs,”
Likewise, in addition to being cost-effective, different studies have shown that dry powder or fine mist inhalers produce a carbon footprint. 10 to 30 times smaller.
In the case in which it is not possible to have an alternative to pMDIs, the experts remember that the treatment must be done with the optimal dose, with the smallest number of devices, preferably using rechargeable devices, and optimizing the treatment: the devices pMDI are usually rescue medications and excessive use can mean poor control of the pathology.
1703027540
#Family #Medicine #calls #prescribe #PMDI #inhalers
