Vartiainen Ville, Janson Christer, Hisinger-Mölkänen Hanna, Lehtimäki Lauri, Wilkinson Alexander
Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
BMJ Open Respir Res. 2025 Sep 1;12(1):e002424. doi: 10.1136/bmjresp-2024-002424.
Physicians are being encouraged to favour dry powder inhalers (DPI) over pressurised metered dose inhalers (pMDI) on environmental grounds. The EU is reviewing the F-gas regulation to accelerate emission phase-down targets. Thoughtful use of inhalers can reduce emissions while promoting positive clinical outcomes. We aim to describe the trends of pMDI and DPI use and associated carbon footprint in Europe.
DPI and pMDI sales data between 2011 and 2021 were extracted from IQVIA MIDAS Quarterly 2022 as total sold doses in 10 European countries. Carbon footprint calculations were based on the Medical and Chemicals Technical Options Committee 2022 assessment report.
Between 2011 and 2021, the carbon footprint of pMDI-based inhalation therapy increased from 3368 to 3891 kilotons (kt) CO equivalents (COe) because of a 16% increase in the number of sold doses of pMDI. Replacing pMDIs with low-carbon inhalers such as DPIs over this period would have produced 92% lower CO emissions. The UK was the largest source of pMDI-related emissions in 2021 with 1235 kt COe (31% of all emissions) in Europe. Short-acting beta-2 agonist (SABA) dose sales were associated with 1642 kt COe emissions in 2021, 94% from pMDIs.
The carbon footprint of inhaler therapy in Europe grew due to an increased use of pMDIs in many European countries. Greater focus on guideline-based controller therapy will potentially improve patient outcomes and decrease SABA over-reliance. Prioritising DPIs or soft mist inhalers when clinically appropriate can lower inhaler greenhouse gas emissions.
出于环保考虑，鼓励医生选择干粉吸入器（DPI）而非压力定量吸入器（pMDI）。欧盟正在审查氟气体法规，以加快减排目标。合理使用吸入器可减少排放，同时促进良好的临床效果。我们旨在描述欧洲pMDI和DPI的使用趋势以及相关的碳足迹。
2011年至2021年期间的DPI和pMDI销售数据从艾昆纬MIDAS 2022年季度报告中提取，作为10个欧洲国家的总销售剂量。碳足迹计算基于医学和化学品技术选择委员会2022年评估报告。
2011年至2021年期间，基于pMDI的吸入疗法的碳足迹从3368千吨增加到3891千吨二氧化碳当量（COe），这是因为pMDI的销售剂量增加了16%。在此期间，用低碳吸入器（如DPI）替代pMDI可使二氧化碳排放量降低92%。英国是2021年pMDI相关排放的最大来源，在欧洲排放了1235千吨COe（占所有排放的31%）。2021年，短效β2激动剂（SABA）剂量销售产生了1642千吨COe排放，其中94%来自pMDI。
由于许多欧洲国家pMDI使用量增加，欧洲吸入疗法的碳足迹有所增长。更多地关注基于指南的控制疗法可能会改善患者预后，并减少对SABA的过度依赖。在临床适当时优先选择DPI或软雾吸入器可降低吸入器的温室气体排放。
