Inhalers generate over 2 million metric tons of carbon emissions annually — study

In what is the largest study ever on the environmental impact of inhalers in the U.S., UCLA Health finds they are responsible for over 2 million metric tons of carbon emissions annually in the U.S. over the past decade. This is equivalent to emission from 530,000 gasoline-powered cars. The study — published in the journal JAMA — provides the most comprehensive analysis to date of inhaler-related emissions in the United States.

The study — which measured emissions from inhalers approved for asthma or COPD between 2014 and 2024 — found that metered dose inhalers were overwhelmingly the most harmful to the environment, accounting for 98% of the emissions. This is because they use hydrofluoroalkane (HFA) propellants, which are potent greenhouse gases. Also within this group, albuterol, budesonide-formoterol, and fluticasone propionate inhalers were responsible for 87% of total emissions. On the other hand, other types of inhalers like dry powder and soft mist inhalers deliver medication without the need for these propellants.

Over the 10-year period, the estimated 1.6 billion inhalers generated an estimated 24.9 million metric tons of carbon dioxide equivalent (CO₂e) emissions, resulting in an estimated social cost of $5.7 billion. The researchers also noted a growth in emissions, with annual emissions having increased by 24% from 2014 to 2024.

Inhalers add to the growing carbon footprint of the U.S. health care system... On the upside, there is tremendous opportunity to make changes that protect both patients and the planet by utilizing lower-emission alternatives. — Dr. William Feldman, a researcher at UCLA and the study's lead author.