Minimising the environmental impact of inhaled therapies: problems with policy on low carbon inhalers

As global citizens, we have a duty to reduce the serious threats posed to planetary well-being and population health by environmental degradation and climate change. These now unquestionable threats to our future are due to human population growth and the resource consumption patterns of the human race. In tandem, as healthcare professionals, we should seek the best possible outcomes of our treatment for our patients and we need to consider equity between different groups of patients. In the speciality of respiratory medicine, the current controversy over how to deal with the role in global warming of the propellants used in pressurised metered dose inhalers (pMDIs) is a very pressing example of how these sometimes conflicting imperatives confront us in our daily practice. Uncritical implementation of policy risks deterioration in patient inhaler choice