NHS Scotland has announced plans to reduce the use of metered dose inhalers by 70 per cent in under six years in a bid to tackle harmful emissions.

In a strategy document on handling the climate emergency published last week, the health service estimated that estimated that MDIs emitted 79,000 tonnes of CO2 equivalent in 2020-21, with around 4.5 million prescribed that year. This made up a greater overall emission “than NHS fleet and waste combined”.

It said the propellant used in MDIs to treat asthma and COPD contain powerful greenhouse gases with global warming potentials of 1,430 or 3,220 times greater than CO2 depending on the type”.

“Rapid reductions in emissions are achievable,” the report notes, pointing to the higher proportion of MDI use in the UK (70 per cent) compared to the rest of Europe (less than half) and Scandinavia (between 10 and 30 per cent).

To help meet the goal of reducing MDI use by 70 per cent by 2028, NHS Scotland will publish an updated Scottish Quality Respiratory Prescribing guide to ensure they are “only used where they are clinically necessary,” carry out awareness campaigns for patients and clinicians and support inhaler return to pharmacy schemes to help patients dispose of used MDIs. 

It will also track the progress made by pharmaceutical manufacturers in developing low emissions propellant for MDIs.

“Through improvements to the way asthma and COPD are managed, the NHS can improve outcomes for patients and reduce the number of short-acting inhalers which are used,” the strategy document stated, noting that dry powder inhalers are “suitable for many patients and have a far lower carbon impact than MDIs”.

In his foreword to the report, Scottish health secretary Humza Yousaf said: “The climate and ecological emergency is a health emergency. Human health is inextricably linked to the health of our planet and its natural systems. 

“To play our part in tackling the climate crisis, NHS Scotland is aiming to become a net-zero health service by 2040 at the latest.

“We want to maximise our contribution to reducing emissions from the manufacture and supply of medicines and equipment and from staff, patient and visitor travel.

“The level of these emissions is determined by clinical decisions and models of care and so the involvement of all health professionals in efforts to improve sustainability is essential to success.”