Highlights from Orion’s webinar: Sustainable care of asthma and COPD — partnership between patients and professionals (April 26, 2022)Publikationer | 2022-06-30
Green way to respiratory health
Professor Emeritus Tari Haahtela, MD, PhD
Skin and Allergy Hospital, Helsinki University Hospital
University of Helsinki, Finland
Professor Emeritus Tari Haahtela has made significant contributions in the field of allergy and asthma research, especially in exploring causative factors. In his talk, Professor Haahtela discussed how the interconnected issue of global warming and biodiversity loss pose a major threat to overall human health and respiratory health. According to the biodiversity hypothesis, contact with natural environments enriches the microbiome, promotes immune balance, and protects from chronic inflammatory diseases.1,2 Professor Haahtela elucidated the success of the Finnish Allergy Programme, a national initiative to promote immune tolerance and nature contact. For example, the prevalence of asthma levelled off and asthma hospitalisations halved in the 10 years of the programme.3 Haahtela also discussed the recent results from the first human intervention trial in which urban environmental biodiversity was manipulated to study its effects on the immune system of children.4
See Professor Emeritus Haahtela’s presentation to learn why planetary health and sustainability should be a priority among health professionals.
Life cycle assessment and carbon footprint of inhalers
Respiratory consultant Alex Wilkinson, MD, PhD
East and North Herts NHS Trust, Stevenage UK
Doctor Alex Wilkinson has contributed to research on the environmental impact of inhalers and sustainable respiratory care. His presentation explained why the carbon footprint of inhalers has attracted much interest and why many agencies have proposed a switch to “low carbon inhalers”, such as dry powder inhalers (DPIs).5 The propellants used in metered dose inhalers (MDIs) are very powerful greenhouse gases, far more powerful than carbon dioxide.5 As a result, MDIs can make up a significant proportion of the carbon footprint of healthcare, as they do in England.6 DPIs do not contain any propellant gases, which makes their carbon footprint far smaller compared to MDIs.5
Watch Doctor Wilkinson’s presentation for an insightful summary of analyses on inhaler life cycle and carbon footprint.
Role of disease control on carbon footprint of asthma and COPD care
Professor Lauri Lehtimäki, MD, PhD
Faculty of Medicine and Health Technology, University of Tampere
Allergy Centre, Tampere University Hospital
Professor Lauri Lehtimäki’s recent research has focused on airway inflammation in asthma, COPD, and occupational lung diseases. In his talk, Professor Lehtimäki elucidated the huge potential for decreasing the carbon footprint of inhaler treatment if DPIs are favoured over MDIs. He also showed that worse asthma control is associated with higher carbon footprint at every treatment step.7 Reducing exacerbations and reliance to short-acting β2-agonist (SABA) benefits both the patient and the environment.7
See Professor Lehtimäki’s presentation to find out more about the impact of good disease control on the carbon footprint of respiratory care.
Treatment strategies on national levels
Professor Christer Janson, MD, PhD
Department of Medical Sciences: Respiratory, Allergy and Sleep Research
Uppsala University, Uppsala, Sweden
Professor Christer Janson’s research focus areas are asthma, allergy, COPD, and sleep apnea. In his presentation, Professor Janson shed light on the large differences in inhaler device preference among different countries. For example, in 2017 in England, 70% of all inhalers sold were MDI and this number was 94% for SABA inhalers. Whereas in Sweden, 13% of all inhalers and 10% of SABA were MDI.8 Professor Janson revealed that using DPIs instead of MDIs would result in an annual carbon footprint reduction equivalent to 422 kg CO2e per patient, which corresponds to the carbon reduction obtained if changing from a meat-based diet to a plant-based diet.8 He also noted that it is possible to switch from an MDI-based to DPI-based therapy without loss of asthma control.9
Watch Professor Janson’s presentation to learn how the choice of inhalation device can influence the environment in a positive way.
- Haahtela T. A biodiversity hypothesis. Allergy. 2019;74(8):1445-1456. doi:10.1111/all.13763
- von Hertzen L, Hanski I, Haahtela T. Natural immunity. Biodiversity loss and inflammatory diseases are two global megatrends that might be related. EMBO Rep. 2011;12(11):1089-1093. doi:10.1038/embor.2011.195
- Haahtela T, Valovirta E, Saarinen K, et al. The Finnish Allergy Program 2008-2018: Society-wide proactive program for change of management to mitigate allergy burden. J Allergy Clin Immunol. 2021;148(2):319-326.e4. doi:10.1016/j.jaci.2021.03.037
- Roslund MI, Puhakka R, Grönroos M, et al. Biodiversity intervention enhances immune regulation and health-associated commensal microbiota among daycare children. Sci Adv. 2020;6(42):eaba2578. doi:10.1126/sciadv.aba2578
- Wilkinson AJK, Braggins R, Steinbach I, Smith J. Costs of switching to low global warming potential inhalers. An economic and carbon footprint analysis of NHS prescription data in England. BMJ Open. 2019;9(10):e028763. doi:10.1136/bmjopen-2018-028763
- Greener NHS » Delivering a net zero NHS. Accessed April 11, 2022. https://www.england.nhs.uk/greenernhs/a-net-zero-nhs/
- Wilkinson A, Maslova E, Janson C, et al. Greenhouse gas emissions associated with asthma care in the UK: results from SABINA CARBON. Eur Respir J. 2021;58(suppl 65). doi:10.1183/13993003.congress-2021.OA76
- Janson C, Henderson R, Löfdahl M, Hedberg M, Sharma R, Wilkinson AJK. Carbon footprint impact of the choice of inhalers for asthma and COPD. Thorax. 2020;75(1):82-84. doi:10.1136/thoraxjnl-2019-213744
- Woodcock A, Janson C, Rees J, et al. Effects of switching from a metered dose inhaler to a dry powder inhaler on climate emissions and asthma control: post-hoc analysis. Thorax. Published online February 7, 2022:thoraxjnl-2021-218088. doi:10.1136/thoraxjnl-2021-218088