The carbon footprint of inhalers in secondary care: a cross-sectional analysis

<bold>Introduction:</bold> Understanding the pattern of usage of inhaled therapies is the first step in planning interventions to reduce their carbon footprint. <bold>Objective:</bold> To describe the annual number, types and carbon footprint of inhaler devices dispensed across a large acute hospital trust in the UK. <bold>Methods:</bold> Data was retrieved from internal records of University Hospitals Sussex NHS Foundation Trust for the financial year 2022-23 of the number of inhalers dispensed from each cost centre. Inhaler names were matched to the device type (metered dose (MDI), dry-powder (DPI) or soft-mist (SMI) inhaler) and drug class. Cost-centres were grouped by setting. The carbon footprint (scopes 1+3) per inhaler was estimated by matching the device type to Greener NHS Emissions Factors (Nov. 2023 ed.) for 2022-23. <bold>Results:</bold> 22139 inhalers were dispensed, which had a carbon footprint of 335.46 tCO2e. 79.9% inhalers were MDI, 17.6% DPI and 2.5% SMI. MDI made up 99% of the carbon footprint. 49.6% inhalers dispensed were SABA (Figure 1). Settings with the highest rates of dispensing were medical inpatient wards (38.0% total number of inhalers dispensed), emergency departments (36.8%) and surgical inpatient areas (12.2%). Of medical inpatient settings, respiratory and care of the elderly wards had the highest rates. <bold>Conclusions:</bold> Targeted interventions in this hospital trust should focus on reducing the rates of MDI use, particularly SABA, in the identified settings. <fig><object-id>erj;64/suppl_68/PA3911/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>