The move to low carbon inhalers will help Oxford University Hospitals NHS Foundation Trust (OUH) reduce its carbon emissions, supporting the wider NHS ambition to reach net zero and reduce the environmental impact of care.
We are helping to reduce the carbon footprint of inhaler use across the Trust by changing prescribing practices, increasing staff training and improving support for patients to use and dispose of their inhalers correctly.
Carbon emissions associated with pressurized metered dose inhalers (pMDIs) administered to patients across the Trust’s four hospitals decreased by 18% in 2025/26 compared to the previous year (2024/25) and by 22% compared to the first year of record in 2022/23. This number reflects changes in the types of inhalers used.
This has the potential to save 300 tonnes of carbon dioxide equivalent (CO2e) over a 12-month period, which is equivalent to approximately 764,000 miles driven in a gas-powered vehicle and just over three one-way trips to the moon.
pMDI is often known as “puffer” and contains a potent greenhouse gas. Although these inhalers remain essential for many people with asthma and chronic obstructive pulmonary disease (COPD), dry powder inhalers (DPIs) have a much lower environmental impact and are suitable for many patients.
Clinicians across OUH are supporting patients to switch to dry powder inhalers when clinically safe and effective, alongside improved education on correct inhalation techniques in line with national guidelines. Improper use of inhalers can reduce therapeutic efficacy, increase medical needs, and increase environmental impact.
Sarah Poole, Senior Clinical Pharmacist Lead in Respiratory Medicine at OUH, is leading this work across the Trust’s four hospitals, supporting asthma and COPD guidelines that are shared across the Thames Valley Integrated Care Board.
“This project shows that you don’t have to choose between quality patient care and protecting the environment; you can achieve both. For many patients, switching to dry powder inhalers is clinically appropriate and will significantly reduce their carbon footprint.”
“Equally important is giving people the confidence to use their inhalers properly. Good inhaler technology supports better health outcomes, helps avoid unnecessary additional treatments, and also reduces our environmental footprint.”
For patients for whom dry powder inhalers are not suitable, alternative new options can also help reduce emissions by using lower-impact propellants while ensuring effective treatment.
Safely disposing of your inhaler is also a simple but important step. When the inhaler is empty, up to 30% of the original gas may remain in the canister. If disposed of as household waste and sent to a landfill, this gas can be released into the atmosphere.
Patients using pMDIs are encouraged to return used or expired inhalers to their local pharmacy for safe disposal.
Around 25% of carbon dioxide emissions in the UK NHS come from medicines, with inhalers accounting for around 3% of this total.
“Reducing our carbon footprint is an essential part of our current and future healthcare delivery,” said Lisa Hoven, Chief Real Estate and Facilities Officer for Sustainability at OUH.
“This significant reduction in inhaler emissions demonstrates the impact that clinical leadership, innovation, and patient engagement can have when sustainability is integrated into routine care.
“I would like to thank all my colleagues and teams involved in this accomplishment.”
OUH is now looking to build on this success, including developing educational resources for the effective use of inhalers, expanding staff training, and exploring opportunities to reintroduce an inhaler recycling scheme.
