James Oxley is an Anthrozoologist, independent researcher and PhD student at the University of Liverpool, Liverpool.

Ihave suffered from asthma for over 30 years and am one of the estimated 5.4 million people currently being treated for asthma in the UK.1 Like many asthmatics, to help to prevent and relieve the symptoms I use inhalers prescribed by my general practitioner. These Metered Dose Inhalers (MDI’s) are often made of three components: the pressured canister, the plastic holder, and the cap (covering the plastic holder mouthpiece). In some cases, an additional plastic counter is added to let the user know how many doses are remaining.

Currently, newly prescribed inhalers are pre-packaged and include one plastic holder and cap per inhaler, even when multiple inhalers are received at the same time. Many people, including myself, require prescription renewals every couple of months. For these renewals there is no need to obtain a new plastic holder each time. The additional plastic appears to be an unneeded waste. The plastic holder can be cleaned and reused multiple times (with new ones available upon request for no charge) to reduce waste and CFC gases.2,3,4

There is no need to obtain a new plastic holder each time.

Yet, it appears that disposal of the inhalers is not a priority for inhaler distributing companies, evidenced by the lack of disposal directions in the enclosed patient information leaflet. Typically, the only disposal information is a directive to talk with one’s pharmacist. Of course, caution is needed when disposing of the pressurised canisters. Yet little information is provided by the pharmaceutical companies, GP practices or pharmacies on how to properly dispose of the canisters, nor how to recycle the plastic components.

Little information is provided …. how to recycle the plastic components

It is important to educate users on the correct method of usage of MDIs.5 Yet it is suggested that there is a lack of research and discussion about the responsibilities of pharmaceutical companies, GPs and pharmacies in educating individuals about the correct way to dispose of these. Given the increasing problems of pollution, helping people recycle plastic inhaler components and creating more environmentally friendly components should be a priority. A recent example of environmentally friendly designs includes the AER8 spacer made from cardboard.6 Additionally, recycling programs modelled after those in place for ink cartridges, mobile phones, and batteries, may be be of benefit.

Acknowledgement: The author would like to thank professor Lori Kogan (Colorado State University) for useful comments on this article.

References
1. Asthma UK (no date.) Asthma facts and statistics. https://www.asthma.org.uk/about/media/facts-and-statistics/?gclid=CjwKCAjw4MP5BRBtEiwASfwAL_WhJXS10feRZIjtutgzyacbvOJnMhTiB2wzr7PlxfSffJ0KGbi5JRoCKtkQAvD_BwE  (accessed 10/08/2020).

2. Jeswani, H.K. and Azapagic, A., 2019. Life cycle environmental impacts of inhalers. Journal of Cleaner Production, 237, p.117733.

3. Usmani, O. S., Scullion, J., & Keeley, D. (2019). Our planet or our patients—is the sky the limit for inhaler choice?. The Lancet Respiratory Medicine, 7(1), 11-13.

4. Wilkinson, A. J., and Anderson, G. (2020). Sustainability in Inhaled Drug Delivery. Pharmaceutical Medicine.

5. Price, D., Bosnic-Anticevich, S., Briggs, A., Chrystyn, H., Rand, C., Scheuch, G., Bousquet, J. and Inhaler Error Steering Committee, 2013. Inhaler competence in asthma: common errors, barriers to use and recommended solutions. Respiratory medicine, 107(1), pp.37-46.

6. AER Beatha (no date.) Order AER8 spacer https://www.aerbeatha.com/en/order.html

 

 

 

Featured photo by Hermes Rivera on Unsplash