With over 20 million inhalers being prescribed in Australia per year and roughly one in nine Australians having asthma, respiratory inhalers are a required medical device to control disease and provide symptom relief.

With so many Australians relying on inhalers, a group of clinical Net Zero Leads from Royal North Shore Hospital have been working on a number of projects to mitigate the environmental impact of some of these inhalers.

RNSH Respiratory and Sleep Medicine Physician, and one of NSLHD’s Net Zero Leads, Sophie Timmins says the single pressurised meter dose inhalers (PMDI) are a major culprit in respiratory medicine’s carbon footprint.

“Dry powder inhalers and soft mist inhalers don’t use propellant gas and have far less carbon footprint; 25 times less per dose,” she said.

Sophie has teamed up with Respiratory and Sleep Physician Katrina Tonga and Senior Clinical Pharmacist Mellissa Batger who have also worked as NSLHD Net Zero Leads.

Sophie said the group have been busy working across three different projects to help the district’s planetary health efforts within respiratory health.

“We have three projects that are ongoing to help reduce the district’s carbon footprint in this space,” she said.

“The first is an educational campaign for district staff and general practitioners though the Primary Health Network (PHN) where we have been holding workshops and seminars.”

The education sessions touched on all-round care when it comes to inhalers, such as making the correct diagnosis, choosing the right device, selecting the right drug, and ensuring the right disposal of inhalers.  

Sophie said the group’s second project has been an inhaler collection pilot at RNSH across various departments, which has led to a 12 month inhaler and blister pack recycling program to commence this year at the hospital.

“An audit of salbutamol prescription helped us identify high use wards and over eight weeks we collected 122 inhalers and measured that there were remaining doses in many of the inhalers,” she said.

“The new recycling program will see inpatient wards at RNSH having a designated bin for empty blister packs and inhalers, which if successful may be rolled out to other hospitals in the district.”

The third and final project the Net Zero Leads are working on in 2024 is the development of an asthma pathway for the RNSH emergency department.

“The aim of the asthma pathway will be to provide guidance to medical staff on appropriate inhaler dosing and guidance on discharge medications and appropriate follow up,” Sophie said.

The team were also recognised at the 2023 NSLHD Exceptional People Awards, being named team winners of the Sustainability and Planetary Health award.