The carbon footprint associated with the overuse of short-acting β2-agonists in asthma patients

Background . In recent years, greenhouse gas (GHG) emissions from inhalers have received more attention. The inhalers are classified as controllers and relievers, which are mainly short-acting beta-agonists (SABA), and SABAs account for more than 50% of all inhaler use in most countries. The overuse...

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Main Authors: Chao-Hsien Chen, I-Chih Lin, Chih-Cheng Lai, Hsing-hui Liu, Ya-Hui Wang, Cheng-Yi Wang, Hao-Chien Wang
Format: Article
Language:English
Published: IOP Publishing 2024-01-01
Series:Environmental Research Communications
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Online Access:https://doi.org/10.1088/2515-7620/ad9818
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author Chao-Hsien Chen
I-Chih Lin
Chih-Cheng Lai
Hsing-hui Liu
Ya-Hui Wang
Cheng-Yi Wang
Hao-Chien Wang
author_facet Chao-Hsien Chen
I-Chih Lin
Chih-Cheng Lai
Hsing-hui Liu
Ya-Hui Wang
Cheng-Yi Wang
Hao-Chien Wang
author_sort Chao-Hsien Chen
collection DOAJ
description Background . In recent years, greenhouse gas (GHG) emissions from inhalers have received more attention. The inhalers are classified as controllers and relievers, which are mainly short-acting beta-agonists (SABA), and SABAs account for more than 50% of all inhaler use in most countries. The overuse of SABA is common in asthma patients, but the environmental impact related to these patients has not yet been studied. Methods . Asthma patients were retrieved from Taiwan’s National Health Insurance Database between 2011 and 2020. These patients were classified as SABA overuse (≥3 canisters annually) and controlled (<3 canisters annually) according to the 12-month baseline period, and the GHG emission in the following year was calculated. The propensity score matching (PSM) was used to balance patients in two groups. Results . A total of 243,136 asthma patients were included for analysis. The annual mean GHG emission associated with the use of inhalers was 69.90 kg/person/year carbon dioxide equivalent in the SABA overuse group. After PSM, there were 22,605 patients in each group, and the mean GHG emission was 2.85 times higher in the SABA overuse group compared to the control group, which was due to both the increased use of SABAs and controller inhalers. Conclusion . The asthma patients who overused SABAs had a greater environmental impact compared to those with acceptable SABA use. It is essential to consider environmental implications when developing asthma treatments, and further research is needed on how to decrease the amount of GHG emissions from inhalers.
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spelling doaj-art-d45e8e0655ad40a39a37d237f9e0c7fa2025-08-20T02:50:27ZengIOP PublishingEnvironmental Research Communications2515-76202024-01-0161212500910.1088/2515-7620/ad9818The carbon footprint associated with the overuse of short-acting β2-agonists in asthma patientsChao-Hsien Chen0https://orcid.org/0000-0002-2176-3504I-Chih Lin1Chih-Cheng Lai2https://orcid.org/0000-0002-6334-2388Hsing-hui Liu3https://orcid.org/0009-0009-1474-6106Ya-Hui Wang4Cheng-Yi Wang5https://orcid.org/0000-0001-7426-0743Hao-Chien Wang6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan; Department of Medicine, MacKey Medical College , New Taipei City, Taiwan; Master of Science in Decision Analysis, Minerva’s University , San Francisco, CA, United States of AmericaDepartment of Emergency Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University , New Taipei City, TaiwanDivision of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; School of Medicine, College of Medicine, National Sun Yat-sen University , Kaohsiung, TaiwanSchool of Medicine, College of Medicine, Fu Jen Catholic University , New Taipei City, TaiwanMedical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University , New Taipei City, TaiwanDepartment of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University , New Taipei City, TaiwanDepartment of Medicine, National Taiwan University Cancer Center, Taipei, TaiwanBackground . In recent years, greenhouse gas (GHG) emissions from inhalers have received more attention. The inhalers are classified as controllers and relievers, which are mainly short-acting beta-agonists (SABA), and SABAs account for more than 50% of all inhaler use in most countries. The overuse of SABA is common in asthma patients, but the environmental impact related to these patients has not yet been studied. Methods . Asthma patients were retrieved from Taiwan’s National Health Insurance Database between 2011 and 2020. These patients were classified as SABA overuse (≥3 canisters annually) and controlled (<3 canisters annually) according to the 12-month baseline period, and the GHG emission in the following year was calculated. The propensity score matching (PSM) was used to balance patients in two groups. Results . A total of 243,136 asthma patients were included for analysis. The annual mean GHG emission associated with the use of inhalers was 69.90 kg/person/year carbon dioxide equivalent in the SABA overuse group. After PSM, there were 22,605 patients in each group, and the mean GHG emission was 2.85 times higher in the SABA overuse group compared to the control group, which was due to both the increased use of SABAs and controller inhalers. Conclusion . The asthma patients who overused SABAs had a greater environmental impact compared to those with acceptable SABA use. It is essential to consider environmental implications when developing asthma treatments, and further research is needed on how to decrease the amount of GHG emissions from inhalers.https://doi.org/10.1088/2515-7620/ad9818asthmacarbon footprintgreenhouse gas emissionsinhalersSABASABA overuse
spellingShingle Chao-Hsien Chen
I-Chih Lin
Chih-Cheng Lai
Hsing-hui Liu
Ya-Hui Wang
Cheng-Yi Wang
Hao-Chien Wang
The carbon footprint associated with the overuse of short-acting β2-agonists in asthma patients
Environmental Research Communications
asthma
carbon footprint
greenhouse gas emissions
inhalers
SABA
SABA overuse
title The carbon footprint associated with the overuse of short-acting β2-agonists in asthma patients
title_full The carbon footprint associated with the overuse of short-acting β2-agonists in asthma patients
title_fullStr The carbon footprint associated with the overuse of short-acting β2-agonists in asthma patients
title_full_unstemmed The carbon footprint associated with the overuse of short-acting β2-agonists in asthma patients
title_short The carbon footprint associated with the overuse of short-acting β2-agonists in asthma patients
title_sort carbon footprint associated with the overuse of short acting β2 agonists in asthma patients
topic asthma
carbon footprint
greenhouse gas emissions
inhalers
SABA
SABA overuse
url https://doi.org/10.1088/2515-7620/ad9818
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