Providence makes environmental data of inhalers more accessible
Clinicians can compare inhalers using new tool from Providence environmental stewardship team
RENTON, Wash., Jan. 12, 2026 — Following a 2025 study about the environmental impacts of inhalers, Providence’s environmental stewardship team has developed and released a resource table that shows the impact of each inhaler. The goal is to equip providers with this information to consider as they prescribe inhalers for patients with asthma, COPD and other conditions.
“Our resource tool offers an assessment of the environmental impact associated with specific inhalers to be considered alongside factors like efficacy, compliance with clinical guidelines, patient-centeredness, safety, financial cost and insurance coverage to arrive at a final choice offering the most benefit,” said Brian Chesebro, M.D., medical director for the Providence Center for Environmental Stewardship.
Dr. Chesebro supervised two studies, released in 2025 and published in the October issue of JAMA, that provide a detailed national context of inhaler-related emissions in the U.S. over the past decade. Metered-dose inhalers use a hydrofluorocarbon propellant to deliver a dose of medication into the patient’s lungs. These hydrofluorocarbons, also used for refrigerants and air conditioning in other industries, are greenhouse gases thousands of times more potent than carbon dioxide.
The studies found that, within the United States between 2014 and 2024, all inhalers produced carbon emissions equivalent to burning 2.8 billion gallons of gasoline. However, within the VA health system, emissions dropped about 68% between 2008 and 2023 due to societal policy and VA-specific formulary changes that favored lower-emission inhalers.
Dr. Chesebro and Providence are taking this work a step further in making inhaler data accessible in one place. The newly released table, following methodologies described in the JAMA studies1-3, lists information for 914 inhalers, including brand name, medication, number of inhalations and doses, propellant type and estimated emission data.
“The table is informational, providing an environmental impact estimate associated with each specific inhaler,” Dr. Chesebro said. “Individuals or systems that are interested in minimizing the environmental impact of health care can use this information to assess their practices while also providing safe, effective medications to patients with respiratory disease.”
“Our hope is that clinical staff, parents, people who use inhalers, manufacturers and others will better understand the environmental impacts of inhaler propellants and then work to reduce their unintended harm,” said Beth Schenk, chief environmental stewardship officer, Providence. “It is a complex situation with many factors, including clinical decision-making, pharmaceutical manufacturing, insurance payments, user preference, etc. But there are multiple opportunities across the health care spectrum for people to get involved and help make a difference as we work toward health care that is safe for people and the planet.”
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