Metered dose inhalers

Metered dose inhalers [MDI] are designed to emit a small amount of propellant (i.e. refrigerant) with each use. Moves are afoot to switch to dry powder inhalers [DPI] where possible and to substitute a less potent refrigerant. In healthcare, however, clinical outcomes must determine what is preferred. For some conditions DPI have been shown to produce better outcomes but for others MDI are clearly the best option. Pending some other breakthrough we seem to be stuck with them.

Refrigerant is also at risk of escape when an unwanted inhaler is discarded into general waste. This normally happens when the inhaler is “empty” – in reality a residue of propellant is left in it – and also when a treatment is discontinued.

Recycle Now has a web page on inhalers. If you know someone who uses inhalers, please make sure they know what it says.

All pharmacies are supposed to accept returned inhalers. In addition the pharmaceutical giant GSK runs an alternative Complete the Cycle scheme. That page lets you search for local participating pharmacies, hospitals and dispensaries, of which Reading has several. Other links on that page (in small print) explain the scheme.

GSK recovered 1.2 million inhalers between 2011 and 2017; the UK distributes about 72 million per year, a 0.3% recovery rate over the years. This feels like something that community action could improve.

We do wonder why GSK offers an alternative scheme. Perhaps it is able to refurbish and reuse the recovered inhalers. We would be tempted to use it anyway, to save the NHS the cost of return.