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March 2024

Poor asthma control linked to 8-fold higher greenhouse gas emissions

Patients whose asthma is poorly controlled have eight times excess greenhouse gas emissions compared with those whose condition is well controlled – equivalent to that produced by 124,000 homes each year in the UK – according to the first study of its kind, published online in the journal Thorax.

Improving the care of asthma patients could achieve substantial carbon emissions savings, and help the NHS meet its net zero target, say the researchers. But asthma is poorly controlled in around half of those with the condition in the UK and Europe.

The researchers retrospectively analysed the anonymised health records of 236,506 people with asthma and calculated greenhouse gas (GHG) emissions for asthma-related medication use, healthcare resource utilisation and severe exacerbations during follow-up of patients with asthma.

Excess GHG emissions due to suboptimal asthma control included at least 3 or more SABA canisters per year, severe exacerbations and any GP visits within 10 days of hospitalisation or an emergency department visit.

The researchers calculated that the overall carbon footprint attributed to asthma care when scaled to the entire UK asthma population added up to 750,540 tonnes CO22/year.

Asthma was poorly controlled in just under half (47%; 111,844) of the patients, contributing excess greenhouse gas emissions of 303,874 tonnes CO2e/year. The excess GHG emissions were 8-fold higher on average for a person with poorly controlled asthma than in the well-controlled asthma patients.

The researchers acknowledge that factors other than the level of asthma symptom control, such as prescribing patterns, may also have contributed to high SABA use.

But they said: ‘Our study indicates that poorly controlled asthma contributes to a large proportion of asthma-care related greenhouse gas emissions with inappropriate SABA use emerging as the single largest contributor.’

They concluded that efforts to curtail inappropriate SABA use and implement evidence-based treatment recommendations, could result in substantial carbon savings.

Wilkinson AJK, et al. Thorax 2024;0:1-10. Epub ahead of print: 27 February 2024. doi:10.1136/ thorax-2023-220259

Practice Nurse 2024;54(2):7