The Montreal Protocol on Substances That Deplete the Ozone Layer was an example of an amazing international collaboration that has already led to improvements in the ozone layer, although the full effects will not be seen for decades. As part of the process, large numbers of medical aerosols were reformulated such that chlorofluorocarbons were replaced as propellants in pressurised metered dose inhalers (pMDIs) by new hydrofluoroalkane (HFA) propellants. This involved a massive commitment by the pharmaceutical industry to ensure that those with respiratory ill health continued to receive their medication in familiar but improved inhalers. However, these HFA propellants have a global warming effect, and this has led specialist societies and health service leaders to more recently call for prescribers and patients to consider switching from pMDIs to inhaler devices without propellants, although many patients will still need a pMDI for use in an emergency.1 Others have recently additionally drawn attention to the benefits of using small-volume HFA 134a pMDIs or those containing …

中文翻译：

---

绿色呼吸保健：需要相称性

《关于消耗臭氧层物质的蒙特利尔议定书》是令人惊叹的国际合作的一个例子，它已经导致臭氧层的改善，尽管几十年才能看到全面的影响。作为该过程的一部分，大量医用气雾剂被重新配制，以便将氯氟烃作为加压计量吸入器 (pMDI) 中的推进剂替换为新的氢氟烷 (HFA) 推进剂。这涉及制药业的巨大承诺，以确保呼吸系统疾病患者继续使用熟悉但改进的吸入器接受药物治疗。然而，这些 HFA 推进剂具有全球变暖效应，