When selecting the best inhaler and drug combination for a patient with respiratory disease, a number of factors should be considered. While efficacy and safety of medical treatments are always a priority, in recent years the environmental impacts of all aspects of life have become an increasingly necessary consideration and inhaled therapies are no exception. The carbon footprint of an item, individual or organisation is one of the most important and quantifiable environmental impacts, assessed by the amount of greenhouse gases (often expressed in terms of carbon dioxide equivalents) generated throughout the life cycle. The two most commonly prescribed and manufactured inhaler types worldwide are pressurised metered-dose inhalers (pMDIs) containing hydrofluorocarbon (HFC) propellants and dry powder inhalers (DPIs). Most of the carbon footprint of current pMDIs is a result of the propellants that they contain (HFC-134a and HFC-227ea, which are potent greenhouse gases). In comparison, the powder in DPIs is dispersed by the patient's own inhalation, meaning DPIs do not contain a propellant and have a lower carbon footprint than most pMDIs currently available. Soft mist inhalers are another propellant-free option: the device contains a spring, which provides the energy to disperse the aqueous medication. In this review, we examine the published data on carbon footprint data for inhalers, providing an analysis of potential implications for treatment decision making and industry initiatives.

在为呼吸系统疾病患者选择最佳吸入器和药物组合时，应考虑许多因素。虽然药物治疗的有效性和安全性始终是重中之重，但近年来，生活各个方面对环境的影响已成为越来越必要的考虑因素，吸入疗法也不例外。一个项目、个人或组织的碳足迹是最重要和可量化的环境影响之一，通过在整个生命周期中产生的温室气体量（通常以二氧化碳当量表示）进行评估。全球最常用的两种处方和制造吸入器类型是含有氢氟烃 (HFC) 推进剂的加压计量吸入器 (pMDI) 和干粉吸入器 (DPI)。当前 pMDI 的大部分碳足迹是它们所含推进剂（HFC-134a 和 HFC-227ea，它们是强效温室气体）的结果。相比之下，DPIs 中的粉末通过患者自己的吸入来分散，这意味着 DPI 不含推进剂，并且比目前可用的大多数 pMDI 具有更低的碳足迹。软雾吸入器是另一种无推进剂的选择：该装置包含一个弹簧，它提供能量以分散水性药物。在这篇综述中，我们检查了已发表的吸入器碳足迹数据，分析了对治疗决策和行业举措的潜在影响。DPI 中的粉末通过患者自己的吸入而分散，这意味着 DPI 不含推进剂，并且比目前可用的大多数 pMDI 具有更低的碳足迹。软雾吸入器是另一种无推进剂的选择：该装置包含一个弹簧，它提供能量以分散水性药物。在这篇综述中，我们检查了已发表的吸入器碳足迹数据，分析了对治疗决策和行业举措的潜在影响。DPI 中的粉末通过患者自己的吸入而分散，这意味着 DPI 不含推进剂，并且比目前可用的大多数 pMDI 具有更低的碳足迹。软雾吸入器是另一种无推进剂的选择：该装置包含一个弹簧，它提供能量以分散水性药物。在这篇综述中，我们检查了已发表的吸入器碳足迹数据，分析了对治疗决策和行业举措的潜在影响。