{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:34:32Z","timestamp":1790652872363,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rapid reductions in greenhouse gas (GHG) emissions are vital to combat climate change. Healthcare systems contribute ~5% of global GHG emissions, with pressurised metered\u2010dose inhalers (pMDIs) a significant contributor owing to their hydrofluorocarbon propellants. This study compared GHG emissions of a salbutamol pMDI using a low\u2010carbon propellant in clinical development, hydrofluoroalkane (HFA)\u2010152a, against current salbutamol inhalers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three \u2018cradle\u2010to\u2010grave\u2019 lifecycle analyses compared GHG emissions of salbutamol pMDIs with HFA\u2010152a and HFA\u2010134a, and salbutamol dry\u2010powder inhaler (DPI). Over 600 individual emission factors were calculated from &gt;\u20092000 data points, and categorised into Active Pharmaceutical Ingredients Manufacture, Micronisation, Device, Formulation\/Packaging, Use, Distribution and End\u2010of\u2010Life stages. 2023 manufacturing and supply data were collected from Algeria, Australia, Canada, France, Poland, Romania and Saudi Arabia. Carbon footprints were independently verified by the Carbon Trust.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean total carbon footprint per salbutamol inhaler (based on 100\u2010year global warming potential [GWP100]) was 26.91, 2.06 and 0.69\u2009kgCO\n                      <jats:sub>2<\/jats:sub>\n                      e for HFA\u2010134a pMDI, HFA\u2010152a pMDI and DPI, respectively. This equated to a 92% reduction in total emissions for HFA\u2010152a versus HFA\u2010134a. Most pMDI emissions came from the Use stage (HFA\u2010134a: 21.48\u2009kgCO\n                      <jats:sub>2<\/jats:sub>\n                      e; HFA\u2010152a: 1.45\u2009kgCO\n                      <jats:sub>2<\/jats:sub>\n                      e). Per actuation, emissions were 135, 10 and 11\u2009gCO\n                      <jats:sub>2<\/jats:sub>\n                      e, respectively. For each pMDI, GHG emissions were similar across countries.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The low\u2010GWP propellant, HFA\u2010152a is expected to achieve &gt;\u200990% reduction in the carbon footprint of salbutamol pMDI versus the currently used HFA\u2010134a. The development of salbutamol pMDI with HFA\u2010152a is a crucial step towards ensuring future patient access to salbutamol in a pMDI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.70141","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T05:20:30Z","timestamp":1762492830000},"page":"2357-2365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Decarbonising Respiratory Care: The Impact of a Low\u2010Carbon Salbutamol Pressurised Metered\u2010Dose Inhalers"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2231-9745","authenticated-orcid":false,"given":"James","family":"King","sequence":"first","affiliation":[{"name":"Environment, Health, Safety and Sustainability GSK  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5428-8578","authenticated-orcid":false,"given":"Ashley","family":"Woodcock","sequence":"additional","affiliation":[{"name":"University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7007-588X","authenticated-orcid":false,"given":"Antonio","family":"Anzueto","sequence":"additional","affiliation":[{"name":"South Texas Veterans Health Care System University of Texas Health San Antonio  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1808-3663","authenticated-orcid":false,"given":"Alexander J. 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