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In Australia and New Zealand, pressurized metered dose inhalers (pMDIs) are the leading delivery device prescribed and pMDI salbutamol can be purchased over the counter in Australia. These inhalers are a major contributor to healthcare related greenhouse gases. This is due to the propellants that they currently contain which have extremely high global warming potential (GWP). In this position paper, we report the findings of a Thoracic Society of Australia and New Zealand (TSANZ) working group on the environmental impact of inhaled respiratory medicines. We reviewed the use of inhaled medicines in Australia and New Zealand and their contribution to climate change and other environmental degradation. We propose strategies for health professionals and consumers to reduce environmental impact in the management of airway diseases. These include accurate diagnosis to avoid unnecessary treatment, better disease control to minimize the need for reliever therapy and actively choosing inhaler devices with lower environmental impacts when clinically appropriate. Inhaler selection should be tailored to the individual, aiming to achieve the best possible clinical outcome. Choosing an appropriate inhaler for an individual involves consideration of factors such as dexterity, inspiratory capacity and cost. In our current climate emergency and with the availability of lower carbon alternatives, health professionals should also consider environmental impact.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp14852-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p>","DOI":"10.1111\/resp.14852","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T00:00:01Z","timestamp":1731542401000},"page":"101-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Environmental impact of inhaled medicines: A Thoracic Society of Australia and New Zealand position statement"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2917-2773","authenticated-orcid":false,"given":"Danielle F.","family":"Wurzel","sequence":"first","affiliation":[{"name":"Allergy and Lung Health Unit School of Population and Global Health, University of Melbourne  Melbourne Victoria Australia"},{"name":"Royal Children's Hospital and Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett D.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"General practice, Medical School University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Anderson","sequence":"additional","affiliation":[{"name":"Perioperative Care Program, Perioperative Medicine Team Telethon Kids Institute  Nedlands Western Australia Australia"},{"name":"Medical School Curtin University  Perth Western Australia Australia"},{"name":"Division of Emergency Medicine, Anaesthesia and Pain Medicine Medical School, The University of Western Australia  Perth Western Australia Australia"},{"name":"Institute for Paediatric Perioperative Excellence, The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena K.","family":"Schneider\u2010Futschik","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Pharmacology School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnson","family":"George","sequence":"additional","affiliation":[{"name":"Centre for Medicine Use and Safety &amp; 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