Clinical: anaesthetics and inhalers


Some anaesthetic gases are also powerful greenhouse gases. Two gases; desflurane and nitrous oxide, make up 96% of the total impact. Desflurane is an anaesthetic gas used in surgery which has a climate change impact 2,540 times worse than carbon dioxide. Nitrous oxide, used in ambulances, emergency departments, maternity and surgery, is less damaging, however it is used in large amounts across the NHS.
The NHS is working to reduce the carbon impact of anaesthetics by at least 40% by 2028. This work has the support of the Association of Anaesthetists and groups representing midwives, paramedics and emergency medicine to ensure that health care professionals are aware of how impacts can be reduced.


The annual carbon footprint of inhalers prescribed in England is larger than that produced by many small countries.  This is because the propellant gases used in pressurised inhalers are powerful greenhouse gases, up to 3,350 times more damaging than carbon dioxide (ref). 

The impact of an individual patients’ inhaler use in one year can be the equivalent to driving 2,000 miles in a typical car [3 Ventolin relivers  inhalers at 28kg each and 12 controllers per year  at 19kg each]. In the UK around 70% of prescribed inhalers use propellants, the rest are propellant-free Dry Powder Inhalers or reusable Soft Mist Inhalers. In Sweden 90% of devices used are propellant free. We are working to reduce the carbon impact of inhalers by at least 50% by 2028.

The Royal Pharmaceutical Society, Royal College of General Practitioners and British Thoracic Society, along with other national clinician and patient groups are working with the NHS to achieve this. Industry is also developing low carbon propellants and alternatives to reduce emissions.