Queen's University Belfast

Academic Institute

Dr John Busby

Yes

E080

Healthcare is one of the largest sources of greenhouse gas (GHG) emissions in the public sector, with a carbon footprint equivalent to 4.4% of global net GHG emissions. All medicines and healthcare interactions carry a carbon footprint and asthma inhalers are a substantial contributor within the NHS. Data from mild-to-moderate asthma in the UK has shown that the GHG emissions of a patient with poorly-controlled asthma is up to 8 times higher when compared to a patient whose asthma is well-controlled, however GHGs have yet to be assessed in severe asthma. Recently, several new biologic medications have become available for the treatment of asthma which reduce symptoms, flare-ups and hospitalisations. It is accepted that these medications will also reduce GHGs through lower rates of medication use and healthcare contacts, however the scale of this reduction has yet to be estimated. A finding of substantial reductions could suggest that prescribing these expensive medications earlier in the patient pathway could have an important environmental impact in addition to their known healthcare benefits. To address this important evidence gap we plan to compare the GHGs in a group of patients who were eligible for biologics but didn’t receive them, to a group of patients who are currently being treated in the Belfast City Severe Asthma clinic and did receive biologic medications. The primary aim of this study is to investigate the carbon footprint of patients with severe asthma. Its secondary aim is to estimate the benefits of biologic therapy on GHGs

Climate change is one of the key challenges facing Northern Ireland over the coming decades, and could lead to significant health and economic risks. The latest projections suggest that in 50 years winters could be 3.9 °C warmer, summers could be 4.9 °C hotter and sea levels could rise by nearly a metre. It is crucial that action is taken to slow this process and, as healthcare is responsible for 4.4% of global GHGs, intervention is needed in this sector. Understanding the magnitude of the GHG problem is a crucial first step in tackling this issue and our study will estimate the contribution of severe asthma for the first time. The anticipated benefits of our study is in reducing the carbon footprint of severe asthma, but also providing a methodological template for this type of work in other disease areas and raising the importance of considering the environmental impact of new healthcare interventions. The potential beneficiaries are all the residents of Northern Ireland, including future generations who have yet to be born. More specifically, our project could support the more widespread use of biologic therapy in asthma. These medications, while expensive, have been shown to be highly effective in reducing asthma exacerbations and unscheduled care use in high-quality randomised controlled trials, and real-world cohort studies. The increased use of these medications would undoubtedly have a positive impact on severe asthma patients.

24/11/2022

TRE