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(NEXSTAR) – That small whoosh from an inhaler has a substantial environmental toll that could be putting some people with chronic conditions at risk, according to a new study.

Published Monday in the peer-reviewed Journal of the American Medical Association (JAMA), the University of California Los Angeles Health study looked at emissions from three kinds of inhalers prescribed for asthma or chronic obstructive pulmonary disease (COPD) from 2014 to 2024. So-called “metered-dose” inhalers, which release a measured puff of medicine when pressed, contain hydrofluoroalkane (HFA) propellants and accounted for 98 percent of emissions, according to the study.

A ‘steep environmental cost’

Researchers found that the devices generated more than 2 million metric tons of carbon emissions, or the amount of annual emissions from roughly 530,000 gas-powered cars.

“Inhalers add to the growing carbon footprint of the US healthcare system, putting many patients with chronic respiratory disease at risk,” lead author and pulmonologist Dr. William Feldman stated in a news release.

Feldman added that there is still “tremendous opportunity” to switch to a lower-emission alternative for the good of the planet and patients’ lungs.

Potential alternatives

Feldman told the Agence France-Presse that only a fraction of patients truly need metered devices – older adults who can’t inhale with force, and very young children who must use spacers, a chamber technology that only works with metered inhalers.

In the U.S., Feldman said, the “vast majority of people could use dry powder or soft mist inhalers,” but insurance is less likely to cover them, making them more expensive.

The UCLA Health team is calling for a shift to more environmentally-friendly inhalers that use dry powder and soft mist while a low-emission, propellant-based inhaler is created.

Kate Bender, vice president of national advocacy and public policy for the American Lung Association, told CNN “it drives me crazy that the medication I use to address my symptoms drives climate change.”

Where did the data come from?

The UCLA Health team used a national database of inhaler prescriptions to estimate the resulting, based on measurements from other academic studies. The emission levels were then analyzed by: drug type, device type, propellant type, therapeutic class, branded status, manufacturer, payer, and pharmacy benefit manager.

“A key first step to driving change is understanding the true scale of the problem,” Feldman said. “From there, we can identify what’s fueling these emissions and develop targeted strategies to reduce them — benefiting both patients and the environment.”

The UCLA Health team is planning further research around inhaler usage among certain populations, like Medicaid beneficiaries.

Roughly 16 million Americans have COPD, and another 25 million have asthma, according to the most recent data from the Centers for Disease Control and Prevention.