Dr. Constance Mackenzie, a respirologist at London Health Sciences Centre and St. Joseph's Health Care London, stands in front of the new inhaler recycling box in the LHSC Respirology Clinic.
January 8, 2026
Prescription inhalers can be lifesavers for people with chronic breathing conditions such as asthma and chronic obstructive pulmonary disease (COPD).
Unfortunately, many of these devices are not as healthy for the planet as they are for patients. A recent study shows that metered-dose inhalers (MDIs) containing propellants called hydrofluoroalkanes (HFAs) contribute significantly to climate-changing pollution.
Now London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London (St. Joseph’s) are participating in an initiative to help change that by participating in the Go Zero Recycle program, which collects and recycles all types of inhalers and aerochambers, including recapturing the problematic propellant. Drop-off boxes for used inhalers of all types are located at LHSC and St. Joseph’s respirology outpatient clinics.
“In 2024, LHSC and St. Joseph’s dispensed more than 53,000 inhalers, and close to 70 per cent of these are MDIs,” says LHSC and St. Joseph’s respirologist Dr. Constance Mackenzie, who led the launch of the initiative locally.
These inhalers alone released carbon dioxide equivalents (CO2e) equal to a gas-powered car circling the Earth 96 times, she says. Put another way, one 120-dose inhaler using HFAs can have the same environmental impact as a car trip from London to Toronto.
“Someone with asthma or COPD might need one or two of these inhalers each month,” Mackenzie notes. “Most people don’t know what to do with the inhalers once they are empty or left over after a change in prescription.”
These cartridges can still release greenhouse gases after they are discarded, so they should never be placed in household garbage or regular recycling. While they can be returned to a pharmacy for eventual incineration, this new recycling program offers a better alternative.
One study estimates two thirds of inhaler medications prescribed globally use HFAs as a propellant. A US-based study published in the JAMA medical journal says 1.6 billion inhalers were dispensed in the US from 2014 to 2024 alone, generating almost 25 million tonnes of CO2e - equivalent to the annual greenhouse-gas impact from electrification of five million homes, the report says.
Non-propellant inhaler options
LHSC and St. Joseph’s are taking a two-fold approach both to reduce and recycle by also offering alternate types of inhalers.
“We’re not telling people to stop what’s working for them, and we definitely don’t want people to stop using their inhalers without an alternate treatment plan in place.” Mackenzie emphasizes.
“At the same time, we want patients to know there might be other options that work as well or better for them and have a gentler environmental impact.
Non-propellant options include types of inhalers containing dry powdered medicine or a mist released as tiny breathable particles when inhaled through the mouth.
The Canadian Thoracic Society supports sustainable inhaler prescribing, she notes. It also recommends shared education and decision-making about the best inhaler for patients, along with a coordinated systems approach by clinicians, patients, health organizations, regulators and manufacturers.
“Inhalers are essential for many people with asthma and COPD, but their carbon footprint is often overlooked,” says Beth Jones, Registered Practical Nurse and Team Lead in the Respirology Clinic at LHSC. “By making recycling more accessible across clinics and pharmacies, we can make a real difference for both our patients and the planet.”