JAMA Editors' Summary Inhaler-Related Greenhouse Gas Emissions, Surviving Avalanche Burial, A fib After CABG, and more
Oct 10, 2025
Explore the environmental impact of inhalers as experts discuss greenhouse gas emissions and the push for greener alternatives. Delve into a groundbreaking trial on avalanche survival using innovative devices that could save lives. Discover the surprising statistics on new-onset atrial fibrillation after CABG surgery and its reversibility. Insights on Medicaid spending offer a glimpse into healthcare economics, while conversations around AI caution against cognitive complacency. Each topic weaves a narrative of innovation, survival, and the complexities of modern medicine.
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Meter Dose Inhalers Drive Emissions
- Meter dose inhalers generated the vast majority of inhaler-related greenhouse gas emissions in the U.S. from 2014–2024.
- Feldman et al. reported 1.6 billion inhalers dispensed producing just under 25 million metric tons CO2e, with MDIs causing 98% of emissions.
Formulary Choices Reduce Emissions
- VA switched from budesonide-formoterol MDIs to fluticasone-salmeterol DPIs and cut inhaler-related emissions over 2008–2023.
- Policy and formulary choices materially changed the VA's greenhouse gas footprint, showing feasible institutional decarbonization.
Balance Environment With Clinical Care
- Consider environmental impact when choosing inhaler therapies but prioritize clinical evidence and patient needs.
- Rabin et al. urge that treatment changes for environmental reasons must be implemented with care and grounded in evidence.