Respiratory Care’s Climate Paradox: Treating Lung Disease While Fueling Global Warming

Climate change is increasingly shaping how people breathe, yet the medical systems treating respiratory illness are themselves contributing to the problem. From worsening air pollution to more frequent wildfires, environmental pressures are driving a rise in lung disease, while the care designed to manage these conditions adds to global greenhouse gas emissions.

Doctors and public health experts warn that climate-related factors — including extreme heat, airborne particles, smoke from wildfires and longer pollen seasons — are intensifying respiratory symptoms and accelerating disease progression. According to international estimates, more than 90 percent of the world’s population breathes air that exceeds recommended safety limits for particulate pollution.

Medical specialists note that environmental exposure plays a significant role in respiratory illness. Changes in air quality are linked to spikes in emergency hospital visits for asthma and chronic pulmonary disease, sometimes days after pollution levels rise. Studies suggest that more than one-third of deaths from chronic respiratory conditions in Europe are connected to environmental stressors such as polluted air, heatwaves and allergenic pollen. These findings reflect correlations rather than direct causation, but they underline the scale of the challenge.

The growing burden of respiratory disease feeds into a second, less visible problem: the environmental footprint of health care itself. Global health services are estimated to account for roughly five percent of worldwide greenhouse gas emissions, a level comparable to that of a major industrialised nation. Without significant changes, emissions linked to medical care are projected to rise sharply over the coming decades.

Hospitals — particularly intensive care units — are among the most carbon-intensive parts of the system. High energy use, complex equipment and large volumes of single-use materials contribute to their environmental impact. Respiratory specialists argue that preventing disease deterioration through earlier diagnosis and better long-term control can reduce both patient suffering and the climate cost of care.

One area drawing particular attention is the inhaler, a cornerstone treatment for asthma and chronic obstructive pulmonary disease (COPD). Hundreds of millions of people worldwide rely on these devices. The most commonly used inhalers are pressurised aerosol sprays that contain propellant gases to deliver medication into the lungs.

These propellants are often hydrofluorocarbons, which have a high global warming potential. Estimates suggest that pressurised inhalers release several million tonnes of carbon dioxide equivalent each year in Europe alone, and significantly more worldwide. While this represents a small share of total global emissions, the concentration within health care systems has made inhalers a focal point for decarbonisation efforts.

Pharmaceutical companies have begun developing alternatives that reduce environmental impact without changing how patients use the devices. One reformulated inhaler recently approved in Europe and the United Kingdom replaces the traditional propellant with a lower-impact gas, cutting its warming effect by more than 99 percent compared with earlier versions. The medication and delivery method remain unchanged, a key factor in patient safety and adherence.

Industry leaders argue that such innovations demonstrate how climate and health goals can align. Better disease control reduces emergency admissions and reliance on resource-intensive hospital care, lowering emissions across the system. Drugmakers describe this approach as keeping patients stable in community settings rather than treating repeated acute crises.

Several major pharmaceutical companies have announced long-term climate targets, pledging deep cuts to their emissions over the coming decades. These commitments include reducing emissions linked not only to manufacturing, but also to supply chains and product use. While such pledges are voluntary and timelines vary, they signal growing awareness of health care’s environmental responsibilities.

Technology alone, however, is unlikely to resolve the issue. Industry representatives and health experts point to regulation as a decisive factor in determining how quickly low-carbon medical products reach patients. Complex approval processes and inconsistent standards across regions can slow adoption, even when safer or cleaner alternatives exist.

The challenge for policymakers, specialists argue, is to design regulatory frameworks that protect patients while encouraging innovation aimed at reducing environmental harm. As climate change continues to amplify respiratory disease, the pressure on health systems to address both patient outcomes and their own emissions is expected to intensify.

The link between climate, air quality and respiratory health is no longer theoretical. What remains unresolved is how quickly health care can adapt — not only to treat the damage caused by a warming planet, but to stop adding to it.