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Guest article by Marta Montanari, Policy and Events Officer at the European Respiratory Society 

In 2020, the European Commission started to work on a new initiative to update the current set of rules to reduce Fluorinated gases (F-gases) emissions. There are four main categories of fluorinated gases: hydrofluorocarbons (HFCs), nitrogen trifluoride (NF3), perfluorocarbons (PFCs), and sulphur hexafluoride (SF6). These are used in various products and appliances, like in refrigeration, air conditioning and heat pump sector, as well as asthma inhalers. F-gases are also used as substitutes for ozone-depleting substances because they do not damage the atmospheric ozone layer. However, they have long-lasting consequences with much higher global warming effects than any other man-made greenhouse gases, up to 25 000 times greater than carbon dioxide (CO2).  

It is well known that pollution and climate change have a big effect on humans. The World Health Organization (WHO) has warned that climate change is the biggest global threat to humanity in the 21st century and by 2050 is expected to cause 250,000 yearly deaths due to climate-sensitive diseases. For example, burning fossil fuel produces carbon pollution that drives climate change and creates air pollution such as particulate matter. Exposure to these kinds of elements as well as extreme weather events have a direct impact on air quality levels and therefore on people’s health, increasing the risks of hospitalisation for respiratory patients. People with an already impaired respiratory function e.g., asthmatic or chronic obstructive pulmonary diseases (COPD) patients are particularly sensitive to climate change. 

There is a very complex interplay between respiratory patients, climate change, and asthma inhalers. It is important to offer options to allow patients to make informed and environmentally sustainable choices without compromising their health. The scale of climate change’s impact on planetary and human health requires ambitious actions. However, it is equally fundamental to ensure at global level that the legislation does not impede access or affordability of respiratory devices to patients in low-and middle-income countries. Patients need to have a diversity of devices and inhalers available to treat their conditions. This should be ensured by the new regulation while phasing out F-gases emissions. 

The European Respiratory Society supports the European Commission’s proposed revision of the F-gases regulation as it proposes solutions to urgent issues but still gives the necessary time for patients and health care professionals to transition to a better system.