Supporting environmental sustainability – what can you do to help?

Advice and practical tips on how pharmacists can help lead positive change.

How are climate change and health connected?

Healthcare may not be the first thing that comes to mind when thinking of climate change – yet healthcare represented 7% of Australia’s carbon footprint between 2014 and 2015.¹ That is equivalent to the entire carbon emission output of South Australia!^1,2

Some of the reasons behind this are obvious – hospitals and healthcare clinics can be highly energy intensive, consume large amounts of electricity and produce a large amount of waste,^1,3 but there are other contributors that may not be as obvious.

Take asthma or chronic obstructive pulmonary disease (COPD) for example. Several million inhalers are used every year across Australia,⁴ and when you consider the environmental impact of manufacturing, transportation, disposal of inhalers you can see why this type of medication is adding to the environmental burden.⁴

On top of that there are the properties of the inhalers themselves, some of which use hydrofluorocarbons (HFCs) as propellants  – greenhouse gases that have an effect on the environment thousands of times greater than an equivalent amount of carbon dioxide.⁴

And that is just one example from all of the medications available across the healthcare space.

So, what can pharmacists do?

Peter Guthrey, Senior Pharmacist of Strategic Policy with PSA, says adding your voice is a key factor by ‘being a vocal advocate for change and pushing towards a carbon neutral economy,’ because ‘everyone can have a voice on social media, everyone has a LinkedIn where they can find others that are having success in these areas and you can start to work together and really think about what you can do as an individual in your own work’.

A good place to start is the International Pharmaceutical Federation (also known as Federation Internationale Pharmaceutique or FIP) Global Roadmap 2030.⁵ This report contains 21 development goals covering all aspects of pharmacy, from education to policy development.⁵

Take a look and see if there are any you can help tackle in your pharmacy. A little closer to home is the PSA Position Paper on Environmental Sustainability⁶ – a piece Peter helped to develop through his role at PSA. He notes that ‘as an industry, we need to look at where we can reduce our carbon footprint’.

Things you can start doing now:

• Look for options that have a smaller impact on the environment such as LED lighting
• Switch off non-essential electronics when not in use
• Look out for patients expressing motivations related to sustainability and help guide them where possible
• Consider what non-pharmacological advice you can offer to help manage or reduce their use of medications – e.g. using face masks during times of increased air pollution (such as during the bushfires of 2019).

How might this look in practice?

Peter explains ‘as a routine part of what we do, we provide lifestyle advice and non-pharmacological management advice to patients. For example, with respiratory conditions that can be triggered by air pollution or climate extremes we provide guidance that helps patients understand what can be done to prevent exacerbations (such as using face masks), as well as what to do if they suddenly become short of breath. By helping ensure their condition is well controlled, you can help reduce the use of inhalers’.

As noted above, this type of medication can have a huge impact on the environment,⁴ so any reduction in the need for medication usage can have a positive effect in this area. To put this into perspective in terms of carbon emissions, switching from an inhaler that uses HFCs as propellants to a dry powder inhaler has a similar impact as switching to a hybrid car or becoming vegetarian.⁴

You can take these reductions even further by switching to a reusable device, such as the Respimat® Reusable inhaler (also propellant-free) which can be used with up to six cartridges instead of being disposed of every month of medication use.^7,8 This reduces the number inhalers a patient discards each year from 12 to just two.⁸

Where to go for more information?

The best places to start are:

• The PSA Position Statement on Environmental Sustainability, available at https://my.psa.org.au/s/article/Environmental-Sustainability
• The FIP Global Roadmap 2030, available at: https://developmentgoals.fip.org/globalroadmap2030/

References

1. Malik A, et al. Lancet Planet Health 2018;2:e27–35.
2. Bragge P, et al. Climate Change and Australia’s Health Systems: A Review of Literature, Policy and Practice. Monash Sustainable Development Evidence Review Service, BehaviourWorks Australia, Monash University. Melbourne, October 2021. Available at: https://www.racp.edu.au/advocacy/policy-and-advocacy-priorities/climate-change-and-health (accessed March 2023).
3. Pencheon D. J Health Serv Res Policy 2009;14(1):2–4.
4. Montgomery BD and Blakey JD, Aust J Gen Pract 2022;51(12):929–934.
5. International Pharmaceutical Federation (FIP). The FIP Global Roadmap 2030: Sustainable advancement for pharmacy worldwide. The Hague: International Pharmaceutical Federation; 2022.
6. Pharmaceutical Society of Australia. Environmental sustainability Position Statement  September 2022.
7. Placebo Respimat Instructions for Demonstration.
8. Janson C, ERJ Open Res 2023;9(3):00543–2022.

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