Due to poor reporting, some people now think that inhalers are pumping the atmosphere full of deadly gases. Recently, researchers in the UK examined the carbon footprint of the metered dose inhaler (MDI) and suggested economic models for switching the National Health Service prescriptions to a different kind: the dry powder inhaler (DPI). The MDI is the best at ensuring a consistent dose of aerosolized medication in a single puff and is used not only by asthmatics and sufferers of chronic obstructive pulmonary disease (COPD), but also by many people with short-term breathing problems (think bronchitis) who need quick and reliable relief. As a life-saving medical intervention device, the MDI allows individuals with certain kinds of compromised airways to increase their chances of survival. In comparison, the DPI is harder to use during a fit of coughing or gasping because it involves inhaling the medication as a fine powder instead of a mist. Someone who cannot take a fast, deep breath without blowing out (even a small exhale can cause the entire dose to be wasted) cannot use the DPI to take their medication—presupposing their medication is available in this form since few are manufactured due to higher costs. Why would these researchers explore increasing the number of DPIs in circulation if they are not as functional as MDIs? The answer is found in the aerosolizability of the MDI which is caused by hydrofluoroalkanes, gaseous compounds with fluorine, or “F-gases.” Hydrofluoroalkanes are not to be confused with chlorofluorocarbons (CFC’s), which were implicated in the 1970’s in destroying the ozone layer, but they are nonetheless one of the many compounds which contribute to the greenhouse effect. The lifetime production of greenhouse gases for DPIs is somewhat less than that for MDIs and, the paper argues, the greener choice is to encourage doctors to prescribe them when appropriate and subsidize the production of DPI-compatible medications.
Without missing a beat, the story of this small report on the feasibility of more DPIs in Britain was picked up by Time magazine, BBC News, and Climate News Network to be circulated under sensational headlines like “How One Commonly Used Asthma Inhaler is Damaging the Planet” and “Climate threat from inhalers can prove costly.” Later, the Washington Post published an article titled “No, asthma inhalers are not ‘choking the planet’” as a play on the previous headlines. Christopher Ingraham at the Post used his business analyst column to put the results of the study back into proportion, calculating that the MDI inhalers accounted for at most 0.14 percent of the nation’s annual carbon footprint. The article emphasizes that many consumer choices can be critiqued and readily changed without health complications to reduce individual impact and makes a vague gesture to “activists” calling for “radical systemic change” before reminding readers that poor air quality contributes more to worsened symptoms for asthmatics. While this coverage by the Post is certainly better than that of other magazines that primarily fearmonger about MDIs, it critiques consumer-reduction models of environmental impact without offering an alternative framework beyond “change.” The Post, as a news outlet owned by Amazon CEO Jeff Bezos, who has a direct stake in ensuring that individuals instead of institutions are held accountable for their footprint, cannot truly critique the systems that contribute most to climate change: industry and institutions. The narrative that emphasizes individual changes rather than acknowledges corporations’ and institutions’ roles as the largest contributors to climate change hurts any chance of an effective solution.
Putting aside the individual consumer “choice” of inhalers, emissions data contextualize the problem as a minor source of emissions compared to both overall greenhouse gas emissions and haloalkane emissions. The U.K. Department for Business, Energy, and Industrial Strategy provides statistical data for the carbon emissions of different sectors each year; in 2018, the two largest sources of emission by far were transportation and energy (in that order). Public, non-residential emissions are admittedly rising, but there was only a 1.6 percent increase from 2017 to 2018, once adjusted for heating sources, on the already miniscue slice of 2.0 percent of the national emissions. In comparison, the business sector causes 18 percent of all emissions. Global data collected by the Environmental Protection Agency show a similar trend, with 65 percent of greenhouse gases being carbon dioxide released from fossil fuels and industrial processes; only two percent are “F-gases.” Furthermore, inhalers represent a tiny amount of the emissions of haloalkanes. The primary source of hydrofluoroalkanes are refrigerants, but the EPA does not require manufacturers to report the emissions from their products. The United Nations Environmental Programme estimates that 79 percent of emissions are from refrigerants compared to 5 percent for all aerosol products (of which inhalers are a tiny percentage). Since the hydrofluoroalkanes do not degrade the ozone layer like their CFC cousins and are in fact the “green” alternative to them, there is no substantial difference between them and other heat-trapping gases. While an impact framework focused on the individual is susceptible to over-emphasizing small choices like an MDI inhaler, focusing on how institutions shape our impact requires identifying the truly significant sources.
Not every lifestyle allows one to take the same measures to reduce their individual impact; consumer-based responsibility narratives also serve as a barrier to acknowledging inequitable access. By making environmentally friendly products a commodity, and therefore more expensive than comparable alternatives, poor people are blamed for an environmental impact that they do not have the resources to curb. Companies have calculated that if they slap on the labels “sustainable sourced,” “biodegradable,” “compostable,” or “carbon offset,” they can raise their prices. An “Amazon Basics” plain coffee cup 10 ounce 500-count pack costs $50.42 (10.08 cents per cup) while the equivalent “Amazon Basics” “compostable” cup in the same size and quantity costs $65.00 (13 cents per cup). On top of the green surcharge, the “compostable cup” is actually not usually compostable. Amazon is able to get away with this because the limiting factor, a polylactic acid (PLA) coating, does break down—if only after months and incredibly specific conditions. There are approximately 5,000 composting facilities in the US based on a survey sent to states, and only a fraction of them will accept the cost-inefficient paper products. They are not evenly distributed, either; the top five states have over 33 percent of the reported composting facilities. Within those states, a careful examination will certainly show socioeconomic divides between those who have access to the composting stream and those who do not. Thus, the majority of these more expensive “compostable” cups will end up in landfills regardless. These cups are still available with Amazon Prime, getting shipped on inefficiently packed trucks guzzling fossil fuels to meet consumer demand. All of these calculations presuppose that one has the education to know what kinds of products to demand. Ultimately, companies make more money while avoiding the necessary large-scale changes to their operations to become environmentally conscious.
More broadly, sustainability is inexorably linked to class in American society. Most “greening” efforts, such as taking public transit or carpooling, assume a specific relationship to wealth. For those who cannot afford to buy and maintain a car or live in the suburbs, these are not even options because there is no connection to the sources of pollution and the limited options make it harder to control one’s impact. When you ride a city bus, you do not have the luxury of choosing to ride exclusively electric ones. Similarly, greening one’s living space in any appreciable way (eco-friendly insulation, solar panels, gray water recycling systems, etc.) is not practical for renters who will definitely leave the space and require permission from their landlords first. It is doubtful there will ever be a price point in the free market for these products where short-time residents will see enough in savings to justify the out-of-pocket costs. On a limited budget, even eco-friendly food can become unattainable. The cheapest foods are all pre-processed which means a massive carbon footprint (and negligible health benefit) compared with fresh produce. “Shopping local,” assuming one does not live in a food desert and has access to produce, requires that one lives in an area with enough resources to run a farmer’s market—a custom that is becoming more and more bourgeois by the season. Once a market has moved inside or operates year-round, you can rest assured that the majority of the products will be meals, snacks, small-batch foods like cheese or honey, and artisanal products for top dollar prices. If there is a produce selling stand, it often sells expensive “heirloom” or non-traditional color varieties for surcharges. We see the “green” movement for what it is, then: the petty bourgeoisie spending more money for what amounts to new status symbols.
The individualist framework also makes it easy to ignore the cause of some of the respiratory health issues that harm asthmatics, among others: pollution that disproportionately impacts marginalized communities. The Post article touches briefly upon the fact that poor air quality worsens asthma symptoms (and necessitates more inhaler usage). However, the author fails to mention that asthma is also well-known to have pollution and occupational hazard exposures as risk factors. One or two or ten consumers buying a greener product does not stop factories from toxifying the very air they breath. Thousands of consumers could drastically change their habits to attempt to improve the air quality in cities, but these choices would not stop electricity generation plants and fossil fuel-based transportation from causing the same detrimental effects. These institutional footprints should not be used to absolve all (wealthy) consumers of their impact, however. The broadening of focus that examining institutions requires helps us see that individual consumption is not a monolith. It becomes clear that not all consumers consume resources equally. The most industrially developed nations contribute the most to greenhouse gas emissions. The most industrially developed nations produce a disproportionate amount of waste. Thinking of countries as an institution, we see some making more efforts than others. These observations necessitate the discussion of environmental justice, which emphasizes the inequities in marginalized groups both bearing the consequences of climate change and missing the benefits of conservation and other forms of climate activism.
By placing the responsibility for mitigating the environmental impact on the individual consumer, corporations and institutions create a narrative where blaming themselves is not an option. This leads the public to paint scapegoats and boogeymen out of marginalized people, to blame people who use inhalers in life-saving interventions for the fraction of greenhouse gases they emit instead of demanding immediate intervention in the operations of factories and institutions which have hastened our sprint to the edge of climate crisis. Instead of focusing our efforts on telling people with inhalers to switch to potentially less effective options, we should consider telling billionaires to sell their private jets or companies to offset their pollution from their own profits first.
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