post above explains the broad problems with this video-article really well, but i’ve been doing some research since seeing this video and wanted to expand on a few points (especially for those who, like myself, benefit from having unfamiliar information spelled out a little more).
for the sake of fairness, i want to point out that the video-article DOES state that no one involved is advocating for the total elimination of MDIs. but the wording throughout the video is extremely sensationalized and, as evidenced by the comments on this post, incredibly misleading. furthermore, their given reason for why “not everyone” can switch to DPIs is SUPER oversimplified. more on that in a sec.
MDIs are rescue inhalers, which means that during an asthma attack, they can be used to immediately stop the attack. conversely, DPIs are maintenance inhalers, which means they prevent the likelihood of attacks. the key difference here is that DPIs cannot stop an attack once it starts. both are extremely useful in the management of asthma and other respiratory conditions, but suggesting the only people who can’t switch to DPIs is “people not strong enough to inhale the medication” is a VERY gross oversimplification. a lot of people are prescribed BOTH MDIs and DPIs because they serve two completely different functions; DPIs cannot replace the functionality of MDIs.
DPIs are much less likely to be covered by insurance, and much more expensive. one comment on this post testified that their MDI costs, without insurance, $40 for 200 uses, while their DPI costs, without insurance, $1,500 for 90 days’ worth of uses. this alone makes DPIs extremely inaccessible to a huge number of people. now, i think the idea here is to raise awareness and encourage the price of DPIs to be made more affordable, but as we’ve already discussed, MDIs will still be largely needed even if more people can get DPIs.
someone pointed out that DPIs are a lot harder to use correctly, making it easier to lose a (very expensive) dose completely—and, theoretically, increasing the likelihood of an attack, which you’d need an MDI to stop. they also said, though clarified they weren’t sure if this affects all DPIs or just their specific model, that their DPI comes with an incredibly high risk of developing thrush, which is a fungal infection of the mouth that can, in immunocompromised individuals, spread down the esophagus and into the lungs. another reason DPIs may be simply unusable by certain people.
i think the original article, which i’ve read some of via this post, is trying to showcase an area of medicine we could stand to improve. in theory, regardless of how trivial MDI emissions are compared to other pollutants, reducing those emissions would still be a good thing. BUT… commenters have pointed out that we’ve already banned certain MDI propellants in the past for more eco-friendly alternatives, and these individuals testify that their MDI inhalers are less effective at stopping attacks as a result. so while i think the article has good intentions, i fear it neglects to take into consideration the full scope of the issue—yes, reducing emissions is a good thing, but endangering human lives is a bad thing, and there are countless OTHER ways we can reduce emissions that don’t directly harm millions of people. as others have pointed out, this is another case of “plastic straws bad"—sure, there are cleaner alternatives, but a huge number of disabled people need these tools, and banning them outright (or even "just” getting more strict about who “really needs them”) directly harms them.
at best, this article has good intentions and very, VERY poor execution and/or research. but even in this best case scenario, it perpetuates a recurring problem: the disregard of disabled people in the process of saving our planet. we cannot condemn millions of people because their disability gets in the way of our goals. that, my friends, is eugenics rhetoric.
again, here’s an excerpt from the original article (and instructions on how to read the full thing despite the paywall), and here’s a post dissecting (and linking to) the original study. i’m unable to read either of these in full due to a combination of “on mobile” and “autistic brain can’t parse medical studies”, so if i’ve got anything wrong about either thing please let me know! i felt these points were really important both to understand the article, as well as the problems with its wording and suggestions. this is also why i don’t specify anything particularly wrong with the study itself, only this article’s interpretation of said study.
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