You may not be able to escape cicadas — but you can eat them

posted in: Adventure | 0

In early April, the No. 1 show on Netflix was “3 Body Problem,” about an alien invasion. The final image in the series is of swarming cicadas, and we can expect to see similar scenes all over Chicagoland in the coming months.

In 2007, we witnessed a sizable invasion of cicadas in Brood XIII. This spring, Brood XIII is coming back and will be joined by Brood XIX, a reunion that last ensued over two centuries ago. Illinois could host upward of a trillion cicadas. You cannot escape cicadas, but if it’s any consolation (and I understand if it isn’t), you can eat them.

Grossed out by the thought of eating bugs? Well, consider this: you’ve probably eaten pounds of them … in the past year!

“Insects or insect parts are found in most of the foods that we eat. The FDA has a Defect Levels Handbook that lists the allowable limits on ‘natural and unavoidable defects’ in commercial foods,” said Gina Hunter of Illinois State University and author of “Edible Insects: A Global History.” “For instance, peanut butter is limited to 30 insect fragments for 100 grams. Thus, it’s not surprising that the average American consumes an estimated 2 pounds of insects per year, as reported by the Centers for Invasive Species Research.”

So, it turns out, we’re all entomophages (bug eaters).

During the last infestation, I’d go cicada-hunting in the cool of the morning, when young cicadas (known as nymphs) emerge from their yearslong slumber with one thing in mind: mating. The cicada’s life is played out in three movements: emergence, mating and death. I prefer to snare them just as they’re emerging from the ground. Then they’re cleaned and cooked in boiling water before being stored in the refrigerator.

My wife and I whipped up tempura cicada nori rolls, which were rather pleasant. We dipped the boiled bugs in batter, fried them and lined them up lengthwise in a seaweed-rice roll with green onion, wasabi, lightly steamed carrot and soy sauce. To pair, our recommendation is a cup of sake.

There are many sustainable ecological advantages to eating insects instead of poultry, pork or beef: insects need much less space and water than chickens, pigs or cows, and they produce much less greenhouse gas.

“Many people have suggested that insects are a sustainable protein alternative to conventional meat sources (and) many food companies are investing in insect production,” Hunter said. “It’s mostly for animal feed right now; the market for insects in human food is very small. I do think we will see more insect-based foods in the future, most likely as an ingredient in processed foods.”

Andrew Moore, of Warrenville, tastes battered and fried cicadas that his dad, Kirk, on May 25, 2007. (Antonio Perez/Chicago Tribune)

Though she has found that insects have been a historically important foodstuff in China, Thailand and Australia, Hunter said that in the Western hemisphere, Mexico is undoubtedly the epicenter of insect cuisine. You’ll find bags of spicy Mexican grasshoppers in some Hispanic grocery stores.

I’ve had tacos filled with chapulines (little grasshoppers) in Oaxaca, Mexico, and at some local Mexican restaurants, such as Uptown’s Kie-Gol-Lanee, you can order fried chapulines as a starter. Frying makes many insects crunchy, which is nice, but I must admit it’s difficult to discern flavor in unadorned bugs. In Oaxaca, chapulines are seasoned with spices such as chili, garlic and lime. Spiced up, they’re tasty, but that taste seems to come mostly from what’s added to the grasshoppers.

Cicadas harvested in their teneral stage are pan-fried on June 4, 2021, in Hyattsville, Maryland. (Chip Somodevilla/Getty)

Are any bugs delicious without tasty condiments? “Yes,” Hunter said. “Insects get a lot of flavor from pheromones, which are on the outside of the body. Traditionally people might have eaten insects just straight up.”

Indeed, in the Australian outback, Aboriginal people and others eat witchetty grubs (moth larvae) right off the tree, no cooking, no condiments. We’ve heard they taste like scrambled eggs.

Do some insects taste better than others? “Yes!” Hunter said with enthusiasm. “Some ants have this bright, citrusy flavor that’s delicious.”

Kirk Moore, of Warrenville, prepares cicadas on May 25, 2007. (Antonio Perez/Chicago Tribune)

Insect cuisine is something “we should encourage,” said Maureen Turcatel, collection manager of insects at Chicago’s Field Museum of Natural History. Eating insects, she tells us, is “a very easy way to get a good source of protein” that doesn’t require a lot of resources.

If you’d like to enjoy exotic insects in the comfort of your home, Amazon offers a vast array of insect-based snacks such as salted black ants, dehydrated zebra tarantulas and bags of “mixed bugs” including mole crickets and silkworms. Or you can go into the Midwestern wilds to fetch bags full of cicadas. Turcatel explains that “when the soil gets warm, that’s a good indication that cicadas will emerge.” With the exceptionally mild winter and spring we’ve had, cicadas may emerge sooner than usual.

Caution: Cicadas are arthropods and belong to the same phylum as shrimp, lobsters and crabs. If you have a crustacean allergy, you might have an allergic reaction to eating cicadas. Also, it’s best to harvest cicadas in wooded areas, such as a forest preserve, rather than on local lawns, which may have been sprayed with insecticides and fertilizers.

Before the day comes when you can order a bug burger at a fast-casual restaurant, consider sampling what could be the hyper-local food of the future, soon to be crawling up a tree near you.

A Brood XIII cicada waits for its wings and new exoskeleton to dry and harden after climbing and molting on a tree in a front yard in Homewood on May 22, 2007. (E. Jason Wambsgans/Chicago Tribune)

How to tempura fry cicadas

In a plastic bag, collect 1 cup (or more) of cicada nymphs as they emerge from the ground
Drop cicadas in boiling water and boil for a minute or so
Remove cicadas and place on paper towels to dry
Blend ½ cup cornstarch, 2 tablespoons flour, ¼ teaspoon baking powder. Stir in one beaten egg and 2 tablespoons water; mix thoroughly
Dip each cicada in batter
Drop a handful of cicadas into 1 or 2 cups of hot vegetable oil and fry for about 30 seconds; repeat with other cicadas
Drain cicadas, then sprinkle with salt and pepper (or hot sauce!). Enjoy!

David Hammond is a freelance writer.

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How to know if your car is tracking you, risking higher insurance

posted in: Politics | 0

By Isabel Contreras | NerdWallet

A recent New York Times investigation revealed some automakers sell data on driving behavior, like speeding, hard breaking and late night driving, which can then be purchased by car insurers. This data, known as “telematics” data, could be used to price already high auto insurance rates for the drivers of those vehicle models.

Car insurance companies already use telematics data in their pay-per-mile and telematics programs. Good driving behavior can result in discounts and perks, while bad driving behavior can mean increased rates or even dropped coverage. Customers sign up for these programs likely with the understanding that they are giving up their driving data, since they must either download an app or install a telematics device in their car in order to participate.

But the New York Times investigation found instances where drivers were unknowingly tracked by their car, and their driving behavior was sold and led to increases in their auto insurance premiums. Here’s what to know.

Tracked driving behavior could result in safer driving

Telematics programs often score drivers on their driving behavior and point to areas of improvement. Giving drivers feedback on their habits on the road can help them become safer drivers, especially when there is an incentive linking responsible driving habits to lower car insurance premiums.

“If you’re a safe driver or if you want to understand how your individual safety translates to what you pay for insurance, these programs are incredibly valuable,” says Ryan McMahon, senior vice president of strategy and corporate development at Cambridge Mobile Telematics, a telematics service provider working with auto insurers like Progressive, State Farm and Travelers.

But these programs only work if the driver is aware they are signing up for them. According to some automakers that track driving behavior, drivers must actively sign up for their telematics programs and consent for their data to be shared. But The New York Times investigation found several drivers who were unaware they were being tracked. According to McMahon, without active engagement, it can be hard for these programs to incentivize better driving or reduce auto insurance premiums.

Telematics programs come with privacy concerns

Some think the effects that data collection and sharing can have on drivers outweigh the potential benefits of telematics programs.

“A lot of people are put off by the idea of big brother basically riding shotgun and being your insurance company, and they should rightly be concerned,” says Michael DeLong, research and advocacy associate at the Consumer Federation of America, a nonprofit consumer advocacy group. “In our opinion, you shouldn’t participate in telematics unless there are strong consumer protections regarding your data and your privacy.” Most states don’t have specific laws regulating telematics.

DeLong says that some of the tracked driving behaviors in telematics programs can lead to bias. For example, low-income workers are more likely to work irregular hours, which can lead to frequent late-night drives, a behavior that is typically monitored by telematics programs. If the driver agrees to let their driving behavior be monitored, this could lead to higher auto insurance premiums.

How to know if your driving is being tracked

There are steps you can take to know if your driving is being tracked, whether you decide to participate in a telematics program or not. Here’s how to know your driving behavior is being recorded and how it’s being used:

If you’re driving a newer car model, look into its automaker’s app, telematics program and data sharing policies. If you sign up for any program that tracks or gamifies driving, read its terms and conditions, and only sign up if you feel comfortable sharing your data.
Request a free consumer disclosure report from data brokers LexisNexis and Verisk to see what information is already being tracked.
Check whether your car has GPS or Wi-Fi capabilities by looking up your car model online. If it does, chances are it can also track your driving.

If you’re uncomfortable with telematics programs, you can opt out of them altogether. But if you do want to enroll, use your auto insurer’s program so you can directly benefit from the discounts and perks they offer.

 

Isabel Contreras writes for NerdWallet. Email: icontreras@nerdwallet.com. Twitter: @https://twitter.com/ContrerasNews.

Mistrust, fights and blood sport: How COVID-19 trauma is shaping the 2024 election

posted in: News | 0

Jeffrey Fleishman | (TNS) Los Angeles Times

Much of the country has moved on from the COVID-19 pandemic, but Ruth and Mohammed Nasrullah keep a vigil from their Houston home, posting thousands of pictures and stories of those who have fallen: coaches, tax clerks, teachers, autoworkers and graphic designers.

“We spend our time immersed in death,” Ruth said of the couple’s COVID-19 Wall of Memories, which went on online when graveyards were widening and fear was spreading in January 2021. The wall holds more than 21,000 photographs and histories of those who died. “It gives us perspective. We’ve seen an arc of change in COVID response and grief.”

The pandemic is fading and Americans want to forget, Mohammed said. But people are still dying and the fallout from the virus is playing into attitudes over the divisive state of the country and its politics.

The coronavirus is seldom mentioned by the campaigns of President Biden and Donald Trump, even though its impact on voters and the way the pandemic altered how we live, work, die and mourn has been profound. It accelerated mistrust in government and institutions, emptied downtowns of workers, sparked fights over masks and science, turned school board meetings into political blood sport, hardened the lines between red and blue states and ignited a mental health crisis.

The lingering trauma — 1.2 million people died in the U.S. and an estimated 17 million suffer from long COVID — echoes through issues confronting voters, including inflation, education, crime, immigration and the unease many have for the future. These challenges are shaping a presidential rematch between two candidates most Americans don’t want at a time when the nation appears trapped in a despairing loop of restiveness and uncertainty over the fate of democracy and an economy that has raised rents and kept food prices stubbornly high.

“Society has become more disillusioned over the government’s ability to take on larger issues. The pool of people distrusting the government has gotten larger,” said Kristin Urquiza, who co-founded Marked By COVID, which is calling for an accounting of the government’s pandemic response and establishing a National COVID Memorial. “The pandemic exacerbated everything.”

It wasn’t that long ago that the country and the world slipped through the looking glass. Preachers warned of the end of days. Hospitals filled, ventilators failed and refrigerated trucks were stacked with corpses. The isolated and the lonely sang from windows and balconies. Final goodbyes were spoken over video links and smartphones. No one knew when it would end as collective grief and anger settled in amid news of broken supply chains and the latest from Wuhan, the city in China from where death crossed oceans and borders.

“It completely shifted our lives,” said Natalie Jackson, vice president of the polling firm GQR. “There are ways society has changed that we’re not totally aware of. Historians in a couple of decades will be able to tell us a lot more about how our behavior changed that we’re not able to understand right now.”

Then-President Trump gives a thumbs up upon returning to the White House from Walter Reed National Military Medical Center in October 2020. Trump had been hospitalized for COVID. (Mandel Ngan/AFP/Getty Images/TNS)

Former President Trump — who suggested injecting disinfectant to kill the virus in April 2020 — doesn’t reflect much on the early days of the pandemic, when his administration was criticized for its slow response. Instead, he tells voters, as he did at a recent rally, that America under his leadership was “stronger and tougher and richer and safer and more confident.” President Biden also seldom speaks of COVID, but he recently chided Trump’s handling of the outbreak when he told donors, “I hope everyone in the country takes a moment to think back when it was like in March of 2020.”

Biden, meanwhile, is contending with the consequences of his own pandemic policies.

His administration averted economic catastrophe by pushing through at least $5 trillion in stimulus checks, child tax credits and loans to help families, small businesses, airlines, local governments and others to lessen the ravages of the pandemic. Those protections largely stopped as jobs and the economy began to recover. But the loss of subsidies collided with a sharp jump in inflation. That overall rate has fallen to 3.5%. But steep prices have remained a persistent burden — home mortgage interest rates are around 7.3% — on household incomes and are a constant target by Trump against Biden.

“That’s the problem Biden faces,” said Mark DiCamillo, director of the Berkeley IGS Poll. “It was inevitable that after all those price controls were gone people would notice. That’s the lasting impact of the pandemic.”

A recent survey by the Pew Research Center found that 73% of Americans believe the economy should be the top priority of the next president and Congress. The cost of living is particularly pronounced in California where inflation, high interest rates and escalating rents are demoralizing the working and middle classes. “We’re seeing it in spades,” DiCamillo said. “The American dream seems to be out of reach for renters, and homeowners are stuck.”

The pandemic also changed the dynamics of the nation’s long-standing failure to fix a broken immigration system, which became further politicized in 2022 when busloads of migrants sent from Texas and Florida began appearing in traditionally Democratic controlled cities like Los Angeles, Chicago, New York and Martha’s Vineyard, Massachusetts.

Trump-era restrictions on immigration to prevent the spread of the virus during the pandemic, notably Title 42, limited the influx of illegal migrants. A loosening of those policies by the Biden administration resulted in a record surge of illegal border crossings, hitting 2.2 million in fiscal year 2022. Tough enforcement measures by Texas Gov. Greg Abbott — praised by conservatives — to deter undocumented migrants from entering his state meant that San Diego in April became the main entry point for migrants along the southern border.

Immigration remains a dominant campaign theme for Republicans, even though the Pew survey ranks it behind the economy, healthcare costs, education and terrorism as Americans’ top priorities for the next Congress and president. Illegal crossings have declined since December, but Trump has become increasingly pointed in his attacks on migrants and Biden’s policies. “We need to stop the invasion now!” the Trump campaign posted on social media. “Biden has absolutely FAILED to secure our borders.”

A young shopper, wearing a mask to protect herself from the coronavirus, shops with her mother on Santee Alley in the Garment District in downtown Los Angeles in June 2020. The pandemic accelerated mistrust in government, institutions — and science . (Genaro Molina/Los Angeles Times/TNS)

The pandemic immediately altered our reality and influenced our perceptions afterward, agitating existing anxieties in American life, raising fears not only over a spreading virus but of the safety of our communities. Violent crime and murder soared at the start of the pandemic and the 2020 protests following the police killing of George Floyd in Minneapolis. Gun violence and homicides declined significantly by the end of 2023, but many Americans, notably Republicans and Black voters, remain concerned about violent crime, said Jackson, adding: “Those narratives take time to reverse.”

Conspiracy theories flourished as the number of COVID-related deaths rose. Suspicions and outrage reverberated around the safety of vaccines, wearing masks, and how quickly children should return to the classroom. Battles over each issue broke along political lines that are playing into the 2024 campaign, including the support behind third-party presidential candidate Robert F. Kennedy Jr., an anti-vaccine activist, and how parent groups demanding the reopening of schools became part of wider cultural war issues around book bans, race and gender identity.

“We still have the impacts of increased polarization. Were you a masker or not a masker?” said Mindy Romero, a political sociologist and director of the Center for Inclusive Democracy at USC. “We had a sustained period where our fellow human beings were a potential threat to our health and our lives. I do wonder what that impact will be long term. It’s been so politicized that people are hesitant or outright scared to talk” about what COVID did to their lives.

Urquiza turned her personal grief into political action. After her father died of the virus in 2020, she spoke at the Democratic National Convention and blamed Trump’s handling of the pandemic: “My dad was a healthy 65-year-old,” she said. “His only pre-existing condition was trusting Donald Trump, and for that he paid with his life.”

Her organization, Marked By COVID, is working to raise awareness about the consequences of the pandemic and setting up trust funds for more than 200,000 children who lost one or both parents to the virus. Americans need “a public memory and the truth of what happened,” she said. “We need a clear, unbiased record on the pandemic. What we did well and what we didn’t. We need a 9/11-like commission. The 2024 election is an opportunity to remember what COVID did.”

A lot of service industry and low-income workers “felt abandoned during the pandemic,” she said.”Isn’t it the government’s job to keep us safe? I think the rise of workers’ unions is somewhat related to COVID. It called attention to working conditions.”

Ruth and Mohammed Nasrullah started their online memorial after pandemic deaths rose to more than 100,000: “What was being reported on the news was just numbers,” said Mohammed, a retired project manager who worked with NASA. “But no one was talking about the people behind those numbers. The memorial provides a way to grieve. Families visit it like you would go to a cemetery. They come with stories and leave messages.”

Photographs of people who lost their lives to COVID-19, including Celia Marcos, left, were part of a memorial in front of the Kenneth Hahn Hall of Administration in downtown Los Angeles in August 2020. (Mel Melcon/Los Angeles Times/TNS)

The stories were at once startling and common. A mother and father dying of the virus and leaving behind two young children; an elderly couple who perished within minutes of one another.

“The pandemic became its own period of time. It’s its own era,” said Ruth, whose memorial has been archived by the U.S. Library of Congress. “But we want to minimize and forget that terrible time. I still see people rolling their eyes when I wear a mask. The divisiveness is still there.”

Although it still influences voters’ attitudes, many people don’t mention the pandemic directly. It has been tucked away like a dark family history or a misbegotten war, even as its consequences play out daily. In the Pew survey, COVID was not listed by Americans as one of the top 20 concerns they see for the next president. “It’s not on anyone’s radar,” said Mohammed, who has been a local election judge for years. “The candidates don’t mention it. They look at the polls for the public’s priorities, and for 70 to 80% of the public, COVID is not an issue.”

Between March 31 and April 27, at least 1,589 people in the U.S. died from COVID. The latest vaccine booster is available, but the lines have long since dwindled. The country is engaged with other perils, although, at times, a mask can be glimpsed dangling from a stranger’s arm and a passing conversation can lead to memories of empty shelves and lockdowns.

“A bit of psychology has to come into this,” Jackson said. “You think about a big traumatic event. An individual is not going to realize the degree to which they changed their behavior. … The same thing happens to a nation.”

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This story originally appeared in Los Angeles Times.

©2024 Los Angeles Times. Visit latimes.com. Distributed by Tribune Content Agency, LLC.

Could better inhalers help patients, and the planet?

posted in: Society | 0

Martha Bebinger, WBUR | (TNS) KFF Health News

Miguel Divo, a lung specialist at Brigham and Women’s Hospital in Boston, sits in an exam room across from Joel Rubinstein, who has asthma. Rubinstein, a retired psychiatrist, is about to get a checkup and hear a surprising pitch — for the planet, as well as his health.

Divo explains that boot-shaped inhalers, which represent nearly 90% of the U.S. market for asthma medication, save lives but also contribute to climate change. Each puff from an inhaler releases a hydrofluorocarbon gas that is 1,430 to 3,000 times as powerful as the most commonly known greenhouse gas, carbon dioxide.

“That absolutely never occurred to me,” said Rubinstein. “Especially, I mean, these are little, teeny things.”

So Divo has begun offering a more eco-friendly option to some patients with asthma and other lung diseases: a plastic, gray cylinder about the size and shape of a hockey puck that contains powdered medicine. Patients suck the powder into their lungs — no puff of gas required and no greenhouse gas emissions.

“You have the same medications, two different delivery systems,” Divo said.

Patients in the United States are prescribed roughly 144 million of what doctors call metered-dose inhalers each year, according to the most recently available data published in 2020. The cumulative amount of gas released is the equivalent of driving half a million gas-powered cars for a year. So, the benefits of moving to dry powder inhalers from gas inhalers could add up.

Hydrofluorocarbon gas contributes to climate change, which is creating more wildfire smoke, other types of air pollution, and longer allergy seasons. These conditions can make breathing more difficult — especially for people with asthma and chronic obstructive pulmonary disease, or COPD — and increase the use of inhalers.

Divo is one of a small but growing number of U.S. physicians determined to reverse what they see as an unhealthy cycle.

“There is only one planet and one human race,” Divo said. “We are creating our own problems and we need to do something.”

So Divo is working with patients like Rubinstein who may be willing to switch to dry powder inhalers. Rubinstein said no to the idea at first because the powder inhaler would have been more expensive. Then his insurer increased the copay on the metered-dose inhaler so Rubinstein decided to try the dry powder.

“For me, price is a big thing,” said Rubinstein, who has tracked health care and pharmaceutical spending in his professional roles for years. Inhaling the medicine using more of his own lung power was an adjustment. “The powder is a very strange thing, to blow powder into your mouth and lungs.”

But for Rubinstein, the new inhaler works and his asthma is under control. A recent study found that some patients in the United Kingdom who use dry powder inhalers have better asthma control while reducing greenhouse gas emissions. In Sweden, where the vast majority of patients use dry powder inhalersrates of severe asthma are lower than in the United States.

Miguel Divo shows his patient, Joel Rubinstein, a dry powder inhaler. It has a much lower carbon footprint than a traditional inhaler while being equally effective for many patients with asthma. (Jesse Costa/WBUR/KFF Health News/TNS)

Rubinstein is one of a small number of U.S. patients who have made the transition. Divo said that, for a variety of reasons, only about a quarter of his patients even consider switching. Dry powder inhalers are often more expensive than gas propellant inhalers. For some, dry powder isn’t a good option because not all asthma or COPD sufferers can get their medications in this form. And dry powder inhalers aren’t recommended for young children or elderly patients with diminished lung strength.

Also, some patients using dry powder inhalers worry that without the noise from the spray, they may not be receiving the proper dose. Other patients don’t like the taste powder inhalers can leave in their mouths.

Divo said his priority is making sure patients have an inhaler they are comfortable using and that they can afford. But, when appropriate, he’ll keep offering the dry powder option.

Advocacy groups for asthma and COPD patients support more conversations about the connection between inhalers and climate change.

“The climate crisis makes these individuals have a higher risk of exacerbation and worsening disease,” said Albert Rizzo, chief medical officer of the American Lung Association. “We don’t want medications to contribute to that.”

Rizzo said there is work being done to make metered-dose inhalers more climate-friendly. The United States and many other countries are phasing down the use of hydrofluorocarbons, which are also used in refrigerators and air conditioners. It’s part of the global attempt to avoid the worst possible impacts of climate change. But inhaler manufacturers are largely exempt from those requirements and can continue to use the gases while they explore new options.

Some leading inhaler manufacturers have pledged to produce canisters with less potent greenhouse gases and to submit them for regulatory review by next year. It’s not clear when these inhalers might be available in pharmacies. Separately, the FDA is spending about $6 million on a study about the challenges of developing inhalers with a smaller carbon footprint.

Rizzo and other lung specialists worry these changes will translate into higher prices. That’s what happened in the early to mid-2000s when ozone-depleting chlorofluorocarbons (CFCs) were phased out of inhalers. Manufacturers changed the gas in metered-dose inhalers and the cost to patients nearly doubled. Today, many of those re-engineered inhalers remain expensive.

William Feldman, a pulmonologist and health policy researcher at Brigham and Women’s Hospital, said these dramatic price increases occur because manufacturers register updated inhalers as new products, even though they deliver medications already on the market. The manufacturers are then awarded patents, which prevent the production of competing generic medications for decades. The Federal Trade Commission says it is cracking down on this practice.

After the CFC ban, “manufacturers earned billions of dollars from the inhalers,” Feldman said of the re-engineered inhalers.

When inhaler costs went up, physicians say, patients cut back on puffs and suffered more asthma attacks. Gregg Furie, medical director for climate and sustainability at Brigham and Women’s Hospital, is worried that’s about to happen again.

“While these new propellants are potentially a real positive development, there’s also a significant risk that we’re going to see patients and payers face significant cost hikes,” Furie said.

Some of the largest inhaler manufacturers, including GSK, are already under scrutiny for allegedly inflating prices in the United States. Sydney Dodson-Nease told NPR and KFF Health News that the company has a strong record for keeping medicines accessible to patients but that it’s too early to comment on the price of the more environmentally sensitive inhalers the company is developing.

Developing affordable, effective, and climate-friendly inhalers will be important for hospitals as well as patients. The Agency for Healthcare Research and Quality recommends that hospitals looking to shrink their carbon footprint reduce inhaler emissions. Some hospital administrators see switching inhalers as low-hanging fruit on the list of climate-change improvements a hospital might make.

But Brian Chesebro, medical director of environmental stewardship at Providence, a hospital network in Oregon, said, “It’s not as easy as swapping inhalers.”

Chesebro said that even among metered-dose inhalers, the climate impact varies. So pharmacists should suggest the inhalers with the fewest greenhouse gas emissions. Insurers should also adjust reimbursements to favor climate-friendly alternatives, he said, and regulators could consider emissions when reviewing hospital performance.

Samantha Green, a family physician in Toronto, said clinicians can make a big difference with inhaler emissions by starting with the question: Does the patient in front of me really need one?

Green, who works on a project to make inhalers more environmentally sustainable, said that research shows a third of adults diagnosed with asthma may not have the disease.

“So that’s an easy place to start,” Green said. “Make sure the patient prescribed an inhaler is actually benefiting from it.”

Green said educating patients has a measurable effect. In her experience, patients are moved to learn that emissions from the approximately 200 puffs in one inhaler are equivalent to driving about 100 miles in a gas-powered car. Some researchers say switching to dry powder inhalers may be as beneficial for the climate as a patient adopting a vegetarian diet.

One of the hospitals in Green’s health care network, St. Joseph’s Health Centre, found that talking to patients about inhalers led to a significant decrease in the use of metered-dose devices. Over six months, the hospital went from 70% of patients using the puffers, to 30%.

Green said patients who switched to dry powder inhalers have largely stuck with them and appreciate using a device that is less likely to exacerbate environmental conditions that inflame asthma.

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This article is from a partnership that includes WBUR, NPR, and KFF Health News.

(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

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©2024 Kaiser Health News. Visit khn.org. Distributed by Tribune Content Agency, LLC.