{
  "abstract": "Introduction Current practice in our Clinical Measurement Department is to use the Allen & Hanbury’s Volumatic® spacer, a polycarbonate plastic device, during airway reversibility testing. The department is trialing the Clement Clarke DispozABLE® Spacer, which consists of a paper cup with plastic ends. This study compares their cost and theoretical carbon emissions.Previous studies have compared performance of paperboard and valved chamber spacers. One study by Eynaud et al. (2024) found that paperboard spacers deliver a significantly higher dose of fine particles than less antistatic plastic chambers, ensuring optimal therapeutic effect.Methods Reversibility tests conducted from 01/01/2024 to 31/12/2024 were recorded, noting how many required spacers. The cost per spacer was obtained from the NHS supply chain and scaled to annual demand. Carbon emissions were estimated based on government conversion factors Department for (Energy Security & Net Zero, 2024), manufacturing location, spacer weight, incineration costs/emissions (NHS England, 2021), and recycling potential.Although paper spacers are marketed as fully recyclable, local infection control policies require the plastic components to be disposed as offensive waste. For comparison simplicity, both spacers were assessed under offensive waste disposal.Results Table 1 refers.Conclusions Of 939 reversibility tests, 370 met requirements for bronchodilator administration and therefore required a spacer. Annually, £1,306 was saved by using paperboard spacers. Paperboard spacers reduced incineration carbon emissions by 1.299 CO2e/tonne and used 43% less transportation energy, as they are manufactured in England, unlike plastic spacers from Ireland. Additional benefits include reduced storage and packaging.This small switch supports the NHS Net Zero by 2040 goal which aims for an 80% reduction in controlled emissions by 2028.Abstract P1 Table 1Comparison of plastic volumatic spacers to the paper dizposable spacers. Conversion factors obtained from the department for energy security & net zero (2024). Incineration costs to UHDB according to NHS England waste carbon reduction tool (2021)References Department for Energy Security & Net Zero (2024), UK Government GHG Conversion Factors for Company Reporting. Eynaud, et al. International Journal of Pharmaceutics 2024;666:124774. NHS England, Waste Carbon Reduction Tool (2021).",
  "authors": [
    {
      "affiliations": [
        "University Hospitals of Derby and Burton, Royal Derby Hospital, UK"
      ],
      "name": "Emily Spridgens"
    }
  ],
  "title": "P1 Cutting costs and carbon: the impact of paperboard vs plastic spacers",
  "uid": "6ffe36ee-4620-5cff-a595-67bcd8cde51a"
}