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Introduction Inhaler devices contribute to 3% of the overall NHS greenhouse gas emissions, with the majority of emissions coming from propellant gases in pressurised metered dose inhalers (pMDI). Many inhalers are disposed of when they have doses remaining, 1 resulting in medicines wastage, healthcare costs and adverse environmental impacts.There are no national inhaler recycling schemes available, and the cost of recycling has been prohibitive in many areas of the UK. We report the outcome of a hospital-based inhaler recycling scheme.Methods Data are available from April 2024 to June 2025. We partnered with Grundon Waste Management Ltd to recycle pMDI inhalers, whilst DPI are incinerated locally with energy capture. Inhalers were collected from wards and respiratory outpatient clinics at the Leeds Teaching Hospitals NHS Trust. The number of doses remaining in each device was used to calculate carbon emission savings. For inhalers without a dose counter, the number of doses remaining was assumed to be the same as collected inhalers with a dose counter in the same drug class,or estimated from previous studies. 1 Results A total of 2,907 inhalers were collected, of which 1,934 (66.5%) were pMDIs. The most common class of inhaler device collected were SABA (1,127), ICS/LABA (474), and ICS/LABA/LAMA inhalers (445). The calculated carbon footprint of recycled inhalers was 13.2 tonnes CO2e.We identified a significant wastage of drug; inhalers with a dose counter had an average of 65% of their labelled number of doses remaining, and 46% of these had been in use for no more than three days. The overall wastage costs were estimated at £27,072.Conclusions Hospital-based inhaler recycling has a significant impact on reducing carbon emissions. Significant wastage was identified, likely due to treatment optimisation during hospital admissions. We aim to ensure the long-term viability of our scheme by working with other local hospitals to share recycling costs, and from savings achieved by reducing waste.Acknowledgements This project was supported by a project grant from Chiesi Limited.Reference Murphy AC, et al. BMJ Open Respir Res. 2024;11:e002579.