Following the recognition that the chlorofluorocarbon (CFC) propellants used in all earlier pressurized metered dose inhalers (pMDIs) damage the Earth’s protective ozone layer in the stratosphere, alternative aerosol applicators have become mandatory. Therefore it is clear that prescribers have to move away from CFC-containing pMDIs. Today the ozone hole over the South Pole reaches about the size of Europe. This means for the physician to prescribe aerosol therapy completely free of CFCs, e.g. by DPIs and nebulizers or CFC-free pMDIs.

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