Carbon Footprints and Life Cycle Assessments of Inhalers: A Review of Published Evidence
Round 1
Reviewer 1 Report
Congratulations to the authors for their hard work!
The work is interesting, however, it can be improved further. For example:
1) A detailed discussion of LCA methodology choices, such as attributional vs. consequential LCA, inventory source (e.g., ecoinvent), LCIA method (e.g., ReCiPe, CML), midpoint vs endpoint impacts of the reviewed articles should be presented.
2) The method part of the literature search is also incomplete. For example, the authors should mention the time period of the selected literature, how many papers were initially selected, and then how many were retained for final analysis, is there any consideration of the geographical boundary of the selected papers. The authors mentioned the selection of seven papers for the review, but my doubt is whether the selected seven papers are enough to write this present review? Why not more papers were selected.
Overall, the authors should work on improving the methodological discussion.
Author Response
Dear Reviewer,
Thank you for your valuable feedback. Please see the attachment.
Regards
Authors
Author Response File: 
Author Response.pdf
Reviewer 2 Report
General Comment: The paper is very interesting. However, there are some comments/suggestions for further improvement. The comments are as follows:
（1）Implication(s)/benefits of the study findings should be included in the latter part of the abstract.
(2)The review of the literature could have been much stronger.
(3)The "Discussion" in the paper seems apparently the depth is not enough.The logic of the discussion is not clear.
(4)The theoretical and managerial implications should be clearly specified to highlight the significance of the study.
（5）Please points out some insufficiency and limitation that needs further improvements in the conclusion.
Author Response
Dear Reviewer,
Thank you for your valuable feedback. Please see attachment.
Regards
Authors
Author Response File: Author Response.pdf
Reviewer 3 Report
The authors present a review of the carbon footprint and life cycle analysis of personal use inhalers. In my opinion, the work is interesting and presents a frame of reference regarding the analysis of the sustainability of inhalation technologies, however, it requires important changes before being accepted considering the focus of the journal "Sustainability". Here are some recommendations:
• The summary is not presented in a structured way, it is recommended to include a couple of introductory lines, followed by the description of the case study, and close with substantial conclusions that introduce the relevance of the research and its possible future scope.
• Although the introduction is concise, more context is required about the study that is carried out, incorporating aspects related to the problem addressed in the document and the possible present and future impacts in a scenario of environmental sustainability.
• For the analysis of the life cycle and carbon footprint, it is recommended to make a diagram explaining each of the stages of the process, describing the inputs and outputs of matter and energy, to graphically show the differences in the processes of the useful life of each inhaler studied.
• The inventory analysis, the impact categories, and the interpretation of results are not clear. It is necessary to improve the analysis and presentation of results.
• As it is a review of the literature, as stated in the title of the manuscript, it is expected that there will be a more extensive review and more articles will be included in the references, incorporating relevant aspects from environmental impact analysis to socio-economic impacts. Due to the fact that the case study is of a technological nature, it is recommended to do a brief search in Google patents in order to show that the review of the literature was more extensive for inhalers with low environmental impact, in case there are any.
• Why do the discussion and conclusions focus mainly on the analysis of KgCO2 emissions and the rest of the impact categories are not widely mentioned?
• It is necessary to include a discussion about the results of all the impact categories, it is also recommended to include a section that mentions the environmental and socio-economic scope of the review carried out to visualize with greater precision the contribution of the manuscript.
• It is recommended that the conclusion mention the usefulness of this type of analysis in the short, medium, and long term considering a sustainability approach.
I hope that these comments serve to improve your manuscript.
Author Response
Dear Reviewer,
Thank you for your valuable feedback. Please see attachment.
Regards
Authors
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
The revised paper can be accepted for publication.
Reviewer 3 Report
The authors addressed most comments. Enough to conclude my review
