Reducing the carbon footprint for a 30-bed haemodialysis unit by changing the delivery of acid concentrate supplied by individual 5 L containers to a central delivery system

Abstract

Abstract Background Haemodialysis treatments generate greenhouse gas (GHG) emissions mainly as a result of the equipment, consumables and pharmaceuticals required. An internal audit demonstrated a 33% wastage of acid concentrate when using individual 5.0 L containers at a 1:44 dilution ratio. We therefore investigated whether changing the delivery system for acid concentrate would reduce wastage and any associated greenhouse gas emissions. Methods We calculated the difference for a 30-bed dialysis unit between receiving acid concentrate in single-use 5.0 L plastic containers versus bulk delivery for a central acid delivery system connected to the dialysis machines. Estimates of carbon dioxide equivalent (CO 2 e) emissions were made using the United Kingdom government database and other sources. Results A 30-station dialysis unit functioning at maximum capacity (3 shifts and 6 days/week), switching to bulk delivery and central acid delivery could realise an approximate total reduction of 33,841 kgCO 2 e/year; in reduced product wastage, saving 6192 kgCO 2 e, 5205 kgCO 2 e from fewer deliveries, and 22,444 kgCO 2 e saving from a reduction in packaging and waste generated, which equates approximately to a one tonne reduction in CO 2 e emissions per dialysis station/year. Conclusions Switching from delivering acid concentrate in individual 5.0 L containers to a central acid delivery system can result in substantial reductions in CO 2 e emissions within a dialysis clinic. The emission savings from reducing the single-use plastic packaging greatly outweigh any gains from eliminating wastage of acid concentrate. Dialysis companies and clinicians should consider reviewing the design of current and future dialysis facilities and policies to determine whether reductions in CO 2 e emissions can be made. Graphical Abstract

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