#5120 CARBON FOOTPRINT OF IN-CENTER HEMODIALYSIS: RESULTS OF A FRENCH PILOT STUDY

Abstract

Abstract Background and Aims Since the beginning of the industrial era, human activities have led to a significant increase in the concentration of greenhouse gases (GHGs) in the atmosphere and are the cause of climate change, the negative effects of which on human health are already visible (1). Paradoxically, the health sector also exerts a major pressure on the environment through carbon-based care activities that emit GHGs (2). In this context, a few studies have highlighted the significant carbon footprint associated with hemodialysis (3). However, to date, no similar study has been conducted in France. Method The objective of this work was to evaluate the carbon footprint of a hemodialysis unit in France using the Bilan Carbone ® approach developed by The French Agency for Ecological Transition and the Bilan Carbone Association. Activity data associated with hemodialysis provision at the Charles De Gaulle facility in 2021 was collected and converted to a common measurement unit of tonnes of CO2 equivalents (t CO2-eq) via established emissions factors. This facility, that belongs to the ARTIC 42 association, is located in the town of Saint-Priest en Jarez and provides hemodialysis through a total of 56 hemodialysis generators. Results Over the year 2021, the Charles de Gaulle facility provided a total of 25270 hemodialysis treatments ensuring the care of approximately 162 patients (at a rate of 3 sessions per week). The associated annual carbon footprint for the facility was 1436 t CO2-eq. Annual carbon footprint amounted to 8.9 t CO2-eq/patient/year corresponding to 57 kg CO2-eq /treatment. Emissions were essentially indirect, with more than 90% coming from scope 3. The main sources of emissions were: products and services purchase (30% of total emissions, that is 437 t CO2-eq), patients and staff travels (25% of total emissions, that is 361 t CO2-eq), and fixed assets (21% of total emissions, that is 299 t CO2-eq). Energy consumption (particularly electricity) and waste treatment accounted for a small proportion of GHG emissions (respectively 8% et 6%). Conclusion Our results confirm the high carbon footprint associated with in-center hemodialysis, showing that it is mainly attributable to indirect emissions. These empirical data will serve as a basis for reflection in the development of a strategy to reduce GHG emissions associated with hemodialysis. This work will hopefully be paving the way for the necessary ecological transition of medical practices, focused on the patient and the ecosystems on which he/she depends.