SUN-058 Variations in Environmentally Sustainable Practice within Australian Dialysis Units: Time for a Nationwide Approach?

Abstract

Climate change has been identified as one of the key threats to global health and well-being in the 21st century and will require national and global efforts to combat greenhouse gas (GHG) emissions. Health care systems are responsible for a significant proportion of overall GHG emissions and dialysis programs contribute a disproportionate amount to this. While previous studies have documented environmental practice within dialysis units in the state of Victoria, Australia, no studies have compared practice between Australian states. The Victorian Environmental Sustainability Special Interest Group questionnaire was used to assess and compare environmental practice at 4 satellite dialysis units within Australia; 2 in Brisbane, Queensland and 2 in Sydney, New South Wales. The survey asked 107 questions on energy/water use, waste management, resource consumption and procurement, transport and environmental policies and initiatives. Nurse unit managers completed the survey at each site and were encouraged to discuss with colleagues to improve the accuracy of data recorded. The median number of haemodialysis (HD) sessions performed at each satellite unit was 168/week [157.5-270]. All units reported health service support for waste recycling practices, however this was graded as ‘moderate’ by 2 units and ‘could be better’ by 2 units. 3 units reported available recycling bins for hard and soft plastics but only 1 unit reported available polyvinyl chloride (PVC) recycling bins. Only Sydney based units reported that product suppliers removed pallets after supply delivery. Cardboard was not removed by suppliers at any site, but all 4 units recycled cardboard. No unit captured reverse osmosis (RO) reject water for reuse elsewhere. Procurement of supplies occurred at least weekly across all sites, with the frequency universally determined by storage space. Only 2 units considered environmental sustainability when choosing supplies. None of the units were aware of their power supplier, whether any of their energy was derived from renewable sources or of the green star rating of their building. Movement sensitive lights were only present in 2 units. Only 2 sites offered bicycle storage facilities and 1 site an area for showering and changing. 3 units were accessible by public transport but only 1 unit provided information to patients and staff about this. The level of awareness of sustainability in health was variable, reported as low in 2 units, moderate in 1 unit and very high in the other unit. Only 1 unit reported having an environmental policy in place and 1 other an active green group within the hospital. No units had undertaken a sustainability audit. One of the units also served as a home training facility for both HD and peritoneal dialysis (PD). This service offered both cardboard and PVC recycling to patients; however only 26-50% of patients utilised this service. No patients reclaimed RO reject water, despite potential assistance in establishing a water capture system. There is no universal approach to environmental sustainability within Australian dialysis units, with inter-state and inter-unit variation in practice. This study highlights the need for nationwide data collection regarding environmentally sustainable practice as an important first step in addressing the environmental impact of dialysis.