A Survey of Environmental Sustainability Practices in Dialysis Facilities in Australia and New Zealand.
Australia
New Zealand
climate change
dialysis
environmental sustainability
Journal
Clinical journal of the American Society of Nephrology : CJASN
ISSN: 1555-905X
Titre abrégé: Clin J Am Soc Nephrol
Pays: United States
ID NLM: 101271570
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
08
07
2022
accepted:
19
10
2022
pubmed:
12
11
2022
medline:
7
1
2023
entrez:
11
11
2022
Statut:
ppublish
Résumé
Climate change is the biggest global health threat of the twenty-first century. Health care itself is a significant contributor to greenhouse gas emissions, and dialysis programs contribute disproportionately. Nephrology societies have called for increased recognition and action to minimize the environmental effect of dialysis care, but little data exist regarding environmental sustainability practices within dialysis facilities worldwide. This survey reports a baseline of environmental sustainability practices of dialysis facilities in Australia and New Zealand. An online survey was used to collect data regarding key areas of environmental sustainability practices within dialysis facilities between November 2019 and December 2020. An invitation to complete the survey was sent to the heads of all dialysis facilities in Australia and New Zealand. Responses were received from 132 dialysis facilities, representing 33% (122 of 365) of dialysis services within Australia and New Zealand. Most responses were from public satellite facilities (53 of 132; 40%), in-center dialysis facilities (33 of 132; 25%), and co-located dialysis and home therapies facilities (28 of 132; 21%). Opportunities for improvement in environmental sustainability practices were identified in three domains. ( Environmental sustainability is not currently prioritized in clinical practice, building design and infrastructure, or management systems in Australian and New Zealand dialysis facilities responding to this survey.
Sections du résumé
BACKGROUND AND OBJECTIVES
Climate change is the biggest global health threat of the twenty-first century. Health care itself is a significant contributor to greenhouse gas emissions, and dialysis programs contribute disproportionately. Nephrology societies have called for increased recognition and action to minimize the environmental effect of dialysis care, but little data exist regarding environmental sustainability practices within dialysis facilities worldwide. This survey reports a baseline of environmental sustainability practices of dialysis facilities in Australia and New Zealand.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
An online survey was used to collect data regarding key areas of environmental sustainability practices within dialysis facilities between November 2019 and December 2020. An invitation to complete the survey was sent to the heads of all dialysis facilities in Australia and New Zealand.
RESULTS
Responses were received from 132 dialysis facilities, representing 33% (122 of 365) of dialysis services within Australia and New Zealand. Most responses were from public satellite facilities (53 of 132; 40%), in-center dialysis facilities (33 of 132; 25%), and co-located dialysis and home therapies facilities (28 of 132; 21%). Opportunities for improvement in environmental sustainability practices were identified in three domains. (
CONCLUSIONS
Environmental sustainability is not currently prioritized in clinical practice, building design and infrastructure, or management systems in Australian and New Zealand dialysis facilities responding to this survey.
Identifiants
pubmed: 36368770
pii: 01277230-202212000-00012
doi: 10.2215/CJN.08090722
pmc: PMC9718014
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1792-1799Informations de copyright
Copyright © 2022 by the American Society of Nephrology.
Références
Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R, Friel S, Groce N, Johnson A, Kett M, Lee M, Levy C, Maslin M, McCoy D, McGuire B, Montgomery H, Napier D, Pagel C, Patel J, de Oliveira JA, Redclift N, Rees H, Rogger D, Scott J, Stephenson J, Twigg J, Wolff J, Patterson C: Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission. Lancet 373: 1693–1733, 2009
Watts N, Adger WN, Agnolucci P, Blackstock J, Byass P, Cai W, Chaytor S, Colbourn T, Collins M, Cooper A, Cox PM, Depledge J, Drummond P, Ekins P, Galaz V, Grace D, Graham H, Grubb M, Haines A, Hamilton I, Hunter A, Jiang X, Li M, Kelman I, Liang L, Lott M, Lowe R, Luo Y, Mace G, Maslin M, Nilsson M, Oreszczyn T, Pye S, Quinn T, Svensdotter M, Venevsky S, Warner K, Xu B, Yang J, Yin Y, Yu C, Zhang Q, Gong P, Montgomery H, Costello A: Health and climate change: Policy responses to protect public health. Lancet 386: 1861–1914, 2015
Malik A, Lenzen M, McAlister S, McGain F: The carbon footprint of Australian health care. Lancet Planet Health 2: e27–e35, 2018
Eckelman MJ, Sherman J: Environmental impacts of the U.S. health care system and effects on public health. PLoS One 11: e0157014, 2016
Agar JWM: Green dialysis: The environmental challenges ahead. Semin Dial 28: 186–192, 2015
Intergovernmental Panel on Climate Change: Intergovernmental Panel on Climate Change 2022: Impacts, Adaptation, and Vulnerability. Contribution of Working Group II to the Sixth Assessment Report. Fact Sheet–Australasia, 2022. Available at: https://www.ipcc.ch/report/ar6/wg2/downloads/outreach/IPCC_AR6_WGII_FactSheet_Australasia.pdf . Accessed April 20, 2022
United Nations Environment Programme: United Nations Environment Programme – State of the Climate, 2021. Available at: https://www.unep.org/explore-topics/climate-action/what-we-do/climate-action-note/state-of-climate.html . Accessed April 20, 2022
Beehive.govt.nz, The Official Website of the New Zealand Government: Healthcare sector committed to reducing carbon footprint, 2018. Available at: https://www.beehive.govt.nz/release/healthcare-sector-committed-reducing-carbon-footprint . Accessed September 12, 2022
Healthy Climate Future: Royal Australasian College of Physicians Healthy Climate Future. Available at: https://www.racp.edu.au/advocacy/commit-to-healthcare/healthy-climate-future#colleges . Accessed May 31, 2022
Australian Medical Association: Joint statement - Medical Professionals call for emissions reduction in health care, 2021. Available at: https://www.ama.com.au/media/joint-statement-medical-professionals-call-emissions-reduction-health-care#:~:text=The%20Australian%20Medical%20Association%20 . Accessed May 31, 2022
NHS England News: NHS becomes the world’s first national health system to commit to become ‘carbon net zero’, backed by clear deliverables and milestones, 2020. Available at: https://www.england.nhs.uk/2020/10/nhs-becomes-the-worlds-national-health-system-to-commit-to-become-carbon-net-zero-backed-by-clear-deliverables-and-milestones/ . Accessed May 31, 2022
Lim AE, Perkins A, Agar JW: The carbon footprint of an Australian satellite haemodialysis unit. Aust Health Rev 37: 369–374, 2013
Barraclough KA, Agar JWM: Green nephrology. Nat Rev Nephrol 16: 257–268, 2020
ANZDATA Registry: 44th Report. Chapter 2: Prevalence of Kidney Failure with Replacement Therapy. Adelaide, SA, Australia, Australia and New Zealand Dialysis and Transplant Registry, 2021
Barraclough KA, Gleeson A, Holt SG, Agar JW: Green dialysis survey: Establishing a baseline for environmental sustainability across dialysis facilities in Victoria, Australia. Nephrology (Carlton) 24: 88–93, 2019
Blankestijn PJ, Arici M, Bruchfeld A, Capasso G, Fliser D, Fouque D, Goumenos D, Ketteler M, Malyszko J, Massy Z, Rychlík I, Spasovski G, Zoccali C: ERA-EDTA invests in transformation to greener health care. Nephrol Dial Transplant 33: 901–903, 2018
American Society of Nephrology: American Society of Nephrology Statement on Climate Change, 2022. Available at: https://www.asn-online.org/policy/webdocs/22.4.22StatementOnClimateChange.pdf . Accessed May 31, 2022
Connor A, Mortimer F: The green nephrology survey of sustainability in renal units in England, Scotland and Wales. J Ren Care 36: 153–160, 2010
Mendu ML, Divino-Filho JC, Vanholder R, Mitra S, Davies SJ, Jha V, Damron KC, Gallego D, Seger M; International Home Dialysis Roundtable Steering Committee: Expanding utilization of home dialysis: An action agenda from the First International Home Dialysis Roundtable. Kidney Med 3: 635–643, 2021
Connor A, Lillywhite R, Cooke MW: The carbon footprints of home and in-center maintenance hemodialysis in the United Kingdom. Hemodial Int 15: 39–51, 2011
Agar JW, Simmonds RE, Knight R, Somerville CAJHI: Using water wisely: New, affordable, and essential water conservation practices for facility and home hemodialysis. Hemodial Int 13: 32–37, 2009
Liyanage T, Ninomiya T, Jha V, Neal B, Patrice HM, Okpechi I, Zhao MH, Lv J, Garg AX, Knight J, Rodgers A, Gallagher M, Kotwal S, Cass A, Perkovic V: Worldwide access to treatment for end-stage kidney disease: A systematic review. Lancet 385: 1975–1982, 2015
Knight J, Perkovic V: The Affordable Dialysis Prize steams ahead. Lancet 387: 1040, 2016
Agar JW: Review: Understanding sorbent dialysis systems. Nephrology (Carlton) 15: 406–411, 2010
DaVita Kidney Care: Dialyzer Reuse for Dialysis. Available at: https://www.davita.com/treatment-services/dialysis/dialyzer-reuse-for-dialysis . Accessed September 12, 2022