Project To Reduce Plastic Waste In Dialysis Units Proves Highly Successful
There has been growing interest in finding ways to
deliver health care in more sustainable ways, including reducing the amount of
plastic waste associated with dialysis. In line with this goal, two dialysis
units in BC sought to investigate how interventions (e.g., education, increasing
the number of recycling bins available) could impact recycling practices among
staff. The results show that these easy-to-implement interventions could divert
hundreds of bags of plastic waste from the landfill each year.
A single dialysis treatment produces an average of
2.5 kg of waste, some of which is recyclable plastic. With more than 1,400
in-centre hemodialysis patients in the province of BC alone, this results in
nearly 550 tonnes of waste annually. Encouragingly, the desire to address the
issue of plastic waste is strong among many staff in dialysis units, as
demonstrated by this recent study.
“There’s tremendous enthusiasm to do right for the
environment now, but people don’t know how to incorporate that into their daily
work in a hospital or dialysis setting,” explains Dr. Caroline Stigant, a
nephrologist at Royal Jubilee Hospital in Victoria, who was involved in the
A major challenge, she notes, is that plastic and
paper waste must be sorted properly – if just 10% of garbage or nonrecyclable
plastic waste makes it into the recycling bin, the contents are considered
“contaminated” by recycling collectors, and all of the contents in the bin go to
a landfill instead.
To foster better recycling practices, two groups -
one at Royal Jubilee Hospital and the other at St. Paul’s Hospital in Vancouver
- sought to implement and evaluate interventions within their dialysis units.
First, medical staff volunteers did a baseline
assessment of recycling practices, by visually assessing the amount of
recyclable material in a given bin (this is a common method of measuring waste,
to avoid handling of biohazard materials). As per the recycling guidelines, if
an estimated 0-9% of the bin was contaminated with garbage or plastic that was
not recyclable, the contents were deemed suitable for recycling. Next, project
volunteers implemented the interventions, which included increasing the number
of bins at some sites, ensuring the bins were placed in accessible areas, and
hanging educational posters above the bins with pictures of which plastic or
paper products were recyclable. At Royal Jubilee, direct discussions with staff
regarding good recycling practices also took place.
The post-intervention assessment of recycling
practices showed a dramatic improvement. At Royal Jubilee, recycling of plastic
increased from 44% to 74%; at St. Paul’s, the amount of plastic waste recycled
went from 83% to 100%.
Dr. Justin Xin Bo Cheng is a nephrology fellow at
St. Paul’s who helped analyze the data and co-lead the study. He reflects that
education and accessibility of bins were the biggest reported barriers from
staff, and adds that these issues could be easily addressed at most dialysis
centres. He also notes that many staff members approached him to discuss their
desires and innovative ideas to improve recycling at the workplace.
“There is so much enthusiasm for projects focused on
sustainability and I think what we demonstrated is that perceived barriers can
be overcome,” says Cheng, noting that this initiative required no extra funding
apart from a one time cost of bin purchase. “There’s no project that is too
large or small, and once you get some momentum going, more people will join in.”
While the results of the study are encouraging, Dr. Stigant points out that
recycling is only one aspect of achieving a more environmentally-friendly health
care system. Ultimately, she notes, interventions to prevent chronic kidney
disease, as well as optimizing transplantation in eligible patients, have the
to significantly reduce the need for plastic waste associated with dialysis.