Dr Ben Talbot1,2, Associate Professor Katherine Barraclough3,4, Dr Matthew Sypek3,4, Dr Pedro Gois5,6, Dr Leila Arnold7, Professor Stephen McDonald8, Professor John Knight1,2,9,10
1The George Institute For Global Health, Sydney, Australia, 2Ellen Medical Devices, Sydney, Australia, 3School of Medicine, University of Melbourne, Melbourne, Australia, 4Department of Nephrology, Royal Melbourne Hospital, Melbourne, Australia, 5Department of Nephrology, Fraser Coast Hospital and Health Service, Hervey Bay, Australia, 6University of Queensland, School of Medicine, Brisbane, Australia, 7Renal Service, Wellington Regional Hospital, Wellington, New Zealand, 8Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia, 9Faculty of Medicine, University of New South Wales, Sydney, Australia, 10University of Sydney School of Medicine, Sydney, Australia
Aim
To compare environmental sustainability practices between urban and regional dialysis units in Australia.
Background
Dialysis clinics are encouraged to minimise their environmental impact, but it is unknown if environmental practices differ between dialysis units within major cities and outside.
Methods
An online survey was used to identify environmental practices in dialysis units in Australia between January and December 2020. Accessibility/Remoteness Index of Australia codes were determined through data linkage with the ANZDATA registry and linked to responses.
Results
Survey responses were received from 125 dialysis units. The majority were public in-centre or satellite units (84/125, 67%) or home training (peritoneal dialysis or haemodialysis) units (33/125, 26%). 75/125 (60%) of units were located within a major city and 50/125 (40%) were outside a major city.
Formal teaching to raise awareness of environmental sustainability occurred more frequently in major city units (17/75, 23% vs 4/50, 8%; p=0.03) and suppliers of dialysis products collected pallets for recycling more often in major cities (58/75, 77% vs 28/50, 56%, p=0.01). Major city units were more easily accessed by public transport (52/75, 69% vs 21/50, 42%; p<0.01) and provided information about public transport to patients more frequently (41/75, 55% vs 15/50, 30%; p<0.01). The use of renewable energy sources was reported more frequently in dialysis units outside of major cities (11/50, 22% vs 5/75, 7%; p=0.01), but more frequently for patients dialysing at home in major cities (10/16, 63% vs 2/11, 18%; p=0.02).
Conclusions
Responses to this survey suggest more opportunities for environmental sustainability initiatives are available in major cities than regional areas. A better understanding of these differences could support targeted interventions to improve the environmental impact of dialysis.
Biography:
Ben Talbot is a British nephrologist who has trained in renal medicine in Australia and the UK. He is the clinical advisor for Ellen Medical Devices and the Affordable Dialysis Project and is completing a PhD at the George Institute for Global Health focused on improving the outcomes and economics of treating chronic kidney disease globally.