title: The carbon footprint of an Australian satellite haemodialysis unit.
abstract: OBJECTIVE
  This study aimed to better understand the carbon emission impact of haemodialysis (HD) throughout Australia by determining its carbon footprint, the relative contributions of various sectors to this footprint, and how contributions from electricity and water consumption are affected by local factors.
  
  
  METHODS
  Activity data associated with HD provision at a 6-chair suburban satellite HD unit in Victoria in 2011 was collected and converted to a common measurement unit of tonnes of CO2 equivalents (t CO2-eq) via established emissions factors. For electricity and water consumption, emissions factors for other Australian locations were applied to assess the impact of local factors on these footprint contributors.
  
  
  RESULTS
  In Victoria, the annual per-patient carbon footprint of satellite HD was calculated to be 10.2t CO2-eq. The largest contributors were pharmaceuticals (35.7%) and medical equipment (23.4%). Throughout Australia, the emissions percentage attributable to electricity consumption ranged from 5.2% to 18.6%, while the emissions percentage attributable to water use ranged from 4.0% to 11.6%.
  
  
  CONCLUSIONS
  State-by-state contributions of energy and water use to the carbon footprint of satellite HD appear to vary significantly. Performing emissions planning and target setting at the state level may be more appropriate in the Australian context. What is known about the topic? Healthcare provision carries a significant environmental footprint. In particular, conventional HD uses substantial amounts of electricity and water. In the UK, provision of HD and peritoneal dialysis was found to have an annual per-patient carbon footprint of 7.1t CO2-eq. What does this paper add? This is the first carbon-footprinting study of HD in Australia. In Victoria, the annual per-patient carbon footprint of satellite conventional HD is 10.2t CO2-eq. Notably, the contributions of electricity and water consumption to the carbon footprint varies significantly throughout Australia when local factors are taken into account. What are the implications for practitioners? We recommend that healthcare providers consider local factors when planning emissions reduction strategies, and target setting should be performed at the state, as opposed to national, level. There is a need for more comprehensive and current emissions data to enable healthcare providers to do so.
authors.affiliation: Department of Renal Medicine, Geelong Hospital, Barwon Health, Geelong, Australia.
authors.forename: Allan E K
authors.initials: AE
authors.lastname: Lim
authors.forename: Anthony
authors.initials: A
authors.lastname: Perkins
authors.forename: John W M
authors.initials: JW
authors.lastname: Agar
mesh_terms: D001315:Australia; D058572:Carbon Footprint / Q000706:statistics & numerical data*; D003151:Community Health Centers / Q000706:statistics & numerical data*; D003247:Conservation of Natural Resources / Q000379:methods / Q000706:statistics & numerical data; D004736:Energy-Generating Resources / Q000706:statistics & numerical data*; D004864:Equipment and Supplies / Q000706:statistics & numerical data; D006801:Humans; D017744:Medical Waste Disposal / Q000706:statistics & numerical data; D004364:Pharmaceutical Preparations; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D014186:Transportation / Q000379:methods / Q000706:statistics & numerical data; D014739:Victoria; D014881:Water Supply / Q000706:statistics & numerical data
chemical_list: D017744:Medical Waste Disposal; D004364:Pharmaceutical Preparations