title: Evaluating hazardous waste generation in for-profit outpatient haemodialysis centres.
abstract: BACKGROUND
  "Green" haemodialysis management to reduce the environmental impact of haemodialysis is growing.
  
  
  OBJECTIVE
  Dealing with hazardous waste production could heighten healthcare professionals' awareness of this problem, and improve their healthcare involvement in environmental sustainability and environmental-friendliness.
  
  
  METHODS
  A list of for-profit outpatient haemodialysis centres in the Valencian Community (E Spain) was compiled. Data on their hazardous waste production from 2008 to 2012 through the annual waste reports issued by official organisations competent in environmental issues were collected.
  
  
  RESULTS
  There are 22 for-profit dialysis centres, that managed the treatment for 69.1% of all dialysis patients in the region. Data were collected from 16 centres that collectively offer 350 dialysis places (33.8% of all the places in this region). Mean annual hazardous waste production per dialysis session increased by 14% during the study period: 0.640 kg per session in 2008 vs. 0.740 kg in 2012.
  
  
  CONCLUSIONS
  As hazardous waste production is high, we must examine the reasons why it is growing. Information about haemodialysis waste production and management is scarce and difficult to access. Having an evaluation of its production would motivate further research, especially as end-stage kidney disease is increasing, and whose main long-term treatment, haemodialysis, produces hazardous waste and employs substantial natural resources. Minimising its environmental impact is not mission impossible.
authors.affiliation: Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, Valencia, Spain.|Lluís Alcanyís Hospital, Conselleria de Sanitat, Generalitat Valenciana, Xàtiva, Valencia, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: García-Vicente
authors.affiliation: Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, Valencia, Spain.|CIBER-Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Centre for Public Health Research (CSISP), Valencia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Llopis-González
authors.affiliation: Lluís Alcanyís Hospital, Conselleria de Sanitat, Generalitat Valenciana, Xàtiva, Valencia, Spain.
authors.forename: C
authors.initials: C
authors.lastname: González-Steinbauer
authors.affiliation: Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, Valencia, Spain.|CIBER-Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Centre for Public Health Research (CSISP), Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Morales Suárez-Varela
mesh_terms: D003430:Cross-Sectional Studies; D006256:Hazardous Waste / Q000706:statistics & numerical data*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D017744:Medical Waste Disposal / Q000706:statistics & numerical data*; D010045:Outpatients; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D013030:Spain
chemical_list: D006256:Hazardous Waste; D017744:Medical Waste Disposal
keywords: Ecological and environmental processes; Haemodialysis units; Hazardous waste; Healthcare; Nephrology