GREEN DIALYSIS: SUSTAINABLE DEVELOPMENT VIA SAFETY, HEALTH AND ENVIRONMENTAL(SHE) GOVERNANCE IIN HAEMODIALYSIS CENTRE- A PROCESS CONTROL STUDY

Introduction:

Environmental sustainability conserving water,electricity &recycling of waste have become challenge.In India estimated prevalence of CKD is 17.2%.Yearly about 2.2lakh new patients with ESRD added needing  3.4 crore dialysis.Increasing trend poses Safety,Health& Environmental hazards which need to be addressed

Methods:

Aim:Develop threshold limits per HD for natural resource conservation & evolve  control  mechanism using statistical process for waste generated during Dialysis

Objective

Study the Pattern,Predict,Prevent & Prescribe wastages of 4 colour codes& conservation of Water & Electricity   

Have sustainable development strategy

Reduce environmental impact

Startup HD centre was taken up for studying for 366 days,where 2500 dialysis took place .Min,max & Avg dialysis  sessions were 2,13&6.83 per day respectively.Waste generated at end of dialysis day were segregated & collected  in  respective  bags,weighed on daily basis.Water(RO&reject) &electricity consumption were observed using respective calibrated meters.Statistical process control analysis using cumulative average,process capability,finding pattern,Determining threshold limits, non-conformance above upper limits of each category of waste&water&energy consumption were carried out

Results:

Avg(n2500 dialysis,366 days)waste in KG per dialysis segregated  in Blue, Red,Yellow,Green were 14.5±5.14(CI 14.0-15.1),0.26±0.12(CI 0.25-0.27),22.1±6.95(CI 21.4-22.9),0.2±0.09(CI 0.20-0.21)respectively.Total waste per dialysis was 37.1±4.3.Annually  HD Centre   respectively handled 33.5,589.4,516.3,457.4 Tons in Blue,Red,Yellow &Green, totally 1898 Tons.We have 6 HD machines. Establishing sustainability development via SHE governance from the start is the model. Avg consumption of RO water including reject per dialysis was 146.5± 40.49 litres(CI  142.3-150.6) & electricity consumption per day was  9.1±4.72 KWh/day(CI 8.6-9.6) (Table 1)

Blue & yellow waste generation was 20-30 KG for first 100 dialysis, stabilised at 15 KG per dialysis.Red  waste generation was 0.4-0.6 KG for first 100 dialysis ,stabilised to 0.3 KG per dialysis.Green waste generation was 0.3-0.4 KG for first 100 dialysis stabilised to 0.2 KG per dialysis at 1500 sessions.Learning curve of startup dialysis centre took 500 dialysis to establish control of blue waste at 15 KG,1000 dialysis for red waste at 0.3KG, 500 dialysis for yellow waste,took 1500 dialysis for green waste (Figure 1-6)

Upper threshold limits were fixed statistically depending upon the variations. It was found 5 % above24 KG in Blue  with 3-Parameter lognormal,3.8% was above 0.5 KG in Red with 3-parameter Weibull,4% was above 36 KG in Yellow with lognormal ,5.6% was above 0.38KG in green with 3-parameter Gamma. For RO water with reject water, it was found 4.59% above 226 litres with loglogistic.For electricity it was 3.8% above 8.1Kwh with 3 parameter lognormal (Figure7-12)

Conclusions:

Safety,Health &Environmental impact in dialysis centre directly contribute to environmental sustainability .Efficient use of natural resources with target&  measurable objectives conserves water usage & energy management. Broader & more holistic approach of sustainable development as benchmark for startup HD centers ensuring long term balanced growth& development particularly in populated countries like India

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.