We have just been given the green light to re-cycle all of our concentrate bottles. I'm still in the process of calculating exactly what that will mean in terms of reducing our carbon footprint but as we go through roughly 300 concentrate bottles a week on our unit and each empty bottle weighs 300g thats around 4,700 kg of plastic a year extra we are now re-cycling.
A step in the right direction I hope!
Sounds great Ben.. I'm in the process of doing the same (albeit on a much smaller scale) with our concentrate bottles here at the paediatric unit in Bristol. We only use 10-12 per week which seems hardly worth it compared to your 300, but I suppose every little helps! I've also requested more dry mixed recycling bins for our ward so I can have them in the coffee room and parents rest room as well as the ward area.
Hi Frances, Gerry, Ben and everyone,
is contamination of the cartridges really a common problem? I'm a little surprised. When does it occur - is it when a patient is coming off the machine? If we can find out a little more, we can be more specific with the manufacturers. Anyone else recognise this as a problem?
Also, is it a problem that extends to anything else people are trying to recycle? What do others think?
Andy
hello everybody!
I am a dialysis nurse working in a public hospital in Italy, Hemodialysis service. We are trying to take care of the waste (to save money of course...) and i am looking for written authorizations in order to allow and support the empting of acetate bags and bicarbonate leftovers after dialysis in a regular sink. I know that this is a usual habit - I have contacted several Hemodialysis Centers in Italy - but there ar no protocols or guidelines about it. I have also contacted my ASL ecomanagement office, but they are not able to help in solving our technical problems because they require peculiar and specific equipments, only used for Hemodialysis. Most of all they won't sign and therefore authorize a protocol without some clear and approved rule on it. They just say: "Do that on your own, that's right, but don't ask me to sign it and have it approved officially i can't.."- Some nurses think that the smell and the smokes from the bags could be dangerous for health and they could destroy water pipes too, even if the bags are classified as not-dangerous medical devices. I'm asking some documents about the above situation.. I thak you in advance
Hello
>
> Haemo dialysis concentrate is not classed as hazardous. We use B Braun acid
> concentrate, & it states this on the safety data sheet, so there is no risk
> to you emptying any concentrate remains down the sink.
>
> The same is true of bicarbonate as per the safety data sheet, if your
> dialysis machine does not empty the cart & you need to dispose of it,
> choose a different sink from one you empty concentrate down, so you do not
> a create a chalky blockage
>
>
> Regards
> Jo Bennett
> Dialysis Unit Manager
> 01473 704727
> B Braun
thanks for your answer...have you got something written or officialy approved about it? we use these concentrates:
- Gambro softpack
- Baxter diasol
-AFB safebag
-Fresenius bag
None of these report on their sheets that it's allowed to empty the bag in a regular sink...and I understand why: in case of damages to materials/humans they won't be accused of anything. But it's true that these are not dangerous substances, and putting them in the waste without empting them it's surely uncorrect and very expensive! thanks again...sorry for my not-perfect english!
Hello Silviacorti
we accept that as the concentrates as per the MSDS sheets are not classed as hzardous, we therefore see no reason why unused concentrate cannot be disposed of down the sink. We have been doing this ourselves for many years, with no problems, & our home HD pts do the same
Jo Bennett
In Italy there is a law that say something like this:
- if you let the concentrates flow THROUGH the dialysis machine, that's a wastewater (but you have not time to let it flow until it finishes, and the machine doesn't have a specific function...) and it could go to the sewer.
- if you REMOVE the bag from the machine, that becomes a waste, and it has to be desposed of like all the wastes, and you can't cut the bag and let the leftovers flow into the sink
that's the reason because no one of the dialysis centres have a written and autorized procedure about the concentrates waste...because they are IMPROPER waste, and it's not clear how to dispose of them at the end of their use. You can't finish them through the machine, but you can't empty them into the sink, and if you do it, no one will say that's correct, and no one will write it in a guideline/protocol!!!
Are there some more clever laws in your countries???
thanks to all...
Dear Silvia,
our Department for Health produces guidance on Safe management of healthcare wastes which you can access here:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicat…
Paragraph 8307 (p174 in Version 1) on glass / plastic medicinal containers says:
"Waste medicines should not be discharged to foul sewer, so contaminated containers or their contents should not be rinsed out. Contaminated bottles, vials and ampoules should be disposed of as waste medicines.
"Non-pharmaceutically-active medicines are the exception. Liquids (including sugar and salt solutions), sterile water, and nutritional supplements can be disposed of to foul sewer; if there is any doubt, advice from the sewerage undertaker should be sought. The containers can be rinsed and recycled."
As far as I understand, dialysis concentrate - as a salt solution - can therefore be disposed of down the sink and the containers rinsed and recycled. Does that help?
Best wishes, Frances
Thanks again...my collegues are still not convinced about the not-dangerousity of the substances in the concentrates, because they smell bad ( because of the acetate presence...) and it seems that their eyes and throat burn while ampting the bags...it's frustrating for me, because I can't find evidences about our ideas!!!
Hallo everybody, and hallo to Rachel too! I am still looking for help about concentrates waste in hemodialysis, I still haven't found anything usefull!
Another interesting aspect I discovered is that companies that produce the dialisys equipments don't report the way they have to be disposed of at the end of their use (especially about concentrates, again!). I think that's not casual...They deliberately omit to explain it! Have you got something that can disprove/refute my theory???
PLEASE HELP ME!
The Bradford Unit is considering disposal of bicarbonate cartridges (Gambro) and BiBags bases on the previous posts in this forum. We would like to be sure that we are following best practice and wondered if anyone can direct us to any official recommendations covering:
- Infection control issues
- Can both types of cartridge be recycled?
- Do they need to be handled in a special way?
Thanks in advance,
Dr John Stoves, Green Nephrology Local Representative, Bradford
The discussion in this thread was summarised in June 2012 in this blog article:
http://sustainablehealthcare.org.uk/green-nephrology/blog/2012/06/recyc…
Cheers for replying
We have got rid of most of our landfil black bins and mostly just use our blue recycling bins now in the dialysis unit so we have gone from re-cycling nothing to re-cycling as much as possible. All the packaging from the lines and now the concentrate bottles are re-cycled.
Hopefully in the next few weeks I'll try and do one of those inventories and help reduce the amount of stuff we are actually using. This green link role is actually quite interesting and for the most part the other staff seem to be in support of it (with the odd grumble about the extra 10 seconds it now takes to rinse he concentrate bottles rather than just chuck them in the bin!)
Good luck with your bottles and extra bins!
Ben
Hi, sounds like great progress is being made, congratulations. One concern I have is that these bottles are used in a clinical area and that some attention must be made to any waste that might be contaminated with body fluids or blood splashes. Some dialysis machines are designed such that there is a greater risk of this happening to the dialysate and bicarb containers. Maybe we should lobby the machine manufacturers to protect these from such splashes in their future design. Regards, Gerard Boyle (Renal Technologist, St Georges)
Hi Gerry, that's an important point. I was not aware of the differences between different machines in reducing risk of contamination. What are the design features that can help? Maybe we can take this to the suppliers via our sustainable procurement working group.