Medical waste production and disposal arising from renal replacement therapy

The treatment of end stage renal disease (ESRD) makes extensive use of pre-sterilised disposable items that are contaminated by blood or other body fluids following use. Commonly these items are incinerated. Because they contain substantial amounts of polyvinylchloride (PVC), their incineration releases polychlorinated dibenzo p dioxins (PCDD) and polychlorinated di benzo p furans (PCF), as well as heavy metals. A consequence of the release of these substances has been the introduction of legislation controlling waste disposal. These issues are likely to impact on the management of waste at the healthcare facility level. In parallel, new PVC-free materials for use in renal replacement therapies have been developed whose incineration is less controversial environmentally.