A recent paper in the Canadian Journal of Kidney Health and Disease describes the results of a comprehensive survey of kidney care providers from five provinces across Canada and outlines key ways in which kidney care could be more environmentally-friendly. Of note, the survey found the vast majority of respondents are in support of making kidney care more environmentally sustainable, but more than half were not aware of most environmental strategies in their programs.
Kidney care, and especially dialysis, is critical for tens of thousands of Canadians across the country, but can take a heavy toll on the environment, for example by producing high carbon emissions and plastic waste.
The survey was completed by more than 385 health care providers in 2023 and was conducted by the Canadian Society of Nephrology’s Sustainable Nephrology Action Planning (SNAP) committee.
“We wanted to know the baseline state of sustainability practice within kidney care in Canada,” explains Dr. Caroline Stigant, a BC-based nephrologist and chair of SNAP. She notes it was also an opportunity to prompt health-care workers to reflect more on sustainability opportunities within their workplace.
The results show that survey respondents were most often familiar with sustainability strategies such as deprescribing unnecessary medications, using medical and office supplies only when needed, virtual care options, and general waste management practices. For example, more than 90% of respondents reported “sometimes” or “always” selecting medical products nearing expiration, reviewing medications to explore which ones may not be necessary, and prioritizing oral medications over intravenous ones when appropriate.
Stigant notes this awareness around sustainable medication use is particularly impactful, since about 25% of carbon emissions from health care are related to pharmaceutical products.
However, the survey results also revealed an overall lack of knowledge regarding sustainability practices, with 57% of respondents reporting they did not know if environmentally sustainable policies were in place in their kidney program.
There was also a lack of knowledge on many sustainability practices related to energy and resource consumption, such as energy sourcing, management of reverse osmosis reject water, procurement and product sourcing.
As well, while three quarters of respondents reported being aware of transportation strategies to reduce their carbon footprint, almost none were aware of workplace policies to promote wider adoption of these strategies.
Stigant emphasizes these findings only reflect what policies and practices the survey respondents were aware of, and not the true scope of sustainability efforts in place across Canada.
“A big takeaway was that things that are done at the management level and the administrative level were not widely known or enacted by staff,” she says, noting more communication from management could be beneficial.
Importantly, awareness of sustainability practices varied by region and was highest in BC, Alberta and Saskatchewan, and lowest in Quebec. Also notable is that 80% of respondents were women, many of whom were affiliated with academic institutions. Stigant emphasizes that, although women and academics were more likely to engage in the survey, it’s everyone’s job to address sustainability in their work.
She notes these findings highlight opportunities at every level of kidney care to make it more sustainable. “There are so many things you can do with a flick of a switch or a signature of a pen that can make an immediate difference.”
Stigant adds the SNAP committee members are taking these findings back to their respective health regions and will continue to use the data to support sustainability implementation at all levels of kidney care.
