Autopsy of a Hemodialysis Machine

Key Points Hemodialysis machines contribute to waste production at the end of their life cycle and have a low recycling potential. We studied the composition of the components of hemodialysis machines in terms of plastics, metal, and mixed materials. There is a need to rethink the design of hemodialysis machines in a cradle-to-cradle perspective. Background Hemodialysis contributes significantly to health care's carbon footprint. Worldwide, approximately 100,000 dialysis machines end their life cycle each year. Our aim was to analyze the composition and potential for recyclability of two dialysis machines, from the two companies with the largest market share, which had met their end-of-use terms (10–12 years of use according to French regulations). Methods One 5008 CorDiax (Fresenius Medical Care AG) and one Artis/Evosys (Gambro AB) were dismantled, and each piece was analyzed in terms of weight and principal components (plastic, metal, mixed materials, and electronic components). The time needed to disassemble the machine was recorded. Samples of 15 plastic elements were further studied using Fourier-transform infrared spectroscopy. The results were compared with the data provided by the manufacturers. Results The dismantled hemodialysis machines weighed 125.0 kg and 141.4 kg; plastic, metal, mixed materials, and electronic components accounted for 28%, 15%, 51%, and 6% of the first machine's weight and 28%, 19%, 40%, and 13% of the second's, respectively. The time needed to manually disassemble a dialysis machine into macro elements was around 12 hours. Dismantling into single materials was evaluated as needing at least 1 workweek (35 hours). The plastic elements were mostly a mixture of resins (petroleum-based material used to manufacture plastics), which makes their recycling potential negligible. Conclusions This study demonstrates that hemodialysis machines contribute to waste production at the end of their life cycle, with low recycling potential, and underlines the need to rethink their design in a cradle-to-cradle perspective.