AB048. Environmental footprint of dialysis in Thailand: a life cycle assessment to inform green health policy
Abstract

AB048. Environmental footprint of dialysis in Thailand: a life cycle assessment to inform green health policy

Wilasinee Samniang1,2, Thanakorn Jalearnkittiwut1, Yin May Tun1, Sarin K C1

1Environmental Economics Unit, Health Intervention and Technology Assessment Program Foundation, Ministry of Public Health, Nonthaburi, Thailand; 2School of Civil Engineering and Technology, Sirindhorn International Institute of Technology (SIIT), Thammasat University, Pathum Thani, Thailand

Background: Dialysis is a life-sustaining treatment for end-stage renal disease. In Thailand, peritoneal dialysis (PD) is prioritized under universal health coverage (UHC) due to its accessibility and cost-effectiveness. However, the environmental impacts of PD and hemodialysis (HD) have not been comprehensively evaluated in the Thai context. This study aimed to assess and compare the environmental burdens of both modalities using a life cycle assessment (LCA), contributing evidence for climate-resilient and sustainable health systems.

Methods: An LCA was conducted using SimaPro software version 10.2.0.0 to estimate environmental impacts across four stages: manufacturing, supply chain, service delivery, and waste management. The ReCiPe 2016 midpoint and endpoint methods were applied to quantify effects on disability-adjusted life years (DALYs), species loss, and natural resource depletion. Emission data were collected from PD and HD manufacturers (Baxter and Fresenius), Thailand Post (logistics), five dialysis centers (energy and travel), and the national medical waste agency. Carbon emissions per treatment session were calculated, and key emission hotspots identified.

Results: Preliminary analysis identified significant environmental hotspots in both dialysis modalities. Per-session carbon footprint estimates showed PD produces lower emissions than HD, mainly due to reduced energy use and simpler logistics. These findings will inform a forthcoming green health technology assessment (HTA) that integrates environmental criteria into cost-effectiveness evaluations.

Conclusions: PD was found to have a lower environmental footprint per session than HD. These results emphasize the importance of incorporating environmental performance into clinical and policy decisions under UHC. The study contributes to the global movement toward sustainable healthcare by providing evidence to support greener procurement, treatment choices, and health policy planning in low- and middle-income countries.

Keywords: Dialysis; environmental impact; green Health Technology Assessment (green HTA); life cycle assessment (LCA); planetary health

Footnote

Conflicts of Interest: The manufacturers referenced in this study (Baxter and Fresenius), logistics providers, dialysis centers, and the national medical waste agency contributed data for life cycle inventory purposes only and had no role in the study design, data analysis, interpretation of results, or the decision to submit this abstract for publication. The authors have no other conflicts of interest to declare.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/jphe-26-ab048
Cite this abstract as: Samniang W, Jalearnkittiwut T, Tun YM, Sarin K C . AB048. Environmental footprint of dialysis in Thailand: a life cycle assessment to inform green health policy. J Public Health Emerg 2026;10:AB048.

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