Project Round
Project Number
62R - 2056
Research Organisation
North West Health

Identifying Options for Haemodialysis Reject Water

The Challenge

Haemodialysis services routinely send large amounts of reject reverse osmosis (RO) water to waste as part of normal operations. Victoria’s North West Dialysis Service provides treatment services to 550 patients and has calculated that each year it disposes of 12.8 megaliters of reject RO water.  This project was run to produce a handbook for healthcare facilities (HCF) providing a simple framework for identification and assessment of options for the reuse of reject RO water produced as a by product of dialysis services.

The Project

This project was undertaken by the North West Dialysis Service to produce the handbook titled “Reuse of Haemodialysis Reverse Osmosis Reject Water in Healthcare Facilities” as guidance to Victorian healthcare facilities.

The handbook contains a simple framework for identification and assessment of options for the reuse of reverse osmosis (RO) water rejected as a by-product in the provision of dialysis services.

The handbook examines:

  • opportunities for reuse;
  • safety issues;
  • quality requirements; and
  • legislative requirements.

It is relevant for dialysis service delivery models in Victoria, from large metropolitan hospitals to smaller regional facilities and is based on Victorian guidelines, regulations and survey data.

The manual details the successes of current practices, the scope of reuse applications already extant and some of the pitfalls in pursuing reuse of reject RO water. Lessons learned from surveys of 20 Victorian healthcare services provide valuable insight for assessment of risks, costs and benefits of potential projects.

The risk management framework used to assess compliance, hazard reduction and control measures is compliant with Australian Guidelines (Standards Australia 2004; NRMMC & EPHC 2006; DH 2009).

The Outcome

While there is a strong community motivation to save water, conservation and reuse measures should be well considered and prioritised for maximum benefit from the resources deployed. Efforts to reuse dialysis RO reject water should be evaluated in the context of overall water conservation efforts within the service facility.

Any initiative to undertake a project to reuse RO reject water is at the discretion of the health care facility (HCF) management. All HCFs are advised to commission advance investigations and planning in consultation with the relevant standards and authorities. This reference manual provides a logical basis and guidance for this process.

Supporting documents