A Model for Plastic Neutrality in Dialysis: Converting Surrogate Plastic Waste to Sinkable Pebbles
Main Article Content
Abstract
Dialysis plastic waste is a growing problem in India, with an estimated 3 million kilograms generated each year. Effective disposal of dialysis plastic waste is not uniformly addressed, and there is a need for sustainable solutions.
This study evaluated a plastic pebble model made from surrogate plastic equivalent to twice that generated during dialysis. The model was evaluated for its potential to offset dialysis plastic waste and its role in achieving sustainability in dialysis. Additionally, the model was used to advocate for and carry forward a campaign for plastic neutrality in dialysis.
The amount of dialysis plastic waste generated in one month by 25 patients was quantified. The sinkable plastic pebble aggregate model was created by purchasing waste plastic, double the quantity of calculated DPW, from the market. The purchased plastic was then repurposed into sinkable plastic pebble aggregate to mimic blue metal.
Various sample products were made in the form of slabs and bricks using sinkable plastic pebble aggregate, and compared to those made from blue metal and fired bricks. The stability and strength of the different products were compared, and the costs were analysed. The methodology was further used for advocacy and to campaign for plastic neutrality.
The results showed that the sinkable plastic pebble aggregate model is a feasible and effective way to reduce plastic waste in dialysis. It is cost-effective, contributes to a circular economy, and helps reduce mining for blue metal and fertile soil for bricks. The model can also advocate for the use of plastic-neutral materials in dialysis to reduce environmental pollution.
To conclude Sinkable plastic pebble surrogate model is a promising solution for offsetting plastic waste in dialysis. It is cost-effective, environmentally friendly, and it helps to campaign for plastic neutrality in dialysis. Further study is needed to assess its impact on a larger scale.
Keywords:
green dialysis, plastic waste, Sustainable dialysis, circular economy, plastic neutrality, environment pollution
Article Details
How to Cite
RAVICHANDRAN, Palani.
A Model for Plastic Neutrality in Dialysis: Converting Surrogate Plastic Waste to Sinkable Pebbles.
Medical Research Archives, [S.l.], v. 11, n. 9, sep. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4380>. Date accessed: 15 may 2024.
doi: https://doi.org/10.18103/mra.v11i9.4380.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Stigant CE, Barraclough KA, Harber M, Kanagasundaram NS, Malik C, Jha V, Vanholder RC. Our shared responsibility: the urgent necessity of global environmentally sustainable kidney care. Kidney Int. 2023;104(1):12-15.
doi: 10.1016/j.kint.2022.12.015. PMID: 36642093.
2. Sustainable development is key to improving global kidney health. Nat Rev Nephrol. 2021;17(1):1-3. doi:10.1038/s41581-020-00380-5.
3. Bharati J, Jha V. Global dialysis perspective: India. Kidney360. 2020 Aug 19;1(10):1143-1147. doi:10.34067/KID.0003982020. PMID: 35368789; PMCID: PMC8815477.
4. Niyitanga Evode, Sarmad Ahmad Qamar, Muhammad Bilal, Damià Barceló, Hafiz M.N. Iqbal. Plastic waste and its management strategies for environmental sustainability. Case Studies in Chemical and Environmental Engineering. 2021;4(2):100142. doi:10.1016/j.cscee.2021.100142.
5. Hoenich NA, Levin R, Pearce C. Clinical waste generation from renal units: implications and solutions. Semin Dial. 2005 Sep-Oct;18(5):396-400.
doi:10.1111/j.1525-139X.2005.00078.x. PMID: 16191180.
6. Agar JW. Green dialysis: the environmental challenges ahead. Semin Dial. 2015 Mar-Apr;28(2):186-92. doi:10.1111/sdi.12324. Epub 2014 Nov 30. PMID: 25440109.
7. Piccoli GB, Cupisti A, Aucella F, Regolisti G, Lomonte C, Ferraresi M, Claudia D, Ferraresi C, Russo R, La Milia V, Covella B, Rossi L, Chatrenet A, Cabiddu G, Brunori G; On the Behalf of Conservative treatment, Physical activity and Peritoneal dialysis project groups of the Italian Society of Nephrology. Green nephrology and eco-dialysis: a position statement by the Italian Society of Nephrology. J Nephrol. 2020 Aug;33(4):681-698. doi:10.1007/s40620-020-00734-z. Epub 2020 Apr 15. PMID: 32297293; PMCID: PMC7381479.
8. Yeo SC, Ooi XY, Tan TSM. Sustainable kidney care delivery and climate change - a call to action. Global Health. 2022 Aug 3;18(1):75. doi:10.1186/s12992-022-00867-9. PMID: 35922809; PMCID: PMC9351168.
9. Heidbreder LM, Bablok I, Drews S, Menzel C. Tackling the plastic problem: A review on perceptions, behaviors, and interventions. Sci Total Environ. 2019 Jun 10;668:1077-1093. doi:10.1016/j.scitotenv.2019.02.437. Epub 2019 Mar 6. PMID: 31018449.
10. Government of India. (2023). Pradhan Mantri National Dialysis Programme (PMNDP). Retrieved from https://pmndp.mohfw.gov.in/en
11. Press Information Bureau. National Digital Health Mission: PM launches Nation-wideः Mission of Digital Health for Every Indian (press release). Government of India; 2020 Aug 15. Available from: https://pib.gov.in/newsite/printrelease.aspx?relid=105411. Accessed October 10, 2021https://pib.gov.in/newsite/printrelease.aspx?relid=105411
12. Mahananda, M.. (2015). Bio Medical Waste Generation and Management Practices in V.S.S. Medical College & Hospital, Burla, Odisha, India. Energy and Environmental Engineering. 3. 15-22. 10.13189/eee.2015.030201.
13. Blessy Joseph, Jemy James, Nandakumar Kalarikkal, Sabu Thomas, Recycling of medical plastics, Advanced Industrial and Engineering Polymer Research, Volume 4, Issue 3, 2021,Pages 199-208, ISSN 2542-5048, https://doi.org/10.1016/j.aiepr.2021.06.003.
14. Barraclough KA, Agar JWM. Green nephrology. Nat Rev Nephrol. 2020 May;16(5):257-268. doi: 10.1038/s41581-019-0245-1. Epub 2020 Feb 7. PMID: 32034297.
15. Moura-Neto JA, Barraclough K, Agar JWM. A call-to-action for sustainability in dialysis in Brazil. J Bras Nefrol. 2019 Oct-Dec;41(4):560-563. doi: 10.1590/2175-8239-JBN-2019-0014. PMID: 31268113; PMCID: PMC6979574.
16. Rahat, Md. Hasibul Hasan & Massarra, Carol & Wang, George. (2022). Using Plastic Wastes in Construction: Opportunities and Challenges. 10.29007/6369.
17. Hossain, R.; Islam, M.T.; Shanker, R.; Khan, D.; Locock, K.E.S.; Ghose, A.; Schandl, H.; Dhodapkar, R.; Sahajwalla, V. Plastic Waste Management in India: Challenges, Opportunities, and Roadmap for Circular Economy. Sustainability 2022, 14, 4425. https://doi.org/10.3390/su14084425
18. Opeolu, Olukunle. (2019). Plastic Waste Awareness and Practices among Students. A Case study of the students of the Faculty of Environmental Sciences, University of Lagos.. 10.13140/RG.2.2.29359.18081.
19. Joseph L, Paul H, Premkumar J, Paul R,Michael JS. Biomedical waste management: Study on the awareness and practice among healthcare workers in a tertiary teaching hospital. Indian J Med Microbiol 2015;33:129-31
20. Letho Z, Yangdon T, Lhamo C, Limbu CB, Yoezer S, Jamtsho T, Chhetri P, Tshering D. Awareness and practice of medical waste management among healthcare providers in National Referral Hospital. PLoS One. 2021 Jan 6;16(1):e0243817.
doi: 10.1371/journal.pone.0243817. PMID: 33406119; PMCID: PMC7787467
21. Lee BK, Ellenbecker MJ, Moure-Eraso R. Analyses of the recycling potential of medical plastic wastes. Waste Manag. 2002;22(5):461-70. doi: 10.1016/s0956-053x(02)00006-5. PMID: 12092754.
22. Energy Fuels 2021, 35, 5, 3558–3571 Publication Date:February 15, 2021 https://doi.org/10.1021/acs.energyfuels.0c04017
23. P.O. Awoyera, A. Adesina, Plastic wastes to construction products: Status, limitations And future perspective, Case Studies in Construction Materials, Volume 12, 2020, e00330, ISSN 2214-5095, https://doi.org/10.1016/j.cscm.2020.e00330
24. Geyer, R., Jambeck, J.R., Law, K.L. (2017). Future scenarios of global plastic waste generation and disposal. Palgrave Communications, 5(6), 1-14. doi:10.1057/s41599-018-0212-7
25. Cherain, Abhilash & Yadla, Manjusha. (2022). Trends of biowaste generation in hemodialysis units under the hub-and-spoke model: act and save. Journal of The Egyptian Society of Nephrology and Transplantation. 22. 29. 10.4103/jesnt.jesnt_47_20.
26. Giorgina Barbara Piccoli and others, Eco-dialysis: the financial and ecological costs of dialysis waste products: is a ‘cradle-to-cradle’ model feasible for planet-friendly haemodialysis waste management?, Nephrology Dialysis Transplantation, Volume 30, Issue 6, June 2015, Pages 1018–1027, https://doi.org/10.1093/ndt/gfv031
27. Vanholder R, Annemans L, Bello AK, Bikbov B, Gallego D, Gansevoort RT, Lameire N, Luyckx VA, Noruisiene E, Oostrom T, Wanner C, Wieringa F. Fighting the unbearable lightness of neglecting kidney health: the decade of the kidney. Clin Kidney J. 2021 Apr 20;14(7):1719-1730.
doi: 10.1093/ckj/sfab070. PMID: 34221379; PMCID: PMC8243275.
28. Gauly A, Fleck N, Kircelli F. Advanced hemodialysis equipment for more eco-friendly dialysis. Int Urol Nephrol. 2022 May;54(5):1059-1065.
doi: 10.1007/s11255-021-02981-w. Epub 2021 Sep 4. PMID: 34480255; PMCID: PMC9005388.
29. Borg, M.A., Bi, P. The impact of climate change on kidney health. Nat Rev Nephrol 17, 294–295 (2021). https://doi.org/10.1038/s41581-020-00365-4
30. Himmelfarb J, Vanholder R, Mehrotra R, Tonelli M. The current and future landscape of dialysis. Nat Rev Nephrol. 2020 Oct;16(10):573-585. doi: 10.1038/s41581-020-0315-4. Epub 2020 Jul 30. PMID: 32733095; PMCID: PMC7391926.
31. Klomjit N, Kattah AG, Cheungpasitporn W. The Cost-effectiveness of Peritoneal Dialysis Is Superior to Hemodialysis: Updated Evidence From a More Precise Model. Kidney Med. 2020 Dec 30;3(1):15-17.
doi: 10.1016/j.xkme.2020.12.003. PMID: 33605939; PMCID: PMC7873827.
32. Giorgina Barbara Piccoli and others, Eco-dialysis: the financial and ecological costs of dialysis waste products: is a ‘cradle-to-cradle’ model feasible for planet-friendly haemodialysis waste management? Nephrology Dialysis Transplantation, Volume 30, Issue 6, June 2015, Pages 1018–1027, https://doi.org/10.1093/ndt/gfv031
33. United Nations Framework Convention on Climate Change. United Nations Carbon Offset Platform. Available at: https://unfccc.int/climate-action/united-nations-carbon-offset-platform. Accessed December 1, 2021
34. "Ecobusiness" (2021). What is plastic offsetting and can it really help to fight the plastic crisis? Retrieved from: https://www.eco-business.com/news/what-is-plastic-offsetting-and-can-it-really-help-to-fight-the-plastic-crisis/
35. Bailie GR, Kowalsky SF, Eisele G, Schwartzman MS. Disposal of CAPD waste in the community. Perit Dial Int. 1991;11(1):72-5. PMID: 2049428.
36. Nikiema, J., Asiedu, Z. A review of the cost and effectiveness of solutions to address plastic pollution. Environ Sci Pollut Res 29, 24547–24573 (2022). https://doi.org/10.1007/s11356-021-18038-5
37. Shanker, R., Khan, D., Hossain, R. et al. Plastic waste recycling: existing Indian scenario and future opportunities. Int. J. Environ. Sci. Technol. 20, 5895–5912 (2023). https://doi.org/10.1007/s13762-022-04079-x
38. Blessy Joseph, Jemy James, Nandakumar Kalarikkal, Sabu Thomas, Recycling of medical plastics, Advanced Industrial and Engineering Polymer Research, Volume 4, Issue 3, 2021, Pages 199-208, ISSN 2542-5048, https://doi.org/10.1016/j.aiepr.2021.06.003.
39. Horejs, C. Solutions to plastic pollution. Nat Rev Mater 5, 641 (2020). https://doi.org/10.1038/s41578-020-00237-0
40. Lee, C.J., Chang, L. & Tan, J. Environmental Sustainability Framework for Plastic Waste Management—a Case Study of Bubble Tea Industry in Malaysia. Process Integr Optim Sustain 6, 513–526 (2022). https://doi.org/10.1007/s41660-022-00230-w
41. Wautelet, Thibaut. (2018). The Concept of Circular Economy: its Origins and its Evolution. 10.13140/RG.2.2.17021.87523.
42. Nanda S, Patra BR, Patel R, Bakos J, Dalai AK. Innovations in applications and prospects of bioplastics and biopolymers: a review. Environ Chem Lett. 2022;20(1):379-395. doi: 10.1007/s10311-021-01334-4. Epub 2021 Nov 29. PMID: 34867134; PMCID: PMC8629338
43. Ng Chi Huey, Mistoh Mohd Aizzan, Teo Siow Hwa, Galassi Andrea, Ibrahim Azreen, Sipaut Coswald Stephen, Foo Jurry, Seay Jeffrey, Taufiq‐Yap Yun Hin, Janaun Jidon, Plastic waste and microplastic issues in Southeast Asia ,Frontiers in Environmental Science ; VOLUME=11, 2023 ,https://www.frontiersin.org/articles/10.3389/fenvs.2023.1142071 DOI=10.3389/fenvs.2023.1142071 ,ISSN=2296-665X
44. Ibrahim Almeshal, Bassam A. Tayeh, Rayed Alyousef, Hisham Alabduljabbar, Abdeliazim Mustafa Mohamed, Eco-friendly concrete containing recycled plastic as partial replacement for sand, Journal of Materials Research and Technology, Volume 9, Issue 3, 2020, Pages 4631-4643, ISSN 2238-7854, https://doi.org/10.1016/j.jmrt.2020.02.090.
45. P.O. Awoyera, A. Adesina, Plastic wastes to construction products: Status, limitations and future perspective, Case Studies in Construction Materials, Volume 12, 2020, e00330, ISSN 2214-5095,https://doi.org/10.1016/j.cscm.2020.e00330.
46. Vaccaro, Pietro & P. Galvin, Adela & Ayuso, J. & Lozano-Lunar, Angelica & Lopez Uceda, Antonio. (2021). Pollutant Potential of Reinforced Concrete Made with Recycled Plastic Fibres from Food Packaging Waste. Applied Sciences. 11. 8102. 10.3390/app11178102.
47. Suhaib Yahya Al-Darzi,The effect of using shredded plastic on the behavior of reinforced concrete slab,Case Studies in Construction Materials, Volume 17, 2022, e01681,ISSN 2214-5095,https://doi.org/10.1016/j.cscm.2022.e01681.
48. Islam, Kamrul & Motoshita, Masaharu & Murakami, Shinsuke. (2023). Environmental Sustainability of Bricks in an Emerging Economy: Current Environmental Hotspots and Mitigation Potentials for the Future. Sustainability. 15. 5228. 10.3390/su15065228.
49. PlasticsToday Staff. "Plastics Advocacy and the Power of One." PlasticsToday, 26 Jan. 2021, https://www.plasticstoday.com/packaging/plastics-advocacy-and-power-one
doi: 10.1016/j.kint.2022.12.015. PMID: 36642093.
2. Sustainable development is key to improving global kidney health. Nat Rev Nephrol. 2021;17(1):1-3. doi:10.1038/s41581-020-00380-5.
3. Bharati J, Jha V. Global dialysis perspective: India. Kidney360. 2020 Aug 19;1(10):1143-1147. doi:10.34067/KID.0003982020. PMID: 35368789; PMCID: PMC8815477.
4. Niyitanga Evode, Sarmad Ahmad Qamar, Muhammad Bilal, Damià Barceló, Hafiz M.N. Iqbal. Plastic waste and its management strategies for environmental sustainability. Case Studies in Chemical and Environmental Engineering. 2021;4(2):100142. doi:10.1016/j.cscee.2021.100142.
5. Hoenich NA, Levin R, Pearce C. Clinical waste generation from renal units: implications and solutions. Semin Dial. 2005 Sep-Oct;18(5):396-400.
doi:10.1111/j.1525-139X.2005.00078.x. PMID: 16191180.
6. Agar JW. Green dialysis: the environmental challenges ahead. Semin Dial. 2015 Mar-Apr;28(2):186-92. doi:10.1111/sdi.12324. Epub 2014 Nov 30. PMID: 25440109.
7. Piccoli GB, Cupisti A, Aucella F, Regolisti G, Lomonte C, Ferraresi M, Claudia D, Ferraresi C, Russo R, La Milia V, Covella B, Rossi L, Chatrenet A, Cabiddu G, Brunori G; On the Behalf of Conservative treatment, Physical activity and Peritoneal dialysis project groups of the Italian Society of Nephrology. Green nephrology and eco-dialysis: a position statement by the Italian Society of Nephrology. J Nephrol. 2020 Aug;33(4):681-698. doi:10.1007/s40620-020-00734-z. Epub 2020 Apr 15. PMID: 32297293; PMCID: PMC7381479.
8. Yeo SC, Ooi XY, Tan TSM. Sustainable kidney care delivery and climate change - a call to action. Global Health. 2022 Aug 3;18(1):75. doi:10.1186/s12992-022-00867-9. PMID: 35922809; PMCID: PMC9351168.
9. Heidbreder LM, Bablok I, Drews S, Menzel C. Tackling the plastic problem: A review on perceptions, behaviors, and interventions. Sci Total Environ. 2019 Jun 10;668:1077-1093. doi:10.1016/j.scitotenv.2019.02.437. Epub 2019 Mar 6. PMID: 31018449.
10. Government of India. (2023). Pradhan Mantri National Dialysis Programme (PMNDP). Retrieved from https://pmndp.mohfw.gov.in/en
11. Press Information Bureau. National Digital Health Mission: PM launches Nation-wideः Mission of Digital Health for Every Indian (press release). Government of India; 2020 Aug 15. Available from: https://pib.gov.in/newsite/printrelease.aspx?relid=105411. Accessed October 10, 2021https://pib.gov.in/newsite/printrelease.aspx?relid=105411
12. Mahananda, M.. (2015). Bio Medical Waste Generation and Management Practices in V.S.S. Medical College & Hospital, Burla, Odisha, India. Energy and Environmental Engineering. 3. 15-22. 10.13189/eee.2015.030201.
13. Blessy Joseph, Jemy James, Nandakumar Kalarikkal, Sabu Thomas, Recycling of medical plastics, Advanced Industrial and Engineering Polymer Research, Volume 4, Issue 3, 2021,Pages 199-208, ISSN 2542-5048, https://doi.org/10.1016/j.aiepr.2021.06.003.
14. Barraclough KA, Agar JWM. Green nephrology. Nat Rev Nephrol. 2020 May;16(5):257-268. doi: 10.1038/s41581-019-0245-1. Epub 2020 Feb 7. PMID: 32034297.
15. Moura-Neto JA, Barraclough K, Agar JWM. A call-to-action for sustainability in dialysis in Brazil. J Bras Nefrol. 2019 Oct-Dec;41(4):560-563. doi: 10.1590/2175-8239-JBN-2019-0014. PMID: 31268113; PMCID: PMC6979574.
16. Rahat, Md. Hasibul Hasan & Massarra, Carol & Wang, George. (2022). Using Plastic Wastes in Construction: Opportunities and Challenges. 10.29007/6369.
17. Hossain, R.; Islam, M.T.; Shanker, R.; Khan, D.; Locock, K.E.S.; Ghose, A.; Schandl, H.; Dhodapkar, R.; Sahajwalla, V. Plastic Waste Management in India: Challenges, Opportunities, and Roadmap for Circular Economy. Sustainability 2022, 14, 4425. https://doi.org/10.3390/su14084425
18. Opeolu, Olukunle. (2019). Plastic Waste Awareness and Practices among Students. A Case study of the students of the Faculty of Environmental Sciences, University of Lagos.. 10.13140/RG.2.2.29359.18081.
19. Joseph L, Paul H, Premkumar J, Paul R,Michael JS. Biomedical waste management: Study on the awareness and practice among healthcare workers in a tertiary teaching hospital. Indian J Med Microbiol 2015;33:129-31
20. Letho Z, Yangdon T, Lhamo C, Limbu CB, Yoezer S, Jamtsho T, Chhetri P, Tshering D. Awareness and practice of medical waste management among healthcare providers in National Referral Hospital. PLoS One. 2021 Jan 6;16(1):e0243817.
doi: 10.1371/journal.pone.0243817. PMID: 33406119; PMCID: PMC7787467
21. Lee BK, Ellenbecker MJ, Moure-Eraso R. Analyses of the recycling potential of medical plastic wastes. Waste Manag. 2002;22(5):461-70. doi: 10.1016/s0956-053x(02)00006-5. PMID: 12092754.
22. Energy Fuels 2021, 35, 5, 3558–3571 Publication Date:February 15, 2021 https://doi.org/10.1021/acs.energyfuels.0c04017
23. P.O. Awoyera, A. Adesina, Plastic wastes to construction products: Status, limitations And future perspective, Case Studies in Construction Materials, Volume 12, 2020, e00330, ISSN 2214-5095, https://doi.org/10.1016/j.cscm.2020.e00330
24. Geyer, R., Jambeck, J.R., Law, K.L. (2017). Future scenarios of global plastic waste generation and disposal. Palgrave Communications, 5(6), 1-14. doi:10.1057/s41599-018-0212-7
25. Cherain, Abhilash & Yadla, Manjusha. (2022). Trends of biowaste generation in hemodialysis units under the hub-and-spoke model: act and save. Journal of The Egyptian Society of Nephrology and Transplantation. 22. 29. 10.4103/jesnt.jesnt_47_20.
26. Giorgina Barbara Piccoli and others, Eco-dialysis: the financial and ecological costs of dialysis waste products: is a ‘cradle-to-cradle’ model feasible for planet-friendly haemodialysis waste management?, Nephrology Dialysis Transplantation, Volume 30, Issue 6, June 2015, Pages 1018–1027, https://doi.org/10.1093/ndt/gfv031
27. Vanholder R, Annemans L, Bello AK, Bikbov B, Gallego D, Gansevoort RT, Lameire N, Luyckx VA, Noruisiene E, Oostrom T, Wanner C, Wieringa F. Fighting the unbearable lightness of neglecting kidney health: the decade of the kidney. Clin Kidney J. 2021 Apr 20;14(7):1719-1730.
doi: 10.1093/ckj/sfab070. PMID: 34221379; PMCID: PMC8243275.
28. Gauly A, Fleck N, Kircelli F. Advanced hemodialysis equipment for more eco-friendly dialysis. Int Urol Nephrol. 2022 May;54(5):1059-1065.
doi: 10.1007/s11255-021-02981-w. Epub 2021 Sep 4. PMID: 34480255; PMCID: PMC9005388.
29. Borg, M.A., Bi, P. The impact of climate change on kidney health. Nat Rev Nephrol 17, 294–295 (2021). https://doi.org/10.1038/s41581-020-00365-4
30. Himmelfarb J, Vanholder R, Mehrotra R, Tonelli M. The current and future landscape of dialysis. Nat Rev Nephrol. 2020 Oct;16(10):573-585. doi: 10.1038/s41581-020-0315-4. Epub 2020 Jul 30. PMID: 32733095; PMCID: PMC7391926.
31. Klomjit N, Kattah AG, Cheungpasitporn W. The Cost-effectiveness of Peritoneal Dialysis Is Superior to Hemodialysis: Updated Evidence From a More Precise Model. Kidney Med. 2020 Dec 30;3(1):15-17.
doi: 10.1016/j.xkme.2020.12.003. PMID: 33605939; PMCID: PMC7873827.
32. Giorgina Barbara Piccoli and others, Eco-dialysis: the financial and ecological costs of dialysis waste products: is a ‘cradle-to-cradle’ model feasible for planet-friendly haemodialysis waste management? Nephrology Dialysis Transplantation, Volume 30, Issue 6, June 2015, Pages 1018–1027, https://doi.org/10.1093/ndt/gfv031
33. United Nations Framework Convention on Climate Change. United Nations Carbon Offset Platform. Available at: https://unfccc.int/climate-action/united-nations-carbon-offset-platform. Accessed December 1, 2021
34. "Ecobusiness" (2021). What is plastic offsetting and can it really help to fight the plastic crisis? Retrieved from: https://www.eco-business.com/news/what-is-plastic-offsetting-and-can-it-really-help-to-fight-the-plastic-crisis/
35. Bailie GR, Kowalsky SF, Eisele G, Schwartzman MS. Disposal of CAPD waste in the community. Perit Dial Int. 1991;11(1):72-5. PMID: 2049428.
36. Nikiema, J., Asiedu, Z. A review of the cost and effectiveness of solutions to address plastic pollution. Environ Sci Pollut Res 29, 24547–24573 (2022). https://doi.org/10.1007/s11356-021-18038-5
37. Shanker, R., Khan, D., Hossain, R. et al. Plastic waste recycling: existing Indian scenario and future opportunities. Int. J. Environ. Sci. Technol. 20, 5895–5912 (2023). https://doi.org/10.1007/s13762-022-04079-x
38. Blessy Joseph, Jemy James, Nandakumar Kalarikkal, Sabu Thomas, Recycling of medical plastics, Advanced Industrial and Engineering Polymer Research, Volume 4, Issue 3, 2021, Pages 199-208, ISSN 2542-5048, https://doi.org/10.1016/j.aiepr.2021.06.003.
39. Horejs, C. Solutions to plastic pollution. Nat Rev Mater 5, 641 (2020). https://doi.org/10.1038/s41578-020-00237-0
40. Lee, C.J., Chang, L. & Tan, J. Environmental Sustainability Framework for Plastic Waste Management—a Case Study of Bubble Tea Industry in Malaysia. Process Integr Optim Sustain 6, 513–526 (2022). https://doi.org/10.1007/s41660-022-00230-w
41. Wautelet, Thibaut. (2018). The Concept of Circular Economy: its Origins and its Evolution. 10.13140/RG.2.2.17021.87523.
42. Nanda S, Patra BR, Patel R, Bakos J, Dalai AK. Innovations in applications and prospects of bioplastics and biopolymers: a review. Environ Chem Lett. 2022;20(1):379-395. doi: 10.1007/s10311-021-01334-4. Epub 2021 Nov 29. PMID: 34867134; PMCID: PMC8629338
43. Ng Chi Huey, Mistoh Mohd Aizzan, Teo Siow Hwa, Galassi Andrea, Ibrahim Azreen, Sipaut Coswald Stephen, Foo Jurry, Seay Jeffrey, Taufiq‐Yap Yun Hin, Janaun Jidon, Plastic waste and microplastic issues in Southeast Asia ,Frontiers in Environmental Science ; VOLUME=11, 2023 ,https://www.frontiersin.org/articles/10.3389/fenvs.2023.1142071 DOI=10.3389/fenvs.2023.1142071 ,ISSN=2296-665X
44. Ibrahim Almeshal, Bassam A. Tayeh, Rayed Alyousef, Hisham Alabduljabbar, Abdeliazim Mustafa Mohamed, Eco-friendly concrete containing recycled plastic as partial replacement for sand, Journal of Materials Research and Technology, Volume 9, Issue 3, 2020, Pages 4631-4643, ISSN 2238-7854, https://doi.org/10.1016/j.jmrt.2020.02.090.
45. P.O. Awoyera, A. Adesina, Plastic wastes to construction products: Status, limitations and future perspective, Case Studies in Construction Materials, Volume 12, 2020, e00330, ISSN 2214-5095,https://doi.org/10.1016/j.cscm.2020.e00330.
46. Vaccaro, Pietro & P. Galvin, Adela & Ayuso, J. & Lozano-Lunar, Angelica & Lopez Uceda, Antonio. (2021). Pollutant Potential of Reinforced Concrete Made with Recycled Plastic Fibres from Food Packaging Waste. Applied Sciences. 11. 8102. 10.3390/app11178102.
47. Suhaib Yahya Al-Darzi,The effect of using shredded plastic on the behavior of reinforced concrete slab,Case Studies in Construction Materials, Volume 17, 2022, e01681,ISSN 2214-5095,https://doi.org/10.1016/j.cscm.2022.e01681.
48. Islam, Kamrul & Motoshita, Masaharu & Murakami, Shinsuke. (2023). Environmental Sustainability of Bricks in an Emerging Economy: Current Environmental Hotspots and Mitigation Potentials for the Future. Sustainability. 15. 5228. 10.3390/su15065228.
49. PlasticsToday Staff. "Plastics Advocacy and the Power of One." PlasticsToday, 26 Jan. 2021, https://www.plasticstoday.com/packaging/plastics-advocacy-and-power-one