Water management

For decades, water consumption has been increasing worldwide and water shortages are occurring in more and more regions.1 We too need water both in our production plants and in our health facilities. We therefore handle this scarce and vital resource responsibly. We work with management systems and control systems globally to ensure that water quality meets internal and external regulatory requirements so it can be used safely during production, in processes, and in our health facilities. The health of our patients and employees must be protected. At the same time, we are committed to avoiding a negative impact on the environment. The aim of our water management is therefore not only to ensure the highest quality but also to avoid polluting the sources from which we obtain water or into which we discharge our wastewater.

1 Source: www.unwater.org/publications/world-water-development-report-2019/

Water usage

GRI 303-1

In the fiscal year 2020, Fresenius2 consumed a total of 56.2 million m³ of water (2019: 57.3 million m³). Over the last 3 years, a relative reduction in water consumption was achieved, both in relation to sale as well as to FTE. Around 91% came from the municipal water supply, while about 8% was sourced from groundwater. In the hospital sector in particular, water consumption is sourced from the municipal water supply. This is due to the strict hygiene regulations and high demands on water quality in health care facilities. For example, we can only use rainwater in areas that are not critical for patient safety.

Our approach

Fresenius continuously reviews national and international regulations on water management. Due to these reviews, internal principles, guidelines, and standard operating procedures are always up-to-date or often go beyond regulatory requirements within the framework of global management handbooks.

Since the requirements in our business segments differ, water management at Fresenius is decentralized. Nevertheless, all segments have implemented local, regional, or global management systems to control and manage water resources within their operations. In this way, we can best take into account the specifics and conditions of the respective business models and adapt processes accordingly. The environmental protection departments of the business segments monitor and control the environmental impact of their operations. They strategically analyze environmentally relevant vulnerabilities, develop suitable standard procedures, and implement appropriate measures.

Fresenius Medical Care

Large amounts of water are required for hemodialysis treatment and for cleaning and setting up the machines. The water for dialysis must have a high quality to avoid infections for patients. For this reason, most of the water used by Fresenius Medical Care is municipal water. In 2020, Fresenius Medical Care's reported water consumption decreased by 3% compared to the preceding year. In the United States, the business segment runs a program focused on reducing water during its pre-treatment process. This water reduction program within Fresenius Medical Care's clinics attributed to the decline of water consumption.

In the reporting year, Fresenius Medical Care performed a water scarcity risk assessment of its manufacturing sites with the Aqueduct tool of the World Resources Institute. According to the assessment, 7% of the sites are in areas defined as area locations with an extremely high risk of water scarcity. In a next step, the company is planning to analyze water scarcity risks for the locations of its clinics.

GRI 303-1
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Water consumption Fresenius Group2
m3 in millions 2020 2019 2018 2017
­Fresenius Medical Care 41.7 43.2 42.1 n.a..
­Fresenius Kabi 9.6 9.6 9.7 9.8
­Fresenius Helios 4.1 3.8 3.7 3.2
­Fresenius Vamed 0.8 0.7 0.7 0.3
Total 56.2 57.3 56.2 n.a..
Download (XLSX, 39 KB)
Fresenius Group2 relative water consumption
in m3 2020 2019 2018
Water consumption / € 1 million sales 1,549 1,612 1,676
Water consumption / FTE 203.1 218.7 228.2
2 Fresenius Medical Care figures include energy and water consumption at production sites, as well as electricity and water consumption at dialysis centers. Greenhouse gases are calculated based on energy data. Fresenius Kabi’s data includes all facilities worldwide. The data from Fresenius Helios encompasses as of 2018 all hospitals in Spain. Fresenius Vamed’s data includes all fully consolidated health care facilities and service entities, and, as of 2018, the German post-acute care business transferred from Fresenius Helios to Fresenius Vamed. If data of the business segments is not available in time, it is extrapolated on the basis of existing data. An adjustment will be made in the next report. Prior-year information was adjusted to conform to the current year’s presentation.
Fresenius Kabi

Water is mainly used in Fresenius Kabi’s products and as process water in its production facilities. Fresenius Kabi’s global environmental standard operating procedures and working instructions include instructions for the responsible handling of water, including wastewater. Each of Fresenius Kabi’s manufacturing sites is required to evaluate its environmental impact, e.g., water usage and wastewater. Water discharges are managed locally at the sites in accordance with applicable local regulations.

As part of the evaluation of each ISO-14001-certified manufacturing site’s environmental impact, processes with a significant effect on water usage and the business segment’s influence on these processes are being evaluated. Based on the results, water saving measures are implemented. Environment (Chapter Fresenius Kabi)

Fresenius Helios

As a hospital operator, the availability and quality of water is extremely important to Fresenius Helios, in all countries and at all sites. The focus of water management at the Helios clinics is therefore on ensuring an uninterrupted supply of water of consistently high quality and to preventing microbiological contamination. Compliance with the respective applicable regulatory requirements, e.g., the Trinkwasserverordnung (Drinking Water Ordinance) in Germany, has top priority. In order not to endanger patients, employees, and other people at any time, water management is closely linked to hygiene management.

The use of water as a resource in health care facilities is subject to strict legal requirements. In addition, the hospital's own guidelines and specifications determine the hospital-specific procedures. Further internal requirements regarding drinking water quality apply. These must be implemented in all Fresenius Helios facilities.

For the discharge of wastewater, Fresenius Helios must comply with strict regional and local legal requirements, which are monitored within the respective wastewater treatment plants. Deviations are reported directly to the hospital concerned and forwarded to all responsible departments through established reporting chains. After evaluating the incident, Fresenius Helios checks whether technical improvements or changes to processes and additional training will ensure that the requirements are met in future. Environment (Chapter Fresenius Helios)

Fresenius Vamed

For Fresenius Vamed, a sufficient supply of fresh water for patient well-being and hygiene is a central element in the planning, construction and operation of health care facilities. The health care facilities built by Fresenius Vamed use construction and sanitation technology that enables optimal water management – adapted to local regulations. Fresenius Vamed has introduced ISO 14001 certification for its lead companies as an integrated management system for sustainable water management in the company.

Fresenius Vamed uses local management systems, process owners, and operating procedures to ensure that the respective local guidelines on water and wastewater are strictly adhered to. The internal principles, guidelines, and standard operating procedures are adapted to the applicable regulatory requirements.

In contrast to industrialized countries with good infrastructure and strict regulation, adequate water supply in developing markets is a major challenge. In the non-European countries where Fresenius Vamed is active in project business, legal requirements for water quality are often not comparable with the high standards required for the operation of a health care facility in Europe, for example. The same applies to the treatment of wastewater. Many projects therefore require the use of fresh water and wastewater treatment plants. The non-European projects are constructed according to the guidelines for water quality of the World Health Organization (WHO). Fresenius Vamed aligns the high quality standards for the plants to be built with the requirements set by international project financiers and implements them during the planning phase, please see also the chapter Environmental Management by Fresenius Vamed.


Waste and recycling management