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GRI 306/3-3

Natural resources are becoming increasingly scarce all over the world. We can only operate sustainably if we use the raw materials available to us efficiently. This also includes the responsible handling of waste – because it contains valuable resources that can be returned to production. Through systematic waste management, we aim to reduce our material consumption and minimize the amount of waste produced. In the health sector, strict hygiene requirements apply to the materials used and to the safe disposal of hazardous waste. With clear internal guidelines and comprehensive controls, we ensure that these are complied with.

Our approach

GRI 306/3-3, 306-1, 306-2

For Fresenius as a healthcare Group, professional, safe waste disposal goes hand in hand with the requirements of hygiene and sterility in production processes and treatments in hospitals. Our approach extends from the selection of suitable disposal containers to cleaning and sterilization procedures and the occupational safety of our employees in the disposal of hazardous, e. g., infectious, waste.

The handling of waste in the health sector is strictly regulated. Fundamentally, waste must not pose a danger to our patients, our employees, or the environment. Our production processes and treatments in healthcare facilities must be hygienic and sterile at all times. All business segments must always dispose of their waste professionally and safely. As the business models of our business segments are different, Fresenius conducts waste management on a decentralized basis. The business segments are responsible for assessing individual risks and, where necessary, establishing internal guidelines for dealing with waste. The business segments provide training to their employees and carry out checks to ensure that the standards contained therein are adhered to.

Fresenius Medical Care

Waste is managed on a local and regional level, allowing Fresenius Medical Care to adhere to all applicable laws and regulations.

Progress and measures in 2022

In 2022, Fresenius Medical Care continued to analyze the waste streams of the production sites and dialysisDialysisForm ​of ​renal ​replacement ​therapy ​where ​a ​semipermeable ​membrane ​– ​in ​peritoneal ​dialysis ​the ​peritoneum ​of ​the ​patient, ​in ​hemo­ ​dialysis ​the ​membrane ​of ​the ​dialyzer ​– ​is ​used ​to ​clean ​a ​patient’s ​blood. clinics in all regions. As part of this process, the business segment implemented waste reporting processes at production sites. Furthermore, it is working to consolidate the data on waste generation gathered in dialysis clinics by identifying data sources and improving reporting methodologies. The business segment plans to disclose waste data in its non-financial reporting for 2023.

Fresenius Kabi

Waste at Fresenius Kabi is mainly generated as a byproduct of production processes or packaging material of the product containers in hospitals, private households, or nursing homes. This includes both non-hazardous and hazardous waste, i. e., solvents, cytostaticsCytostaticsSubstances ​that ​slow ​or ​stop ​the ​growth ​of ​cells, ​including ​cancer ​cells, ​without ​killing ​them. ​These ​agents ​may ​cause ​tumors ​to ​stop ​growing ​and ​spreading ​without ​causing ​them ​to ​shrink ​in ​size. ​, or antibiotics.

The business segment’s global environmental standard operating procedures include global requirements for waste management. The instructions constitute a global framework for the business segment’s waste management and set minimum requirements for Fresenius Kabi’s own facilities. As part of waste management, the business segment has established a sequence for the measures to be taken: waste prevention, preparation for reuse, recycling, other recovery, in particular energy recovery and backfilling, and disposal of the resulting waste. The measures taken must always be in compliance with applicable laws and regulations.

Each of Fresenius Kabi’s manufacturing sites is required to separate its waste according to local regulations and to store the waste under consideration of measures to protect the environment, e. g., to avoid contamination. The local Fresenius Kabi organizations are responsible for the disposal of waste in accordance with the applicable local regulations. In general, local EHS managers or dedicated waste managers are responsible for waste management at the respective organizations. Where necessary, local training courses on waste management are conducted. Regular audits of the commissioned waste disposal companies are conducted by the local organizations to ensure compliance with the applicable regulations.

As part of the ISO 14001 requirements, certified organizations evaluate processes that significantly contribute to the generation of waste as well as identifying potential for improvement. The business segment also considers the conservation of resources and options for recycling or direct reuse of the generated waste. Based on the evaluation, measures are implemented to reduce waste or increase the recycling rate.

If the design of a product is under the control of an ISO 14001-certified organization, as part of the life cycle perspective, the design phase of the product must take environmental aspects into account, e. g., sustainable components or required packaging. The influence of the organization on pharmaceutical products can be limited due to the importance of patient safety and product quality requirements. ISO 14001-certified organizations set local targets for their waste management.

Fresenius Kabi records the waste volumes generated at its production sites, logistics centers, compounding centers, and the further ISO 14001-certified organizations and categorizes them by waste type and disposal method. Plastic waste represents the largest portion of classified non-hazardous waste. Hazardous waste is, to a large extent, processed and reused for a different or similar purpose. To a large extent, the internally generated waste is recycled. Non-recyclable hazardous waste is mainly incinerated and a large part of it is led into energy recovery.

The business segment also receives feedback, e. g., from customers or patients, on its product packaging. This feedback is passed on internally to the relevant departments so that it can be considered when improving product packaging and in order to prevent unnecessary waste.

Progress and measures in 2022

In 2022, the management approach and the governance structure of Fresenius Kabi remained as reported in 2021. Progress and measures in 2022 focused on waste management at individual sites. In addition, representatives from relevant sites were trained and shared exemplary practices on waste reduction and improving recycling management including control measures.

Fresenius Helios

Fresenius Helios sees waste disposal management as a process. This begins with waste avoidance and continues through to consistent recycling or environmentally friendly disposal. In hospital operations, the business segment must always meet strict hygiene requirements: medical instruments and aids are cleaned and packed separately so that they can be reused as sterile items. In addition, various disposable medical products are used. This results in waste, the professional and safe disposal of which must be guaranteed.

The Fresenius Helios facilities are subject to strict regulations. In Spain, the Law 22 / 2011 on Waste and Contaminated Soils applies, for example, which sets out requirements for different types of waste applies. Specially trained staff in the hospitals are responsible for ensuring that the respective requirements are met. In particular, if hospitals in Germany generate more than two tons of hazardous waste per calendar year, they must appoint a company or external waste officer with relevant expertise and report this to the responsible authority. When disposing of waste, Fresenius Helios in Spain and in Germany must take into account not only the requirements of environmental protection, occupational safety, and infection control, but also specific hospital hygiene requirements. Appropriate disposal containers and cleaning and sterilization procedures must be used.

As the largest private hospital operator in Germany, Fresenius Helios has the option of using multiregional companies for waste disposal. There are dedicated channels and procedures for handling waste from hospital operations to ensure safe disposal. In addition to the Closed Substance Cycle Waste Management Act (Kreislaufwirtschaftsgesetz), the type of waste disposal in Germany is strictly regulated by the states, districts, and municipalities in which the facilities are located. Furthermore, the regulations of the Federal / State Working Group on Waste (LAGA) and the Technical Regulation for Biological Substances in Health Care and Welfare (TRBA 250) apply. Helios Germany bundles the various types of waste in clusters and assigns them to the respective disposal companies. For three clusters Helios has assigned central framework contracts to disposal companies. Disposal for two other clusters is commissioned decentrally by the hospitals, as they are required by law, due to municipal tendering obligations, to cooperate with special waste management companies. Helios Germany does not currently collect data on material recycling at the disposal companies.

Helios Spain controls cooperation with waste management companies centrally. Waste is disposed of separately in order to recycle the materials when possible. Waste classified as hazardous was disposed of by specialist service providers. Biological sanitary waste is incinerated or treated in a way that makes it less hazardous (inert), depending on the hazard, and sent to a safe landfill. The waste management systems of all Helios Spain clinics are regularly reviewed in self-evaluations and annual independent internal and external audits.

Progress and measures in 2022

In 2021, Helios Germany began to implement or prepare for the implementation of the new regulatory requirements of the German Packaging Act 2021. For instance, an initial concept for reusable packaging in the restaurant and catering segment was drawn up. Starting in 2023, Helios Germany will implement this concept in its clinics. In addition, Helios established a central data collection system for waste volumes at its German hospitals in the reporting year.

Helios Spain is also currently working to reduce single-use plastic in line with European and Spanish legislation. Since 2021, large packs, e. g., with dispensers or dosing aids, have increasingly been used to prevent packaging waste. The division has also been working with a supplier to improve the labeling of recyclable primary packaging. In the reporting year, all hospitals were additionally provided with a catalog of single-use items made from more sustainable materials so that they can reduce their consumption of disposable plastic.

Fresenius Vamed

The waste generated in all of Fresenius Vamed’s business processes is disposed of in accordance with regional, national, and industry-specific regulations. The local management of each healthcare facility is responsible for ensuring compliance with these guidelines. Reusable waste is processed in the required recycling processes. Other waste is disposed of by composting or incineration or is sent to landfill. For clinical and hazardous waste, the individual facilities of Fresenius Vamed cooperate with local disposal companies, who ensure that the waste is disposed of in compliance with the law.

The most important legal basis for waste management in Austria is the Waste Management Act (AWG 2002), which is supplemented in the federal states by state laws to include local aspects, such as the fees to be paid. There are also a large number of legal provisions under European law. All of these regulations create the legal framework to ensure an efficient waste management industry in Austria.

The healthcare facilities built by Fresenius Vamed use construction and sanitation technology that enables optimal resource management adapted to local regulations. The provision of technical management services is a major business segment of Fresenius Vamed. One focus of activities is to ensure the longevity of technical systems through maintenance and repair.

Progress and measures in 2022

In 2022, the decentralized management approach and governance structure in the waste and recycling management area of Fresenius Vamed remained unchanged compared to the previous year.


GRI 306/3-3, 306-3

No Group results are available for waste management in fiscal year 2022. Although no effects can yet be reported at Group level, we report on the measures initiated in 2022 and related progress in the business segments. For 2023, we assess to include at least business segment waste KPIs in the Group Non-financial Report. Furthermore, no incidents were recorded in which the respective environment or the general public were directly harmed.

in %  2022
Non-hazardous waste 80
Hazardous waste 20
1 Excludes data from Fresenius Medical Care and Fresenius Vamed.

Fresenius Kabi's total waste volume increased in the reporting year. Fresenius Kabi is continuously working to increase the recycling rate1 and made progress with hazardous waste. In addition, data quality of internally reported information on waste was improved.

In our healthcare facilities and our clinics, the waste volume caused by disposables and protective gear has increased due to COVID-19. This also applies to the amount of (potentially) infectious waste requiring special disposal.

1 Calculation of the recycling rate has been updated according to the GRI standard 306-4 (2020) for waste by category and disposal method applied as of 2021 for both, 2020 and 2021 data; waste disposed for energy recovery is no longer categorized as recycled waste.