The safety of water is one of important issues of globally SDGs (Sustainable Development Goals) concern. Medical sewage issue also contributes to the concern. Hemodialysis centers are required to comply with wastewater standard. In this study, we suggest appropriate treatment system to fulfil the wastewater quality standard of pH 5.8-8.6 by using waste dialysis fluid as a buffer solution for the sewage water pH fluctuation. This pH fluctuation is mainly caused by disinfection and decalcification solution regularly used in hemodialysis machine piping maintenance. The conditions where buffer tank is connected or not connected to the drain line of a hemodialysis machine were observed and the pH of the wastewater was measured under each condition. When the tank was not used, the wastewater pH was 3.3-10.7 which deviated from the wastewater standard. On the other hand, when the storage tank was connected to the hemodialysis machine, the wastewater sampled from the tank outlet had pH of 6.2-7.5 which met the standard. The results indicate by connecting an appropriately sized wastewater storage tank to the hemodialysis machine drain line, the dialysis fluid can be used as a buffer solution to keep the wastewater pH to the required standard.

The Japanese Ministry of Health, Labour and Welfare established a new system for the remanufacturing of single-use devices (SUDs) on July 31, 2017, and issued a notice under the Pharmaceutical Affairs Law. However, the use of remanufactured SUDs has not yet become widespread in Japan. To identify issues related to remanufactured SUDs, a questionnaire survey was conducted among medical institutions and medical device companies. The survey revealed various issues, such as concerns about the quality and safety of remanufactured SUDs and the perception that the process is cumbersome and has few advantages. Based on these findings, an additional fee for the use of remanufactured SUDs was included in the 2024 revision of medical fees to provide financial incentives for medical institutions. However, many challenges remain, and efforts to promote the adoption of remanufactured SUDs will continue to be crucial.