ESRS E3 Water and marine resources [E3] Water and marine resources

Impacts, risks, and opportunities [E3 SBM-3] Material impacts, risks, and opportunities and their interaction with strategy and business model

Impacts, risks, and opportunities

Within the scope of the materiality analysis, Fresenius has identified one material impact related to Water resources:

Approach [E3-1] Policies related to water resources

Environmental Policy

The Group-wide Environmental Policy also addresses the issue of water. In this policy, Fresenius commits to the responsible use of water and to compliance with the legally applicable regulations for wastewater, e.g., with regard to wastewater limits. In areas with water stress, Fresenius also aims to reduce the process water withdrawal of production facilities. Water stress refers to a situation in which the demand for water exceeds the available quantity or the water quality is so poor that it restricts its use. This often occurs in regions with high or extremely high water abstraction.

Further information on the Environmental Policy can be found in the topical standard E1 Climate change, section E1-2 Approach. Information on responsibilities and requirements for the Management Board as well as the Supervisory Board are explained in standard ESRS 2 General disclosures, section GOV-1 Sustainability organization.

Other concepts related to water resources

Fresenius uses local management systems, process owners, and operating procedures to ensure that the respective local guidelines on water and wastewater are strictly adhered to within its own operations. Water management measures consider a reduction in water and wastewater volumes and monitor the quality and authorized withdrawal of water and discharge of wastewater.

Fresenius continuously reviews national and international regulations on water management. The internal principles, guidelines, and operating procedures – which contain instructions for the responsible handling of water, including the control of wastewater – are adapted to the applicable regulatory requirements. Controls mainly relate to the quality of wastewater, and on a sampling basis to its quantity. The water management is closely linked to the hygiene management. Environmental or hygiene experts ensure that internal guidelines and external regulations are adhered to.

Water usage and withdrawal

In production, water is used for most sterilization and cooling processes, as a component in the production of medical products, and for hygiene procedures. The water used as a product component, e.g., for infusion solutions such as sodium chloride, must meet stringent quality requirements to ensure product quality and patient safety.

For Fresenius’ healthcare facilities, a sufficient supply of fresh water is central to the delivery of healthcare services, patient well-being, and hygiene. Most of the water withdrawal in production and at the healthcare facilities is from municipal water supplies.

Beyond the quality and hygiene requirements, Fresenius does not address any water-related reduction goals in the design of products and services, as water is indispensable wherever Fresenius uses it as a component. Information on the water reduction target can be found in this topical standard, section E3-3 Goals and ambitions.

Water quality

Fresenius has implemented applicable risk management procedures in all facilities that come into action if impurities are detected or if the quality of water is not compliant with standards set – and established dedicated reporting lines. The local government is informed immediately in accordance with legal requirements of any critical deviations from local drinking water provisions that are detected. In Germany, some of the clinic laboratories are accredited as testing centers for local drinking water quality. In this way, Fresenius supports not only the safety of its patients, but also that of the surrounding population and the municipalities that supply the Group with drinking water.

In the case of contaminated fresh water from the public network, many of Fresenius’ German clinics have the option of taking additional protective measures in addition to their own treatment facilities.

In the Spanish clinics, Fresenius does not perform water treatment. However, the Group produces osmosis water, which is required for dialysis treatments, to operate washing machines in sterilization units, and for the biochemical analyzers in the clinical laboratory. Fresenius treats water for the production of certain pharmaceutical products. For example, water for infusion solutions must be of a quality that exceeds that of drinking water.

All hospitals have emergency plans in place to ensure the healthcare of patients in the event of supply bottlenecks. In most Spanish clinics, water tanks are used to ensure supply in the event of a drinking water failure. These tanks are extended pipes in which, during flow, water reserves remain that can be used in an emergency to temporarily bridge supply. Depending on the center and consumption, the autonomy of the systems and thus the amount of water reserves varies. In JCI-certified centers (Joint Commission International accreditation), the emergency plans also include the delivery of water in tankers in case of need.

For further information about water pollution, please refer to the topical standard E2 Pollution.

Identification and management of water risks

To address the potential negative impacts related to the water needs of the production sites and hospitals of Fresenius, the company analyzes water availability using the World Resources Institute’s Aqueduct Water Risk Atlas, which contains information on current and future water risks globally. Fresenius has identified sites that are in areas with extremely high or high risk of water scarcity. At these sites, efficient water management is especially important to ensure water availability for production and hospitals and to prevent negative impact on the local water situation as far as possible. In the Environmental Policy, Fresenius set the goal to reduce process water withdrawal in production in water-stressed areas. For more information, please refer in this topical standard to the section E3-1 Approach and to the section E3-3 Goals and ambitions.

When assessing freshwater dependency as part of the materiality analysis, no material financial risk was identified.

Our manufacturing plants and hospitals are also part of the Group-wide climate risk assessment, which includes water risks such as floods, or heavy rain. So far, no substantial risk has been identified. If individual risks are identified, appropriate measures are derived and implemented.

Fresenius does not include the upstream and downstream value chain in the assessment of water risks.

Actions [E3-2] Actions and resources related to water resources

Production

In the reporting year, Fresenius Kabi began implementing initial measures to help achieve the target set in 2024 for reducing process water in areas with water stress. The focus is on conserving resources and improving efficiency.

The measures at production sites located in areas with water stress were implemented or are in progress during the reporting year and are included in the budget planning through 2028.

To reduce the use of freshwater, wastewater is treated and subsequently reused for cooling processes. In addition, technical equipment is being replaced: for example, instead of conventional vacuum pumps, models are used that either do not require water or keep the water used in a closed-loop system.

Fresenius Kabi will fundamentally redesign the cooling system at one of its production sites. Instead of using river water for cooling, heat pumps will capture waste heat from manufacturing processes and feed it into the municipal network. This heat can then be used, e.g., for heating purposes.

By the end of 2026, Fresenius Kabi aims to systematically map water flows at selected production sites using so-called water maps to identify opportunities for savings and recycling.

Further information on the target and the current progress toward target achievement can be found in the next section, E3-3 Goals and ambitions.

Healthcare facilities

The use of fresh water in Fresenius’ healthcare facilities is essential to meet hygiene requirements and is thus indispensable for patient safety. Therefore, Fresenius does not implement measures that address potential negative impacts related to increased water demand and the associated local withdrawal. Nevertheless, wherever possible and sensible, water-saving technologies such as efficient sanitary fittings and kitchen appliances are used to reduce consumption – without compromising hygiene standards. Due to internal requirements regarding drinking water quality, Fresenius does not reuse water or use gray water – i.e. treated water from showers or washbasins.

Goals and ambitions [E3-3] Targets related to water resources

Fresenius aims to ensure the safe use of water in every area of the business operations so that neither the health of patients nor employees is compromised and sufficient availability is guaranteed. As stated in the Environmental Policy, Fresenius is committed to using water responsibly and complying with the applicable legal regulations. In addition, the company wants to reduce the water withdrawal of the production facilities in areas with water stress. Therefore, in 2024 Fresenius set the voluntary goal of reducing the process water withdrawal of production facilities in areas of water stress by 20% in absolute terms by 2030 (baseline year: 2023; baseline value: 3,518,096 m³). The improvement of water quality is not addressed.

To define the target, Fresenius first evaluated its own water consumption and sources of consumption and analyzed future scenarios (for 2030 and 2050, each optimistic and pessimistic scenario) using the Aqueduct tool and considered the assumption that water stress will increase in certain regions. As no specific targets have been set by the European Union, Fresenius evaluated measures and their potential. The Group also carried out benchmarking in order to compare and adjust ambition levels.

The main factor for target-setting is based on scientific studies evaluating water stress as an increasing risk for the environment and business activities. The data used in the Aqueduct tool is open-source and peer reviewed.

Internal stakeholders were involved via assessment meetings in the target-setting process in order to jointly define the actions, potential, and ambition level. External stakeholders were indirectly involved through considering public opinions, e.g., initiatives, and available standards.

In the reporting year, Fresenius expanded the scope of the target. The target no longer applies only to areas with high and extremely high water stress but also to areas with medium to high water stress. The baseline value of 3,313,000 m³ was increased by 205,096 m³. The intended percentage reduction and the baseline year remain unchanged. This adjustment was intended to ensure that all relevant sites remain within the scope, even if their categorization changes from year to year, e.g., due to variations in precitipation.

In the reporting year, process water withdrawal in areas with water stress amounted to 3,427,196 m³. Fresenius achieved a reduction of 2.6%. This puts the Group on track to reach the target.

Metrics¹ [E3-4] Water consumption

¹ Starting in fiscal year 2025, the remaining units of Fresenius Vamed will no longer be included in the environmental data. According to the recalculation policy, the change compared to the previous year is insignificant, so no recalculation was performed.

Water consumption

In 2025, Fresenius withdrew a total of 14,284,759 m³ of water. This represents a 4.5% decrease year over year (2024: 14,959,196 m³). Water consumption accounts for 2,392,745 m³, an 3.6% rise from the previous year (2024: 2,310,508 m³). In the healthcare facilities, water withdrawal depends on the number of patients treated in hospitals and the type of treatment performed. At the production sites, the production volume has an impact on Fresenius’ water consumption.

Water consumption was calculated as the difference between water withdrawal and water discharge. The water withdrawal is totaled on the basis of meter readings and invoices. If no data is available, the water consumption is extrapolated using reference values. The water consumption of the following units is based on data per FTE (full-time equivalent), collected at the Bad Homburg site: outpatient clinics, offices, research & development sites, locations with unavailable data, and employees of the segment Corporate / Other outside Bad Homburg. The water discharge is totaled on the basis of meter readings and invoices. If there is no value, it is assumed that the quantity of water discharge is equal to the withdrawal.

For the evaluation of water quantity of the water basins, the Aqueduct tool has been used, disclosing those material locations in water stress areas where the available renewable surface and groundwater supplies are limited. The water quality was measured by the Aqueduct tool and by untreated connected wastewater as well as coastal eutrophication potential, which are included in the areas at water risk.

Significant locations were evaluated for water risks and water stress using the Aqueduct tool and their water consumption totaled.

Recycled and reused water is determined on the basis of meter readings. If no readings are available, the quantity of recycled and reused water is estimated by the person responsible for the process and on the basis of reference values.

The amount of stored water is determined on the basis of year-end water level values. If no exact meter reading is available, the quantity is estimated using reference values. 72.0% of the quantitative data on water is based on measurements, 28.0% on estimates.

Water intensity

Water intensity describes the total water consumption per €1 million in net revenue.

At sites with ISO 14001 certification, the water management systems, which are also used to collect the key figures, are audited by an external auditor. The auditor determines the specific aspects to be audited.