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[Display omitted] • An Implicit knowledge-guided machine learning framework is proposed. • The effect is validated by modelling plasma gasification of medical waste. • RMSEs decrease by 36.44% and 2.58% for ANN and SVM. • Knowledge-based errors decrease by 83.22% and 100% for ANN and SVM. • All implicit knowledge-based monotonicity relationships are captured. Ensuring the interpretability of machine learning models in chemical engineering remains challenging due to inherent limitations and data quality issues, hindering their reliable application. In this study, a qualitatively implicit knowledge-guided machine learning framework is proposed to improve plasma gasification modelling. Starting with a pre-trained machine learning model, parameters are further optimized by integrating the heuristic algorithm to minimize the data fitting errors and resolving implicit monotonic inconsistencies. The latter is comprehensively quantified through Monte Carlo simulations. This framework is adaptive to different machine learning techniques, exemplified by artificial neural network (ANN) and support vector machine (SVM) in this study. Validated by a case study on plasma gasification, the results reveal that the improved models achieve better generalizability and scientific interpretability in predicting syngas quality. Specifically, for ANN, the root mean square error (RMSE) and knowledge-based error (KE) reduce by 36.44% and 83.22%, respectively, while SVM displays a decrease of 2.58% in RMSE and a remarkable 100% in KE. Importantly, the improved models successfully capture all desired implicit monotonicity relationships between syngas quality and feedstock characteristics/operating parameters, addressing a limitation that traditional machine learning struggles with. [ABSTRACT FROM AUTHOR]

Effective in-site treatment of medical waste has become a weak link in hospitals. Pyrolysis technology is a treatment method for medical waste that can enable rapid disposal in hospital settings and relieve environmental pressure, while also producing high-value products and reducing disposal costs. In this work, the effects of feedstock ratio and temperature on product yield and components of gauze (GA) and medical bottles (MB) co-pyrolysis have been investigated. The higher yield of solid products was obtained by co-pyrolysis of GA and MB at 400 ℃. With the addition of MB and an increase in temperature for the co-pyrolysis of GA and MB in a similar ratio, the pyrolysis oil and gas yields gradually increased. According to GC–MS analysis, co-feeding 75% MB to GA improved the alcohol content from 33.21% to a maximum yield of 59.8% at a pyrolysis temperature of 700 ℃. The content of aliphatic hydrocarbon reached 38.68% when the pyrolysis temperature and MB addition ratio were 700 °C and 75%, respectively. The GC data shows that the main gas components of co-pyrolysis of GA/MB were CH4 and H2, while the pyrolysis of pure GA or MB resulted in CO or CO2. Additionally, the solid carbon products obtained have an excellent pore structure. This strategy can benefit medical waste control and resource utilization for the low-cost disposal of medical waste and the acquisition of high-value resource products. [ABSTRACT FROM AUTHOR]

Introduction: The disposal of regulated medical waste (RMW) in the healthcare setting can be both costly and environmentally harmful. Prior studies have found large amounts of waste disposed of in RMW containers are inappropriately placed. Few studies to date have investigated the efficacy of waste reduction practices in the dermatology setting. Methods: This study aims to evaluate the effectiveness of a practice-wide intervention in reducing RMW in the outpatient dermatology setting. By performing daily waste audits and two concurrent educational interventions, the amount of RMW produced and percent of appropriately placed RMW will be measured. Further analysis will occur by comparing pre-intervention values to post-intervention values. Results: The percentage of waste properly placed in RMW containers prior to any intervention was 11%. Following both educational interventions, the percentage of waste properly placed in RMW containers increased by 56.1% (CI 43.7–68.5%) and the percentage of total waste produced that was identified and disposed of as RMW decreased by 6.0% (95% CI 1.2–10.8%). Conclusion: Our study provides practical data for dermatology providers to make small changes which can result in significant reductions of regulated medical waste, potentially providing benefits to the environment and cost-savings. [ABSTRACT FROM AUTHOR]

Plastics are a versatile material group with many applications in the healthcare sector. Clinicians, particularly in the operating rooms, have become increasingly dependent on single-use instruments and consumables typically packaged in Polyethylene Terephthalate (PET) resulting in significant amounts of PET waste. In this study, a life cycle assessment (LCA) methodology based on ISO 14040/44 is conducted to assess the environmental impacts of existing and potential future end-of-life options for PET anaesthesia and surgical instrument packaging waste in an Australian hospital context. The results show the reduction potential of environmental impacts by recycling of PET waste via direct collection or in Materials Recovery Facility (MRF) in Australia, Indonesia and New Zealand. When replacing end-of-life options such as landfill or incineration with recycling, a reduction of 88% of total Climate Change (CC) impact can be seen. Furthermore, there is a reduction in environmental impacts across other impact categories through this change. Even if the recyclate quality (up to 30%) was reduced, there is a significant reduction in the environmental impacts. The transition of end-of-life options to recycling offers the potential for reduction of emissions and enables a circular economy for plastics. Furthermore, based on the results of LCA, opportunities and challenges of circular economy pathways in health industry are identified and discussed in this study. [ABSTRACT FROM AUTHOR]

Proper hospital waste management poses important concerns due to the risk capacity of hospital waste to health and the environment. Healthcare management approaches have changed in recent years, motivated by the desire to minimize the environmental impact. The review aims to examine the current HCW and considers the local challenges associated with establishing a circular economy (CE) to improve hospital waste management regarding training along Plan, Do, Check, and Act (PDCA). The study found that mean medical and general waste segregation rates in public hospitals were 50.15 and 49.85, respectively. On average, 3.6 kg of waste was generated per bed per day. Analysis revealed a significant correlation between total waste and infectious waste with the number of occupied beds in the hospital (p < 0.05). Updating national laws by the CE approach is necessary. Our insights into circular hospital waste urge establishing a green management team, new training methods, and continuous supervision. Using PDCA to enhance waste segregation, training, and other aspects of hospital waste management is vital. [ABSTRACT FROM AUTHOR]

Medical waste management is a crucial issue due to its potential health risks to humans and harm to the environment. The World Health Organization (WHO) advises separating medical waste into seven groups based on its type. However, despite the implementation of color-coded bin bags, cases of missegregation still occur frequently, leading to injuries and spreading diseases. Infectious waste such as sharps, human tissue, and body parts are often found mixed in waste bins, posing a severe threat to waste employees. To address this issue, this paper proposes exploring the potential of digitalization in waste segregation. The literature on current segregation methods and technology applications is analysed and compared, and a framework for utilizing barcode tagging and scanning to ensure waste is correctly categorized is presented. The barcodes and scanner will be connected through a monitoring system, which can notify waste generators and collectors of misplacing or mixed waste. This digitalization system is expected to serve as a monitoring agent for segregating waste before it is collected from any health facilities. Additionally, the exchanged data from waste generator bins can inform collectors and other waste stakeholders about the waste's condition, potentially opening up opportunities for recycling companies to purchase used plastics or metals from hospital wastes. By implementing digitalization in medical waste management, waste segregation can improve, reduce the spread of diseases and injuries, and promote the recycling of hospital waste materials. [ABSTRACT FROM AUTHOR]

Taiwan has been an active participant in waste recycling for a long period of time due to the need for resource sustainability. The country believes it can one day eventually achieve the goal of zero waste through the effective use of strategies such as source reduction, resource recovery, reuse, and recycling. Despite Taiwan's long‐standing commitment to waste recycling for purposes of resource sustainability, achieving the goal of zero waste remains an immense challenge. Therefore, putting into effect the previously mentioned strategies will obviously be necessary in order to realize this goal. However, the effective implementation of these strategies requires both comprehensive planning and coordination, particularly in large medical institutions. Here, we have aimed to promote waste reduction throughout the entire hospital system in Taiwan using 3 strategies: (1) standardizing the colors of garbage bags, marking patterns of waste, and reviewing and establishing an internal audit mechanism on a regular basis; (2) the systematic monitoring of individual departments with regard to on waste consumption, brands, and materials while linking departments to the procurement source management team. In addition, any related hardware has been upgraded, precisely controlled, and automatically uploaded to the cloud system for an improved intelligent management system. In addition, the Department of Nutrition has adjusted the handling of ingredients and consumption patterns of hospital employees in order to reduce food waste; and (3) with regard to the disposal of medical waste, medical centers will be consolidating and advancing the knowledge and ability of all hospital personnel through education and training programs established for them. After the implementation of this program to promote awareness, the ratio of biological waste percentage in regard to total hospital waste dropped from 37.3% in 2018 to 33.6% in 2022, with a 49% decrease being seen in food waste, and a 99.32% increase being realized in green designated procurement items. Such an efficient management of medical waste has no doubt been extremely beneficial to the hospital. [ABSTRACT FROM AUTHOR]

• The effect of temperature on plasma gasification of CPMW is explored experimentally. • A temperature of 1800 °C provides the optimum performance for air-CPMW gasification. • The volume fraction of H 2 and CO increases with the increased reactor temperature. Plasma gasification melting (PGM) provides reliable disposal of toxic medical waste with a low heating value, which is capable of converting waste into energy. This study investigates the performance of experiments on plasma gasification for the treatment of chemical-pharmaceutical medical waste (CPMW) with an air medium. A comparative analysis is performed for gasification characteristics at three reactor temperatures (1000, 1400, and 1800 °C). Moreover, a thermodynamic equilibrium model is developed to assess performance features such as syngas yield, high heating value, and cold gas efficiency in the gasification temperature range of 1000–1800 °C. A comparison of the experiment and computational outcomes shows a good agreement. The results show that the quality of syngas and heating value is improved by increasing the temperature of the plasma gasifier so that at 1800 °C, H 2 , CO, and higher heating value (HHV) are obtained as 41 %, 37 %, and 10 MJ/Nm3, respectively. The obtained syngas is a clean fuel with low sulfur-containing and nitrogen-containing. The experimental results provide an extensive comprehension of CPMW gasification in a plasma reactor and consider a possibility for hydrogen and energy production. [ABSTRACT FROM AUTHOR]

In December 2022, the epidemic prevention and control policy was upgraded, and China entered a different stage of epidemic control. This study aims to identify implications for better infection control and health care supply during the epidemic. A longitudinal quantitative and qualitative study was performed based on 2 comprehensive questionnaire surveys among 497 hospital infection prevention and control practitioners (HIPCPs) before and during the epidemic peak in Tianjin, China. The workload (8.2 hours vs 10.14 hours, P = 0) and self-reported mental health problems (23.5% vs 61.8%, P <.05) among the HIPCPs increased significantly in the peak period. Ward reconstruction and resource coordination were the most needed jobs in hospital infection control, and rapidly increased medical waste during the epidemic needs to be considered in advance. Community support for health care personnel and their families, maintaining full PPE to reduce simultaneous infection of medical staff, and clinical training of infectious diseases for medical staff, especially doctors, in advance are the most important things we learned. Although it has been 4 years since the first outbreak of coronavirus disease 2019, more improvements should be made to prepare for the next epidemic of potential diseases. • A comprehensive research on hospital infection prevention and control practitioners. • Workload and mental health problems increased among HIPCPs during the pandemic. • Infection among family members is an important source of anxiety and depression. • Clinical training on infectious diseases shall be applied for doctors in advance. • Online diagnosis and prescriptions alleviated the shortage of medical resources. [ABSTRACT FROM AUTHOR]

This study was conducted to estimate medical wastes generation rates in Viet Nam. Within 3 years (from 2017 to 2019), total medical wastes generated daily of 1,737 health-care facilities at different levels from 19/63 provinces in Viet Nam were surveyed. The calculation was based on the median daily generation (in kg) of 6 medical waste groups and total actual patient beds in 9 health-care facility categories. Six medical waste groups were sharps, non-sharps, high-risk infectious, pathological, non-infectious hazardous, recyclable and non-recyclable wastes. Surveyed health-care facilities were categorized in central general hospitals, central specialist hospitals, provincial general hospitals, provincial specialist hospitals, district health centers, regional clinics, commune health stations, private hospitals and private clinics. The results showed that waste generation rates varied from 0.0009 to 1.619 kg/bed/day depends on type of medical wastes or health-care facilities. For no-patient-bed facilities (commune health stations and private clinics), medical waste generation rates of these two were calculated in kg/day and varied from 0.1 to 1.75 kg/day. [ABSTRACT FROM AUTHOR]

In this study. Baghdad hospital waste ash was analyzed to determine the type of heavy and toxic concentrations in the waste and to study the potential effects of radioactive waste, health risks and the effectiveness of S/S hardening/stabilization processes based on local cement. Toxic medical waste was used in this work as bottom ash, which includes large amounts of pollutants such as As, Co, Cr, and Hg. Ash samples were taken from the medical waste incinerators of the main hospital in the city. The heavy metal sludge is stabilized and solidified using this bottom ash. The curing matrix was between 7% and 25% local cement in varying amounts. Before arriving at the physical and chemical properties of the solid, it underwent six different periods of treatment. Filtration experiments using solid-liquid partitioning as a function of pH, the filtration method was deployed to determine treatment efficiency. The compressive strength confined to the forms was also measured to ensure the solidity and durability of the molds. After disposal, the most effective solid material with good strength was found, which contains 25% of local cement. In addition, the results of the study showed that the efficiency of treating the filtration method for toxicological properties Ranging from 85% to 100%. The range of treatment efficiency in liquid/solid technology was 75%-100%. The S/S process can be a very good, effective and safe treatment process for handling and disposing of toxic medical waste ash or the possibility of reusing the formwork in bridges and roads. [ABSTRACT FROM AUTHOR]

Abstract Introduction The disposal of regulated medical waste (RMW) in the healthcare setting can be both costly and environmentally harmful. Prior studies have found large amounts of waste disposed of in RMW containers are inappropriately placed. Few studies to date have investigated the efficacy of waste reduction practices in the dermatology setting. Methods This study aims to evaluate the effectiveness of a practice-wide intervention in reducing RMW in the outpatient dermatology setting. By performing daily waste audits and two concurrent educational interventions, the amount of RMW produced and percent of appropriately placed RMW will be measured. Further analysis will occur by comparing pre-intervention values to post-intervention values. Results The percentage of waste properly placed in RMW containers prior to any intervention was 11%. Following both educational interventions, the percentage of waste properly placed in RMW containers increased by 56.1% (CI 43.7–68.5%) and the percentage of total waste produced that was identified and disposed of as RMW decreased by 6.0% (95% CI 1.2–10.8%). Conclusion Our study provides practical data for dermatology providers to make small changes which can result in significant reductions of regulated medical waste, potentially providing benefits to the environment and cost-savings.

Aiming at the uncertainty of medical waste recycling network, with the quantity and transportation cost of medical waste as the key variables, a multi-objective nonlinear integer programming model with multiple uncertain parameters was constructed, and robust optimization was introduced to deal with the uncertain factors. Multi-objective particle swarm optimization (MOPSO) and genetic algorithm (GA) were combined to solve the model. The outer GA was responsible for location decision, and the inner MOPSO was responsible for distribution path optimization based on location selection results. A domestic city was selected as the empirical object for the simulation. The results show that compared with the traditional genetic algorithm, the proposed algorithm reduces the total cost by 10.37%, the total risk by 1.86% and the workload deviation by 50.18%; Sensitivity analysis proves that the uncertainty of medical waste volume has more significant influence on the objective function. The proposed mode can help the decision makers adjust the uncertain parameters according to the risk appetite to obtain the best medical waste recycling network optimization scheme, which provides some reference for further study of medical waste recycling.

Abstract Proper hospital waste management poses important concerns due to the risk capacity of hospital waste to health and the environment. Healthcare management approaches have changed in recent years, motivated by the desire to minimize the environmental impact. The review aims to examine the current HCW and considers the local challenges associated with establishing a circular economy (CE) to improve hospital waste management regarding training along Plan, Do, Check, and Act (PDCA). The study found that mean medical and general waste segregation rates in public hospitals were 50.15 and 49.85, respectively. On average, 3.6 kg of waste was generated per bed per day. Analysis revealed a significant correlation between total waste and infectious waste with the number of occupied beds in the hospital (p

Abstract Medical waste management is a crucial issue due to its potential health risks to humans and harm to the environment. The World Health Organization (WHO) advises separating medical waste into seven groups based on its type. However, despite the implementation of color-coded bin bags, cases of missegregation still occur frequently, leading to injuries and spreading diseases. Infectious waste such as sharps, human tissue, and body parts are often found mixed in waste bins, posing a severe threat to waste employees. To address this issue, this paper proposes exploring the potential of digitalization in waste segregation. The literature on current segregation methods and technology applications is analysed and compared, and a framework for utilizing barcode tagging and scanning to ensure waste is correctly categorized is presented. The barcodes and scanner will be connected through a monitoring system, which can notify waste generators and collectors of misplacing or mixed waste. This digitalization system is expected to serve as a monitoring agent for segregating waste before it is collected from any health facilities. Additionally, the exchanged data from waste generator bins can inform collectors and other waste stakeholders about the waste's condition, potentially opening up opportunities for recycling companies to purchase used plastics or metals from hospital wastes. By implementing digitalization in medical waste management, waste segregation can improve, reduce the spread of diseases and injuries, and promote the recycling of hospital waste materials.

Medical wastes include wastes created by biomedical research institutes, medical labs, and hospitals. Through exposure to infectious pathogens, improper waste treatment offers substantial hazards of disease transmission to wastes workers, wastes pickers, patients, health workers, , and the population in general. Poor wastes management releases dangerous and detrimental constituents into society. However, due of the volumes of wastes generated and its infectious nature, contamination of highly contagious agents such as the sudden pandemic has created huge instability in medical wastes treatments and consequent recycling. Several nations have implemented safety procedures to counteract this pollution and manage medical wastes; nevertheless, these efforts are inadequate and vary depending on the nation. Moreover, worldwide organizations have recognized recommendations for the handling of medical wastes. Those rules are aiding in the management of highly infectious medical wastes generated by all-medical centers. Instead of sending things to landfills, proper medical wastes management may make available value by limiting disease transmission and enhancing recyclability. Disinfecting and classifying medical wastes enables for more sustainable management and the reuse of important resources. This paper addresses the various medical solid wastes environmental impacts, management and disposal techniques used in various nations, the issues encountered throughout these strategies, and potential solutions to these challenges.

The COVID-19 outbreak has impacted many daily activities and services we depend on. Due to changes in waste quantity and types, solid waste management (SWM) services such as waste collection, transportation, and treatment/disposal suffered. Global rules and mandates were issued to address these changes and the COVID-19 pandemic. This mini review examines seven countries and summarises the pandemic’s effects on municipal solid waste (MSW) and medical waste (MW) generation in terms of amount and composition, the SWM sector’s challenges, and government or other SWM guidelines and management measures. The data are analysed to provide suggestions for stakeholders on SWM worker protection, waste segregation, and recycling. This article identified that extending MW incineration, separating infectious waste at the source, and discontinuing recycling for infection control are the best ways to manage solid waste. The waste management system’s readiness was crucial to the pandemic response. Thus, countries like China, which has a robust SWM system, were able to contain the crisis and restrict danger, while others with weaker systems struggled. Additionally, the study highlights the importance of revising waste management policies and developing crisis response strategies that integrate flexible, innovative solutions to adapt quickly to changing waste demands and ensure public health and environmental protection during global health crises.

Ting Yang,1,2 Yanan Du,1 Mingzhen Sun,1 Jingjing Meng,1 Yiyi Li1 1School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China; 2Intelligent Interconnected Systems Laboratory of Anhui Province (Hefei University of Technology), Hefei, Anhui, 230009, People’s Republic of ChinaCorrespondence: Ting Yang, Email yangting@ahmu.edu.cnAbstract: Over the past decade, the global outbreaks of SARS, influenza A (H1N1), COVID-19, and other major infectious diseases have exposed the insufficient capacity for emergency disposal of medical waste in numerous countries and regions. Particularly during epidemics of major infectious diseases, medical waste exhibits new characteristics such as accelerated growth rate, heightened risk level, and more stringent disposal requirements. Consequently, there is an urgent need for advanced theoretical approaches that can perceive, predict, evaluate, and control risks associated with safe disposal throughout the entire process in a timely, accurate, efficient, and comprehensive manner. This article provides a systematic review of relevant research on collection, storage, transportation, and disposal of medical waste throughout its entirety to illustrate the current state of safe disposal practices. Building upon this foundation and leveraging emerging information technologies like Internet of Things (IoT), cloud computing, big data analytics, and artificial intelligence (AI), we deeply contemplate future research directions with an aim to minimize risks across all stages of medical waste disposal while offering valuable references and decision support to further advance safe disposal practices.Keywords: medical waste, safe disposal, major infectious diseases, progress and challenges

Addressing the pollution problems caused by improper disposal of effluents and wastes from pharmaceutical companies and medical facilities are important for the safety of humans and animals. This work highlights the challenges and developments in medical and pharmaceutical waste management practices across the world as well as their potential for bio-energy production. It involves the study of these waste properties, their impacts on the ecosystem and treatment or recycling methods. Various studies have shown that successes have been recorded in converting some antibiotic contaminated wastewater to biogas in advance anaerobic digesters. Moreover, not all medical wastes are degradable, the use of placentas, hospital cotton waste, human urine, waste blood and surgery waste has been used in biogas plants built at close proximity to hospitals, in some cases. However, such plants are few and are only located in Tanzania, India and Philippines, among others to generate biogas to power hospitals, boil hot water needed by patients and for cooking. This is because the level of awareness as regards the dangers associated with indiscriminate disposal of medical and pharmaceutical waste is low and hence the development of waste disposal policy by countries is often overlooked. The implication of this is the spread of diseases in affected areas which can results in epidemics. It is therefore necessary to formulate policies that allow the harnessing of these wastes to biogas/ bioenergy or the creation of better waste management practices that is environmentally safe. [ABSTRACT FROM AUTHOR]

Supply chain management is a crucial task for all companies, as it is essential to respond to increased demand and competitiveness. An exponential increase in hospital waste can cause very significant risks to both humans and the environment if it is not treated adequately. In this way, the efficient management of this waste can bring benefits and prevent an increase in the likelihood of disease occurring. With the growth of technology, there are various tools available to improve decision-making in the supply chain. Simulation, one of the pillars of Industry 4.0, is one of the tools being used. With the complexity of systems increasing, hybrid simulation provides more precise solutions to problems. The aim of this article is therefore to systematically research and analyze the literature on the use of simulation/hybrid simulation in supply chains in the health sector. In this way, 20 articles that approach simulation as a decision support tool in hospital waste supply chains were analyzed in the context of Industry 4.0. The results indicate that the years 2020 and 2023 had the highest number of publications (with five each) and that countries such as China and Indonesia had the highest number of documents on this topic (with five each). The topics in this research area with more related documents were environmental sciences, computer sciences and medicine. This research highlights the fundamental role of simulation approaches in improving the performance of supply chains in the healthcare sector, promoting resilience and improving healthcare outcomes for patients. [ABSTRACT FROM AUTHOR]

During major epidemic outbreaks, the generation of medical waste has increased dramatically. Medical waste becomes more infectious than usual under these circumstances, and turnover personnel may be affected or become ill due to infection. These unforeseen factors have significantly increased the complexity of task assignment for medical waste turnover personnel. In addition, medical waste requires daily collection and disposal. To ensure the smooth collection of medical waste, the reasonable arrangement of turnover personnel is particularly important. It is well known that the fewer times medical waste turnover personnel are assigned to different temporary storage points for medical waste, the less likely cross-infection occurs. In this paper, aiming to minimize the number of assignments and the number of medical waste turnover personnel assigned, while ensuring a balanced collection task for the assigned medical waste turnover personnel, a multi-objective medical waste turnover personnel assignment model is established, aiming to minimize the number of assignments while ensuring a balanced workload among the assigned personnel. To facilitate solving, this paper converts nonlinear constraints in the model into linear constraints using the Big M method. Finally, based on the medical waste collection and disposal data of a medical waste disposal unit in a certain district of Chengdu city on April 13, 2022, relevant numerical examples are designed and solved using IBM ILOG Cplex Studio IDE 12.7.1, thereby verifying the efficiency and applicability of the model. Our model is designed to provide a relatively rational personnel scheduling plan under the context of major epidemic outbreaks, where the uncertainty for medical waste collection and transportation personnel is heightened. This model aims to minimize the number of personnel required for medical waste collection and transportation while ensuring a balanced workload distribution among them. In comparison to manual scheduling methods, our model significantly enhances the efficiency of scheduling. [ABSTRACT FROM AUTHOR]

Background: The healthcare sector contributes directly to global warming and environmental decline. This is partly due to disproportionately large waste generation compared to other sectors and the environmental consequences of medical waste incineration. Waste separation and recycling decrease the total waste generation of the theatre complex, decreasing the cost of waste disposal, and if properly implemented, can generate revenue. Waste separation is not performed uniformly, and no recycling programmes exist in the theatre complexes of the academic hospitals in Johannesburg. Potentially recyclable anaesthetic waste is not identified in our setting. Methods: Recyclable anaesthetic waste items were identified. Anaesthetic waste was collected after every anaesthetic case. General and medical waste were weighed respectively and inspected for correct separation. Recyclable items were separated from general waste and weighed. Results: A total of 107.6 kg of anaesthetic waste was evaluated. Per anaesthetic case, 74.6% (65.0-84.2%) was medical waste, and 25.4% (15.8-35.0%) was general waste. Of the general waste, 68.8% (57.7-78.8%) was recyclable. Only 6.8% of medical and 61.4% of general waste bags inspected were correctly separated. Within each medical waste bag, 6.9% (2.3-15.5%) of waste was incorrectly placed general waste. Similarly, each general waste bag contained 6% (0-21.6%) incorrectly placed medical waste. Waste generated per surgical discipline was significantly different. Conclusion: Correct waste separation, a key step in decreasing the burden of healthcare waste, was poor. The study demonstrated that most general anaesthetic waste is recyclable. [ABSTRACT FROM AUTHOR]

Medical wastes include the wastes created by biomedical research institutes, medical labs, and hospitals. Through exposure to infectious pathogens, improper waste treatment causes substantial hazards of disease transmission to waste workers, waste pickers, patients, health workers, and the population in general. Poor waste management releases dangerous and detrimental constituents into society. However, due of the volumes of wastes generated and its infectious nature, contamination of highly contagious agents such as the sudden pandemic has created huge instability in medical waste treatments and consequent recycling. Several nations have implemented safety procedures to counteract this pollution and manage medical wastes; nevertheless, these efforts are inadequate and vary depending on the nation. Moreover, worldwide organizations have recognized recommendations for the handling of medical wastes. Those rules are aiding in the management of highly infectious medical wastes generated by all-medical centers. Instead of sending things to landfills, proper medical wastes management may make available value by limiting disease transmission and enhancing recyclability. Disinfecting and classifying medical wastes enables for more sustainable management and reuse of important resources. This paper addresses the various medical solid wastes environmental impacts, management and disposal techniques used in various nations, the issues encountered throughout these strategies, and potential solutions to these challenges. [ABSTRACT FROM AUTHOR]

Indiscriminate dumping of infectious and toxic medical wastes generated from the hospital as well as open burning of these wastes are becoming prevalent in recent times. This usually result in several health and environmental problems. The objective of this study was to determine the soil elemental compositions in hospital waste disposal sites in Uyo metropolis. The study areas, included Uniuyo Teaching Hospital, St. Luke's Hospital, Uniuyo Medical Centre and Children Hospital. Underlying soil samples in the waste disposal sites were collected in a cellophane bag and tied properly to prevent air ingress. Atomic absorption spectrophotometer was employed to determine trace metals present in the waste disposal sites which were compared to World Health Organization Standards. The results were analyzed using statistical analysis, ANOVA. Results obtained from the atomic absorption spectrophotometer revealed that each of the samples contained one of the following elements such Pb, Ni, Cr, As, Cd, Al. The ANOVA results showed that mean values of the heavy metals were within WHO permissible limit, like lead Pb (1.302) at the children hospital site, Nickel Ni (0.448) at Uniuyo Teaching Hospital site, Aluminum Ai (0.486333) at the Uniuyo Medical Centre site, Arsenic As (0.239333) at the control site. Except chromium Cr (0.343667) at the children hospital site that was above the WHO standard. From the result of the statistical analysis, it was observed that medical wastes had a significant effect on the environment of Uyo metropolis. Based on the findings, it is recommended that effective method of waste segregation and disposal should be implemented, and designated sites should be used as dump sites. [ABSTRACT FROM AUTHOR]

Infectious waste disinfection is an essential process in medical waste management that may cause release of some pollutants. In this study, the PAHs concentration at the disinfection was investigated. The change in the release rate of PAHs in two including infectious waste reduction and increasing the segregation ratio was estimated. The results showed that the PAHs concentration was 1172 – 2066 ng/m3. The specific concentration of PAHs was 852 ng/ton of infectious waste in average. The annual emission of the PAHs resulting from infectious waste disinfection is estimated to be 612.6 kg. Reduction of infectious waste caused by redefining infectious waste and increasing the segregation ratio leads to reduction of PAHs concentration by 50%. Increasing the ratio of segregation and redefinition of infectious waste that led to reduced waste loading volume are essential measures that reduce the emissions of pollutants as by-products of disinfection. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak has impacted many daily activities and services we depend on. Due to changes in waste quantity and types, solid waste management (SWM) services such as waste collection, transportation, and treatment/disposal suffered. Global rules and mandates were issued to address these changes and the COVID-19 pandemic. This mini review examines seven countries and summarises the pandemic's effects on municipal solid waste (MSW) and medical waste (MW) generation in terms of amount and composition, the SWM sector's challenges, and government or other SWM guidelines and management measures. The data are analysed to provide suggestions for stakeholders on SWM worker protection, waste segregation, and recycling. This article identified that extending MW incineration, separating infectious waste at the source, and discontinuing recycling for infection control are the best ways to manage solid waste. The waste management system's readiness was crucial to the pandemic response. Thus, countries like China, which has a robust SWM system, were able to contain the crisis and restrict danger, while others with weaker systems struggled. Additionally, the study highlights the importance of revising waste management policies and developing crisis response strategies that integrate flexible, innovative solutions to adapt quickly to changing waste demands and ensure public health and environmental protection during global health crises. [ABSTRACT FROM AUTHOR]

Plastics are a versatile material group with many applications in the healthcare sector. Clinicians, particularly in the operating rooms, have become increasingly dependent on single-use instruments and consumables typically packaged in Polyethylene Terephthalate (PET) resulting in significant amounts of PET waste. In this study, a life cycle assessment (LCA) methodology based on ISO 14040/44 is conducted to assess the environmental impacts of existing and potential future end-of-life options for PET anaesthesia and surgical instrument packaging waste in an Australian hospital context. The results show the reduction potential of environmental impacts by recycling of PET waste via direct collection or in Materials Recovery Facility (MRF) in Australia, Indonesia and New Zealand. When replacing end-of-life options such as landfill or incineration with recycling, a reduction of 88% of total Climate Change (CC) impact can be seen. Furthermore, there is a reduction in environmental impacts across other impact categories through this change. Even if the recyclate quality (up to 30%) was reduced, there is a significant reduction in the environmental impacts. The transition of end-of-life options to recycling offers the potential for reduction of emissions and enables a circular economy for plastics. Furthermore, based on the results of LCA, opportunities and challenges of circular economy pathways in health industry are identified and discussed in this study.

Smart medical waste management is significant during the ongoing COVID-19 pandemic. This research presents a smart medical waste management system with real-time monitoring of medical waste data and an end-user application. The functional and technical design of a smart trolley by integrating various sensors for authenticated automatic lid opening and closing, waste level, weight, and storage time monitoring are discussed. Subsequently, the implementation of a cloud server and web application that provide automatic notifications to stakeholders are also presented. The users can monitor the entire process to take actions and approvals whenever necessary. The experiments are conducted to test the functionalities of the smart trolley and web application prototype. The results showed that the sensing system is efficient and avoids manual checking by sending necessary notifications. Healthcare institutions can adopt the proposed system for medical waste transfer to ensure process transparency, worker safety, and environmental cleanliness.

This research aims to identify current procedures of hospital waste management in educational hospitals, in western Iran. This study examined upon to be current procedures of medical waste management focusing on the management of hazardous medical waste, under a circular economy. Three criteria environmental situation, environmental management, and environmental performance. The environmental assessment was done by pair matrixes between criteria and sub-criteria, and between scale levels of the indicators were done. The questionnaire structure adopted in the Romero and Carnero study. The Analytic Hierarchy Process method indicates that aspect of the hazardous waste improvement program is essential. The results demonstrated that 56 % of the total environmental criteria score was VERY DEFICIENT in the scale factors classification. The lowest values indicated in the environmental management aspect and 63 % of the total score was VERY DEFICIENT. The results indicated a deficient value in environmental criteria based on the values received for the commitment to environmental policy standards and waste management procedures. The results of environmental performance criteria have shown; that no data was on atmospheric emission. The lack of rules in green purchasing and renewable energy was indicated. In waste management criteria, the total value was reasonable, but there weren't comprehensive rules for redefining waste types and staff training obligations. However, the redefinition of rules, public and staff training, using new technologies, and determination of specific budgets and green teams by proper supervising cycle can be essential to improve hazardous waste management.

Oil and gas production activities elevate the risk of marine oil spills, exacerbated by oceanic dynamics that disperse and emulsify spilled oil. Coalescence emerges as a preferred oil/water separation method for its eco-friendly process. Coalescing media, crucial for effective oil removal, are composed of diverse materials. The healthcare sector generates substantial disposable fiber-based plastic waste, posing environmental threats upon disposal. This study presents a novel approach: creating a hierarchical porous structure on medical waste substrates using a cost-effective method. This structure, featuring macropores from pristine fibers maintaining high permeation rates and micropores from PVDF coating enhancing oil removal capabilities, offers an efficient coalescing medium. The design’s simplicity hints at industrial scalability. Testing the modified waste materials as coalescing media yielded an 85 % oil removal efficiency across varied oil types and water salinities. This study aligns with a circular economy paradigm, transforming waste into valuable resources.

Climate change poses a growing threat to human health and well-being, with emerging evidence pointing to its intricate relationship with liver diseases. Indeed, climate change influences liver diseases through various direct and indirect mechanisms. Alcohol-related liver disease, Metabolic dysfunctionassociated liver disease (MASLD), and viral hepatitis are the three most common causes of liver disease, and all are susceptible to the effects of climate change. Shifts in dietary habits driven by altered food availability, substance abuse exacerbated by social instability, extreme weather events affecting healthcare access, and the emergence of waterborne infections are among the factors exacerbating liver disease incidence and severity. On the flip side, healthcare systems, including liver units, significantly contribute to climate change through energy consumption, medical waste, and transportation emissions. The need for sustainable healthcare practices, telemedicine, and waste reduction strategies is becoming increasingly evident. Recognizing this intricate interplay and addressing the dual interaction between climate change and liver disease is imperative for safeguarding human health and reducing the environmental footprint of healthcare facilities. As climate change continues to unfold, understanding its implications for liver disease is critical for public health and environmental sustainability. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic resulted in the generation of large quantities of medical waste and highlighted the importance of efficient waste management systems. One good example of this is rapid antigen tests, which contain valuable resources, and which are usually incinerated after their use. The present study aimed to evaluate the potential of waste rapid antigen test cassettes (RATCs) as a resource for the preparation of sustainable flame-retardant plastics. Milled RATCs were compounded with different concentrations (10–30 wt.%) of aluminium diethylphosphinate (ADP) and injection moulded into test specimens. Prepared samples were exposed to ultraviolet (UV) ageing for varying durations and characterised by Fourier-transform infrared spectroscopy (FT-IR), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), dynamic mechanical analysis (DMA), tensile tests, Charpy impact tests, and vertical burning tests. FT-IR analysis revealed that RATCs are composed mainly of high-impact polystyrene (HIPS), which was further confirmed by suitable glass transition temperatures (Tg) determined by DSC and DMA. The addition of ADP resulted in progressive embrittlement of HIPS with increasing concentration, while flammability decreased significantly and reached V-1 classification at loading of 30 wt.%. UV ageing caused photo-oxidative degradation of HIPS, which resulted in decreased strain-at-break, while flammability was not affected. [ABSTRACT FROM AUTHOR]

With the ever-increasing focus on sustainable development, recycling waste and renewable use of waste products has earned immense consideration from academics and policy makers. The serious pollution, complex types, and strong infectivity of medical waste have brought serious challenges to management. Although several researchers have addressed the issue by optimizing medical waste management networks and systems, there is still a significant gap in systematically evaluating the efficiency of medical waste recycling systems. Therefore, this paper proposes a two-stage data envelopment analysis (DEA) approach that combines the virtual frontier and the global bounded adjustment measure (BAM-VF-G), considering both undesirable inputs and outputs. In the first stage, the BAM-G model is used to evaluate the efficiency of medical waste recycling systems, and the BAM-VF-G model is used to further rank super-efficient medical waste recycling systems. In the second stage, two types of efficiency decomposition models are proposed. The first type of models decompose unified efficiency into production efficiency (PE) and environment efficiency (EE). Depending upon the system structure, the second type of models decompose unified efficiency into the efficiency of the medical waste collection and transport subsystem (MWCS) and the efficiency of the medical waste treatment subsystem (MWTS). The novel approach is used to measure the efficiency of the medical waste recycling systems in China's new first-tier cities, and we find that (1) Foshan ranks the highest in efficiency, followed by Tianjin and Qingdao, with efficiency values of 0.386, 0.180, and 0.130, respectively; (2) the EE lacks resilience and fluctuated the most from 2017 to 2022; and (3) the efficiency of MWCSs has always been lower than that of MWTSs and is a critical factor inhibiting the overall efficiency of medical waste recycling systems. [ABSTRACT FROM AUTHOR]

Medical waste management is essential to the hospital's operational activities. Health workers are needed to manage medical waste in hospitals because they are in direct contact with it. Therefore, the behaviour of health workers plays a vital role in medical waste management. This study determined the relation of knowledge, awareness, interest, and attitude of health workers on medical waste management practices at Sinar Kasih Purwokerto Hospital, Indonesia. In addition, this study also aims to determine the attitude of health workers in mediating the relation of knowledge, awareness, and interest in medical waste management practices at Sinar Kasih Purwokerto Hospital, Indonesia. The sampling method was cluster random sampling with 68 health workers: general practitioners, dentists, specialists, nurses, sanitisers, and public workers (PW). The data collection tool uses a questionnaire tested for reliability and validity to determine the level of knowledge, awareness, interest, attitude, and practice of medical waste management. Data analysis in this study used Partial Least Square (PLS) testing. This study showed that knowledge and interest had no significant positive effect on medical waste management practices. In contrast, awareness and attitude significantly positively impacted medical waste management practices. In addition, the attitude of health workers mediates the effect of knowledge and interest on medical waste management practices. However, attitude does not mediate the impact of awareness on medical waste management practices. The attitude of health workers is a mediator of knowledge and interest toward medical waste management practices. [ABSTRACT FROM AUTHOR]

The healthcare sector represents a major source of waste production, and healthcare workers (HCWs) are crucial in waste management. Educational interventions (EIs) can be delivered through a single component (mono-component) or by combining different components (multi-component); although they have a potential impact on the sustainability of healthcare, their effectiveness in waste management still needs to be identified. The aim of this systematic review and meta-analysis was to describe EIs to improve waste management knowledge, attitudes, and practices among HCWs and provide an estimate of their effectiveness. Six relevant databases were searched; 24 articles were included, and 19 were meta-analyzed. These were mainly from low-income countries and did not consider EIs for recycling, reducing, and reusing. Compared to the mono-component EIs, the multi-component Eis showed a higher statistically significant positive post-intervention effect on knowledge, with greater retention in the medium–long term, and on practices, particularly among non-hands-on HCWs. The effects of the EIs on attitudes were not significant. Our results suggest that multi-component EIs should be preferred to improve waste management standards in the healthcare sector. Given the heterogeneity found among EIs, the standardization of types, content, duration, and assessment methods should be considered. Finally, their harmonization at a global level could influence international and national policies on sustainability. [ABSTRACT FROM AUTHOR]

Introduction: Although healthcare waste is generated in small quantities, improper management can lead to significant health risks. This study aimed to develop a model for assessing the requirements for effective medical waste management on Qeshm Island. Methods: In this descriptive-analytical study, data were initially collected on the number of centers generating medical waste and the current status of waste management practices at these facilities. Subsequently, the quantitative and qualitative characteristics of waste from various medical waste-producing centers on Qeshm Island were assessed. Finally, the study identified the requirements, equipment, facilities, and machinery needed for effective medical waste management on the island. Results: The study found that Qeshm Island generates 104 kg of medical waste daily, necessitating a 500-liter autoclave, a van for waste transport, a driver, and 100 square meters of land for operational use, including a storage shed. The study also revealed that the quantity of medical waste generated in different clinical environments was considerably greater than that produced by general doctor's offices. In particular, midwifery offices, non-surgical specialists, surgeons, orthopedics, laboratories, dental offices, and obstetrics specialists generated medical waste at rates 1.19, 1.3, 1.97, 2.81, 7.5, 2.75, and 2.56 times higher than that of a general doctor's office, respectively. Moreover, each medical office is required to pay a minimum of 7,725,706 rials monthly for effective waste management. Conclusion: Based on this study, the condition for the success and continuity of the medical waste management in this island is the support of the Qeshm free zone organization and Hormozgan university of medical sciences from the activities of investor company. [ABSTRACT FROM AUTHOR]

He aim of the study is to know the extent of the commitment of government hospitals in Taiz city to health conditions related to the management of medical waste in its various stages; collection and sorting, transportation and temporary storage, and final disposal. The researcher used the analytical descriptive method to carry out the study. The researcher also used a questionnaire to collect the basic information for the study. It is the appropriate tool for collecting such information. The researcher, in addition, carried out irregular interviews with managers and employees of government hospitals in Taiz city. The researcher also reviewed many previous studies, books and relevant scientific journals to provide secondary resources, which had a major role in enriching this study with information and knowledge that formed a foundation for this research in many aspects of the study. The Population of the study represented all the five public hospitals in Taiz City. The study came at many results, for example, government hospitals have an independent Management in the supervision and follow-up of waste collection and sorting works, and there are regulations and arranging instructions management process of the waste and the relative commitment of workers to preventive means/tools. However, there is a great shortcoming in following preventive measures in general, which causes danger to hospital staff and visitors. The results of the study also showed that there is a relative commitment to the process of collecting and sorting medical waste in government hospitals, but this does not represent an actual commitment by those hospitals and is considered a formal commitment, as most of the elements of sorting and collection are not available: - activating commitment with the medical conditions for waste management in its various stages. - Providing special rooms by the hospital administration designated for storing medical waste that are compatible with the volume of waste generated within two days according to the recommendations of the World Health Organization. - Conducting awareness and training courses for workers in the field of collecting and transporting solid waste continually outside those hospitals. [ABSTRACT FROM AUTHOR]

Recently, hospitals around the world have been taking important steps to improve their sustainable environmental practices and minimize their negative effects on the environment while providing health services. In this context, in Türkiye, the "Zero Waste Regulation" was published in 2019 and it was reported that all institutions and organizations should gradually establish, document, and implement the "Zero Waste Management System" (ZWMS) until 31 December 2022. "Zero Waste", which is a full system approach to prevent waste, takes the generation of waste under control through recycling and reuse; it focuses on restructuring and improving production and/or service systems to reduce waste. With the publication of the Zero Waste Regulation, health institutions and organizations took on important responsibilities in the fight against the epidemic, due to the first cases of COVID-19 at the global level. For this reason, the majority of health institutions had to complete their transition to ZWMS during the pandemic period. It is necessary for the hospital management to implement ZWMS, which will help prevent, reduce, and recycle waste by including the patient and their relatives, especially the hospital staff. In order to ensure the continuity of this system, it is important to establish ZWMS policies and to create "Corrective and Preventive Actions-CPA" by constantly checking the practices on site. The effectiveness of ZWMS will be primarily ensured by preventing the generation of waste. In addition, the success of waste reduction, recycling, and recovery efforts will play an important role in this process. Processing and monitoring the waste instantly in the system according to its type and amount on a unit basis, comparing it with the data of previous years and questioning the unusual waste movements will increase the effectiveness of ZWMS policies. The aim of this study is to increase the awareness of health personnel on this issue, together with the concepts and models that will contribute to a better understanding of ZWMS, which is still in the implementation phase, in health institutions, and to offer suggestions to health managers on how to improve the quality of health care provided by ensuring sustainability. [ABSTRACT FROM AUTHOR]

BACKGROUND & OBJECTIVE: Ragpickers are free-lance workers who wander throughout the day or for the time that suits them to pick and gather recyclable waste materials. This material is collected from street wastebins and sold to various scrapyards that compensate them with a minimal amount. The conditions they work in are harsh, with health hazards around every corner of which they are unaware. This study aimed to explore the awareness of health hazards among Ragpickers in Lahore. METHODOLOGY: The study was conducted in the slum vicinity near The University of Lahore adjacent to Raiwind, Lahore. The perception of health hazards among Ragpickers was assessed through a proforma before the start of the study. The Snowball technique was used to collect data. An analysis among the same population was done two weeks later after being given awareness about health hazards. The data was analyzed using chi-square and McNamara Test with p-value <0.05 considered as significant. RESULTS: The results show that amongst the 150-sample population, the awareness level of the subjects increased by 50% about all diseases, but the knowledge about personal hygiene practices remained unchanged. Only 9% were aware of the diseases tetanus, and none of them was aware of hepatitis, etc.; however, after counseling, they became aware of the common hazards encountered during such work. The awareness level increased significantly (P<0.001). The data was analyzed using chi-square and paired sample t-tests with p-value <0.05 considered as significant. CONCLUSION: There was a prominent lack of awareness in the ragpickers included in the study, and after the intervention, they showed a greater understanding of infectious diseases. Through health care programs sponsored by the government and NGOs, significant improvement in health among Ragpickers could be seen by following simple hygiene principles. [ABSTRACT FROM AUTHOR]

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