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Medical waste management: a review
... Despite these challenges, these methods can reduce the hazards mentioned earlier. The treatments currently in the field are incineration, autoclave disinfection, microwave disinfection, and mechanical and chemical disinfection [21]. ...
... The high temperatures kill the pathogens, destroy 90% of organics, and change the waste characteristics such as weight, volume, and shape [23]. This process is governed by several parameters such as [21]: ...
... The operating conditions are 60 min, at 121 • C and 1 bar, followed by a cycle of 60 min at 134 • C to ensure the complete disinfection of waste [20]. The following aspects govern the operation of the autoclave [21]: ...
Many nations struggle with the collection, separation, and disposal of medical waste. However, extra caution is required to avoid the risk of injury, cross-contamination, and infection; thus, healthcare workers and individuals responsible for waste management must follow the mandatory safety procedures. In this review, a classification of the various types and categories of medical waste and its treatment methods are discussed. Due to the fact that medical waste can be contaminated and hazardous, it must be managed and processed using complex steps and procedures. In many countries, the primary medical/hospital waste treatment method is incineration, which is regarded as a highly polluting process that emits numerous pollutants that degrade air quality and pose a threat to human health and the environment. As case studies, medical waste treatment and disposal practices in Germany, China, USA, and Egypt were compared, and the legislations and laws enacted to regulate medical waste in each of these countries are reviewed and discussed.
... However we are in the dark about the unfavorable impacts of the refuse generated by them on environment. The waste produced in the course of health care activities entails a higher risk of infection, injuries and detrimental effects on environment: poisonous missions from improper burning of medical waste, pollution of soil and water sources than any other type of waste [1,2]; and is the second dangerous after radiation wastes in the world [3][4][5]. ...
... The report at United Nation (UN) general assembly explained approximately 75 to 80% of the total waste Desta Debalkie Atnafu and Abera Kumie: Healthcare Waste Composition and Generation Rate in Menellik II Referral Hospital, Addis Ababa, Ethiopia: A Cross Sectional Study generated by medical facilities is general waste and does not pose any risk to public health or the environment, the remaining waste is regarded as hazardous and may create a variety of health risks if not managed and disposed of in an appropriate manner [1,5,6]. Unlike general wastes that do not require special handling, improper management of healthcare wastes from hospitals, clinics, and other health facilities poses occupational and public health risks to patients, health workers, waste handlers, haulers, and communities [1,5]. ...
... The report at United Nation (UN) general assembly explained approximately 75 to 80% of the total waste Desta Debalkie Atnafu and Abera Kumie: Healthcare Waste Composition and Generation Rate in Menellik II Referral Hospital, Addis Ababa, Ethiopia: A Cross Sectional Study generated by medical facilities is general waste and does not pose any risk to public health or the environment, the remaining waste is regarded as hazardous and may create a variety of health risks if not managed and disposed of in an appropriate manner [1,5,6]. Unlike general wastes that do not require special handling, improper management of healthcare wastes from hospitals, clinics, and other health facilities poses occupational and public health risks to patients, health workers, waste handlers, haulers, and communities [1,5]. ...
... The medical waste management process encompasses waste generation, segregation, collection, transportation, and treatment. The absence of proper treatment can have several consequences, including [133] Toxin-induced poisoning, bacterial and fungal infections, release of toxins into the atmosphere, soil and aquifer contamination through leaching, Bioaccumulation, Environmental impacts, and habitat destruction. Waste disposal methods include Incineration: a carefully managed burning procedure where garbage is fully burned, and dangerous microbes are eliminated at high temperatures [134]. ...
... It is commonly agreed in modern society that the inefficient use of resources (especially energy) and its major ramifications, such as social inequality and the environmental load, render the production and consumption models of the past inadequate. Within this setting, the CE has arisen as a sustainable economic paradigm aided by creative company models and responsible consumers [133]. Global countries are implementing policies to reduce waste and transition to a CE. ...
The pressing need to address environmental challenges offers a significant opportunity to adopt zero-waste technologies, which can facilitate sustainable management across different levels of governance. This review focuses on recent innovative zero-waste technologies and their implementation frameworks for effective application at international, national, and state levels. The overarching concept of zero-waste involves the development of strategies aimed at eradicating waste throughout the lifecycle of products, including design, production, consumption, and disposal. The aim of this approach is not only to decrease environmental consequences but also to establish a circular economy in which resources are perpetually reused, recycled, or composted. At the global level, organizations such as the United Nations Environment Programme (UNEP) and the International Solid Waste Association (ISWA) have promoted initiatives for zero waste through worldwide frameworks and guidelines that encourage member states to adopt environmentally friendly waste management practices. These international efforts include setting ambitious targets for waste reduction, sharing best practices, and supporting the development of innovative technologies. It is crucial for national governments to translate the international guidelines into concrete policies and regulations. For instance, countries such as Japan and Germany have successfully implemented zero-waste programs through comprehensive legislative frameworks, public awareness campaigns, and the integration of advanced waste-management technologies. These national policies provide a foundation for state and local governments to develop tailored strategies to address specific regional challenges. At the state level, innovative zero-waste technologies such as advanced recycling systems, waste-to-energy solutions, and biodegradable materials are being tested and refined. States serve as laboratories for experimentation, showcasing successful models that can be scaled or adapted for broader applications. Collaborative efforts among state agencies, businesses, and communities are essential for the effective deployment of these technologies. This review emphasizes the interconnected roles of international, national, and state frameworks in advancing zero-waste technologies. It emphasizes the importance of cohesive strategies and multilevel collaboration in achieving a sustainable future, where waste is minimized, and resources are conserved for future generations.
... [5] Furthermore, the quantity of waste produced by anthropogenic activities is anticipated to double by 2025. [6,7]. Solid waste is a major contribution to the degradation of the environment's visual value [6]. ...
... [6,7]. Solid waste is a major contribution to the degradation of the environment's visual value [6]. Nigeria is not an anomaly in this sense [8,9]. ...
an obvious environmental problem in cities all over the world is the solid waste produced by industry and consumption. In rapidly expanding metropolitan areas, this accumulation is more of a catastrophe problem than ever before. Municipal solid waste is a significant environmental issue in Bauchi. Government laments that the current disposal sites are quickly filling up following the privatization of services with various businesses known as private sector participants (PSPs) that run as Bauchi State Environmental Protection Agency (BASEPA) franchisees. In order to increase the amount of trash that is diverted from landfills as a result of the rapidly filling dumpsites, BASEPA plans to implement a solid waste source separation policy in the city. Examining the feasibility of implementing a source-separation policy in the less compliant low-income population segment by assessing the aspects of attitude and perception is intended to give insight into the practical feasibility of instituting source-separation in all population segments. The data for this study were collected using a structured questionnaire. All analyses were conducted using the statistical package for social sciences (SPSS v25). According to the study, more than half (50.9%) of surveyed households have a poor perception of source separation, while 49.1% had a good perception of source separation. Similarly, it was also found that over half (52.5%) of surveyed households have a poor attitude toward source separation, while 47.5% of them have a good attitude toward source separation. It is recommended that a bottom-to-top approach of sensitization, orientation, and community engagement be adopted to improve the dimensions of perception and attitudes towards solid waste source separation in the metropolis.
... However, Guru Shri Gorakshnath Chikitsalay (GSGC), District Women Hospital (DWH), Life Care Hospital (LCH), Raj Eye Hospital (REH) and M.M. Nursing Home (MMNH) has provided their data for the month of January 2020 in our survey. We have found that 27. 16 Metric tons (MT) BMW was generated on monthly basis by seven hospitals form all type of wastes; in which, BRDMC generated 164.7 quintals, 33.8 quintals in NSCBDH, 29.9 quintals in GSGC, 20.7 quintals in DWH, 10.3 quintal in LCH, 7.9 quintals in REH and 4.3 quintals in MMNH respectively for all type of wastes. The hospital's waste was also calculated by the average BMW generated per day among hazardous (collected in yellow, red, blue and white containers) and non-hazardous (collected in black containers or dump in any site of hospital campus and send to Nagar Nigam for disposal) wastes in our study. ...
... This study was quite similar to the studies of Delhi, Agra and Dhaka city, Bangladesh [1,[13][14]. In India, the range of hazardous waste could vary from 15% to 30% depending on the total corpus of waste produced [15][16]. However, in our study the hazardous waste was slightly higher around 10-40%. ...
Biomedical waste (BMW) generated from medical centers have become serious health threat worldwide including India. Unsegregated and insensitive disposal of BMW can become a source of spreading the serious diseases not only for hepatitis, tuberculosis, HIV but also the recent pandemic of COVID-19 among their handlers and society. Our investigation was carried out to assess the waste handling, their segregation, disposal and treatment system of hospital BMW in the various medical institutes’ established in the Gorakhpur city. Study was conducted in accordance to questionnaire as per guidelines of “BMW Management Rules, 2016” amended in 2018. We found that almost 27 Metric tons BMW was generated monthly by seven hospitals; in which, medical centers with the name of BRDMC generated 164.7 followed by NSCBDH, GSGC, DWH, LCH, REH and MMNH produced 33.8, 29.9, 20.7, 10.3, 7.9 and 4.3 quintals of wastes, respectively. They also generated 20.74%, 35.78%, 9.8%, 32.3%, 12.7%, 41.3% and 28.6% per day hazardous wastes in the above sequence of hospitals in comparison of non-hazardous wastes. A yellow color container waste (potential source of infection) was higher among the hospitals of BRDMC, GSGC, DWH and MMNC; whereas, red color containers wastes (recyclable contaminated waste) was higher among NSCBDH, LCH and REH, respectively. Our surveyed hospitals produce approximately 10-40% of hazardous wastes daily. Proper guidelines of segregation and treatment are essential component for reducing the risk of BMW generated infections. Continuous training and fixing the responsibility of medical staffs are the key criteria's for reduction the chance of contamination and per unit BMW generation.
... Improper waste management generally results in adverse effects on the environment and the public health 5 . Numerous studies have reported that the inappropriate handling and disposal of HCW poses risks to health workers who may be directly exposed and people near health facilities, particularly children and scavengers who make a living of recycling materials from open dump sites accessed to infectious waste specially sharps waste which had higher risk of diseases like hepatitis and HIV/AIDS 5,10-12 . ...
... The study by WHO strengthen this idea that unsterilized syringes cause 8 to 16 million cases of hepatitis B, 2.3 to 4.7 million cases of hepatitis C, and 80,000 to 160,000 cases of HIV every year 1,13 . Five point two million People in the world (including 4 million children) also die each year from waste-related diseases 5 . ...
Healthcare wastes generated in Hospitals from medical activities have not given sufficient attention. In developing countries, healthcare wastes are still handled and disposed indiscriminately creating an immense threat to the public health and the environment. This situation is much worse in Ethiopia where there is paucity of convincing evidence about healthcare waste generation rate and management system. A crossectional study was conducted in Menellik II hospital to evaluate the healthcare waste management system. Primary data on the healthcare waste management system was collected using observational checklist. Key informant interview guide was also employed on 11 selected informants to assess waste management practice and analyzed by thematic framework. The results revealed that there was no segregation of healthcare waste by type at the point of generation and disinfection of infectious waste before disposal. The main HCW treatment and disposal mechanism was incineration using low temperature, single chamber incinerator; open burning; burring in to amputation pit and open dumping on municipal dumping site as well as on the hospital back yard. Furthermore, there was negligence, attitudinal problem and low level of awareness about safe healthcare waste management. To diminish the risk of healthcare waste on public health and environment, a cost effective interventions include providing better medical waste management facilities, adherence to national regulatory and rising awareness of all concerned need to adopt in the hospital.
... More than ever the risk to the natural environment caused by these materials requires a strict and rigorous supervision in the process of collection, transportation and disposal. Obviously, any negligence in the management of these wastes 772 FARZADKIA M. et al. may have direct or indirect adverse effect on the environment and human health (Amooei, 2003, Tudor et al., 2005, Da Silva et al., 2005, Akter, 2000. ...
... This statue was seen in other studies (Coker et al., 2009, Akter et al., 2002, Rasheed et al., 2005.The result mentioned above, despite training classes with the content of waste management, confirmed inefficiency of teaching in the studied hospitals. Creating the necessary infrastructure and Forcing employees to adhere to the rules and regulations by the managers are basic and essential items for hospital waste separation (Akter, 2000). Fig. 3d presents that the employees member status were poor in 37.5%, moderate in 25%, and good in 37.5% of hospitals. ...
ABSTRACT
The integrated hospital solid waste management emphasizes the need to conduct a survey based on a standardized method that equally be analyzed at national level. This study aimed to test the usability of a national tool to do integration data analysis of hospital waste management status. Then, a typical study was conducted in Karaj hospitals. Also, critical analysis of hospital’s solid waste management aspects was done, and shortcomings in the aspects were identified. The pilot study results showed that the daily per capita waste generations were reported to be 4.2±0.49 kg/available bed, 5.8±0.63 kg/occupied bed, and 10.3±0.9 kg/inpatient. The names of the hospitals were omitted when they were named from H1 to H8. So the highest and lowest daily waste generation rate were 5.5±0.35 and 2.6±0.78 kg/available bed in H7 and H3 hospitals, respectively. In this study, total infectious wastes per capita were reported to be 2.3±0.39 kg/available bed/day, 3±0.5 kg/occupied bed/day and 5.2±0.84 kg/inpatient/day. Furthermore, the averages per capita of total general waste were 2±0.4 kg/available bed/day, 2.8±0.51 kg/occupied bed/day and 5.1±0.8 kg/inpatient/day. Analysis of the Karaj hospital waste management status showed statue of hospital waste management in 88% of hospitals were ranked moderate when others were achieved to be poor by 12%. The hospital waste management had been evaluated poor in term of collection, transportation and manpower aspects, moderate in the separation and temporary storage aspects and good in the disposal aspect. It was also found that the MOHME tool is appropriate tool to investigate the status of waste management in hospitals.
Keywords: Hazardous waste, Hospital waste, Waste management
... The contribution from residential and industrial sources is minimal. According to the World Health Organization [10,11], approximately 85 percent of medical waste is harmless in its natural state; about 10 percent is infectious waste; and approximately 5 percent of waste is harmless but falls into a risky category. In the United States, certain types of biomedical waste have been regulated since August 15, 1945, as they belong to the infectious category. ...
The annual production of medical waste from healthcare facilities in Pakistan is around 250,000 tons. An effective waste management system is essential for disposing of hazardous medical waste, and incineration is considered the most effective and accessible technology. Disposal of medical waste ash in landfills without proper treatment could lead to groundwater contamination due to leachate. This research paper aims to evaluate the feasibility of using hospital waste ash obtained from the National Cleaner Production Center (NCPC) in Rawalpindi as a partial replacement for cement. The primary variable in this study was the amount of hospital waste ash (0%, 3%, 7%, and 10% by weight of cement), while the amount of cementitious material, water-to-cement ratio, and fine and coarse aggregate content were kept constant. A total of 36 cubes were cast, with nine cubes for each replacement level for curing periods of 7, 14, and 28 days. The slump value and density of fresh concrete decreased with the increase in the proportion of hospital waste ash in the mix. The compressive strength of mixes with 3% hospital waste ash was higher than that of the control mix. The best results (20.13 MPa) were obtained from the 3% mix after 28 days of curing, while the result obtained with the 7% mix was nearly equal to that of the control mix.
... Unscientific disposal of waste can cause fatal consequence related to health and environment. One study showed that some 5.2 million people including 4 million children die each year from waste-related diseases all over the world (Akter, 2000). MWs may cause disease and illness in human being, either through direct contact or indirectly by contamination of soil, groundwater, surface water and air etc. ...
Although Medical Waste (MW) accounts for less than one percent of total waste generation, it needs much more attention than other wastes do because of its hazardous and infectious nature. Being a developing country, unplanned and unscientific disposal of MW is a common practice in Bangladesh, especially in its capital city Dhaka. This article is a mixture of both quantitative and qualitative study. Data and information were collected through questionnaire survey and interview and were analyzed with simple calculation. It investigated that authorities and staff of the HCEs were well aware of the issue but were less willing to adopt scientific standard for MW. It also explored that process of management from waste generation to final disposal of the HCEs required much more development in achieving full scientific disposal. It found lacking in formulation and enforcement of laws and the deficiency of appropriate organizational for the proper management. Measures like adopting required guidelines, punitive compulsion and government responsibility had to be undertaken for the improvement of the situation. These would have to be accompanied by adopting scientific methods and by incorporating all the HCEs under a systematic management process.
... Unscientific disposal of waste can cause fatal consequence related to health and environment. One study showed that some 5.2 million people including 4 million children die each year from waste-related diseases all over the world (Akter, 2000). MWs may cause disease and illness in human being, either through direct contact or indirectly by contamination of soil, groundwater, surface water and air etc. ...
Although Medical Waste (MW) accounts for less than one percent of total waste generation, it needs much more attention than other wastes do because of its hazardous and infectious nature. Being a developing country, unplanned and unscientific disposal of MW is a common practice in Bangladesh, especially in its capital city Dhaka. This article is a mixture of both quantitative and qualitative study. Data and information were collected through questionnaire survey and interview and were analyzed with simple calculation. It investigated that authorities and staff of the HCEs were well aware of the issue but were less willing to adopt scientific standard for MW. It also explored that process of management from waste generation to final disposal of the HCEs required much more development in achieving full scientific disposal. It found lacking in formulation and enforcement of laws and the deficiency of appropriate organizational for the proper management. Measures like adopting required guidelines, punitive compulsion and government responsibility had to be undertaken for the improvement of the situation. These would have to be accompanied by adopting scientific methods and by incorporating all the HCEs under a systematic management process.
... Hazard/risk potential Proper waste management strategy is needed to ensure avoidance of any risk factors that affect public health [35,36]. ...
The growing urban population and increased use of healthcare services have brought significant attention to the safe and sustainable management of medical waste. Selecting the proper technology in medical waste management (MWM) represents one of the most critical challenges for decision-makers to ensure public health. In order to evaluate and choose the best MWM methodology, the current research provides a novel multi-criteria decision-making (MCDM) strategy for a variety of social stakeholders, to compute criteria weights, decision-making weights, and alternative ranking algorithms. The suggested structure addresses uncertain assessments of alternatives by extending weighting and ranking methods to acquire the decision-making weight and rank the MWM alternatives based on uncertain conditions. It also uses ‘intuitionistic fuzzy’ linguistic variables to indicate criteria weights. To assess all the factors pertaining to the sustainability of MWM actions, this study suggests the creation of a decision support system (DSS). Our DSS is built upon a novel strategy that utilizes a collection of MCDM models that are grounded on contemporary intuitionistic fuzzy logic methodologies. Alternative scenarios have been assessed for the instance of Greece, after specialists in the healthcare management field imposed 17 criteria and sub-criteria. The IF-MCDM methodologies used were the Intuitionistic Fuzzy DEMATEL, TOPSIS, and CORPAS. The alternative scenarios ranged from the prioritizing of safety laws and regulations to public acceptance and awareness, with the handling of hazardous risks and transportation playing a crucial part in the process. All ensemble methods produced the same ranking of the alternatives, demonstrating that safety and risk avoidance is the most significant scenario for sustainable urban development and public health.
... Medical waste refers to all waste generated from healthcare or diagnostic activities, specifically originating from diagnostic, monitoring, therapeutic, preventive, or palliative procedures conducted in human and veterinary medicine settings. It also encompasses any solid or liquid waste produced during treatment or immunization of humans or animals, scientific research related to these procedures, or the production and testing of biological substances [1][2][3] . ...
INTRODUCTION: Hospitals in Bangladesh grapple with
inadequate waste disposal systems and a lack of effective
waste management policies, posing substantial health
and safety risks to patients and healthcare workers.
This study aimed to assess the current state of hospital
waste management practices, covering waste generation,
segregation, collection, transportation, storage, treatment,
and disposal in both tertiary private and government
hospitals in Dhaka.
METHODS: A cross-sectional survey was conducted, in both
a government institution, Shaheed Suhrwardy Medical
College & Hospital (ShSMCH), and a private tertiary
hospital, Bangladesh Medical College and Hospital (BMCH),
located in Dhaka, Bangladesh. A total of 217 participants
were chosen via convenience sampling. The study utilized
a semi-structured questionnaire comprising sections
on sociodemographic information, general institutional
characteristics, waste management practices, and the
implementation of UN-WHO HCWM (United Nations-World
Health Organizations Health Care Waste Management) Rapid
Assessment Tools.
RESULTS: Our findings revealed that the majority of
participants (96.4% in ShSMCH and 100% in BMCH)
reported practicing waste segregation based on the waste
category, with 97.4% mentioning the shredding of plastic
syringes after use in both hospitals. Additionally, 82% of
respondents in ShSMCH and 51.3% in BMCH indicated the
maintenance of hospital waste records at their workplace.
Most respondents (87.1%) across both hospitals were
vaccinated against tetanus and hepatitis B. Training on
Hospital Waste Management (HWM) was reported by
69.8% in ShSMCH and 29.5% in BMCH. The study further
assessed the level of practice in waste management,
revealing that 58.3% of respondents in ShSMCH and 89.7%
in BMCH demonstrated a good level of practice. Significant
associations were observed between the level of practice and
age group (p=0.002) and professional status (p<0.001).
CONCLUSIONS: The study recommends forming trained
waste management teams and infection control committees,
along with clear guidelines to improve waste management
practices. Effective management requires adequate supplies
and equipment in all departments. Budgeting for HCWM
should be part of both short- and long-term operational plans
to ensure compliance and sufficient resources.
... In some other countries, hospital effluents have not been legally declared (Dutta, 1998;Kwok-Kuen, 1998). Often medical staffs was found to generate revenue through sale of medical waste due lack of knowledge and interest in safe waste disposal and absence of a budget to effectively implement safe waste disposal (Akter, 2000). At present, Bangladesh has no rigorous laws or regulation which is enforced in various cities of the country. ...
Urbanization and population growth enhance facilities in public and private sectors where health facility is one of the main peak point. In this focus, an immense amount of clinical waste is generated everyday in the metropolitan cities in Bangladesh. Moreover, the clinical waste management has become a critical environmental concern all over the world. The study mainly illustrates the existing clinical waste management in Khulna city, classification of different types of clinical waste, waste generation rate, contribution of public organization (KCC) and private organization involved in clinical waste management. The methodology of this project was consisted of questionnaire survey and interviews with the authorities of the different health centers and personnel involved in the management of clinical waste. There are about 150 health facilities in Khulna City Corporation and the total waste generation in Khulna city is about 520 ton/day and the amount of clinical waste generation is 2.5 ton/day. Huge amount of waste leads this study to conclude a sustainable solution for the recyclable wastes and proper scientific dispose of non-recycle able waste. Abstract-Urbanization and population growth enhance facilities in public and private sectors where health facility is one of the main peak point. In this focus, an immense amount of clinical waste is generated everyday in the metropolitan cities in Bangladesh. Moreover, the clinical waste management has become a critical environmental concern all over the world. The study mainly illustrates the existing clinical waste management in Khulna city, classification of different types of clinical waste, waste generation rate, contribution of public organization (KCC) and private organization involved in clinical waste management. The methodology of this project was consisted of questionnaire survey and interviews with the authorities of the different health centers and personnel involved in the management of clinical waste. There are about 150 health facilities in Khulna City Corporation and the total waste generation in Khulna city is about 520 ton/day and the amount of clinical waste generation is 2.5 ton/day. Huge amount of waste leads this study to conclude a sustainable solution for the recyclable wastes and proper scientific dispose of non-recycle able waste. The management procedure for clinical waste such as collection, transportation and disposed at dumping site is demonstrated one by one for KCC area.KCC authority and Prodipan are involved in off-site transport of clinical waste from various health centers to dispose at Rajbandh. Though Prodipan extends its hand in managing clinical waste, the condition of maximum health centers is hazardous as most of the owners of the health centers are found to be disinclined to dispose the clinic waste with sufficient care, workers and money. So proper segregation, collection, transportation, final disposal as well as public awareness and training of staff are mandatory for sound medical waste management.
... This waste also increase the risk of exposure range from gastro-enteric, respiratory, Ocular infection, Anthrax, Meningitis, Acquired immunodeficiency syndrome (AIDS), Viral hepatitis A, B &C, Avian influenza, Haemorrhagic fevers, Septicaemia, Bacteraemia, and skin problems to more lethal diseases such as HIV/AIDS and Hepatitis (Rao, 2008;Babanyara and Ibrahim, 2013;New WHO Handbook on Healthcare Waste Management, 2013). Around 5.2 million people (including 4 million children) die annually from waste-related diseases globally (Akter, 2000). Despite this progress, in 2010, unsafe injections were still responsible for as many as 33 800 new HIV infections, 1.7 million hepatitis B infections, and 315 000 hepatitis C infections (Pépin et al., 2014). ...
The plight of humanity in refugee camps is an age-old issue, as is the ever-increasing issue of waste management, especially medical waste. Though situations have improved in recent times for refugee camps, the same cannot be concurred about medical waste management, as it increases in amount every day. This is the first study on the refugee camp, which was conducted to assess the status of medical waste management and to quantify and characterize medical wastes disposed of in the Rohingya refugee camp at Cox’s Bazar, Bangladesh. A cross-sectional, qualitative, and quantitative study was done. A total of 499 households, 30 solid waste collectors, 30 HCF workers, and 21 solid waste management (SWM) plant workers were interviewed by KoBo Toolbox. Monthly medical waste collection data from February to June 2022 was also collected. Data collection, processing, and statistical analysis were done using Origin Pro and SPSS software. It was found that the camps did not follow any specific guidelines for medical waste management except for a few segregations in healthcare facilities (HCF). Though 88% of the respondents were aware of the hazardous nature of medical waste, most of them disposed of these wastes in open places (49%) and drains (44%), and 70% did not segregate it from regular waste at the household level. Moreover, 73% of solid waste management workers found medical waste daily in communal bins. The HCF did not keep any records on the production of medical waste. Different types of medical waste were found in communal bins; glass bottles containing medicines were common among them. Data from the material recovery facility (MRF) of this camp showed that the highest amount of medical waste found in the communal bins was in April (65 kg) during the seasonal change from spring to summer and the lowest in February (12.7 kg). Moreover, HCF’s existing medical waste management practices were analyzed with SWOT and DPSIR framework. Based on all the findings, a comprehensive on-site and off-site management plan for medical waste is also proposed here. That will help the concerned prepare a camp medical waste management guideline.
... Pollutants from healthcare waste are persistent in the environment as observed in a review conducted by Akter (2000). Other environmental hazards of medical wastes according to the review include; accumulation of toxic chemicals within the soil, ground water contamination, decrease in water quality, bioaccumulation in organism's fat tissues, biomagnification through food chain, repeated and indiscriminate application of chemicals over a long period of time that have serious adverse effects on soil microbial population -reducing the rate of decomposition, generally lowering the soil fertility, wind blown dusts from indiscriminate dumping that have the potential to carry hazardous particulates, and public nuisance (such as odors, scenic view, blocking of walkway, aesthetics, etc.). ...
Health-care services in rural or urban settings inevitably generate wastes that may be hazardous tohealth or have harmful environmental effects. This paper therefore assesses the generation,characterization and disposal of hospital waste of some selected hospitals within Kaduna metropolis.Nine hospitals were selected for the study. The weight of waste generated in these facilities ismeasured after which the wastes were segregated into various classes. 927 kg per day was generatedout of which 84% is non-hazardous and 16% hazardous. Waste generation rate in these facilitiesrange from 1.14 to 2.32 Kg/bed/day and 0.13 to 0.50 Kg/out-patient/day. The composition of wasteacross these facilities include; non-hazardous, infectious, sharps, and pharmaceutical wastes. Out ofthe facilities surveyed, two have locally built incinerator for waste pretreatment, three employ the useof open burning method, and four facilities do not have any form of waste pretreatment. The paperrecommends pretreating of hazardous hospital waste before disposal.
(PDF) GENERATION, CHARACTERIZATION AND DISPOSAL OF HOSPITAL WASTES IN SOME SELECTED HOSPITALS WITHIN KADUNA METROPOLIS. Available from: https://www.researchgate.net/publication/365040376_GENERATION_CHARACTERIZATION_AND_DISPOSAL_OF_HOSPITAL_WASTES_IN_SOME_SELECTED_HOSPITALS_WITHIN_KADUNA_METROPOLIS#fullTextFileContent [accessed Feb 22 2023].
... In healthcare units' medical facilities like burial, entombing, removal by municipal containers, burning and dumping etc., are available to dispose medical wastes (Akter, 2000). ...
Social aspects, management, and development are important in all the industries including the pharmaceutical industries. Sustainability management is necessary to be followed even in pharmaceutical industries, and there are many measures or pharmaceutical management practices that will help to achieve social management of pharma products. The chapter will cover the effective pharma products management through proper disposal of medicines and their use by sustainable approach.
... In healthcare units' medical facilities like burial, entombing, removal by municipal containers, burning and dumping etc., are available to dispose medical wastes (Akter, 2000). ...
... Around 5.2 million people die from a waste-related disease every year worldwide (including four million children) [41]. Medical waste also contains potentially harmful microorganisms capable of killing patients in hospitals, in medical personnel and in the general public. ...
... The harmful impact of medical waste[25] (Akter, 2000) ...
Metalworking fluids (MWFs) are used in various machining processes in order to
reduce friction, dissipate heat and transport metal swarf. Most MWFs are based on finite
resource - mineral oil and, in order to prevent bacterial contamination during the prolonged
use, contain biocides additionally harmful for human health. Their use in metal machining
generates metal swarf categorized as hazardous waste, thus making its recycling economically unjustified. This paper examines the literature on glycerol as a feedstock for MWF production, due to its abundance as it is the major by-product of the biodiesel industry. Glycerol has been shown to have biostatic and corrosion protection characteristics, and similar functional performance during use phase compared to oil-based and oil emulsion MWFs. An overview of a novel glycerol-based biocide-free MWF is presented. Its use would be in line with the principles of circular economy, while eliminating the hazards of traditional MWFs.
... Inefficient management of hospital waste, Caused environmental pollution, Unpleasant odor, Proliferation of insects, Rodent and Worms and Lead to transmission of some disease such as Typhoid, cholera, hepatitis and AIDS resulting from Needles and syringes that contaminated by human blood (Askarian, Vakili, & Kabir, 2004). It estimated that almost 5.2 million people (Including 4 million children) died because of waste-related diseases annually (Akter, 2000). In this regard, waste management laws has been established in 2005 and in Article 11 of this Law, the Responsibility for supervision on hospital waste Was assigned to the Ministry of Health and also in 2008 in order to an Appropriate Supervision on hospital waste, Medical Waste Management Regulations by Commission of fundamental task, Industry and environment and suggest of environmental department has been established. ...
Hospital waste due to their environmental pollutants and hazardous waste, are so important in waste management system. The nature of hazardous medical waste and problems caused by inconsistent management such as lack of planning in production And chemicals consumption, Failure to manage the separation and segregation, Storage and collection, Shipping and handling and disposal Cause environmental and health problems in the community. In this paper, according to the research that has been done in the country, in the Beginning there is an explanation of Waste Management, then Status of Waste Management Based on hospital waste regulations Approved by the Ministry of Health in 2008 has been studied. After estalishized Waste Management regulation in 2005, And the Waste Management Regulations in 2008, Hospital waste management situation in the country has improved. But the guidelines of these regulations have not been properly implemented and this has resulted that the hospital has not reached an ideal point in term of sanitary.
... In Bangladesh, the indiscriminate and improper disposal of hospital waste endangers the lives of healthcare workers and others who come into contact with this waste, causing diseases and illnesses to people. Hospital waste composes 5.7% of the total waste in Dhaka [21] and is disposed of openly in places such as City Corporation dustbins, dustbins near hospitals or holes dug in the ground, open!landfills, roadsides, drains, and rivers; 59% of the hospitals dispose of their wastes in municipal bins without segregation [22], even though 22.6% of the waste is infectious [23]. In other cities such as Rajshahi, hospital waste is disposed of together with other municipal waste in open landfills [24]. ...
Bangladesh has been grappling with the issues of improper hospital waste management. To reflect the inadequacies in existing management practices and the potential implications on the environment and health, this study evaluated the Knowledge, Attitude, and Practice (KAP) of doctors and nurses in a private and a public hospital in Chattogram city via a structured questionnaire survey. At the public hospital, 20.4% of the doctors and 6% of the nurses had occupational illnesses, compared to 36% of the doctors and 26.5% of the nurses at the private hospital. At the public hospital, 67.8% of the nurses wore PPE during waste collection, compared to 17.7% in the private hospital. Hospital wastes and occupational safety are not properly dealt with in both hospitals. An inadequacy was observed in the knowledge of hospital waste management among healthcare workers. The route of hospital wastes from the sources to the end destination was also traced via interviews and focus group discussions, which revealed that disposal practices of the hospital solid waste were environmentally unsustainable. In attempts to show opportunities for environmental and health risks from the hospital wastewater, this study also investigated the quality of the wastewater and tested it for the presence of resistant enteric pathogens. E. coli and S. aureus from both hospitals showed resistance against some common antibiotics used in Bangladesh. The physicochemical properties of the samples were nearly compliant with the Bangladesh Water Quality Standards for hospital wastewater. While more robust sampling and water quality analysis are required, this study provides basic water quality indicators and scope for future research to understand the apparent significant negative impact on the environment and health.
... Researchers such as Amooel (2003), Tudor et al.(2005), Da Silva et al. (2005) and Akter (2000) reported that any negligence in the management of the waste may be of direct or indirect adverse effect on the human health and its environment. Recently, one of the reasons of an increase in medical waste generation was notable advances in the field of medicine and health care (Kardanmoghadamet al., 2014) It is an understatement to say that the effective management of waste and sanitation marks an entry point for development. ...
Recent happening globally especially in the developing country such as Nigeria has shown that there is need to conduct a survey on medical waste management due to direct or indirect adverse effect on the environment and human health. The medical waste management in private hospitals in Lagos State was assessed. Information on hospitals was collected from Lagos State Ministry of Health, Aluasa. Nine hospitals were visited and questionnaires and schedules were administered on the current status of medical waste management such as hospital generation information, waste amount, separation, collection, temporary storage and training.Data collected were analysed using descriptive statistics. The results showed that the total medical wastes were 207.16 Kg/day. Of the total medical wastes produced in studied area in one day, 119.07 Kg consisted of hazardous-infectious wastes, 85.91 Kg municipal wastes and 2.18 Kg sharp wastes. The average generation rate of total medical waste was 1.14 ± 0.2 Kg/bed-day. However, these rates were 0.72 ± 0.01 Kg/bed-day, 0.47 ± 0.01 Kg/bed-day and 0.01 ± 0.002 Kg/bed-day for hazardous-infectious, municipal and sharp wastes respectively. The percentages of hazardous-infectious wastes, municipal wastes and sharp wastes were 60.00%, 39.10% and 0.83% respectively. The hospitals waste management was evaluated poor in terms of separation, collection, transportation, temporary storage and training aspects and good in the treatment aspect.
... In fact, the problem arises due to BMW is a question of its nature, infectious and hazardous nature, rather than BMW quantity. An approximate estimate of around 5.2 million population (including 4 million children) failed to escape from the diseases which may be due to waste every year (Nasima, 2000). The forms of generated waste rely upon various factors such as type of health-care institution, established waste management methods, number of patients treated daily, hospitals specializations and proportion of reusable items, employed in health care centers (Pruss et al., 1999). ...
... Contamination of ground water may occur by using landfills for disposal of hazardous waste from hospitals [4]. Accordingly, approximately 5.2 million people (including 4 million children) die annually from waste-related diseases globally (Akter, 2000)[5]. ...
Background: Gender-Based Violence (GBV) is a global threat to health and remains widespread despite a number of policies instituted to address it. Gender Based Violence is conceptualized as synonymous with violence against Women (VAW) which excludes other gender identities. This has led to the conceptualization of GBV in low and middle income countries (LMICs) in a way which promotes gender inequalities, social exclusion and power imbalances.
Methods:An analytic documentary review of 30 GBV literature sources from 1990 to 2016 was conducted. A World Health Organisation, Social Determinants of Health (SDH) framework was used to explain the relationship between GBV conceptualization and SDH.
Results: A definition of GBV which parallels VAW excludes other groups, is reinforced by gender definition which is biased and is influenced by exclusive social power structures, patriarchy and heteronormativity. These social power structures influence GBV policies, constitute structural violence and jeopardize the rights of others. The interplay of social power systems creates dominance in favor of some social groups and submission of other social groups.
Conclusion: Gender Based Violence remains a global health problem. Definitions of GBV and gender which include all persons affected by GBV will improve conceptualization of GBV in LMICs. Such inclusive definitions are offered to inform GBV policy making.
... Due to lack of knowledge and interest in safe waste disposal and absence of a budget to effectively implement safe waste disposal often medical staffs was found to generate revenue through sale of medical waste [15]. Bangladesh lack rigorous laws & regulation regarding enforced clinical waste management [16]. Waste management plan in hospitals is a significant social & environmental obligation, which requires a proper plan. ...
Increasing population & urbanization enhanced several facilities for public; health facilities are among such top priority of human being. Beside these health facilities, an immense amount of clinical waste is generated everyday throughout Pakistan. There are more than 150 health facilities in Hyderabad City only. As per past findings, the total clinical solid waste generation rate in Hyderabad city is 8 tons/day. Moreover, the clinical waste management has become a critical environmental concern in the city. This study illustrates the existing clinical waste management issue of Hyderabad city including; classification of different types of clinical waste, its generation rate and contribution of public & private organization involved in clinical waste management. The research also focusses on generated amount of recyclable and non-recyclable clinical wastage. To investigate the data, three major hospitals of Hyderabad city were targeted i.e. Rajputana hospital, Civil hospital & Bhittai hospitals. The data collection involves various interviews with the authorities of these hospitals, and unstructured interview with personnel involved in the management of clinical waste. Furthermore, several personal visits on waste disposal sites of the hospitals took place to have more data. This study results in unfolding several issues involved in clinical waste and the concern problems of the facilities. This investigation is a road map for the concerned authorities to pay attention over these serious growing issues of the city and the country, and resolve the consequences of such wastages on human health.
... The present practice of improper handling of generated clinical wastes in Khulna city is playing a contributing rule in spreading out various diseases such as diarrhea, tuberculosis, heamorrtetanus, AIDS, STD, meningitis, infection of the liver, stomach, breathing infection, infection of the reproductive organs, various skin diseases, etc. However Khulna is currently facing the impacts of improper management of clinical wastes. Often medical staffs were found to generate revenue through sale of medical waste due lack of knowledge and interest in safe waste disposal and absence of a budget to effectively implement safe waste disposal (Akter, 2000). Realizing the intensity of the problem, some NGOs have already extended their helping hand to KCC for the management of clinical waste, yet the existing management system is a threat to environment and human health (Khandaker, 1999). ...
A huge amount of clinical waste is generated everyday in various cities of the countries of the world due to urbanization and people growth. Thus the clinical waste management has become one of the crucial environmental concerns everywhere. This study mainly shows the existing clinical waste management and waste generation rate in Khulna city. The methodology of this project was comprised of questionnaire survey and interviews with the authorities and personnel of various health centers. The total waste generation in Khulna city is about 520 ton/day among which the amount of clinical waste is 2.5 ton/day. KCC authority and Prodipan take part in off-site transportation of clinical waste from various health centers to dispose at Rajbandh about 8 kilometers to the south of Khulna city. Even though Prodipan expands its hand in managing of clinical waste, nevertheless the condition of maximum health centers is dangerous due to lack of sufficient care, workers and money. That is why proper segregation, collection, transportation, final disposal, public awareness and training of staff are obligatory for sound medical waste management and all metropolitan cities in Bangladesh should be more improved in their respective clinical waste management practices.
... 5 Heavy metals in hospital sludge originate from feces, paint, wear and tear of utensils and equipment, and radioactive materials from radiology departments. 5,6 Sewage sludge is often used for agricultural applications due to its abundance of organic matter and nutrients. 7 However, the presence of hazardous contents such as heavy metals, pathogenic organisms, and soluble salts limits its land application. ...
Background. The use of strain-specific microbial fermentation in the production of organic acids for the removal of heavy metals from sludge has been extensively studied. However, there is scarce information on the use of microflora for fermentation.
Objectives. To assess the efficacy of cassava peel extracts for the removal of heavy metals from hospital sewage sludge in Nigeria.
Methods. A composite sewage sludge sample was collected from the University College Hospital sewage treatment plant in Ibadan, Nigeria and analyzed for heavy metals using standard methods. Aspergillus niger fermentation and crude fermentation extract were obtained from the cassava peels strain of Aspergillus niger and indigenous microflora, respectively. The experiment was carried out by adding 10 ml of the treatment to 3 g of each sludge sample (extracts and controls) at varied temperatures (room and elevated) and pH (3–5). The mixture was centrifuged after a contact time of 1–12 days at 1000 rpm for 1 hour. The filtrate was analyzed for heavy metals concentrations and compared with the standards. Data were analyzed using descriptive statistics and adsorption models.
Results. Mean heavy metal concentrations in the sludge were estimated for copper (2.22±0.2 mg/kg), zinc (52.3±0.1 mg/kg), chromium (1.46±0.1 mg/kg), nickel (5.6±0.01 mg/kg), and lead (1.9±0.1 mg/kg) and were below permissible limits. Optimum heavy metal removal for Aspergillus niger fermentation extract at room temperature was achieved on day 12 at pH 3.5 for zinc (74.5%), while optimum heavy metal removal at elevated temperature was achieved on day 9 at pH 3.0 for lead (79.3%). The optimum pH for crude fermentation extract lies between pH 3.0–4.5 for nickel (76.2%) at room temperature and chromium (76.6%) at elevated temperature.
Conclusions. Crude fermentation extract of cassava peel was found to be effective in removing heavy metals from sewage sludge. Therefore, its use could be adopted and promoted for removing heavy metals from sewage sludge to achieve safe disposal.
Competing Interests. The authors declare no competing financial interests.
... This problem is an emergent concern in both developed and developing countries as the hazards related to the waste are increasing the possibilities of spreading infection and injury among the individuals, communities and environment through direct or indirect contact if not cautiously handled (Bardy et aI., 2005;Jang, Lee, Yoon, & Kim, 2006;Ray, Roychoudhury, Mukherjee, Roy, & Lahiri, 2005;Silva CE, 2005).The particular concern is for the people who are dealing with the recycling of medical waste components especially waste collectors, scavengers and recycle operators (patwary, 0'Hare, & Sarker, 2011;Perry, Jagger, Parker, Phillips, & Gomaa, 2012). If medical wastes are simply disposed of it can be very hazardous particularly when the infectious waste gets mixed with municipal waste (Akter, 2000;Asase, Yanful, Mensah, Stanford, & Amponsah, 2009;Coutinho, Pereira, Rodrigues, & Borrego, 2006;Silva CE, 2005;Singh, Kumari, Srivastava, & Wakhlu, 2014;Sundell-Bergman, De la Cruz, Avila, & Hasselblad, 2008). Commonly in Bangladesh all (medical, household and industrial) wastes are disposed of by open dumping in either low depressions or high areas for natural degradation and safe disposal of medical waste has been ignored till today (Akter, Chowdhury, & Kazi, 1999).Therefore, appropriate medical waste management is essential for not only human health concerns but also for environmental threats (Jang et aI., 2006 Majority healthcare facilities don't have any in-house waste management site where waste can be segregated and treated before disposal. ...
Waste generated from the healthcare facilities are infectious and hazardous that poses serious threats to environment. So it requires proper management prior to its final disposal. This paper shows the exiting scenario of medical waste management practice in the health care facilities of Bangladesh. This cross-sectional study utilizes data from the Bangladesh Health Facility Survey (BHFS) 2014. The study shows that open burning of both sharp and medical wastes are practiced in rural areas as well as government own healthcare facilities. On the other hand, privately owned and urban healthcare facilities usually remove offsite. The paper also shows that general wastes are managed same as sharp wastes though the type of wastes are different. Therefore, medical waste management needs sufficient consideration in both private and governmental hospitals as there is inadequate medical waste management. The Ministry of Health and Family Welfare should pay more attention towards policies for the disposal of wastes and proper management to ensure improvement and adequacy in the medical waste management practices. Moreover, there is need for regular worker training, continuing education, and management evaluation processes for systems and personnel for awareness.
... al., 2002). A study showed that some 5.2 million people including 4 million children die each year from waste-related diseases all over the world (Akter, 2000). ...
Recent days, medical waste management (MWM) is the major issue through the world as medical waste contains hazardous elements which are posing high risk to human health as well as the environment. In Bangladesh, medical waste has not received sufficient attention especially in rural areas (example: union, village etc.). Healthcare establishment (HCE) of Bangladesh is rapidly increasing in rural areas. Healthcare network has been expanded from hospitals to community clinics. Therefore, it is necessary to focus on the medical waste management system throughout the country from urban to rural level.
To achieve an effective and sustainable MWM system for the rural area of the country, in this study, Singra Upazila of Natore district in Rajshahi division has been selected. Different types of HCEs such as upazila health complex, union sub center, union health and family welfare center, community clinic and private clinic and diagnostic center of the upazila were included in this study.
To find the present MWM situation field observations were conducted at HCEs of the upazila. It helped to find the current practice of waste separation, handling, storage, treatment and disposal. A structured questionnaire was designed to collect information regarding public knowledge about MWM. Interviews were conducted with people involved in providing medical services and handling and disposing medical waste.
The results were analyzed and presented through graphs, tables and charts. It was found that, awareness, perception and knowledge of the employees were not much affected by their professional position, gender, age, education and job experience. Employees’ nature of job and training on MWM mostly influenced the results. It was also found that all the non-government employees are non-trained. Whereas most of government employees were found trained.
Non-government workers experienced higher health injury compared to the government employees during handling of medical waste. Because government workers were more conscious about occupational health hazard and they also used some safety measures during the waste handling.
It was observed that, most of the government employees were not much satisfied with their current medical waste management system. Improper disposal and lack of treatment facility were the major problems identified by the government employees in their HCEs. They suggested to more improvement on those areas. A large number of non-government employees were not satisfied on their current MWM. Because they did not have proper facilities for the MW management in their HCEs. Regarding storage, collection, waste transportation, treatment, disposal and safety issues, non-government employees were found to face significantly more difficulties compared to government employees. So the improvement of all these facilities were suggested.
After analyzing all the data, geographical situations and suggestions, two different approaches were proposed for two different levels of upazila. In pourashava level, the Combined Centralized Practice (CCP) approach was suggested. In union and village level, Individual Practice (IP) approach was suggested. These MWM systems could be implemented by government as well as non-government or private organizations. A GIS map was also prepared to show the positions of HCEs in the study area. It helped to show the suggested approaches in the study area. The GIS map will also help for any kind of further study in this issue.
To find the possible optimum technology Multi Criteria Decision Analysis (MCDA) matrix were used. For pourashava level, low cost concrete incinerator was suggested for the waste treatment. Whereas for union and village level, mini incinerator was found more appropriate.
... al., 2002). About 5.2 million people including 4 million children die each year from waste-related diseases all over the world (Akter, 2000). Healthcare establishment (HCE) of Bangladesh is rapidly increasing (DGHS, 2014a). ...
In this study, Singra Upazila of Natore district in Rajshahi division has been selected to achieve an effective and sustainable medical waste management system for the rural area of the country. Different types of HCEs such as upazila health complex, union sub centre, union health and family welfare centre, community clinic and Private clinic and diagnostic centre of the upazila were included in this study. To find the present Medical Waste Management (MWM) situation field observations were conducted at HCEs of the upazila. It helped to find the current practice of waste separation, handling, storage, treatment and disposal. A structured questionnaire was designed to collect information regarding public knowledge about MWM. Interviews were conducted with people involved in providing medical services and handling and disposing medical waste. After getting all the data from field observation and questionnaire survey, the results are accumulated by using MS Excel software. After that, results were presented by tables, graphs and charts. A GIS map also prepared to show the positions HCEs in the study area. It helped to show the communication system of the upazila. It also helped to visualize the current status and future system of MWM for the study area. To finding the possible optimum technology MCDA matrix were used. Finally, analysing all data, there were suggested possible solution solutions for different HCEs to improve of current MWM system.
... al., 2002). About 5.2 million people including 4 million children die each year from waste-related diseases all over the world (Akter, 2000). Healthcare establishment (HCE) of Bangladesh is rapidly increasing (DGHS, 2014a). ...
In this study, Singra Upazila of Natore district in Rajshahi division has been selected to achieve an effective and sustainable medical waste management system for the rural area of the country. Different types of HCEs such as upazila health complex, union sub centre, union health and family welfare centre, community clinic and Private clinic and diagnostic centre of the upazila were included in this study. To find the present Medical Waste Management (MWM) situation field observations were conducted at HCEs of the upazila. It helped to find the current practice of waste separation, handling, storage, treatment and disposal. A structured questionnaire was designed to collect information regarding public knowledge about MWM. Interviews were conducted with people involved in providing medical services and handling and disposing medical waste. After getting all the data from field observation and questionnaire survey, the results are accumulated by using MS Excel software. After that, results were presented by tables, graphs and charts. A GIS map also prepared to show the positions HCEs in the study area. It helped to show the communication system of the upazila. It also helped to visualize the current status and future system of MWM for the study area. To finding the possible optimum technology MCDA matrix were used. Finally, analysing all data, there were suggested possible solution solutions for different HCEs to improve of current MWM system.
... Contamination of ground water may occur by using landfills for disposal of hazardous waste from hospitals [4]. Accordingly, approximately 5.2 million people (including 4 million children) die annually from waste-related diseases globally (Akter, 2000)[5]. ...
... Contamination of ground water may occur by using landfills for disposal of hazardous waste from hospitals [4]. Accordingly, approximately 5.2 million people (including 4 million children) die annually from waste-related diseases globally (Akter, 2000) [5]. ...
Disaster recovery is multifaceted and depends upon various actors who are involved in coping up after a natural disaster. Gender plays a significant role during every phase of disaster management. Thailand suffered from its largest and most expensive floods in 2011 which devastated the industrial sectors hitting hardest on Small and Medium Enterprises (SMEs). This study aims at learning from the experiences of women entrepreneurs who went through 2011 floods. The methods involved questionnaire survey, key informant interviews and focus group discussions. Findings included barriers, success and failure stories among the women entrepreneurs in SMEs of the Pathumthani province in Thailand. Gendered approach was found to be key factor in faster recovery of SMEs from 2011 floods.
Author's copy available till 02 August, 2017 https://authors.elsevier.com/a/1VCpd7t2zYpsRN
... Contamination of ground water may occur by using landfills for disposal of hazardous waste from hospitals [4]. Accordingly, approximately 5.2 million people (including 4 million children) die annually from waste-related diseases globally (Akter, 2000) [5]. ...
Health Risks and Vulnerabilities Assessment of Internally Displaced People and Refugees Living In The Camps of Khyber-Pukhtunkhwah, Pakistan
Background:
With the realization, that the impacts of disasters can be mitigating, many researcher initiate different researches to assess hazards, risks and vulnerabilities. A substantial number of researchers focused on Geo-Physical and Hydro-meteorological risks, hazards and vulnerabilities. Some other researchers advanced the science of disaster management to a next level, by focusing on social and economic risks and vulnerabilities. But till today limited research has been undertaken in the domain of public health risks and vulnerabilities in the context of disasters.
Objectives:
(a) To assess public health risks and vulnerabilities in the context of disasters.
(b) To assess the health care services coverage of the population affected by disasters.
Scope of The study Population and Target Population:
In general, population in developing countries remains at high risk and are highly vulnerable to various health hazards, risks and vulnerabilities. But some population is relatively at high risk and highly vulnerable such as those displaced from their homelands as result of natural and man-made disasters such wars & conflicts. The scope of this research is limited to the population displaced by natural and man-made disasters and resides in different refugee villages and camps in Khyber-Pukhtunkhwah province of Pakistan, set by the government and international organizations. According to estimates about 2.5 million people are displaced in KPK, Pakistan, but the scope of this study limited to 0.75 million people residing in different refugee villages / camps in KPK – Pakistan.
Results:
The study finds out that the levels of risks and vulnerabilities of different camps are different against same indicators. Some are at very high risk to one indicator, but at very low risk against another indicator. Same is the case of levels of vulnerabilities.
Conclusion:
It is concluded on basis of study findings that different camps require different camp management interventions and strategies to overcome the existing and predictive risks and vulnerabilities in the domain of public health. Same programs, projects or interventions for all camps may not be affective to achieve the desire goals and objectives.
Recommendation
It is highly recommended that further research should be undertaken in the domain of Public Health in the context of disasters. This will help in communities and organizations / institution resilience, which will ultimately result in disaster mitigation and management. There is serious need to assess all aspects of public health hazards, risks and vulnerabilities of population living in refugee camps/ villages. More attention should be paid to solve the issues related to malnutrition, poor hygienic condition and communicable diseases. And most important special consideration should be taken into account related to vaccine coverage and basic health facilities in the aftermath of disasters.
... Inefficient management of hospital waste, Caused environmental pollution, Unpleasant odor, Proliferation of insects, Rodent and Worms and Lead to transmission of some disease such as Typhoid, cholera, hepatitis and AIDS resulting from Needles and syringes that contaminated by human blood (Askarian, Vakili, & Kabir, 2004). It estimated that almost 5.2 million people (Including 4 million children) died because of waste-related diseases annually (Akter, 2000). In this regard, waste management laws has been established in 2005 and in Article 11 of this Law, the Responsibility for supervision on hospital waste Was assigned to the Ministry of Health and also in 2008 in order to an Appropriate Supervision on hospital waste, Medical Waste Management Regulations by Commission of fundamental task, Industry and environment and suggest of environmental department has been established. ...
Hospital waste due to their environmental pollutants and hazardous waste, are so important in waste management system. The nature of hazardous medical waste and problems caused by inconsistent management such as lack of planning in production And chemicals consumption, Failure to manage the separation and segregation, Storage and collection, Shipping and handling and disposal Cause environmental and health problems in the community. In this paper, according to the research that has been done in the country, in the Beginning there is an explanation of Waste Management, then Status of Waste Management Based on hospital waste regulations Approved by the Ministry of Health in 2008 has been studied. After estalishized Waste Management regulation in 2005, And the Waste Management Regulations in 2008, Hospital waste management situation in the country has improved. But the guidelines of these regulations have not been properly implemented and this has resulted that the hospital has not reached an ideal point in term of sanitary.
Biosensors are transforming point-of-care diagnostics by simplifying the detection process and enabling rapid, accurate testing. This study introduces a novel, reusable biosensor designed for direct viral RNA detection from unfiltered saliva, targeting SARS-CoV-2. Unlike conventional methods requiring filtration, our biosensor leverages a unique electrode design that prevents interference from saliva debris, allowing precise measurements. The biosensor is based on electrochemical principles, employing oligonucleotide probes immobilized on a hydrophobic-coated electrode, which prevents air bubbles and salt crystal formation. During validation, the biosensor demonstrated a sensitivity and specificity of 100%, accurately identifying SARS-CoV-2 in saliva samples without false positives or negatives. Cross-validation with RT-qPCR, the gold standard for COVID-19 diagnostics, confirmed the reliability of our device. The biosensor’s performance was tested on 60 participants, yielding 12 true positive results and 48 true negatives, aligning perfectly with RT-qPCR outcomes. This reusable, easy-to-use biosensor offers significant potential for point-of-care applications in various healthcare settings, providing a fast, efficient, and cost-effective method for detecting viral infections such as COVID-19. Its robust design, minimal sample preparation requirements, and multiple-use capability mark a significant advancement in biosensing technology.
Drugs and related goods are widely used in order to promote public health and the quality of life. One of the most serious environmental challenges affecting public health is the ongoing presence of antibiotics in the effluents generated by pharmaceutical industries and hospitals. Antibiotics cannot be entirely removed from wastewater using the traditional wastewater treatment methods. Unmetabolized antibiotics generated by humans can be found in urban and livestock effluent. The antibiotic present in effluent contributes to issues with resistance to antibiotics and the creation of superbugs. Over the recent 2 years, the coronavirus disease 2019 pandemic has substantially boosted hospital waste volume. In this situation, a detailed literature review was conducted to highlight the harmful effects of untreated hospital waste and outline the best approaches to manage it. Approximately 50 to 70% of the emerging contaminants prevalent in the hospital wastewater can be removed using traditional treatment strategies. This paper emphasizes the numerous treatment approaches for effectively eliminating emerging contaminants and antibiotics from hospital wastewater and provides an overview of global hospital wastewater legislation and guidelines on hospital wastewater administration. Around 90% of ECs might be eliminated by biological or physical treatment techniques when used in conjunction with modern oxidation techniques. According to this research, hybrid methods are the best approach for removing antibiotics and ECs from hospital wastewater. The document outlines the many features of effective hospital waste management and might be helpful during and after the coronavirus disease 2019 outbreak, when waste creation on all hospitals throughout the globe has considerably increased.
Graphical Abstract
This study presents an analysis of consumer opinions on waste medicine management. The study explores consumers' concerns, preferences, and suggestions regarding correctly disposing unused or expired medications. The analysis shows the key points that emerged from consumer opinions, including environmental impact, public health and safety, accessibility and affordability, education and awareness, pharmaceutical industry responsibility, convenience and ease of disposal, privacy and confidentiality, community engagement, alternatives to disposal, extended producer responsibility, international collaboration, technology solutions, environmental stewardship, and government regulation and support. This study shows the importance of understanding consumer perspectives in developing effective waste medicine management strategies prioritizing environmental sustainability, public health, and consumer satisfaction. We used the multi-criteria decision-making (MCDM) methodology to deal with these criteria. We gathered 15 criteria concerned with waste medicine management. We used the DEMATEL method to show the criteria weights and relationships between criteria. The DEMATEL method is integrated with the single-valued neutrosophic set to deal with uncertain data. The results show the environmental impact has the most significant weight.
Medical waste (MW) is all waste generated in healthcare institutions during the provision of healthcare services and conducting scientific research and experiments in the field of medicine, regardless of its composition and origin, i.e., a heterogeneous mixture of classic municipal waste and hazardous MW. Medical systems, including hospitals, clinical centers, and places where diagnosis and treatment are conducted, generate waste that is highly hazardous and puts people at risk of fatal diseases. In general, MW does not take up much of the environmental pollution, but its specific characteristics make it potentially one of the most dangerous types of waste. Inadequate care can affect the health of the medical workers, the population, and the surrounding areas in which the waste is stored, but it can also lead to outbreaks of global infection and poisoning. However, extra caution is required to avoid the risk of injury, cross-contamination, and infection; thus, healthcare workers and individuals responsible for waste management must follow the mandatory safety procedures. In this review, a classification of the various types and categories of MW and its treatment methods is discussed. Since MW can be contaminated and hazardous, it must be managed and processed using complex steps and procedures. The meaning of MW, the risks of exposure, MW management regulatory acts, MW management procedures, and control techniques are presented.
Medical wastes include all solid and liquid wastes that are produced during the
treatment, diagnosis, and immunization of animals and humans. A significant
proportion of medical waste is infectious, hazardous, radioactive, and contains
potentially toxic elements (PTEs) (i.e., heavy metal(loids)). PTEs, including arsenic
(As), cadmium (Cd), lead (Pb) and mercury (Hg), are mostly present in plastic,
syringes, rubber, adhesive plaster, battery wastes of medical facilities in elemental
form, as well as oxides, chlorides, and sulfates. Incineration and sterilization are the
most common technologies adopted for the safe management and disposal of medical
wastes, which are primarily aimed at eliminating deadly pathogens. The ash materials
derived from the incineration of hazardous medical wastes are generally disposed of in
landfills after the solidification/stabilisation (S/S) process. In contrast, the ash materials
derived from nonhazardous wastes are applied to the soil as a source of nutrients and
soil amendment. The release of PTEs from medical waste ash material from landfill
sites and soil application can result in ecotoxicity. The present study is a review paper
that aims to critically review the dynamisms of PTEs in various environmental media
after medical waste disposal, the environmental and health implications of their poor
management, and the common misconceptions regarding medical waste.
Introduction: Medical waste is generated by healthcare facilities such as hospitals, clinics, blood banks, and laboratories, which may cause infection to any person coming into contact with it. therefore, medical waste can be considered as being of the greatest environmental concern since it can harbor potentially harmful microorganisms and carries the risk of transmission of infections from healthcare facilities to healthcare workers, patients, and general public. Method: This cross sectional descriptive study was carried out in Almak Nimer University Hospitals - River Nile state -Sudan during the year 2021 with the aim to assess knowledge, attitudes and practices among the health care personnel towards medical waste management. Total 125 respondents were participated in the study; the study uses questionnaires, interviews and observations as tools for data collection. The collected data were analyzed by Software Package for Social Sciences (SPSS) and the result was presented in figures and tables. Result: A total of 125 subjects participated in this study which included ( 34 doctors, 56 nurse, 18 lab technician, 17 class IV employees). The study revealed that (96.8%) of the respondents have good knowledge about hazardous waste. (94.4 % )of the respondents have good knowledge concerning waste transmitting diseases. ( 84.08%) have good attitudes towards BMW ,the study most of participant want to upgrade knowledge of BMW management. about practices (77.6%) wearing personal protective measure while handling BMW during the work .( 96%) wash their hands after the work, but only (61%) use drugs for cleaning the hand if injured. Conclusion: The study revealed that level of knowledge over all (73.5%), there is good knowledge among health worker except class IV which is found to be reasonable. There are reasonable level of knowledge by class IV regarding define color-coding system. The attitude support BMW management is a team work which is found to be good as well as attitude of upgrading knowledge is found to be good. Some of participant had not received vaccination , there is good practice toward handling of BMW as well as have good practice about using special container for disposal.
Microalgae can grow rapidly in all moistening locations and pick up harmful chemical compounds from the soil environment. The soil ecosystem is highly contaminated by human activity comprising urbanization, herbicides, various dyes, and hazardous chemical compounds. So, the dangerous chemicals were favorably impacted by groundwater and the food chain. In many scientific works of literature, the solution to soil pollution and the role of microalgae cultivation have been documented day by day. The best way to extract the toxins from the soil ecosystem is to cultivate microalgae. In a sewage like polluted soil environment containing toxic contaminants, heavy metals, and some of the non-degraded particles that are absorbed by microalgae and release O2 via their oxygenic photosynthetic process, degrade the toxic pollutants and the microalgal biomass thus produced can be used for biodiesel production, microalgae in general and extremophilic microalgae, in particular, grow well. In this chapter, we examine the removal of toxic chemical compounds from the soil environment using the cultivation of microalgae and the production of biofuel from algal oil for the next generation. The biofuel reduces air pollution and can be generated quickly.KeywordsMicroalgaeEmerging pollutantsGreenhouse effectContaminated soilBiodiesel production
The waste generated at healthcare facilities has two distinct categories: hazardous and non-hazardous waste. 10- 15% of the total waste generated at hospitals is hazardous which is termed as clinical waste. This review article has reported and reviewed the practices of clinical waste management in Pakistan’s major cities. Researches demonstrated that about 1.35 Kg / bed waste has been produced by the tertiary health care facilities in Pakistan. Studies for review process are selected through an iterative process. More than 100 research articles, National legislations, international protocols and newspaper reports are consulted and reviewed to extract the data of interest. Clinical waste management in Pakistan is the responsibility of the individual health care facility producing it under Hospital Waste Management Rules, 2005. Due to lack of proper checks and weak implementation of legislations many gaps have been identified in this review article like lack of segregation, inappropriate vehicles for transportation, poor storage and no advanced pollution control treatment strategies. Most of the hospitals lack documented waste management plan. Staff was mostly untrained and under educated. International standards for safe hazardous waste disposal are not being followed resulting in spread of diseases like hepatitis and AIDS. Cases of poor recycling and reuse of used clinical instruments is also documented. However, the condition is much satisfactory in big cities. There is an understanding to focus on the proper implementation of clinical waste management rules with strict checks. Establishment of incineration facility at major hospitals with proper maintenance, safe transportation to secure landfills and utilization of proper SOPs are suggested improvements towards safe management of clinical waste.
Introduction
Health-care waste is a great concern because, in addition to containing conventional toxic pollutants like mercury, chlorinated plastics, and solvents; it also includes a number of toxic materials not found in typical waste. There were no scientific data in Ethiopia that reveal practice toward management of health-care waste. Therefore, the aim of this study was to assess the management of health professionals toward health-care waste in South Omo zone public health facilities, South West Ethiopia, 2018.
Methods
A facility-based cross-sectional study was used with in the period of February 1–30, 2018. A total of 362 health-care workers were sampled using the lottery method. Coding and entry of data was done using Epi Info™ version: 7.2 and analyzed with SPSS version 20 computer software. Descriptive statistics were computed. Bivariate analyses and multivariable logistic regression were used to identify predictor variables for practice of health-care providers.
Results
The overall finding of safe practice on health-care waste management among health-care workers was only 29.3%. Receiving training regarding medical waste management, work hours per day among respondents, availability and usage of color coded containers and yellow plastic bags for infectious waste had significant association with safe practice on health-care waste management.
Conclusions and Recommendation
The overall finding of safe practice on health-care waste management was only 29.3% among health-care workers. This study showed that most of health-care workers did not meet standard practice. Providing training on medical waste management is essential to encourage safe practices among health-care workers and more attention should be directed at the health-care attendants in order to close the yawning gap in their practice level of medical waste management.
Background: Improper collection, segregation, transportation, treatment and disposal of healthcare wastes waste pose risk to public health and the environment. The aim of this assessment was to determine the healthcare waste generation rate, composition and management practice in Dilla University Referral Hospital.
Methods: An institutional based cross-sectional study was conducted in Dilla University Referral hospital from May to June 2019. The quantitative data was collected for eight consecutive days using direct measurment of healthcare waste. The qualitative data was collected by using questionnaire, observation checklist, and in-depth interview. The qualitative data was collected and transcribed and thematic content analysis was done.
Result: A total of 1212.5 kg of healthcare waste was generated in the study period with an average of 151.56 kg (±73.4). The hazardous fraction of the healthcare waste was 581.9 kg (48 %) while the generation rate was 0.866 kg bed⁻¹day⁻¹. From the total healthcare waste, general waste was the highest 630.6 kg (52%) followed by infectious waste which was 299.5 kg (24.7%). There was no segregation of healthcare waste by type at the point of generation and there was no pre-treatment of infectious wastes. Placenta pit was used for pathological wastes and open burning was the main disposal mechanism for the remaining wastes.
Conclusion: The finding indicated that the proportion of hazardous waste generated from the hospital was above the threshold set by the World Health Organization. There was a lack of appropriate waste segregation, storage, transport, treatment and disposal practices in the referal hospital.
The emergence of modern medicinal practices and diagnosis process has resulted in health risks and threat to the environment, and thus it is a matter of global concern. However, the improper waste management rules adopted in healthcare hospitals around the world cause a potential health impact to ecosystem which generates contagious and deadly diseases affected by human beings. In this chapter, an attempt is made to investigate an overview of biomedical waste management practices in healthcare facilities in India as well as around the world. This chapter intends to provide the origin and types of biomedical waste, requirement of waste management rules and containment in hospitals and research centres and followed by the safe disposal of wastes which are unaffected to the environment. More emphasis was given to the biomedical health risks, handling and disposal methodologies adopted by different countries and the steps taken to eradicate the infections caused due to COVID-19 pandemic in much reliable ways.
Healthcare waste encompasses a significant quantity of hazardous substances. Poor healthcare waste management can result in serious environmental and human health risks. Asian developing countries are densely populated, and some are highly resource constrained. These countries commonly fail to practice appropriate healthcare waste management. Moreover, facilities in these countries extensively lack proper waste segregation, collection, safe storage, transportation, and disposal. This mini-review recapitulates key issues of healthcare waste management confronting Asian developing countries. Regulations, legislation, and policies are found to be recent, and their implementation varies from one another. Variation in waste generation rate is common. Contradictory methods of waste measurement used by researchers leave these variations questionable. The absence of waste management training programmes roots ignorance among staff and handlers, which leads to unsafe waste handling and causes different health risks. Unsafe and illegal recycling of hazardous waste is a threat to human health, also landfilling is often confused with open dumping, causing environmental damage. Outdated incineration plants need to be replaced with autoclaving, steam sterilisation, and comparatively reasonable new practice of pyrolysis to avoid the emission of toxic gases. The significance of proper healthcare waste management cannot be ignored, especially in Asian developing countries; substantial improvements are required in order to protect the environment and human health from serious risks.
Healthcare profession is one of the most Nobel professions, but it generates a lot of waste material referred as health care waste (HCW) or Bio-waste. HCW is not only hazardous to human life, but also for all living organisms and whole of the environment if not properly handled and disposed. The HCW is composed of various fractions with variable dangers depending on their origin and content. The HCW cannot be treated as a general waste, but needs to be treated specially considering its danger to human and environment. There are various methods for disposing HCW which must be selected in view of the waste properties and suitability. Health care centers must design and follow appropriate waste management policies and methodologies to reduce and minimize deleterious effects on human and other living beings and environment.
p class="Pa9"> Introduction: Medical wastes include all the waste generated by health care establishments, research facilities, and laboratories. Medical waste is any waste that is generated in the diagnosis, treatment or immunization of human beings or animals, in research pertaining there to or in the productions or testing of biological culture.
Methods: The fourteen numbers of health care institutions (HCIs) having inpatient facilities, were sampled for the study. After taking observation, the collected information was entered into a computer. Basically, the percentages, projection analysis, simple average, and scenario analysis were used as an analysis tools.
Results: Out of the HCIs surveyed, only 21.43% of them had a separate room assigned for primary storage of all sorts of waste and remaining 78.57% of them had open storage facilities for un-segregated mass of waste nearby the incineration area or open burning area.
Conclusion: There was lack of appropriate information on waste storage practices, and unaware of designing central storage system in HCIs. In most of the HCIs, a separate storage room was not assigned for storage of all sorts of waste.
Journal of Gandaki Medical College
Vol. 10, No. 1, 2017, page: 31-33</p
Medical waste (MW) poses a significant impact on health and environment especially for the third world country like Bangladesh. As one of biggest cities in Bangladesh, Rajshahi is facing various hygienic and environmental hazards due to lack of knowledge and awareness of individuals involved in medical waste generation, handling and disposal. The methodology of this project was descriptive and consisted of the use of field survey and interviews with the authorities of the different HCEs and personnel involved in the management of MW. The survey reveal that the surveyed HCEs generate a total of 1441 kg/day of MW, of which about 1287.1 kg/day (89.32%) are non-infectious and about 153.9 kg/day (10.68%) are infectious. The waste generation rate for surveyed HCEs is 1.55 kg/bed/day or 0.29 kg/patient/day. It was also found that there is no proper and systematic medical waste management in surveyed HCEs.
Recent litigation has demonstrated that the requirements for environmental impact assessment ('EIA'), first introduced by Directive 85/337 ('the Directive'), play an important role in development control. Failure to comply has created serious difficulties for a number of development consents: see WWF v. Bozen, R. v. Rochdale B.C., ex p. Tew and, in the context of the review of old minerals permissions, in R. v. North Yorkshire C.C., ex p. Brown and R. v. Durham County Council, ex p. Huddleston. Most recently, in Berkeley v. Secretary of State the House of Lords took a radically different approach from the Court of Appeal to the question of non-compliance with the regulations. This article, first, highlights certain issues in the Directive in the light of the case law of the ECJ. Secondly, it considers a number of issues related to the importance, when applying the implementing legislation, of having regard to the concept of 'project' under the Directive. The third part considers recent cases in the English courts relating to discretion, direct effect, and old minerals permissions.
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