16S rRNA Amplicons Survey Revealed Unprecedented Bacterial Community in Solid Biomedical Wastes

Introduction: To improve current practices and create the most effective healthcare waste treatment system, solid medical waste composition needs to be analyzed. This study aims to develop models to predict the rate of medical waste production in hospitals in Hilla city, Iraq. Predictive mode can be used to set standards, evaluate current methods for treating and disposing medical waste, and optimize healthcare solid waste management systems.
 Materials and Methods: Predictive models and long-term data on the composition and rate of solid medical waste generation were developed using a longitudinal study design. A standardized questionnaire and weighted scale were used to measure solid medical waste generated from the five public hospitals. Statistics were used to create models predicting the amount of waste generated at each hospital.
 Results: These models demonstrated a significant correlation between inpatient and outpatient numbers and waste generation. Different hospitals treat different numbers of inpatients and outpatients. Different models have been created based on various types of hospitals.
 Conclusion: Linear rule-based models accurately represent the weights of variables, identify the sources and implications of solid medical waste, and control waste levels by using a variety of parameters. The research model can help in the development of an effective strategic plan for setting up a medical solid waste (MSW) management system.

Purpose This study analyzed factors related with medical solid waste management. Method A qualitative study, involved 172 health workers as participants. Findings This study explained variables related with medical solid waste management were educational level (p = 0.0081; PR = 0.63), attitude (p = 0.0202; OR = 1.27), availability of medical solid waste disposal facility (p = 0.000; OR = 2.01), implementation of policy in medical solid waste (p = 0.0140; PR = 1.340). The most variable related with medical solid waste management was availability of solid medical waste disposal facility (OR = 4.588). However, length of work and knowledge were no relation. Conclusion This study suggested significant relationship between education level, attitude, availability of medical solid waste disposal facility and implementation of policy in medical solid waste management. The most variable related with medical solid waste management was availability of medical solid waste disposal facility.

Objectives: In the face of the complicated developments of the COVID-19 epidemic, the increasing number of cases, accompanied by an increase in the number of personal protective equipment has contributed mainly to the increased amount of medical solid waste. Updating knowledge and practicing the correct classifications of solid medical waste according to regulations is an urgent issue to minimize the risk of pandemic spread, health, and the environment, as well as responding to incidents and exposures. To determine the proportion of health workers with correct knowledge and practice in classifying solid medical waste and related factors at District 4 Hospital, Ho Chi Minh City. Methods: A cross-sectional study was conducted on 149 health workers at District 4 hospital in 2022. Self- administrated questionnaires including personal data, 50 knowledge questions and practice checklists for solid medical waste classification were used. Determine the relationship using the Χ2 test, PR, and the 95% confidence interval. Results: Health staff have knowledge account for 87.25%; general practice 53,69%. Knowledge of color coding non-infectious hazardous waste accounts for less than 50%. Waste bin cleaning 9.4%, exposure reporting procedures 30.87%. The age group >30, the subclinical departments, the information sources from radio, and friends have a higher rate of practice correctly than the other group, p < 0.05. Conclusions: Health staff have correct knowledge account for 87.25%; correct practice account for 53.69%. Health facilities need to maintain training on solid waste classification knowledge, focusing on color coding, symbols, handling and responding to incidents of exposure to medical waste and occupational safety. Fully equipped with different means of communication to instruct, supervision classification, collection and transportation of solid waste to take timely remedial measures.

SummaryTo quantify the major environmental drivers of stream bacterial population dynamics, we modelled temporal differences in stream bacterial communities to quantify community shifts, including those relating to cyclical seasonal variation and more sporadic bloom events. We applied Illumina MiSeq 16S rRNA bacterial gene sequencing of 892 stream biofilm samples, collected monthly for 36‐months from six streams. The streams were located a maximum of 118 km apart and drained three different catchment types (forest, urban and rural land uses). We identified repeatable seasonal patterns among bacterial taxa, allowing their separation into three ecological groupings, those following linear, bloom/trough and repeated, seasonal trends. Various physicochemical parameters (light, water and air temperature, pH, dissolved oxygen, nutrients) were linked to temporal community changes. Our models indicate that bloom events and seasonal episodes modify biofilm bacterial populations, suggesting that distinct microbial taxa thrive during these events including non‐cyanobacterial community members. These models could aid in determining how temporal environmental changes affect community assembly and guide the selection of appropriate statistical models to capture future community responses to environmental change.

During the Covid-19 pandemic, there was an increase in medical waste, especially in healthcare facilities. Medical waste, if not managed properly, will potentially pollute the environment. The behavior of health workers in managing medical waste is influenced by knowledge and attitudes. The study aimed to analyze the relationship between knowledge and attitudes with the behavior of health workers in managing medical waste in Indonesia using a systematic review approach and according to an Islamic perspective. This study uses the method of literature review and systematic review. The selection of articles used the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) method on the Google Scholar journal website. Search for articles with the keyword "Medical and Behavioral and Bivariate Waste." Articles were selected based on the 2020-2022 year of publication and a cross-sectional research design. The results of filtering articles using the PRISMA method obtained ten articles. The behavior of health workers in managing medical waste from the ten articles includes disposal of solid medical waste, management of medical waste, segregation of medical waste, disposal of medical and non-medical waste, management of solid medical waste, and sorting of solid medical waste. Nine articles show that there is a significant relationship between the knowledge and behavior of health workers. Eight articles show a significant relationship between the attitudes and behavior of health workers. The review of the Islamic religion concluded that health workers must have a trustworthy nature, work ethic, responsibility, and accountability. Health workers are also required to maintain personal hygiene and the environment.

Medical waste denoted solid waste products that proved to be hazardous to hospitals and maycause health problems if not managed properly. An initial survey has been conducted in Bangil districthospital in Pasuruan. Outside components. that proved to have met the requirements, several problemswere discovered such as a practice of mixing medical waste and non - medical solid wastes, wastemedical bins were found to have different shape, size and color and there were no labels, the temperaturereached by incenerator combustion chamber was only :t: 800°C and it was not equipped with gas cleaningmechanism, and no special handling of the resulted ashes. This study was aimed to evaluate themanagement of solid medical waste in Bangil Pasuruanhospital.With regard to the research method, this was .a descriptive research. This research wasconducted in March - May 2014, the collected data were subjected to descriptive type of analysis/ resultswere discussed in reference to Minister of Health decree No. 1204/Menkes/SK/X/2004 on EnvironmentalHealth Requirementsfor Hospital.Solid medical waste generated in Bangil Pasuruan hospital were derived from health careactivities, ERand other facilities that included infectious materials and sharps. The largest generation ofsolid medical wastes was on Saturdays at 214.7 kg, while the smallest production was Wednesdaysthatamounted to 118.8 kg. Evaluation of solid medical waste management resulted in a value of 64, 1 % andcategorized as poor. The smallest percentage was obtained. at the generation phase by 25 % and thehighest percentage related to storage 90 %.This study concluded that the management of solid medical waste in Bangil Pasuruan hospital didnot meet the designated requirements. As a suggestion, Bangil Pasuruan hospital needs to reform themanagement of solid medical wastes, to complete insfrastructures and job descriptions should be madeavailable in writing, all requirements should be tailored to Minister of Health Decree No.1204/Menkes/SK/X/2004 on Environmental Health Requirementsfor Hospital.

Health care facilities produce medical solid waste such as household waste and waste categorized as medical waste as well as large amounts of hazardous and toxic waste (B3). From the risks posed, the solid waste produced by health care facilities which is non-medical waste, namely household waste does not contain risks, the amount is around 70-90%. While the remaining 10-25% is waste that can cause various health impacts because it is considered dangerous. The purpose of this study is to investigate the risks that can arise from the waste generated by health care facilities and to evaluate the waste management of health agencies. The stages of this research include preparation, literature review, data collection both primary and secondary data, data analysis, and data evaluation. The occurrence of the COVID-19 pandemic at the end of 2019 to 2020 resulted in a significant increase in the generation of medical waste at the Tangerang City General Hospital by 77.1%. Transportation of B3 waste by third parties is hampered because the amount of solid medical waste has increased in the COVID-19 pandemic.

We aimed to determine the feasibility of ozone for disinfection of infectious solid waste in hospital. Spores of Bacillus atrophaeus were used to monitor the process of inactivating microbial agents using ozone in medical solid waste in the hospitals of Tabriz City, Iran. For this purpose, culture medium containing the mentioned bacteria was placed in the bags containing medical wastes. The ozone generator was equipped with a constant dose of 5 grams per liter, with a discharge of 1 and 3 liters per minute and contact time of 10 to 120 min. Then the ozone exposure indicators were incubated for 24-48h at 36 ± 1 °C and, finally, the absence of colony growth in the culture medium was considered as the success of ozone in disinfection of infectious solid waste. This process was performed with 4-time replications. The complete removal of B. atrophaeus was obtained for non-compacted and compacted infectious solid waste, at contact time of 15 and 50 min, respectively. The efficiency of removal of B. atrophaeus by the process of wet ozone injection through a glass column was 100% in 30 minutes and by separate injection of water vapor into the contact tank was 100% in 50 minutes. The results of this study showed that the use of ozone technology was effective in the inactivation and destruction of microbial agents in medical solid waste. Employing different advanced technology of oxidization especially ozone in order to decrease the environmental pollution is considered as one of management approaches.

Background: Hospital is a public health service agency that produces daily medical waste, especially solid waste that must be handled properly. Although the Indonesian Naval Hospital Samuel J. Moeda has implemented waste management and disposal, management is still ineffective in light of the lack of managerial resources, basic management processes, and incinerator unavailability as a final waste management tool. This study aimed to analyze the management of medical waste starting from input, process, and output, at Samuel J. Moeda Naval Hospital, Kupang, Nusa Tenggara Timur. Subjects and Method: This study was descriptive with qualitative approach. It was conducted at Samuel J. Moeda Naval Hospital, Kupang, Nusa Tenggara Timur. A sample of 14 informants were selected for this study. The data were collected by in-depth interview, direct obesrvation, and document review. Checklist sheets were used to assist direct observation. Results: Waste management was not well-performed with limited facilities and infrastructure, unspecified and inadequate budgeting. The process of solid medical waste management was not optimally performed, and there were some errors found during the process. Similarly, the output of solid medical waste management did not meet the standards set by the Minister of Health Regulation No. 1204/ 2004. It appears that waste management issues received little attention from the hospital management. Conclusion: Medical waste management at Samuel J. Moeda, Naval Hospital, Kupang has not been well-performed. The hospital can pay attention to the potential of medical waste recycle for extended hospital purposes. Recruitment, education, and training, of medical waste management staff are urgently needed. Routine waste management evaluation is also needed to help create a healthy hospital environment. Keywords: solid medical waste, management, hospital

Mamami Kupang General Hospital as a health service facility produces medical and non-medical waste. The results of surveys carried out by infectious solid medical waste at Mamami General Hospital are usually collected from waste producing places/rooms, including the Emergency Unit (ER), laboratory, nurse station, operating room, pharmacy installation, VK room, outpatient room/polyclinic. . For the process of burning/destroying medical waste, Mamami General Hospital collaborates with PT. Wastec Internasional (destroyer) and PT. Sagraha Satya Sawahita (Carrier). The average amount of solid infectious waste produced every day is around 7 kg. This research aims to determine the process of managing solid medical waste at the Mamami Kupang General Hospital. This type of research is quantitative research, with a descriptive research design. The population in this study was the solid medical waste producing unit at the Mamami Kupang General Hospital and health workers who handled the problem under study. The technique used in this research is nonprobability sampling, namely total sampling. The research results show that the medical waste management process at Mamami Kupang General Hospital, especially in temporary shelters, still requires attention. Transportation of solid medical waste from waste generating units is not encouraged using special trolleys and the accumulation of medical waste in temporary storage areas due to the unavailability of containers.

Community health centers are the frontliners of healthcare services which in its activities produces medical waste and non-medical waste both in solid and liquid form. This waste needs to be managed in accordance with existing regulations where environmental management must be carried out systematically and sustainably. Regarding the management of Covid-19 medical waste in the health facilities of North Toraja Regency, this study aims to determine the management process, management constraints and compare the management of wastewater and hazardous and toxic solid medical waste generated from handling Covid-19 patients at hospitals and health centers in Toraja Regency. North. The research method used is descriptive research method with case study design. Data collection techniques are carried out by observations, interviews, and documentation of secondary data. The results show that the management of hazardous and toxic solid medical waste water and waste for Covid-19 patients in private hospitals leaves the processing to third parties and government hospitals destroy solid hazardous medical waste with incinerators, while at community health center the wastewater is directly discharged into water bodies and medical hazardous waste. handed over to a third party. The process of treating waste water and hazardous and toxic solid medical waste for Covid-19 patients at the health facilities of North Toraja Regency has not been in accordance with the guidelines issued by the Indonesian Ministry of Health. The main obstacle in processing solid medical waste water and hazardous waste for Covid-19 patients at the health facilities of North Toraja Regency is the lacking of operational costs and delays in disbursing operational costs. Government-owned hospitals were found to be slow to comply the Covid-19 Health Facilities Waste Management Guidelines issued by the Ministry of Health of the Republic of Indonesia.

As industrial globalisation and waste output continue to grow, solid waste management is one of the most pressing worldwide environmental challenges. Solid wastes include both the heterogeneous mass of urban throwaways and the homogeneous accumulations of agricultural, industrial, and mineral wastes. Clinical waste (CW) has a significant negative influence on both human health and the environment. To dispose hazardous CW, a proper waste management system should be necessary, and incineration should be the best possible option for reducing the volume of this hazardous waste. Incineration is being developed in Malaysia as a means of disposing clinical and hazardous waste. Currently, 170 common CW treatment facilities with 140 incinerators are accessible around the country. The combustion procedure kills pathogens and reduces waste volume and weight, but it leaves a solid residue known as clinical waste ash (CWA), which raises heavy metal, inorganic salt, and organic compound levels in the environment. Because metals are not eliminated during incineration, dumping CWA in a landfill could contaminate groundwater. Leachate is the liquid created when waste decomposes in a landfill and water filters through it. The most common method of disposing of CW ashes is to transfer them to a landfill. Landfills should install a top cover after closure for hazardous waste landfills. Due to a lack of space and the high expense of land disposal, recycling technologies and the reuse of ash in various systems have developed. Clinical waste incineration fly ash (CWIFA), a solid waste substance from CW incineration, typically includes mobile heavy metals and can cause significant pollution when reused. The standard requirement for removing CWIFA in dumpsites should be below the metal limit stated by the U.S. Environmental Protection Agency (USEPA). Much recent research on the usage of CWIFA has concentrated on mitigating their effects on the environment. Several studies have confirmed the utilisation of CWIFA in the construction field and agriculture to reduce the leaching of its hazardous components into the environment. Compressive strength decreased with the percentage amount of CWIFA due to the substitution of cement with CWIFA. CWIFA mix with 20% cement is the broad-scale application of CWIFA for geotechnical constructions. Heavy metals (Cd, Cu, Ni, Pb, and Zn) are strongly immobilised by the cementitious matrix. Solidification/stabilisation (S/S) materials can be dumped in landfills with less environmental protection than untreated waste. When utilising a CWIFA in mortar, the primary environmental concern is if any harmful materials leach out during the initial curing process or throughout the life of the mortar. Toxicity characteristic of leaching procedure (TCLP) analysis of all CWIFA specimens found amounts of heavy metals below regulatory limits. Solidification of waste with cement and solidified waste has become a popular way of minimising the atmosphere's emissions. The amount of CWIFA generated is expected to increase nationally and globally. There is an immediate need for further evaluation of ash leachate investigations for proper disposal and usage of ash in construction materials.

Objectives: This study has two objectives as the follows: to describe the management situation medical solid waste management and some factors affecting of solid medical waste management at the Traditional Medicine Institute Ho Chi Minh City by 2020. Methods: This is a cross-sectional descriptive study, combining quantitative and qualitative method. medical solid waste storage tanks, medical solid waste transportation vehicles, medical solid waste storage area at 13 clinical and subclinical with 130 times of classifying and collecting, 52 times of transporting, 16 times of storage and 13 times returning to medical equipment. Information gathered through 4 in-depth interviews with 4 leaders of the Institute, department, department and 3 group discussions. Qualitative data was collected from 04 in-dept interviews and 03 focus groups discussion. Main findings: The research results show: sorting of medical solid waste at source and non-communicable hazardous medical solid waste must be put into a black bag / bin reaching=90%; in the stage of medical solid waste collection: the content of not collecting medical solid waste together reaches 92.3%; medical solid waste is transported according to the prescribed road, reaching 92.3%; Medical solid waste content that does not contain the same barrels and in solid medical waste warehouses must have a centralized waste container with a lid in accordance with regulations, all reaching 93.7%. The Institute has 4 medical solid waste warehouses that fully comply with the regulations on the management of medical solid waste, only not meeting the warehouse area. Key words: Solid medical waste, influenced factor, Traditional Medicine Institute Ho Chi Minh City.

Management of medical waste is of great importance due to its infectious and hazardous nature that can cause adverse impacts on human health and environment. The objectives of this study were to estimate the current generation of medical solid waste and its existing management practices in Hanoi city, Vietnam. This study also aimed at providing the predictions for future generation of medical solid waste that could serve as scientific basis for planning of medical waste management in Hanoi city. Based on the collected secondary data, the analyses indicated that the generation rate of total medical waste (including normal and hazardous medical waste) is 0.86 kg/bed.day, in which the generation rate of hazardous medical waste is 0.14 kg/bed.day. The major problem associated with existing management practices of medical waste is the treatment and disposal stage. There are no official recycling activities for normal medical waste at present although its legal basis has been setting up in the Medical Waste Management Regulation in 2007 issued by Ministry of Health. With respect to the treatment of hazardous medical waste, incinerators-the major applied technology are being operated inefficiently. For overcoming these obstacles, the local government and relating agencies need to put more effort, in terms of financial and human resources, in facilitating the official recycling activities for normal medical waste and developing more environmentally-friendly alternative treatment technologies for medical waste, towards the gradual replacement of unnecessary incineration. The study predicted that in 2020 and 2030, the quantities of total medical waste generated in Hanoi city would be 30.44 and 46.05 tons/day, respectively which 1.7 and 2.6 times higher than those in 2010. This would be challenging the local government in managing medical waste generated in the future.

This research investigates solid waste management in Al-Kut City. It included the collection of medical and general solid waste generated in five hospitals different in their specialization and capacity through one week, starting from 03/02/2012. Samples were collected and analyzed periodically to find their generation rate, composition, and physical properties. Analysis results indicated that generation rate ranged between (1102 – 212) kg / bed / day, moisture content and density were (19.0 % - 197 kg/ m3) respectively for medical waste and (41%-255 kg/ m3) respectively for general waste. Theoretically, medical solid waste generated in Al-Kut City (like any other city), affected by capacity, number of patients in a day, and hospital specialty The research exposed the incorrect ways used in collecting, storing, waste transport, and inefficient incinerators processing .Laboratory test for six ash collected samples indicated high concentration of heavy metals (Pb, Cd, Cr) , having the rang of (51.0 – 62.0) mg / l of lead, (3.0 – 8.5) mg / l for cadmium, and (43.0 -69.0) mg / l for chrome. In comparison with the US Environmental Protection Agency standards, these samples are higher than the recommended levels that may threat groundwater. A comprehensive and integrated solution there must be to manage medical waste, with the participation of all parties concerned, especially, the Ministry of Health, environment authorities concerned, and the participation of civil society organizations. A color-code trash bags and containers are recommended by the World Health Organization and the Environmental Protection Agency to be used in hospitals that propose red bags for collecting medical waste while black bags for general waste provided that they are resistant to tearing seeping and should be provided in sufficient numbers.