Assessing future scenarios for health care waste management using a multi-criteria decision analysis tool: A case study in the Turkish West Black Sea Region

Abstract

The aim of this paper is to identify the best possible health care waste management option in the West Black Sea Region by taking into account economic, social, environmental, and technical aspects in the concept of multi-criteria decision analysis. In the scope of this research, three different health care waste management scenarios that consist of different technology alternatives were developed and compared using a decision-making computer software, called Right Choice, by identifying various criteria, measuring them, and ranking their relative importance from the point of key stakeholders. The results of the study show that the decentralized autoclave technology option coupled with the disposal through landfilling with energy recovery has potential to be an optimum option for health care waste management system, and an efficient health care waste segregation scheme should be given more attention by the authorities in the region. Furthermore, the discussion of the results points out multidisciplinary approach and the equilibrium between social, environmental, economic, and technical criteria. The methodology used in this research was developed in order to enable the decision makers to gain an increased perception of a decision problem. In general, the results and remarks of this study can be used as a basis of future planning and anticipation of needs for investment in the area of health care waste management in the region and also in developing countries that are dealing with the similar waste management problems.Implications: Alternative technologies are not capable to treat some categories of health care wastes, and Turkish practice has to be revised urgently. In doing so, internal health care waste separation is critical for determination of treatment technology. The author verified the methodology in a decision-making framework for a real-world problem. Results indicated that incinerating all health care wastes is not a feasible option due to high cost.