Comparative life cycle assessment of hospital waste management scenarios in Isfahan, Iran: Evaluating environmental impacts and strategies for improved healthcare sustainability

Abstract

This study presents a life cycle assessment (LCA) of hospital waste management scenarios in Isfahan, Iran. Daily hospital waste generation totals 20 tons, with 44 % infectious and 56 % non-infectious waste. The non-infectious stream comprises 40 % food waste. Pyrolysis, chemical disinfection, composting, and material recovery were evaluated across ten environmental impact categories using TRACI 2014 methodology. Composting and material recovery reduce smog-forming emissions by 126.79 kg O3 eq/ton and 129.02 kg O3 eq/ton, respectively, and fossil fuel depletion by 255.04 MJ surplus/ton and 471.97 MJ surplus/ton compared to incineration. Chemical disinfection of infectious waste shows lower global warming potential (859.89 kg CO2 eq/ton) than pyrolysis (1483.15 kg CO2 eq/ton). The third scenario, prioritizing composting and material recovery, minimizes ecotoxicity with lowest emissions of cadmium (0.33 g/ton) and nickel (16.23 g/ton) to air, and arsenic (0.003 g/ton) and chromium (0.28 g/ton) to water. This study addresses a rarely assessed system in LCA literature, offering valuable insights for improving waste management in similar contexts worldwide. Recommendations include developing regulatory frameworks, investing in infrastructure, promoting collaboration, implementing training programs, and adopting circular economy principles. The research contributes to building life cycle thinking capability within the Iranian healthcare sector through stakeholder engagement, workshops, and public dissemination of findings.