Development of a decision support tool for choosing the optimal medical waste management scenario using waste flow analysis and life cycle cost

Abstract

Every year, healthcare centers such as hospitals produce millions of metric tons of medical waste. The effective management of medical waste is crucial due to its environmental consequence, so decision-making tools are necessary for this purpose in various aspects, including cost-benefit balance. In this study official data on the quantity and composition of medical waste in five hospitals in Tehran were analyzed. An economic model based on the cost of hospital waste management steps from storage to disposal was used to interpret the situation. Different scenarios of waste management were defined by the variables of segregation ratio and disinfection types. The results showed that in the studied hospitals, on average 3600 kg/day of solid waste was generated, of which 52.53 % was infectious waste and 1.58 % was chemical and pharmaceutical waste. The ratio of collection, disinfection, and transportation in the total costs of hospital waste management was 12.3, 67.3, and 16.5 %, respectively. The effect of change in segregation ratio and change in the location of disinfection in the cost of hospital waste management was 16 % and 37 %, respectively. Also, reducing the emission of pollutants such as PAHs into the indoor air was one of the consequences of changing the studied approach in the scenarios. Hospitals and health policymakers could use these results to implement more cost-effective and environmentally sustainable hospital waste management strategies.