Impact of COVID-19 on healthcare waste generation: correlations and trends from a tertiary hospital

Abstract

Abstract Background COVID-19 has represented an emergency not only for the sanitary issues, but also from the environmental and operative perspective, with largely increased waste disposal due to non-reusable personal protective equipment and packaging. This study aimed at estimating the increase in healthcare waste (HW) generation during the outbreak, based on data from a tertiary hospital. Methods From the purveying office statements of “SS Antonio e Biagio e Cesare Arrigo” Hospital of Alessandria (Italy), monthly data on HW generation from January 2015 to March 2021 were retrospectively retrieved. Trend analyses were performed through linear regression and the impact of COVID was evaluated following the Interrupted-Time Series regression model. Moreover, HW generation data were compared to the proportion of patient-days and admissions due to COVID (out of respective totals) through Pearson's correlation test. Results HW generation rose from a baseline of 35.9 ± 3.8 tons/month (2.4 ± 0.2 kg per patient-day, kg/PD) in 2015-2019, to 46.3 ± 6.0 tons/month (3.3 ± 0.6 kg/PD) during the outbreak (2020-2021), with a peak in March-April 2020. Segmented regression showed that the already increasing trend was not appreciably modified as for its slope, whereas a significant level change could be detected between baseline and outbreak period (+0.6 kg/PD, corresponding to a 28.6% increase compared to baseline intercept, p < 0.001). HW generation was significantly correlated to the proportion of admissions (p = 0.005, R2=0.70) and patient-days (p = 0.006, R2=0.69) related to COVID-19. Conclusions The study showed a significant rise in HW generation in 2020-2021, reasonably due to the COVID-19 outbreak. Moreover, this happened without affecting the generally increasing trend. These results underline the effect of the pandemic on the amounts of waste generated by healthcare facilities, with noticeable impact on the environment and higher costs associated with HW management and disposal. Key messages Due to extensive use of disposable equipment and packaging, COVID-19 strongly impacted on healthcare waste generation, with an average 28.6% increase compared to baseline levels (+0.6 kg/patient-day). The generally increasing trend in healthcare waste generation, along with the remarkable increase due to COVID-19, results in high environmental impact and management costs for healthcare facilities.