Medical Waste Generation Rate Research Articles

Recycling potential of medical plastic waste

Medical plastic waste threatens the environment and human health if not properly handled and disposed of. This study used field visits, multi-criteria decision analysis, material testing, and data analysis to assess the feasibility of recycling medical plastic waste. The study identified medical plastic products (syringes, intravenous bags, and infusion sets) with high recyclability potential and proposed targeted recommendations for improving waste management practices. Medical plastic waste generation rates in kg/bed/day were 0.486 and 0.428. 55 kg/day and 5 kg/day of recyclable medical plastic waste are generated at KATH and KNUST hospitals, respectively. The contextual relevance of this research extends beyond the Ghanaian healthcare system, with implications for waste management practices in low and middle-income countries by contributing to the advancement of sustainable waste management practices.

Reverse Logistics Network Design for Medical Waste Disposal under the Scenario of Uncertain Proposal Demand

With the development of the healthcare industry, the demand for medical services and protective equipment is boosted, causing the generation rate of infectious medical waste to increase rapidly. Therefore, it is of utmost importance for decision makers to effectively predict the potential risks and propose corresponding solutions. This paper investigates the reverse logistics network optimization for medical waste under the conditions of an uncertain proposal demand. Firstly, a prediction model of medical waste based on the SEIR epidemiological dynamics is constructed, in which both routine and public health emergency scenarios are simultaneously considered. Secondly, a bi-objective location-routing optimization model for a medical waste reverse logistics network is proposed, by simultaneously optimizing the total economic cost and potential risk throughout the entire logistics process. Subsequently, an NSGA-II algorithm is designed for a model solution in response to the model’s characteristics. The epidemiological dynamics-based prediction model is validated by the real case to be scientifically effective in predicting the amount of generated medical waste with a mean absolute percentage error (MAPE) of 18.08%. The constructed reverse logistics network model and the NSGA II algorithm provide a medical waste process center location, transportation routing, and vehicle selection solutions for both routine and emergency public health cases of Xi’an city with large, medium, and small scales. The above results indicate that the research scheme proposed in this paper could significantly reduce the medical waste logistics-related risks and costs and provide decision makers with more safe and reliable logistical solutions.

Medical waste generation rate and management practices among government hospitals in Eastern Ethiopia. A descriptive survey.

Healthcare facilities generate medical waste, also known as healthcare waste or health facility waste, during the healthcare delivery process, which is improperly managed as a result of underfunded healthcare systems, poor training, and lack of awareness of policies and legislation on handling medical waste as well as do not have national guidelines in place to adhere to the correct disposal of such wastage in developing countries like Ethiopia. To estimate the healthcare waste generation rate among selected public hospitals in eastern Ethiopia. A cross-sectional study design was conducted in eight public in eastern Ethiopia from 1st June 2023 to 30th July 2023. The "Bed-Patient-healthcare wastes" model was used to estimate the healthcare waste generation rate based on WHO and empirical evidence. HCW generation rate = No of (Inpatients (Inpts) + Outpatients (Outpts))/day*0.53 kg/day. Meanwhile, general (GW), infectious (IW), pharmaceutical (PW), sharps (SW), and pathological (PtW) are computed as follows: GW = No. of (Inpt + Oupt)/day*0.53 kg/day and IW, PW, SW, and PtW = No. of Inpts/day*0.53 kg/day. In contrast, for hazardous and non-hazardous healthcare wastes, No of HCWs/day*0.8 and no. of HCWs/day*0.2 were utilized, and Key informant interviews and field observational were also applied. Descriptive analysis such as percentage, mean, and standard deviation were presented. According to the current assessment, 105.1-142.8 kg/day healthcare waste was generated from outpatient and 167.3-244.2 kg/day from inpatients of public hospitals. From these, the Mean ± SD of daily healthcare waste generation rate estimated by non-hazardous and hazardous waste were 164.6 ± 80.9 kg/patients/day and 41.2 ± 20.2 kg/patients/day, respectively. In daily generation, the mean and standard deviations (Mean ± SD) of general wastes, infections waste, pharmaceutical wastes, sharp wastes, and pathological waste/patient were 62% (521.9), 23% (194.8), 4% (35.4), 2% (17.7), and 9% (70.9), respectively. The current assessment concluded that a large volume of healthcare waste is generated from selected public hospitals, which were not effectively segregated, separated at the source, and haven't conventional or standard treatment. As a result, the study advised that regional and global collaboration in hospital waste and wastewater management be encouraged.

Assessment of medical waste generation rate in Viet Nam.

This study was conducted to estimate medical wastes generation rates in Viet Nam. Within 3 years (from 2017 to 2019), total medical wastes generated daily of 1,737 health-care facilities at different levels from 19/63 provinces in Viet Nam were surveyed. The calculation was based on the median daily generation (in kg) of 6 medical waste groups and total actual patient beds in 9 health-care facility categories. Six medical waste groups were sharps, non-sharps, high-risk infectious, pathological, non-infectious hazardous, recyclable and non-recyclable wastes. Surveyed health-care facilities were categorized in central general hospitals, central specialist hospitals, provincial general hospitals, provincial specialist hospitals, district health centers, regional clinics, commune health stations, private hospitals and private clinics. The results showed that waste generation rates varied from 0.0009 to 1.619 kg/bed/day depends on type of medical wastes or health-care facilities. For no-patient-bed facilities (commune health stations and private clinics), medical waste generation rates of these two were calculated in kg/day and varied from 0.1 to 1.75 kg/day.

A Model for Predicting Medical Solid Waste in Hilla City, Iraq

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.

Symbiotic Mechanism of Multiple Subjects for the Resource-Based Disposal of Medical Waste in China in the Post-Pandemic Context

In the post-pandemic era, the continuous growth in the rate of medical waste generation and the limited capacity of traditional disposal methods have posed a double challenge to society and the environment. Resource-based disposal is considered an efficient approach for solving these problems. Previous studies focused on the methods of medical waste disposal and the behavior of single stakeholders, lacking consideration of cooperation among different stakeholders. This study establishes an evolutionary game model of the resource-based disposal of medical waste to analyze the behavioral decision evolution of governments, medical institutions, and disposal enterprises. This study also explores the influencing factors in the achievement of the symbiotic state and investigates the conditions that participants need to meet. The results show that joint tripartite cooperation can be achieved when the subsidies and penalties from governments are sufficient, as well as the efficiency of resource-based disposal, which can effectively promote the evolution of the three subjects from the state of “partial symbiosis” to the state of “symbiosis”. However, the resource-based classification level cannot directly change the symbiotic state of the system due to the goal of minimizing cost and risk. When evolutionary subjects have reached the state of “symbiosis”, the improvement in the classification level can enhance the willingness of disposal enterprises to choose the resource-based classification strategy. Under such circumstances, governments reduce their corresponding level of intervention. At this time, the whole system is in a more idealized symbiotic state.

THE MANAGEMENT OF SOLID MEDICAL WASTE AT HOSPITAL X IN PASURUAN REGENCY DURING THE COVID-19 PANDEMIC

Background – The COVID-19 pandemic has increased the rate of medical waste generation in hospitals. The amount of medical waste generated during the COVID-19 pandemic must be followed by the handling of solid medical waste by standard operating procedures. Improper handling of solid medical waste will harm the environment and human health. This study aimed to determine the solid medical waste management strategy during the COVID-19 pandemic. Methods – This descriptive observational study was conducted at X Hospital, Pasuruan Regency. Data was collected using observation, interviews and secondary data collection during 2020 and 2021. Interview respondents were the Head of the Medical Support Division, the K3RS and B3 Admin sections and the PPI team leader. Results – There was an increase in the amount of solid medical waste during the COVID-19 pandemic, from an average of 2,495.87 kg in 2020 and 2509.41 kg in 2021. This problem was overcome by a strategy in solid waste management during the COVID-19 pandemic. The strategy was carried out at the sorting and storage stage, namely by involving the PPI team directly in waste management and regular and scheduled training for all Hospital X staff which had not been carried out before the pandemic; at the collection stage, namely by adding garbage collection to 3 (three) times a day according to the guard shift by using PPE level 2; and the waste transportation stage, the strategy adopted is to add a third party medical waste from 1 (one) to 3 (three). Conclusion – There was a change in strategy in the management of solid medical waste at Hospital X, Pasuruan Regency during the Covid-19 pandemic, namely at the stages of sorting and storing, storing and transporting waste. However, at the temporary collection stage, there was no change.

An Evaluation of Health Care Waste Generation and Disposal at Ramadi Teaching Hospital in Iraq

In recent years, hospital waste has been one of the most serious issues in Iraq and other parts of the world. The current study aims to measure and analyze hospital waste output across all departments at the Ramadi Teaching Hospital. The data on waste generation rates gathered for the study were primarily based on existing records of field management of hospital waste over the course of eight months (one week per month) for all departments in the hospital; however, some random sampling information was provided to supplement the data. The results revealed that the estimated rate of medical waste creation at Ramadi hospital was between 144 and 188 kg/day, whereas the general (non-medical) waste generation was between (240-278) kg/day. In terms of patient numbers and per occupied bed, the average medical waste generation rates were from 0.60 to 0.90 kg/patient/day and (0.85-1.11) kg/bed/day, respectively, whereas the average general trash generation rates ranged from 0.86 to 1.15 kg/patient/day and 1.42-1.64 kg/bed/day. The recent analysis concluded that the hospital's segregation procedure is still inefficient, and there is room for improvement in terms of reducing hazardous medical waste creation

Medical laboratory waste generation rate, management practices and associated factors in Addis Ababa, Ethiopia.

Biomedical wastes (BMWs) generated from medical laboratories are hazardous and can endanger both humans and the environment. Highly infectious biomedical wastes are produced at an unacceptably high rate from health laboratories in developing countries with poor management systems, such as Ethiopia. The purpose of this study was to assess the rate of biomedical waste generation, management practices, and associated factors in public healthcare medical laboratories in Addis Ababa, Ethiopia. From July 13 to September 25, 2020, a health institution-based cross-sectional study was conducted in 6 hospital laboratories and 20 health centres laboratories in Addis Ababa, Ethiopia. Data on socio-demographic characteristics, knowledge and practice of biomedical waste management and generation rate were collected d in health facilities using pre tested data collection tools. SPSS version 20 was used to manage the data. To identify independent predictors of the dependent variable, descriptive statistics, Pearson correlation, linear, and logistic regression analysis were used. The strength of the association was determined using an odds ratio with a 95% confidence interval. In this study, the mean ± SD daily generation rate of biomedical wastes was 4.9 ± 3.13 kg/day per medical laboratory. Nineteen medical laboratories (74.3%) had proper biomedical waste management practice, which is significantly associated with professionals' knowledge of biomedical waste management policies and guidelines, the availability of separate financial sources for biomedical waste management, and the level of training of professionals. The study found that medical laboratories in Addis Ababa's public healthcare facilities generate a significant amount of biomedical waste. Nearly two-thirds of hospitals performed proper waste segregation, collection, storage, and treatment procedures for biomedical waste generated in their laboratories. However, there was a poor transportation and disposal method. As a result, paying special attention and implementing the current national guidelines for biomedical waste management is recommended.

Infectious medical waste management during the COVID-19 pandemic in public hospitals of West Guji zone, southern Ethiopia

IntroductionCOVID-19 has swept through the world in a very short period; large volumes of medical waste are being generated in response to the pandemic. Hence, it is imperative to plan and develop evidence-based additional waste management systems. ObjectiveTo assess infectious medical waste management system during the COVID-19 pandemic in public hospitals of the West Guji zone, southern Ethiopia, 2020. MethodsInstitution-based cross-sectional study design was conducted from November 05-25/2020. To determine infectious medical waste generation rate, different color plastic buckets and bags was distributed to each ward of the hospitals. Then, its quantity was measured by using a calibrated weighing balance for seven consecutive days. An interviewer-administered questionnaire and an observational checklist were used to collect data related to the existing waste management system, and the knowledge, attitude and practice of waste handlers. The data were analyzed by SPSS version 25 and presented in tables, figures and texts as appropriate. ResultThe average infectious medical waste generation rate was determined to be 2.1 kg/bed/day and/or 0.57kg/patient/day. Besides, there was limited segregation of infectious medical waste at the point of generation. Mixed medical waste was collected and transported by using open plastic bin and burned in a brick incinerator or/and dumped in an open field. Moreover, about 42%, 44.6% and 64.8% of the waste handlers had adequate knowledge; a positive attitude and adequate practice respectively. ConclusionThe average infectious medical waste generation rate is above the threshold value (0.2kg/bed/day) set by the WHO. Besides, its management was limited. There was also a gap in the knowledge and attitude of waste handlers towards infectious medical waste management during the COVID-19 pandemic.

Amassing the Covid-19 driven PPE wastes in the dwelling environment of Chittagong Metropolis and associated implications

This study investigates the Covid-19 driven indiscriminate disposal of PPE wastes (mostly face mask and medical wastes) in Chittagong metropolitan area (CMA), Bangladesh. Based on the field monitoring, the mean PPE density (PPE/m2± SD) was calculated to be 0.0226 ± 0.0145, 0.0164 ± 0.0122, and 0.0110 ± 0.00863 for July, August, and September 2021, respectively (during the peak time of Covid-19 in Bangladesh). Moreover, gross information on PPE waste generation in the city was calculated using several parameters such as population density, face mask acceptance rate by urban population, total Covid-19 confirmed cases, quarantined and isolated patients, corresponding medical waste generation rate (kg/bed/day), etc. Moreover, the waste generated due to face mask and other PPEs in the CMA during the whole Covid-19 period (April 4, 2020 to September 5, 2021) were calculated to be 64183.03 and 128695.75 tons, respectively. It has been observed that the negligence of general people, lack of awareness about environmental pollution, and poor municipal waste management practices are the root causes for the contamination of the dwelling environment by PPE wastes. As a result, new challenges have emerged in solid waste management, which necessitates the development of an appropriate waste management strategy. The ultimate policies and strategies may help to achieve the SDG goals 3, 6, 11, 12, 13, and 15, and increase public perception on the use and subsequent disposal of PPEs, especially face masks.

Assessment of medical waste generation, associated environmental impact, and management issues after the outbreak of COVID-19: A case study of the Hubei Province in China.

COVID-19 greatly challenges the human health sector, and has resulted in a large amount of medical waste that poses various potential threats to the environment. In this study, we compiled relevant data released by official agencies and the media, and conducted data supplementation based on earlier studies to calculate the net value of medical waste produced in the Hubei Province due to COVID-19 with the help of a neural network model. Next, we reviewed the data related to the environmental impact of medical waste per unit and designed four scenarios to estimate the environmental impact of new medical waste generated during the pandemic. The results showed that a medical waste generation rate of 0.5 kg/bed/day due to COVID-19 resulted in a net increase of medical waste volume by about 3366.99 tons in the Hubei Province. In the four scenario assumptions, i.e., if the medical waste resulting from COVID-19 is completely incinerated, it will have a large impact on the air quality. If it is disposed by distillation sterilization, it will produce a large amount of wastewater and waste residue. Based on the results of the study, we propose three policy recommendations: strict control of medical wastewater discharge, reduction and transformation of the emitted acidic gases, and attention to the emission of metallic nickel in exhaust gas and chloride in soil. These policy recommendations provide a scientific basis for controlling medical waste pollution.

Modelling, Composition and production rate of medical solid waste in Tikrit: A case study of Tikrit Teaching Hospital (TTH) in Iraq

Tikrit Teaching Hospital (TTH), Tikrit, Iraq, was selected for investigation as a case study. Data collection was carried out during TTH visits and by questionnaires. Sampling was performed during a 10-month period, one week each sampling month. The medical waste analyzed was comprised of 63.04% general waste (non-risk) and 36.96% hazardous waste. The results indicated that the medical waste generation rate is 0.9 kg/bed.day and 0.75 kg/patient.day. Statistically significant linear correlations were established between the daily production of medical solid waste and the respective number of patients and the occupied beds in TTH as whole. Based on the average daily production of medical solid waste produced by the departments of TTH (kg /d), the larger producer of general medical solid waste was obstetric department with average daily production of 25 kg/d, while the larger producer of hazardous medical solid waste was obstetric department with average daily production of 11 kg/d. The average specific weight of total medical waste, general waste, and hazardous waste were determined to be 218.6, 206.5 and 225.54 kg/m3, respectively. The average moisture content of total medical waste, general waste, and hazardous waste were determined to be 21, 20.4 and 23.4 %, respectively. The average general medical waste composition was: 40% organics, 21% plastics, 19% paper, 11% glass and 9% metals. Pathological wastes and sharp objects comprised 43% and 25% of the hazardous medical waste components.

Face Mask Consumption and Medical Waste Generation During the COVID-19 Pandemic in Iran: Challenges and Problems

Background: The outbreak of COVID-19 has caused a devastating pandemic scenario in the world. The mortality rate has increased and new socio-economic challenges are emerging. Millions of gloves, gowns, face masks, and face shields are used daily to prevent airborne transmission and facilitate the treatment of COVID-19. Mismanagement of these wastes can lead to increased concerns due to their contamination potential. A comprehensive plan to improve the management of medical wastes in every country requires awareness of the current status of solid waste. Objectives: The study aimed to calculate and estimate the consumption rate of face masks and medical waste generation rate during the COVID-19 pandemic in Iran. Also, the performance of different departments of medical waste management and future challenges are discussed. Methods: The daily consumption of face masks and medical waste generation were calculated based on the population data, the percentage of the urban population, face mask acceptance rate, the number of face masks needed per person per day, total COVID-19 confirmed cases, and medical waste generation rate (kg/bed/day). Results: The consumption of face masks in Iran is estimated at 46576000 pieces per day. Also, the three provinces of Tehran (9,560,000 pieces), Khorasan Razavi (3,825,600 pieces), and Isfahan (3,523,200 pieces) have the highest consumption rate of masks, respectively. Increasing the number of confirmed COVID-19 cases has increased the medical waste generation rate. Until April 3, 2021, more than 1,920,394 cases of COVID-19 have been confirmed in Iran, and calculations show that the medical waste generation rate in Iran is about 7,585.56 tons per day. Conclusions: COVID-19 is a highly infectious and problematic disease. The continuous increase in the number of confirmed COVID-19 cases has increased face mask consumption rate and medical waste generation rate, and as a result, new challenges have emerged in the field of solid waste management. These emerging challenges in managing solid waste during the COVID-19 pandemic necessitate the development of appropriate waste management policies and strategies.

Impact of COVID-19 pandemic on medical waste management in Lebanon.

Worldwide, there is a growing concern about the negative effects of infectious medical waste produced during the COVID-19 pandemic and the contamination risks associated with waste management. Therefore, measures to ensure that medical waste is managed safely and in an environmentally sound manner will avoid negative health and environmental effects from such waste, thus protecting the health of patients, health workers and the public in general. Despite that infectious medical waste generation rate is important for management planning and policy development, there is a limitation on national data availability and its accuracy, particularly in developing economies. This study analyses the infectious healthcare waste generation rates and management patterns in Lebanon before and after the COVID-19 pandemic. The estimated average of COVID-19-related infectious healthcare waste generation in this study is 39,035 kg per month or 1.3 tonnes per day, which constitute between 5% and 20% of total infectious healthcare waste in Lebanon. This study illuminates on the impact of COVID-19 on the existing challenges of waste management in Lebanon. It highlights the need for proper management and disposal of the amounts of medical waste generated to reduce contamination risks or related environmental threats, particularly during the pandemic. It also shows that Lebanon has a defective system for monitoring of waste from healthcare institutions and gaps in waste statistics. Finally, the study summarizes recommendations related to medical waste management, which can provide valuable insight for policymakers.

REGRESION MODEL OF COVID-19 MEDICAL HARZARDOUS WASTE GENERATION BASED ON MAXIMUM BEDS CAPACITY OF REGIONAL HOSPITALS IN DKI JAKARTA

Abstract The Covid-19 pandemic disaster in DKI Jakarta has shown a significant increasing in confirmed positive cases starting in September 2020, resulting in the re-implementing of Large-Scale Social Distancing (PSBB). The main factor that led to the re-implementing of the PSBB in DKI Jakarta is the limited bed capacity in the 67 Covid-19 referal Local General Hospitals (RSUD). Handling Covid-19 patients requires more medical equipment such as masks, glasses, protective clothing and so on, which will increase the rate of medical waste generation. This study will discuss the prediction of minimum and maximum generation of Covid-19 medical hazardous waste (B3) in 67 Covid-19 referal RSUD in DKI Jakarta which can be calculated based on the maximum capacity of available isolation and ICU beds during the period 23 August - 4 October 2020 and the average of medical waste generation per patient treated. From the prediction, a regression model of increasing number of minimum and maximum medical hazardous waste produced in several Covid-19 referal RSUD in DKI Jakarta can be made. Keywords: covid-19, hazardous waste, hospital, maximum capacity, regression model.

QUANTIFICATION AND CHARACTERIZATION OF MEDICAL WASTE IN PUBLIC HEALTH CARE FACILITIES WITHIN AKURE METROPOLIS, ONDO STATE, NIGERIA

This study investigated the quantity and rate of medical waste generation in purposely selected public hospitals located within Akure metropolis of Ondo State and determined the characteristics of the waste generated. The quantity of medical waste generated was measured daily in kg per day, kg per bed per day, and kg per patient per day while, the physical and chemical characteristics were determined according to standard methods. This study indicated that the quantity of medical waste generated by Ondo State Specialist Hospital Akure, and Mother and Child Hospital Akure were 124.5 kg/day and 0.44 kg/patient/day. Over two-thirds were general waste while the remainder (30.9%) were considered to be infectious and hazardous wastes. The result obtained from physical characterization of the medical waste revealed that the percentage of moisture content and bulk density of cellulose in the medical waste composition exceed other components of the waste. However, from proximate analysis of the medical waste, cellulose has the highest percentage of fixed carbon, volatile matter and ash while the result obtained from ultimate analysis indicated that the percentage content of hydrogen, nitrogen, sulphur, oxygen and carbon is higher than that of other composition of medical waste.

Medical waste management in Iraq: a case study of Baghdad

There is a lack of information about medical waste management in Iraq. This study aims to monitor and evaluate the current situation of medical waste management in Baghdad as it represents the capital and the biggest populated city in Iraq. About 32% of hospitals are located in Baghdad. Ten state-owned hospitals in Baghdad with the biggest bed capacity were investigated. The study used structured interviews with staff in charge of waste management in the sampled hospitals to collect data. The results showed that the generation rate of medical waste in the ten hospitals was 0.5 kg/(bed·day). The study also found that there were insufficient, ineffective, and improper isolation, collection, storing, processing, and safe disposal of medical wastes in the sampled public hospitals of Baghdad. The study recommended that the Iraqi Ministry of Health takes extensive and quick effective measures to better monitor and evaluate medical waste management and provide ongoing training to personnel responsible for waste management in the hospitals.

Medical waste management of village clinics in rural China

Medical waste is rising on policy agendas as a serious public health and environmental issue. The aim of this study was to assess current practices of medical waste management, which include waste generation, collection, storage, segregation, disposal, and use of protective equipment, in village clinics in rural China. Based on survey results from 236 randomly selected village clinics in 21 counties from three provinces of China, we used descriptive statistics to determine the medical waste management of village clinics in sample area. We found that the generation rate of medical waste in sampled village clinics was approximately 0.65 kg per day or 0.17 kg/patient per day on average. Given the large number of primary healthcare facilities and population in rural areas of China, the total quantity of medical waste generated in these facilities is noteworthy. However, we also found poor compliance levels with the national regulations regarding medical waste management practices. A large proportion of medical waste was still not packed in required containers, and almost all village clinics did not segregate correctly. Moreover, a significant portion of village clinics used improper disposal methods and lacked the necessary protective equipment. Medical staff in these facilities pointed out four main difficulties in complying with national regulations: a lack of funding, equipment, designated areas, and management personnel specifically delegated for medical waste management. These findings suggest that Chinese policymakers and health administrators should pay more attention to rural areas in addressing potentially hazardous medical waste management practices by investing financial support as well as developing specific guidelines tailored to resource-strained rural primary healthcare facilities.

Reverse logistics network design for medical waste management in the epidemic outbreak of the novel coronavirus (COVID-19)

The recent pandemic triggered by the outbreak of the novel coronavirus boosted the demand for medical services and protective equipment, causing the generation rate of infectious medical waste (IMW) to increase rapidly. Designing an efficient and reliable IMW reverse logistics network in this situation can help to control the spread of the virus. Studies on this issue are limited, and minimization of costs and the risks associated with the operations of this network consisting of different types of medical waste generation centers (MWGC) are rarely considered. In this research, a linear programming model with three objective functions is developed to minimize the total costs, the risk associated with the transportation and treatment of IMW, and the maximum amount of uncollected waste in MWGCs. Also, multiple functions that calculate the amount of generated waste according to the parameters of the current epidemic outbreak are proposed. Revised Multi-Choice Goal Programming method is employed to solve the multi-objective model, and a real case study from Iran is examined to illustrate the validation of the proposed model. The final results show that the model can create a balance between three considered objectives by determining the flow between centers, deciding to install two new temporary treatment centers, and allowing the network to only have uncollected waste in the first two periods in some MWGCs. Also, managerial insights for health organization authorities extracted from the final results and sensitivity analyses are presented for adequately handling the IMW network.