Hazardous Medical Waste Research Articles

Influences of temperature, waste size and residence time on the generation of polycyclic aromatic hydrocarbons during the fast pyrolysis of medical waste

Mismanagement of Medical wastes can lead to human health and environmental risks. Currently, new pyrolysis technologies are being used to treat medical waste that can reduce the amount of landfilled waste, make it safe, and eventually convert it to a hydrocarbon fuel. Polycyclic aromatic hydrocarbons (PAHs) are pyrolysis by-products and major environmental pollutants. In this study, hazardous medical wastes were pyrolyzed using a semi-industrial pilot scale fast pyrolysis reactor with the purpose of improving the quality of the char for its recovery or use as fuel. The generation of total 4-6 rings PAHs was studied in char product from hazardous medical waste fast pyrolysis under different pyrolysis conditions variables including a vast temperature range (300-700°C), different residence times (100-190 s) and various waste particle sizes (1-3 cm). GC analyzer coupled with a FID detector was used to detect and measure the PAH compounds in char residues. The results demonstrated that the PAHs are present in significant concentrations in char product (54-1184 mg kg-1). Generation of total 4-6 rings PAHs varied by temperature, residence time and waste size. Significant interaction was observed between residence time and temperature that influenced the PAHs generation. By optimizing the pyrolysis operating conditions it is possible to minimize the amount of PAHs generation in the char.

Medical and technical aspects of activities at hospital departments of infectious diseases during the pandemic of the Coronavirus disease 2019 and other highly infectious diseases

Introduction. The article presents information on the activities of inpatient facilities for infectious diseases during the pandemic of the new coronavirus disease 2019, taking into account current regulatory documents. The authors reviewed the principles of hospital zoning and patient controlled movement in hospitals for infectious diseases. The paper deals with the organization of the admission departments and equipment of the diagnostic units of hospitals for infectious diseases, providing a graphical presentation of an individual isolation unit (Melzer box) including description of the control and management system for safe access to infectious units. The characteristics of engineering and communication systems, disposal of hazardous medical waste, catering, navigation systems, operational remote communication between doctors and patients, application of barcoding for patient identification and medical records are also discussed. The purpose of this paper was to: Identify the shortcomings of the existing regulatory framework concerning the management and organization of health care institutions that provide medical care to patients with the new coronavirus infection; Identify areas that require adjustments, given the modern requirements for high quality treatment, as well as to ensure epidemiological safety for medical staff and patients; Specify additional requirements for hospitals for infectious diseases, which should be taken into account when planning major repairs, reconstruction and construction of new medical facilities for providing health care during the pandemic of new coronavirus disease 2019 and other highly infectious infections.

A bi-level and robust optimization-based framework for a hazardous waste management problem: A real-world application

Abstract Hazardous waste management is a hierarchical process. In the upper level of the hierarchy, the government’s policies on planning and controlling the waste management infrastructure aim to overcome the environmental concerns related to the disposal of waste materials. On the other hand, the follower of the hierarchical process decides about waste collection plans considering the government-approved infrastructure to minimize total operational costs. From this point of view, the present study proposes a bi-level mathematical formulation to model the problem of hazardous waste management. Also, to tackle the highly fluctuating nature of hazardous waste generation rates, our study addresses the most probable, optimistic and pessimistic scenarios of this key parameter. To solve the problem under uncertainty, a multi-part solution methodology combining the robust optimization approach, a method of reformulating the bi-level model into Mixed-Integer Linear Programming (MILP) formulation as well as a feasibility repairing mechanism is applied. In the end, the model and the solution methodology are illustrated with a real-life hazardous medical waste management problem and practical insights are derived.

Ways to Resolve Global Problem of Collection, Conveyance and Disposal of Hazardous Medical Wastes in Ukraine

This scientific paper studies the procedure and specific aspects of collection, conveyance and disposal of hazardous medical wastes in Ukraine. Drawing on analysis of the state of matters in the sphere of collection, conveyance and disposal of hazardous medical wastes in Ukraine, we proposed effective ways to resolve this problem. With a view to improve the procedure for collection, conveyance and disposal of hazardous medical wastes in Ukraine, we proposed, firstly, to strengthen public control over the state procurement with the help of “DoZor public”, an online platform, where everyone can provide a feedback to a state customer or supplier, society or law enforcement authorities regarding the conducted procurement procedure, discuss and evaluate the terms of a particular purchase, and analyze purchases of a particular customer. Secondly, insufficient control by the state also provokes emergence of such situations. In this context, it is expedient to lift the moratorium on inspections of business entities by the controlling bodies. It has been established that the main sources of generation of pharmaceutical and medical wastes in Ukraine are: medical waste from hospitals, health centers, health resorts, outpatient clinics, etc.; materials from laboratories and pharmaceutical manufacturing enterprises; tissues and body parts from surgical theaters; expired drug products; medical devices; leftover medicines in the form of liquid medicines, pills, solutions, etc. in a household setting; waste from pharmacies, pharmacy branches and pharmacy kiosks; packaging materials from drug products, etc. The author has investigated the main methods employed for destruction of poor-quality drugs in the form of solid products, powders (pills, capsules, granules, powders for injection), semisolid drugs (creams, gels, ointments) by means of encapsulation, inertization or high-temperature incineration.

The Routing of Hazardous and Toxic (B3) Medical Waste Transportation Using Network Analysis (Case Study: Primary Health Care Services, Depok, Indonesia)

The hazardous and toxic (B3) medical must be managing carefully. The B3 medical waste management is a series of operations, including the collection, storing, transporting, processing, recycling or disposal, and monitoring of B3 waste and the disposal of the products of such processing. The process is very important because several categories are dangerous and toxic. Moreover, Solid medical waste can contain infections, sharp objects, drugs, cytotoxic, chemical, radioactive, pressurized containers, and have a high heavy metal content. This paper is aim to recommend the B3 medical waste transportation system for primary health care service (PHCS) and institutions related. The good of management and effective transportation are needed because it cannot endanger the increasingly of the crowded population. The data were collected in 11 of PHCS using survey and questionnaire. The point survey was processed by Google Earth/Maps and analyzed using ArcGIS. The statistic method was used to analyze the questionnaires which collected from 35 of PHCS. Based on the results, the mean value is between 4 and 3.9. It is represented that 11 PHCS have worked using waste transportation properly. Some of the PHCS was using the third party for managing the waste medical. Hence, more 37% from 13 PHCS transporting the material to the last pool of waste every day. Whereas the other (46% from 16 PHCS) carried out once a month, and 8 PHCS (23%) done twice in a month. Only 1 PHCS (3%) transported once a week. Therefore, we recommended the 13 best route for medical waste transportation using network analysis.

Optimization of medical hazardous waste management in community health centers of depok city using analytical hierarchy process (AHP) method

The 35 Community Health Centers in Depok City have limited resources and other duties besides serving patients. This limitation makes the Community Health Centers difficult to comply with the regulation of Regulation of Environmental and Forestry Ministry Number 56 Year 2015 on “Procedures and Technical Requirement of Hazardous Waste Management from Healthcare Facilities”, therefore there is need for adjustments and appropriate decision making in hazardous waste management, which can be done using Analytical Hierarchy Process (AHP) methods. AHP methods use 3 principles, which is hierarchy making, priority determination, and consistency ratio. The objective of this research is to choose the most optimal alternative for hazardous medical waste management, starting from reducing, sorting, storing, transporting, treatment, until burial. After conducting pair comparison from all respondent, the data processing is done using Expert Choice 11 software. This software helps in choosing alternatives via many criteria by inputting the comparison value from each respondent and display the priority value from each alternatives. The chosen alternative is as follows: reducing wasteby a good housekeeping, sorting phase with two containers or plastic bags, storing phase with freezer as described in Regulation of Environmental and Forestry Ministry Number 56 Year 2015, transportation phase using closed truck, off-site treatment, and burialusing secure landfill.

واقع التخزين والتخلص من النفايات الطبية الخطرة في مجمع الشفاء الطبي في قطاع غزة

هدفت هذه الدراسة إلى اﻟﺘﻌرفﻋﻠﻰ مصادر النفاياتاﻟطﺒﯿﺔ المتداولة في مجمع الشفاء الطبي،ولطرق تخزينها وآليات التخلص منها، والى أماكن التخزين والشروط المتبعة لإدارة النفايات الطبية وقت الأزمات والكوارث. استخدم الباحثان المنهج الوصفي للوصول إلى نتائج الدراسة. كانت أداة الدراسة عبارة إجراء مقابلات شخصية مع العاملين في مجمع الشفاء الطبي. خلصت الدراسة إلى مجموعة من النتائج منها أنه لا تتم عملية فرز النفايات الخطرة وغير الخطرة بالشكل الصحيح، وأن مواقع التجميع والتخزين المؤقتة المستخدمة داخل المستشفى غير مطابقة لمواصفات منظمة الصحة العالمية. واستنتجت الدراسة أن هذه المخلفات تشكل خطورة كبيره ومشاكل عديدة يعاني منها المجتمع الفلسطيني، وأوصت الدراسة بضرورة رفع مستوى التعاون بين الجهات المعنية لعملية تخزين النفايات الطبية الخطرة، وإلى إنشاء سجل خاص لكل نوع من أنواع النفايات الطبية وطرق تخزينها، وكذلك ضرورة إجراء فحوصات طبية دورية للعاملين في مجال النفايات الطبية.

واقع إدارة النفايات الطبية في عيادات الأسنان دراسة حالة: عيادة الأسنان في محافظة خانيونس

هدفت الدراسة إلى تقييم واقع إدارة النفايات الطبية في عيادات الأسنان بمحافظة خانيونس (دراسة حالة) من حيث عمليات الفرز للنفايات الطبية الخطرة، والجمع وهي عملية جمع النفايات في أكياس مغلقة بإحكام عند امتلائها، والنقل من خلال شاحنات النقل الخاصة بنقل النفايات الطبية والتخلص منها، وقام الباحثان باستخدام منهجية المقابلة الميدانية والملاحظة المباشرة للعيادة، وطرح مجموعة من الأسئلة على العاملين في العيادة، وكان من أهم نتائج الدراسة أنه لا توجد عملية فرز للنفايات الطبية بطريقة سليمة حيث تتم بطريقة عشوائية، وعدم الالتزام التعليمات لقوانين منظمة الصحة العالمية الخاصة بإدارة النفايات بطريقة سليمة ويتم التخلص منها عن طريق المحارق التابعة لوزارة الصحة بمحافظات غزة. وأوصت الدراسة بضرورة وجود نظام خاص بفرزالنفايات الطبيةالخطرة عن النفاياتالطبيةغيرالخطرةمن مصدر انتاجها وبالطرق السليمة، وتعزيز وضع تشريعات كسياسات لإدارةالنفايات الصحيةمن أجل السلامةالصحية، وزيادة الوعي لدى العاملين بالمؤسسات الصحية حول مفهوم إدارة النفايات الطبية وخطورتها وتوفير سيارات نقل خاصة لنقلها

ROLE OF GEOGRAPHIC INFORMATION SYSTEMS (GIS) IN LOCATING THE MOST SUITABLE SITES FOR HAZARDOUS MEDICAL WASTE DUMPSTERS (CASE STUDY: SOHAG CITY)

Hazardous medical waste is a very serious source on human health and environmental system،for its highly hazardous chemicals، organic، and radiant content. The disposal process of hazardous medical waste is carried out in several stages: collection، sorting، storage، transportation and treatment، and ending with the final safe disposal. The final disposal phase is an important stage from these stages. The landfill or burial is one of the most important methods of waste final disposal process. This is done by using waste dumpsters with specific specifications prepared for this purpose. It is important in this regard to determine the location of sanitary dumpsters، which need to determine their places accurately، in a way that does not adversely affect the environment، and provide adequate safety means، by using scientific methods as a substitute for the traditional means of self-experience and decision-makers experience. From here the study importance in Sohag city،where Sohag is one of the areas that suffer from medical waste management and disposal problem in accordance with the principles and standards of health and safety the public، Where the reliance on the means of burning only for the final disposal of tit at the complex of incinerators in (Kawther) area، Sohag city، which is not contain any sites for the burial of hazardous medical waste.

Modern Management of Medical Waste in UNRWA Clinics in Gaza Strip Governorates

هدفت هذه الدراسة إلى التعرف على واقع إدارة النفايات الطبية الحديثة في وكالة الغوث الدولية والتي تشمل: أولا: عمليات الفرز، وهي عبارة عن فصل النفايات الطبية العادية عن النفايات الطبية الخطرة عند مصدر إنتاجها، وكذلك وضعها في أكياس حسب تصنيفها من قبل منظمة الصحة العالمية. ثانياً: عمليات الجمع، وهي عملية جمع النفايات الطبية في أكياس مغلقة بإحكام عند امتلائها حتى ثلاثة أرباعها، وعمليات النقل الداخلي من خلال توفير عربات مناسبة لنقل النفايات الطبية من داخل أقسام العيادة إلى غرفة التخزين المؤقتة. ثالثاً: عمليات التخزين، وهي تخصيص غرفة كنقطة لتجميع النفايات فيها. رابعاً: عمليات التخلص النهائي حيث يتم تحديد كمية النفايات الطبية التي يتم إنتاجها من خلال وزنها ونقلها بواسطة شاحنات وزارة الصحة ليتم معالجتها والتخلص النهائي منها. كما تهدف الدراسة للتعرف على إجراءات السلامة المهنية للعاملين من مخاطر النفايات الطبية، وذلك من أجل تقديم توصيات تتعلق بإدارة النفايات الطبية والتعامل الآمن معها، وحماية العاملين من حوادث الإصابة بالعدوى والأخطار الناجمة عن النفايات الطبية، وتقليل نسبة حدوث الأخطاء والحوادث أثناء القيام بإدارة النفايات الطبية، والحفاظ على سلامة البيئة. وقد اعتمدت الدراسة على عدة طرق لجمع المعلومات شملت الزيارات الميدانية، وتقارير وأدلة إدارة النفايات الخاصة بوكالة الغوث الدولية.

Current Scenario of the Tehran Municipal Solid Waste Handling Rules towards Green Technology.

This study aims to study the waste management process and recycling of municipal waste in Tehran. Currently, Kahrizak is the defined landfill area which collects the waste generated from 22 districts of Tehran. The organic wastes undergo to the windrow composting method in order to manage the partial of the waste generated in the city. Samples from the compost pile generated in Kahrizak were examined to evaluate its fertilizer value to be used further by the farmers. The results show that the obtained compost does not reach the acceptable quality to be used further in agriculture, due to lack of homogeneity, aeration and presence of heavy metals. Overall, it has been concluded that, due to the improper waste segregation and management prior to sending to landfill and presence of non-organic materials such as hazardous metals and medical wastes, causes difficulties in proper waste management, implementation and producing high quality compost. Based on this study the existence of stakeholders, society, economy and proper handling rules can effectively improve the waste management system in the country and leads to the sustainable green environment.

Increase adherence to waste management policy at healthcare facility in Egypt

BackgroundProper management of medical wastes can help prevent serious consequences of catastrophic events or accidents in the hospital and its near or far environment.MethodA quality performance improvement project has been carried out to increase adherence to waste management policy of infection control, to ensure that departments are following basic health rules of their communities. In this project, the team utilized the basic Six Sigma breakthrough problem-solving methodology: Define, Measure, Analyze, Improve and Control (DMAIC) to examine the original (root) causes of the problem, in a healthcare facility in Egypt from January to August 2016. The team re-modulated a place for interim storage of hospital-regulated hazardous medical waste and compensate for workers’ fatigue by participation of professional housekeeping company.ResultsWeekly recording of errors in performance in waste management process demonstrates process stability through the first 12 weeks, and shifting towards the desired direction of reduced errors in waste management performance was obtained from the 13th week ongoing.ConclusionInfection preventionists using their routine monitoring data could help the organization to fulfill accreditation requirements for quality assurance through the performance improvement project and to keep all hospital staff, visitors, and the surrounding environment safe and secure.

Development of an Environmentally Safe Process for Medical Waste Disposal Based on Pyrolysis

Upon analyzing the methods for processing epidemiologically hazardous medical waste (MW), it has been shown that the problem of safe disposal of MW with respect to the formation of polychlorinated dibenzo-para-dioxins and dibenzofurans (dioxins and furans) is acute and requires scientifically sound solutions. The typical morphological and elemental composition of the MW classes B and C and their thermal properties were determined, and the modern literature on the processes of thermal detoxification of dangerous MW was analyzed. It has been found that the process of pyrolysis is the most adaptive to various types of solid waste. Currently, pyrolysis attracts special attention due to its flexibility in treating various combinations of wastes only by changing the operating parameters of the process, such as temperature and heating rate. Pyrolysis is particularly important in connection with the growing amount of polymers in the waste of medical institutions, including those containing chlorine. In this case, the pyrolysis method presents the possibility of using a number of circuit solutions to prevent the formation of dioxins and furans. It has been shown that the use of the pyrolysis method ensures, along with full satisfaction of the requirements of sanitary and hygienic standards, the environmental safety of the MW detoxification process as compared to other high temperature methods (combustion and gasification). Next, possible directions of utilization of secondary resources received in the process under consideration were analyzed. In the proposed scheme of the installation for safe disposal of medical waste on the basis of the pyrolysis process, its products (excess gas, heat of the products of combustion, etc.) are expected to be used to generate electrical and thermal energy; semicoke as a solid residue of the process will be converted to activated carbon.

Medical waste management in three areas of rural China.

ObjectiveThe purpose of this paper is to describe current practices of medical waste management, including its generation, investments, collection, storage, segregation, and disposal, and to explore the level of support from upper tiers of the government and health care system for medical waste management in rural China.MethodsThe authors draw on a dataset comprised of 209 randomly selected rural township health centers (THCs) in 21 counties in three provinces of China: Anhui, Shaanxi and Sichuan. Surveys were administered to health center administrators in sample THCs in June 2015.ResultsThe results show that the generation rate of medical waste was about 0.18 kg/bed, 0.15 kg/patient, or 0.13 kg/person per day on average. Such per capita levels are significant given China’s large rural population. Although investments of medical waste facilities and personnel in THCs have improved, results show that compliance with national regulations is low. For example, less than half of hazardous medical waste was packed in sealed containers or containers labeled with bio-hazard markings. None of the THCs segregated correctly according to the categories required by formal Chinese regulations. Many THCs reported improper disposal methods of medical waste. Our results also indicate low levels of staff training and low rates of centralized disposal in rural THCs.ConclusionsMedical waste is a serious environmental issue that is rising on the agenda of policymakers. While a large share of THCs has invested in medical waste facilities and personnel, it appears that actual compliance remains low. Using evidence of low rates of training and centralized disposal, we surmise that a lack of support from upper tiers of management is one contributing factor. Given these findings, we recommend that China’s policymakers should enhance support from upper tiers and improve monitoring as well as incentives in order to improve medical waste management.

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.
 
 © 2018 JASET, International Scholars and Researchers Association

Determining the Hazardous Medical Waste Generation Rates of Private Health Care Facilities-Case Study from Dhaka City of Bangladesh

Many developing countries are lagging behind the developed countries to properly manage their hazardous healthcare waste. These waste pose a significant epidemiological risks to the general people. To estimate the epidemiological risks and to establish parameters of any waste management plan, quantitative estimation of healthcare waste generation is essential. Most researches on quantitative estimation of healthcare wastes to date, have not addressed the differences in waste generation trends between the government and private healthcare sectors. This study was carried out to estimate the hazardous healthcare waste generation from private healthcare sector of Bangladesh; with a future aim do the same for government healthcare sector. A total of 50 privates healthcare facilities of different categories from Dhaka North City Corporation (DNCC) and Dhaka South City Corporation (DSCC) were selected for this study following a random sampling technique. Secondary data was obtained from PRISM Bangladesh (PRISM Bangladesh Foundation is a non-profit voluntary development organization established in 1989. In the context of environmental management, PRISM Bangladesh operates in different areas of Bangladesh with the assistance and support of UN organizations such as UNDP, UNICEF, UNDRO and UNCDF.) for these 50 healthcare facilities and personal visits to waste treatment sites were made. The estimated the hazardous healthcare waste generation rate for the private healthcare sector was found to be 0.17 kg bed-1 day-1 on per patient per day basis and an overall of 6796 kg daily. The estimated waste quantity and the proportion of hazardous healthcare waste to total healthcare waste was found to vary significantly due to different parameters related to the type and size of healthcare facility, seasonal variation etc. Based on the findings of this research, more accurate strategic planning of waste management systems for developing countries can be established by governments and municipal authorities to reduce the epidemiological risks.

ПРОБЛЕМИ ЕКОЛОГІЧНОЇ БЕЗПЕКИ УТИЛІЗАЦІЇ МЕДИЧНИХ ВІДХОДІВ

Проаналізовано проблеми утилізації лікарських засобів, термін придатності яких закінчився, та медичних відходів в Україні. Показано, що медичні та фармацевтичні відходи належать до категорії "небезпечних відходів" і потребують спеціальних методів і засобів поводження з ними. Оцінено механізм надходження медичних відходів у навколишнє природне середовище та їхній вплив на організм людини. Показано, що медичні відходи є джерелом значного, зростаючого, екологічно небезпечного навантаження на довкілля. Проаналізовано етапи, закономірності та проблеми наявної практики поводження з медичними відходами в Україні. Окремою проблемою як України, так і світу загалом є поводження з лікарськими засобами, термін придатності яких закінчився, та невикористаними препаратами, які потрапляють на сміттєзвалища. Доведено, що це призводить до виникнення непередбачуваних фізико-хімічних та біохімічних процесів, продуктами яких є чисельні токсичні хімічні сполуки. З'ясовано недопустимість їх потрапляння на полігони твердих побутових відходів. Виявлено, що питання збирання та знешкодження лікарських засобів, термін яких закінчився, або невикористаних ліків в Україні абсолютно не вирішено. Запропоновано пріоритетний напрям для України щодо поводження з медичними відходами в найближчі роки.

Don’t Waste the Medical Waste: Reducing Improperly Classified Hazardous Waste in a Medical Facility

Hospitals in the United States generate over one million tons of waste each year, approximately a quarter of which is classified as hazardous medical waste. There are environmental, infectious, and financial burdens associated with this waste, and those burdens increase significantly when the waste is hazardous. Managing waste can be difficult, but training is an effective approach to reducing waste. We conducted a quality improvement project at the Johns Hopkins Hospital Pathology Core Laboratory from 2015 through 2017. We hypothesized that improved staff training is an effective way to reduce the amount of general waste in a medical facility that is incorrectly classified as hazardous. Two interventions were identified and implemented, the first being a series of classroom-based training sessions and the second being a simple informational poster that was displayed over waste bins. The impact of the training and posters was measured by two surveys that were performed before and after the interventions. The first survey was a web-based instrument that was completed by laboratory staff, while the second survey was observational and measured how many bins contained improperly disposed waste. Some of the data from these interventions supports the hypothesis. The observational survey, in particular, recorded an increase in proper waste disposal from 7.5% to 71.9% following the classroom intervention. Future studies can help determine if these improvements can be increased and sustained over time by assessing the cost and benefit of different interventions and measuring how long the gains from each can be sustained.

Preliminary Assessment of the Status of Hospital Incineration Facilities as a Health Care Waste Management Practice in Addis Ababa City, Ethiopia

Healthcare institutions generate different types of infectious and/or hazardous medical waste that poses enormous risk to patients, healthcare providers, waste pickers, and the community at large, if their disposal is not comprehensively and scientifically managed. This study was focused on the assessment of waste management practice, the status of existing medical waste incinerator facility found in Addis Ababa city government and private hospitals. A cross sectional descriptive study was carried out with the aim of assessing the current facility status and practices. The study approach involved literature review, use of survey, an empirical investigation comprising physical visit, observation checklist, and group discussion. The results showed that poor hazardous waste handling practice indicating all hospital incinerator have 100% some sort of incinerator but in different grade level which were categorized in three groups such as 93% of them were local ordinary brick incinerator in various and poorly designed, constructed and operated manner, whereas 7% of them were modern imported incinerator still among these only 5% of them were functional but still operated below the standard whereas the rest were old and nonfunctional. This paper has highlighted the pitfalls of poor status of incinerator facility and management practices in hospital waste management.

Healthcare waste management in Greece. The example of Health Region of Western Greece, Peloponnese, Epirus and Ionian Islands

The aim of the present study is a) to examine the healthcare waste management practices in W. Greece, Peloponnese, Epirus and Ionian islands b) to investigate the implementation of the institutional frame and c) to make suggestions in order to achieve a proper Hospital Healthcare Waste Management utilizing best practices. A questionnaire was prepared and distributed to selected people in 29 hospitals. The survey was conducted in the period 2015-2016. The results showed that more hospitals have an established Hazardous Medical Waste Management System, based on internal regulation of infectious waste management. The quantities of infectious wastes produced by the studied hospitals, expressed per day and bed (kg bed -1 day -1) were within the range illustrated both in Greek and International literature. In relation to waste management policy, the replies to the questionnaire show that most attention is given to the management of hazardous medical wastes, while the necessary importance is not given in the appropriate management of urban wastes (separation, recycling and reuse). In addition, according to the findings of the present study, the wastewater management in hospitals is considered of minor importance. Thus, more investigation is required to evaluate the best operation wastewater treatment scheme to achieve the protection of human health and ecosystems. The hospitals studied have not tried to adopt an Ecological Management and Audit Scheme (EMAS) a fact that reinforces our observation that none of them had made a commitment to minimize the environmental impact related to their function.