Healthcare Waste Research Articles

Congress Takes a Positive Swing at an Unsung Public Health Crisis: Preventing Pressure Injuries in Veterans Affairs Facilities.

Congress Takes a Positive Swing at an Unsung Public Health Crisis: Preventing Pressure Injuries in Veterans Affairs Facilities.

The Impact of COVID-19 on Waste Infrastructure: Lessons Learned and Opportunities for a Sustainable Future.

The onset of the COVID-19 pandemic posed many global challenges, mainly in the healthcare sector; however, the impacts on other vital sectors cannot be overlooked. The waste sector was one of the significantly impacted sectors during the pandemic, as it dramatically changed the dynamics of waste generation. Inadequate waste management practices during COVID-19 shed light on the opportunities for developing systematic, sustainable, and resilient waste infrastructure in the future. This study aimed to exploit the learnings of COVID-19 to identify any potential opportunities in post-pandemic waste infrastructure. A comprehensive review on existing case studies was conducted to understand the waste generation dynamics and the waste management strategies during COVID-19. Infectious medical waste from healthcare facilities had the largest influx of waste compared with non-medical waste from residential and other sectors. This study then identified five key opportunities from a long-term operational perspective: considering healthcare waste sector as a critical area of focus; encouraging the integration and decentralization of waste management facilities; developing systematic and novel approaches and tools for quantifying waste; shifting towards a circular economy approach; and modernizing policies to improve the effectiveness of the post-pandemic waste management infrastructure.

Pharmaceutical waste disposal practices: a case study of an Australian public hospital pharmacy department

AbstractBackgroundIn Queensland, each hospital and health service (local hospital network) has its own waste reduction and recycling plan to comply with the Queensland Government's Waste Reduction and Recycling Act 2011 (Qld). The aim is to reduce both the hospital's carbon footprint and waste handling costs. Hospital environmental waste services staff do not audit pharmaceutical waste bins as this requires the presence of a registered pharmacist.AimSince previous published studies of healthcare waste disposal practices have not included pharmacy waste bin audits, this study aimed to investigate waste disposal behaviours in a hospital pharmacy department.MethodThis sequential, two‐phase mixed methods study was conducted in a metropolitan, tertiary public hospital's pharmacy department in Queensland. Phase I involved semi‐structured interviews of hospital pharmacists and pharmacy technicians while Phase II comprised bin audits of the pharmacy department's waste streams.ResultsThe bin audits revealed 36.1%, 23.8%, and 4.9% of recyclable waste in the clinical waste stream for each of the three bin audits respectively. In the general waste stream, the two bin audits of this stream revealed 14.3% and 44.4%, respectively. The reasons were identified in the interviews: there were no recycling bins in the main dispensing areas and there was confusion surrounding correct disposal of original containers and non‐contaminated packaging waste. Non‐paper waste was found in the confidential (shredded) waste stream in the two bin audits of this stream (10.1% and 16.7%, respectively).ConclusionProvision of commingled recycling bins and clean office paper waste bins in dispensing areas and education of staff on correct waste segregation processes will improve waste segregation in hospital pharmacy departments with both financial and environmental benefits for the hospital and the general population.

Rank and Analysis Several Solutions of Healthcare Waste to Achieve Cost Effectiveness and Sustainability Using Neutrosophic MCDM Model

Managing healthcare waste (HCWTT) from healthcare facilities is difficult. It's high up on the list of health concerns. This growth in HCWTT has been especially visible in recent years, as the quantity of medical services available has increased. Because of the potential danger, this garbage poses to people and the planet, it must be properly disposed of. Because of ineffective waste management practices, inadequate financial resources, and a lack of adequate facilities, HCWT administration is especially crucial in developing nations. Reducing HCWT via appropriate treatment is important for the area's financial and environmental health. In order to solve single-valued neutrosophic (SVN) group decision-making issues with missing weight details, this research creates a unique multi-criterion decision-making (MCDM) approach. First, it's important to remember that various decision-makers (DMs) have varying levels of expertise. To get over the problem that the standards cannot compensate for each other, an improved version of ELECTRE is studied. The ELECTRE method is used under neutrosophic environment to rank solutions of HCWT.

Estimation of Persistent Organic Pollutants releases and emission levels from Healthcare Waste in Mwananyamala and Temeke Regional Hospitals in Tanzania

This study estimated the amount of polychlorinated dibenzodioxin (PCDDs) and polychlorinated dibenzofurans (PCDFs) from healthcare wastes generated in Mwananyamala and Temeke regional hospitals located in Dar es Salaam using Standardized Toolkit for sources of persistent organic pollutant (POPs) developed by UNEP. Healthcare wastes were collected in different categories and measured for fourteen (14) consecutive days. By using a weighing scale machine, the assessment of the healthcare waste generation rate in each hospital was measured. The average amount of healthcare waste were 67.12 Tons/year and 105.34 Tons/year at Mwananyamala and Temeke hospitals respectively. The recommended tolerable daily intake (TDI) of dioxin/furans for an adult is 1.75 x 10-10 g I-TEQ/day. The value obtained in this study (2.38 x 10-4 g 1-TEQ/day) at Mwananyamala hospital and 3.62 x 10-4 g 1- TEQ/day at Temeke is about 1.36 x 106 and 2.07 x 106 times higher than the recommended value for adults respectively. It is hereby recommended the emission of dioxin/furan from hospitals must be controlled and if possible, reduced to below the recommended limit. More detailed studies and the permanent monitoring of air quality around different healthcare facilities would be appropriate.

Status of health care waste management plans and practices in public health care facilities in Gauteng Province, South Africa

BackgroundHealth care waste management is a challenge due to the composition of the waste generated within a health care facility, of which 85% is domestic waste, and at least 15% is hazardous waste or health care risk waste (has been in contact with blood, body fluids or tissues from humans and could cause disease). In this study, we evaluated the status quo of health care waste management plans (HCWMPs) and practices in public health care facilities in Gauteng Province, South Africa.MethodsA situational analysis was employed in health care facilities (HCFs) that generated more than 20 kg (N = 42) of health care risk waste (HCRW) per day. Data was collected from officials responsible for the management of health care waste using a self-administered questionnaire whilst Chief Executive Officers/ managers of the HFCs were interviewed.ResultsThe results showed that most (79.0%) of the health care waste officers (HCWOs) as well as management (84.6%) agreed to have HCWMPs in place. The majority (76.9%) of the HCFs have a dedicated person appointed to manage health care waste with the majority (67%) being environmental health practitioners. According to management, only 30.8% have formally appointed an integrated HCW committee. Only 11.7% of the HCWOs are guided by the Occupational Health and Safety Act to develop their HCWMPs with only 20.5% with health care waste minimisation strategies in place.ConclusionThe study concluded that there is limited integration of HCWMPs as inadequate health and safety aspects, environmental pollution as well as community participation was reported. The novelty of the study is to contribute to a body of knowledge, information on the establishment of an effective health care waste management system in public health care facilities and for decision-making purposes.

Healthcare waste management practice and its predictors among health workers in private health facilities in Ilu Aba Bor Zone, Oromia region, South West Ethiopia: a community-based cross-sectional study

ObjectivesA lack of safe healthcare waste management (HCWM) practice poses a risk to healthcare staff, patients and communities. In low-income countries like Ethiopia, studies on the level of safe HCWM...

Impacts of COVID-19 pandemic on solid medical waste management in a hospital environment

In the context of the COVID-19 pandemic, the increase in the generation of solid health-care waste can be understood as a factor related to the incidence of SARS-CoV-2 cases and its impacts on society. This investigation aimed to verify the consequences of the increase in solid health-care waste as well as the response practices to the handling of these materials in times of a pandemic. A documentary analysis regarding the generation of solid health-care waste was developed at the Hospital de Clínicas of the Federal University of Uberlândia located in Uberlândia/Minas Gerais, Brazil. The results showed that the increase in the generation of solid health-care waste increased significantly in the hospital. The study suggests the implementation of a continuing education program for the health professionals of the institution, in order to reinforce knowledge about the management of solid health-care waste.

Hydrolysis of Blended Cotton/Polyester Fabric from Hospital Waste using Subcritical Water

Currently in Malaysia, most wastes are disposed into poorly managed systems with little or no pollution protection measures. Large amounts of wastes such as textiles are generated through hospitals and health care centers. However, the improper management of these abundantly generated wastes may pose an environmental pollution problems and fire hazard. Cotton textile is a potential biomass for bioethanol production. Subcritical water (Sub-CW) hydrolysis was investigated as an alternative technology for the recycling of cotton textile waste for current health care waste management. The aim of this study was to investigate the possibility of complete conversion of cotton textile waste to ethanol via Sub-CW hydrolysis and fermentation. Sub-CW was carried out to facilitate the hydrolysis of cellulose component in cotton textile (cotton 75%+polyester 25%). The study was divided into two parts; (i) To evaluate the subcritical water parameters such as temperature and time to achieve maximum yield of sugars. (ii) Fermentation of the hydrolysate obtained from Sub-CW hydrolysis to ethanol. Under Sub-CW conditions of temperature (140 °C - 350 °C), reaction time (1-10 min) and water to cotton ratio (3:1) showed that cotton textile treated at 280 °C for 4 min, was optimal for maximizing yield of sugar, which was 0.213 g/g-dry sample. The quantitative analysis by HPLC showed that the soluble carbohydrates in the water phase were mainly composed of glucose. The obtained glucose concentration, 171 mg/L was then fermented at 36 °C for 24 hours by Saccharomyces cerevisae (yeast) to ethanol. Highest yield of ethanol was 0.415 g/g glucose, which was 81.2 % of theoretical yield. Hydrolysis with Sub-CW showed the potential to decompose the cotton textile into simple sugar while keeping sugar degradation to minimal phase and the possibility of complete conversion of cotton textile waste to ethanol via Sub-CW and fermentation.

Healthcare Waste Segregation Practice and Associated Factors among Healthcare Professionals Working in Public and Private Hospitals, Dire Dawa, Eastern Ethiopia.

The key to the effective management of healthcare wastes is the segregation of the waste at the point of generation; no matter what final strategy for the treatment and disposal of wastes is selected, it is critical that waste streams are separated. The aim of the study is to assess the practice of healthcare waste segregation and associated factors among healthcare workers at public and private hospitals in Dire Dawa, Eastern Ethiopia. An institution-based cross-sectional study was conducted among 280 healthcare workers from public and private hospitals. Data were collected through self-administered structured questionnaires and observation checklists. Bivariate and multivariable logistic regression were used to identify factors associated with the practice of healthcare workers using SPSS (Statistical Package for Social Sciences) version 25. This study showed that 56.4% (95% CI: 43.7-60.2) study participants had good healthcare waste segregation practices. Working in a public hospital (AOR = 0.09, 95% CI: (0.03-0.23)), working less than 40 hours a week (AOR = 4.28, 95% CI: (2.11-8.68)), adequate knowledge on healthcare waste management (AOR = 2.42, 95% CI: (1.27-4.61)), ever trained on waste management ((AOR = 2.74, 95% CI: (1.15-6.53)), the presence of guidelines, instructive posters on healthcare waste segregation ((AOR = 8.21, 95% CI: (3.84-17.55)), and availability of color-coded waste bins ((AOR = 9.53, 95% CI: (4.52-20.10)) were factors significantly associated with healthcare waste segregation practices. The study revealed that healthcare waste segregation practices were unacceptably poor. It is very crucial to address the identified factors through ongoing enforcement of healthcare waste management rules and regulations, by providing training, instructive posters around the work area, and making color-coded bins available.

Integrated MCDM Approaches for Exploring the Ideal Therapeutic Plastic Disposal Technology: Probabilistic Hesitant Fuzzy Domain.

The probabilistic hesitant fuzzy set (PHFS) is a useful extended version of the hesitant fuzzy set (HFS), which allows decision-makers greater freedom in espousing their preferences through the use of hesitant evidence in the real DM method. As the implications for individuals and global concerns have grown, efficient clinical diagnosis of medical waste has been a major challenge, particularly in developing countries. Medical waste can be disposed of in a variety of ways. The essential thing is to decide which strategies work best. The optimal healthcare plastic waste disposal (HCPWD) option is a MCDM method involving a wide range of qualitative characteristics. The MCDM technique (ARAS) is then described, whereby the criterion weights are assessed using the recommended entropy weighted method (EWM) proportion and score function in order to increase the process utilisation. Moreover, the above-described approach is used to address a real-world problem by determining the optimal treatment option for healthcare waste (HCW) disposal. Finally, a feasibility analysis is given to support the stated viewpoint on HCPWD options being prioritised.

Healthcare Waste-A Serious Problem for Global Health.

Healthcare waste (HCW) is generated in different healthcare facilities (HCFs), such as hospitals, laboratories, veterinary clinics, research centres and nursing homes. It has been assessed that the majority of medical waste does not pose a risk to humans. It is estimated that 15% of the total amount of produced HCW is hazardous and can be infectious, toxic or radioactive. Hazardous waste is a special type of waste which, if not properly treated, can pose a risk to human health and to the environment. HCW contains potentially harmful microorganisms that can be spread among healthcare personnel, hospital patients and the general public, causing serious illnesses. Healthcare personnel are the specialists especially exposed to this risk. The most common medical procedure, which pose the highest risk, is injection (i.e, intramuscular, subcutaneous, intravenous, taking blood samples). The World Health Organization (WHO) estimates that around 16 billion injections are administered worldwide each year. However, if safety precautions are not followed, and needles and syringes are not properly disposed of, the risk of sharps injuries increases among medical staff, waste handlers and waste collectors. What is more, sharps injuries increase the risk of human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV/HCV), tuberculosis (TB), diphtheria, malaria, syphilis, brucellosis and other transmissions. Disposing of medical waste in a landfill without segregation and processing will result in the entry of harmful microorganisms, chemicals or pharmaceuticals into soil and groundwater, causing their contamination. Open burning or incinerator malfunctioning will result in the emission of toxic substances, such as dioxins and furans, into the air. In order to reduce the negative impact of medical waste, waste management principles should be formulated. To minimize health risks, it is also important to build awareness among health professionals and the general public through various communication and educational methods. The aim of this paper is to present a general overwiev of medical waste, its categories, the principles of its management and the risks to human health and the environment resulting from inappropriate waste management.

Targeting repetitive laboratory testing with electronic health records-embedded predictive decision support: A pre-implementation study

IntroductionUnnecessary laboratory testing contributes to patient morbidity and healthcare waste. Despite prior attempts at curbing such overutilization, there remains opportunity for improvement using novel data-driven approaches. This study presents the development and early evaluation of a clinical decision support tool that uses a predictive model to help providers reduce low-yield, repetitive laboratory testing in hospitalized patients. MethodsWe developed an EHR-embedded SMART on FHIR application that utilizes a laboratory test result prediction model based on historical laboratory data. A combination of semi-structured physician interviews, usability testing, and quantitative analysis on retrospective laboratory data were used to inform the tool’s development and evaluate its acceptability and potential clinical impact. Key resultsPhysicians identified culture and lack of awareness of repeat orders as key drivers for overuse of inpatient blood testing. Users expressed an openness to a lab prediction model and 13/15 physicians believed the tool would alter their ordering practices. The application received a median System Usability Scale score of 75, corresponding to the 75th percentile of software tools. On average, physicians desired a prediction certainty of 85% before discontinuing a routine recurring laboratory order and a higher certainty of 90% before being alerted. Simulation on historical lab data indicates that filtering based on accepted thresholds could have reduced ∼22% of repeat chemistry panels. ConclusionsThe use of a predictive algorithm as a means to calculate the utility of a diagnostic test is a promising paradigm for curbing laboratory test overutilization. An EHR-embedded clinical decision support tool employing such a model is a novel and acceptable intervention with the potential to reduce low-yield, repetitive laboratory testing.

Knowledge, attitude, and perceived practice of sanitary workers on healthcare waste management: A descriptive cross-sectional study in Dodoma region,Tanzania.

Healthcare facilities produce a variety of trash that, if handled improperly, could endanger the environment, the health of patients and clients, healthcare personnel, and the general public. Health staff have been given training on infection control and healthcare waste management. It is not apparent whether similar initiatives are taken for sanitary personnel, though. By evaluating sanitary workers' knowledge, attitudes, and practices about healthcare waste treatment in the Dodoma region of Tanzania, this study sought to clarify the situation. From March to August 2022 in Dodoma, Tanzania, a descriptive cross-sectional study using a quantitative methodology was conducted on 156 randomly chosen sanitary workers. The primary data collection instruments were structured questionnaires that were conducted by interviewers and a trash checklist that the research team created. Statistical Package for Social Sciences computer software was used to conduct a descriptive analysis of the data with a 95% confidence level and a 5% level of significance. The average age was 28 ± 6.2 years, and there were 74.4% females. Of all of the health institutions under study, 78.4% of the generated medical waste was non-infectious, whereas 21.6% of it was infectious. The share of non-infectious and infectious healthcare waste created by regional referral hospitals was 43.5% and 13.2%, respectively. While 67.8% of sanitary workers believed that handling healthcare waste was not their problem and 63.6% of sanitary workers actually displayed subpar practices of handling healthcare waste, 74.4% of sanitary workers had low understanding about handling healthcare waste. Their procedures for handling medical waste were substantially influenced by the kind of healthcare facility, sex, education, job experience, knowledge, and attitude (p < 0.05). Sanitary staff members had limited understanding and thought they were less concerned with gathering, moving, and storing medical waste. To provide the highest level of health safety, national health policy and facility-based interventions must support and fund participatory waste management training that is tailored to the sociodemographic profiles of sanitary employees.

Treatment Option Selection for Medical Waste Management under Neutrosophic sets

Due to the possible threat, it poses to human health and the ecosystem, healthcare waste (HCW) handling and disposal are of major concern, especially in poor nations. Many countries are now turning to technology innovations as viable waste management solutions. Nevertheless, is still difficult for governments to choose an appropriate technology and an efficient waste management technique for the disposal of HCW. The difficulty of estimating these numbers inaccurately is addressed by using a neutrosophic set. The best alternative to HCW is hard to choose, and the process of doing so may be thought of as a multi-criteria decision-making (MCDM) issue. In this study, we propose a neutrosophic TOPSIS approach for assessing potential HCW alternatives. The weights of the requirements are calculated TOPSIS method. The best HCW alternative is assessed using the suggested approach.

Aspen Plus designing and optimizing the hospital wastewater treatment by wet air oxidation method

Healthcare establishments, pharma industries, and medical laboratories generate various waste materials, collectively called hospital or healthcare waste. Waste management regulations differ depending on the laws and acts adopted by the authorities and their level of compliance. For instance, in the United States of America, hospitals follow the rules set by the Environmental Protection Agency. In Europe, hospitals adhere to guidelines and standards set by the European Environmental Agency, while globally, the World Health Organization has established standardized policies and regulations. As a result, waste treatment technologies have become more prevalent for making medical waste non-infectious. These treatments include thermal treatment using microwave technologies (e.g., Wet air oxidation), steam sterilization, electro-pyrolysis, and chemical and mechanical systems. This research aims to model the treatment of hospital wastewater by wet air oxidation method using Aspen Plus for the first time in Lebanon. The simulation showed that the reaction conversion yield for thiols or mercaptans was 89.7% and 83.8% for sodium hydrosulfide, and the COD and BOD5 levels were reduced by 79.1% and 88%, respectively.

Lagos State Hospital Waste Management Practices: A Descriptive Overview with Stakeholders’ Role and Key Recommendations

Background: Waste generation and its disposal is an essential issue in the sustainability of the environment and the planet’s future. Waste management is essential across sectors, likewise the health sector. Therefore, there is a need to employ extra care and attention to handling waste generated from healthcare facilities to avoid the dangers of poor biomedical waste management. We carried out this study to examine the waste management practice in healthcare facilities in Lagos State. Methods: The study was a descriptive survey carried out in one-thousand two hundred and fifty-six (1256) healthcare facilities in Lagos State. Nine hundred sixty-nine (969) of these facilities are located in urban areas, while two hundred and eighty-seven (287) are rural. The facilities studied are government/public health facilities (15.45%), private-for-profit facilities (82.88%), NGOs, Mission/Faith-Based medical facilities (1.67%). The data collected were analyzed using descriptive statistics. Specifically, we utilized bar charts, frequency, and percentage. Result: The result shows that 98.4% (1236) of the studied facilities are registered with the Lagos State Waste Management Authority (LAWMA), while 1.6% (20) are not registered. 98.5% (191) of the 194 government-owned facilities, 98.5% (1025) of the 1041 private-for-profit facilities, and 98.2% (20) of the 21 NGOs/faith-based health facilities are registered with Lagos State Waste Management Authority. The result also shows that 94% of the healthcare facilities studied in Lagos State use color-coded waste bags to segregate waste at the point of origin. 58.7% of the facilities use red-colored bags, 33.3% use yellow-colored bags, 10.7% use black-colored bags, and 1.3% use brown biohazard bags for segregating Infectious waste. Also, 34.2% of the health facilities in Lagos state use red-colored bags, 36.9% use yellow-colored bags, 11% use black-colored bags, and 4.1% use brown-colored bags to segregate their hazardous waste. Conclusion: Some healthcare facilities in Lagos State do not follow the recommended guidelines for medical waste segregation. Waste generated is not appropriately segregated at the point of origin into the recommended colored bags/bins in some facilities. Thus, a policy and procedure regulating healthcare waste are mandatory. It is important to regularly train healthcare workers on proper waste management practices and encourage staff to read and apply WHO rules in managing healthcare waste. Healthcare personnel should realize that hazardous material is a potential cause of a public disaster.

A multi-objective network design for recycling healthcare waste from large-scale immunization

This paper presents a Goal programming-based optimization model for managing the recycling operations of healthcare waste generated from large-scale vaccination drives. The model proposes an efficient system by integrating the decisions of locating recycling units and the routing of generated waste to them, considering the risks to the environment and the associated population. The objectives include the minimization of setup and transportation costs, risks to the population, and the number of installed units. A set of randomly selected test instances is used to test the effectiveness of the model. The results reveal that a compromised solution offers cost advantages and population risk mitigation. The approach effectively supports the strategic choices in recycling healthcare waste generated from immunization.

Assessment of Health Care Waste Management in Malaysian Hospital Environment

Assessment of Health Care Waste Management in Malaysian Hospital Environment

Sistemas de gestión de desechos sanitarios bajo la Norma ISO 31000:2018

The main objective of this research was to propose the design of a useful and applicable methodology according to the requirements of ISO 31000: 2018 for risk management focused on the health care waste management process that takes place in any institution that provides Health services. All this is based on the main theoretical approaches in this regard. A qualitative methodology was applied, bibliographic and descriptive typology, using the analytical-synthetic method. Within the analysis of results, a standard sanitary waste management process was defined with its related activities. The main risks that they could generate were identified. From there, the risks were classified and evaluated through the application of the risk matrix. This also facilitated a measure plan approach to mitigate the harmful effect of risks according to their probability and importance degree. Therefore, it is concluded that it is necessary to adopt a holistic approach to successfully manage the risks present throughout the sanitary waste management process.