Hospital Waste Management Practices Research Articles

Assessing the Effectiveness of Hospital Waste Management Practices Among Tertiary Care Hospitals and Primary Health Centres in KPK: A Comparative Cross-Sectional Study

Assessing the Effectiveness of Hospital Waste Management Practices Among Tertiary Care Hospitals and Primary Health Centres in KPK: A Comparative Cross-Sectional Study

Frequency of occupational health hazards and factors responsible among the waste handlers at the tertiary care hospitals of Karachi.

Hospital waste handlers (HWHs) are in contact with contaminated waste that put them at risk for occupational health hazards. The objective of the study was to determine the frequency of occupational health hazards and identify factors contributing to them among the HWHs at tertiary care hospitals of Karachi. A cross sectional survey was conducted from January 2021 till June 2022 on 417 conveniently selected HWHs of the public and private tertiary care hospitals of the Karachi including three Public sector hospitals (Civil Hospital Karachi, National Institute of Child Health, Jinnah Post Graduate Medical Center) and five private sector hospitals (Sohail University Hospital, Darulsehat Hospital, Kharadar General Hospital, Patel Hospital and Hamdard University Hospital) using a structured questionnaire. Chi Square test was applied to determine the differences in occurrence of different hazardous outcomes (Needle stick injury, Sharp Injury, Eye Symptoms, Skin symptoms, Cough) between different groups of age, gender, type of hospitals and status of being trained in Hospital Waste Management (HWM). Around half of the HWHs (52.6%) labeled the bins of the waste according to their level of hazard. Only 17.9% disinfected the infected waste. The proportion of participants who experienced needle stick and sharp injury in the last six months was 16.3% and 15.8% respectively. Majority of them used disposable gloves (95.7%) and face masks (94.3%). One thirds had access to aprons while only 10.5% had access to protective shoes at their work place. HWHs of private sector were significantly less likely to experience Needle stick injuries, skin symptoms, cough, breathing difficulty and throat burning. The HWM practices in tertiary care hospitals of Karachi is far from being satisfactory. HWHs must be trained and monitored for safe disposal of waste.

Environmental assessment of hospital waste management practices: A study of hospitals in Kermanshah, Iran

This research aims to identify current procedures of hospital waste management in educational hospitals, in western Iran. This study examined upon to be current procedures of medical waste management focusing on the management of hazardous medical waste, under a circular economy. Three criteria environmental situation, environmental management, and environmental performance. The environmental assessment was done by pair matrixes between criteria and sub-criteria, and between scale levels of the indicators were done. The questionnaire structure adopted in the Romero and Carnero study. The Analytic Hierarchy Process method indicates that aspect of the hazardous waste improvement program is essential. The results demonstrated that 56 % of the total environmental criteria score was VERY DEFICIENT in the scale factors classification. The lowest values indicated in the environmental management aspect and 63 % of the total score was VERY DEFICIENT. The results indicated a deficient value in environmental criteria based on the values received for the commitment to environmental policy standards and waste management procedures. The results of environmental performance criteria have shown; that no data was on atmospheric emission. The lack of rules in green purchasing and renewable energy was indicated. In waste management criteria, the total value was reasonable, but there weren't comprehensive rules for redefining waste types and staff training obligations. However, the redefinition of rules, public and staff training, using new technologies, and determination of specific budgets and green teams by proper supervising cycle can be essential to improve hazardous waste management.

Sustainable Hospital Waste Management Practices in the Western Province of Sri Lanka: Problems and Prospects

Ensuring the sustainability of hospital waste management practices has become a burning issue. Due to the growing population coinciding with rapid urbanization and industrialization, practicing sustainable methods of medical waste management is an urgent requirement. Like other developing countries, Sri Lanka also faces various difficulties when dealing with high-risk hospital waste material, spreading diseases rapidly and making the environment unclean. Thus, moving towards sustainable hospital waste management has received urgent attention. The primary purpose of this study is to explore whether the existing hospital waste management practices are sustainable. Further, this study identifies weaknesses of the existing waste management practices and examines factors affecting Sustainable Hospital Waste Management (SHWM) in the Western province of Sri Lanka. Data were collected from 18 officers involved in waste management from 14 government hospitals in the western province. Both inductive and deductive thematic analyses were used to explore whether the hospital waste management practices are sustainable. The study revealed that most selected hospitals failed to achieve sustainability in waste management practices. Achieving sustainability of waste management practices has become a challenge to government hospitals due to financial constraints, limited facilities and infrastructure, lack of social support, and poor management and administration. Patient mindset and health capacity, positive attitudes, knowledge, awareness, and experience, training on hospital waste management, availability of basic infrastructure and resources, financial facilities for hospital waste management, availability of rules and regulations, and intra and inter-organizational supports significantly affect sustainable hospital waste management. Exploring the sustainability of waste management practices using empirical data related to Sri Lanka is an initial attempt in the sustainable hospital waste management literature. Finally, policy measures are suggested for sustainable hospital waste management in Sri Lanka.

A comprehensive protocol for evaluating health, safety, and environmental risks of hospital solid waste through FMEA technique

This protocol outlines a comprehensive approach to evaluating hospital solid waste levels and assessing associated health, safety, and environmental (HSE) risks using the Failure Mode and Effects Analysis (FMEA) methodology. The study focuses on Imam Khomeini Hospital (RA) and employs both quantitative and qualitative methods. Over a 3-month period, waste production and potential risks are assessed, with specific attention to household, infectious, medicinal, and sharps waste. Through FMEA, potential failure modes and associated risks in waste management sectors are identified, enabling targeted interventions for risk mitigation. The protocol emphasizes the importance of aligning waste management practices with international standards and highlights the need for comprehensive training, awareness campaigns, and effective waste management methods to ensure the safety and environmental responsibility of hospital waste management practices

Comprehensive Assessment of Pharmaceutical Waste Disposal Practices in Ishaka-Bushenyi Municipality: Implications for Public Health and Environmental Sustainability

Proper management of pharmaceutical waste is crucial for safeguarding public health and the environment. This study aimed to comprehensively assess pharmaceutical waste management practices in hospitals, pharmacies, and households within Bushenyi-Ishaka Municipality, Uganda. The study employed a qualitative case study design, gathering data through observations, interviews, and questionnaires administered to five pharmacies, two hospitals, and 100 households. The results revealed that the mean amount of pharmaceutical waste generated by pharmacies and hospitals in Ishaka was 40.5 kg ± 32.39 kg per month, of which 26.83 kg ± 29.10 kg were disposed of safely. However, 60% of the waste was categorized as hazardous. The study found that while most facilities used labeled or color-coded containers for waste segregation, the practice of segregation was inconsistent, with 71.43% of the facilities not segregating their waste. Incineration (42.86%) and dilution followed by flushing in protected soak pits (42.86%) were the primary disposal methods employed by the facilities. Concerningly, only 4% of households returned unused or expired medications to pharmacies, with the majority disposing of them in dustbins (46%) or flushing them down toilets (41%). The findings also highlighted gaps in awareness and training, with 50% of pharmacy staff not receiving any training on proper pharmaceutical waste disposal, and only 14.29% of the facilities having established waste management guidelines. These deficiencies in knowledge and practices contribute to the suboptimal management of pharmaceutical waste, posing significant risks to public health and the environment. The study underscores the urgent need for comprehensive policies, targeted training programs, and community-based initiatives to enhance pharmaceutical waste management practices in Bushenyi-Ishaka Municipality and similar settings. Addressing these challenges is crucial for mitigating the adverse impacts of improper pharmaceutical waste disposal and promoting sustainable healthcare waste management. Keywords: Pharmaceutical waste, Waste management, Disposal practices, Awareness, Hazardous waste.

The Study on Hospital Waste Management Practices among the Different Hospitals of Bheemdatta Municipality of Kanchanpur District, Far-western Region, Nepal

Background: Hospital waste refers to the wastes generated by healthcare facilities, from their departments like laboratories, pathology, nursing, surgical, mortuary & autopsy & various other units in either solid or liquid form which can be either general non-hazardous waste, hazardous waste, infectious waste toxic or radioactive waste. The proper management of healthcare waste is essential to prevent from the adverse outcomes that the improper waste can cause to deteriorate the health of human beings, animals, hospital patients etc. It also forbids the possibility of infectious disease spreading, & greatly reduces the risk to public health. Hospital wastes are dangerous for each & every life in the earth thus, they need to be managed safely with proper plan, policy that helps to make environment hygienic, infection free & clean. Objectives: The overall objective of this study is to identify the hospital waste management practices among the different hospitals. Methodology: A cross sectional study was conducted in the hospitals of Bheem dutta municipality of Kanchanpur district where the convenience hospital staffs were selected & used to collect the data. The total sample size of 81 is taken which by using non-probability convenience sampling by considering limited time, resources & accessibility. Structured questionnaire was used as a major tool for this study. Result: According to the data analyzed, it is found that all the hospitals have proper HCW management plan & each of them follows it too but, only 66.7 percentages are following 3R technique, 71.6 percentages of staffs are satisfied with the waste management in the hospitals, 70 percentages have awareness regarding the nature & risk of the waste they handle daily, and only 56.8 percentages of the hospitals are following the WHO recommendation in waste management. Conclusion: Although having a proper HCW management plan by a hospital is not being sufficient for waste management in a hospital because of lack of strict adherence to the rules, no strict policies from the municipality & government, lack of ample fund with the hospitals & lack of proper knowledge on safe handling of wastes along with lack of awareness on staff about the consequences of improper waste handling it is becoming a crucial for the hospitals to manage the wastes properly.

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.

Medical Waste Management and Design of a Low-Cost Incinerator for Reduction of Environmental Pollution in a Multi-System Hospital

Pollution of the environment and inappropriate management of medical wastes are major challenges facing developing countries and this must be tackled with recent technology for public health, enhanced natural ecosystems, and a better environment. This research is a two-step process that involves the assessment of the existing Hospital waste management practices in a multi-system Hospital in Ado-Ekiti, Nigeria. Excess air, kerosene (auxiliary fuel), single chamber, Batch-fed (Manual feeding), and controlled air incinerator were designed. Wastes were loaded once at the beginning of the combustion cycle followed by combustion, ash burnout, cool down, and ash removal to assist medical waste management. Findings revealed that personnel involved in handling medical waste were equipped with inadequate protective gear. Medical waste was handled together with municipal waste and both wastes were incinerated in an open dumpsite without engineered sanitary landfill at disposal locations constituting a nuisance with a high risk of pollution to the surrounding environment. The incinerator was designed for a waste load of 269 kg.day-1. It consists of four zones; the waste and combustion zone (2.7 m × 1.8 m × 1 m), the ash zone (0.23 m height), the combustion fumes and one-second retention zone (0.43 m height) as well as the excess air zone (0.46 m height). This low-cost medical waste incinerator has a lot of improvement, operational effectiveness, and efficiency to the currently available techniques. Viable recommendations made will improve the state of environmental health and reduce the harmful effects of medical waste.

THE KNOWLEDGE REGARDING BIO-MEDICAL WASTE AND ITS MANAGEMENT AMONG CLASS IV WORKERS

The biomedical waste [management & handling] rules, 1998 gives a wider definition of biomedical waste, covers different sources generation of biomedical: includes different types of biomedical waste. Biomedical waste management & handling rules 1998 of India provide different waste categories like human anatomical waste, animal waste, microbiological & biotechnology waste, waste sharps, discarded medicine etc. The quantity of biomedical waste generated per bed per day will vary depending upon the type of health problems, the type of care provided & the hospital waste management practices. It is estimated that the hospital in India generates around 1-2 kg/bed/day of biomedical waste in a general practitioner’s clinic. Approximately 75% of biomedical waste is as harmless as other municipal waste, the remaining 25% however differ from others.

Social Determinants, Working Status, Knowledge and Attitude Regarding Hospital Waste Management Practices in Hospitals of Bengkulu Province

Introduction: Healthcare waste are considered infectious and hazardous. It requires specific handlingprior to its disposal and poses a stern dangers to ecological, occupational and public health if not managedwith caution. Hazardous waste management is a concern for every health care organization and for everyhealthcare professional.Objective: The objective of the study was to know association demographic social determinants, workingstatus, knowledge and attitude with practice of disposal infectious waste among health personal in hospitalProvince of BengkuluMethodology: A quantitative descriptive cross-sectional Study design was used. The research was carriedfor the period of five months from February 2019 to August 2019 and the sample size is estimate base on themultiple logistic regressions.Result: In this study, most of the respondents (42.06%) not good practice of disposal infectious waste.The multivariate analysis reported age (Adjusted OR: 1.44, 95% CI: 1.04 to 2.01) with p-value: <0.030,education (Adjusted OR: 1.40, 95% CI: 1.04 to 1.90) with p-value: <0.028, management system (AdjustedOR: 5.24, 95% CI: 3.04 to 9.03) with p-value: <0.001, knowledge (Adjusted OR: 1.85, 95% CI: 1.30 to 2.63with p-value: <0.001, attitude (Adjusted OR: 5.21, 95% CI: 3.06 to 8.86) with p-value: <0.001.Conclusion: Almost half of hospital health personal had poor practice of disposal handling infectious wastein Bengkulu Province, Indonesia. Infectious waste management system was strongly influence on practicedisposal waste.

The Study of Infectious Hospital Waste Management in Two Hospital of Pakistan

The Infectious hospital waste management practices in hospital PNS Hafeez Hospital and PAF Hospital Islamabad, Pakistan in the light of environmental laws and hospital waste management rules. Data were collected using various methods such as survey questionnaires, interviews, group discussions informal, site observation, photographic documentation to study the current Infectious hospital waste management system and practices. Studies revealed many discrepancies and weaknesses in the hospital waste management system. The survey results showed that segregation of all wastes was not conducted according to standards rules and regulations. waste management team was not effective even the team member was not aware about environmental laws and standard waste management practices. Waste handling was also not according to the guideline provided by environmental laws. No protective clothing, gloves, masks were provided to waste management workers. Waste management team, doctors, nurses; sanitary staffs were not trained in dealing with hospital waste. It was concluded that the unsatisfactory current hospital waste management practices in both hospitals were mainly due to the lack of training, lack of awareness, and lack of knowledge of hospital waste management rules and laws.

Assessment of Hospital Waste Management Practices in Public and Private Healthcare establishments of Rahim Yar Khan

Background: Hospital waste is considered dangerous as it may pose undesirable effects on human health. Objective: To assess the hospital waste management practices in private and public-sector healthcare establishments at district Rahim Yar Khan. Methodology: This cross-sectional study was conducted in conveniently selected 34 healthcare establishments (HCEs) of district Rahim Yar Khan, from 1st January to 30th March 2018. Healthcare establishments included wards of a tertiary care hospital, basic health units, private clinics and hospitals of the district. Variables included were number of beds, color coding, hospital waste segregation at source, appropriate transportation vehicle, storage site and vehicles. SPSS version 21 was used for data entry and analysis. Results: Twenty-six (76.5%) of the healthcare establishments have waste segregation at source and 1 (2.9%) of HCE have no proper color coding and 21 (61.8%) of the HCEs have workers wearing protective gears and fifteen (44.1%) have appropriate vehicle for waste transport. Waste disposal was incineration in nineteen (55.89%) of HCEs. Eleven (57.9%) of the public sector HCEs were following segregation. (p=0.00) In private sector method of disposal of waste was mostly land disposal 7 (46.7%) while in public sector HCEs, was mostly incineration in 14 (73.7%%). (p=0.00) and out of total 34 HCEs, training about handling and waste management were given in only one (6.6%) of Private Hospitals. Conclusion: Most of the healthcare establishments have a good waste segregation, baskets with color coding, individual bed side bins available however personal protective gears, waste transport system and waste disposal methods were deficient. There was a mixed pattern of individual steps of waste handling among private and public sector hospitals.

Assessment of waste management practices in hospitals of Islamabad and Abbottabad-Pakistan

Assessment of waste management practices in hospitals of Islamabad and Abbottabad-Pakistan

LCA of Hospital Solid Waste Treatment Alternatives in a Developing Country: The Case of District Swat, Pakistan

Improper management of hospital waste leads to serious health and environmental issues, particularly in the case of developing countries, where, often, applied technologies are obsolete and there is a lack of compliance with respect to international best practices. The present study is designed to assess the environmental impacts of hospital waste management practices in Swath District, Pakistan. For this purpose, a life-cycle assessment (LCA) is applied for the estimation of different impacts of current and alternative hospital solid waste (HSW) treatment practices. Two scenarios are used to describe the current alternative practices (Scenario A and Scenario B), referring either to incineration or to direct landfilling of HSW without any sorting of collected materials. Conversely, Scenario C, which includes the use of pyrolysis and chemical disinfection, are considered as an up-to-date alternative, based on current international recommendations in this field. Prior to the analysis of impacts, due to the lack of available information, data were directly collected from both government and private hospitals in District Swat, involving measurements and a characterization of collected waste. In parallel, interviews were conducted, involving the hospitals’ personnel. With respect to waste generation, government hospitals produce a larger amount of waste (74%) compared to private hospitals (24%). Poor regulatory indications and the absence of clear obligations for collection, disposal and management still represent a first obstacle to implement good practices. After defining the boundary of the system and the functional unit, according to standardized LCA practices, a life--cycle impact assessment (LCIA) was conducted, considering eight impact categories: human toxicity, freshwater eco-toxicity, marine aquatic eco-toxicity, terrestrial eco-toxicity, acidification potential, climate change, eutrophication and photochemical oxidation. The current practices (Scenario A and Scenario B) turned out to be the worst for all categories. In particular, the largest impact of all is recorded for human toxicity generated by incineration. In parallel, it must be considered that, currently, no recycling or reusing practices are implemented. Conversely, Scenario C (alternative up-to-date practices) would generate lower impacts. In detail, the highest value was recorded for marine aquatic ecotoxicity in relation to pyrolysis. Applying Scenario C, it would be possible to recover some materials, such as plastics, paper and sharps. In detail, considering the observed compositional characteristics, it would be possible to recover up to 78% of sharps and recycle 41% of plastic and paper from the general waste stream. Moreover, energy could be recovered from the pyrolysis process, generating a further benefit for the surrounding area. A lack of awareness, knowledge and infrastructures prevents the application of correct management practices, further degrading life and environmental conditions of this remote region of Pakistan. The huge difference in impacts between current practices and alternatives is demonstrated, showing a clear alternative for future management plans in this remote region and supporting future actions for local policymakers and hospital managers.

Analysis of Risk Associated with Hospital Waste Management Practices in Public Hospitals in Port Harcourt

The study set out to investigate the risk associated with hospital waste management in Port Harcourt. To achieve this, five research questions and five research objectives alongside two hypotheses were put forth to guide the study. The study adopted the use of cross sectional survey research design. A total of 90 persons were purposively sampled from three public hospitals using the stratified sampling technique to ensure all the class of persons working in the hospital was captured in the study. Questionnaire was used as the data collection instrument in the study. The results from the study revealed that waste is generated often in the sampled hospitals, Liquids, human waste and sharps are the most generated waste in the hospitals, the major waste disposal method amongst the hospitals is the use of waste contractors and that the health risk associated with hospital waste is high.

Assessing knowledge, performance, and efficiency for hospital waste management-a comparison of government and private hospitals in Pakistan.

Proper management of healthcare waste is a critical concern in many countries of the world. Rapid urbanization and population growth rates pose serious challenges to healthcare waste management infrastructure in such countries. This study was aimed at assessing the situation of hospital waste management in a major city of Pakistan. Simple random sampling was used to select 12 government and private hospitals in the city. Field visits, physical measurements, and questionnaire survey method were used for data collection. Information was obtained regarding hospital waste generation, segregation, collection, storage, transportation, and disposal. Data envelopment analysis (DEA) was used to classify the hospitals on the basis of their relative waste management efficiencies. The weighted average total waste generation at the surveyed hospitals was discovered to be 1.53kg/patient/day of which 75.15% consisted of general waste and the remaining consisted of biomedical waste. Of the total waste, 24.54% came from the public hospital and the remaining came from the private hospitals. DEA showed that seven of the surveyed hospitals had scale or pure technical inefficiencies in their waste management activities. The public hospital was relatively less efficient than most of the private hospitals in these activities. Results of the questionnaire survey showed that none of the surveyed hospitals was carrying out waste management in strict compliance with government regulations. Moreover, hospital staff at all the surveyed hospitals had low level of knowledge regarding safe hospital waste management practices. The current situation should be rectified in order to avoid environmental and epidemiological risks.

Biomedical waste management practices in a tertiary care hospital: a descriptive study in Srinagar, Garhwal, India

Background: Biomedical waste (BMW) is generated in every health facility, which if not disposed off properly poses a risk for health and environment. Handling, segregation, mutilation, disinfection, storage, transportation and final disposal are vital steps for safe and scientific management of biomedical waste in any establishment. The objective were to assess the biomedical waste management (BMWM) practices and knowledge regarding BMWM in a tertiary care hospital.Methods: A descriptive study was carried out in the tertiary care hospital during July and August 2014. Hospital waste management practices were observed by making visits to the waste collection sites at different sites of the hospital and for assessment of knowledge regarding waste management a total of 113 health care personnel were interviewed.Results: The overall mean score for “Condition of waste receptacles” was 44.3%. The mean score for segregation of waste was 77%, for mutilation of recyclable waste the mean score was 88% and the disinfection mean score was 72%. There were some good practices observed like presence of posters regarding disposal of BMW in most places, availability of gloves, masks etc. to the workers collecting BMW .There was no separate route for transport of biomedical waste. The knowledge regarding BMWM was not satisfactory among the participants and scope of improvement is there.Conclusions: While there were some good practices observed, there were inconsistencies observed regarding BMWM in the hospital.

Assessment of hospital waste management in a major city of Pakistan

Proper management of healthcare waste is a critical concern in many resource constrained countries of the world. Pakistan is the sixth most populous country in the world with one of the highest urbanisation and population growth rates in South Asia. Data and analyses regarding hospital waste management practices in Pakistan are scarce in scientific literature. This study was meant to determine waste management practices at the largest hospital in a major city of Pakistan. The hospital was thoroughly analysed for a week to quantify its wastes by category using a digital balance. Medical waste generation at the hospital came out as 2.63 Kg/patient-day of which 6.8% consisted of sharps and the remaining consisted of hazardous infectious items. Gynaecology and paediatrics wards had the largest and the smallest waste generation rates respectively. More than 1.06 Tonne of general waste was also generated at the hospital. Waste segregation, storage, transportation and disposal practices at the hospital had serious shortcomings.

Management of wastes from hospitals: A case study in Pakistan

Proper management of hospital waste is a critical concern in many countries of the world. Pakistan is the sixth most populous country in the world, with one of the highest urbanisation and population growth rates in South Asia. Data and analyses regarding hospital waste management practices in Pakistan are scarce in scientific literature. This study was meant to determine waste management practices at selected hospitals in a major city in Pakistan, Gujranwala. A total of 12 different hospitals were selected for the survey, which involved quantification of waste generation rates and investigation of waste management practices. The results were analysed using linear regression. The weighted average total, general and infectious hospital waste generation rates were found to be 0.667, 0.497 and 0.17 kg bed-day(-1), respectively. Of the total, 73.85% consisted of general, 25.8% consisted of hazardous infectious and 0.87% consisted of sharps waste. The general waste consisted of 15.76% paper, 13.41% plastic, 21.77% textiles, 6.47% glass, 1.99% rubber, 0.44% metal and 40.17% others. Linear regression showed that waste generation increased with occupancy and decreased with number of beds. Small, private and specialised hospitals had relatively greater waste generation rates. Poor waste segregation, storage and transportation practices were observed at all surveyed hospitals.