Healthcare Waste Management Research Articles

Comparative Studies on Knowledge, Attitude and Practice of Health Workers towards Medical Waste Management in Two Developed Regions of the World

Background: Worldwide, healthcare waste still remains a challenge to public health and potential source of hazard to biosphere. Assessment of knowledge, attitude and practice (KAP) of healthcare workers towards healthcare waste management was carried out in Sweden and Hungary for comparative analysis.
 Methods: Data was collected using a pretested questionnaire and analyzed using spss version 20.0. Total Sample size of 210 was used for the study; comprising of 105 from each area.
 Results: In Hungary, 11(10.5%) were male while 94(89.5%) were female. While Sweden comprised of 28(26.7%) male and 77(73.3%) female. In Sweden frequencies of 5.7%, 56.2%, 22.9%, 3.8%, 6.7% and 4.8% were recorded for age groups of <20 years, 20-30years, 31-40years, 41-50years,51-60years and ≥61years respectively. While amongst the Hungarian respondents, the respective age groups yielded frequencies of 1.0%, 18.1%, 21.0%, 36.2%, 17.1% and 6.7% respectively(p<0.05).More Doctors(63.8%) and Nurses(63.8%) in Hungary participated in the study than in Sweden(Doctors=15.2%;.Nurses=15.2%). The proportion of medical students was highest (32.4%) in Sweden than in Hungary (7.6%). According to educational qualifications, respondents with Bachelors degree occurred most in equal proportion (50.5%) in the two study areas. While those with doctorate degree recorded highest frequency of 11.4% in Sweden and least (1.0)% in Hungary. Respondents with masters degree occurred with frequencies of 27.6% and 21.0% in Hungary Sweden respectively. Result of respondents’ knowledge on healthcare waste shows that in Hungary, 81% of the respondents affirmed they are aware of waste management guidelines used in their hospital while in Sweden the proportion was 51.4%. Conversely, 19.0% of respondents from Hungary said they are not aware while in Sweden it was 26.7% and the remaining proportion (21.9%) said they don’t have idea. Where waste disposal guidelines exist, only 43.8% of Swedish respondents said they are aware of the contents while in Hungary, the proportion is high (81.0%). Those that responded “no” to the question;-meaning they are not aware of such guidelines occurred most (37.1%) in Sweden than in hungary(11.4%), though the proportion that said they don’t have idea is low in Hungary(7.6%) than in Sweden(19.0%) (P<0.05).Also from the result, few proportion (19.0% in Hungary; 24.8% in Sweden) of the respondents believed that disposal of hazardous waste is extra burden to them. While most of the respondents (76.2% in Hungary; 48.6% in Sweden) said “no” to the question;- meaning that disposal of hazardous waste is not extra burden to them. More (68.6%) of the respondents from Hungary said they have been educated/trained on waste handling than the Swedish respondents where 54.3% had education/training on waste handling. The proportion that was not trained was high in Sweden (41.9%) than Hungary (31.4%). However, knowledge and attitude on healthcare waste management yielded high percentage rating scores for Hungarian respondents than those of Sweden. On the contrary, Swedish respondents demonstrated more practice than Hungarian counterparts in the area of HBV vaccination (Sweden=90.5%; Hungary=6.7%), use of personal protective equipment (Sweden=93.3%; Hungary=91.4%), change of personal protective equipment (Sweden=52.4%; Hungary=19.0%).
 Conclusion: Good knowledge and attitude was noted in the two areas but more in Hungary while Practice was mostly demonstrated in Sweden. This stands as a useful tool to relevant stakeholders in health sectors in the two areas.

Assessing and overcoming the barriers for healthcare waste management in India: an integrated AHP and Fuzzy TOPSIS approach

PurposeDue to the coronavirus disease 2019 (COVID-19) pandemic, the world faces different issues, and proper healthcare waste (HCW) treatment is one of them. If appropriate disposal of HCW is not performed, it will have hazardous effects on humanity. This paper has identified the significant barriers hindering the proper treatment of healthcare waste management (HCWM) with the strategies to overcome these barriers.Design/methodology/approachThis paper has identified the significant barriers hindering the proper treatment of HCWM with the strategies to overcome these barriers, and different barriers are identified and categorized into organizational, waste handling, human resource and technical barriers. The analytical hierarchy process (AHP) process is used to rank the barriers and sub-barriers. Then, the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method evaluates the strategies for proper implementation of HCWM.FindingsThe results show that organizational barriers are the most significant barrier, with a lack of coordination of hospitals with other authorities and no priority given to waste management issues as highly ranked barriers. The results of the Fuzzy TOPSIS method indicate that “Increase govt support and policies” and “Enhance training and awareness of employees” are the most feasible strategies to overcome these barriers for the successful implementation of HCWM.Practical implicationsThis study will be helpful in policy formulations for the proper treatment of HCW in an efficient manner. This paper helps to complete the research gap by providing the different characteristics of barriers.Originality/valueThis paper fills the research gap by expanding the limited knowledge in this field and providing further evidence on this phenomenon. The study also enables the distinctive characteristics of barriers to be understood within a particular context.

Management of healthcare waste collection and segregation for developing countries.

Healthcare waste (HCW) consists of hazardous material that may be radioactive, toxic or infectious. Inappropriate treatment and disposal of HCW may pose health risks to humans indirectly through the release of pathogens and toxic pollutants into the environment. The biggest problem in HCW management is its handling, which causes anxiety over sorting and categorizing the waste. Hence, the current study identifies and addresses the challenges towards sustainable environmental development by managing infectious HCW in developing countries. Fuzzy Delphi method is used in the present study to carefully examine the barrier drawn from the literature and experts' opinions. The number of barriers taken into consideration for study are 30, which are then grouped into four main categories, that is, social, environmental, technological and economic barriers. Additionally, a hybrid strategy based on the fuzzy decision-making trial and evaluation laboratory is developed in this work to examine the significance and interrelationships of the identified barrier. The research outcome is a hierarchy and classification model based on the relative importance of the barriers. The results of this study indicate that: 'Lack of segregation', 'Inconsistency in waste collection', 'Unregulated disposal site' and 'Inadequate programme for training and awareness' require quick action. The conclusions obtained through the study would facilitate the preparation of check sheets for documenting HCW management procedures by the healthcare administration and Pollution Control Boards. Understanding the priority cause-group barrier would improve the long-term protection of the hospital environment from the spread of infection caused by the HCW.

Impacts and Regulations of Healthcare Solid Waste Management during the COVID-19 Pandemic: A Systematic Review

In a pandemic context, it is essential to intensify precautions related to healthcare solid waste, known as HCSW, ensuring the continuous search for safer management and handling protocols of these materials. In this sense, the aim of this paper is to conduct a comprehensive review of the literature about the management of healthcare waste during the COVID-19 pandemic. The current investigation was underpinned by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) framework, selected to ensure the comprehensive and transparent presentation of the systematic review. In pursuit of this objective, three distinct keyword combinations were employed, namely, “solid waste management”, “medical waste”, and “COVID-19 pandemic”. Consequently, a total of 76 documents were incorporated into the analysis. The results of this analysis indicate that the amount and treatment of hospital solid waste were significantly affected by the pandemic, bringing impacts on social, economic, and environmental aspects. Recent studies have focused on mitigating these impacts by pursuing “green” solutions, such as implementing sustainable strategies, preserving biodiversity, adopting an eco-conscious lifestyle, improving healthcare infrastructure, raising public awareness, and changing HCSW management policies. In addition, alternative technologies have been explored for the adequate treatment of these wastes, as well as the replacement of harmful materials by safer substances. However, more scientific research on this topic is still needed, especially in the Brazilian context, in order to contribute to the development of strategies that minimize the impacts of the pandemic on both society and the environment.

Management of COVID-19 healthcare waste based on the circular economy hierarchy: A critical review.

The overall objective of this work was to conduct a critical literature review on the application of the circular economy (CE) hierarchy for the management of COVID-19 healthcare waste (HCW). To describe the problem created by COVID-19 HCW, first, the subsystems of the overall management system, including generation, segregation, classification, storage, collection, transport, treatment and disposal, were reviewed and briefly described. Then, the CE hierarchy using the 10R typology was adapted to the management of COVID-19 HCW and included the strategies Refuse, Reduce, Resell/Reuse, Repair, Reprocess, Refurbish, Remanufacture, Repurpose, Recycle and Recover (energy). Disposal was added as a sink of residues from the CE strategies. Using the detailed 10R CE hierarchy for COVID-19 HCW management is the novelty of this review. It was concluded that R-strategy selection depends on its position in the CE hierarchy and medical item criticality and value. Indicative HCW components, which can be managed by each R-strategy, were compiled, but creating value by recovering infectious downgraded materials contaminated with body fluids and tissues is not currently possible. Therefore, after applying the circular solutions, the end of pipe treatment and disposal would be necessary to close material cycles at the end of their life cycles. Addressing the risks, knowledge gaps and policy recommendations of this article may help to combat COVID-19 and future pandemics without creating environmental crises.

Blockchain adoption challenges in the healthcare sector: a waste management perspective

AbstractThe proposed study aims to identify the major challenges for blockchain adoption to manage reverse logistics activities of recyclable hospital waste in the Indian healthcare sector, in the COVID era. Fifteen challenges are identified through literature review and experts’ views and are prioritized and analyzed for cause-and-effect relationships using a hybrid approach combining Best–Worst Method (BWM) and Decision-Making Trial and Evaluation Laboratory (DEMATEL). A sensitivity analysis is performed to evaluate the results’ robustness. The results reveal that the Technological and Regulatory challenges category plays the most influential role consisting of Lack of Government Support and Policies, Lack of Strategic Planning, Lack of Knowledge and Qualified Expertise, Lack of Standards and Regulations, High Cost Involved, and Lack of Top Management Support are the most significant challenges affecting blockchain adoption. This study can support healthcare stakeholders, policymakers, government, and researchers in planning the strategic removal of the challenges to blockchain adoption in the Indian healthcare sector. The identification of the mutual interaction among the challenges will help healthcare decision makers address strategic questions of waste management from a holistic point of view. Since the work is achieved in the Indian healthcare context, generalization of the results must be carefully considered. The present study contributes significantly to discussing blockchain’s potential in healthcare waste management. The study’s findings can aid decision making process of managers, policymakers, and benefit researchers in this field.

Sustainable utilization of mixed healthcare waste as aggregate in lightweight concrete mixes: mechanical behavior, water absorption and leaching studies

Wastes generated from healthcare practices are a serious problem for humans as well as for the environment. In this study, an attempt was made to use mixed solid medical waste (WPN) which consisted of shredded waste plastic and chopped waste needles for partial replacement of natural fine aggregate (sand) in concrete mixes at 0%, 2%, 4%, 6%, 8% and 10% by weight. To examine the validity of the suggested approach, the fundamental concrete properties including workability, fresh and hard densities, water absorption, compressive strength, and flexural strength as well as a leaching test were performed. The curing ages for the concrete mixes were considered to be 7, 14, and 28 days. Fifty-four cubes were molded for compressive strength test, and 72 prisms were cast for flexural strength, whereby 162 cubes were prepared for density tests as well as water absorption test. The results revealed that WPN-concrete mixes exhibited improvement in the workability and steadily decreased both the compressive and flexural strength values of the WPN-concrete mixes which were higher than the mean target strength of lightweight concrete grade M17. Leaching test results indicated the absence of the target components in the leachant. The outcomes of this experimental study demonstrated that reusing WPN as a sand-substitution aggregate in concrete is a good approach to reducing the adverse impact resulting from the improper management of healthcare and medical solid waste.

Artículo traducido] Farmacia hospitalaria ecológica: un enfoque sostenible del proceso de utilización de medicamentos en un hospital de tercer nivel

BackgroundSustainable management of healthcare waste has a positive impact on the global environment. In order to reduce it, the sustainable practice of the pharmacotherapeutic process in all its stages is essential. ObjectiveTo analyse the sustainability strategies proposed by the pharmacy service to reduce drug waste derived from the pharmacotherapeutic process. Secondary objectives: To analyse the stage of the pharmacotherapeutic process and the number and type of drugs involved. MethodsThe study was carried out in a tertiary-level hospital. To coordinate the proposals, a referent pharmacist from every pharmacy department area was selected. Four stages of the process were evaluated (management, validation, dispensing and compounding), patients concerned were classified as outpatients or inpatients, and drugs potentially involved were analysed by the administration route: Into oral or parenteral. ResultsTwenty eight ideas were proposed, which could affect more than 1200 drugs. 39.3% would affect the validation process, 17.9% the procurement management, 17.9% dispensing, and 7.1% the compounding. Implementation feasibility and acceptability of these proposals were evaluated. Those with the greatest potential were: Limiting the duration of treatments when possible, favouring the implementation of computer prescription order entry, favouring the use of the oral route over the parenteral route, and implementing computers in the preparation areas to avoid the use of paper guides. DiscusionIn our study, many ideas have been proposed by hospital pharmacists to improve the sustainability of the medication use process. When assessing these proposals by impact and feasibility, according to our results, shorten as much as possible the duration of treatments, computerization of the medication use process, and oral administration over intravenous should be prioritized in order to reduce environmental impact.

Association between Socio-demographics of Nurses and their Knowledge about Hospital Waste Management in Tertiary Care Hospital Lahore

The management of healthcare waste is very important due to the possible environmental dangers and threats to public health. Additionally, the direct exposure and handling of waste can results in disastrous events. Therefore, health care professionals should handle it carefully because majority of professionals does not give it importance to follow all the steps of waste management. Objective: To assess association between socio- demographics of nurses and knowledge about hospital waste management in Tertiary Care Hospital Lahore. Methods: A quantitative correlational study design was used for this study. The setting of study was Mayo Hospital Lahore. The study was completed in 3-month after approval of Ethical Research Committee. Sample size of 110 cases was calculated with 95% confidence interval. Data were collected by using Self developed demographic form and Knowledge Scale. Data were analyzed using SPSS version 24.0. Results: The result showed that among 110, the most of the participants are the age group of 31-40 years. Out of 110, majority of the participants (93.6%) are married. The study findings revealed that about 80(86.5%) participants had poor knowledge about hospital waste management and only 30(13.5%) nurses had good knowledge. Additionally, there was a statistically significant relationship between nurses’ knowledge and their age, marital status, and qualification. Conclusions: It was concluded that majority of participants had poor knowledge regarding waste management. The knowledge of participants about waste management had statistically significant relationship with age, marital status, and qualification.

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.

Effect of a waste management intervention program on knowledge, attitude, and practice (KAP) of nurses and housekeepers: a quasi-experimental study, Egypt

BackgroundImproper healthcare waste management practice is alarming in developing countries because resources are inadequate and waste management is often delegated to poorly educated and untrained laborers. This study aimed to compare the pre-KAP versus post-KAP towards the waste management program for nurses and housekeepers. In addition, it aimed to explore possible factors affecting the pre- and post-KAP in Mansoura Emergency University Hospital, Egypt.Subjects and methodsOne hundred thirty-three newly employed nurses, housekeepers, and those who need refreshment training as nominated by head nurses and link occupational health and safety nurses in the hospital were recruited for the study. The study’s intervention included multiple training sessions using a PowerPoint presentation in Arabic with appropriate illustrations followed by an open discussion. An Arabic self-administered questionnaire containing demographic and occupational history, knowledge (27 questions), attitude (10 questions), and practice (9 questions) was used pre- and post-intervention.ResultsThe overall KAP scores among the studied healthcare workers were significantly higher after the intervention. The pre- and post-knowledge scores were significantly different with respect to education, job description, and duration of employment (p < 0.05). The post-attitude scores were significantly different with respect to education and job description only (p < 0.05). The total pre-practice scores were significantly different with respect to education and job description (p < 0.05). However, the post-practice scores were significantly different with respect to sex, age, education, and job description (p < 0.05).ConclusionThere was a significant improvement in the KAP scores post-intervention. The post-knowledge and attitude scores were significantly better in nurses and participants with a higher education. The post-practice score was significantly better for females, participants with an age ≥ 30 years, higher education, and nursing jobs. The combination of training and supervision was crucial for the success of waste management programs. Higher education levels are required for housekeepers to be capable of gaining better knowledge, follow rules, and be ready for any challenges in the future.

Healthcare waste management practice and associated factors among healthcare workers in public healthcare facilities of Southwest Shewa Zone, Oromia regional state, Ethiopia.

Poor management of waste can cause serious disease to healthcare personnel, cleaners, waste handlers, patients and the public. An observation-supported cross-sectional study was conducted to assess healthcare waste (HCW) management practice and professional, management and resource availability-associated factors among healthcare workers of 23 public health facilities in Southwest Shewa Zone, Oromia regional state, Ethiopia, 2021. A total of 424 health workers participated in this study. The level of proper healthcare waste management (HCWM) practice was 38.4%. Lack of knowledge on different methods of healthcare waste treatment (adjusted odds ratio (AOR): 0.101, 95% confidence interval (CI) (0.042, 0.242, p < 0.05)), lack of knowledge about the types of healthcare waste (AOR: 0.136, 95% CI (0.039, 0.481, p < 0.05)), lack of knowledge on the use of different colour-coded waste bin and safety box (AOR: 0.145, 95% CI (0.040, 0.520, p < 0.05)), and healthcare workers who had no training/orientation on HCWM practice (AOR: 0.396, 95% CI (0.245, 0.639, p < 0.05)) were less likely to practice effective HCWM compared to their counterparts. The current HCWM practices in studied health facilities was inadequate. Professional knowledge and availability of training were independently associated with HCWM practice. Therefore, regular orientation during employment and on-job training on HCWM practice, regular monitoring and supervision of HCWM are important. Further research should be conducted on the area of HCWM, and its associated environmental impacts by using more strong methods and wider health facilities.

A multi-compartment VRP model for the health care waste transportation problem

Health-care waste (HCW) is a special category of refuse generated when providing health care and can comprise materials with infectious and/or toxic characteristics. The disposal of this waste involves its transport from health-care facilities to treatment centers. This step can be threatening to humans and the environment if not managed with the utmost care. To ensure the safe management of HCW, this article proposes a new model for HCW transportation that separates hazardous from non-hazardous waste along the transportation route. The proposed model is based on the multi-compartment vehicle routing problem, where each type of waste is carried in a dedicated compartment, and the objective is to minimize the total route cost. Considering the NP-hardness of the problem, an adaptive genetic algorithm is proposed based on the results of statistical pre-post testing of the population. The experimental study, conducted on benchmark instances and real data instances, show the efficiency of the proposed approach against state-of-the-art algorithms.

Waste from health services generated during the COVID-19 pandemic at the University Hospital

The objective of this study was to evaluate the generation of waste at Alcides Carneiro University Hospital (HUAC) during the COVID-19 pandemic in Campina Grande, PB. The data were collected through field observation, photographic recording, database records from the hospital, and documentary analysis of the existing Healthcare Waste Management Plan in the institution, between the years 2019 and 2020. It was found that the year 2019 had the highest annual waste generation quantity (approximately 233 tons) compared to the years 2020 and 2021. There was an increase in the generation of infectious waste in the year 2021, possibly associated with the treatment of COVID-19 infected patients. During the pandemic period, there was a decrease in the total quantification of waste generated at HUAC, possibly due to the suspension of several other services during the pandemic, reflecting the unpreparedness of institutions to cope with the high demand of infected patients.

Green hospital pharmacy: A sustainable approach to the medication use process in a tertiary hospital

BackgroundSustainable management of healthcare waste has a positive impact on the global environment. In order to reduce it, the sustainable practice of the pharmacotherapeutic process in all its stages is essential. ObjectiveTo analyze the sustainability strategies proposed by the pharmacy service to reduce drug waste derived from the pharmacotherapeutic process. Secondary objectives: to analyze the stage of the pharmacotherapeutic process and the number and type of drugs involved. MethodsThe study was carried out in a tertiary level hospital. To coordinate the proposals, a referent pharmacist from every pharmacy department area was selected. Four stages of the process were evaluated (procurement, validation, dispensing and compounding), patients concerned were classified as outpatients or inpatients, and drugs potentially involved were analyzed by the administration route: into oral or parenteral. Results28 ideas were proposed, which could affect more than 1200 drugs. 39.3% would affect the validation process, 17.9% the procurement management, 17.9% dispensing and 7.1% the compounding. Implementation feasibility and acceptability of these proposals were evaluated. Those with the greatest potential were: limiting the duration of treatments when possible, favoring the implementation of computer prescription order entry, favoring the use of the oral route over the parenteral route, and implementing computers in the preparation areas to avoid the use of paper guides. DiscussionIn our study, many ideas have been proposed by hospital pharmacists to improve the sustainability of the medication use process. When assessing these proposals by impact and feasibility, according to our results, shorten as much as possible the duration of treatments, computerization of the medication use process and oral administration over intravenous should be prioritized in order to reduce environmental impact.

On optimizing healthcare waste routing systems using waste separation policies: A case study

This article investigates the transportation task of Health-care waste (HCW). The particularity of HCW, compared to ordinary waste, is that it may contain infectious and/or toxic substances. The disposal of this waste involves transporting it from healthcare facilities (HCF) to treatment centers. This step can be threatening to humans and the environment if not managed with the utmost care. To ensure the safe management of HCW, the separation policy between dangerous and normal waste should be honored. Hence, a vehicle routing problem with multi-compartment vehicles is adopted with the underlying objective of minimizing the total travel distance. Given the NP-hardness of the problem, an adaptive evolutionary algorithm is proposed based on the results of pre–post statistical tests of the population. The proposed algorithm is compared to the best so far solutions on medium and large instances using benchmarks from the literature. The experimental study confirms the efficiency of the proposed approach against the competing algorithms. Finally, a case study is provided to illustrate the managerial insights of the studied problem.

Addressing the healthcare waste management barriers: A structural equation modeling approach.

Due to the growing population and advancing economy, medical waste accumulation has come to the attention of all facets of society. Although the issue of medical waste management planning has been addressed in developed nations, it still exists in several developing nations. This paper examines the effects of barriers under the Organization action, work handling, and Human Resource Practices section on the healthcare waste management (HCWM) sector in a developing country India. In this study, three hypotheses were constructed and tested using Structural equation modeling. The questionnaire was distributed among 200 health professionals to collect their responses. Ninety-seven responses were received, and 15 barriers were identified affecting the healthcare waste management sector. The results show that all three barriers (i.e., Organizational, Waste handling, and Human resources) hinder the Healthcare waste management sector. Organizational Barriers are the most significant among other barriers. So, the hospitals have to take appropriate actions to overcome these barriers. This paper helps to complete the research gap by providing the different characteristics of barriers. The development of a model for the analysis of barriers influencing HCWM is the Author's original contribution.

Infectious healthcare waste management among private dental practitioners in the Rabat-Salé-Kénitra region, Morocco: A cross-sectional study on knowledge, attitudes, and practices.

The increase in dental healthcare facilities and the use of single-use equipment have increased the production of healthcare waste. Their mismanagement exposes healthcare workers, waste managers, and the population to an infectious risk and negatively impacts the environment. Therefore, a correct management procedure has to be adopted from separation through storage to disposal. This study aimed to investigate dentists' knowledge, attitudes, and practices regarding managing infectious healthcare waste in private dental offices. A descriptive and analytical cross-sectional survey was conducted between December 2020 and March 2021 among private dentists registered at the Moroccan National Council of Dentists in the Rabat-Salé-Kénitra region. A questionnaire was developed to assess waste management in dental offices. Of the 500 questionnaires distributed, 190 completed and exploitable questionnaires were collected. Only 27.3% of healthcare waste managers in dental practices received training, 21,5% of practitioners assimilated the used gloves into household waste, 71.5% disposed of the waste generated by their offices directly into public bins, and 86.4% were unaware of Moroccan law 28-00 on waste management and disposal. This study highlights dentists' apparent lack of knowledge regarding healthcare waste management, and significant gaps were identified between actual practices and recommended regulations. To address these issues, developing a comprehensive medical waste management plan is crucial to encourage the practical cooperation of all stakeholders in this sector.

Knowledge and Practice of Healthcare Workers Regarding the Healthcare Waste Management

Background: Healthcare waste management (HWM) issues are getting worse in Pakistan since there are more and more hospitals, clinics, diagnostic labs, etc. One of the major individuals in charge of properly managing healthcare wastes at any healthcare facility is the medical staff. But how well you perform will rely on how much you know and do about waste management. Aim: To ascertain the knowledge and practice of healthcare professionals about the management of healthcare waste. Study design: Cross-sectional descriptive study. Methodology: The Children Hospital Lahore has conducted the current study. The current study included 400 participants. Structured, pre-tested, and self-administered questionnaires were used to collect data. The survey was cleaned, revised, and reviewed for completeness. The analysis of the data was done using SPSS 23. Results: 400 individuals were involved, 174(43.5%) of whom had sufficient understanding of health care waste management, whereas 226(56.5%) had insufficient knowledge. Of the 400 participants, 188(47%) had good practice managing medical waste, whereas the remaining 212(50%) had bad practice. Practical Implication: This study helped researchers investigate the knowledge and practice of health workers. It would help in estimating the practice and knowledge of health waste management by health care workers. Conclusion: It was determined that most workers had inadequate knowledge of waste management and had poor practice on health care waste management. All employees must receive the appropriate training and supervision in HCW management, as well as pertinent and continuous in-service training, to ensure that they have the necessary information, attitudes, and safe practices. Keywords: Health Care Workers, Waste Management, Knowledge, Practices and Training.

Healthcare Waste and Sustainability: Implications for a Circular Economy

The field of healthcare waste systems is an emerging research field with new methodologies being developed to reinforce sustainability. Medical treatments are becoming more sophisticated and in demand due to increasing incidences of chronic disease. Healthcare is also becoming widely available worldwide. Healthcare waste disposal includes multiple disposal methods including incineration, landfilling, and chemical treatments. These rudimentary methods and their increased prevalence present their own problems that negatively impact both the environment and public health. As a result, there is a global call for healthcare waste systems to transition from a linear to a circular economy (CE). The CE philosophy is employed in other waste management industries. There are limited studies, however, that assess the challenges to CE implementation, particularly in the United States. This research presents the challenges to the implementation of a CE in healthcare waste management systems. The challenges were determined by an extensive literature review. Three experts from the industry verified and provided additional context to the challenges through meetings. The challenges were grouped into seven categories: supply chain management, regulations and policies, industry, organizations internal, technology and operational, economic, and funding, and social. A decision-making trial and evaluation (DEMATEL) was used to rank the challenges and illustrate interrelationships between the challenges. The most significant challenge was found to be a lack of governmental legislation on CE healthcare policies, followed by a lack of a realistic CE business model and lack of consumer interest in the environment. The research will provide context to further developments into adopting CE practices. The limitations and future scope of the research are presented.