Medical Disposal Research Articles

Practice Towards Storage of Unused and Disposal of Expired Medicines among Households in Dharan, Nepal

Introduction: Improper disposal of unused medications has been a public health problem, as unused drug adversely effects on health and environment. Objective: The main objective of this study was to assess the extent of unused medications disposal knowledge, attitude, and practice of among household in Dharan, Province 1, Nepal. Methods: A survey based descriptive study was used. Households were conveniently selected and interviewed using structured questionnaires. Attitudes and practices regarding medicine disposal and storage were asked. The data were analyzed by SPSS version 20.0 software and presented descriptively. Results: Among 380 household surveyed, majority of respondents (82%) reported storing unused medications in their home and only 5% reported returning medication to a pharmacy. Predominant reason for medication non-used was disease or symptoms felt improved (80 %). Less than half of respondents (45%) had check the expiry date of their medicine before purchasing. Most respondents (88%) thought that improper disposal of medicine may cause harmful effects to health and environment. Conclusion: Incorrect practices were found in Dharan families with regard to the storage and disposal of unused medications. Along with a comprehensive media campaign to inform consumers about safe medication disposal techniques, an efficient method for disposing of leftover medications should be offered. This system should be supported by local pharmacist.

Investigating the capabilities of advanced large language models in generating patient instructions and patient educational material

ObjectivesLarge language models (LLMs) with advanced language generation capabilities have the potential to enhance patient interactions. This study evaluates the effectiveness of ChatGPT 4.0 and Gemini 1.0 Pro in providing...

Insights into Drug Donation Practices and Public Perceptions in Saudi Arabia

Background: Effective medication management, disposal, and donation are vital for public health and environmental sustainability. Improper handling of medications can lead to drug misuse, accidental poisoning, and environmental damage. This study examines current practices and challenges in Saudi Arabia, identifying opportunities for improvement. Method: A cross-sectional survey conducted in October and November 2023 targeted the general population in Saudi Arabia. This study employed convenience sampling to explore medication usage, storage, disposal practices, and awareness of donation procedures. Data were analyzed through both descriptive and inferential statistical methods. Results: This study involved 430 respondents. Of these, 73.0% held a university degree, yet 66.3% were unaware of drug donation programs, and 84.2% lacked knowledge about proper medication disposal. Despite this, 71.4% believed that drug donation programs positively impact healthcare, and 87.9% saw them as reducing drug waste and environmental pollution. However, 48.1% expressed concerns about the potential misuse of donated medicines. Awareness and knowledge were significantly higher among participants aged 30 and above. Conclusions: The findings highlight the need for enhanced public awareness, clear medication disposal guidelines, and ethically governed donation practices in Saudi Arabia. These measures can improve healthcare outcomes, protect the environment, and support global health and sustainability goals.

Comparing modalities of opioid education in patients undergoing total knee arthroplasty: a randomized pilot trial

BackgroundPatients undergoing total knee arthroplasty (TKA) experience significant postoperative pain and routinely require opioids, yet they often lack knowledge regarding appropriate use and handling of these medications. Evidence suggests that...

Evaluation of a drug deactivation system for safe disposal of opioids after ambulatory surgery

BackgroundPrescription opioids are commonly prescribed postoperatively and increase the risk of diversion or misuse when left unused and accessible. Despite awareness of the risks associated with unused opioids, harm reduction strategies like safe storage and drug take-back events may be limited by inconvenience and patient-specific barriers to access. ObjectiveTo evaluate a quality improvement project designed to facilitate at-home disposal of unused opioids after day surgery. MethodsAn observational, prospective quality improvement project was conducted in patients undergoing elective outpatient surgery at Newton-Wellesley Hospital from December 2019 to June 2020. Upon discharge, eligible patients received a Deterra drug disposal packet which deactivates unused medication. Follow-up surveys assessed packet use and reasons for nonuse 1 to 2 weeks after surgery. ResultsOne hundred six participants received a disposal packet and responded to the survey. Among the 67 respondents with unused medication, 30% used the packet. Women were more likely to use the packet than men (predicted probability 30.2% vs. 10.4%, P = 0.033), and patients aged 18–25 were more likely to use the packet than those aged 26–40 (40.0% vs. 9.5%, P = 0.049). The most common reasons for packet nonuse included procrastination, holding onto prescriptions in case of future pain, and waiting to dispose of multiple medications. ConclusionThe majority of patients surveyed had unused opioids 1 to 2 weeks after surgery, and approximately 1 in 3 patients with unused doses utilized the disposal packet. Common reasons for nonuse included procrastination and concerns about needing future medication for pain. Going forward, safe drug disposal efforts may emphasize improved patient education, partial prescription fill options, or alert systems to remind patients to safely dispose of unused medication.

GIS-technologies and algorithm for developing regional systems for handling medical waste on the example of three regions

Introduction. GIS is a modern computer technology designed for collecting, storing, analyzing and visualizing spatial data – mapping. GIS is also actively used in healthcare to solve many regional problems, including optimization and management of healthcare resources. Over last decade, many researchers have used mathematical software models for healthcare waste management. A review of the literature shows facility location, risk to the public, and economic feasibility to be among the issues that have been extensively covered in the literature. Designing a reverse logistics network using mathematical software tools is an efficient and effective way to manage healthcare waste. The objective of the study. To determine the optimal approach to creating a functional model of a system for managing medical waste of class B and C using GIS-technologies for each of the three regions, based on the characteristics of each. Materials and methods. Medical institutions in three regions (St. Petersburg, Leningrad Region and Krasnoyarsk Territory) as sources of medical waste generation were considered taking into account their capacity and specialization. The composition and volumes of waste by class were determined using a calculation method based on indicative waste generation standards. The identification of local technologies for the neutralization of medical waste existing in medical institutions was carried out. The obtained data was processed statistically and displayed on electronic maps for subsequent use in GIS technologies, as well as for the development and justification of a waste management system for medical institutions, taking into account the prospects for the development of healthcare. Results. Based on the analysis of data on medical waste of classes B and C in individual medical institutions, as well as an analysis of the power of existing technologies for neutralizing this waste using GIS technologies, proposals were developed to improve the medical waste management system in three regions. The proposals are aimed at improving the sanitary and epidemiological situation in the regions over a five-year period and take into account the features of the existing transport infrastructure and the requirements of sanitary legislation. Limitations. The model of a medical waste management system using GIS technologies was used only for managing waste of classes B and C. Conclusion. To ensure the safe and environmentally sustainable functioning of the waste management system of classes B and C in the regions, it is necessary to apply an integrated approach based on GIS technologies. This approach should take into account the regional characteristics of the management of the medical waste disposal system and its economic feasibility and take into account the regional characteristics of transport logistics and the prospects for the development of healthcare.

Knowledge and practices on home medication storage and disposal in Syria: a population-based, cross-sectional study

BackgroundMedications are commonly found in every household. In Syria, where healthcare infrastructure faces significant challenges, improper storage can lead to reduced medication efficacy and increased health risks. Additionally, inappropriate disposal practices pose serious environmental concerns, especially in a region already grappling with environmental degradation. This study aimed to evaluate the knowledge, and practices of Syrian individuals regarding the appropriate storage and disposal of home medications.MethodA cross-sectional study was conducted from September 22 to October 20, 2023, using an online survey distributed via social media apps (WhatsApp, Facebook, and Telegram) in Syria. The questionnaire, adapted from a similar study in Saudi Arabia, was translated to Arabic using the forward–backward translation technique. A convenience sampling technique was used. Inclusion criteria were participants over eighteen with expired or unused medications at home. Descriptive statistics, Chi-square tests, and binary logistic regression analysis were performed using SPSS version 27, with statistical significance defined as p < 0.05.ResultsA total of 2,217 responses were analyzed, with the majority of participants being female (79%) and aged between 21–30 years (56%). The study found that 90.7% of respondents dispose of expired medications in the garbage, while 95% keep medications in their original containers. Additionally, 30% consult pharmacists for storage instructions, and 64% read storage information on medication leaflets. Logistic regression analysis revealed that males were less likely to check expiration dates before use (OR: 0.58, 95% CI: 0.40–0.84) and periodically (OR: 0.68, 95% CI: 0.54–0.85). Participants aged 31–40 years were less likely to check expiration dates periodically (OR: 0.46, 95% CI: 0.31–0.68), while those with children under six years old were more likely to do so (OR: 1.29, 95% CI: 1.01–1.67). Males were also less likely to read storage instructions (OR: 0.61, 95% CI: 0.50–0.76) but more likely to ask pharmacists about them (OR: 1.26, 95% CI: 1.01–1.57). There was no significant difference in these practices between medical professionals and the general population.ConclusionThis study reveals gaps in the practices related to the storage and disposal of medications among the Syrian public. The findings suggest a need for targeted public education and awareness programs to improve these practices and reduce the associated health and environmental risks.

Promoting long-lasting changes in student well-being through a pharmacy general education course: A pilot study

Objective Colleges and universities need effective strategies to help students develop medication-use behaviors that positively support their well-being. This pilot study evaluated the utility of Fink’s Taxonomy of Significant Learning (FTSL), an evidence-based instructional strategy, to create long-lasting changes in students’ well-being during a pharmacy general education course. Participants and methods Using a mixed methods survey design, we assessed 84 undergraduate students’ changes in self-reported well-being at three different time points (pre-intervention, post-intervention, and 6-month follow-up) through five variables (safe medication practices, general healthcare behaviors, healthcare self-efficacy, safe medication storage, and safe medication disposal). Results The results of multiple repeated-measures ANCOVAs, four McNemar chi-square tests, and qualitative thematic analysis showed significant positive changes in several variables over time. Conclusions This pilot study demonstrated that intentional integration of FTSL during the course design process helped students develop long-lasting general healthcare and safe medication-use behavior intentions. We discuss holistic approaches for promoting student well-being.

Digitalization and Digital Applications in Waste Recycling: An Integrative Review

The rapid growth of urbanization and industrialization has brought the issue of waste management to the forefront. Industrial, household, and medical waste management and disposal are major issues affecting the whole world. The adoption of digital technologies across society is largely a result of the increasing processing power of waste and decreasing costs. Waste management and recycling is also benefiting from emerging digital technologies. The Internet of Things, cloud computing, artificial intelligence, robotics, and data analytics are a few examples of specific digital technologies that are currently in use and are predicted to have a significant impact on the efficiency of the waste recycling industry in the future. The objective of this review, which was conducted using the bibliometric method and visualized with scientific mapping, is to demonstrate how the digital transformation of waste recycling has evolved over the last decade and to identify which issues have been overlooked or have become more prominent. The scope of the research is based on studies carried out all over the world and on digital applications and works in the field of waste recycling. In this review, bibliometric analysis was used to scan the entire field and the results were classified and interpreted according to the PRISMA (preferred reporting of systematic reviews and meta-analyses) methodology.

The management of unused and expired medications in Thai households: Influencing factors and prevailing practices.

Although the improper disposal of unused and expired medications represents a global environmental concern, its significance is often underestimated. This research delves into the practices and factors related to the management of unused and expired medications. Data was collected through a comprehensive survey of Thai households, with 400 structured questionnaires. Multiple regression was then employed to analyze the data. Findings show an intriguing paradox. The participants in the survey demonstrated commendable knowledge regarding the appropriate management of unused or expired medications. Yet, this knowledge was not sufficiently put into practice. This study identifies the factors that have a positive influence on proper medication disposal practices, such as age, level of education, attitude, and perception. Surveyed participants exhibited a tendency to retain unused medications and discard expired ones with household waste. Most of them showed a low degree of medication management, pointing to the need for targeted interventions. This research provides tangible benefits for policymakers, healthcare practitioners, and researchers addressing waste management paradigms. In terms of policy, the study highlights the need for comprehensive interventions, including medication take-back systems, infrastructure development, and educational initiatives. Policymakers are urged to bridge the gap between knowledge and behavior by promoting access to collection points for proper medication disposal to avoid perpetuating the cycle of suboptimal medication management. This research informs strategies to encourage responsible medication management practices globally, addressing the adverse environmental and health impacts associated with the improper accumulation of medications.

Green Occupational Health, Safety and Performance of Devolved Healthcare Services in Kenya

Green human resource management is the adoption of policies and practices to attain sustainable use of a firm's resources while enhancing environmental sustainability, which also boosts employee morale and satisfaction with firm performance. Level Five hospitals in Kenya are increasingly expected by law to implement environmentally sustainable practices. This study aimed to determine the effect of green occupational safety and health on the performance of devolved healthcare services in Kenya. A mixed-methods research design was used, whereby the researchers combined the elements of quantitative and qualitative approaches. The study targeted 5,960 employees working in 12 Level 5 hospitals in Kenya. This study applied multi-stage random sampling, which refers to dividing the population into units or smaller and smaller groups and selecting the sample (Kothari, 2019). In the first stage, simple random sampling was used to select four of the 12 Level Five hospitals with an accessible population of 1310. In the second stage, purposive sampling was used to select a sample of 131 respondents, representing 10% of the accessible population (Mugenda &amp; Mugenda, 2013). Data collection tools were questionnaires, interviews, and document analysis. Quantitative data was analyzed descriptively and inferentially while qualitative data was subjected to content analysis. The findings revealed a strong positive and significant relationship between green occupational safety and health and the performance of devolved healthcare services in Kenya. The study concluded that green occupational safety and health had a significant effect on the performance of devolved healthcare services. The study recommended that devolved healthcare services should improve if they continuously used green occupational safety and health management systems that reduce accidents and injuries; utilized paperless offices so as to create a clean and safe work environment; applied eco-friendly medical waste disposal methods such as waste minimization, segregation, and recycling; used eco-friendly safety gadgets; and conducted regular safety and health audits.

Perceptions of disposal options for unused opioid analgesics among people who have been prescribed an opioid analgesic in North Carolina

ABSTRACT Background: Medication disposal programs have been promoted as one solution to the opioid crisis, but uptake by community members has been minimal. Objectives: To clarify perceptions of medication disposal options among people who have been prescribed an opioid analgesic in North Carolina to inform interventions that can facilitate the disposal of unused opioids. Methods: In 2022, we conducted focus groups with participants who received an opioid medication in the past year to gain information to develop an intervention related to the disposal of unused opioid medication (12 focus group discussions (FGDs); total N = 37; 30 identified as female, 6 as male, and 1 as another gender). Participants were shown a slide with the Food and Drug Administration’s recommended disposal options and asked about their perceptions of each option. Themes were derived using an inductive, thematic, qualitative approach. Results: Seven themes about perceptions of medication disposal programs emerged from the data. Four of the themes reflect potential barriers to medication disposal: failed disposal attempts, lack of sufficient education on proper disposal, unclear meaning of specific disposal language, and concerns about existing disposal options. Three of the themes provide insight on potential facilitators of medication disposal: preference of low-cost disposal options, ease and accessibility among disposal methods, and preferred disposal methods. Conclusion: Patients should be provided clear and consistent guidance from prescribers and dispensing pharmacists on when and how to dispose of unused medications and opportunities to dispose of medications at no cost to the patient.

Association of Opioid Disposal Practices with Parental Education and a Home Opioid Disposal Kit Following Pediatric Ambulatory Surgery.

The majority of opioid analgesics prescribed for pain after ambulatory pediatric surgery remain unused. Most parents do not dispose of these leftover opioids or dispose of them in an unsafe manner. We aimed to evaluate the association of optimal opioid disposal with a multidisciplinary quality improvement (QI) initiative that proactively educated parents about the importance of optimal opioid disposal practices and provided a home opioid disposal kit before discharge after pediatric ambulatory surgery. Opioid disposal behaviors were assessed during a brief telephone interview pre- (Phase I) and post-implementation (Phase II) after surgery. For each phase, we aimed to contact the parents of 300 pediatric patients ages 0 to 17 years who were prescribed an opioid after an ambulatory surgery. The QI initiative included enhanced education and a home opioid disposal kit including DisposeRX®, a medication disposal packet that renders medications inert within a polymeric gel when mixed with water. Weighted segmented regression models evaluated the association between the QI initiative and outcomes. We considered the association between the QI initiative and outcome significant if the beta coefficient for the change in intercept between the end of Phase I and the beginning of Phase II was significant. Safe opioid disposal and any opioid disposal were evaluated as secondary outcomes. The analyzed sample contained 161 pediatric patients in Phase I and 190 pediatric patients in Phase II. Phase II (post-QI initiative) cohort compared to Phase I cohort reported higher rates of optimal (58%, n = 111/190 vs 11%, n = 18/161) and safe (66%, n = 125/190 vs 34%, n = 55/161) opioid disposal. Weighted segmented regression analyses demonstrated significant increases in the odds of optimal (odds ratio [OR], 26.5, 95% confidence interval [CI], 4.0-177.0) and safe (OR, 4.4, 95% CI, 1.1-18.4) opioid disposal at the beginning of Phase II compared to the end of Phase I. The trends over time (slopes) within phases were nonsignificant and close to 0. The numbers needed to be exposed to achieve one new disposal event were 2.2 (95% CI, 1.4-3.7]), 3.1 (95% CI, 1.6-7.4), and 4.3 (95% CI, 1.7-13.6) for optimal, safe, and any disposal, respectively. A multidisciplinary approach to educating parents on the importance of safe disposal of leftover opioids paired with dispensing a convenient opioid disposal kit was associated with increased odds of optimal opioid disposal.

A Double-Blinded Randomized Controlled Trial Assessing the Efficacy of Opioid Disposal Instructions with Parental Education on Proper Opioid Disposal Rates Following Ambulatory Pediatric Urologic Surgery

ObjectivesTo determine if the administration of standardized opioid disposal instructions with focused parental education improves proper disposal of leftover opioid medication among families of children undergoing ambulatory urologic surgery compared to routine postoperative instructions. MethodsA prospective, double-blinded, single-center randomized controlled trial was conducted in children 6-18y undergoing ambulatory urology procedures between October 2021-April 2023. Patients were randomized (1:1) to receive either the Food and Drug Administration (FDA) opioid disposal best practices worksheet plus nursing parental education or routine postoperative instructions alone. All patients were prescribed acetaminophen and ibuprofen and a per-protocol rescue opioid prescription. The primary outcome was rate of proper opioid disposal at 10-14d post-procedure. Secondary outcomes included parents postoperative pain measure (PPPM) scores, numerical pain scale (NPS) scores, and weight-based opioid utilization at 48h and 10-14d. ResultsWe randomized 104 participants (53 intervention, 51 control) with 97% (101/104) complete follow-up data at 10-14d. Patient demographics, procedural characteristics, and analgesia use were similar between groups. We observed no significant difference in proper opioid disposal rates between arms (31% intervention vs. 18% control; estimated difference in proportion 13% [95% CI, -4–29%]; p=0.1). There was no increased odds of proper disposal of leftover opioid medication at 10-14d with the intervention compared to the control (OR 2.0 [95% CI 0.8–5.1]; p=0.1). We observed no differences in PPPM scores, NPS scores, or opioid utilization at 48h or 10-14d. ConclusionsProviding formal opioid disposal instructions with parental education did not improve proper disposal of leftover opioid medication nor did it alter post-discharge opioid utilization after pediatric urologic surgery.

Medication Disposal Patterns and Practices with Awareness of Environmental Contamination Caused by Pharmaceuticals among the General Public in Malaysia.

The proper disposal of pharmaceuticals has become a prime concern in contemporary healthcare and environmental management. The evolving awareness highlights the ecological and public health risks associated with pharmaceutical waste. Therefore, evaluating medication disposal patterns and public awareness regarding pharmaceutical-related environmental issues is crucial for promoting responsible practices. The primary aim of this study is to identify the determinants of participation in the Medicine Return Program (MRP) among Malaysians. This cross-sectional study employed snowball sampling and an online questionnaire, disseminated via multiple social media platforms. Results: Out of 389 respondents, 46% were 18 to 29 years old, 61% were female, and 69.7% attained a tertiary educational level. Most of them (71.5%) reported disposing of their unused medicines into the rubbish bin, indicating that this disposal method is prevalent among Malaysians. Only 26.2% participated in the MRP program. The study revealed that 73.0% of respondents were aware of pharmaceutical-related environmental contamination. Furthermore, significant associations were demonstrated between a factor of receiving advice from healthcare professionals (p < 0.001), awareness level on environmental pharmaceutical contamination (p < 0.001) and MRP (p < 0.001) and willingness to participate in MRP (p < 0.001) with MRP support. This study provides valuable insights on Malaysian pharmaceutical disposal practices and the factors influencing MRP participation. These findings can inform targeted interventions and public health campaigns to improve medication disposal behaviors and reduce pharmaceutical waste's environmental impact.

Pyxis Proximity Improves Narcotic Waste Compliance Among Anesthesia Personnel.

Introduction Controlled substance waste processes in perioperative areas can be cumbersome. Streamlining this process is a critical component of improving operating room efficiency. At our institution, unused controlled substances require a two-person waste prior to disposal. We hypothesized that access to a centrally located automated medication dispensing system to conduct medication waste would decrease the amount of time required to perform a two-person waste and dispose of unused medications after the completion of a case. We further hypothesized that a decrease in the time required to waste would improve user satisfaction with the waste process. Methods This was a single-center, retrospective, IRB-approved quality assurance analysis. Research Electronic Data Capture (REDCap, Stony Brook, NY, United States) software was used to design an anonymous survey, which was distributed via email from 06/09/2021 to 09/09/2021. Wilcoxon signed-rank tests were used to compare before and after paired responses for individuals. Analyses were performed using SAS 9.4 © (Cary, NC, United States) software. Results Participants reported a significant decrease in time carrying used narcotics after a surgical case. For the primary outcome, median (IQR) scores demonstrated a significant decrease from 2, representing "10-20 minutes" (IQR 1-3), to 1, indicating "<10 minutes" (IQR 1-2) spent carrying used narcotics (p < 0.0001). Reported satisfaction with the process significantly increased from 2 to 3 points, on a scale of 5, after using the new centrally located Pyxis (p < 0.0001). Participants reported the wasting process as less time-consuming, carried fewer used controlled substances, and were less likely to wait until the end of the shift to waste. Conclusions By improving the ergonomics of the waste process after adding a Pyxis system in a more central location, the time anesthesia clinicians spent carrying used controlled substances decreased. Additionally, provider satisfaction increased, likely related to the ease of finding a partner to witness wasted medications.

Impact of veterinary pharmaceuticals on environment and their mitigation through microbial bioremediation.

Veterinary medications are constantly being used for the diagnosis, treatment, and prevention of diseases in livestock. However, untreated veterinary drug active compounds are interminably discharged into numerous water bodies and terrestrial ecosystems, during production procedures, improper disposal of empty containers, unused medication or animal feed, and treatment procedures. This exhaustive review describes the different pathways through which veterinary medications enter the environment, discussing the role of agricultural practices and improper disposal methods. The detrimental effects of veterinary drug compounds on aquatic and terrestrial ecosystems are elaborated with examples of specific veterinary drugs and their known impacts. This review also aims to detail the mechanisms by which microbes degrade veterinary drug compounds as well as highlighting successful case studies and recent advancements in microbe-based bioremediation. It also elaborates on microbial electrochemical technologies as an eco-friendly solution for removing pharmaceutical pollutants from wastewater. Lastly, we have summarized potential innovations and challenges in implementing bioremediation on a large scale under the section prospects and advancements in this field.

. Medical waste management and disposal in emergency military service situations

The article aims to analyze and justify the need for improving the safety system for handling and recycling medical waste in order to optimize the medical waste management in emergency situations of military service. The legal acts of the Russian Federation and the regulatory acts of the Ministry of Defense of the Russian Federation providing for the service safety requirements for military personnel, including the medical waste management system and their disposal, were analyzed. The concept of medical waste and its role in the structure of production and consumption waste was explored. The features of medical waste management in military emergencies were identified. The requirements for medical waste disposal plants, including productivity, compactness, reliability, safety for the personnel and the environment and mobility, were specified. A high-temperature installation for the medical waste disposal was developed, its technical characteristics and examples of positive testing in medical institutions were identified. The analysis and the results obtained are an obligatory condition for improving the medical waste management system in emergency military situations.

The environmental impacts of anesthesia.

The healthcare sector has a substantial environmental footprint, and the delivery of anesthesia contributes significantly. Inhaled anesthetics themselves are potent greenhouse gases, unused intravenous medication exert toxic effects on the environment, and the increasing reliance on single-use devices has led to an ever-growing amount of solid waste produced in operating rooms. This review discusses many of these environmental impacts and suggests practices to mitigate the environmental footprint of anesthetic practice. The choice of anesthesia maintenance has significant environmental implications, with nitrous oxide and desflurane having the highest carbon footprint of all anesthetic agents. Using low fresh gas flows and supplementing or replacing inhalational agents with propofol leads to a significant reduction in emissions. Many intravenous anesthetic agents pose a risk of environmental toxicity, and efforts should be made to decrease medication waste and ensure appropriate disposal of unused medications to minimize their environmental impacts. Additionally, consideration should be given to replacing single-use devices in the operating rooms with reusable alternatives that are often both environmentally and economically superior. And solid waste generated in the operating room should be segregated thoughtfully, as processing regulated medical waste is a highly energy-intensive process. Significant opportunities exist to improve the environmental footprint of anesthesia practice, and with the rapidly worsening climate crisis, the importance of implementing changes is greater than ever.

T-Spherical fuzzy TOPSIS method based on distance measures and Hamacher Heronian mean averaging aggregation operators and its application to waste management

T-Spherical fuzzy sets provide a robust framework for handling uncertainty in real-world decision-making. This paper addresses the construction of T-Spherical fuzzy Heronian mean averaging aggregation operators using novel Hamacher operations. The study mathematically verifies the properties of these operators and develops new distance measures such as Hamming, Euclidean and Jaccard for quantifying dissimilarity between T-Spherical fuzzy numbers. Furthermore, the TOPSIS method is implemented using the proposed operators and distance measures to solve a practical decision-making problem in selecting the best transportation firm for medical waste disposal. A sensitivity analysis is made to assesses the efficacy of the proposed operators, while a comparison study with existing methods is exhibited to establish their efficiency.