A low-background gas chromatography-atmospheric pressure chemical ionization-tandem mass spectrometry method for the determination of volatile methylsiloxanes in medical waste syringes.

Dermatologic surgery generates considerable medical waste due to its high procedural volume, yet specialty-specific guidance on sustainable practices remains limited. To present an evidence-based framework for reducing waste in dermatologic surgery while maintaining safety and efficacy. A comprehensive search of PubMed was conducted for articles published from 2000 onward using key terms combining predefined waste reducing interventions (e.g. multipack nonsterile gloves, reusable drapes and instruments, longer-acting anesthetics, continuous suturing, simplified dressings) with ("waste reduction" OR "sustainability"). Evidence was graded by Oxford CEBM (1a-5) and GRADE (A-D). Twenty-eight sustainability strategies were identified across the preoperative, intraoperative, and postoperative phases of dermatologic surgery, 15 of which were supported by level 1 to 2 evidence. High-level interventions included the use of nonsterile gloves, longer-acting anesthetics, reusable drapes and instruments, absorbable and continuous suturing techniques, and occlusive dressings. This review summarizes evidence-based sustainability strategies shown to reduce environmental impact and provides a practical framework for potential implementation in dermatologic surgery.

Creation and evaluation of 3D printed compostable myringotomy sets: A sustainable proof of concept.

Technology and application of harmless co-incineration of medical waste and domestic waste.

Waste management is a crucial task due to its direct impact on environmental sustainability, public health, and resource conservation. Rapid urbanization, population growth, and industrialization have led to a significant increase in the volume and complexity of waste generated by municipal, biomedical, electronic, and hazardous waste. Therefore, technology-based waste classification is needed to address the global waste management crisis. However, deploying an accurate classification model on resource-constrained hardware demands a careful balance between model accuracy and overall computational efficiency. This research employs an EfficientNet-B1 + Transformer model along with Cosine Annealing Learning Rate Scheduling (CALRS) and optimized Label Smoothing (LS) techniques, and this method is known as EN-CALS. This unified pipeline is trained on six classes of waste dataset of 2,527 images (cardboard, glass, metal, paper, plastic, and trash). It was compared with several fine-tuned models such as ResNet-50, ViT-B/16, MobileNet-V2, MobileNet-V3-Small, MobileNet-V3-Large, ShuffleNet-V2, EfficientNet-B0/B2, and DenseNet-121. Results show us that EfficientNet-B1 with these optimizations achieves the best test accuracy of 93.68. Large-scale architectures like ResNet-50 with 87.37% accuracy, ViT-B/16 with 61.58% accuracy and DenseNet121 with 92.63% accuracy, show clear overfitting and are unsuitable for the target edge hardware. The ablation studies proved the importance of individual components in EN-CALS for the waste classification system. This research establishes a reusable model template and deployment pipeline for waste classification and is designed to scale as better datasets and hardware become feasible.

Transitioning from landfill to cross-regional centralized recycling: Uncovering the mechanisms and potentials of hard-to-treat hazardous waste through medical waste incineration fly ash recycling.

Biomedical waste management is an essential element of hospital infection control, particularly in Ayurveda facilities where panchakarma procedures generate diverse and potentially infectious waste. Despite its significance, there is absence of standardized tools to comprehensively measure the knowledge, attitude, and practice (KAP) of healthcare workers in this field. Hence the present research work aims to design and validate a questionnaire that is crucial to capture accurate, comparable data, identify knowledge gaps, and guide targeted training or policy interventions. A single-centre, cross-sectional psychometric study using convenience sampling was conducted on 190 Ayurveda healthcare workers in a tertiary care Ayurveda healthcare setting in Kerala, India. An initial 38-item questionnaire draft was generated on the basis of review of literature and focus group discussion with relevant area experts. Then judgement of questionnaire was based on Content validity and Face validity by expert panel. Test-retest reliability, internal consistency reliability, and construct validity of instrument were established later by using SPSS version 25. Measurement model and structural components were derived using partial least squares structural equation modeling (PLS-SEM) with SmartPLS 4. Goodness- of- fit between model and actual data of study was determined through various fit indices. Item-level content validity (I-CVI > 0.79) and face validity (scores ≥ 8/10) confirmed relevance and clarity. Four items with weak test-retest reliability were removed. The final 34-item questionnaire demonstrated good internal consistency (Cronbach's α = 0.788-0.830, overall α = 0.877) and stability (ICC = 0.769-0.812, overall ICC = 0.771). Exploratory factor analysis (EFA) supported a three-factor structure (Knowledge, Attitude, Practice) explaining 54.98% of variance. PLS-SEM indicated large effect sizes for Knowledge and Attitude (f² = 0.492, 0.466) and moderate explanatory power for Practice (R² = 0.443), with overall good model fit. Results showed evidence for validity and reliability of questionnaire assessing knowledge, attitude and practice regarding biomedical waste management among Ayurveda healthcare workers. The tool was developed and validated in a single Ayurveda tertiary care centre; further validation is needed in other settings.

Waste generated in medical facilities poses chemical, toxic, carcinogenic, mutagenic, and radiation risks to the human body, alongside the risks of injury and infection. The microbial load in medical waste is one thousand times higher than in municipal solid waste. Rational and safe management of medical waste is one of the most pressing challenges in healthcare, as it directly impacts infection control and public health protection. An increasing number of countries worldwide are legislating medical waste management. By 2035, the volume of medical waste in Ukraine is expected to reach 141,000 tons, including 35,000 tons of epidemiologically infectious waste. Therefore, it is critically important to ensure sufficient capacities for its safe treatment. An analysis of the regulatory framework allows for the identification of existing differences in the medical waste management systems of Ukraine and the EU member states, as leading European countries have already established frameworks that Ukraine has only recently begun to implement. This review provides a comparative analysis of the regulatory framework for medical waste management in Ukraine and the European Union countries, while substantiating priority measures for reforming the national management system in accordance with European epidemiological safety practices. Based on theoretical, analytical, and comparative methods, the paper reviews current scientific publications and examines relevant regulatory and legal documents of Ukraine, the European Union, and individual member states in the field of medical waste management. The current state of medical waste management in Ukraine and the European Union, as well as the hazardous potential of this waste type for public health, was considered. The review assesses the legislative regulation of medical waste management in EU countries and the regulatory documents of Ukraine. It was established that the current state of legal support for waste management in Ukraine is hindered by a lack of efficient control and supervision over waste management entities and insufficient funding for relevant programs. The expediency of introducing amendments to the regulatory framework has been substantiated, particularly regarding the strengthening of state control over the activities of business entities and the implementation of European waste accounting standards. As a modern state governed by the rule of law, Ukraine has prioritized the development of medical waste management by aligning its legislation with the experience of EU member states. Given that the volume of hazardous waste continues to increase while comprehensive statistical records remain absent, the application of European law and best practices will facilitate the successful implementation of medical waste management programs. To achieve full alignment with EU standards, Ukraine must not only adopt relevant laws but also ensure their effective enforcement, develop modern infrastructure, and strengthen control in the field of medical waste management. The ultimate goal should be the creation of a comprehensive and sustainable management system that meets the best international practices and ensures the protection of human health and the environment.

Radioactive technetium-99 (99Tc) is present in nuclear and medical wastes. Its immobilization by magnetite (FeIIFeIII2O4) has been studied in the last decades, showing that magnetite reduces pertechnetate (TcVIIO4-) to TcIV, which is either incorporated into the magnetite structure or forms TcIV-TcIV-dimers attached to the magnetite surface. The distribution between both phases and the incorporation mechanism remain, however, unclear. Therefore, we investigated the molecular environment of Tc after contacting TcVII with synthesized nanoparticulate magnetite as a function of pH (2-13) and time (up to 7 weeks). X-ray absorption spectroscopy was combined with density functional theory (DFT) simulations to decipher the mechanism of TcIV incorporation. We observed that the sorption of TcIV-TcIV-dimers initially occurs at pH 5 and pH 7, while TcIV incorporation in magnetite prevails at longer times and at pH 10. We suggest that TcIV-TcIV-dimer sorption on magnetite is due to (surficial) maghemitization of the magnetite nanoparticles, whereas TcIV incorporation is due to the electron transfer from sorbed Fe2+ through magnetite and subsequent release of FeII in solution (redox conveyor belt model), "burying" TcIV into the magnetite structure. DFT calculations indicate that TcIV incorporates in magnetite by an exchange of two FeII atoms for one TcIV, keeping the charge balanced by creating a vacancy.

Laboratory medicine remains the cornerstone of disease detection, clinical management, monitoring, and public health surveillance. Increasing population needs and rising disease burdens, particularly in low- and middle-income countries (LMICs), continue to expand the volume of diagnostic testing, resulting in substantial generation of biomedical waste. Effective laboratory waste management is therefore essential for protecting personnel, maintaining high-quality service delivery, and minimizing environmental harm. However, many LMICs face persistent challenges due to inadequate infrastructure, insufficient training, limited financial resources, and weak regulatory enforcement-that compromise safe and efficient waste handling. This review explores affordable, scalable and sustainable measures to strengthen laboratory waste management in resource-constrained settings. It categorizes the main types of laboratory waste-infectious/biological, chemical, sharps, and general waste-and examines common barriers to appropriate disposal. Guided by various international standards including International Organization for Standardization (ISO) 15189 and 14001, Eco-Management and Audit Scheme (EMAS) and World Health Organization (WHO) recommendations, and drawing on experiences from other LMICs, the review discusses practical, low-cost interventions such as improved test utilization, workflow optimisation, Artificial Intelligence (AI)-supported waste classification and digital tracking systems. The importance of workforce training, government engagement, public-private partnerships, and involvement of non-governmental organisations is also emphasised. To foster a culture of responsible waste management, the review proposes behavioural and accountability mechanisms including linking efficiency to key performance indicators, providing institutional recognition, documenting non-conformances, and applying consequence management where necessary. Sustainable and cost-effective waste management is achievable in resource-limited settings when supported by committed leadership, coordinated stakeholder action, and continuous quality improvement. Corporate bodies can play a pivotal role by providing strategic leadership, mobilising resources and strengthening workforce capacity.

Tissue Engineering (TE) represents an effective approach for addressing tissue or organ defects and functional impairments. Cells, scaffolds, and growth factors, as the three elements of TE, play an important role in tissue repair. In recent years, there has been growing interest in Wharton's Jelly (WJ), obtained from the umbilical cord of postpartum medical waste. Mesenchymal stem cells, extracellular matrix, and growth factors derived from WJ have been widely used in TE. WJ has shown the potential to treat a wide range of diseases in clinical applications. This review discusses the mechanisms of action of WJ, focusing on their applications in the field of tissue damage repair. We also highlight the advantages, current limitations, and future directions of WJ-based therapies, including challenges related to standardization, scalability, long-term safety, and clinical translation.

The health care sector makes a substantial contribution to the ecological burden on health in part through the generation of large volumes of medical waste. Incorporating the principles of the circular economy-particularly the reuse of medical equipment-has become an important topic of discussion. This manuscript examines the principles of reusing medical materials and the potential implications for patient safety after appropriate reconditioning. Qualitative and quantitative data from the existing literature were used to guide a discussion of a multidisciplinary panel of experts in ethics, clinical practice, environmental sustainability, hospital waste management, and health economics. The consequences of reusing medical equipment for patient infections were investigated through a detailed literature review. On the basis of this multidisciplinary approach, we found that when selected medical equipment is adequately reconditioned for reuse, patient safety is not endangered. A central rationale for the use of single-use medical materials is the assumption that they improve patient safety. Our findings suggest that the economic and ecological benefits of reusing medical materials outweigh the potential risks to patient safety.

Point-of-care diagnostics are reshaping healthcare worldwide by enabling rapid, decentralized testing across clinical and non-clinical settings, particularly in regions with limited laboratory infrastructure. These technologies are transforming telemedicine and disease surveillance by providing timely results. However, the performance and accuracy of these devices heavily rely on the choice of the substrate material. In point-of-care diagnostics, the substrate is the base material of a device that supports sensing components and facilitates interaction between the biological sample and the detection system, as in lateral flow assays for pregnancy testing, electrochemical biosensor strips for glucose monitoring, and reagent dipsticks for urine analysis. Conventional polymeric materials are commercialized as substrates due to their low cost and ease of processing. Nevertheless, their limited biocompatibility, non-degradability, and potential to generate toxic medical waste have raised growing concerns regarding their single-time use. This push for greener materials has turned attention toward biopolymers. Biopolymers derived from plants, animals, marine sources, and microbes are increasingly being explored as point-of-care substrates. Among these, bacterial cellulose stands out as a promising candidate due to its environmentally friendly production route and interconnected nanofibrillar network with high porosity, hydrophilicity, and water-retention capacity while maintaining superior mechanical strength. The abundance of hydroxyl groups allows diverse surface functionalization, while its tunable optical characteristics and biodegradability make it suitable for scientific integration and environmentally responsible disposal. Although notable progress has been made, comprehensive studies linking the structural features of bacterial cellulose to its performance in healthcare testing remain scarce. This review bridges this gap by systematically compiling recent research, examining modification approaches, and outlining how material-driven routes can be implemented to improve the reliability of disease diagnostics. This review also discusses emerging directions where bacterial cellulose may play a broader role in future diagnostic technologies.

The burden of waste: Environmental justice, health risks, and socioeconomic disparities near waste management facilities.

Cutting Waste in Bronchoscopy: A Multicenter Observational Study in the German Health Care System.

Understanding the environmental effects of surgery can help develop environmentally sound practices. Examine the environmental impact of performing septorhinoplasty. Case study. A primary septorhinoplasty was selected. Materials, medications, devices, and energy used were identified, and medical waste and torn plastics were characterized and measured. Global warming potential (GWP) and microplastics generated were calculated using published conversion rates. GWP of this septorhinoplasty was 192.3 kg CO2 equivalent (CO2e). The greatest contributor to GWP was the use of disposable supplies (160.95 kg CO2e), with smaller contributions from the sterilization of surgical equipment, anesthetic gases, environmental HVAC energy, surgical instrument manufacturing, and incineration of regulated medical waste. Microplastic production ranged between 97,637 and 530,638 microplastics. The environmental cost of septorhinoplasty was dominated by disposable items, contributing to GWP and microplastic production. Through awareness of the environmental impact of their choices, surgeons can develop mitigation strategies to minimize their effect.

Botulinum neurotoxin (BoNT) is approved as single-use vials containing doses higher than necessary for most patients, which contributes to waste and lost revenue. It is common practice to administer a single-use BoNT vial to multiple patients, but data are lacking to support the safety of this practice. To determine the safety and efficacy of a multiuse vial protocol for BoNT at an academic medical center. A retrospective review of the electronic medical record identified patients receiving cosmetic BoNT at Oregon Health & Science University between 2020 and 2025. Adverse events that occurred within 30 days of the procedure were recorded. A total of 2,666 patients receiving cosmetic BoNT were included. Overall, 354 (13.28%) follow-ups occurred within 30 days, and 39 (1.46%) adverse events occurred. The majority of these were related to inadequate paralysis (16) or asymmetrical paralysis (12). No serious complications or infections were identified. Complications when using a multiuse vial policy for BoNT are infrequent and not related to infection. Adoption of similar policies nationwide will lead to a reduction in medical waste and increased revenue.

Analysis of Solid Medical Hazardous Waste Generation at a Type A Hospital (Case Study of Hospital X, Riau Province)

As data about the environmental sustainability of core-needle breast biopsy are lacking, this study aims to investigate current practices regarding materials usage, waste generation, and pre-procedural and procedural variability. A panel of five breast imaging experts developed a 56-item online questionnaire, distributed from February 20 to March 31, 2024, to members of APS Senonetwork Italia. The questionnaire explored materials usage for core-needle breast biopsy during all pre-procedural and procedural steps. Responses were analyzed using descriptive statistics. A total of 176 responses from 101 centers were received, with 135 respondents actively performing core-needle breast biopsies. The study revealed substantial variability in sterility practices, with only 0.7% (1/135) of respondents meeting all sterility criteria. While many centers used sterile materials, their application was inconsistent, leading to suboptimal sterility and excessive waste. The most frequently used materials included sterile gloves (56.3%), sterile drapes (34.8%), and probe covers (37.5%). However, only 5.9%of respondents used sterile gowns, and 9.0% used sterile caps. Post-procedural infection rates were reported as uncommon, with 86.7% of respondents never or rarely encountering infections. Additionally,after completing the biopsy, 66.7% of respondents discarded both used and unused materials, contributing to biomedical waste. This study highlights the potential for materials usage optimization and waste reduction in core-needle breast biopsy across centersaffiliated with APS Senonetwork Italia. As infectious complications were most frequentlyreported as rare or absent, minimization of unnecessary use of sterile and non-sterile materials could contribute to sustainable healthcare practices while maintaining high-quality patient care.

In 2023, the World Health Organization (WHO) concluded that climate change is the biggest threat to public health. Health care has a large carbon footprint with operating rooms contributing an inordinate amount to this issue. Surgeons have an opportunity to lead sustainability efforts by changing individual practices and collaborating with other stakeholders. Some of these changes that have been suggested include using reusable devices, including gowns, drapes, and specula; updating instrument trays and surgeon preference cards to minimize opening unused instruments; using clean energy sources where possible and adapting energy-saving options, including powering down operating room lights and heating, ventilation, and air conditioning (HVAC), turning off water faucets when not in use, and running decontamination equipment at capacity; educating staff on properly separating waste to reduce regulated medical waste and increase recyclables; and encouraging anesthesia colleagues to use regional anesthetic and intravenous propofol when appropriate. In addition to decreasing adverse environmental impact, many of these strategies result in significant cost savings. Ultimately, a culture change must occur where all health care professionals recognize and take responsibility for the significant and adverse effect that health care, most notably procedural and surgical care, has on the environment while balancing the potential effects to the health of our patients.