Medical Waste Research Articles

СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫ ЗАГРЯЗНЕНИЯ ОКРУЖАЮЩЕЙ СРЕДЫ СРЕДСТВАМИ ИНДИВИДУАЛЬНОЙ ЗАЩИТЫ МЕДИЦИНСКОГО НАЗНАЧЕНИЯ

A new coronavirus infection (COVID-19) caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has changed the lives of many people around the world. During the pandemic, hundreds of thousands of genomic sequences of the new coronavirus were formed, and its steady transmission from person to person remains. The use of disposable personal protective equipment (PPE) has become necessary to combat the COVID-19 pandemic, which has led to an unprecedented increase in the number of their production. Is of great concern the accumulation of the number of used PPE (medical and household waste), as well as their further disposal. The presence of various fragments of plastic and chemicals in disposable PPE can cause ecotoxicological effects on representatives of aquatic and terrestrial habitats at different levels of biological organization. In addition, PPE is a great danger for the further spread of various viruses, including SARS-CoV-2, since viruses can remain on different surfaces for several days. In the current situation, it is obvious that there is a need to conduct research to assess environmental risks and the impact of used PPE on the environment and human health

Resource utilization of medical waste incineration fly ash to activate peroxydisulfate for tetracycline degradation: Synergy between adsorption and PDS activation

Medical waste incineration fly ash (MWI FA) is classified as a hazardous solid waste. Therefore, the development of recycling technologies to convert MWI FA into useful products is necessary and challenging. In this study, we developed a sustainable approach for preparing a catalyst through the pyrolysis of water-washed MWI FA (WW FA-x, where x corresponds to the pyrolysis temperature). Subsequently, it was applied as a potent peroxydisulfate (PDS) activator to remove tetracycline (TC) from water. The results showed that the WW FA-800 exhibited remarkable adsorption performance as well as highly efficient catalytic activation of PDS, with a 115 mg/g maximum TC adsorption capacity and 93.5% (reaction kinetic rate = 315 μmol/g/h) TC removal within 60 min. A synergistic effect was achieved by adsorption and PDS activation. TC degradation was primarily driven by non-radical (1O2 and electron transfer) processes. WW FA-800 possesses multiple active sites, including defects, π–π*, O–CO groups, Fe0, and Cu(I). Three possible pathways for TC decomposition have been proposed, with the majority of intermediates exhibiting less toxicity than TC. Furthermore, the WW FA/PDS system exhibited an excellent anti-interference ability, and universality in the degradation of various organic contaminants. Notably, energy consumption was minimal, approximately 2.80 kWh/(g·TC), and the leachability of heavy metals in the WW FA-800 was within acceptable limits. This study provides a MWI FA recycling route for the development of highly active catalysts.

Optimizing the Elimination of Dioxin-Like Compounds (PCDD/Fs and PCBs) Through Effective Combustion Practices in the Flue Gas in the Medical Waste Incineration Facility

Optimizing the Elimination of Dioxin-Like Compounds (PCDD/Fs and PCBs) Through Effective Combustion Practices in the Flue Gas in the Medical Waste Incineration Facility

Experimental and modeling study of medical waste based on plasma gasification

Plasma gasification melting (PGM) provides reliable disposal of toxic medical waste with a low heating value, which is capable of converting waste into energy. This study investigates the performance of experiments on plasma gasification for the treatment of chemical-pharmaceutical medical waste (CPMW) with an air medium. A comparative analysis is performed for gasification characteristics at three reactor temperatures (1000, 1400, and 1800 °C). Moreover, a thermodynamic equilibrium model is developed to assess performance features such as syngas yield, high heating value, and cold gas efficiency in the gasification temperature range of 1000–1800 °C. A comparison of the experiment and computational outcomes shows a good agreement. The results show that the quality of syngas and heating value is improved by increasing the temperature of the plasma gasifier so that at 1800 °C, H2, CO, and higher heating value (HHV) are obtained as 41 %, 37 %, and 10 MJ/Nm3, respectively. The obtained syngas is a clean fuel with low sulfur-containing and nitrogen-containing. The experimental results provide an extensive comprehension of CPMW gasification in a plasma reactor and consider a possibility for hydrogen and energy production.

Burn pit exposure in military personnel and the potential resulting lung and neurological pathologies

IntroductionMilitary personnel and local civilians at various deployment locations are plagued with serious health conditions. Evidence points to burn pit emissions as the cause of these pathologies; however, similar diseases are also caused by environmental exposures, smoking, genetic predispositions, or other comorbidities. Burn pits, which are large smoldering piles of refuse ignited with jet or diesel fuel, contain human and medical waste as well as paint, plastics, ammunition, and other materials—each of which can be attributed to health concerns in other industrial settings. Here we compare various pathologies attributable to toxic aerosol exposures and discuss distinct pathologies that may be linked to burn pit exposures.ObjectivesWe performed a literature review where we provide information on toxic exposures that may pose relevance to burn pit exposure and furthermore, highlight what is already known about burn pit exposures and what steps need to be taken to diagnose and correlate certain respiratory pathologies to chronic exposure from overseas burn pits.Data sourcesWe conducted searches through PubMed and Google Scholar to determine where gaps in our knowledge of burn pit exposure lie. Thorough review on jet-fuel properties and particulate matter were performed as supporting evidence of potential toxins from burn pit emissions.ResultsTo date, studies on burn pit emissions consist mainly of systematic reviews and discussions to address the problem, with very few acute-exposure studies and little to no chronic-exposure studies. We found that symptoms range from respiratory pathologies to neurological deficits, but treatment has been limited as medical facilities, such as the Veterans Administration (VA), require proof that a condition is service-connected.ConclusionsTo determine the effects of burn pit exposure on humans, chronic exposure to mimicked burn pit emissions is necessary to draw definitive conclusions between phenotypic differences in pathologies linked to exposure. By determining phenotypic differences, conclusions can be made about the pathologic origins, potentially leading to future diagnoses and treatments for veterans and affected civilians.

Removal of 177Lu from radioactive wastewater using Montmorillonite clay

Because radioactive 177Lu has a wide range of possible applications in radiopharmaceuticals, its removal from medical wastewater is particularly important. Montmorillonite clay was employed as an adsorbent in this study. Radioactive solutions were prepared with dilutions of the solution containing 177Lu at various concentrations, in which it was present as Lu3+. ULEGe detector in gamma spectrometer was used to measure 177Lu gamma rays emitted from the radioactive aqueous solutions. The results obtained showed that it is possible to remove 177Lu with a high yield of approximately 90% and it is effective in a period of 90 min under acidic conditions. From the findings, it can be argued that Montmorillonite clay, as an abundant and sustainable adsorbent, may also be suitable for the disposal of different radioactive medical wastes such as 131I and 99mTc, and also the technique based on gamma ray spectroscopy can be used for fast and practical measurements of radioactive material amounts.

A study of indoor air pollution caused by disinfection equipment as a consequence of infectious waste management

ABSTRACT Infectious waste disinfection is an essential process in medical waste management that may cause release of some pollutants. In this study, the PAHs concentration at the disinfection was investigated. The change in the release rate of PAHs in two including infectious waste reduction and increasing the segregation ratio was estimated. The results showed that the PAHs concentration was 1172 – 2066 ng/m3. The specific concentration of PAHs was 852 ng/ton of infectious waste in average. The annual emission of the PAHs resulting from infectious waste disinfection is estimated to be 612.6 kg. Reduction of infectious waste caused by redefining infectious waste and increasing the segregation ratio leads to reduction of PAHs concentration by 50%. Increasing the ratio of segregation and redefinition of infectious waste that led to reduced waste loading volume are essential measures that reduce the emissions of pollutants as by-products of disinfection.

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.

A comparative analysis before and after pandemic on environmental accounting public hospital

Purpose: This study conducted a comparative analysis of the application of environmental accounting in hospitals before, during, and after the pandemic. Research methodology: This qualitative study used a comparative analytical approach. The data used in the research are primary data from interviews with three informants directly involved and secondary data from relevant financial information at the Regional Public Hospital. Mohamad Soewandhie, Surabaya. Results: The COVID-19 pandemic has impacted hospital environmental accounting. Hospitals commonly charge environmental costs for managing solid, liquid, and gaseous waste. The pandemic has increased hospital waste processing expenditure for these three classes. The growth in hospital waste and vendor waste processing costs due to increased demand, since hospitals cannot yet process their waste, are the main causes of the cost increase. Once the outbreak ended, hospitals could control the costs. Limitations: Financial data from the hospital was simply an illustration because it had to be integrated with the Surabaya City Government's financial reports and was not published. Contribution: It can be seen that it is important for hospitals to be able to budget environmental costs more seriously as a preventive measure if similar problems like the pandemic or other forces significantly occur in the future. Novelty: Previous similar research only studied how environmental accounting is implemented in a hospital and did not compare its implementation before, during, and after the pandemic.

Bioprotective Respirator Assembled by Defective Carbon Nitride for Long-Term Light Triggered Health Protection.

Wearing face masks is the best way to stop the spread of respiratory infections. However, if masks are not sterilized, changing them too frequently can actually increase the risk of cross-contamination. Herein, the construction of an antipathogen photocatalytic mask with carbon vacancy-modified carbon nitride nanosheets (g-C3N4-VC Ns) coated on the non-woven fabrics of the out layer of the mask, offering effective and long-term protection against damaging pathogens when exposed to light is reported. The introduced carbon vacancies are found capable of creating energy-disordered sites and inducing energetic electric force to overcome the Coulomb interactions between electron-hole pairs, thus promoting the electron-hole separation to achieve a high generation of reactive oxygen species (ROS). Thanks to its high activity in generating ROS upon exposure to light, the as-prepared photocatalytic mask shows high pathogen sterilization performance. This, in turn, prolongs the mask's protective lifetime, decreases the need for regular replacement, and decreases medical waste production. The work demonstrated here opens new viewpoints in designing pathogens biocidal protective devices for health protection, offering significant promise in specific environment self-protection.

Sustainable Waste Management in Orthopedic Healthcare Services

It is estimated that globally medical surgical specialties, including orthopedics, produce large amounts of hospital waste. However, the possibilities of recycling materials are not well highlighted. Orthopedic hospitals can collect larger volumes of recyclables that could be kept out of landfills. The general objective of this study is to identify the categories and related amounts of waste and recyclable materials produced by the main types of medical interventions in orthopedics. The specific objective is to evaluate the amounts of waste produced in the preoperative and intraoperative periods, but also their recycling potential. For one month, we analyzed eight types of orthopedic medical interventions, of which five were surgical and three were nonsurgical. These were performed at the County Emergency Clinical Hospital of Targu Mures in Romania. For surgical interventions, the waste was collected separately in the preoperative and intraoperative periods. Waste was divided into recyclable, nonrecyclable, and biological categories. The waste bags were weighed with a portable scale. The main results are the average amounts of recyclable waste produced per case in the eight types of medical interventions. The secondary results show the average amounts per case of nonrecyclable, biological, and total waste. To test for statistically significant differences between the types of medical interventions, we performed an analysis of variance. Seventy-four cases were included in the study. An amount of 466.2 kg of waste was collected, with an average mass of 6.3 kg per case. During the preoperative period, 130.3 kg of waste was produced, of which 78% was recyclable. During the intraoperative period, 303.8 kg of waste was produced and only 11% was recyclable. Trauma surgery produced the largest amount of waste, followed by arthroplasty. A quarter of orthopedic waste is recyclable, and the greatest potential for recycling is preoperative waste, which can be effectively recycled at three-quarters. Through effective recycling programs, the ecological footprint of orthopedic–traumatology interventions can be reduced.

"EFFECT OF WEBINAR REGARDING IMPACT OF BIOMEDICAL WASTE ON ENVIRONMENT AND IT’S PREVENTION AMONG NOVICE NURSING STUDENTS OF SELECTED COLLEGES OF ODISHA"

Biomedical waste, sometimes known as hospital trash, is created during the treatment of people as well as during biologics research, that contains potentially contagious materials and affect the environment due to improper disposal of waste. As nurses are backbone of the health care delivery system though they are working 24 hours a day. Novice nursing students have less knowledge on impact of biomedical waste on environment& its prevention. The current Pre-experimental one group pre-test post-test research study conducted in 3 nursing colleges of Odisha with 500 first year nursing students who are selected randomly by using convenience sampling technique. The result of the current study revealed that, majority of nursing students in Post-test (77.33%) are having good knowledge than Pre-test knowledge (3.33%).There was a significant mean difference (7.1) exists between pre-post test knowledge score and 0.1 SD difference exists between the pre and post-test. The present study revealed that, there is lack of adequate knowledge among nursing students regarding management of biomedical waste in view of its impact on the different aspects of the environment. The management of biomedical waste should be assessed as soon as possible in order to raise awareness for proper collection, segregation and disposal to prevent contamination of waste towards environment amongfuture nursing officers at their training courses.

Compliance of healthcare workers in a psychiatric inpatient ward to infection control practices during the COVID-19 pandemic: a participant observation study supplemented with a self-reported survey

BackgroundAs an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in healthcare-associated infections (HAIs) and posed a significant challenge to infection control practices (ICPs) in healthcare settings. While the unique characteristics of psychiatric patients and clinical settings may make the implementation of ICPs difficult, evidence is lacking for compliance with ICPs among healthcare workers (HCWs) in a psychiatric setting during the COVID-19 pandemic.MethodsA cross-sectional multi-method study based on participant unobtrusive observation coupled with the completion of a self-administered ICP survey was conducted to assess compliance with ICPs among HCWs in a psychiatric inpatient ward in a regional hospital. An online checklist, called eRub, was used to record the performance of HCWs in hand hygiene (HH) and other essential ICPs. Furthermore, a well-validated questionnaire (i.e., Compliance with Standard Precautions Scale, CSPS) was used to collect the participants’ self-reported ICP compliance for later comparison.ResultsA total of 2,670 ICP opportunities were observed from January to April 2020. The overall compliance rate was 42.6%. HCWs exhibited satisfactory compliance to the wearing of mask (91.2%) and the handling of clinical waste (87.5%); suboptimal compliance to the handling of sharp objects (67.7%) and linen (72.7%); and poor compliance to HH (3.3%), use of gloves (40.9%), use of personal protective equipment (20%), and disinfection of used surface/area (0.4%). The compliance rates of the nurses and support staff to HH were significantly different (χ2 = 123.25, p < 0.001). In the self-reported survey, the overall compliance rate for ICPs was 64.6%.ConclusionThe compliance of HCWs in a psychiatric inpatient ward to ICPs during the COVID-19 pandemic ranged from poor to suboptimal. This result was alarming. Revisions of current ICP guidelines and policies that specifically target barriers in psychiatric settings will be necessary.

Bioleaching of low-grade copper sulfide enhanced by nutrients from sterilized medical waste

Medical waste (MW) is originated from healthcare activities, which is difficult to dispose and potential to cause environmental pollution. The effect of MW on bioleaching of low-grade copper sulfide ore was studied, which showed that using MW can improve copper recovery through decreasing Fe3+ concentration and facilitating mutual conversion between Fe2+ and Fe3+. An appropriate-dosage MW improved bacterial concentration and attached bacteria proportion, while excessive MW caused harm to bacterial community structure succession. Using MW contributed the conversion from Fe3+ to Fe2+ to impede Fe3+ hydrolysis, thus diminishing the formation of passivation layer and augmenting copper recovery. The optimal distribution of bacterial species and maximum copper recovery of 82.79 % were obtained when 30 mg/L MW was used. Species including Acidithiobacillus ferrooxidans, Acidibacillus ferrooxidans and Leptospirillum ferriphilum were found predominant, accounting for more than 97 % according to 16 S rDNA analysis. Possible mechanism suggesting I- contained in MW worked as reducing agent to decrease Fe3+ hydrolysis and thus improving bioleaching was proposed.

Medical Waste Management: A Case of Tier-II Cities

Medical waste management is a critical aspect of healthcare operations, ensuring the safe handling, treatment, and disposal of waste generated from medical activities. This report provides a comprehensive overview of Medical waste management practices, regulations, and challenges. It highlights the importance of adhering to regulatory frameworks, such as the Medical Waste Management Rules, to mitigate health risks and environmental impacts associated with improper waste management. Keywords : Medical waste management, Regulations, Healthcare facilities, Hazardous waste, Waste handling, Waste disposal

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.

Handling of radioactive waste from the use of radionuclides in hospitals

The waste that is generated during the different applications of radionuclides in medicine is considered as biomedical radioactive waste. This waste includes contaminated materials and syringes generated from Nuclear Medicine procedures, unused radioactive seeds from implants in Radiation Oncology as well as sealed sources used for calibration purposes, which are no longer useful. The overall goal of biomedical radioactive waste handling is to minimize the hazards posed by the waste prior to discharge or disposal. In order to plan the treatment of radionuclides in medical facilities, it is important to design an effective system for the overall management of radioactive biomedical waste. In this scientific paper I make a general assessment of the planning methods used in the handling of radioactive waste in medical facilities, including the collection, separation and packaging of radioactive biomedical waste.

Sustainable location-routing problem for medical waste management using electric vehicles

The sustainable management of medical waste is essential for environmental protection and public health safety, contributing to urban development and societal well-being. This study focuses on the medical waste Location-Routing Problem with Electric Vehicles (EVs), aiming to mitigate infection risk while providing cost-effective and energy-efficient logistics solutions. It encompasses diverse elements such as disposal location selection, vehicle scheduling, recharge strategies, time windows, working duration, and load-dependent energy consumption. To tackle this complex problem, we introduce an Evolutionary Decomposition-based Adapted Large Neighborhood Search algorithm (E-ALNS/D), which surpasses existing methods such as MOEA/D-HGS, MOEA/D-LNS, MPGA, and NSGAII-LNS across various urban settings. Empirical analysis and a case study reveal opportunities for enhancing medical waste management with EVs. Key findings show that optimizing service times, adopting fast-charging infrastructure, and strategically placing temporary disposal facilities in response to unforeseen demand spikes significantly reduce energy consumption, lower infection risk, and cut charging cost. Furthermore, selecting peripheral over central disposal locations better minimizes infection risks. This research offers valuable insights for decision-makers in EV-based medical waste management, emphasizing the need to balance public health, environmental sustainability, and economic efficiency. Our methodology paves the way for future research in sustainable medical waste management with EVs.

Safe Hands, Safe Earth: Prioritizing Security and Sustainability in Medical Waste Management

Safe Hands, Safe Earth: Prioritizing Security and Sustainability in Medical Waste Management

Quantification of Oversupply of Chronic Disease Medications among Patients Aged ≥55 Years in Japan.

Medication waste may be caused by medication oversupply; however, the degree of medication oversupply in Japan is unclear. This study aimed to quantify the degree of oversupply of chronic disease medications per patient, the proportion of oversupplied patients, and the excess days and costs of the oversupplied medications in Japan. This retrospective nationwide cohort study using a large insurance claims database from Japan was conducted in patients aged ≥55 years who received one or a combination of the following five classes of medications dispensed in FY 2019: third-generation calcium antagonists, angiotensin 2 receptor blockers, statins, dipeptidyl peptidase-4 inhibitors, and biguanides. Medications with the same ingredient having the same specification were treated as the same medication. Medication oversupply was defined as a medication possession ratio (MPR) during persistence >1.0. The proportions of oversupplied patients and excessively oversupplied patients with ≥30 excess days/year were approximately 16 and 1-2% for all drug classes, respectively. Three-quarters of the oversupplied patients had fewer excess day (≤14/year), and the median oversupplied medication cost was less than 1000 yen/year for all classes. However, there was a patient with oversupplied medication estimated as 983 excess days per year and a patient with oversupplied medication costs of nearly 90000 yen per year. Using the MPR and excess days as indicators, it is necessary to accelerate estimation of the oversupply per patient, as well as the development of patient intervention strategies and a national system to reduce medication oversupply.