Results of a hospital waste survey in private hospitals in Fars province, Iran

Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. In Iran, neither rules have been compiled nor does exact information exist regarding hospital waste management. The survey presented in this article was carried out in all 15 private hospitals of Fars province (Iran) from the total numbers of 50 governmental and private hospitals located in this province, in order to determine the amount of different kinds of waste produced and the present situation of waste management. The results indicated that the waste generation rate is 4.45 kg/bed/day, which includes 1830 kg (71.44%) of domestic waste, 712 kg (27.8%) of infectious waste, and 19.6 kg (0.76%) of sharps. Segregation of the different types of waste is not carried out perfectly. Two (13.3%) of the hospitals use containers without lids for on-site transport of wastes. Nine (60%) of the hospitals are equipped with an incinerator and six of them (40%) have operational problems with the incinerators. In all hospitals municipal workers transport waste outside the hospital premises daily or at the most on alternative days. In the hospitals under study, there aren't any training courses about hospital waste management and the hazards associated with them. The training courses that are provided are either ineffective or unsuitable. Performing extensive studies all over the country, compiling and enacting rules, establishing standards and providing effective personnel training are the main challenges for the concerned authorities and specialists in this field.     

A mathematical model to predict the composition and generation of hospital wastes in Iran

The aim of this study is to investigate the quality and quantity of hospital wastes in Iran. The generated hospital wastes have been estimated by the number of hospitals and the number of active beds in each province of Iran in 2001. All data and information have been gathered from: (i) Iran Statistics Center, (ii) literature review, and (iii) hospital waste investigations for an average hospital. Physical analyses have been conducted in terms of various materials (plastic, textile, paper, metal, and others) and components (biological, infectious, medical, and regular wastes). Based on the above-mentioned investigation and information, a mathematical model has been developed to calculate the generation of (infectious) hospital wastes for any desired year. Utilizing the model, generated infectious hospital wastes has been estimated as 698,937 tones for 2008 (short-term) and 3,494,387 tones for 2028 (long-term period). If the real infectious wastes are collected separately, then the generated infectious wastes will be reduced by 15.1% of the above-mentioned amount (139,787 tones for 2008, and 698,877 tones for 2028). Results of physical analysis show the components of the hospital waste as: (a) infectious, 67.3%; (b) medical, 8.8%; (c) biological, 1.8%; and (d) common municipal wastes, 22.1%. An appropriate collection method requires training the staff at hospitals along with preparation of the required facilities. Of course, both of these requirements are cost intensive.     

Hospital solid waste management practices in Limpopo Province, South Africa: a case study of two hospitals

The shortcomings in the management practices of hospital solid waste in Limpopo Province of South Africa were studied by looking at two hospitals as case studies. Apart from field surveys, the generated hospital waste was weighed to compute the generation rates and was followed through various management practices to the final disposal. The findings revealed a major policy implementation gap between the national government and the hospitals. While modern practices such as landfill and incineration are used, their daily operations were not carried according to minimum standards. Incinerator ash is openly dumped and wastes are burned on landfills instead of being covered with soil. The incinerators used are also not environmentally friendly as they use old technology. The findings further revealed that there is no proper separation of wastes according to their classification as demanded by the national government. The mean percentage composition of the waste was found in the following decreasing order: general waste (60.74%)>medical waste (30.32%)>sharps (8.94%). The mean generation rates were found to be 0.60kg per patient per day.     

A GIS based transportation model for solid waste disposal--a case study on Asansol municipality

Uncontrolled growth of the urban population in developing countries in recent years has made solid waste management an important issue. Very often, a substantial amount of total expenditures is spent on the collection of solid waste by city authorities. Optimization of the routing system for collection and transport of solid waste thus constitutes an important component of an effective solid waste management system. This paper describes an attempt to design and develop an appropriate storage, collection and disposal plan for the Asansol Municipality Corporation (AMC) of West Bengal State (India). A GIS optimal routing model is proposed to determine the minimum cost/distance efficient collection paths for transporting the solid wastes to the landfill. The model uses information on population density, waste generation capacity, road network and the types of road, storage bins and collection vehicles, etc. The proposed model can be used as a decision support tool by municipal authorities for efficient management of the daily operations for transporting solid wastes, load balancing within vehicles, managing fuel consumption and generating work schedules for the workers and vehicles. The total cost of the proposed collection systems is estimated to be around 80 million rupees for the fixed cost of storage bins, collection vehicles and a sanitary landfill and around 8.4 million rupees for the annual operating cost of crews, vehicles and landfill maintenance. A substantial amount (25 million rupees/yr) is currently being spent by AMC on waste collection alone without any proper storage/collection system and sanitary landfill. Over a projected period of 15 yr, the overall savings is thus very significant.     

Status and challenges of hospital solid waste management: case studies from Thailand, Pakistan, and Mongolia

Healthcare waste management is a serious public health concern. In developing countries, compared to developed nations, the management of infectious wastes has not received sufficient attention. Recently, worldwide awareness has grown of the need to impose stricter controls on the handling and disposal of wastes generated by healthcare facilities. This exploratory study attempted in seven selected hospitals to explain the situation of healthcare waste management, with a focus on handling practices, occupational safety, and the implementation status of waste management policy, together with other pertinent policy issues. It was noted that the current system of healthcare waste management was underdeveloped and was in dire need of immediate attention and improvement, especially in Mongolia and Pakistan; the medical waste management practices were better in the hospitals studied in Thailand. This study underscores the importance for improvement of medical waste management of a national regulatory framework, a sound internal management system, and programs to train and ensure the safety of related personnel, as well as programs to estimate quantities of waste generated and to evaluate appropriate techniques of disposal. Once a healthcare waste management plan has been prepared, a regular program of inspection and review can be undertaken within the healthcare institution. A good inspection program can also expose problems and new issues in managing healthcare wastes.     

Integrated waste management--looking beyond the solid waste horizon

Waste as a management issue has been evident for over four millennia. Disposal of waste to the biosphere has given way to thinking about, and trying to implement, an integrated waste management approach. In 1996 the United Nations Environmental Programme (UNEP) defined 'integrated waste management' as 'a framework of reference for designing and implementing new waste management systems and for analysing and optimising existing systems'. In this paper the concept of integrated waste management as defined by UNEP is considered, along with the parameters that constitute integrated waste management. The examples used are put into four categories: (1) integration within a single medium (solid, aqueous or atmospheric wastes) by considering alternative waste management options, (2) multi-media integration (solid, aqueous, atmospheric and energy wastes) by considering waste management options that can be applied to more than one medium, (3) tools (regulatory, economic, voluntary and informational) and (4) agents (governmental bodies (local and national), businesses and the community). This evaluation allows guidelines for enhancing success: (1) as experience increases, it is possible to deal with a greater complexity; and (2) integrated waste management requires a holistic approach, which encompasses a life cycle understanding of products and services. This in turn requires different specialisms to be involved in the instigation and analysis of an integrated waste management system. Taken together these advance the path to sustainability.     

Measurement and management of hospital waste in southern Iran: a case study

One of the requirements for development of human societies is the establishment of new healthcare centers. A variety of wastes are generated in healthcare centers depending on the type of activities. This study was conducted to identify, measure and manage different types of hospital wastes as a case study in a hospital located in southern Iran. For this purpose, a questionnaire was initially designed and distributed among the relevant experts to survey the current trend of waste management in the hospital in terms of waste collection, storage and disposal. Afterwards, the hospital waste was sampled during two seasons of fall and winter. The samples were weighted for seven consecutive days in the middle of each season. Approximately, 10 % of the total waste bags per day collected round the clock were selected for further analysis. The obtained results indicated that infectious-hazardous and pseudo-household wastes were, respectively, about 3.79 kg/day/bed, 1.36 kg/day/bed and 2.43 kg/day/bed of the total generated waste in the hospital. As the research findings suggest, proper separation of infectious and pseudo-household wastes at the source would be an essential step towards mitigating environmental and health risks and minimizing the cost of the hospital waste management.     

A system dynamics approach for hospital waste management

Healthcare services provided by hospitals may generate some infectious wastes. Although a large percentage of hospital waste is classified as general waste, which has similar nature as that of municipal solid waste and, therefore, could be disposed in municipal landfills, a small portion of infectious waste has to be managed in the proper manner in order to minimize risk to public health. Many factors involved in the hospital waste management system often link to one another, which require a comprehensive analysis to determine the role of each factor in the system. In this paper, we present a hospital waste management model based on system dynamics to determine the interaction among factors in the system using a software package, Stella. A case study of the City of Jakarta, Indonesia is selected. The hospital waste generation is affected by various factors including the number of beds in the hospitals and the NIMBY (not in my back yard) syndrome. To minimize the risk to public health, we found that waste segregation, as well as infectious waste treatment prior to disposal, has to be conducted properly by the hospital management, especially when scavenging takes place in landfill sites in developing countries.     

A multi-criteria assessment of scenarios on thermal processing of infectious hospital wastes: A case study for Central Macedonia

In Greece more than 14,000 tonnes of infectious hospital waste are produced yearly; a significant part of it is still mismanaged. Only one off-site licensed incineration facility for hospital wastes is in operation, with the remaining of the market covered by various hydroclave and autoclave units, whereas numerous problems are still generally encountered regarding waste segregation, collection, transportation and management, as well as often excessive entailed costs. Everyday practices still include dumping the majority of solid hospital waste into household disposal sites and landfills after sterilization, still largely without any preceding recycling and separation steps. Discussed in the present paper are the implemented and future treatment practices of infectious hospital wastes in Central Macedonia; produced quantities are reviewed, actual treatment costs are addressed critically, whereas the overall situation in Greece is discussed. Moreover, thermal treatment processes that could be applied for the treatment of infectious hospital wastes in the region are assessed via the multi-criteria decision method Analytic Hierarchy Process. Furthermore, a sensitivity analysis was performed and the analysis demonstrated that a centralized autoclave or hydroclave plant near Thessaloniki is the best performing option, depending however on the selection and weighing of criteria of the multi-criteria process. Moreover the study found that a common treatment option for the treatment of all infectious hospital wastes produced in the Region of Central Macedonia, could offer cost and environmental benefits. In general the multi-criteria decision method, as well as the conclusions and remarks of this study can be used as a basis for future planning and anticipation of the needs for investments in the area of medical waste management.     

The role played by environmental factors in the integration of a transfer station in a municipal solid waste management system

Transfer stations are an integral part of present-day municipal solid waste management systems. The main criteria used to decide on the location of a transfer station has traditionally been the minimization of transport costs, since it is cheaper to transport great amounts of waste over long distances in large loads than in small ones. In this study, we are going to consider the environmental factor in order to compare the feasibility of using a transfer station integrated within a waste management system. Applying the Life Cycle Assessment technique will enable us to obtain an objective parameter that quantifies the environmental impact of transportation and of operating a transfer station. Taking the current rates of solid wastes generation in the Plana region of Castellón (Spain) as our starting point, in this study we compare the environmental costs involved in the process of taking municipal wastes directly to the nearest waste treatment facility, with those involved in a waste management system integrating a transfer station. Comparing these two cases, an average reduction of 16.8% in the environmental impact can be obtained when a transfer station is incorporated in the waste management system.     

Hazardous chemical site remediation through capping: Problems with long-term protection

The capping of waste management units and contaminated soils is receiving increasing attention as a low-cost method for hazardous chemical site remediation. Capping is used to prevent further groundwater pollution by existing waste management units and contaminated soils through limiting the moisture that enters the wastes. In principle, for wastes located above the water table, the construction of an impermeable cap can prevent leaching of the wastes (leachate generation) and groundwater pollution. In practice, appropriately designed and constructed RCRA caps can provide for only short-term prevention of groundwater pollution. Alternative approaches are available for capping of wastes that can be effective in preventing moisture from entering the wastes and concomitant groundwater pollution. These approaches recognize the inability of the typical RCRA cap to keep wastes dry for as long as waste constituents will be a threat and, most importantly, provide the necessary funds to effectively address all plausible worst-case scenario failures that could occur at a capped waste management unit or contaminated soil area.     

Characteristics of healthcare wastes

A comprehensive understanding of the quantities and characteristics of the material that needs to be managed is one of the most basic steps in the development of a plan for solid waste management. In this case, the material under consideration is the solid waste generated in healthcare facilities, also known as healthcare waste. Unfortunately, limited reliable information is available in the open literature on the quantities and characteristics of the various types of wastes that are generated in healthcare facilities. Thus, sound management of these wastes, particularly in developing countries, often is problematic. This article provides information on the quantities and properties of healthcare wastes in various types of facilities located in developing countries, as well as in some industrialized countries. Most of the information has been obtained from the open literature, although some information has been collected by the authors and from reports available to the authors. Only data collected within approximately the last 15 years and using prescribed methodologies are presented. The range of hospital waste generation (both infectious and mixed solid waste fractions) varies from 0.016 to 3.23kg/bed-day. The relatively wide variation is due to the fact that some of the facilities surveyed in Ulaanbaatar include out-patient services and district health clinics; these facilities essentially provide very basic services and thus the quantities of waste generated are relatively small. On the other hand, the reported amount of infectious (clinical, yellow bag) waste varied from 0.01 to 0.65kg/bed-day. The characteristics of the components of healthcare wastes, such as the bulk density and the calorific value, have substantial variability. This literature review and the associated attempt at a comparative analysis point to the need for worldwide consensus on the terms and characteristics that describe wastes from healthcare facilities. Such a consensus would greatly facilitate comparative analyses among different facilities, studies and countries.     

Current status and future focus of hazardous waste management in China

 Rapid social and economic development in China has caused the amount of hazardous wastes being generated to increase drastically. The necessary regulations and systems regarding the management of hazardous wastes are currently still not in place. Based on an analysis of the characteristics of hazardous waste pollution and pollution trends in China, this paper reports on China's current status regarding hazardous waste management, and introduces the main difficulties to be faced. The principles and objectives, and the action plan for hazardous waste pollution control in China are also explained in detail. These principles and objectives have been stipulated in the Technological Policies on Hazardous Waste Pollution Control, which is issued by China State EPA, State ETC, and the Science and Technology Ministry. Received: April 30, 2002 / Accepted: October 17, 2002     

A method for livestock waste management planning in NE Spain

A method of decision-making on livestock wastes management in areas with nutrient surplus due to high livestock density is applied in Catalonia (NE Spain). Nutrient balance is made considering soil nitrogen application as the limiting factor. Special attention is paid to the centralized treatment option. The method presented consists of: 1. minimizing livestock waste generation (at farm scale) as a step previous to any other, both in amount and limiting components, 2. applying the nitrogen balance method at regional and municipal scale and providing enough storage capacity in order to apply wastes in an agronomically correct way, 3. spatially refining the results of the nitrogen balance by a proposed method that allows precisely pinpointing the hotspots of livestock waste generation, where centralized treatment might be an interesting option, and 4. deciding on the waste treatment objectives, provided that treatments be necessary. Knowledge about the wastes, meeting the interests and merging the efforts of the various actors, as well as an adequate budget are necessary ingredients for the success of any waste management plan.     

Municipal solid waste management in Rasht City, Iran

Pollution and health risks generated by improper solid waste management are important issues concerning environmental management in developing countries. In most cities, the use of open dumps is common for the disposal of wastes, resulting in soil and water resource contamination by leachate in addition to odors and fires. Solid waste management infrastructure and services in developing countries are far from achieving basic standards in terms of hygiene and efficient collection and disposal. This paper presents an overview of current municipal solid waste management in Rasht city, Gilan Province, Iran, and provides recommendations for system improvement. The collected data of different MSW functional elements were based on data from questionnaires, visual observations of the authors, available reports and several interviews and meetings with responsible persons. Due to an increase in population and changes in lifestyle, the quantity and quality of MSW in Rasht city has changed. Lack of resources, infrastructure, suitable planning, leadership, and public awareness are the main challenges of MSW management of Rasht city. However, the present situation of solid waste management in this city, which generates more than 400tons/d, has been improved since the establishment of an organization responsible only for solid waste management. Source separation of wastes and construction of a composting plant are the two main activities of the Rasht Municipality in recent years.     

An environmental analysis for comparing waste management options and strategies

The debate on different waste management practices has become an issue of utmost importance as human activities have overloaded the assimilative capacity of the biosphere. Recent Italian law on solid waste management recommends an increase in material recycling and energy recovery, and only foresees landfill disposal for inert materials and residues from recovery and recycling. A correct waste management policy should be based on the principles of sustainable development, according to which our refuse is not simply regarded as something to eliminate but rather as a potential resource. This requires the creation of an integrated waste management plan that makes full use of all available technologies. In this context, eMergy analysis is applied to evaluate three different forms of waste treatment and construct an approach capable of assessing the whole strategy of waste management. The evaluation included how much investment is needed for each type of waste management and how much "utility" is extracted from wastes, through the use of two indicators: Environmental yield ratio (EYR) and Net eMergy. Our results show that landfill is the worst system in terms of eMergy costs and eMergy benefits. Composting is the most efficient system in recovering eMergy (highest EYR) from municipal solid waste (MSW) while incineration is capable of saving the greatest quantity of eMergy per gram of MSW (highest net eMergy). This analysis has made it possible to assess the sustainability and the efficiency of individual options but could also be used to assess a greater environmental strategy for waste management, considering a system that might include landfills, incineration, composting, etc.     

Municipal solid waste management in Tehran: current practices, opportunities and challenges

Tehran, the capital city of Iran and a metropolis with a population of 8.2 million and containing 2.4 million households, generated 2,626,519 tons of solid waste in 2005. The present study is aimed at evaluating the generation, characteristics and management of solid waste in Tehran. Municipal solid waste comprises more than 97% of Tehran's solid waste, while three other types of solid waste comprise less than 3% of it, namely hospital waste (1.0%), industrial waste (0.6%) and construction and demolition waste (0.5%). The contribution of household solid waste to total municipal solid waste is about 62.5%. The municipality of Tehran is responsible for the solid waste management of the city; the waste is mainly landfilled in three centers in Tehran, with a small part of it usually recycled or processed as compost. However, an informal sector is also active in collecting recyclable materials from solid waste. The municipality has recently initiated some activities to mechanize solid waste management and reduce waste generation. There remain important challenges in solid waste management in Tehran which include: the proper collection and management of hospital waste; public education aimed at reducing and separating household waste and educating municipal workers in order to optimize the waste collection system; and the participation of other related organizations and the private sector in solid waste management.     

Disposal of solid waste in Istanbul and along the Black Sea coast of Turkey

The increasing amount of solid waste arising from municipalities and other sources and its consequent disposal has been one of the major environmental problems in Turkey. Istanbul is a metropolitan city with a current population of around 14 million, and produces about 9000 ton of solid waste every day. The waste composition for Istanbul has changed markedly from 1981 to 1996 with large decreases in waste density, much of which is related to decreased amounts of ash collected in winter. In recent years, the Istanbul region has implemented a new solid waste management system with transfer stations, sanitary landfills, and methane recovery, which has led to major improvements. In the Black Sea region of Turkey, most of the municipal and industrial solid wastes, mixed with hospital and hazardous wastes, are dumped on the nearest lowlands and river valleys or into the sea. The impact of riverside and seashore dumping of solid wastes adds significantly to problems arising from sewage and industry on the Black Sea coast. Appropriate integrated solid waste management systems are needed here as well; however, they have been more difficult to implement than in Istanbul because of more difficult topography, weaker administrative structures, and the lower incomes of the inhabitants.     

Getting to the bottom of food waste: identifying obstacles to effective circular economy practices in a Thai semi-urban context

Journal of Material Cycles and Waste Management - In 2016, Thailand has instituted a national master plan to gradually improve the management of all types of solid waste, calling upon the...     

Planning for integrated solid waste management at the industrial park level: a case of Tianjin, China

Industrial parks play a significant role in the production and use of goods and services. The proper management of solid waste is a major challenge for industrial parks due to the large quantity of wastes and the variability of waste characteristics from these types of developments. Therefore, integrated solid waste management has become very crucial to the industrial park managers. Such an approach requires industrial park managers to assess the overall use of resources, and to seek waste reduction, reuse and recycling opportunities both at the individual company level and among different tenant companies. The adoption of this method can bring both economic and environmental benefits. This paper introduces the planning efforts of a real case in China. It first presents the basic information on Tianjin Economic Development Area (TEDA), and then introduces its current practices on solid waste management. The main focus of this paper is to describe how to plan an integrated solid waste management system at TEDA. Benefits and challenges are all identified and analyzed. The experiences and methods from this case study should be applied in other industrial parks so as to improve the overall eco-efficiency of the whole industrial park.