Medical waste generation in selected clinical facilities in Taiwan

This study investigated the type and amount of medical waste generated from small clinical facilities in Taiwan. We sampled 200 small medical establishments, with few or no patient beds, to survey the wastes generated and disposed. The surveyed medical facilities consisted of four groups including private clinics, medical laboratories, blood centers and public clinics. Private clinics providing surgical, dental, obstetrical, and dialysis services were included in this survey because they may generate higher amounts of infectious waste than other specialties. The overall mean general waste production rate was 3.97 kg/bed/day (or 0.075 kg/patient/day) at all the surveyed facilities, higher than that obtained from larger hospitals in Taiwan, which ranged from 2.41 to 3.26 kg/bed/day. The highest amount of infectious wastes generated among the four groups of facilities were from blood centers (3.14 kg/bed/day), followed by private clinics, medical laboratories and public clinics (1.91, 1.07, and 0.053 kg/bed/day, respectively). The overall average was 2.08 kg/bed/day. This study suggests that the waste generated at small medical facilities ranged widely.     

Healthcare waste management in Algeria and Mostaganem department

Algeria as other developing countries faces an array of challenges for healthcare waste management. The management of healthcare waste is of major importance due to its public health risks and potential environmental hazards. Many efforts have been made by the government authorities in order to better manage the waste from healthcare facilities. However most healthcare facilities do not comply with the principles stated in Algerian legislation. A data study was made on 95 hospitals across the country, and the three health sectors of Mostaganem department (Mostaganem, Ain Tédles, and Sidi Ali) were surveyed. The yearly production of infectious healthcare waste in this Algerian department is estimated at 92 tons, which is 1.38% of the national waste production. This represents an average of 0.15 kg/bed/day, which is lower than the national value of 0.72 kg/bed/day. The total healthcare waste by sector ranges from 0.7 to 1.22 kg/bed/day, and healthcare waste comprises 16% of total waste, which is equal to the national percentage.     

A total quality management approach to healthcare waste management in Namazi Hospital,Iran

BackgroundHealthcare waste comprises all wastes generated at healthcare facilities, medical research centers and laboratories. Although 75–90% of these wastes are classified as household waste posing no potential risk, 10–25% are deemed to be hazardous, representing a potential threat to healthcare workers, patients, the environment and even the general population, if not disposed of appropriately. If hazardous and non-hazardous waste is mixed and not segregated prior to disposal, costs will increase substantially. Medical waste management is a worldwide issue. In Iran, the majority of problems are associated with an exponential growth in the healthcare sector together with low- or non-compliance with guidelines and recommendations. The aim of this study was to reduce the amounts of infectious waste by clear definition and segregation of waste at the production site in Namazi Hospital in Shiraz, Iran.Materials and methodsNamazi Hospital was selected as a study site with an aim to achieving a significant decrease in infectious waste and implementing a total quality management (TQM) method. Infectious and non-infectious waste was weighed at 29 admission wards over a 1-month period.ResultsBefore the introduction of the new guidelines and the new waste management concept, weight of total waste was 6.67 kg per occupied bed per day (kg/occupied bed/day), of which 73% was infectious and 27% non-infectious waste. After intervention, total waste was reduced to 5.92 kg/occupied bed/day, of which infectious waste represented 61% and non-infectious waste 30%. The implementation of a new waste management concept achieved a 26% reduction in infectious waste.ConclusionA structured waste management concept together with clear definitions and staff training will result in waste reduction, consequently leading to decreased expenditure in healthcare settings.     

Medical waste management in China: A case study of Nanjing

Medical waste management is of great importance due to its infectious and hazardous nature that can cause undesirable effects on humans and the environment. The objective of this study was to analyze and evaluate the present status of medical waste management in the light of medical waste control regulations in Nanjing. A comprehensive inspection survey was conducted for 15 hospitals, 3 disposal companies and 200 patients. Field visits and a questionnaire survey method were implemented to collect information regarding different medical waste management aspects, including medical waste generation, segregation and collection, storage, training and education, transportation, disposal, and public awareness.The results indicated that the medical waste generation rate ranges from 0.5 to 0.8 kg/bed day with a weighted average of 0.68 kg/bed day. The segregated collection of various types of medical waste has been conducted in 73% of the hospitals, but 20% of the hospitals still use unqualified staff for medical waste collection, and 93.3% of the hospitals have temporary storage areas. Additionally, 93.3% of the hospitals have provided training for staff; however, only 20% of the hospitals have ongoing training and education. It was found that the centralized disposal system has been constructed based on incineration technology, and the disposal cost of medical waste is about 580 US$/ton. The results also suggested that there is not sufficient public understanding of medical waste management, and 77% of respondents think medical waste management is an important factor in selecting hospital services.The problematic areas of medical waste management in Nanjing are addressed by proposing some recommendations that will ensure that potential health and environmental risks of medical waste are minimized.     

Analysis of potential RDF resources from solid waste and their energy values in the largest industrial city of Korea

The production potential of refuse derived fuel (RDF) in the largest industrial city of Korea is discussed. The purpose of this study is to evaluate the energy potential of the RDF obtained from utilizing combustible solid waste as a fuel resource. The total amount of generated solid waste in the industrial city was more than 3.3 million tonnes, which is equivalent to 3.0 tonnes per capita in a single year. The highest amount of solid waste was generated in the city district with the largest population and the biggest petrochemical industrial complex (IC) in Korea. Industrial waste accounted for 89% of the total amount of the solid waste in the city. Potential RDF resources based on combustible solid wastes including wastepaper, wood, rubber, plastic, synthetic resins and industrial sludge were identified. The amount of combustible solid waste that can be used to produce RDF was 635,552 tonnes/yr, consisting of three types of RDF: 116,083 tonnes/yr of RDF-MS (RDF from municipal solid waste); 146,621 tonnes/yr of RDF-IMC (RDF from industrial, municipal and construction wastes); and 372,848 tonnes/yr of RDF-IS (RDF from industrial sludge). The total obtainable energy value from the RDF resources in the industrial city was more than 2,240,000 × 10⁶ kcal/yr, with the following proportions: RDF-MS of 25.6%, RDF-IMC of 43.5%, and RDF-IS of 30.9%. If 50% or 100% of the RDF resources are utilized as fuel resources, the industrial city can save approximately 17.6% and 35.2%, respectively, of the current total disposal costs.     

Medical waste production at hospitals and associated factors

This study was conducted to evaluate the quantities of medical waste generated and the factors associated with the generation rate at medical establishments in Taiwan. Data on medical waste generation at 150 health care establishments were collected for analysis in 2003. General medical waste and infectious waste production at these establishments were examined statistically with the potential associated factors. These factors included the types of hospital and clinic, reimbursement payment by National Health Insurance, total number of beds, bed occupancy, number of infectious disease beds and outpatients per day. The average waste generation rates ranged from 2.41 to 3.26kg/bed/day for general medical wastes, and 0.19-0.88kg/bed/day for infectious wastes. The total average quantity of infectious wastes generated was the highest from medical centers, or 3.8 times higher than that from regional hospitals (267.8 vs. 70.3Tons/yr). The multivariate regression analysis was able to explain 92% of infectious wastes and 64% of general medical wastes, with the amount of insurance reimbursement and number of beds as significant prediction factors. This study suggests that large hospitals are the major source of medical waste in Taiwan. The fractions of medical waste treated as infectious at all levels of healthcare establishments are much greater than that recommended by the USCDC guidelines.     

Composition and production rate of medical waste from a small producer in Greece

The objective of this work was to determine the composition and production rate of medical waste from the health care facility of social insurance institute, a small waste producer in Xanthi, Greece. Specifically, produced medical waste from the clinical pathology (medical microbiology) laboratory, the X-ray laboratory and the surgery and injection therapy departments of the health facility was monitored for six working weeks. A total of 240 kg medical solid waste was manually separated and weighed and 330 L of liquid medical waste was measured and classified. The hazardous waste fraction (%w/w) of the medical solid waste was 91.6% for the clinical pathology laboratory, 12.9% for the X-ray laboratory, 24.2% for the surgery departments and 17.6% for the injection therapy department. The infectious waste fraction (%w/w) of the hazardous medical solid waste was 75.6% for the clinical pathology laboratory, 0% for the X-ray laboratory, 100% for the surgery departments and 75.6% for the injection therapy department. The total hazardous medical solid waste production rate was 64 ± 15 g/patient/d for the clinical pathology laboratory, 7.2 ± 1.6 g/patient/d for the X-ray laboratory, 8.3 ± 5.1 g/patient/d for the surgery departments and 24 ± 9 g/patient/d for the injection therapy department. Liquid waste was produced by the clinical pathology laboratory (infectious-and-toxic) and the X-ray laboratory (toxic). The production rate for the clinical pathology laboratory was 0.03 ± 0.003 L/patient/d and for the X-ray laboratory was 0.06 ± 0.006 L/patient/d. Due to the small amount produced, it was suggested that the most suitable management scheme would be to transport the hazardous medical waste, after source-separation, to the Prefectural Hospital of Xanthi to be treated with the hospital waste. Assuming this data is representative of other small medical facilities, medical waste production can be estimated for such facilities distributed around Greece.     

Sustainable sanitary landfills for neglected small cities in developing countries: The semi-mechanized trench method from Villanueva,Honduras

Open dumping is the most common practice for the disposal of urban solid wastes in the least developed regions of Africa, Asia and Latin America. Sanitary landfill design and operation has traditionally focused on large cities, but cities with fewer than 50,000 in population can comprise from 6% to 45% of a given country’s total population. These thousands of small cities cannot afford to operate a sanitary landfill in the way it is proposed for large cities, where heavy equipment is used to spread and compact the waste in daily cells, and then to excavate, transport and apply daily cover, and leachate is managed with collection and treatment systems. This paper presents an alternative approach for small cities, known as the semi-mechanized trench method, which was developed in Villanueva, Honduras. In the semi-mechanized trench method a hydraulic excavator is used for 1–3 days to dig a trench that will last at least a month before it is filled with waste. Trucks can easily unload their wastes into the trench, and the wastes compact naturally due to semi-aerobic biodegradation, after which the trenches are refilled and covered. The exposed surface area is minimal since only the top surface of the wastes is exposed, the remainder being covered by the sides and bottom of the trench. The surplus material from trench excavation can be valorized for use as engineering fill onsite or off. The landfill in Villanueva has operated for 15 years, using a total land area of approximately 11 ha for a population that grew from 23,000 to 48,000, with a land requirement of 0.2 m²/person year, a cover to waste ratio of 0.2, and an estimated soil surplus of 298,000 m³ that is valorized and used onsite. The landfill has been operated solely by the municipality with an operational cost in 2010 estimated at US$4.60 per ton. A modified water balance analysis at Villanueva shows negligible leachate generation from covered trenches and 700 m³/yr (60 m³/ha yr) from the two open trenches required for daily operation. If the site were an open dump, however, leachate generation is estimated to be 3900 m³/ha yr and contaminated runoff 5000 m³/ha yr. A simple model used to estimate dilution of generated leachate based on groundwater flow data and aquifer stratigraphy suggests that the leachate will be diluted by a factor of 0.01 in the aquifer. Leachate contaminants will not accumulate because the aquifer discharges to the Ulua River 2 km south of the landfill. While not suitable for all sites, the Villanueva method nevertheless serves as an excellent example of how a small city landfill with natural compaction of waste and attenuation of leachate can be sustainably operated.     

Potential of anaerobic digestion for material recovery and energy production in waste biomass from a poultry slaughterhouse

This study was carried out to assess the material and energy recovery by organic solid wastes generated from a poultry slaughterhouse. In a poultry slaughterhouse involving the slaughtering of 100,000 heads per day, poultry manure & feather from the mooring stage, blood from the bleeding stage, intestine residue from the evisceration stage, and sludge cake from the wastewater treatment plant were discharged at a unit of 0.24, 4.6, 22.8, and 2.2 Mg day^?1, consecutively. The amount of nitrogen obtained from the poultry slaughterhouse was 22.36 kg 1000 head^?1, phosphate and potash were 0.194 kg 1000 head^?1 and 0.459 kg 1000 head^?1, respectively. As regards nitrogen recovery, the bleeding and evisceration stages accounted for 28.0% and 65.8% of the total amount of recovered nitrogen. Energy recovered from the poultry slaughterhouse was 35.4 N m³ 1000 head^?1 as CH₄. Moreover, evisceration and wastewater treatment stage occupied 88.1% and 7.2% of the total recovered CH₄ amount, respectively.     

Long-term thermophilic mono-digestion of rendering wastes and co-digestion with potato pulp

In this study, mono-digestion of rendering wastes and co-digestion of rendering wastes with potato pulp were studied for the first time in continuous stirred tank reactor (CSTR) experiments at 55 °C. Rendering wastes have high protein and lipid contents and are considered good substrates for methane production. However, accumulation of digestion intermediate products viz., volatile fatty acids (VFAs), long chain fatty acids (LCFAs) and ammonia nitrogen (NH₄-N and/or free NH₃) can cause process imbalance during the digestion. Mono-digestion of rendering wastes at an organic loading rate (OLR) of 1.5 kg volatile solids (VS)/m³ d and hydraulic retention time (HRT) of 50 d was unstable and resulted in methane yields of 450 dm³/kg VS_fed. On the other hand, co-digestion of rendering wastes with potato pulp (60% wet weight, WW) at the same OLR and HRT improved the process stability and increased methane yields (500–680 dm³/kg VS_fed). Thus, it can be concluded that co-digestion of rendering wastes with potato pulp could improve the process stability and methane yields from these difficult to treat industrial waste materials.     

Co-composting rice hulls and/or sawdust with poultry manure in NE Argentina

Rice hulls and sawdust are two common C-rich wastes derived from rice and timber agro-industries in subtropical NE Argentina. An alternative to the current management of these wastes (from bedding to uncontrolled burning) is composting. However, given their C-rich nature and high C/N ratio, adequate composting requires mixing with a N-rich waste, such as poultry manure. The effect of different proportions of poultry manure, rice hulls and/or sawdust on composting efficiency and final compost quality was studied. Five piles were prepared with a 2:1 and 1:1 ratio of sawdust or rice hulls to poultry manure, and 1:1:1 of all three materials (V/V). Different indicators of compost stability and quality were measured. Thermophilic phase was shorter for piles with rice hulls than for piles with sawdust (60 days vs. 105 days). Time required for stability was similar for both C-rich wastes (about 180 days). Characteristics of final composts were: pH 5.8–7.2, electrical conductivity 2.5–3.3 mS/cm, organic C 20–26%, total N 2.2–2.9%, lignin 19–22%, total Ca 18–24 g/kg, and extractable P 6–8 g/kg, the latter representing 60% of total P. Nitrogen conservation was high in all piles, especially in the one containing both C-rich wastes. Piles with sawdust were characterized by high total and available N, while piles with only rice hulls had higher Si, K and pH. Extractable P was higher in 1:1 piles, and organic C in 2:1 piles.     

Solid waste recycling in Rajshahi city of Bangladesh

Efficient recycling of solid wastes is now a global concern for a sustainable and environmentally sound management. In this study, traditional recycling pattern of solid waste was investigated in Rajshahi municipality which is the fourth largest city of Bangladesh. A questionnaire survey had been carried out in various recycle shops during April 2010 to January 2011. There were 140 recycle shops and most of them were located in the vicinity of Stadium market in Rajshahi. About 1906 people were found to be involved in recycling activities of the city. The major fraction of recycled wastes were sent to capital city Dhaka for further manufacture of different new products. Only a small amount of wastes, specially plastics, were processed in local recycle factories to produce small washing pots and bottle caps. Everyday, an estimated 28.13 tons of recycled solid wastes were handled in Rajshahi city area. This recycled portion accounted for 8.25% of the daily total generated wastes (341 ton d^?1), 54.6% of total recyclable wastes (51.49 ton d^?1) and 68.29% of readily recyclable wastes (41.19 ton d^?1). Major recycled materials were found to be iron, glass, plastic, and papers. Only five factories were involved in preliminary processing of recyclable wastes. Collecting and processing secondary materials, manufacturing recycled-content products, and then buying recycled products created a circle or loop that ensured the overall success of recycling and generated a host of financial, environmental, and social returns.     

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.     

High solids co-digestion of food and landscape waste and the potential for ammonia toxicity

A pilot-scale study was completed to determine the feasibility of high-solids anaerobic digestion (HSAD) of a mixture of food and landscape wastes at a university in central Pennsylvania (USA). HSAD was stable at low loadings (2 g COD/L-day), but developed inhibitory ammonia concentrations at high loadings (15 g COD/L-day). At low loadings, methane yields were 232 L CH₄/kg COD fed and 229 L CH₄/kg VS fed, and at high loadings yields were 211 L CH₄/kg COD fed and 272 L CH₄/kg VS fed. Based on characterization and biodegradability studies, food waste appears to be a good candidate for HSAD at low organic loading rates; however, the development of ammonia inhibition at high loading rates suggests that the C:N ratio is too low for use as a single substrate. The relatively low biodegradability of landscape waste as reported herein made it an unsuitable substrate to increase the C:N ratio. Codigestion of food waste with a substrate high in bioavailable carbon is recommended to increase the C:N ratio sufficiently to allow HSAD at loading rates of 15 g COD/L-day.     

Effect of an acidic and readily-biodegradable non-hazardous industrial process waste on refuse decomposition

Non-hazardous industrial process wastes are receiving increased interest from landfill owners, especially with respect to bioreactor operation. These wastes could benefit bioreactors as they represent sources of liquid, nutrients, and/or substrate as well as revenue. However, landfill operators should exercise caution in accepting these wastes, as some could have detrimental effects on refuse decomposition. In this research, the use of laboratory-scale tests to evaluate the effect of one such waste on refuse decomposition is demonstrated. The waste evaluated, referred to as burnt sugar, is an acidic byproduct of corn-based polylactic acid production and represents a source of readily-biodegradable carbon. Lactic acid was the primary constituent of the BS at 0.73 g/g and the COD was measured at 1230 mg COD/g. Testing protocols were adapted to address the specific concerns surrounding the material. Abiotic dissolution tests conducted at mesophilic temperatures indicated that the majority of the waste dissolved into leachate recirculated over a layer of the waste within several days. Abiotic mixing tests suggested that the waste would acidify refuse to pH 6.41 at a loading of 21.9 g/dry kg refuse. However, in biologically active tests, the refuse was able to convert loadings as high as 196.7 g/dry kg refuse to methane. As the loadings increased toward and beyond this level, pronounced detrimental effects to the refuse ecosystem were observed, including a decrease in pH, accumulation of volatile fatty acids and COD, and lag in methane production. The results suggested that actively decomposing refuse has the potential to attenuate relatively high loading of a rapidly degradable but acidic substrate. Nonetheless, caution in the implementation of a field program to accept rapidly biodegradable acidic wastes is critical.     

Municipal solid waste characteristics and management in Gümüşhane, Turkey

This paper presents a general overview of the current municipal solid waste (MSW) management in Gümüşhane Province, Turkey. In order to characterize the solid waste stream in the Municipality of Gümüşhane, a long-term study was conducted over a 52-week period between the spring of 2004 and the winter of 2005. In this study, percentage of components and specific weight of the MSW, the composting parameters (moisture content, total organic carbon, total nitrogen and pH), organic matter content, calorific value and the heavy metal concentrations (Cd, Cr, Cu, Ni, Pb, Zn, Fe, Mn, Co) of the compostable wastes sorted from the mixed MSW were determined and evaluated. In Gümüşhane, a mean of 70 tons of MSW are generated each day or 1 kg/day/capita. Approximately 4500 kg of the MSW were collected and sorted in a year, and the mean specific weight of these is 308 kg/m³. Approximately 30% of the MSW generated is compostable wastes and the yearly mean moisture content, organic matter content, C/N ratio and pH of these are 78%, 92.1%, 21.6/1 and 4.73, respectively, and approximately 24% of the MSW consists of recyclable materials. The recommended system deals with maximizing recycling and minimizing landfilling of the MSW, and consists of separation at source, collection, sorting, recycling, composting and sanitary landfilling. Heavy metal concentrations of the compostable wastes from the open dump were determined to decrease in the following order: Fe > Mn > Zn > Cr > Cu > Pb > Ni > Cd > Co.     

Investigation of health care waste management in Binzhou District,China

In China, national regulations and standards for health care waste management were implemented in 2003. To investigate the current status of health care waste management at different levels of health care facilities (HCF) after the implementation of these regulations, one tertiary hospital, one secondary hospital, and four primary health care centers from Binzhou District were visited and 145 medical staff members and 24 cleaning personnel were interviewed.Generated medical waste totaled 1.22, 0.77, and 1.17 kg/bed/day in tertiary, secondary, and primary HCF, respectively. The amount of medical waste generated in primary health care centers was much higher than that in secondary hospitals, which may be attributed to general waste being mixed with medical waste. This study found that the level of the HCF, responsibility for medical waste management in departments and wards, educational background and training experience can be factors that determine medical staff members’ knowledge of health care waste management policy. Regular training programs and sufficient provision of protective measures are urgently needed to improve occupational safety for cleaning personnel. Financing and administrative monitoring by local authorities is needed to improve handling practices and the implementation of off-site centralized disposal in primary health care centers.     

Determination of biogas generation potential as a renewable energy source from supermarket wastes

Fruit, vegetable, flower waste (FVFW), dairy products waste (DPW), meat waste (MW) and sugar waste (SW) obtained from a supermarket chain were anaerobically digested, in order to recover methane as a source of renewable energy. Batch mesophilic anaerobic reactors were run at total solids (TS) ratios of 5%, 8% and 10%. The highest methane yield of 0.44 L CH₄/g VS_added was obtained from anaerobic digestion of wastes (FVFW + DPW + MW + SW) at 10% TS, with 66.4% of methane (CH₄) composition in biogas. Anaerobic digestion of mixed wastes at 5% and 8% TS provided slightly lower methane yields of 0.41 and 0.40 L CH₄/g VS_added, respectively. When the wastes were digested alone without co-substrate addition, the highest methane yield of 0.40 L CH₄/g VS_added was obtained from FVFW at 5% TS. Generally, although the volatile solids (VS) conversion percentages seemed low during the experiments, higher methane yields could be obtained from anaerobic digestion of supermarket wastes. A suitable carbon/nitrogen (C/N) ratio, proper adjustment of the buffering capacity and the addition of essential trace nutrients (such as Ni) could improve VS conversion and biogas production yields significantly.     

Assessment of medical wastes management practice: a case study of the northern part of Jordan

This study includes a survey of the procedures available, techniques, and methods of handling and disposing of medical waste at medium (between 100 and 200 beds) to large (over 200 beds) size healthcare facilities located in Irbid city (a major city in the northern part of Jordan). A total of 14 healthcare facilities, including four hospitals and 10 clinical laboratories, serving a total population of about 1.5 million, were surveyed during the course of this research. This study took into consideration both the quantity and quality of the generated wastes to determine generation rates and physical properties. Results of the survey showed that healthcare facilities in Irbid city have less appropriate practices when it comes to the handling, storage, and disposal of wastes generated in comparison to the developed world. There are no defined methods for handling and disposal of these wastes, starting from the personnel responsible for collection through those who transport the wastes to the disposal site. Moreover, there are no specific regulations or guidelines for segregation or classification of these wastes. This means that wastes are mixed, for example, wastes coming from the kitchen with those generated by different departments. Also, more importantly, none of the sites surveyed could provide estimated quantities of waste generated by each department, based upon the known variables within the departments. Average generation rates of total medical wastes in the hospitals were estimated to be 6.10 kg/patient/day (3.49 kg/bed/day), 5.62 kg/patient/day (3.14 kg/bed/day), and 4.02 kg/patient/day (1.88 kg/bed/day) for public, maternity, and private hospitals, respectively. For medical laboratories, rates were found to be in the range of 0.053-0.065 kg/test-day for governmental laboratories, and 0.034-0.102 kg/test-day for private laboratories. Although, based on the type of waste, domestic or general waste makes up a large proportion of the waste volume, so that if such waste is not mixed with patient derived waste, it can be easily handled. However, based on infections, it is important for healthcare staff to take precautions in handling sharps and pathological wastes, which comprises only about 26% of the total infectious wastes. Statistical analysis was conducted to develop mathematical models to aid in the prediction of waste quantities generated by the hospitals studied, or similar sites in the city that are not included in this study. In these models, the number of patients, number of beds, and hospital type were determined to be significant factors on waste generation. Such models provide decision makers with tools to better manage their medical waste, given the dynamic conditions of their healthcare facilities.     

Continuous-feeding vermicomposting as a recycling management method to revalue tomato-fruit wastes from greenhouse crops

Huge quantities of discarded fruits generated from greenhouse crops represent a worldwide environmental problem. The aim of this work was to assess the efficiency of vermicomposting as a recycling management option for biotransforming tomato-fruit wastes from greenhouses into an organic nutrient-rich product available for agricultural purposes. A pilot vermireactor was constructed. It was provided with a manure layer, where an initial population of Eisenia fetida was introduced and fed continuously at a high organic loading rate (13.6 kg TOC m^?3 wk^?1) for 150 days. Vermicompost chemical and enzymatic parameters as well as the bacterial and fungal community structure were determined for 210 days (vermicomposting plus a maturation period). Earthworm biomass increased after 90 days, and then declined due to increasing pH, electrical conductivity and ammonium concentration. The temporal patterns of dehydrogenase, β-glucosidase, protease and urease were related to earthworm growth and the stabilization of organic matter. Bacterial DGGE profiles differed between the period of degradation of labile substrates and the maturation step. Fungal communities at the stage of maximum earthworm biomass differed most, suggesting a gut passage effect. The end product was chemically stable and enriched in nutrients, demonstrating that tomato-fruit wastes can be successfully vermicomposted into a valuable soil amendment. We suggest continuous-feeding vermicomposting as an environmentally sound management option for greenhouse wastes.