Solid waste workers and livelihood strategies in Greater Port-au-Prince,Haiti

The solid waste management industry in Haiti is comprised of a formal and an informal sector. Many basic activities in the solid waste management sector are being carried out within the context of profound poverty, which exposes the failure of the socioeconomic and political system to provide sufficient job opportunities for the urban population. This paper examines the involvement of workers in the solid waste management industry in Greater Port-au-Prince and the implications for livelihood strategies. The findings revealed that the Greater Port-au-Prince solid waste management system is very inclusive with respect to age, while highly segregated with regard to gender. In terms of earning capacity, the results showed that workers hired by the State agencies were the most economically vulnerable group as more than 50% of them fell below the official nominal minimum wage. This paper calls for better salary scales and work compensation for the solid waste workers.     

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.     

Infectious waste management in Japan: a revised regulation and a management process in medical institutions

In Japan, the waste management practice is carried out in accordance with the Waste Disposal Law of 1970. The first rule of infectious waste management was regulated in 1992, and infectious wastes are defined as the waste materials generated in medical institutions as a result of medical care or research which contain pathogens that have the potential to transmit infectious diseases. Revised criteria for infectious waste management were promulgated by the Ministry of Environment in 2004. Infectious waste materials are divided into three categories: the form of waste; the place of waste generation; the kind of infectious diseases. A reduction of infectious waste is expected. We introduce a summary of the revised regulation of infectious waste management in this article.     

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.     

Report: biomedical waste management practices at Balrampur Hospital, Lucknow, India.

Biomedical waste has become a serious health hazard in many countries, including India. Careless and indiscriminate disposal of this waste by healthcare establishments and research institutions can contribute to the spread of serious diseases such as hepatitis and AIDS (HIV) among those who handle it and also among the general public. The present study pertains to the biomedical waste management practices at Balrampur Hospital, a premier healthcare establishment in Lucknow, in North India. The study shows that infectious and non-infectious wastes are dumped together within the hospital premises, resulting in a mixing of the two, which are then disposed of with municipal waste at the dumping sites in the city. All types of wastes are collected in common bins placed outside the patients wards. For disposal of this waste the hospital depends on the generosity of the Lucknow Municipal Corporation, whose employees generally collect it every 2 or 3 days. The hospital does not have any treatment facility for infectious waste. The laboratory waste materials, which are disposed of directly into the municipal sewer without proper disinfection of pathogens, ultimately reach the Gomti River. All disposable plastic items are segregated by the rag pickers from the hospital as well as municipal bins and dumps. The waste is deposited either inside the hospital grounds, or outside in the community bin for further transportation and disposal along with municipal solid waste. The open dumping of the waste makes it freely accessible to rag pickers who become exposed to serious health hazards due to injuries from sharps, needles and other types of material used when giving injections. The results of the study demonstrate the need for strict enforcement of legal provisions and a better environmental management system for the disposal of biomedical waste in the Balrampur Hospital, as well as other healthcare establishments in Lucknow.     

Waste collection in developing countries – Tackling occupational safety and health hazards at their source

Waste management procedures in developing countries are associated with occupational safety and health risks. Gastro-intestinal infections, respiratory and skin diseases as well as muscular-skeletal problems and cutting injuries are commonly found among waste workers around the globe. In order to find efficient, sustainable solutions to reduce occupational risks of waste workers, a methodological risk assessment has to be performed and counteractive measures have to be developed according to an internationally acknowledged hierarchy. From a case study in Addis Ababa, Ethiopia suggestions for the transferral of collected household waste into roadside containers are given. With construction of ramps to dump collected household waste straight into roadside containers and an adaptation of pushcarts and collection procedures, the risk is tackled at the source.     

Mad cow and related diseases: Challenges for waste management

Mad cow disease and related transmissible spongiform encephalopathy diseases (TSEs) in both animals and humans have received worldwide attention. Interestingly, the issue of managing biohazardous wastes, for which TSE agents are an issue, has received little attention by environmental professionals. The burial of wastes associated with mad cow and related diseases may eventually lead to unusual challenges for remediation professionals. The core challenge is that medical researchers have confirmed the incredible difficulty in destroying TSE infectious agents or pathogens, generally called prions. Risk reduction is certainly possible with treatment technologies, but complete elimination of risk by reliable and verifiable destruction of all TSE agents is probably infeasible. Proving the efficacy of any waste treatment method for TSE-infected wastes is not practical because there is no commercially available test for TSE pathogens (although one is expected soon) and in only a few cases is there a reasonable surrogate approach. These circumstances have contributed to some biohazardous waste managers discounting the TSE issue. The goal of this article is to more thoroughly analyze available information and various risks to identify useful implications for alternative waste management technologies. A number of prudent actions can be taken in recognition of the TSE problem, including more careful assessment of treatment technologies, avoiding any reuse or recycling of waste treatment residues, using air pollution control systems to avoid releases of materials possibly containing infectious agents, and using wastewater pretreatment prior to sewer disposal.     

Composition and production rate of solid waste from dental laboratories in Xanthi, Greece

The composition and production rate of solid waste produced by four dental laboratories were measured in the Prefecture of Xanthi (Greece) during 2002. The selected dental labs in Xanthi were expected to produce approximately 75% of the waste produced from of all seven dental laboratories in the Xanthi Prefecture. Sampling was performed during a 2-month period. Solid waste was categorized into three major categories: (a) infectious and potentially infectious waste, (b) non-infectious toxic waste and (c) household type solid waste. Dental laboratories solid waste (DLSW) was produced at a rate of 0.059 g/cap/day (or 22 g/cap/year) at the time of the study. Household type waste, infectious and potentially infectious waste and non-infectious toxic waste comprised approximately 74%, 26% and less than 0.5% of the total DLSW weight produced, respectively. DLSW was estimated to be approximately 0.007% of the amount of municipal solid waste produced in the Prefecture of Xanthi.     

Conventional and alternative technologies for the treatment of infectious waste

 The limited scientific information about infectious waste, and the heightened public awareness of this special component of the waste stream, have contributed to the implementation or strengthening of the regulations in this area. This paper proposes a general working definition of infectious waste, and describes the systems used to limit its potential occupational and public health impacts. Although incineration and autoclaving are the most widely used methods of treating infectious waste, the introduction of more stringent air-quality standards for incinerators, and the inherent limitations to the application of autoclaves, have created a demand for other methods of processing this segment of the solid and liquid waste streams. These alternative technologies use one or more of the following methods: (1) heating the waste to a minimum of 90–95°C; (2) exposing the waste to suitable chemicals; (3) subjecting the waste to heated chemicals; (4) irradiating the infectious waste with ionizing sources. The advantages and disadvantages of each of these alternative forms of treatment are discussed in this paper. Received: April 22, 2002 / Accepted: October 14, 2002     

Composition and production rate of dental solid waste in Xanthi, Greece: variability among dentist groups

The objective of this work was to determine the composition and production rate of dental solid waste, produced by dental practices in the Prefecture of Xanthi, a multicultural area in Northeast Greece with a population of 102,000. For the study, 22 private dental practices and 1 public dental practice were selected of the 48 private and 5 public dental practices in operation. The 22 private dental practices included 16 owned by Christian Greek-born dentists, 3 by Moslem dentists and 3 by Christian dentists repatriated from the former Soviet Union. Differentiation on the basis of religion is directly related to the countries from which dentists received their training, e.g., Greece-European Union, Turkey and former Soviet Union. Thus, including the one public dental practice, 4 study groups were considered. Waste collection took place for 22 working days, from 20 May to 27 June 2002. This period was considered to be a representative one for a semi-rural area, such as Xanthi. Dentists were instructed to collect the total amount of waste they produced. A total of 260 kg dental solid waste was collected during the study period and was manually separated. Dental solid waste was classified in three main categories: (1) Infectious and potentially infectious waste, accounting for 94.7% by weight. (2) Non-infectious waste accounting for 2.0%. (3) Domestic-type waste, accounting for 3.3% by weight. The category of infectious waste is classified as hazardous and includes components containing metal (8.51%), components without metal (91.18%) and amalgam (0.33%). Using the weight data, the production rate of dental solid waste for the study period in the Prefecture of Xanthi was determined to be 513 g/practice/day and of infectious and potentially infectious waste 486 g/practice/day. The latter includes the production rate of sharps (9.8 g/practice/day), non-sharps (31.6), infectious waste without metal (443) and amalgam (1.6 g/practice/day). Since dental solid waste is currently disposed of in landfills together with the municipal solid waste, the results of the study were used to suggest an appropriate management scheme. The results were also used to compare the composition and production rates of dental solid waste produced by the 4 study groups.     

Disaster waste management: a review article

Depending on their nature and severity, disasters can create large volumes of debris and waste. The waste can overwhelm existing solid waste management facilities and impact on other emergency response and recovery activities. If poorly managed, the waste can have significant environmental and public health impacts and can affect the overall recovery process.This paper presents a system overview of disaster waste management based on existing literature. The main literature available to date comprises disaster waste management plans or guidelines and isolated case studies. There is ample discussion on technical management options such as temporary storage sites, recycling, disposal, etc.; however, there is little or no guidance on how these various management options are selected post-disaster. The literature does not specifically address the impact or appropriateness of existing legislation, organisational structures and funding mechanisms on disaster waste management programmes, nor does it satisfactorily cover the social impact of disaster waste management programmes.It is envisaged that the discussion presented in this paper, and the literature gaps identified, will form a basis for future comprehensive and cohesive research on disaster waste management. In turn, research will lead to better preparedness and response to disaster waste management problems.     

Clinical solid waste management practices and its impact on human health and environment--A review

The management of clinical solid waste (CSW) continues to be a major challenge, particularly, in most healthcare facilities of the developing world. Poor conduct and inappropriate disposal methods exercised during handling and disposal of CSW is increasing significant health hazards and environmental pollution due to the infectious nature of the waste. This article summarises a literature review into existing CSW management practices in the healthcare centers. The information gathered in this paper has been derived from the desk study of open literature survey. Numerous researches have been conducted on the management of CSW. Although, significant steps have been taken on matters related to safe handling and disposal of the clinical waste, but improper management practice is evident from the point of initial collection to the final disposal. In most cases, the main reasons of the mismanagement of CSW are the lack of appropriate legislation, lack of specialized clinical staffs, lack of awareness and effective control. Furthermore, most of the healthcare centers of the developing world have faced financial difficulties and therefore looking for cost effective disposal methods of clinical waste. This paper emphasizes to continue the recycle-reuse program of CSW materials after sterilization by using supercritical fluid carbon dioxide (SF-CO2) sterilization technology at the point of initial collection. Emphasis is on the priority to inactivate the infectious micro-organisms in CSW. In that case, waste would not pose any threat to healthcare workers. The recycling-reuse program would be carried out successfully with the non-specialized clinical staffs. Therefore, the adoption of SF-CO2 sterilization technology in management of clinical solid waste can reduce exposure to infectious waste, decrease labor, lower costs, and yield better compliance with regulatory. Thus healthcare facilities can both save money and provide a safe environment for patients, healthcare staffs and clinical staffs.     

Resolving complexities in healthcare waste management: a goal programming approach.

The wide variety of activities at healthcare facilities generates different types of waste. There is always a danger of spreading infection due to mishandling of infectious waste or sharps. Hence, a variety of policies and actions have been taken to improve healthcare waste management systems. A large body of literature is available which suggests methods for tackling different problematic situations but management is confronted with a variety of complex problems, such as the choice of technological options to control infection, legal and budget restrictions and the timely removal of waste, which can, at times, conflict with each other. Hence, a planning model is presented that is based on a trans-shipment goal programming approach wherein the waste flow is optimized for multiple objectives under different priority structures or with different relative importance (weights). The use of the model is demonstrated as a decision-making tool that would help the management to understand the effects of their policies on the system performance. The model is validated for a case application representing a real-life situation. It can be easily seen that, in the case in which the management is biased toward a higher level of safety protection towards infection control, they have to compromise on cost control and to some extent on environmental pollution control.     

Neighbourhood-based waste management: a solution for solid waste problems in Jakarta, Indonesia

Municipal solid waste management in the capital city of Indonesia, Jakarta, is examined from a point of view of researchers and waste management practitioners. Major impediments to waste management in Jakarta include non-involvement of stakeholders in planning and decision-making, unskilled staff undertaking the duty, the absence of long-term waste management strategies, and weak coordination between authorities and neighbourhood association workers who undertake primary collection. It was revealed that lack of resources is seen as the least important of all impediments. The success of managing solid waste in Jakarta cannot be separated from the presence and the role of a neighbourhood association, which performs waste collection on a daily basis as well as keeping their respective areas clean by employing their own waste service workers. A neighbourhood-based waste management strategy is a promising solution for Jakarta, because it is more applicable and suitable for Jakarta's context compared to community-based waste management. The performance of this approach is examined and the improvement for wider adoption is discussed for a long-term solution.     

Potential of chicken by-products as sources of useful biological resources

By-products from different animal sources are currently being utilised for beneficial purposes. Chicken processing plants all over the world generate large amount of solid by-products in form of heads, legs, bones, viscera and feather. These wastes are often processed into livestock feed, fertilizers and pet foods or totally discarded. Inappropriate disposal of these wastes causes environmental pollution, diseases and loss of useful biological resources like protein, enzymes and lipids. Utilisation methods that make use of these biological components for producing value added products rather than the direct use of the actual waste material might be another viable option for dealing with these wastes. This line of thought has consequently led to researches on these wastes as sources of protein hydrolysates, enzymes and polyunsaturated fatty acids. Due to the multi-applications of protein hydrolysates in various branches of science and industry, and the large body of literature reporting the conversion of animal wastes to hydrolysates, a large section of this review was devoted to this subject. Thus, this review reports the known functional and bioactive properties of hydrolysates derived from chicken by-products as well their utilisation as source of peptone in microbiological media. Methods of producing these hydrolysates including their microbiological safety are discussed. Based on the few references available in the literature, the potential of some chicken by-product as sources of proteases and polyunsaturated fatty acids are pointed out along with some other future applications.     

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.     

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.     

Composition analysis of dental solid waste in Brazil

When developing proper waste management strategies, it is essential to characterize the volume and composition of solid waste. The aim of this work was to evaluate the composition of dental waste produced by three dental health services in Belo Horizonte, Minas Gerais State, Brazil. Two universities, one public and one private, and one public dental health service were selected. Waste collection took place from March to November 2007. During this period, three samples were collected from each dental health service. The total amount of dental waste produced in one day of dental work was manually separated into three categories: infectious and potentially infectious waste, accounting for 24.3% of the total waste; non-infectious waste, accounting for 48.1%; and domestic-type waste, accounting for 27.6% (percentages are for mean weights of solid waste). Our results showed that most of the waste considered as biomedical may be misclassified, consequently making the infectious waste amount appear much larger. In addition, our results suggest that the best waste minimization method is recycling, and they help to define an appropriate waste management system in all three of the dental health services involved in this study.     

Biomedical solid waste management in an Indian hospital: a case study

The objectives of this study were: (i) to assess the waste handling and treatment system of hospital bio-medical solid waste and its mandatory compliance with Regulatory Notifications for Bio-medical Waste (Management and Handling) Rules, 1998, under the Environment (Protection Act 1986), Ministry of Environment and Forestry, Govt. of India, at the chosen KLE Society's J. N. Hospital and Medical Research Center, Belgaum, India and (ii) to quantitatively estimate the amount of non-infectious and infectious waste generated in different wards/sections. During the study, it was observed that: (i) the personnel working under the occupier (who has control over the institution to take all steps to ensure biomedical waste is handled without any adverse effects to human health and the environment) were trained to take adequate precautionary measures in handling these bio-hazardous waste materials, (ii) the process of segregation, collection, transport, storage and final disposal of infectious waste was done in compliance with the Standard Procedures, (iii) the final disposal was by incineration in accordance to EPA Rules 1998, (iv) the non-infectious waste was collected separately in different containers and treated as general waste, and (v) on an average about 520 kg of non-infectious and 101 kg of infectious waste is generated per day (about 2.31 kg per day per bed, gross weight comprising both infectious and non-infectious waste). This hospital also extends its facility to the neighboring clinics and hospitals by treating their produced waste for incineration.     

Treatment and disposal alternatives for health-care waste in developing countries--a case study in Istanbul, Turkey.

Efficient health-care waste management is crucial for the prevention of the exposure of health-care workers, patients, and the community to infections, toxic wastes and injuries as well as the protection of the environment (Safe Management of Wastes from Health-care Activities. World Health Organization, Geneva). The amount of health-care waste produced in the Istanbul Metropolitan City in Turkey is 30 ton day(-1) in total. The method used for the final disposal of most of the health-care waste of Istanbul is incineration. However, a great portion of the infectious waste is disposed of with the domestic waste into the sanitary landfill because of improper segregation practices applied in the health-care institutions. Therefore the alternatives for the treatment and disposal of health-care waste were evaluated. The technical information related to the available treatment technologies including incineration, microwave irradiation, mobile or stationary sterilization, etc. were also investigated. The capital investment cost, transportation/operational costs for each alternative method and the different locations for installation were compared. When the data collected were evaluated, it was found that separate handling and disposal of health-care waste generated on the European and the Asian sides of the city was the most economic and practicable solution. As a result, it was concluded that the capacity of the Kemerburgaz-Odayeri incineration plant is enough to incinerate the health-care waste generated on the European side of Istanbul, the construction of a new incineration plant or a stationary sterilization unit for the disposal of health-care waste generated on the Asian side was the most effective alternative.