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.     

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.     

Recycling of plastic packaging waste in Bandung City,Indonesia

Economic growth, changing consumption and production patterns are resulting in rapid increase in the generation of plastic wastes, including plastic packaging waste (PPW). A variety of PPW is identified in the municipal solid waste (MSW) stream. In this paper, quantity and composition of PPW at generators (residential and nonresidential sectors) and at the informal sector of waste recycling were measured, and accordingly the flow of PPW within Bandung City, Indonesia was analyzed. Though the generation rate per capita is not so high (25.1 g per day), total PPW generated by 2.3 million inhabitants in Bandung becomes 58.4 tonnes per day (3.76 % of total MSW generated). Due to lack of integrated MSW management, most of PPW is neither collected properly nor disposed of in appropriate manner by the municipality. Collection of valuable wastes including PPW is done predominantly by the informal sector without regard to health and safety. It is predicted that total PPW recycled by various informal waste recycling players like scavengers, junkmen, intermediates, and dealers is 27.5 tonnes per day (64.6 % of total PPW generated). Interviews regarding the existing handling methods and incentives preferred by generators to increase the recycling rate are also presented.