Assessment of health-care waste disposal methods using a VIKOR-based fuzzy multi-criteria decision making method

Nowadays selection of the appropriate treatment method in health-care waste (HCW) management has become a challenge task for the municipal authorities especially in developing countries. Assessment of HCW disposal alternatives can be regarded as a complicated multi-criteria decision making (MCDM) problem which requires consideration of multiple alternative solutions and conflicting tangible and intangible criteria. The objective of this paper is to present a new MCDM technique based on fuzzy set theory and VIKOR method for evaluating HCW disposal methods. Linguistic variables are used by decision makers to assess the ratings and weights for the established criteria. The ordered weighted averaging (OWA) operator is utilized to aggregate individual opinions of decision makers into a group assessment. The computational procedure of the proposed framework is illustrated through a case study in Shanghai, one of the largest cities of China. The HCW treatment alternatives considered in this study include “incineration”, “steam sterilization”, “microwave” and “landfill”. The results obtained using the proposed approach are analyzed in a comparative way.     

Transshipment site selection using the AHP and TOPSIS approaches under fuzzy environment

Site selection is an important issue in waste management. Selection of the appropriate solid waste site requires consideration of multiple alternative solutions and evaluation criteria because of system complexity. Evaluation procedures involve several objectives, and it is often necessary to compromise among possibly conflicting tangible and intangible factors. For these reasons, multiple criteria decision-making (MCDM) has been found to be a useful approach to solve this kind of problem. Different MCDM models have been applied to solve this problem. But most of them are basically mathematical and ignore qualitative and often subjective considerations. It is easier for a decision-maker to describe a value for an alternative by using linguistic terms. In the fuzzy-based method, the rating of each alternative is described using linguistic terms, which can also be expressed as triangular fuzzy numbers. Furthermore, there have not been any studies focused on the site selection in waste management using both fuzzy TOPSIS (technique for order preference by similarity to ideal solution) and AHP (analytical hierarchy process) techniques. In this paper, a fuzzy TOPSIS based methodology is applied to solve the solid waste transshipment site selection problem in Istanbul, Turkey. The criteria weights are calculated by using the AHP.     

Sustainable management measures for healthcare waste in China

This paper discusses actions aimed at sustainable management of healthcare wastes (HCW) in China, taking into account the current national situation in this field, as well as the requirements deriving from the Stockholm Convention on Persistent Organic Pollutants and the WHO recommendations. By the end of 2005, there were 149 low-standard HCW disposal facilities in operation in China, distributed throughout different areas. According to the National Hazardous Waste and Healthcare Waste Disposal Facility Construction Plan, 331 modern, high-standard, centralized facilities will be built up in China in municipal level cities. Although incineration is still the main technical option for HCW disposal in China, it is expected that, especially for medium and small size facilities, non-incineration technologies will develop quickly and will soon become the main technical option. The basic management needs – both from the point of view of pollution control and final disposal – have been defined, and a system of technical and environmental standards has been formulated and implemented; however, there are still some shortages. This is particularly true when considering the best available techniques and best environmental practices developed under the Stockholm Convention, with which the present technological and managing situations are not completely compliant. In this framework, the lifecycle (from generation to final disposal of wastes) of HCW and holistic approaches (technology verification, facilities operation, environmental supervision, environmental monitoring, training system, financial mechanism, etc.) towards HCW management are the most important criteria for the sustainable and reliable management of HCW in China.     

Report: Healthcare waste characterization in Chittagong Medical College Hospital, Bangladesh

Healthcare waste management (HCWM) options are inconsistent in Bangladesh. One of the first critical steps in the process of developing a reliable waste management plan requires a comprehensive understanding of the quantities and characteristics of the waste that needs to be managed. This study took into consideration both the quantity and quality of the generated waste to determine the generation rates and physical properties of healthcare waste (HCW) in Chittagong Medical College Hospital (CMCH) and also to estimate the amount of infectious and non-infectious waste generated in different wards. CMCH, the second largest hospital in Bangladesh, comprises 34 wards, 12 of which were selected randomly. Waste materials were collected from these wards and then segregated and weighed. Waste generation per day was found to be 73.22 kg/ward, 1.28 kg/bed and 0.57 kg/patient. A total of 2490 kg of HCW was produced each day in CMCH (37% being infectious and the rest being non-infectious waste). Infectious waste was 27.07 kg per ward, 0.47 kg per bed and 0.21 kg per patient and the non-infectious waste was 46.15 kg per ward, 0.81 kg per bed and 0.36 kg per patient per day. HCW comprised eight categories of waste materials with vegetable/food waste being the largest component (50.21%) and varied significantly (P < 0.05) among the 12 different wards studied. The greatest amount of HCW was recorded (154 kg) in Orthopaedics followed by 96.66 kg in the Medicine Unit-3 and the smallest amount was recorded in Casualty (8.79 kg). The amount of HCW was positively correlated with the number of occupied beds (rxy = 0.79, P < 0.01). There is no structured form of medical waste treatment in CMCH and most waste materials are dumped in open areas for natural degradation or re-sold by scavengers. It is essential to develop a national policy and implement a comprehensive action plan for HCWM that will provide environmentally sound technological measures to improve HCWM in Bangladesh.     

Solid waste facilities location using of analytical network process and data envelopment analysis approaches

Selection of the appropriate site for solid waste facilities is a complex problem and requires an extensive evaluation process, because it is very difficult to develop a selection criterion that can precisely describe the preference of one location over another. Therefore selection of these sites can be viewed as a multiple criteria decision-making or multiple attributes decision-making problem. For this purpose, we propose a technique that can effectively take managerial preferences and subjective data into consideration, along with quantitative factors. The tool proposed here relies on the use of the analytical network process (ANP) and to help integrate managerial evaluations into a more quantitatively based decision tool, data envelopment analysis (DEA) is applied. In this paper, a location selection procedure is presented to construct an undesirable facility applying ANP and DEA approaches in two stages. In the first stage ANP approach is used, results of this stage are inputs for the second stage. In this stage, DEA is applied to select the best location. Finally, to illustrate the proposed framework, at "Results and discussion" section, a total of four undesirable facility locations are evaluated.     

Inexact fuzzy-stochastic constraint-softened programming – A case study for waste management

In this study, an inexact fuzzy-stochastic constraint-softened programming method is developed for municipal solid waste (MSW) management under uncertainty. The developed method can deal with multiple uncertainties presented in terms of fuzzy sets, interval values and random variables. Moreover, a number of violation levels for the system constraints are allowed. This is realized through introduction of violation variables to soften system constraints, such that the model’s decision space can be expanded under demanding conditions. This can help generate a range of decision alternatives under various conditions, allowing in-depth analyses of tradeoffs among economic objective, satisfaction degree, and constraint-violation risk. The developed method is applied to a case study of planning a MSW management system. The uncertain and dynamic information can be incorporated within a multi-layer scenario tree; revised decisions are permitted in each time period based on the realized values of uncertain events. Solutions associated with different satisfaction degree levels have been generated, corresponding to different constraint-violation risks. They are useful for supporting decisions of waste flow allocation and system-capacity expansion within a multistage context.     

Using MCDA and GIS for hazardous waste landfill siting considering land scarcity for waste disposal

The main aim of this study was to develop a procedure that minimizes the wasting of space for the siting of hazardous waste landfills as part of a solid waste management system. We wanted to tackle the shortage of land for waste disposal that is a serious and growing problem in most large urban regions. The procedure combines a multi-criteria decision analysis (MCDA) approach with a geographical information system (GIS). The GIS was utilised to obtain an initial screening in order to eliminate unsuitable areas, whereas the MCDA was developed to select the most suitable sites. The novelty of the proposed siting procedure is the introduction of a new screening phase before the macro-siting step aimed at producing a “land use map of potentially suitable areas” for the siting of solid waste facilities which simultaneously takes into consideration all plant types. The issue of obtaining sites evaluations of a specific facility was coupled with the issue of not wasting land appropriate to facilitate other types of waste management options. In the developed case study, the use of an innovative criteria weighting tool (the “Priority Scale”) in combination with the Analytic Hierarchy Process was useful to easier define the priorities of the evaluation criteria in comparison with other classic methods such as the Paired Comparison Technique in combination with the Simple Additive Weighting method.     

Multi-objective optimization of solid waste flows: environmentally sustainable strategies for municipalities

An approach to sustainable municipal solid waste (MSW) management is presented, with the aim of supporting the decision on the optimal flows of solid waste sent to landfill, recycling and different types of treatment plants, whose sizes are also decision variables. This problem is modeled with a non-linear, multi-objective formulation. Specifically, four objectives to be minimized have been taken into account, which are related to economic costs, unrecycled waste, sanitary landfill disposal and environmental impact (incinerator emissions). An interactive reference point procedure has been developed to support decision making; these methods are considered appropriate for multi-objective decision problems in environmental applications. In addition, interactive methods are generally preferred by decision makers as they can be directly involved in the various steps of the decision process. Some results deriving from the application of the proposed procedure are presented. The application of the procedure is exemplified by considering the interaction with two different decision makers who are assumed to be in charge of planning the MSW system in the municipality of Genova (Italy).     

Cleanup levels for pcbs and their combustion products at an industrial facility

In 1991, a fire occurred at a foundry in western Pennsylvania. The fire started in capacitors that contained polychlorinated biphenyls (PCBs) and subsequent sampling has indicated that PCBs and products of their incomplete combustion, the polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs), were released as a result of the fire. This article develops and provides justification for site-specific cleanup levels for the PCBs, PCDDs, and PCDFs accidentally released into this industrial facility during the fire. Cleanup levels were calculated using standard risk assessment approaches and assumptions, and these riskbased values were compared with cleanup criteria used for other sites. Final criteria were established based on this comparison and a consideration of such site-specific factors as migration potential, industrial use patterns, and the small mass of material present.     

Waste management project's alternatives: A risk-based multi-criteria assessment (RBMCA) approach

This paper examines the evaluation of a waste management project’s alternatives through a quantitative risk analysis. Cost benefit analysis is a widely used method, in which the investments are mainly assessed through the calculation of their evaluation indicators, namely benefit/cost (B/C) ratios, as well as the quantification of their financial, technical, environmental and social risks. Herein, a novel approach in the form of risk-based multi-criteria assessment (RBMCA) is introduced, which can be used by decision makers, in order to select the optimum alternative of a waste management project. Specifically, decision makers use multiple criteria, which are based on the cumulative probability distribution functions of the alternatives’ B/C ratios. The RBMCA system is used for the evaluation of a waste incineration project’s alternatives, where the correlation between the criteria weight values and the decision makers’ risk preferences is analyzed and useful conclusions are discussed.     

Making the CERCLA Criteria Analysis of Remedial Alternatives More Objective

This article shows how decision analysis techniques assisted decision makers in the critical RI/FS task of technology selection at a specific Superfund site. Each remediation alternative's performance was quantified by creating a set of objective evaluation measures tied to the criteria mandated in the comprehensive Environmental Response, Compensation and Liability Act of 1980. The evaluation measure scores were input into a quantitative decision analysis model used to rank alternatives based on their performance relative to the CERCLA criteria, and to provide insight to the sensitivity of the results to changes in decision maker preferences or technology performance. The model is designed to reflect the site decision maker's preferences and the site-specific characteristics within the framework of the nine CERCLA criteria. This model will give Superfund site decision makers an objective and transparent framework to evaluate remedial technologies.     

Fuzzy multicriteria disposal method and site selection for municipal solid waste

The use of fuzzy multiple criteria analysis (MCA) in solid waste management has the advantage of rendering subjective and implicit decision making more objective and analytical, with its ability to accommodate both quantitative and qualitative data. In this paper a modified fuzzy TOPSIS methodology is proposed for the selection of appropriate disposal method and site for municipal solid waste (MSW). Our method is superior to existing methods since it has capability of representing vague qualitative data and presenting all possible results with different degrees of membership. In the first stage of the proposed methodology, a set of criteria of cost, reliability, feasibility, pollution and emission levels, waste and energy recovery is optimized to determine the best MSW disposal method. Landfilling, composting, conventional incineration, and refuse-derived fuel (RDF) combustion are the alternatives considered. The weights of the selection criteria are determined by fuzzy pairwise comparison matrices of Analytic Hierarchy Process (AHP). It is found that RDF combustion is the best disposal method alternative for Istanbul. In the second stage, the same methodology is used to determine the optimum RDF combustion plant location using adjacent land use, climate, road access and cost as the criteria. The results of this study illustrate the importance of the weights on the various factors in deciding the optimized location, with the best site located in Çatalca. A sensitivity analysis is also conducted to monitor how sensitive our model is to changes in the various criteria weights.     

Analyzing composition and generation rates of biomedical waste in selected hospitals of Uttarakhand,India

In India, a few studies have been conducted for analyzing the generation rates and composition of medical waste (MW). Inadequate information about the amount and composition of MW results in ineffective management practices. The present study seeks to evaluate healthcare waste (HCW) generation rates by healthcare facilities (HCFs) available in Uttarakhand, a northern state of India. Study also focuses on modeling the quantity of different types of MW generated at various HCFs and determining significant factors contributing towards MW generation. Seasonal variation in amount of MW generated from various HCFs has also been considered. To achieve these objectives, cross-sectional as well as longitudinal data have been collected from various HCFs in Uttarakhand, India. The survey revealed that around 36% of the total HCFs did not segregate their MW as per policy guidelines. Cross-sectional data for May 2015 were collected from 75 HCFs to analyze and model the composition and quantity of HCW generated. Multiple Linear Regression and Artificial Neural Network techniques were applied to model cross-sectional data. In the composition of the overall MW, ‘yellow waste’ carries the maximum share, followed by ‘red waste’ and then the ‘blue waste’. In addition, the ‘type of HCF’ and ‘bed occupancy’ have been modeled as the important factors, contributing towards the MW generations rates. Longitudinal data for 2 years (2013 and 2014) were collected to examine seasonal variation in HCW generation rates using polynomial regression analysis. Result shows that MW quantity also varies with the change in the season. Findings of the study will help hospitals and waste treatment facilities to predict amount of waste that may be generated, and plan resources towards efficient handling and disposal of MW.     

An integrated multi criteria approach for landfill siting in a conflicting environmental, economical and socio-cultural area

Landfill site selection is a complicated multi criteria land use planning that should convince all related stakeholders with different insights. This paper addresses an integrating approach for landfill siting based on conflicting opinions among environmental, economical and socio-cultural expertise. In order to gain optimized siting decision, the issue was investigated in different viewpoints. At first step based on opinion sampling and questionnaire results of 35 experts familiar with local situations, the national environmental legislations and international practices, 13 constraints and 15 factors were built in hierarchical structure. Factors divided into three environmental, economical and socio-cultural groups. In the next step, the GIS-database was developed based on the designated criteria. In the third stage, the criteria standardization and criteria weighting were accomplished. The relative importance weights of criteria and subcriteria were estimated, respectively, using analytical hierarchy process and rank ordering methods based on different experts opinions. Thereafter, by using simple additive weighting method, the suitability maps for landfill siting in Marvdasht, Iran, was evaluated in environmental, economical and socio-cultural visions. The importance of each group of criteria in its own vision was assigned to be higher than two other groups. In the fourth stage, the final suitability map was obtained after crossing three resulted maps in different visions and reported in five suitability classes for landfill construction. This map indicated that almost 1224 ha of the study area can be considered as best suitable class for landfill siting considering all visions. In the last stage, a comprehensive field visit was performed to verify the selected site obtained from the proposed model. This field inspection has confirmed the proposed integrating approach for the landfill siting.     

Setting Site Specific Critical Loads: An Approach using Endorsement Theory and Dempster–Shafer

There is an increasing demand from conservation agencies for site-specific critical loads (CL); unfortunately, there is often very little specific information on a site to determine the important parameters needed to calculate the CL or on the spatial location of the “designated feature” in a site. Determining the most appropriate CL therefore involves using expert judegement to make decisions with incomplete and uncertain information. Endorsement Theory (Cohen, 1985) and Dempster–Shafer statistics (Dempster, 1967; Shafer, 1976) are, respectively, a decision-theoretic and a statistical technique for reasoning under those conditions (uncertainty and incompletness). A key reason for applying these techniques is that they make expert opinion explicit and available for scrutiny. Both techniques have been applied to the problem of setting an appropriate site specific CL, using heathland sites as a case study. Inital findings are encouraging; the uncertainty in expert judgement is made explict, the end results are intuitively reasonable and the methodology apparently acceptable to decision makers.     

Waste disposal technology transfer matching requirement clusters for waste disposal facilities in China

Even though technology transfer has been part of development aid programmes for many decades, it has more often than not failed to come to fruition. One reason is the absence of simple guidelines or decision making tools that help operators or plant owners to decide on the most suitable technology to adopt. Practical suggestions for choosing the most suitable technology to combat a specific problem are hard to get and technology drawbacks are not sufficiently highlighted. Western counterparts in technology transfer or development projects often underestimate or don’t sufficiently account for the high investment costs for the imported incineration plant; the differing nature of Chinese MSW; the need for trained manpower; and the need to treat flue gas, bunker leakage water, and ash, all of which contain highly toxic elements.This article sets out requirements for municipal solid waste disposal plant owner/operators in China as well as giving an attribute assessment for the prevalent waste disposal plant types in order to assist individual decision makers in their evaluation process for what plant type might be most suitable in a given situation. There is no ‘best’ plant for all needs and purposes, and requirement constellations rely on generalisations meaning they cannot be blindly applied, but an alignment of a type of plant to a type of owner or operator can realistically be achieved. To this end, a four-step approach is suggested and a technology matrix is set out to ease the choice of technology to transfer and avoid past errors. The four steps are (1) Identification of plant owner/operator requirement clusters; (2) Determination of different municipal solid waste (MSW) treatment plant attributes; (3) Development of a matrix matching requirement clusters to plant attributes; (4) Application of Quality Function Deployment Method to aid in technology localisation.The technology transfer matrices thus derived show significant performance differences between the various technologies available. It is hoped that the resulting research can build a bridge between technology transfer research and waste disposal research in order to enhance the exchange of more sustainable solutions in future.     

Stochastic analysis of radioactive waste package performance using first-order reliability method

In order to license an underground radioactive waste repository, it is important to demonstrate regulatory compliance with authoritative regulations. Also it is evidence from NRC's criteria for waste package performance that a stochastic analysis is necessary to provide that these criteria can be met with confidence. The first-order reliability method is an attractive tool to the stochastic analysis and particularly useful when statistical information is incomplete, as is common for problems occurring in the subsurface environment. The method is based on using the first-order Taylor series expansion at a specific linearization point to calculate a measure of reliability. Results from a first-order reliability analysis include an estimate of the probability of exceeding a specified performance criteria and measures of the sensitivity of the stochastic solution to the changes in input random variables and their statistical moments. The method of stochastic analysis is illustrated by analyzing the canister corrosion in a radioactive waste package.     

The potential of recycling and reusing municipal solid waste incinerator ash in Taiwan

By 2004, there were 19 municipal solid waste incinerators (MSWI) with a total yearly treatment capacity of 7.72 million tons in service in Taiwan. All 19 incinerators operated daily to generate about 1.05 million tons of incinerator ash, including bottom ash and stabilized fly ash in 2003, and the average ash yield is 18.67%. The total number of incinerators is expected to increase to 27, serving almost all cities in Taiwan by 2007. The authors have suggested a set of criteria based on the yield of incinerator ash (Phi) to study the ash recycle and reuse potential. The Taiwan Environmental Protection Administration has studied the treatment and reuse of MSWI ashes for many years and collected references on international experience accumulated by developed nations for establishing policies on treatment and reuse of MSWI ashes. These citations were analyzed as the basis for current governmental decision making on policies and factors to be considered for establishing policies on recycle and reuse of MSWI ashes. Feasible applications include utilization of ashes, which after sieving and separation of metal particles, produce granular materials. When granular materials comply with TCLP limitations, they can be utilized as cement additives or road base. The procedures of evaluation have been proposed in the performance criteria to be included in the proposed decision-making process of ash utilization.     

Applications of life cycle assessment and cost analysis in health care waste management

The establishment of rules to manage Health Care Waste (HCW) is a challenge for the public sector. Regulatory agencies must ensure the safety of waste management alternatives for two very different profiles of generators: (1) hospitals, which concentrate the production of HCW and (2) small establishments, such as clinics, pharmacies and other sources, that generate dispersed quantities of HCW and are scattered throughout the city. To assist in developing sector regulations for the small generators, we evaluated three management scenarios using decision-making tools. They consisted of a disinfection technique (microwave, autoclave and lime) followed by landfilling, where transportation was also included. The microwave, autoclave and lime techniques were tested at the laboratory to establish the operating parameters to ensure their efficiency in disinfection. Using a life cycle assessment (LCA) and cost analysis, the decision-making tools aimed to determine the technique with the best environmental performance. This consisted of evaluating the eco-efficiency of each scenario. Based on the life cycle assessment, microwaving had the lowest environmental impact (12.64 Pt) followed by autoclaving (48.46 Pt). The cost analyses indicated values of US$ 0.12 kg^?1 for the waste treated with microwaves, US$ 1.10 kg^?1 for the waste treated by the autoclave and US$ 1.53 kg^?1 for the waste treated with lime. The microwave disinfection presented the best eco-efficiency performance among those studied and provided a feasible alternative to subsidize the formulation of the policy for small generators of HCW.     

Two decision analysis approaches: Choosing a chemical analysis method

This article illustrates how two different decision analysis (DA) methods can be used to assist in making environmental remediation decisions. The two DA methods are Multiattribute Utility Theory (MAUT) and the Analytic Hierarchy Process (AHP). MAUT and AHP differ greatly in their underlying philosophies. MAUT employs an interval scale and constructs utility functions that quantify the total utility to the decision maker of each technology alternative; AHP employs a ratio scale and uses pairwise comparisons to produce a final ranking of the alternatives that reflects the decision maker's comparative preferences. In this study, the same technology was ranked first by both methods; however, the remaining rankings did not agree. Also, statistical analysis indicated that some score differences may be statistically insignificant. These results are presented and discussed along with a comparison of the features, advantages, and disadvantages of these two DA approaches.