Healthcare waste management in Asia

The risks associated with healthcare waste and its management has gained attention across the world in various events, local and international forums and summits. However, the need for proper healthcare waste management has been gaining recognition slowly due to the substantial disease burdens associated with poor practices, including exposure to infectious agents and toxic substances. Despite the magnitude of the problem, practices, capacities and policies in many countries in dealing with healthcare waste disposal, especially developing nations, is inadequate and requires intensification. This paper looks upon aspects to drive improvements to the existing healthcare waste management situation. The paper places recommendation based on a 12 country study reflecting the current status. The paper does not advocate for any complex technology but calls for changes in mindset of all concerned stakeholders and identifies five important aspects for serious consideration. Understanding the role of governments and healthcare facilities, the paper also outlines three key areas for prioritized action for both parties – budget support, developing policies and legislation and technology and knowledge management.     

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.     

Quantitative assessment of medical waste generation in the capital city of Bangladesh

There is a concern that mismanagement of medical waste in developing countries may be a significant risk factor for disease transmission. Quantitative estimation of medical waste generation is needed to estimate the potential risk and as a basis for any waste management plan. Dhaka City, the capital of Bangladesh, is an example of a major city in a developing country where there has been no rigorous estimation of medical waste generation based upon a thorough scientific study. These estimates were obtained by stringent weighing of waste in a carefully chosen, representative, sample of HCEs, including non-residential diagnostic centres. This study used a statistically designed sampling of waste generation in a broad range of Health Care Establishments (HCEs) to indicate that the amount of waste produced in Dhaka can be estimated to be 37 ± 5 ton per day. The proportion of this waste that would be classified as hazardous waste by World Health Organisation (WHO) guidelines was found to be approximately 21%. The amount of waste, and the proportion of hazardous waste, was found to vary significantly with the size and type of HCE.     

State of municipal solid waste management in Delhi, the capital of India

Delhi is the most densely populated and urbanized city of India. The annual growth rate in population during the last decade (1991-2001) was 3.85%, almost double the national average. Delhi is also a commercial hub, providing employment opportunities and accelerating the pace of urbanization, resulting in a corresponding increase in municipal solid waste (MSW) generation. Presently the inhabitants of Delhi generate about 7000tonnes/day of MSW, which is projected to rise to 17,000-25,000tonnes/day by the year 2021. MSW management has remained one of the most neglected areas of the municipal system in Delhi. About 70-80% of generated MSW is collected and the rest remains unattended on streets or in small open dumps. Only 9% of the collected MSW is treated through composting, the only treatment option, and rest is disposed in uncontrolled open landfills at the outskirts of the city. The existing composting plants are unable to operate to their intended treatment capacity due to several operational problems. Therefore, along with residue from the composting process, the majority of MSW is disposed in landfills. In absence of leachate and landfill gas collection systems, these landfills are a major source of groundwater contamination and air pollution (including generation of greenhouse gases). This study describes and evaluates the present state of municipal solid waste management in Delhi. The paper also summarizes the proposed policies and initiatives of the Government of Delhi and the Municipal Corporation of Delhi to improve the existing MSW management system.     

Healthcare waste management: current practices in selected healthcare facilities, Botswana

Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.     

Improving the solid waste management in Phnom Penh city: a strategic approach

Though the solid waste management (SWM) system in Phnom Penh city in general has been upgraded since the waste collection service was franchised out to the private sector, the performance of the existing SWM system is still low. Unreliable and irregular collection service still exists. This means that there are shortcomings in the existing SWM system that need correction. This paper is an attempt to identify those shortcomings in order to find ways to improve the existing system. First, the present SWM system is reviewed. Then the system is evaluated to find constraints and shortfalls and finally some appropriate strategies are proposed that may help make SWM in the city more effective and efficient to meet environmentally sound objectives.     

Changing scenario of municipal solid waste management in Kanpur city,India

Journal of Material Cycles and Waste Management - Generation of municipal solid waste (MSW) depends upon lifestyle, urbanization and income level of population. Solid waste management is one of the...     

Healthcare waste management in Botswana: storage,collection, treatment and disposal system

Journal of Material Cycles and Waste Management - Healthcare waste management has become a major issue of concern for solid waste managers due the treatment of healthcare waste being generated and...     

Modeling of urban solid waste management system: the case of Dhaka city

This paper presents a system dynamics computer model to predict solid waste generation, collection capacity and electricity generation from solid waste and to assess the needs for waste management of the urban city of Dhaka, Bangladesh. Simulated results show that solid waste generation, collection capacity and electricity generation potential from solid waste increase with time. Population, uncleared waste, untreated waste, composite index and public concern are projected to increase with time for Dhaka city. Simulated results also show that increasing the budget for collection capacity alone does not improve environmental quality; rather an increased budget is required for both collection and treatment of solid wastes of Dhaka city. Finally, this model can be used as a computer laboratory for urban solid waste management (USWM) policy analysis.     

Healthcare waste management: a case study from the National Health Service in Cornwall, United Kingdom

This paper looks at steps taken towards the development of a 10-year strategy for the management of healthcare waste from the National Health Service (NHS) in Cornwall, United Kingdom. The major issues and challenges that affect the management of waste by the NHS, including its organisational structure and collection infrastructure, are outlined. The waste flows of the main acute medical site are detailed, using waste audits of domestic and clinical bags, redundant equipment, bulky waste, and special waste. Some of the common barriers to change, such as staff habits and public perceptions, are also identified. Recommendations are made with respect to improvements in the overall organisational infrastructure and increased localised control. The recommendations also centre around the formation of strategic partnerships, within the site, between sites and at the broader level between the NHS and its surrounding community. An important challenge to be overcome is the need to progress from the concept of "waste management", to one of sustainable decision making regarding resource use, including methods of waste minimisation at the source and recycling. Staff training and awareness underpin several of the short and medium/long term solutions suggested to reduce the waste at the source and recover value from that produced. These measures could potentially reduce disposal quantities by as much as 20-30% (wt.) and costs by around 25-35%.     

Healthcare waste management practices and risk perceptions: Findings from hospitals in the Algarve region,Portugal

The management of healthcare wastes is receiving greater attention because of the risks to both human health and the environment caused by inadequate waste management practices. In that context, the objective of this study was to analyse the healthcare waste management practices in hospitals of the Algarve region, Portugal, and in particular to assess the risk perceptions of, and actual risk to, healthcare staff. The study included three of the six hospitals in the region, covering 41% of the bed capacity. Data were collected via surveys, interviews, and on-site observations. The results indicate that waste separation is the main deficiency in healthcare waste practice, with correct separation being positively related to the degree of daily contact with the waste. Risk perceptions of healthcare staff show the highest levels for the environment (4.24) and waste workers (4.08), and the lowest for patients (3.29) and visitors (2.80), again being positively associated with the degree of daily contact. Risk perceptions of healthcare staff are related to the difficulties of the correct separation of wastes and the lack of knowledge concerning the importance of that separation. The risk of infection with needlesticks/sharps is higher during patient care than during waste handling, and the frequency of these injuries is related to the daily tasks of each healthcare group (doctors, nurses, and housekeepers). Furthermore, legislative definitions and classifications of healthcare wastes appear to have conditioned the management practices associated with, and the perceptions of risk concerning, healthcare wastes.     

An overview of municipal solid waste management in Inner Mongolia Autonomous Region,China

Rapid industrialization and urbanization in developing countries have created serious problems in municipal solid waste (MSW) management. New case studies can shed light on these problems and point the way to potential solutions for improving the overall eco-efficiency of MSW management. This paper employs a case study approach, analyzing MSW management in Inner Mongolia. This study encompasses all aspects of MSW management, including collection, separation, recycling, and disposal. Problems and challenges are identified through our analysis, and recommendations are raised by considering the local realities. Our main findings are: (1) while large cities have already established a solid foundation for MSW management, small- and medium-sized cities deserve more attention; (2) MSW in rural areas is even worse than urban areas; (3) enforcement of MSW regulations is ineffective and needs improvement; (4) lack of funds, R&D efforts and advanced technologies have impeded sustainable MSW management; (5) lack of coordination and communication among different stakeholders further damages the efforts for improvement of MSW management. Therefore, integrated efforts that combine the above concerns should be initiated so that the overall effectiveness and efficiency of MSW management can be improved.     

Integrated approach to solid waste management in Chennai: an Indian metro city

Management of municipal solid waste is a major problem for most of the Indian cities due to the growing urban population and per capita waste generation rate, inadequate public participation and the deplorable organizational and financial capacities of urban local bodies. This article highlights the interventions required for sustainable solid waste management in Indian cities by analyzing the waste generation, collection, and disposal scenario of a metro city in India along with the regulatory and institutional frame work. It advocates a phased and integrated approach taking into account the operational hurdles and the capacity building of local bodies with the support of educational organizations.     

Quantifying capital goods for waste incineration

Materials and energy used for the construction of modern waste incineration plants were quantified. The data was collected from five incineration plants (72,000–240,000 tonnes per year) built in Scandinavia (Norway, Finland and Denmark) between 2006 and 2012. Concrete for the buildings was the main material used amounting to 19,000–26,000 tonnes per plant. The quantification further included six main materials, electronic systems, cables and all transportation. The energy used for the actual on-site construction of the incinerators was in the range 4000–5000 MW h. In terms of the environmental burden of producing the materials used in the construction, steel for the building and the machinery contributed the most. The material and energy used for the construction corresponded to the emission of 7–14 kg CO₂ per tonne of waste combusted throughout the lifetime of the incineration plant. The assessment showed that, compared to data reported in the literature on direct emissions from the operation of incinerators, the environmental impacts caused by the construction of buildings and machinery (capital goods) could amount to 2–3% with respect to kg CO₂ per tonne of waste combusted.     

Community-based solid waste bank program for municipal solid waste management improvement in Indonesia: a case study of Padang city

Journal of Material Cycles and Waste Management - Indonesia has a regulation UU No. 18/2008 which changes the paradigm from waste dumping to recycling. The purpose of this study is to understand...     

The contribution of waste management to the reduction of greenhouse gas emissions with applications in the city of Bucharest.

Waste management is a key process to protect the environment and conserve resources. The contribution of appropriate waste management measures to the reduction of greenhouse gas (GHG) emissions from the city of Bucharest was studied. An analysis of the distribution of waste flows into various treatment options was conducted using the material flows and stocks analysis (MFSA). An optimum scenario (i.e. municipal solid waste stream managed as: recycling of recoverable materials, 8%; incineration of combustibles, 60%; landfilling of non-combustibles, 32%) was modelled to represent the future waste management in Bucharest with regard to its relevance towards the potential for GHG reduction. The results indicate that it can contribute by 5.5% to the reduction of the total amount of GHGs emitted from Bucharest.     

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.     

Efficiency of waste management in municipalities and the importance of waste separation

Journal of Material Cycles and Waste Management - The European Union emphasises the need to sever the link between economic growth, resource consumption and waste production and has set targets to...     

A choice experiment of the residential preference of waste management services - the example of Kagoshima city, Japan

Municipal governments have attempted to reduce waste disposal and increase recycling rates in Japan. However, it is difficult to get full cooperation from residents. Using experiments in which residents are given an opportunity to choose the components of the waste management system (choice experiments), we measure the cost of each characteristic of the waste collection services. The estimation result reveals that there are trade-offs between the risk, payments, and handling costs. The marginal loss in utility revenues from an increase in the types of waste being separated is almost 200 yen (US$ 1.74) and a 1% increase in the recycling rate raises the cost of service by 53 yen (US$ 0.46). In addition, the results show the need for communications about risks between municipal authorities and residents.