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.     

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.     

Investigating solid waste production and associated management practices in private dental units

In the municipality of Thessaloniki in 2006 mercury-bearing dental wastes were not managed properly by 80% of dentists and metal-bearing waste was handled in accordance with internationally established best management practices by less than 50% of dentists. Those results were documented through a biennial field-based research study that took place in private dental units within the Thessaloniki Urban Area. For quantifying the waste produced, structured questionnaires were used and interviews with dentists were performed. In the present work, results of this survey are presented; critical parameters and factors affecting the quantity and quality of the dental waste stream are reported together with the analysis and classification of dominant conditions and needs of the dental sector in the waste management field.     

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.     

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.     

Site investigation on medical waste management practices in northern Jordan

This study investigated the medical waste management practices used by hospitals in northern Jordan. A comprehensive inspection survey was conducted for all 21 hospitals located in the study area. Field visits were conducted to provide information on the different medical waste management aspects. The results reported here focus on the level of medical waste segregation, treatment and disposal options practiced in the study area hospitals. The total number of beds in the hospitals was 2296, and the anticipated quantity of medical waste generated by these hospitals was about 1400 kg/day. The most frequently used treatment practice for solid medical waste was incineration. Of these hospitals, only 48% had incinerators, and none of these incinerators met the Ministry of Health (MoH) regulations. As for the liquid medical waste, the survey results indicated that 57% of surveyed hospitals were discharging it into the municipal sewer system, while the remaining hospitals were collecting their liquid waste in septic tanks. The results indicated that the medical waste generation rate ranges from approximately 0.5 to 2.2 kg/bed day, which is comprised of 90% of infectious waste and 10% sharps. The results also showed that segregation of various medical waste types in the hospitals has not been conducted properly. The study revealed the need for training and capacity building programs of all employees involved in the medical waste management.     

Composition and production rate of pharmaceutical and chemical waste from Xanthi General Hospital in Greece

The objective of this work was to determine the composition and production rates of pharmaceutical and chemical waste produced by Xanthi General Hospital in Greece (XGH). This information is important to design and cost management systems for pharmaceutical and chemical waste, for safety and health considerations and for assessing environmental impact. A total of 233 kg pharmaceutical and 110 kg chemical waste was collected, manually separated and weighed over a period of five working weeks. The total production of pharmaceutical waste comprised 3.9% w/w of the total hazardous medical waste produced by the hospital. Total pharmaceutical waste was classified in three categories, vial waste comprising 51.1%, syringe waste with 11.4% and intravenous therapy (IV) waste with 37.5% w/w of the total. Vial pharmaceutical waste only was further classified in six major categories: antibiotics, digestive system drugs, analgesics, hormones, circulatory system drugs and "other". Production data below are presented as average (standard deviation in parenthesis). The unit production rates for total pharmaceutical waste for the hospital were 12.4 (3.90) g/patient/d and 24.6 (7.48) g/bed/d. The respective unit production rates were: (1) for vial waste 6.4 (1.6) g/patient/d and 13 (2.6) g/bed/d, (2) for syringe waste 1.4 (0.4) g/patient/d and 2.8 (0.8) g/bed/d and (3) for IV waste 4.6 (3.0) g/patient/d and 9.2 (5.9) g/bed/d. Total chemical waste was classified in four categories, chemical reagents comprising 18.2%, solvents with 52.3%, dyes and tracers with 18.2% and solid waste with 11.4% w/w of the total. The total production of chemical waste comprised 1.8% w/w of the total hazardous medical waste produced by the hospital. Thus, the sum of pharmaceutical and chemical waste was 5.7% w/w of the total hazardous medical waste produced by the hospital. The unit production rates for total chemical waste for the hospital were 5.8 (2.2) g/patient/d and 1.1 (0.4) g/exam/d. The respective unit production rates were: (1) for reagents 1.7 (2.4) g/patient/d and 0.3 (0.4) g/examination/d, (2) for solvents 248 (127) g/patient/d and 192 (101) g/examination/d, (3) for dyes and tracers 4.7 (1.4) g/patient/d and 2.5 (0.9) g/examination/d and (4) for solid waste 54 (28) g/patient/d and 42 (22) g/examination/d.     

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.     

Hospital waste management and toxicity evaluation: a case study

Hospital waste management is an imperative environmental and public safety issue, due to the waste's infectious and hazardous character. This paper examines the existing waste strategy of a typical hospital in Greece with a bed capacity of 400-600. The segregation, collection, packaging, storage, transportation and disposal of waste were monitored and the observed problematic areas documented. The concentrations of BOD, COD and heavy metals were measured in the wastewater the hospital generated. The wastewater's toxicity was also investigated. During the study, omissions and negligence were observed at every stage of the waste management system, particularly with regard to the treatment of infectious waste. Inappropriate collection and transportation procedures for infectious waste, which jeopardized the safety of staff and patients, were recorded. However, inappropriate segregation practices were the dominant problem, which led to increased quantities of generated infectious waste and hence higher costs for their disposal. Infectious waste production was estimated using two different methods: one by weighing the incinerated waste (880 kg day(-1)) and the other by estimating the number of waste bags produced each day (650 kg day(-1)). Furthermore, measurements of the EC(50) parameter in wastewater samples revealed an increased toxicity in all samples. In addition, hazardous organic compounds were detected in wastewater samples using a gas chromatograph/mass spectrograph. Proposals recommending the application of a comprehensive hospital waste management system are presented that will ensure that any potential risks hospital wastes pose to public health and to the environment are minimized.     

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.     

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.     

Research on solid waste management system: to improve existing situation in Corlu Town of Turkey

Over the past decades, uncontrolled population growth and rapid urbanization and industrialization have resulted in environmental problems in Corlu Town, Turkey. One of the most important problems is solid waste due to inadequate management practices. Nowadays, increasing public awareness of the environment compels local authorities to define and to adopt new solutions for waste management. This paper presents a general overview of current solid waste management practices in Corlu Town and principles of the recommended municipal solid waste (MSW) management system. In Corlu, 170 tonnes of municipal solid waste are generated each day, or 1.150 kg per capita per day. Approximately one-half of the municipal solid waste generated is organic material and 30% of the MSW consists of recyclable materials. The recommended system deals with maximizing recycling and minimizing landfilling of municipal solid waste, and consists of separation at source, collection, sorting, recycling, composting and sanitary landfilling. This study also analyzed the recommended system with respect to feasibility and economics. To evaluate whether the suggested system is cost effective or not, the operating cost of the recommended system and market prices of recyclable materials were compared, and the results show that the recommended system will reduce required landfill volume up to 27% of compared to the present situation. The profit of the recommended system is estimated to be about 80 million US dollars.     

Results of a hospital waste survey in private hospitals in Fars province, Iran

Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. In Iran, neither rules have been compiled nor does exact information exist regarding hospital waste management. The survey presented in this article was carried out in all 15 private hospitals of Fars province (Iran) from the total numbers of 50 governmental and private hospitals located in this province, in order to determine the amount of different kinds of waste produced and the present situation of waste management. The results indicated that the waste generation rate is 4.45 kg/bed/day, which includes 1830 kg (71.44%) of domestic waste, 712 kg (27.8%) of infectious waste, and 19.6 kg (0.76%) of sharps. Segregation of the different types of waste is not carried out perfectly. Two (13.3%) of the hospitals use containers without lids for on-site transport of wastes. Nine (60%) of the hospitals are equipped with an incinerator and six of them (40%) have operational problems with the incinerators. In all hospitals municipal workers transport waste outside the hospital premises daily or at the most on alternative days. In the hospitals under study, there aren't any training courses about hospital waste management and the hazards associated with them. The training courses that are provided are either ineffective or unsuitable. Performing extensive studies all over the country, compiling and enacting rules, establishing standards and providing effective personnel training are the main challenges for the concerned authorities and specialists in this field.     

Generation, storage, collection and transportation of municipal solid waste--a case study in the city of Kathmandu, capital of Nepal

Solid waste management (SWM) services have consistently failed to keep up with the vast amount of solid waste produced in urban areas. There is not currently an efficient system in place for the management, storage, collection, and transportation of solid waste. Kathmandu City, an important urban center of South Asia, is no exception. In Kathmandu Metropolitan City, solid waste generation is predicted to be 1091 m(3)/d (245 tons/day) and 1155 m(3)/d (260 tons/day) for the years 2005 and 2006, respectively. The majority (89%) of households in Kathmandu Metropolitan City are willing to segregate the organic and non-organic portions of their waste. Overall collection efficiency was 94% in 2003. An increase in waste collection occurred due to private sector involvement, the shutdown of the second transfer station near the airport due to local protest, a lack of funding to maintain trucks/equipment, a huge increase in plastic waste, and the willingness of people to separate their waste into separate bins. Despite a substantial increase in total expenditure, no additional investments were made to the existing development plan to introduce a modern disposal system due to insufficient funding. Due to the lack of a proper lining, raw solid waste from the existing dumping site comes in contact with river water directly, causing severe river contamination and deteriorating the quality of the water.     

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.     

Review of municipal solid waste management options in Malaysia,with an emphasis on sustainable waste-to-energy options

A beautiful and clean environment is the desire of every society. Malaysia is facing an uncontrolled increase in municipal solid waste (MSW) generation due to population growth, economic advancement, and industrialization, but the current, most common waste disposal practice of landfilling is not sustainable. The increasing standard of living also saps more energy from the power generation systems in which fossil fuels are the major source of fuel for the plants. Malaysia generates about 0.5–1.9 kg/capita/day of MSW; a total of about 25,000 tonnes/day of MSW is currently generated and is estimated to exceed 30,000 tonnes/day by 2020. Malaysian MSW is mainly composed of 45 % food waste, 24 % plastic, 7 % paper materials, 6 % metal, 4 % wood and 3 % glass, which are commingled, and is thus characterised by 52–66 % moisture content. Currently, 80–95 % of collected MSW is landfilled and 5 % is recycled, while composting and energy recovery are rarely practiced. This paper reviews the solid waste practice in Malaysia and looks into alternative management options for sustainability. Malaysia MSW represents recyclable power and energy potential if properly sorted. This study considered the practice of sorting at the source and the use of combustible MSW components as fuel to generate heat for a hybrid solar, flue gas, chimney power plant.     

Management of immunization solid wastes in Kano State, Nigeria

Inadequate management of waste generated from injection activities can have a negative impact on the community and environment. In this paper, a report on immunization wastes management in Kano State (Nigeria) is presented. Eight local governments were selected randomly and surveyed by the author. Solid wastes generated during the Expanded Programme on Immunization were characterised using two different methods: one by weighing the waste and the other by estimating the volume. Empirical data was obtained on immunization waste generation, segregation, storage, collection, transportation, and disposal; and waste management practices were assessed. The study revealed that immunization offices were accommodated in either in local government buildings, primary health centres or community health care centres. All of the stations demonstrated a high priority for segregation of the infectious wastes. It can be deduced from the data obtained that infectious waste ranged from 67.6% to 76.7% with an average of 70.1% by weight, and 36.0% to 46.1% with an average of 40.1% by volume. Non-infectious waste generated ranged from 23.3% to 32.5% with an average of 29.9% by weight and 53.9% to 64.0% with an average of 59.9% by volume. Out of non-infectious waste (NIFW) and infectious waste (IFW), 66.3% and 62.4% by weight were combustible and 33.7% and 37.6% were non-combustible respectively. An assessment of the treatment revealed that open pit burning and burial and small scale incineration were the common methods of disposal for immunization waste, and some immunization centres employed the services of the state or local government owned solid waste disposal board for final collection and disposal of their immunization waste at government approved sites.     

Municipal solid waste management in Malaysia: Practices and challenges

Rapid economic development and population growth, inadequate infrastructure and expertise, and land scarcity make the management of municipal solid waste become one of Malaysia’s most critical environmental issues. The study is aimed at evaluating the generation, characteristics, and management of solid waste in Malaysia based on published information. In general, the per capita generation rate is about 0.5–0.8 kg/person/day in which domestic waste is the primary source. Currently, solid waste is managed by the Ministry of Housing and Local Government, with the participation of the private sector. A new institutional and legislation framework has been structured with the objectives to establish a holistic, integrated, and cost-effective solid waste management system, with an emphasis on environmental protection and public health. Therefore, the hierarchy of solid waste management has given the highest priority to source reduction through 3R, intermediate treatment and final disposal.     

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.