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.     

Techno-economic assessment of municipal solid waste management in Jordan

Mismanagement of solid waste leads to public health risks, adverse environmental impacts and other socio-economic problems. This is obvious in many developing countries around the world. Currently, several countries have realized that the way they manage their solid wastes does not satisfy the objectives of sustainable development. Therefore, these countries, including Jordan, which forms the case study presented here, have decided to move away from traditional solid waste management (SWM) options to more integrated solid waste management approaches. Unfortunately, in many developing countries like Jordan, the lack of adequate resources to implement the necessary changes is posing a serious obstacle. The present paper discusses the various practices and challenges of solid waste management in Jordan from both a technical and economic perspective. An overview of the current practices and their environmental implications in three major cities of the country, which generate more than 70% of the country's solid waste, is presented. Recent literature on solid waste management in Jordan has been reviewed; and data on the total amount of municipal solid waste generated, compositional variations over the last two decades, and future projections are presented. The necessity, importance and needs of solid waste recovery and reuse are identified. The review of the legal frameworks indicated that there is a need for detailed and clear regulations dealing specifically with solid waste. The service cost analysis revealed that none of the municipalities in Jordan sufficiently recover the cost of the services, with more than 50% being subsidized from the municipalities' budgets. The allocation of the available resources was analyzed and service performance indicators assessed. Factors that should be taken into consideration when making the decision to move from a traditional SWM approach to a more integrated approach are highlighted and suggestions for a more smooth transition are recommended.     

Household waste disposal in Mekelle city, Northern Ethiopia

In many cities of developing countries, such as Mekelle (Ethiopia), waste management is poor and solid wastes are dumped along roadsides and into open areas, endangering health and attracting vermin. The effects of demographic factors, economic and social status, waste and environmental attributes on household solid waste disposal are investigated using data from household survey. Household level data are then analyzed using multinomial logit estimation to determine the factors that affect household waste disposal decision making. Results show that demographic features such as age, education and household size have an insignificant impact over the choice of alternative waste disposal means, whereas the supply of waste facilities significantly affects waste disposal choice. Inadequate supply of waste containers and longer distance to these containers increase the probability of waste dumping in open areas and roadsides relative to the use of communal containers. Higher household income decreases the probability of using open areas and roadsides as waste destinations relative to communal containers. Measures to make the process of waste disposal less costly and ensuring well functioning institutional waste management would improve proper waste disposal.     

A multiple criteria analysis for household solid waste management in the urban community of Dakar

Household solid waste management is a severe problem in big cities of developing countries. Mismanaged solid waste dumpsites produce bad sanitary, ecological and economic consequences for the whole population, especially for the poorest urban inhabitants. Dealing with this problem, this paper utilizes field data collected in the urban community of Dakar, in view of ranking nine areas of the city with respect to multiple criteria of nuisance. Nine criteria are built and organized in three families that represent three classical viewpoints: the production of wastes, their collection and their treatment. Thanks to the method PROMETHEE and the software ARGOS, we do a pair-wise comparison of the nine areas, which allows their multiple criteria rankings according to each viewpoint and then globally. Finding the worst and best areas in terms of nuisance for a better waste management in the city is our final purpose, fitting as well as possible the needs of the urban community. Based on field knowledge and on the literature, we suggest applying general and area-specific remedies to the household solid waste problems.     

Municipal solid waste management in Rasht City, Iran

Pollution and health risks generated by improper solid waste management are important issues concerning environmental management in developing countries. In most cities, the use of open dumps is common for the disposal of wastes, resulting in soil and water resource contamination by leachate in addition to odors and fires. Solid waste management infrastructure and services in developing countries are far from achieving basic standards in terms of hygiene and efficient collection and disposal. This paper presents an overview of current municipal solid waste management in Rasht city, Gilan Province, Iran, and provides recommendations for system improvement. The collected data of different MSW functional elements were based on data from questionnaires, visual observations of the authors, available reports and several interviews and meetings with responsible persons. Due to an increase in population and changes in lifestyle, the quantity and quality of MSW in Rasht city has changed. Lack of resources, infrastructure, suitable planning, leadership, and public awareness are the main challenges of MSW management of Rasht city. However, the present situation of solid waste management in this city, which generates more than 400tons/d, has been improved since the establishment of an organization responsible only for solid waste management. Source separation of wastes and construction of a composting plant are the two main activities of the Rasht Municipality in recent years.     

A study of the dental solid waste produced in a school of dentistry in Turkey

Dental wastes are regulated under medical waste control regulations in most countries. Even though the quantity of hazardous wastes in dental solid wastes is a small proportion, there is still cross infection risk and potential danger for environment associated with mismanaged wastes. For this reason, knowledge of waste composition and development of proper management alternatives are necessary. In this study, the composition of solid wastes coming from eight clinics of the dental school of a University hospital in Turkey is examined. Although the waste has some variations between the two samplings, the general picture is such that the major components remain pretty much the same (in terms of %) for a fixed clinic. The composition of waste changes from one clinic to the other as expected. However, one can deduce from the data obtained that at about 35%, rubber gloves constitute close to the half of the total solid waste in almost all the clinics. Other major component is paper forming approximately 30% of the solid waste. In general, total waste coming from the clinics is related with the number of procedures conducted on patients at the clinics. Only a small fraction of the waste is hazardous indicating that at Hacettepe University School of Dentistry, hazardous waste collection rules are obeyed in most of the times.     

Municipal solid waste management in India: From waste disposal to recovery of resources?

Unlike that of western countries, the solid waste of Asian cities is often comprised of 70-80% organic matter, dirt and dust. Composting is considered to be the best option to deal with the waste generated. Composting helps reduce the waste transported to and disposed of in landfills. During the course of the research, the author learned that several developing countries established large-scale composting plants that eventually failed for various reasons. The main flaw that led to the unsuccessful establishment of the plants was the lack of application of simple scientific methods to select the material to be composted. Landfills have also been widely unsuccessful in countries like India because the landfill sites have a very limited time frame of usage. The population of the developing countries is another factor that detrimentally impacts the function of landfill sites. As the population keeps increasing, the garbage quantity also increases, which, in turn, exhausts the landfill sites. Landfills are also becoming increasingly expensive because of the rising costs of construction and operation. Incineration, which can greatly reduce the amount of incoming municipal solid waste, is the second most common method for disposal in developed countries. However, incinerator ash may contain hazardous materials including heavy metals and organic compounds such as dioxins, etc. Recycling plays a large role in solid waste management, especially in cities in developing countries. None of the three methods mentioned here are free from problems. The aim of this study is thus to compare the three methods, keeping in mind the costs that would be incurred by the respective governments, and identify the most economical and best option possible to combat the waste disposal problem.     

Storage,collection and disposal of Kariakoo market wastes in Dar es Salaam,Tanzania

In many developing countries, the market is still the most important source of commerce for traders and provisions for the general public. The transmission of disease in the market place involves factors relating to the host, the agent and the environment. This study examines the quality of solid waste management in Kariakoo market, Dar es Salaam. The main problems identified were poor market design and lack of a well organized waste storage, collection and disposal systems. Two-thirds of the waste consists of vegetable matter. Proposals for improved design of storage and collection facilities are described. Experiments revealed wastes from the market are readily decomposable by composting. A change in the design of covered markets and improvements in waste handling are essential to reduce the potential health hazards in developing countries.     

Searching quality data for municipal solid waste planning

Effective waste reduction and recycling is predicated upon credible data on refuse generation and disposal. Despite improvements in the quality of data for municipal solid wastes (MSW) disposal, dependable generation and recycling statistics to support planning, regulation and administration are lacking. The available aggregates on national waste production from two sources do not conform to each other and fail to serve the requirements of local solid waste planning. As recycling estimates will be difficult to discern, the collection of generation data based on weighing waste samples at generator sites has been portrayed as the key for developing sustainable local databases. The coefficients developed from the databases for the various categories of residential, commercial, industrial and institutional wastes can be used as variables for waste generation models.     

Generation of solid wastes in typhoon disasters and their emergent cleaning and treatment means

In Taiwan, typhoons usually result in a large amount of waste that needs to be removed in a short time from July to October. This study reviewed the relevant regulations on the clean-up of typhoon waste, including emergency response regulations, organizations and information systems; and we also discuss different typhoon waste clean-up and disposal methods. The results indicate that the parameters other than the maximum wind speed, such as the maximum accumulated rainfall, flooded area, waste output, sludge output, disinfected area and government dispatched attendance reached statistical significance (p < 0.05). Waste, tree branches and bird carcasses were primarily incinerated, while silt and building materials were buried, and pig and cattle carcasses were placed in a landfill with the tertiary treatment of wastewater. This study also reports on the relevant regulations for prevention of epidemics among personnel working in disaster areas. The results can provide important references for the disposal of typhoon waste in developing countries. As Asian countries have similar life styles and are often attacked by typhoons, the results of this study provide Asian countries with the operating experience of Taiwan in emergency treatment of solid waste resulting from typhoons as a reference for them to plan response systems and operation.     

Determination of the best appropriate management methods for the health-care wastes in Istanbul

Health-care waste management has been a significant problem in most economically developing countries as it is in Turkey. Most of the time, the main reason for the mismanagement of these wastes is the lack of appropriate legislation and effective control; other reasons are: financial strains and a lack of awareness. Being aware of the significance of the subject, in this paper the management of the health-care wastes in Istanbul, as a Metropolitan City of Turkey, was analyzed to create an integrated health-care waste management system in the city. Within the scope of the study, the existing situation and management practices such as the amount of the health-care wastes generated, segregation procedures, collection, temporary storage and transportation of the wastes within and outside of the institution were examined. Deficiencies, inconsistencies and improper applications were revealed. The existing Turkish Medical Wastes Control Regulation and institutional structure of the health-care waste management body were reviewed. After the evaluation and comparison with the requirements of other national and international organizations, items to be changed/added in the Regulation were identified. At the end of the study, the best management methods for the Istanbul City were determined and started to be applied at the institutions. After this study, the existing Regulation has been changed. The modified Regulation was published in 2005 and implementation has started. It is expected that by the application and implementation of the research outcomes, the management of health-care wastes in Istanbul and then in all over Turkey will be improved. The results obtained can also be used in most economically developing countries where there are similar environmental problems and strict budgets.     

Cost estimation for solid waste management in industrialising regions--precedents, problems and prospects

The importance of cost planning for solid waste management (SWM) in industrialising regions (IR) is not well recognised. The approaches used to estimate costs of SWM can broadly be classified into three categories - the unit cost method, benchmarking techniques and developing cost models using sub-approaches such as cost and production function analysis. These methods have been developed into computer programmes with varying functionality and utility. IR mostly use the unit cost and benchmarking approach to estimate their SWM costs. The models for cost estimation, on the other hand, are used at times in industrialised countries, but not in IR. Taken together, these approaches could be viewed as precedents that can be modified appropriately to suit waste management systems in IR. The main challenges (or problems) one might face while attempting to do so are a lack of cost data, and a lack of quality for what data do exist. There are practical benefits to planners in IR where solid waste problems are critical and budgets are limited.     

Assessment and analysis of industrial liquid waste and sludge disposal at unlined landfill sites in arid climate

Municipal solid waste disposal sites in arid countries such as Kuwait receive various types of waste materials like sewage sludge, chemical waste and other debris. Large amounts of leachate are expected to be generated due to the improper disposal of industrial wastewater, sewage sludge and chemical wastes with municipal solid waste at landfill sites even though the rainwater is scarce. Almost 95% of all solid waste generated in Kuwait during the last 10 years was dumped in five unlined landfills. The sites accepting liquid waste consist of old sand quarries that do not follow any specific engineering guidelines. With the current practice, contamination of the ground water table is possible due to the close location of the water table beneath the bottom of the waste disposal sites. This study determined the percentage of industrial liquid waste and sludge of the total waste dumped at the landfill sites, analyzed the chemical characteristics of liquid waste stream and contaminated water at disposal sites, and finally evaluated the possible risk posed by the continuous dumping of such wastes at the unlined landfills. Statistical analysis has been performed on the disposal and characterization of industrial wastewater and sludge at five active landfill sites. The chemical analysis shows that all the industrial wastes and sludge have high concentrations of COD, suspended solids, and heavy metals. Results show that from 1993 to 2000, 5.14+/-1.13 million t of total wastes were disposed per year in all active landfill sites in Kuwait. The share of industrial liquid and sludge waste was 1.85+/-0.19 million t representing 37.22+/-6.85% of total waste disposed in all landfill sites. Such wastes contribute to landfill leachate which pollutes groundwater and may enter the food chain causing adverse health effects. Lined evaporation ponds are suggested as an economical and safe solution for industrial wastewater and sludge disposal in the arid climate of Kuwait.     

Disposal of solid waste in Istanbul and along the Black Sea coast of Turkey

The increasing amount of solid waste arising from municipalities and other sources and its consequent disposal has been one of the major environmental problems in Turkey. Istanbul is a metropolitan city with a current population of around 14 million, and produces about 9000 ton of solid waste every day. The waste composition for Istanbul has changed markedly from 1981 to 1996 with large decreases in waste density, much of which is related to decreased amounts of ash collected in winter. In recent years, the Istanbul region has implemented a new solid waste management system with transfer stations, sanitary landfills, and methane recovery, which has led to major improvements. In the Black Sea region of Turkey, most of the municipal and industrial solid wastes, mixed with hospital and hazardous wastes, are dumped on the nearest lowlands and river valleys or into the sea. The impact of riverside and seashore dumping of solid wastes adds significantly to problems arising from sewage and industry on the Black Sea coast. Appropriate integrated solid waste management systems are needed here as well; however, they have been more difficult to implement than in Istanbul because of more difficult topography, weaker administrative structures, and the lower incomes of the inhabitants.     

Life cycle environmental benefit and waste-to-energy potential of municipal solid waste management scenarios in Indonesia

Journal of Material Cycles and Waste Management - Appropriate municipal solid waste management transition should be promoted for developing Asian countries. Thus, we established a life-cycle...     

Medical wastes management in the south of Brazil

In developing countries, solid wastes have not received sufficient attention. In many countries, hazardous and medical wastes are still handled and disposed together with domestic wastes, thus creating a great health risk to municipal workers, the public and the environment. Medical waste management has been evaluated at the Vacacai river basin in the State of Rio Grande do Sul, Brazil. A total of 91 healthcare facilities, including hospitals (21), health centers (48) and clinical laboratories (22) were surveyed to provide information about the management, segregation, generation, storage and disposal of medical wastes. The results about management aspects indicate that practices in most healthcare facilities do not comply with the principles stated in Brazilian legislation. All facilities demonstrated a priority on segregation of infectious-biological wastes. Average generation rates of total and infectious-biological wastes in the hospitals were estimated to be 3.245 and 0.570 kg/bed-day, respectively.     

Solid waste management practices in Turkey

As an economically developing country, Turkey has very well operated integrated solid waste management applications structured on modern facilities, besides over 2,000 scattered open dump areas in the country. Integrated waste management applications seem eligible for the metropolitan cities like Istanbul and Izmit (Kocaeli). Attempts have not been encouraging for the scattered regional settlements using central storage sites due to financial shortages and received rejections from nearby settlements. Small-scale compact solid waste management systems with materials recycling and composting can be more suitable alternatives in the small-scale regional settlements. The major constituents of municipal solid waste are organic in nature and approximately a quarter of municipal solid waste is recyclable. Although paper, including cardboard, is the main constituent, the composition of recyclable waste varies strongly by the source or the type of collection point. Solid wastes need primary treatment in order to be suitable for incineration and composting. Turkey needs to give more emphasis on the usage of modern solid waste removal technologies to overcome the overgrowing solid waste disposal problems.     

Sustainable solutions for solid waste management in Southeast Asian countries

Human activities generate waste and the amounts tend to increase as the demand for quality of life increases. Today’s rate in the Southeast Asian Nations (ASEANs) is alarming, posing a challenge to governments regarding environmental pollution in the recent years. The expectation is that eventually waste treatment and waste prevention approaches will develop towards sustainable waste management solutions. This expectation is for instance reflected in the term ‘zero emission systems’. The concept of zero emissions can be applied successfully with today’s technical possibilities in the agro-based processing industry. First, the state-of-the-art of waste management in Southeast Asian countries will be outlined in this paper, followed by waste generation rates, sources, and composition, as well as future trends of waste. Further on, solutions for solid waste management will be reviewed in the discussions of sustainable waste management. The paper emphasizes the concept of waste prevention through utilization of all wastes as process inputs, leading to the possibility of creating an ecosystem in a loop of materials. Also, a case study, focusing on the citrus processing industry, is displayed to illustrate the application of the aggregated material input–output model in a widespread processing industry in ASEAN. The model can be shown as a closed cluster, which permits an identification of opportunities for reducing environmental impacts at the process level in the food processing industry. Throughout the discussion in this paper, the utilization of renewable energy and economic aspects are considered to adapt to environmental and economic issues and the aim of eco-efficiency. Additionally, the opportunities and constraints of waste management will be discussed.     

A review of waste prevention through 3R under the concept of circular economy in China

The large waste generation has become one of the worldwide environmental problems. Circular economy has been seen as a way to tackle its urgent problems of environmental degradation and source scarcity. In recent years, under the concepts of circular economy, waste prevention through “Reduce, Reuse and Recycle” (3R) rules have attracted a broad concern in China. China has made some great achievements on waste management, and at the same time is facing many challenges. It is very necessary to share the management experiences and practices with the scholars and managers in other countries. This review covered the current situation and progress of circular economy development from the perspective of the legal regime and project practices, and the recycling practices of typical waste. The typical household wastes, including municipal solid wastes (MSW), e-waste, and end of life vehicles (ELV), were studied as the typical cases. Based on an examination of the statistical results, we also identified the potential problems and challenges for waste prevention through 3R in China. Finally, we provided some effective measures to further improve the waste management and recycling in China.