Health-care waste management in Lao PDR: a case study.

This study investigated the health-care waste (HCW) management at each health-care facility level at two selected sites in the Lao People's Democratic Republic (Lao PDR): Vientiane Municipality; and Bolikhamxay province. It focused on the amount of HCW, its segregation and the factors influencing HCW management, particularly segregation procedures. A high proportion of incorrectly segregated medical waste was found at each level of health-care facility. Re-segregation revealed 39, 62, 57 and 37% at national hospital, provincial hospital, district hospital and health centre level, respectively, was poorly segregated. The mean of generated HCW was 0.62 kg/bed per day (Vientiane Municipality) and 0.38 kg/bed per day (Bolikhamxay) at two study sites. A higher proportion of medical waste (MW) from the inpatient department at the primary health-care level was found. Thus, HCW management at primary health-care facilities needs more attention and should be better understood.     

Construction waste management based on industrial management models: a Swedish case study.

This paper describes a methodology for estimating the true internal costs of construction waste, aimed at promoting environmentally friendly waste management. The study employs cost-benefit analysis, contribution margin analysis, the polluter-pays principle and a mathematical model: the model for Efficient Use of Resources for Optimal Production Economy (EUROPE), which has been introduced previously by the author for assigning industrial costs to waste. The calculations are performed on construction waste created in a case study of a building project. Moreover, waste is regarded as, in a business sense, having the same basic status as any normal industrial product, namely the 'equality principle'. Application of the methodology is suggested to create incentives for environmental and profitability improvement in construction companies and other types of industrial sectors. The results of the case study show the generation of construction waste to substantially decrease the final operating income, due to the internal shadow price cost it creates. This paper is intended to reduce the gap between the choice of waste management procedures and their economic impact, the overall objective being to accomplish an improved industrial environmental situation.     

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.     

Regional medical waste management in China: a case study of Shenyang

Medical waste management is of great importance due to its potential environmental and public health risks, especially in developing countries where both financial and technological resources on medical waste management are still lacking. Although many studies have focused on country-scaled medical waste management, few have paid close attention to regional (city-scale) management, particularly in China. This paper fills such a gap by employing a case study approach. Due to its representative nature, Shenyang was selected as the case study. After a review of China’s medical waste management, an empirical study in Shenyang was conducted in order to analyze the current state as well as identify key challenges on regional medical waste management. Based upon the local realities and aiming to better manage medical wastes, an integrated medical waste management framework is developed. Such a platform encourages the establishment of a specific medical waste management authority, a city scaled capacity building program on improving the general public’s awareness, an information platform, application of state-of-the-art technologies, as well as creation of an effective financial system. The combination of such initiatives can significantly improve the overall eco-efficiency of medical waste management at the regional level and should be promoted to other developing cities.     

Hospital waste management in Libya: A case study

In Libya, as in many developing countries, little information is available regarding generation, handling and disposal of hospital waste. This fact hinders the development and implementation of hospital waste management schemes. The specific objective of this study is to present an appraisal of the current situation regarding hospital waste management in Libya. Procedures, techniques, methods of handling, and disposal of waste are presented, as well as the amounts and compositions of hospital waste. This research was conducted in the form of a case study. Fourteen different healthcare facilities in three cities, Tripoli, Misurata, and Sirt, all located in the northwestern part of Libya, were selected for investigation. The investigation showed that the hospitals surveyed had neither guidelines for separated collection and classification, nor methods for storage and disposal of generated waste. This deficiency indicates the need for an adequate hospital waste management strategy to improve and control the existing situation. The average waste generation rate was found to be 1.3 kg/patient/day, comprised of 72% general healthcare waste (non-risk) and 28% hazardous waste. The average general waste composition was: 38% organic, 24% plastics, and 20% paper. Sharps and pathological elements comprised 26% of the hazardous waste component.     

Developing a master plan for hospital solid waste management: a case study

Disposal of about 1750tons of solid wastes per day is the result of a rapid population growth in the province of Khuzestan in the south west of Iran. Most of these wastes, especially hospital solid wastes which have contributed to the pollution of the environment in the study area, are not properly managed considering environmental standards and regulations. In this paper, the framework of a master plan for managing hospital solid wastes is proposed considering different criteria which are usually used for evaluating the pollution of hospital solid waste loads. The effectiveness of the management schemes is also evaluated. In order to rank the hospitals and determine the share of each hospital in the total hospital solid waste pollution load, a multiple criteria decision making technique, namely analytical hierarchy process (AHP), is used. A set of projects are proposed for solid waste pollution control and reduction in the proposed framework. It is partially applied for hospital solid waste management in the province of Khuzestan, Iran. The results have shown that the hospitals located near the capital city of the province, Ahvaz, produce more than 43% of the total hospital solid waste pollution load of the province. The results have also shown the importance of improving management techniques rather than building new facilities. The proposed methodology is used to formulate a master plan for hospital solid waste management.     

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.     

Measurement and management of hospital waste in southern Iran: a case study

One of the requirements for development of human societies is the establishment of new healthcare centers. A variety of wastes are generated in healthcare centers depending on the type of activities. This study was conducted to identify, measure and manage different types of hospital wastes as a case study in a hospital located in southern Iran. For this purpose, a questionnaire was initially designed and distributed among the relevant experts to survey the current trend of waste management in the hospital in terms of waste collection, storage and disposal. Afterwards, the hospital waste was sampled during two seasons of fall and winter. The samples were weighted for seven consecutive days in the middle of each season. Approximately, 10 % of the total waste bags per day collected round the clock were selected for further analysis. The obtained results indicated that infectious-hazardous and pseudo-household wastes were, respectively, about 3.79 kg/day/bed, 1.36 kg/day/bed and 2.43 kg/day/bed of the total generated waste in the hospital. As the research findings suggest, proper separation of infectious and pseudo-household wastes at the source would be an essential step towards mitigating environmental and health risks and minimizing the cost of the hospital waste management.     

Report: The assessment of hospital waste management:a case study in Tehran

Hospital waste management is an important process that must be dealt with diligently. The management of hazardous waste material requires specific knowledge and regulations and it must be carried out by specialists in the field. In this cross-sectional study, we assessed the main stages of hospital waste management including separation, containment, removal and disposal of waste materials in public hospitals affiliated with Tehran University of Medical Sciences (TUMS). We selected 108 units of six hospitals (three general hospitals and three subspecialty hospitals) from those hospitals supervised by TUMS using the cluster sampling method. The measurement was conducted through a questionnaire and direct observation by researchers. Association analysis was done by statistical tests; Fisher exact test and chi-squared using SPSS software. According to the results obtained by the questionnaire, most of the studied wards scored moderately in terms of quality of their performance in all stages of waste management. About one-fifth of the wards were suffering from poor management of their medical waste and only a minority of wards obtained good scores for managing their waste materials. The findings also revealed significant associations between temporary waste storage and collection and the level of education of the managers (P = 0.040, P = 0.050, respectively). In summary, the study indicated a moderate management in all processes of separation, collection, containment, removal and disposal of waste materials in hospitals with several observed problems in the process.     

Stakeholder coordination analysis in hazardous waste management: a case study in China

Journal of Material Cycles and Waste Management - Hazardous waste management (HWM) in chemical industrial parks is an important issue related to sustainable development. Previous researches...     

Medical waste management in Turkey: A case study of Istanbul

The objective of this study was to analyze the present status of medical waste management in the light of the Medical Waste Control Regulation (MWCR) in Istanbul, the largest city in Turkey. About 17% of the hospitals, 20% of bed capacity, and 54% of private hospitals in Turkey are located in Istanbul. The first regulation about medical waste management in Turkey was published in 1993, and as a candidate state, it was changed in 2005 in accordance with EU Environmental Directives. In this work, a survey of 14 questions about the amount, collection, and temporary storage of medical wastes was applied to 192 hospitals in Istanbul through face-to-face interviews. It was found that the estimated quantity of medical waste from the hospitals is about 22tons/day and the average generation rate is 0.63kg/bed-day. Recyclable materials are collected separately at a rate of 83%. Separate collection of different types of wastes is consistently practiced, but 25% of the hospitals still use inappropriate containers for medical waste collection. Almost 77% of the hospitals use appropriate equipment for the medical waste collection personnel. The percentage of the hospitals that have temporary storage depots is 63%. Medical waste management in Istanbul is carried out by applying the MWCR.     

Medical waste management in China: A case study of Nanjing

Medical waste management is of great importance due to its infectious and hazardous nature that can cause undesirable effects on humans and the environment. The objective of this study was to analyze and evaluate the present status of medical waste management in the light of medical waste control regulations in Nanjing. A comprehensive inspection survey was conducted for 15 hospitals, 3 disposal companies and 200 patients. Field visits and a questionnaire survey method were implemented to collect information regarding different medical waste management aspects, including medical waste generation, segregation and collection, storage, training and education, transportation, disposal, and public awareness.The results indicated that the medical waste generation rate ranges from 0.5 to 0.8 kg/bed day with a weighted average of 0.68 kg/bed day. The segregated collection of various types of medical waste has been conducted in 73% of the hospitals, but 20% of the hospitals still use unqualified staff for medical waste collection, and 93.3% of the hospitals have temporary storage areas. Additionally, 93.3% of the hospitals have provided training for staff; however, only 20% of the hospitals have ongoing training and education. It was found that the centralized disposal system has been constructed based on incineration technology, and the disposal cost of medical waste is about 580 US$/ton. The results also suggested that there is not sufficient public understanding of medical waste management, and 77% of respondents think medical waste management is an important factor in selecting hospital services.The problematic areas of medical waste management in Nanjing are addressed by proposing some recommendations that will ensure that potential health and environmental risks of medical waste are minimized.     

A charge model for household waste management services: a case study of Tehran municipality

In practice, it is difficult to implement Pay-As-You-Throw charge systems based on accurate estimates of waste generation. In many cities, this is made impossible, due to lack of technical and administrative infrastructure and cultural considerations, especially in developing countries. This paper presents an alternative two-component charge model that is the combination of cost-accounting technique of Waste Management Services (WMSs) and econometric functions of waste generation. Practical and computation steps considered by the model are presented as a proposal to reform the current system of waste charge in Tehran municipality. The presented model is simple to implement and resolves some of the disadvantages of the traditional methods of waste charge systems, including insufficient revenue to cover the cost of waste management and unfairness related to social inequality.     

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...     

Co-benefit as an approach to align climate change concerns with national development objectives: solid waste management

Impinging local environmental problems on the one hand and constantly persuasive climate change concerns on the other put developing Asian cities in a dilemma as to which direction they should channel their efforts. While local matters are their immediate mandate, increasing awareness of climate change vulnerabilities adds weight to global problems. In this context, the concepts of co-benefits and ancillary benefits play an important role in aligning climate change concerns into sector-specific developmental goals. This article presents the conceptual aspects of co-benefits and the integration of climate concerns into sustainable development goals. The possible synergies between these two different but very important strategic pathways are examined along with possible ways to align them. The bottlenecks that can occur during such integration are also highlighted.     

Environmental assessment of alternative municipal solid waste management strategies. A Spanish case study

The aim of this study is to compare, from an environmental point of view, different alternatives for the management of municipal solid waste generated in the town of Castellón de la Plana (Spain). This town currently produces 207 ton of waste per day and the waste management system employed today involves the collection of paper/cardboard, glass and light packaging from materials banks and of rest waste at street-side containers.The proposed alternative scenarios were based on a combination of the following elements: selective collection targets to be accomplished by the year 2015 as specified in the Spanish National Waste Plan (assuming they are reached to an extent of 50% and 100%), different collection models implemented nationally, and diverse treatments of both the separated biodegradable fraction and the rest waste to be disposed of on landfills.This resulted in 24 scenarios, whose environmental behaviour was studied by applying the life cycle assessment methodology. In accordance with the ISO 14040-44 (2006) standard, an inventory model was developed for the following stages of the waste management life cycle: pre-collection (bags and containers), collection, transport, pre-treatment (waste separation) and treatment/disposal (recycling, composting, biogasification + composting, landfill with/without energy recovery). Environmental indicators were obtained for different impact categories, which made it possible to identify the key variables in the waste management system and the scenario that offers the best environmental behaviour. Finally, a sensitivity analysis was used to test some of the assumptions made in the initial life cycle inventory model.     

Municipal solid waste management challenges in developing countries--Kenyan case study

This paper provides an overview of the state of municipal solid waste management (MSWM) by local authorities in Kenya as a case study of a low-income developing country. Approaches of possible solutions that can be undertaken to improve municipal solid waste (MSW) services are discussed. Poor economic growth (1.1% in 1993) has resulted in an increase in the poverty level which presently stands at 56%. Migration from the rural areas to the urban areas has resulted in unplanned settlements in suburban areas accommodating about 60% of the urban population on only 5% urban land area. Political interference also hampers smooth running of local authorities. Vulnerability of pollution of surface and groundwater is high because local authorities rarely considered environmental impact in siting MSW disposal sites. Illegal dumping of MSW on the river banks or on the roadside poses environmental and economic threats on nearby properties. Poor servicing of MSW collection vehicles, poor state of infrastructure and the lack of adequate funding militate against optimization of MSW disposal service. The rural economy needs to be improved if rural-urban migration is to be managed. Involvement of stakeholders is important to achieve any meaningful and sustainable MSWM. The role of the informal sector through community-based organizations (CBOs), Non-Governmental Organizations (NGOs) and the private sector in offering solutions towards improvement of MSWM also is explored.