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Medical waste management (MWM) is an important and necessary problem in the COVID-19 situation for treatment staff. When the number of infectious patients grows up, the amount of MWMs increases day by day. We present medical waste chain network design (MWCND) that contains health center (HC), waste segregation (WS), waste purchase contractor (WPC), and landfill. We propose to locate WS to decrease waste and recover them and send them to the WPC. Recovering medical waste like metal and plastic can help the environment and return to the production cycle. Therefore, we proposed a novel viable MWCND by a novel two-stage robust stochastic programming that considers resiliency (flexibility and network complexity) and sustainable (energy and environment) requirements. Therefore, we try to consider risks by conditional value at risk (CVaR) and improve robustness and agility to demand fluctuation and network. We utilize and solve it by GAMS CPLEX solver. The results show that by increasing the conservative coefficient, the confidence level of CVaR and waste recovery coefficient increases cost function and population risk. Moreover, increasing demand and scale of the problem makes to increase the cost function.

This study examines the importance of medical waste management activities for developing a sustainable green healthcare environment. This study applied a multiple methodological approach as follows. A thorough review of the literature was performed to delineate the factors that have been explored for reducing medical waste; hospital staff who handle medical waste were surveyed to obtain their opinions on these factors; the analytic hierarchy process (AHP) was applied to determine the priorities among the identified key factors; and experts’ opinions were consulted to assess the actual applicability of the results derived by the AHP. The study identified the following factors as the most important: medical waste management (26.6%), operational management issues (21.7%), training for medical waste management procedures (17.8%), raising awareness (17.5%), and environmental assessment (16.4%). This study analyzed the contributing factors to the generation of medical waste based on the data collected from medical staff and the AHP for developing a sustainable green healthcare environment. The study results provide theoretical and practical implications for implementing effective medical waste management toward a sustainable green healthcare environment.

Medical wastes are considered hazardous because they may possess infectious agents and can cause unsafe effects on the environment and human health. This study is to analyze and evaluate the current status of medical waste management at Jenin’s district in light of medical waste control regulations recommended by the World Health Organization. The results demonstrated that the average hazardous healthcare waste generation rate ranges from 0.54 to 1.82 kg/bed/day with a weighted average of 0.78 kg/bed/day. There was no established waste segregation of healthcare waste types in all hospitals, and these wastes were finally disposed of in a centralized municipal sanitary landfill, namely Zahrat Al-Finjan. The results suggest that there is a need for activation and enforcement of medical waste laws. This can be achieved through cooperation among key actors: Ministry of Health, Environmental Quality Authority, Ministry of Local Government, and Non-Governmental Organizations working in related fields. Additional remediation measures proposed to tackle the problematic areas of medical waste management in Jenin’s district hospitals are addressed. Some recommendations to minimize potential health and environmental risks of medical waste are also introduced.

Proper hospital waste management poses important concerns due to the risk capacity of hospital waste to health and the environment. Healthcare management approaches have changed in recent years, motivated by the desire to minimize the environmental impact. The review aims to examine the current HCW and considers the local challenges associated with establishing a circular economy (CE) to improve hospital waste management regarding training along Plan, Do, Check, and Act (PDCA). The study found that mean medical and general waste segregation rates in public hospitals were 50.15 and 49.85, respectively. On average, 3.6 kg of waste was generated per bed per day. Analysis revealed a significant correlation between total waste and infectious waste with the number of occupied beds in the hospital ( p  < 0.05). Updating national laws by the CE approach is necessary. Our insights into circular hospital waste urge establishing a green management team, new training methods, and continuous supervision. Using PDCA to enhance waste segregation, training, and other aspects of hospital waste management is vital.

The management and treatment of Medical Waste (MW) are of great concern owing to its potential hazard to human health and the environment, particularly in developing countries. In Bhutan, although guidelines exist on the prevention and management of wastes, the implementation is still hampered by technological, economic, social difficulties and inadequate training of staff responsible for handling these waste. The study aimed at assessing the awareness and practice of medical waste management among health care providers and support staff at the National Referral Hospital and its compliance with the existing National guidelines and policies. An observational cross-sectional study was conducted from March to April 2019. Three research instruments were developed and used; (i) Demographic questionnaire, (ii) Awareness questions, and (iii) the Observational checklist. The data was coded and double entered into Epi data version 3.1 and SPSS version 18 was used for analysis. Descriptive statistics were used to present the findings of the study. The majority of the respondents were female (54.1%) with a mean age of 32.2 (±7.67) years, most of whom have not received any waste management related training/education (56.8%). About 74.4% are aware of medical waste management and 98.2% are aware on the importance of using proper personal protective equipment. Only 37.6% knew about the maximum time limit for medical waste to be kept in hospital premises is 48 hours. About 61.3% of the observed units/wards/departments correctly segregated the waste in accordance to the national guidelines. However, half of the Hospital wastes are not being correctly transported based on correct segregation process with 58% of waste not segregated into infectious and general wastes. The awareness and practice of medical waste management among healthcare workers is often limited with inadequate sensitization and lack of proper implementation of the existing National guidelines at the study site. Therefore, timely and effective monitoring is required with regular training for healthcare workers and support staff. Furthermore, strengthening the waste management system at National Referral Hospital would provide beneficial impact in enhancing safety measures of patients.

The concept of a “green hospital” is used in reference to a hospital that includes the environment as part of its quality services and one that pays attention to the sustainable design of buildings. Waste disposal represents a potential risk for the environment; therefore, waste collection from healthcare centers is a key environmental issue. Our study aims to systematically review the experiences acquired in worldwide nosocomial settings related to the management of healthcare waste. Nineteen studies, selected between January 2020 and April 2022 on Scopus, MEDLINE/PubMed and Web of Science databases were included in our systematic narrative review. Operating room and hemodialysis activities seem to be the procedures most associated with waste production. To deal with waste production, the 5Rs rule (reduce, reuse, recycle, rethink and research) was a common suggested strategy to derive the maximum practical benefit while generating the minimum amount of waste. In this context, the COVID-19 pandemic slowed down the greening process of nosocomial environments. Waste management requires a multifactorial approach to deal with medical waste management, even considering the climate change that the world is experiencing. Education of health personnel and managers, regulation by governmental institutions, creation of an “environmental greening team”, and awareness of stakeholders and policymakers are some of the measures needed for the greening of healthcare facilities.

Operating rooms contribute greatly to hospital waste and greenhouse gas production. Efforts to “green the operating room” have focused on the 5R's of sustainability: reduce, reuse, recycle, rethink, and research. We propose a “6th R” —repurposing— as simple yet effective means of addressing operating room waste. Clean, non-reusable surgical supplies were collected from a satellite facility of a children's hospital during a six-week pilot program. Materials were catalogued and repurposed throughout the community. The potential financial benefits were estimated based upon the value of repurposed goods and savings from reduced waste disposal. Over 960 items were collected during the 6-week pilot. Materials ranging from plastic trays to surgical towels were donated to organizations throughout the community. Approximate retail value of repurposed items was over $1200. When extrapolated to the entire hospital system, these repurposing efforts could account for over $50,000 in donations and $1300 in operational savings over a calendar year. Repurposing unused surgical items provide environmental, societal, and financial benefits, all while promoting more sustainable healthcare systems. •Operating rooms contribute the most to hospital waste and its environmental impact.•Repurposing unused surgical supplies is under-recognized but simple and effective.•Clean, non-reusable surgical supplies may be repurposed throughout the community.•These repurposing efforts lead to environmental, community, and financial benefits.

BackgroundEndoscopic procedures are a notable source of medical waste, contributing significantly to environmental pollution. Prior studies report 0.5–3.0 kg of waste per procedure—compared with just 1.2 kg of household waste generated per person per day in Germany.ObjectiveTo quantify endoscopic waste in hospitals and outpatient settings, assess its impact on the healthcare system and identify strategies for reduction.DesignThis prospective, multicentre, observational study was conducted over 4 weeks in two tertiary hospitals and two gastroenterology offices. Waste from 2275 patients across 2889 procedures was collected, sorted, weighed and categorised for recyclability. National waste generation from GI endoscopy was estimated using published insurance data.ResultsThe average waste per procedure was 1119 g (hospitals: 1167 g; offices: 1094 g). Office-based procedures produced significantly less waste than their hospital counterparts—by 51% for oesophagogastroduodenoscopy (EGD), 50% for colonoscopy, 47% for combined procedures and 69% for sigmoidoscopy (all p<0.001). Performing consecutive procedures reduced waste by up to 39% for EGD and colonoscopy, and 33% for endoscopic ultrasound and endoscopic retrograde cholangiopancreatography. Switching from single-use to reusable gowns could reduce personal protective equipment waste by 54%. Overall, 23% of waste was potentially recyclable. Nationally, GI endoscopy generates an estimated 8024 tonnes of waste annually—equivalent to the yearly household waste of 18 533 German citizens.ConclusionThe waste generated by endoscopy per year in Germany rivals that of a small town. Adopting targeted waste reduction strategies—focusing on prevention, reduction, reuse, recycling and recovery—can substantially mitigate the environmental footprint of endoscopic practice.Trial registration numberNCT05921136

Global health resources have expanded quickly and global health has improved in many places. However, such progress has resulted in a demand for the management and safe disposal of medical waste, particularly in many developing countries which still lack adequate facilities and regulatory framework to deal with their medical waste. This study analyzes decarbonization and circular economy principles of sustainable medical waste management to find optimal solutions for reducing environmental impact and enhancing system efficiency. A novel hybrid MCDM model which combines DEMATEL-ANP is applied for identifying the key factors influencing the decarbonization and medical waste practices. It takes into account the interaction between factors and assists in decision making under uncertainty, particularly when data are scarce. The outcomes of the study highlight the sustainable management of medical waste and their correlation with certain UN-SDGs. According to DEMATEL results, both sustainable development (C1) and advanced technology adoption (C3) have significant cause-effect relationships on the other CE practices, whereas according to ANP findings, prospective investigative dominances of the advanced technology adaption (C2) and sustainable development (C1) are great backbones of decarbonization circular economies. The finding of this study offer specific insights for policymakers and administrators for reducing their environmental burdens, enhancing resource efficiency, and developing the resilience and sustainability of healthcare systems. To the best of our knowledge, this study becomes the first to emphasize medical waste management as a climate challenge and a sustainability issue and utilize a hybrid DEMATEL- ANP approach to facilitate evidence based policy making in low-resource settings in developing countries concurrently considering environmental sustainability as well as healthcare operations gap.

The outbreak of an epidemic disease may pose significant treats to human beings and may further lead to a global crisis. In order to control the spread of an epidemic, the effective management of rapidly increased medical waste through establishing a temporary reverse logistics system is of vital importance. However, no research has been conducted with the focus on the design of an epidemic reverse logistics network for dealing with medical waste during epidemic outbreaks, which, if improperly treated, may accelerate disease spread and pose a significant risk for both medical staffs and patients. Therefore, this paper proposes a novel multi-objective multi-period mixed integer program for reverse logistics network design in epidemic outbreaks, which aims at determining the best locations of temporary facilities and the transportation strategies for effective management of the exponentially increased medical waste within a very short period. The application of the model is illustrated with a case study based on the outbreak of the coronavirus disease 2019 (COVID-19) in Wuhan, China. Even though the uncertainty of the future COVID-19 spread tendency is very high at the time of this research, several general policy recommendations can still be obtained based on computational experiments and quantitative analyses. Among other insights, the results suggest installing temporary incinerators may be an effective solution for managing the tremendous increase of medical waste during the COVID-19 outbreak in Wuhan, but the location selection of these temporary incinerators is of significant importance. Due to the limitation on available data and knowledge at present stage, more real-world information are needed to assess the effectiveness of the current solution.