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Pharmaceuticals wastes are drugs and medicines that can no longer be used. The improper disposal of unused medicines is a growing problem throughout the world. This study assessed the pharmaceutical wastage rate and pharmaceutical waste management for the year 2015 to 2017 in the public health facility of Dessie, Ethiopia. A cross-section study design was used to review logistic data retrospectively from health commodity management information systems and manual records in 8 health facilities. Health professionals' (135) pharmaceutical waste management practices were assessed using the world health organization waste management checklist. Descriptive and inferential statistics were made using a statistical package for social sciences version 20. Supplies were the leading class of pharmaceuticals with an overall wastage rate of 37.1%. Tablet and injectable constituted the highest class of pharmaceuticals dosage form with the overall wastage rate of 20.78% and 16.49%. The overall pharmaceutical wastage rate was 3.68% amounting to USD 159,762.66 and expiry (92.05%) was the major reason for wastage. The pharmaceutical wastage rate of health centers was nearly twofold higher than hospitals. Pharmaceutical waste management was practiced by 105 (77%; 95% CI; 69.9%, 84.9%) health professionals. Determinants of pharmaceutical waste management were being male (P value = 0.08, AOR = 3.72), receiving training (P value = 0.01, AOR = 4.34), writing label (P value = 0.02, AOR = 5.04), storage of segregated waste in dispensing unit (P value = 0.01, AOR = 0.72) and the presence of disposal plan (P value = 0.002, AOR = 16.93). Supplies and tablets constituted the highest wastage class of pharmaceuticals and dosage form. The pharmaceutical wastage rate was higher than the standard and increasing in successive years. Pharmaceutical waste management was not fully practiced. Appropriate inventory control and waste management are recommended.

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

Introduction The improper disposal of unused and expired medications poses significant environmental hazards and increases the risk of human harm. Even in countries with established policies for safe disposal, improper practices persist. In Nigeria, where there is a lack of stringent policies on medication disposal, this issue may be more pronounced. This study aims to assess the patterns of disposal of unused and expired medications among outpatients in selected hospitals in Ibadan. Methods A cross-sectional, questionnaire-based study was conducted between December 2023 and February 2024. The survey was administered by interviewers to consenting outpatients at three healthcare facilities in Ibadan. Statistical analysis was performed using SPSS version 26, with a p -value of < 0.05 considered statistically significant. Results A total of 864 outpatients participated in the study, with a mean age of 45.1 ± 14.92 years. More than two-fifths of participants had secondary education, while nearly one-third had tertiary education. About two-thirds (66.3%) of the respondents reported obtaining their medications through self-medication. Approximately 39.1% of participants always checked the expiration dates before purchasing medications, while 24.7% did so before reusing them. Majority (70.8%) reported having unused medications at home, with over 95% and nearly 90% disposing of expired solid and liquid medications, respectively, via household waste. Notably, 96.1% of participants reported never receiving education on proper medication disposal. While 47.3% of respondents recognized the environmental impact of improper medication disposal, 46.9% agreed on the need for a strategy to retrieve unused or expired medications. Overall, 68.4% of respondents demonstrated poor perceptions about safe medication disposal practices. Significant associations were found between gender (χ 2 = 10.362, p = 0.001), marital status (χ 2 = 9.824, p = 0.007), education level (χ 2 = 56.91, p < 0.001), and patients' perception towards the disposal of unused and expired medications (UEMs). Conclusion The findings highlight the urgent need for public education, awareness campaigns, and policy reform to promote proper disposal of unused and expired medications in Ibadan, Nigeria.

BackgroundAnesthesia-related activities produce 25% of all operating room (OR) waste and contribute to environmental pollution and climate change. The aim of this study was to document Canadian anesthesiologists’ current practice, attitudes towards, and perceived barriers regarding recycling of OR waste and environmental sustainability efforts.MethodsWith Research Ethics Board approval, members of the Canadian Anesthesiologists’ Society (CAS) completed an online survey consisting of 25 questions assessing current environmentally sustainable practices in anesthesiology and gaps, barriers, and interest in gaining further knowledge on this topic.ResultsFour hundred and twenty-six of 2,695 (16%) CAS members responded to the questionnaire. Despite a willingness to recycle at work among most anesthesiologists (393/403, 97.5%), only 122/403 (30.2%) did so. Other sustainability efforts in Canadian ORs included donating unused medical equipment and supplies to medical missions (198/400, 49.5%) and evening shut-off of anesthesia machines and other OR equipment (185/400, 46.3%). Reported barriers to recycling in the OR included a lack of support from hospital/OR leadership (254/400, 63.5%) and inadequate information/education (251/400, 62.8%). Only 122/389 (31.4%) of respondents were aware of any efforts to expand sustainability programs at their institutions but 273/395 (69.1%) of respondents indicated an interest in obtaining further education on the topic.ConclusionCanadian anesthesiologists appear ready to incorporate environmental sustainability in their practice but indicate that significant barriers exist. Our study highlights the need for further educational programs and implementation strategies.

“Significant change at all levels, from the global to the hospital floor, in how we manage the health-care waste stream is a basic requirement of climate-smart health care systems, which many countries committed to at the recent UN Climate Change Conference,” noted Neira. The report presents a set of recom-mendations, which include using eco-friendly packaging and shipping, safe and reusable PPE (eg, gloves and medical masks), recyclable or biodegradable materials, investment in non-burn waste treatment technologies (eg, autoclaves), and reverse logistics to support centralised treatment and investment in the recycling sector. Maggie Montgomery, technical officer with WHO's water, sanitation, hygiene, and health unit, and a lead author of the report told The Lancet that around 30% of health-care facilities globally do not segregate hazardous and non-hazardous waste, making recycling more difficult.

The purpose of this paper is to describe current practices of medical waste management, including its generation, investments, collection, storage, segregation, and disposal, and to explore the level of support from upper tiers of the government and health care system for medical waste management in rural China. The authors draw on a dataset comprised of 209 randomly selected rural township health centers (THCs) in 21 counties in three provinces of China: Anhui, Shaanxi and Sichuan. Surveys were administered to health center administrators in sample THCs in June 2015. The results show that the generation rate of medical waste was about 0.18 kg/bed, 0.15 kg/patient, or 0.13 kg/person per day on average. Such per capita levels are significant given China's large rural population. Although investments of medical waste facilities and personnel in THCs have improved, results show that compliance with national regulations is low. For example, less than half of hazardous medical waste was packed in sealed containers or containers labeled with bio-hazard markings. None of the THCs segregated correctly according to the categories required by formal Chinese regulations. Many THCs reported improper disposal methods of medical waste. Our results also indicate low levels of staff training and low rates of centralized disposal in rural THCs. Medical waste is a serious environmental issue that is rising on the agenda of policymakers. While a large share of THCs has invested in medical waste facilities and personnel, it appears that actual compliance remains low. Using evidence of low rates of training and centralized disposal, we surmise that a lack of support from upper tiers of management is one contributing factor. Given these findings, we recommend that China's policymakers should enhance support from upper tiers and improve monitoring as well as incentives in order to improve medical waste management.

Background The risk of hepatitis B virus infection among medical waste handlers who undergo collection, transportation, and disposal of medical wastes in the health institutions is higher due to frequent exposure to contaminated blood and other body fluids. There is limited evidence on the seroprevalence of hepatitis B among medical waste handlers in eastern Ethiopia. The study was aimed at studying the seroprevalence of Hepatitis B Virus and associated risk factors among medical waste collectors at health facilities of eastern Ethiopia. Methods A facility-based cross-sectional study was conducted among randomly selected medical waste collectors from public health facilities in eastern Ethiopia from March to June 2018. A pre-tested and well-structured questionnaire was used to collect data on socio-demographic characteristics and hepatitis B infection risk factors. A2.5ml venous blood was also collected, centrifuged and the serum was analyzed for hepatitis B surface antigen using the instant hepatitis B surface antigen kit. Descriptive summary measures were done. Chi-square and Fisher exact tests were used to assess the risk of association. Multivariate logistic regression was conducted with 95% CI and all value at P -value < 0.05 was declared statistically significant. Results From a total of 260 (97.38%) medical waste collectors participated, HBV was detected in 53 (20.4%) of the participants [95%CI; 15.8, 25.6]. No significant differences were observed in the detection rates of HBV with respect to socio-demographic characteristics. In both bivariate and multivariable logistic regression analysis, being unvaccinated (AOR = 6.35; 95%CI = [2.53–15.96], P  = 0.001), history of blood transfusion (receiving) (AOR; 3.54; 95%CI; [1.02–12.24], P =  0.046), history of tattooing (AOR = 2.86; 95%CI = [1.12–7.27], p  = 0.03), and history of multiple sexual partner (AOR = 10.28; 95%CI = [4.16–25.38], P = 0.001) remained statistically significantly associated with HBsAg positivity. Conclusion This cross-sectional study identified that HBV infection is high among medical waste collectors in eastern Ethiopia. Immunization and on job health promotion and disease prevention measures should be considered in order to control the risk of HBV infection among medical waste collectors in eastern Ethiopia.

Medical waste represents a significant health risk and an environmental pollution concern due to its hazardous characteristics. The knowledge and practice of healthcare personnel in respect of the disposal of medical waste is essential to perform effective medical waste management. Therefore, the aim of this study was to assess the knowledge, attitudes, and practices related to medical waste management among healthcare workers in clinics (medical and dental clinics, specialized medical, laboratory clinics, polyclinics, and midwifery clinics) in Phuket, Thailand. A cross-sectional study was designed with stratified-random sampling used to select the sample of 344 respondents from 172 clinics of which data were collected using face-to-face interviews. The results showed that the majority of respondents (87.2%) were female of whom 36.9% were aged (20–29), 52.0% had more than 5 years working experience, and 51.2% had participated in at least one training course regarding medical waste management. The overall scores for knowledge, attitude, and practice were at a high level (89.5%, 91.9%, and 92.2%, respectively). Significant and positive correlations were found between knowledge and attitude (r = 0.464), knowledge and practice (r = 0.396), and practice and attitude (r = 0.519). Statistical analysis using t tests and one-way analysis of variance showed that working experience and its duration were significant factors influencing good medical waste management practice. However, local authorities should implement a well-planned collection and transfer process for medical waste in order to reduce the risk of environmental pollution and the risk of infection or injury to healthcare workers and the general public.

IntroductionThe management of healthcare waste is a crucial issue for public health and the environment. To minimise risks, it is essential to ensure that the management of healthcare waste is meticulously applied. Additionally, among the evaluation methods adopted by the hospital hygiene department to monitor the degree of compliance. The aim of this study was to assess the degree of compliance with healthcare waste management before and after a training and support programme.MethodsThis is a pre-experimental study based on two audits of healthcare waste management at Farhat Hached University Hospital in Sousse, Tunisia. All medical, surgical and laboratory departments were included. The first audit was carried out, followed by training of the responsible staff, which was carried out according to a cycle of training and coaching hygiene technicians, and finally, a second audit was conducted. The compliance rate is compared between 2021 and 2022.ResultsWhen comparing the averages of the compliance percentages for the four audit areas, there was a statistically significant improvement between the years 2021 and 2022 in the availability of equipment and consumables required for the management of infectious and sharp healthcare waste (p=0.029) as well as intramural transport (p=0.014).ConclusionThe study highlights the central role of effective waste management training in promoting compliance, awareness and responsible practices. Constant attention and training are essential to maintain progress at Farhat Hached University Hospital. This helps create safer care environments, better public health outcomes and long-term sustainability.

Objectives Many international dental organizations have been advocating for sustainable practices in dentistry, whereby significant reductions in environmental impacts are needed. The aim of this study was to analyze dental clinical waste in a university clinic setting to explore opportunities for sustainable practices. Material and Methods Fifty dental units (chairs) that are routinely used in delivery of dental treatment and involved supervising clinicians, dental students, and patients were randomly selected, and the clinical waste generated was collected, segregated, and weighed. Statistical analysis was performed to analyze differences in waste production based on treatment performed. Results The mean waste production generated by each chair was 81.4 g of aprons, 56.2 g of gloves, 17.2 g of masks, 24.0 g of sterile wrappings, 48.8 g of other plastics, 100.8 g of cellulose‐based items, and 25.8 g of miscellaneous items. Higher waste was generated from the chairs performing endodontic procedures when compared with examinations. A potential annual greenhouse gas saving of approximately 10 kg CO2e per year (when one patient is treated daily) can be achieved if sterile wrapping plastics were to be recycled. Conclusions Simple yet achievable opportunities for efficient clinical waste management at university clinics exist, which in turn will increase environmental sustainability in the post‐COVID‐19 era. Increased awareness and incentives for sustainable measures could potentially enhance the possibility of wider adoption of ecofriendly approaches.