ABSTRACT
With the increasing generation of medical waste worldwide, managing medical waste has become crucial, given its potential environmental and public health risks. Previously in the Republic of Korea, medical waste was often mixed with municipal waste and disposed of in residential landfills or unsuitable treatment facilities (e.g., improperly managed incinerators). Environmental regulators and waste producers have made extensive efforts in recent years to improve waste management at healthcare facilities. This study presents an overview of the status of medical waste management in Korea and discusses information on the generation, composition, separation, transportation, and treatment of medical waste. Incineration was confirmed to be the most preferred treatment method for medical waste and was the only one used until late 2005. Large-scale medical waste incinerators are used for treating medical waste from most medical facilities in Korea;however, with increasing regulations on toxic air emissions (e.g., dioxins and furans), air emission standards are being tightened for all existing small-scale incineration facilities without air pollution control. Since medical waste usually contains various plastic materials such as polyvinyl chloride, these incinerators are highly likely to emit toxic air pollutants if improperly operated and managed. Waste minimization and recycling, control of toxic air emissions from medical waste incinerators, and alternative treatment methods to incineration are seen as major challenges. Incineration capacity cannot be expanded as quickly as the rising quantities of medical waste in Korea;thus, there is a growing need to reconsider the overall management system. Accordingly, we examined various medical waste treatment policies and methods that are being implemented in other countries, in addition to the main strategy of waste management. To determine preferable directions for the improvement of the medical waste management system, we investigated and compared the status of domestic and foreign waste management and proposed directions for improvement, focusing on several issues related to the current medical waste management system in Korea.
ABSTRACT
ABSTRACT: Coronavirus disease 2019 might have an impact on patients with Parkinson disease because of the neuroinvasive potential. Herein, we report the case of a patient with Parkinson disease who developed severe and prolonged oropharyngeal dysphagia after a coronavirus disease 2019 infection. A 73-yr-old male patient with Parkinson disease was diagnosed with coronavirus disease 2019 and admitted to a tertiary care hospital. Before hospitalization, he was assessed at Hoehn and Yahr stage 4 and showed no symptoms of dysphagia. After admission, the patient gradually recovered; however, he was fed through a nasogastric tube. A videofluoroscopic swallowing study revealed a severe oropharyngeal dysphagia with a severely delayed oral phase. Therefore, he underwent percutaneous gastrostomy tube insertion. After discharge, although he received swallowing therapy for 4 mos, he still had severe dysphagia, which made him dependent on enteral feeding. We speculate that the impact of coronavirus disease 2019 on dopaminergic and nondopaminergic mechanisms could lead to the development of dysphagia in this patient. The present case suggests that clinicians must have a high index of suspicion without dismissing the possibility of dysphagia and subsequent aspiration pneumonia in coronavirus disease 2019 patients with Parkinson disease.