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Background: The prevalence of emerging and re-emerging diseases has made the need for basic preparations for all health care organizations more crucial. Strengthening preparedness and formulating crisis strategies will have a great impact on reducing casualties. Given the importance of preparing hospitals to deal with such an outbreak and reduce the resulting mortality, the present study was conducted to assess their readiness against Covid-19. Method(s): The present study is a quantitative and descriptive cross-sectional research conducted from October to March 2019. Data collection used the standard checklists prepared by the European Center for the Prevention and Control of Coronavirus and the Centers for Disease Control and Prevention, consisting of eight domains and 21 components. The minimum score that each hospital could get in this checklist was 143 and the maximum was 429. The sampling method in the present study was a census, and nine reference hospitals for Corona were included in the study. All hospitals' directors, managers, quality officers and crisis secretaries and others related to hospital readiness during Covid-19 were recruited by the census. Result(s): On average, the hospitals scored 391 out of 429, indicating a fairly "high readiness" in dealing with Covid-19. The highest score obtained by the hospitals was 425 and the lowest score was 349. In terms of preparation areas, the hospitals' readiness was higher than 80% in all areas. The highest readiness of hospitals was in the fifth domain, i.e. Hand hygiene, personal protective equipment and hospital waste management. The 7th domain namely, patient placement and relocation, and patient visitor access was of the lowest preparation. Conclusion(s): The hospitals were of fairly appropriate readiness to deal with Covid-19. This level of preparedness, despite being desirable, might not reflect the real capacity of hospitals to deal with this disease. Regular evaluation of the Covid referral hospitals could help make these hospitals more prepared. Also, the experiences of hospitals that were more prepared should be used to improve the condition of other hospitals.Copyright © 2022 Jaafaripooyan et al. Published by Tehran University of Medical Sciences.
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Wastes generated in the face of COVID-19 pose enormous risks to the environment and heath. Environmental pollution from deficiencies in disposal patterns of hospital wastes may result in widespread recycling of SARS-CoV-2 infection. This paper aimed at creating awareness of the impact of inaptly disposed medical wastes on the environment;produced from managing COVID-19 leading to SARS-CoV-2 widespread recycling. Assemblage of recent and suitable literatures relating to keywords like waste disposal, medical wastes, coronavirus, COVID-19, SARS-CoV-2 and environmental pollution were revised/reviewed. Data suggest that factors like reduced awareness, negligence, ignorance, lack of polices among others are the chief influences contributing to improper medical wastes collection, disposal and management leading to environmental hazards. Therefore, improper disposal of medical wastes can lead to toxic environmental pollution thereby recycling SARS-CoV-2 in the face of COVID-19 management. Hence, incineration after prior disinfection remains the best management option in the prevailing coronavirus era. Copyright © 2022 Inderscience Enterprises Ltd.
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Hospitals generate huge amounts of nonwoven residues daily. This paper focused on studying the evolution of nonwoven waste generated in the Francesc de Borja Hospital, Spain, over the last few years and its relation to the COVID-19 pandemic. The main objective was to identify the most impacting pieces of nonwoven equipment in the hospital and to analyze possible solutions. The carbon footprint of the nonwoven equipment was studied through a life-cycle assessment. The results showed an apparent increase in the carbon footprint in the hospital from 2020. Additionally, due to the higher annual volume, the simple nonwoven gown used primarily for patients had a higher carbon footprint over a year than the more sophisticated surgical gowns. It can be concluded that developing a local circular economy strategy for medical equipment could be the solution to avoid the enormous waste generation and the carbon footprint of nonwoven production.
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Medical waste deserves particular attention due to its potential for causing serious damage to people and the environment. Although the factors influencing the generation of medical waste are critical for designing policies aimed at effectively reducing medical waste and improving medical waste management, they have not been extensively studied. The rapid development of China's medical and health services and the sudden outbreak of Covid-19 have brought significant challenges to managing medical waste in China. Therefore, based on panel data from eight cities in China from 2013 to 2019, this study used a fixed-effects model to investigate the influencing factors of medical waste generation (MWG) in China, and tested the environmental Kuznets curve (EKC) hypothesis. The results show that there is a non-linear N-shaped curve relationship between MWG and per capita gross domestic product (GDP);MWG will continue to increase with economic growth, but the growth rate will slow down from fast to slow, and then from slow to fast with economic growth. The analysis also reveals that implementing a tiered diagnosis and treatment policy may negatively affect MWG by reducing the waste of medical resources and thus reducing the generation of medical waste. The positive effect of population size on MWG is also highly significant, so when the aging of the population increases, the generation of medical waste also increases. The three policy suggestions are provided: 1) improve the disposal capacity and efficiency of medical waste;2) give full play to the advantages of hierarchical diagnosis and treatment policy;3) improve the management level of medical waste in primary medical institutions. © 2023
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Introduction: Improper waste management has a negative impact on the health of medical professionals, sanitary staff, general public and the environment in general. Objective(s): To assess the Knowledge and Practice regarding COVID-19 biomedical waste management (BMWM) among healthcare workers (HCW) of government health facilities of rural Ghaziabad. Methodology: A cross-sectional study was conducted to assess the knowledge and practices regarding Bio-Medical waste, in rural blocks of the district Ghaziabad at C.H.C, P.H.C and Sub-centres. Health care worker (HCW) like Doctor, Nursing Staff, Laboratory technician and Sanitary staff working in the Health care facilities were selected for the Study. A total number of 122 HCW were selected, which included 27 Doctors, 75 Nurse, 06 Lab technician and 14 sanitary staff, using Proportional allocation scheme respectively. Result(s): The Knowledge regarding Biomedical waste management of COVID-19 was 62.2% and practice was 50.8% among the HCW. Multinomial regression between socio-demographic features of HCW and their practice regarding COVID-19 Biomedical waste revealed that the practice was three times better 3.859 (1.378-10.811) in graduate and four times 4.062 (1.030-16.024) in post graduate than diploma holders. Doctors had three time better 3.595 (1.304-9.908) practice of COVID-19 biomedical waste management than nurses. Similarly, the CHC's COVID 19 biomedical waste management practices were more than four time 4.440 (1.482-13.974) better than sub centers. Conclusion(s): Level of knowledge and practice scores were unsatisfactory. Healthcare facilities should provide periodic training and adequate supplies for the waste handlers. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Aims & Objectives: COVID-19 clinical waste management has become a concern with increasing number of medical practitioners in India. Being health care professionals, one should be aware regarding safe disposal of biomedical waste and recycling of the materials to minimize biohazards to the environment. The aim of the present study was to assess awareness regarding biomedical waste management among medical practitioners. Material(s) and Method(s): This cross-sectional study was conducted among medial practitioners belonging from all medical colleges and private practitioners in Khorda district, Odisha (India) from February 2022 to April 2022. A total of 100 doctors (58 males and 42 females) participated in the study, which was conducted in two phases. A form was distributed to assess the attention of COVID-19 clinical waste management and information of effective utilisation of materials, and picked up knowledge was examined on a 5-point unipolar scale in percentages to assess the relative awareness relating to these 2 totally different categorizes. The applied math Package for Social Sciences was accustomed analyzed collected data. Result(s): Twenty-four percent of the medical practitioners were not at all aware about the management of COVID-19 clinical waste, 29% were moderately aware, 37% slightly aware, 7% very aware, and 3% fall in extremely aware category. A higher percentage of participants were completely unaware regarding recycling and reusing of COVID-19 clinical waste. Conclusion(s): There is a lack of sufficient knowledge among medical practitioners regarding management of COVID-19 clinical waste and recycling of materials. Considering its impact on the environment, COVID-19 clinical waste management requires immediate academic assessment to increase awareness during training courses. Copyright © 2022 Ubiquity Press. All rights reserved.
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Background: The prevalence of emerging and re-emerging diseases has made the need for basic preparations for all health care organizations more crucial. Strengthening preparedness and formulating crisis strategies will have a great impact on reducing casualties. Given the importance of preparing hospitals to deal with such an outbreak and reduce the resulting mortality, the present study was conducted to assess their readiness against Covid-19. Method(s): The present study is a quantitative and descriptive cross-sectional research conducted from October to March 2019. Data collection used the standard checklists prepared by the European Center for the Prevention and Control of Coronavirus and the Centers for Disease Control and Prevention, consisting of eight domains and 21 components. The minimum score that each hospital could get in this checklist was 143 and the maximum was 429. The sampling method in the present study was a census, and nine reference hospitals for Corona were included in the study. All hospitals' directors, managers, quality officers and crisis secretaries and others related to hospital readiness during Covid-19 were recruited by the census. Result(s): On average, the hospitals scored 391 out of 429, indicating a fairly "high readiness" in dealing with Covid-19. The highest score obtained by the hospitals was 425 and the lowest score was 349. In terms of preparation areas, the hospitals' readiness was higher than 80% in all areas. The highest readiness of hospitals was in the fifth domain, i.e. Hand hygiene, personal protective equipment and hospital waste management. The 7th domain namely, patient placement and relocation, and patient visitor access was of the lowest preparation. Conclusion(s): The hospitals were of fairly appropriate readiness to deal with Covid-19. This level of preparedness, despite being desirable, might not reflect the real capacity of hospitals to deal with this disease. Regular evaluation of the Covid referral hospitals could help make these hospitals more prepared. Also, the experiences of hospitals that were more prepared should be used to improve the condition of other hospitals. Copyright © 2022 Jaafaripooyan et al. Published by Tehran University of Medical Sciences.
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Introduction: Growing healthcare facilities to provide better health for patients have contributed in increased generation of Biomedical Waste (BMW). Emergence of Coronavirus Disease-2019 (COVID-19) has added to this burden. BMW carries a higher risk of infections, injuries and also environmental hazards. Effective management of BMW is a fundamental practice of healthcare providers in averting health and environmental hazards. Aim: To know about the awareness and practice concerning BMW management among healthcare provider at tertiary care hospital. Materials and Methods: The present cross-sectional study was conducted at district hospital attached to Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India, for seven months during July 2021 to January 2022. A total of 232 Healthcare Workers (HCWs) who were involved in patient caring participated in this study. Study included Questionnaires (30 questions) regarding awareness and practice of BMW management. The data was procured by structured self-administered questionnaire through Google forms. Results: The study showed that majority of participants had good awareness and modest numbers of participants were practicing proper method of waste management. About 93.5% were aware of BMW management categories, 98.7% of participants knew regarding which coloured bags are used for collection. Study identified some gaps in awareness and practices. About 49.1% participants dispose used Personal Protective Equipment (PPE) during COVID-19 into proper bag, only 27.6% participants knew correctly regarding maximum time limit to store BMW.Conclusion: Every healthcare provider must have proper knowledge and awareness of BMW management. It is necessary to contain transmission of infection and prevention of environmental hazards caused due to BMW. The study emphasises the need for regular monitoring and training requirement at all level to bridge the awareness gap. Proper BMW handling and disposal are components of infection control measures.
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BACKGROUND: The SARS-CoV-2 virus that causes COVID-19 entered Indonesia in January 2020, though the government first announced its entrance on March 2, 2020. This pandemic has affected this country for more than 2 years, and it has caused many casualties and material losses. The Indonesia government still undergoes efforts to prevent the spread of this disease. One of its medium of infection is COVID-19 medical waste. It is estimated that Indonesia produces 138 tons of COVID-19 medical waste daily, with limited management capabilities. AIM: This research aims to describe the Indonesian government’s policies or regulations on the acceleration in handling the COVID-19 pandemic, by cutting the chain of infection through the management of hazardous and toxic waste, namely, the medical waste from health service facilities and self-isolation activities of COVID-19 sufferers. METHOD: This research uses the doctrinal approach. RESULTS AND DISCUSSION: It is shown that the Indonesian government’s regulations are well-prepared. However, due to the quick spread of the virus, the government needed to issue different regulations several times to adapt to the situation in the field. After sometime, the vaccination program has reached the target and the quantity of the spread has decreased. Thus, the government issued new policies on the status of the COVID-19 medical waste from the category of hazardous and toxic waste into common domestic waste.
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This manuscript proposes an integrated system for treating hospital solid waste (H.S.W.) consisting of an incineration and frictional sterilization system capable of operating during normal and emergency situations. We analyzed the benefits of integrating different hospital solid waste (H.S.W.) treatment systems with the existing stand-alone incineration system, with a particular emphasis on the thermal friction sterilization integration system. The objective was to define the economic advantages and benefits in terms of resources recovery of using the thermal frictional sterilization–incineration integrated system during the hospital’s normal and emergency/pandemic operating conditions. We modeled three modeling scenarios based on normal and emergency operating conditions. The results show that the H.S.W. was composed of 74% general H.S.W. Existing incineration systems would be the most expensive process because the sanitary transportation cost represented approximately 96% of the H.S.W. costs. The hospital would realize 40–61% savings relative to the existing method if the integrated incineration–frictional systems were implemented to treat 50–70% of H.S.W.;the savings were better than in other scenarios. Proposed scenario 3 had a much better resources recovery factor than scenarios 1 and 2. This modeling study showed that a thermal frictional sterilization–incineration system could work well even under emergency conditions if the H.S.W. in-house sorting/transportation/storage process is modified to cater to other H.S.W. treatment/sterilization systems.
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Asphalt pavement, as an important engineering structure under various conditions such as freeze–thaw cycles and temperature fluctuations, suffers from failures such as low-temperature cracks (LTCs) and intermediate-temperature cracks (ITCs). Therefore, studying and providing a suitable solution is a concern of researchers in this field. On the other hand, the amount of hospital waste is increasing due to the Covid-19 pandemic;hence, one of the appropriate solutions is to recycle and use them in engineering structures such as asphalt pavement to reduce environmental pollution. In this study, a hospital waste pyrolytic carbon black (HWPCB) additive from recycled hospital waste resulting from the COVID-19 pandemic was used to improve the LTCs and ITCs resistance of Warm Mix Asphalt (WMA). For this purpose, three geometries called Symmetric specimen SCB (containing vertical cracks), Classical-Modified specimen SCB-1 (containing angular cracks), and Symmetric specimen ENDB (containing vertical cracks) were subjected to mode I loading conditions. In order to adapt the actual conditions of the pavement to the laboratory conditions, the samples were subjected to 0 and 3 cycles of freeze–thaw damage (FTD). They were fractured at 15°Celsius. The results showed that adding 18 % HWPCB to the WMA mixture increased the fracture energy and fracture toughness of all three geometries under mode I in both 0 and 3 FTD cycles at ± 15 °C. Also, it was concluded that the HWPCB additive was able to compensate for the reduction in resistance created by the 3 FTD cycles and increase it to some extent. On the other hand, the results of the Tensile Stiffness Index (TSI) and Tensile Strength (TS) indices showed that adding 9 and 18 % HWPCB increased the resistance to elastic deformation at ± 15 °C (under 0 and 3 FTD cycles) in addition to improving the crack resistance of the WMA mixture. The results of the Flexibility Index (FI), Toughness Index (TI), and Cracking Resistance Index (CRI) brittleness indices for WMA mixtures containing different percentages of HWPCB additive showed that this additive slightly reduced the flexibility of the mixture under 0 and 3 FTD cycles at temperatures of ± 15 °C. Finally, it was concluded that using HWPCB additive in the WMA mixture improved the behavior of LTC and ITC under mode I and FTD conditions.
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Introduction and Aim: Healthcare workers (HCWs) are always at a risks of contacting infection due to their frequent exposure to infected individuals. Knowledge regarding various infection control practices especially in this pandemic era is mandatory to safeguard the HCWs. An interventional study was carried out to assess the level of knowledge of Infection control practices and standard precautions with especial reference to COVID-19 among the health care workers of a tertiary care teaching Hospital. Materials and Methods: A total of 202, undergraduate students (UGs), post graduate students (PGs) and non-teaching staff (NTS) participated in this study. A pre-test self-structured questionnaire regarding infection control practices and standard precautions with especial reference to COVID-19 was distributed to all the participants. The study participants were then trained by faculty of Microbiology and infection control team vigorously. The post-training questionnaire was subsequently given to the same group of subjects. The data from before and after training was evaluated and compared. Results: On post-training evaluation after intervention, there was a significant increase in knowledge of various infection control practices among HCWs, as seen by comparing the results of the post-test questionnaire to its pre-test counterpart, because the HCWs' doubts were cleared in the education sessions. Conclusion: The knowledge regarding the various infection control practices among the HCWs is short lived and significant increase was observed on post training. The health care settings should make a policy to carry out mandatory rotational repeated trainings by the Infection control team for all the groups of HCWs for better compliance.
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Most vaccines have a similar method of delivery, utilizing a needle-based system to administer vaccines. Moreover, many require the maintenance of a cold chain to preserve their integrity and usability. While these options are feasible in developed parts of the world, delivering these vaccines to underdeveloped areas becomes difficult. Many vaccines go to waste due to breakages in the cold chain, leaving people without vaccinations. Furthermore, with the recent COVID-19 crisis, needs are emerging around strategies to deliver products that do not require extreme temperatures for storage and allow for efficient vaccine delivery on a mass scale. Many companies, including Pfizer, Moderna, and Johnson & Johnson, have brought to market COVID-19 vaccines. Pfizer and Moderna have found development success and profitability from their vaccine technology, both now and potentially in the future. Still, storage, administration, and waste challenges exist with these current options, creating opportunities for alternative delivery mechanisms. With these vaccines being essential for the current global situation, other administration strategies, such as BioneedleTM, could provide a valuable alternative and help mitigate the associated cold chain and sustainability issues seen with currently available options. Bioneedle Drug Delivery B.V. (BDD), a European biotechnology company, is developing a needleless vaccine-device combination product, the BioneedleTM. This technology value proposition focuses on solving the logistical issues associated with many vaccine products. These include eliminating cold-chain requirements, increasing the speed of vaccination, and reducing non-recyclable, medical waste (e.g., plastic syringes). It employs a reusable delivery system that administers multiple vaccines using biodegradable mini-implants to aid mass immunization efforts. This approach could significantly reduce plastic waste from syringes, translating to a significant sustainability benefit consistent with the United Nation's initiatives. Accordingly, BDD seeks support from a venture, corporate, government, or foundation for developing this novel delivery platform. This case aims to achieve two objectives. First, it seeks to provide an in-depth overview of the value proposition of BioneedleTM, sparking discussion around its feasibility in a real-world setting. The second involves creating dialog regarding improvements to the BioneedleTM system and other innovations that may help mitigate cold chain issues while still providing needleless delivery of vaccines. This case discussion highlights the potential of a new vaccine delivery system that various healthcare settings can use. This approach may pose a cost-effective solution to the loss of vaccines in the cold chain and address the growing concerns around plastic waste and the environment. In closing, this narrative allows for an open-forum discussion around the opportunity of introducing a new medical device platform in a thriving vaccine market. It is a learning experience that requires strategic decision-making in response to questions posed for new startups and the new vaccine technology.
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The Covid-19 pandemic has a big impact. The requirement to use masks to prevent the spread of the virus increases the amount of mask waste. This study aims to analyze the environment due to the accumulation of mask waste during the Covid-19 pandemic in Indonesia. This research uses the literature study method from various literature references and qualitative analysis. Medical waste that is not managed with proper procedures has the potential to transmit the virus to other people. In addition, the pile of mask waste is also bad for the environment. Various appropriate designs and technologies are made for more appropriate and environmentally friendly management of mask waste.
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In this study, the hospital waste generation rates and compositions in Delhi were examined temporally and spatially during the first COVID-19 wave of April 2020. A total of 11 representative hospitals located in five districts were considered. The pre-COVID hospital waste generation rates were relatively consistent among the districts, ranging from 15 to 23 tonne/month. It is found that the number of hospital beds per capita may not be a significant factor in the hospital waste quantity. Strong seasonal variations were not observed. All districts experienced a drastic decrease in generation rates during the 1-month lockdown. The average rates during the COVID period ranged from 12 to 24 tonne/month. Bio-contaminated and disposable medical product wastes were the most common waste in Delhi's hospitals, representing 70-80% by weight. The changes in waste composition were however not spatially consistent. The lockdown appeared to have had a higher impact on hospital waste generation rate than on waste composition. The findings are important as the design and operation of a waste management system are sensitive to both waste quantity and quality. Waste records at source helped to minimize waste data uncertainties and allowed a closer examination of generation trends.
Subject(s)
COVID-19 , Medical Waste Disposal , Medical Waste , COVID-19/epidemiology , Communicable Disease Control , Hospitals , Humans , India/epidemiology , Medical Waste/analysis , PandemicsABSTRACT
Background:COVID 19 being a Pandemic outbreak, the current situation of usage of PPE and the generation of all the other medical waste has been greatly increased in the laboratories and the hospital which are highly infectious. Improp- er handling of the biomedical waste at this time has the high potential risk to develop local COVID outbreak in the hospi- tal environment. Hence during this current COVID Pandemic it is important to assess Knowledge, Attitude and Practice (KAP) regarding awareness on Biomedical Waste Management (BMW) among health care workers. Methods:This Cross-sectional study was conducted at Government Kilpauk Medical College and Hospital, Chennai. The study consists of 100 Health care workers as participants which includes Doctors, Technicians, and Paramedical stu- dents. The data was collected using predesigned semi structured questionnaire containing questions KAP regarding Bio- medical Waste Management Results:The awareness regarding legislation and disposal of BMW as per colour coded bags was found in 80% and 85% of the participants respectively. Knowledge regarding biomedical waste management among doctors and nursing staff is satisfactory as compared to other health care workers due to awareness and adequate training. Conclusions:Hence awareness of BMW among healthcare workers is important to reduce exposing themselves to health and environment hazards
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Background:Pandemic situation of SARS CoV-2 has made every country to gear up quickly for the prevention, control and testing. Accordingly, India has developed the guidelines and policies and requested all medical colleges to establish the COVID-19 testing facility under the mentorship of ICMR and NABL. Methods:As we, at our college already having the central research facility, the urgent national need has made us easy to create a testing facility for the COVID-19. As per NABL guidelines to have the requirements, we have worked together with wholehearted support and active participation from Human Resource Department, Central Purchase Department, Dean Office and honourable management excellences. All the requirements like physical lab setup, necessary equip- ment’s with calibration and validation, dedicated biosafety cabinets, PPEs, biomedical waste management, UPS system, SOPs, quality consumables, trained manpower, entry protocol, working protocol, exit protocol, result reporting system made functional systematically. Accordingly, data generated and communicated to AIIMS, Nagpur and NABL, subse- quently auditing by NABL was conducted toughly and thoroughly. Results:Without NC we got the NABL Accreditation. On the basis of recommendations of AIIMS, Nagpur and NABL Ac- creditation, the ICMR has provided the login to us. Afterwards the lab started receiving the samples for COVID -19 testing. With minimum samples we started testing and reporting to ICMR, PCMC and State Govt. following all the bi- osafety measures and necessary guidelines compliances. Due to heavy load of samples in our state, authorities have requested to increase the testing capacity, so we have geared up accordingly by improving biosafety by using powered air-purifying respirator (PAPR), additional biosafety cabinets type II B2, weekly decontamination / fumigation of lab and necessary logistics and trained staff. Till now we have tested more than 6000 samples providing the results / reports within TAT of 24 hrs. We achieved 100% concordance for external quality control.
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Use of protective face mask is recommended to prevent/reduce COVID19 (SARS- CoV-2) human to human transmission. However, situation analysis of rational of use in view of different guidelines and its implementation at ground level, availability of mask, use, public perception, and disposal methods is required. Hence this online survey from literate population of 1019 adults across India from high and upper middle group (mean age 26.4 years) was conducted during lockdown April- May2020. High awareness (99.7%) and use (99.6%) of mask is reported, however mask disposal knowledge was found to be low as only 44.4% were doing waste segregation while using non-biodegradable mask. As such bio-waste may become potential reservoir for secondary transmissions, hence require attention and public education. If measures are not undertaken, 11.7 lakh Kg of non-biodegradable waste and through this 7.8 X 1016 virus copy anticipated to spread in environment per day. Despite limitation of design, language and representation of all this study provides matching assumptions on biomedical waste burden.
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Healthcare waste management is considered one of the biggest challenges that the world is going to face in the future. This threat is becoming reality owing to the worldwide sharp rise in healthcare waste generation particularly during the current COVID-19 pandemic. Like many other environmental crises, hospital plastic waste management is an area that got very little attention despite being highlighted in the literature, local media, as well as in international electronic and print media. This mini-review was conducted to assess the overall prevailing situation regarding hospital plastic waste management in Pakistan. Several illegal and unethical activities have been observed regarding hospital plastic waste management in Pakistan which includes unhygienic recycling, repacking of used hospital plastic items, open dumping on land, and disposal of hospital plastic waste in the ocean. To improve these conditions, suggestions have been made regarding the better management of hospital plastic waste.