Review on distribution, fate, and management of potentially toxic elements in incinerated medical wastes.

Medical wastes include all solid and liquid wastes that are produced during the treatment, diagnosis, and immunisation of animals and humans. A significant proportion of medical waste is infectious, hazardous, radioactive, and contains potentially toxic elements (PTEs) (i.e., heavy metal (loids)). PTEs, including arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg), are mostly present in plastic, syringes, rubber, adhesive plaster, battery wastes of medical facilities in elemental form, as well as oxides, chlorides, and sulfates. Incineration and sterilisation are the most common technologies adopted for the safe management and disposal of medical wastes, which are primarily aimed at eliminating deadly pathogens. The ash materials derived from the incineration of hazardous medical wastes are generally disposed of in landfills after the solidification/stabilisation (S/S) process. In contrast, the ash materials derived from nonhazardous wastes are applied to the soil as a source of nutrients and soil amendment. The release of PTEs from medical waste ash material from landfill sites and soil application can result in ecotoxicity. The present study is a review paper that aims to critically review the dynamisms of PTEs in various environmental media after medical waste disposal, the environmental and health implications of their poor management, and the common misconceptions regarding medical waste.

Valorisation of hazardous medical waste using steam injected plasma gasifier: a parametric study on the modelling and multi-objective optimisation by integrating Aspen plus with RSM.

The COVID-19 Pandemic has a detrimental effect on the environment related to the exponential rise in medical waste (MW). Extraction of energy from the toxic MW with the latest gasification technology instead of conventional incineration is of utmost importance to promote sustainable development. This present study investigates the processing of MW for the generation of enriched hydrogen syngas using steam injected plasma gasifier. Modelling of Plasma gasifier was performed in Aspen Plus and Model validation was done with the experimental result and, a good agreement was attained. Sensitivity analysis was implemented on MW in which the influence of gasification temperature, equivalence ratio (ER), and Steam/Biomass (S/B) on the producer gas (PG) composition, gas yield, H2/CO ratio, cold gas efficiency (CGE), and the higher heating value (HHV) was calculated. Furthermore, Response surface methodology (RSM) has been incorporated for the multi-objective optimisation of the variable gasification parameters. R2 values obtained from ANOVA for H2, CGE, and HHV are 98.62%, 99.10%, and 98.9% respectively. Using the response optimiser, the optimum values of H2, CGE, and HHV were found to be 0.43 (mole frac), 89.95%, and 7.49 MJ/Nm3 for temperature at 1560.60°C, equivalence ratio 0.1, and S/B 0.99, respectively. The observed coefficient of desirability was about 0.97.

Identifying and Predicting Healthcare Waste Management Costs for an Optimal Sustainable Management System: Evidence from the Greek Public Sector.

The healthcare sector is an ever-growing industry which produces a vast amount of waste each year, and it is crucial for healthcare systems to have an effective and sustainable medical waste management system in order to protect public health. Greek public hospitals in 2018 produced 9500 tons of hazardous healthcare wastes, and it is expected to reach 18,200 tons in 2025 and exceed 18,800 tons in 2030. In this paper, we investigated the factors that affect healthcare wastes. We obtained data from all Greek public hospitals and conducted a regression analysis, with the management cost of waste and the kilos of waste as the dependent variables, and a number of variables reflecting the characteristics of each hospital and its output as the independent variables. We applied and compared several models. Our study shows that healthcare wastes are affected by several individual-hospital characteristics, such as the number of beds, the type of the hospital, the services the hospital provides, the number of annual inpatients, the days of stay, the total number of surgeries, the existence of special units, and the total number of employees. Finally, our study presents two prediction models concerning the management costs and quantities of infectious waste for Greece's public hospitals and proposes specific actions to reduce healthcare wastes and the respective costs, as well as to implement and adopt certain tools, in terms of sustainability.

Biomedical waste disposal practices among healthcare workers during COVID-19 pandemic in secondary and tertiary care facilities of Tamil Nadu.

PURPOSE: The ongoing COVID-19 crisis has drastically changed the practice of biomedical waste (BMW) generation and management. Studies venturing into the facility level preparedness at various levels of healthcare delivery during pandemic situation is the need of the hour. Hence, we did this study to assess the BMW disposal practices amongst secondary and tertiary health facilities during COVID-19 pandemic in Tamil Nadu. MATERIALS AND METHODS: This cross-sectional survey was conducted amongst doctors, nurses and allied healthcare staffs across various departments in 18 public health facilities across six districts of Tamil Nadu. Multivariable logistic regression analysis was done based on the random-intercept model to assess the determinants of BMW disposal practices. The effect size was reported as adjusted odds ratio (aOR) with 95% confidence interval (CI). RESULTS: In total, 2593 BMW disposal observations were made. During nearly three-fourth of the observations (73%), the BMW was disposed of appropriately. Nurses (aOR â€‹= â€‹1.54; 95%CI: 1.06-2.23) and doctors (aOR â€‹= â€‹1.60; 95%CI: 1.05-2.45), healthcare workers in Paediatrics department (aOR â€‹= â€‹1.77; 95%CI: 1.13-2.76), healthcare workers in inpatient department (aOR â€‹= â€‹2.77; 95%CI: 1.95-3.94) and injection outpatient department (aOR â€‹= â€‹2.69; 95%CI: 1.59-4.47) had significantly better odds of having appropriate BMW disposal practices. CONCLUSION: Our study shows that nearly during three-fourth of the observations, healthcare workers performed appropriate BMW disposal practices. However, measures should be taken to achieve 100% compliance by healthcare workers especially the target groups identified in our study by allocating appropriate resources and periodically monitor the BMW disposal practices.

Dynamic pyrolytic reaction mechanisms, pathways, and products of medical masks and infusion tubes.

Given the COVID-19 epidemic, the quantity of hazardous medical wastes has risen unprecedentedly. This study characterized and verified the pyrolysis mechanisms and volatiles products of medical mask belts (MB), mask faces (MF), and infusion tubes (IT) via thermogravimetric, infrared spectroscopy, thermogravimetric-Fourier transform infrared spectroscopy, and pyrolysis-gas chromatography/mass spectrometry analyses. Iso-conversional methods were employed to estimate activation energy, while the best-fit artificial neural network was adopted for the multi-objective optimization. MB and MF started their thermal weight losses at 375.8 °C and 414.7 °C, respectively, while IT started to degrade at 227.3 °C. The average activation energies were estimated at 171.77, 232.79, 105.14, and 205.76 kJ/mol for MB, MF, and the first and second IT stages, respectively. Nucleation growth for MF and MB and geometrical contraction for IT best described the pyrolysis behaviors. Their main gaseous products were classified, with a further proposal of their initial cracking mechanisms and secondary reaction pathways.

Mapping healthcare waste management research: Past evolution, current challenges, and future perspectives towards a circular economy transition.

Improper healthcare waste (HCW) management poses significant risks to the environment, human health, and socio-economic sustainability due to the infectious and hazardous nature of HCW. This research aims at rendering a comprehensive landscape of the body of research on HCW management by (i) mapping the scientific development of HCW research, (ii) identifying the prominent HCW research themes and trends, and (iii) providing a research agenda for HCW management towards a circular economy (CE) transition and sustainable environment. The analysis revealed four dominant HCW research themes: (1) HCW minimization, sustainable management, and policy-making; (2) HCW incineration and its associated environmental impacts; (3) hazardous HCW management practices; and (4) HCW handling and occupational safety and training. The results showed that the healthcare industry, despite its potential to contribute to the CE transition, has been overlooked in the CE discourse due to the single-use mindset of the healthcare industry in the wake of the infectious, toxic, and hazardous nature of HCW streams. The findings shed light on the HCW management domain by uncovering the current status of HCW research, highlighting the existing gaps and challenges, and providing potential avenues for further research towards a CE transition in the healthcare industry and HCW management.

High-value utilization of mask and heavy fraction of bio-oil: From hazardous waste to biochar, bio-oil, and graphene films.

At present, it is very common to wear mask outdoors in order to avoid coronavirus disease 19 (COVID-19) infection. However, this leads to the formation of numerous plastic wastes that threaten humans and ecosystem. Against this major background, a novel co-pyrolysis coupled chemical vapor deposition (CVD) strategy is proposed to systematically convert mask and heavy fraction of bio-oil (HB) into biochar, bio-oil, and three-dimensional graphene films (3DGFs) is proposed. The biochar exhibits high higher heating value (HHV) (33.22-33.75 MJ/kg) and low ash content (2.34%), which is obviously superior to that of the walnut shell and anthracite coal. The bio-oil contains rich aromatic components, such as 1,2-dimethylbenzene and 2-methylnaphthalene, which can be used as chemical feedstock for insecticides. Furthermore, the 3DGF800 has a wide range of applications in the fields of oil spill cleanup and oil/water separation according to its fire resistance, high absorbability (40-89 g g-1) and long-term cycling stability. This research sheds new light on converting plastic wastes and industrial by-products into high added-value chemicals.