A review of the applicability of Environmental Management Systems in waste management in the medical sector of Zimbabwe.

Environmental Management Systems (EMS) are currently the cornerstone of achieving sustainability globally. Nevertheless, the question is applicability of EMS in the medical sector. Hence, the review focused on applicability of EMS in medical waste management Zimbabwe. EMS involves overall processes that facilitate reduction of dire impacts of company's activities while increasing performance. EMS framework consists of environmental policy, planning, implementation, checking, review and improvement stages. To examine applicability of EMS in management of medical sector waste, published secondary sources with information related to the topic were utilised. Analysis of strengths and opportunities of EMS was used as a base to examine its applicability in medical waste management. Zimbabwean medical sector consist of hospitals and primary healthcare facilities. Medical waste includes pathological, pharmaceutical, cytotoxic, radioactive, chemical, sharp, infectious and general waste. However, twenty-first century witnessed expansion of medical institutions to accommodate COVID-19 patients, resulting in generation of construction and demotion waste. Medical institutions in Zimbabwe are accountable for solid waste management at generation source although municipalities are responsible for conveying solid waste to landfills. Solid waste from medical sector is disposed through traditional strategies namely landfilling, incineration, open pits and open burning, resulting in water, air, and soil contamination. However, EMS can reduce quantity of solid waste disposed through waste reuse, recycle and recovery. Moreover, achievement of integrated approach, effective legislation, policies and inclusive participation in medical waste management is adopted through use of EMS. Therefore, EMS were utilised to develop an integrated sustainable medical waste management model to achieve sustainability.

COVID-19 pandemic: Solid waste and environmental impacts in Brazil.

The World Health Organization has recently declared South America the new epicenter of the COVID-19 pandemic, as Brazil has become one of the most affected countries. Besides public health and economic impacts, social isolation has also caused indirect environmental effects. The aim of this study was to assess environmental impacts caused by shifts on solid waste production and management due to the COVID-19 pandemic in Brazil. We have analyzed data from 30 cities, representing a population of more than 53.8 million people (25.4% of the Brazilian population). Unexpectedly, solid waste production in the main cities in Brazil has decreased during the social isolation period, possibly because of reduced activity in commercial areas. The latest data on solid waste in Brazil have revealed that more than 35% of medical waste has not been treated properly. Furthermore, improper disposal of facemasks has been reported in several cities and may increase the risk for COVID-19 spread. The suspension of recycling programs has hindered natural resources from being saved, with emphasis on 24,076 MWh of electric power and 185,929 m3 of potable water - respectively enough to supply 152,475 households and 40,010 people, over a month. Furthermore, total sale price for recyclable materials during the suspension of recycling programs reaches more than 781 thousand dollars, being these materials disposed in landfills - demanding an extra volume of 19,000 m3 - reducing landfill lifespan, and hence causing a double loss: economic and environmental.

A review on emergency disposal and management of medical waste during the COVID-19 pandemic in China.

The surge of medical waste (MW) generated during the COVID-19 pandemic has exceeded the disposal capacity of existing facilities. The timely, safe, and efficient emergency disposal of MW is critical to prevent the epidemic spread. Therefore, this review presents the current status of MW generation and disposal in China and analyzes the characteristics and applicability of emergency disposal technologies. The results show that movable disposal facilities can dispose of infectious MW on site, even though most of their disposal capacity is at a low level (<5 t/day). Co-disposal facilities need to be reformed completely for emergency MW disposal, in which separate feeding systems should be taken seriously. Specifically, municipal solid waste (MSW) incineration facilities have great potential to improve emergency MW disposal capacities. For hazardous waste incineration facilities, compatibility of the wastes must be matched to the composition and calorific value of the waste. As for cement kiln, MW can only be used as an alternative fuel instead of a raw material for cement. Based on the environmental risk and technical adaptability, the six emergency MW disposal technologies are recommended to be prioritized as follows: movable microwave sterilization, movable steam sterilization, movable incineration, co-incineration with hazardous waste, co-incineration with MSW and co-disposal in cement kilns. Infectious MW, especially COVID-19 MW, should be prioritized for disposal by centralized and movable disposal facilities, while non-infectious MW can be disposed of using co-disposal facilities. All stakeholders should strengthen the delicacy management of the end-of-life stage of MW, including collection, classification, packaging identification, transportation, and disposal. Currently, it is necessary for centralized disposal enterprises to follow the emergency disposal operation flowchart. From a long-term strategic perspective, making full use of regional movable and co-disposal facilities in the megacities can effectively enhance the emergency MW disposal capacity.

Application of ArcGIS and QFD-based model for site selection for bio-medical waste disposal.

With the increasing formalisation of the health sector in India, the bio-medical waste (BMW) disposal regulations are getting stringent and its implementation is being enforced strictly. The coronavirus disease 2019 (COVID-19) created a healthcare crisis because of the highly contagious nature of the novel virus. Measures employed for the prevention and management of COVID-19 resulted in the generation of an unprecedented amount of BMW in Indian medical history. This BMW needs to be disposed of safely at a suitable site to prevent secondary infection and the potential spread of the virus in the environment. The selection of an appropriate site for BMW disposal requires comparing a wide range of social, economic and environmental factors corresponding to different site locations, which makes it a multi-criteria decision-making (MCDM) problem. This study aims to solve the BMW site selection problems using a quality function deployment-based model that can consider both the subjective and the objective criteria, and evaluate them as per the user's requirements. The proposed model is applied to evaluate the suitability of waste disposal sites in the city of Bilaspur in Chhattisgarh, India. At first, eight possible locations for BMW disposal are identified, while utilising geographical information system (GIS). Consequently, the developed model is applied to evaluate the identified sites, taking 18 relevant criteria into consideration. A software prototype is developed in Visual BASIC 6 to automate the entire decision-making process, further adding to the novelty of the work.

A novel wastewater-based epidemiology indexing method predicts SARS-CoV-2 disease prevalence across treatment facilities in metropolitan and regional populations.

There is a need for wastewater based epidemiological (WBE) methods that integrate multiple, variously sized surveillance sites across geographic areas. We developed a novel indexing method, Melvin's Index, that provides a normalized and standardized metric of wastewater pathogen load for qPCR assays that is resilient to surveillance site variation. To demonstrate the utility of Melvin's Index, we used qRT-PCR to measure SARS-CoV-2 genomic RNA levels in influent wastewater from 19 municipal wastewater treatment facilities (WWTF's) of varying sizes and served populations across the state of Minnesota during the Summer of 2020. SARS-CoV-2 RNA was detected at each WWTF during the 20-week sampling period at a mean concentration of 8.5 × 104 genome copies/L (range 3.2 × 102-1.2 × 109 genome copies/L). Lag analysis of trends in Melvin's Index values and clinical COVID-19 cases showed that increases in indexed wastewater SARS-CoV-2 levels precede new clinical cases by 15-17 days at the statewide level and by up to 25 days at the regional/county level. Melvin's Index is a reliable WBE method and can be applied to both WWTFs that serve a wide range of population sizes and to large regions that are served by multiple WWTFs.

Viable medical waste chain network design by considering risk and robustness.

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.

SARS-CoV-2 and other pathogens in municipal wastewater, landfill leachate, and solid waste: A review about virus surveillance, infectivity, and inactivation.

This review discusses the techniques available for detecting and inactivating of pathogens in municipal wastewater, landfill leachate, and solid waste. In view of the current COVID-19 pandemic, SARS-CoV-2 is being given special attention, with a thorough examination of all possible transmission pathways linked to the selected waste matrices. Despite the lack of works focused on landfill leachate, a systematic review method, based on cluster analysis, allows to analyze the available papers devoted to sewage sludge and wastewater, allowing to focalize the work on technologies able to detect and treat pathogens. In this work, great attention is also devoted to infectivity and transmission mechanisms of SARS-CoV-2. Moreover, the literature analysis shows that sewage sludge and landfill leachate seem to have a remote chance to act as a virus transmission route (pollution-to-human transmission) due to improper collection and treatment of municipal wastewater and solid waste. However due to the incertitude about virus infectivity, these possibilities cannot be excluded and need further investigation. As a conclusion, this paper shows that additional research is required not only on the coronavirus-specific disinfection, but also the regular surveillance or monitoring of viral loads in sewage sludge, wastewater, and landfill leachate. The disinfection strategies need to be optimized in terms of dosage and potential adverse impacts like antimicrobial resistance, among many other factors. Finally, the presence of SARS-CoV-2 and other pathogenic microorganisms in sewage sludge, wastewater, and landfill leachate can hamper the possibility to ensure safe water and public health in economically marginalized countries and hinder the realization of the United Nations' sustainable development goals (SDGs).

Digital solutions for continued operation of WRRFs during pandemics and other interruptions.

This paper includes survey results from 17 full-scale water resource recovery facilities (WRRFs) to explore their technical, operational, maintenance, and management-related challenges during COVID-19. Based on the survey results, limited monitoring and maintenance of instrumentation and sensors are among the critical factors during the pandemic which resulted in poor data quality in several WRRFs. Due to lockdown of cities and countries, most of the facilities observed interruptions of chemical supply frequency which impacted the treatment process involving chemical additions. Some plants observed influent flow reduction and illicit discharges from industrial wastewater which eventually affected the biological treatment processes. Delays in equipment maintenance also increased the operational and maintenance cost. Most of the plants reported that new set of personnel management rules during pandemic created difficulties in scheduling operator's shifts which directly hampered the plant operations. All the plant operators mentioned that automation, instrumentation, and sensor applications could help plant operations more efficiently while working remotely during pandemic. To handle emergency circumstances including pandemic, this paper also highlights resources and critical factors for emergency responses, preparedness, resiliency, and mitigation that can be adopted by WRRFs.

Modeling of municipal waste disposal rates during COVID-19 using separated waste fraction models.

Municipal waste disposal behaviors in Regina, the capital city of Saskatchewan, Canada have significantly changed during the COVID-19 pandemic. About 7.5 year of waste disposal data at the Regina landfill was collected, verified, and consolidated. Four modeling approaches were examined to predict total waste disposal at the Regina landfill during the COVID-19 period, including (i) continuous total (Baseline), (ii) continuous fraction, (iii) truncated total, and (iv) truncated fraction. A single feature input recurrent neural network model was adopted for each approach. It is hypothesized that waste quantity modeling using different waste fractions and separate time series can better capture disposal behaviors of residents during the lockdown. Compared to the baseline approach, the use of waste fractions in modeling improves both result accuracy and precision. In general, the use of continuous time series over-predicted total waste disposal, especially when actual disposal rates were less than 50 t/day. Compared to the baseline approach, mean absolute error (MAE), mean absolute percentage error (MAPE), and mean square error (MSE) were reduced. The R value increased from 0.63 to 0.79. Comparing to the baseline, the truncated total and the truncated fraction approaches better captured the total waste disposal behaviors during the COVID-19 period, probably due to the periodicity of the weeklong data set. For both approaches, MAE and MAPE were lower than 70 and 22%, respectively. The model performance of the truncated fraction appears the best, with an MAPE of 19.8% and R value of 0.92. Results suggest the uses of waste fractions and separated time series are beneficial, especially if the input set is heavily skewed.

Comparative life cycle assessment of emergency disposal scenarios for medical waste during the COVID-19 pandemic in China.

The COVID-19 pandemic attracts concerns globally and leads to an exponential increase in medical waste generation, and disposal of medical waste is an urgent need for preventing the epidemic spread. Emergency disposal scenarios of medical waste generated during the COVID-19 pandemic require a systematic assessment to quantify their potential environmental impacts. The environmental impacts and key factors of three movable disposal scenarios (i.e. incineration disposal vehicle, movable steam and microwave sterilization equipment both followed by co-incineration with municipal solid waste) were quantified via life cycle assessment approach. Furthermore, the environmental impacts of three movable disposal and two co-incineration scenarios were compared via life cycle assessment by expanding system boundaries. The results show that co-incineration with municipal solid waste has the lowest environmental impacts due to environmental benefits produced by power generation, while co-incineration with hazardous waste is the highest due to the high energy consumption. Energy consumption (i.e. kerosene, electricity and diesel) are the key factors for three movable disposal scenarios. For movable steam and microwave sterilization equipment followed by co-incineration with municipal solid waste, power generation from incinerating disinfected medical waste has significant beneficial environmental impacts due to avoided impacts of electricity consumption. The recommendations for improvement of the emergency disposal and management of medical waste during the COVID-19 pandemic globally and other serious epidemic in the future are provided.

Time Evolution of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Wastewater during the First Pandemic Wave of COVID-19 in the Metropolitan Area of Barcelona, Spain.

Two large wastewater treatment plants (WWTP), covering around 2.7 million inhabitants, which represents around 85% of the metropolitan area of Barcelona, were sampled before, during, and after the implementation of a complete lockdown. Five one-step reverse transcriptase quantitative PCR (RT-qPCR) assays, targeting the polymerase (IP2 and IP4), the envelope (E), and the nucleoprotein (N1 and N2) genome regions, were employed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection in 24-h composite wastewater samples concentrated by polyethylene glycol (PEG) precipitation. SARS-CoV-2 was detected in a sewage sample collected 41 days ahead of the declaration of the first COVID-19 case. The evolution of SARS-CoV-2 genome copies in wastewater evidenced the validity of water-based epidemiology (WBE) to anticipate COVID-19 outbreaks, to evaluate the impact of control measures, and even to estimate the burden of shedders, including presymptomatic, asymptomatic, symptomatic, and undiagnosed cases. For the latter objective, a model was applied for the estimation of the total number of shedders, evidencing a high proportion of asymptomatic infected individuals. In this way, an infection prevalence of 2.0 to 6.5% was figured. On the other hand, proportions of around 0.12% and 0.09% of the total population were determined to be required for positive detection in the two WWTPs. At the end of the lockdown, SARS-CoV-2 RNA apparently disappeared in the WWTPs but could still be detected in grab samples from four urban sewers. Sewer monitoring allowed for location of specific hot spots of COVID-19, enabling the rapid adoption of appropriate mitigation measures.IMPORTANCE Water-based epidemiology (WBE) is a valuable early warning tool for tracking the circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among the population, including not only symptomatic patients but also asymptomatic, presymptomatic, and misdiagnosed carriers, which represent a high proportion of the infected population. In the specific case of Barcelona, wastewater surveillance anticipated by several weeks not only the original COVID-19 pandemic wave but also the onset of the second wave. In addition, SARS-CoV-2 occurrence in wastewater evidenced the efficacy of the adopted lockdown measures on the circulation of the virus. Health authorities profited from WBE to complement other inputs and adopt rapid and adequate measures to mitigate the effects of the pandemic. For example, sentinel surveillance of specific sewers helped to locate COVID-19 hot spots and to conduct massive numbers of RT-PCR tests among the population.

Waste disposal characteristics and data variability in a mid-sized Canadian city during COVID-19.

COVID-19, declared a global pandemic by the World Health Organization, has caused governments to react swiftly with a variety of measures to quell the spread of the virus. This study investigates changes in waste disposal characteristics and the relationship between the mass of biomedical waste disposed and new COVID-19 tests performed in Regina, Canada. Results suggest that between May and September 2020, significant differences in the median amount of waste disposed exist. The amount of monthly waste disposed was slightly lower to about 450-550 tonnes/month. Monthly waste data variability, however, was significantly lower. Seasonal effects on total waste disposal is observed, but is less obvious than pre-COVID time. Furthermore, the distribution of different waste fractions varies, probably due to operational and industrial characteristics. A non-linear relationship exists between the number of COVID-19 tests performed and the mass of biomedical waste disposed, perhaps due to a lagged relationship between biomedical waste generation and disposal.