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.

Healthcare waste in Bangladesh: Current status, the impact of Covid-19 and sustainable management with life cycle and circular economy framework.

COVID-19 has accelerated the generation of healthcare (medical) waste throughout the world. Developing countries are the most affected by this hazardous and toxic medical waste due to poor management systems. In recent years, Bangladesh has experienced increasing medical waste generation with estimated growth of 3 % per year. The existing healthcare waste management in Bangladesh is far behind the sustainable waste management concept. To achieve an effective waste management structure, Bangladesh has to implement life cycle assessment (LCA) and circular economy (CE) concepts in this area. However, inadequate data and insufficient research in this field are the primary barriers to the establishment of an efficient medical waste management systen in Bangladesh. This study is introduced as a guidebook containing a comprehensive overview of the medical waste generation scenario, management techniques, Covid-19 impact from treatment to testing and vaccination, and the circular economy concept for sustainable waste management in Bangladesh. The estimated generation of medical waste in Bangladesh without considering the surge due to Covid-19 and other unusual medical emergencies would be approximately 50,000 tons (1.25 kg/bed/day) in 2025, out of which 12,435 tons were predicted to be hazardous waste. However, our calculation estimated that a total of 82,553, 168.4, and 2300 tons of medical waste was generated only from handling of Covid patients, test kits, and vaccination from March 2021 to May 2022. Applicability of existing guidelines, and legislation to handle the current situation and feasibility of LCA on medical waste management system to minimize environmental impact were scrutinized. Incineration with energy recovery and microwave sterilization were found to be the best treatment techniques with minimal environmental impact. A circular economy model with the concept of waste minimizaton, and value recovery was proposed for sustainable medical waste management. This study suggests proper training on healthcare waste management, proposing strict regulations, structured research allocation, and implementation of public-private partnerships to reduce, and control medical waste generation for creating a sustainable medical waste management system in Bangladesh.

Waste Management and the Perspective of a Green Hospital-A Systematic Narrative Review.

The concept of a "green hospital" is used in reference to a hospital that includes the environment as part of its quality services and one that pays attention to the sustainable design of buildings. Waste disposal represents a potential risk for the environment; therefore, waste collection from healthcare centers is a key environmental issue. Our study aims to systematically review the experiences acquired in worldwide nosocomial settings related to the management of healthcare waste. Nineteen studies, selected between January 2020 and April 2022 on Scopus, MEDLINE/PubMed and Web of Science databases were included in our systematic narrative review. Operating room and hemodialysis activities seem to be the procedures most associated with waste production. To deal with waste production, the 5Rs rule (reduce, reuse, recycle, rethink and research) was a common suggested strategy to derive the maximum practical benefit while generating the minimum amount of waste. In this context, the COVID-19 pandemic slowed down the greening process of nosocomial environments. Waste management requires a multifactorial approach to deal with medical waste management, even considering the climate change that the world is experiencing. Education of health personnel and managers, regulation by governmental institutions, creation of an "environmental greening team", and awareness of stakeholders and policymakers are some of the measures needed for the greening of healthcare facilities.

Collection and transportation system construction of potentially viral municipal solid waste during the COVID-19 pandemic in China.

The transmission route of COVID-19 through municipal solid waste (MSW) has been confirmed and receives increasing attention. Potentially viral municipal solid waste (PVMSW) refers to the domestic waste generated by risky areas and epidemic-related populations under a major epidemic in their daily lives or in activities that provide services for their daily lives. For its potential infectivity, PVMSW should be properly collected and transported. This study aimed to standardize the collection and transportation of PVMSW and proposed specific construction schemes of PVMSW collection and transportation systems for three situations which were city-wide lockdown status, medium and high-risk area, and home quarantine separately. In the cases of city-wide lockdown status and home quarantine, PVMSW collection and transportation systems were constructed qualitatively with the examples of Wuhan and Shanghai respectively, and in the case of medium and high-risk area, the systems were constructed quantitatively through the development of a waste collection and transportation costs model. To reduce the risks of virus transmission during the collection and transportation process, the collection and transportation links should be minimized. For the disposal of PVMSW, medical waste treatment facilities and MSW incineration plants should be prioritized. Furthermore, the results showed that the total number of people and the transfer capacity of MSW transfer facility were the two main influencing factors for the selection of PVMSW collection and transportation systems in medium and high-risk area. This article could help manage MSW for preventing virus transmission during the COVID-19 pandemic or similar future epidemics.

Collaborative Reverse Logistics Network for Infectious Medical Waste Management during the COVID-19 Outbreak.

The development of COVID-19 in China has gradually become normalized; thus, the prevention and control of the pandemic has encountered new problems: the amount of infectious medical waste (IMW) has increased sharply; the location of outbreaks are highly unpredictable; and the pandemic occurs everywhere. Thus, it is vital to design an effective IMW reverse logistics network to cope with these problems. This paper firstly introduces mobile processing centers (MPCs) into an IMW reverse logistics network for resource-saving, quick response, and the sufficient capacity of processing centers. Then, a multi-participant-based (public central hospitals, disposal institutions, the logistics providers, and the government) collaborative location and a routing optimization model for IMW reverse logistics are built from an economic, environmental perspective. An augmented ε-constraint method is developed to solve this proposed model. Through a case study in Chongqing, it is found that for uncertain outbreak situations, fixed processing centers (FPCs) and MPCs can form better disposal strategies. MPC can expand the processing capacity flexibly in response to the sudden increase in IMW. The results demonstrate good performance in reduction in cost and infection risk, which could greatly support the decision making of IMW management for the government in the pandemic prevention and control.

Challenges associated with household solid waste management (SWM) during COVID-19 lockdown period: a case of ward 12 Gweru City, Zimbabwe.

The research assessed the challenges associated with household solid waste management during COVID-19 lockdown period. A mixed method approach was used triangulating both quantitative and qualitative methods. Ten-percent sample size of 1690 households (target population) participated in the research. Stratified random and purposive sampling methods were used to select the participants. Statistical Package for Social Science (SPSS) version 16 and content analysis were used to analyze the data. Chi-square test was used to test whether education level determines the disposal strategy used during the COVID-19 lockdown period. Research findings demonstrates that compulsive use of personal protection equipment such as masks, spending more time at home, bulk buying, and storage of food has skewed the trend of waste generation resulting in the increase in quantity of waste produced daily. COVID-19 lockdown period resulted in reduced waste collection since waste refuse collectors were not operating during lockdown period leading to illegal dumping and burning of waste. On average amount of waste produced weekly per household level was 73 kg (organic waste 35.2 kg, toxic waste 10 kg, and recyclable waste 26.8 kg). A chi-square p value of 0.35 was obtained, showing that there is a relationship between waste disposal strategy used during COVID-19 lockdown period and level of education of the respondents. The research concludes that COVID-19 has greatly affected waste management strategies from generation, collection, transportation, and disposal. It is recommended that the responsible authorities must prioritize collection of waste during the lockdown period as well as ensuring that waste recyclers and collectors are among the essential service providers during the pandemic.

Waste management, COVID-19 and occupational safety and health: Challenges, insights and evidence.

Different fields of knowledge have faced challenges due to the COVID-19 pandemic. Essential public services serving the population's needs were maintained. Previous studies have addressed the possibility of health hazards from handling solid waste (SW) among trash collection service workers, without introducing any data proving or dismissing those risks. Occupational health is stated in at least 2 of the 17 Sustainable Development Goals. Pearson Coefficient (r) was employed to analyze the correlation between the number of cases of COVID-19 in SW collection workers in the city of São Paulo, considering the district city halls where the COVID-19 patients live and the SW collection workers' route, from March 2020 to March 2021. Employees who collected wastes with COVID-19: 2% collected healthcare SD, 4% worked at the waste transshipment stations, 10% household variable route collection, and 83% in defined routes collecting household wastes. Positive and moderate correlation was confirmed (r = 0.59) between the total number of COVID-19 cases and the trash collection routes, and the number of contaminated COVID-19 workers from their trash collection routes. Considering concessionary companies separately, the correlation found in the Southeastern grouping is 0.77 (positive and high correlation), and the correlation found in the Northwestern grouping is 0.18 (positive but insignificant correlation). The Northwestern grouping's concessionary had implemented more effective occupational health and safety management policies and disclosed them among their stakeholders. Results suggest concern related to occupational health and safety for SW collection workers and substantiating the vulnerability of this essential activity during the pandemic.

Examining challenges and multi-strategic approaches in waste management during the COVID-19 pandemic: A systematic review.

The COVID-19 pandemic has a negative impact on the environment. Waste generation and improper management during the COVID-19 pandemic posed a major threat to human health and the environment. Irregular and improper waste collection, handling, suspension of waste recycling and unsanitary disposal were all important issues in the processing and management of generated waste. This study emphasised a systematic review and content analysis to categorise all types of waste management (WM) during the COVID-19 pandemic to accomplish a well understanding of the relation between the COVID-19 pandemic and its impacts on WM within the literature. In this systematic review, a number of published papers on different aspects of WM during March 2020 to February 2021 were considered in order to identify major challenges in handling WM during the pandemic time and highlight multi-strategic approaches suggested. A content analysis of the 58 relevant papers was carried out by incorporating different types of WM at local as well as global scales. The present review results revealed that the COVID-19 has impacted the quantity and composition of waste, and the crisis caused by the pandemic has also altered the nature of global WM system. A comprehensive analysis on how the systems of WM were affected through the advancement of COVID-19 and what would be the healthier solutions was also highlighted in this systematic review. The results of this systematic review would be beneficial for better policymakers to holistically address potential future pandemics, if any.

Safe practices of biomedical and dental waste management amongst practicing dental professionals amid the COVID-19 pandemic.

BACKGROUND: Biomedical waste can potentially compromise the environment and public safety if not safely disposed. OBJECTIVE: The aim was to assess the understanding and safe practices of biomedical and dental waste amongst the dental practitioners and practical year students amid the COVID-19 pandemic. METHODS: A structured and validated questionnaire consisting of 21 closed ended questions was used to collect data from dental practitioners and students working in hospitals and clinics. The questionnaire was distributed in paper and digital form amongst the participants. Descriptive analysis was performed for categorical and numerical variables. Spearman correlation test was used to assess the relationship between awareness and waste disposal practices of dentists. A p-value of≤0.05 was considered as statistically significant. RESULTS: More than three fourth of the participants were aware of proper dental waste disposal steps. One half was aware of the color-coded segregation of biomedical waste management. Two third of the participants were deploying safe biomedical waste practices. Nearly 68% subjects allocated separate labeled containers for disposal of COVID-19 suspected patient's waste. Furthermore, 71.63% participants were practicing PCR test before aerosol procedures. While 88.65% participants believed that the COVID-19 pandemic has increased the financial burden in terms of safe practices and dental waste management. CONCLUSION: The awareness and practices of the participants towards dental waste management was found to be moderate. Satisfactory COVID-19 prevention and transmission measures were observed amongst the participants. BMW management lessons should be included in the academic curriculum and training program needs to be adopted for mass awareness.

Facemasks and ferrous metallurgy: improving gasification reactivity of low-volatile coals using waste COVID-19 facemasks for ironmaking application.

The global pandemic response to COVID-19 has led to the generation of huge volumes of unrecyclable plastic waste from single use disposable face coverings. Rotary hearth furnaces can be used to recover Zn and Fe from non-recyclable steelmaking by-product dusts, and waste plastic material such as facemasks could be utilized as a supplementary reductant for the rotary hearth furnace (RHF), but their fibrous form makes milling and processing to appropriate sizing for RHF application extremely challenging. A scalable method of grinding facemasks to powder by melting and mixing with Welsh coal dust reported herein provides a solution to both environmental challenges. The melt-blended PPE/coal dust shows a dramatically improved CO2 gasification reactivity (Ea = 133-159 kJmol-1) when compared to the untreated coal (Ea = 183-246 kJmol-1), because of improved pore development in the coal during the pyrolysis stage of heating and the catalytic activity of the CaO based ash present in the facemask plastic. The results are promising for the application of waste facemasks in recycling steelmaking by-product dusts in rotary hearth furnaces and may also be suitable for direct injection to the blast furnace subject to further study.

Assessment of medical waste generation, associated environmental impact, and management issues after the outbreak of COVID-19: A case study of the Hubei Province in China.

COVID-19 greatly challenges the human health sector, and has resulted in a large amount of medical waste that poses various potential threats to the environment. In this study, we compiled relevant data released by official agencies and the media, and conducted data supplementation based on earlier studies to calculate the net value of medical waste produced in the Hubei Province due to COVID-19 with the help of a neural network model. Next, we reviewed the data related to the environmental impact of medical waste per unit and designed four scenarios to estimate the environmental impact of new medical waste generated during the pandemic. The results showed that a medical waste generation rate of 0.5 kg/bed/day due to COVID-19 resulted in a net increase of medical waste volume by about 3366.99 tons in the Hubei Province. In the four scenario assumptions, i.e., if the medical waste resulting from COVID-19 is completely incinerated, it will have a large impact on the air quality. If it is disposed by distillation sterilization, it will produce a large amount of wastewater and waste residue. Based on the results of the study, we propose three policy recommendations: strict control of medical wastewater discharge, reduction and transformation of the emitted acidic gases, and attention to the emission of metallic nickel in exhaust gas and chloride in soil. These policy recommendations provide a scientific basis for controlling medical waste pollution.

Stepping towards benign alternatives: sustainable conversion of plastic waste into valuable products.

The extensive use of plastic and the absence of efficient and sustainable methods for its degradation has raised critical concerns about its disposal and degradation. Furthermore, the escalated use of personal protective equipment (PPE) and masks during the ongoing COVID-19 pandemic has put us under tremendous pressure of generating huge amounts of plastic waste. Traditional plastic waste disintegration protocols, while effective, pose additional inevitable environmental risks. Owing to this, almost all the used plastic is directly discarded into the marine and terrestrial bodies, causing great harm to the flora and fauna. Plastic has even started entering the food chain in the form of micro- and nano-plastics, leading to deleterious effects. Considering the global need for finding sustainable ways to degrade plastic, several approaches have been developed. Herein we highlight and rationally compare the recent reports on the development of benign alternatives for the sustainable disintegration of plastic detritus into value-added products. Here we discuss, in depth, photoreforming of a variety of polymers to liquid fuels under natural conditions; enzyme-based deconstruction of polymeric materials via microorganisms and their engineered mutants into useful virgin monomers at ambient temperature; and pyrocatalytic degradation of polyethylene through efficient synthetic materials into valuable fuels and waxes. By critically analyzing the methods, we also provide our opinion on such sustainable techniques and discuss newer approaches related to bioinspired and biomimetic chemistry principles for the management of plastic waste.

Study of solid waste (municipal and medical) management during the COVID-19 pandemic: a review study.

The COVID-19 pandemic has resulted in a global emergency crisis and created waste management challenges worldwide. Such a critical point has changed solid waste (municipal and medical) management prospects and posed fact challenges to the health decision-makers and policy-makers to make decisions to ensure sustainable management of the environment. One of the most negative prospects of COVID-19 pandemic is the increased waste generation, especially plastic waste in developing and developed countries. This study systematically reviews the potential influences of the COVID-19 pandemic on medical and municipal waste, and discusses the corresponding measures and policies of solid waste management in several countries. The results show that the highest and lowest quality of final disposal is observed in Finland with 75% recycling and in India with 90% open dumping, respectively. In many countries, the medical waste showed an increase by 350-500%.The pandemic has brought particular problems to the disposal capacity of municipal waste and medical waste across the world. We think that this point of view study provides valuable data for scientists, policy makers, health decision-makers, consultants, medical staff, medical supplies, those working in public health sector, and field engineers responsible for solid waste management.

Cuckoo optimization algorithm in reverse logistics: A network design for COVID-19 waste management.

Today, reverse logistics (RL) is one of the main activities of supply chain management that covers all physical activities associated with return products (such as collection, recovery, recycling and destruction). In this regard, the designing and proper implementation of RL, in addition to increasing the level of customer satisfaction, reduces inventory and transportation costs. In this paper, in order to minimize the costs associated with fixed costs, material flow costs, and the costs of building potential centres, a complex integer linear programming model for an integrated direct logistics and RL network design is presented. Due to the outbreak of the ongoing global coronavirus pandemic (COVID-19) at the beginning of 2020 and the consequent increase in medical waste, the need for an inverse logistics system to manage waste is strongly felt. Also, due to the worldwide vaccination in the near future, this waste will increase even more and careful management must be done in this regard. For this purpose, the proposed RL model in the field of COVID-19 waste management and especially vaccine waste has been designed. The network consists of three parts - factory, consumers' and recycling centres - each of which has different sub-parts. Finally, the proposed model is solved using the cuckoo optimization algorithm, which is one of the newest and most powerful meta-heuristic algorithms, and the computational results are presented along with its sensitivity analysis.

Current perspectives of biomedical waste management in context of COVID-19".

COVID-19 pandemic and it's consequent biomedical waste is an unprecedented challenge worldwide. Biomedical waste generated during COVID-19 patient isolation, testing and care needs special consideration as it challenges the previous notion that only 15-20% of waste can be considered infectious. With establishment of new home quarantine facility, isolation/quarantine centres the chances of general waste getting contaminated with biomedical waste has increased exponentially. Through this systematic review the authors searched for all possible queries raised by different researchers on COVID19 waste management on Pubmed. A summary of all the different issues unique to COVID19 waste was prepared. Guidelines, rules and recommendation given by national and international agencies published till date were taken into account while trying to answer all the above questions raised by different studies. The key step in COVID19 waste management is segregation of biomedical waste from solid waste. Waste generated from COVID19 patients is like any other infectious waste, therefore creating public awareness about the COVID19 waste hazards and segregation at source is highlighted in all guidelines as a recommendation. These guidelines for management of waste generated during diagnostics and treatment of COVID-19 suspected or confirmed patients, are required to be followed in addition to existing practices under regulation. BMWM in COVID-19 context is a public health concern and is both a legal and social responsibility for all stakeholders.

Utilization of greenhouse effect for the treatment of COVID-19 contaminated disposable waste - A simple technology for developing countries.

Countries with abundant solar radiation have the potential to invest in simple technologies for deactivation of many bacteria and viruses in medical solid waste. In addition to the traditional Infection and Prevention Control (IPC) measures, these simple technologies contribute to better protection of health care workers in countries with compromised solid management schemes. Monitoring of temperature, relative humidity and ultraviolet inside containers soundly designed to collect disposal infectious waste illustrated to deactivate several viruses and bacteria. Casanova et al., 2010, used some surrogate viruses to overcome the challenges of working with SARS-CoV, concluded that by temperature above 40 °C most of viruses become below levels of detection after 90 min. Here we are proposing a model of a simple transparent container almost 200 L in volume that allow solar energy to be accumulated inside. In summer conditions in the testing site, temperature inside the container reached above 50 °C when the ambient air temperature was around 30 °C. The container was built using epoxy glass to guarantee maximum heat penetration. Actual temperature measurement inside the container was measured in real time against ambient air temperature. We present a mathematical model for predication of maximum temperature at different positions inside the container and their relation to different ambient air temperature scenarios. The mathematical formulas used are based on the conservation laws and a good agreement of a full month of field measurements were obtained. Even in winter conditions in many of developing countries air temperature can maintain levels above 20 °C, which will produce temperature around 30 °C and viruses can reach levels below detection limit in maximum 3 h.

Guidelines for various laboratory sections in view of COVID-19: Recommendations from the Indian Association of Pathologists and Microbiologists.

Declared as a pandemic by WHO on March 11, 2020, COVID-19 has brought about a dramatic change in the working of different laboratories across the country. Diagnostic laboratories testing different types of samples play a vital role in the treatment management. Irrespective of their size, each laboratory has to follow strict biosafety guidelines. Different sections of the laboratory receive samples that are variably infectious. Each sample needs to undergo a proper and well-designed processing system so that the personnel involved are not infected and also their close contacts. It takes a huge effort so as to limit the risk of exposure of the working staff during the collection, processing, reporting or dispatching of biohazard samples. Guidelines help in preventing the laboratory staff and healthcare workers from contracting the disease which has a known human to human route of transmission and high rate of mortality. A well-knit approach is the need of the hour to combat this fast spreading disease. We anticipate that the guidelines described in this article will be useful for continuing safe work practices by all the laboratories in the country.