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.

A systematic scoping review of environmental and socio-economic effects of COVID-19 on the global ocean-human system.

The global outbreak of the coronavirus disease 2019 (COVID-19) has strongly affected human lives. The restrictions taken to slow down the spread of the virus impact socio-economic activities and the environment. A comprehensive review of these COVID-19 impacts on the ocean-human system is lacking. The current study fills this gap by synthesizing the environmental and socio-economic effects of the COVID-19 pandemic on the global ocean by conducting a systemic scoping review of 92 published articles. From a geospatial perspective, the studies covered a total of 37 countries, mainly from Asia, Europe, and North America, with a particular focus on the Indian Ocean and the Mediterranean Sea. From an environmental perspective, both positive and negative effects on global oceans were summarized. Notably, improved coastal water quality and reduced underwater noise were reported. On the other hand, the increasing COVID-19-related medical waste such as personal protective equipment leads to severe pollution, which threatens the marine ecosystem and wildlife. From a socioeconomic perspective, the impacts of the pandemic were negative throughout with marine tourism and the fishery industry being severely disrupted. Coastal communities suffered from loss of income, unemployment, inequalities and health problems. The COVID-19 pandemic offers an opportunity for transformation of management and economic practices in order to save our ocean and boost progress towards Sustainable Development Goal 14 (SDG 14). Future research should include other sectors such as marine biodiversity, marine renewable energy, climate change, and blue economy development of Small Island Developing States. Effective policies and strategies across land and ocean around the world need to be developed and implemented to enhance resilience of the human-ocean system and to achieve post-pandemic global sustainable ocean development.

Fermentative bioconversion of food waste into biopolymer poly(3-hydroxybutyrate-co-3-hydroxyvalerate) using Cupriavidus necator.

Dependency on plastic commodities has led to a recurrent increase in their global production every year. Conventionally, plastic products are derived from fossil fuels, leading to severe environmental concerns. The recent coronavirus disease 2019 pandemic has triggered an increase in medical waste. Conversely, it has disrupted the supply chain of personal protective equipment (PPE). Valorisation of food waste was performed to cultivate C. necator for fermentative production of biopolymer poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV). The increase in biomass, PHBV yield and molar 3-hydroxy valerate (3HV) content was estimated after feeding volatile fatty acids. The fed-batch fermentation strategy reported in this study produced 15.65 ± 0.14 g/L of biomass with 5.32 g/L of PHBV with 50% molar 3HV content. This is a crucial finding, as molar concentration of 3HV can be modulated to suit the specification of biopolymer (film or fabric). The strategy applied in this study addresses the issue of global food waste burden and subsequently generates biopolymer PHBV, turning waste to wealth.

Climatic, Environmental and Health Impacts of Disused Coronavirus Protective Equipment: Towards Effective Regulatory and Containment Measures.

Though global health care delivery systems have been under inevitable pressure and risks from the ongoing coronavirus disease (COVID-19) pandemic, our natural human environment is also increasingly threatened. The reason is that efforts to contain the pandemic have resulted in a vast generation of medical waste from disused personal protective equipment, such as facemasks, face-shields, hand-gloves, hand-sanitisers, and related single-use products. Unprofessional management of medical waste can result in environmental contagion. This article, adopting an analytical approach, argues that COVID-19 waste represents a mode of contagion, and hence demands special regulatory attention, management, and disposal procedures at all levels of governance. The article offers an epidemiological perspective on COVID-19 waste and its place in medical waste. It provides insights into the best practices for managing COVID-19 waste and examines how global objectives and frameworks visibly support COVID-19 medical waste management globally.

Assessment of COVID-19 vaccination-related medical waste management practices in Bangladesh.

The COVID-19 pandemic forces people to be vaccinated as early as possible. The COVID-19 vaccination program certainly raised the medical waste volume all over the world, including in Bangladesh. Numerous recent reports showed a fragile medical waste management system in Bangladesh; during the pandemic, the situation became worse. In addition, the nation-wide ongoing COVID-19 vaccination processes have been posing an extra burden to the existing biomedical waste management in the country. Failing to proper management of this waste might be a threat to human and environmental health. Therefore, the study investigated the current COVID-19 vaccine waste management practices in Bangladesh and made a comparison to the proposed standard operating procedures of international organizations and vaccine waste management practices of two other countries (USA and India). The study was carried out through a mixed methodological approach such as qualitative and quantitative, including a questionnaire survey in 15 Upazila of 4 Districts (Dhaka, Narayanganj, Manikganj, and Gazipur) of Bangladesh. The article focused on a nation-wide legitimate COVID-19 vaccination waste estimation, strength, weakness, opportunity, and threat (SWOT) analysis and drivers, pressure, state, impact, and response (DPSIR) framework analysis to identify the present state of medical waste management in the study area. The study found an excellent segregation system (100%) but very poor waste handling (35.5%) along with very poor syringes and sharps disposal method (open burning without buried 46.6%) and poor vials disposal method (without disinfection/open dump 52%) of vaccine waste. It is estimated that about 58 and 257.85 tonnes of syringes (with needles and packaging) and vaccine vials (Sinopharm 2 doses) waste have been generated since the mass-vaccination program started. Upon SWOT analysis, good separation techniques, poor waste management (ex-situ), enough space for management, and environmental and human health concerns were mostly identified as a strength, weakness, opportunity, and threat, respectively. Finally, a DPSIR framework was prepared for vaccine waste generation and its consequences in the studied area. This study will be useful to prepare a suitable vaccination waste management system in Bangladesh.

A dual hesitant q-rung orthopair enhanced MARCOS methodology under uncertainty to determine a used PPE kit disposal.

Healthcare waste management is regarded as the most critical concern that the entire world is currently and will be confronted with in the near future. During the COVID-19 pandemic, the significant growth in medical waste frightened the globe, prompting it to investigate safe disposal methods. Plastics are developing as a severe environmental issue as a result of their increased use during the COVID-19 pandemic which has triggered a global catastrophe and prompted concerns about plastic waste management. One of the biggest challenges in this circumstance is the disposal of discarded PPE kits. The purpose of this research is to find a viable disposal treatment procedure for enhanced personal protective equipment (PPE) (facemasks, gloves, and other protective equipment) and other single-use plastic medical equipment waste in India during the COVID-19 crises, which will aid in effectively reducing their increasing quantity. To analyse the PPE waste disposal problem in India, we used the fuzzy Measurement Alternatives and Ranking according to the Compromise Solution (MARCOS) technique, which included the dual hesitant q-rung orthopair fuzzy set. The fuzzy Best Worst Method (BWM), which is compatible with the existing MCDM approaches, is used to establish the criteria weights. Sensitivity and comparative analyses are utilised to confirm the stability and validity of the proposed strategy.

Hospital waste generation during the first wave of COVID-19 pandemic: a case study in Delhi.

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.

Pyrolysis dynamics of two medical plastic wastes: Drivers, behaviors, evolved gases, reaction mechanisms, and pathways.

The public has started to increasingly scrutinize the proper disposal and treatment of rapidly growing medical wastes, in particular, given the COVID-19 pandemic, raised awareness, and the advances in the health sector. This research aimed to characterize pyrolysis drivers, behaviors, products, reaction mechanisms, and pathways via TG-FTIR and Py-GC/MS analyses as a function of the two medical plastic wastes of syringes (SY) and medical bottles (MB), conversion degree, degradation stage, and the four heating rates (5,10, 20, and 40 °C/min). SY and MB pyrolysis ranged from 394.4 to 501 and from 417.9 to 517 °C, respectively. The average activation energy was 246.5 and 268.51 kJ/mol for the SY and MB devolatilization, respectively. MB appeared to exhibit a better pyrolysis performance with a higher degradation rate and less residues. The most suitable reaction mechanisms belonged to a geometrical contraction model (R2) for the SY pyrolysis and to a nucleation growth model (A1.2) for the MB pyrolysis. The main evolved gases were C4-C24 alkenes and dienes for SY and C6-C41 alkanes and C8-C41 alkenes for MB. The pyrolysis dynamics and reaction pathways of the medical plastic wastes have important implications for waste stream reduction, pollution control, and reactor optimization.

Reverse logistics network design for medical waste management in the epidemic outbreak of the novel coronavirus (COVID-19).

The recent pandemic triggered by the outbreak of the novel coronavirus boosted the demand for medical services and protective equipment, causing the generation rate of infectious medical waste (IMW) to increase rapidly. Designing an efficient and reliable IMW reverse logistics network in this situation can help to control the spread of the virus. Studies on this issue are limited, and minimization of costs and the risks associated with the operations of this network consisting of different types of medical waste generation centers (MWGC) are rarely considered. In this research, a linear programming model with three objective functions is developed to minimize the total costs, the risk associated with the transportation and treatment of IMW, and the maximum amount of uncollected waste in MWGCs. Also, multiple functions that calculate the amount of generated waste according to the parameters of the current epidemic outbreak are proposed. Revised Multi-Choice Goal Programming method is employed to solve the multi-objective model, and a real case study from Iran is examined to illustrate the validation of the proposed model. The final results show that the model can create a balance between three considered objectives by determining the flow between centers, deciding to install two new temporary treatment centers, and allowing the network to only have uncollected waste in the first two periods in some MWGCs. Also, managerial insights for health organization authorities extracted from the final results and sensitivity analyses are presented for adequately handling the IMW network.