A study of indoor air pollution caused by disinfection equipment as a consequence of infectious waste management.

Infectious waste disinfection is an essential process in medical waste management that may cause release of some pollutants. In this study, the PAHs concentration at the disinfection was investigated. The change in the release rate of PAHs in two including infectious waste reduction and increasing the segregation ratio was estimated. The results showed that the PAHs concentration was 1172 - 2066 ng/m3. The specific concentration of PAHs was 852 ng/ton of infectious waste in average. The annual emission of the PAHs resulting from infectious waste disinfection is estimated to be 612.6 kg. Reduction of infectious waste caused by redefining infectious waste and increasing the segregation ratio leads to reduction of PAHs concentration by 50%. Increasing the ratio of segregation and redefinition of infectious waste that led to reduced waste loading volume are essential measures that reduce the emissions of pollutants as by-products of disinfection.

Risk Management for Whole-Process Safe Disposal of Medical Waste: Progress and Challenges.

Over the past decade, the global outbreaks of SARS, influenza A (H1N1), COVID-19, and other major infectious diseases have exposed the insufficient capacity for emergency disposal of medical waste in numerous countries and regions. Particularly during epidemics of major infectious diseases, medical waste exhibits new characteristics such as accelerated growth rate, heightened risk level, and more stringent disposal requirements. Consequently, there is an urgent need for advanced theoretical approaches that can perceive, predict, evaluate, and control risks associated with safe disposal throughout the entire process in a timely, accurate, efficient, and comprehensive manner. This article provides a systematic review of relevant research on collection, storage, transportation, and disposal of medical waste throughout its entirety to illustrate the current state of safe disposal practices. Building upon this foundation and leveraging emerging information technologies like Internet of Things (IoT), cloud computing, big data analytics, and artificial intelligence (AI), we deeply contemplate future research directions with an aim to minimize risks across all stages of medical waste disposal while offering valuable references and decision support to further advance safe disposal practices.

Experimental and modeling study of medical waste based on plasma gasification.

Plasma gasification melting (PGM) provides reliable disposal of toxic medical waste with a low heating value, which is capable of converting waste into energy. This study investigates the performance of experiments on plasma gasification for the treatment of chemical-pharmaceutical medical waste (CPMW) with an air medium. A comparative analysis is performed for gasification characteristics at three reactor temperatures (1000, 1400, and 1800 °C). Moreover, a thermodynamic equilibrium model is developed to assess performance features such as syngas yield, high heating value, and cold gas efficiency in the gasification temperature range of 1000-1800 °C. A comparison of the experiment and computational outcomes shows a good agreement. The results show that the quality of syngas and heating value is improved by increasing the temperature of the plasma gasifier so that at 1800 °C, H2, CO, and higher heating value (HHV) are obtained as 41 %, 37 %, and 10 MJ/Nm3, respectively. The obtained syngas is a clean fuel with low sulfur-containing and nitrogen-containing. The experimental results provide an extensive comprehension of CPMW gasification in a plasma reactor and consider a possibility for hydrogen and energy production.

A study of the stabilization and solidification of heavy metals in co-vitrification of medical waste incineration ash and coal fly ash.

Medical waste incineration ash (MWIA) has significant concentrations of heavy metals, dioxins, and chlorine that, if handled incorrectly, might cause permanent damage to the environment and humans. The low content of calcium (Ca), silicon (Si), and aluminum (Al) is a brand-new challenge for the melting technique of MWIA. This work added coal fly ash (CFA) to explore the effect of melting on the detoxication treatment of MWIA. It was found that the produced vitrification product has a high vitreous content (98.61%) and a low potential ecological risk, with an initial ash solidification rate of 67.38%. By quantitatively assessing the morphological distribution features of heavy metals in ashes before melting and molten products, the stabilization and solidification rules of heavy metals during the melting process were investigated. This work ascertained the feasibility of co-vitrification of MWIA and CFA. In addition, the high-temperature melting and vitrification accelerated the detoxification of MWIA and the solidification of heavy metals.

Resource utilization of medical waste incineration fly ash to activate peroxydisulfate for tetracycline degradation: Synergy between adsorption and PDS activation.

Medical waste incineration fly ash (MWI FA) is classified as a hazardous solid waste. Therefore, the development of recycling technologies to convert MWI FA into useful products is necessary and challenging. In this study, we developed a sustainable approach for preparing a catalyst through the pyrolysis of water-washed MWI FA (WW FA-x, where x corresponds to the pyrolysis temperature). Subsequently, it was applied as a potent peroxydisulfate (PDS) activator to remove tetracycline (TC) from water. The results showed that the WW FA-800 exhibited remarkable adsorption performance as well as highly efficient catalytic activation of PDS, with a 115 mg/g maximum TC adsorption capacity and 93.5% (reaction kinetic rate = 315 µmol/g/h) TC removal within 60 min. A synergistic effect was achieved by adsorption and PDS activation. TC degradation was primarily driven by non-radical (1O2 and electron transfer) processes. WW FA-800 possesses multiple active sites, including defects, π-π*, O-CO groups, Fe0, and Cu(I). Three possible pathways for TC decomposition have been proposed, with the majority of intermediates exhibiting less toxicity than TC. Furthermore, the WW FA/PDS system exhibited an excellent anti-interference ability, and universality in the degradation of various organic contaminants. Notably, energy consumption was minimal, approximately 2.80 kWh/(g·TC), and the leachability of heavy metals in the WW FA-800 was within acceptable limits. This study provides a MWI FA recycling route for the development of highly active catalysts.

Green radiology: How to develop sustainable radiology.

The phenomenon of global warming due to the increased emission of greenhouse gases makes it necessary to raise public awareness about the importance of promoting sustainable practices. The field of radiology is not an exception, as it consumes a large amount of energy and resources to operate equipment and generate images. Green radiology is a sustainable, innovative, and responsible approach in radiology practice that focuses on minimizing the negative environmental effects of the technologies and procedures used in radiology. Its primary goal is to reduce the carbon, water and ecological footprint in our services based on four strategic pillars: decreasing energy, water, and helium usage; properly recycling and/or disposing of waste and residues (including contrast media); minimizing the environmental impact of ionizing radiation; and promoting eco-friendly radiology practices.

The collateral effects of COVID-19 on marine pollution.

The COVID-19 pandemic has gained significant attention to the intersection of public health crises and environmental challenges, particularly in the context of marine pollution. This paper examines the various impacts of the pandemic on marine environments, focusing on the pollution attributed to single-use plastics (SUPs) and personal protective equipment (PPE). Drawing on a comprehensive analysis of literature and case studies, the paper highlights the detrimental effects of increased plastic waste on marine ecosystems, biodiversity, and human health. Statistical data and graphical representations reveal the scale of plastic pollution during the pandemic, emphasizing the urgent need for mitigation strategies. The study evaluates innovative monitoring techniques and future recommendations, emphasizing stakeholder collaboration in sustainable waste management. By broadening geographic examples and comparative analyses, it provides a global perspective on the pandemic's impact, highlighting the importance of international cooperation for safeguarding marine ecosystems.

Predicting medical waste generation and associated factors using machine learning in the Kingdom of Bahrain.

Effective planning and managing medical waste necessitate a crucial focus on both the public and private healthcare sectors. This study uses machine learning techniques to estimate medical waste generation and identify associated factors in a representative private and a governmental hospital in Bahrain. Monthly data spanning from 2018 to 2022 for the private hospital and from 2019 to February 2023 for the governmental hospital was utilized. The ensemble voting regressor was determined as the best model for both datasets. The model of the governmental hospital is robust and successful in explaining 90.4% of the total variance.Similarly, for the private hospital, the model variables are able to explain 91.7% of the total variance. For the governmental hospital, the significant features in predicting medical waste generation were found to be the number of inpatients, population, surgeries, and outpatients, in descending order of importance. In the case of the private hospital, the order of feature importance was the number of inpatients, deliveries, personal income, surgeries, and outpatients. These findings provide insights into the factors influencing medical waste generation in the studied hospitals and highlight the effectiveness of the ensemble voting regressor model in predicting medical waste quantities.

What we learned from the infection control and what we need in the future: A quantitative and qualitative study on hospital infection prevention and control practitioners (HIPCPs) in Tianjin, China.

BACKGROUND: In December 2022, the epidemic prevention and control policy was upgraded, and China entered a different stage of epidemic control. This study aims to identify implications for better infection control and health care supply during the epidemic. METHODS: A longitudinal quantitative and qualitative study was performed based on 2 comprehensive questionnaire surveys among 497 hospital infection prevention and control practitioners (HIPCPs) before and during the epidemic peak in Tianjin, China. RESULTS: The workload (8.2 hours vs 10.14 hours, P = 0) and self-reported mental health problems (23.5% vs 61.8%, P < .05) among the HIPCPs increased significantly in the peak period. Ward reconstruction and resource coordination were the most needed jobs in hospital infection control, and rapidly increased medical waste during the epidemic needs to be considered in advance. Community support for health care personnel and their families, maintaining full PPE to reduce simultaneous infection of medical staff, and clinical training of infectious diseases for medical staff, especially doctors, in advance are the most important things we learned. CONCLUSION: Although it has been 4 years since the first outbreak of coronavirus disease 2019, more improvements should be made to prepare for the next epidemic of potential diseases.

Upcycling of SARS-CoV-2 Rapid Antigen Test Cassettes into Flame Retardant Plastics.

The COVID-19 pandemic resulted in the generation of large quantities of medical waste and highlighted the importance of efficient waste management systems. One good example of this is rapid antigen tests, which contain valuable resources, and which are usually incinerated after their use. The present study aimed to evaluate the potential of waste rapid antigen test cassettes (RATCs) as a resource for the preparation of sustainable flame-retardant plastics. Milled RATCs were compounded with different concentrations (10-30 wt.%) of aluminium diethylphosphinate (ADP) and injection moulded into test specimens. Prepared samples were exposed to ultraviolet (UV) ageing for varying durations and characterised by Fourier-transform infrared spectroscopy (FT-IR), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), dynamic mechanical analysis (DMA), tensile tests, Charpy impact tests, and vertical burning tests. FT-IR analysis revealed that RATCs are composed mainly of high-impact polystyrene (HIPS), which was further confirmed by suitable glass transition temperatures (Tg) determined by DSC and DMA. The addition of ADP resulted in progressive embrittlement of HIPS with increasing concentration, while flammability decreased significantly and reached V-1 classification at loading of 30 wt.%. UV ageing caused photo-oxidative degradation of HIPS, which resulted in decreased strain-at-break, while flammability was not affected.

Co-incineration of medical waste in municipal solid waste incineration increased emission of chlorine/brominated organic pollutants.

Co-incineration of medical waste (MW) in municipal solid waste incinerators (MSWIs) is a crucial disposal method for emergency disposal of MW and the management of MW in small and medium-sized towns. This study aims to analyze and compare the levels and distribution patterns of chlorine/brominated dioxins and their precursors in fly ash from MSWIs and medical waste incinerators (MWIs) while also focusing on identifying the new pollution concerns that may arise from the co-incineration of municipal solid waste (MSW) mixed with MW (MSW/MW). The concentration of chlorobenzene (CBzs), polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins/dibenzofurans (PCDD/Fs) in fly ash from co-incineration of MSW/MW are 887.4, 134.4 and 27.6 µg/kg, respectively, which are 5.1, 2.0 and 2.9 times higher than that from MSWIs. The levels of polybrominated dibenzo-p-dioxins/dibenzofurans (PBDD/Fs) are about three orders of magnitude lower than that of PCDD/Fs. For the fly ash from MSWIs, the predominant PCDD/Fs congener is OCDD, which prefers synthesis and adsorption on fine-grained fly ash. For fly ash from MWIs, the major PCDD/Fs congeners are 1, 2, 3, 4, 6,7, 8-HpCDF, and OCDF, which prefer synthesis and adsorption on coarse-grained fly ash. Correlation analysis exhibited that both 1,2,3-TriCBz and 1,2,4-TriCBz in fly ash have a markedly linear correlation with PCDD/Fs and PCBs, but PBDD/Fs shows a poor negative correlation with PCDD/Fs.

Predictors of biomedical waste management practices among staff nurses of a tertiary care teaching hospital in India.

BACKGROUND: Inappropriate handling of biomedical waste (BMW) may pose serious threats to the health of patients and hospital personnel. Among all healthcare workers, staff nurses play a vital role in BMW management (BMWM). Thus, the present study aimed to determine the predictors of BMWM practices among staff nurses of a tertiary care teaching hospital in India. MATERIALS AND METHODS: A prospective cross-sectional study was conducted among 150 staff nurses, working at a tertiary care teaching hospital in South India, from July to August 2018. Data were collected using a pretested, semi-structured, and self-administered questionnaire after taking their written informed consent. Regression analysis was carried out to identify the predictors of satisfactory BMWM practice status. RESULTS: Of the total 150 staff nurses, most of them were young females with a work experience of ≤ 5 years. Concerning knowledge scores, most staff nurses (63.3%) belonged to the moderate category, whereas a few (24%) were in the high category. Also, most of them (62.7%) were in the high category of attitude scores. For practice scores, half of the participants were in moderate and high categories, each. Female gender, attended training status, and moderate and high knowledge scores were significantly associated with satisfactory BMWM scores in unadjusted analysis. After adjusting for other independent variables, all these three factors were found significantly associated with satisfactory BMWM practice scores. CONCLUSION: The present study shows that the female gender, attending training in BMWM, and having a moderate and high knowledge of BMWM were significant predictors of satisfactory BMWM practice among staff nurses. Thus, all hospitals must periodically train their staff nurses to strengthen their BMWM practices. Safe BMWM leads to environmental protection and safeguards the health of patients, hospital personnel, and the public.

Impact of medical waste bin on contamination of patient's environment: An experimental study.

BACKGROUND: Medical waste bins are a potential source of microbial contamination in the hospital environment, while there is no clear guidance for the management of them. We aimed to assess the impact of medical waste bins on patient's environment. METHODS: This experimental study simulated microbial contamination by performing medical procedures on a patient model with fluorescent lotion. The waste bin was set as initially empty or two-thirds filled with waste, open or with a lid. The percentage of fluorescent-contaminated area in designated patient's environments was analyzed by 2 independent observers. RESULTS: Among a total of 120 experiments, the sides of the bins were more contaminated in open-occupied bins compared to open-empty bins and in open-occupied bins compared to lid-occupied bins (median 1.9175% vs 0.0916% [P = .001] and 1.9175% vs 0.0899% [P = .003], respectively). The top of the bedside equipment trolley for preparing medical procedures was more contaminated in lid-occupied bins than open-occupied bins (median 0.0080% vs 0.0040%, P = .013). DISCUSSION: In addition to reducing contamination of the bin itself, the manually operated lid had a potential risk of contributing to microbial transmission by contaminating the equipment trolley. CONCLUSIONS: Medical waste bins should be kept no more than two-thirds full, and caution should be taken when using the manually operated lid, to avoid cross-contamination.

Medical waste incineration fly ash-based magnesium potassium phosphate cement: Calcium-reinforced chlorine solidification/stabilization mechanism and optimized carbon reduction process strategy.

The traditional solidification/stabilization (S/S) technology, Ordinary Portland Cement (OPC), has been widely criticized due to its poor resistance to chloride and significant carbon emissions. Herein, a S/S strategy based on magnesium potassium phosphate cement (MKPC) was developed for the medical waste incineration fly ash (MFA) disposal, which harmonized the chlorine stabilization rate and potential carbon emissions. The in-situ XRD results indicated that the Cl- was efficiently immobilized in the MKPC system with coexisting Ca2+ by the formation of stable Ca5(PO4)3Cl through direct precipitation or intermediate transformation (the Cl- immobilization rate was up to 77.29%). Additionally, the MFA-based MKPC also demonstrated a compressive strength of up to 39.6 MPa, along with an immobilization rate exceeding 90% for heavy metals. Notably, despite the deterioration of the aforementioned S/S performances with increasing MFA incorporation, the potential carbon emissions associated with the entire S/S process were significantly reduced. According to the Life Cycle Assessment, the potential carbon emissions decreased to 8.35 × 102 kg CO2-eq when the MFA reached the blending equilibrium point (17.68 wt.%), while the Cl- immobilization rate still remained above 65%, achieving an acceptable equilibrium. This work proposes a low-carbon preparation strategy for MKPC that realizes chlorine stabilization, which is instructive for the design of S/S materials.

Evaluating the effect of the COVID-19 pandemic on medical waste disposal using preference selection index with CRADIS in a fuzzy environment.

The COVID-19 pandemic has caused a surge in essential medical supplies usage, leading to a notable increase in medical waste generation. Consequently, extensive research has focused on sustainable disposal methods to handle used medical equipment safely. Given the necessity to evaluate these methods considering qualitative and quantitative criteria, this falls within the realm of multi-criteria decision-making (MCDM). This study introduces a framework for selecting the most suitable medical waste treatment methods, taking into account economic, technological, environmental, and social aspects. Sixteen criteria were assessed using the Fuzzy Preference Selection Index (F-PSI) to determine the optimal waste disposal approach. Additionally, the Fuzzy Compromise Ranking of Alternatives from Distance to Ideal Solution (F-CRADIS) method was employed to evaluate nine technologies for medical waste disposal. Notably, disinfection efficiency emerged as the most crucial criterion, with autoclaving identified as the preferred method for medical waste treatment. A practical case study conducted in Sivas, Turkey, validates the feasibility of these strategies. Multiple sensitivity analyses were performed to ensure the stability and reliability of the proposed approach.

An application of BWM for risk control in reverse logistics of medical waste.

The pollution posed by medical waste complicate the procedures of medical waste logistics (MWL), and the increasingly frequent occurrence of public health emergencies has magnified the risks posed by it. In this study, the authors established an index of the factors influencing the risks posed by MWL along five dimensions: the logistics business, emergency capacity, equipment, personnel, and management. The best-worst case method was used to identify the critical risk-related factors and rank them by importance. Following this, we assessed the risk posed by MWL in four major cities in China as an example and propose the corresponding measures of risk control. The results showed that the linking of business processes was the most important factor influencing the risk posed by MWL. The other critical risk-related factors included the location of the storage site, the capacity for emergency transportation, measures to manage emergencies, and the safety of packaging. Of the cities considered, Beijing was found to be a high-risk city, and its MWL needed to be improved as soon as possible in light of the relevant critical risks. Shanghai, Guangzhou, and Shenzhen were evaluated as general-risk cities, which meant that the risks of MWL were not a priority in these areas, and the other goals of urban development should be comprehensively considered during the long-term planning for MWL in these municipalities.