Developing an effectiveness index for biomedical waste management in Indian states using a composite indicators approach

The Use of Information Entropy and Expert Opinion in Maximizing the Discriminating Power of Composite Indicators

This research offers a solution to a highly recognized and controversial problem within the composite indicator literature: sub-indicators weighting. The research proposes a novel hybrid weighting method that maximizes the discriminating power of the composite indicator with objectively defined weights. It considers the experts' uncertainty concerning the conceptual importance of sub-indicators in the multidimensional phenomenon, setting maximum and minimum weights (constraints) in the optimization function. The hybrid weighting scheme, known as the SAW-Max-Entropy method, avoids attributing weights that are incompatible with the multidimensional phenomenon's theoretical framework. At the same time, it reduces the influence of assessment errors and judgment biases on composite indicator scores. The research results show that the SAW-Max-Entropy weighting scheme achieves greater discriminating power than weighting schemes based on the Entropy Index, Expert Opinion, and Equal Weights. The SAW-Max-Entropy method has high application potential due to the increasing use of composite indicators across diverse areas of knowledge. Additionally, the method represents a robust response to the challenge of constructing composite indicators with superior discriminating power.

The Efficient Disposal of Biomedical Waste Is Critical to Public Health: Insights from the Central Pollution Control Board Guidelines in India

Biomedical waste (BMW), encompassing hazardous medical materials, poses environmental and public health risks if not correctly managed. The Central Pollution Control Board (CPCB) in India is a statutory organization that oversees BMW disposal standards, aimed at mitigating these hazards. BMW mismanagement is a major problem and potentially poses threats to the environment as well as public health. During the coronavirus disease 2019 (COVID-19) pandemic, increased use of personal protective equipment (PPE) and other medical equipment was witnessed which led to a marked raised BMW generation. To ensure proper and optimized BMW management, CPCB established guidelines and rules to be followed by the medical facilities as well as the common BMW treatment facilities (CBWTFs). The challenges in implementing proper waste management practices were lack of awareness and inadequate infrastructure. Strategies for better BMW management were proposed, including color-coded bins, improved infrastructure, advanced technology, and awareness campaigns. Highlighting CPCB's vital role, this emphasizes healthcare facilities' proactive role in implementing and evolving regulations for sustainable BMW disposal, ensuring both public health and environmental well-being through compliance and responsible waste management partnerships.

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.

Biomedical waste generation and management during COVID-19 pandemic in India: challenges and possible management strategies

The COVID-19 pandemic has resulted in the massive generation of biomedical waste (BMW) and plastic waste (PW). This sudden spike in BMW and PW has created challenges to the existing waste management infrastructure, especially in developing countries. Safe disposal of PW and BMW is essential; otherwise, this virus will lead to a waste pandemic. This paper reviews the generation of BMW and PW before and during the COVID-19 pandemic, the regulatory framework for BMW management, policy interventions for COVID-19-based BMW (C-BMW), the capacity of BMW treatment and disposal facilities to cope with the challenges, possible management strategies, and perspectives in the Indian context. This study indicated that policy intervention helped minimize the general waste treated as C-BMW, especially during the second pandemic. Inadequacy of common BMW treatment facilities' (CBMWTFs) capacity to cope with the BMW daily generation was observed in some states resulting in compromised treatment conditions. Suggestions for better management of BMW and PW include decontamination of used personal protective equipment (PPEs) and recycling, alternate materials for PPEs, segregation strategies, and use of BMW for co-processing in cement kilns. All upcoming CBMWTFs should be equipped with higher capacity and efficient incinerators for the sound management of BMW. Post-pandemic monitoring of environmental compartments is imperative to assess the possible impacts of pandemic waste.