Suggested guidelines for emergency treatment of medical waste during COVID-19: Chinese experience

Can pyrolysis handle biomedical wastes?: Assessing the potential of various biomedical waste treatment technologies in tackling pandemics

Globally, COVID-19 has not only caused tremendous negative health, social and economic impacts, but it has also led to environmental issues such as a massive increase in biomedical waste. The biomedical waste (BMW) was generated from centralized (hospitals, clinics, and research facilities) and extended (quarantine camps, COVID-19 test camps, and quarantined homes) healthcare facilities. Many effects, such as the possibility of infection spread, unlawful dumping/disposal, and an increase in toxic emissions by common BMW treatment facilities, are conjectured because of the rise in waste generation. However, it is also an opportunity to critically analyze the current BMW treatment scenario and implement changes to make the system more economical and environmentally sustainable. In this review, the waste disposal guidelines of the BMW management infrastructure are critically analyzed for many functional parameters to bring out possible applications and limitations of individual interventions. In addition, an investigation was made to select appropriate technology based on the environmental setting.

An in-depth study of the oxidative liquefaction process for polymeric waste reduction and chemical production from wind turbine blades and personal protective equipment used in the medical field

An in-depth study of the oxidative liquefaction process has been provided to degrade the polymeric waste from personal protective equipment (PPEs) and wind turbine blades (WTBs). Thermogravimetric investigations demonstrate that WTBs have three prominent peaks throughout the degradation, whereas PPEs display solitary peak features. Experiments are carried out employing specific experimental design approaches, namely the Central Composite Face-Centered Plan (CCF) for WTBs and the Central Composition Design with Fractional Factorial Design for PPEs in a batch-type reactor at temperature ranges of 250-350 °C, pressures of 20-40 bar, residence times of 30-90 min, H2O2 concentrations of 15-45 %, and waste/liquid ratios of 5-25 % for WTBs. These values were 200-300 °C, 30 bar, 45 min, 30-60 % and 5-7 % for PPE. A detailed comparison has been provided in the context of total polymer degradation (TPD) for PPE and WTBs. Liquid products from both types of wastes after the oxidative liquefaction process are subjected to gas chromatography with flame ionization detection (GC-FID) to identify the existence of oxygenated chemical compounds (OCCs). For WTBs, TPD was 20-49 % and this value was 55-96 % for PPE while the OCC yield for WTBs (36.31 g/kg - 210.59 g/kg) and PPEs (39.93 g/kg - 212.66 g/kg) was also calculated. Detailed optimization of experimental plans was carried out by performing the analysis of variance (ANOVA) and optimization goals were maximum TPD and OCCs yields against the minimum energy consumption, though a considerable amount of complex polymer waste can be reduced and high concentrations of OCC can be achieved, which could be applied for commercial and environmental benefits.

Public attitudes toward medical waste: Experiences from 141 countries

BACKGROUND

Medical Waste (MW), conceptualized as waste generated in the diagnosis, treatment, or immunization of human beings or animals, posing massive threat to public health. Environment-friendly public attitudes promotes the shaping of pro-environmental behavior. However, the public attitudes of MW and the potential determinants remained scarce. The present study aims to reveal globally public attitudes towards MW and captured the determinants.

METHODS

We integrated the crawler technology with sentiment analysis to captured the public attitudes toward MW across 141 specific countries from 3,789,764 related tweets. Multiple cross-national databases were integrated to assess characteristics including risk, resistance, environment, and development. The spatial regression model was taken to counterbalence the potential statistical bias.

RESULTS

Overall, the global public attitudes towards MW were positive, and varied significantly across countries. Resilience (β = 0.78, SD = 0.14, P < 0.01) and development (β = 1.66, SD = 0.13, P < 0.01) posed positive influence on public attitudes towards MW, meanwhile, risk (β = -0.1, SD = 0.12, P > 0.05) and environment (β = 0.09, SD = 0.09, P > 0.05) were irrelated to the shaping of positive MW public attitudes. Several positive moderating influences was also captured. Additionally, the cross-national disparities of the determiants were also captured, more specific, public attitudes towards MW in extremely poor areas were more likely to be negatively affected by risks, resilience and development.

CONCLUSIONS

This study focused mainly on the public attitudes as well as captured the potential determinants. Public attitudes towards MW were generally positive, but there were large cross-national disparities. Stakeholders would need to designate targeted strategies to enhance public satisfaction with MW management.

Does medical waste research during COVID-19 meet the challenge induced by the pandemic to waste management?

The COVID-19 pandemic has resulted in an unprecedented amount of medical waste, presenting significant challenges for the safe disposal of hazardous waste. A systematic review of existing research on COVID-19 and medical waste can help address these challenges by providing insights and recommendations for effective management of the massive medical waste generated during the pandemic. This study utilized bibliometric and text mining methods to survey the scientific outcomes related to COVID-19 and medical waste, drawing on data from the Scopus database. The results show that the spatial distribution of medical waste research is unbalanced. Surprisingly, developing countries rather than developed countries lead research in this area. Especially, China, a major contributor to the field, has the highest number of publications and citations, and is also a centre of international cooperation. The main study authors and research institutions are also mainly from China. And the research on medical waste is a multidisciplinary field. Text mining analysis shows that COVID-19 and medical waste research is mainly organized around four themes: (i) medical waste from personal protective equipment; (ii) research on medical waste in Wuhan, China; (iii) threats of medical waste to the environment and (iv) disposal and management of medical waste. This would serve to better understand the current state of medical waste research and to provide some implications for future research.

Environmental and economic assessments of industry-level medical waste disposal technologies - A case study of ten Chinese megacities

Medical waste (MW) is exploding due to the COVID-19 pandemic, posing a significant environmental threat, and leading to the urgent requirement for affordable and environmentally friendly MW disposal technologies. Prior research on individual MW disposal plants is region-specific, applying these results to other regions may introduce bias. In this study, major MW disposal technologies in China, i.e., incineration technologies (pyrolysis incineration and rotary kiln incineration), and sterilization technologies (steam sterilization, microwave sterilization, and chemical disinfection) with residue landfill or incineration were analyzed from an industry-level perspective via life cycle assessment (LCA), life cycle costing (LCC) and net present value (NPV) methods. Life cycle inventories and economic cost data for 4-5 typical companies were selected from 128 distinct enterprises and academic sources for each technology. LCA results show that microwave sterilization with residue incineration has the lowest environmental impact, emitting only 480 kg CO2 eq. LCC and NPV analyses indicate that steam sterilization with landfilling is the most economical, yielding revenues of 1,210 CNY/t and breaking even in the first year. Conversely, pyrolysis and rotary kiln incineration break even between the 4th and 5th years. Greenhouse gas emissions from the MW disposal in ten cities with the largest MW production in 2020 increased by 7% over 2019 to 43,800 tons and other pollutants increased by 6% to 12%. Economically, Shanghai exhibits the highest cost-effectiveness, while Nanjing delivers the lowest. It can be observed that the adoption of optimal environmental technologies has resulted in a diminution of greenhouse gas emissions by 279,000 tons and energy conservation of 1.76 billion MJ.

A review on medical waste treatment in COVID-19 pandemics: Technologies, managements and future strategies

Since the outbreak of COVID-19 few years ago, the increasing of the number of medical waste has become a huge issue because of their harmful impact to environment. A major concern associated to the limitation of technologies for dealing with medical waste, especially conventional technologies, are overcapacities since pandemic occurs. Moreover, the outbreak of new viruses from post COVID-19 should become a serious attention to be prevented not only environmental issues but also the spreading of viruses to new pandemic near the future. The high possibility of an outbreak of new viruses and mutation near the future should be prevented based on the experience associated with the SARS-CoV-2 virus in the last 3 yr. This review presented information and strategies for handling medical waste during the outbreak of COVID-19 and post-COVID-19, and also information on the current issues related to technologies, such as incineration, pyrolysis/gasification, autoclaves and microwave treatment for the dealing with high numbers of medical waste in COVID-19 to prevent the transmission of SARS-CoV-2 virus, their advantages and disadvantages. Plasma technology can be considered to be implemented as an alternative technology to deal with medical waste since incinerator is usually over capacities during the pandemic situation. Proper treatment of specific medical waste in pandemics, namely face masks, vaccine vials, syringes, and dead bodies, are necessary because those medical wastes are mediums for transmission of the SARS-CoV-2 virus. Furthermore, emission controls from incinerator and plasma are necessary to be implemented to reduce the high concentration of CO2, NOx, and VOCs during the treatment. Finally, future strategies of medical waste treatment in the perspective of potential outbreak pandemic from new mutation viruses are discussed in this review paper.Implications: Journal of the air and waste management association may consider our review paper to be published. In this review, we give important information related to the technologies, managements and strategies for handling the medical waste and control the transmission of SARS-CoV-2 virus, starting from proper technology to control the high number of medical waste, their pollutants and many strategies for controlling the spreading of SARS-CoV-2 virus. Moreover, this review also describes some strategies associated with control the transmission not only the SARS-CoV-2 virus but also the outbreak of new viruses near the future.

Assessment of inorganic solid waste management techniques using full consistency and extended MABAC method

Population and industrial growth have spiked product consumption, which in turn have caused an abrupt rise in municipal solid waste (MSW) production. Due to the lack of resources allocated to waste management, municipal inorganic solid waste (ISW) has increased exponentially, posing a significant strain on the environment and health. To mitigate these issues, sustainable waste management strategies need to be implemented to reduce environmental impacts and improve waste collection and disposal efficiency. The objective of our work was to analyse and identify the most effective techniques for disposing of ISW in India by employing multi-criteria decision-making (MCDM). This technique entails selecting the most suitable alternative based on a variety of competing and interactive criteria. A fusion decision model named the FULL COnsistency Method (FUCOM) and Multi-Attributive Border Approximation area Comparison (MABAC) based on the interval-valued q-rung orthopair fuzzy (IV q-ROF) was developed. Finally, a comparative analysis was performed to demonstrate the system's robustness.

Life cycle assessment of Tehran Municipal solid waste during the COVID-19 pandemic and environmental impacts prediction using machine learning

Life cycle assessment and machine learning were combined to find the best option for Tehran's waste management for future pandemics. The ReCipe results showed the waste's destructive effects after COVID-19 were greater than before due to waste composition changes. Plastic waste has changed from 7.5 to 11%. Environmental burdens of scenarios were Sc-1 (increase composting to 50%) > Sc-3 > Sc-4 > Sc-b2 > Sc-5 > Sc-2 (increase recycling from 9 to 20%). The artificial neural network and gradient-boosted regression tree could predict environmental impacts with high R2. Based on the results, the environmental burdens of solid waste after COVID-19 should be investigated.

Impact of disposable mask microplastics pollution on the aquatic environment and microalgae growth

The COVID-19 pandemic has mandated people to use medical masks to protect the public. However the improper management of disposable mask waste has led to the increase of marine pollution, in terms of water quality, and the decline in aquatic microorganisms. The aim of this research was to investigate the impact of disposable mask waste on fresh water and microalgae biomass quality. Disposable masks (untreated or treated with Enterococcus faecalis) were placed in 10-L glass reactors containing fresh water or water containing algal Chlorella sp. and its growth supplements (Chlorella medium) (four 10-L reactors in total) and kept in controlled conditions for 3 months. Water and biomass yield quality were evaluated using water quality analysis, spectroscopy, scanning electron microscopy (SEM), and proximate lipid and protein analysis. Disposable masks, incubated in either fresh water or Chlorella medium, affected several water quality parameters such as chemical oxygen demand (COD), biological oxygen demand (BOD), dissolved oxygen (DO), and pH. Microplastic identification revealed that some fibers were present in the water following a 100-day treatment process. Fourier transform-infrared spectroscopy (FTIR) analysis was used to determine the change in important, organic functional groups and highlighted the disappearance of a peak at 1530 cm^-1 corresponding to the primary protein (C-N) and the appearance of new peaks at 1651 cm^-1 and 1270 cm^-1 corresponding to methyl alcohol (CH₂OH) and ketone (C = O), respectively. This indicated the detrimental effect of disposable mask fragmentation on the biomass quality. The SEM investigation has shown a damage to the surface membrane of Chlorella sp. cells. Altogether, disposable masks decreased the water quality and damaged microalgae by inhibiting their growth. Therefore, the disposable mask contaminated by various microbes, after being used by a human, may be one of the most dangerous hazards to the environment.

Circular economy of medical waste: novel intelligent medical waste management framework based on extension linear Diophantine fuzzy FDOSM and neural network approach

Environmental pollution has been a major concern for researchers and policymakers. A number of studies have been conducted to enquire the causes of environmental pollution which suggested numerous policies and techniques as remedial measures. One such major source of environmental pollution, as reported by previous studies, has been the garbage resulting from disposed hospital wastes. The recent outbreak of the COVID-19 pandemic has resulted into mass generation of medical waste which seems to have further deteriorated the issue of environmental pollution. This necessitates active attention from both the researchers and policymakers for effective management of medical waste to prevent the harm to environment and human health. The issue of medical waste management is more important for countries lacking sophisticated medical infrastructure. Accordingly, the purpose of this study is to propose a novel application for identification and classification of 10 hospitals in Iraq which generated more medical waste during the COVID-19 pandemic than others in order to address the issue more effectively. We used the Multi-Criteria Decision Making (MCDM) method to this end. We integrated MCDM with other techniques including the Analytic Hierarchy Process (AHP), linear Diophantine fuzzy set decision by opinion score method (LDFN-FDOSM), and Artificial Neural Network (ANN) analysis to generate more robust results. We classified medical waste into five categories, i.e., general waste, sharp waste, pharmaceutical waste, infectious waste, and pathological waste. We consulted 313 experts to help in identifying the best and the worst medical waste management technique within the perspectives of circular economy using the neural network approach. The findings revealed that incineration technique, microwave technique, pyrolysis technique, autoclave chemical technique, vaporized hydrogen peroxide, dry heat, ozone, and ultraviolet light were the most effective methods to dispose of medical waste during the pandemic. Additionally, ozone was identified as the most suitable technique among all to serve the purpose of circular economy of medical waste. We conclude by discussing the practical implications to guide governments and policy makers to benefit from the circular economy of medical waste to turn pollutant hospitals into sustainable ones.

The Impact of COVID-19 on Waste Infrastructure: Lessons Learned and Opportunities for a Sustainable Future

The onset of the COVID-19 pandemic posed many global challenges, mainly in the healthcare sector; however, the impacts on other vital sectors cannot be overlooked. The waste sector was one of the significantly impacted sectors during the pandemic, as it dramatically changed the dynamics of waste generation. Inadequate waste management practices during COVID-19 shed light on the opportunities for developing systematic, sustainable, and resilient waste infrastructure in the future. This study aimed to exploit the learnings of COVID-19 to identify any potential opportunities in post-pandemic waste infrastructure. A comprehensive review on existing case studies was conducted to understand the waste generation dynamics and the waste management strategies during COVID-19. Infectious medical waste from healthcare facilities had the largest influx of waste compared with non-medical waste from residential and other sectors. This study then identified five key opportunities from a long-term operational perspective: considering healthcare waste sector as a critical area of focus; encouraging the integration and decentralization of waste management facilities; developing systematic and novel approaches and tools for quantifying waste; shifting towards a circular economy approach; and modernizing policies to improve the effectiveness of the post-pandemic waste management infrastructure.

Knowledge and practice of facemask disposal among university students in Thailand: A new normal post the COVID-19 pandemic

The use of facemasks is essential to prevent the transmission of COVID-19. University students are a significant demographic that generates substantial infectious waste due to the new normal practice of using disposable facemasks. In this cross-sectional study, we investigated the facemask disposal knowledge and practices among university students in Thailand between September and October 2022. We used a self-report questionnaire comprising 29 questions to determine the students' demographic characteristics and facemask disposal knowledge and practices. We then applied a logistic regression model to estimate the association between the students' facemask disposal knowledge and practices and their demographic characteristics. A total of 433 participants completed the questionnaire comprising health science (45.27%) and non-health science (54.73%) students. Surgical masks were the most popular masks (89.84%), followed by N95 (26.33%) and cloth masks (9.94%). While their levels of knowledge regarding facemask disposal were poor, the students' practices were good. The factors associated with proper facemask disposal were sex (AOR = 0.469, 95% CI: 0.267, 0.825), academic grade (AOR = 0.427, 95% CI: 0.193, 0.948), and knowledge level (AOR = 0.594, 95% CI: 0.399, 0.886). No demographic factors influenced knowledge. Our findings highlight the influence of facemask disposal knowledge on students' disposal practices. Information promoting the appropriate disposal practices should therefore be promoted extensively. Furthermore, continuous reinforcement by raising awareness and educating students on proper facemask disposal combined with the provision of adequate infectious waste disposal facilities could help reduce the environmental contamination of infectious waste and thus improve general waste management.

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.

A sustainable approach on the utilisation of COVID-19 plastic based isolation gowns in structural concrete

Single-use isolation gowns have become an important practice across medical centres, testing sites, and emergency rooms since the onset of the Coronavirus pandemic; within the later months of 2019. Although reusable isolation gowns have proved beneficial, 80% of frontline centres opt for disposable isolation gowns, increasing the demand for plastic-based personal protective equipment (PPE) and the environmental strain from excess waste in landfills. This research aims to explore the practicability of using plastic-based isolation gowns in structural concrete to scale back the quantity of pandemic-generated waste ending up in landfills. The shredded isolation gowns were added to aggregates at 0.01%, 0.02%, and 0.03% of the volume of concrete. The effects of various concentrations of shredded isolation gowns on the mechanical properties of the concrete were investigated through a series of experiments alongside an SEM-EDS analysis. Results demonstrate an enhanced bridging effect between the cement matrix and shredded isolation gowns, allowing for the steady trend of improved mechanical properties with increases of 15.5%, 20.6%, and 11.73% across compressive strength, flexural strength, and the modulus of elasticity, respectively.

Hygiene knowledge and practices and determinants of occupational safety among waste and sanitation workers in Bangladesh during the COVID-19 pandemic

Waste and sanitation workers provide essential services to society. In most low-and middle-income countries, they are often mistreated and lack access to necessary personal protective equipment (PPE) and hygiene facilities that ensure occupational safety in workplaces. COVID-19 has also imposed serious health risks upon these worker groups. This study explores factors associated with poor occupational health and safety based on a conceptual framework. We conducted 499 surveys with five categories of waste and sanitation workers across ten cities in Bangladesh. We performed descriptive analysis and used Firth's logistic regression model following the conceptual framework. The analysis revealed consistent distinctions between workers considered to be in "safe" versus "unsafe" working conditions. The result showed that workers had not been adequately trained, not provided with proper equipment, and many had an informal status that prevented access to hygiene facilities. The workers who received occupational training, knew how to prevent COVID-19 by wearing a face mask, hand washing, and maintaining social distance, maintained protective measures, and practiced proper disposing of PPEs were more likely to be in safe condition. Initiatives to improve the situation of the waste workers who work in unsafe work conditions are still inadequate. Therefore, we recommend supplying proper protective equipment, ensuring a regular supply of gender-specific PPEs, and providing functional facilities necessary to practice personal hygiene and occupational safety, such as handwashing stations, changing rooms, and disposal facilities of used PPEs at the workplace. We also urge increased institutional management procedures, infrastructure that facilitates hygiene practices, and social policies to reduce occupational hazards for the waste workers in Bangladesh during and beyond the COVID-19 pandemic.

Hydrothermal deconstruction of single-use personal protective equipment during the COVID-19 pandemic

To minimise the transmission of the SARS-CoV-2 virus, there has been a substantial increase in the production and usage of synthetic personal protective equipment (PPE) globally. Consequently, single-use PPE have been widely adopted without appropriate regulations for their disposal, leading to extensive environmental contamination worldwide. This study investigates the non-catalytic hydrothermal deconstruction of different PPE items, including isolation gowns, gloves, goggles, face shields, surgical masks, and filtering-facepiece respirators. The selected PPE items were subjected to hydrothermal deconstruction for 90 min in the presence of 30-bar initial oxygen pressure, at temperatures ranging between 250 °C and 350 °C. The solid content in form of total suspended solids (TSS) was reduced up to 97.6%. The total chemical oxygen demand (tCOD) and soluble chemical oxygen demand (sCOD) decreased with increasing deconstruction temperature, and at 350 °C the lowest tCOD and sCOD content of 546.6 mg/L and 470 mg/L, respectively, was achieved. Short-chained volatile fatty acids were produced after 90 min of deconstruction, predominantly acetic acid at concentrations up to 8974 mg/L. Ammonia nitrogen content (NH₃-N) of up to 542.6 mg/L was also detected. Carbon dioxide (CO₂) and unreacted oxygen (O₂) were the main gaseous by-products at up to 15.6% (w/w) and 88.7% (w/w), respectively. The findings suggest that non-catalytic hydrothermal deconstruction is a viable option to process and manage PPE waste.

COVID-19: An Accelerator for Global Plastic Consumption and Its Implications

Plastic has been ingrained in our society. Repercussions on the usage of nonbiodegradable plastics and their problems have been recently realized. Despite its detrimental environmental impact, the COVID-19 epidemic has compelled worldwide citizens to increase their plastic use due to affordability and availability. The volume of hospital solid waste, particularly plastics, is overgrowing due to an unexpected increase in medical waste, culminating in the global waste management catastrophe. Henceforth, adopting good waste management practices along with appropriate technologies and viewing the current issue from a fresh perspective would be an opportunity in this current scenario. Accordingly, this review study will focus on the plastic waste scenario before and during the COVID-19 epidemic. This review also disseminates alternative disposal options and recommends practical solutions to lessen human reliance on traditional plastics. Further, the responsibilities of various legislative and regulatory authorities at the local, regional, and worldwide levels are addressed.

Impact of COVID-19 on healthcare waste generation: Correlations and trends from a tertiary hospital of a developed country

The SARS-CoV-2 (COVID-19) coronavirus pandemic has represented an emergency not only from a clinical point of view, but also for the environment due to the largely increased waste disposal. This study aimed at estimating, in the context of current trends, the increase in healthcare waste (HW) generation during the outbreak, based on data from a tertiary hospital. From the purveying office statements of 'SS Antonio e Biagio e Cesare Arrigo' Hospital of Alessandria (Italy), monthly HW generation data from January 2015 to March 2021 were retrospectively retrieved. Trends and COVID's impact were evaluated by Interrupted Time Series (ITS) design with linear regression models. Locally Weighted Scatterplot Smoothing was used to model the relation between infectious HW generation and proportion of COVID-related bed days. HW generation rose from 35.9 ± 3.8 tonnes month^-1 (2.4 ± 0.2 kg per patient-day, kg PD^-1) in 2015-2019, to 46.3 ± 6.0 tonnes month^-1 (3.3 ± 0.7 kg PD^-1) during the outbreak. The increasing trend was not appreciably modified as for its slope (p = 0.363), while a significant level change was found between baseline and outbreak (+ 0.72 kg PD^-1, p < 0.001). The proportion of COVID-related bed days non-linearly affected the infectious HW generated per patient-day, with steeper increases for proportions above 20%. The study showed a significant rise in HW generation in 2020-2021, reasonably due to the COVID outbreak; in addition, the generally increasing trend was not affected. Therefore, urgent measures are needed to conciliate safety requirements with HW generation issues.

Principal of environmental life cycle assessment for medical waste during COVID-19 outbreak to support sustainable development goals

Disposal of medical waste (MW) must be considered as a vital need to prevent the spread of pandemics during Coronavirus disease of the pandemic in 2019 (COVID-19) outbreak in the globe. In addition, many concerns have been raised due to the significant increase in the generation of MW in recent years. A structured evaluation is required as a framework for the quantifying of potential environmental impacts of the disposal of MW which ultimately leads to the realization of sustainable development goals (SDG). Life cycle assessment (LCA) is considered as a practical approach to examine environmental impacts of any potential processes during all stages of a product's life, including material mining, manufacturing, and delivery. As a result, LCA is known as a suitable method for evaluating environmental impacts for the disposal of MW. In this research, existing scenarios for MW with a unique approach to emergency scenarios for the management of COVID-19 medical waste (CMW) are investigated. In the next step, LCA and its stages are defined comprehensively with the CMW management approach. Moreover, ReCiPe2016 is the most up-to-date method for computing environmental damages in LCA. Then the application of this method for defined scenarios of CMW is examined, and interpretation of results is explained regarding some examples. In the last step, the process of selecting the best environmental-friendly scenario is illustrated by applying weighting analysis. Finally, it can be concluded that LCA can be considered as an effective method to evaluate the environmental burden of CMW management scenarios in present critical conditions of the world to support SDG.

The impact of COVID-19 pandemic in medical waste amounts: a case study from a high-populated city of Turkey

In this study, the amount of medical waste generated in a high-populated city in Turkey between January 2018 and August 2021 was evaluated, and the effect of the COVID-19 pandemic on waste amounts and waste production rate was investigated. While a total of 79,027 kg/month of medical waste was produced in the city before COVID-19, this value reached 116,714 kg/month after COVID-19. The increase in the amount of medical waste due to the COVID-19 pandemic in the province was calculated as 48% on average. It was determined that 75% of this waste amount originates from public hospitals in the city. While the production of medical waste was 0.86 kg/bed day in the pre-COVID-19 period, this value increased to 0.96 kg/bed day in 2020 and to 1.34 kg/bed day in 2021 with the COVID-19 pandemic. According to the results obtained, the amount of medical waste reached in the province due to COVID-19 is the amount of medical waste expected to be generated in the 2040s under normal conditions. It is a very important issue in terms of public health that the capacity of waste disposal in medical waste management in cities is flexible to respond to severe epidemic conditions. Based on the information obtained within the scope of the study, changes in the amount of medical waste in a city with a dense population under pandemic conditions can be obtained based on real data and projections regarding disposal capacity can be made more realistically.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10163-022-01428-3.

An assessment of hospital wastewater and biomedical waste generation, existing legislations, risk assessment, treatment processes, and scenario during COVID-19

Hospitals release significant quantities of wastewater (HWW) and biomedical waste (BMW), which hosts a wide range of contaminants that can adversely affect the environment if left untreated. The COVID-19 outbreak has further increased hospital waste generation over the past two years. In this context, a thorough literature study was carried out to reveal the negative implications of untreated hospital waste and delineate the proper ways to handle them. Conventional treatment methods can remove only 50%-70% of the emerging contaminants (ECs) present in the HWW. Still, many countries have not implemented suitable treatment methods to treat the HWW in-situ. This review presents an overview of worldwide HWW generation, regulations, and guidelines on HWW management and highlights the various treatment techniques for efficiently removing ECs from HWW. When combined with advanced oxidation processes, biological or physical treatment processes could remove around 90% of ECs. Analgesics were found to be more easily removed than antibiotics, β-blockers, and X-ray contrast media. The different environmental implications of BMW have also been highlighted. Mishandling of BMW can spread infections, deadly diseases, and hazardous waste into the environment. Hence, the different steps associated with collection to final disposal of BMW have been delineated to minimize the associated health risks. The paper circumscribes the multiple aspects of efficient hospital waste management and may be instrumental during the COVID-19 pandemic when the waste generation from all hospitals worldwide has increased significantly.

Effects of medical waste incineration fly ash on the promotion of heavy metal chlorination volatilization from incineration residues

High contents of heavy metals and Cl are major challenges for incineration residue disposal. Classification by the Chinese government and the coronavirus disease 2019 pandemic have changed the characteristics of incineration residues, thereby increasing the difficulty of disposal. In this study, medical waste incineration fly ash (MWI FA) was proposed as an additive to promote chlorination volatilization of heavy metals from municipal solid waste incineration fly ash (MSWI FA) and medical waste incineration slag (MWI S). When the mixing ratio of MWI FA to MSWI FA was 1:3, the chlorination volatilization efficiencies of Cu, Zn, Pb, and Cd at 1000 °C for 60 min were 50.2%, 99.4%, 99.7%, and 97.9%, respectively. When MWI FA was mixed with MWI S at a ratio of 1:1, the chlorination volatilization efficiencies of Cu, Zn, Pb, and Cd at 1200 °C for 40 min were 88.9%, 99.7%, 97.3%, and 100%, respectively. Adding MWI FA can replenish Cl in MSWI FA and MWI S while increasing the surface area and forming pore structures by sublimation of NaCl and decomposition of CaSO₄, or can reduce the melting point and viscosity by Na₂O destroying the glass matrix. Therefore, MWI FA can be co-disposed with MSWI FA and MWI S respectively to enhance the chlorination volatilization of heavy metals.

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.

Implications of COVID-19 on global environmental pollution and carbon emissions with strategies for sustainability in the COVID-19 era

The impacts of COVID-19 on global environmental pollution since its onset in December 2019 require special attention. The rapid spread of COVID-19 globally has led countries to lock down cities, restrict traffic travel and impose strict safety measures, all of which have implications on the environment. This review aims to systematically and comprehensively present and analyze the positive and negative impacts of COVID-19 on global environmental pollution and carbon emissions. It also aims to propose strategies to prolong the beneficial, while minimize the adverse environmental impacts of COVID-19. It systematically and comprehensively reviewed more than 100 peer-reviewed papers and publications related to the impacts of COVID-19 on air, water and soil pollution, carbon emissions as well as the sustainable strategies forward. It revealed that PM_2.5, PM₁₀, NO₂, and CO levels reduced in most regions globally but SO₂ and O₃ levels increased or did not show significant changes. Surface water, coastal water and groundwater quality improved globally during COVID-19 lockdown except few reservoirs and coastal areas. Soil contamination worsened mainly due to waste from the use of personal protective equipment particularly masks and the packaging, besides household waste. Carbon emissions were reduced primarily due to travel restrictions and less usage of utilities though emissions from certain ships did not change significantly to maintain supply of the essentials. Sustainable strategies post-COVID-19 include the development and adoption of nanomaterial adsorption and microbial remediation technologies, integrated waste management measures, "sterilization wave" technology and energy-efficient technologies. This review provides important insight and novel coverage of the environmental implications of COVID-19 in more than 25 countries across different global regions to permit formulation of specific pollution control and sustainability strategies in the COVID-19 and post-COVID-19 eras for better environmental quality and human health.

Medical Waste from COVID-19 Pandemic-A Systematic Review of Management and Environmental Impacts in Australia

The coronavirus (COVID-19) pandemic has created a global medical emergency. The unforeseen occurrence of a pandemic of this magnitude has resulted in overwhelming levels of medical waste and raises questions about management and disposal practices, and environmental impacts. The amount of medical waste generated from COVID-19 since the outbreak is estimated to be 2.6 million tons/day worldwide. In Australia, heaps of single-use gowns, facemasks/face shields, aprons, gloves, goggles, sanitizers, sharps, and syringes are disposed everyday as a result of the pandemic. Moreover, the establishment of new home/hotel quarantine facilities and isolation/quarantine centres in various Australian states and territories have increased the risks of transmission among people in these facilities and the likelihoods of general waste becoming contaminated with medical waste. This warrants the need to examine management and disposal practices implemented to reduce the transmission and spread of the virus. This study reviews the various management and disposal practices adopted in Australia for dealing with medical waste from the COVID-19 pandemic and their impacts on public health and the environment. To achieve the aims of this study, prior studies from 2019-2021 from various databases are collected and analysed. The study focuses on generation of medical waste from COVID-19, management and disposal methods, current problems/challenges and environmental and public health impacts. Considering the enormous risks involved and the significance of appropriate handling and disposal of medical waste from COVID-19, this study provides insights on short and long term responses towards managing COVID-19 waste in Australia. The study contributes to Australia's efforts against the transmission and spread of COVID-19 and provides recommendations for the development of workable and sustainable strategies for mitigating similar pandemics in the future.

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.

Public concerns and burdens associated with face mask-wearing: Lessons learned from the COVID-19 pandemic

This study attempts to identify and categorize the key concerns of wearing masks. An online survey was used to collect data from 2746 people in the United States. Results show that the mask-wearing concerns can be classified into three categories; discomfort barriers (physical discomfort and communication discomfort), external factors (overstated news about coronavirus threat, political beliefs, and absence of mask-wearing culture), and usability issues (lack of effectiveness, unnecessariness of masks in certain cases, and mask maintenance issues). The findings demonstrate that all mentioned concerns strongly shape people's attitudes toward wearing masks, except for political beliefs and lack of effectiveness.

How to Dispose of Medical Waste Caused by COVID-19? A Case Study of China

The rapid increase in novel coronavirus (COVID-19) patients also means a rapid increase in medical waste that could carry the novel coronavirus (SARS-CoV-2). How to safely dispose of medical waste caused by COVID-19 is a huge challenge that needs to be solved urgently. The outbreak of the COVID-19 has led to a significant increase in the daily generation of medical waste in China and has placed a severe test on the Chinese medical waste disposal system. Unlike ordinary wastes and garbage, medical waste that is untreated or incompletely treated will not only cause environmental pollution, but also directly or indirectly cause infections and endanger people's health. Faced with difficulties, the Chinese government formulated a policy for medical waste management and a response plan for the epidemic, which provides policy guarantee for the standardized disposal of epidemic medical waste. In addition, the government and medical institutions at all levels formed a comprehensive, refined, and standardized medical treatment process system during research and practice. China has increased the capacity of medical waste disposal in various places by constructing new centralized disposal centers and adding mobile disposal facilities. China has achieved good results in the fight against COVID-19, and the pressure on medical waste disposal has been relieved to a certain extent. However, the global epidemic situation is severe. How to ensure the proper and safe disposal of medical waste is related to the prevention and control of the epidemic situation. This study summarizes China's experience in the disposal of medical waste in the special case of COVID-19 and hopes to provide some reference for other countries in the disposal of medical waste.

Reuse of COVID-19 face mask for the amelioration of mechanical properties of fat clay: A novel solution to an emerging waste problem

Not only has the COVID-19 pandemic caused a global health crisis, but it has also changed the dynamics of waste generation around the world. This situation demands a productive solution for face mask (FM) waste management to solve several associated environmental issues. In the current study, a novel soil treatment method is proposed for the improvement of mechanical characteristics of fat clay by using FM as fiber reinforcement and silica fume (SF) as the cementitious agent in the form of a composite binary admixture (CBA). The performance of the proposed CBA is compared with SF and FM as the lone stabilizers by conducting extensive geotechnical testing. The SF treatment exponentially improves the strength characteristics of soil but it marginalizes the ductility of soil, inviting sudden failure and instability under dynamic loadings. It is observed that the proposed CBA not only improves the strength characteristics more than SF but also regulates the ductility and deformability of treated soil due to the presence of FM fibers. In addition, the policies and protocols on the logistics of collecting FM waste and making it ready for the proposed geotechnical application are reviewed; associated health risks, socioeconomic conditions and available technologies are the major governing factors to formulate and implement these policies. Moreover, the prolonged storage of COVID-19 FM waste for disinfection is found to be suitable for the proposed soil stabilization method as per the literature. The current study helps in achieving cost-effective filler/foundation material, solving COVID-19 FM waste problems and promoting resource conservation.

Public perception towards medical waste generated in the environment during the COVID-19 pandemic in Eastern Province, Saudi Arabia

Airborne droplets and contaminated surfaces are the main routes for the epidemic virus outbreak that causes the novel coronavirus. To reduce virus spread, people wear face masks and gloves daily, which massively increases the amount of waste generated in the environment. Also, the inappropriate disposal of used masks and gloves in communities may boost the spread of the novel coronavirus. However, no studies have been conducted to evaluate a public perception regarding the management of generated masks and gloves during the global health threat. Therefore, this paper proposes a study of public awareness, attitudes, and practices towards gloves and masks generated during the novel coronavirus pandemic in Saudi Arabia. The study showed that most of the participants (74%) have adequate awareness regarding the proper way to dispose of used masks and gloves, with 76% showing positive attitudes toward waste management. Gender shows a significant correlation with the regulations of medical waste collection and disposal (r = 0.169, p = 0.0001), and the consideration of the effective disposal of COVID-19 waste management as a collective responsibility of the community (r = 0.158, p = 0.0001). Also, the study shows that the majority of participants were aware on the availability of regulations for the collection and disposal of biomedical waste. Moreover, it demonstrates that public awareness regarding the attitude and measures taken by regional municipalities to reduce the spread of coronavirus has a significant positive correlation (r = 0.279, p = 0.0001). The study further recognized that the effective management of contagious wastes significantly protects the public against the improper practices of wastes disposal generated during the novel coronavirus pandemic.

Redefining bio medical waste management during COVID- 19 in india: A way forward

India is ranked 120 among 165 nations with respect to sustainable development and critically suffers from insufficient waste treatment provisions and amenities. And the abrupt occurrence of the COVID-19 virus has aggravated the issue of managing of medical waste in India, manifolds. As a result, the safe disposal of a huge volume of hazardous medical waste has become a top priority. This conceptual study evaluates India's management of medical waste during the COVID-19 pandemic. Additionally, this article aims to highlight the inadequacies in India's implementation of the BMW 2016 standards by a synthesis of multiple agency reports (government and non-government) and data obtained directly from the Central Pollution Control Board (CPCB). The findings indicate that India is well behind in terms of COVID-19 waste management and requires comprehensive monitoring and implementation systems to enable the achievement of SDGs related to environmental health.

COVID-19 and dynamics of environmental awareness, sustainable consumption and social responsibility in Malaysia

Despite a profound evidence of the human unsustainable behaviours' impact on the environment, stark disparities prevail on this narrative especially in the context of the current epidemiological situation ushered by the COVID-19. The ongoing pandemic is a global public health concern due to its sagacious impacts on environmental sustainability, social responsibility and people's quality of life. This study primarily focuses on analysing the impact of COVID-19 (COV) on the environmental awareness (EA), sustainable consumption (SC) and social responsibility (SR). Additionally, we aspire to investigate the impact of demographics of generations and religion on the proposed nexus in this study. The data was collected from 700 participants of different age groups and religious backgrounds in Malaysia, and structural equation modelling (SEM) was used to analyse this data and test the hypotheses. The findings indicate that COVID-19 has a significantly positive impact on EA, SC and SR, and the generations and religiosity moderate the relationship between COVID-19 and its impact on sustainable behaviours. This study contributes to analyse the difference in the perception of EA, SC and SR among the people that eventually will stimulate the scientific reasoning among the governments, policymakers and scientists to develop a holistic framework to combat unprecedented event such as COVID-19 and ensure the authentication of sustainable environment and exceptional quality of life. The policymakers in Malaysia may use the findings of this study to inspect the social and environmental aspects of the people during the transformation events.

COVID-19 and waste management in Indian scenario: challenges and possible solutions

The outbreak of COVID-19 pandemic has created havoc all across the globe causing exponential casualties and tremendous health and economic loss. With increasing COVID-19 cases, the amount of biomedical waste has increased manifolds making more people vulnerable to the pandemic. The developing and underdeveloped countries are already facing the challenges of waste management, and the waste generated during the pandemic scenario has added to the already existing challenges. The improper waste management practices need to be corrected; otherwise, the world will be facing a new disaster that could be termed as 'waste disaster'. The increase in COVID-19-associated waste (CAW) quantity and their availability in the environment will result in their easy approach to other organisms, which will possibly increase the potential risk of food chain contamination. Some of the countries have already started to make backup plans and are struggling to overcome the 'waste disaster'. In light of the limited knowledge available on the mutational properties and possible hosts of this newly emerged COVID-19, there is a great demand to have an efficient strategy to prevent the environment from further contamination in India. The necessity of the prevailing time is to create a more efficient, automatic, mechanized, and well-modified waste management system for handling the present situation and delaying the projected waste disaster in the near future in the era of COVID-19. The article aims to address the issues that originated from waste discharges, their potential sources along with possible sustainable solutions.

A review of the medical waste management system at Covid-19 situation in Bangladesh

Medical waste (MW) poses serious threats to environmental and public health. Throughout the world, existing challenges of medical waste management (MWM) have been heightened in the Covid-19 situation due to an increase in the massive amount of MW. Even before the pandemic, MWM has always been a concern in Bangladesh. The objectives of this research are to review the related national policy initiatives and guidelines in Bangladesh in comparison with the international guidelines, to evaluate the present scenario of the MWM system, and to explore the scope of Impact Assessment (IA) in improving the system. From the analysis, it has been found that several national guidelines have been formulated during this pandemic covering important issues related to the MWM system, which is commendable. Some of these guidelines comply with international guidelines, but there are inconsistencies among these. However, neither the previous MWM policy tools nor these guidelines are implemented accordingly. In this pandemic, an IA framework has also been published in Bangladesh, which is praiseworthy. Although no evidence could be found on its implementation either. Therefore, it is necessary to take initiative for the implementation of this IA framework. Thereby the policy makers will be able to identify the gaps prohibiting the implementation of the MWM policy tools and guidelines. This will enable them to take corrective actions accordingly to improve the MWM system by enhancing the preparedness and capacity against any possible future situations like pandemic overwhelming the MW situation in Bangladesh.

Review of the valorization options for the proper disposal of face masks during the COVID-19 pandemic

The COVID-19 pandemic has affected not only human health and economies but also the environment due to the large volume of waste in the form of discarded personal protective equipment. The remarkable increase in the global usage of face masks, which mainly contain polypropylene, and improper waste management have led to a serious environmental challenge called microplastic pollution. Potential practices for waste management related to waste valorization of discarded face masks as the major type of waste during the COVID-19 pandemic are explored in this study. Recommendations based on governmental practices, situation of state facilities, and societal awareness and engagement applicable to emergency (including COVID-19 pandemic) and postpandemic scenarios are offered while considering potential solutions and available waste management practices in different countries during emergency conditions. However, multicriteria decision making for a country must determine the optimal solution for waste management on the basis of all affecting factors. Awareness of scientific, governments, and communities worldwide will successfully eradicate this important environmental issue.

Influence of the SARS-CoV-2 pandemic: a review from the climate change perspective

Ever since the global outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2/COVID-19) in the early part of 2020, there is no doubt that the SARS-CoV-2 pandemic has placed great tension globally and has affected almost all aspects of human endeavors. There are presently several research studies on the atmospheric environmental and economic effects of this dreaded virus. Supposedly, the responses ought to have also present innovations that would advance scientific research to mitigate its impacts since most of the ensuing consequences impact the atmospheric climatic conditions. Even when it appears that economic events would possibly return in no time, the circumstances will change. Specifically, from the existing literature, it appears that not much has been done to study the influence of the SARS-CoV-2 pandemic on climate change. Hence, this present review article will explore the possible connection between the SARS-CoV-2 pandemic and climate change. The utilization of various scientific domains for climate change studies during the SARS-CoV-2 pandemic and exploring the positive influences of the SARS-CoV-2 pandemic and measures to avoid the negative impacts on climate change owing to SARS-CoV-2 have also been discussed.

Updates on biomedical waste management during COVID-19: The Indian scenario

Biomedical waste poses various health and environmental hazards. Hence, it should be handled with the utmost care and disposed off safely. Several lacunas exist in the management of biomedical waste in India, and the pandemic posed by the coronavirus has made it even more challenging. The sudden outbreak of the virus led to an exponential rise in the quantity of biomedical waste. Furthermore, the poor infrastructure and lack of human resources have aggravated this situation. To combat this serious problem in a timely manner, the government has formulated various standard operating procedures and has amended the existing rules and guidelines.

Safe distance-based vehicle routing problem: Medical waste collection case study in COVID-19 pandemic

In addition to the increasing population and rapid urbanization, the amount and variety of medical waste are rapidly increasing due to the coronavirus disease (COVID-19) pandemic affecting the whole world. COVID-19 does not only increase the amount of medical waste produced, medical wastes generated in the care of COVID-19 carries a high risk of transmission as well. In this regard, the safe and effective management of medical wastes has become a serious health and safety issue. This research aims to determine the safest and shortest transportation routes for medical waste vehicles. The safety scores used in this study were obtained in our previous study. The resulting safety scores were used in a multi-objective traveling salesman problem for deriving two objective functions, which are based on safety scores and total transportation distance. A conciliating solution was obtained by solving this linear programming model. The proposed model faced by health institutions in Istanbul has been applied for a specific district. According to the obtained results, suggestions for the direction of medical waste vehicles have been proposed.

Investigation of potential safety hazards during medical waste disposal in SARS-CoV-2 testing laboratory

This study aims to investigate the potential safety hazards and provide reference for improving the medical waste disposal procedure in SARS-CoV-2 testing laboratory. Our SARS-CoV-2 testing group detected the RNA residue on the surface of medical waste with Droplet Digital PCR, and held a meeting to discuss the risks in the laboratory medical waste disposal process. After effective autoclaving, SARS-CoV-2 contaminated on the surface of medical waste bags was killed, but the average concentration of viral RNA residues was still 0.85 copies/cm2. It would not pose a health risk, but might contaminate the laboratory and affect the test results. When the sterilized medical waste bags were transferred directly by the operators without hand disinfection, re-contamination would happen, which might cause the virus to leak out of the laboratory. Furthermore, we found that sterilization effect monitoring and cooperation among operators were also very important. In summary, we investigated and analyzed the potential safety hazards during the medical waste disposal process in SARS-CoV-2 testing laboratory, and provided reasonable suggestions to ensure the safety of medical waste disposal.

Challenges and practices on waste management and disposal during COVID-19 pandemic

The COVID-19 pandemic has imposed a global emergency and also has raised issues with waste management practices. This study emphasized the challenges of increased waste disposal during the COVID-19 crisis and its response practices. Data obtained from the scientific research papers, publications from the governments and multilateral organizations, and media reports were used to quantify the effect of the pandemic towards waste generation. A huge increase in the amount of used personal protective equipments (facemasks, gloves, and other protective stuffs) and wide distribution of infectious wastes from hospitals, health care facilities, and quarantined households was found. The amount of food and plastic waste also increased during the pandemic. These factors caused waste treatment facilities to be overwhelmed, forcing emergency treatment and disposals (e.g., co-disposal in a municipal solid waste incinerator, cement kilns, industrial furnaces, and deep burial) to ramp up processing capacity. This paper discussed the ways the operation of those facilities must be improved to cope with the challenge of handling medical waste, as well as working around the restrictions imposed due to COVID-19. The study also highlights the need for short, mid, and longer-term responses towards waste management during the pandemic. Furthermore, the practices discussed in this paper may provide an option for alternative approaches and development of sustainable strategies for mitigating similar pandemics in the future.

Quantitative evaluation of infectious health care wastes from numbers of confirmed, suspected and out-patients during COVID-19 pandemic: A case study of Wuhan

The fight against coronavirus disease 2019 (COVID-19) is still running its courses. Proper management and disposal of health care wastes (HCWs) are critical to win the fight. To achieve aforementioned tasks, prediction of their production is highly desired. In this study, primary data of production of three kinds of HCWs collected from Wuhan, the first epidemic epicenter worldwide and a mega city with more than 10 million population who has went through a lockdown period of 78 days, were reported for their first time. HCWs were classified into routine HCWs, infectious HCWs (IHCWs) and infectious municipal solid wastes. Among them, infectious HCWs from designated hospitals for COVID-19 were recognized as the most dangerous one. A multiple linear regression (MLR) model was built to predict the production of IHCWs with high significance. Numbers of patients were demonstrated high correlations with the production of IHCWs in an order of confirmed patients ＞ out-patients ＞ suspected patients. By the MLR model, production rates of IHCWs by confirmed, suspected and out patients were determined as 3.2, 1.8 and 0.1 kg/patient, respectively. In addition, constant production of IHCWs during the pandemic period was determined as 13 tons/d. This is the first study on quantitative evaluation of infectious HCWs during COVID-19 pandemic. The achievements in this study have potentials to shed light on global efforts to the prediction, management and disposal of vast HCWs generated in the war against COVID-19.

Coronavirus disease 2019 (COVID-19) induced waste scenario: A short overview

The COVID-19 pandemic and lockdown situation have shown both positive and negative effects on the environmental aspects. With an unprecedented rate the different types of waste volume have up surged along with the COVID-19 contamination rate. As the situation has mandated people as well as the most infected persons to stay at home, the amount of generated hazardous waste is 3.40 kg that can be expected daily from each infected person. China and other countries have seen a massive increment in the hazardous waste generation (about 600 % increase in Hubei province) amount. While dealing with this sudden increase in waste amount, the conventional incineration facilities have been outstripped and waste management industry is facing an immense pressure over handling hazardous waste generated from COVID-19 infected patients. Alongside with the hazardous waste volume, single-use plastic items and personal protective equipment (PPEs) have induced a new type of "PPE pollution" in the land and aquatic environment. The current review provides a countrywide waste generation amount, estimated using the infected number of cases for some selected countries. In contrast with the poor waste management noticed during this pandemic, some suggested approaches towards a better waste management service and future implications of waste management are discussed with viable consideration for the waste workers.

Impact of COVID-19 pandemic on waste management

The containment of the spread of COVID-19 pandemic and limitations on commercial activities, mobility and manufacturing sector have significantly affected waste management. Waste management is critical to human development and health outcomes, especially during the COVID-19 pandemic. The invaluable service provided by the waste management sector ensures that the unusual heaps of waste that poses health risks and escalate the spread of COVID-19 is avoided. In this study, we assess the impact of COVID-19 pandemic on waste management by observing lockdown and social distancing measures. We found that the quantity of waste increased across countries observing the social distancing measure of staying at home. The intensification of single-use products and panic buying have increased production and consumption, hence thwarting efforts towards reducing plastic pollution. However, several countries have thus far instituted policies to ensure sustainable management of waste while protecting the safety of waste handlers.

Impact of COVID-19 pandemic on waste management

The containment of the spread of COVID-19 pandemic and limitations on commercial activities, mobility and manufacturing sector have significantly affected waste management. Waste management is critical to human development and health outcomes, especially during the COVID-19 pandemic. The invaluable service provided by the waste management sector ensures that the unusual heaps of waste that poses health risks and escalate the spread of COVID-19 is avoided. In this study, we assess the impact of COVID-19 pandemic on waste management by observing lockdown and social distancing measures. We found that the quantity of waste increased across countries observing the social distancing measure of staying at home. The intensification of single-use products and panic buying have increased production and consumption, hence thwarting efforts towards reducing plastic pollution. However, several countries have thus far instituted policies to ensure sustainable management of waste while protecting the safety of waste handlers.

Water, sanitation, hygiene and waste disposal practices as COVID-19 response strategy: insights from Bangladesh

The COVID-19 pandemic has caused a global emergence, and the absence of a proven vaccine or medicine has led to the implementation of measures to prevent and control the spread of the virus. Wearing protective equipment like mask and gloves, washing hands via soap, frequent use of antiseptic solution and maintaining social distance are being applied globally to reduce the transmission rate. Therefore, this study was intended to investigate water, sanitation and hygienic (WASH) behaviour, protective equipment use and their disposal practices among Bangladeshi residents amid the COVID-19 pandemic. Based on the study aims, data were collected mainly via an online survey and analysed through a set of statistical tools including T test, one-way ANOVA and principal component analysis (PCA). This study found that almost 89.80% of the respondents reported to know about the COVID-19 and its preventive measures. WASH status of the respondents is found quite good, where 94.60% stated to have available potable water, 99% have improved toilet facilities, 95% wash their hands via soap, and 79.80% clean their house and toilets by antiseptic solutions properly. Moreover, nearly 94.50% and 54.80% people reported to use face mask and hand gloves, respectively, but the disposal practice of these protective equipment is inappropriate. More than 50% of people reported disposing of their used mask, gloves and tissue with other household wastes, which is alarming for public health and environmental perspective. Moreover, the WASH and waste disposal practices of the marginal people were found very poor and not at a satisfactory level. The results of statistical analysis focused on WASH and waste disposal practices as well as the factors which influence these practices. It is found that gender, occupation, area of residence, and level of education of the participants mainly influence the WASH and waste disposal practices. It is expected that this study exposed the necessity to introduce proper infectious waste management policy and also the increase in awareness level among mass people regarding the preventive measures of COVID-19 infection to combat against disease transmission and environmental pollution.

SUPPLEMENTARY INFORMATION

The online version of this article (10.1007/s10668-020-01151-9) contains supplementary material, which is available to authorized users.

Perception and Attitudes Toward PPE-Related Waste Disposal Amid COVID-19 in Bangladesh: An Exploratory Study

Personal protective equipment (PPE) is an essential item to protect from exposure to infectious pathogens or contaminants, which is frequently used at health care settings and public spheres since the coronavirus disease 2019 (COVID-19) outbreak. There is no prior study investigating public perception and attitudes toward PPE-related waste disposal in Bangladesh. Hence, an online survey was carried out among 1,303 Bangladeshi adult residents to explore the issue. Results stated that face mask and hand gloves were the widely used PPE, where around 45.50% mask and 31.60% hand gloves were disposable. Approximately 94.50% of the participants percepted to use at least one type of PPE while going outside. Only 18.65% of the respondents percepted to burn the PPE-related waste, while most of them reported other less protective disposal measures. Females, urban residents, and participants with higher education were found to have better perception and attitudes toward PPE-related waste disposal. To the best of the authors' knowledge, being the first exploratory study in the country, the present findings are anticipated to be helpful at policy levels with respect to arranging awareness programs.

Environmental effects of COVID-19 pandemic and potential strategies of sustainability

The global outbreak of coronavirus disease 2019 (COVID-19) is affecting every part of human lives, including the physical world. The measures taken to control the spread of the virus and the slowdown of economic activities have significant effects on the environment. Therefore, this study intends to explore the positive and negative environmental impacts of the COVID-19 pandemic, by reviewing the available scientific literatures. This study indicates that, the pandemic situation significantly improves air quality in different cities across the world, reduces GHGs emission, lessens water pollution and noise, and reduces the pressure on the tourist destinations, which may assist with the restoration of the ecological system. In addition, there are also some negative consequences of COVID-19, such as increase of medical waste, haphazard use and disposal of disinfectants, mask, and gloves; and burden of untreated wastes continuously endangering the environment. It seems that, economic activities will return soon after the pandemic, and the situation might change. Hence, this study also outlines possible ways to achieve long-term environmental benefits. It is expected that the proper implementation of the proposed strategies might be helpful for the global environmental sustainability.

Environmental effects of COVID-19 pandemic and potential strategies of sustainability

The global outbreak of coronavirus disease 2019 (COVID-19) is affecting every part of human lives, including the physical world. The measures taken to control the spread of the virus and the slowdown of economic activities have significant effects on the environment. Therefore, this study intends to explore the positive and negative environmental impacts of the COVID-19 pandemic, by reviewing the available scientific literatures. This study indicates that, the pandemic situation significantly improves air quality in different cities across the world, reduces GHGs emission, lessens water pollution and noise, and reduces the pressure on the tourist destinations, which may assist with the restoration of the ecological system. In addition, there are also some negative consequences of COVID-19, such as increase of medical waste, haphazard use and disposal of disinfectants, mask, and gloves; and burden of untreated wastes continuously endangering the environment. It seems that, economic activities will return soon after the pandemic, and the situation might change. Hence, this study also outlines possible ways to achieve long-term environmental benefits. It is expected that the proper implementation of the proposed strategies might be helpful for the global environmental sustainability.

Measuring productivity of healthcare services under environmental constraints: evidence from China

BACKGROUND

Despite the growing literature on the efficiency and productivity of the Chinese healthcare system, less attention has been given to examining the undesirable outputs linked to healthcare services, including environmental pollution. Taking the atmospheric environmental pollution resulting from the incineration of medical waste as an undesirable output of the healthcare system, this study analyzed the growth and decomposition of Total Factor Productivity (TFP) of healthcare services across 31 Chinese provinces during the period 2005-2016.

METHODS

The Meta-frontier undesirable super-efficiency slack-based measure (SBM) model and the Global Malmquist-Luenberger (GML) Index were employed to analyze the growth and decomposition of TFP using the Max DEA software.

RESULTS

The results revealed that the years 2009 and 2015 marked significant changes in TFP of healthcare services in Chinese provinces. During the study period, the rate of technological change (TC) slowly declined, whereas the rate of efficiency change (EC) steadily increased. With the national average being the benchmark, the results indicated that: the TFP of 17 provinces and cities exceeded the average, the EC of 16 provinces and cities exceeded the average, the TC of 9 provinces and cities exceeded the average, and the value in the Technology Gap Ratio (TGR) changes of 13 provinces and cities were above the national average.

CONCLUSIONS

(1) The TFP of the healthcare services across China continued to decline slowly during the study period. (2) The effect of technical catch-up in the eastern, central, and western regions of China was significant across the three regions, whereas the effect of technical innovation was negative. (3) The TFP varied considerably among the Chinese provinces. These findings suggest that, under existing environmental constraints, relevant government departments should improve technical innovation in the supply of healthcare services and medical waste treatment, increase technical efficiency in the factor of healthcare production, strengthen regional health planning, and balance the development of regional healthcare.