What medical waste management system may cope With COVID-19 pandemic: Lessons from Wuhan

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.

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.

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.

Research on transportation management model of COVID-19 medical waste: a case study in Beijing, China

During the COVID-19 pandemic, disposable masks, protective clothing, gloves, and nasopharyngeal swabs collected by nucleic acid testing formed a large amount of medical waste. Medical waste has strict temporary storage time requirements in hospitals, which need to be transported to medical waste disposal plants within the specified time. However, as most of disposal plants are far away from downtown, they also need to be responsible for the transportation and disposal of medical waste in many hospitals, and put forward higher requirement for transportation routes. Rapid and safe disposal of all types of medical waste generated by COVID-19 is crucial to the prevention and control of the epidemic. This paper designs the transportation route optimization model using Anylogic simulation software based on the regional distribution of 118 tertiary hospitals and 2 large medical waste disposal plants in Beijing, China. At the same time, transportation routes of 118 tertiary hospitals in the morning peak, evening peak, all-day, and ordinary periods were simulated based on the Beijing traffic index in 2017. On this basis, through the analysis of the simulation data, the selection of medical waste transport routes for 118 tertiary hospitals in the morning peak, evening peak, all day, and ordinary periods is further clarified, so as to ensure that medical waste can be transported to the medical waste disposal plant in the shortest time. The shortest path and fastest speed transport mode, medical waste transport data set, and the selection of transport mode of 118 tertiary hospitals formed by this research provide certain reference experience for the rapid and safe transport of medical waste during the epidemic period, and also provides corresponding data support for medical waste transportation management in the post-epidemic era and medical waste transportation decision-making when facing major public health problems.

The energy assessment of COVID-19 medical waste as a potential fuel

The COVID-19 pandemic has caused huge health and economic damages. Various protective face masks, such as single-use, cotton, and the most widespread FFP2 or KN95 masks, are used to prevent the spread of this virus. However, these face masks are usually packaged in plastic packaging, which increases the amount of plastic waste. Plastic gloves are also often used in the connection of the pandemic. All this leads to a large production of protective equipment, but their use contributes to the increase of this type of waste, which presents a new challenge in waste management. This article investigates a complete element analysis of these mentioned materials and observes potential harmful substances. Further, pellets, as a potential fuel for combustion or pyrolysis purposes, were produced with the content of 5% and 10% of face masks. FFP2 were firstly separated from ear straps and wires, then disintegrated, added to spruce sawdust, and compressed into pellets. A series of experiments were realized and aimed at elemental, thermogravimetric, and calorific value analyses of produced pellets. Based on the results, it can be concluded that the presence of face masks FFP2 in pellets increases the content of carbon, hydrogen, and nitrogen, volatile matter, and calorific values, but decreases the content of fixed carbon. According to elemental analysis of produced pellets, no significant amounts of harmful elements were found.

Regulation of biomedical waste management in Kazakhstan during the pandemic in the context of best practices

The COVID-19 pandemic actualized questions about the proper management of biomedical waste while creating several regulatory challenges and requiring countries to look for an appropriate response. These issues have become particularly relevant for Kazakhstan, where waste management issues traditionally face inefficient legal regulation and are particularly acute. This study aims to answer the question of what regulatory problems Kazakhstan currently face in the area of proper biomedical waste management, and how existing foreign experience can help solve them. The present study highlights several pertinent challenges within the context of medical waste management. These include issues concerning the licencing activities associated with waste management, the absence of well-defined regional plans for the management of medical waste and the lack of effective strategies to address the proper handling and disposal of this specific category of waste. At the same time, there are reasons to say that the country requires additional technical and expert support in the field of medical waste management.

The Impacts of Plastic Waste from Personal Protective Equipment Used during the COVID-19 Pandemic

The period from 2019 to 2022 has been defined by the COVID-19 pandemic, resulting in an unprecedented demand for and use of Personal Protective Equipment (PPE). However, the disposal of PPE without considering its environmental impact and proper waste management practices has become a growing concern. The increased demand for PPE during the pandemic and associated waste management practices have been analyzed. Additionally, the discussion around treating these residues and exploring more environmentally friendly alternatives, such as biodegradable or reusable PPE, is crucial. The extensive use of predominantly non-degradable plastics in PPE has led to their accumulation in landfills, with potential consequences for marine environments through the formation of microplastics. Therefore, this article seeks to establish a connection between these issues and the Sustainable Development Goals, emphasizing the importance of efficient management aligned with sustainable development objectives to address these emerging challenges and ensure a more sustainable future.

Recycling COVID-19 health care wastes in bitumen modification: a case of disposable medical gloves

Disposable medical gloves (DMGs) have long been used to mitigate the risk of direct exposure to diverse microorganisms and body fluids; hence, they are a critical weapon to protect patients and healthcare staff from infectious diseases. Measures to control the spread of COVID-19 have sparked the production of an excessive number of DMGs, most of which are eventually being disposed of in landfills. Untreated DMGs in landfills do not only pose a direct risk of transmitting coronavirus and other pathological germs but also pollute air, water, and soil dramatically. As a healthier alternative, recycling discarded polymer-rich DMGs into bitumen modification is considered to be a prospective waste management strategy applicable to the asphalt pavement industry. In this study, this conjecture is tested by examining two common DMGs - latex gloves and vinyl gloves - at four different percentages (1%, 2%, 3%, and 4% by weight). The morphological characteristics of DMG-modified specimens were inspected by using a high-definition scanning electron microscope (SEM) equipped with an energy dispersive X-ray analyzer (EDX). A wide range of laboratory tests including penetration, softening point temperature, ductility, and elastic recovery were undertaken to evaluate the impact of waste gloves on the conventional engineering properties of bitumen. Moreover, viscoelastic behavior and modification processing were studied by conducting the dynamic shear rheometer (DSR) test and the Fourier transform infrared spectroscopy (FTIR) analysis. Test results have revealed the outstanding potential of recycled DMG waste for modifying neat asphalt binder. More specifically, bitumens modified with 4% latex glove and 3% vinyl glove were seen as capable of superiorly withstanding permanent deformations caused by heavy axle loads at high service temperatures. Furthermore, it has been shown that 1.2 tons of modified binder would embed approximately 4000 pairs of recycled DMGs. This study shows that DMG waste can be used as a viable modifier, which would help open a new avenue for mitigating the environmental pollution arising from the COVID-19 pandemic.

Assessing the challenges to medical waste management during the COVID-19 pandemic: Implications for the environmental sustainability in the emerging economies

Emerging economies are struggling with proper and efficient management of waste due to their constrained resources and weak management. In recent days, this crisis has worsened due to the outbreak of the highly contagious COVID-19 pandemic. To avoid building up stockpiles and contaminating communities with potentially contagious medical waste (MW), and to ensure sustainability in the current and post-COVID-19 era, it is a dire need to develop and implement a safe and efficient medical waste management (MWM) system. This research, thereby, aims to identify, assess, and prioritize the key challenges to efficient and sustainable MWM to mitigate the impacts of the disruptions caused by situations like the pandemic in emerging economies. An integrated approach consisting of the Best-Worst Method (BWM), Interpretive Structural Modeling (ISM), and Cross-Impact Matrix Multiplication Applied to Classification (MICMAC) has been proposed to achieve the objectives. Based on the literature review and expert feedback, a total of seventeen challenges were identified and later prioritized by using BWM. The top twelve challenges have been further analyzed using ISM-MICMAC to examine their interrelationships. This study reveals that lack of proper law enforcement and insufficient financial support from investors and the government are two crucial challenges for efficient MWM implementation. The research insights can assist healthcare facility administrators, practitioners, and city managers in identifying the associated challenges and shaping strategic decisions for establishing and managing efficient MWM systems to ensure sustainable development in the post-COVID-19 era.

Multi-criteria evaluation of medical waste management process under intuitionistic fuzzy environment: A case study on hospitals in Turkey

Waste management has come to the fore in the whole world with the increasing impact of the Covid-19 pandemic along with concerns about human health, environmental threats, and socio-economic factors, etc. Medical waste is one of the waste types that need special management processes including particularly collection, storage, separation, and disposal. Healthcare activities create a great amount of medical waste deriving from the hospitals. This study aims to determine the hospital that carries out medical waste management in the most effective way in Erzurum, Turkey. To handle intense uncertainty in the evaluation process, the case is analyzed by Intuitionistic Fuzzy Multi-Criteria Decision-Making (IFMCDM) methods. The present study contributes to the literature by focusing on a real case problem under IF environment in a Group Decision-Making (GDM) framework. Additionally, based on the literature review and expert judgments, the evaluation criteria relevant to the case are defined in this paper. To this end, a four-phased integrated methodology that involves Intuitionistic Fuzzy Weighted Averaging (IFWA), IF Analytical Hierarchy Process (IFAHP), IF Technique for Order Preference by Similarity to Ideal Solution (IFTOPSIS) and One-Dimensional Sensitivity Analysis, is conducted. Firstly, IFWA is aimed to express the significance levels of decision makers (DMs) based on their knowledge, qualifications and experiences. Secondly, IFAHP is used to calculate the importance weights of the decision criteria and IFTOPSIS is preferred to rank the available hospitals. Then, sensitivity analysis is employed to display robustness. According to the results, the most important criteria are Qualified personnel, Health institution infrastructure, and Control of waste, respectively and the most efficient hospital is determined.

COVID-19 medical waste transportation risk evaluation integrating type-2 fuzzy total interpretive structural modeling and Bayesian network

With the amount of medical waste rapidly increasing since the corona virus disease 2019 (COVID-19) pandemic, medical waste treatment risk evaluation has become an important task. The transportation of medical waste is an essential process of medical waste treatment. This paper aims to develop an integrated model to evaluate COVID-19 medical waste transportation risk by integrating an extended type-2 fuzzy total interpretive structural model (TISM) with a Bayesian network (BN). First, an interval type-2 fuzzy based transportation risk rating scale is introduced to help experts express uncertain evaluation information, in which a new double alpha-cut method is developed for the defuzzification of the interval type-2 fuzzy numbers (IT2FNs). Second, TISM is combined with IT2FNs to construct a hierarchical structural model of COVID-19 medical waste transportation risk factors under a high uncertain environment; a new bidirectional extraction method is proposed to describe the hierarchy of risk factors more reasonably and accurately. Third, the BN is integrated with IT2FNs to make a comprehensive medical waste transportation risk evaluation, including identifying the sensitive factors and diagnosing the event's causation. Then, a case study of COVID-19 medical waste transportation is displayed to demonstrate the effectiveness of the proposed model. Further, a comparison of the proposed model with the traditional TISM and BN model is conducted to stress the advantages of the proposed model.

Two-phase COVID-19 medical waste transport optimisation considering sustainability and infection probability

A safe and effective medical waste transport network is beneficial to control the COVID-19 pandemic and at least decelerate the spread of novel coronavirus. Seldom studies concentrated on a two-phase COVID-19 medical waste transport in the presence of multi-type vehicle selection, sustainability, and infection probability, which is the focus of this paper. This paper aims to identify the priority of sustainable objectives and observe the impacts of multi-phase and infection probability on the results. Thus, such a problem is formulated as a mixed-integer programming model to minimise total potential infection risks, minimise total environmental risks, and maximise total economic benefits. Then, a hybrid solution strategy is designed, incorporating a lexicographic optimisation approach and a linear weighted sum method. A real-world case study from Chongqing is used to illustrate this methodology. Results indicate that the solution strategy guides a good COVID-19 medical waste transport scheme within 1 min. The priority of sustainable objectives is society, economy, and environment in the first and second phases because the total Gap of case No.35 is 3.20%. A decentralised decision mode is preferred to design a COVID-19 medical waste transport network at the province level. Whatever the infection probability is, infection risk is the most critical concern in the COVID-19 medical waste clean-up activities. Environmental and economic sustainability performance also should be considered when infection probability is more than a certain threshold.

Waste management beyond the COVID-19 pandemic: Bibliometric and text mining analyses

The outbreak of the COVID-19 pandemic has significantly increased the demand for personal protective equipment, in particular face masks, thus leading to a huge amount of healthcare waste generated worldwide. Consequently, such an unprecedented amount of newly emerged waste has posed significant challenges to practitioners, policy-makers, and municipal authorities involved in waste management (WM) systems. This research aims at mapping the COVID-19-related scientific production to date in the field of WM. In this vein, the performance indicators of the target literature were analyzed and discussed through conducting a bibliometric analysis. The conceptual structure of COVID-19-related WM research, including seven main research themes, were uncovered and visualized through a text mining analysis as follows: (1) household and food waste, (2) personnel safety and training for waste handling, (3) sustainability and circular economy, (4) personal protective equipment and plastic waste, (5) healthcare waste management practices, (6) wastewater management, and (7) COVID-19 transmission through infectious waste. Finally, a research agenda for WM practices and activities in the post-COVID-19 era was proposed, focusing on the following three identified research gaps: (i) developing a systemic framework to properly manage the pandemic crisis implications for WM practices as a whole, following a systems thinking approach, (ii) building a circular economy model encompassing all activities from the design stage to the implementation stage, and (iii) proposing incentives to effectively involve informal sectors and local capacity in decentralizing municipal waste management, with a specific focus on developing and less-developed countries.

COVID-19 and environmental health: A systematic analysis for the global burden of biomedical waste by this epidemic

Since the beginning of this outbreak, much evidence stated that the climb in the amount of biomedical waste harmed human health and had adverse effects on the environment. With the increase of cases of COVID-19 all around the globe, the amount of biomedical waste was also constantly rising. Also, many solutions regarding either reducing or recycling biomedical waste. However, the potential global burden of biomedical waste during this pandemic was not yet been analyzed. Herein, we perform a systematic review of literature on these modalities, including mentioning types of biomedical waste, the effect on health, the environment, and methods of handling biomedical waste during this pandemic. A total of 3551 published papers were identified by two databases. In the end, 15 references were selected for this systematic analysis. Most of the included studies focus on research on the impact of medical waste caused by the COVID-19 pandemic on the environment. The total biomedical waste during the COVID-19 pandemic was approximately 16,649.48 tons/day. Most publications agreed that the amount of waste has also increased due to the rapidly rising number of COVID-19 patients. In 15 articles, we identified 2 mentioning the COVID-19 biomedical waste on health. 9 out of 15 gave out the context related to the solution of BMW by COVID-19. More studies, including meta-analyses, are recommended to shed more light on the effects of medical waste on environmental health during the COVID-19 pandemic.

Sustainable development-oriented location-transportation integrated optimization problem regarding multi-period multi-type disaster medical waste during COVID-19 pandemic

After the outbreak of COVID-19 pandemic, devising an effective reverse logistics supply chain to clean up disaster medical waste is conducive to controlling and containing novel coronavirus transmission. Thus, the focus of this paper concentrates on multi-period multi-type disaster medical waste location-transportation integrated optimization problem with the concern of sustainability, which is formulated as a tri-objective mixed-integer programming model with the goals of maximizing total economic benefits, minimizing total carbon emissions and total potential social risks. Then, a real-world case from Wuhan using CPLEX solver is used to validate the developed model. Results indicate that constructing DMWTTSs with flexible capacity in different periods is encouraged to handle the sharply increasing disaster medical waste. The multi-period decision model outperforms the single-period one in disaster medical waste supply chains because the former has the capability of handling the uncertainties in the future periods. Increasingly, since the increase of budget doesn't always work well and social resources are limited, the estimation of minimum budget to obtain optimum overall performance is of great importance.

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

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

Data analytics during pandemics: a transportation and location planning perspective

The recent COVID-19 pandemic once again showed the value of harnessing reliable and timely data in fighting the disease. Obtained from multiple sources via different collection streams, an immense amount of data is processed to understand and predict the future state of the disease. Apart from predicting the spatio-temporal dynamics, it is used to foresee the changes in human mobility patterns and travel behaviors and understand the mobility and spread speed relationship. During this period, data-driven analytic approaches and Operations Research tools are widely used by scholars to prescribe emerging transportation and location planning problems to guide policy-makers in making effective decisions. In this study, we provide a review of studies which tackle transportation and location problems during the COVID-19 pandemic with a focus on data analytics. We discuss the major data collecting streams utilized during the pandemic era, highlight the importance of rapid and reliable data sharing, and give an overview of the challenges and limitations on the use of data.

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

In this study, the hospital waste generation rates and compositions in Delhi were examined temporally and spatially during the first COVID-19 wave of April 2020. A total of 11 representative hospitals located in five districts were considered. The pre-COVID hospital waste generation rates were relatively consistent among the districts, ranging from 15 to 23 tonne/month. It is found that the number of hospital beds per capita may not be a significant factor in the hospital waste quantity. Strong seasonal variations were not observed. All districts experienced a drastic decrease in generation rates during the 1-month lockdown. The average rates during the COVID period ranged from 12 to 24 tonne/month. Bio-contaminated and disposable medical product wastes were the most common waste in Delhi's hospitals, representing 70-80% by weight. The changes in waste composition were however not spatially consistent. The lockdown appeared to have had a higher impact on hospital waste generation rate than on waste composition. The findings are important as the design and operation of a waste management system are sensitive to both waste quantity and quality. Waste records at source helped to minimize waste data uncertainties and allowed a closer examination of generation trends.

A novel hybrid multi-criteria group decision-making approach with intuitionistic fuzzy sets to design reverse supply chains for COVID-19 medical waste recycling channels

The COVID-19 pandemic has led to exponential growth in COVID-19 medical waste (CMW) generation worldwide. This tremendous growth in CMW is a major transmission medium for COVID-19 virus and thus brings serious challenges to medical waste (MW) management. Designing an efficient and reliable CMW reverse supply chain in this situation can help to prevent epidemic spread. Nowadays, the assessment of CMW recycling channels has become a challenging mission for health-care institutions, especially in developing countries. It can be seen as a complex multi-criteria group decision-making (MCGDM) problem that requires the consideration of multiple conflicting tangible and intangible criteria. Nevertheless, few academics have been concerned about this issue. Moreover, current MCGDM methods have limited support for CMW recycling channel evaluation and they do not consider hospitals' reverse supply chain strategy when evaluating. Thus, this study presents a novel MCGDM approach based on intuitionistic fuzzy sets (IFSs) and the VIKOR method for assessing the capacity of CWM recycling channels. According to the characteristics of CMW, processing flow and the TOE (Technology, Organization and Environment) theoretical framework, we established a new CMW recycling channel capacity evaluation index system which makes our proposed method more targeted and efficient. In the decision-making process, we integrate the best-worst method (BWM) and entropy to determine the decision makers (DMs) weighting in a more comprehensive way, considering both subjective and objective criteria, which was ignored by many MCGDM methods. A new aggregation operator called IFWA is proposed by us, considering the priority of DMs. Based on both the ranking of capacity and disposal charges, we then position the alternatives in the recycling channel priority index (RCPI) matrix constructed by us. According to this PCPI matrix and the reverse supply chain strategy of hospitals, a more reasonable CMW allocation strategy is determined and a more efficient CMW reverse supply chain is designed. Finally, a real case study from Wuhan was examined to illustrate the validation of our approach.

Locating temporary waste treatment facilities in the cities to handle the explosive growth of HCWs during pandemics: A novel Grey-AHP-OCRA hybrid approach

The COVID-19 outbreak has not only put the community health at stake but, also the environmental health. Usually, the healthcare wastes (HCWs) are composed of 15-20% of the infectious wastes and the rest of the non-infectious wastes. But, during any communicable health outbreak like COVID-19, the whole HCWs coming from the infected people become contagious. During the COVID-19 outbreak, the infectious waste is not only limited to the hospitals' premises, but also comes from the households, where COVID19 infected people are under home quarantine. Hence, keeping in mind the explosive growth in generation rates of infectious HCWs, the present study targets to expand the treatment and disposal capacity by installing temporary healthcare waste treatment facilities (HCWTFs). The study identifies ten criteria from the literature review and in consultation with the field experts, to evaluate the potential candidates for setting up temporary HCWTF during the health outbreaks. The study proposes a hybrid methodology based on grey analytical hierarchy process (G-AHP) and grey operational competitiveness rating analysis (grey-OCRA) for prioritizing the evaluation criteria and selecting the optimal temporary HCWTF location by considering the experts' inputs, respectively. The stakeholders consider the 'proximity to the inhabitation', 'infrastructure availability', and 'transportation distance' are the most important criteria for selecting the temporary HCWTF location. The proposed methodology is applied to select the temporary HCWTF location in Sundargarh District, Odisha, India. The study identifies the four locations by using geographical information system (GIS) tools and sequences them as per the preferences given by the stakeholders on various identified criteria. The study may be useful for the administration to set up the temporary facilities to quickly dispose of the extra HCWs during the pandemics. However, the future studies can be targeted to coordinate the collection, storage and transportation activities with the temporary HCWTFs.

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.

Evolutionary Game Analysis of Medical Waste Disposal in China under Different Reward and Penalty Models

Although local governments have issued relevant reward and penalty policies, there are still problems of medical waste disposal in China, particularly in light of the special situation of the COVID-19 pandemic. Furthermore, these problems are generated in the game between local governments and disposal enterprises. Accordingly, based on the evolutionary game theory, this paper establishes and analyzes the game system between local governments and disposal enterprises under four modes: static reward and static penalty, dynamic reward and static penalty, static reward and dynamic penalty, and dynamic reward and dynamic penalty. The theoretical analysis is verified through numerical simulation of a medical waste disposal case in China. The results showed that when local governments choose the static reward and static penalty mode, the game system hardly always has an evolutionary stable state, and the dynamic reward or dynamic penalty mode can make up for the shortcomings of the static reward and static penalty mode. The static reward and dynamic penalty mode is considerably better than the other two dynamic reward and penalty modes, which has the best effect on improving the quality of medical waste disposal. Additionally, if the reward or penalty increases dynamically, local governments tend to implement a “relaxed supervision” strategy, and disposal enterprises will still improve the disposal quality of medical waste. The suggestions proposed based on the research conclusions offer some enlightenment for policymakers to formulate reasonable reward and penalty measures.

Application of Machine Learning to Predict the Performance of an EMIPG Reactor Using Data from Numerical Simulations

Microwave-driven plasma gasification technology has the potential to produce clean energy from municipal and industrial solid wastes. It can generate temperatures above 2000 K (as high as 30,000 K) in a reactor, leading to complete combustion and reduction of toxic byproducts. Characterizing complex processes inside such a system is however challenging. In previous studies, simulations using computational fluid dynamics (CFD) produced reproducible results, but the simulations are tedious and involve assumptions. In this study, we propose machine-learning models that can be used in tandem with CFD, to accelerate high-fidelity fluid simulation, improve turbulence modeling, and enhance reduced-order models. A two-dimensional microwave-driven plasma gasification reactor was developed in ANSYS (Ansys, Canonsburg, PA, USA) Fluent (a CFD tool), to create 644 (geometry and temperature) datasets for training six machine-learning (ML) models. When fed with just geometry datasets, these ML models were able to predict the proportion of the reactor area with temperature above 2000 K. This temperature level is considered a benchmark to prevent formation of undesirable byproducts. The ML model that achieved highest prediction accuracy was the feed forward neural network; the mean absolute error was 0.011. This novel machine-learning model can enable future optimization of experimental microwave plasma gasification systems for application in waste-to-energy.

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.

Sustainable municipal solid waste management (MSWM) in the smart cities in Indian context

Purpose

Smart cities in India are going to be a reality very soon by turning challenges into opportunities for the society. However, due to rapid increase in population burden, fast urbanization and growing demand of advanced services in the smart cities, the quantity of per capita municipal solid waste (MSW) has escalated. Moreover, the COVID-19 pandemic has further challenged the municipal solid waste management (MSWM) system with the increasing amount of infectious wastes coming from households (HHs), quarantine centers, healthcare facilities, vaccination centers, etc. Therefore, the present study attempts to explore and analyze the various dimensions of sustainable MSWM system in the smart cities.

Design/methodology/approach

The study identifies 13 factors of sustainable MSWM system from the literature, field surveys and stakeholders' opinions. Thereafter, stakeholders' opinions are collected and analyzed using total interpretive structural modeling (TISM) approach to explore the interrelationships among the factors of sustainable MSWM system. These relationships are further validated through the empirical investigation of the real-life case study of Rourkela Municipal Corporation (RMC), Odisha, India.

Findings

The TISM approach places all 13 factors into six levels in the hierarchical digraph depending upon the inputs received from the various stakeholders on their interrelationships. Study also validates the proposed TISM model by collecting the data of RMC, Odisha, on the development of MSWM system over the period of 2015–2021.

Practical implications

The study also highlights various implications for the other developing cities and stakeholders to set up the roadmap for developing the sustainable MSWM system. Study defines “IT platform” and “awareness among citizens” as the base of the sustainable MSWM system in any smart city.

Originality/value

The present study is the first of its kind to explore the interrelationships among the factors of sustainable MSWM system by using TISM approach. Moreover, the proposed TISM framework is further validated through the empirical journey of one of the smart cities in India.

Plastic Pollution, Waste Management Issues, and Circular Economy Opportunities in Rural Communities

Rural areas are exposed to severe environmental pollution issues fed by industrial and agricultural activities combined with poor waste and sanitation management practices, struggling to achieve the United Nations’ Sustainable Development Goals (SDGs) in line with Agenda 2030. Rural communities are examined through a “dual approach” as both contributors and receivers of plastic pollution leakage into the natural environment (through the air–water–soil–biota nexus). Despite the emerging trend of plastic pollution research, in this paper, we identify few studies investigating rural communities. Therefore, proxy analysis of peer-reviewed literature is required to outline the significant gaps related to plastic pollution and plastic waste management issues in rural regions. This work focuses on key stages such as (i) plastic pollution effects on rural communities, (ii) plastic pollution generated by rural communities, (iii) the development of a rural waste management sector in low- and middle-income countries in line with the SDGs, and (iv) circular economy opportunities to reduce plastic pollution in rural areas. We conclude that rural communities must be involved in both future plastic pollution and circular economy research to help decision makers reduce environmental and public health threats, and to catalyze circular initiatives in rural areas around the world, including less developed communities.

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.

End-of-use and end-of-life medicines-insights from pharmaceutical care process into waste medicines management

End-of-use and end-of-life medicines waste management has been a challenge for public and private managers in different countries. Reverse logistics is a waste management strategy whose application to public pharmaceutical care processes faces legal restrictions and incertitude. Nevertheless, reverse logistics of end-of-use and end-of-life medicines may be both a saving and an environmental strategy in developing countries that manage health under limited resources. How to overcome restrictions to reverse logistics mainly in the context of primary health level? This study aims to investigate the most relevant critical factors for implementing medicine waste management in pharmaceutical care process. The unit analysis is the primary health level process in a developing country capital. Considering the characteristics of the issue at hand, it was designed a qualitative study. Data was collected through semi-structured interviews. The interviewees were key individuals who work directly with the process-from administering medicine to patients to managing waste at the end of the medicine's lifespan or after its use. Results indicated that despite reverse logistics arising from end users is legally forbidden, another type of reverse flow emerged from process analysis. The reverse flow, named reassignment flow, consists of still useful end-of-use medicines exchanged among the 10 government-ran pharmacies and over 140 health centers, where healthcare professionals administer and offer guidance on how to use them correctly. Another result was the identification of the most critical factors in implementing reverse logistics strategies in the public management context. The factors mentioned included aspects pertaining to management, information technology, infrastructure, and government, but they differ from the private context management, in which decision-makers has more freedom. Due to the barriers named by interviewees, the political barriers and complexity of primary health system, results of this investigation point to (i) reinforcing the reassignment flows inside pharmaceutical care logistics cycle, for saving purposes, and (ii) further development of a specific management unit to perform reverse logistics of end-of-use medicines arising from consumers, for environmental purposes. In times of shortage or resources caused by the COVID-19 pandemic, to know the critical factors is a step necessary in overcoming the current restrictions in direction of a well-succeeded medicines reverse logistics, either of reassignment or from final consumers. These results clarify the literature on end-of-use and end-of-life medicines reverse logistics. It also provides managers of 5000 municipalities in the country a perspective on the most relevant critical factors involved in their decision-making process, concerning the reuse of end-of-use medicines or the adequate disposal of end-of-life medicines in the environment.

Selection of healthcare waste disposal firms using a multi-method approach

The aim of this study is to propose a hybrid multi criteria decision making model with a linear programming (LP) model to tackle the issue of safe disposal of hazardous and infectious healthcare waste. For this, ten criteria in this study have been identified from literature and field surveys which are modelled using Decision making trial and evaluation (DEMATEL) and Analytic network process (ANP) methods to select the best disposal firm i.e. single sourcing for a hospital. We found that Experience of the firm, Technology for disposal, and Waste collection infrastructure acts as the most vital criteria in selecting a healthcare waste disposal firm for single sourcing. Furthermore, to optimize the total value of disposal and mitigating the risk involved in disposing waste through single sourcing; the LP model considering constraints such as waste lose constraint and waste processing constraint etc. Is solved for multiple sourcing using Lingo 18.0. The solution to LP results into allocation of 500, 500, and 1000 (kg/day) disposables to healthcare waste disposal firms D1, D2 and D3, respectively. The multi-method approach proposed in this study helps the hospital management in selecting economically, socially, and environmentally sustainable healthcare waste disposal firm.