Disinfection technology and strategies for COVID-19 hospital and bio-medical waste management

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.

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.

Research on the impact mechanism of changes in the production of medical solid waste in China before and after COVID-19

The changes of medical solid waste (MSW) output in recent years have had a significant impact on the spread of the virus. There is a high-risk transmission of MSW in various stages such as storage, transportation, and treatment during the COVID-19. To cope with the risks brought by the epidemic, normalized prevention consumes a large amount of protective clothing, medical masks, goggles, packaging bags, and other related medical supplies. There is a significant uncertainty in the amount of MSW output that poses a risk of COVID-19 infection in the event of an emergency, which increases the difficulty of collecting and handling epidemic prevention MSW. The analysis of MSW data from 2000 to 2022 found a stable growth trend before 2019. However, the MSW data was a sudden increase trend from 2020 to 2022, and the COVID-19 in China was characterized by an initial stage, an outbreak stage, and a stable growth stage. The range of MSW output during the epidemic was (1.19-1.75) × 106 t a-1. The amount of MSW was approximately 1.19 × 106 t a-1 during the normalized epidemic period, and its treatment cost was as high as 3.57 × 109 yuan (RMB)·a-1. The distribution of MSW output was uneven due to factors such as climate conditions, population data, and local economy. This study has important reference value for epidemic medical material reserves and MSW treatment.

Variability of the treated biomedical waste disposal behaviours during the COVID lockdowns

Literature review suggests that studies on biomedical waste generation and disposal behaviors in North America are limited. Given the infectious nature of the materials, effective biomedical waste management is vital to the public health and safety of the residents. This study explicitly examines seasonal variations of treated biomedical waste (TBMW) disposal rates in the City of Regina, Canada, from 2013 to 2022. Immediately before the onset of COVID-19, the City exhibited a steady pattern of TBMW disposal rate at about 6.6 kg∙capita-1∙year-1. However, the COVID-19 pandemic and its associated lockdowns brought about an abrupt and persistent decline in TBMW disposal rates. Inconsistent fluctuations in both magnitude and variability of the monthly TBMW load weights were also observed. The TBMW load weight became particularly variable in 2020, with an interquartile range 4 times higher than 2019. The average TBMW load weight was also the lowest (5.1 tonnes∙month-1∙truckload-1) in 2020, possibly due to an overall decline in non-COVID-19 medical emergencies, cancellation of elective surgeries, and availability of telehealth options to residents. In general, the TBMW disposal rates peaked during the summer and fall seasons. The day-to-day TBMW disposal contribution patterns between the pre-pandemic and post-pandemic are similar, with 97.5% of total TBMW being disposed of on fixed days. Results from this Canadian case study indicate that there were observable temporal changes in TBMW disposal behaviors during and after the COVID-19 lockdowns.

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.

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.

Towards environmentally sustainable management: A review on the generation, degradation, and recycling of polypropylene face mask waste

There has been a considerable increase in the use of face masks in the past years. Managing face mask waste has become a global concern, as the current waste management system is insufficient to deal with such a large quantity of solid waste. The drastic increase in quantity, along with the material's inability to degrade plastic components such as polypropylene, has led to a large accumulation of plastic waste, causing a series of environmental and ecological challenges. In addition, the growing use also imposes pressure on waste management methods such as landfill and incineration, raising concerns about high energy consumption, low value-added utilization, and the release of additional pollutants during the process. This article initially reviews the impact of mask-related plastic waste generation and degradation behavior in the natural environment. It then provides an overview of various recently developed methods for recycling face mask plastic waste. The article also offers forward-looking strategies and recommendations on face mask plastic waste management. The review aims to provide guidance on harnessing the complexities of mask waste and other medical plastic pollution issues, as well as improving the current waste management system's deficiencies and inefficiencies in tackling the growing plastic waste problem.

Evaluation of biomedical waste generation in Himachal Pradesh before and during the Covid 19 pandemic

Himachal Pradesh dealt with the same crisis as other states in India due to the extensive dissemination of the COVID-19 coronavirus infection. Biomedical waste management is crucial for public health and environmental safety, and the pandemic's impact on waste generation is an understudied area. This study specifically utilizes data from the Himachal Pradesh Pollution Control Board as well as information from other governmental and non-governmental organizations, which are analysed and compared for the pre-pandemic and pandemic periods. This research offers a thorough analysis of waste generation of Himachal Pradesh both before and during the COVID-19 outbreak. Kangra (671 kg/day), Shimla (526 kg/day), are found to be high Bio medical waste generation (BMWG) districts whereas Kinnour (22 kg/day), Lahul Spiti (6 kg/day) are observed as lowest BMW generating districts in Himachal Pradesh on average basis in the year 2018 to 2020. The unexpected COVID-19 viral pandemic has caused a huge increase in Bio-medical waste (584 kg/day) in the year 2021 in comparison to that in the year 2020 (139 kg/day). The gaps analysis of Himachal Pradesh implementation of the Biomedical waste regulations was also assessed in this study. Deep burials have been severely prohibited by the Himachal Pradesh government; yet, two districts continue to dispose of BMWs using deep burial techniques. The findings reveal important insights into the changing patterns of BMW generation, shedding light on the challenges and requirements for effective waste management strategies during health crises. The insights obtained from this study can contribute in development of resilient waste management system that can effectively respond to future pandemics or health crises, ensuring the safety of healthcare workers, the public, and the environment.

An innovative medical waste management system in a smart city using XAI and vehicle routing optimization

Background

The management of medical waste is a complex task that necessitates effective strategies to mitigate health risks, comply with regulations, and minimize environmental impact. In this study, a novel approach based on collaboration and technological advancements is proposed.

Methods

By utilizing colored bags with identification tags, smart containers with sensors, object recognition sensors, air and soil control sensors, vehicles with Global Positioning System (GPS) and temperature humidity sensors, and outsourced waste treatment, the system optimizes waste sorting, storage, and treatment operations. Additionally, the incorporation of explainable artificial intelligence (XAI) technology, leveraging scikit-learn, xgboost, catboost, lightgbm, and skorch, provides real-time insights and data analytics, facilitating informed decision-making and process optimization.

Results

The integration of these cutting-edge technologies forms the foundation of an efficient and intelligent medical waste management system. Furthermore, the article highlights the use of genetic algorithms (GA) to solve vehicle routing models, optimizing waste collection routes and minimizing transportation time to treatment centers.

Conclusions

Overall, the combination of advanced technologies, optimization algorithms, and XAI contributes to improved waste management practices, ultimately benefiting both public health and the environment.

Event-related potentials for investigating the willingness to recycle household medical waste

Household medical waste (HMW) recycling in the reverse supply chain has become a primary channel for infectious, toxic, or radioactive substances for environmental protection and a circular economy. Recycling managers need to understand the recycling decision-making mechanisms of households to improve the intention-behavior gap and recycling participation rate, especially in cognitive neuroscience. This study designed an event-related potential (ERPs) experiment to explore the differences in ERPs components between the willingness and unwillingness to make recycling decisions. Our findings confirmed that willingness and unwillingness to recycle can lead to a significant difference in the P300 and N400 scores. A larger P300 was evoked by willingness rather than unwillingness in the prefrontal, frontal, and frontal-temporal regions. This indicates that willingness to recycle results from a rational choice in the decision-making process. However, a larger N400 was evoked by unwillingness rather than willingness in the parietal, parietal-occipital, and occipital regions. A negative wave was evoked in households unwilling to recycle because they thought it was dangerous and unsanitary, causing a higher conflict with intrinsic cognition. The combination of HMW recycling decisions and neurology may accurately measure pro-environmental decision-making processes through brain science. Advancing the knowledge of psychological and brain mechanism activities for understanding pro-environmental choices. In turn, this can help recycling managers to accurately understand household demands for increasing the recycling intention and designing effective HMW take-back systems to solve the intention-behavior gap related to the global recycling dilemma.

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

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

Face masks: a COVID-19 protector or environmental contaminant?

Face masks, a prime component of personal protective equipment (PPE) items, have become an integral part of human beings to survive under the ongoing COVID-19 pandemic situation. The global population requires an estimated 130 billion face masks and 64 billion gloves/month, while the COVID-19 pandemic has led to the daily disposal of approximately 3.5 billion single-use face masks, resulting in a staggering 14,245,230.63 kg of face mask waste. The improper disposal of face mask wastes followed by its mismanagement is a challenge to the scientists as the wastes create pollution leading to environmental degradation, especially plastic pollution (macro/meso/micro/nano). Each year, an estimated 0.15-0.39 million tons of COVID-19 face mask waste, along with 173,000 microfibers released daily from discarded surgical masks, could enter the marine environment, while used masks have a significantly higher microplastic release capacity (1246.62 ± 403.50 particles/piece) compared to new masks (183.00 ± 78.42 particles/piece). Surgical face masks emit around 59 g CO2-eq greenhouse gas emissions per single use, cloth face masks emit approximately 60 g CO2-eq/single mask, and inhaling or ingesting microplastics (MPs) caused adverse health problems including chronic inflammation, granulomas or fibrosis, DNA damage, cellular damage, oxidative stress, and cytokine secretion. The present review critically addresses the role of face masks in reducing COVID-19 infections, their distribution pattern in diverse environments, the volume of waste produced, degradation in the natural environment, and adverse impacts on different environmental segments, and proposes sustainable remediation options to tackle environmental challenges posed by disposable COVID-19 face masks.

Psychological Toll of the COVID-19 Pandemic: An In-Depth Exploration of Anxiety, Depression, and Insomnia and the Influence of Quarantine Measures on Daily Life

The COVID-19 pandemic, on a global scale, has prompted multifaceted challenges, including a notable psychological toll on the general population. This study uses mixed-method approach for a nuanced exploration of these experiences. Using a phenomenological strategy, qualitative responses from 999 participants were analyzed regarding their pandemic-induced anxiety and the influence of quarantine measures on their lives. Quantitative measures, including the revised Impact of Event Scale (IES-R), patient health questionnaire-9 (PHQ-9), the seven-item generalized anxiety disorder assessment (GAD-7), and Insomnia Severity Index (ISI), were used to quantify trauma, depression, anxiety, and insomnia attributed to COVID-19. Partial least squares structural equation modeling (PLS-SEM) was utilized for quantitative data analysis. The anxiety-related responses were mainly clustered into four themes: life threats, support shortage, economic consequences, and disruptions to family and social life. Subthemes that addressed the perceived effects encapsulated disruptions to academic and professional lives, familial and social relationships, psychopathological stress, and movement limitations. The findings from quantitative analysis revealed the significant associations between COVID-19-related trauma and symptoms of anxiety, depression, and insomnia, as indicated by coefficients exceeding 0.10 (all z-values > 1.96; p-values < 0.05). In conclusion, the findings underscore COVID-19's role in escalating anxiety, influenced by various factors, and its disruptive effects on daily life due to quarantine measures. The strong associations between the pandemic and the symptoms of depression, anxiety, and insomnia underscore the urgency of comprehensive psychological and public health interventions to alleviate these impacts.

Comparison of medical waste management methods in different countries: a systematic review

Medical waste status is a severe public health problem worldwide. Proper medical waste management is of paramount importance. However, there is insufficient information about medical waste management and lack of management in different countries. The aim of this research was to investigate and evaluate the present status of medical waste management in different countries. We systematically searched Embase, PubMed/MEDLINE, Scopus, PubMed Central, Google Scholar databases, as well as medRxiv using the following keywords: medical waste, waste management, disposal, healthcare per-capita generation, gross domestic product (GDP), and hospital. A total of 38 eligible articles were identified. Correlations were calculated between the amount of medical waste generated (kg bed.day^-1) vs. GDP per capita ($) and ranking of healthcare system performance. A negative correlation was found between medical waste generation rate and ranking of healthcare system performance. According to the findings of this study, the medical waste generation rate in different countries ranged from 0.14 to 6.10 kg bed.day^-1. About 25% of countries segregated medical waste, and about 17% used standard storage for all medical waste. Shortcomings were also found in waste collection, storage, transportation and transfer, and disposal of medical waste management activities in different countries. Only about 25% of countries simultaneously used three techniques, such as autoclaving, incineration, and landfill for disposal and treatment of medical waste, and 91% used incineration method. This study highlights an essential need for particular medical waste management guidelines and regulations, technologies, knowledge and financing to upgrade medical waste management worldwide. This study can be considered to be a good guide for further research on medical waste management in developing and developed countries.

Temporary COVID-19 Specialized Hospital: Management Strategies for Public Health Emergencies

During the coronavirus disease 2019 (COVID-19) outbreak in Shanghai with the Omicron variant in March 2022, locally accessible hospitals and healthcare centres encountered difficulties quickly responding to a demand for hospitals that were rapidly increasing, optimizing clinical results and controlling the infection. In this commentary, we summarize the management strategies of patients in a temporary COVID-19 specialized hospital during the outbreak in Shanghai, China. The present commentary was considered eight characteristics of management system, including general idea, infection prevention team, and efficient time management, and preventive and protective measures management, strategies for the management of infected patients, disinfection management, drug supply management strategies, and medical waste management. Following eight characteristics, the temporary COVID-19 specialized hospital operated effectively for 21 days. A total of 9674 patients were admitted, 7127 cases (73.67%) were cured and discharged, and 36 were transferred to designate hospitals for better treatment. Twenty-five management staff, 1130 medical, nursing staff, 565 logistics staff, and 15 volunteers participated in the temporary COVID-19 specialized hospital, and no infection prevention team member was infected. We speculated that these management strategies could be potential references for public health emergencies.

Biogenic production of silver, zinc oxide, and cuprous oxide nanoparticles, and their impregnation into textiles with antiviral activity against SARS-CoV-2

Nanotechnology is being used to fight off infections caused by viruses, and one of the most outstanding nanotechnological uses is the design of protective barriers made of textiles functionalized with antimicrobial agents, with the challenge of combating the SARS-CoV-2 virus, the causal agent of COVID-19. This research is framed within two fundamental aspects: the first one is linked to the proposal of new methods of biogenic synthesis of silver, cuprous oxide, and zinc oxide nanoparticles using organic extracts as reducing agents. The second one is the application of nanomaterials in the impregnation (functionalization) of textiles based on methods called "in situ" (within the synthesis), and "post-synthesis" (after the synthesis), with subsequent evaluation of their effectiveness in reducing the viral load of SARS-CoV-2. The results show that stable, monodisperse nanoparticles with defined geometry can be obtained. Likewise, the "in situ" impregnation method emerges as the best way to adhere nanoparticles. The results of viral load reduction show that 'in situ' textiles with Cu2O NP achieved a 99.79% load reduction of the SARS-CoV-2 virus.

Antidepressant exposure as a source of disinfectant resistance in waterborne bacteria

The emergence of disinfectant-resistant pathogens in water is a major threat to public health. However, whether human-consumed pharmaceuticals can induce bacterial resistance to disinfectants remains unclear. Herein, Escherichia coli was exposed to 12 antidepressants, and susceptibility of antidepressant-induced chloramphenicol (CHL)-resistant mutants to disinfectants was tested. Whole genome sequencing, global transcriptomic sequencing, and real-time quantitative polymerase chain reaction were used to elucidate the underlying mechanisms. We observed that duloxetine, fluoxetine, amitriptyline, and sertraline significantly increased the mutation frequency of E. coli against CHL by 15- to 2948-fold. The resultant mutants increased the average MIC₅₀ of sodium hypochlorite, benzalkonium bromide, and triclosan roughly 2- to 8-fold. Consistently, marRAB and acrAB-tolC genes, together with ABC transporter genes (e.g., yddA, yadG, yojI, and mdlA), were triggered to increase the efflux of disinfectants out of the cell, while ompF was inhibited, reducing disinfectant penetration into the cell. Additionally, the occurrence of DNA mutations in marR and acrR in the mutants was observed, potentially resulting in increased synthesis of the AcrAB-TolC pump. This study indicates that pharmaceutical exposure may create disinfectant-resistant bacteria, which may then be released into water systems, providing novel insights into the potential source of water-borne disinfectant-resistant pathogens.

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.

Biomedical waste plastic: bacteria, disinfection and recycling technologies-a comprehensive review

Plastic recycling reduces the wastage of potentially useful materials as well as the consumption of virgin materials, thereby lowering the energy consumption, air pollution by incineration, soil and water pollution by landfilling. Plastics used in the biomedical sector have played a significant role. Reducing the transmission of the virus while protecting the human life in particular the frontline workers. Enormous volumes of plastics in biomedical waste have been observed during the outbreak of the pandemic COVID-19. This has resulted from the extensive use of personal protective equipment such as masks, gloves, face shields, bottles, sanitizers, gowns, and other medical plastics which has created challenges to the existing waste management system in the developing countries. The current review focuses on the biomedical waste and its classification, disinfection, and recycling technology of different types of plastics waste generated in the sector and their corresponding approaches toward end-of-life option and value addition. This review provides a broader overview of the process to reduce the volume of plastics from biomedical waste directly entering the landfill while providing a knowledge step toward the conversion of "waste" to "wealth." An average of 25% of the recyclable plastics are present in biomedical waste. All the processes discussed in this article accounts for cleaner techniques and a sustainable approach to the treatment of biomedical waste.

Graphical abstract

Conversion of medical waste into value-added products using a novel integrated system with tail gas treatment: Process design, optimization, and thermodynamic analysis

The COVID-19 pandemic has generated substantial medical waste (MW), posing risks to society. Based on widespread MW incineration, this study proposes an integrated system with tail gas treatment to convert MW into value-added products with nearly zero emissions. Herein, steam generators and supercritical CO₂ cycles were used to recover energy from MW to produce high-temperature/pressure steam and electricity. A simple power generation cycle achieved a net electricity efficiency of 22.4% through optimization. Thermodynamic analysis revealed that the most energy and exergy loss occurred in incineration. Furthermore, a pressurized reactive distillation column purified the resultant tail gas. The effects of inlet temperature, pressure, liquid/gas ratio, and recycle ratio on the removal and conversion efficiencies of NO₂ and SO₂ were evaluated. Nearly 100% of the SO₂ and 75% of the NO₂ generated by the incineration of MW have been converted into their acid forms. Based on the proposed tail gas treatment unit, high-purity CO₂ (∼98% purity) was finally obtained.

The implementation of green supply chain management (GSCM) and environmental management system (EMS) practices and its impact on market competitiveness during COVID-19

Despite great academic interest in global green supply chain management (GSCM) practices, its effectiveness for environmental management systems (EMS) and market competitiveness during COVID-19 remains untapped. Existing literature suggests that a fundamental link between GSCM, EMS, and market competitiveness is missing, as supply management is critical to maintain market competitiveness. To fill this gap in the literature, this study examines whether environmental management systems influence the link between GSCM practice and market competitiveness in China. We also propose the articulating role of big data analytics and artificial intelligence (BDA-AI) and environmental visibility toward these associations in the context of the COVID-19 pandemic. We evaluated the proposed model using regression-based structural equation modeling (SEM) with primary data (n = 330). This result provides empirical evidence of the impact of GSCM on EMS and market competitiveness. Moreover, the results show that the BDA-AI and the environmental visibility enhanced the positive relationship between GSCM-EMS and EMS and market competitiveness in China. Recent research shows that supply chain professionals, policymakers, managers, and researchers are turning to formal EMS, BDA-AI, and environmental visibility to help their organizations achieve the competitiveness that the market indicates they need.

Selection of healthcare waste management treatment using fuzzy rough numbers and Aczel-Alsina Function

The COVID-19 pandemic led to an increase in healthcare waste (HCW). HCW management treatment needs to be re-taken into focus to deal with this challenge. In practice, there are several treatments of HCW with their advantages and disadvantages. This study is conducted to select the appropriate treatment for HCW in the Brčko District of Bosnia and Herzegovina. Six HCW management treatments are analyzed and observed through twelve criteria. Ten-level linguistic values were used to bring this evaluation closer to human thinking. A fuzzy rough approach is used to solve the problem of inaccuracy in determining these values. The OPA method from the Bonferroni operator is used to determine the weights of the criteria. The results of the application of this method showed that the criterion Environmental Impact ( C 4 ) received the highest weight, while the criterion Automation Level ( C 8 ) received the lowest value. The ranking of HCW management treatments was performed using MARCOS methods based on the Aczel-Alsina function. The results of this analysis showed that the best-ranked HCW management treatment is microwave (A6) while landfill treatment (A5) is ranked worst. This study has provided a new approach based on fuzzy rough numbers where the Bonferroni function is used to determine the lower and upper limits, while the application of the Aczel-Alsina function reduced the influence of decision-makers on the final decision because this function stabilizes the decision-making process.

Healthcare waste in Bangladesh: Current status, the impact of Covid-19 and sustainable management with life cycle and circular economy framework

COVID-19 has accelerated the generation of healthcare (medical) waste throughout the world. Developing countries are the most affected by this hazardous and toxic medical waste due to poor management systems. In recent years, Bangladesh has experienced increasing medical waste generation with estimated growth of 3 % per year. The existing healthcare waste management in Bangladesh is far behind the sustainable waste management concept. To achieve an effective waste management structure, Bangladesh has to implement life cycle assessment (LCA) and circular economy (CE) concepts in this area. However, inadequate data and insufficient research in this field are the primary barriers to the establishment of an efficient medical waste management systen in Bangladesh. This study is introduced as a guidebook containing a comprehensive overview of the medical waste generation scenario, management techniques, Covid-19 impact from treatment to testing and vaccination, and the circular economy concept for sustainable waste management in Bangladesh. The estimated generation of medical waste in Bangladesh without considering the surge due to Covid-19 and other unusual medical emergencies would be approximately 50,000 tons (1.25 kg/bed/day) in 2025, out of which 12,435 tons were predicted to be hazardous waste. However, our calculation estimated that a total of 82,553, 168.4, and 2300 tons of medical waste was generated only from handling of Covid patients, test kits, and vaccination from March 2021 to May 2022. Applicability of existing guidelines, and legislation to handle the current situation and feasibility of LCA on medical waste management system to minimize environmental impact were scrutinized. Incineration with energy recovery and microwave sterilization were found to be the best treatment techniques with minimal environmental impact. A circular economy model with the concept of waste minimizaton, and value recovery was proposed for sustainable medical waste management. This study suggests proper training on healthcare waste management, proposing strict regulations, structured research allocation, and implementation of public-private partnerships to reduce, and control medical waste generation for creating a sustainable medical waste management system in Bangladesh.

Implication of nanotechnology to reduce the environmental risks of waste associated with the COVID-19 pandemic

The COVID-19 pandemic is the largest global public health outbreak in the 21^st century so far. It has contributed to a significant increase in the generation of waste, particularly personal protective equipment and hazardous medical, as it can contribute to environmental pollution and expose individuals to various hazards. To minimize the risk of infection, the entire surrounding environment should be disinfected or neutralized regularly. Effective medical waste management can add value by reducing the spread of COVID-19 and increasing the recyclability of materials instead of sending them to landfill. Developing an antiviral coating for the surface of objects frequently used by the public could be a practical solution to prevent the spread of virus particles and the inactivation of virus transmission. Relying on an abundance of engineered materials identifiable by their useful physicochemical properties through versatile chemical functionalization, nanotechnology offers a number of approaches to address this emergency. Here, through a multidisciplinary perspective encompassing various fields such as virology, biology, medicine, engineering, chemistry, materials science, and computer science, we describe how nanotechnology-based strategies can support the fight against COVID-19 well as infectious diseases in general, including future pandemics. In this review, the design of the antiviral coating to combat the spread of COVID-19 was discussed, and technological attempts to minimize the coronavirus outbreak were highlighted.

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.

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.

The IoT-enabled sustainable reverse supply chain for COVID-19 Pandemic Wastes (CPW)

Supply chains have been impacted by the COVID-19 pandemic, which is the most recent worldwide disaster. After the world health organization recognized the latest phenomena as a pandemic, nations became incapacitated to provide the required medical supplies. In the current situation, the world seeks an essential solution for COVID-19 Pandemic Wastes (CPWs) by pushing the pandemic to a stable condition. In this study, the development of a supply chain network is contrived for CPWs utilizing optimization modeling tools. Also, an IoT platform is devised to enable the proposed model to retrieve real-time data from IoT devices and set them as the model's inputs. Moreover, sustainability aspects are appended to the proposed IoT-enabled model considering its triplet pillars as objective functions. A real case of Puebla city and 15 experiments are used to validate the model. Furthermore, a combination of metaheuristic algorithms utilized to solve the model and also seven evaluation indicators endorse the selection of efficient solution approaches. The evaluation indicators are appointed as the inputs of statistical and multicriteria decision-making hybridization to prioritize the algorithms. The result of the Entropy Weights method and Combined Compromise Solution approach confirms that MOGWO has better performance for the medium-sizes, case study and an overall view. Also, NSHHO outclasses the small-size and large-size experiments.

Post-pandemic micro/nanoplastic pollution: Toward a sustainable management

The global health crisis caused by the COVID-19 pandemic has resulted in massive plastic pollution from the use of personal protection equipment (PPE), with polypropylene (PP) being a major component. Owing to the weathering of exposed PPEs, such contamination causes microplastic (MP) and nanoplastic (NP) pollution and is extremely likely to act as a vector for the transportation of COVID-19 from one area to another. Thus, a post-pandemic scenario can forecast with certainty that a significant amount of plastic garbage combined with MP/NP formation has an adverse effect on the ecosystem. Therefore, updating traditional waste management practices, such as landfilling and incineration, is essential for making plastic waste management sustainable to avert this looming catastrophe. This study investigates the post-pandemic scenario of MP/NP pollution and provides an outlook on an integrated approach to the recycling of PP-based plastic wastes. The recovery of crude oil, solid char, hydrocarbon gases, and construction materials by approximately 75, 33, 55, and 2 %, respectively, could be achieved in an environmentally friendly and cost-effective manner. Furthermore, the development of biodegradable and self-sanitizing smart PPEs has been identified as a promising alternative for drastically reducing plastic pollution.

Resource recovery from discarded COVID-19 PPE kit through catalytic fast pyrolysis

During the COVID-19 pandemic, the world saw an exponential surge in the production of Personal Protective Equipment (PPE) kits, which eventually got discarded in the biomedical waste stream. In this study, thirteen different polymer samples from the PPE kit were collected and characterized using Fourier transform infrared spectrometer, thermogravimetric analysis, and analytical pyrolysis-gas chromatograph/mass spectrometry. The characterization data showed that about 94 % by mass of components were made of only three polymers, viz. polypropylene (PP, 75.6 wt %), polyethylene terephthalate (PET, 12.5 wt %), and polycarbonate (PC, 6 wt %). The analytical pyrolysis of the PPE coverall suit (PP) yielded mainly alkenes containing 2,4-dimethyl-1-heptene as the major compound with 17 wt % yield at 600 °C. The pyrolysates from face shield (PET) were rich in benzoic acid (5.8 wt %) and acetophenone (4.8 wt %), while those from safety goggles (PC) were rich in phenol (17.6 wt %) and p-cresol (12.4 wt %) at 600 °C. HZSM-5 and HY zeolites were used for the catalytic upgradation of pyrolysates especially from PP, PET and PC. The temperature and feed-to-catalyst ratio were optimized by performing catalytic fast pyrolysis experiments at 500 °C, 600 °C and 700 °C with different feed-to-catalyst ratios 1:2, 1:4, and 1:6 (w/w). The yield of aromatic hydrocarbons, viz., BTEX (benzene, toluene, ethylbenzene, xylenes) and naphthalene, was maximum (∼25.7 wt %) from PP coverall when HY catalyst was used at 600 °C and 1:6 (w/w) loading. In the case of PET face shield, the total yield of BTEX, naphthalene and biphenyl was maximum (27.9 wt %) at 600 °C and 1:4 (w/w) of HZSM-5, while in the case of PC goggles, it was maximum (18.6 wt %) at 700 °C and 1:4 (w/w) of HY. This study shows that the entire PPE kit can be valorized via catalytic fast pyrolysis to generate petrochemical products and platform molecules like monoaromatic hydrocarbons at high selectivities.

Laboratory investigation on added-value application of the COVID-19 disposable mask in hot mix asphalt (HMA)

The outbreak of the COVID-19 pandemic has stimulated the demand for disposable masks to an unprecedented level, which also poses a significant risk to the natural environment from the improper treatment or disposal of waste masks. To lower such an environmental risk and maximize the added value of the waste masks, this paper proposed to recycle the waste mask fiber (MF) in combination with the waste cooking oil (WCO) for hot mix asphalt (HMA) application. A series of MF + WCO modified asphalt binders were first designed and fabricated. Their performance properties were then systematically measured. The physical-rheological test results showed that the incorporation of MF can significantly improve the high-temperature rutting resistance performance of asphalt binder. However, it may also lower the asphalt's low-temperature anti-cracking performance. The addition of WCO was found to compensate for this low-temperature performance loss effectively, and the MF5% + WCO3% was identified as the best combination. The Fourier transform infrared (FTIR) spectroscopy test results revealed that the asphalt modified by the MF + WCO involved only a physical modification. The performance test results indicated that the high-temperature permanent deformation resistance and low-temperature anti-cracking of MF5% + WCO3% modified HMA was greatly enhanced, while its moisture stability was slightly reduced but still met the specification requirement. The environmental benefit assessments proved that recycling the waste masks for asphalt paving can provide an enormous added value to pavement engineering in terms of carbon emission reduction and land resource saving.

Strategies for safe management of hospital wastewater during the COVID-19 pandemic

Management of hospital wastewater is a challenging task, particularly during the situations like coronavirus 2019 (COVID-19) pandemic. The hospital effluent streams are likely to contain many known and unknown contaminants including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) along with a variety of pollutants arising from pharmaceuticals, life-style chemicals, drugs, radioactive species, and human excreta from the patients. The effluents are a mixed bag of contaminants with some of them capable of infecting through contact. Hence, it is essential to identify appropriate treatment strategies for hospital waste streams. In this work, various pollutants emerging in the context of COVID-19 are examined. A methodical review is conducted on the occurrence and disinfection methods of SARS-CoV-2 in wastewater. An emphasis is given to the necessity of addressing the challenges of handling hospital effluents dynamically involved during the pandemic scenario to ensure human and environmental safety. A comparative evaluation of disinfection strategies makes it evident that the non-contact methods like ultraviolet irradiation, hydrogen peroxide vapor, and preventive approaches such as the usage of antimicrobial surface coating offer promise in reducing the chance of disease transmission. These methods are also highly efficient in comparison with other strategies. Chemical disinfection strategies such as chlorination may lead to further disinfection byproducts, complicating the treatment processes. An overall analysis of various disinfection methods is presented here, including developing methods such as membrane technologies, highlighting the merits and demerits of each of these processes. Finally, the wastewater surveillance adopted during the COVID-19 outbreak is discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13762-023-04803-1.

Knowledge, Attitude and Practice of Personnel Involved in Bio Medical Waste Handling about COVID-19 & Its Bio-Medical Waste Management: A Descriptive Analysis

Background: The COVID-19 pandemic has led to an increased amount of biomedical waste, worsening the already strained biomedical waste management system in India. As biomedical waste handlers are the core of biomedical waste handling, their knowledge, attitude, and practices regarding sorting, segregation, transport, and storage of the waste are of prime concern. This study aims to evaluate the knowledge, attitude and practices of personnel involved in biomedical waste handling about COVID-19 and its biomedical waste management at All India Institute of Medical Sciences Mangalagiri. Design: Cross-sectional survey. Setting: AIIMS Mangalagiri and common bio-medical waste treatment facility at Guntur. Participants- Personnel involved in bio-medical waste handling Methodology: The study enrolled a total of 139 participants from December 2020 to January 2021. A convenient sampling technique was used and a questionnaire was administered by face-to-face interview. Results: The study showed that half of the participants had favorable knowledge about bio-medical waste management (average score 5.08 and range 1-9). Two-thirds of the respondents felt that handling COVID-19 waste is necessary to contain the infection. Conversely, the practices regarding COVID-19 and its biomedical waste management were not in conformity with attitudes and knowledge. Fewer participants knew the exact sequence of donning (15.80%) and doffing (31.70%). Majority of participants (72.7%) desired a hands-on training for handling biomedical waste. Conclusion: Participants have good knowledge and attitudes regarding COVID-19 bio-medical waste management, but are not adhering to it. This explains the need for comprehensive training programs for all those involved in bio-medical waste management of COVID-19.

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.

Energy-saving COVID-19 biomedical plastic waste treatment using the thermal - Catalytic pyrolysis

The rate of Biomedical waste generation increases exponentially during infectious diseases, such as the SARS-CoV-2 virus, which burst in December 2019 and spread worldwide in a very short time, causing over 6 M casualties worldwide till May 2022. As per the WHO guidelines, the facemask has been used by every person to prevent the infection of the SARS-CoV-2 virus and discarded as biomedical waste. In the present work, a 3-ply facemask was chosen to be treated using the solvent, which was extracted from the different types of waste plastics through the thermal-catalytic pyrolysis process using a novel catalyst. The facemask was dispersed in the solvent in a heating process, followed by dissolution and precipitation of the facemask in the solvent and by filtration of the solid facemask residue out of the solvent. The effect of peak temperature, heating rate, and type of solvent is observed experimentally, and it found that the facemask was dissolved completely with a clear supernate in the solvent extracted from the (polypropylene + poly-ethylene) plastic also saved energy, while the solvent from ABS plastic was not capable to dissolute the facemask. The potential of the presented approach on the global level is also examined.

Healthcare Waste-A Serious Problem for Global Health

Healthcare waste (HCW) is generated in different healthcare facilities (HCFs), such as hospitals, laboratories, veterinary clinics, research centres and nursing homes. It has been assessed that the majority of medical waste does not pose a risk to humans. It is estimated that 15% of the total amount of produced HCW is hazardous and can be infectious, toxic or radioactive. Hazardous waste is a special type of waste which, if not properly treated, can pose a risk to human health and to the environment. HCW contains potentially harmful microorganisms that can be spread among healthcare personnel, hospital patients and the general public, causing serious illnesses. Healthcare personnel are the specialists especially exposed to this risk. The most common medical procedure, which pose the highest risk, is injection (i.e, intramuscular, subcutaneous, intravenous, taking blood samples). The World Health Organization (WHO) estimates that around 16 billion injections are administered worldwide each year. However, if safety precautions are not followed, and needles and syringes are not properly disposed of, the risk of sharps injuries increases among medical staff, waste handlers and waste collectors. What is more, sharps injuries increase the risk of human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV/HCV), tuberculosis (TB), diphtheria, malaria, syphilis, brucellosis and other transmissions. Disposing of medical waste in a landfill without segregation and processing will result in the entry of harmful microorganisms, chemicals or pharmaceuticals into soil and groundwater, causing their contamination. Open burning or incinerator malfunctioning will result in the emission of toxic substances, such as dioxins and furans, into the air. In order to reduce the negative impact of medical waste, waste management principles should be formulated. To minimize health risks, it is also important to build awareness among health professionals and the general public through various communication and educational methods. The aim of this paper is to present a general overwiev of medical waste, its categories, the principles of its management and the risks to human health and the environment resulting from inappropriate waste management.

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.

A review on enhanced microplastics derived from biomedical waste during the COVID-19 pandemic with its toxicity, health risks, and biomarkers

The COVID-19 pandemic led to the explosion of biomedical waste, a global challenge to public health and the environment. Biomedical waste comprising plastic can convert into microplastics (MPs, < 5 mm) by sunlight, wave, oxidative and thermal processes, and biodegradation. MPs with additives and contaminants such as metals are also hazardous to many aquatic and terrestrial organisms, including humans. Bioaccumulation of MPs in organisms often transfers across the trophic level in the global food web. Thus, this article aims to provide a literature review on the source, quantity, and fate of biomedical waste, along with the recent surge of MPs and their adverse impact on aquatic and terrestrial organisms. MPs intake (ingestion, inhalation, and dermal contact) in humans causing various chronic diseases involving multiple organs in digestive, respiratory, and reproductive systems are surveyed, which have been reviewed barely. There is an urgent need to control and manage biomedical waste to shrink MPs pollution for reducing environmental and human health risks.

Environmental challenges of COVID-19 pandemic: resilience and sustainability - A review

The emergence of novel respiratory disease (COVID-19) caused by SARS-CoV-2 has become a public health emergency worldwide and perturbed the global economy and ecosystem services. Many studies have reported the presence of SARS-CoV-2 in different environmental compartments, its transmission via environmental routes, and potential environmental challenges posed by the COVID-19 pandemic. None of these studies have comprehensively reviewed the bidirectional relationship between the COVID-19 pandemic and the environment. For the first time, we explored the relationship between the environment and the SARS-CoV-2 virus/COVID-19 and how they affect each other. Supporting evidence presented here clearly demonstrates the presence of SARS-CoV-2 in soil and water, denoting the role of the environment in the COVID-19 transmission process. However, most studies fail to determine if the viral genomes they have discovered are infectious, which could be affected by the environmental factors in which they are found.The potential environmental impact of the pandemic, including water pollution, chemical contamination, increased generation of non-biodegradable waste, and single-use plastics have received the most attention. For the most part, efficient measures have been used to address the current environmental challenges from COVID-19, including using environmentally friendly disinfection technologies and employing measures to reduce the production of plastic wastes, such as the reuse and recycling of plastics. Developing sustainable solutions to counter the environmental challenges posed by the COVID-19 pandemic should be included in national preparedness strategies. In conclusion, combating the pandemic and accomplishing public health goals should be balanced with environmentally sustainable measures, as the two are closely intertwined.

Microbial strategies for degradation of microplastics generated from COVID-19 healthcare waste

COVID-19 pandemic has led to the generation of massive plastic wastes, comprising of onetime useable gloves, masks, tissues, and other personal protective equipment (PPE). Recommendations for the employ of single-use disposable masks made up of various polymeric materials like polyethylene, polyurethane, polyacrylonitrile, and polypropylene, polystyrene, can have significant aftermath on environmental, human as well as animal health. Improper disposal and handling of healthcare wastes and lack of proper management practices are creating serious health hazards and an extra challenge for the local authorities designated for management of solid waste. Most of the COVID-19 medical wastes generated are now being treated by incineration which generates microplastic particles (MPs), dioxin, furans, and various toxic metals, such as cadmium and lead. Moreover, natural degradation and mechanical abrasion of these wastes can lead to the generation of MPs which cause a serious health risk to living beings. It is a major threat to aquatic lives and gets into foods subsequently jeopardizing global food safety. Moreover, the presence of plastic is also considered a threat owing to the increased carbon emission and poses a profound danger to the global food chain. Degradation of MPs by axenic and mixed culture microorganisms, such as bacteria, fungi, microalgae etc. can be considered an eco-sustainable technique for the mitigation of the microplastic menace. This review primarily deals with the increase in microplastic pollution due to increased use of PPE along with different disinfection methods using chemicals, steam, microwave, autoclave, and incineration which are presently being employed for the treatment of COVID-19 pandemic-related wastes. The biological treatment of the MPs by diverse groups of fungi and bacteria can be an alternative option for the mitigation of microplastic wastes generated from COVID-19 healthcare waste.

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.

Collection and transportation system construction of potentially viral municipal solid waste during the COVID-19 pandemic in China

The transmission route of COVID-19 through municipal solid waste (MSW) has been confirmed and receives increasing attention. Potentially viral municipal solid waste (PVMSW) refers to the domestic waste generated by risky areas and epidemic-related populations under a major epidemic in their daily lives or in activities that provide services for their daily lives. For its potential infectivity, PVMSW should be properly collected and transported. This study aimed to standardize the collection and transportation of PVMSW and proposed specific construction schemes of PVMSW collection and transportation systems for three situations which were city-wide lockdown status, medium and high-risk area, and home quarantine separately. In the cases of city-wide lockdown status and home quarantine, PVMSW collection and transportation systems were constructed qualitatively with the examples of Wuhan and Shanghai respectively, and in the case of medium and high-risk area, the systems were constructed quantitatively through the development of a waste collection and transportation costs model. To reduce the risks of virus transmission during the collection and transportation process, the collection and transportation links should be minimized. For the disposal of PVMSW, medical waste treatment facilities and MSW incineration plants should be prioritized. Furthermore, the results showed that the total number of people and the transfer capacity of MSW transfer facility were the two main influencing factors for the selection of PVMSW collection and transportation systems in medium and high-risk area. This article could help manage MSW for preventing virus transmission during the COVID-19 pandemic or similar future epidemics.

The Impact of COVID-19 on the Sustainable Development Goals: Achievements and Expectations

The COVID-19 pandemic has had a significant impact on almost all the Sustainable Development Goals (SDGs), leaving no country unaffected. It has caused a shift in political agendas, but also in lines of research. At the same time, the world is trying to make the transition to a more sustainable economic model. The research objectives of this paper are to explore the impact of COVID-19 on the fulfilment of the SDGs with regard to the research of the scientific community, and to analyze the presence of the Circular Economy (CE) in the literature. To this end, this research applies bibliometric analysis and a systematic review of the literature, using VOSviewer for data visualization. Five clusters were detected and grouped according to the three dimensions of sustainability. The extent of the effects of the health, economic and social crisis resulting from the pandemic, in addition to the climate crisis, is still uncertain, but it seems clear that the main issues are inefficient waste management, supply chain issues, adaptation to online education and energy concerns. The CE has been part of the solution to this crisis, and it is seen as an ideal model to be promoted based on the opportunities detected.

Recent advances in sterilization and disinfection technology: A review

Sterilization and disinfection of pollutants and microorganisms have been extensively studied in order to address the problem of environmental contamination, which is a crucial issue for public health and economics. Various form of hazardous materials/pollutants including microorganisms and harmful gases are released into the environment that enter into the human body either through inhalation, adsorption or ingestion. The human death rate rises due to various respiratory ailments, strokes, lung cancer, and heart disorders related with these pollutants. Hence, it is essential to control the environmental pollution by applying economical and effective sterilization and disinfections techniques to save life. In general, numerous forms of traditional physical and chemical sterilization and disinfection treatments, such as dry and moist heat, radiation, filtration, ethylene oxide, ozone, hydrogen peroxide, etc. are known along with advanced techniques. In this review we summarized both advanced and conventional techniques of sterilization and disinfection along with their uses and mode of action. This review gives the knowledge about the advantages, disadvantages of both the methods comparatively. Despite, the effective solution given by the advanced sterilization and disinfection technology, joint technologies of sterilization and disinfection has proven to be more effective innovation to protect the indoor and outdoor environments.

Treatment of hospital wastewater by electron beam technology: Removal of COD, pathogenic bacteria and viruses

The effective treatment of hospital sewage is crucial to human health and eco-environment, especially during the pandemic of COVID-19. In this study, a demonstration project of actual hospital sewage using electron beam technology was established as advanced treatment process during the outbreak of COVID-19 pandemic in Hubei, China in July 2020. The results indicated that electron beam radiation could effectively remove COD, pathogenic bacteria and viruses in hospital sewage. The continuous monitoring date showed that the effluent COD concentration after electron beam treatment was stably below 30 mg/L, and the concentration of fecal Escherichia coli was below 50 MPN/L, when the absorbed dose was 4 kGy. Electron beam radiation was also an effective method for inactivating viruses. Compared to the inactivation of fecal Escherichia coli, higher absorbed dose was required for the inactivation of virus. Absorbed dose had different effect on the removal of virus. When the absorbed dose ranged from 30 to 50 kGy, Hepatitis A virus (HAV) and Astrovirus (ASV) could be completely removed by electron beam treatment. For Rotavirus (RV) and Enterovirus (EV) virus, the removal efficiency firstly increased and then decreased. The maximum removal efficiency of RV and EV was 98.90% and 88.49%, respectively. For the Norovirus (NVLII) virus, the maximum removal efficiency was 81.58%. This study firstly reported the performance of electron beam in the removal of COD, fecal Escherichia coli and virus in the actual hospital sewage, which would provide useful information for the application of electron beam technology in the treatment of hospital sewage.

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.

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

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

Assessment of knowledge, attitude and practice about biomedical waste management among healthcare staff of Fasa educational hospitals in COVID-19 pandemic

An efficient management of biomedical waste (BMW) is essential to maintaining health and preventing environmental threats during the COVID-19 pandemic. Thus, the present research aimed to explore the knowledge, attitude, and practice about BMW among the healthcare staff of Fasa educational hospitals. The present cross-sectional study used an online questionnaire survey to collect data from 251 employees in Valiasr and Shariati hospitals in 2021. T-test, ANOVA, and Pearson correlation coefficient were used to test the relationships between and among the variables. Demographic findings showed that the men and women participated to an almost equal rate. Most participants were young and had less than 5 years' work experience. Their mean scores of knowledge, attitude, and practice were 38.8±6.1, 83.0±8.8, and 47.5±14.5, respectively. These values point to a satisfactory level of each variable in relation to BMW management. Pearson's correlation coefficient test showed a strong positive association between knowledge and practice (r = 0.725). The T-test results showed a statistically significant relationship among knowledge, attitude, and practice across demographic variables. These included gender, ward (COVID vs. Non-COVID), and workplace (p < 0.05). ANOVA results showed statistically significant divergences in knowledge, attitude, and practice across the demographic variables, including education, position, and employment type (p < 0.05). Considering the current deficiencies among employees in terms of BMW acronyms, lack of waste training courses, and inappropriate waste plans for COVID-19 waste management, BMW training courses should be held continuously and regularly, and the content of the programs should be updated according to the emergencies.

Nanomaterials to combat SARS-CoV-2: Strategies to prevent, diagnose and treat COVID-19

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the associated coronavirus disease 2019 (COVID-19), which severely affect the respiratory system and several organs and tissues, and may lead to death, have shown how science can respond when challenged by a global emergency, offering as a response a myriad of rapid technological developments. Development of vaccines at lightning speed is one of them. SARS-CoV-2 outbreaks have stressed healthcare systems, questioning patients care by using standard non-adapted therapies and diagnostic tools. In this scenario, nanotechnology has offered new tools, techniques and opportunities for prevention, for rapid, accurate and sensitive diagnosis and treatment of COVID-19. In this review, we focus on the nanotechnological applications and nano-based materials (i.e., personal protective equipment) to combat SARS-CoV-2 transmission, infection, organ damage and for the development of new tools for virosurveillance, diagnose and immune protection by mRNA and other nano-based vaccines. All the nano-based developed tools have allowed a historical, unprecedented, real time epidemiological surveillance and diagnosis of SARS-CoV-2 infection, at community and international levels. The nano-based technology has help to predict and detect how this Sarbecovirus is mutating and the severity of the associated COVID-19 disease, thereby assisting the administration and public health services to make decisions and measures for preparedness against the emerging variants of SARS-CoV-2 and severe or lethal COVID-19.

Tracking the impacts of COVID-19 pandemic-related debris on wildlife using digital platforms

Since the start of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) pandemic in December 2019, there have been global surges of single-use plastic use. Due to the importance of personal protective equipment (PPE) and sanitation items in protecting against virus transmission and from testing, facemasks, respirators, disposable gloves and disposable wet wipes have become global staples in households and institutions. Widespread use and insufficient infrastructure, combined with improper waste management have resulted in an emerging category of litter. With widespread presence in the environment, such items pose a direct threat to wildlife as animals can interact with them in a series of ways. We examined the scope of COVID-19 pandemic-related debris, including PPE and sanitation items, on wildlife from April 2020 to December 2021. We document the geographic occurrence of incidents, debris types, and consequences of incidents that were obtained from social media searches, unpublished reports from colleagues, and reports available from the citizen science database "Birds and Debris". There were 114 unique sightings of wildlife interactions with pandemic-related debris (38 from 2020 and 76 from 2021). Within the context of this dataset, most incidents involved birds (83.3 %), while fewer affected mammals (10.5 %), invertebrates (3.5 %), fish (1.8 %), and sea turtles (0.9 %). Sightings originated in 23 countries, and consisted mostly of entanglements (42.1 %) and nest incorporations (40.4 %). We verified sightings by contacting the original observers and were able to identify replicated sightings and increase the resolution of the data collected compared with previously published results. Due to the complexities associated with global use and accessibility of digital platforms, we likely underestimate the number of animals harmed by debris. Overall, the global scope of this study demonstrates that online and social media platforms are a valuable way to collect biologically relevant citizen science data and track rapidly emerging environmental challenges.