Resolving complexities in healthcare waste management: a goal programming approach

Multi-purpose reverse logistics network design for medical waste management in a megacity: Istanbul, Turkey

In the study, a multi-purpose reverse logistics network has been designed to create effectual management of medical waste (MW) generated in 39 districts of Istanbul, a heavily populated city, during the COVID-19 pandemic as well as that to be generated in the next decade. With the model, the medical waste management system in Istanbul is analyzed during the pandemic and for the next 10 years. The model attempts to integrate economic, environmental, and social objectives within the sustainable development goals. It aims to maximize the number of personnel and government earnings for the estimated MW of a megacity while minimizing the total fixed cost and the cost of carbon emissions and transportation. The results indicated that the existing facilities are sufficient for the treatment and disposal of MW generated even under pandemic conditions. However, the capacity of the sterilization facility could be insufficient to treat the estimated amount of MW in the next decade. Opening a sterilization facility near the sanitary landfill in Komurcuoda with a total management cost of 62,450,332 €/year would be an optimum solution for Istanbul MW. In comparison to the single-purpose model results, the multi-purpose model resulted in approximately 42,000 € more in total cost. Sensitivity analyses show that the amount of MW has the most significant effect on the total cost. This simple model created an effective MW management proposal for Istanbul, which can be a model for megacities.

Reverse logistics research of municipal hazardous waste: a literature review

The reverse logistics of municipal hazardous waste (RLMHW) have received close attention from researchers and practitioners alike, given the essential impact of safe transportation and effective management of hazardous waste on public health and environmental sustainability. There are a great number of studies in the extant literature on RLMHW, with many and diverse research topics; however, a concise and complete overview of the research works already conducted in this particular area is conspicuous by its absence. This paper strives to fill the gap through the conduct of rigorous systematic literature review of RLMHW in the past three decades, and then establish a framework of studies on RLMHW. The main contributions of this study are as follows: (1) to identify the trend of journals publishing research papers on RLMHW; (2) to extract the main topics in studies on RLMHW; (3) to locate the most popular research areas of RLMHW; (4) to summarize the methods adopted in studies on RLMHW; (5) to identify research deficiencies in certain categories of RLMHW; and (6) to establish the future research directions of RLMHW. The main implications of the study are to offer a better understanding of RLMHW by systematic crystallization of archival data in a systematic chronological order across central issues. This study contributes to scholarly debate in this field by serving as a snapshot paper to document the development of the field and gives input to policymakers in process design and policy making in the domain of RLMHW.

Medical Waste Treatment Technologies for Energy, Fuels, and Materials Production: A Review

The importance of medical waste management has grown during the COVID-19 pandemic because of the increase in medical waste quantity and the significant dangers of these highly infected wastes for human health and the environment. This innovative review focuses on the possibility of materials, gas/liquid/solid fuels, thermal energy, and electric power production from medical waste fractions. Appropriate and promising treatment/disposal technologies, such as (i) acid hydrolysis, (ii) acid/enzymatic hydrolysis, (iii) anaerobic digestion, (vi) autoclaving, (v) enzymatic oxidation, (vi) hydrothermal carbonization/treatment, (vii) incineration/steam heat recovery system, (viii) pyrolysis/Rankine cycle, (ix) rotary kiln treatment, (x) microwave/steam sterilization, (xi) plasma gasification/melting, (xii) sulfonation, (xiii) batch reactor thermal cracking, and (xiv) torrefaction, were investigated. The medical waste generation data were collected according to numerous researchers from various countries, and divided into gross medical waste and hazardous medical waste. Moreover, the medical wastes were separated into categories and types according to the international literature and the medical waste fractions’ percentages were estimated. The capability of the examined medical waste treatment technologies to produce energy, fuels, and materials, and eliminate the medical waste management problem, was very promising with regard to the near future.

An optimization model for collection, haul, transfer, treatment and disposal of infectious medical waste: Application to a Greek region

The objective of this work was to develop an optimization model to minimize the cost of a collection, haul, transfer, treatment and disposal system for infectious medical waste (IMW). The model calculates the optimum locations of the treatment facilities and transfer stations, their design capacities (t/d), the number and capacities of all waste collection, transport and transfer vehicles and their optimum transport path and the minimum IMW management system cost. Waste production nodes (hospitals, healthcare centers, peripheral health offices, private clinics and physicians in private practice) and their IMW production rates were specified and used as model inputs. The candidate locations of the treatment facilities, transfer stations and sanitary landfills were designated, using a GIS-based methodology. Specifically, Mapinfo software with exclusion criteria for non-appropriate areas was used for siting candidate locations for the construction of the treatment plant and calculating the distance and travel time of all possible vehicle routes. The objective function was a non-linear equation, which minimized the total collection, transport, treatment and disposal cost. Total cost comprised capital and operation costs for: (1) treatment plant, (2) waste transfer stations, (3) waste transport and transfer vehicles and (4) waste collection bins and hospital boxes. Binary variables were used to decide whether a treatment plant and/or a transfer station should be constructed and whether a collection route between two or more nodes should be followed. Microsoft excel software was used as installation platform of the optimization model. For the execution of the optimization routine, two completely different software were used and the results were compared, thus, resulting in higher reliability and validity of the results. The first software was Evolver, which is based on the use of genetic algorithms. The second one was Crystal Ball, which is based on Monte Carlo simulation. The model was applied to the Region of East Macedonia - Thrace in Greece. The optimum solution resulted in one treatment plant located in the sanitary landfill area of Chrysoupolis, required no transfer stations and had a total management cost of 38,800 €/month or 809 €/t. If a treatment plant is sited in the most eastern part of the Region, i.e., the industrial area of Alexandroupolis, the optimum solution would result in a transfer station of 23 m³, located near Kavala General Hospital, and a total cost of 39,800 €/month or 831 €/t. A sensitivity analysis was conducted and two alternative scenarios were optimized. In the first scenario, a 15% rise in fuel cost and in the second scenario a 25% rise in IMW production were considered. At the end, a cost calculation in €/t/km for every type of vehicle used for haul and transfer was conducted. Also, the cost of the whole system was itemized and calculated in €/t/km and €/t. The results showed that the higher percentage of the total cost was due to the construction of the treatment plant.

Multi-criteria decision making to support waste management: A critical review of current practices and methods

Solid waste management is a complex domain involving the interaction of several dimensions; thus, its analysis and control impose continuous challenges for decision makers. In this context, multi-criteria decision-making models have become important and convenient supporting tools for solid waste management because they can handle problems involving multiple dimensions and conflicting criteria. However, the selection of the multi-criteria decision-making method is a hard task since there are several multi-criteria decision-making approaches, each one with a large number of variants whose applicability depends on information availability and the aim of the study. Therefore, to support researchers and decision makers, the objectives of this article are to present a literature review of multi-criteria decision-making applications used in solid waste management, offer a critical assessment of the current practices, and provide suggestions for future works. A brief review of fundamental concepts on this topic is first provided, followed by the analysis of 260 articles related to the application of multi-criteria decision making in solid waste management. These studies were investigated in terms of the methodology, including specific steps such as normalisation, weighting, and sensitivity analysis. In addition, information related to waste type, the study objective, and aspects considered was recorded. From the articles analysed it is noted that studies using multi-criteria decision making in solid waste management are predominantly addressed to problems related to municipal solid waste involving facility location or management strategy.

Radial-interval linear programming for environmental management under varied protection levels

In this study, a radial-interval linear programming (RILP) approach was developed for supporting waste management under uncertainty. RILP improved interval-parameter linear programming and its extensions in terms of input reasonableness and output robustness. From the perspective of modeling inputs, RILP could tackle highly uncertain information at the bounds of interval parameters through introducing the concept of fluctuation radius. Regarding modeling outputs, RILP allows controlling the degree of conservatism associated with interval solutions and is capable of quantifying corresponding system risks and benefits. This could facilitate the reflection of interactive relationship between the feasibility of system and the uncertainty of parameters. A computationally tractable algorithm was provided to solve RILP. Then, a long-term waste management case was studied to demonstrate the applicability of the developed methodology. A series of interval solutions obtained under varied protection levels were compared, helping gain insights into the interactions among protection level, violation risk, and system cost. Potential waste allocation alternatives could be generated from these interval solutions, which would be screened in real-world practices according to various projected system conditions as well as decision-makers' willingness to pay and risk tolerance levels. Sensitivity analysis further revealed the significant impact of fluctuation radii of interval parameters on the system. The results indicated that RILP is applicable to a wide spectrum of environmental management problems that are subject to compound uncertainties.

Assessment of dental waste management in a Nigerian tertiary hospital

This study assessed the practice of disposing of waste from the eight dental clinics of Obafemi Awolowo University Teaching Complex, Ile-Ife, Nigeria. All the cleaners (14) in the hospitals were surveyed through questionnaire. Information obtained from the cleaners included socio-economic characteristics (biodata), personal protection, facilities available for them to work with and job satisfaction. Two soil samples were obtained from the open dump site (0.15 and 0.30 m depth) and two water samples were also collected (at 0.00 and 50.00 m) within the vicinity of the dump site. Both the soil and water samples were taken to the central science laboratory for chemical analyses. Ten (71.4%) of the 14 cleaners were not satisfied with their job. The laboratory findings suggested a very high content of lead, chromium, mercury, cadmium and manganese in both soil and water samples in comparison with the Nigerian Federal Environmental Protection Agency standards. The study concludes that the use of tooth-coloured restorative materials and digital X-ray facility to serve as alternatives to the generation of these wastes is recommended and that farming activities should not be allowed in the area until an audit of the soil and water have been performed.