Assessment of bio-medical waste before and during the emergency of novel Coronavirus disease pandemic in India: A gap analysis

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.

Generation, types and impacts of biomedical waste during COVID-19: Indian context

India's already-stressed waste disposal system has been strained by the COVID-19 outbreak. The challenge of managing biomedical Waste (BMW) in India has become more complicated in recent years, mainly due to the sudden emergence of COVID-19. As a methodology, a literature review was carried out with the help of Google Scholar, Research Gate, PubMed, and academic journal databases. Additionally, publications from numerous non-academic sources (such as news websites etc.) and current guidelines, such as those from the Ministry of Health and Family Welfare, Government of India, were also accessed. The review study identifies that PPE (Personal Protective Equipment) made up the majority of biomedical waste, followed by vaccine waste, during the peak of the COVID-19 vaccination campaign. The increase in PPEs such as face masks, aprons, face shields, gloves, goggles, and sanitizers, as well as other medical waste like bandages, plastic containers, syringes, testing kits, and tissues, has significantly changed the makeup of the BMW. This pandemic has hampered the proper management of solid waste, which has now surfaced as a major threat to developing countries. In this paper, biomedical waste management strategies followed in India and its disposal methods, cost-effective and environment-friendly methods to treat medical waste are also discussed.

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.

Personal protective equipment-derived pollution during Covid-19 era: A critical review of ecotoxicology impacts, intervention strategies, and future challenges

During the COVID-19 pandemic, people used personal protective equipment (PPE) to lessen the spread of the virus. The release of microplastics (MPs) from discarded PPE is a new threat to the long-term health of the environment and poses challenges that are not yet clear. PPE-derived MPs have been found in multi-environmental compartments, e.g., water, sediments, air, and soil across the Bay of Bengal (BoB). As COVID-19 spreads, healthcare facilities use more plastic PPE, polluting aquatic ecosystems. Excessive PPE use releases MPs into the ecosystem, which aquatic organisms ingest, distressing the food chain and possibly causing ongoing health problems in humans. Thus, post-COVID-19 sustainability depends on proper intervention strategies for PPE waste, which have received scholarly interest. Although many studies have investigated PPE-induced MPs pollution in the BoB countries (e.g., India, Bangladesh, Sri Lanka, and Myanmar), the ecotoxicity impacts, intervention strategies, and future challenges of PPE-derived waste have largely gone unnoticed. Our study presents a critical literature review covering the ecotoxicity impacts, intervention strategies, and future challenges across the BoB countries (e.g., India (162,034.45 tons), Bangladesh (67,996 tons), Sri Lanka (35,707.95 tons), and Myanmar (22,593.5 tons). The ecotoxicity impacts of PPE-derived MPs on human health and other environmental compartments are critically addressed. The review's findings infer a gap in the 5R (Reduce, Reuse, Recycle, Redesign, and Restructure) Strategy's implementation in the BoB coastal regions, hindering the achievement of UN SDG-12. Despite widespread research advancements in the BoB, many questions about PPE-derived MPs pollution from the perspective of the COVID-19 era still need to be answered. In response to the post-COVID-19 environmental remediation concerns, this study highlights the present research gaps and suggests new research directions considering the current MPs' research advancements on COVID-related PPE waste. Finally, the review suggests a framework for proper intervention strategies for reducing and monitoring PPE-derived MPs pollution in the BoB countries.

Spatial shifting of COVID-19 clusters and disease association with environmental parameters in India: A time series analysis

BACKGROUND

The viability and virulence of COVID-19 are complex in nature. Although the relationship between environmental parameters and COVID-19 is well studied across the globe, in India, such studies are limited. This research aims to explore long-term exposure to weather conditions and the role of air pollution on the infection spread and mortality due to COVID-19 in India.

METHOD

District-level COVID-19 data from April 26, 2020 to July 10, 2021 was used for the study. Environmental determinants such as land surface temperature, relative humidity (RH), Sulphur dioxide (SO₂), Nitrogen dioxide (NO₂), Ozone (O₃), and Aerosol Optical Depth (AOD) were considered for analysis. The bivariate spatial association was used to explore the spatial relationship between Case Fatality Rate (CFR) and these environmental factors. Further, the Bayesian multivariate linear regression model was applied to observe the association between environmental factors and the CFR of COVID-19.

RESULTS

Spatial shifting of COVID-19 cases from Western to Southern and then Eastern parts of India were well observed. The infection rate was highly concentrated in most of the Western and Southern regions of India, while the CFR shows more concentration in Northern India along with Maharashtra. Four main spatial clusters of infection were recognized during the study period. The time-series analysis indicates significantly more CFR with higher AOD, O₃, and NO₂ in India.

CONCLUSIONS

COVID-19 is highly associated with environmental parameters and air pollution in India. The study provides evidence to warrant consideration of environmental parameters in health models to mediate potential solutions. Cleaner air is a must to mitigate COVID-19.

Capacity assessment to secure COVID-19 waste treatment in Vietnam

The accelerated generation of COVID-19 waste under the Delta-fuelled outbreak placed a sudden burden on waste disposal in Vietnam. To secure the treatment of COVID-19 waste amid the pandemic uncertainty, treatment capacity was assessed by determining treatment occupancy rate-the ratio of estimated demand to calculated capacity-both nationally and in Ho Chi Minh City. At the general occupancy rate for COVID-19 waste treatment of 7.4%, the country was capable of handling COVID-19 waste, with a capacity to treat 62 191 t month^-1. However, Ho Chi Minh City became overwhelmed, indicated by a treatment occupancy rate of up to 780% during the Delta outbreak, as the unanticipated growth of demand for COVID-19 waste treatment caused waste to back up. The assessment results, in addition to current legislation, support collaboration in waste treatment as a solution to using existing resources to address the acute shortage of treatment capacity, so as to secure COVID-19 waste treatment. The findings could be used by other developing countries to tackle the waste problem in the pandemic era.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10163-022-01529-z.

Challenges and measures during management of mounting biomedical waste in COVID-19 pandemic: an Indian approach

Background

During coronavirus pandemic, an unpredictable pile of biomedical waste (BMW) gathers at the top. India produces 710 tonnes of biomedical waste daily. The contribution of COVID-19 related biomedical waste was 126 tonnes per day in first wave of the pandemic. BMW's rapid growth is putting a strain on current waste management facilities, especially in developing countries. A sudden boost in biomedical waste needs rapid and proper segregation and disposal methods to avoid future consequences.

Main body of the abstract

From literatures and statistical data available on Central Pollution Control Board (CPCB) it shows that India lags behind in large-scale sorting, collection, careful storage, transfer and disposal of bio waste. India has its own guidelines set by the CPCB to ensure the safe disposal of biomedical waste during diagnosis, treatment and quarantine of COVID-19 patients. Although there are strict guidelines for bio-waste management, many hospitals in the process of implementing them often dispose of waste in inappropriate, chaotic and indiscriminate ways due to negligence or laziness. Often, due to poor separation practices, hospital waste is mixed with general waste, resulting in harmful overall waste flow. Waste disposal handlers are not safe due to their exposure to various health risks and inadequate training in waste management. The present review sheds light on guidelines, measures, and challenges related to biomedical waste management.

Short conclusion

Improper waste separation leads to improper waste disposal. Waste generation and management issues are causing daily problems as they have a profound impact on the dramatically changing global environment, including air, water and soil pollution. In addition, BMW's daily production and its processing are inversely proportional. This situation suggests that India will soon be drowning in its own garbage. The focus of this review is on the generation and disposal of biomedical waste. Based on a review of the literature, this evaluation provides a comparative picture of the current status of waste generation, national waste management strategies, and some measures to contribute to waste management and avoid future disasters.

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

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

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

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