Analysis of medical waste management and impact analysis of COVID-19 on its generation in Taiwan

Unraveling charge transfer dynamics in AgBr/Bi4Ti3O12/Bi2Sn2O7 ternary S-scheme heterojunction photocatalyst

In this study, AgBr/Bi4Ti3O12/Bi2Sn2O7 (ABr/BTO/BSO) composites were successfully synthesized to facilitate multi-channel fast charge transfer. This directs the charge carriers to travel along multichannel pathways and suppresses carrier recombination. The mechanisms underlying charge transfer in the dual S-scheme heterojunction composites were elucidated using density functional theory (DFT) and in situ irradiated X-ray photoelectron spectroscopy (ISI-XPS). Furthermore, electron spin resonance (ESR) and burst experiments verified h+, ·O2 -, and ·OH as the primary active species in the catalytic process. The ABr/BTO/BSO composites demonstrated exceptional photocatalytic redox capabilities, completely degrading rhodamine B (RhB) and achieving degradation rates of 77.21% for tetracycline (TC) and 81.04% for Cr (VI). Both experimental and theoretical analyses confirmed the intrinsic efficacy of photo-induced electron movement within the composites. This research introduces innovative design concepts and strategies for the advanced exploration of electron channel transfer in ABr/BTO/BSO ternary composites and the development of novel composite photocatalytic systems.

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.

Knowledge, perceptions and practices on healthcare waste management and associated occupational health hazards among healthcare professionals in the Colombo District, Sri Lanka: a cross-sectional study

Background

Proper Healthcare Waste (HW) management is directly influenced by the knowledge and attitudes of Healthcare Professionals (HCP). However, studies that characterize the knowledge and practices of HCP on HW management are limited in Sri Lanka. This study was conducted to characterize the knowledge, perceptions and practices of HCP on the management of HW and to determine the risk factors influencing HW related occupational health hazards in the Colombo District of Sri Lanka.

Methods

A total of 407 HCP were recruited as the study population from selected hospitals in the Colombo District. Information on socio-demographic factors, knowledge, attitudes and practices on HW management were gathered using an interviewer-administrated questionnaire. The Binary Logistic Regression (BLR) was used to determine the socio-economic risk factors associated with the occurrence of HW related health issues among the respondents.

Results

The majority of respondents were characterized with a high knowledge level (76.9%) and positive attitudes (53.8%) on HW management. Incineration (82.6%) was recognized as the most widely used HW treatment method. Personal Protective Equipment (PPE) was used at a satisfactory level (85.5%), while liquid waste treatment was limited (57.5%). The occupational designation, level of training received in HW management, professional experience, vaccination status for tetanus, degree of knowledge and attitudes on HW management were recognized as significant risk factors (p < 0.05) associated with the occurrence of HW related occupational hazards.

Conclusion

Even though, the treatment of HW was satisfactory, strengthening the existing mechanisms for monitoring of HW management, provisioning more resources and organizing training and awareness programmes on HW management for HCP are recommended.

Pharmaceutical waste management system - Are the current techniques sustainable, eco-friendly and circular? A review

Most households and healthcare facilities usually dispose of contaminated, unused, or expired (CUE) medicines with municipal wastes, the disposal of which usually amounts to $790/ton in the USA and £450/ton in the UK. Solid (e.g., tablets, capsules, powders) and semi-solid (e.g., ointment, creams) pharmaceuticals are managed with incineration/pyrolysis, encapsulation, and engineered landfills, whereas wastewater treatment plants (WWTPs) are recommended for liquid pharmaceutical wastes (PWs). However, to date, the sustainability and eco-friendliness profile of these techniques are only subjectively ensured, leading to controversial viewpoints in many guidelines. Each technique has relative strengths and weaknesses, and their comparative weighting to maximize these profiles is sought after. The present comprehensive review aims to fulfil knowledge gaps in this regard. Four electronic databases (e.g., PubMed/MEDLINE, Scopus, and ScienceDirect) were searched for PW management (PWM)-related qualitative and quantitative articles published till December 31, 2022. Articles without details of waste disposal techniques and their health and environmental impacts were excluded. Based on the literature review, we determine that incineration can be considered a sustainable option for solid and semi-solid PWs, and WWTPs can be eco-friendly for liquid PWs, whereas encapsulation and landfilling are less sustainable. It is high time that objectively proven sustainable and eco-friendly techniques be implemented for PWM based on their dosage forms or nature of hazards. Medicine take-back, eco-pharmacovigilance, extended producer responsibility, co-payment, and life cycle analysis of pharmaceuticals focusing on reduction, reuse/re-dispensing can be integrated to make existing models sustainable, circular, and eco-friendly.

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.

MoSe2-modified ZIF-8 novel nanocomposite for photocatalytic remediation of textile dye and antibiotic-contaminated wastewater

COVID-19-led antibiotic waste generated from hospitals and health centres may cause serious health issues and significantly impact the environment. In the coming decades, antibiotic resistance will be one of the most significant threats to global human health. Photocatalytic water remediation is an effective and promising environmental solution that can be utilized to address this issue, to convert antibiotic waste into non-toxic products by utilizing renewable and abundant solar energy. In the present study, a novel nanocomposite of zeolitic imidazolate frameworks (ZIF-8) and molybdenum diselenide (MoSe₂) was efficiently synthesized by the solvothermal method for the complete degradation of the antibiotics and textile waste from water. The morphology, crystallinity and band gap of the samples were characterized by field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD) and UV-visible spectroscopy. Fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) provide the binding information of the sample. The photocatalytic activity was tested for degradation of the antibiotics (tetracycline hydrochloride (TC) and metronidazole (MNZ)) used in COVID-19 treatment and textile dye (malachite green). Time-resolved photoluminescence spectroscopy confirmed the enhanced charge separation in the MoSe₂@ZIF-8 nanocomposite with an average lifetime of 4.72 ns as compared to pristine samples. The nanocomposite showed ~ 100% removal efficiency with rate constants of 63 × 10^-3, 49 × 10^-3 and 42 × 10^-3 min^-1 for TC, MNZ and malachite green, respectively. The photocatalytic degradation of TC was carried out under different pH conditions (4, 7 and 9), and the degradation mechanism was explained on the basis of zeta potential measurements and active species trapping experiment. The by-products of the photocatalytic treatment of TC antibiotics were tested using liquid chromatography-mass spectroscopy (LC-MS), and they were found to be non-toxic for aquatic and human life. The regeneration property of the nanocomposite was confirmed by FESEM with regeneration efficiency of 88.7% in the 4th cycle. Thus, MoSe₂@ZIF-8-based photocatalysts have potential application in water remediation, especially in making the antibiotic waste less toxic.

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.

Viable medical waste chain network design by considering risk and robustness

Medical waste management (MWM) is an important and necessary problem in the COVID-19 situation for treatment staff. When the number of infectious patients grows up, the amount of MWMs increases day by day. We present medical waste chain network design (MWCND) that contains health center (HC), waste segregation (WS), waste purchase contractor (WPC), and landfill. We propose to locate WS to decrease waste and recover them and send them to the WPC. Recovering medical waste like metal and plastic can help the environment and return to the production cycle. Therefore, we proposed a novel viable MWCND by a novel two-stage robust stochastic programming that considers resiliency (flexibility and network complexity) and sustainable (energy and environment) requirements. Therefore, we try to consider risks by conditional value at risk (CVaR) and improve robustness and agility to demand fluctuation and network. We utilize and solve it by GAMS CPLEX solver. The results show that by increasing the conservative coefficient, the confidence level of CVaR and waste recovery coefficient increases cost function and population risk. Moreover, increasing demand and scale of the problem makes to increase the cost function.

A Review of the Impact That Healthcare Risk Waste Treatment Technologies Have on the Environment

Health-Care Risk Waste (HCRW) treatment protects the environment and lives. HCRW is waste from patient diagnostics, immunization, surgery, and therapy. HCRW must be treated before disposal since it pollutes, spreads illnesses, and causes harm. However, waste treatment increases the healthcare sector's carbon footprint, making the healthcare sector a major contributor to anthropogenic climate change. This is because treating HCRW pollutes the environment and requires a lot of energy. Treating HCRW is crucial, but its risks are not well-studied. Unintentionally, treating HCRW leads to climate change. Due to frequent climate-related disasters, present climate-change mitigation strategies are insufficient. All sectors, including healthcare, must act to mitigate and prevent future harms. Healthcare can reduce its carbon footprint to help the environment. All contributing elements must be investigated because healthcare facilities contribute to climate change. We start by evaluating the environmental impact of different HCRW treatment technologies and suggesting strategies to make treatments more sustainable, cost-effective, and reliable to lower the carbon footprint.

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

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

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.

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

Considering the widespread transmission of Coronavirus disease (COVID-19) globally, India is also facing the same crisis. As India already has inadequate waste treatment facilities, and the sudden outbreak of the COVID-19 virus has led to significant growth of Bio-medical waste (BMW), consequently safe disposal of a large quantity of waste has become a more serious concern. This study provides a comprehensive assessment of BMW of India before and during the COVID-19 pandemic. Additionally, this article highlights the gaps in the implementation of BMW rules in India. This study uses various government and non-government organizations, reports and data specifically from the Central Pollution Control Board (CPCB). The finding of the study demonstrated that most of the States/Union Territories (UTs) of India are lacking in terms of COVID-19 waste management. India has generated over 32,996 mt of COVID-19 waste between June and December 2020. During this period, Maharashtra (789.99 mt/month) is highest average generator of COVID-19 waste, followed by Kerala (459.86 mt/month), Gujarat (434.87 mt/month), Tamil Nadu (427.23 mt/month), Uttar Pradesh (371.39 mt/month), Delhi (358.83 mt/month) and West Bengal (303.15 mt/month), and others respectively. We draw attention to the fact that many gaps were identified with compliance of BMW management rules. For example, out of all 35 States/UTs, health care facilitates (HCFs), only eight states received authorization as per BMW management rules. Moreover, the government strictly restricted the practice of deep burials; however, 23 States/UTs are still using the deep burial methods for BMW disposal. The present research suggests that those States/UTs generated on an average of 100 mt/month COVID-19 waste in the last 7 months (June-December 2020) should be considered as a high priority state. These states need special attention to implement BMW rules and should upgrade their BMW treatment capacity.

Location-aware hazardous litter management for smart emergency governance in urban eco-cyber-physical systems

Smart city management is facing a new challenge from littered face masks during COVID-19 pandemic. Addressing the issues of detection and collection of this hazardous waste that is littered in public spaces and outside the controlled environments, usually associated with biomedical waste, is urgent for the safety of the communities around the world. Manual management of this waste is beyond the capabilities of governments worldwide as the geospatial scale of littering is very high and also because this contaminated litter is a health and safety issue for the waste collectors. In this paper, an autonomous biomedical waste management framework that uses edge surveillance and location intelligence for detection of the littered face masks and predictive modelling for emergency response to this problem is proposed. In this research a novel dataset of littered face masks in various conditions and environments is collected. Then, a new deep neural network architecture for rapid detection of discarded face masks on the video surveillance edge nodes is proposed. Furthermore, a location intelligence model for prediction of the areas with higher probability of hazardous litter in the smart city is presented. Experimental results show that the accuracy of the proposed model for detection of littered face masks in various environments is 96%, while the speed of processing is ten times faster than comparable models. The proposed framework can help authorities to plan for timely emergency response to scattering of hazardous material in residential environments.

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.

Estimation of COVID-19 waste generation and composition in Vietnam for pandemic management

Despite its initial success in COVID-19 pandemic control, Vietnam faces a growing risk of outbreaks as new infection waves driven by the highly contagious Delta variant surge in the region. In the context of preparedness through waste management, this study estimated the rate and quantity of generation and the composition of COVID-19 waste in Vietnam from the supply of resources and equipment. Over a year under COVID, 1486 t of COVID-19 waste was produced from the treatment of isolated COVID-19 patients (4.64 kg bed^-1 day^-1), quarantine in medical facilities (3.86 kg bed^-1 day^-1), centralised quarantine (46.43 g bed^-1 day^-1), testing (50 g test^-1) and vaccination (10.46 g shot^-1). Plastic dominated the waste at 76.7%, followed by paper. The additional management of waste from households with persons under quarantine is likely to reduce infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - contaminated waste. Thorough assessment is recommended for the establishment of regional collaboration to secure COVID-19 waste treatment capacity. These findings will support COVID-19 waste planning in Vietnam in association with pandemic scenarios and could be used as a reference by other developing countries for pandemic control.

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

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

Municipal solid waste management during COVID-19 pandemic: effects and repercussions

The COVID-19 pandemic has an adverse effect on the environment. This epidemic's effect on the waste composition and management and the impacts of municipal solid waste management (MSWM) on disease transmission or controlling are considered a compelling experience of living in the COVID-19 pandemic that can effectively control the process. This systematic review research was conducted to determine the effects of COVID-19 on the quantity of waste and MSWM. Searches were conducted in three databases (using keywords covid 19, coronaviruses, and waste), and among the published articles from 2019 to 2021, 56 ones were selected containing information on the quantity and waste management during the COVID-19 pandemic. The results showed that COVID-19 caused the quantity variation and composition change of MSW. COVID-19 also has significant effects on waste recycling, medical waste management, quantity, and littered waste composition. On the other hand, the COVID-19 pandemic has changed waste compounds' management activities and waste generation sources. Recognizing these issues can help plan MSWM more efficiently and reduce virus transmission risk through waste.