The safety of non-incineration waste disposal devices in four hospitals of Tehran

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.

Occupational exposure to BTEX and styrene in West Asian countries: a brief review of current state and limits

The aim of introducing occupational exposure limits (OELs) is to use them as a risk management tool in order to protect workers' health and well-being against harmful agents at the workplace. In this review we identify OELs for benzene, toluene, ethylbenzene, xylene (BTEX), and styrene concentrations in air and assess occupational exposure to these compounds through a systematic literature search of publications published in West Asian countries from 1980 to 2021. OELs for BTEX and styrene have been set in Iran and Turkey to levels similar to those in European countries and the US. The search yielded 49 full-text articles that cover studies of exposure assessment in six countries, but most (n=40) regard Iran. Average occupational exposure to benzene of workers in oil-related industries is higher than recommended OEL, while average occupational exposure to other compounds is lower than local OELs (where they exist). Currently, information about levels of occupational exposure to BTEX and styrene is insufficient in West Asian countries, which should be remedied through OEL regulation and application. Furthermore, coherent research is also needed to determine actual levels of occupational exposure, dose-responses, and the economic and technical capacity of local industries to address current issues.

Spatial analysis and risk assessment of urban BTEX compounds in Urmia, Iran

Land Use Regression models (LUR) are the most common tools to estimate intra-urban air pollutant exposure in epidemiological studies. However, number of available and published models in developing and middle up income countries is still scarce. Here, we developed seasonal and overall LUR models for the spatial distribution of benzene, toluene, ethylbenzene and xylene (BTEX) based on 20 monitoring stations and 166 potentially predictive variables (PPVs) in Urmia, Iran. Carcinogenic and non-carcinogenic risks of exposure to BTEX and its sensitivity analysis were assessed using a probabilistic approach. The mean and standard deviation (in brackets) of overall benzene, toluene, ethylbenzene and xylene were 12.83 (16.19), 27.03 (32.00), 4.72 (4.15) and 27.35 (29.36) μg/m³, respectively. In all models the R² value of LUR models of benzene, toluene, ethylbenzene, xylene and total BTEX ranged from 0.66 to 0.85, 0.61, 0.88, 0.72 to 0.94, 0.75 to 0.84 and 0.67 to 0.93. The root mean square error (RMSE) for leave-one-out cross-validations (LOOCV) for benzene, toluene, ethylbenzene and xylene ranged from 7.48 to 10.31, 23.0 to 30.0, 3.40 to 6.90, 16.27 to 24.49, 36.10-50.0 μg/m³, respectively. The estimated lifetime carcinogenic risk (LTCR) indicated that ambient concentration of benzene is at a risk level for Urmia inhabitants (LTCR >10^-6). Sensitivity analysis for LTCR model indicated that concentration of benzene (C) was the most effective variable in increasing the carcinogenic risk (correlation coefficient ranged from 0.97 to 0.98 for all models).

Use of urinary biomarkers to characterize occupational exposure to BTEX in healthcare waste autoclave operators

Urinary benzene, toluene, ethylbenzene, and xylenes (BTEX) can be used as a reliable biomarker of exposure to these pollutants. This study was aimed to investigate the urinary BTEX concentration in operators of healthcare waste (HCW) autoclaves. This cross-sectional study was conducted in selected hospitals in Tehran, Iran between April and June 2017. Twenty operators (as the case group) and twenty control subjects were enrolled in the study. Personal urine samples were collected at the beginning and end of the work shift. Urinary BTEX were measured by a headspace gas chromatography-mass spectrometry (GC/MS). A detailed questionnaire was used to gather information from subjects. Results showed that the median of urinary benzene, toluene, ethylbenzene, m-p xylene, and o-xylene levels in the exposed group were 3.26, 3.36, 0.84, 3.94 and 4.48 μg/L, respectively. With the exception of ethylbenzene, subjects in the exposed group had significantly higher urinary BTEX levels than control group (p < 0.05). Urinary BTEX concentrations in the exposed case group were 2.5-fold higher than in the control group. There was a significant relationship between the amount of generated waste per day and the urinary BTEX in the exposed group. Smoking status and type of autoclave used were also identified as predictors of urinary BTEX concentrations. The healthcare waste treatment autoclaves can be considered as a significant BTEX exposure source for operators working with these treatment facilities. The appropriate personal protection equipment and control measures capable in reducing BTEX exposure should be provided to HCW workers to reduce their exposures to BTEX.