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The healthcare industry is a major contributor to greenhouse gas emissions. Within the hospital, operating rooms are responsible for the largest proportion of emissions due to high resource utilization and waste generation. Our aim was to generate estimates of greenhouse gas emissions avoided and cost implications following implementation of a recycling program across operating rooms at our freestanding children's hospital. Data were collected from three commonly performed pediatric surgical procedures: circumcision, laparoscopic inguinal hernia repair, and laparoscopic gastrostomy tube placement. Five cases of each procedure were observed. Recyclable paper and plastic waste was weighed. Emission equivalencies were determined using the Environmental Protection Agency Greenhouse Gas Equivalencies Calculator. Institutional cost of waste disposal was $66.25 United States Dollars (USD)/ton for recyclable waste and $67.00 USD/ton for solid waste. The proportion of recyclable waste ranged from 23.3% for circumcision to 29.5% for laparoscopic gastrostomy tube placement. The amount of waste redirected from landfill to a recycling stream could result in annual avoidance of 58,500 to 91,500 kg carbon dioxide equivalent emissions, or 6583 to 10,296 gallons of gasoline. Establishing a recycling program would not require additional cost and could lead to modest cost savings (range $15 to 24 USD/year). Incorporation of recycling into operating rooms has the potential to reduce greenhouse gas emissions without increased cost. Clinicians and hospital administrators should consider operating room recycling programs as they work towards improved environmental stewardship. Level VI – evidence form a single descriptive or qualitative study. [ABSTRACT FROM AUTHOR]

T-Spherical fuzzy sets provide a robust framework for handling uncertainty in real-world decision-making. This paper addresses the construction of T-Spherical fuzzy Heronian mean averaging aggregation operators using novel Hamacher operations. The study mathematically verifies the properties of these operators and develops new distance measures such as Hamming, Euclidean and Jaccard for quantifying dissimilarity between T-Spherical fuzzy numbers. Furthermore, the TOPSIS method is implemented using the proposed operators and distance measures to solve a practical decision-making problem in selecting the best transportation firm for medical waste disposal. A sensitivity analysis is made to assesses the efficacy of the proposed operators, while a comparison study with existing methods is exhibited to establish their efficiency. • Novel Hamacher operational laws for T-spherical fuzzy (T-SF) numbers. • New distance measures: Hamming, Euclidean, Jaccard and T-SF Heronian mean averaging operators. • TOPSIS method using proposed operators and distance measures. • Effective handling of complexities and uncertainties. • Example: selecting best transportation firm. [ABSTRACT FROM AUTHOR]

Healthcare services create medical waste that may be dangerous to healthcare personnel, patients, the general public, and the environment. Medical waste disposal method selection is among the most important decisions that must be made by healthcare organizations, and such a problem has a number of contradictory criteria and alternatives. On the other hand, decision experts may have considerable uncertainty while evaluating these alternatives. In this paper, new fuzzy multi-criteria decision-making (MCDM) methodologies are provided for assessing the medical waste disposal alternatives. The CRiteria Importance Through Intercriteria Correlation (CRITIC) is used for obtaining criterion weights in an objective manner, and the Weighted Aggregated Sum Product ASsessment (WASPAS) approach is utilized to rank the alternatives. For modeling the uncertainty in the nature of the problem, the proposed methodology is developed in single and interval-valued spherical fuzzy environments. Single-valued spherical fuzzy sets enable users to model the membership, non-membership, and hesitancy parameters independently. On the other hand, interval-valued spherical fuzzy sets provide increased fuzziness modeling capacity. The step-by-step solution of the proposed methodologies are followed by sensitivity and comparative analyses, and a discussion. This study contributes to the work of both academics and practitioners in the healthcare industry, as well as other sectors facing similar types of decision-making problems. • CRITIC-WASPAS method is extended with single and interval-valued spherical fuzzy sets. • The proposed methodology provides extensive fuzziness modeling capacity. • The CRITIC phase enables calculating criteria weights in an objective manner. • Medical waste disposal alternatives are prioritized with the WASPAS technique. • Sensitivity analyses for decision expert, criterion, and threshold parameter weights are provided. [ABSTRACT FROM AUTHOR]

Nowadays there is a growing concern in the treatment of solid medical waste due to the increase in waste generation that has been accelerated by the pandemic. This accentuated the problems of medical waste management, related to separation, storage, and transportation. In addition, current medical waste treatments are not globally accepted, since most of them generate pollutants, or simply not all treatment technologies are applied correctly. This review analyzes the basis for proper management, and the main existing technologies and developments carried out so far. An exhaustive comparison between them allows for distinguishing the pros, cons, scales, and applicability of each one. This is complemented with a TRL analysis to describe their degree of development. Furthermore, some waste-to-energy (WtE) alternatives are discussed since they represent an appealing option that can positively affect the environment and the economy of existing technologies. Finally, some tools and technology selection criteria shown in the literature are presented, along with some discussion of their economics. This paper exposes a theoretical approach based on the literature on the current situation of solid medical waste treatment and provides the basis for decision-making to implement some existing technologies. Likewise, it presents the limitations in the current system that are the kick for future research. [Display omitted] • The recent sharp increase of medical waste raises the urgent need to a proper management. • High thermal technologies or their combination push power plants. • Analytical decision methodologies applied to select the most convenient technology. • Costs of medical waste recovery and recycling represent the main bottleneck. [ABSTRACT FROM AUTHOR]

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Medical wastes include all solid and liquid wastes that are produced during the treatment, diagnosis, and immunisation of animals and humans. A significant proportion of medical waste is infectious, hazardous, radioactive, and contains potentially toxic elements (PTEs) (i.e., heavy metal (loids)). PTEs, including arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg), are mostly present in plastic, syringes, rubber, adhesive plaster, battery wastes of medical facilities in elemental form, as well as oxides, chlorides, and sulfates. Incineration and sterilisation are the most common technologies adopted for the safe management and disposal of medical wastes, which are primarily aimed at eliminating deadly pathogens. The ash materials derived from the incineration of hazardous medical wastes are generally disposed of in landfills after the solidification/stabilisation (S/S) process. In contrast, the ash materials derived from nonhazardous wastes are applied to the soil as a source of nutrients and soil amendment. The release of PTEs from medical waste ash material from landfill sites and soil application can result in ecotoxicity. The present study is a review paper that aims to critically review the dynamisms of PTEs in various environmental media after medical waste disposal, the environmental and health implications of their poor management, and the common misconceptions regarding medical waste. [Display omitted] • Safe management of hazardous medical wastes is a major global challenge. • A significant proportion of medical waste is infectious, hazardous and radioactive. • Potentially toxic elements (PTEs) in medical waste occur mostly as oxides. • Incinerated medical waste ash application can release PTEs to environment. • Chemical stabilisation is effective in preventing PTEs release into the environment. [ABSTRACT FROM AUTHOR]

The study investigated the solid waste characterization in private health institutions in Ibadan metropolis, Nigeria. Primary data were obtained through the measurement of solid waste generated in the selected private health institutions segregated into sharps, plastic and nylon, paper, food waste, pharmaceutical, pathological components. PHI in each LGAs of Ibadan metropolis were stratified according to the services they render. Simple random sampling technique was used to select one PHI from each stratum for data collection. Waste components categorized as 'others' was the highest waste generated (10.68kg). This accounted for 23.6% of the total waste generated and a daily average of 0.51kg. The per capita waste generation was 0.01kg/head/day. The lowest waste component (0.38kg) generated was pharmaceutical waste and it represented 0.84% of the total waste generated. The daily average for this waste component was 0.02kg. The per capita generation of sharp waste components was 0.01kg/head/day. Food waste represented 19.2% of the total waste generated while nylon/plastic represented 18.4%. The study concluded that a better understanding of the composition of medical solid waste is fundamental in order to choose the best management approach sequel to generation. This study has shown that very little has been done on medical waste management in the study area. Thus, this study recommends that; the stakeholders (the state ministries of Environment and Health and the Oyo State Waste Management Agency) should pursue strict enforcement of legislation that will have a significant impact on the sorting, segregation and storage of medical solid waste in the study area. [ABSTRACT FROM AUTHOR]

The assessment of the treatment technologies is a vital point for health care waste (HCW) management. The assessment process is regarded as a multi-attribute group decision-making problem. Considering individual knowledge backgrounds and psychological preferences, and various uncertainty factors which are difficult to describe numerical and precisely, experts often portray their individual assessments by employing qualitative expressions. Linguistic term with weakened hedge (LTWH) is an effective tool to quantify the qualitative information. Additionally, the Bonferroni mean (BM) can capture the interrelationship between input data and the combined compromise solution (CoCoSo) method could produce reliable outcomes. In this paper, we extend the BM operator into the LTWH environment and propose the linguistic term with weakened hedge BM (LTWHBM) operator and the weighted version, i.e., LTWHWBM, to depict the indeterminacy in the HCW management and cope with assessment of the treatment technology problems based on the developed novel operational rules of LTWHs. Various properties and special cases of these operators are investigated in detail. Furthermore, we design a LTWHWBM based CoCoSo group decision-making model, herein the LTWHWBM operator is employed to integrate individual experts' preferences and the extend CoCoSo method is utilized to yield the ranking of alternatives. Ultimately, a case study concerning the assessment of the HCW treatment technologies is performed. The feasibility and favorable characteristics of the established model are justified by the comparisons with several prevailing methodologies and sensitivity analyses. • New score function and partial order of LTWHs are presented. • New operations of LTWHs with good properties are defined. • An integrated method for qualitative group decision making is developed. • The method is testified in a case study regarding health care waste management. [ABSTRACT FROM AUTHOR]

As dental practitioners, we must recognize that some of the materials and procedures we use to provide dental health services may present challenges to the environment. Realizing this, we can begin to take measures to minimize the production of these wastes and their potential environmental effects. This paper identifies some common wastes produced by dental offices (dental amalgam, lead, silver, biomedical and general office waste) and provides practical suggestions for reducing the impact of our profession on the environment. [ABSTRACT FROM AUTHOR]

• We reviewed the performance of medical waste management during the pandemic. • Medical institutions have a storage space shortage on 17% of the days on average. • Temporary disposal methods are effective supplements during emergencies. • COVID-19 led to a five-fold increase in Wuhan's treatment capacity. The global pandemic caused by the 2019 coronavirus (COVID-19) has led to a dramatic increase in medical waste worldwide. This tremendous increase in medical waste is an important transmission medium for the virus and thus poses new and serious challenges to urban medical waste management. This study investigates the response of medical waste management to the COVID-19 pandemic and subsequent changes in Wuhan City based on the most detailed data available, including waste generation, storage, transportation, and disposal. The results show that despite a 5-fold increase in the demand for daily medical waste disposal in the peak period, the quick responses in the storage, transportation, and disposal sectors during the pandemic ensured that all medical waste was disposed of within 24 hours of generation. Furthermore, this paper discusses medical waste management during future emergencies in Wuhan. The ability of the medical waste management system in Wuhan to successfully cope with the rapid increase in medical waste caused by major public health emergencies has important implications for other cities suffering from the pandemic and demonstrates the need to establish resilient medical emergency systems in urban areas. [ABSTRACT FROM AUTHOR]

• Development of a novel decision making tool, named BWM-GIS-Grey MARCOS. • Addressing sustainable landfill location during COVID-19 Era. • Involvement of GIS for sustainable landfill selection problem. • Applying the proposed decision making tool for a real case study. Healthcare waste generated by medical activities in big cities includes a vast spectrum of materials, from blood, body parts, medical devices, pharmaceuticals, chemicals, diagnostic samples, soiled dressings, syringes and needles, and radioactive material. Improper management of health-care waste places the urban community and society, urban residents, patients, and water resources at risk from the toxic effects of environmental pollution, which can bring up many social and environmental costs for municipalities. Location selection for sitting a landfill for health-care waste with a sustainable development perspective is a complicated decision making problem in the urban and social planning area. This study develops a novel integrated decision-making model for landfill location selection for the health-care waste system. In this study, Geographic Information System (GIS), Best-Worst Method (BWM), and Measurement of alternatives and ranking according to COmpromise solution (MARCOS) method under grey interval set considering sustainability factors. To generate the GIS suitability maps, location criteria are first calculated using the BWM model. The GIS suitability maps suggest eight potential locations for landfilling, which are prioritized using G-MARCOS in order to select the best alternative location. To the best of our knowledge, the present study is the first study to integrate GIS, BWM, and G-MAROCS methods for sustainable landfill location selection problem for health-care waste. This paper investigates a real case of the municipality of Hamedan, Iran, to show the applicability of the developed methodology for urban planning problems. Sensitivity analysis tests are performed to establish the reliability and robustness of the results. Alternative A 7 , A 8 , and A 4 are selected respectively as the top three potential location for sitting a landfill for health-care waste. However, locations A 6 , and A 1 are the least suitable alternatives for sitting in a landfill. [ABSTRACT FROM AUTHOR]