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Hospitals release significant quantities of wastewater (HWW) and biomedical waste (BMW), which hosts a wide range of contaminants that can adversely affect the environment if left untreated. The COVID-19 outbreak has further increased hospital waste generation over the past two years. In this context, a thorough literature study was carried out to reveal the negative implications of untreated hospital waste and delineate the proper ways to handle them. Conventional treatment methods can remove only 50%-70% of the emerging contaminants (ECs) present in the HWW. Still, many countries have not implemented suitable treatment methods to treat the HWW in-situ. This review presents an overview of worldwide HWW generation, regulations, and guidelines on HWW management and highlights the various treatment techniques for efficiently removing ECs from HWW. When combined with advanced oxidation processes, biological or physical treatment processes could remove around 90% of ECs. Analgesics were found to be more easily removed than antibiotics, β-blockers, and X-ray contrast media. The different environmental implications of BMW have also been highlighted. Mishandling of BMW can spread infections, deadly diseases, and hazardous waste into the environment. Hence, the different steps associated with collection to final disposal of BMW have been delineated to minimize the associated health risks. The paper circumscribes the multiple aspects of efficient hospital waste management and may be instrumental during the COVID-19 pandemic when the waste generation from all hospitals worldwide has increased significantly., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The COVID-19 pandemic has imposed a global emergency and also has raised issues with waste management practices. This study emphasized the challenges of increased waste disposal during the COVID-19 crisis and its response practices. Data obtained from the scientific research papers, publications from the governments and multilateral organizations, and media reports were used to quantify the effect of the pandemic towards waste generation. A huge increase in the amount of used personal protective equipments (facemasks, gloves, and other protective stuffs) and wide distribution of infectious wastes from hospitals, health care facilities, and quarantined households was found. The amount of food and plastic waste also increased during the pandemic. These factors caused waste treatment facilities to be overwhelmed, forcing emergency treatment and disposals (e.g., co-disposal in a municipal solid waste incinerator, cement kilns, industrial furnaces, and deep burial) to ramp up processing capacity. This paper discussed the ways the operation of those facilities must be improved to cope with the challenge of handling medical waste, as well as working around the restrictions imposed due to COVID-19. The study also highlights the need for short, mid, and longer-term responses towards waste management during the pandemic. Furthermore, the practices discussed in this paper may provide an option for alternative approaches and development of sustainable strategies for mitigating similar pandemics in the future., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Pharmaceutical pollution in surface waters poses a range of risks to public health and aquatic ecosystems. Consumers contribute to pharmaceutical pollution via use and disposal of medications, though data on such behaviors is limited. This paper investigates the purchasing, use, and disposal practices among a population that has been researched only minimally to date, yet will determine pharmaceutical pollution for decades to come: young adults represented by a university student population. We employed an online, 21-question survey to examine behaviors related to pharmaceuticals among students at the University of Vermont (n = 358). Results indicate that the majority of respondents had purchased medications in the previous 12 months (94%), and had leftover drugs (61%). Contrary to previous studies of older populations, only a small proportion of students had disposed of drugs (18%); municipal trash was the primary route of drug disposal (25%), and very few students disposed drugs via flushing (1%). Less than a quarter of students were aware of drug take-back programs (24%), and only 4% had ever used take-back services. These findings indicate that the university student population may be storing a large volume of unused drugs that will require future disposal. Increasing awareness of, access to, and participation in pro-environment pharmaceutical behaviors, such as purchasing over-the-counter medication in smaller quantities and utilizing drug take-back programs, could minimize future pharmaceutical pollution from this population., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

This paper examines medical waste management, including the common sources, governing legislation and handling and disposal methods. Many developed nations have medical waste legislation, however there is generally little guidance as to which objects can be defined as infectious. This lack of clarity has made sorting medical waste inefficient, thereby increasing the volume of waste treated for pathogens, which is commonly done by incineration. This review highlights that the unnecessary classification of waste as infectious results in higher disposal costs and an increase in undesirable environmental impacts. The review concludes that better education of healthcare workers and standardized sorting of medical waste streams are key avenues for efficient waste management at healthcare facilities, and that further research is required given the trend in increased medical waste production with increasing global GDP., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

This paper presents the results of a study of an experimental system with thermal treatment (incineration) of medical waste conducted at a large complex of hospital facilities. The studies were conducted for a period of one month. The processing system was analysed in terms of the energy, environmental and economic aspects. A rotary combustion chamber was designed and built with the strictly assumed length to inner diameter ratio of 4:1. In terms of energy, the temperature distribution was tested in the rotary kiln, secondary combustion (afterburner) chamber and heat recovery system. Calorific value of medical waste was 25.0 MJ/kg and the thermal efficiency of the entire system equalled 66.8%. Next, measurements of the pollutant emissions into the atmosphere were performed. Due to the nature of the disposed waste, particular attention was paid to the one-minute average values of carbon oxide and volatile organic compounds as well as hydrochloride, hydrogen fluoride, sulphur dioxide and total dust. Maximum content of non-oxidized organic compounds in slag and bottom ash were also verified during the analyses. The best rotary speed for the combustion chamber was selected to obtain proper afterburning of the bottom slag. Total organic carbon content was 2.9%. The test results were used to determine the basic economic indicators of the test system for evaluating the profitability of its construction. Simple payback time (SPB) for capital expenditures on the implementation of the project was 4 years., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The lack of proper management of medical waste leads to environmental pollution and threatens the lives of communities. Good medical waste management means appropriate planning and monitoring at all stages, including collection, separation, treatment, recycling, and disposal which promotes a circular approach. This paper presents a multi-item, multi-period, and bi-objective mixed-integer linear programming circular economy transition model for medical waste management considering the uncertainty in the amount of waste generated to design a green reverse network. In this paper, for the first time, the concept of queuing theory is applied to manage the waiting time of trucks carrying infectious waste in treatment centers. In addition, the proposed model simultaneously addresses the centers' location and heterogeneous vehicles routing, and uses a stochastic scenario-based approach to deal with uncertainty of the waste generated. The purpose of the proposed model is to minimize total cost and population risk, and for this end, to employ an improved augmented epsilon-constraint method (AUGMECON2). Finally, the efficiency of the proposed model and solution approach is examined using the data of a case study in Alborz province that includes six hospitals, three potential collection centers, three potential treatment centers, four potential recycling centers, and three potential disposal centers. • Designing a green reverse logistic network to manage medical waste using an MILP model and the queuing theory. • Using a scenario-based approach to deal with uncertainty in amount of waste generated by hospitals. • Applying AUGMECON2 method for solving the proposed bi-objective MILP model. • Validating the proposed model using the real-world data. [ABSTRACT FROM AUTHOR]

Hospital effluents are loaded with pathogenic microorganisms, partially metabolized pharmaceutical substances, radioactive elements, and other toxic substances. Such effluents if not treated properly can damage the natural environment and create a biological imbalance. This paper points out the areas of concern for hospital wastewater disposal and reports the findings of a limited physico-chemical study of treatment options for hospital effluents conducted at Christian Medical College and Hospital, Vellore, Tamil Nadu. The effluent collected was checked for conventional parameters and subjected to coagulation experiments. The raw and settled effluents were coagulated with FeCl(3), filtered and disinfected. Physico-chemical treatment seems to be an attractive option for the cost-effective disposal of hospital effluents. The results of this study call for further detailed study in this area.

The management of medical waste is of great importance due to its potential environmental hazards and public health risks. In the past medical waste was often mixed with municipal solid waste and disposed of in residential waste landfills or improper treatment facilities (e.g. inadequately controlled incinerators) in Korea. In recent years, many efforts have been made by environmental regulatory agencies and waste generators to better manage the waste from healthcare facilities. This paper presents an overview of the current management practices of medical waste in Korea. Information regarding generation, composition, segregation, transportation, and disposal of medical wastes is provided and discussed. Medical waste incineration is identified as the most preferred disposal method and will be the only available treatment option in late 2005. Faced with increased regulations over toxic air emissions (e.g. dioxins and furans), all existing small incineration facilities that do not have air pollution control devices will cease operation in the next few years. Large-scale medical waste incinerators would be responsible for the treatment of medical waste generated by most healthcare facilities in Korea. It is important to point out that there is a great potential to emit air toxic pollutants from such incinerators if improperly operated and managed, because medical waste typically contains a variety of plastic materials such as polyvinyl chloride (PVC). Waste minimization and recycling, control of toxic air emissions at medical waste incinerators, and alternative treatment methods to incineration are regarded to be the major challenges in the future.

Solid waste management is one of the major global environmental issues, as there is continuous increase in industrial globalization and generation of waste. Solid wastes encompass the heterogeneous mass of throwaways from the urban community as well as the homogeneous accumulations of agricultural, industrial and mineral wastes. Biomedical waste pose a significant impact on health and environment. A proper waste management system should be required to dispose hazardous biomedical waste and incineration should be the best available technology to reduce the volume of this hazardous waste. The incineration process destroys pathogens and reduces the waste volume and weight but leaves a solid material called biomedical waste ash as residue which increases the levels of heavy metals, inorganic salts and organic compounds in the environment. Disposal of biomedical waste ash in landfill may cause contamination of groundwater as metals are not destroyed during incineration. The limited space and the high cost for land disposal led to the development of recycling technologies and the reuse of ash in different systems. In order to minimize leaching of its hazardous components into the environment several studies confirmed the successful utilization of biomedical waste ash in agriculture and construction sector. This paper presents the overview on the beneficial use of ash in agriculture and construction materials and its leachate characteristics. This review also stressed on the need to further evaluate the leachate studies of the ashes and slag for their proper disposal and utilization. [Copyright &y& Elsevier]