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Lead (Pb) contamination in the black paper that recovers intraoral films (BKP) has been investigated. BKP samples were collected from the Radiology Clinics of the Dental School of Ribeirão Preto, University of São Paulo, Brazil. For sake of comparison, four different methods were used. The results revealed the presence of high lead levels, well above the maximum limit allowed by the legislation. Pb contamination levels achieved after the following treatments: paper digestion in nitric acid, microwave treatment, DIN38414-54 method and TCLP method were 997 microg g(-1), 189 microg g(-1), 20.8 microg g(-1), and 54.0 microg g(-1), respectively. Flame atomic absorption spectrometry (FAAS) and inductively coupled plasma mass spectrometry (ICP-MS) were employed for lead determination according to the protocols of the applied methods. Lead contamination in used BKP was confirmed by scanning electron microscopy coupled with energy dispersive X-ray microanalysis (SEM-EDS). All the SEM imaging was carried out in the secondary electron mode (SE) and backscattered-electron mode (QBSD) following punctual X-ray fluorescence spectra. Soil contamination derived from this product revealed the urgent need of addressing this problem. These elevated Pb levels, show that a preliminary treatment of BKP is mandatory before it is disposed into the common trash. The high lead content of this material makes its direct dumping into the environment unwise.

Sustainability in human development sets exact standards for the management of natural resources, including their extraction, use, and the introduction of waste products into a complex, inventive circuit as a consequence of exploitation. Because of the negative influence that medical waste has on the environment and people, it needs specific handling. Medical waste is increasing in amount all the time and has a wide range of consequences across a wide range of activity domains. This paper discusses various issues of the sustainable management of blood sample bio-medical waste and evaluates the properties of alternative samples which are made of geactin-coated sample paper. A unique bar-coded paper-based blood sample method has prevented complications during blood tests and is much more environmentally friendly. [ABSTRACT FROM AUTHOR]

The cost estimation and assessment of healthcare waste treatment systems (HCWTSs) for preventing financial and environmental damage are essential. This work reports economic analyses of treatment of hazardous-infectious waste based on WHO approach in HCWTS S of 43 hospitals in Tehran, Iran. The waste generation rate for total hospital waste in 43 HCWTS S was 4.42 ± 2.77 kg/active-bed/day. The mean of chemical, sharps, infectious, and general wastes in 43 HCWTS S were 13.79 ± 19.71, 30.29 ± 37.46, 336.28 ± 291.31, and 539.6 ± 383.13 kg/day, respectively. Economic analyses proved that general hospitals spent 1.63 times more than specialized hospitals on treating hazardous-infectious waste per year. The annual cost of treating each kilogram of hazardous healthcare waste in studied HCWTS S was 0.3 dollars. A range of total annual costs in 43 HCWTS S was limited to 7.9-118 thousand dollars. The results of ANOVA test demonstrated that the age and performance levels of hospitals significantly affect the annual capital and operating costs, respectively. Hence, improving recycling knowledge and increasing source-separated recycling should be considered to control the costs in HCWTS S . The results of this work have implications for the hospital managers in especially developing countries to evaluate previously unknown economic analyses and policies and take action to control wasted costs in HCWTS S ., (© 2024. The Author(s).)

The sudden outbreak and prolonged impact of the global novel coronavirus disease (COVID-19) epidemic has caused an increase in demand for medical products, such as masks and protective clothing, leading to an exponential increase in the generation of medical waste. As medical waste under the epidemic is highly infectious, it poses a great danger to human health. Therefore, with the proliferation of medical waste, it has become crucial to construct a reverse logistics recycling network that can handle medical waste quickly and efficiently. In this study, we construct a multi-period medical waste emergency reverse logistics network siting model with the objectives of minimum cost, minimum safety risk, and minimum time for the safe and quick disposal of medical waste. The model considers disposal capacity bottlenecks of existing facilities. Based on an empirical analysis using the COVID-19 epidemic in New York City, USA, as a case study, we find that the use of a suitable number of synergistic facilities and the establishment of temporary medical waste disposal centers are viable options for handling the dramatic increase in medical waste during the peak of the COVID-19 epidemic., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Abstract: Healthcare workers (HWs) perform a critical role not only in the clinical management of patients but also in providing adequate infection control and prevention measures and waste management procedures to be implemented in healthcare facilities. The aim of this study was to evaluate the awareness and knowledge of COVID-19 infection control precautions and waste management procedures among HWs in Saudi Arabian hospitals.This was a descriptive, cross-sectional study. Information on knowledge, awareness, and practice of infection control and waste management procedures were obtained from the HWs using a structured questionnaire. A thematic analysis was used to analyze the data.Our findings indicated that most of the study participants were knowledgeable, with a mean score of 78.3%. In total, 92.5%, 90.3%, and 91.7% of the participants were aware of the infection control precautions, COVID-19 waste management procedures, the availability of infection control supplies, respectively. HWs' Knowledge regarding waste management and infection control procedures correlated significantly with sex (P ≤ .001 and <.001), education (P = .024 and .043), and working experience (P = .029 and .009), respectively.Most participants appreciated the importance of their role in infection control, surveillance, and monitoring of the ongoing safety practices in their patients as well as their facilities and communities., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: In Queensland, each hospital and health service (local hospital network) has its own waste reduction and recycling plan to comply with the Queensland Government's Waste Reduction and Recycling Act 2011 (Qld). The aim is to reduce both the hospital's carbon footprint and waste handling costs. Hospital environmental waste services staff do not audit pharmaceutical waste bins as this requires the presence of a registered pharmacist. Aim: Since previous published studies of healthcare waste disposal practices have not included pharmacy waste bin audits, this study aimed to investigate waste disposal behaviours in a hospital pharmacy department. Method: This sequential, two‐phase mixed methods study was conducted in a metropolitan, tertiary public hospital's pharmacy department in Queensland. Phase I involved semi‐structured interviews of hospital pharmacists and pharmacy technicians while Phase II comprised bin audits of the pharmacy department's waste streams. Results: The bin audits revealed 36.1%, 23.8%, and 4.9% of recyclable waste in the clinical waste stream for each of the three bin audits respectively. In the general waste stream, the two bin audits of this stream revealed 14.3% and 44.4%, respectively. The reasons were identified in the interviews: there were no recycling bins in the main dispensing areas and there was confusion surrounding correct disposal of original containers and non‐contaminated packaging waste. Non‐paper waste was found in the confidential (shredded) waste stream in the two bin audits of this stream (10.1% and 16.7%, respectively). Conclusion: Provision of commingled recycling bins and clean office paper waste bins in dispensing areas and education of staff on correct waste segregation processes will improve waste segregation in hospital pharmacy departments with both financial and environmental benefits for the hospital and the general population. [ABSTRACT FROM AUTHOR]

Hospitals in Europe produce approximately 6 million tons of medical waste annually, about one-third of this originating in operating rooms. Most of it is solid waste, which can be recycled if bodily fluids do not contaminate it. Only 2-3% of hospital waste must be disposed of as infectious waste, and this is much lower than the 50-70% of garbage in the biohazard waste stream. In June 2021, at the main operating room of the Department of General Surgery of the University of Turin, we began a separate collection program for materials consisting of plastic, paper, TNT (material not contaminated by bodily fluids), and biohazardous waste. We calculated the number of boxes and the weight of special waste disposed produced every month in one operating room for 18 months. The monthly number of Sanibox and the monthly weight of biohazardous waste decreased during the observation period. The reduction trend was not constant but showed variations during the 18 months. Direct proportionality between number of low-complexity procedures and production of biohazardous waste was found (p = 0.050). We observed an optimization in the collection and filling of plastic, paper and TNT boxes separated and sent for recycling. One of the barriers to recycling hospital waste, and surgical waste in particular, is the failure to separate infectious waste from clean waste. A careful separate collection of waste in the operating room is the first step in reducing environmental pollution and management costs for the disposal of hospital waste., (© 2024. The Author(s).)

Introduction: Healthcare waste is any waste generated by healthcare facilities that is considered potentially hazardous to health. Solid healthcare waste is categorized into infectious and non-infectious wastes. Infectious waste is material suspected of containing pathogens and potentially causing disease. Non-infectious waste includes wastes that have not been in contact with infectious agents, hazardous chemicals, or radioactive substances, similar to household waste, i.e. plastic, papers and leftover foods. This study aimed to investigate solid healthcare waste management practices and develop guidelines to improve solid healthcare waste management practices in Ethiopia. The setting was all health facilities found in Hossaena town., Method: A mixed-method study design was used. For the qualitative phase of this study, eight FGDs were conducted from 4 government health facilities, one FGD from each private health facility (which is 37 in number), and forty-five FGDs were conducted. Four FGDs were executed with cleaners; another four were only health care providers because using homogeneous groups promotes discussion. The remaining 37 FGDs in private health facilities were mixed from health professionals and cleaners because of the number of workers in the private facilities. For the quantitative phase, all health facilities and health facility workers who have direct contact with healthcare waste management practice participated in this study. Both qualitative and quantitative study participants were taken from the health facilities found in Hossaena town., Result: Seventeen (3.1%) health facility workers have hand washing facilities. Three hundred ninety-two (72.6%) of the participants agree on the availability of one or more personal protective equipment (PPE) in the facility ''the reason for the absence of some of the PPEs, like boots and goggles, and the shortage of disposable gloves owes to cost inflation from time to time and sometimes absent from the market''. The observational finding shows that colour-coded waste bins are available in 23 (9.6%) rooms. 90% of the sharp containers were reusable, and 100% of the waste storage bins were plastic buckets that were easily cleanable. In 40 (97.56%) health facilities, infectious wastes were collected daily from the waste generation areas to the final disposal points. Two hundred seventy-one (50.2%) of the respondents were satisfied or agreed that satisfactory procedures are available in case of an accident. Only 220 (40.8%) respondents were vaccinated for the Hepatitis B virus., Conclusion: Hand washing facilities, personal protective equipment and preventive vaccinations are not readily available for health workers. Solid waste segregation practices are poor and showed that solid waste management practices (SWMP) are below the acceptable level., (© 2024. The Author(s).)

Due to the growing population and advancing economy, medical waste accumulation has come to the attention of all facets of society. Although the issue of medical waste management planning has been addressed in developed nations, it still exists in several developing nations. This paper examines the effects of barriers under the Organization action, work handling, and Human Resource Practices section on the healthcare waste management (HCWM) sector in a developing country India. In this study, three hypotheses were constructed and tested using Structural equation modeling. The questionnaire was distributed among 200 health professionals to collect their responses. Ninety-seven responses were received, and 15 barriers were identified affecting the healthcare waste management sector. The results show that all three barriers (i.e., Organizational, Waste handling, and Human resources) hinder the Healthcare waste management sector. Organizational Barriers are the most significant among other barriers. So, the hospitals have to take appropriate actions to overcome these barriers. This paper helps to complete the research gap by providing the different characteristics of barriers. The development of a model for the analysis of barriers influencing HCWM is the Author's original contribution., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Environmental sustainability has emerged as a significant issue in dental practices. Notably, the increased usage of personal protective equipment (PPE), primarily composed of single-use plastics (SUPs), poses a significant challenge to sustainable dentistry. This discussion paper explores the environmental implications of dental practices in Aotearoa New Zealand and the necessary interventions for transitioning towards sustainable dentistry, focusing on waste reduction. Despite the growing awareness of environmental impacts among oral health practitioners, substantial barriers persist. These include a perceived conflict between high-quality patient care, infection control, and environmental sustainability. A lack of education on managing resources and robust sustainable guidelines heightens the lack of sustainable actions. The paper explores potential plastic waste reduction strategies and sustainable practices such as digitisation, 3D printing, and the development of eco-friendly materials for personal protective equipment (PPE). It also highlights the need for preventive care, effective recycling of SUPs and PPE, and meaningful partnerships with dental product companies for innovative solutions. The paper advocates for creating sustainability dentistry guideline that align with the objectives of the Dental Council, Ministry of Health, and Ministry of Environment. Such guidelines would promote the integration of sustainability into daily operations of dental practices, using a plan-do-check-act (PDCA) model, and contribute towards a circular economy within the dental sector. The transition towards a more sustainable future for dentistry in New Zealand requires a multifaceted approach. This includes reevaluating traditional practices, increased research and collaboration, and formulating clear guidelines and sustainable waste management strategies. [ABSTRACT FROM AUTHOR]

Medical waste (MW) is exploding due to the COVID-19 pandemic, posing a significant environmental threat, and leading to the urgent requirement for affordable and environmentally friendly MW disposal technologies. Prior research on individual MW disposal plants is region-specific, applying these results to other regions may introduce bias. In this study, major MW disposal technologies in China, i.e., incineration technologies (pyrolysis incineration and rotary kiln incineration), and sterilization technologies (steam sterilization, microwave sterilization, and chemical disinfection) with residue landfill or incineration were analyzed from an industry-level perspective via life cycle assessment (LCA), life cycle costing (LCC) and net present value (NPV) methods. Life cycle inventories and economic cost data for 4-5 typical companies were selected from 128 distinct enterprises and academic sources for each technology. LCA results show that microwave sterilization with residue incineration has the lowest environmental impact, emitting only 480 kg CO 2 eq. LCC and NPV analyses indicate that steam sterilization with landfilling is the most economical, yielding revenues of 1,210 CNY/t and breaking even in the first year. Conversely, pyrolysis and rotary kiln incineration break even between the 4th and 5th years. Greenhouse gas emissions from the MW disposal in ten cities with the largest MW production in 2020 increased by 7% over 2019 to 43,800 tons and other pollutants increased by 6% to 12%. Economically, Shanghai exhibits the highest cost-effectiveness, while Nanjing delivers the lowest. It can be observed that the adoption of optimal environmental technologies has resulted in a diminution of greenhouse gas emissions by 279,000 tons and energy conservation of 1.76 billion MJ., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Medical wastes include the wastes created by biomedical research institutes, medical labs, and hospitals. Through exposure to infectious pathogens, improper waste treatment causes substantial hazards of disease transmission to waste workers, waste pickers, patients, health workers, and the population in general. Poor waste management releases dangerous and detrimental constituents into society. However, due of the volumes of wastes generated and its infectious nature, contamination of highly contagious agents such as the sudden pandemic has created huge instability in medical waste treatments and consequent recycling. Several nations have implemented safety procedures to counteract this pollution and manage medical wastes; nevertheless, these efforts are inadequate and vary depending on the nation. Moreover, worldwide organizations have recognized recommendations for the handling of medical wastes. Those rules are aiding in the management of highly infectious medical wastes generated by all-medical centers. Instead of sending things to landfills, proper medical wastes management may make available value by limiting disease transmission and enhancing recyclability. Disinfecting and classifying medical wastes enables for more sustainable management and reuse of important resources. This paper addresses the various medical solid wastes environmental impacts, management and disposal techniques used in various nations, the issues encountered throughout these strategies, and potential solutions to these challenges. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, disposable masks, protective clothing, gloves, and nasopharyngeal swabs collected by nucleic acid testing formed a large amount of medical waste. Medical waste has strict temporary storage time requirements in hospitals, which need to be transported to medical waste disposal plants within the specified time. However, as most of disposal plants are far away from downtown, they also need to be responsible for the transportation and disposal of medical waste in many hospitals, and put forward higher requirement for transportation routes. Rapid and safe disposal of all types of medical waste generated by COVID-19 is crucial to the prevention and control of the epidemic. This paper designs the transportation route optimization model using Anylogic simulation software based on the regional distribution of 118 tertiary hospitals and 2 large medical waste disposal plants in Beijing, China. At the same time, transportation routes of 118 tertiary hospitals in the morning peak, evening peak, all-day, and ordinary periods were simulated based on the Beijing traffic index in 2017. On this basis, through the analysis of the simulation data, the selection of medical waste transport routes for 118 tertiary hospitals in the morning peak, evening peak, all day, and ordinary periods is further clarified, so as to ensure that medical waste can be transported to the medical waste disposal plant in the shortest time. The shortest path and fastest speed transport mode, medical waste transport data set, and the selection of transport mode of 118 tertiary hospitals formed by this research provide certain reference experience for the rapid and safe transport of medical waste during the epidemic period, and also provides corresponding data support for medical waste transportation management in the post-epidemic era and medical waste transportation decision-making when facing major public health problems., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This paper proposes a personalized comprehensive cloud-based method for heterogeneous multi-attribute group decision-making (MAGDM), in which the evaluations of alternatives on attributes are represented by LTs (linguistic terms), PLTSs (probabilistic linguistic term sets) and LHFSs (linguistic hesitant fuzzy sets). As an effective tool to describe LTs, cloud model is used to quantify the qualitative evaluations. Firstly, the regulation parameters of entropy and hyper entropy are defined, and they are further incorporated into the transformation process from LTs to clouds for reflecting the different personalities of decision-makers (DMs). To tackle the evaluation information in the form of PLTSs and LHFSs, PLTS and LHFS are transformed into comprehensive cloud of PLTS (C-PLTS) and comprehensive cloud of LHFS (C-LHFS), respectively. Moreover, DMs' weights are calculated based on the regulation parameters of entropy and hyper entropy. Next, we put forward cloud almost stochastic dominance (CASD) relationship and CASD degree to compare clouds. In addition, by considering three perspectives, a comprehensive tri-objective programing model is constructed to determine the attribute weights. Thereby, a personalized comprehensive cloud-based method is put forward for heterogeneous MAGDM. The validity of the proposed method is demonstrated with a site selection example of emergency medical waste disposal in COVID-19. Finally, sensitivity and comparison analyses are provided to show the effectiveness, stability, flexibility and superiorities of the proposed method. [ABSTRACT FROM AUTHOR]

The major environmental hazard in this pandemic is the unhygienic disposal of medical waste. Medical wastage is not properly managed it will become a hazard to the environment and humans. Managing medical wastage is a major issue in the city, municipalities in the aspects of the environment, and logistics. An efficient supply chain with edge computing technology is used in managing medical waste. The supply chain operations include processing of waste collection, transportation, and disposal of waste. Many research works have been applied to improve the management of wastage. The main issues in the existing techniques are ineffective and expensive and centralized edge computing which leads to failure in providing security, trustworthiness, and transparency. To overcome these issues, in this paper we implement an efficient Naive Bayes classifier algorithm and Q-Learning algorithm in decentralized edge computing technology with a binary bat optimization algorithm (NBQ-BBOA). This proposed work is used to track, detect, and manage medical waste. To minimize the transferring cost of medical wastage from various nodes, the Q-Learning algorithm is used. The accuracy obtained for the Naïve Bayes algorithm is 88%, the Q-Learning algorithm is 82% and NBQ-BBOA is 98%. The error rate of Root Mean Square Error (RMSE) and Mean Error (MAE) for the proposed work NBQ-BBOA are 0.012 and 0.045. [ABSTRACT FROM AUTHOR]

Background: In dental practices, biomedical waste (BMW) management is essential to preserving a clean and safe atmosphere for patients and medical personnel. Dental facilities generate different forms of BMW, which include sharps, contaminated materials, and/or potentially infectious substances, which require proper handling, storage, and disposal to minimize the risk of infection and environmental contamination. Aim: The study aimed to assess the knowledge and awareness of BMW management among dental students in Chennai city using paper-based questionnaire. Materials and Methods: An observational cross-sectional survey containing 28 questions was framed to assess the knowledge and awareness of BMW management among the final-year BDS, interns, and postgraduate students (a total of 100 students). Statistical analysis was done using SPSS version 27.0. Results: The results of our study showed statistically significant results with P = 0.01 among the study groups. The overall knowledge, attitude, and practice score was observed to be 67.5% for final-year BDS students, 68.09% for interns, and 71.76% for postgraduates. Conclusion: The knowledge assessed was found to be average among the participants. Hence, proper training and assessment are necessary for the proper handling and practice of BMW management. [ABSTRACT FROM AUTHOR]

In the last years, particularly after Covid-19, Health care waste (HCW) has increased significantly due to the increasing population and number of healthcare organizations. HCW produces a significant risk of infectious contamination and injury. Accordingly, healthcare waste management plays a vital role in creating waste management strategies, and policies and implementing waste management plans. To build robust healthcare management systems, the risk assessment process is a key step. This paper assesses the top hazards of healthcare waste at Sultan Qaboos University Hospital (SQUH) in Oman using the Exponential Weighted Geometric Mean-Failure Mode and Effect Analysis (EWGM-FMEA). Fifteen healthcare waste hazards were selected to apply the tool. These hazards are ranked to prioritize the top hazards wastes. This assessment helps in identifying the most crucial hazards, whiche the policymakers should pay attention thus, the main countermeasures could be conducted. These hazards were proposed based on the conducted survey questionnaire and interviews accordingly, and analyses of the data have been carried out. The applied tool examined the importance of quantifying healthcare waste to apply the appropriate corrective actions which can be applied to mitigate the harm and the negative effects of healthcare waste. The results of the assessment tool will help policymakers in developing clear plans for management, disposal of wastes, and segregation. Furthermore, prioritizing healthcare waste explored the importance of integrating tthe raining plans of workers with the healthcare waste management policy. Although the prospective managerial and policy implications of this research, some limitations could be studied by future researchers. Firstly, the sample covered one hospital that may be representative of only one hospital in Oman which constrains the generalization of results. Secondly, the number of identified waste hazards is fifteen so, increased the number of hazards may help policymakers in building a more effective healthcare waste management plan which will reflect in improving the healthcare management system in the organization, mitigating the harmful effects on human health and the negative effects on the environment. [ABSTRACT FROM AUTHOR]

Healthcare waste (HCW) is generated in different healthcare facilities (HCFs), such as hospitals, laboratories, veterinary clinics, research centres and nursing homes. It has been assessed that the majority of medical waste does not pose a risk to humans. It is estimated that 15% of the total amount of produced HCW is hazardous and can be infectious, toxic or radioactive. Hazardous waste is a special type of waste which, if not properly treated, can pose a risk to human health and to the environment. HCW contains potentially harmful microorganisms that can be spread among healthcare personnel, hospital patients and the general public, causing serious illnesses. Healthcare personnel are the specialists especially exposed to this risk. The most common medical procedure, which pose the highest risk, is injection (i.e, intramuscular, subcutaneous, intravenous, taking blood samples). The World Health Organization (WHO) estimates that around 16 billion injections are administered worldwide each year. However, if safety precautions are not followed, and needles and syringes are not properly disposed of, the risk of sharps injuries increases among medical staff, waste handlers and waste collectors. What is more, sharps injuries increase the risk of human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV/HCV), tuberculosis (TB), diphtheria, malaria, syphilis, brucellosis and other transmissions. Disposing of medical waste in a landfill without segregation and processing will result in the entry of harmful microorganisms, chemicals or pharmaceuticals into soil and groundwater, causing their contamination. Open burning or incinerator malfunctioning will result in the emission of toxic substances, such as dioxins and furans, into the air. In order to reduce the negative impact of medical waste, waste management principles should be formulated. To minimize health risks, it is also important to build awareness among health professionals and the general public through various communication and educational methods. The aim of this paper is to present a general overwiev of medical waste, its categories, the principles of its management and the risks to human health and the environment resulting from inappropriate waste management. [ABSTRACT FROM AUTHOR]

Waste has become a pivotal public health and environmental problem during the COVID-19 pandemic. In this interdisciplinary review, we move beyond the 'coronalitter' and 'coronawaste' discourses, which have come to dominate public imaginaries of waste, to consider less-visible dimensions of waste infrastructures and systems. We demonstrate how waste is coming to matter in new ways that offer opportunities for reconfiguring health research. By examining the literature addressing the impacts of COVID-19 on the geographies of waste, we shed light on how waste is being problematised and researched through logics of public, environmental, and occupational health. We argue that these logics structure understandings and practice, whilst drawing attention to the overlaps and limits that allow links across disciplinary silos and problem domains to be forged. Developing a multi-logics approach, the paper outlines a research agenda for approaching waste as a critical public health problem at a time of intersecting health crises. [ABSTRACT FROM AUTHOR]

Aim: To identify and synthesize research on the awareness, attitudes and action related to sustainability and climate change from the perspective of nursing students and educators globally. Design: Integrative review. Methods: The review was guided by Whittemore and Knafl. Included studies were appraised using the Mixed Methods Appraisal Tool. A deductive content analysis based on Elo and Kyngäs' methodology was employed. Data Sources: CINAHL, MEDLINE, EMBASE, Web of Science, British Education Index, GreenFILE and Scopus were searched up to the 8th November 2022. Results: Thirty‐two studies were included in the review. Two studies included nursing educators in their samples, the rest focused solely on students. Findings suggest that whilst some students were aware of sustainability issues and felt that nurses have a responsibility to mitigate climate change, others showed limited awareness and believed that nurses have more important priorities. A global interest was seen among students for increased curricular content related to sustainability and climate change. Waste management and education of others were suggested actions students can take; however, barriers included lack of confidence and limited power. Conclusion: There is a need for sustainability education within nursing curricula, accompanied by student support. Implications for the Profession: The review acts as a starting point to make sustainable healthcare and climate change mitigation integral aspects of nursing. Impact: Sustainability education within nursing curricula can positively impact on sustainable healthcare and climate change mitigation. More research is needed on the perspectives of nursing educators. Reporting Method: The review is reported according to the PRISMA guidelines. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to map out the ways in which the intellectual structure and research trends of scientific publications come together in business-to-business (B2B) marketing strategies in the health-care sector. More specifically, it aims first to identify the fundamental contributions of research in this area of knowledge and second to determine the lines of research that constitute the most prominent intellectual contribution to the development of a solid future research agenda. Design/methodology/approach: The statistical and analytical methods include bibliometric, co-citation and cluster analysis techniques. To identify useful patterns of information within the paper, this study sought paid special attention to scholarship that was jointly cited. This study then applied hierarchical cluster analysis to the totality of the co-cited paper and then grouped the interrelated paper into distinct sets. Findings: This study were able to systematically identify and classify various theoretical perspectives of B2B marketing strategies within the health-care sector into four main approaches, namely, decision-making strategies; relational marketing; co-creation; new challenges. Originality/value: By systematically identifying, exploring and analyzing the key priorities of B2B marking within the health-care sector, this study contributes positively to the existing literature. The added value is that the work will help to further improve the international standards of excellence within the health-care sector and its marking apparatuses. [ABSTRACT FROM AUTHOR]

COVID-19's developing trend has put the waste management systems of governments all over the world in jeopardy. The increasing rise of infectious medical waste has now become a serious problem. This paper presents a multi-period multi-objective model for designing a medical waste management system during the COVID-19 pandemic. The model aims to reduce total costs of infectious medical waste management while also reducing the environmental impact of treatment centers, disposal centers, and transportation. It also aims to maximize the suitability of treatment technology based on social considerations and reduce the risk associated with processing and transporting COVID-19 waste. Different strategic and operational decisions are taken into account that include the selection of treatment technologies, the location of treatment and disposal centers, the flow of generated medical waste between facilities, and the number of vehicles required for the medical waste transport. The model tackles the uncertainty associated with model parameters, and it uses a credibility-based possibilistic programming method to deal with uncertainties. The suggested model is solved using an interactive fuzzy programming method and the importance of social indicators for selecting treatment technology is determined using the fuzzy best–worst approach. The effectiveness of the model is demonstrated by a practical case study in Shiraz, Iran. The numerical results can help system designers to achieve the most suitable trade-off between the sustainability goals and the safety viewpoint. [ABSTRACT FROM AUTHOR]

This paper proposes a mathematical model of Sustainable Closed-Loop Supply Chain Networks (SCLSCNs). When an outbreak occurs, environmental, economic, and social aspects can be traded off. A novelty aspect of this paper is its emphasis on hygiene costs. As well as healthcare education, prevention, and control of COVID-19, this model offers job opportunities related to COVID-19 pandemic. COVID-19 damages lead to lost days each year, which is one of the negative social aspects of this model. COVID-19 was associated with two environmental novelties in this study. positive and negative effects of COVID-19 can be observed in the environmental context. As a result, there has been an increase in medical waste disposal and plastic waste disposal. Multi-objective mathematical modeling whit Weighted Tchebycheff method scalarization. In this process, the software Lingo is used. The COVID-19 pandemic still has a lot of research gaps because it's a new disease. An SC model that is sustainable and hygienic will be developed to fill this gap in the COVID-19 condition disaster. Our new indicator of sustainability is demonstrated using a mixed-integer programming model with COVID-19-related issues in a Closed-Loop Supply Chain (CLSC) overview. [ABSTRACT FROM AUTHOR]

Health-care waste (HCW) may pose a risk to human health and the environment because of its infectious and/or toxic properties. This study was conducted to evaluate the quantity and composition of all the HCW generated by different producers in Antalya, Turkey, using data obtained from two online systems. Accordingly, this study explored the trends in healthcare waste generation (HCWG) between 2010 and 2020 and the impact of COVID-19 on HCWG by comparing the post- and pre-COVID-19 patterns based on the data obtained from 2,029 different producers. The collected data were based on the waste codes reported by the European Commission, were characterised based on the definition of the World Health Organization, and were further analysed according to the healthcare types defined by the Turkish Ministry of Health to characterize HCW. The findings indicate that the main HCW contributor was infectious waste (94.62 %), most of which was generated by hospitals (80 %). This is due to the inclusion of only HCW fractions in this study and to the definition of infectious waste considered. This study indicates that the categorisation into the type of HCSs may be a good option to assess the increase of HCW quantities, in accordance with the service type, size, and the effects of COVID-19. The correlation results for hospitals offering primary HCS revealed a strong relationship between the HCWG rate and the population per year. This approach may help estimate future trends to promote better HCW management practices for the specific cases considered, and it can even be applied to other cities., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

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., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

Biomedical waste from healthcare activities poses a higher hazard of infection and damage than other types of trash. The main objective of the study was to assess the awareness knowledge and practices of biomedical waste management (BMWM) among health care professionals in the health care units. The cross-sectional study was carried out to access the awareness, knowledge and practices of health care professionals for BMWM. Using a qualitative approach, the study was escorted in two Apex hospitals i.e. the Allied Hospital and the District Head Quarter Hospital, Faisalabad, Pakistan from August 5, 2019 to October 15, 2019. More than 90% of respondents knew the phrase BMWM, but just 35.4% had awareness about biomedical waste regulations. About 71.6% of the respondents were familiar with biomedical waste's color-coding segregation. The study concludes gap in the awareness, knowledge and practices for BMWM. The sanitary workers of the hospitals had no knowledge about BMWM and the BMWM/healthcare waste management rule 2005 established in Pakistan due to the lack of training regarding waste management and the segregation process. Some of the staff members were aware of the BMWM practices under the rules and regulations of Pakistan but were unable to implement at their work place. It is necessary to dispose of the biomedical waste according to the established terms and conditions of BMWM rules (2005) of Pakistan. Weak structure of BMWM was observed at the study sites due to the lack of training, liabilities and absence of penalties against improper biomedical waste disposal as violation of the rules and regulations. It's a dire need of the time to consider the biomedical waste as hazardous waste and make policies for its safe disposal and ensure the implementation of the policies in all the medical centers of Pakistan., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

More and more serious games have been developed in recent years for patients with aging, rehabilitation, mental, and other healthcare needs. Often, such healthcare games have different experiments or evaluations associated. Rapid advancements in healthcare games see increased regulatory concerns. Unfortunately, there is no authority like the Food and Drug Administration (FDA) in United States for regulatory approvals of healthcare games. Yet, it is not appropriate to use the traditional pharmaceutical FDA approval, which is a tedious and time-consuming process, for healthcare games. We propose a Healthcare Game Blockchain (HGB) to support game developers, healthcare providers, healthcare authorities, and patients. For healthcare game developers, HGB is a common platform to deposit healthcare game prototypes or products. HGB can collect feedback data for analysis similar to drug clinical trials on efficacy and toxicity. Volunteers can be recruited for clinical trials using the healthcare games available on HGB. Once the healthcare games are accepted with a recommended usage, patient gamers can leverage the same HGB platform for treatments following the instructions of healthcare providers. HGB allows healthcare professionals to track the patient responses during their healthcare game medication. Big data analytics can be developed to monitor patient outcomes and healthcare game efficacy. Security and privacy issues are critical in healthcare data handling. HGB has the potential to resolve these limitations and inefficiencies improving data collection, data sharing, and data security by leveraging on the intrinsic properties that blockchain technology provides. This paper explores the possibility of integrating blockchain and healthcare games supporting clinical trials and treatment monitoring. [ABSTRACT FROM AUTHOR]