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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 presence of toxic and pathogenic agents in the dental waste products has made it to be classified as ""hazardous waste.""~Background~Background~To assess dental waste production rate and composition and approaches used to manage these waste products in 2017 in Birjand, Iran.~Objective~Objective~48 dental clinics were evaluated in two months of 2017. Sampling was performed from each clinic 3 times a week. Samples were manually divided into 5 categories of chemical-pharmaceutical, infectious, semi-household, sharp and cutting materials, and toxic waste products, and weighed. A checklist containing 25 questions was used to evaluate the aspects of waste management in dental clinics.~Methods~Methods~The total amount of waste products generated in dental clinics was 7848.02 kg/ year in which semi-household waste had the highest quantity (4263.411 kg/year) and toxic waste had the lowest quantity (9.275 kg/year). Components with the highest amounts in dentistry waste products were nylon gloves (16.7%), paper and cardboard (13.4%), latex gloves (10.8%), and pharmaceuticals (10.2%). Waste separation was restricted to sharp and cutting waste. More than half (57%) of dental units were equipped with amalgam filter. Fixing solutions were directly discharged to sewage in 48.6% of clinics. There was no program to reduce waste generation in 54% of the clinics. Autoclave was the main tool for sterilizing dental instruments.~Results~Results~This study showed a remarkable share of recyclable materials in the composition of dental waste and lack of special approach to manage waste in dental clinics. It is necessary to plan for minimizing generation of, separating, and recycling waste at source.~Conclusion~Conclusions" [ABSTRACT FROM AUTHOR]

Background: As dental solid waste are among the most important environmental pollutants due to its high contents of toxic and hazardous agents, suitable treatment and management of it are of great importance. The objective of this study was to quantity & quality analyses of dental solid waste and associated management practices in the general dentistry offices in the city of Arak. Materials and Methods: 15 samples of solid waste were taken from the 5 selected general dentistry offices, classified into 66 components and 4 fractions, and then the quantity & quality characteristics were evaluated. Management practices of the solid waste were also investigated by using a questionnaire. Results: According to the results, per capita and the average generation rate of each dentistry office were 66.71 g/day-patient and 1340.45 g/day, respectively. Potential infectious, domestic-type, chemical & pharmaceutical, and toxic wastes consisted of 54.25%, 35.14%, 8.19%, and 2.14% of the waste generated, respectively. 10 components including latex gloves, nylon & plastic, saliva & blood-contaminated kleenex, paper & cardboard, used ampoules, saliva ejector tubes, gypsum, food waste, saliva & blood-contaminated dental rolls, and nylon gloves were responsible for more than 80% of the total waste generated, respectively. Conclusion: Each fraction of dental solid waste (toxic, chemical & pharmaceutical, potential infectious and domestic-type wastes) should be separately collected and disposed of according to the related criteria. [ABSTRACT FROM AUTHOR]

Hospital solid waste assessment is regularly characterized by a large number of known criteria that are both qualitative and quantitative in nature. The qualitative criteria can only be assessed by human judgments, which predictably engage a variety of uncertainties such as fuzziness and ignorance. Therefore, hospital solid waste assessments need to be analyzed and modeled using approaches that can handle uncertainties. The evidential reasoning (ER) approach can be utilized for such an analysis. In this paper, perhaps for the first time, the ER approach is applied to regional hospital solid waste assessment. The assessment criteria are characterized by a set of assessment grades assumed to be commonly exclusive and communally exhaustive. All assessment information, incomplete or complete, qualitative or quantitative, and imprecise or precise, are modeled using a cohesive belief structure. The ER approach will be used to aggregate multiple hospital solid waste assessment criteria, resulting in distributed assessment for each alternative. The proposed methodology is applied for regional hospital solid waste assessment in the province of Khuzestan, Iran., (Copyright © 2012 Elsevier B.V. All rights reserved.)

The objective of this study was to identify the components, composition and production rate of dental solid waste and associated management practices in dental offices in Hamadan. A total of 28 offices, including ten general dentist offices, eight specialist dentist offices, five practical dentist offices and five denture maker offices were selected in a random way. Three samples from each selected type were taken and the waste was manually separated into 74 sub-fractions and each sub-fraction was weighed. The results showed that the total annual dental waste production in dental offices was 41947.43 kg. Domestic type, potentially infectious, chemical and pharmaceutical and toxic waste constituted 71.15, 21.40, 7.26 and 0.18%, respectively of this amount. Only seven fractions including gypsum, latex gloves, nylon, dental impression material, used medicine ampoules, saliva-contaminated paper towels and saliva ejectors constituted about 80% of the waste. It was also indicated that there were no effective activity for waste minimization, separation, reuse and recycling in dental offices and the management of sharps, potentially infectious waste and other hazardous waste was poor.

Disposal of about 1750tons of solid wastes per day is the result of a rapid population growth in the province of Khuzestan in the south west of Iran. Most of these wastes, especially hospital solid wastes which have contributed to the pollution of the environment in the study area, are not properly managed considering environmental standards and regulations. In this paper, the framework of a master plan for managing hospital solid wastes is proposed considering different criteria which are usually used for evaluating the pollution of hospital solid waste loads. The effectiveness of the management schemes is also evaluated. In order to rank the hospitals and determine the share of each hospital in the total hospital solid waste pollution load, a multiple criteria decision making technique, namely analytical hierarchy process (AHP), is used. A set of projects are proposed for solid waste pollution control and reduction in the proposed framework. It is partially applied for hospital solid waste management in the province of Khuzestan, Iran. The results have shown that the hospitals located near the capital city of the province, Ahvaz, produce more than 43% of the total hospital solid waste pollution load of the province. The results have also shown the importance of improving management techniques rather than building new facilities. The proposed methodology is used to formulate a master plan for hospital solid waste management.

Hospital waste contains large quantities of hazardous materials. In Iran, as in many developing countries, not much attention has been paid to this matter. Little information is available regarding the generation and disposal of medical waste in Iran, and this fact hinders planning for a better management of the aforementioned waste. This paper describes a survey performed on the collection and disposal of waste in the university hospitals of the Fars province, which are the medical referral centres in the southern half of the country, and the results obtained are fully discussed. The lack of separation between hazardous and non- hazardous waste, an absence of necessary rules and regulations applying to the collection of waste from the hospital wards and the on-site transport to a temporary storage location, a lack of proper waste treatment, disposal of hospital waste along with municipal garbage, insufficient training of personnel, insufficient personal protective equipment and lack of knowledge regarding the proper use of such equipment, were the main findings. For a rapid improvement of existing conditions, performing extensive research for the assessment of present situation in the hospitals of this country, compilation of rules and establishment of standards along with effective training for the personnel is recommended.

A number of factors have contributed to the increase in waste production and diversity of waste, such as the increase in population, alterations in consumption patterns, economic development, income changes, urbanization, and industrialization. The production of different types of waste, such as electronic, urban, hospital, and industrial waste, makes it necessary to classify waste accurately and recognize effective criteria for waste management. To design and operate waste management systems, it is necessary to understand the sources and types of waste, as well as information about their composition and rate of production. As a result, this study aims to rank 21 types of waste according to Iran's economic, social, and environmental criteria, as well as 13 sub-criteria related to those criteria. For this aim, proposed a novel decision-making approach based on the extension of the base criterion method (BCM) and combined compromise solution (CoCoSo) methods under fuzzy Z-numbers. Additionally, sensitivity analysis and comprehensive analysis are conducted on the results of the criteria and alternatives of sustainable waste management. Based on the results of this study, direct profit and reduced landfill are the most important criteria for assessing sustainable waste management alternatives. According to the results of this study, the sub-alternative of industrial metal waste is the most important waste management option. Examining the next sub-alternative ranks under sustainable waste management options (mobile, communication equipment, and battery) shows that electronic waste requires more attention for recycling and sustainable waste management. [ABSTRACT FROM AUTHOR]

Elevated medical waste has urged the improvement of sustainable medical waste treatments. A bibliometric analysis is initially conducted to investigate scientific development of medical waste management to pinpoint the publication trends, influential articles, journals and countries and study hotspots. Publications on medical waste and its management sharply increased since 2020. The most influential article was written by Klemeš et al., and "Waste Management and Research" is the most productive journal. India, China, the United Kingdom, Iran and Italy have published the most works. The research spotlights have switched from "human" and "sustainable development" in 2019 to "COVID-19" and "circular economy" in 2021. Since government acts essentially in handling medical waste and controlling disease transmission, rule implementations among the abovementioned countries are summarized to seek gaps between scientific advancement and regulatory frameworks. For accomplishing a circular economy, waste-to-energy technologies (incineration, gasification, pyrolysis, plasma-based treatments, carbonization, hydrogenation, liquefaction, biomethanation, fermentation and esterification) are comprehensively reviewed. Incineration, gasification, pyrolysis and carbonization are relatively feasible methods, their characteristics and limitations are further compared. By holistically reviewing current status of medical waste research, the focal points involved in management at the policy and technical level have been highlighted to find proper routes for medical waste valorization. [ABSTRACT FROM AUTHOR]

Population growth and increasing access to medical services have led to an increase in the generation of medical wastes, out of which most components are reported to be infectious. Medical wastes include wastes generated in hospitals, dental clinics, clinics, clinical laboratories, and other health-related care centres. The aim of this study was to identify the status of medical waste management in Iran as a developing country and its comparison with neighbouring countries. For this purpose, a systematic method for selection of related articles was performed by defining the search protocol and identifying most relevant keywords in five databases that included one Persian database. We found and screened articles from Scopus, Web of Knowledge, PubMed, ProQuest and Scientific Information Database (SID) (Persian). In addition, Scopus dataset was employed to search studies focused on the status of the medical waste management in neighbouring countries with Iran. Finally, 49 articles covering medical waste management information in Iran and 8 articles in neighbouring countries were selected to investigate the quantity and status of medical waste management in Iran and its comparison with neighbouring countries. [ABSTRACT FROM AUTHOR]

Background: Waste produced in dental clinics has been the topic of investigations for many years. These waste materials have important health impacts and are hazardous to humans and the environment. Objective: To investigating solid waste production and its management in dental clinics in Gorgan, northern Iran. Methods: In this cross-sectional study, 45 of 143 public dental practices and 5 of 25 private dental practices were selected and studied. From each clinic, 3 samples were taken and analyzed at the end of successive working days (Tuesday and Wednesday). Samples were manually sorted into 50 components. The measured components were then classified on the basis of their characteristics, hazard potentials, and WHO classification. Results: The total annual amount of dental waste produced in public and private dental practices in Gorgan was 12 015.1 and 3135.0 kg, respectively. Production percentages of infectious, domestic, chemical and pharmaceutical, and toxic waste in public dental practices were 38.4%, 33.7%, 6.6%, and 0.6%, respectively. The percentages for private practices were 8.7%, 10.6%, 1.1%, and 0.1%, respectively. Conclusion: Dental waste management in Gorgan is inadequate; dental waste is not properly segregated, collected, and disposed, as demanded by the WHO. Employees in dentist offices must be trained in correct handling of waste products and the associated risks. [ABSTRACT FROM AUTHOR]

• A novel healthcare waste location-routing problem is developed with a new perspective in healthcare logistics networks. • A stochastic essence for the emission of contamination is considered. • The management of medical wastes in Coronavirus Disease 2019 is focused. • A real case study is modeled to manage the logistics of infectious and non-infectious healthcare wastes. • A Multi-Objective Water-Flow like Algorithm with novel operators is developed and compared with the others. This paper presents a novel healthcare waste location-routing problem by concentrating on a new perspective in healthcare logistics networks. In this problem, there are healthcare, treatment, and disposal centers. Locations of healthcare centers are known, however, it is required to select appropriate locations for treatment, recycling, and disposal centers. Healthcare wastes are divided into infectious and non-infectious wastes. Since a great volume of healthcare wastes are infectious, the emission of contamination can have obnoxious impacts on the environment. The proposed problem considers a stochastic essence for the emission of contamination which depends on the transferring times. In this respect, transferring times between healthcare and treatment centers have been considered as normal random variables. As transferring time increases, it is more likely for the contamination to spread. Having visited a treatment center, infectious wastes are sterilized and they will no longer be harmful to the environment. This research develops a bi-objective mixed-integer mathematical formulation to tackle this problem. The objectives of this model are minimization of total costs and emission of contamination, simultaneously. Complexity of the proposed problem led the researchers to another contribution. This study also develops a Multi-Objective Water-Flow like Algorithm (MOWFA), which is a meta -heuristic, to solve the problem. This algorithm uses a procedure based on the Analytical Hierarchy Process (AHP) to rank the non-dominated solutions in the archive set. By means of a developed mating operator, the MOWFA utilizes the best ranked solutions of the archive in order to obtain high quality offspring. Two neighborhood operators have been designed for the MOWFA as the local search methods. Extensive computational experiments have been conducted to evaluate the effectiveness of the MOWFA on several test problems compared with other meta -heuristics, namely the Multi-Objective Imperialist Competitive Algorithm (MOICA) and Multi-Objective Simulated Annealing (MOSA). These experiments also include a real healthcare waste logistic network in Iran. The computational experiments demonstrate that our proposed algorithm prevails these algorithms in terms of some well-known performance evaluation measures. [ABSTRACT FROM AUTHOR]

Clinical laboratories are significant generators of infectious waste, including microbiological materials, contaminated sharps, and pathologic wastes such as blood specimens and blood products. Most waste produced in laboratories can be disposed of in the general solid waste stream. However, improper management of infectious waste, including mixing general wastes with infectious wastes and improper handling or storage, could lead to disease transmission. The aim of this study was to assess waste management processes used at clinical laboratories in Shiraz, Iran. One hundred and nine clinical laboratories participated In this cross sectional study, Data collection was by questionnaire and direct observation. Of the total amount of waste generated, 52% (by weight) was noninfectious domestic waste, 43% was non-sharps infectious waste and 5% consisted of sharps. There was no significant relationship between laboratory staff or manager education and the score for quality of waste collection and disposal at clinical laboratories. Improvements in infectious waste management processes should involve clearer, more uniformly accepted definitions of infectious waste and increased staff training. [ABSTRACT FROM PUBLISHER]