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Aims: To measure nurses' compliance with standard precautions during the COVID‐19 pandemic, compare findings with previous assessments and describe the barriers affecting nurses' compliance. Background: Healthcare providers' compliance with standard precautions is still limited worldwide. Implementation of infection control policies in hospitals is needed internationally, especially during a pandemic. Surprisingly, studies exploring nurses' compliance with standard precautions are lacking during COVID‐19. Methods: A multicenter cross‐sectional study was adopted in two Italian hospitals. Nurses' compliance with standard precautions was measured through The Compliance with Standard Precautions Scale (Italian version). An open‐ended question explored the barriers to nurses' compliance with standard precautions. Reporting, followed the STROBE guidelines. Results: A total of 201 nurses were enrolled in 2020. Nurses' compliance with standard precautions was suboptimal. A statistically significant improvement in the compliance rate with standard precautions was observed between pre‐ and during COVID‐19 assessments. High compliance was found in the appropriate use of surgical masks, gloves and sharps disposal. Nurses perceived personal, structural and organizational barriers to standard precautions adherence. Conclusion: Nurses' compliance with standard precautions was not 100%, and different factors impeded nurses to work safely. Our findings provide institutional leaders and educators with the basis for implementing policies to optimize nurse safety, well‐being and patient care. Implications for nursing and health policies: Nurses have the right to work safely, and when the shortage of personal protective equipment and nurses during an emergency threatens healthcare quality worldwide, policymakers are challenged to act by establishing an effective allocation of resources for consistent compliance with standard precautions. Moreover, nurses should actively engage in the implementation of infection control policies to improve safe behaviours among citizens and students accessing hospitals. [ABSTRACT FROM AUTHOR]

Objective To identify evidence-based interventions that reduce greenhouse gas emissions in health-care systems in low- and middleincome countries and explore potential synergies from these interventions that aid climate change adaptation while mitigating emissions. Methods We systematically searched 11 electronic databases for articles published between 1990 and March 2023. We assessed risk of bias in each article and graded the quality of evidence across interventions in health-care operations, energy and supply chains. Findings After screening 25 570 unique records, we included 22 studies published between 2000 and 2022 from 11 countries across six World Health Organization regions. Identified articles reported on interventions spanning six different sources of emissions, namely energy, waste, heating and cooling, operations and logistics, building design and anaesthetic gases; all of which demonstrated potential for significant greenhouse gas emission reductions, cost savings and positive health impacts. The overall quality of evidence is low because of wide variation in greenhouse gas emissions measuring and reporting. Conclusion There are opportunities to reduce the greenhouse gas emissions from health-care systems in low- and middle-income countries, but gaps in evidence were identified across sources of emissions, such as the supply chain, as well as a lack of consideration of interactions with adaptation goals. As efforts to mitigate greenhouse gas intensify, rigorous monitoring, evaluation and reporting of these efforts are needed. Such actions will contribute to a strong evidence base that can inform policy-makers across contexts. [ABSTRACT FROM AUTHOR]

Objective: This review aims to address the critical role of sample size calculation in designing and conducting animal studies related to diabetes and obesity, particularly focusing on experimental comparison methods like ANOVA design. Materials and Methods: We discuss the factors influencing sample size decisions, including type I and type II errors, effect size, and standard deviation. We emphasize the importance of avoiding common pitfalls, such as using rules of thumb or arbitrary choices, and advocate for utilizing established formulas to ensure accurate and reliable sample size determination. Results: This review presents relevant equations for calculating sample size in animal studies with an ANOVA design, providing researchers with a framework for determining the appropriate number of animals needed to achieve robust and ethical research. Conclusion: Accurate sample size calculation is essential for achieving powerful and statistically sound animal studies in diabetes and obesity research. Utilizing established formulas and avoiding arbitrary choices ensures reliable and ethical research practices while minimizing resource waste and maximizing the validity of collected data. [ABSTRACT FROM AUTHOR]

Purpose In current hospital pharmacy practice, the need to compound medications ahead of patient orders often results in an increase in medication waste. The purpose of this study was to implement a strategic approach for anticipatory sterile compounding and evaluate its effect on the reduction of expired medication waste. Methods This was a pre-/post-intervention quasi-experimental study with 3 weeks of data collection for both arms and a 1-week washout period to implement process changes. A par log was placed on the medication storage refrigerator used for anticipatory compounding, with minimum and maximum levels determined by the demand-forecasting model. The primary outcome was the percentage of observations associated with waste. The secondary outcomes were the overall percentage of sterile compounding spending attributable to waste, median wasted dollars per sterile compounded product, and median dollars spent per sterile product compounded as anticipatory stock. Descriptive statistics were calculated using Minitab version 20, with the α level set to 0.05. Results A total of 4,619 observations were included in the analysis: 2,433 in the preintervention group and 2,186 in the postintervention group. Despite the median price being higher in the postintervention group than in the preintervention group, both the primary and secondary outcomes indicated that waste was reduced following the intervention. Conclusion Overall, implementation of the framework reduced sterile products waste at our institution. More research is needed to evaluate the effects of this framework at institutions of different sizes and with different patient populations. Further research on probabilistic models for sterile compounded products is also needed. [ABSTRACT FROM AUTHOR]

Medical waste poses high risks to healthcare workers, patients, the environment, and public health. Governments have adopted measures and enacted policies to ensure proper medical waste management. Through a retrospective policy analysis, we analyzed the waste management policy for primary healthcare centers in Saudi Arabia. By adopting Walt and Gilson's health policy analysis framework, we conducted a thematic analysis of documents to analyze the policy context, process, actors, and content. Contextual factors including accreditation, the Saudi Vision-2030 and the healthcare transformation plan contributed to the development of the policy. The policy was adapted from a regional policy that was enacted about 15 years ago. The policy content overlooked components relevant to the specific context of primary healthcare centers. Lack of training and cooperation among stakeholders challenged successful implementation and thus compliance with the policy. Respective stakeholders must take further actions to ensure implementation fidelity and sustainability of the policy. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has resulted in an unprecedented amount of medical waste, presenting significant challenges for the safe disposal of hazardous waste. A systematic review of existing research on COVID-19 and medical waste can help address these challenges by providing insights and recommendations for effective management of the massive medical waste generated during the pandemic. This study utilized bibliometric and text mining methods to survey the scientific outcomes related to COVID-19 and medical waste, drawing on data from the Scopus database. The results show that the spatial distribution of medical waste research is unbalanced. Surprisingly, developing countries rather than developed countries lead research in this area. Especially, China, a major contributor to the field, has the highest number of publications and citations, and is also a centre of international cooperation. The main study authors and research institutions are also mainly from China. And the research on medical waste is a multidisciplinary field. Text mining analysis shows that COVID-19 and medical waste research is mainly organized around four themes: (i) medical waste from personal protective equipment; (ii) research on medical waste in Wuhan, China; (iii) threats of medical waste to the environment and (iv) disposal and management of medical waste. This would serve to better understand the current state of medical waste research and to provide some implications for future research. [ABSTRACT FROM AUTHOR]

Background: Biomedical waste is unwanted materials that contains potentially infectious elements and produced during medical procedures such as diagnosis, therapy, surgery, vaccination, or research. Healthcare waste poses serious dangers to public health and the environment, making its management crucial. This study aimed to assess knowledge and practices of nursing staff regarding biomedical waste management at rural health units in Tanta city. Research design: Descriptive study design was utilized to achieve the aim of this study. Setting: This study was conducted at 14 rural health units affiliated to Tanta district. Sample: All the available nursing staff working (325) at the previous mentioned settings was included in this study. Tool of the study: A structured questionnaire sheet was used including three parts: (1) Socio-demographic characteristics of the studied nursing staff, (2) Nurses' knowledge regarding biomedical waste and its management (3) Self-reported practices of nursing staff regarding biomedical waste management. Results: 43.4% nurses who were studied knew very little about biomedical waste management and 60.6% had unsatisfactory reported practice. Conclusion: Highly a statistically significant positive association between the study nurses' overall knowledge score and their overall reported practice score regarding biomedical waste management (p < 0.001). Recommendation: It is essential to identify nurses training needs regarding safe waste management policies and guidelines through ongoing evaluation of nurses' expertise and methods in waste control in health care units. [ABSTRACT FROM AUTHOR]

[Display omitted] • Selected 37 typical data comparing the industry's eight MW disposal technologies. • The average disposal of 1 ton of MW produces 0.94–1.2 tons of CO 2. • LCC and NPV results showed that steam sterilization with landfill is the best. • The environmental and economic impacts of MW disposal in 10 megacities were studied. • 10 megacities employ MS-MSWI technology to reduce 279,000 tons of CO 2 emissions. 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. [ABSTRACT FROM AUTHOR]

In this study, it is aimed to examine the relationship between green behaviors of health professionals and green practices in the workplace. The study sample consisted of 174 health professionals from 34 Family Healthcare Centers (FHCs) in Turkey. Number, percent, mean, standard deviation, student's test, Mann – Whitney U test, One Way Anova test, Kruskal-Wallis H test, linear regression analysis were used for statistical analysis. Energy-saving (β: 0.197; 95%CI: 0.040;0.266) and waste reduction practices (β: 0.174; 95%CI: 0.019;0.256) in the workplace were positive associated with environmental sensitivity. Waste reduction practices (β: 0.228; 95%CI: 0.093;0.478) in the workplace were positive associated with environmental participation. Recycling bins (β: 0.181; 95%CI :0.084;0.799) and using solar energy (β: 0.198; 95%CI: 0.030; 0.785) in the workplace were positive associated with technological sensitivity. Health professionals who work in workplaces with energy-saving, waste reduction practices, recycling bins and using solar energy more likely to display green behaviors. [ABSTRACT FROM AUTHOR]

Background: Blood wastage leads to additional costs and reduced blood availability to patients. Above all is the moral issue of wasting donor gifts. This study aimed to determine the rate of blood wastage before and after implementing a new standard operating procedure (SOP) in Iran. Methods: In this interventional study, a SOP for wastage management was prepared and implemented in all blood centers throughout the country. Data were extracted from the integrated software of the Iranian Blood Transfusion Organization (IBTO). The wastage rate of blood components in the post-intervention years (2016-2017) was then compared with that in the pre-intervention years (2013-2015) using the Z test. Results: The overall wastage rate decreased by 36.86% (P < 0.001, 95% CI [36.84-36.88]) after the intervention. Red blood cell (RBC) wastage decreased from 2.6% to 2.5%, platelet wastage from 19.5% to 10.6% and plasma wastage from 15.5% to 7.3% (P < 0.001). The highest percentage of waste reduction pertained to plasma components, which decreased by 52.90% (P < 0.001, 95% CI [52.86-52.94]). Expiration was the most common cause of RBC and platelet wastage. The most common causes of plasma wastage were RBC contamination and rupture or leakage of the bags. The intervention resulted in a drop of over 250 000 discarded components each year, equal to approximately thirty-six million dollars in savings. Conclusion: This intervention effectively reduced waste and increased efficiency. Ongoing blood wastage reviews, auditing, and receiving feedback from the central headquarters were powerful tools in following the compliance of blood centers. Further studies are recommended, especially concerning blood wastage in hospital blood banks and various wards. [ABSTRACT FROM AUTHOR]

Introduction: To achieve continuous environmental sustainability and protect the population's health, healthcare waste (in liquid or solid form) needs appropriate management and suitable treatment strategies before its final disposal in the environment in order to reduce its adverse impacts. This study aims to identify disparities in the waste management of anti-cancer drugs and the wastewater generated in Lebanese hospitals. Methods: Three questionnaires were designed to evaluate the level of knowledge, awareness and experience of hospital personnel regardless of their job levels. Data was collected in December 2019 from three departments of each participating hospital: pharmacy, oncology and maintenance departments. A descriptive analysis was conducted to summarise the survey results. Results: The results revealed a lack of transparency and awareness of the participants, with a high frequency of 'prefer not to say' responses when asked about the disposal methods of anti-cancer drugs and with only 5.7% of the participants in the pharmacy department sharing their disposal procedures. The same perception was deduced regarding hospitals' wastewater treatment, where responses were often contradicting, preventing making assumptions about the fate of hospital wastewater. Conclusion: The results of this survey support the need to establish a more comprehensive waste management programme in Lebanon that would be maintained through regular training and supervision. [ABSTRACT FROM AUTHOR]

Proper disposal of waste medical masks has become increasingly urgent in order to protect the ecosystem. Our exploratory study has proven the feasibility of producing waste mask microfibers (WMMF) and pretreating them with graphene oxide (GO) to enhance the strengths of cement composites. This study further explored the resistance of designed WMMF/GO-WMMF mortar (w/c of 0.40) to chloride migration and frost damage, to address the knowledge gap related to durability. The GO-pretreated WMMF improved the chloride migration resistance (by ∼50%) and the freeze–thaw resistance (by ∼20%), likely due to the tortuosity-increasing, hydration-accelerating, and hydrates-regulating roles of GO in the cementitious material. The microscopic investigation, including backscatter electron imaging, scanning electron microscopy, and thermogravimetric analysis, shed light on the mechanistic roles of GO and WMMF in cement composites. In addition, the two-parameter Weibull distribution was employed to model the frost damage and compare the remaining capacity of freeze–thaw resistance of the three designed mortar samples at the same reliability level; the Bayesian method was also utilized to model the uncertainty during the cyclic freeze–thaw process. [ABSTRACT FROM AUTHOR]

Background and Objectives: Operating rooms (ORs) disproportionally contribute 20% to 33% of hospital waste nationwide and therefore have a major impact on hospital waste management. Seventy percent of general OR waste is incorrectly eliminated as clinical waste, which compounds unnecessary financial burden and produces negative environmental impact. The primary purpose of this quality improvement (QI) project was to evaluate the effectiveness of waste segregation education for OR anesthesia staff on improving waste segregation compliance in the OR. Methods: A waste segregation QI project was implemented at a 19-OR hospital. Sharps bins in each OR were monitored for weight in pounds and 6 ORs were monitored for percent compliance both pre- and post-institution of a waste segregation education. In addition, a waste segregation knowledge assessment, waste segregation barriers assessment, and a demographic survey were administered to anesthesia staff. Twenty-two certified registered nurse anesthetists (CRNAs), 13 anesthesiologists, and 4 anesthesia technicians responded to the initial surveys and assessments while 30 of these original 39 participants (77%) responded following the educational intervention. A cost analysis was calculated pre- and post-implementation by multiplying total weight of the sharps bins by the price per pound of sharps. Results: Twenty-three percent of participants reported having formal waste segregation training. Survey responses revealed that the greatest barrier to waste segregation involved bin location (56.4%), followed by lack of time to segregate (25.6%), lack of knowledge of what content goes in the bin (25.6%), and lack of incentive (25.6%). A waste segregation knowledge assessment showed improvement from pre- (M = 9.18, SD = 1.66) to post-implementation (M = 9.90, SD = 1.64). Pre-implementation sharps bin compliance was 50.70% while postimplementation bin compliance improved to 58.44%. A 27.64% decrease in sharps disposal cost occurred following implementation, which is estimated to produce a $2964 cost savings per year. Conclusions: Waste segregation education for anesthesia staff increased their waste management knowledge, improved sharps waste bin compliance, and produced an overall cost savings. [ABSTRACT FROM AUTHOR]

In recent years, the pyrolysis technique has been adopted for converting non-degradable materials into biofuels and the yields of this process, oil and gas can be substituted as a fuel in CI engine. In this study, the medical waste plastics such as masks, gloves, personal protective equipment (PPE) kit and other plastics associated with hospitals were seen as the feedstock material for the pyrolysis process. It is collected from Government Medical College Hospital Villupuram, Tamil Nadu, India. The proximate and ultimate characterization of these wastes shows the percentage of volatile matter in the mask, gloves, and PPE kit are 81.2%, 79.3%, and 79.6%, respectively, and carbon percentage lies in the range of 75% to 78%, which ensures that the feedstock can be used in this process. The pyrolysis technique is carried out separately for all the collected feedstock such as mask, glove and other PPE kits. In this research, the mask waste showed a higher pyrolytic oil yield rate and is 80.3 wt% at 350°C than other plastics wastes. Further, FTIR of all the plastic waste confirms that pyrolytic oil is in acidic nature and it contains carboxylic acids and other heavier compounds, which are unstable in nature. To improve the fuel characteristics of pyrolytic oil, blending it with diesel requires the utilization of surfactants such as Span 80, Tween 60 and Atlox 4916. In this analysis, 5% of surfactant is mixed with 15% of pyrolytic oil and 80% of diesel. Among the various surfactants Atlox 4916, shows better fuel properties than other pyrolytic oil of plastic waste used in the analysis. Emulsifier fuel blend is prepared from different pyrolytic oils such as masks, gloves and PPE kit with Atlox 4916 surfactant, and MA, GA and PA, respectively. However, the pyrolytic oil from mask with Atlox 4916 surfactant blend has a (42.26 MJ/kg) higher calorific value. The evaluation of performance and emissions is conducted for the test fuels with surfactants derived from mask (MA), gloves (GA) and PPE (PA). Among these blends, MA showed better results in performance and emission behavior. The BTE of MA is 28.4%, which is 4.69% lower diesel and it is 2.077% and 2.95% higher than blend GA and PA. Blend MA shows lower emissions than other blends. [ABSTRACT FROM AUTHOR]

This study explores the progression of global healthcare and medical waste (HMW) disposal technologies and emerging practices in China including the COVID-19 pandemic period through patent technology innovation analysis. Trends were identified through both the Derwent Innovation Index database and bibliometric methods. Based on the bibliometric analysis of 4128 patents issued from 2002 to 2021, the development status and research trends of HMW disposal technology were revealed. Regarding patents, China significantly advanced post-2011. However, a large number of applications are filed only in China and are more focused on domestic rather than overseas markets. As the pandemic remains a threat, and increasing amounts of medical waste are generated, new technologies are being sought in China that will be safer for humans and the environment, and will also be in line with the zero waste technology trend. Incineration and waste crushing are core methodologies in medical waste disposal. Future directions pivot towards innovations in large-scale and distributed processing equipment, automation and unmanned systems and high-temperature steam disinfection collaborative disposal methods—including the "High temperature steam–municipal solid waste incineration collaborative technology" and the "High temperature steam–thermal magnetic gasification collaborative technology". This patent analysis enhances our understanding of the impact of COVID-19 on HMW disposal practices, guiding improved policymaking and research in the HMW sector. [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]

Any hospital's primary goal is to restore human health and save lives through health services provided to patients, but at the same time, hazardous wastes are produced. Inconsistent management of unsafe wastes might cause adverse effects and other issues for workers, the environment, and public health. Segregation is considered the critical stage in successful medical waste management. Mixing hazardous medical waste with non-hazardous medical waste will be avoided by correctly applying practices at the segregation stage. This study aimed to assess personnel's knowledge about infectious medical waste and segregation practices used at six wards in Nicosia General Hospital. An analytical cross-sectional study was conducted, and data were collected through a structured self-administered questionnaire. The Statistical Package of Social Science (SPPS) version 25 was used with a minimum statistical significance of α = 0.05. The study population was nurses, nurse assistants, ward assistants, and cleaners working at the study wards. Out of 191 questionnaires, 82 were received, with a response rate of 42.93%. Most participants were female (72%) and nurses (85.4%). Participants had moderate knowledge about infectious medical waste management and good knowledge regarding segregation practices applied in their ward. Segregation was not carried out as it should have been, since most participants stated that infectious medical waste was mixed with non-hazardous medical waste. The number of correct answers the participants gave regarding the colour-coding of different medical waste categories was 67.5%, and only four answered correctly to all questions. Although participants knew segregation practices and the colour-coding process applied to medical waste, they did not use them satisfactorily. They applied methods regarding segregation without specific training, knowledge and guidance. Due to the issue's importance, training programs must be implemented and performed. [ABSTRACT FROM AUTHOR]

There are four categories of medical waste that cannot be mixed as this will cause serious problems such as environmental pollution or infection. In the past, the classification of medical waste often involved a lot of human and material resources to process, with workers at risk of exposure to infectious substances. Therefore, an augmented reality (AR) and artificial intelligence (AI) medical waste classification system and method were developed. This innovative medical waste classification system and method combines AR and AI identification technology to reduce the risk of manual judgment errors by clinical staff when handling medical waste. [ABSTRACT FROM AUTHOR]

Background. Tokunoshima is a remote island in the Amami Islands, 470 km southwest of the Kagoshima mainland. It has a population of 23,000 and consists of three towns: Tokunoshima, Isen, and Amagi. Three medical institutions on the island are responsible for blood transfusion medicine, but there is no blood stockpiling station on the island, and blood is stockpiled in each of the hospitals. Although Tokunoshima Tokushukai Hospital is responsible for 70% of transfusion medicine on Tokunoshima, it is difficult to maintain a sufficient amount of blood in stock considering disposal. Aim. To determine whether changing the distribution of blood types in a hospital's stockpile would reduce the transfusion disposal rate. Methods. This was a retrospective survey. By changing the in-house stock of blood products for transfusions delivered to our hospital over 10 years from January 2013 to December 2017 (preintervention) and from January 2018 to December 2022 (postintervention), we compared the cost-saving effects of these two intervention strategies on disposal rates and blood inventories, as well as the survival rates of case profiles requiring transfusion interventions in hospital-donated transfusion and ABO-incompatible transfusion between two periods. The hospital's stock of RBC had changes that storage of type (A, B, O, AB) RBC from (4, 4, 4, 2) units in the pre-interventon to (2, 2, 6, 0) units in the postintervention. Results. The annual blood product waste rate decreased from 23.4% in the preintervention period to 17.9% in the post-intervention period. Conclusion. By changing the blood products stockpiled for transfusion medicine in Tokunoshima, the transfusion disposal rate can be reduced. [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. [ABSTRACT FROM AUTHOR]

Background: Chemotherapeutic and immunomodulatory medications can pose a serious risk to patient and healthcare provider safety because of complex processes, cytotoxicity, and prevalent medication use. Objective: To evaluate chemotherapeutic and ancillary medication compounding in hospital pharmacies using a remote verification system, focusing on pharmaceutical deviations from best practice, compounding time, medication waste, and cost. Methods: This retrospective, blinded observational study used a remote intravenous (IV) workflow verification system to examine IV chemotherapeutic compounding errors in large hospital systems. A Patient Safety Organization securely obtained >5000 compounding records and photos from the IV workflow system. Blinded pharmacists evaluated IV chemotherapy preparations using picture slide viewers to assess any deviations from best practice. Time variables, medication waste, STAT vs non-STAT orders, and cost were also evaluated. Results: The most frequently reported deviations from best practice included medications exceeding the >10% additive volume guideline (35.9%) and inaccurate dose labels (28.3%). Time flow analyses demonstrated a substantial increase in total compounding time per vial for 1 vs 2 vials. Most medications in this analysis had an average waste ranging from 0-.36 vials. STAT orders, accounting for 38.4% of all orders, wasted more medication than non-STAT orders. Gemcitabine cost analyses showed an association for number of vials and compounding time with overall cost per dose. Conclusion: Substantial inconsistencies between workflow stations were observed—highlighting the lack of standardization across chemotherapeutics, volume of medication waste during preparation, and the need to establish improved quality controls to safeguard patient and health care provider safety. [ABSTRACT FROM AUTHOR]

This study aimed to present a strategic waste management in two private hospitals in Yazd using models of the strengths, weaknesses, opportunities, and threats (SWOT) and quantitative strategic planning matrix (QSPM). The strengths, weaknesses, opportunities, and threats of the organization was identified according to existing documents and expert team. The internal and external factors were identified by internal factor evaluation (IFE) and external factor evaluation (EFE) matrices. The strategies to improve waste management in two hospitals were presented by comparing internal and external factors. Finally, the attractiveness table was compiled and weighted using the QSPM method to prioritize the strategies. The results demonstrated that 24 strengths, 30 weaknesses, 16 opportunities, and 22 threats were identified. The final score of internal and external factors for hospital A and B were (X: 2.37, Y:1.88) and (X: 2.37, Y: 2.01), respectively. Based on the results, 12 strategies were presented. Finally, the strategy of "the improvement of green management indicators" was implemented as a priority according to QSPM matrix. The result of this study duplicated that using the QSPM and SWOT models is assist to present viable strategies to improve the health-care waste management. [ABSTRACT FROM AUTHOR]

Biomedical waste can lead to severe environmental pollution and pose public health risks if not properly handled or disposed of. The efficient management of biomedical waste poses a significant challenge to healthcare facilities, environmental agencies, and regulatory bodies. Traditional management methods often fall short of efficient handling of biomedical waste due to its enormous quantity, diverse, and complex nature. In recent years, different approaches employing Artificial Intelligence (AI) techniques have been introduced and have shown promising potential in biomedical waste management. Wireless detection and IoT methods have enabled the monitoring of waste bins, predictions for the amount of waste, and optimization of the performance of waste processing facilities. This review paper aims to explore the application of AI through machine learning and deep learning models in optimizing the collection, segregation, transportation, disposal, and monitoring processes, which leads to improved resource allocation with risk mitigation of biomedical waste along with prediction, and decision-making using AI algorithms. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused a surge in essential medical supplies usage, leading to a notable increase in medical waste generation. Consequently, extensive research has focused on sustainable disposal methods to handle used medical equipment safely. Given the necessity to evaluate these methods considering qualitative and quantitative criteria, this falls within the realm of multi-criteria decision-making (MCDM). This study introduces a framework for selecting the most suitable medical waste treatment methods, taking into account economic, technological, environmental, and social aspects. Sixteen criteria were assessed using the Fuzzy Preference Selection Index (F–PSI) to determine the optimal waste disposal approach. Additionally, the Fuzzy Compromise Ranking of Alternatives from Distance to Ideal Solution (F-CRADIS) method was employed to evaluate nine technologies for medical waste disposal. Notably, disinfection efficiency emerged as the most crucial criterion, with autoclaving identified as the preferred method for medical waste treatment. A practical case study conducted in Sivas, Turkey, validates the feasibility of these strategies. Multiple sensitivity analyses were performed to ensure the stability and reliability of the proposed approach.

Abstract Background Several studies revealed that medical students have low performance levels of hand hygiene (HH) and biomedical waste management (BMWM). However, there have been limited interventions directed at young students targeting HH and BMWM enhancement. Given these data, we aimed at assessing HH and BMWM among medical students after two training methods. Methods We performed a quasi-experimental study from September 2021 to May 2022, which included fifth-year medical students enrolled in the faculty of Medicine of Monastir (Tunisia). We relied on a conventional training based on presentations and simulations guided by the teacher and a student-centred training method based on courses and simulated exercises prepared by students. We used the WHO HH Knowledge Questionnaire and the “BMWM audit” validated by The Nosocomial Infection Control Committee in France. Results A total of 203 medical students were included (105 in the control group and 98 in the experimental group) with a mean age of 23 ± 0.7 years. Regarding HH, we found a statistically significant increase in post-test scores for both training methods. A higher post-test mean score was noted for student-centred method (14.1 ± 1.9 vs. 13.9 ± 2.3). The overall improvement in good HH knowledge rates was greater after student-centred method compared to conventional training (40.5% vs. 25%). Concerning infectious waste, mean scores were higher after student-centred learning in all hazardous waste management steps (25 ± 3.3 vs. 23.6 ± 5.5). Results Coupling student-centred teaching and continuous supervision could improve HH and BMWM knowledge and practices among medical students.

Background: Expansion of pharmaceutical industries and improved availability of pharmaceuticals across the world have contributed to an increase in drug usage and accumulation in homes. Improper disposal of expired and unused medications has several consequences such as environmental pollution, and childhood poisoning. Objectives: The aim of the study was to assess the knowledge on disposal as well as disposal practices of unused and expired household medicines in the Parker Corner Road Community in Brewerville, Liberia. Methods: This study was a cross-sectional survey conducted among 162 residents of Parker Corner Road Community using face-to-face interviews. Outcomes measured were knowledge of disposal as well as disposal practices of unused and expired household medicines. The data collected were analysed using descriptive statistics. Results: Majority of respondents (55.6%) were female and 23.5% had university education. 71% of the respondents reported that they had not received any information on safe disposal practices while 64.2% admitted that they often did not read and follow disposal instructions. The most popular disposal practices were disposal of the drugs along with household waste (61.1%) and flushing them down the toilets or sinks (25.3%). Majority of the respondents (82.1%) were aware of the health effects arising from improper disposal of unused and expired medicines while 64.2% usually read medicine disposal instruction on the package. Only about 3% of them knew of expired medication take-back system and 33.3% knew nothing about medication expiration date. Conclusion: The study revealed insufficient knowledge as well as inappropriate disposal practices of unused and expired medicines among residents of Parker Corner Road Community in Brewerville. There is need to organize a public enlightenment programme on safe, appropriate use, as well as disposal of unused and expired medicines.

Background: The world faces a significant global health threat – climate change, which makes creating more environmentally sustainable healthcare systems necessary. As a resource-intensive specialty, anesthesiology contributes to a substantial fraction of healthcare's environmental impact. This alarming situation invites us to reconsider the ecological health determinants and calls us to action. Methods: We conducted a single-center qualitative study involving an online survey to explore the environmental sustainability from anesthesia providers' perspectives in a center implementing internal environmentally-sustainable anesthesia guidelines. We asked care providers how they perceive the importance of environmental issues in their work; the adverse effects they see on ecological sustainability in anesthesia practice; what measures they take to make anesthesia more environmentally friendly; what barriers they face in trying to do so; and why they are unable to adopt ecologically friendly practices in some instances. Using a thematic analysis approach, we identified dominating themes in participants' responses. Results: A total of 62 anesthesia providers completed the online survey. 89% of the participants stated that environmental sustainability is essential in their work, and 95% reported that they implement measures to make their practice greener. A conscious choice of anesthetics was identified as the most common step the respondents take to reduce the environmental impact of anesthesia. Waste production and improper waste management was the most frequently mentioned anesthesia-associated threat to the environment. Lacking knowledge/teaching in sustainability themes was recognized as a crucial barrier to achieving ecology goals. Conclusions: Sustainable anesthesia initiatives have the potential to both encourage engagement among anesthesia providers and raise awareness of this global issue. These findings inspire opportunities for action in sustainable anesthesia and broaden the capacity to decrease the climate impact of health care. [ABSTRACT FROM AUTHOR]

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]

Background & Objective: The safety of women during childbirth and personnel working in maternity care amidst the COVID-19 pandemic is a priority for the health system. Hence, good risk management practices need to be implemented to reduce the spread of infection between healthcare workers and pregnant women who have contracted COVID-19. Therefore, this study aimed to establish a risk map for managing dyspneic parturients suffering from COVID-19-related pneumopathy during delivery. Materials & Methods: This study focuses on examining potential risks beforehand in the context of the management of a dyspneic parturient suffering from COVID-19- related pneumopathy during delivery, executed using the method FMECA (Failure Mode, Effects and Criticality Analysis); this was conducted from September to December 2021 in the maternity service of the Hospital Center ElJadida, Morocco. Results: The risk analysis of a dyspneic parturient suffering from COVID-19-related pneumopathy during delivery revealed thirteen failure modes. Proposed are corrective measures aimed at addressing the failure modes of criticality class C3 whose vital risks are linked to the care of the dyspneic parturient suffering from COVID-19-related pneumopathy at the level of the reanimation service and the level of the neonatal intensive care unit. Conclusion: Employing risk mapping is a fundamental instrument for the ongoing enhancement of quality to maximize the safety of the parturient care process by changing the organizational culture from a reactive to a preventive approach. [ABSTRACT FROM AUTHOR]

Healthcare facilities generate medical waste. If not properly managed, medical waste may damage the environment and spread diseases. Many hospitals in Indonesia do not adhere to medical waste management regulations. This study aimed to evaluate the management of solid medical waste at four public hospitals in Bogor District, Indonesia. A case study design was used to obtain a comprehensive description of the solid medical waste management activities in the hospitals. Data were collected through direct observations, interviews, and document reviews. This study revealed that the medical waste generated in all hospitals was infectious, pathological, pharmaceutical, chemical, and cytotoxic, totaling approximately 4,000-12,000 kg. Hospitals A, B, C, and D fulfilled the Regulation of the Indonesian Ministry of Environment and Forestry No. P56 of 2015 criteria, achieving compliance rates of 77%, 83.78%, 83.3%, and 86.48%, res pectively. However, several activities of the hospitals did not meet the standards for waste reduction, segregation, on-site transport, temporary storage, and human resource quality. It is important that hospitals establish comprehensive and compliant medical waste management systems. [ABSTRACT FROM AUTHOR]

Urbanization is a contributing factor to global warming, as asphalt, concrete, and other light-absorbing materials replace vegetated areas, causing an increase in Land Surface Temperature (LST) and creating Surface Urban Heat Islands (SUHI). Although thermal satellite imagery has been a powerful tool in mapping LST and SUHI spatio-temporal changes, the number of studies in Africa, including Egypt, remains limited. Thus, in this research, an automated model was developed in ArcGIS and used to map LST and SUHI and detect Urban Hot Spots (UHS) in Alexandria city, Egypt, using Landsat 8 time series (2013 to 2021). The results revealed an increase of 41.31% in urban areas and a decrease of 49.51% in agricultural areas, a change that was demonstrated by a decline in the Normalized Difference Vegetation Index (NDVI) from 0.84 in 2013 to 0.53 in 2021. Correspondingly, LST and SUHI displayed an increasing pattern, with the highest recorded values observed in 2021. Thus, this study showed the negative impact of urbanization on Alexandria city's temperature - a city that is already facing a climate catastrophe because of the sea level rise resulting from climate change. Furthermore, the developed estimation model can be similarly useful for climate change researchers and decision makers. [ABSTRACT FROM AUTHOR]

Introduction: To date, there is limited literature to guide emergency providers (EPs) on the proper dosing of prescription opioids. Our study aims to assess the self-reported opioid use, storage, and disposal practices of patients presenting to the emergency department (ED) with acute pain. Methods: This prospective cohort study employed a validated, cross-sectional survey of subjects identified using electronic medical records. The survey link was e-mailed to a continuous sample of eligible participants 3–4 weeks following ED discharge. Nonrespondents were surveyed through telephone after 1 week. We used descriptive and nonparametric statistics to report survey results. Results: Of 500 eligible subjects, 97 completed the questionnaire. Only 28% of respondents reported that they took all of the prescribed pills. Of the remaining responses, 20% stated that they did not take any pills, 33% took about one-fourth, 7.2% took about half, and 12.4% took about three-fourths of the pills. Among those who did not take any pills, 42% filled the prescription. Most (71.2%) reported storing their leftover pills; among those who stored their pills, less than one-fourth (23.8%) used a locked storage location. Conclusions: Our findings suggest that less than one-third of patients who receive prescriptions in the ED for acute pain use all of their prescribed pills, suggesting that many patients are unnecessarily prescribed opioids for acute conditions. The findings of this study also suggest that many patients with unused prescription opioids do not practice safe storage or proper disposal of leftover pills. This represents a potential opportunity for EPs to improve medication safety by educating patients on proper storage and disposal practices. Limitations include low response rate and the use of self-reporting. [ABSTRACT FROM AUTHOR]

Introduction: Health Care Waste (HCW) is generated by various activities in healthcare facilities like hospitals, clinical, research institutions, laboratories, blood banks, etc. HCW is both infectious and hazardous and, unless rendered noninfectious and safe, can prove to be hazardous to people coming in contact with it. Objectives: To assess the Knowledge and Practice regarding HCW Management among health functionaries of districts of Gujarat and its association between the designation and qualification with the Knowledge and Practice score. Methodology: It was an observational and crosssectional study using pretested, reliable, and valid questionnaire. A sample size of 152 was calculated based on the findings of a pilot study. We have implemented our study in Gujarat, divided into four parts (Saurashtra, Central, South, and North Gujarat). Study sites were selected equally in all four areas. Results: A total of 163 healthcare participants were involved in the study, most respondents were from primary healthcare centers (31.7%), followed by medical college hospitals (14.5%). In our study, Bhavnagar district had the highest number of contributors (21.7%), followed by Morbi district (19.1%). The hospital administrator category had the highest knowledge score, while Infection Control or Waste Management Officer had the highest practice score. MBBS/AYUSH graduates had the highest knowledge and practice scores. It is also apparent that staff nurses had better knowledge and practice scores than ANM. Conclusion: The overall assessment score was good for all health workers. Doctors' better knowledge and practice scores signify qualification's role in BMW management. [ABSTRACT FROM AUTHOR]

This article discusses the use of a mosque as a surge capacity facility during the Covid-19 pandemic in Iran. Due to limited healthcare capacity, a mosque in Neyshabur was repurposed into a clinic for triage patients. The clinic operated for 30 days and admitted up to 800 patients per day. The article highlights the advantages of using religious sites as additional treatment venues, such as parking availability and suitable physical structures. It also emphasizes the importance of teamwork, safety standards, and utilizing healthcare professionals from universities and volunteer organizations. The article concludes by emphasizing the need for preparedness and planning for future outbreaks. [Extracted from the article]

Background: The reverse logistics of medicines consists of the logistical procedure of collection, transport, storage, treatment and final disposal of postconsumer or expired waste. Medicines can be toxic to the environment and affect the health of citizens of the territory. Community pharmacies, as a health facility, play a key role in this process. Objectives: Define the spatial analysis and cases of reverse logistics of medicines in community pharmacies in Brazil. Methods: This is a cross-sectional study, and the research covered the medicines collected by 400 community pharmacies in the period from 2020 to 2022. To obtain the data, the medicines were collected, weighed, segregated and the weight released on a dedicated waste management platform. All regions of Brazil subject to georeferencing were processed using the free software Geographic Information System (QGIS). Data were expressed as median and range or as frequency of occurrence. Chi-square t-test and Fisher's exact test were used to compare variables. The accepted significance level was 5%. Results: Of the five existing regions in Brazil, only three had records of reverse medication logistics. 4,519.74 Kg of products were collected, and the North region of Brazil was responsible for 69.1% of the collection. In the spatial analysis, it was possible to perceive a difference between the areas of concentration of the RDL, that is, locations where collections were carried out in the period from 2020 to 2022. Conclusion: The present study preliminarily analyzed the reverse logistics of medicines in Brazil. The data obtained can contribute to the knowledge of this area and to the strengthening of the process. Thus, these places must exercise a task force for the educational process of the population about the risks of incorrect disposal of medicines and that this could harm the environment, economic aspects of society, food and the entire context that involves health and well-being of citizens. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Good health and a safe environment are essential for sustainable development, including the appropriate management of healthcare wastes. The study intends to assess the generation rate and management methods of healthcare waste in the regional hospital center and a private clinic in Tangier, Morocco, with a focus on potential risks to health workers from infectious diseases. METHODS: The study collected data on healthcare waste generation over a period of two months by measuring and analyzing general and hazardous waste using an electronic scale. The data was presented as averages in kilograms per bed per day and as percentages. A questionnaire was provided to 100 healthcare workers. It included questions on their sociodemographic characteristics and their knowledge and attitudes regarding healthcare waste management. FINDINGS: The case study revealed that the healthcare waste production in the two institutions varied, with the private clinic producing 0.76 kilograms per day per bed and the regional hospital center producing 1.84 kilograms per day per bed. The survey also discovered that the hazardous fraction of waste generated in the regional hospital center was 40 percent, which was much higher than the World Health Organization's estimation. The daily amount of hazardous waste generated increased from 260.49 kilograms to 436.81 kilograms post-COVID-19. The survey found gaps in knowledge, attitudes, and daily challenges in waste management practices among the health workers in both facilities. CONCLUSION: The survey findings suggest that the healthcare waste management methods in Tangier are unsafe and may endanger the health workers and patients. The study found that the lack of monitoring and control contributed significantly to noncompliance with good practices. These findings can be used by the regional divisions of the Ministry of Health to develop specific protocols for managing sanitary emergencies and perform routine observation and training at all levels in the two facilities studied. [ABSTRACT FROM AUTHOR]

This study uses a normative legal research type, while the nature of the research used in this writing is descriptive, analytical to analyze and describe the comparative legal responsibility of B3 waste producers in solid medical B3 waste management in hospitals in Indonesia and South Korea. The regulation of the legal responsibility of B3 waste producers in the management of solid medical B3 waste in hospitals in Indonesia is regulated in Law No. 32 of 2009 which states that everyone who produces B3 waste is obliged to manage the waste they produce, including in this case health service facilities that produce medical B3 waste. Medical B3 waste management activities include Reduction and sorting, Storage, Transportation, Processing, Burial and/or Landfill activities of B3 Waste. The management of solid medical B3 waste in hospitals in South Korea was regulated by the Medical Law under the Ministry of Health and Welfare until 1999. The Ministry of Environment announced several regulations for the definition, segregation, packaging, tracking, and final disposal of medical waste. Medical B3 waste management in Korea and Indonesia has similarities in legal, technical and operational aspects. This is one of them because Korea and Indonesia adhere to the same legal system, namely the continental European legal system (civil law). [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic actualized questions about the proper management of biomedical waste while creating several regulatory challenges and requiring countries to look for an appropriate response. These issues have become particularly relevant for Kazakhstan, where waste management issues traditionally face inefficient legal regulation and are particularly acute. This study aims to answer the question of what regulatory problems Kazakhstan currently face in the area of proper biomedical waste management, and how existing foreign experience can help solve them. The present study highlights several pertinent challenges within the context of medical waste management. These include issues concerning the licencing activities associated with waste management, the absence of well-defined regional plans for the management of medical waste and the lack of effective strategies to address the proper handling and disposal of this specific category of waste. At the same time, there are reasons to say that the country requires additional technical and expert support in the field of medical waste management. [ABSTRACT FROM AUTHOR]

In order to build a more comprehensive emergency disposal and transportation network system for medical waste, it is necessary to consider various uncertain factors and data characteristics. Therefore, in the context of intelligent transportation, this article considers the uncertainty of the quantity and regional population density of infectious medical waste generation as well as the emergency disposal of infectious medical waste under multi-cycle and multi-objective conditions, and it constructs a multi-cycle emergency disposal logistics network optimization model for infectious medical waste under uncertain conditions. Through deterministic transformation of the model and data mining of the medical waste disposal logistics network in Wuhan, China, the multi-objective model under uncertain conditions was also solved and sensitivity analyzed using the MOPSO-NSGA2 intelligent algorithm, verifying the effectiveness and superiority of the algorithm. [ABSTRACT FROM AUTHOR]

Background: Several studies revealed that medical students have low performance levels of hand hygiene (HH) and biomedical waste management (BMWM). However, there have been limited interventions directed at young students targeting HH and BMWM enhancement. Given these data, we aimed at assessing HH and BMWM among medical students after two training methods. Methods: We performed a quasi-experimental study from September 2021 to May 2022, which included fifth-year medical students enrolled in the faculty of Medicine of Monastir (Tunisia). We relied on a conventional training based on presentations and simulations guided by the teacher and a student-centred training method based on courses and simulated exercises prepared by students. We used the WHO HH Knowledge Questionnaire and the "BMWM audit" validated by The Nosocomial Infection Control Committee in France. Results: A total of 203 medical students were included (105 in the control group and 98 in the experimental group) with a mean age of 23 ± 0.7 years. Regarding HH, we found a statistically significant increase in post-test scores for both training methods. A higher post-test mean score was noted for student-centred method (14.1 ± 1.9 vs. 13.9 ± 2.3). The overall improvement in good HH knowledge rates was greater after student-centred method compared to conventional training (40.5% vs. 25%). Concerning infectious waste, mean scores were higher after student-centred learning in all hazardous waste management steps (25 ± 3.3 vs. 23.6 ± 5.5). Results: Coupling student-centred teaching and continuous supervision could improve HH and BMWM knowledge and practices among medical students. [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]