Medical Waste Management

This study comes to understand and to issue solutions for the previous big problem
through collect actual data and facts regarding wastes (specially medical wastes) generated
at the Healthcare Establishments (HCE) located in Amman City (in Jordan). Also, to
approve the effectiveness of the incineration treatment method for the solid waste
(especially medical waste) based on experimental analysis for the emission gases and the
reminder ashes from an incinerator located at University of Jordan hospital. And then make
a comparison between the results that obtained and the reported results in the literature.

This chapter utilizes a green criminological perspective to examine this key issue as it pertains to waste dumping in rural northwestern China. First, we offer a brief review of green criminology’s approach to waste crime and summarize the literature on top-down environmental regulation enforcement in China. Next, we describe the development of the medical waste regulation framework and highlight the current obstacles to enforcement in China. The chapter then utilizes a case study to illustrate how institutional incentives in the job performance evaluation system of bureaucrats shaped the under-enforcement of medical waste regulations at the grassroots level of rural governance. Our chapter concludes with a discussion of how the study expands our understanding of waste crime and environmental regulation enforcement in an illiberal context.

Background: This Paper aims at analyzing and defining the reasons and factors that lead to the absence and failure of medical waste management in Yemen. This absence has a catastrophic effect by causes a wide spread of epidemics, diseases, infections, pollutions, deaths and long-range effects on the environment. And despite the lake of data, statistics and rare previous studies in this field. This paper will be a systematic study of the key factors causing this poor performance of this important Field.

Objective: To determine the knowledge levels of hospital administrators about the process of collection, temporary storage and delivery to the authorities about disposal of medical wastes. Methodology: This descriptive study was conducted in Turkey in June 2010. Questionnaire technique was used as the data collection tool in the study. Data were analyzed using descriptive statistical methods. The results were assessed at significance level of p < 0.05. Results: There was at least one manager responsible for waste management at each healthcare institution and all institutions had a medical waste management plan. Majority of institutions had a temporary storage for medical wastes. Genotoxic pharmaceutical chemical and heavy metal-containing wastes, as well as pressurized vessels were collected separately from other medical wastes. Average 1697 Kg medical waste per/day, and average 1.39 Kg medical waste per/bed were produced in healthcare institutions. Conclusion: Effective medical waste management depends on active support of hospital administration and training of staff which are responsible for segregation, collection, storage, transportation and disposal of medical wastes.

The study was conducted at healthcare establishments of Abhaynagar Upazila of Jessore District in Bangladesh to quantify amount of medical waste (MW) generated from the medical services; determine physical composition of MW; find out the correlation of waste quantity with relevant factors; identify problems and develop future guideline regarding management. The average waste generation rate was 37.11 kg/hospital, 1.56 kg/bed/day, and 1.90 kg/patient/day. The hazardous waste was recorded 9.71%, whereas, non-hazardous waste 90.29%. MW consisted eight categories of waste materials with vegetable/food being the largest component (74%), and varied significantly (p≤0.05) among other hospitals surveyed. The quantity of MW was positively correlated with the number of occupied beds (R2=0.898, P≤0.05) and with the number of patients (R2=0.785, P≤0.05). Separate legislation must be formulated to address the issue of medical waste management as a separate environmental mandate and regular supervision of them are very much necessary.

The world's population consists roughly of 50% women and girls. Slum and gender interrelate in many ways; women have lower rates of access to and control over water resources and weaker influence on planning and management of local development processes than men . Many of the health problems in urban slums stem from the lack of access to safe water or demand for it. Lack of domestic water is posing series of threats to the health of slum dwellers, women and girls in particular, as they spend most of their time in and around the unhygienic environment. They are responsible for collecting water for cooking, cleaning, health and hygiene and have to walk long distances to access water often spending four to five hours per day carrying heavy containers and suffering acute physical problems (Khosla 2004). Such water stressed and unhygienic urban environment of Jorhat Town is due to water scarcity. Therefore, an attempt has been made in the present paper to analyze the women health implications due to water stress, especially in slums of Jorhat town, Assam. Water stress levels have been determined with the help of water supply stress index (WaSSI) method and its impact on women health has been discussed in the paper. The study is based on both primary and secondary data.

Disposal of medical waste (MW) must be considered as a vital need to prevent the spread of pandemics during Coronavirus disease of the pandemic in 2019 (COVID-19) outbreak in the globe. In addition, many concerns have been raised due to the significant increase in the generation ofMWin recent years. A structured evaluation is required as a framework for the quantifying of potential environmental impacts of the disposal ofMWwhich ultimately leads to the realization of sustainable development goals (SDG). Life cycle assessment (LCA) is considered as a practical approach to examine environmental impacts of any potential processes during all stages of a product's life, including material mining, manufacturing, and delivery. As a result, LCA is known as a suitable method for evaluating environmental impacts for the disposal of MW. In this research, existing scenarios for MW with a unique approach to emergency scenarios for the management of COVID-19 medical waste (CMW) are investigated. In the next step, LCA and its stages are defined comprehensively with the CMW management approach. Moreover, ReCiPe2016 is the most up-to-date method for computing environmental damages in LCA. Then the application of this method for defined scenarios of CMW is examined, and interpretation of results is explained regarding some examples. In the last step, the process of selecting the best environmental-friendly scenario is illustrated by applying weighting analysis. Finally, it can be concluded that LCA can be considered as an effective method to evaluate the environmental burden of CMW management scenarios in present critical conditions of the world to support SDG.

Medical waste is of great importance due to its hazardous nature that can cause undesirable effects on humans and the environment. This study focuses on medical waste management in hospitals of Iran. Data were collected based on questionnaires and for self-report of medical waste management. The results along with other information were sent to the ministry of health network system. Results indicated that the mean generation rate of non-hazardous and sharp and infectious and total wastes in Iran were, respectively, 1.84, 1.09 (36.9% of total waste generated) and 2.98 kg/bed/day. Chemical waste generation rate in Iran is 0.02 kg/bed/day (0.68%) that relative to infectious waste and total waste generation rate is much lower which could be due to improper segregation of medical wastes. There is significant differences between private and governmental hospitals, in terms of infectious and sharp waste generation rates (P=0.027). Also there are significant differences between specialized and general hospitals in group of non-hazardous waste (P=0.039), infectious waste (P=0.001) and total waste generation rate (P=0.02). 65.41% of governmental hospitals used autoclave for infectious waste treatment. In the private and governmental hospitals 14.8% and 24.29%, respectively not have any treatment devices and hazardous waste was disposed without treatment.

Purpose – The purpose of this paper is to identify the type of waste generation and the management of
waste in order to reduce pollution in the health care sector with special reference to Colombo, Sri Lanka. The
paper further aims to determine the relationship between top management and staff attitudes toward waste
management and to identify the level of technology used in medical waste management in various types of
health care organizations.
Design/methodology/approach – A survey questionnaire was developed using the designed conceptual
framework to achieve the objectives of the study.
Findings – The study identifies that, though governments provide legislations and regulatory support,
organizations of any size must have a positive attitude, awareness, capability and technology to initiate
improvements for waste management processes and be prepared to adapt to new trends. Developing positive
attitudes and improved knowledge on changes in waste management technology will assist in encouraging
organizations to invest in this area.
Research limitations/implications – The scope of this project is limited to private health care institutions
in the Colombo district in Sri Lanka from where data were gathered.
Originality/value – Health care center waste management is a relatively new discipline in the Sri Lankan
health sector. This study provides an opportunity for management to identify the level of waste generated by
health care institutions and the methods followed for the disposal of waste. Environmental groups can gain
benefit through this project, since they can identify whether the private institutes in the health care sector are
following world-accepted methods in disposing of waste.
Keywords Waste management, Environmental pollution, Medical waste, Capital requirement
Paper type Research paper

Medical waste management is of major concern due to the potentially high risks to both human health and the environment caused by inadequate waste management practices. In Morocco, as in many developing countries, little information is available regarding generation handling, and disposal of medical waste. The specific objective of this study was to analyse the medical waste management practices in the Souss-Massa-Drâa region, Morocco. The study was carried out in seven of the twelve hospitals in the region, covering 66.2% of the bed capacity. A total of 219 healthcare personnel and their assistants were included: 35 doctors, 98 nurses, and 86 housekeepers. Site visits, interviews, and survey questionnaires were implemented to collect information regarding different medical waste management aspects, including medical waste generation, separation, collection, storage, transportation, and disposal. The results indicated that the medical waste generation rate ranged from 0.4 to 0.7 Kg/bed-day with a weighted average of 0.53 Kg/bed-day. The percentage of infectious and hazardous wastes in the total medical waste stream was about 30.5%. The remaining 69.5% was general wastes similar in properties to municipal wastes. Concerning waste separation, housekeepers demonstrate a slightly higher knowledge about waste separation, with 49.4% of correct answers, with nurses at 45.7%, and doctors the lowest value at 38.6%. The results about other management aspects indicated that practices in most surveyed hospitals did not comply with the principles stated in Moroccan legislation. Based on the findings, some measures are suggested to improve the present conditions and ensure that potential health and environmental risks of medical waste are minimized.

Health care institutions (HCIs) generate waste which can causes various injuries and infections to the patients, healthcare workers and also causes harm to the surrounding environment. Medical waste management (MWM) is vital for safe town development and the misconduct of medical waste may be a significant risk factor for the infectious diseases diffusion on our environment. The study carried out on 22 HCIs included public hospital, diagnostic centers, private hospitals and clinic in Jessore town of Bangladesh. This present study focused on the existing management structure, generation rate and difficulties of MWM. An inadequate number of HCIs are following the MWM method over their self-management. The findings of this study exposed that around 3 ton of medical waste is produced per day that is about 5.56% of entire waste production in this town. Over on an ordinary 0.98kg/day/bed medical waste that covering 10.89% infectious, 15.82% plastic, 3.46% sharp, 3.87% pathological, 60.94% domestic and 5.52% pharmaceutical waste were generated in this town. Keywords: medical waste (MW), health care institutions (HCIs), health effect, handling of medical waste, medical waste management (MWM)

El propósito de esta directriz es contribuir a la estandarización de la comunicación visual de seguridad para la gestión de los residuos generados en los EAS, que informe y advierta a los trabajadores y al público sobre la presencia de un peligro o la existencia de una prohibición u obligación, a fin de prevenir daños que puedan afectar su salud o el ambiente.

The management of medical waste is of great importance due to its potential environmental hazards and public health risks. In the past, medical waste was often mixed with municipal solid waste and disposed in residential waste landfills or improper treatment facilities in Iran. In recent years, many efforts have been made by environmental regulatory agencies and waste generators to better managing the wastes from healthcare facilities. This study was carried in 12 educational hospitals of Tehran University of Medical Sciences. The goals of this study were to characterize solid wastes generated in healthcare hospitals, to report the current status of medical waste management and to provide a framework for the safe management of these wastes at the considered hospitals. The methodology was descriptive, crosssectional and consisted of the use of surveys and interviews with the authorities of the healthcare facilities and with personnel involved in the management of the wastes. The results showed that medical wastes generated in hospitals were extremely heterogeneous in composition. 42% of wastes were collected in containers and plastic bags. In 75% of hospitals, the stay-time in storage sites was about 12-24h. 92% of medical wastes of hospitals were collected by covered-trucks. In 46% of hospitals, transferring of medical wastes to temporary stations was done manually. The average of waste generation rates in the hospitals was estimated to be 4.42kg/bed/day.

Berdasarkan prinsip “pembuat polusi yang membayar”, setiap Fasilitas Pelayanan Kesehatan harus bertanggung jawab secara finansial atas pengelolaan limbahnya secara aman. Biaya tersebut harus didanai dengan alokasi khusus dari anggaran rumah sakit. Total biaya umumnya terdiri atas investasi modal awal, penyusutan peralatan dan bangunan, biaya pengoperasian elemen-elemen tersebut seperti petugas dan barang habis pakai, biaya operasional sarana, biaya pengelolaan pihak ketiga, biaya perizinan, dan biaya-biaya lain yang semuanya harus dipertimbangkan secara hati-hati jika akan memilih opsi yang paling rendah biayanya. Penelitian ini membahas perbandingan biaya pengelolaan limbah medis padat di Rumah Sakit X antara sistem swakelola dengan sistem outsourcing. Penelitian ini adalah penelitian deskriptif kuantitatif dan dilakukan dengan cara pengamatan, telaah dokumen langsung, dan perhitungan biaya menggunakan metode Activity Based Costing (ABC). Dari hasil penelitian diketahui bahwa alur proses pengelolaan limbah medis sudah berjalan baik dan pengelolaan limbah medis padat secara outsourcing lebih murah dibanding swakelola. Untuk mengurangi limbah medis padat, masih dapat dilakukan upaya minimisasi limbah.

Kata kunci: biaya; pengelolaan limbah medis padat; swakelola; outsourcing

This work points out the main challenges of municipal and medical waste management sectors in the context of the COVID-19 pandemic in Romania. Key environmental threats are identified based on waste management deficiencies related to illegal dumping practices, waste collection schemes, landfills, and hazardous waste incinerators, waste statistics gaps, and unsound environmental awareness. COVID-19 related waste flow is estimated taking into consideration the potentially infectious waste from healthcare facilities and municipal waste generated in quarantine places and selfisolated persons at national levels. Some best practices are highlighted in management COVID-19 related waste flow and future perspectives are discussed.

It is of utmost importance to protect our healthcare professionals, who are the most important resources for any country today. The commitment behind this article and proposal is to ensure that we do not lose even one more doctor or nurse to COVID-19. In the opinion of the authors, the current design of most of the ICUs, where the air is recirculated through the air-conditioning, is not suited for treating the highly infectious patients of COVID-19, and may be one of the causes of the thousands of infections among the healthcare workers, which has also led to the death of more than two thousands of them around the world. One is not sure whether this is the reason behind the unusual death rate of patients put on ventilators too. This article proposes a cost-effective redesign of the existing ICUs and suggestions for choosing the buildings intended to be converted to makeshift hospitals to take care of the patients infected by the corona virus. Also, where the personal protective equi...

Medical wastes from health care institutions pose risks for public health therefore proper management of medical waste is very important. The purpose of this study is to present the general situation of medical waste management system in Turkey. In this context, first definition and amount of medical waste are given. Then, medical waste treatment methods are explained. Finally, medical waste management in Turkey is evaluated. The amount of medical waste generated in Turkey is approximately 1.5 kg/bed-day and 80000 tons/year. Considerable amount of medical wastes was disposed to landfills and covered with lime until 2009. Since 2010, sterilized medical wastes were sent to municipal landfills in a separate cell as a general practice. Besides the sterilization of medical wastes, incineration method is also rarely used. Medical waste disposal costs (excluding tax) ranged between 0.5-0.9 (average 0.7) €/kg for metropolitan municipalities and 0.6-1.1 (average 0.8) €/kg for other municipalities according to 2015 data. It is suggested that reduction of medical waste disposal costs is possible via removal of municipality cuts and decrease the amount of municipal solid waste in medical waste.

Objective: This paper aims to describe waste management in primary health care centers of the Secretary of Health in the municipality of Xalapa, Veracruz, Mexico, as a model case for developing countries. Material and methods: A observational, descriptive and crosssectional study was conducted. The sample was made up of the seven primary healthcare centers of the Secretary of Health located in the municipality of Xalapa, Veracruz, México. Data collection was carried out with a checklist designed according to the current legislation for the primary health care centers. Results: The global percentage of compliance was 55%, with variation between 47% and 63%. The stage of identification, separation and packaging recorded the highest percentage of compliance, while the temporary storage showed a lower percentage. Conclusion: The waste management in primary health care centers resulted in a level of compliance ranging from low to medium, which suggests the need for specific actions in order to improve waste management in health centers.

Pathological/Anatomical waste: This includes recognizable body parts and contaminated animal carcasses. Pathological waste consists of organs, tissues, body parts or fluid such as blood and plasma. Though the pathological waste may contain healthy body parts, it has to be considered as highly infectious waste for precautionary reasons.

It is of utmost importance to protect our health-care professionals, who are the most important resources for any country today. The commitment behind this article and proposal is to ensure that we do not lose even one more doctor or nurse to COVID-19. In the opinion of the authors, the current design of most of the ICUs, where the air is recirculated through the airconditioning , is not suited for treating the highly infectious patients of COVID-19, and may be one of the causes of the thousands of infections among the healthcare workers, which has also led to the death of more than a thousand of them around the world. One is not sure whether this is the reason behind the unusual death rate of patients put on ventilators too. This article proposes a cost-effective redesign of the existing ICUs and suggestions for choosing the buildings intended to be converted to makeshift hospitals to take care of the patients infected by the corona virus. Also, where the personal protective equipm...

Özet Bu çalışmada, Sakarya ilindeki entegre katı atık yönetimi, katı atık özellikleri, atıkların toplanması ve bertaraf uygulamaları incelenmiştir. Sakarya da günlük olarak ortalama 441 ton katı atık toplanıp, depolama sahasında bertaraf edilmektedir. Kişi başı atık oluşumu ise 1,24 kg/kişi/gündür. Mutfak atıkları toplam atık içerisinde en yüksek paya sahip iken geri dönüştürülebilir atık miktarında önemli bir artış gözlenmiştir. 2008 yılında 4.689.461 kg ambalaj atığı toplanırken 2010 yılında %100 artışla 10.000.000 kg ambalaj atığı toplanmıştır. Atıkların uzaklaştırılma ve bertarafında düzenli depolama yöntemi kullanılmaktadır. Düzenli depolamadan oluşan gaz ise 11 tane dikey gaz toplama bacası ile toplanmaktadır. Sakarya entegre atık yönetiminde sızıntı suyu arıtımı ve yetersiz geri dönüşüm gibi eksikler olmasına rağmen bu problemlerin gelecekte çözülmesi beklenmektedir. Sonuç olarak tavsiye edilen entegre atık yönetim sistemi geri dönüşümü arttırarak düzenli depolamayı azaltmaktır. Abstract In this study, integrated solid waste management, solid waste quantity and composition and collection, transportation and disposal options of solid wastes in Sakarya are determined and explained. In Sakarya, approximately 441 tons of the MSW were collected and landfilled each day. The average MSW generation rate was found to be 1.24 kg/day per capita. The major constituent of MSW in Sakarya is food waste, but the percentage of recyclable waste has increased significantly recently. The amount of packaging waste collected in Sakarya has increased from 4.689.461 kg in 2008 to 10.000.000 kg in 2010. A sanitary landfill facility has been implemented for waste disposal. Landfill gas from this sanitary landfill is collected by 11 vertical gas collection pipes. There are some deficiencies in the new MSW management system such as no leachate treatment and poor source separation collection. However, these problems will be solved in the near future. The recommended system deals with maximizing recycling and minimizing landfilling of the MSW, and consists of separation at source, collection, sorting, recycling and sanitary landfilling.

Developing methods for treating hazardous waste from medical activities is currently a priority. These medical activities aim to obtain a final product which is friendly for the environment and for people's health. This paper is going to present the existing methods for the disposal of medical waste, the necessity to introduce alternative treatment technologies in the material flow management of hazardous medical waste and a method for treating medical waste is developed; the method is based on existing technologies at this moment. The proposed method consists in chemical disinfection of infectious medical waste and turning them into household waste without any dangerous character and the recovery of disinfected plastic waste, in order to be used in the production of asphalt mixtures. For the proposed method was developed a project planner into Microsoft Project 2013 application.

The last decade has seen an unprecedented, worldwide acceleration of environmental and climate changes. These processes impact the dynamics of natural systems, which include components associated with human communities such as vector-borne diseases. The dynamics of environmental and climate variables, altered by global change as reported by the Intergovernmental Panel on Climate Change, affect the distribution of many tropical diseases. Complex systems, e.g. the El Niño/La Niña-Southern Oscillation (ENSO), in which environmental variables operate synergistically, can provoke the reemergence and emergence of vector-borne diseases at new sites. This research investigated the influence of ENSO events on malaria incidence by determining the relationship between climate variations, expressed as warm, cold and neutral phases, and their relation to the number of malaria cases in some north-eastern municipalities of Venezuela (Estado Sucre) during the period 1990-2000. Significant differe...

Thoracic aortic aneurysms can be triggered by genetic disorders such as Marfan syndrome (MFS) and related aortic diseases as well as by inflammatory disorders such as giant cell arteritis or atherosclerosis. In all these conditions, cardiovascular risk factors, such as systemic arterial hypertension, may contribute to faster rate of aneurysm progression. Optimal medical management to prevent progressive aortic dilatation and aortic dissection is unknown. β-blockers have been the mainstay of medical treatment for many years despite limited evidence of beneficial effects. Recently, losartan, an angiotensin II type I receptor antagonist (ARB), has shown promising results in a mouse model of MFS and subsequently in humans with MFS and hence is increasingly used. Several ongoing trials comparing losartan to β -blockers and/or placebo will better define the role of ARBs in the near future. In addition, other medications, such as statins and tetracyclines have demonstrated potential benefit in experimental aortic aneurysm studies. Given the advances in our understanding of molecular mechanisms triggering aortic dilatation and dissection, individualized management tailored to the underlying genetic defect may be on the horizon of individualized medicine. We anticipate that ongoing research will address the question whether such genotype/pathogenesis-driven treatments can replace current phenotype/syndromedriven strategies and whether other forms of aortopathies should be treated similarly. In this work, we review currently used and promising medical treatment options for patients with heritable aortic aneurysmal disorders.

Risk management in medical waste needs extra care since many health professionals are in contact with this type of waste. Medical waste can induce infections in result of handling accidents, or when they are treated with neglect. It is the responsibility of the producing entities to establish a waste management plan and prevention, and to train and equip their staff against the risks that this waste represents. The purposes of this research are to identify risks and gaps in the processes of medical waste management, created in human and animal healthcare in the island of Pico-Azores, and investigate current practices regarding training in this area, proposing improvements in the process. This research is based on a case study in the island of Pico, covering entities such as health centers, medical clinics, pharmacies, veterinary clinics, nursing homes and physical therapy clinics. The data collection is done through interviews and surveys to healthcare professionals in order to investigate the risk throughout the life cycle of medical waste. This research concludes that, although there are already some procedures implemented, there are still many risks that can be minimized. It was also concluded that these risks are mainly associated with the lack of training and awareness of health professionals. Identified the risks, its proposed viable solutions for the gaps found.

The whole world today is facing an enormous increase in plastic waste pollution caused by the emergence of the COVID-19 pandemic. A complex chemical composition of personal protective equipment (PPE) mainly containing polypropylene (PP) complicates the recycling process, and it could take at least 450 years to degrade. Plastic pollution was already one of the greatest threats to our planet before the coronavirus outbreak. Disposal of millions of contaminated PPEs would end up as wastes, which, if improperly managed, can generate tonnes of plastic waste and consequently plastic pollution which is a significant threat to oceans and marine life. Eight million tons of plastic waste already end up in the world's oceans every year, and the impact of COVID-19 will only increase those figures. To reduce the amount of waste after using face masks and gloves which ends up in the environment have been proposed by different waste management companies and discussed in detail. Moreover, an eco-friendly way for photocatalytic degradation of polypropylene via TiO 2-based nanomaterials under solar irradiation is present. Catalytic conversion of PP is also proposed for the reduction of environmental pollution. This review aimed to provide a comprehensive overview of plastic pollution and discussing potential strategies to overcome them.

2) INTRODUÇÃO O artigo analisa a experiência de construção de uma proposta de modelo de indicadores voltado para a qualificação das águas em Salvador, em uma área pauperizada da cidade, incorporando as dimensões ambiental, econômica, social e político-institucional, sendo este último aspecto o diferencial em relação às demais experiências em curso no Brasil. O contexto político-institucional local e regional marcou profundamente a realização desse trabalho. A relação da Universidade com os moradores do entorno do Dique de Campinas e com as instituições públicas com atuação na área foi, inicialmente, permeada de conflito, sobretudo em função da implementação, por parte da Prefeitura Municipal de Salvador, de um controverso projeto de urbanização no entorno do manancial. O primeiro desafio enfrentado foi conferir identidade ao trabalho de pesquisa e às instituições responsáveis, além de explicitar o significado estratégico que o mesmo poderia ter para os moradores, organizações comunitárias e o Poder Público, ressaltando, sobretudo, o caráter político da informação, -condição necessária para uma participação qualificada no debate público A abordagem teórica adotada discutiu, ainda, questões relacionadas com o significado da informação e da participação no atual contexto de reestruturação das funções do Estado. Nesse debate, a relação entre informação, descentralização e democratização ganha significado estratégico. O artigo apresenta o processo de elaboração e os indicadores propostos (1) Escola Politécnica da Universidade Federal da Bahia [email protected] (2) Escola de Administração/UFBA O artigo apresenta o processo de elaboração de um sistema de indicadores urbanoambientais em uma área periurbana de Salvador, Bahia. A peculiaridade dessa experiência reporta, necessariamente, ao contexto político-institucional local e as características de uma bacia hidrográfica urbana que conjuga pobreza e degradação dos recursos ambientais, particularmente, das águas. A reflexão teórica desenvolvida trata das experiências nacional e internacional de estruturação de indicadores, do seu caráter político e do desafio da incorporação da dimensão ambiental e da participação de moradores e agentes públicos nas fases de elaboração do referido sistema.

La reemergencia y persistencia de enfermedades metaxénicas, como la malaria, en Venezuela y en particular en la región de la península de Paria, estado Sucre, constituyen un serio problema ambiental y de salud pública que requiere de un enfoque multidisciplinario, a fin de alcanzar una mejor comprensión de la dinámica de esta enfermedad dada su complejidad, y más aún frente a las alteraciones en el patrón de variabilidad climática. La malaria ya se ha hecho endémica en esta zona y tiene impactos sobre las poblaciones humanas. Una seria limitante en el estudio de las variables ambientales que influyen en esta dinámica, lo constituye la carencia de registros climáticos de temperatura y otros parámetros relevantes, que puede en parte, ser compensada con los análisis de temperatura superficial obtenidos mediante el procesamiento de la banda térmica del sensor, en este caso LANDSAT 7 ETM+. Para ello se seleccionó una imagen correspondiente al mes de Marzo del 2003 del catalogo de la USGS, con cobertura para toda el área de estudio. Una vez restituida la imagen y corregida geométricamente (Latitud/Long WGS84), se procedió mediante la técnica de algebra de imágenes, a realizar los análisis de temperatura superficial (LST). En un sistema de información geográfico se desplegaron los mapas provenientes de los análisis térmicos para la península, conjuntamente con el modelo espacial de incidencia malárica (focos) para ese año y se consideró al fenómeno ENSO con sus diferentes fases (frías, cálidas y neutras), encontrando y visualizando relación entre los focos y las temperaturas superficiales registradas entre 25 y 28ºC. Igualmente, se pone en evidencia la importancia de la información proveniente del procesamiento de la banda térmica como sustituto frente a la falta de datos analógicos. Se espera con estas técnicas poder contribuir a la caracterización de la dinámica de esta enfermedad en este estado.
Palabras Clave: Análisis térmico, Geomática aplicada, Malaria

This paper provides a rapid assessment method of potentially infectious waste flow related to the coronavirus disease (COVID-19) pandemic in Romania focusing on the emergency state (from 16 March to 14 May 2020) where a national lockdown was in force with restrictive and social distancing measures concerning population mobility and economic activities. Medical and municipal waste management systems are critical services in combating the virus spread in the community. This assessment is useful due to poor available data of medical waste flow in environmental reports and it covers COVID-19 patients, quarantined, and self-isolated persons as the main potential infectious waste sources. The proposed model estimates that COVID-19 related waste flow is 4312 t at the national level from 25 February to 15 June of which 2633 t in the emergency state period. This assessment is correlated with deficiencies of medical and municipal waste management systems in Romania before the COVID-19 pandemic as stress factors of public health and environment. This study points out the main challenges of waste operators and reveals some best practices during this pandemic crisis. Based on the results and discussion section, several recommendations are proposed to COVID-19 waste-related issues and points out the crucial role of the reliable medical and municipal waste database in managing such biologic hazards at national and EU levels. Monitoring of COVID-19 waste flow through such models are important for decision-makers, particularly in low and middle-income countries which are facing waste management deficiencies and gaps in waste statistics, to reduce other contamination risks or related environmental threats.

Abstrak-Fasilitas kesehatan menghasilkan limbah padat dimana pengelolaannya yang tidak tepat dapat menimbulkan pencemaran lingkungan. Salah satu faktor yang menyebabkan adalah keterbatasan biaya operasional. Untuk itu diperlukan kajian mengenai besarnya kemampuan dan kemauan membayar (ATP dan WTP) fasilitas kesehatan terhadap pengelolaan limbah padat fasilitas kesehatan. Kajian ATP dan WTP ini dilakukan dengan metode Contingent Valuation sebagai upaya perbaikan tarif pengelolaan. Penelitian ini dilakukan pada fasilitas kesehatan yaitu rumah sakit, puskesmas dan laboratorium kesehatan di Kota Ponorogo. Secara umum fasilitas kesehatan ini belum melakukan pengelolaan limbah padat secara tepat. Berdasarkan kajian diperoleh besarnya ATP rata-rata untuk pengolahan limbah padat medis adalah Rp. 8.975/Kg. Sedangkan WTP rata-rata untuk pengolahan limbah padat medis adalah Rp. 4.875/Kg. Nilai ATP dan WTP ini di atas tarif pengolahan limbah padat medis yang berlaku yaitu Rp. 4.000/Kg. Untuk itu masih memungkinkan dilakukan kenaikan tarif sesuai dengan biaya insinerasi ideal yaitu Rp. 5.833/Kg dan diiringi perbaikan pengelolaan. Selain itu besarnya ATP rata-rata untuk retribusi pengelolaan limbah padat non medis rumah sakit adalah Rp. 204.150/bulan dengan WTP rata-rata sebesar Rp. 120.000/bulan. Keduanya berada di bawah retribusi kebersihan (biaya pengelolaan limbah padat non medis) yang ditetapkan oleh pemerintah daerah yaitu Rp. 450.000/bulan sehingga perlu dilakukan penyesuaian retribusi dan pemberian subsidi pemerintah. Besarnya ATP rata-rata untuk retribusi pengelolaan limbah padat non medis puskesmas dan laboratorium kesehatan adalah Rp. 5.200/bulan dengan WTP rata-rata sebesar Rp. 2.500/bulan. Keduanya berada di atas retribusi kebersihan (biaya pengelolaan limbah padat non medis) yang ditetapkan pemerintah daerah yaitu Rp. 1.000/bulan sehingga masih memungkinkan dilakukan kenaikan tarif retribusi kebersihan. Kata kunci : biaya insinerasi, kemampuan membayar, kemauan membayar, limbah padat fasilitas kesehatan, retribusi kebersihan I. PENDAHULUAN Kota Ponorogo adalah ibukota Kabupaten Ponorogo dengan jumlah penduduk pada tahun 2010 mencapai 139.916 jiwa (Kabupaten Ponorogo Dalam Angka 2010). Seiring meningkatnya jumlah penduduk maka akan diiringi pula dengan meningkatnya kebutuhan penduduk di bidang kesehatan. Hal ini dapat dilihat dari peningkatan jumlah pengguna fasilitas kesehatan dari tahun ke tahun. Dampak lain dari peningkatan jumlah pengguna fasilitas kesehatan adalah meningkatnya timbulan limbah padat dari fasilitas kesehatan. Secara umum pengelolaan limbah padat dari fasilitas kesehatan Kota Ponorogo belum dilakukan dengan baik mulai dari sumber hingga pengolahan terakhir. Limbah padat dari fasilitas kesehatan dibagi menjadi limbah padat medis dan non medis. Kegiatan pengelolaan limbah padat dari fasilitas kesehatan yang kurang baik dapat memicu resiko kesehatan seperti penularan penyakit (hepatitis, diare, campak, AIDS), bahaya radiasi, bahaya kimia serta resiko kecelakaan kerja (Nurtarikasmalini, 2010). Salah satu faktor penyebabnya adalah keterbatasan biaya operasional dalam pengelolaan limbah padat dari fasilitas kesehatan. Berdasarkan uraian di atas, maka perlu dilakukan kajian yang bertujuan mengetahui tingkat kemampuan (Ability To Pay-ATP) dan tingkat kemauan fasilitas kesehatan untuk membayar (Willingness To Pay-WTP) biaya operasional atas upaya pengelolaan limbah padat dari fasilitas kesehatan. 203

The whole world today is facing an enormous increase in plastic waste pollution caused by the emergence of the COVID-19 pandemic. A complex chemical composition of personal protective equipment (PPE) mainly containing polypropylene (PP) complicates the recycling process, and it could take at least 450 years to degrade. Plastic pollution was already one of the greatest threats to our planet before the coronavirus outbreak. Disposal of millions of contaminated PPEs would end up as wastes, which, if improperly managed, can generate tonnes of plastic waste and consequently plastic pollution which is a significant threat to oceans and marine life. Eight million tons of plastic waste already end up in the world's oceans every year, and the impact of COVID-19 will only increase those figures. To reduce the amount of waste after using face masks and gloves which ends up in the environment have been proposed by different waste management companies and discussed in detail. Moreover, an eco-friendly way for photocatalytic degradation of polypropylene via TiO2-based nanomaterials under solar irradiation is present. Catalytic conversion of PP is also proposed for the reduction of environmental pollution. This review aimed to provide a comprehensive overview of plastic pollution and discussing potential strategies to overcome them.

In the paper, an assessment of the compliance with air emission limit values and the impact on air quality of one of the largest medical waste incinerators in Poland, with a total capacity of about 300 kg/h (two waste incineration lines) is presented.
The assessment took the results of continuous and periodic measurements of emissions in the plant’s installation over a period of 12 months’ operation into account. For this period, a calculation was performed for the spread of air pollutants emitted by the two operating incineration lines. According to the analysis and calculations, the analysed medical waste incineration plant does not significantly affect air quality. For the location of such facilities in the urban area, an adequate distance from residential buildings is, however, desirable to reduce the risk of elevated concentrations of certain substances in air (especially NO2).

The Central Valley of California is a broad basin between two mountain ranges that captures dust in the fall, fog in the winter, pollen in the spring and chemicals in the summer heat. This environment has been identified as a catch basin for smog and air pollution. Speech-language pathologists practicing in the Central Valley are confronted with complications of allergy and irritation that may impair progress of recovery for their patients. Indigenous farmworkers are a specific population with a higher exposure to damaging particulate matter than any other employed in the region. These indigenous Mexican farmworkers use seven main native language dialects of the Spanish language with at least 23 dialects which have been recorded across the culture (State population data regarding Japanese, Hispanic, Hmong and other cultures revealed more dense populations in the agricultural zones. It is proposed that the diagnoses of vocal function referrals located from within this environment be differentiated and classified so that they may be compared to the air quality scales in the geographic regions represented by medical professional respondents from the Central California's San Joaquin Valley Air Pollution Control District (SJVAPCD). According to the National Center for Farmworker Health (NCFH, 2011), these hometown networks, the highest concentration is in the Central Valley, and according to California Rural Legal Assistance these workers are the least apt to be counted in a census or to apply for healthcare assistance because of the fear of deportation (Simas, J., 2010).

Objective: This paper aims to describe waste management in primary health care centers located in the municipality of Xalapa, Veracruz, Mexico, as a model case for developing countries. Material and methods: A observational, descriptive and cross-sectional study was conducted. The sample was made up of the seven primary healthcare centers located in the municipality of Xalapa, Veracruz, México. Data collection was carried out with a checklist designed according to the current legislation for the primary health care centers. Results: The global percentage of compliance was 55%, with variation between 47% and 63%. The stage of identification, separation and packaging recorded the highest percentage of compliance, while the temporary storage showed a lower percentage. Conclusion: The waste management in primary health care centers resulted in a level of compliance ranging from low to medium, which suggests the need for specific actions in order to improve waste management in health cen...

The present paper presents, in a clear-cut manner, the overall management of dangerous waste and, in particular, of medical waste on board Disney Cruise Line (DCL) ships. In a previous paper, we analyzed the company's environmental policy and cruise waste management, while another paper focused on waste collection, sorting and storage methods on board DCL company ships, as well as on their food waste management. The paper is based on the analysis of the activity performed by the fleet's environmental protection personnel, on the company's internal regulation, as well as on field observations and the data collected by the specialized personnel. This complex work aims to analyze the prevention of the DCL cruise ships' environmental impact by means of a rigorous dangerous waste (including medical waste) management. DCL is one of the global leaders in the entertainment industry, but also one of the " greenest " and most eco-friendly players in the field. The paper complements the findings of other studies conducted on this somewhat understudied topic. The paper concludes that DCL aims to minimize its ships' environmental impact by choosing environmentally-friendly methods and technologies for its dangerous waste management system, as well as by making an effort to reduce waste amounts and associated risks on board the ships. In 2013, DCL was declared the most environmentally-responsible cruise line. The company complies with all national and international environmental regulations, laws and conventions. The keywords that best define the framework that ensures the company's eco-friendly approach, well-functioning operation and full compliance of integrated environmental policy norms are keeping thorough records, monitoring, oversight, awareness, responsibility and constant communication.

Mass gathering has made certain negative impact on our environment. the earth. It is one of the most important and sacred festival banks of river Ganga (Haridwar the Ganges, the Yamuna paper studies the water and 2019 at Prayagraj with the help of relevant data of that event collected. Moreover, it discusses what steps have been taken by the government to curb the ill effects of the place of event to be held technologies like Geo-tubes and Bio Sanitation with use of 1.2 managed at most of the locations with the help of Tipper vehicles which carried the solid waste to the treatment plants. Several new STPs were installed to manage the waste generated.

Mass gathering has made certain negative impact on our environment. the earth. It is one of the most important and sacred festival banks of river Ganga (Haridwar the Ganges, the Yamuna paper studies the water and 2019 at Prayagraj with the help of relevant data of that event collected. Moreover, it discusses what steps have been taken by the government to curb the ill effects of the place of event to be held technologies like Geo-tubes and Bio Sanitation with use of 1.2 managed at most of the locations with the help of Tipper vehicles which carried the solid waste to the treatment plants. Several new STPs were installed to manage the waste generated.

It is of utmost importance to protect our healthcare professionals, who are the most important resources for any country today. The commitment behind this article and proposal is to ensure that we do not lose even one more doctor or nurse to COVID-19. In the opinion of the authors, the current design of most of the ICUs, where the air is recirculated through the air-conditioning, is not suited for treating the highly infectious patients of COVID-19, and may be one of the causes of the thousands of infections among the healthcare workers, which has also led to the death of more than two thousands of them around the world. One is not sure whether this is the reason behind the unusual death rate of patients put on ventilators too. This article proposes a cost-effective redesign of the existing ICUs and suggestions for choosing the buildings intended to be converted to makeshift hospitals to take care of the patients infected by the corona virus. Also, where the personal protective equi...

The increase in chronic illnesses globally has sparked a need for home-based healthcare interventions. In the African context, home-carers play a preponderant role in addressing the shortage of trained healthcare professionals by providing primary healthcare services. These nursing care activities offered by the home-carers generate medical waste in homes. There is a need to be concerned about medical waste in homes because unlike healthcare facilities, homes are not meant to accommodate medical waste. Scanty literature in South Africa reveals that, there is improper management of medical waste in homes which poses health risks to the home carers, patients, community members and the environment. Hence, this paper presents a mobile technology-driven system designed to educate and stimulate home-carers' proper disposal of medical waste in South Africa. This paper firstly investigates the stakeholders involved in the dispensation of home-based care in the eThekwini health district of South Africa. Then the paper proposes a design of a mobile platform-enabled system that involves the identified stakeholders. The paper further presents the functionality of the system and its limitations. It is anticipated that this paper will contribute knowledge on how technology can contribute towards safe medical practices and a greener environment.