Evaluation of a training programme on the management of infectious and sharp healthcare waste in Tunisia.

INTRODUCTION: The management of healthcare waste is a crucial issue for public health and the environment. To minimise risks, it is essential to ensure that the management of healthcare waste is meticulously applied. Additionally, among the evaluation methods adopted by the hospital hygiene department to monitor the degree of compliance. The aim of this study was to assess the degree of compliance with healthcare waste management before and after a training and support programme. METHODS: This is a pre-experimental study based on two audits of healthcare waste management at Farhat Hached University Hospital in Sousse, Tunisia. All medical, surgical and laboratory departments were included. The first audit was carried out, followed by training of the responsible staff, which was carried out according to a cycle of training and coaching hygiene technicians, and finally, a second audit was conducted. The compliance rate is compared between 2021 and 2022. RESULTS: When comparing the averages of the compliance percentages for the four audit areas, there was a statistically significant improvement between the years 2021 and 2022 in the availability of equipment and consumables required for the management of infectious and sharp healthcare waste (p=0.029) as well as intramural transport (p=0.014). CONCLUSION: The study highlights the central role of effective waste management training in promoting compliance, awareness and responsible practices. Constant attention and training are essential to maintain progress at Farhat Hached University Hospital. This helps create safer care environments, better public health outcomes and long-term sustainability.

A local-to-global emissions inventory of macroplastic pollution.

Negotiations for a global treaty on plastic pollution1 will shape future policies on plastics production, use and waste management. Its parties will benefit from a high-resolution baseline of waste flows and plastic emission sources to enable identification of pollution hotspots and their causes2. Nationally aggregated waste management data can be distributed to smaller scales to identify generalized points of plastic accumulation and source phenomena3-11. However, it is challenging to use this type of spatial allocation to assess the conditions under which emissions take place12,13. Here we develop a global macroplastic pollution emissions inventory by combining conceptual modelling of emission mechanisms with measurable activity data. We define emissions as materials that have moved from the managed or mismanaged system (controlled or contained state) to the unmanaged system (uncontrolled or uncontained state-the environment). Using machine learning and probabilistic material flow analysis, we identify emission hotspots across 50,702 municipalities worldwide from five land-based plastic waste emission sources. We estimate global plastic waste emissions at 52.1 [48.3-56.3] million metric tonnes (Mt) per year, with approximately 57% wt. and 43% wt. open burned and unburned debris, respectively. Littering is the largest emission source in the Global North, whereas uncollected waste is the dominant emissions source across the Global South. We suggest that our findings can help inform treaty negotiations and develop national and sub-national waste management action plans and source inventories.

Viability of a circular economy for space debris.

The orbital debris population is rapidly growing, increasing the chance of a Kessler-style collision event. We report a novel method for the production of estimates for the total monetary value of all debris objects and total mass of all objects currently in orbit. The method was devised using debris object data from the European Space Agency's DISCOS dataset, classified via a decision tree. 'Reuse' and 'scrap material' scenarios were developed. A high-end estimate for reuse shows a net value of $1.2 trillion. Median and low-end net value estimates of $600 billion and $570 billion, respectively, are probably judicious. A scrap material scenario produced a high mass estimate of 19,124 tonnes, a median of 6,978 tonnes and a low estimate of 5,312 tonnes. Development of in-orbit services will be crucial to solve the orbital debris problem. A future circular economy for space may be financially viable, with potentially beneficial consequences for risk reduction; resource efficiency; additional high-value employment; and climate-change knowledge, science, monitoring and early warning data.

Impacto de una intervención educativa en el conocimiento y manejo de residuos peligrosos biológico-infecciosos / Impact of an educational intervention on the knowledge and management of infectious biological hazardous waste

Introducción: el personal de enfermería tiene una participación fundamental en el manejo de los residuos peligrosos biológico-infecciosos (RPBI) durante la atención en salud, situación que hace indispensable el conocimiento respecto a la peligrosidad y riesgo en el manejo de estos residuos. Objetivo: evaluar el impacto de una intervención educativa acerca del conocimiento y manejo de RPBI, en el personal de enfermería de un hospital general regional. Metodología: estudio cuasi experimental, pretest/postest, prospectivo y longitudinal. Se realizó una intervención educativa, y antes y después de esta se aplicó un cuestionario para evaluar conocimientos relacionados con RPBI y una lista de cotejo del Modelo Institucional para la Prevención de Infecciones Nosocomiales (MIPRIN) para evaluar el manejo de RPBI. Resultados: la intervención educativa demostró un efecto positivo en los conocimientos del personal de enfermería en relación con el manejo de RPBI. En la evaluación pretest se obtuvo un porcentaje de conocimientos de 65.2% y en la postest fue de 78.3% (p < 0.001). Respecto al cumplimiento en el manejo de RPBI, hubo un incremento; sin embargo, no se puede atribuir a la intervención, puesto que se evaluó por servicio y no de manera directa con los participantes. Conclusión: la intervención educativa mostró cambios significativos en los conocimientos y el manejo de RPBI del personal de enfermería.

Introduction: Nursing staff represent an important percentage in the management of biological hazardous waste (BHW) during health care, a situation that makes this knowledge essential regarding the danger and risk in handling these wastes. Objective: To evaluate the impact of an educational intervention about the knowledge and management of BHW in the nursing staff of a regional general hospital. Methods: quasi-experimental, pre-test/post-test, prospective and longitudinal study. An educational intervention was carried out; before and after this intervention, a questionnaire was administered to evaluate knowledge related to BHW and a checklist of the Institutional Model for the Prevention of Nosocomial Infections (MIPRIN, according to its initials in Spanish) to evaluate the management of BHW. Results: The educational intervention showed a positive effect in the nursing staff's knowledge in relation to BHW. In the pre-test evaluation a knowledge percentage of 65.2% was obtained and in the post-test evaluation it was 78.3% (p < 0.001). Regarding compliance in the management of BHW there was an increase; however, it cannot be attributed to the intervention, since it was evaluated by service and not directly with the participants.

Assessment of medical waste generation, associated environmental impact, and management issues after the outbreak of COVID-19: A case study of the Hubei Province in China.

COVID-19 greatly challenges the human health sector, and has resulted in a large amount of medical waste that poses various potential threats to the environment. In this study, we compiled relevant data released by official agencies and the media, and conducted data supplementation based on earlier studies to calculate the net value of medical waste produced in the Hubei Province due to COVID-19 with the help of a neural network model. Next, we reviewed the data related to the environmental impact of medical waste per unit and designed four scenarios to estimate the environmental impact of new medical waste generated during the pandemic. The results showed that a medical waste generation rate of 0.5 kg/bed/day due to COVID-19 resulted in a net increase of medical waste volume by about 3366.99 tons in the Hubei Province. In the four scenario assumptions, i.e., if the medical waste resulting from COVID-19 is completely incinerated, it will have a large impact on the air quality. If it is disposed by distillation sterilization, it will produce a large amount of wastewater and waste residue. Based on the results of the study, we propose three policy recommendations: strict control of medical wastewater discharge, reduction and transformation of the emitted acidic gases, and attention to the emission of metallic nickel in exhaust gas and chloride in soil. These policy recommendations provide a scientific basis for controlling medical waste pollution.

Post-consumer food waste generation while dining out: A close-up view.

Food loss and food waste occur along the food supply chain, negatively impacting the environment, global economy, and food security. There is a growing global interest in tackling this issue to mitigate or handle the waste generated and limit its repercussions, as one in eight people suffer from undernourishment worldwide. In the Arab world, where there is a high dependency on imports and limited potential of increasing local food production, addressing food loss and waste becomes substantial. Research has mainly been focused on household food waste generation, while data on post-consumer plate food waste in the foodservice sector remains scarce. In this study, managers from a representative sample of 222 restaurants located in Municipal Beirut, Lebanon, were surveyed about food waste generation. Plate food waste was measured to establish baseline information. Multiple Tobit regression analyses were performed to explore the determinants for plate food waste generation. Plate waste generation was also compared between Lebanese and non-Lebanese cuisine restaurants. Results revealed that 1,620 tons of plate food waste are generated per year in Beirut, equivalent to 0.15% of Lebanon's total organic waste. Furthermore, Lebanese cuisine restaurants serving Mediterranean Mezze were found to generate 34 kg of organic waste per day more than restaurants that serve international non-Lebanese cuisine. The type of cuisine, kind of service, and menu planning were significantly associated with post-consumer food waste generation. This study revealed an increasing concern towards the amount of plate waste generated in Beirut, and thereby further research is needed to create baseline information at the national level.

Research on residual strength characteristics of high water materials based on improved H-B criterion.

To develop a new gangue polymer filling material with low compressive ratio, this paper intends to add high water cementing material to the gangue for backfilling. Uniaxial and tri-axial bearing experiments were conducted to study its bearing characteristics and residual strength. Based on Hock-Brown model theory, it is proposed that friction angle φr can be introduced to substitute model parameter mi, and the degree of cohesion loss can characterize the value of s. So the improved H-B model is established to characterize the residual strength of materials with ductile failure characteristics. The results show that the compressive strength of high water filling material increases linearly corresponding to the rise of confining pressure, and its strength characteristics conform to Mohr-Coulomb strength criterion. The ductile failure characteristics of the sample endow it with high residual strength, which in turn qualifies it for underground filling. After the introduction of cohesion and friction angle, the improved H-B criterion can fit the residual strength curve of the high water filling material more competently. The fitting coefficient of the samples with three water contents is 1.00, 0.99, and 1.00, respectively. The improved H-B model of residual strength demonstrates the change rule of residual strength of the samples corresponding to the change of confining pressure; under tri-axial loading, the angle between fracture surface and axial direction becomes larger as the confining pressure rises; and the failure mode of the material transforms from splitting failure to shear failure.

Knowledge, Perceptions, and Practices of Electronic Waste Management among Consumers in Kampala, Uganda.

Background: Although proper management of electronic waste (e-waste) is key to preventing disease and protecting the environment, there is no clear mechanism for its management in Uganda. This study assessed knowledge, perceptions, and practices of e-waste management among consumers in Kampala city, Uganda. Methods: We conducted a cross-sectional study among people who used, repaired, or sold electronics (consumers). Both quantitative and qualitative methods of data collection using a sequential explanatory strategy were utilized. The quantitative survey involved 640 study participants, while qualitative interviews included 18 key informant interviews with stakeholders and six focus group discussions with 57 consumers. Modified Poisson regression was used to establish associations with corresponding 95% confidence intervals, and qualitative data analysed thematically. Results: Two-thirds (67.7%; 433/640) of electronics consumers had poor knowledge on the management of e-waste. More than three-quarters 79.1% (506) of the consumers had positive perceptions towards e-waste management. Consumers perceived e-waste as harmful to human health and the environment. Participants in informal employment were 0.96 times less likely to have positive perceptions towards e-waste management compared to those in formal employment (adjusted PR = 0.96, 95% CI: 0.93-0.99). Mobile phones and televisions were the most owned e-waste with only 7.96% (18/226) and 13.2% (7/53) disposed off, respectively. Selling e-waste to repair shops and donation were the common disposal options. Conclusion: Knowledge on proper e-waste management is poor among electronic consumers in Kampala, Uganda, though most have positive perceptions. There is need for increased awareness on e-waste management to prevent its effects on health and the environment. Special attention should be towards sensitisation on e-waste handling practices before disposal and final disposal options available.

Dumpster Diving in the Emergency Department.

INTRODUCTION: Healthcare contributes 10% of greenhouse gases in the United States and generates two milion tons of waste each year. Reducing healthcare waste can reduce the environmental impact of healthcare and lower hospitals' waste disposal costs. However, no literature to date has examined US emergency department (ED) waste management. The purpose of this study was to quantify and describe the amount of waste generated by an ED, identify deviations from waste policy, and explore areas for waste reduction. METHODS: We conducted a 24-hour (weekday) ED waste audit in an urban, tertiary-care academic medical center. All waste generated in the ED during the study period was collected, manually sorted into separate categories based on its predominant material, and weighed. We tracked deviations from hospital waste policy using the hospital's Infection Control Manual, state regulations, and Health Insurance Portability and Accountability Act standards. Lastly, we calculated direct pollutant emissions from ED waste disposal activities using the M+WasteCare Calculator. RESULTS: The ED generated 671.8 kilograms (kg) total waste during a 24-hour collection period. On a per-patient basis, the ED generated 1.99 kg of total waste per encounter. The majority was plastic (64.6%), with paper-derived products (18.4%) the next largest category. Only 14.9% of waste disposed of in red bags met the criteria for regulated medical waste. We identified several deviations from waste policy, including loose sharps not placed in sharps containers, as well as re-processable items and protected health information thrown in medical and solid waste. We also identified over 200 unused items. Pollutant emissions resulting per day from ED waste disposal include 3110 kg carbon dioxide equivalent and 576 grams of other criteria pollutants, heavy metals, and toxins. CONCLUSION: The ED generates significant amounts of waste. Current ED waste disposal practices reveal several opportunities to reduce total waste generated, increase adherence to waste policy, and reduce environmental impact. While our results will likely be similar to other urban tertiary EDs that serve as Level I trauma centers, future studies are needed to compare results across EDs with different patient volumes or waste generation rates.

Ocean plastic crisis-Mental models of plastic pollution from remote Indonesian coastal communities.

The crisis facing the world's oceans from plastics is well documented, yet there is little knowledge of the perspectives, experiences and options of the coastal communities facing overwhelming quantities of plastics on their beaches and in their fishing waters. In emerging economies such as those in the Coral Triangle, the communities affected are among the poorest of their countries. To understand the consequences of ocean plastic pollution in coastal regions, through the eyes of local people, this study examines the knowledge, use, disposal and local consequences of single use plastics in remote island communities in two archipelagos of southern Sulawesi, Indonesia. Using mixed methods-a survey of plastic literacy and behaviour, household interviews about purchasing and disposal, and focus group discussions to generate shared mental models-we identify a complex set of factors contributing to extensive plastic leakage into the marine environment. The rising standard of living has allowed people in low resource, remote communities to buy more single-use plastic items than they could before. Meanwhile complex geography and minimal collection services make waste management a difficult issue, and leave the communities themselves to shoulder the impacts of the ocean plastic crisis. Although plastic literacy is low, there is little the coastal communities can do unless presented with better choice architecture both on the supply side and in disposal options. Our results suggest that for such coastal communities improved waste disposal is urgent. Responsible supply chains and non-plastic alternatives are needed. Producers and manufacturers can no longer focus only on low-cost packaged products, without taking responsibility for the outcomes. Without access to biodegradable, environmentally friendly products, and a circular plastic system, coastal communities and surrounding marine ecosystems will continue to be inundated in plastic waste.

An Evaluation of Staff Engagement with Infectious Healthcare Waste Management Policies: A Case Study of Tunisia.

This study evaluated the engagement of staff regarding infectious healthcare waste management, in two case-study universities in Tunisia. Using a questionnaire survey, it was found that the most significant reported factors that influenced engagement were the availability of technical sheets and posters, training and education programs, and the age range of the staff. While there was some accordance with the Tunisian Decree application n° 2008-2745 of July 28th, 2008, as well as international guidelines and best practice (e.g. the use of color coded bins, waste management teams, and infection control measures), there were also limitations in the provision of training. This limitation in training and, to a lesser extent, awareness impacted on the beliefs about infectious healthcare waste management of staff and their practices. Recommendations for addressing these issues are suggested.

Assessment of Occupational Health and Safety among Scavengers in Gaza Strip, Palestine.

This study deals with the occupational health and safety of valuable and recyclable waste collectors (called scavengers) in the Gaza Strip, Palestine. The analytical descriptive approach was used in this study to achieve this goal. Waste pickers in the study area are working informally at existing dumpsites, solid waste transfer stations, landfills, and community streets' bins areas. A sample of 301 scavengers was surveyed filling a structured questionnaire designed for this purpose, during individual interviews. In addition, interviews with key Palestinian officials in the Gaza Strip have been conducted to provide accurate data and comprehensive information regarding waste pickers activities. The results showed that the occupational health and safety of the waste pickers is in constant deterioration mainly due to the informal nature of their work. The waste pickers are reportedly suffering in the current situation and the majority has no access to potable water, sanitation, and hygienically appropriate place to sleep and have meals. None of them has ever received occupational health and safety training. The study recommends that local decision makers should uptake short-term and long-term measures in waste management sector both aiming at improving this vulnerable social group's health and safety life status.

Distribution Characteristics of Volatile Organic Compounds and Contribution to Ozone Formation in a Coking Wastewater Treatment Plant.

Ozone pollution, which can be caused by photochemical reactions, has become a serious problem. The ozone formation potential (OFP) is used to describe the photochemical reactivity. Volatile organic compounds (VOCs) are main precursors of ozone formation, and wastewater treatment plants (WWTPs) are important sources of VOCs. Therefore, it is necessary to study the concentration level and OFP of VOCs from WWTPs. In this work, a coking WWTP with anaerobic-oxic-oxic (A/O/O) processes in Shaoguan city, Guangdong province, China, was selected to investigate the characteristics of VOCs at wastewater treatment areas and office areas. The OFP of VOCs was estimated by the maximum incremental reactivity (MIR) coefficient method. Results showed that 17 VOCs were detected, and the total concentration of VOCs was the highest at the raw water tank (857.86 µg m-3). The benzene series accounted for 69.0%-86.9% and was the main component of VOCs in the WWTP. Based on OFP data, the top six VOCs contributing most to the OFP were m-xylene, toluene, p-xylene, o-xylene, styrene, and benzene. This study provides field data and information on the environmental risk of VOCs for coking companies and environmental departments. We found that the priority control sources of VOCs were wastewater treatment units because of their larger OFP contributions.

Analysis of Waste Generation Characteristics during New Apartment Construction-Considering the Construction Phase.

The waste generation rate (WGR) is used to predict the generation of construction and demolition waste (C&DW) and has become a prevalent tool for efficient waste management systems. Many studies have focused on deriving the WGR, but most focused on demolition waste rather than construction waste (CW). Moreover, previous studies have used theoretical databases and thus were limited in showing changes in the generated CW during the construction period of actual sites. In this study, CW data were collected for recently completed apartment building sites through direct measurement, and the WGR was calculated by CW type for the construction period. The CW generation characteristics by type were analyzed, and the results were compared with those of previous studies. In this study, CW was classified into six types: Waste concrete, waste asphalt concrete, waste wood, waste synthetic resin, waste board, and mixed waste. The amount of CW generated was lowest at the beginning of the construction period. It slowly increased over time and then decreased again at the end. In particular, waste concrete and mixed waste were generated throughout the construction period, while other CWs were generated in the middle of the construction period or towards the end. The research method and results of this study are significant in that the construction period was considered, which has been neglected in previous studies on the WGR. These findings are expected to contribute to the development of efficient CW management systems.

Willingness to pay for improved solid waste management and associated factors among households in Injibara town, Northwest Ethiopia.

OBJECTIVE: Globally, cities generate 1.3 billion tons of solid waste per year, amounting to a rate of 1.2 kg per person per day. Solid waste management is an important challenge to both the developed and developing countries. This study aimed to assess the willingness to pay for the improved solid waste management and associated factors among households in Injibara town, Ethiopia. RESULTS: A total of 903 household heads participated in the study. The finding indicated that 81.06% were willing to pay for the service. The average amount of money the participants would be willing to pay per month was 29.7 ETB ($1.07)). The study revealed that sex (ß = 3.24, (95% CI 1.98, 4.50)), age (ß = - 0.09: 95% CI - 0.19, - 0.01), educational status (ß = 6.19: 95% CI 3.54, 8.84), occupation (ß = 2.43: 95% CI 1.009, 3.86), amount of solid waste generated (ß = 1.74: 95% CI 0.19, 3.29), distance from dump site (ß = 1.58: 95% CI 0.45, 2.72), satisfaction with the existing service (ß = 3.89, (95% CI 2.75, 5.06) and wealth status (ß = 2.43: 95% CI 1.0, 3.86) were statistically significant. Therefore, the level of premium load should consider the amount of waste generated, wealth status and the distance from the dump site.

Exploring the Potential Health Risks Faced by Waste Pickers on Landfills in South Africa: A Socio-Ecological Perspective.

Landfill and street waste pickers in South Africa are responsible for collecting substantial volumes of recyclable material, saving municipalities millions and contributing to a generally healthier and cleaner environment. Yet waste pickers continue to operate on the fringes of the economy and are exposed to many risks, particularly health risks which have a direct impact on the sustainability of their livelihoods. This article, using a mixed-methods approach, explores the health risks to which waste pickers working on nine different landfills in the country are exposed. The socio-ecological framework was used to analyse and present the results. A key finding was that waste picking, by its very nature, lends itself to innumerable health risks, but that these can be lessened through concerted and collaborative efforts on the part of landfill operators, local authorities and other stakeholders. Integrating the 'self-employed' waste pickers into the formal waste management system should be comprehensive in order to limit health risks. Waste pickers will never have a risk-free environment, but facilitative policies and supportive institutions can collaboratively help to mitigate these risks and create a more sustainable and dignified working environment towards sustaining their livelihoods.

A bibliometric analysis on waste electrical and electronic equipment research.

Waste electrical and electronic equipment (WEEE) contains both toxic and valuable materials. Due to rapid development of information and communication technologies (ICT), a large amount of WEEE have been produced, leading to increasing academic efforts in this field. This study aims to depict the trends and features of WEEE-related studies through a bibliometric analysis. The results show that the total number of WEEE-related publications had sharply increased, with China as the leading country. University of Chinese Academy of Sciences is the most productive WEEE-related research institution, while Mai BX is the most productive author. As such, Waste Management, Journal of Cleaner Production, and Environmental Science & Technology are the most influential journals. The research hotspots of WEEE mainly focus on the recycling and treatment technologies, environmental impacts, and relevant policies of WEEE. By tracing the evolutionary pathway of WEEE research, it is clear that the research frontiers have switched from electronic equipment, extended producer responsibility, sediment, environment and design, risk assessment to life cycle assessment, mobile phone, and behaviors. This study provides valuable insights to those WEEE-related scholars so that they can identify their own research topics and partners. This paper is one of the first studies in WEEE research field that offers critical discussions and suggestions related to research development and future trends, and used visualized tools to present the holistic picture of this field.

Assessing young consumers' awareness and participation in sustainable e-waste management practices: a survey study in Northwest China.

The massive generation of electronic waste (e-waste) and the informal recycling of e-waste are serious concerns in China. As a hazardous waste stream, e-waste calls for sustainable management practices to avoid adverse effects on environment and health. However, consumers' awareness and active participation are needed to make e-waste management successful. Therefore, this study is an exploratory attempt to investigate young consumer awareness, knowledge, and participation in sustainable e-waste management practices. Meanwhile, the study reviews the current situation of e-waste recycling, its related legislative framework, and practices in China. The survey revealed that the respondents have keen environmental consciousness, while they have low awareness about e-waste-related rules and regulations, recycling programs, and the formal and informal recycling sector. The findings provide valuable insights for practitioners in order to promote environmental awareness and sustainable e-waste management practices among young consumers in China.