The scenario of household pharmaceutical products: consumption, wastes, and disposal practices from a case study in Chile.

Concerns about the increasing consumption of medicines have been raised due to their contribution to waste pollution and environmental impacts. However, limited research addresses the profile and disposal practices of household medicines, particularly in Latin America. Therefore, this study analyzes the consumption, waste, and disposal of medicines within households in the commune of La Serena, Chile. Primary data were gathered through a semi-structured survey administered directly to a random sample of 430 households. The results indicate that women play a central role in managing medicines within households, with four therapeutic groups being most frequently used in medicines and generating waste: anti-inflammatory/analgesics, antihypertensives, lowering cholesterol, and antidiabetics. Ninety-six% of respondents were unaware of the collection points for this waste, and they disposed of it mainly in household garbage (78%) and sewage (13%). However, over 70% of them considered storing or disposing of medicines in household garbage or sewage to be "dangerous or very dangerous." Furthermore, 97% expressed support for collection campaigns. These results indicate the need for public policies to establish collection points for this waste and to inform consumers about the responsible use and proper disposal of medicines, particularly for women and patients with chronic illnesses.

Developing environmental, social and governance (ESG) strategies on evaluation of municipal waste disposal centers: A case of Mexico.

Waste disposal systems are crucial components of environmental management, and focusing on this sector can contribute to the development of various other sectors and improve social welfare. Urban waste is no longer solely an environmental issue; it now plays a significant role in the economy, energy, and value creation, with waste disposal centers (WDCs) being a key manifestation. The purpose of this study is to measure the performance of WDCs in the state of Nuevo León, Mexico, with the aim of developing environmental, social, and governance (ESG) strategies to strengthen and prepare the WDCs for the industrial developments in this state. By identifying environmental variables and undesirable factors, the efficiency and managerial capacity of 32 WDCs were assessed. The analysis revealed that 9 out of the 32 WDCs are technically efficient, while the remaining 23 require significant improvements. Using the Data Envelopment Analysis (DEA) technique, an average efficiency score of 0.91 was found, with a standard deviation of 0.08. The managerial capacity analysis indicated that the highest-ranked WDC achieved an efficiency score of 1, whereas the lowest-ranked WDC scored 0.67. Finally, an operational map of development strategies was developed using the Interpretive Structural Modeling (ISM) and Matrix Impact Cross-Reference Multiplication Applied to a Classification (MICMAC) approach. The results indicate that four phases of development should be followed for real development and maturity of development in these WDCs, including Groundwork, Structuring, Development and Growth, and Smart Maturity.

Nutritional and technological potential of chicken feathers for the food industry.

1. The production of chicken meat has resulted in high volumes of byproducts, such as feathers, bones, skin, viscera, and feet. The structure of feathers is one of the most complex among vertebrates, with a central axis and lateral filamentary structures, providing rigidity, lightness, and flexibility. Chicken feathers are composed of proteins, lipids, and water, with the highest protein content, especially keratin, which is responsible for the material's rigidity.2. Industries still make little use of feathers, which are generally intended for the production of flour or organic fertilisers. These are low added value products, and discarded feathers can harm the environment.3. Keratin extraction techniques and resulting protein hydrolysates have been studied in chicken feathers. Acid, alkaline or enzymatic hydrolysis is the most commonly used method for obtaining molecules with functional properties such as antioxidant, antimicrobial, antihypertensive and antidiabetic activity.4. The development of keratin-based biodegradable films represents an area of interest for reducing the economic and environmental impacts caused by inappropriate disposal of feathers.

Guidance provided by pharmacists to customers regarding to destination of unused household medications: disposal of household medications.

BACKGROUND: Discarding pharmaceuticals in the garbage or into the sewage system are still the most common methods in many countries. This study aims to investigate the guidance provided by pharmacists to customers on the disposal of unused and expired household medications in São Paulo State, Brazil. METHOD: The study population consisted of 630 pharmacists from the State of São Paulo, who work in community pharmacies. They answered an online questionnaire with questions composed in three blocks: demographic, work, and academic information on the pharmacist; guidance about the disposal of household medications; and knowledge regarding the reverse logistics of these medications. An invitation to participate in the questionnaire was made via WhatsApp, individually and collectively. Inferential statistics were performed using the chi-square test and were considered significant when p < 0.05%. RESULTS: Among the participating pharmacists, the majority were women under 60 years old,56 (8.89%) stated that they never orient the customer regarding the disposal of unused and expired household medications, while 574 (91,12%) indicated that they almost provide guidance. The frequency with which they provided guidance was influenced by the number of years since graduation (p = 0.0047), the time they had worked in pharmacies and drugstores (p = 0.0007), and whether or not they had a graduate degree (p = 0.0181). Regarding the disposal of medications, among the 643 responses provided by the pharmacists,516 (80.25%) indicated that they oriented customers to return them to a pharmacy. CONCLUSION: A small number of pharmacists always orient customers on the proper disposal that should be followed for unused and expired household medications, prioritizing their return to a pharmacy. In general, these pharmacists have longer periods of work experience and higher academic qualifications. Thus, it is important to increase knowledge through professional training and further education programs.

Medical Household Waste as a Potential Environmental Hazard: An Ecological and Epidemiological Approach.

Nowadays, the contamination caused by emerging pollutants is a global concern due to the lack of scientific evidence to demonstrate the risk or toxicity to humans due to the presence of pharmaceutical residues in the environment. This study aimed to identify and describe the disposal practices of unused and unwanted medications, as well as to analyze and identify the most frequent drugs determined on water bodies adjacent to the biggest urban population in Mexico. A two-phase study with an epidemiological and an ecological assessment was performed. The epidemiological phase was carried out with a descriptive cross-sectional study among citizens from Mexico City and the metropolitan area using an electronic survey applied to 719 subjects aimed to assess practices in which pharmaceutical products are disposed. The ecological phase included a review of scientific reports. The results show that nearly 83.5% of those surveyed use inappropriate practices for disposal medicines, the main ones are through the municipal dump or directly in the drain. The ecological approach was carried out by a systematic literature review of original reports published between 2013 to 2023; information about the class of drugs, active substance, environmental compartments, location, and concentration was extracted and presented. Fifty-one different types of pharmaceutical residues were detected in wastewater in Mexico City in the last decade. The results of this study can contribute to the application of public policies for waste management authorities to mitigate the socio-environmental risks due to the inappropriate disposal of medicines.

Descarte de medicamentos e os impactos ambientais: uma revisão integrativa da literatura / Disposal of drugs and the ensuing environmental impacts: an integrative review of the literature

Resumo O objetivo deste artigo é investigar as evidências nacionais e internacionais disponíveis sobre o descarte de medicamentos e os impactos em matrizes ambientais. Trata-se de uma revisão integrativa da literatura realizada nas bases de dados PubMed, SciELO e Biblioteca Virtual em Saúde (BVS) e que incluiu artigos em inglês, espanhol e português publicados entre 2010 e 2020. Foram selecionados 26 artigos, que evidenciaram o descarte incorreto de medicamentos por profissionais e consumidores devido, principalmente, à falta de conhecimentos sobre os impactos ambientais que esses podem ocasionar. Estudos apontaram a contaminação de água, esgoto e sedimentos por fármacos descartados de forma incorreta. Além disso, observou-se que seres vivos aquáticos podem ser impactados pela presença de medicamentos em matrizes ambientais. O descarte de medicamentos incorreto ainda é uma realidade nas evidências avaliadas, que promove a contaminação de matrizes ambientais e muitas vezes não é removido por estações de tratamento de águas residuárias e interfere no equilíbrio da vida ambiental.

Abstract The scope of this article is to investigate the national and international evidence available on the forms of drug disposal and the presence of drugs in environmental matrices. It involved an integrative review of the literature conducted in the PubMed, SciELO and Virtual Health Library (VHL) databases, which included articles in English, Spanish and Portuguese published between 2010 and 2020. Twenty-six articles were selected, which revealed the incorrect disposal of medicines by professionals and consumers due mainly to the lack of knowledge about the environmental impacts that they may cause. Studies have highlighted the contamination of water, sewage and sediments by incorrectly discarded drugs. Furthermore, it was observed that aquatic living creatures can be impacted by the presence of drugs in environmental matrices. The incorrect disposal of drugs continues to be a reality in the evidence assessed, which leads to the contamination of environmental matrices and is often not removed by wastewater treatment plants and interferes with the equilibrium of environmental life.

Comparative Analysis of the Implementation of Support Vector Machines and Long Short-Term Memory Artificial Neural Networks in Municipal Solid Waste Management Models in Megacities.

The development of methodologies to support decision-making in municipal solid waste (MSW) management processes is of great interest for municipal administrations. Artificial intelligence (AI) techniques provide multiple tools for designing algorithms to objectively analyze data while creating highly precise models. Support vector machines and neuronal networks are formed by AI applications offering optimization solutions at different managing stages. In this paper, an implementation and comparison of the results obtained by two AI methods on a solid waste management problem is shown. Support vector machine (SVM) and long short-term memory (LSTM) network techniques have been used. The implementation of LSTM took into account different configurations, temporal filtering and annual calculations of solid waste collection periods. Results show that the SVM method properly fits selected data and yields consistent regression curves, even with very limited training data, leading to more accurate results than those obtained by the LSTM method.

Radiological assessment of the disposal of bulk oil NORM waste: Case study from Brazil.

The oil and gas industries are the largest producers of NORM wastes that are continuously generated during production and extraction activities. In addition, an increasing trend is observed in waste production worldwide due to the decommissioning of oil platforms. The problem is that most of these wastes are in activity concentration levels above the exemption and the clearance limits and are being accumulated in storage sites because no repositories exist in Brazil for NORM wastes generated by oil industries. There are regulations for radioactive wastes and for the licensing of repositories for managing wastes with low and intermediate levels of radiation but the current regulations apply only to packaged wastes. Therefore an initial radiological assessment was carried out with the RESRAD-OFFSITE code to show that bulk NORM wastes (not packaged wastes) could be disposed of in repositories near the surface without causing additional risk to the public above the criteria used. The results can also support decision-making by the Regulatory Authority to change the current regulations and allow for the disposal of wastes in bulk form.

An assessment of higher-value recyclable wastes in Mexico City households using a novel waste collector citizen science approach.

The ability to accurately characterize and collect data on household waste generation and composition is essential for promoting recycling and developing city management plans. However, traditional data collection approaches in developing countries are hampered by jurisdictional and budgetary constraints. Here, we explore whether citizen science projects that collaborate with waste collectors can solve this problem and be a viable tool for addressing household waste generation across temporal and geographic boundaries. In this regard, this first study evaluated recyclable household waste generation by engaging waste collectors both door-to-door individuals and trucks as citizen scientists daily in an urbanized colony (5797 inhabitants and 1747 houses) in Mexico City between September and October 2022. To understand their distribution and consumption patterns on a regional basis, we stratified the colony's households into 2 distinct non-overlapping sub zones and one Wednesday market based on waste collectors' routine using a Geographical Information System. Results show that for seven weeks, household waste constitutes up to 12.19 t of recyclables, ranging from 99.5 to 480.8 kg/day, with 35 % cardboard, 23 % PET plastics, 21 % hard plastics, 17 % glass, and 4 % aluminum. The average amount of recyclable waste produced was 54 g/person/day, resulting in an annual recycling generation of 114 t. Statistical analysis revealed that recyclable waste generation varied by day and subzone. Furthermore, informal centers rather than municipal waste disposal facilities are in charge of the final disposition of the collected recyclables, suggesting that a substantial waste proportion may go unaccounted for in the local government's annual MSW report and calling for the implementation of formal recycling sectors. Overall, this study show how effective waste collector engagement in science can be and imply that the proposed citizen science approach is vital for future waste projects and the generation of transparent datasets in developing cities.

Descarte de medicamentos domiciliares: uma análise de amostra obtida de uma ação de extensão realizada no município de Seropédica-Rj / Disposal of home medicines: a sample analysis obtained from an extension action carried out in the municipality of Seropédica-Rj / Descarga de medicamentos domiciarios: análisis de muestra obtenido de una acción de extensión realizada en el municipio de la Seropedic-Rj

O Brasil é um dos países que mais consomem medicamentos no mundo, em contrapartida não há uma legislação que regulamente o descarte de medicamentos domiciliares, sendo a maioria deles descartados incorretamente no lixo comum ou esgoto, contaminando o meio ambiente e trazendo prejuízos ambientais, sociais e econômicos. Ao analisar o material foi observado que 95,98% eram sólidos, 2,58 líquidos, 1,51% semissólidos e 0,24% outros. Já em relação às classes terapêuticas 27,25% eram medicamentos de ação cardiovascular, 15,30% de ação gastrointestinal, 15,07% de antimicrobianos, 14,44% de ação no SNC, 10,71% anti-inflamatórios, 5,49% analgésicos e antipiréticos, 3,52% antialérgicos, 3,31% de ação no trato respiratório, 2,83% hormônios e 2,09% outros. E o prejuízo econômico decorrente da perda dos medicamentos foi de aproximadamente R$ 9470,00. Diante do exposto, podemos concluir que o uso irracional de medicamentos, a não adesão terapêutica, a falta de fracionamento, as estratégias do marketing farmacêutico, as prescrições irracionais, a venda sem prescrição e a falta de educação sanitária da população a respeito dos medicamentos levam a um consumo indiscriminado dos mesmos, o que corrobora para o acúmulo nas residências e o descarte incorreto.

Brazil is one of the countries that consume most medicines in the world, in contrast there is no legislation that regulates the disposal of home medicines, most of them being disposed of incorrectly in common garbage or sewage, contaminating the environment and bringing environmental, social and economic damages. When analyzing the material, it was observed that 95.98% were solid, 2.58 liquids, 1.51% semi-solid and 0.24% others. With regard to the therapeutic classes, 27.25% were medicines with a cardiovascular action, 15.30% with a gastrointestinal action, 15.07% with antimicrobials, 14.44% with an CNS action, 10.71% with anti-inflammatories, 5.49% with analgesics and antipyretics, 3.52% with antiallergies, 3.31% with an action on the respiratory tract, 2.83% with hormones and 2.09% others. And the economic loss resulting from the loss of the medicines was approximately R$ 9470.00. In the light of the above, we can conclude that the irrational use of medicines, the non-adherence to treatment, the lack of fractionation, the strategies of pharmaceutical marketing, the irrational prescriptions, the non-prescription sale and the lack of health education of the population regarding the medicines lead to an indiscriminate consumption of the medicines, which corroborates for the accumulation in the residences and the incorrect disposal.

Brasil es uno de los países que más consumen medicinas en el mundo, en contraste, no existe legislación que regule la eliminación de medicinas domésticas, la mayoría de las cuales son descartadas incorrectamente en desechos o aguas residuales comunes, contaminando el medio ambiente y ocasionando pérdidas ambientales, sociales y económicas. Al analizar el material se observó que el 95,98% eran sólidos, 2,58 líquidos, 1,51% semisólidos y 0,24% otros. En cuanto a las clases terapéuticas, el 27,25% fueron medicamentos de acción cardiovascular, el 15,30% de acción gastrointestinal, el 15,07% antimicrobianos, el 14,44% de acción del SNC, el 10,71% antiinflamatorios, el 5,49% analgésicos y antipiréticos, el 3,52% 3,31% de acción en el tracto respiratorio, 2,83% de hormonas y 2,09% de otras. Y la pérdida económica resultante de la pérdida de los medicamentos fue de aproximadamente R$ 9470,00. A la luz de lo que antecede, podemos concluir que el uso irracional de los medicamentos, la no adhesión a la terapia, la falta de fraccionamiento, las estrategias de comercialización farmacéutica, las prescripciones irracionales, la venta sin receta y la falta de educación en la salud de la población sobre los medicamentos conducen a su consumo indiscriminado, lo que corrobora la acumulación en los hogares y la eliminación incorrecta.

Pharmacists knowledge, perception and practice regarding medication disposal.

Background: Medications that are improperly disposed contribute to environmental contamination with proven negative impacts on biological ecosystems. The role of the pharmacist in providing medication disposal advice is paramount to reducing this effect. Objective: To investigate pharmacists' knowledge, perception and practices regarding medication disposal in Trinidad. Methods: A cross-sectional study was conducted electronically over 4 months amongst public and private sector pharmacists using a self-administered questionnaire. The questionnaire comprised 32 questions and four sections - demographics, knowledge, perception and practice regarding medication disposal. Ethical approval was obtained from the Ethics Committee, the University of the West Indies, the four Regional Health Authorities in Trinidad, and the Ministry of Health, Government of the Republic of Trinidad and Tobago. Data were analysed using IBM SPSS Statistics Version 24. Chi-squared tests sought to detect significant associations between demographics and responses. Results: Of 400 pharmacists, (response rate 52.0%) most were female (63.0%), had <5 years experience (47.1%), and worked in a community pharmacy (68.0%). Most (79.3%) believed that improperly disposed medications can negatively affect the environment but only 45.2% thought that improperly disposed antibiotics could lead to antimicrobial resistance. Most returned expired drugs to the pharmaceutical distributor (80.8%), or disposed of through the Drug Inspectorate (63.9%), but 32.3% still disposed of expired medicines in the workplace garbage, with community pharmacies being more likely to carry out this practice (p = 0.011). Most pharmacists (36.5%) do not counsel patients on medication disposal and 64.4% would not recommend flushing expired drugs down the toilet. Only 20.7% would recommend flushing narcotics, which is considered the best practice to prevent accidental poisoning. Conclusions: Continuing education for pharmacists is needed to increase awareness of the best practices of medication disposal, along with an awareness campaign on medication disposal.

Past, Present, and Future of Copper Mine Tailings Governance in Chile (1905-2022): A Review in One of the Leading Mining Countries in the World.

How mine tailings storage facilities (TSF) are managed reflects the history, regulatory framework, and environment of a country and locale of the mine. Despite many attempts to find an environmentally friendly strategy for tailings management and governance that balances the needs of society and the ecosystem, there is no worldwide agreement regarding the best practices for tailings management and governance. This article reviews the evolution of copper tailings management and governance in Chile, current practices, and changes that could be or may need to be made to improve practices in response to local environmental conditions and local tolerance for risk. The progress to date in developing a holistic tailings management strategy is summarized. This article also describes recent proposals for the best available technologies (BATs), case histories of Chilean TSF using conventional technology, thickened tailings, paste tailings, filtered tailings, water use reduction, tailings reprocessing to obtain rare earth elements (REEs), circular economy, submarine deep-sea tailings disposal, and ways to avoid failure in a seismic region. Finally, the Chilean tailings industry's pending issues and future challenges in reducing the socioenvironmental impacts of tailings are presented, including advances made and lessons learned in developing more environmentally friendly solutions.

Medicamentos vencidos e/ou armazenados no domicílio de estudantes e o correto descarte: um estudo de caso

Objetivos Quantificar e qualificar por classes terapêuticas os medicamentos vencidos e/ou armazenados no domicílio de estudantes dos cursos técnicos do eixo saúde do Colégio Tecnológico Jerônimo Carlos do Prado, em Goiatuba, GO. Metodologia: A pesquisa foi realizada através de coleta de medicamentos em desuso obtidos da farmácia domiciliar dos estudantes por entrega voluntária e anônima. Resultados: Foram coletados 86 medicamentos, dos quais 77,9% estavam com a validade expirada. O número de medicamentos prescritos sem retenção de receita foi maior em relação aos prescritos com retenção de receita e venda livre. A classe terapêutica mais comum foi o anti-inflamatório não-esteroide, seguido dos analgésicos e os antimicrobianos. Alguns medicamentos apresentaram lascas e alteração de cor dos comprimidos e, no caso das soluções, foram encontradas crostas ao redor da tampa, evidenciando oxidação e alteração do produto. Conclusões: Logo, mesmo entre estudantes da área de saúde ocorre a prática do armazenamento de medicamentos e alguns em condições inadequadas. A aquisição racional de medicamentos deve ser um tema imprescindível a ser trabalhado em todos os níveis de ensino e também nas palestras educativas oferecidas pelas Unidades Básicas de Saúde. A população precisa de educação em saúde para apreender sobre as práticas corretas de armazenamento e descarte de medicamentos.

Objetivo: Cuantificar y clasificar los medicamentos por clases terapéuticas vencidos o almacenados en los domicilios de alumnos de cursos técnicos en el eje de salud del Colegio Tecnológico Jeronimo Carlos do Prado, en Goiatuba, GO. Metodología: La investigación se realizó a través de la recolección de medicamentos en desuso obtenidos de la farmacia domiciliaria de los estudiantes por entrega voluntaria y anónima. Resultados: Se recogieron 86 medicamentos, de los cuales el 77,9% estaban vencidos. El número de medicamentos de prescripción sin retención de prescripción fue mayor en relación a los prescritos con retención de prescripción y venta sin receta. La clase terapéutica más común fue el antiinflamatorio no esteroideo, seguido de los analgésicos y los antimicrobianos. Algunas drogas mostraron astillas y cambio de color en los comprimidos y, en el caso de las soluciones, costras alrededor de la tapa, evidenciando oxidación y alteración del producto. Conclusiones: Incluso entre estudiantes del área de la salud, se da la práctica de almacenar medicamentos y algunos en condiciones inadecuadas. La adquisición racional de medicamentos debe ser un tema fundamental a trabajar en todos los niveles educativos y también en las charlas educativas ofrecidas por las Unidades Básicas de Salud. La población necesita educación sanitaria para conocer las prácticas correctas de almacenamiento y disposición de medicamentos.

SUMMARY Aim: To quantify and classify the medicines by therapeutic classes expired or stored in the homes of students of technical courses in the health eje del Colegio Tecnológico Jeronimo Carlos do Prado, in Goiatuba, GO. Methodology: The investigation was carried out through the collection of disused medicines obtained from the home pharmacy of students by voluntary and anonymous delivery. Results: 86 medications were recovered, of which 77.9% were expired. The number of prescription drugs without prescription retention was greater in relation to prescriptions with prescription retention and sale without prescription. The most common therapeutic class was the anti-inflammatory drug on the steroid, followed by analgesics and antimicrobials. Some drugs showed astills and color change in pills and, in the case of solutions, around the tapa, evidencing oxidation and alteration of the product. Conclusions: Even among students from the health area, there is a practice of storing medicines and some in inadequate conditions. The rational acquisition of medicines should be a fundamental issue to work at all educational levels and also in the educational talks offered by the Basic Health Units. The population needs health education to know the correct practices of storage and disposal of medicines.

Perfil de medicamentos descartados nas farmácias públicas de um município do leste de Minas Gerais / Profile of medicines discarded in the public pharmacies of an eastern municipality of Minas Gerais

O descarte inadequado de medicamentos pode levar a impactos ambientais negativos e deve ser considerado um problema de saúde pública. O presente estudo teve como objetivo levantar dados quantitativos e qualitativos relacionados ao perfil dos medicamentos descartados no município de Governador Valadares - MG. O trabalho foi desenvolvido nas UAPS/ESF que possuíam farmácias, e também na Farmácia Central/Policlínica Municipal. Nesses locais, foi realizada uma análise dos medicamentos descartados no período de julho de 2017 a maio de 2018. Por meio dos dados obtidos nesse período foi possível perceber que as principais classes de medicamentos descartadas foram os inibidores da enzima conversora de angiotensina, antagonistas da angiotensina II, agentes betabloqueadores, diuréticos, hipoglicemiantes, contraceptivos hormonais e agentes modificadores de lipídeos. Além disso, foi realizada uma ação de educação em saúde e aplicado um questionário semiestruturado aos usuários participantes dos grupos operativos. Dos 34 usuários respondentes do questionário, 23 (69,70%) não tinham acesso a informação sobre o local correto de descarte e armazenamento de medicamentos. Após a ação de educação em saúde verificou-se um aumento no quantitativo de medicamentos descartados pelos usuários nas UAPS/ESF Mãe de Deus I e II, Altinópolis III e IV, Santa Rita II, São Pedro I e II e Esperança e Nossa Senhora das Graças. O trabalho desenvolvido permitiu apresentar dados relevantes para a gestão municipal demonstrando a importância do farmacêutico no cuidado em saúde e o caráter epidemiológico local da prevalência das doenças crônico não transmissíveis.

The inadequate disposal of drugs can lead to negative environmental impacts and should be treated as a public health problem. This study aimed at surveying quantitative and qualitative data related to the profile of drugs discarded in the city of Governador Valadares - MG. The work was developed in the UAPS / ESF that had pharmacies, and also in the Central Pharmacy/Municipal Polyclinic. In these locations, an analysis of the drugs discarded between July 2017 and May 2018 was carried out. Through the data obtained in this period, it was possible to notice that the main classes of drugs discarded were angiotensin-converting enzyme inhibitors, angiotensin II antagonists, beta-blocking agents, diuretics, hypoglycemic agents, hormonal contraceptives, and lipid-modifying agents. In addition, a health education action was carried out and a semi-structured questionnaire was applied to users participating in the operating groups. From the 34 users who responded the questionnaire, 23 (69.70%) did not have access to information on the correct place to dispose and store medicines. After the health education action, there was an increase in the amount of drugs discarded by users in the UAPS/ESF Mãe de Deus I and II, Altinópolis III and IV, Santa Rita II, São Pedro I and II, and Esperança and Nossa Senhora das Graças. The work carried out made it possible to present relevant data for municipal management, demonstrating the importance of the pharmacist in health care and the local epidemiological character of the prevalence of chronic non-communicable diseases.

Biomass production, metal and nutrient content in sorghum plants grown on soils amended with sewage sludge.

Sludge generation from wastewater treatment plants in Uruguay has increased in recent years. Agricultural soils may be a final destination. A greenhouse experiment was conducted to quantify the effect of this sludge on 1) plant biomass production and nutrient concentration of sorghum (Sorghum bicolor var. vulgare); 2) the chemical properties of amended soils; and 3) assess whether heavy metal concentrations in sludge are appropriate according to environmental regulations. Two soils (S1 and S2) were amended with pure sludge (PS) and limed sludge (LS), with low dose (LD) of 16.0 and 17.3 Mg ha-1 and high dose (HD) of 32.0 and 34.6 Mg ha-1, respectively. Sludge treatments increased plants' nutrient absorption and dry matter production. The LS treatments incremented plant biomass production, depending on soil pH and nutrient availability. The effect of sludge treatments on elemental concentration in aboveground biomass depended on the element, treatments, and soil type. Mineralized nitrogen (N) and plant available phosphorus (P-Bray 1) values increased with sludge addition without exceeding Uruguay's critical soil level of P-Bray 1 for the sorghum crop. The PS did not increase metal concentration in soils. The LS slightly decreased soil Pb and slightly increased Cr and Zn soil concentration; levels were according to Uruguayan environmental guidelines. Therefore, agriculture soils are a viable final destination for PS and LS. Land applied sludge has acceptable levels of metals and promotes crop development.

Solid waste generation indicators, per capita, in Amazonian countries.

Countries participating in the Amazon Cooperation Treaty Organization have few options for the environmentally appropriate final disposal of municipal solid waste. Thus, sustainable practices aimed at reducing the negative effects of such a disposal on the environment are complex and hard to accomplish, since solid waste generation per capita proportionally increases as populations grow (≈ 2.7% > world average), mainly in countries inserted in Amazon Cooperation Treaty Organization. Thus, demographic, socioeconomic, management, and ecological factors represented by 18 independent variables were statistically analyzed to explain waste per capita variation in Amazonian countries and sub-regions. Multiple Kruskal-Wallis tests were applied; 13 of them recorded significant results (p < 0.05). Subsequently, simple and multivariate regression analyses were carried out by taking into consideration waste per capita and significant variables. Simple regression results recorded for variables "IAC" and "Gini index" were significant (RIAC2 = 60.09%, RGini2 = 30.83%), with emphasis on "Amazon biome" (DF = 33, p < 0.01, RBiome2 = 5.34%). Multivariate models resulted in wide explainability variation, depending on the number and type of available variable (54.47% ≤ Raj2 ≤ 70.83%), with emphasis on "IAC," "Ptot," "Purb," "Wton," "Lon," Area, "HDI," "Gini," and "SDG11" (p < 0.01). In conclusion, waste per capita estimation models can present variations and geographical interdependencies due to different variables and factors that reflect the current public policies and municipal solid waste management practices.

mpacto ambiental y riesgos potenciales generados en los rellenos sanitarios: revisión narrativa de la literatur / Environmental Impact and Potential Risks Generated in Sanitary Landfills - Narrative literature review / Impactos ambientais e riscos potenciais dos aterros sanitários: Revisão narrativa da literatura

Introducción: El derecho a un medio ambiente sano posibilita a las personas desarrollarse y vivir de manera satis-factoria. Desafortunadamente, la actividad humana ha impactado en el ambiente y no siempre de forma positiva, y uno de los aspectos perjudiciales para el medio ambiente son los desechos o residuos sólidos y su inadecuado manejo, tratamiento y disposición. Objetivo: Caracterizar el impacto ambiental y riesgos potenciales generados en los rellenos sanitarios. Metodología: Revisión narrativa de la literatura sobre el impacto ambiental y los riesgos potenciales en los relle-nos sanitarios, obtenida en bases de datos como Ovid, Proquest, SciELO, ScienceDirect, Taylor & Francis, Google Scholar, Scopus, Redalyc y Pubmed. Desarrollo y discusión: Los rellenos sanitarios constituyen riesgos potenciales de contingencias que afectan la salud, como enfermedades (respiratorias, cutáneas o gastrointestinales) y accidentes (cortaduras, pinchazos o quemaduras) y daños en el ambiente, como sobrecalentamiento y contaminación atmosférica derivados de la inadecuada disposición de desechos. Entre los factores de riesgo se identifican gases, lixiviados contaminados, material electrónico, olores, incendios, contaminación del agua subterránea por lixiviados, cambio climático global y el incumplimiento de normas en la construcción de rellenos sanitarios. Conclusión: Se advierte un impacto negativo para el medio ambiente y la salud de la población derivado de la inadecuada eliminación de desechos sólidos en los rellenos sanitarios.

Introduction: The right to a healthy environment enables people to develop and live satisfactorily. Unfortunately, human activity has impacted the environment and not always in a positive way, one of the harmful aspects for the environment is the generation of waste products or solid waste and the inadequate, handling, treatment and disposal of them. Objective: To characterize the environmental impact and potential risks generated in landfills. Methodology: A narrative review of the literature regarding the environmental impact and potential risks in landfills was carried out, obtained from databases such as Ovid, Proquest, SciELO, Science-Direct, Taylor & Francis, Google Scholar, Scopus, Redalyc, Pubmed. For the information search, the keywords were considered and for their choice the inclusion and exclusion criteria. Development and Discussion: Landfills demonstrate potential risks of contingencies that affect health, such as diseases (respiratory, cutaneous, gastrointestinal) and accidents (cuts, punctures, burns) and damage to the environment such as overheating and air pollution derived from the in-adequate disposal of waste. Risk factors identify gases, contaminated leachate, electronic material, odors, fires, groundwater contamination by leachate, global climate change and non-compliance with landfill construction. Conclusion: There is a negative impact on the environment and the health of the population derived from the inadequate disposal of solid waste in landfills.

Introdução: O direito a um ambiente saudável permite que as pessoas se desenvolvam e vivam de forma satisfatória. Infelizmente, a atividade humana teve impacto sobre o meio ambiente e nem sempre de forma positiva, e um dos aspetos prejudiciais para o meio ambiente são os resíduos sólidos e seu manejo, tratamento e disposição inadequados. Objetivo: Caracterizar o impacto ambiental e os potenciais riscos gerados nos aterros sanitários. Métodos: Revisão narrativa da literatura sobre o impacto ambiental e os potenciais riscos nos aterros sanitários, obtida de bancos de dados como Ovid, Proquest, SciELO, ScienceDirect, Taylor & Francis, Google Scholar, Scopus, Redalyc e Pubmed. Desenvolvimento e discussão: Os aterros sanitários constituem riscos potenciais de contingencias que afetam a saúde, tais como doenças (respiratórias, cutâneas ou gastrointestinais) e acidentes (cortes, furos ou queimaduras) e danos ao meio ambiente, tais como superaquecimento e poluição atmosférica derivados da inadequada disposição dos resíduos. Os fatores de risco incluem gases, lixiviado contaminado, material eletrônico, odores, incêndios, contaminação de águas subterrânea por lixiviado, mudança climática global e não conformidade com as normas na construção de aterros sanitários.Conclusão: Há um impacto negativo sobre o meio ambiente e a saúde da população devido ao descarte inadequado de resíduos sólidos em aterros sanitários.

5R y Sustentabilidad hospitalaria: Nuestro aporte en la emergencia climática. Parte I. Reducir, Reutilizar y Reciclar / 5R and Hospital Sustainability: Our contribution in the climate emergency. Part I. Reduce, Reuse and Recycle

INTRODUCTION: Climate change is a health problem and, at the same time, health systems are important contributors. Hospitals stand out due to their high rates of energy consumption, resources and waste generation. The purpose of the study is to know and identify the determinants of sanitary waste and the measures that can be implemented that allow reducing the production of hospital waste, seeking to achieve a general and updated appreciation of this phenomenon and taking into account hospital sustainability. METHOD: A bibliographic search was carried out in pubmed that included keywords related to the concepts of carbon footprint, recycling and hospital waste. The screening yielded a total of 37 articles and later 12 publications founded from references (or that were previously known by the authors) were added. RESULTS: The results are presented into 5 points known as the "5 Rs", named below. "Reduce" (through adequate segregation of waste, correct management of effluents and energy, significant reduction of excesses and automatic administration of anesthetic gases), "Reuse" (through device reprocessing, reusable material and donation), "Recycle", "Rethink" (with examples such as selection of less polluting gases, selective use of containers, staff education) and "Investigate" through different models. DISCUSSION: Several of the recognized measures could have an application in many hospital areas despite the fact that most of the available evidence refers to the operating room. The organization and education of the personnel is important in order to implement the measures found.

INTRODUCCIÓN: La estrategia de disposición y generación de residuos influye en el cambio climático y éste, al mismo tiempo, afecta la salud de las personas, incrementando la frecuencia de enfermedades cardiovasculares, respiratorias e infecciosas, entre otras. Los sistemas sanitarios son contribuyentes importantes, debido a sus altas tasas de consumo de energía, recursos y generación de desechos. Esta revisión de la literatura pretende obtener una apreciación general y actualizada de los determinantes de desechos sanitarios y las medidas implementables para disminuir la producción de residuos hospitalarios y nuestro impacto en el medio ambiente. MÉTODO: Se realizó una amplia búsqueda bibliográfica en la base de datos Medline que incluyó palabras clave relacionadas a huella de carbono, reciclaje y residuos hospitalarios. El cribado arrojó un total de 48 publicaciones. RESULTADOS: Se presentan los resultados organizados en 5 puntos, a los que se les conoce como las "5 R" y que corresponden a "Reducir" (a través de segregación adecuada de residuos, correcta gestión de efluentes, energía y disminución de excesos), "Reusar" (a través de reprocesamiento de dispositivos), "Reciclar" (transformación de residuos), "Repensar" (búsqueda de nuevas formas, innovadoras y sustentables, de las prácticas clínicas) e "Investigar" (Research, generar nuevo conocimiento). DISCUSIÓN: Numerosas estrategias pueden ser implementadas para contribuir a la sustentabilidad hospitalaria y podrían tener una aplicación en muchas áreas, a pesar de que la mayoría de la evidencia disponible hace referencia al sector quirúrgico. La investigación nos ofrece herramientas para desarrollar nuevas alternativas de gestión, donde la organización y educación del personal son esenciales.