Research on the Current Status and Future Development Prospects of Medical Waste Disposal Technologies and Management in China

Abstract

The ongoing improvement in healthcare standards and the frequent occurrence of epidemic outbreaks have led to a significant rise in medical waste (MW) generation, revealing weaknesses in China’s existing management system and disposal technologies for MW. This situation underscores the urgent need to reassess the effectiveness of MW management and disposal practices. This study analyzes China’s centralized MW disposal capacity, the distribution of facilities, the evolution and characteristics of disposal technologies, and the current policy framework. Challenges such as limited technological applicability, inadequate disposal capacity in rural and remote areas, and a lack of emergency disposal capabilities have been identified. Given the new challenges and complexities in the MW industry, two strategies are proposed, including comprehensive whole-process management and the integration of routine and emergency disposal. This research offers a systematic solution for MW disposal, aiming to improve management practices, enhance disposal efficiency, and strengthen emergency response capabilities.

1. Introduction

Medical waste (MW) produced by healthcare institutions during diagnostic and treatment procedures is distinguished by its infectious, hazardous, and contaminating characteristics. Compared to general solid waste, MW presents a greater environmental risk, as it often contains large amounts of viruses, bacteria, chemical pollutants, and even radioactive materials [1]. Since the 20th century, China has experienced several epidemic outbreaks, including the SARS (Severe Acute Respiratory Syndrome) epidemic from 2002 to 2003, the H1N1 influenza outbreak in 2009, the H7N9 avian influenza outbreak from 2013 to 2014, the COVID-19 (Coronavirus Disease 2019) pandemic that began in 2020, and the ongoing monkeypox epidemic that started in 2022 [2,3]. The intervals between these outbreaks have progressively shortened, and a detailed timeline was provided in Supplementary Material Figure S1. However, efforts by society and the government to enhance MW disposal capacity have not kept pace with the increased demand for MW disposal, resulting in unresolved public health risks [4]. The safe and effective disposal of MW is the last line of defense for public health and has received attention worldwide. The World Health Organization (WHO) has been committed to managing MW as hazardous waste and actively encourages countries to establish comprehensive whole-process management and disposal systems for MW [5]. China is also continuously exploring sustainable disposal technologies and efficient management measures for MW. From 2011 to 2022, the disposal volume of MW in China increased by 376%, rising from 498,000 tons in 2011 to 2,370,000 tons in 2022 [6].

China’s MW disposal technology has experienced rapid development. Initially, MW disposal primarily relied on incineration and landfilling. However, with increasing environmental demands and rapid technological advancements, modern MW disposal techniques have evolved to prioritize efficiency, safety, and reduced pollution [7]. Currently, various technologies coexist in MW disposal, including incineration, steam sterilization, microwave disinfection, and chemical treatment, each with its own unique characteristics. In terms of management systems, the Chinese government has introduced a series of laws, regulations, and policies that address technical and management requirements across the entire MW disposal process, including the collection, storage, transportation, incineration, disinfection, construction of facilities, environmental assessment, operation of facilities, performance testing, and emission control [8]. Additionally, local governments in China have developed management measures and policies tailored to regional needs, continually improving the refined management of MW disposal [9]. Relevant standards and policy documents are provided in Supplementary Materials Tables S1 and S2. The continuous improvement of medical standards and the surge in MW during epidemic outbreaks pose significant challenges for timely, safe, and effective disposal, revealing shortcomings in China’s management system and disposal technologies, particularly regarding the uneven distribution of centralized facilities and inadequate capacity [10]. Although the Chinese government has introduced a series of policies to enhance the management of MW disposal facilities, upgrade technologies, and optimize facility distribution, the current centralized disposal capacity and facility distribution still struggle to meet future demands. These challenges become even more pronounced during large-scale public health crises.

Against the backdrop of evolving treatment technologies and persistent risks of infection and public health emergencies, imbalances between routine and emergency medical waste management in China have become increasingly prominent [11]. A comprehensive understanding of regulatory requirements, technological developments, and emerging trends is critical for building an effective and science-based governance system. This study systematically evaluates China’s treatment capacity, facility distribution, technological trajectories, and research landscape, while analyzing the evolution and challenges of relevant policies, aiming to inform future system optimization and evidence-based policymaking.

2. Materials and Methods

2.1. Data Collection

Data on the distribution and changes in the disposal capacity of centralized MW disposal plants in China were obtained from the Statistical Yearbook on Environmental Quality, published by the Ministry of Ecology and Environment of China from 2011 to 2023. Relevant management measures, policy initiatives, and standards were sourced from the official websites of the Ministry of Ecology and Environment and regional environmental departments in China.

The collection of patent bibliometric data was conducted through searches in the Derwent Innovations Index (DII) and Patsnap databases. The details were as follows: (1) The search terms included ALL = “medical waste” or “medical incineration flue gas” or “medical incineration exhaust” or “hospital liquid waste” or “hospital liquid medical waste” or “medical sewage” or “hospital wastewater” or “medical liquid waste” or “medical liquid medical waste” or “medical sewage” or “medical wastewater”. (2) The application year was set to start from 2002, as that was when the first patent related to MW was recorded. (3) The patent languages included Chinese, English, Japanese, Korean, and French. (4) The relevant data were exported from the DII and Patsnap databases and integrated based on the patent publication numbers, resulting in a total collection of patents.

The bibliometric data were collected through searches in the “China National Knowledge Infrastructure (CNKI)” and the “SciELO Citation Index” database within “Web of Science (WOS)”. The details were as follows: (1) The search term used was ALL = “medical waste”. (2) The publication year was set to begin in 2002, focusing on regions in China. (3) The language was set to “unrestricted”. (4) The analysis of MW disposal was based on the frequency of keyword occurrences, with manual screening conducted throughout the process, resulting in a total of 1961 documents. This study’s database included only research articles and review papers. Other document types, such as letters, book chapters, and news items, were excluded, as they typically do not undergo peer review during the publication process.

2.2. Data Analysis and Visualization

The patents were imported into the Patsnap system for online analysis [12]. Keyword trends in a large number of academic papers were analyzed and visualized using bibliometric tools CiteSpace (version 6.3) and VOS-Viewer (version 1.6.20). Incorporating a temporal dimension, the analysis elucidates shifts in significance across time, thereby enabling the identification of burgeoning research trends and the progressive development of subject matter. Spearman correlation analysis was conducted using Origin 2024.

3. Results and Discussion

3.1. Disposal Capacity of MW

The development of MW disposal in China has undergone a significant transformation, evolving from a single technology to a diverse range of technologies. This shift has also involved a transition from small, on-site facilities within individual medical institutions to large, regionally centralized facilities. Before 2003, the disposal of MW in China primarily depended on small incineration units installed within hospitals. These facilities had limited disposal capacity and were technologically outdated, and the concept of centralized disposal had not yet been implemented. Since 2004, China has established an MW disposal model that is primarily based on incineration, supplemented by various other technologies. In the past few decades, the number of MW disposal facilities in China has significantly increased, rising from 43 emergency centralized incineration units in 2003 to 441 centralized disposal centers by 2022. These centers have a combined processing capacity of up to 60,220 tons per day [13,14]. As illustrated in Figure 1a, the number of disposal facilities and their capacities in China (excluding data from Hong Kong, Macau, and Taiwan) have experienced significant growth from 2011 to 2017, with a notable acceleration after 2018. This indicated that China has strengthened the construction and capacity of MW treatment facilities. Additionally, the pandemic significantly accelerated the increase in both the number and capacity of centralized disposal facilities, reaching historical highs between 2021 and 2022. Future trends may require the establishment of more facilities and enhanced disposal capacity to meet the increasing demand for MW treatment. The distribution of centralized MW disposal facilities (Independent disposal) in China is shown in Figure 1b. China has gradually developed an MW management and disposal model that is centered around urban areas [15]. However, a significant imbalance in MW disposal capacity persists among provinces. Coastal and developed regions, such as Jiangsu, Zhejiang, and Guangdong, possess a considerably higher number of disposal facilities compared to central, western, and remote areas, which fall short in both the quantity of facilities and their growth rates. The layout of disposal facilities is closely related to the economic development and population structure of each province and municipality [16]. This article conducts a correlation analysis based on the GDP, total population, population structure distribution, and the number of MW disposal facilities in various provinces and municipalities in China for the year 2022, with the results presented in Supplementary Material Table S3. The analysis reveals a significant relationship among these four factors (p < 0.05). Analysis of big data on urban aging in China reveals that Sichuan has the highest number of deeply aging cities, totaling 17, while Henan has 8. Currently, both Sichuan and Henan have a significantly high number of centralized disposal facilities. Overall, the eastern region, particularly the economically developed areas, has noticeably more disposal facilities than the western region [17]. This regional disparity may lead to increased disposal pressures for central, western, and remote areas during future pandemics or public health emergencies. Additionally, the current infrastructure predominantly serves metropolitan and medium-sized urban areas [18]. Shandong currently boasts a network of 18 sophisticated centralized MW disposal facilities, strategically located in key urban areas such as Jinan and Qingdao. Similarly, the Tibet Autonomous Region hosts 6 cutting-edge centralized MW disposal facilities, strategically located in cities like Shigatse, Chamdo, and Nagqu. Notably, data from 2019 indicate that China’s 196 major urban hubs collectively produced 843,000 tons of MW, all of which were meticulously managed. However, the challenge persists in remote areas, where MW disposal often requires secondary transfers. This situation not only increases transportation costs and the risk of leakage but also highlights the lack of real-time on-site management capabilities [19].

The evolution and development of international MW treatment technologies have generally transitioned from incineration disposal to disinfection disposal [20]. Based on extensive international experience, China has consistently enhanced the technical requirements for the whole process of MW management. Currently, China’s MW management model includes a range of procedures, such as generation, classification, packaging, collection, storage, transportation, and treatment, as shown in Figure 1c. Each stage adheres to standardized operational procedures and utilizes specialized treatment technologies. In 2021, approximately 1.4 million tons of MW were processed nationwide, with about 787,000 tons incinerated at centralized facilities and about 613,000 tons treated using disinfection methods. Notably, MW treated with high-temperature steam disinfection accounted for about 70% of the total disinfection volume [14]. Overall, incineration and disinfection disposal technologies have developed in parallel, indicating significant progress in non-incineration treatment methods and a continuous enhancement of technical capabilities.

3.2. Disposal Technologies for MW

Over the past two decades, incineration disposal technologies centered around rotary kilns and fixed-bed furnaces, and non-incineration disposal technologies centered around high-temperature steam treatment, chemical treatment, microwave technologies, and high-temperature dry heat methods have been widely applied. This integration of various technologies has enabled the current utilization of both incineration and non-incineration technologies, promoting the coexistence of diverse waste management strategies [21]. A comparative analysis of conventional MW disposal technologies is presented in

Table 1. Comparative analysis of conventional MW treatment and disposal technologies.

Type	Incineration		Non-Incineration
	Rotary Kiln Firing	Pyrolysis Incineration	High-Temperature Steam-Based	Chemical	Microwave	High-Temperature Dry Heat
Scope can be treated	Acceptable for all waste types		Infectious and damaging MW
Processing scale	>10 t·d−1	5–10 t·d−1	One unit < 10 t·d−1
Equipment requirements	High temperature and corrosion resistance	High temperature and corrosion resistance	High-temperature and high-pressure resistant, sealed, and insulated	Corrosion-resistant, negative-pressure operation	Electromagnetic protection, sealed, and high-temperature resistant	Corrosion-resistant, negative-pressure operation
Assignment method	Continuous operation	Continuous/Intermittent Operation	Intermittent Operation
Pollutants emission	PCDD/PCDFs, SO2, HCl, NOx, heavy metals, etc.		Odor, VOCs	VOCs, waste gas disinfectant	VOCs, microwave radiation	Odor, VOCs
Disadvantages	High operating costs and specialized control of dioxins	Difficulty in achieving stable combustion, specialized control of dioxins	Condensate and steam boiler exhaust gas need to be treated	Easy to produce disinfectants Secondary pollution	Electromagnetic radiation Protection required	High requirements for temperature control
Advantages	Good disposal effect, strong adaptability, and large processing capacity	Low smoke and high heat utilization rate	Low operating costs, strong adaptability, minimal secondary pollution, no generation of pollutants such as dioxins, easy operation and management, and stable operating effects

. Compared to non-incineration technologies, incineration offers significant advantages as a comprehensive approach, including efficient processing, strong adaptability, and high throughput capacity. It can manage five categories of MW, including infectious, pathological, sharps, pharmaceutical, and chemical waste. In contrast, non-incineration technologies are characterized by their cost-effectiveness, adaptability, minimal secondary environmental impact, and the absence of dioxin emissions. However, these technologies are primarily suitable for managing infectious waste, sharps, and certain types of pathological MW. Currently, the most widely adopted non-incineration technologies include high-temperature steam treatment, chemical disinfection, microwave technology, and high-temperature dry heat methods [22].

In addition to analyzing the advantages and limitations of incineration and non-incineration techniques, this study aims to provide a deeper understanding of technological advancements and to identify future directions for development. Furthermore, we explored the landscape of intellectual property and trends in academic research related to these technologies. To trace the trajectory of advancements in MW disposal technologies in China, foundational data were collected from Derwent Innovations Index (DII) and Patsnap databases. Leveraging the thematic keyword “MW disposal technology” and International Patent Classification (IPC) codes, a comprehensive search algorithm was developed to curate patent data [12]. This analysis complemented the technological review by providing insights into the evolution of innovation, the competitive landscape, and significant technological advancements in MW disposal, with a focus on China’s prominent role in the global patent landscape. Additionally, bibliometric tools were employed to conduct a cluster analysis of the “medical waste” keywords in the CNKI and WOS databases, which further elucidated key trends and research priorities in this field.

As shown in Figure 2a, the global spread of SARS across Southeast Asia in 2002 highlighted the emerging concern of MW pollution. Therefore, our patent statistics start from this year. However, the progression of patent applications exhibited a slow trajectory, rising from just 4 in 2002 to a modest 25 by 2011, with only a few originating from China. Notably, this developmental phase primarily focused on advancements in waste collection and disposal methods. Following this, two significant infectious diseases occurred in 2012 and 2014: the Middle East Respiratory Syndrome (MERS) in Saudi Arabia and the Ebola epidemic. These events sparked a surge in research and development efforts related to MW disposal technologies, accompanied by a gradual expansion in the scope and scale of these activities. In 2012, a significant increase in global patent filings related to MW disposal technologies resulted in a substantial rise in patent submissions from China, highlighting its leadership in this field. Subsequently, starting from 2016, the global annual number of patent applications consistently exceeded 100, with an impressive annual growth rate of over 22%. Through sorting and analysis, it was found that as of 2020, approximately 82.8% of global patents for MW disposal technologies are concentrated in China, totaling 970 patents (the distribution of source countries for global medical waste disposal technologies is shown in Figure S2). In-depth thematic analysis revealed China’s extensive research efforts across various domains, including pre-treatment technologies (e.g., cutting and shredding), treatment and disposal methods (e.g., incineration, disinfection, and sterilization), and pollution mitigation strategies (e.g., waste gas and wastewater treatment), with a significant number of patents in each field, as shown in Figure 2b. Examining the patent figures across provinces and cities in China provides valuable insights into their respective capabilities in technological innovation and activity levels. As shown in Figure 2c, the leaders in this domain are Jiangsu (109), Shandong (101), Beijing (74), Henan (67), Zhejiang (67), Guangdong (66), Hunan (46), Guizhou (44), Shanghai (43), and Tianjin (38). Notably, Jiangsu and Shandong collectively command a substantial 67.4% share of China’s total patent applications, emblematic of a robust culture of technological ingenuity in these locales.

To address the potential limitations of patentometric analysis, this study utilized bibliometric tools to analyze keywords related to MW from a large volume of academic literature in the CNKI and WOS databases. The results are illustrated in Figure 2d,e. In VOS-Viewer, during the keyword cluster analysis, a higher frequency of keyword occurrences resulted in larger point sizes, while different colored lines indicated the years in which the keywords appeared. An analysis of the results revealed that the development of MW disposal technology in China can be divided into three stages. The first stage (2010–2015): This period primarily concentrated on traditional MW disposal technologies, particularly incineration, with related keywords including “combustion”, “incineration”, and “municipal solid waste”. These keywords reflect common waste treatment technologies that were the focus of early attention. The second stage (2016–2019): With the rise in new technologies and research, keywords such as “Plasma Gasification”, “High-Temperature Steam Microwave”, and “Pyrolysis Gasification” emerged, reflecting the exploration of more environmentally friendly and efficient waste treatment technologies. Non-incineration methods and other innovative disposal technologies gained increasing attention. The third stage (2019–Present): In this phase, terms related to “Management System Measures”, “Emergency Management”, and “COVID-19” appeared, including “Waste Sorting” and “Infection Control”. This likely indicates that, as the importance of MW management has increased, there is a growing focus on systematic management and emergency measures. Additionally, how to effectively classify and manage MW generated during the pandemic has become an urgent and important issue. Keywords like “Optimization”, “Generation”, and “Lifecycle Assessment” suggest that, particularly in the context of a surge in waste post-pandemic, optimizing management systems to reduce environmental impact is a key research direction.

In summary, the frequency of keyword occurrences and changes over time indicated that the development trends of MW disposal technology and management strategies in China have evolved over the past decade. The transition from early technological research to systematic management, and subsequently to emergency measures in response to public health crises, demonstrated ongoing advancements and improvements in this field. Future research and practice in China may enhance efforts to promote the sustainable development of MW management. Additionally, technologies such as artificial intelligence and machine learning can be utilized to optimize various aspects of MW management, thereby improving efficiency, reducing costs, and further supporting lifecycle assessments and sustainability. The future of MW management in China is expected to exhibit four trends: the dominance of policy and regulations, continuous innovation in disposal technologies, widespread application of lifecycle assessments, and a deeper integration of technology and algorithms.

3.3. The Evolution of Management Policies for MW

As shown in Figure 3, China’s evolution in MW disposal governance can be divided into three main periods. The first phase, the Legislative Exploration Phase (1989–2001), was characterized by a strategic exploration of management practices. During this period, China promulgated key legislative measures, including the Law of the People’s Republic of China on the Prevention and Treatment of Infectious Diseases [23] and Environmental Protection Law of the People's Republic of China [24], and established the National Hazardous Waste List [25]. These legislative measures established the legal foundation for MW management, marking the beginning of the exploratory phase in the development of China’s MW disposal framework. The second stage, Management System Improvement Phase (2003–2010): During this period, China refined its MW management system [26]. “The enforcement of the Regulations on the Management of MW” marked the formalization and legitimization of the whole process, encompassing waste generation, temporary storage, transportation, and centralized disposal. Additionally, the introduction of the “National Plan for the Construction of Hazardous Waste and Medical Waste Disposal Facilities” [27], prioritized incineration technology while integrating complementary non-incineration methods. The third stage, the Institutional Advancement and Standardization Phase (2011–present), marks an era of institutional progress. During this period, a series of standardized regulations governing disposal technologies has been implemented sequentially. Additionally, the resilience of the MW management system has been tested by the challenges posed by COVID-19 [28]. Currently, China has developed a sophisticated standard system focused on environmental oversight and pollution reduction in MW management. This framework offers comprehensive guidance throughout the whole MW management process, covering aspects such as engineering construction, technology assessment, pollution control, and operational oversight. As a result, China has successfully adopted a comprehensive approach to managing MW, ensuring its safe handling from generation to final disposal. This marks a significant milestone, indicating that China’s MW management system and disposal technologies have entered a new stage of development [29,30].

China has made significant progress in establishing a regulatory framework, policy system, and standards for MW management, along with a significant number of MW disposal facilities. However, compared to international experiences in MW disposal, China has not yet established a comprehensive management system. Several issues persist, including a lack of systematic management throughout the whole MW management process, incomplete technical policies for MW disposal in remote areas, and insufficient emergency response mechanisms for disposal technologies.

(1)

The management of MW lacks systematization throughout its entire lifecycle.

This study investigated the management practices related to production, collection, transportation, storage, and disposal in countries such as the United States, the European Union, Japan, and Singapore, as shown in Supplementary Material Table S4. The research found that current policies in China fail to fully address the entire lifecycle of MW, with the backend disposal phase being particularly underdeveloped. Although the “Regulations on the Management of Medical Waste” and related laws clearly outline responsibilities for the generation, collection, transportation, and disposal of MW, there is insufficient guidance regarding subsequent technology choices. This is especially true for non-incineration technologies, which are rapidly developing but have not received comprehensive policy support. As a result, local authorities lack standardized management requirements for selecting specific technologies, which hinders effective supervision and complicates improvement efforts. The management and disposal of MW involve multiple administrative departments with distinct yet interconnected roles. The overall effectiveness of MW management largely depends on the scope of each department’s responsibilities, the methods they employ, and the degree of coordination among them. To improve outcomes, future efforts should focus on establishing a collaborative system characterized by clearly defined roles and active participation from all stakeholders. Furthermore, enhancing public education and implementing appropriate take-back mechanisms can significantly strengthen overall management performance [31,32].

(2)

The policies for MW disposal technologies in remote areas are inadequate.

Current policy support primarily focuses on urban and densely populated areas. However, challenges such as inadequate infrastructure and high transportation costs severely restrict the effective disposal of MW in remote regions. While some policies address the management of MW in rural areas, remote and rural regions still lack corresponding support measures. Existing centralized disposal facilities are primarily located in urban areas, while the disposal of MW in remote areas is hindered by logistical barriers, resulting in untimely or non-compliant MW treatment and posing environmental and public health risks. Therefore, future policies need to incorporate more regionally adaptable responses, such as encouraging and supporting mobile treatment facilities or regional small-scale processing centers, as well as providing subsidies and technical support specifically for rural and remote regions.

(3)

The emergency mechanisms for disposal technologies are inadequate.

Current policies in China have not effectively addressed the surge in MW during emergencies, particularly during public health crises such as the pandemic. As MW volumes increase dramatically, existing centralized treatment facilities are struggling to expand their processing capacity. The current policies regarding MW disposal are inadequate, as evidenced by the lack of a robust collaborative disposal mechanism, including weak inter-industry coordination and limited rapid deployment capacities. Although there is a framework for emergency plans at the national level, the actual implementation is hindered by slow coordination between local governments and disposal companies, as well as delays in resource integration. Therefore, policies must further refine emergency plans by clearly outlining procedures for emergency processing and establishing inter-regional coordination mechanisms to manage surges in MW. Additionally, a flexible and rapid response system for MW disposal should be established to enhance the capacity to address large-scale outbreaks, such as COVID-19.

3.4. The Sustainable Development Directions of MW

Based on the analysis presented in this study, the disposal and management of MW in China can be guided by two main points:

(1)

China should actively promote the establishment of a comprehensive lifecycle system aiming at achieving whole-process management from MW generation to disposal. This includes systematic management of the collection, classification, packaging, temporary storage, transportation, and treatment of MW to ensure compliance with environmental protection and safety standards at all stages. Additionally, as technology continues to develop, comprehensive technical certification should be implemented to ensure both applicability and effectiveness. Furthermore, engineering construction should prioritize the operational management of facilities to guarantee efficient equipment usage and oversight by environmental protection authorities. The implementation of monitoring management is essential and should be integrated with the facility operation and supervision to enable real-time tracking and assessment of management effectiveness. Figure 4 clearly illustrates the proposed blueprint for China’s management system for MW technology. The primary objective is to establish a comprehensive MW management infrastructure that addresses the urgent needs in environmental, economic, social, and institutional aspects, ultimately fostering the sustainable development of MW management.

(2)

The methods for constructing and developing MW disposal systems in China should prioritize the coordination between routine operations and emergency response efforts. Cities should effectively allocate existing disposal facilities and adopt diverse strategies to strengthen emergency preparedness. As shown in

Table 2. The basic path for the future development of MW disposal.

Technical Approach	Application Scenarios	Disposal Measures
Hospital on-site disinfection treatment + disposal at a waste-to-energy plant	Cities within the region with existing municipal waste incineration facilities	Leveraging hospitals for on-site disinfection of MW, with the disinfected waste then transferred to municipal waste incineration facilities for disposal by incineration.
Coordinated disposal of municipal solid waste incineration facilities	Cities within the region that have existing municipal waste incineration facilities	Relying on domestic waste incineration facilities to form an MW co-disposal capacity. By setting up a special feeding port for MW and related supporting facilities, the domestic waste incineration facilities are utilized for the co-disposal of MW in routine and emergency situations, and the proportion of MW blended in is generally no more than 5%.
Centralized MW treatment facility	All cities	Utilizing the facilities of the Centralized Medical Expense Disposal Center (CMEDC) for the treatment and disposal of MW. Applicable to traditional and emergency disposal of MW.
Miniaturized in situ rapid start and stop safe disposal technology	Outbreaks and remote areas	Emergency treatment of MW in cities (or counties) during traditional and epidemic situations; emergency treatment of MW in earthquake and other disaster areas; routine and emergency treatment of MW in remote areas.

, cities with municipal solid waste incineration facilities can manage MW through two main approaches: ① Hospitals can be responsible for onsite disinfection of MW, which is then sent to municipal solid waste incineration facilities for disposal. ② Municipal solid waste incineration facilities can assist in the disposal of MW, typically maintaining an incineration rate of below 5%. In remote areas facing epidemics, it is recommended to implement in situ rapid start and stop disposal technologies. Nationwide, efforts should continue to enhance the infrastructure for both routine and emergency MW disposal facilities, accelerate the development of centralized MW disposal facilities, and enhance the treatment and disposal capacity for MW.

4. Conclusions

The disposal of MW is a critical component of the solid waste management system. Over the past two decades, China has made substantial progress in both disposal technologies and management practices, particularly in response to multiple public health emergencies. This study provides a systematic analysis of the evolution and current state of China’s medical waste disposal system through the lenses of policy development, technological advancement, regional disparities, and anticipated future trends. An integrated analytical framework was established to examine the interactions among technology, governance, and spatial coordination. The findings reveal a steady enhancement of China’s disposal capacity, with incineration and non-incineration technologies developing in parallel. Among these, non-incineration methods exhibit strong environmental compatibility and operational adaptability, indicating their potential for broader adoption. A bibliometric analysis of patent data further shows that innovation is heavily concentrated in eastern coastal regions, pointing to significant regional disparities that may strain emergency disposal capabilities in less developed areas. The study also outlines four key trends likely to shape the future trajectory of China’s medical waste management system.

This research contributes by integrating multi-source data to uncover the coordinated development pathways and latent structural challenges across policy, technology, and regional implementation dimensions. It offers valuable strategic insights and practical implications for optimizing medical waste governance in China. Nonetheless, the study is not without limitations. Some datasets may lack timeliness or representativeness, and the empirical coverage of disposal practices at the grassroots level remains limited. Future research should address these gaps by exploring the evolving dynamics of regional capacity, assessing the real-world feasibility of emerging technologies, and enhancing the responsiveness and resilience of the system in the face of future public health emergencies.