Search Results (24)

In Mexico, hospital wastewater (HWW) is a source of chemical and microbiological contamination, and it is released into the municipal sewage system without prior treatment. This water may contain pathogenic bacteria and antimicrobial resistance genes, which represent a risk to Public Health and the environment. So far, there are no studies that analyse this problem comprehensively, relating bacterial population structures, chemical contaminants, and seasonality. The aim of this work was to seasonally characterise the bacterial communities of HWW, including clinically relevant bacteria and resistance genes in Hospital Juárez de México (HJM), and to evaluate the impact of physicochemical factors on their composition. A one-year observational, cross-sectional study was conducted at five HWW discharge points of HJM. Fourteen physicochemical parameters were determined by using standard methodologies, and statistical differences between discharges and seasons were evaluated. Bacterial communities were analysed by targeted amplicon sequencing of the V3-V4 region of the 16S rRNA gene. In addition, the presence of eight antimicrobial resistance genes of local epidemiological importance was assessed. Data were analysed using alpha and beta diversity indices, principal component analysis, and multivariate statistical tests. HWW showed high taxonomic diversity, with Proteobacteria, Firmicutes, and Bacteroidetes standing out. Clinically relevant bacteria were identified in 73.3% of the analyses, with Enterobacter and Escherichia-Shigella predominating. Total and dissolved solids, temperature, nitrate, and pH significantly influenced the bacterial composition of HWW. Seven out of the eight genes evaluated were identified, with bla_KPC, bla_OXA-40, and mcr-1 being the most frequent, showing significant seasonal differences. This study underlines the microbiological and chemical complexity of HWW, highlighting the impact of clinically relevant bacteria and antimicrobial resistance genes on Public Health. The findings emphasise the need to implement hospital waste management programmes and ideally specific treatment plants to minimise the associated risks and protect the environment and human health. Full article

Background: Bicomponent split microfiber reusable wipers and flat mops are innovative textiles used to hygienically clean healthcare surfaces and, hence, reduce hospital-acquired infections. Sustainability improvements are reflected as reduced energy and mass requirements over a life cycle. Methods: The environmental impacts of reusables were compared to disposable equivalents using standard life cycle assessment procedures. Results: With information from 80 hospitals, disposable flat mops and wipers were used at a higher rate than reusable counterparts; the disposable/reusable ratio was 2.3:1 for wipers and 2.5:1 for flat mop pads. Bicomponent split microfiber reusable products had lower impacts (65–95%) in all categories considered: global warming potential, natural resource energy, blue water use, and solid waste production. Discussion: Results reinforce other studies that compare reusable and disposable textile options in healthcare. Laundry energy is an important driver of energy use for reusables. The energy associated with water consumption for disposables’ supply chains is significantly greater than net water consumption for reusables laundry. Conclusions: Selecting disposables versus bicomponent split microfiber reusable flat mops and wipers increases these specific environmental life cycle assessment (LCA) impacts by 320% to 2000%, which is clearly not an environmental sustainability improvement. Group Purchasing Organizations may be barriers to hospital adoption of these reusables. Full article

The priority during an emergency, regardless of the type, is to rescue as many lives as possible. Field hospitals are usually installed to provide the primary relief to the affected population when hospitals are compromised or absent. There are several sanitary units worldwide ready to be transported to disaster areas. An average field hospital is equipped with an operating room, laboratory, and radiological equipment, but it does not include a unit for the infectious hospital solid waste treatment, which results in improper management with high infection risks and emissions due to incorrect operations (e.g., open incineration). Therefore, the present study identified two market-available solutions (an incinerator and a sterilizer) designed to be transported even under the challenging conditions typical of disasters and are suitable for treating infectious waste. The systems were assessed by a life cycle assessment (LCA), proving an emission savings >90% (considering all impact categories) using the sterilization system. The avoided combustion allows to halve the effect on climate change due to a portable incinerator. This study supplies interesting food for thought for the emergency managers, proving the possibility of integrating the sustainability also in the planning of the response to catastrophic events. Full article

Background: Several Acinetobacter species live in different ecosystems, such as soil, freshwater, wastewater, and solid wastes, which has attracted considerable research interests in public health and agriculture. Methods: We assessed the distribution of Acinetobacter baumannii and Acinetobacter nosocomialis in three freshwater resources (Great Fish, Keiskemma, and Tyhume rivers) in South Africa between April 2017–March 2018. Molecular identification of Acinetobacter species was performed using Acinetobacter-specific primers targeting the recA gene, whilst confirmed species were further delineated into A. baumannii and A. nosocomialis. Similarly, virulence genes; afa/draBC, epsA, fimH, OmpA, PAI, sfa/focDE, and traT in the two Acinetobacter species were assessed. Results: Our finding revealed that 410 (48.58%) and 23 (2.7%) of the isolates were confirmed as A. baumannii and A. nosocomalis, respectively. Additionally, three hundred and eight (75.12%) A. baumannii and three (13.04%) A. nosocomialis exhibited one or more of the virulence genes among the seven tested. OmpA was the most prevalent virulence gene in A. baumannii in freshwater sources. Conclusions: The distribution of clinically important Acinetobacter species in the freshwater sources studied suggests possible contamination such as the release of hospital wastewater and other clinical wastes into the environment thereby posing a risk to public health. Full article

Dhaka, the economic hub of Bangladesh, houses numerous healthcare facilities, resulting in increased medical waste generation. However, waste management systems in these facilities are often inadequate, posing a threat to public health and the environment. Wastewater characteristics vary regionally, making treatment strategies location-specific. This study characterizes medical waste streams in Dhaka, and suggests appropriate treatment strategies. Twenty samples from four major public hospitals were analyzed for various parameters, including dissolved oxygen (DO), pH, Total Dissolved Solids (TDS), Total Suspended Solids (TSS), color, Total Coliform counts, Chemical Oxygen Demand (COD), and Biochemical Oxygen Demand (BOD₅). Samples were categorized as acceptable, moderate, or highly polluted. Results were compared to the standard values provided by the department of Environment of Bangladesh to find that samples show moderate to high pollution levels in terms of TDS, TSS, color, and bacteria. Effective wastewater treatment strategies are needed to mitigate pollution and ensure health and safety. Treatment recommendations include the implementation of pre-treatment processes such as sedimentation and filtration to remove solids and aeration to increase dissolved oxygen levels. To reduce organic pollution, treatment methods including sequencing batch reactor (SBR), Moving Bed Biofilm Reactor (MBBR), and Membrane Bio Reactor (MBR) were recommended according to the applicability of the processes in respective hospitals. Advanced treatment methods such as activated carbon adsorption and ultraviolet disinfection processes were also suggested to address the specific issues like color and bacterial contamination. Full article

In a pandemic context, it is essential to intensify precautions related to healthcare solid waste, known as HCSW, ensuring the continuous search for safer management and handling protocols of these materials. In this sense, the aim of this paper is to conduct a comprehensive review of the literature about the management of healthcare waste during the COVID-19 pandemic. The current investigation was underpinned by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) framework, selected to ensure the comprehensive and transparent presentation of the systematic review. In pursuit of this objective, three distinct keyword combinations were employed, namely, “solid waste management”, “medical waste”, and “COVID-19 pandemic”. Consequently, a total of 76 documents were incorporated into the analysis. The results of this analysis indicate that the amount and treatment of hospital solid waste were significantly affected by the pandemic, bringing impacts on social, economic, and environmental aspects. Recent studies have focused on mitigating these impacts by pursuing “green” solutions, such as implementing sustainable strategies, preserving biodiversity, adopting an eco-conscious lifestyle, improving healthcare infrastructure, raising public awareness, and changing HCSW management policies. In addition, alternative technologies have been explored for the adequate treatment of these wastes, as well as the replacement of harmful materials by safer substances. However, more scientific research on this topic is still needed, especially in the Brazilian context, in order to contribute to the development of strategies that minimize the impacts of the pandemic on both society and the environment. Full article

This study aims to investigate the potential scope of rural bioenergy production from the valorisation of non-hazardous waste, particularly from institutional health and family planning facilities. A crude bioenergy production potential will be determined, as well as relevant interrelationships with food security, equality and inclusivity, poverty reduction, and their contribution to achieving sustainable development goals (SDGs). Solid waste generation at LAMB Hospital in Bangladesh was assessed. Its energy yield capacity and replacement of conventional, inefficient fuel sources were estimated, analysed, and specified. Results showed that the biogas yield capacity of non-hazardous solid waste from the LAMB hospital is 62 m³, which is equivalent to the gas required to cook 31 family meals. From small-to-medium institutes, such as the LAMB hospital, derived waste has the capacity to meet the cooking energy demand of rural villages. The electrical yield capacity of this amount of gas is 124 kWh, and this amount of energy can replace the use of 41 tonnes of firewood that cause emissions, deforestation, and increases the propensity for flooding. The adoption of Anaerobic Digestion (AD) for biogas production also has an impact on waste management, stimulating improved governance and infrastructure and supporting agriculture through the production of nutrient-dense biofertiliser. Further analysis showed that biogas not only provides a clean and affordable fuel but, in turn, has benefits with regard to health issues. Emissions from traditional cooking fuels have deleterious impacts on health due to Indoor Air Pollution (IAP), which generally affects women to a greater extent. All of these factors contribute to achieving sustainable development goals. This study could help to reduce environmental pollution from the health sector and mitigate climate change impacts, and there is a potential for scaling up this study nationwide. Full article

This manuscript proposes an integrated system for treating hospital solid waste (H.S.W.) consisting of an incineration and frictional sterilization system capable of operating during normal and emergency situations. We analyzed the benefits of integrating different hospital solid waste (H.S.W.) treatment systems with the existing stand-alone incineration system, with a particular emphasis on the thermal friction sterilization integration system. The objective was to define the economic advantages and benefits in terms of resources recovery of using the thermal frictional sterilization–incineration integrated system during the hospital’s normal and emergency/pandemic operating conditions. We modeled three modeling scenarios based on normal and emergency operating conditions. The results show that the H.S.W. was composed of 74% general H.S.W. Existing incineration systems would be the most expensive process because the sanitary transportation cost represented approximately 96% of the H.S.W. costs. The hospital would realize 40–61% savings relative to the existing method if the integrated incineration–frictional systems were implemented to treat 50–70% of H.S.W.; the savings were better than in other scenarios. Proposed scenario 3 had a much better resources recovery factor than scenarios 1 and 2. This modeling study showed that a thermal frictional sterilization–incineration system could work well even under emergency conditions if the H.S.W. in-house sorting/transportation/storage process is modified to cater to other H.S.W. treatment/sterilization systems. Full article

Acinetobacter baumannii is a prominent emerging pathogen responsible for a variety of hospital-acquired infections. It can contaminate inanimate surfaces and survive in harsh environmental conditions for prolonged periods of time in the form of biofilm. Biofilm is difficult to remove with only one method of disinfection, so combined disinfection methods and biocidal active substances are needed for biofilm eradication. Additionally, having in mind ecological demands, legislators are more prone using fewer toxic substances for disinfection that produce less solid waste and hazardous disinfection byproducts. Gaseous ozone and citric acid are natural biocidal compounds, and the purpose of this study was to determine their combined biocidal effects on A. baumannii biofilm formed on ceramics and polystyrene. Twenty-four-hour A. baumannii biofilm formed on ceramic tiles and polystyrene was exposed to different combinations of disinfection protocols with 25 ppm of gaseous ozone for 1 h exposure time and 15% citric acid for 10 min exposure. The total number of bacteria was counted afterwards and expressed as CFU/cm². The determined disinfection protocols of A. baumannii biofilm with combined citric acid and gaseous ozone caused reduction of 2.8 to 5.89 log₁₀ CFU (99.99% inhibition rate) of total viable bacteria for each method, with the citric acid–ozone–citric acid disinfection protocol being most successful in eradication of viable bacteria on both ceramics and polystyrene. In conclusion, gaseous ozone and citric acid showed good combined biocidal effects on A. baumannii biofilm and successfully reduced early A. baumannii biofilm from ceramic and polystyrene surfaces. The given combination of active substances can be a good option for eco-friendly disinfection of hospital inanimate surfaces from A. baumannii biofilm contamination with prior mechanical cleaning. Full article

In addition to the numerous health effects caused by the COVID-19 pandemic, the scientific community has considered other emerging effects such as water-related impacts worthy of deep investigation. In this regard, the transmission cycles of the SARS-CoV-2 virus from fecal, vomiting, and sputum routes to sewage have led health authorities to diagnose, prevent, and use novel wastewater treatment technologies. Once they enter the gastrointestinal canal of a healthy person, viral particles can infect via the nominal amount of Angiotensin-Converting Enzyme 2 (ACE2) present in alimentary canal epithelial cell surfaces and further infect lung, heart, kidney, and other organs. The current review highlights the detection, status, and fate of SARS-CoV-2 from sewage treatment facilities to water bodies. Besides, it addresses the potential wastewater treatment processes to cope with various viruses, especially SARS-CoV-2. Many processes can manage contaminated wastewater and solid wastes over the long term, including membrane technologies, disinfectants, UV-light and advanced oxidation methods like photocatalysis, ozonation, hydrogen peroxide, nanomaterials, and algae. Future work must focus on implementing the selected actions for the treatment of the wastewater released from the COVID-19 hospitals and self-quarantine centers to better regulate future waves of SARS-CoV-2. Full article

Sub-optimal feeding practices among under-5 children are the major drivers of malnutrition. This study aims to assess the prevalence of malnutrition and the factors affecting exclusive breastfeeding, bottle feeding, and complementary feeding practices among under 5 children amid the COVID-19 pandemic as well as the economic and the political crises in Lebanon. A nationally representative stratified random sample of mother–child dyads (n = 511) was collected from households using a stratified cluster sampling design. The survey inquired about infant’s feeding and complementary feeding practices using a valid questionnaire. Anthropometric measurements of the mother and child were collected. Multivariate logistic regression was conducted to explore the determinants associated with under-5 children’s practices. The prevalence of underweight, stunting, wasting, overweight and obese children was 0.5%, 8.4%, 6.7%, 16.8% and 8.9%, respectively. In total, among under-5 children, the prevalence of ever breastfeeding, exclusive breastfeeding, and bottle feeding at birth was 95.1%, 59.1% and 25.8%, respectively. Half the children in this study started solid foods between 4 and 6 months. Regression analysis showed that supporting breastfeeding at hospital (aOR = 8.20, 95% CI (3.03–22.17)) and husband’s support (aOR = 3.07, 95% CI (1.9–4.92)) were associated with increased breastfeeding odds. However, mother’s occupation (aOR = 0.18, 95% CI (0.55–0.58)) was inversely associated with breastfeeding practices. Male children (aOR = 2.119, 95% CI (1.37–3.27), mothers diagnosed with COVID-19 (aOR = 0.58, 95% CI (0.35–0.95)), and bottle feeding at hospital (aOR = 0.5, 95% CI (0.32–0.77)) were more likely to induce early initiation of solid foods at 4 months of age. This study demonstrated non-negligible rates of malnutrition, low prevalence of exclusive breastfeeding, and high rates of early introduction of formula feeding and solid foods among Lebanese under-5-children amid escalating crises. Full article

Existing research recognizes the COVID-19 impact on waste generation. However, the preliminary studies were made at an early pandemic stage, focused on the household waste fraction, and employed descriptive statistics that lacked statistical support. This study tries to fill this gap by providing a reliable statistical analysis setting inferential confidence in the waste generation differences found in Castellón. Repeated measures ANOVA were carried out for all the waste fractions collected and recorded in the city landfill database from 2017 to 2020. Additionally, Bonferroni’s multiple comparison test (p < 0.05) was used to assure confidence level correction and identify which pairs of years’ differences appeared. The longitudinal study identified trends for each waste fraction before the pandemic and showed how they changed with the advent of the crisis. Compared to 2019, waste collection in 2020 significantly grew for glass and packaging; remained unchanged for beaches, paper and cardboard, and dropped substantially for households, streets, markets, bulky waste, hospitals, and recycling centres. Total waste showed no differences between 2017 and 2019 but dropped significantly in 2020. These findings may help us better understand the long-term implications of COVID-19 and improve municipal solid waste management in a similar crisis. Full article

Solid waste is one of the social and environmental challenges that urban areas are facing. The study assesses the state of solid waste in Addis Ababa during 2016–2020 to provide implications for achieving green architecture concepts through better management of solid waste and its economic contribution. The study uses secondary and primary data. Quantitative and qualitative data are analyzed through descriptive statistics and context analysis, respectively. The result reveals that most solid waste is generated from households, followed by commercial centers, street sweeping, industries/factories, hotels, and hospitals, respectively. From 2016 to 2020, an average of 80.28% of solid waste is collected, whereas 19.72% of the waste is not collected. There are little or no efforts made to segregate solid waste at the source. The generated waste is disposed of in the Reppi open landfill. Together with Ethiopian electric power (EEP) and the City Government of Addis Ababa, waste has been converted to energy since 2019. The study suggests minimizing waste from its source by reducing generation, composting, reusing, recycling, waste-to-energy strategy, and well-designed buildings to achieve the concept of green architecture in Addis Ababa through better solid waste management. Full article

Background: Medicines reuse, the idea of re-dispensing returned medicines to others following quality control, is yet to be implemented in the UK. This practice is potentially a sustainable way of dealing with returned medicines, which are otherwise classed as medication waste and destroyed. To inch towards medicines reuse, it is important to know more about the different therapeutic classes and dosage forms that make up medication waste. For example, it is helpful to know if medicines being returned are mostly solid-dosage forms and thus have the potential to be reused or are from therapeutic classes that would make medicines reuse cost-effective. Little is known about the therapeutic classes and the dosage forms of wasted medicines. This study aimed to narratively review and report findings from the international literature on the different therapeutic classes and the dosage forms of medicines that are returned by patients to community pharmacies, hospitals, general practitioners’ clinics, or collected through waste campaigns. Studies based on surveys without physically returning medicines were also included where relevant. Methods: A comprehensive electronic search of databases, including PubMed and Google Scholar, was carried out over one month in 2017 and updated by 5 November 2020, using a combination of carefully created keywords. Results: Forty-five studies published in English between 2002 and 2020, comprising data from 26 countries were included and reviewed. Oral solid dosage forms (mostly tablets) were the commonly reported dosage form of all wasted medicines in 14 studies out of the 22 studies (64%) that described the dosage form, with percentages ranging from 40.6% to 95.6% of all wasted medicines. Although there was variability among the levels of medication waste reported in different countries, findings from the UK and Ethiopia were relatively consistent; in these, medicines for the cardiovascular system and anti-infective medicines, respectively, were the most common therapeutic classes for medication waste. Conclusion: This narrative review provides insights about the different therapeutic classes and dosage forms of medication waste either returned by patients, collected through waste campaigns, or indicated in survey responses. The findings could help policy makers understand the potential implications of treating most unused medicines as medication waste and whether therefore pursuing a medicines reuse scheme could be environmentally or financially logical. The quality and the safety of these returned medicines using criteria related to the storage conditions (such as heat and humidity), physical shape (such as being sealed, unopened, unused, and in blister packaging), and tampering are other important considerations for a medicines reuse scheme. Full article

Bangladesh has been grappling with the issues of improper hospital waste management. To reflect the inadequacies in existing management practices and the potential implications on the environment and health, this study evaluated the Knowledge, Attitude, and Practice (KAP) of doctors and nurses in a private and a public hospital in Chattogram city via a structured questionnaire survey. At the public hospital, 20.4% of the doctors and 6% of the nurses had occupational illnesses, compared to 36% of the doctors and 26.5% of the nurses at the private hospital. At the public hospital, 67.8% of the nurses wore PPE during waste collection, compared to 17.7% in the private hospital. Hospital wastes and occupational safety are not properly dealt with in both hospitals. An inadequacy was observed in the knowledge of hospital waste management among healthcare workers. The route of hospital wastes from the sources to the end destination was also traced via interviews and focus group discussions, which revealed that disposal practices of the hospital solid waste were environmentally unsustainable. In attempts to show opportunities for environmental and health risks from the hospital wastewater, this study also investigated the quality of the wastewater and tested it for the presence of resistant enteric pathogens. E. coli and S. aureus from both hospitals showed resistance against some common antibiotics used in Bangladesh. The physicochemical properties of the samples were nearly compliant with the Bangladesh Water Quality Standards for hospital wastewater. While more robust sampling and water quality analysis are required, this study provides basic water quality indicators and scope for future research to understand the apparent significant negative impact on the environment and health. Full article