Authors

1 Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

2 Department of Environmental Health Engineering, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

3 Department of Environmental Health Engineering, School of Public Health, Hamedan University of Medical Sciences, Hamedan, Iran

Abstract

Background and Aims: There are various methods for the disinfection of infectious wastes which are of great importance due to their potential health and environmental risks and there are different insights about their management in Iran. Hence, the aim of this study was to survey the various aspects of disinfection methods of infectious waste on the basis of environmental health specialist insights.
Material and Methods: For performing this study, a questionnaire was prepared and the opinions of the specialists were gathered about five disinfection and disposal methods of infectious wastes, and finally the data were analyzed. Moreover, the preferences of the specialists for selecting each method were also asked based on 9 various aspects.
Results: It was found that health issues received the highest priority (with 26% of desirability) from the specialists in selecting the method, while the lowest priority was assigned for financial issues (with 8% of desirability) and political acceptability (with 6% of desirability). Environmental health specialists believed that autoclaving and waste incinerating with 77.8% and 44.1% of desirability, respectively, are the most favorable and undesirable methods for disinfecting the infectious wastes. The results showed that the disinfection is a top priority for the specialists, and, with respect to current situation, they did not make any significant difference between on-site and ex-situ disinfecting methods, which is reflected in the scores of 3.65 and 3.72 for these two scenarios.
Conclusion: Overall, health aspects have the most important priority in the management of infectious wastes. Therefore, autoclaving and microwaving are the most appropriate methods for the disinfection of such wastes. Landfilling and incineration were not suggested for the disposal or treatment of infectious wastes.

Keywords

1. Windfeld ES, Brooks MS. Medical waste management–A review. J Env Manage 2015;163:98-108.  
2. Koolivand A, Mahvi A, Azizi K, Binavapour M, Alipour V. Quality analysis and management of health-care WasteProducts. Hormozgan Med J. 2010; 14 (1):72-79 
3. Makajic-Nikolic D, Petrovic N, Belic A, Rokvic M, Radakovic JA, Tubic V. The fault tree analysis of infectious medical waste management. J Clean Prod 2016;113:365-73.
 4. Lee BK, Ellenbecker MJ, Moure-Ersaso R. Alternatives for treatment and disposal cost reduction of regulated medical wastes. Waste Manage 2004;24(2):143-51. 
5. Levendis YA, Atal A, Carlson JB, Quintana MD. PAH and soot emissions from burning components of medical waste: examination/surgical gloves and cotton pads. Chemosphere. 2001;42(5-7):775-83. 
6. Cheng YW, Li KC, Sung FC. Medical waste generation in selected clinical facilities in Taiwan. Waste Manage. 2010;30(8-9):1690-5. 
7. Taghipour H, Mosaferi M. Characterization of medical waste from hospitals in Tabriz, Iran. Sci Total Environ 2009;407(5):1527-35. 
8. Insa E, Zamorano M, Lopez R. Critical review of medical waste legislation in Spain. Resources, Conservation and Recycling. 2010;54(12):1048-59. 
9. Chen Y, Ding Q, Yang X, Peng Z, Xu D, Feng Q. Application countermeasures of non-incineration technologies for medical waste treatment in China. Waste Manage Res 2013; 31(12): 1237-44.
10. Dengchao J, Zhenbo B, Xinping Y. Effects of vacuum on sterilizing rate in medical waste steam treatment process. Procedia Environ Sci 2011;11:1407-11. 
11. Garibaldi BT, Reimers M, Ernst N, Bova G, Nowakowski E, Bukowski J, Ellis BC, Smith C, Sauer L, Dionne K, Carroll KC. Validation of autoclave protocols for successful decontamination of category a medical waste generated from care of patients with serious communicable diseases. J Clin Microb 2017;55(2):545-51. 
12. Marinković N, Vitale K, Holcer NJ, Džakula A, Pavić T. Management of hazardous medical waste in Croatia. Waste Manage 2008;28(6):1049-56.
 13. Tufail M, Khalid S. Heavy metal pollution from medical waste incineration at Islamabad and Rawalpindi, Pakistan. Microchem J 2008;90(1):77-81.
 14. Voudrias EA. Technology selection for infectious medical waste treatment using the analytic hierarchy process. J Air & Waste Manage Assoc 2016;66(7):663-72. 
15. Jang YC, Lee C, Yoon OS, Kim H. Medical waste management in Korea. J Environ Manage 2006;80(2):107-15.
 16. Sukandar S, Yasuda K, Tanaka M, Aoyama I. Metals leachability from medical waste incinerator fly ash: a case study on particle size comparison. Environ Pol 2006;144(3):726-35. 
17. Veronesi P, Leonelli C, Moscato U, Cappi A, Figurelli O. Nonincineration microwave assisted sterilization of medical waste. J Microwave Power EE 2005;40(4):211-8.