As the world grapples with the Covid-19 pandemic, there is some positive climate news coming out,
which is caused by the said crisis. The news headlines are: "Enjoy the clean sky", "Clean air", "The world has started to breathe again", etc.
All these news are true and beneficial for our mental health as a positive spark in the flood of negative information we receive every day. However, the question arises whether this positive effect on the climate will be long-term? Unfortunately, not if the international community has not taken appropriate measures regarding the management of medical/paramedical waste generated by the said crisis. Wastes that are generated and generated...
Medical waste and related products include a wide range of different materials:
Infectious waste - waste contaminated with blood and other biological fluids (e.g. used diagnostic tools), bacterial cultures and infectious agents from laboratory activities (e.g. autopsy waste and infected laboratory animal waste), or waste from an infected patient (taken swabs, dressings , disposable medical devices.)
• pathological waste - human tissues, organs and biological fluids, body parts;
• Sharp waste: syringes, needles, disposable scalpels, lancets, etc.
• Chemical waste - e.g. Solvents and reagents used in laboratory activities, disinfectants, sterilizers and heavy metals in medical devices (eg mercury in thermometers and batteries).
•Pharmaceutical waste - expired, unused and contaminated drugs, vaccines.
Cytotoxic waste - substances with genotoxic properties, which are very dangerous and contain mutagenic, teratogenic or carcinogenic substances. These wastes are produced by cytotoxic drugs used in cancer treatment;
• Radioactive waste - products contaminated with radionuclides, including radioactive diagnostic tools or radiation therapy materials;
•Non-hazardous or general waste - waste that does not carry any specific biological, chemical, radioactive or physical danger.
The main sources of healthcare waste are:
• Hospitals and other medical institutions;
• Laboratories and research centers;
• Morgue and autopsy centers;
• animal research and testing laboratories;
• Blood banks and blood collection sites;
• Care homes for the elderly.
About 85% of the total amount of waste generated in the healthcare sector is general, non-hazardous waste, the remaining 15% is considered hazardous material, which can be infectious, toxic or radioactive. On average, one infected patient generates 0.5 kg of hazardous and 3 kg of non-hazardous waste per day,1 which means that one hospitalized patient infected with COVID-19 generates 73.5 kg of waste if the patient is hospitalized for 21 days, as recommended by the European Union by health guidelines.2 Thus, to date, 80,000 tons of medical waste has been generated globally from hospitalized Covid-19 infected patients.
Medical waste generated from hospitalized patients is not the only problem. Masked and gloved people pose even more risks and dangers to the environment and, of course, these risks again pose a danger to human health. Cautious people, with the recommendation from the media, use disposable masks, gloves and antiseptic wipes several times a day. If we assume that the world's population Only 10% use these products only once a day, which means that 35,000 tons of waste are produced worldwide every day. Antiviral masks are made from chemically derived synthetic materials that remain in the environment for centuries. As for disposable gloves, there are several types of gloves available today: latex, nitrile, and vinyl. Latex and nitrile gloves are made from biodegradable materials (derived from the bark of rubber trees), but Vinyl gloves are made of pure synthetic material, like disposable masks. No matter the type of raw material used in production, both masks and disposable gloves must be put in the mixed waste bin. 27 EU countries have the ability to safely collect from the mixed waste bins and incinerate it and get it from energy. But not all of the remaining 180 countries have access to safe collection and incineration of medical/paramedical waste.
Georgia does not have proper medical waste management and mixed waste incineration infrastructure at all. Mismanaged medical waste contains harmful microorganisms that can infect patients, health care workers and the general public in the country..Other potential threats associated with unmanaged medical waste may be drug-resistant microorganisms that spread from medical facilities and landfills into the environment.
Improper handling and disposal of medical and paramedical waste can also indirectly cause health risks through the release of pathogens and toxic pollutants into the environment.
• Disposal of untreated medical waste in landfills can lead to contamination of drinking water, surface and ground water, if these landfills are not constructed according to appropriate standards.
• Disinfection of waste with chemical disinfectants can lead to environmental pollution with chemical substances, if these disinfected wastes are not properly stored and placed together with chemical means.
• Incineration of medical waste is a common method of managing this type of waste, but improper incineration techniques and improper selection of waste for incineration lead to the emission of pollutants into the atmosphere and the generation of large amounts of ash. Incinerated waste, which is further treated with chlorine or contains chlorine from this waste itself during its incineration, produces dioxins and furans in the air, which cause cancer and cause irreparable damage to health. heavy metals or wastes containing them (especially lead, mercury, etc.)
cadmium) during incineration, toxic metals are released into the air.
• Only modern furnaces operating at a temperature of 850-1100 °C and equipped with a special gas cleaning device can meet the international standards of dioxin and furan emissions during incineration.
• Alternatives to incineration, such as autoclaves, microwave ovens, hot steam ovens with internal waste swirl function, minimize the generation of chemicals or hazardous emissions during incineration and its emission into the atmosphere. Therefore, such technologies should be considered and implemented a priori, if, of course, there are resources for the construction and then the operation of the already mentioned type of infrastructure.
Lack of awareness about medical waste and the dangers arising from it, inappropriate trainings in terms of medical waste management, absence of waste management and disposal systems, limited financial and human resources and giving low priority to the issue are the most common problems of medical waste management in Georgia.
Medical waste management requires more attention and foresight to avoid adverse health consequences, which may include infectious outbreaks and air poisoning.
The main elements of improving healthcare waste management are:
• Implementation of practices that reduce the amount of generated waste and ensure waste segregation;
• Developing strategies and systems, with strong oversight and regulation, that improve waste segregation, decontamination and disposal practices that are self-compatible with international standards;
• As far as possible, preference should be given to safe and environmentally appropriate disposal technology of medical waste hazardous to health (eg autoclave, microwave ovens, steam ovens..) rather than incineration technology;
• Creation of a comprehensive system where responsibilities and obligations are transparent, as well as allocation of waste management and disposal resources
• Raising awareness of health risks and safe practices;
• Choosing a safe and eco-friendly management style, the purpose of which is to protect people from the dangers arising from the process of waste collection, management, storage, transportation, disposal or disposal.
To sum it up briefly, open burning, disposal and incineration of medical/paramedical waste, as is done in Georgia, causes the release of furans and dioxins into the air and creates risks for the spread of microbes. The steps taken to improve the situation in this regard would significantly protect us from those chemical and biological threats that cause irreparable damage to our health and, what is most dangerous, would solve the spread of microbes resistant to medicines in nature, which is a very big threat to patients, healthcare workers and society.
To conclude, Covid 19 not only contributes to the generation of large amounts of medical/paramedical waste, but it threatens the sound waste management systems implemented in developed countries and successful companies:
• Several US cities have closed waste recycling centers because officials fear the risk of disease spreading in such centers. With the current crisis, the waste management process has been pushed back in the particularly affected European countries: Italy has banned the families of infected patients and suspicious people from separating waste altogether!
• The business sector has taken advantage of the opportunity and restarted the production and consumption of single-use polythene bags, despite the fact that environmental experts claim that single-use polythene bags and their surfaces can still pose a threat of viruses and bacteria.
• Businesses that used to encourage their customers to use reusable bags and cups are increasingly using single-use items. In early March, Starbucks announced a temporary levy on reusable cups.
• Consumers are staying home and they are increasingly shopping and ordering food online, and that food is delivered to them with a lot of packaging.
• Water infrastructures have been asked to strengthen their disinfection procedures to reduce the possibility of the spread of covid-19 through sewage systems. This situation leads to the increased consumption of chlorine and, therefore, the release of this poisonous substance into nature.
• In a crisis situation, the psychological mood of a person pushes him to create a stock of primary needs, and this logically leads to the generation of an increased amount of food waste.