Preprint has been published in a journal as an article
DOI of the published article https://doi.org/10.1080/10643389.2022.2150495
Preprint / Version 2

Medical and healthcare waste generation, storage, treatment and disposal: A systematic review of risks to occupational and public health

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DOI:

https://doi.org/10.31224/osf.io/tb7ng

Keywords:

Global South, Health and safety, Healthcare waste, Medical waste, Medical waste incineration, Open burning, Resource recovery, Risk, Sharps injury, Solid waste

Abstract

Systems to safely store, handle, treat and dispose of medical (healthcare) waste are well developed in the 21st century. Yet across many parts of the Global South (low- and middle-income countries) such systems, resources and know-how are lacking; to the extent that medical waste could be posing a serious threat to the health, safety and lives of millions of healthcare workers and waste handlers who regularly interact with this material. We present here a novel scope and dimension to investigating the risks and hazards to people who come into contact with medical waste, focusing on activity types and established medical practice. Based on a systematic review of the evidence (PRISMA approach, adapted), we critically analyzed and comparatively summarized data, and identified prevalent combinations of hazards, exposure and risk with a global scope. Subsequently, we assigned indicative comparative risk scores for such combinations. Our critical analysis unveils extensive mismanagement of medical waste globally, including the co-disposal with municipal solid waste (MSW), burning in open pits, and dumping even on public streets. Alarmingly, a small but non-negligible trade in reused medical equipment is proliferated by a cohort of waste reclamation specialists (sub-group of waste pickers): they collect hypodermic needles, and other single use medial items for resale to substance abusers and back into the healthcare system. We also highlight the dilemma faced by medical waste handlers in many parts of the world where a difficult choice is made between creating hazardous emissions from burning waste in the open or discarding it on land (e.g. in dumpsites) from where it risks accidentally infecting people with pathogens.

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Posted

2020-12-05 — Updated on 2020-12-05

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