Risks and Challenges of Hazardous Waste Management: Reviews and Case Studies

Healthcare waste (HCW) is the waste generated by the activities of healthcare facilities, educational institutions and medical research which is harmful to both human and animal health. About 10 to 15% of HCW presents hazardous characteristics, including a broad range of materials from sharps, used needles and syringes to soiled-dressings, body fluids or wastes contaminated by chemical and/or containing a high concentration of microorganisms. Such kind of waste requires very specific treatment to ensure proper final disposal. Its generation depends on different factors such as the economic development of the country and the type of service provided by the above-mentioned institutions. In this context, HCW management (HCWM) is a public health and environmental concern worldwide, especially for nondeveloped countries. Furthermore, HCWM is a complex and challenging process that covers a wide variety of actions, including segregation, minimization, previous treatment, packaging, temporary storage, collection, internal transportation and external storage of HCW. The first priority in this waste management should be the segregation and reduction in order to decrease the contaminated solid waste and to ensure selective collection. Furthermore, a great part of HCW can be recycled. In order to encourage successful best management practices, the results of a GEF-funded national development report headed by the Ministry of Health of Argentina are hereby exposed including proposed actions for training, guidelines, supervision, appropriate utility supply, management support and specific regulations to face future challenges. Improvements in the management system through HCW indicators may prove failures in segregation procedures, showing an opportunity for continual advances. To reduce potential problems that expose the healthcare facility staff, patients and their attendants to the risk of serious health hazards, there should be sufficient resource allocation, periodic training and strict supervision by stakeholders. Institutional planning for an efficient HCWM will assure HCF to both save money and provide a safe environment for patients and healthcare personnel.

Medical care activities can produce various types of risks (hazardous) wastes. Poor management of these wastes can lead to environmental pollution and health risks to healthcare personnel, patients, and the community at large. Adequate knowledge, attitudes, and practices of managing medical waste are vital. This paper reviews the main issues in medical waste management by healthcare workers in developing countries. Results from reviewed literature showed that in developing countries, Medical waste management is inefficient. Knowledge and awareness concerning safe medical waste management are inadequate as a result of lack of or absence of training for medical waste management personnel, absence of waste management and disposal systems, lack of safety equipment and immunization in most of the health centers. This paper concludes by recommending ways by which poor medical waste management can be ameliorated in healthcare centers.

Blood Exposure Accidents (BEA) are a real risk to personnel health, particularly in developing countries. The objective of this study is to assess the knowledge and attitudes of health personnel on BEA, know the existing safety equipment and its application by the staff, and propose improvements to have an effective protection prevention system. We have, therefore, conducted a survey during the month of May 2019 in order to assess the current situation. A previously developed questionnaire was provided to health personnel who had direct daily contact with patients. The results showed a good knowledge of the risk and indicate that accidents involving exposure to blood are frequent and can result in serious consequences, including infection with hepatitis B and C viruses, as well as human immunodeficiency virus (HIV), they may be due to neglect of preventive measures, lack of contact with occupational medicine, work overload…etc. Blood Exposure Accidents are still a concern in our community. There is a high rate of needle stick injuries in daily hospital practice. Then information tools are needed both training for staff with regard to BEA, can reduce the severity of exposure.

Today, there are major environmental challenges associated with hazardous waste management in India. In this regard, hazardous production is increasing rapidly and it's required proper management to be improving the future of India. In this context, the Indian government's policy and legislation are not working properly on Hazardous Waste Management (HWM), thereby triggering enormous public health issues. The effective Hazardous waste (HW) treatment practices are of paramount importance to protect human health, and in addition, this is a social responsibility for the safety of the future generation. This chapter reviews the current situation on the rules and regulations of HWM and policy to adopt new successful approaches and techniques that are used worldwide to address this issue in India. Current systems in India cannot cope with the volumes of waste generated by an increasing urban population because of the lack of adequate infrastructure but these challenges will allow to transforming barriers in good opportunities for sustainable growth.

The chapter provides a brief vision into the perception of E-waste, its production in India, along with the ecological and health issues involved in it. The condition is startling because India produces around two million tonnes of E-waste per year, and practically all of it gets into the natural segment due to the lack of any substitute existing at present. Particularly, cosmopolitan cities like Mumbai, Delhi, and Bangalore are at higher risk of environmental contamination because of E-waste. Personnel in the E-waste dumping segment are ill-protected. They disassemble Ewaste, regularly with hands, in awful situations. Nearly 26,000 workers are working in scrap-yards at Delhi itself, where 15 000 to 25 000 tonnes E-waste is moved annually, with PCs alone contributing to 25% of E-waste. Additional E-waste scrap-yards are present in Chennai, Mumbai, Bangalore, Firozabad, and Meerut. The dangerous elements present in E-waste comprise considerable amounts of chromium, cadmium, lead and other fire-resistant plastics. Cathode-ray components and tubes with great lead content are very hazardous for health. Huffing or handling such materials and being in contact with these on a daily basis, may harm the nervous system, brain, kidneys, lungs and also the reproductive system. Functioning in poorly ventilated and bounded areas without practical knowledge and masks leads to contact with hazardous chemicals. The absence of experience made the people endanger their environment and health. There is a dire need for progress in E-waste management encompassing technical development, operative strategy, protecting procedures for the employees involved in E-waste dumping.

The environmental situation is very complex, in Italy, and in particular, in some areas (Naples and Caserta provinces) of the Campania region that have experienced numerous problems correlated with hazardous waste management. In particular, an area of Naples province has been referred to "Land of Fire" (LoF) (or Terra dei fuochi-TdF) for the open burning of uncollected trash, including chemical and other potentially hazardous waste. Different academic publications and the national press have reported this dramatic situation. Findings from several articles suggest that the toxic wastes dumping is destroying this land and in addition, it is seriously damaging the health of the local population. Moreover, the high anthropization of these provinces in association with the simultaneous presence and interaction of extremely active volcanic, tectonic and morpho-dynamic phenomena increases the environmental risk in this territory. In this scenario, the Ministry of Italian Health commissioned epidemiological and geological studies to evaluate both contaminations of soil due to illegal dumps and the health risks on the population in Campania. This chapter aims to examine the epidemiological data considering a geochemical/environmental perspective to better understand the correlation between the incidence of different diseases (such as some cancers type) and the distribution patterns of contaminants.

Waste generation rates continue to grow around the world, creating a need for more comprehensive waste management strategies to meet sustainability needs. Uncontrolled disposal generates complex and challenging situation that involves the entire population. In particular, the illegal dumping and burning of toxic waste in Campania (Italy) has caused immense environmental damage and an increase in cancer rate among the population. Different epidemiological studies were commissioned by the Ministry of Health to assess the magnitude of contamination under an illegal dump in Campania and to evaluate the population health impact. The data and other available evidence testify the dramatic situation in Caserta and Naples provinces about the severe impairment of the environmental conditions in several places and increase of cancer incidence. For this reason, the Campania region is known, such as Triangle of Death” and “Land of Fires” (LoF) (or Terra dei fuochi-TdF), as reported both in academic publications and the national press. This chapter is aimed to provide the findings regarding human health and environmental contamination in this region.

This chapter provides a reassessment of the waste ‘crises’ in the so-called Land of Fires in Italy and highlights the contribution of local social mobilizations in advancing environmental justice and sustainability concerns. It is based on the longterm collaboration between a social scientist and two activists, and it draws from a dialogue of academic and activist knowledge in the tradition of Environmental Justice organizations and scholarship. Our contention is that local communities and ecologies of this area have borne the brunt of the socio-environmental costs of waste disposal and industrial production. This translated into risks of contamination for the residents, suffering threats to health and stigmatization. To this state of affairs, local grassroots environmental movements answered by confederating into a regional coalition that arranged on November 16, 2013, one of the biggest environmental justice demonstrations in Italian history, spurring the intervention of the State via legislation and resources. The coalition was also instrumental in the elaboration of the Pact for the Land of Fires, a programmatic commitment to end illegal waste disposal that defined the obligations for the institutional and civil society signatories. Finally, we show how the experience of activists is systematized and coordinated today through the initiative of the Civic Observers, an association of citizens that monitors environmental crimes and conditions in cooperation with public officials.

Today, the global outbreak of the pandemic of coronavirus disease 2019 has the potential to wreak a serious impact on human health and to further trigger a global crisis. A great repercussion of this pandemic is occurring on sustainable medical waste management practices with a profound impact. On the one hand, medical waste management companies need to be ready to assist countries worldwide as they seek to manage the great volumes of infectious material; on the other hand, the use of gloves and face masks is increasing among population to stop the spread of the novel coronavirus. In addition to potentially being a biohazard, face masks and gloves can increase the plastic pollution if the disposal directions are not proper. Therefore, the current pandemic of the novel coronavirus poses new challenges regarding the management of medical waste practices above all for health measures for employees, proper waste treatment requirements.

The aim of this review is to collect data on the different systems and solutions implemented worldwide to manage municipal waste in the current situation.