The article, “Waste Management and the Perspective of a Green Hospital—A Systematic Narrative Review,” authored by Sabrina Lattanzio, Pasquale Stefanizzi, Marilena D’ambrosio, Eustachio Cuscianna, Giacomo Riformato, Giovanni Migliore, Silvio Tafuri, and Francesco Paolo Bianchi, published in the International Journal of Environmental Research and Public Health in 2022, comprehensively addresses the critical issue of healthcare waste management within the evolving concept of a “green hospital”.
Context and Problem: The concept of a “green hospital” is defined as a healthcare facility that integrates environmental considerations into its quality services and prioritizes sustainable building design. Within this framework, waste disposal is identified as a significant environmental risk, making efficient waste collection and management in healthcare centers a crucial environmental challenge. While 75–90% of waste generated in hospitals is considered non-hazardous (similar to household waste), the remaining 10–25% is deemed dangerous due to potential infection and injury risks. Despite these challenges, green healthcare offers opportunities for environmental preservation, community leadership, educational outreach, and capital savings.
Study Aim and Scope: This systematic narrative review specifically aimed to:
- Systematically review global experiences in healthcare waste management within nosocomial settings.
- Define the medical procedures most associated with waste production.
- Focus on strategies to manage this waste issue.
- Analyze the impact of the COVID-19 pandemic on this subject.
- Address future challenges related to climate change in the context of healthcare waste.
- Examine strategies employed by hospitals and policymakers to deal with healthcare waste.
- Identify strategies suggested by scientific literature for waste management and potential research gaps.
Methodology: To achieve its aims, the study conducted a systematic search across Scopus, MEDLINE/PubMed, and ISI Web of Knowledge databases. The researchers included research articles, brief reports, commentaries, and letters published between 1 January 2020 and 30 April 2022, using the keywords “(green hospital) AND (waste)”. After screening and excluding duplicates and irrelevant studies, 19 eligible studies were included in the review.
Key Findings: The review highlighted several significant points regarding healthcare waste management:
- Major Waste Producers: Operating rooms and hemodialysis activities were identified as the procedures most significantly associated with waste production. Operating rooms, including endoscopy services and anesthesia, contribute between 30% and 70% of all healthcare waste. Hemodialysis is also a substantial source, generating 1.5–8 kg of waste per session.
- Waste Management Strategies: The 5Rs rule (reduce, reuse, recycle, rethink, and research) emerged as a commonly suggested strategy to maximize practical benefits while minimizing waste. This includes reducing waste volume, improving segregation, reusing medical equipment, and innovating through research. Cost-neutral and cost-negative approaches, such as regular waste audits and digitalizing paper directives, are also recommended.
- Impact of COVID-19: The pandemic notably slowed down the greening process in healthcare settings. It led to a dramatic increase in demand for and production of waste from personal protective equipment like N95 respirators and surgical masks. For instance, an estimated 37.22 million kg of waste from N95 respirators alone were produced in the USA during the first six months of the pandemic. Strategies like decontamination and reusable respirator-based approaches are proposed to mitigate this environmental impact.
- Multifactorial Approach Needed: Effective waste management necessitates a multifactorial approach, particularly in the context of global climate change. Key measures proposed include:
- Education of health personnel and managers.
- Mandatory regulation by governmental institutions.
- Creation of an “environmental greening team” within health facilities.
- Raising awareness among stakeholders and policymakers.
Conclusion and Future Directions: The authors conclude that medical waste is a deeply felt international issue, requiring a multifactorial and multistep approach. In the short term, healthcare facilities should focus on understanding their waste production quantitatively and qualitatively. For the medium term, establishing “environmental greening teams” is suggested to boost knowledge and facilitate green initiatives, potentially leading to long-term savings. In the long term, the environmental costs of waste and medical procedures should be integrated into financial planning and purchasing decisions. The review emphasizes the crucial role of clear and restrictive governmental rules, possibly coupled with economic incentives, to encourage hospital greening, especially given the pressing challenge of climate change.
APA Reference:
Lattanzio, S., Stefanizzi, P., D’ambrosio, M., Cuscianna, E., Riformato, G., Migliore, G., Tafuri, S., & Bianchi, F. P. (2022). Waste Management and the Perspective of a Green Hospital—A Systematic Narrative Review. International Journal of Environmental Research and Public Health, 19(23), 15812. https://doi.org/10.3390/ijerph192315812
