Environmental Science and Technology Research Center, Department of Environmental Health Engineering, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Environmental Science and Technology Research Center, Department of Environmental Health Engineering, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Environ Int. 2019 Nov;132:105073. doi: 10.1016/j.envint.2019.105073. Epub 2019 Aug 14.
Many studies have been conducted on hospital solid waste management (HSWM) throughout the world, especially developing countries. This interdisciplinary study aims to summarize the available knowledge on the health and environmental risks of hospital solid waste (HSW) and also, develop a dynamic associational assessment among hospital solid waste generation rate (HSWGR), hospital solid waste composition (HSWC), gross domestic product (GDP) per capita, and environmental performance index (EPI) in some developing countries for the first time. The results of this study showed that researchers from India, China, Pakistan, Brazil, and Iran had found more evidence about the health, economic, and environmental issues in HSW than the other developing countries. The literature showed that the highest and lowest reported HSWGR (in national average level) belonged to Ethiopia (6.03) and India (0.24) kg bed day, respectively. It has also been shown that all studied countries except Serbia, have higher levels of hazardous waste in their HSWC, based on the WHO's standard. Furthermore, the quantity and quality of HSW in developing countries depend on the service provided by the hospital, type of hospital, HSWM system, and the level of regional economic and culture. The association analysis showed that the EPI and GDP per capita of developing countries were significantly (p-value <0.05) associated with HSWGR, non-hazardous HSW, and hazardous HSW by the Spearman coefficients equal to 0.389, 0.118, -0.118, and 0.122, 0.216, and -0.346, respectively. However, it can be concluded that GDP per capita and EPI have a weak correlation with hazardous HSW and non-hazardous HSW. Moreover, HSW has many hazardous health and environmental risks such as dioxin and furan, that must be controlled and managed through implementing programs and policies based on sustainable development. As a final point, we believed that the present study can be considered to be a guide for future studies on HSWM in developing countries.
世界上，特别是发展中国家，已经有许多关于医院固体废物管理（HSWM）的研究。本跨学科研究旨在总结关于医院固体废物（HSW）的健康和环境风险的现有知识，并首次在一些发展中国家开发医院固体废物产生率（HSWGR）、医院固体废物成分（HSWC）、人均国内生产总值（GDP）和环境绩效指数（EPI）之间的动态关联评估。本研究结果表明，来自印度、中国、巴基斯坦、巴西和伊朗的研究人员发现了比其他发展中国家更多的关于 HSW 的健康、经济和环境问题的证据。文献表明，报告的最高和最低 HSWGR（在国家平均水平）分别属于埃塞俄比亚（6.03）和印度（0.24）kg 床 天。根据世界卫生组织的标准，还表明除塞尔维亚以外的所有研究国家的 HSWC 中都有更高水平的危险废物。此外，发展中国家的 HSW 的数量和质量取决于医院提供的服务、医院类型、HSWM 系统以及区域经济和文化水平。关联分析表明，发展中国家的 EPI 和人均 GDP 与 HSWGR、非危险 HSW 和危险 HSW 显著相关（p 值<0.05），Spearman 系数分别为 0.389、0.118、-0.118 和 0.122、0.216 和-0.346。然而，可以得出结论，人均 GDP 和 EPI 与危险 HSW 和非危险 HSW 相关性较弱。此外，HSW 存在许多危险的健康和环境风险，如二恶英和呋喃，必须通过实施基于可持续发展的方案和政策来加以控制和管理。最后，我们认为本研究可以被视为发展中国家未来 HSWM 研究的指南。
