Wei Yujun, Cui Meng, Ye Zhonghua, Guo Qingjun
Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China.
Qianhai Institute for Innovative Research, Shenzhen, 518052, China.
J Clean Prod. 2021 Apr 1;291:125246. doi: 10.1016/j.jclepro.2020.125246. Epub 2020 Nov 24.
Medical waste is a special class of hazardous pollutants. Improper treatment would cause secondary environmental pollution, especially when responding to public health emergencies. However, there are relatively few researches on the generation of medical waste, and there is a lack of basic understanding of its spatial-temporal heterogeneity. The outbreak of SARS in 2002 is a turning point in China's medical system reform. We estimated the production of medical waste and pollutants on a provincial scale in China from 2002 to 2018, using the data of medical statistics. Moreover, we forecasted the trend of medical waste in China until 2030, using a combination of environmental pressure model (STIRPAT) and time series model (ARIMA). We found that with the development of China's medical system and economy (such as the increase in personal income and popularization of universal health care), the number of seeking medical treatment rapidly increase led to explosive growth in medical waste (∼240%) and pollutants (∼260%), and large hospitals are the major sources. By 2030, the production of medical waste would still increase by more than 50% compared with 2018 even there is no the pandemic due to the huge population. The production of medical waste in the eastern region was higher than that in the west under the influence of higher population and GDP, while the per capita medical waste was only affected by household consumption level which had no regional characteristic. Additionally, Hg loads from medical waste are more than twice as high as that from discharged wastewater in some regions, which are facing great control pressures. In the future, when planning for medical waste disposal, policymakers shall increase the disposal facilities based on population and promote mobile treatment equipment to improve efficiency, increase the number of beds in medical institutions rather than building more hospitals, and strengthen basic research on the environmental impact.
医疗废物是一类特殊的有害污染物。处理不当会造成二次环境污染，尤其是在应对突发公共卫生事件时。然而，关于医疗废物产生量的研究相对较少，对其时空异质性缺乏基本认识。2002年非典疫情的爆发是中国医疗体制改革的一个转折点。我们利用医疗统计数据，估算了2002年至2018年中国省级层面的医疗废物及污染物产生量。此外，我们结合环境压力模型（STIRPAT）和时间序列模型（ARIMA），预测了中国直至2030年的医疗废物产生趋势。我们发现，随着中国医疗体系和经济的发展（如个人收入增加和全民医保普及），就医人数迅速增长导致医疗废物（约240%）和污染物（约260%）呈爆发式增长，大型医院是主要来源。到2030年，即使没有疫情，由于人口众多，医疗废物产生量仍将比2018年增加50%以上。受人口和GDP较高影响，东部地区医疗废物产生量高于西部，而人均医疗废物仅受家庭消费水平影响，无区域特征。此外，一些地区医疗废物中的汞含量比污水排放中的汞含量高出两倍多，面临巨大管控压力。未来，在规划医疗废物处置时，政策制定者应根据人口增加处置设施，推广移动处理设备以提高效率，增加医疗机构床位数量而非新建更多医院，并加强对环境影响的基础研究。
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