Hospital waste management in Germany and the European Union during the Industry 5.0 era for carbon neutrality by 2050: A critical review.

Hospital waste management (HWM) is critical to advancing environmental sustainability, particularly as Germany and the European Union (EU) pursue carbon neutrality by 2050. This review examines the potential of Industry 5.0 technologies to transform waste management through intelligent, human-centric systems. The study adopts a mixed-methods approach, including a comprehensive literature review, site visits to five German hospitals and interviews with 20 key stakeholders such as hospital staff, policymakers and waste service providers. Germany generates an estimated 210,000 tonnes of hospital waste annually, with 25-30% classified as hazardous. However, only 17% is currently recycled or recovered. The integration of Industry 5.0 tools - Artificial Intelligence (AI)-driven sorting, robotics and Internet of Things-enabled tracking - combined with staff training and participatory design, can improve segregation accuracy by 40%, reduce landfill reliance by 35% and cut waste-related carbon emissions by 22% within 10 years. Pilot technologies such as plasma gasification and autoclaving have further reduced CO emissions by 28% compared to traditional incineration. Beyond technical innovation, the study emphasizes the importance of worker involvement, ethical AI and feedback systems in fostering responsible waste practices. It also identifies policy enablers like the EU Green Deal and Germany's Hospital Future Act, which support the digital and sustainable transformation of healthcare. The findings highlight the need for a collaborative ecosystem connecting healthcare professionals, technologists and regulators. Such synergy is essential to achieving a circular, low-carbon and socially inclusive HWM system aligned with Industry 5.0 values and climate goals.