The SARS-CoV-2 (COVID-19) coronavirus pandemic has represented an emergency not only from a clinical point of view, but also for the environment due to the largely increased waste disposal. This study aimed at estimating, in the context of current trends, the increase in healthcare waste (HW) generation during the outbreak, based on data from a tertiary hospital. From the purveying office statements of ‘SS Antonio e Biagio e Cesare Arrigo’ Hospital of Alessandria (Italy), monthly HW generation data from January 2015 to March 2021 were retrospectively retrieved. Trends and COVID’s impact were evaluated by Interrupted Time Series (ITS) design with linear regression models. Locally Weighted Scatterplot Smoothing was used to model the relation between infectious HW generation and proportion of COVID-related bed days. HW generation rose from 35.9 ± 3.8 tonnes month−1 (2.4 ± 0.2 kg per patient-day, kg PD−1) in 2015–2019, to 46.3 ± 6.0 tonnes month−1 (3.3 ± 0.7 kg PD−1) during the outbreak. The increasing trend was not appreciably modified as for its slope (p = 0.363), while a significant level change was found between baseline and outbreak (+ 0.72 kg PD−1, p < 0.001). The proportion of COVID-related bed days non-linearly affected the infectious HW generated per patient-day, with steeper increases for proportions above 20%. The study showed a significant rise in HW generation in 2020–2021, reasonably due to the COVID outbreak; in addition, the generally increasing trend was not affected. Therefore, urgent measures are needed to conciliate safety requirements with HW generation issues.
AghapourPNabizadehRNouriJ, et al. (2013) Analysis of hospital waste using a healthcare waste management index. Toxicological & Environmental Chemistry95: 579–589.
2.
AmadorMMatias-GuiuXSancho-PardoG, et al. (2021) Impact of the COVID-19 pandemic on the care of cancer patients in Spain. ESMO Open6: 100157.
3.
BernalJLCumminsSGasparriniA (2017) Interrupted time series regression for the evaluation of public health interventions: A tutorial. International Journal of Epidemiology46: 348–355.
4.
Centers for Disease Control and Prevention (2021) COVID-19 vaccine breakthrough infections reported to CDC. Morbidity and Mortality Weekly Report. Available at: https://www.cdc.gov/mmwr/volumes/70/wr/mm7021e3.htm (accessed 25 July 2021).
5.
DasAKIslamNBillahM, et al. (2021) COVID-19 pandemic and healthcare solid waste management strategy: A mini-review. Science of the Total Environment778: 146220.
6.
De Aguiar HugoADa Silva LimaR (2021) Healthcare waste management assessment: Challenges for hospitals in COVID-19 pandemic times. Waste Management & Research39: 56–63.
7.
De-La-TorreGEPizarro-OrtegaCIDioses-SalinasDC, et al. (2021) Investigating the current status of COVID-19 related plastics and their potential impact on human health. Current Opinion in Toxicology27: 47–53.
HantokoDLiXPariatambyA, et al. (2021) Challenges and practices on waste management and disposal during COVID-19 pandemic. Journal of Environmental Management286: 112140.
HicksATemizel-SekeryanSKontarW, et al. (2021) Personal respiratory protection and resiliency in a pandemic, the evolving disposable versus reusable debate and its effect on waste generation. Resources, Conservation and Recycling168: 105262.
15.
IlyasSSrivastavaRRKimH (2020) Disinfection technology and strategies for COVID-19 hospital and bio-medical waste management. Science of the Total Environment749: 141652.
KalantaryRRJamshidiAGolbini MofradMM, et al. (2021) Effect of COVID-19 pandemic on medical waste management: A case study. Journal of Environmental Health Science and Engineering19: 831–836.
18.
KampfGTodtDPfaenderS, et al. (2020) Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection104: 246–251.
19.
KlemešJJFanYVTanRR, et al. (2020) Minimising the present and future plastic waste, energy and environmental footprints related to COVID-19. Renewable and Sustainable Energy Reviews127: 109883.
20.
KorkutEN (2018) Estimations and analysis of medical waste amounts in the city of Istanbul and proposing a new approach for the estimation of future medical waste amounts. Waste Management81: 168–176.
21.
KustinTHarelNFinkelU, et al. (2021) Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2-mRNA-vaccinated individuals. Nature Medicine. Epub ahead of print 14 June. DOI: 10.1038/s41591-021-01413-7.
22.
LiangYSongQWuN, et al. (2021) Repercussions of COVID-19 pandemic on solid waste generation and management strategies. Frontiers of Environmental Science and Engineering15: 115–132.
23.
MaYLinXWuA, et al. (2020) Suggested guidelines for emergency treatment of medical waste during COVID-19: Chinese experience. Waste Disposal & Sustainable Energy2: 81–84.
24.
MaamariOBrandamCLteifR, et al. (2015) Health Care Waste generation rates and patterns: The case of Lebanon. Waste Management43: 550–554.
25.
MolMPGCaldasS (2020) Can the human coronavirus epidemic also spread through solid waste?Waste Management & Research38: 485–486.
26.
MühlichMScherrerMDaschnerFD (2003) Comparison of infectious waste management in European hospitals. Journal of Hospital Infection55: 260–268.
27.
NzediegwuCChangSX (2020) Improper solid waste management increases potential for COVID-19 spread in developing countries. Resources, Conservation and Recycling161: 104947.
Patrício SilvaALPrataJCWalkerTR, et al. (2020) Rethinking and optimising plastic waste management under COVID-19 pandemic: Policy solutions based on redesign and reduction of single-use plastics and personal protective equipment. Science of the Total Environment742: 140565.
30.
R Core Team (2020) R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. Available at: https://www.r-project.org (accessed 25 July 2021).
31.
Rodríguez-LeorOCid-ÁlvarezBOjedaS, et al. (2020) Impact of the COVID-19 pandemic on interventional cardiology activity in Spain. REC: Interventional Cardiology2: 82–89.
32.
RupaniPFNilashiMAbumallohRA, et al. (2020) Coronavirus pandemic (COVID-19) and its natural environmental impacts. International Journal of Environmental Science and Technology17: 4655–4666.
33.
SangkhamS (2020) Face mask and medical waste disposal during the novel COVID-19 pandemic in Asia. Case Studies in Chemical and Environmental Engineering2: 100052.
34.
SanidaGKaragiannidisAMavidouF, et al. (2010) Assessing generated quantities of infectious medical wastes: A case study for a health region administration in Central Macedonia, Greece. Waste Management30: 532–538.
35.
SarkodieSAOwusuPA (2021) Impact of COVID-19 pandemic on waste management. Environment, Development and Sustainability23: 7951–7960.
36.
SelvaranjanKNavaratnamSRajeevP, et al. (2021) Environmental challenges induced by extensive use of face masks during COVID-19: A review and potential solutions. Environmental Challenges3: 100039.
37.
SkeggDGluckmanPBoultonG, et al. (2021) Future scenarios for the COVID-19 pandemic. Lancet397: 777–778.
38.
TorkashvandJJonidi JafariAGodiniK, et al. (2021) Municipal solid waste management during COVID-19 pandemic: A comparison between the current activities and guidelines. Journal of Environmental Health Science and Engineering19: 173–179.
39.
TsaiW-T (2021) Analysis of medical waste management and impact analysis of COVID-19 on its generation in Taiwan. Waste Management & Research39: 27–33.
VoudriasEGraikosA (2014) Infectious medical waste management system at the regional level. Journal of Hazardous, Toxic, and Radioactive Waste18: 1–9.
42.
WangJChen Zhuqi LangXWangS, et al. (2021) Quantitative evaluation of infectious health care wastes from numbers of confirmed, suspected and out-patients during COVID-19 pandemic: A case study of Wuhan. Waste Management126: 323–330.
WeiYCuiMYeZ, et al. (2021) Environmental challenges from the increasing medical waste since SARS outbreak. Journal of Cleaner Production291: 125246.
46.
WilcoxR (2017) The regression smoother LOWESS: A confidence band that allows heteroscedasticity and has some specified simultaneous probability coverage. Journal of Modern Applied Statistical Methods16: 29–38.
47.
WindfeldESBrooksMSL (2015) Medical waste management: A review. Journal of Environmental Management163: 98–108.
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
