an official journal of: published by:
an official journal of: published by:
Editor in Chief: RAFFAELLO COSSU

SOLID MEDICAL HOSPITAL WASTE IN TIMES OF CORONA : INCREASED VOLUME BUT NO INCREASED BIOHAZARD RISK.

  • Norbert Fraeyman - Faculty of Medicine and Health Sciences, Ghent University, Belgium
  • Eva Van Braeckel - Faculty of Medicine and Health Sciences, Ghent University, Belgium
  • Bruno Verhasselt - Faculty of Medicine and Health Sciences, Ghent University, Belgium
  • Pascal De Waegemaecker - Faculty of Medicine and Health Sciences, Ghent University, Belgium
  • Susanne Mahnik - VAMED-KMB, Austria
  • Marc Hoffmann - University Hospital Jena, Germany
  • Paul Gemmel - Faculty of Economics and Bussiness Administration, Ghent University, Belgium
  • Kristof Eeckloo - Faculty of Medicine and Health Sciences, Ghent University, Belgium
  • Eric Mortier - Faculty of Medicine and Health Sciences, Ghent University, Belgium

Released under CC BY-NC-ND

Copyright: © 2022 CISA Publisher


Abstract

The effect of the COVID-19 pandemic on medical waste EWC/EURAL code 180103* (infectious medical waste) and 180104 (non-infectious medical waste) was investigated in 6 university hospitals and 6 general hospitals. Data on the number of in-hospital patients and on quantity and volume of waste were obtained during 2019 (control period) and in 2020 up to March 2021 (COVID-19 period) for the hospitals, from the waste managing company, and from the regional destruction facility. The presence of SARS-CoV-2 on the surface of waste recipients was analyzed using RT-PCR. We found that the effect of the pandemic on the total weight of waste is limited during the first wave (March 2020), while during the second wave, the quantity of waste type 180103* increased. The main effect is a nearly doubling of the volume of waste during both waves caused by the use of cardboard hospital boxes with a yellow inner plastic bag. We demonstrated that the average weight of these cardboard boxes generated for the treatment of COVID-19 patients is significantly lower compared to the weight of the waste from non-COVID-19 patients. COVID-19-related health care activities caused a weight increase of the 180103* waste from historical data (0.2-1.4 kg/day/bed) up to 5-8 kg/day/bed. RT-PCR analysis of swabs demonstrated the absence of viral RNA on personal protection materials and on the surface of recipients containing the waste. We conclude that COVID-19-related hospital waste is predominantly of the EWC 180104 type.

Keywords


Editorial History

  • Received: 12 Feb 2022
  • Revised: 09 Jun 2022
  • Accepted: 09 Jun 2022
  • Available online: 30 Jun 2022

References

Abu-Qdais HA, Al-Ghazo MA and Al-Ghazo EM. Statistical analysis and characteristics of hospital medical waste under novel coronavirus outbreak. Global Journal of environmental science and management 6(2020)21-30.
DOI 10.22034/GJESM%.2019.06.SI.03

Bedrosian N, Mitchell E, Rohm E, Rothe M, Kelly C, String G, Lantagne D. A Systematic Review of Surface Contamination, Stability, and Disinfection Data on SARS-CoV-2 (Through July 10, 2020). Environ Sci Technol 55(2021)4162-4173.
DOI 10.1021/acs.est.0c05651

Ben-Shmuel A, Brosh-Nissimov T, Glinert I, Yitzhaki S, Levy H, Weiss S, et al. Detection and infectivity potential of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination in isolation units and quarantine facilities. Clinical microbiology and infection 26(2020)1658-1662.
DOI 10.1016/j.cmi.2020.09.004

Bueckert M, Gupta R, Gupta A, Garg M, Mazumder A. Infectivity of SARS-CoV-2 and Other Coronaviruses on Dry Surfaces: Potential for Indirect Transmission. Materials (Basel) 13(2020)5211.
DOI 10.3390/ma13225211

Castano N, Cordts SC, Jalil MK, Zhang KS, Koppaka S, Bick AD, Paul R and Tand SKY. Fomite transmission, physicochemical origin of virus-surface interactions and disinfection strategies for enveloped viruses with applications to SARS-CoV-2. ACS Omega 6(2021)6509-6527.
DOI 10.1021/acsomega.Oc06335

CDC, 2021. https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html#Waste-ManagementCheng VC, Wong SC, Chan VWM, So SYC, Chen JHK, Yip CCY, Chan KH, Chu H, Chung TWH, Sridhar S, To KKW, Chan JKW, Hung IFN, Ho PL, Yuen KY. Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19). Infection Control & Hospital Epidemiology (2020), 41, 1258–1265.
DOI 10.1017/ice.2020.282

Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed 91(2020)157-160.
DOI 10.23750/abm.v91i1.9397

Das AK, Islam N, Billah M and Sarker A. COVID-19 pandemic and healthcare solid waste management strategy – a mini review. Science of the total environment 778(2021)146220.
DOI 10.1016/j.scitotenv.2021.146220

Dubey, A., Choudhary, S., Kumar, P. et al. Emerging SARS-CoV-2 Variants: Genetic Variability and Clinical Implications. Curr Microbiol 79, 20 (2022).
DOI 10.1007/s00284-021-02724-1

ECDC 2020. https://ec.europa.eu/info/sites/default/files/waste_management_guidance_dg-env.pdf.Goldman E.Exaggerated risk of transmission of COVID-10 by fomites. www.thelancet.com/infection 20(2020).
DOI 10.1016/S1473-3099(20)30561-2

Haque S, Uddin S, Sayem S, Mohib KM. Coronavirus disease 2019 (COVID-19) induced waste scenario: A short overview. J Environ Chem Eng 9(2021)104660.
DOI 10.1016/j.jece.2020.104660

Hens L and Fraeyman N. Environmental and sustainability aspects of the COVID-19 pandemic. Superior Health Council – Belgium – in preparation (2021)

Hebbani AV, Pulakuntla S, Pannuru P, Aramgam S, Badri KR and Reddy VD. COVID-19: comprehensive review on mutations and current vaccines. Archives of microbiology 204, 8 (2022).
DOI 10.1007/s00203-021-02606-x.

Hororo LTS, Musik S, Bryant D, Brooks WW and Porter IM. Questioning COVID-19 surface stability and fomite spreading in three aeromedical cases : a case series. Military medicine 2020.
DOI 10.1093/milmed/usaa548

Hoseinzadeh E, Safoura Javan, Farzadkia M, Mohammadi F, Hossini H, Taghavi M. An updated min-review on environmental route of the SARS-CoV-2 transmission. Ecotoxicol Environ Saf. 202(2020)111015.
DOI 10.1016/j.ecoenv.2020.111015

Huraimel KA, Alhosani M, Kunhabdulla S, Stietiya MH. SARS-CoV-2 in the environment : modes of tranmismission, early detection and potential role of pollutions. Sience of the total environment 744(2020)140946.
DOI 10.1016/j.scitotenv.2020.140946

John Hopkins University, 2022. https://coronavirus.jhu.edu/map.htmlKampf G, Todt D, Pfaender S and Steinmann E. Presistence of coronavirus on inanimate surfaces and their inactivation with biocidal agents. Journal of hospital infection 104(246-251)2020.
DOI 10.1016/j.jhin.2020.01.022

Lavagnolo MC. “Closing the loop” of circular economy and COVID-19. Detritus 10(2020)1-2.
DOI 10.31025/2611-4135/2020.13949

Meyerowitz EA, Richterman A, Gandhi RT, Sax PE. Transmission of SARS-CoV-2: A Review of Viral, Host, and Environmental Factors. Ann Intern Med. 174(2021)69-79.

Mol MPG & Caldas S. Can the human coronavirus epidemic also spread through solid waste ? Waste management & research 38(2020)485-486.
DOI 10.1177/0734242x20918312

Mondelli MU, Calaneri M, Seminari EM, Baldanti F and Bruno R. Low risk of SARS-CoV-2 tranmission by fomites in real-life conditions. www.thelancet.com/infection 21(2021).
DOI 10.1016/S1473-3099(20)30678-2

Olsen M, Campos M, Lohning A, Jones P, Legget J, Bannach-Brown A, McKirdy S, Alghafri S, Tajouri L. Mobile phones represent a pathway for microbial transmission: A scoping review. Travel Med Infect Dis 35(2020)101704.

Ong SWX, Tan YK, Chia PY, et al. Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient. JAMA. 323(2020)1610–1612.
DOI 10.1001/jama.2020.3227

Pastorino B, Touret F, Gilles M, de Lamballerie X, Charrel RN. Prolonged Infectivity of SARS-CoV-2 in Fomites. Emerg Infect Dis 26(2020)2256-2257.

Peng J, Wu X, Wang R, Li C, Zhang Q, Wei D. Medical waste management practice during the 2019-2020 novel coronavirus pandemic: Experience in a general hospital. Am J Infect Control 48(2020)918-921.

Ren SY, Wang WB, Hao YG, Zhang HR, Wang ZC, Chen YL, Gao RD. Stability and infectivity of coronaviruses in inanimate environments. World J Clin Cases 26(2020)1391-1399.
DOI 10.12998/wjcc.v8.i8.1391

Saadat S, Rawtani D, Hussain CM. Environmental perspective of COVID-19. Sci Total Environ. 728(2020)138870.

Sarkodie SA, Owusu PA. Global assessment of environmental, health and economic impact of the novel coronavirus (COVID-19). Environment, development and sustainability (2020).
DOI 10.1007/s10668-020-00801-2

Shah MR, Jan I, Johns J, Singh K, Kumar P, Belarmino N, Saggiomo KJ, Hayes C, Washington K, Toppmeyer DL, Haffty BG, Libutti SK and Evens AM. SARS-CoV-2 nosocomial infection: real-world results of environmental surface testing from a large tertiary cancer centre. Cancer 127(2021)1926-1932.
DOI 10.1002/cncr.33453

Singh N, Tand Y, Zhang Z, Zheng C. COVID-19 waste management: effective and successful measures in Wuhan, China. Resources, conservation and recycling 163(2020)105071.
DOI 10.1016/j.resconrec.2020.105071

van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, Tamin A, Harcourt JL, Thornburg NJ, Gerber SI, Lloyd-Smith JO, de Wit E, Munster VJ. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med 382(2020)1564-1567.
DOI 10.1056/NEJMc2004973

Wang Z, Fu Y, Guo Z, Li J, Li J, Cheng H, Lu B, Sun Q. Transmission and prevention of SARS-CoV-2. Biochemical society transactions 48(2020)2307-2316.
DOI 10.1042/BST20200693

Wei L, Huang W, Lu X, Wang Y, Cheng L, Deng R, Long H, Zong Z. Contamination of SARS-CoV-2 in patient surroundings and on personal protective equipment in a non-ICU isolation ward for COVID-19 patients with prolonged PCR positive status. Antimicrob Resist Infect Control 9(2020)167.

WHO, 2020. Water, sanitation, hygiene and waste management for COVID-19: technical brief. 03 march 2020

WHO,2020.https://www.who.int/docs/default-source/coronaviruse/laboratory-biosafety-novel-coronavirus-version-1-1.pdf?sfvrsn=912a9847_2

WHO, 2021. https://app.powerbi.com/view?r=eyJrIjoiMDk2MTQwMzAtZWVjNC00NmE3LWE1ZTEtYmE4NzM5NTdlYTZmIiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9&pageName=ReportSectionc35b8bd8278bcae587e9

Wiktorczyk-Kapischke N, Grudlewska-Buda K, Walecka-Zacharska E, Kwiencinska-Pirog J, Radtke L, Gospodarek-Komkowska E and Skowron K. SARS-CoV-Z in the environment – non-droplet spreading routes. Science of the total environment 770(2021)145260.
DOI 10.1016/j.scitotenv.2021.145260

Yang L, Yu X, Wu X, Wang J,Yan X, Jiang S, Chen Z. Emergency response to the explosive growth of health care wastes during COVID-19 pandemic in Wuhan, China. Resources, conservation and recycling 164(2021)105074.
DOI 10.1016/j.resconrec.2020.105074

You S, Sonne C and Ok YS. COVID-19 unsustainable waste management. Science 368(2020)1438.
DOI 10.1126/science.abc7778

Yu H, Sun X, Solvang WD, Zhao X. Reverse Logistics Network Design for Effective Management of Medical Waste in Epidemic Outbreaks: Insights from the Coronavirus Disease 2019 (COVID-19) Outbreak in Wuhan (China). Int J Environ Res Public Health 17(2020)1770.
DOI 10.3390/ijerph17051770