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A SIMPLE METHOD FOR DIFFERENTIATING HAZARDOUS FROM NON-HAZARDOUS SOLID MEDICAL WASTE CONTAMINATED WITH PATHOGENS

  • Norbert Fraeyman - Medical School, University Ghent, Belgium - University Hospital Ghent, Belgium
  • Simon Malfait - Medical School, University Ghent, Belgium - University Hospital Ghent, Belgium
  • Veerle Duprez - University Hospital Ghent, Belgium
  • Eric Mortier - Medical School, University Ghent, Belgium - University Hospital Ghent, Belgium
  • Susanne Mahnik - VAMED, Austria

DOI 10.31025/2611-4135/2026.20613

Released under CC BY-NC-ND

Copyright: © 2025 CISA Publisher

Abstract

Solid medical waste generated during patient care and contaminated with pathogens is generally classified as hazardous. It must be managed in accordance with a strict legal framework, including special packaging and mandatory destruction by incineration. In this paper, we focus on the potential health impact of this medical waste on employees who handle it. Using a simple algorithm based on pathogen properties, we describe a flexible method for distinguishing hazardous from non-hazardous medical waste and conclude on the risk to employees. The procedure involves constructing a two-dimensional Coordinate system, where the x-axis represents the WHO scoring system, ranging from I to IV for disease severity and where the y-axis represents a quantitative score for pathogenicity. This score is obtained by answering and quantifying a sequence of questions, only if the pathogen survives outside the host: transmission of the disease linked to the pathogen through body fluids, mode of entry into a potential victim, and infectious dose. The resulting coordinates of each pathogen enable an objective assessment of its risk to waste handlers. By applying rational threshold values, the approach allows for data-driven classification of waste as either equivalent to household waste or genuinely hazardous. Implementing this method could lead to a significant reduction in hazardous waste without compromising the health of waste handlers.

Keywords

Editorial History

  • Received: 08 Nov 2025
  • Revised: 16 May 2026
  • Accepted: 01 Jul 2026
  • Available online: 28 Jul 2026

References

Anand, U., Li, X., Sunita, K., Lokhandwala, S., Gautam, P., Suresh, S., . . . Jiang, G. M. (2022). SARS-CoV-2 and other pathogens in municipal wastewater, landfill leachate, and solid waste: A review about virus surveillance, infectivity, and inactivation. Environmental Research, 203, 16.
DOI 10.1016/j.envres.2021.111839

Athanasopoulou, K., Adamopoulos, P. G., & Scorilas, A. (2023). Unveiling the Human Gastrointestinal Tract Microbiome: The Past, Present, and Future of Metagenomics. Biomedicines, 11(3), 16.
DOI 10.3390/biomedicines11030827

Blumenthal, D., Fowler, E. J., Abrams, M., & Collins, S. R. (2020). Covid-19-Implications for the Health Care System. New England Journal of Medicine, 383(15), 1483–1488.
DOI 10.1056/NEJMsb2021088

Cryan, J. F., O’Riordan, K. J., Sandhu, K., Peterson, V., & Dinan, T. G. (2020). The gut microbiome in neurological disorders. Lancet Neurology, 19(2), 179–194.
DOI 10.1016/s1474-4422(19)30356-4

Filip, R., Puscaselu, R. G., Anchidin-Norocel, L., Dimian, M., & Savage, W. K. (2022). Global Challenges to Public Health Care Systems during the COVID-19 Pandemic: A Review of Pandemic Measures and Problems. Journal of Personalized Medicine, 12(8), 22.
DOI 10.3390/jpm12081295

Fraeyman, N., Van Braeckel, E., Verhasselt, B., De Waegemaeker, P., Mahnik, S., Hoffmann, M., . . . Mortier, E. (2022). SOLID MEDICAL HOSPITAL WASTE IN TIMES OF CORONA: INCREASED VOLUME BUT NO INCREASED BIOHAZARD RISK. Detritus, 19, 94–103.
DOI 10.31025/2611-4135/2022.15197

Huttenhower, C., Gevers, D., Knight, R., Abubucker, S., Badger, J. H., Chinwalla, A. T., . . . Human Microbiome Project, C. (2012). Structure, function and diversity of the healthy human microbiome. Nature, 486(7402), 207–214.
DOI 10.1038/nature11234

Janik-Karpinska, E., Brancaleoni, R., Niemcewicz, M., Wojtas, W., Foco, M., Podogrocki, M., & Bijak, M. (2023). Healthcare Waste-A Serious Problem for Global Health. Healthcare, 11(2), 14.
DOI 10.3390/healthcare11020242

Kanwar, V. S., Sharma, A., Rinku, Kanwar, M., Srivastav, A. L., & Soni, D. K. (2023). An overview for biomedical waste management during pandemic like COVID-19. International Journal of Environmental Science and Technology, 16.
DOI 10.1007/s13762-022-04287-5

Leggett, H. C., Cornwallis, C. K., Buckling, A., & West, S. A. (2017). Growth rate, transmission mode and virulence in human pathogens. Philosophical Transactions of the Royal Society B-Biological Sciences, 372(1719), 8.
DOI 10.1098/rstb.2016.0094

Lynch, S. V., & Pedersen, O. (2016). The Human Intestinal Microbiome in Health and Disease. New England Journal of Medicine, 375(24), 2369–2379.
DOI 10.1056/NEJMra1600266

Mahnik, S. N., Hoffmann, M., Fraeyman, N., & Komilis, D. (2023). HOSPITAL WASTE - LEGISLATIVE FRAMEWORK AND MANAGEMENT DIFFERENTIATIONS IN AUSTRIA, BELGIUM, GERMANY AND GREECE. Detritus, 25, 71–77.
DOI 10.31025/2611-4135/2023.18325

Mims C, Dockrell HM, Goering RV, Roitt I, Wakelin D and Zuckerman M. (2004) Medical Microbiology. Elsevier Mosby eds

Martinez, J. L. (2014). Short-sighted evolution of bacterial opportunistic pathogens with an environmental origin. Frontiers in Microbiology, 5, 4.
DOI 10.3389/fmicb.2014.00239

Rackaityte, E., & Lynch, S. V. (2020). The human microbiome in the 21(st) century. Nature Communications, 11(1), 3.
DOI 10.1038/s41467-020-18983-8

Ranjbari, M., Esfandabadi, Z. S., Shevchenko, T., Chassagnon-Haned, N., Peng, W. X., Tabatabaei, M., & Aghbashlo, M. (2022). Mapping healthcare waste management research: Past evolution, current challenges, and future perspectives towards a circular economy transition. Journal of Hazardous Materials, 422, 18.
DOI 10.1016/j.jhazmat.2021.126724

Sachs, J. D., Karim, S. S. A., Aknin, L., Allen, J., Brosbol, K., Colombo, F., . . . Michie, S. (2022). The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet, 400(10359), 1224–1280.
DOI 10.1016/s0140-6736(22)01585-9

Schmid-Hempel, P., & Frank, S. A. (2007). Pathogenesis, virulence, and infective dose. Plos Pathogens, 3(10), 1372–1373.
DOI 10.1371/journal.ppat.0030147

Shapiro-Ilan, D. I., Fuxa, J. R., Lacey, L. A., Onstad, D. W., & Kaya, H. K. (2005). Definitions of pathogenicity and virulence in invertebrate pathology. Journal of Invertebrate Pathology, 88(1), 1–7.
DOI 10.1016/j.jip.2004.10.003

Sorboni, S. G., Moghaddam, H. S., Jafarzadeh-Esfehani, R., & Soleimanpour, S. (2022). A Comprehensive Review on the Role of the Gut Microbiome in Human Neurological Disorders. Clinical Microbiology Reviews, 35(1), 50.
DOI 10.1128/cmr.00338-20

Thomas, S. R., & Elkinton, J. S. (2004). Pathogenicity and virulence. Journal of Invertebrate Pathology, 85(3), 146–151.
DOI 10.1016/j.jip.2004.01.006

Ursell, L. K., Metcalf, J. L., Parfrey, L. W., & Knight, R. (2012). Defining the human microbiome. Nutrition Reviews, 70, S38–S44.
DOI 10.1111/j.1753-4887.2012.00493.x

Wankhede, P., & Wanjari, M. (2021). Health Issues and Impact of Waste on Municipal Waste Handlers: A Review. Journal of Pharmaceutical Research International, 33(46B), 577–581.
DOI 10.9734/JPRI/2021/v33i46B32979

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