REVISITING THE CIRCULAR MANAGEMENT OF HEALTHCARE WASTE: THE 10R CIRCULAR ECONOMY HIERARCHY
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Abstract
This is a position paper to support the application of the Circular Economy (CE) hierarchy to management of healthcare waste (HCW). This hierarchy is based on the 10R typology and includes the strategies Refuse, Reduce, Resell/Reuse, Repair, Reprocess, Refurbish, Remanufacture, Repurpose, Recycle and Recover (energy). Disposal was added as a sink of residues from the CE strategies. The need for this hierarchy and its comparison with other similar systems is presented. In the author’s view, the 10R hierarchy proposed in this paper is best suited for circular management of HCW, but indicative risks, knowledge gaps and policy recommendations must be addressed. End-of-pipe treatment and disposal would be required for the downgraded infectious fraction of HCW.Keywords
Editorial History
- Received: 21 Dec 2024
- Accepted: 20 Mar 2025
- Available online: 25 Apr 2025
References
Abhilash, Inamdar, I., 2022. Recycling of plastic wastes generated from COVID-19: A comprehensive illustration of type and properties of plastics with remedial options. Science of the Total Environment 838, 155895
Barbosa, F.C.L., Mol, M.P.G., Barros, R.T.V., 2020. Minimizing laboratory waste and improving material reuse through chemical waste exchange: Case of a Brazilian institution. Waste Management & Research 38, 1064-1072
Cossu, R., Williams, I., 2024. The need for sinks during the transition to a global circular economy – Editorial. Detritus, 28, 1-4.
DOI 10.31025/2611-4135/2024.19427
Debnath, B., Ghosh, S., Dutta, N., 2022. Resource resurgence from COVID-19 waste via pyrolysis: A circular economy approach. Circular Economy and Sustainability 2, 211–220.
DOI 10.1007/s43615-021-00104-2
EC – European Commission, 2020. Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions: A new Circular Economy Action Plan for a cleaner and more competitive Europe. Brussels, 11.3.2020, COM(2020) 98 final. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=COM%253A2020%253A98%253AFIN
Fan, Y.V., Jiang, P., Klemes, J.J., Liew, P.W., Lee, C.T., 2021. Integrated regional waste management to minimize the environmental footprints in circular economy transition. Resources, Conservation and Recycling 168, 105292.
DOI 10.1016/j.resconrec.2020.105292
Felix, C.B., Ubando, A.T., Chen, W.H., Goodarzi, V., Ashokkumar, V., 2022. COVID-19 and industrial waste mitigation via thermochemical technologies towards a circular economy: A state-of-the-art review. Journal of Hazardous Materials 423, 127215
Fletcher, C.A., Clair, R.St., Sharmina, M., 2021. A framework for assessing the circularity and technological maturity of plastic waste management strategies in hospitals. Journal of Cleaner Production 306, 127169
Ibn-Mohammed, T., Mustapha, K.B., Godsell, J., Adamu, Z., Babatunde, K.A., Akintade, D.D., Acquaye, A., Fujii, H., Ndiaye, M.M., Yamoah, F.A., Koh, S.C.L., 2021. A critical analysis of the impacts of COVID-19 on the global economy and ecosystems and opportunities for circular economy strategies. Resources, Conservation and Recycling 164, 105169
Kane, G.M., Bakker, C.A., Balkenende, A.R., 2018. Towards design strategies for circular medical products. Resources, Conservation and Recycling 135, 38-47
Kermenidou, M., Voudrias, E.A., Konstantoula, A.C., 2019. Composition and production rate of cytostatic pharmaceutical waste from a Greek cancer treatment hospital. Global Nest Journal, 21(2), 131–140
Kwakye, G., Brat, G.A., Makary, M.A., 2011. Green surgical practices for health care. Arch. Surg. 146 (2), 131–136
Loomba, A.P.S., 2014. Repurposing medical devices for LRCs–Sustainability considerations. In: International conference on engineering, technology and innovation (ICE), Bergamo, Italy, 23–25 June 2014, pp. 1-6, New York, NY: IEEE
Reike, D., Vermeulen, W.J.V., Witjes, S., 2018. The circular economy: New or refurbished as CE 3.0? – Exploring controversies in the conceptualization of the circular economy through a focus on history and resource value retention options. Resources, Conservation and Recycling 135, 246-264
Stanislaus, M., 2019. 5 ways to unlock the value of the circular economy. Available at: https://www.wri.org/insights/5-ways-unlock-value-circulareconomy
Teymourian, Ta., Teymoorian, Te., Kowsari, E., Ramakrishna, S., 2021. Challenges, strategies, and recommendations for the huge surge in plastic and medical waste during the global COVID-19 pandemic with Circular Economy approach. Materials Circular Economy, 3, 6.
DOI 10.1007/s42824-021-00020-8
USGAO – US Government Accountability Office, 2008. Report to the committee on oversight and government reform, house of representatives. Reprocessed Single-Use Medical Devices, GAO-08-147, Washington, DC: GAO
Voudrias, E.A., 2018. Healthcare waste management from the point of view of circular economy – Editorial. Waste Management 75, 1-2
Voudrias, E.A., 2023. Management of COVID-19 healthcare waste based on the circular economy hierarchy: A critical review. Waste Management and Research, Volume 42, Issue 11.
DOI 10.1177/0734242X231198424
Voudrias, E., Graikos, A., 2014. Infectious medical waste management at the regional level. Journal of Hazardous, Toxic and Radioactive Waste, ASCE, ISSN 2153-5493/04014020(9)
WHO – World Health Organization, 2014. Safe management of wastes from health-care activities, 2nd Edition. Edited by Chartier, Y., Emmanuel, J., Pieper, U., Prüss, A., Rushbrook, P., Stringer, R., Townend, W., Wilburn, S., and Zghondi, R. https://www.euro.who.int/__data/assets/pdf_file/0012/268779/Safe-management-of-wastes-from-health-care-activities-Eng.pdf
Wuyts, W., Marin, J., Brusselaers, J., Vrancken, K., 2020. Circular economy as a COVID-19 cure? Resources, Conservation and Recycling 162, 105016