**4. The problem of hospital waste**

The healthcare sector can be a great nuisance, if HCW is not given due importance and handled properly and become the worrisome source that emits different greenhouse gases and is home to different pathogens that can cause damage to human and animal health and affect the environment. HCW also is the source of particulate matter and the area close to HCW dumping or processing site has a relatively very high level of the same [1].

### *Nonbiodegradable Hospital Waste Burden and Implications DOI: http://dx.doi.org/10.5772/intechopen.105009*

Considering the segregation of HCW, the nonhazardous waste usually constitutes 80–85% of the total HCW and hazardous waste is about 15–20% based on rough estimations provided by WHO [2]. HCW is a worldwide issue as the AAMC found that globally approximately 4.4% of all greenhouse gas emissions and over 5 million tons of waste come from hospitals [3].

This estimation needs to be further investigated with respect to the degradation potential of total health care waste as the nonhazardous waste may not be biodegradable. **Table 4** gives the classification of overall HCW based on biodegradation. The list indicates that though the waste may not be hazardous but it may also not be biodegradable thus aggravating the problem of long-term environmental pollution and subsequent effects.

Various studies reported an increased incidence of health issues among employees and the resident population living nearby of waste processing facilities especially living near landfill sites, incinerators, composting facilities, and nuclear installations. Studies also reported that pathogens originating at HCW treatment plants pose a high risk of gastrointestinal infections [4].


#### **Table 4.** *Biodegradable and nonbiodegradable medical waste.*

Rapid and uncontrolled growth of medical care facilities are resulting in an increase in waste generation because of the marked increase in the use of disposable items and their illegal recycling. Illegal recycling affects the local community, especially health workers, hospital employees, waste processing staff, and rag pickers [5]. A study in Iranian some selected hospitals indicate that the average of total medical waste generated was about 3.48 kg/bed of which approximately 1.039 kg/bed was hazardous-infectious waste, and 2.439 kg/bed-day was general waste [6]. Some studies reported the concern that large quantity of nonbiodegradable HCW such as disposable syringes, infusion bags, IV fluid bottles and administration sets, oxygen masks, etc. Are dumped in-properly by health care facilities and picked up by rag pickers and returned back into the market without any processing, posing a dangerous threat to the health of patients [7]. Exposure to HCW may spread communicable diseases through skin contact, injection, inhalation, and improper sterilization of containers and plastic materials before recycling [8].

HCW directly impacts on the health of the community, healthcare workers, animals, and surrounding environment. The HCW is saturated with infectious and hazardous waste. Impromptu, haphazard, and nonscientific disposal of HCW results in exposing the public in general and healthcare workers in specific to pathogenic waste which can cause different diseases. This also leads to contamination of all components of the surrounding environment by various hazardous content of HCW especially nonbiodegradable. Hence, HCW requires due attention and specific treatment and management prior to its final disposal.

Most of the times, the HCW gets mixed with domestic waste before disposal creating different types of problems in the long run. In economically developing or underdeveloped countries, the public, health workers, and waste processing personnel in particular, are not aware of the hazards of HCW or trained in management of HCW leading to the escalation of dangers of HCW. Also, in these countries, the lack of sufficient funds and proper information and awareness is a barrier for HCW management [9, 10].

One of the problems with HCW is that due to well-developed, superior, and well spread medical facilities available, the quantum of the pollution by HCW is much more than that of developing or poor countries, which have relatively underdeveloped and scarcely available health care systems [11, 12]. However, the global increment of the HCW production worldwide is increasing at an alarming rate, The middle and lowincome countries contributing to this as HCW production is sharply increasing due to improved healthcare services and in the wealthy nations, the rapidly aging population


#### **Table 5.**

*HCW generation and economic status of country.*

*Nonbiodegradable Hospital Waste Burden and Implications DOI: http://dx.doi.org/10.5772/intechopen.105009*


#### **Table 6.**

*Healthcare waste generation rates in different continents.*

that need frequent usage of health care systems is increasing HCW generation rate (HCWGR) [13]. **Table 5** illustrate the average rate of HCW generation with respect to the economic status of the country and **Table 6** indicates that of continents [14].

As per WHO report of 2018, in general, hazardous medical waste generation per hospital bed per day in high-income countries is on an average up to 0.5 kg [3].
