Assessment of healthcare waste management practices and associated problems in Isfahan Province (Iran)

Few studies have paid close attention to a regional (provincial scale) healthcare waste management, particularly in Iran. An inventory of all 58 healthcare facilities in the province of Isfahan was performed and the results were analyzed using statistical procedures. The results indicated that 36.2, 4.6, and 59.2 % of total wastes produced were infectious, sharp, and general wastes, respectively. Only 20.7 % of medical centers had designated collection vehicles. As for the treatment of medical wastes, only 6.9 % of centers were equipped with autoclave. In terms of tonnage about 10 % of infectious and sharp wastes were treated by incinerators. Collected wastes from 70.7 % of facilities were landfilled in separate trenches, while collected wastes from the remaining 29.3 % centers were disposed together (mixed) with the municipal wastes at the same landfill trenches. The waste generation rates for total waste, general waste, infectious, and sharp wastes were 3.03, 1.84, 0.75, and 0.17 kg/active bed/day, respectively. The main drawbacks of the existing waste management system are the lack of any program for waste minimization, commingling of hazardous and non-hazardous portions of wastes generated at healthcare centers, and the lack of resources (appropriate treatment equipment such as autoclaves and incinerators) and trained personnel.