Healthcare waste from clinical analysis laboratories in Sao Tome and Principe - Current state and constrains in the framework of least developed countries

Laboratories of clinical analysis are essential to the diagnosis of many diseases but also generate waste that is a potential risk to humans and the environment, especially in the context of least developed countries with structural impediments. The main objective of the work was to assess the current state of waste management from clinical analysis laboratories in Sao Tome ' and Principe (STP) and to propose suggestions to increase environmental and social sustainability.Data was collected by interviews between March and April 2022. Waste from clinical analysis laboratories reaches 123.7 t/year (0.35% of waste in the country). Critical issues are: pretreatment to prevent biological contamination is carried out in 50% of the laboratories; at 93% of the sites, the staff does not have proper training; 43% of the laboratories do not have a dedicated space for storing the waste; 79% of the laboratories only segregate sharp-objects, 14% segregate infectious waste and 7% have no source-segregation. Sharp waste is incinerated, while other waste is dumped or buried (93% of laboratories) or is burned in pits on the ground (7%). Most of the waste produced in clinical analysis laboratories in STP is disposed and treated in an inappropriate manner, likely resulting in soil, water and air pollution that impact on human health. Critical issues that have been identified at STP are likely found also in other least developed countries and need addressing in the path towards sustainable development goals.