https://doi.org/10.1177/0734242X19857470
Waste Management & Research
2019, Vol. 37(9) 863–875
© The Author(s) 2019
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DOI: 10.1177/0734242X19857470
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Introduction
Waste management is a sensitive issue all around the world.
Mishandling and ignorance have created various environmental
problems; especially in densely populated countries, such as
China, India, Pakistan, and Bangladesh. These countries are among
many that have reported to have waste management issues, par-
ticularly with waste generated from healthcare facilities (Harhay
et al., 2010; Kumar et al., 2016; Patwary et al., 2009a). These
countries are included in the category of ‘Developing Countries’,
and to date, various studies have reported on the inadequacies of
waste management in the healthcare sector of these countries
(Abdulla et al., 2008; Birpınar et al., 2009; Farzadkia et al., 2009;
Mohee, 2005; Patil and Shekdar, 2001; Shinee et al., 2008).
Healthcare waste is generated from the treatment, diagnosis, or
immunisation of humans and animals. This waste is comprised of
two different categories, namely hazardous and non-hazardous
waste (Abd El-Salam, 2010; Ananth et al., 2010; Hossain et al.,
2011; Patwary et al., 2011). According to World Health
Organization (WHO), 75% to 90% of healthcare-related waste is
non-hazardous, while the remaining percentage, is considered as
hazardous (Yves Chartier et al., 2013). Hazardous waste is further
categorised on the basis of its risk of causing infection and injury
during its management process. These categories include sharps
(scalpel blades and contaminated needles), infectious waste items
contaminated with blood, body fluids, dressings, and intravenous
(IV) lines, pathological waste, including microbiological cultures,
blood samples, and anatomical body parts (World Health
Organization, 2005). Other waste includes instruments containing
mercury, polyvinyl chloride (PVC) plastic, and radioactive waste
(Sarkar et al., 2006). The magnitude of waste generation is con-
tinually rising with the increase in global population, along with a
plethora of medical facilities, and a general inclination towards
Healthcare waste management in Asian
developing countries: A mini review
Bilal Ahmed Khan
1
, Longsheng Cheng
1
, Aves A Khan
2
and Haris Ahmed
3
Abstract
Healthcare waste encompasses a significant quantity of hazardous substances. Poor healthcare waste management can result in serious
environmental and human health risks. Asian developing countries are densely populated, and some are highly resource constrained.
These countries commonly fail to practice appropriate healthcare waste management. Moreover, facilities in these countries
extensively lack proper waste segregation, collection, safe storage, transportation, and disposal. This mini-review recapitulates key
issues of healthcare waste management confronting Asian developing countries. Regulations, legislation, and policies are found to be
recent, and their implementation varies from one another. Variation in waste generation rate is common. Contradictory methods of
waste measurement used by researchers leave these variations questionable. The absence of waste management training programmes
roots ignorance among staff and handlers, which leads to unsafe waste handling and causes different health risks. Unsafe and illegal
recycling of hazardous waste is a threat to human health, also landfilling is often confused with open dumping, causing environmental
damage. Outdated incineration plants need to be replaced with autoclaving, steam sterilisation, and comparatively reasonable new
practice of pyrolysis to avoid the emission of toxic gases. The significance of proper healthcare waste management cannot be ignored,
especially in Asian developing countries; substantial improvements are required in order to protect the environment and human health
from serious risks.
Keywords
Infectious waste, waste generation, healthcare waste, Asia, developing countries, waste management
Received 1st December 2018, accepted 24th May 2019 by Associate Editor Navia, Rodrigo.
1
School of Economics and Management, Nanjing University of
Science and Technology, Nanjing, China
2
School of Economics and Management, Southeast University,
Nanjing, China
3
Institute of Business Administration, University of Sindh, Jamshoro,
Pakistan
Corresponding author:
Longsheng Cheng, School of Economics and Management, Nanjing
University of Science and Technology, Nanjing, Jiangsu 210094,
China.
Email: cheng_longsheng@163.com
857470WMR 0 0 10.1177/0734242X19857470Waste Management & ResearchKhan et al.
review-article 2019
Mini-Review Article