91 Medical Waste Management in Turkey Osman Atilla Arikan 1 , Izzet Ozturk 1 , Ibrahim Demir 1 , Kadriye Elif Macin 1 Abstract Medical wastes from health care institutions pose risks for public health therefore proper management of medical waste is very important. The purpose of this study is to present the general situation of medical waste management system in Turkey. In this context, first definition and amount of medical waste are given. Then, medical waste treatment methods are explained. Finally, medical waste management in Turkey is evaluated. The amount of medical waste generated in Turkey is approximately 1.5 kg/bed-day and 80000 tons/year. Considerable amount of medical wastes was disposed to landfills and covered with lime until 2009. Since 2010, sterilized medical wastes were sent to municipal landfills in a separate cell as a general practice. Besides the sterilization of medical wastes, incineration method is also rarely used. Medical waste disposal costs (excluding tax) ranged between 0.5- 0.9 (average 0.7) €/kg for metropolitan municipalities and 0.6-1.1 (average 0.8) €/kg for other municipalities according to 2015 data. It is suggested that reduction of medical waste disposal costs is possible via removal of municipality cuts and decrease the amount of municipal solid waste in medical waste. Keywords: Cost, management, medical waste, sterilization. 1. DEFINITION AND AMOUNT OF MEDICAL WASTE Wastes generated from health care institutions are classified as medical wastes, hazardous wastes, radioactive wastes and domestic (municipal) solid wastes according to ―Regulation on Control of Medical Wastes‖ which was issued in 2005 in Turkey [1]. In this regulation, medical waste is defined as waste generated from health care institutions and has infectious, pathological and sharp characteristics. World Health Organization (WHO) classifies wastes from health care institutions as infectious wastes, pathological wastes, sharps, genotoxic wastes, pharmaceutical wastes, chemicals, wastes containing high amounts of heavy metals, pressurized containers and radioactive wastes [2]. The amount of medical wastes changes according to the intensity of health care, location (rural or urban), type of health care facilities and clinics, the prevalence of single-use products, waste classification policies and regulations, separation and waste reduction practices, the procurement policies and country development [3]. The amount of medical waste in different countries ranges 0.5 to 4.4 kg/bed-day (Table 1) [4], and it increases proportionally with the income level of the country [5]. The amount of medical waste generated in Turkey is approximately 1.5 kg / bed- day [4]. According to the World Health Organization wastes from health institutions consist of 85% domestic waste, 5% chemical and radioactive waste and 10% medical waste (pathological, infectious and sharp waste) [2]. Table 4. Medical waste amounts in different countries [4] Country Medical Waste Amount (kg/bed- day) Nepal 0.5 Iran 1.0 Vietnam 1.4 Turkey 1.5 Serbia 1.9 Pakistan 2.1 United Kingdom 3.3 Kuwait 3.7 Canada 4.1 USA 4.4 2. MEDICAL WASTE TREATMENT/DISPOSAL METHODS In this section, information about the commonly used medical waste treatment/disposal methods such as landfilling, incineration, autoclave sterilization and microwave irradiation are given. 1 Corresponding author: Istanbul Technical University, Department of Environmental Engineering, 34469, Maslak/İstanbul, Turkey. arikan@itu.edu.tr/ ozturkiz@itu.edu.tr /idemir@itu.edu.tr /macinelif@gmail.com