As infection rates from the Covid-19 pandemic begin to decline in some countries, the long-term effects of its impact are now becoming clearer.
In the wake of rising mortality rates, massive blows to the economy and disruptions to our daily routines, the virus has also shed light on the limited capacities of hospitals and has also highlighted the many shortcomings of our healthcare systems.
Covid-19 prompted a significant increase in both the production of personal protective equipment (PPE) and the amount being discarded. Estimates show that globally, we use about 129 billion face masks and 65 billion gloves monthly.
Coronavirus-related litter could be found discarded across urban and coastal settings everywhere. Much of the medical equipment used by hospitals and health clinics is single-use, which burdens disposal sites and storage facilities with empty vials, needles, latex gloves and single-use masks.
Although Covid-19 may eventually dissipate, the plastic waste from protective gear and vaccine equipment will remain much longer, perhaps even forever.
The Covid-19 litter that was once protecting humans from transmitting the diseases now entraps, entangles and endangers wildlife. A marine animal might become entangled, resulting in death from suffocation or drowning.
With the emergence of new Covid-19 variants, medical waste management is likely to continue to play a crucial role in its impact on the environment.
Luckily, an Israeli invention is tackling the surge in increased medical waste.
The Envomed 80 is an on-site machine that reduces medical waste into a safe product that is disposable alongside municipal waste and is environmentally friendly.
Making sense of medical waste
The World Health Organization (WHO) defines medical waste as all forms of waste generated by healthcare facilities; about 20% of it is considered infectious and hazardous.
Hazardous waste can take many forms. Infectious waste is contaminated with bodily fluids whereas pathological waste might contain organs, tissues or body parts. Sharp waste refers to needles, blades and similar equipment. Pharmaceutical waste includes expired or contaminated drugs as well as unused vaccines.
If overlooked or mismanaged, these various forms of medical waste can directly cause infections including HIV and hepatitis A, B and C.
Medical waste disposal is neither cost-effective, nor sustainable. The need to properly transport, store and dispose of medical waste is labor-intensive and expensive.
Compared to most developed countries, Israel is quite behind regarding the collection of household medical waste. More than 85% of publicly accumulated medications disposed of at home are either flushed down the toilet or sink or thrown away in garbage that will eventually be transferred to landfills where the active materials in the medications might leak into the groundwater. Plus, medication residues may contaminate purified wastewater used for agricultural irrigation.
These environmental hazards have dire implications on the health of both humans and animals. With the potential to contaminate water reservoirs and aquifers that provide drinking water, pharmaceutical compounds contaminate all kinds of ecological systems.
Insufficient training, little public awareness, and a lack of effective regulations and legislation are some of the reasons holding Israel back from improving its waste management. With medical waste now on the rise, the need for a comprehensive and effective solution is becoming urgent.
The environmental detriment of improper disposal
Studies show an increase in the quantity of packaging waste by nearly 20% when compared to pre-pandemic levels as a result of widespread lockdowns.
This “at-home” waste of used masks, gloves and protective gear is considered medical waste because it can enable the transmission of bodily fluids and even Covid-19 viral particles via its surfaces.
Given the disproportionate amount of marine pollution from land-based sources, researchers have grown concerned that the additional discarded surgical masks, medical gowns, face shields, safety glasses, protective aprons, sanitizer containers, plastic shoes and gloves arising from the current coronavirus pandemic could end up in our aquatic ecosystems, thereby compounding existing marine pollution.
A safe and sustainable solution
Israeli company Maabarot Metal Works developed the Envomed 80 to come up with a sustainable solution that can sort, segregate and store medical waste.
In under 20 minutes, one Envomed 80 treats up to 250 kilograms (2,220 liters) of waste per nine-hour shift, serving nearly 350 hospital beds.
“We were looking for a field in which there’s a scarcity of technical solutions. We came across infectious or medical waste treatment, and after exploring this market, we identified two problems,” says Envomed CEO David Segev.
“The first one was that there is no on-site treatment; it’s all done off site, which makes no sense. The second thing is that off-site treatment mainly involves incinerators, which is horrible. When we re-explored the market, we found that hospitals don’t process on-site because there’s no adequate alternative.”
The original solutions were mainly heat treatment technologies – autoclaves. The problem is that “infectious waste carries both liquid and solid phases, which autoclaves cannot tackle,” Segev explained.
“The challenge was finding a process that is valid for both solid and liquid waste. Even so, every stream of waste has different materials, so there’s really no way to know exactly what’s going through the machine every time. Also, hospitals are highly regulated institutes that don’t like uncertainty. We needed to design a solution that would have repetitive and valid infectious waste sterilization results for both solids and liquids.”
Shreds and sterilizes
Envomed 80 first shreds the waste, reducing volume up to 80% before fully sterilizing the collected materials to STAATT (State and Territorial Association on Alternate Treatment Technologies) Level IV.
“Our machine uses a strong oxidizer, so the efficiency is high. After the activation stage agitates the shredded waste with the sterilization agent, the outcome yields both solids and liquids. From there we have a liquid and solid separator where the liquid will go directly to the sewage, because at that point it will dissolve into water, oxygen, and acetic acid, so it’s totally eco-friendly. The solid product will later be dried, leaving a confetti-shaped municipal-grade waste product,” says Segev.
During the sterilization step, the materials undergo rigorous agitation using a powerful oxidizer combining peracetic acid and hydrogen peroxide. It can attack all cell components, like proteins and enzymes, to fight bacterial spores.
Leaving zero live pathogens behind, Envomed 80 eliminates the need for off-site management, bringing with it the reassurance of safety and hygiene within healthcare facilities, says Segev.
Envomed has begun pilots in Asia-Pacific and European countries with installations in progress in Israel with Clalit Health Services, one of largest HMOs in Israel.
“We have machines in Soroka Medical Center in Beersheva, and we’re installing more in Beilinson Hospital in Petah Tikva,” says Segev.
“There’s also some installations in Scandinavia. Installing our machinery in these places is relatively easy for us because they’re all fairly sustainable countries so they can appreciate our technology.”
Although current practices and regulations of waste management are suited for off-site solutions, Segev believes Envomed has the potential to pave the way for other initiatives in waste management as installations proliferate.
“If you have good technology, it makes no sense to treat [waste] off-site. It makes more sense to treat it immediately at the place where it was generated.”
One step further
“We’ve seen in Israel that the amount of waste grows tremendously, particularly from Covid-19,” says Segev.
“When you have an on-site instrument, it’s really helpful in avoiding pileups of waste. Especially during the pandemic, there’s no everyday waste pick-up service, so waste pileups become very dangerous. When you have the instrument at the site, you are not beholden to pick-up services, so there’s closure in knowing how the waste is managed.”
However, Envomed 80 alone cannot reverse the damage caused by the Covid-19 pandemic and the medical waste problem it exacerbated.
“We need to take things one step further,” Segev says. “In Israel now, municipal-grade waste ends up in landfills. We are trying to take things one level higher by recycling it. Let’s take the waste product and make something of it.”
Adopting technology like Envomed 80 and incentivizing more eco-friendly energy consumption and waste management is a recipe for a happier, healthier and safer future.
It is crucial that medical waste management be prioritized to avoid the spread of illness, maintain human hygieneand protect all forms of life on our planet, especially during the transition from a global pandemic to a state of normalcy.
Rena Lenchitz writes for ZAVIT – Science and the Environment News Agency