GREENS TRUST Environmental Health and Pollution Research 3115-9281 1 1 2026 01 01 Hospital waste management in Isfahan: excessive infectious waste, treatment gaps, and pathways to sustainability post-COVID-19 1 7 233487 10.22034/ehpr.2025.233487 EN Maysam Mohammadi Student Research Committee, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran 0009-0007-4279-2869 Journal Article 2025 10 20 <span style="font-size: 10.0pt; line-height: 107%; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: black; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">Effective hospital waste management is vital for public health and environmental sustainability in growing urban centers like Isfahan, Iran. This study analyzed waste generation, composition, treatment, and disposal barriers across four hospitals (representing ~20% of Isfahan's hospital waste) to identify practical solutions. Using a mixed-methods approach from January to June 2025, quantitative waste audits and qualitative interviews with 20 stakeholders were conducted. Findings revealed an average daily waste generation of 3,232 kg, with 29% infectious waste—exceeding WHO guidelines (15–20%) due to poor segregation. Public hospitals relied heavily on incineration (55–60%), yet only 50% of incinerators had gas-cleaning systems. Private hospitals preferred autoclaving (50–55%) and showed higher compliance with standards (80–85% vs. 65–70%). Key barriers included inadequate segregation (80% of respondents), insufficient infrastructure (65%), and funding shortages (60%). The COVID-19 pandemic exacerbated challenges, increasing landfilling rates 3.6-fold due to PPE waste surges. Recommendations include enhanced staff training, investment in advanced technologies like plasma pyrolysis, and stricter regulatory enforcement. Adopting circular economy principles, such as composting, could reduce landfill reliance, offering a roadmap for Isfahan and similar urban settings.</span> https://www.ehpr.ir/article_233487_3e624a4626e0cd1226f5cecf7c83425d.pdf