Hospital waste management in Isfahan: excessive infectious waste, treatment gaps, and pathways to sustainability post-COVID-19

Document Type : Original Article

Author
Maysam Mohammadi
Student Research Committee, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
10.22034/ehpr.2025.233487
Abstract
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.

Graphical Abstract

Hospital waste management in Isfahan: excessive infectious waste, treatment gaps, and pathways to sustainability post-COVID-19

Highlights

·       Infectious waste in Isfahan hospitals reaches 29%, exceeding WHO standards by 9–14%.

·       Incineration dominates treatment (47.5%), but 50% lack gas-cleaning, raising emission risks.

·       Public-private gap: private hospitals achieve 80-85% compliance vs. the public's 65-70%.

·       80% of staff cite poor segregation as the top barrier, inflating hazardous waste volume.

·       COVID-19 increased landfilling 3.6x, halting recycling and compounding disposal challenges.

Keywords
Healthcare Waste
Infectious Waste
Sustainability
Waste Segregation
Subjects
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Environmental Health and Pollution Research
Volume 1, Issue 1
Winter 2026
Pages 1-7

  • Receive Date 20 October 2025
  • Revise Date 01 November 2025
  • Accept Date 03 November 2025
  • First Publish Date 03 November 2025
  • Publish Date 01 January 2026