Given rising spend on the provision of healthcare services, the sustainable management of waste from healthcare facilities is increasingly becoming a focus as a means of reducing public health risks and financial costs. Using data on per capita healthcare spend at the national level, as well as a case study of a hospital in Italy, this study examined the relationship between trends in waste generation and the associated costs of managing the waste. At the national level, healthcare spend as a percentage of gross domestic product positively correlated with waste arisings. At the site level, waste generation and type were linked to department type and clinical performance, with the top three highest generating departments of hazardous healthcare waste being anaesthetics (5.96 kg day -1 bed -1 ), paediatric and intensive care (3.37 kg day -1 bed -1 ) and gastroenterology-digestive endoscopy (3.09 kg day -1 bed -1 ). Annual overall waste management costs were $US5,079,191, or approximately $US2.36 kg -1 , with the management of the hazardous fraction of the waste being highest at $US3,707,939. In Italy, reduction in both waste arisings and the associated costs could be realised through various means, including improved waste segregation, and linking the TARI tax to waste generation.
Roma communities represent the main involved actors in the informal activities in the Balkan regions, especially because the state does not formally recognize them as formal inhabitants. The Roma community in Zavidovici, despite being resident since the beginning of the 20th century, is still considered a marginalized and vulnerable group. They are actively involved in and dependent on the informal solid waste sector. Waste collection is a 'family business', a kind of self-employment and the main source of income for households. Informal recyclers have a central role in the solid waste management system and they recover a significant amount of materials, especially iron, copper, brass, lead and exhausted batteries. Despite the negative fluctuations of the raw material prices, because of the international economic crisis, informal recyclers remain dependent on the waste recycling sector. They are crucial actors in the value chain of recyclables: though they cannot access the final buyers of recyclables, they provide more than 50% of the market to the middle dealers in the Zenica-Doboj Canton. This research activity consists of a deep socio-economic analysis of the informal recyclers' community living in Zavidovici city. In particular, this paper describes the composition and welfare status of informal recyclers' households, the role of informal recyclers in waste collection, the geographical coverage and the related pattern of waste picking, types, volumes and price fluctuations of recyclable materials, and the middle dealers involved in the informal recycling system.
Purpose The management of public health risks is a key focus for the European Union. One of the key factors that has been shown to pose a public health risk is that of the management of needles from healthcare facilities. The paper aims to discuss this issue. Design/methodology/approach Using audits of two case study hospitals based in northern Italy, this study sought to examine the key factors that resulted in needle stick injuries amongst staff and suggest measures to minimise these risks. Findings The number of needle stick injuries was influenced by various key factors including the time period during the year, the length of time employed, the location within the site, staff category and working hours. Practical implications Suggestions for overcoming the risk factors, including redesigning working patterns, staff training and awareness building, and the use of safety-engineered devices are outlined. Originality/value This study examined the incidence of needle stick injuries amongst healthcare staff in two Italian hospitals, which was lower than in other countries due to various factors, including recapping of needles not being allowed, the introduction of self-retractable needles and awareness campaigns about the correct disposal procedures of potentially infectious waste.
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