Wastes generated in healthcare facilities have been discussed and the World Health Organization has proposed a guideline for controlling the spread of the virus that causes Coronavirus Disease 2019 (COVID-19). However, waste management outside the generating facility should be discussed in more detail, taking into account factors such as virus resistance, differences in waste management systems and the climatic conditions in each affected region. Patients infected by human coronavirus being treated at home are generating infected waste possibly discarded as domestic waste, which can pose risks to workers and the environment, depending on the conditions of transport and disposal. In particular, the spread of the coronavirus may be increased by inadequate waste management, highlighting poor handling conditions associated with inappropriate use of personal protective equipment and other unfavourable conditions presented mainly in developing countries.

Infection with the hepatitis B and C viruses may occur through parenteral contact associated with infected body fluids, including injury with infected sharps. Collectors of domestic or healthcare wastes are potentially exposed to these infections. The aim of this paper is to investigate the risk factors associated with the prevalence of hepatitis B and C (HBV and HCV) infection of domestic and healthcare waste workers in Belo Horizonte, Brazil. A cross-sectional study of hepatitis B and C infection was conducted from November 2014 to January 2015, through blood sample collection and interviews about socio-demographic factors with 61 workers exposed to healthcare waste ("exposed") and 461 exposed only to domestic wastes ("unexposed"). The prevalence of Anti-HCV antibodies was 3.3% in "exposed" workers and 0.9% in "unexposed", and of AntiHBc was 9.8% and 5.6% in "exposed" and "unexposed" workers, respectively. Only 207 (44.9%) of those exposed to domestic waste and 45 (73.8%) of those handling healthcare waste were higher among healthcare waste workers compared to domestic waste workers, probably because of needlestick accidents due to deficient sharps management systems. Immunization against hepatitis B and screening test to ensure the success of vaccination should be a condition for recruitment for both groups of waste workers.

Hepatitis delta virus (HDV) has been associated with acute or chronic hepatitis in Latin America, but there is no prevalence study covering South American countries. This meta-analysis aimed to estimate anti-HDV prevalence through a systematic review of published articles in English, Portuguese and Spanish until December 2017. Searches were conducted in Health Virtual Library, Capes, Lilacs, PubMed, and SciELO, according to defined criteria regarding participant selection and geographical setting. Study quality was assessed using the GRADE guidelines. Pooled anti-HDV prevalence was calculated using the DerSimonian-Laird random-effects model with Freeman-Tukey double arcsine transformation. Out of the 405 identified articles, only 31 met the eligibility criteria for inclusion in the meta-analysis. In South America, pooled anti-HDV prevalence among hepatitis B virus carriers was 22.37% (95% confidence interval: 13.72-32.26), though it appeared less frequently in some countries and populations, according to the data collection date. The findings indicated significant successive reductions in anti-HDV prevalence over thirty years. However, there was a scarcity of HDV epidemiological studies outside the Amazon Basin, notably in the Southwest continent and absence of target population standardization. There was a high HDV prevalence in South American countries, despite differences in methodological characteristics and outcomes, highlighting a drastic decline in the last decades. Future studies should identify HDV prevalence estimates in other regions of the continent and identify risk factors.

Objetivo. Verificar a existência de associação de indicadores de gestão de resíduos sólidos e socioeconômicos municipais com índices de incidência de dengue, Zika e Chikungunya nos municípios do estado brasileiro de Minas Gerais. Métodos. Este estudo de caráter exploratório, quantitativo e transversal abrangeu os 853 municípios do estado de Minas Gerais. Todos os dados utilizados foram secundários, coletados e agrupados por regionais de planejamento. Como variáveis independentes, foram consideradas a cobertura de coleta de resíduos sólidos urbanos, cobertura de coleta seletiva e massa de resíduos sólidos urbanos, além de um indicador da qualidade da destinação final de resídulos, índices de desenvolvimento humano municipal e de Gini, renda mensal per capita e porcentagem de vulneráveis à pobreza. Os fatores potencialmente associados aos desfechos – incidências municipais de dengue, Chikungunya e Zika – foram selecionados inicialmente através de análises univariadas. Posteriormente, os modelos de regressão linear para as incidências de dengue, Chikungunya ou Zika foram gerados considerando os preditores selecionados pela análise univariada. Resultados. Não foi observada associação entre gestão de resíduos sólidos e incidência de Chikungunya e Zika. Por sua vez, a incidência de dengue associou-se à gestão de resíduos sólidos e apresentou relação inversa significativa com o percentual de vulneráveis à pobreza. Houve também associação direta o índice de Gini, sugerindo que quanto maiores os registros de incidência de dengue de 2007 a 2016, maiores os valores de Gini dos municípios – ou seja, maior a desigualdade social. A cobertura da coleta seletiva apresentou relação inversa e significativa com os casos de dengue, sugerindo que quanto menor a cobertura da coleta de seletiva, maiores foram os casos registrados de dengue. Conclusões. A gestão de resíduos sólidos pode influenciar os casos de dengue e, por isso, deve ser considerada nas ações de saúde pública.

Healthcare waste (HCW) management is a challenge for establishments that generate this type of waste, especially hospitals, as they are one of the largest generators. A determining factor in waste management is the amount of waste generation, which must be used for management planning. This study aims to compile and evaluate information on the management of HCW generated in Belo Horizonte’s (located in Brazil) hospitals declared in their respective Healthcare Waste Management Plans (HCWMP) sent for approval by the municipality’s Superintendency of Urban Cleaning. Therefore, a comparative analysis of the hospitals’ generations in relation to their characteristics (nature, specialty, and size) was carried out, using the Kruskal–Wallis statistical test with post hoc in Nemenyi. For the study hospitals, a generation rate of 7.18 (6.17–8.23) kg·bed −1 ·day −1 was estimated, a generation rate close to that of developed countries. When comparing the generation according to the specialty of the hospitals, it was identified that the maternity hospitals (9.00 (7.05–10.90)) kg·bed −1 ·day −1 had a significantly higher generation rate than the low-complexity hospitals (4.75 (3.28–6.18)) kg·bed −1 ·day −1 . It was also possible to demonstrate that the specialty and size of hospitals influence the structure available for waste storage. Finally, it can be observed that there are few treatment alternatives, with incineration and autoclaving being the technologies most commonly used by hospitals. It is expected that the results presented can serve as a reference for waste managers, in a context where there is little shared information on the subject.

Hepatitis B and C in household and health services solid waste workersHepatite B e C em profissionais que coletam resíduos de serviço de saúde e domiciliares Hepatitis B y C en los trabajadores responsables de la recolección de residuos sólidos domiciliarios y de servicios de salud

Some healthcare waste presents hazardousness characteristics and requires specific procedures to ensure the safety management. Waste segregation is an important action to control the risks of each type of waste. Healthcare waste indicators also may improve the waste management system. The aim of this article was to evaluate the healthcare waste management in a Brazilian university hospital, as well as the waste indicators, quantifying and qualifying the waste generation. Weighing of wastes occurred by sampling occurred sampling of seven consecutive days or daily, between 2011 and 2017. General wastes represent more than 55.6% of the total generated, followed by infectious, sharps and chemicals wastes, respectively, 39.1%, 2.9% and 2.4%. The generation rate in 2017 was 4.09 kg bed−1 day−1, including all types of wastes. Non-dangerous wastes represented around 93.3%, including infectious wastes with low potential risks, while dangerous was represented by high infectious risk (1.4%), chemicals (2.4%) and sharps (2.9%). Healthcare waste indicators may favour the risk identification and improve the waste management system, in particular when involving hazardous wastes. Failures in healthcare waste segregation could represent, in addition to the health risks, unnecessary expenses.

As more urban solid waste is generated, managing it becomes ever more challenging and the potential impacts on the environment and human health also become greater. Handling waste - including collection, treatment and final disposal - entails risks of work accidents. This article assesses the perception of waste management workers regarding work-related accidents in domestic and health service contexts in Belo Horizonte, Brazil. These perceptions are compared with national data from the Ministry of Social Security on accidents involving workers in solid waste management. A high proportion of accidents involves cuts and puncture injuries; 53.9% among workers exposed to domestic waste and 75% among those exposed to health service waste. Muscular lesions and fractures accounted for 25.7% and 12.5% of accidents, respectively. Data from the Ministry of Social Security diverge from the local survey results, presumably owing to under-reporting, which is frequent in this sector. Greater commitment is needed from managers and supervisory entities to ensure that effective measures are taken to protect workers' health and quality of life. Moreover, workers should defend their right to demand an accurate registry of accidents to complement monitoring performed by health professionals trained in risk identification. This would contribute to the improved recovery of injured workers and would require managers in waste management to prepare effective preventive action.