Economical Benefits Resulting from Waste Minimization in ... - ijbbb

International Journal of Bioscience, Biochemistry and Bioinformatics, Vol. 2, No. 2, March 2012
Economical Benefits Resulting from Waste Minimization
in Hospitals by Using Different Equipments (Case Study:
Shahid Akbar Abadi Hospital)
Samin Hojati, Zeynab Erfani, Seyed Mostafa Khezri, and Lila Asad Amraji
Abstract—Nowadays, hospital wastes are dangerous for
human health in developing countries. Construction waste is
becoming a serious environmental problem in many large cities
in the world (Chen et al., 2002). Hospital wastes because of its
production nature usually have high potential to damage
environment. Minimization in production process of hospital
wastes can decrease wastes and it has economical profits. Goal
of this study to find methods to minimize the special hospital
wastes, therefore we introduce different part of a pilot hospital
(Akbar Abadi hospital) and checking statics status produce and
segregation stages for special wastes. After doing research,
biochemical laboratory part because of having Sn and Sulphure
compounds in wastes of consumed kit is important part of
hospital for minimize special hospital wastes. By changing
technology and usage of new equipment (Ecom and Auto
analyzer) in biochemical laboratory producing special wastes
caused by using kit like sugar, cholesterol, Triglyceride, Ore,
Uric acid, SGOT-SGPT-ALKP, Calcium and Phosphorus ,can
be minimize equal to 55 and 83 liters wastes in a year, and
economical profits of these equal to 61,259,600 and 41,164,400
Rials in a year. In hormonology laboratory with use of
automatic washer, amount of produce wastes equal to 19,800gr
in year and economical profit of it is equal to 17,786,000 Rials in
year.
Index Terms—Dispelling hospital wastes, minimization of
wastes, spectrophotometer, ecom and auto analyzer.
I INTRODUCTION
Hospital waste are those of wastes that contain hazardous
waste environmental garbage, sharp waste and also wastes
which are produced by disease, or immunization of human or
even animal, or those which achieved during hospital
operations. It is well known that the residual which are
produced by health or medical operations have potentially
higher risk due to being infected and the possibility to create
injury with respect to other types of wastes.
According to research conducted by the World Health
Organization (WHO), between 75 to 95% of produced
residuals in hospital or health units have no risk. These
residuals are produced by administrative and housekeeping
activities, and the remaining 10 to 25% are considered
dangerous which are referred to the industrial byproducts and
Manuscript received February 14, 2012; revised March 16, 2012.
S. Hojati is with the Department of Water Resources, Faculty of
Environment, Science and Research Branch, Islamic Azad University,
Tehran, Iran (phone: +9821 22605849; e-mail: samin6662002@
yahoo.com).
Z. Erfani, S. M. Khezri, and L. A. Amraji are with the Faculty of
Environment, Science and Research Branch, Islamic Azad University,
Tehran, Iran (e-mail: helia.erf2000@yahoo.com, khezri_m@yahoo.com).
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hospital wastes, home, business centers, training centers for
health, safety, human property and environmental risk. They
are wastes including infectious, pathological, sharp,
medicinal, Genotoxic, chemical materials and also containing
heavy and radioactive metals.
Based on the global estimates, it is reported large
quantities for developing countries who have not prepared
their national offers:
80% Health residuals can be considered normal and can be
treated in ordinary manner like city residuals.
15% of pathologic and infectious waste
1% sharp and winning residual
3% chemical or pharmaceutical residual
Less than 1% of wastes such as radioactive or sitostatic and
broken thermometer, etc.
Currently, regarding to the industrial and technological
advances, dangerous infectious wastes can be disposed by
using variety of methods such as incineration, microwave,
chemical, autoclave and healthy disposal which each had
certain disadvantages and need particular conditions.
In 1990, the organization of medical waste management
presented programs in the codification of managing rules and
controlling of medical wastes including separation and
sanitation treatment, packaging and labeling, collection
technology, transportation, treatment and disposal.
The selected method is based on the waste disposal
technology of the country, the climate and consideration of all
conditions for making use of a suitable method with the
highest efficiency and least pollution.
According to the Ministry of Health, it is estimated that a
budget of 720 million IRR is required for proper disposal of
hospital wastes.
Tehran generates daily average of about 75 tons of hospital
wastes which due to having several biological contaminations
and chemical or carcinogen materials have a special
sensitivity. Nevertheless, the Ministry of Health still cannot
make decision on selection of correct waste disposal methods
and also the budget.
The aim of this study is investigation of the economical
efficiency of the minimization of hospital waste production
and knowledge of various sectors and the status of statistical
production and waste separation in Shahid Akbar Abadi
Hospital located in Tehran.
Currently, 2 major processing methods in management of
hospital waste are used, which include: saving method in the
source and burning garbage. Currently, the Ministry of Health
has rejected waste incineration system and has considered
non-fuel system in which the waste is disinfected, the most

International Journal of Bioscience, Biochemistry and Bioinformatics, Vol. 2, No. 2, March 2012
appropriate way.
Basically, the hospital waste should be segregated in the
origin and its hospital infectious part should be sterilized and
then in destination to be burned with incinerators. This is a
process that today is done everywhere.
According to the World Bank 2005, the current production
of hospital wastes in Iran has reciprocal trend with respect to
the estimates of WHO for developing countries. [1] found that
the amount of waste produced in the teaching hospitals of
Tehran University of Medical Sciences is 4.42 kg.bed -1 .day -1 .
In Words, about 75 % of wastes are hazardous and of 25%
are normal. Based on the same report, it is unlikely that
instruction of segregation and separation in the origin has
enough efficiency. Another important point is that the
production of hospital waste in Tehran is estimated about 2 to
3 times higher than other developing countries located in
Middle East and Africa. Per active hospital bed a figure
around 2.5 to 3 kg of waste per day is produced. While in
other cities such as Cairo and Beirut, it is about 1.1 to 1.3 Kg.
Similar study done by the [2], [3] and (Birpinar, 2008) [4]
have found that the produced average hospital waste has been
about 0.83, 0.61 and 0.63 kg per day of each active hospital
beds. The results of these studies compared with WHO, 1999
in production of hospital waste was lower than what expected.
In countries of the Mediterranean region average hospital
waste is (1.3-3 kg.bed -1 .day -1 ), for Central Asia is (1.8-2.2
kg.bed -1 .day -1 ), and for Latin America is 3 kg.bed -1 .day -1 .
(Franka, 2006) [5] has found that the total major waste
produced by the health in Libya is 47.0 kg.bed -1 .day -1 . In
addition, the waste produced by health guards at a hospital in
Bangladesh has been 1.28 and 1.9 2 kg.bed -1 .day -1 [6].
According to the “Assessment of macro economic Plan in
reorganization of hospital waste,” related to the ministry of
health in April 2004, there are about 138 hospitals in Tehran
province which 58 of them are affiliated to the ministry of
health. And there are 28,842 and 15,174 of fixed beds and
22,053 and 10,640 of active beds in them respectively.
Economic and environmental resources resulting from
waste minimization and recycling are great [7], since this
benefit appears to every 2 parts of the environmental and the
structural organization.
The significance of this study is to address a point that has
not already considered; the economic aspects and making
profit and calculating values of decreased hospital costs and
comparing different modes of utilizing different devices and
its impact on reducing current hospital costs and the more
profitability. This can be an incentive tool for managers and
officials, heads of hospitals and organizations and encourage
them to use advanced equipment and devices.
Now we want to know economically, for example in a
laboratory of this hospital such as bio-chemistry laboratory, if
waste minimization measures are handled, how much this
causes to save costs and provides benefits for the mentioned
hospital?
105
A. Review Stage
II MATERIAL AND METHODS
This research has been conducted in “Shahid Akbar Abadi”
hospital and maternity located southwest of Tehran in the
summer of 2004. Hospital is belonged to the government and
it is first class. Number of approved hospital beds are 320,
which currently has 213 active beds. Hospital building has 4
floors and consists of 7 sections. The number of employees is
equal to 260.
Data collection of hospital waste has been done by frequent
field visits and taking list of materials from the drug store
located in the hospital which will be distributed to all sectors
and it is based on the random removal of wastes and their
separations and also interview with the hospital staffs in
different sectors.
The average daily hospital waste outlet in “Shahid Akbar
Abadi” is 603 Kg which 315 Kg of them are infectious,
hazardous and sharp wastes and 288 Kg are the regular home
residuals. Amount of weight and volume and density of the
produced wastes in this study are approximately 220.09 tons,
5.15 m 3 /day and 130 kg/m 3 respectively. 52% of the produced
wastes are infectious and 48% are common and home
residuals.
In addition, according to the classification done by (WHO,
1983) it was found that 61.1% of wastes are household and
38.9% are hazardous. (Hassan, 2008) [8] showed that the
amount of household wastes in Bangladesh is 77.4% and
other 22.6% are hazardous wastes.
Infectious wastes are: operating room wastes, delivery
room, treatment, ICU part, NICU part, the dressing room,
pathology department, laboratory, isolation room, expired
drug, textiles and clothing contaminated with blood, gas and
cotton used for dressing, laboratory samples and related
culture environment, plastic materials including nylon, gloves,
urine bag, Infusion Set, sickroom parts, needles and razor.
Plastic wastes makes up 19% of hospital wastes and this
high unexpected percentage is due to the overuse of
non-recyclable trash instead of recycling and reusing for
different purposes [9], [10]. These results are contrary to
findings of F. Abdulla, H. Abu Qdais, A. Rabi. (Dehghani,
2008) reported in Iran hospitals that the plastic contents are
24%, 27%, 29% respectively. Glass makes up over 18.7% of
hospital wastes which is due to the high number of serum and
empty vial. Plastic wastes have the highest percent of 2.5%
which are observed in hospitals with dialysis services;
including rubber filters, rubber tubing and rubber gloves.
Normal office wastes are including official and financial
parts and also kitchen. In 46% of Iran’s hospitals, hospital
wastes are transferred to the temporary stations manually.
III RESULTS
A. Ordinary Waste Minimization Practices in the “Shahid
Akbar Abadi” Hospital
1) Radiology Section
In Radiology Sectors, Radiology films due to having silver
are separated and sold separately. Additional fixation solution
also is not discarded and will be sold. These section’s wastes

are chemical wastes and they are in the group of infectious
wastes. Their approximated weights appear 2 Kg daily.
2) Food Wastes
Bread is removed from the food wastes and sold separately.
3 Kg of common wastes per day are including bread. Totally,
5 Kg of wastes has been reduced daily in the “Shahid Akbar
Abadi” hospital.
B. Wastes Minimization in the “Shahid Akbar Abadi”
Hospital
1) Plastics Waste, paper and paperboard, glass, metal,
cotton
The approximated weight of these wastes comprises about
156 Kg every day. This group can be sold. The proper
separation in the origin in addition to reducing wastes and
increasing environmental beneficial effects have economic
exploitation. This work takes place in the semi-functional.
These materials are sent to landfill due to lack of proper
separation from the remaining wastes.
2) Minimization measures in the laboratory
Using Device called the Auto analyzer and auto metal
system instead of manual methods in bio-chemistry and
hematology laboratories reduces consumption of laboratory
kits and also the number of cleaning pipes and increases water
savings. Totally, the benefits of this machine in minimization
are the following:
Reduce the purchase of materials and laboratory kits
Full use of older material and kit
Type of
Machine
International Journal of Bioscience, Biochemistry and Bioinformatics, Vol. 2, No. 2, March 2012
Machine
Regular control on drug use and laboratory kits before
reaching their expirations
Full use of all materials in kits containing materials and
laboratory glass
3) Drug minimization measures
In this section by regular inspecting on medicines and also
checking their expiration dates, we can significantly decrease
the production of this type of wastes.
C. Minimization Measures in the Bio-Chemistry
Laboratory
If you use an Ecom machine instead of Spectrophotometer,
the average consumption of solution and kits reduces to half.
Due to the availability of cyanide and sulfur compounds in
solution and kits and also entering of these wastes directly
into urban sewage, minimization of consumption in this
section is very important.
Auto analyzer machine is new and modern system. By
using this machine, the consumption of materials and
laboratory kits reduces to half of what it is for Ecom machine.
Other advantages of this device is to reduce personnel
required for the lab work which in turn reduces the risk of
personnel’s contacting with cyanide and sulfur material and
their related illnesses. Also, answer to the testing sample for
Ecom device is equal to 4 or 5 days. By using the auto
analyzer system this time is reduced to 1 day as in table 1, 2.
TABLE I: COST OF KITS CONSUMPTION FOR SPECTROPHOTOMETER, ECOM AND AUTO ANALYZER
Quantit
y
Daily
Tests
Volume
(cc)
Consume
d Kits
Spectrophotometer 153 306
Ecom 153 153
Auto Analyzer 153 76.5
Cost of
Purchasing
(IRR)
Cost
(IRR)
Each
Kits
1484
0
1484
0
1484
0
Cost
(IRR)
Consume
d
Daily Kits
Volume
(cc)
Consume
d Monthly
Kits
Cost
(IRR)
Consume
d Monthly
Kits
Volume
(cc)
Consume
d
Annually
Kits
411720 9180 12351600 110160
Cost (IRR)
Consumed
Annually
Kits
14821920
0
205860 4590 6175800 55080 74109600
102930 2295 3087009 27540 37054800
TABLE II: CURRENT COST OF SPECTROPHOTOMETER, ECOM AND AUTO ANALYZER
Cost of
Depreciation
(IRR)
Cost of
Maintenance
(IRR)
Annual Cost of
Wages (IRR)
Cost of Consumed
Annually Kits (IRR)
Cumulative
Cost (IRR)
Spectrophotometer 20000000 4000000 2000000 48000000 148219200 222219200
Ecom 35000000 35000000 350000 48000000 74109600 160959600
Auto Analyzer 10000000 10000000 10000000 24000000 37054800 181054800
Fig. 1. Consumed volume – each machine
106
Fig. 2. Cost of using spectrophotometer, ecom and auto analyzer machines in
bio-chemistry lab.

Fig. 3. The cumulative costs of using different machines in the bio-chemistry
lab
D. Hormone Minimization Measures in the Biology
Laboratory
In Hormone Laboratory Studies, average of 55 tests in day
is performed. For each test a vial of volume of 5 cc of distilled
water is consumed. The average annual amount of distilled
water in the laboratory is 100,375 cc. Boxes containing vial of
distilled water are in fifty and price of 30,000 IRR 1 , so the
cost of annually consumed distilled water is equal to
10,245,000 IRR. Now for operators and identifying
operations, ten employees in this laboratory are used which
their average wages in the year are 48,000,000 IRR. Costs of
the current system equals to 60,045,000 IRR per year also,
vial containing distilled water are made from plastic and each
weight is equal to 1 gr. Thus, the amount of waste produced
annually is equal to 19,800 gr. By using automatic washing
machines which costs approximately 15,000,000 IRR one can
use gallons of distilled water instead of vials of distilled water.
Volume of each gallon equals to 5,000 cc and its cost is equal
to 30,000 IRR as in table 3 and figure 4.
TABLE III: COST OF CONSUMED DISTILLED WATER, DAILY, MONTHLY AND
ANNUALLY IN USING THE AUTOMATIC WASHING SYSTEMS IN THE HORMONE
LABORATORY STUDIES IN SHAHID AKBAR ABADI HOSPITAL
Cost of Each cc of
Distilled Water
(IRR)
Cost of Daily
Consumed
Distilled Water
(IRR)
Cost of Monthly
Consumed
Distilled Water
(IRR)
Cost of Annually
Consumed
Distilled Water
(IRR)
6 1,650 49,500 594,000
Fig. 4. The curve for cost of consumed distilled water in the hormone
laboratory studies
By using automatic washing machine, we can use one staff.
1 Iranian Rial
International Journal of Bioscience, Biochemistry and Bioinformatics, Vol. 2, No. 2, March 2012
107
Useful lifetime of the device equals to 15 years and the ratio
of depreciation expense is equal to 10% as in figure 5.
Cost of
Purchasing
Distilled
Water
(IRR)
TABLE IV: COST OF USING AUTOMATIC WASHING MACHINE
Cost of
Purchasing
Machine
(IRR)
Cost of
Annually
Depreciation
(IRR)
Cost of
maintenance
(IRR)
Cost of
Wage
(IRR)
Cumulative
Costs
(IRR)
594,000 15,000,000 1,000,000 1,500,000 24,000,000 42,094,000
Fig. 5. The curve of cost related to using automatic washing machine
Considering the difference in cost calculations and change
of IT systems in Hormone Laboratory Studies, by using
Automatic washing system in addition to minimization of
plastic wastes, it causes economic benefits as well.
IV CONCLUSION AND DISCUSSION
1) Spectrophotometer is used in bio-chemistry laboratory
for diagnostic testing of kits, which due to being old
device, its intake kits and special wastes due to
consumption of fine kits, in day, month and year is equal
to 306 cc, 91,189 cc, and 111,690 cc respectively.
2) In the case of using the device called Ecom in the
bio-chemistry Laboratory, amount of waste from small
consumable kits in day, month and year is 153 cc 4,590
cc 55,080cc respectively.
3) Auto analyzer as a new device available for analysis in
bio-chemistry laboratories, reaches the amount of waste
from small consumable kits on the day, month and year
to 76.5cc, 2,295 cc and 27,540 cc respectively.
4) Using the Ecom device instead of Spectrophotometer
device in bio-chemistry Laboratory reduces the special
wastes production or consumption of kits in 55,845 cc.
5) Using the Auto analyzer device instead of
Spectrophotometer device in bio-chemistry laboratory
reduces the special wastes production or consumption of
kits in 82,640 cc.
6) Total current annual cost of the Spectrophotometer,
Ecom and Auto analyzer is equal to 222,219,200 ,
160,959,600 and 181,054,800 IRR respectively.
7) Cost of special waste reduction from consumable kits by
application of Ecom and Auto analyzer devices in the
bio-chemistry laboratory is equal to 61,259,600 and
41,164,400 IRR respectively.
8) Using Ecom and Auto analyzer device causes 27% and

International Journal of Bioscience, Biochemistry and Bioinformatics, Vol. 2, No. 2, March 2012
19% annual benefit to the current situation respectively.
9) Total cost of operations in the current system of hormone
laboratory studies is 59,880,000 IRR. By using the
technology of automatic washer, these costs reduced to
42,094,000 IRR which is equivalent to 17,786,000 IRR
of cost reduction in consumption of distilled water and
the cost of personnel.
10) Using the automatic washer in Hormone Laboratory
Studies causes minimization of 19,800 gr in plastic
wastes production.
According to the calculations in Table 1, volume of the
residual resulting from the use of laboratory kits by
Spectrophotometer equals to 111,690 cc which is equivalent
to 111.69 lit/year. By using the Ecom device instead of
Spectrophotometer amount of waste reduction is equal to
55,845 cc (55.84 liters per year) and by using the auto
analyzer device instead of Spectrophotometer amount of
waste reduction is equal to 83,767.5 cc (83.76 liters per year).
The cost reduction resulting from the using of Ecom device
instead of Spectrophotometer in kits consumption is
75,423,600 IRR and using the auto analyzer device instead of
Spectrophotometer is 1,044,787,850 IRR in year.
In the next stage, for the current estimation of the cost of
these three devices, including initial cost of purchasing of the
device, the annual depreciation expense, maintenance costs
annually, the annual cost of staff, salary costs, cost of
consumables kits annually we use the below method:
Using the Spectrophotometer and Ecom machines require
hiring 2 people master in Laboratory and average wage of
20,000,000 IRR per month per person, whereas by using the
auto analyzer device one staff can perform the diagnosis and
operator work.
Also the useful lifetime of Spectrophotometer, Ecom and
auto analyzer is 5, 10 and 10 years respectively and annual
depreciation coefficient is 10%.
According to the results, the amount of total annually
profit, including costs of kits consuming and payroll of
personnel by using Ecom compared to Spectrophotometer
equals to 62,004,200 IRR in the year and the auto analyzer
compared to Spectrophotometer device equals to 42,708,350
IRR per year. Totally by using Ecom and auto analyzer in bio-
Chemistry laboratory 27% and 19% of total annual costs
reduces respectively, and causes economic benefit with a
reduction in special waste laboratory.
V SUGGESTIONS
If we don’t apply management and expertise in hospital
waste problem, by increasing volume of hospital waste at the
country level, raising the specific infectious disease
transmission and also serious dangers for environment,
especially large cities such as Tehran faces serious problems.
These problems threaten the health of the individual and
society and also will waste a significant part of the national
properties.
The following solutions to remove obstacles to make
progress in hospital waste management are recommended:
1) More accurate monitoring and controlling of hospital
waste separation process by the ministry of health and
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medical education and environmental protection agency.
2) Materials management in a way that the 3 primary criteria
of using less, reusing and recycling to be considered.
3) Review reasonably related laws to facilitate the process
of reducing the danger of hospital waste and removing
their problems.
4) Review the laws in the process of the hospital waste
separation at source and related definitions to prevent
from confusion of officials responsible for hospital waste
separation.
5) Participation of private sector’s specialists in the process
of hospital waste management.
6) Domestic and foreign investment to import modern
technology in the country by public and private sector.
7) Meetings with managers and officials for a closer
relationship and familiarity with available scientific and
practical solutions.
8) Helping of the University to improve the implementation
of the plans and suggests new scientific
recommendations.
9) Advertising extensively by the public media for more
awareness of the public.
10) Using new technology capable of reducing waste in
different parts of the hospital, especially areas with
potential of production of hazardous wastes.
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Samin Hojati born in Tehran, Iran, 1987. Ph.D.
Candidate of Environmental Engineering. M.Sc.
Environmental Engineering, Department of Water
Resources, Faculty of Environment, Science and
Research Branch, Islamic Azad University, Tehran,
Iran, 2012. B.Sc. Water Engineering, Tehran
University, Tehran, Iran, 2009. She works in Abangan
Sanat Co. an EPC contractor in the field of water and
wastewater treatment plant from 2009 up to know.
Previous Author’s publications formal included: Economical Benefit Resulting From Waste
Minimization in Hospitals (Case Study: Shahid Akbar Abadi Hospital), 3 rd
photo
International Conference on Chemical, Biological and Environmental
Engineering (ICBEE 2011). Usage of Wireless Communication Technology
in Engineering and Management, International Conference on Network and
Computer Science (ICNCS 2012).
Uses compounds containing waste rubber powder and polypropylene
fibers and vegetable fibers to repair oil and fuel stains (Oil Spill), The 4 th
Conference and Exhibition on Environmental Engineering (2010). Research
interests are in Water Treatment, Sanitary & Industrial Wastewater
Treatment, Pump stations, Sludge Reuse, Water Reuse, Water & Wastewater
Minimization Management Systems, and Environmental Management
Systems.
109
Zeynab Erfani born in Tehran, Iran, 1981. M.Sc.
Environmental Engineering, Islamic Azad University,
Tehran, Iran, 2011. B.Sc. Environmental Health,
Azad University, Tehran, Iran, 2007. She works in
Iranian Oil Terminals Company, Kharg Island,
General Operation, Municipal Waste Recycling and
Processing Centre from 2011. Previous publications
included: Economical Benefit Resulting From Waste
Minimization in Hospitals (Case Study: Shahid Akbar
Abadi Hospital), 3 rd International Conference on Chemical, Biological and
Environmental Engineering (ICBEE 2011). Waste Minimization in
Hospitals (Case Study: Shahid Akbar Abadi Hospital), International
Conference on Environment and BioScience (ICEBS 2011). Evaluation of
Odor Emissions (By Software OdorSim in Water), The 4 th Conference and
Exhibition on Environmental Engineering (2010).
Seyed Mostafa Khezri Assistant Professor Ph.D.
Environmental Engineering, Tarbiat Modares
University, Tehran, Iran, 1997. M. Sc. Environmental
Engineering, Sharif University of Technology, Tehran,
Iran, 1992. B.Sc. Mechanical Engineering, Sharif
University of Technology, Tehran, Iran, 1978.
Department of Environmental Engineering, Graduate
school of Environment and Energy, Science and
Research Branch, Islamic Azad University, Tehran,
Iran. Teaching interests; Water Resources Engineering, Water and
Wastewater Treatment, Water and Wastewater Management, Fluid
Mechanic and Thermodynamic, Environmental Management Systems.
Research interests; Sludge Reuse, Water Reuse, Industrial Wastewater
Treatment, Water & Wastewater Minimization Management Systems.
Membership in Scientific Associations; Iranian Society of
Environmentalists (IRSEN), Sweden Borg Scientific Association, American
Water Resource Association, Australian Water Association.