Issues Regarding the Management of Hazardous Medical Waste During the COVID-19 Crisis in Romania

Abstract

The SARS-CoV2 epidemic’s course in Romania between 2020 and 2021 has exposed numerous flaws and difficulties with the country’s healthcare system. These have negative effects; thus, it’s critical that flaws are identified and fixed in order to build a defence against contagious diseases. This chapter provides a much-needed analysis of Romania’s hazardous medical waste disposal process and makes an educated guess as to how the COVID-19 pandemic may affect the volume generated. The chapter also highlights the capacities for getting rid of dangerous medical waste.

The major goal of this chapter is to determine the amount of hazardous waste produced in Romania, the impact of the COVID-19 epidemic on the production of medical waste and the examination of safe disposal options utilising the current infrastructure. In order to achieve this, the authors developed data sets on the volumes of medical waste produced over time using the information that was available and examined the operational waste disposal facilities.

The forecasts developed in this research took into account that the data were collected in conditions of uncertainty. The severe data deficit and the availability of different data sets, strategies and reports employing computational tools that evolved over time must all be highlighted. As a result, the similarity of the data should be evaluated with caution. Future actions and initiatives to lessen and prevent the harmful effects of the COVID-19 outbreak may be supported by this research.

Annexes

Annex 12.1 Legislation on Medical Waste

National waste legislation

• Law no. 426/2001 on approving Emergency Ordinance no. 78/2000 on the regime of waste

• Government Decision (GD) no. 856/2002 on the keeping of waste management records and approving a list of types of waste, including hazardous waste

• GD no. 349/2005 on the landfill of waste, with subsequent amendments

• GD no. 1862/2005 for the approval of the project ‘Incineration of hazardous waste and medical activity’

• Ordinance no. 18/2005 for the amendment of Law no. 98/1994 on the establishment and sanctioning of contraventions to the legal norms of hygiene and public health

• GD no. 1175/2007 for the approval of the Norms for carrying out the activity of road transport of dangerous goods in Romania

• GD no. 788/2007 on establishing measures for the application of Regulation 1013/2006 on the shipment of waste, as amended and supplemented

• GD no. 1061/2008 on the transport of hazardous and non-hazardous waste on the territory of Romania

• GD no. 870/2013 on the approval of the National Waste Management Strategy 2014–2020

• GD no. 243/2013 on minimum occupational safety and health requirements for the prevention of injuries caused by sharp objects in activities in the hospital and healthcare sectors

Orders of the Minister of Health for the management of medical waste:

• Order of the Minister of Health no. 916/2006 on the approval of Norms for the surveillance, prevention and control of nosocomial infections in health facilities

• Order of the Minister of Health no. 613/2009 on the approval of the Methodology for the evaluation of vehicles used for the transport of hazardous waste resulting from medical activity

• Order of the Minister of Health no. 1226/2012 for the approval of the Technical Norms on the management of waste resulting from medical activities and of the Methodology for data collection for the national database on waste resulting from medical activities

• Order of the Minister of Health no. 1279/2012 on the approval of Criteria for evaluation of the operating conditions and monitoring of the equipment for the treatment of hazardous medical waste by thermal decontamination at low temperatures

Annex 12.2 Main Types of Medical Waste Generated by the COVID-19 Outbreak

Article	Type of waste	Requires safe handling and treatment
Medical masks	Infectious	Yes
Gloves	Infectious	Yes
Medical gowns	Infectious	Yes
Rapid SARS-CoV antigen tests	Non-hazardous	Most of the components are recyclable. In a large number of tests, a very small volume of reagents may require safe handling and disposal
PCR test cartridges	Chemical	Yes (contain guanidine thiocyanate)
Vaccine vials	Non-hazardous	Not
Vaccine needles	Sharp	Yes (the packaging material is recyclable)
Plastic packaging and containers	Non-hazardous	Not

1. Source: UN Environment Programme, 2020