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Many studies have been conducted on hospital solid waste management (HSWM) throughout the world, especially developing countries. This interdisciplinary study aims to summarize the available knowledge on the health and environmental risks of hospital solid waste (HSW) and also, develop a dynamic associational assessment among hospital solid waste generation rate (HSWGR), hospital solid waste composition (HSWC), gross domestic product (GDP) per capita, and environmental performance index (EPI) in some developing countries for the first time. The results of this study showed that researchers from India, China, Pakistan, Brazil, and Iran had found more evidence about the health, economic, and environmental issues in HSW than the other developing countries. The literature showed that the highest and lowest reported HSWGR (in national average level) belonged to Ethiopia (6.03) and India (0.24) kg bed -1 day-1, respectively. It has also been shown that all studied countries except Serbia, have higher levels of hazardous waste in their HSWC, based on the WHO's standard. Furthermore, the quantity and quality of HSW in developing countries depend on the service provided by the hospital, type of hospital, HSWM system, and the level of regional economic and culture. The association analysis showed that the EPI and GDP per capita of developing countries were significantly (p-value <0.05) associated with HSWGR, non-hazardous HSW, and hazardous HSW by the Spearman coefficients equal to 0.389, 0.118, -0.118, and 0.122, 0.216, and -0.346, respectively. However, it can be concluded that GDP per capita and EPI have a weak correlation with hazardous HSW and non-hazardous HSW. Moreover, HSW has many hazardous health and environmental risks such as dioxin and furan, that must be controlled and managed through implementing programs and policies based on sustainable development. As a final point, we believed that the present study can be considered to be a guide for future studies on HSWM in developing countries.

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Household waste has evolved into a core urban challenge, with increased quantities of waste being generated and with more complex material compositions, often containing toxic and hazardous elements. Critical systems theory understands cities as urban metabolisms, with different material and energy flows, highlighting the circularity in production, consumption, and discard. Waste pickers in low- and medium-income countries work on dumps and landfills, sifting through highly contaminated household waste and are exposed to health hazards. This paper discusses the risk factors, hazards, and vulnerabilities waste pickers are exposed to during collection and separation of recyclables, based on the review of literature on waste and environmental health and on findings from participatory research with waste pickers conducted in Brazil. We take a social and environmental justice perspective and identify the vulnerabilities and waste-borne hazards of household waste, associated with these workers, their communities, watersheds, and the environment. Household waste, although not always per se toxic or hazardous, can become a hazard if not collected or inadequately managed. Those communities where household waste is not collected or waste collection is insufficient are the most critical places. Informal and organized waste pickers, municipal or private waste collectors/workers, small waste traders and sometimes residents, particularly small children, may be considered vulnerable if exposed to waste-borne hazards. The results include recommendations to address household waste-borne hazards and vulnerabilities, according to waste workers involved in this research.

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This work introduces the outcomes of the first process for the identification and evaluation of sites potentially contaminated in the Region of the Bio Bio, Chile. The methodology combined qualitative and quantitative elements from Austrian and German risk assessment procedures, calibrated and adapted to the Chilean reality. The developed process consists of collecting historical and current registers on soil use, effects of materials handling on the population's health, and the description of the site conditions. The first analytical step corresponds to an image algebra analysis, through which the most vulnerable areas of the region are established. The sites identified inside the most vulnerable areas are classified into five priority classes, giving an approximate degree of endangerment from these sites. Through the experience, from a total of 507 sites identified as suspicious of contamination, five sites were classified under the highest priority. The results of this analysis have allowed Chilean authorities to focus their resources on the detailed investigations to be carried out in the five priority locations, whilst planning the future strategy to follow for the practical management of all sites found as currently posing a risk to the environment and to the society.

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Household hazardous waste (HHW) generation in two Mexican regions was examined, a northern region (bordering with the USA) and a central region. The aim of this work was to determine the dynamics of solid waste generation and to be able to compare the results of both regions, regarding consumption patterns and solid waste generation rates. In the northern region, household solid waste was analysed quantitatively. In order to perform this analysis, the population was categorized into three socioeconomic strata (lower, middle, upper). Waste characterization revealed the presence of products that give origin to household hazardous waste. In the northern region (Mexicali city), household hazardous waste comprised 3.7% of municipal solid waste, the largest categories in this fraction were home care products (29.2%), cleaning products (19.5%) and batteries and electronic equipment (15.7%). In the central region, HHW comprised 1.03% of municipal solid waste; the main categories in this fraction were represented by cleaning products (39%), self care products (27.3%), and insecticides (14.4%). In Mexicali, the socioeconomic study demonstrated that the production of HHW is independent of the income level. Furthermore, the composition of the solid waste stream in both regions suggested the influence of another set of variables such as local climate, migration patterns and marketing coverage. Further research is needed in order to establish the effect of low quantities of HHW upon the environment and public health.

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En México más del 90 por ciento de los residuos peligrosos que se producen al año se manejan inadecuadamente. Por conseguir, el grueso de los residuos se dispone de manera anómala en el ambiente, contaminando ríos, cañadas, desiertos, etcétera. En el presente trabajo se mencionan los efectos sobre la salud ocasionados por dichos contaminantes, las alternativas tecnológicas para enfrentar ese problema y se hacen propuestas para un programa que trate de manera simultánea el control de los residuos que se están produciendo y el estudio de los sitios que ya han sido contaminados. Este programa debe considerar las limitaciones de los países en desarrollo, entre otras: falta de laboratorios, escasez de recursos humanos y apoyos económicos restringidos. Además, se señala, deberá completar la desnutrición de la población y las enfermedades microbiológicas que aún son un impotante factor de morbilidad en muchas zonas del país. Aunado a lo anterior, es fundamental una mayor participación de la Secretaría de Salud en los temas relacionados con los residuos peligrosos

In Mexico about 90% of the hazardous waste is not treated adequately. Thus, a sizable proportion of the waste is improperly disposed of and released into the environment, polluting rivers, deserts, etcetera. The present article describes the health effects of hazardous waste and the technological alternatives to tackle these problems. In order to assess the risks posed by hazardous waste sites, a new approach, adapted to the health conditions and scarce resources of the country, has to be developed. The health conditions include malnutrition and infectious diseases; the scarcity of resources refers to qualified environmental laboratories, human resources with expertise in environmental sciences, and funding for the evaluation of hazardous waste sites. Furthermore, a more direct participation of the Ministry of Health in issues related to hazardous waste is needed. These elements should be taken into account to create a National Program for the Study of Hazardous Waste in Mexico.

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This paper calls for studies of the potential health implications of today's hazardous waste disposal practices, and suggests that such studies are urgently needed in Third World countries where industrial nations are increasingly dumping their unwanted waste materials. The United States produces enormous quantities of hazardous waste each year, and approximately 1,200 "priority hazardous waste sites" presently threaten the nation's health. Because of environmental regulations, landfill closings, and citizen opposition to local waste facilities, industrialized countries are increasingly disposing of their problematic materials by shipping them to the Third World, where they pose substantial threats to human health and the environment. From a political economy perspective, this paper suggests that global health would be better served by reducing hazardous waste production, encouraging reusing and recycling, and restricting or banning international shipment of toxic wastes.

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