DOI:http://doi.org/10.65281/703878
Dr. Kholladi Abdelghani
University of El Oued
dr.kholladi84@gmail.com
Received: 11 November 2025/ Accepted: 10 March 2026 / Published online: 19 April 2026
Abstract:
This research paper aims to highlight the problems affecting the environment, as environmental issues and pollution have become topics of major concern for the international community, including academics, media professionals, and human rights activists. Over the past two decades, there has been increasing attention from many societies and countries due to technological advancement, as well as efforts toward scientific and academic consolidation, which led to the emergence of environmental science.
One manifestation of this growing interest is the international focus on environmental pollution in its various forms. The problem of waste has arisen partly from scientific and technological shortcomings on one hand, and from social factors such as population growth—leading to increased quantities of waste—on the other. Moreover, this waste has a significant impact on all parts of the world.
This paper also includes a field study conducted at Ibn Hayyan Clinic in El Oued Province, aiming to identify waste associated with medical activities and to examine the mechanisms and costs of its disposal. The study concluded that there are several methods for waste disposal, each with its own specific characteristics. Furthermore, raising environmental awareness is essential to reduce waste and protect the environment.
Keywords: Medical waste, medical waste management, environmental, health and psychological risks, sustainable development, Ibn Hayyan Clinic.
Introduction:
The issue of medical waste is considered one of the most significant problems facing the world due to its danger to the environment. This has led to increased attention to environmental issues and the search for mechanisms capable of controlling this problem within the framework of sustainable development, especially when there is a lack of skill and efficiency in managing this type of waste.
Algeria, like other countries, has recognized that the problem of medical waste and its relationship with sustainable development is not limited to environmental protection alone, but also extends to considering the economic cost of managing such waste—particularly in light of the development in healthcare services, which ultimately increases the volume of waste generated.
Research Problem:
Based on the above, the main research question can be formulated as:
How does medical waste management contribute to enhancing sustainable development?
Sub-questions:
- What is meant by waste?
- To what extent do healthcare institutions pay attention to medical waste management?
- What are the potential effects of the accumulation of medical waste?
- What are the methods and mechanisms for its disposal?
Importance of the Study:
The importance of this study lies in the following points:
- Establishing the basic concepts of waste, particularly medical waste;
- The significant development in healthcare services and the expansion of medical centers and pharmaceutical factories, making the resulting waste a pressing issue that requires treatment;
- Identifying the effects of medical waste;
- Understanding the current state of medical waste management in healthcare institutions.
Study Axes:
To address the main problem and sub-questions, the researchers divided the paper into the following sections:
- The concept of medical waste;
- Risks resulting from medical waste;
- Common methods for disposing of medical waste;
- The impact of medical waste on sustainable development;
- A field study on medical waste management – Ibn Hayyan Clinic in El Oued.
Previous Studies:
1. Study by Mustafa Zerfaoui & Adam Djedi (2016):
“Medical Waste Management and Assessment of Its Environmental Impacts”
This study aimed to answer the question:
To what extent does the management of medical waste by Algerian healthcare institutions affect environmental protection?
The study used descriptive and analytical survey methods. Key findings include:
- The importance of having an independent law regulating medical waste management concepts within environmental protection and sustainable development frameworks;
- Waste generated by public healthcare institutions (hazardous and non-hazardous) harms the environment, with untreated medical waste posing severe risks to ecosystems;
- Waste sorting is the cornerstone of effective management, though errors sometimes occur due to mixing waste types;
- Lack of proper transport equipment and inadequate storage conditions do not meet international standards;
- High costs of treatment technologies require rational investment decisions;
- Random incineration remains an unacceptable practice with serious environmental and human risks;
- Improper disposal of toxic chemical waste has severe public health consequences;
- Weak governance, lack of training, and low efficiency among staff contribute to unsafe practices;
- Worker negligence and insufficient training increase risks.
2. Study by Rawiya Fajkhi (2016):
“Cost of Managing Medical Activity Waste in Health Institutions – Case Study of Suleiman Amirat Public Hospital”
This study addressed:
What is the impact of medical waste management policies on the budget of health institutions?
Key findings include:
- Environmental protection is a priority for the state;
- Health institutions provide essential medical care and require significant financial resources;
- Medical waste poses serious risks requiring specialized handling methods;
- Lack of waste sorting at the source in many hospital departments;
- Reliance mainly on incineration as the primary disposal method;
- Weak qualifications, low awareness, and negligence among staff;
- Failure to consistently use protective equipment such as gloves, boots, and safety goggles.
3. Study by Filali Mohamed El Amine (2007):
“Sustainable Management of Healthcare Activity Waste – Applied Study at Ibn Badis University Hospital, Constantine”
This study aimed to answer the following question:
What is the appropriate sustainable management approach for healthcare activity waste in accordance with national legal frameworks and international standards, given its accumulated risks and impacts?
The study relied on a descriptive and analytical approach for the theoretical part, and a survey-based method in the applied section through questionnaires distributed to workers at Ibn Badis Hospital. The key findings include:
- Despite the diversity of approaches in defining healthcare waste, the legal framework remains the primary reference for determining responsibilities of healthcare institutions regarding their waste;
- Healthcare waste consists of 70% ordinary waste similar to household waste and 30% hazardous waste; mixing them classifies all as hazardous;
- Chemical and biological pollutants in such waste are major causes of infectious diseases and environmental contamination, mainly due to poor management and lack of expertise;
- The legal system for healthcare waste falls ضمن environmental protection within sustainable development, but still requires stronger regulations and clearer procedures;
- Sustainable waste management is based on global frameworks such as Agenda 21 (1992), Basel Convention guidelines (2002), and WHO standards;
- Effective management relies on preventive strategies, including reducing waste generation, organizing transport, and ensuring safe treatment;
- Waste sorting is the cornerstone of effective management, enabling proper handling, cost control, and recycling opportunities;
- Multiple treatment technologies exist, but pre-treatment equipment is essential to reduce hazardous waste volume and lower costs.
First: The Concept of Medical Waste
1. Definition of Medical Waste
- Linguistically: Anything discarded due to its poor quality;
- Terminologically: A product with no commercial value or with negative value;
- According to the World Health Organization (WHO): All solid waste resulting from diagnosis, treatment, immunization of humans or animals, and research activities involving biological materials;
- According to Algerian law: All residues resulting from production, transformation, or use processes, and generally any substance or object that its holder disposes of, intends to dispose of, or is required to dispose of.
2. Types of Medical Waste
Medical waste is classified into five groups:
- Group A:
- Surgical dressings, contaminated materials;
- Infectious waste;
- Human and animal tissues and laboratory-related materials.
- Group B:
- Syringes, needles;
- Broken glass;
- Other sharp objects.
- Group C:
- Laboratory and autopsy waste not included in Group A.
- Group D:
- Certain pharmaceutical waste (e.g., mercury-containing waste requiring special handling).
- Group E:
- Patient-related disposables such as covers, urine containers, and waste bags.
3. Sources of Medical Waste
Primary sources:
- Hospitals;
- Healthcare institutions (e.g., clinics);
- Laboratories and research centers;
- Autopsy centers and morgues;
- Animal testing facilities;
- Blood banks and collection services.
Secondary sources:
- Small healthcare providers;
- Medical cosmetic centers;
- Funeral service institutions;
- Home healthcare.
4. Characteristics of Medical Waste
Medical waste shares several general characteristics:
- Residual materials: It consists of discarded remains or by-products;
- Solid or liquid: Includes solid items (e.g., needles, surgical tools) and liquids (e.g., blood, medical solutions);
- Treatable: Medical waste, like other types of waste, is characterized by its capacity for treatment, whether through collection, sorting, transformation, recovery (recycling), or even by incineration or landfilling.
Second Axis: Risks Resulting from Medical Waste
The main risks arising from medical waste can be summarized as follows:
1. Health Risks
According to a United Nations report on waste management issues in developing countries:
- Children are more exposed to health hazards due to the accumulation of solid waste in streets, as they frequently play near it;
- The biological, physical, and chemical effects of such waste pose serious health risks to populations;
- There is a strong correlation between infectious diseases and the accumulation of solid waste, with diseases spreading through vectors such as flies and fleas;
- Diseases like typhoid and hepatitis are more prevalent in low socio-economic areas, highlighting the link between disease spread and poor healthcare and living conditions;
- High infant mortality rates are observed in communities of sanitation workers;
- Over 90% of hospital cases in developing countries are linked to microbial transmission via insects and parasites associated with waste;
- Burning waste—whether intentional or spontaneous—causes severe air pollution, leading to respiratory diseases and eye infections.
2. Environmental Risks
- Occupation of large land areas used as dumping sites, limiting their use for agriculture;
- Contamination of groundwater due to seepage from decomposing or fermenting medical waste.
3. Psychological Risks
These risks affect the perceived value of healthcare institutions, both in terms of service quality and societal image. The presence and accumulation of waste reflect poor hygiene standards and deteriorating healthcare services, increasing fear among patients and the community—especially since patients are already vulnerable and more susceptible to infections.
Third Axis: Common Methods of Medical Waste Disposal
1. Medical Waste Management Mechanism
Medical waste management goes through several stages:
a. Collection and Sorting:
- Separation of infectious and hazardous waste from non-hazardous waste using color-coded bags and containers with warning labels;
- Separation of recyclable materials such as paper and plastic;
- Waste should not be transported manually but via carts to prevent tearing and contamination.
b. Storage:
- Waste is placed in large plastic bags and stored in designated areas suitable for the volume produced.
c. Transport and Treatment:
- Waste is transported outside the healthcare facility if no on-site disposal unit is available.
2. Disposal Methods
- Incineration: The most commonly used method, preferably in specialized facilities located away from residential areas;
- Landfilling: Suitable for large quantities but requires strict safety procedures, especially for hazardous waste;
- Encapsulation: Placing waste in sealed containers with stabilizing materials (e.g., sand or foam);
- Inertization (stabilization): Mixing expired pharmaceuticals with cement, lime, and water to neutralize them;
- Other methods: Such as ultraviolet radiation and electrical treatment.
Fourth Axis: Impact of Medical Waste on Sustainable Development
1. Definition of Sustainable Development
- According to the Brundtland Report: development that meets present needs without compromising future generations;
- A process aimed at improving well-being while ensuring ecological balance;
- A comprehensive form of development integrating economic, social, and environmental dimensions;
- According to Algerian law: balancing sustainable economic and social development with environmental protection.
2. Pillars of Sustainable Development
- Environmental pillar: Protect biodiversity and reduce all forms of waste;
- Economic pillar: Efficient resource use and environmentally sound policies;
- Social pillar: Equity, poverty reduction, and preservation of cultural heritage.
These pillars are reflected in Agenda 21, which includes frameworks for managing toxic, hazardous, solid, and radioactive waste.
3. Indicators of Sustainable Development in Medical Waste Management
- Financial resources allocated to waste management;
- Percentage of recycled and reused waste;
- Spending on hazardous waste treatment;
- Volume of radioactive waste produced.
4. Principles of Sustainable Medical Waste Management
- Information principle: Awareness of rights, responsibilities, and environmental impacts;
- Precautionary principle: Preventing risks through environmental impact assessments;
- Polluter pays principle: Polluters bear the cost of environmental damage;
- Action principle: Implementation of local environmental plans;
- Participation principle: Involvement of citizens in environmental initiatives;
- Cooperation principle: Collaboration between communities and institutions to reduce costs and improve outcomes.
Fifth Axis: Field Study on Medical Waste Management – Ibn Hayyan Clinic, El Oued
Ibn Hayyan Clinic is considered one of the largest investments in the healthcare sector at both the national (Algeria) and African levels. It is managed primarily by a medical and administrative staff from El Oued Province. The clinic is equipped with the latest and most advanced international medical technologies and is regarded as one of the leading facilities in North Africa. It includes all medical specialties, advanced imaging technologies, diagnostic equipment, and high-quality laboratory analysis services.
The clinic is staffed by highly qualified doctors and specialists from داخل وخارج الوطن, ensuring high-quality healthcare services for local residents and visitors from across the country. It contains 10 operating rooms covering various surgical specialties, including orthopedics, neurosurgery, and ENT (ear, nose, and throat), with a dedicated floor for surgical operations. Additionally, a separate wing is allocated for comprehensive medical examinations across different specialties.
1. Hospital Services at Ibn Hayyan Clinic
Regarding the management of medical waste at Ibn Hayyan Clinic, its activities revolve around three main functions:
- Healthcare services (general and highly specialized);
- Medical and paramedical training;
- Scientific research.
The clinic is a multidisciplinary medical-surgical facility equipped with modern technologies and collaborates with medical teams from France and Switzerland.
It offers the following services:
- Hospitalization;
- 24/7 emergency services;
- Gynecology and obstetrics;
- Minimally invasive (laparoscopic) general surgery;
- Urology and nephrology surgery;
- Intensive care and rapid emergency response;
- Spinal surgery;
- MRI and CT scan diagnostics;
- ENT surgery;
- Orthopedic surgery and joint replacement;
- Neurosurgery;
- Cardiovascular surgery;
- Pediatric surgery and congenital malformations;
- Medical laboratory analyses.
2. Medical Waste Management at Ibn Hayyan Clinic
The clinic is required to establish a dedicated management system for its medical waste, which involves the following resources:
Human resources:
- General supervisor;
- Team leader;
- 25 workers responsible for cleaning and collecting waste from different departments.
Material resources:
- A truck for waste transport;
- 2 containers designated for medical waste;
- 1 container for household (general) waste.
3. Collection, Sorting, and Disposal Frequency
- Household waste: Black bags (50–75 kg/day), disposed of twice daily in public landfills;
- Sharps waste: Red bags (5–7 kg/day), treated by incineration;
- Infectious waste: Red bags (40–65 kg/day), treated by incineration;
- Toxic (pharmaceutical) waste: Treated by incineration;
- Radioactive waste: (mentioned as a category requiring specific handling).
4. Classification of Medical Waste at the Clinic
(Source: Prepared by the researchers based on statistics from the clinic’s administrative department.)
5. Components of Different Types of Medical Waste
Source: Prepared by the researchers based on statistics from the clinic’s administrative department.
6. Components of Hazardous Medical Waste:
Source: Prepared by the researchers based on statistics from the clinic’s administrative department.
7. Annual Waste Treatment Costs
The costs are as follows:
| Type of Cost | Average Quarterly Cost (3 months) | Average Annual Cost |
| Labor | 115,000 DZD | 460,000 DZD |
| Public landfill | 95,000 DZD | 380,000 DZD |
| Waste bags (various types) | 135,000 DZD | 540,000 DZD |
| Other expenses (trucks, incinerators, etc.) | 157,000 DZD | 628,000 DZD |
| Total annual cost | — | 2,008,000 DZD |
Source: Prepared by the researchers based on statistics from the clinic’s administrative department.
Conclusion
Medical waste management has become a major issue that has seen significant development due to its negative impacts on both human health and the environment. As a result, mechanisms have been developed to ensure the proper treatment of waste without harming environmental and health systems, while also considering the economic aspect through determining disposal costs and, where possible, recycling part of this waste.
Based on this research paper, the following results and recommendations can be outlined:
Results and Recommendations
- Establish a comprehensive national strategy for medical waste disposal;
- Strengthen the role of society and enhance environmental awareness and culture among all individuals;
- Develop an integrated solution for medical waste management involving all stakeholders, especially the Ministry of Health, environmental authorities, civil society organizations, and relevant actors;
- Provide dedicated storage rooms for medical waste in hospitals, aligned with WHO recommendations (capacity for two days of waste), along with training and awareness programs for workers involved in waste collection and transport;
- Seek environmentally and economically sound alternative technologies to incineration, such as autoclave sterilization combined with shredding equipment;
- Ensure the use of personal protective equipment (PPE) for all workers handling medical waste;
- Promote health education to change behaviors and encourage proper practices;
- Enforce strict segregation of medical waste within healthcare institutions;
- Implement training programs on waste collection, sorting, and management;
- Establish a specialized body for medical waste management under healthcare institutions or the Ministry of Environment to ensure monitoring and control;
- Apply pre-treatment methods (e.g., disinfection and sterilization) before disposal, and develop high-tech incineration facilities to reduce environmental pollution.
References and Footnotes:
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- Zoulikifouli Radji, Improving the Logistics of Infectious Healthcare Solid Waste Management, Master’s thesis in Transport Logistics, Republic of Senegal, 2010/2011, p. 14.
- Ndeta Mobimba Nivard, Medical Waste Issues: An Ecological Challenge, Juricongo, No. 04, February 2000, p. 2.
- Article 03 of Law 01-19 dated December 12, 2001 (27 Ramadan 1422), relating to waste management, control, and disposal, Official Gazette No. 77 issued on December 15, 2001 (27 Ramadan 1422).
- Executive Decree No. 03-478 dated December 9, 2003, defining the modalities for managing healthcare activity waste, Official Gazette No. 78 issued on December 14, 2003.
- World Health Organization Report, Safe Management of Wastes from Health-Care Activities, Regional Office for the Eastern Mediterranean, Amman, Jordan, 2006, p. 2.
- Mohamed El-Sayed Arnout, Methods of Utilizing Waste and Solid and Liquid Residues, Arab House Library, Cairo, 2003, p. 27.
- Filali Mohamed El Amine, Sustainable Management of Healthcare Activity Waste – Applied Study at Ibn Badis University Hospital, Constantine, unpublished Master’s thesis, Faculty of Economics and Management Sciences, Mentouri University – Constantine, 2007, p. 24.
- Ibrahim Abdelhamid Al-Ghweil & Abu Bakr Abdelrazak Al-Mujirsi, Solid Waste in Benghazi Hospitals, Third Arab Conference on Environmental Management – Modern Trends in Managing Environmentally Polluting Waste, Egypt, November 23–24, 2004, p. 273.
- Rawiya Fajkhi, Cost of Managing Medical Activity Waste in Health Institutions – Case Study of Suleiman Amirat Public Hospital, Ain M’lila, unpublished Master’s thesis, Faculty of Economics and Management Sciences, Larbi Ben M’hidi University – Oum El Bouaghi, 2016, p. 35.
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- Article 04 of Law 03-10 relating to environmental protection within the framework of sustainable development, dated July 19, 2003, p. 9.
- Laurent Comélian et al., Territorial Approach to Sustainable Development: Guidelines for Local Agenda 21, Groupe Caisse des Dépôts and Ministry of Spatial Planning and Environment, 2005.
- United Nations, Environment and Development – Agenda 21: www.un.org/arabic/conferences/WSSd/agenda21/index.html
- Ismail Mohamed Al-Madani, Integrated and Sustainable Management of Municipal Solid Waste, Arab Cities Journal, Issue 92, 1999, Arab Towns Organization, Kuwait, p. 19.
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