CO2 production in waste management during the COVID pandemic in an Italian hospital

Abstract Background Personal protection equipment (PPE) use in hospitals has consistently increased due to the Sars-Cov-2 outbreak, in wards repurposed for Covid-19 patients and wards that kept their usual activity. This increase influenced an environmental emergency in terms of health waste (HW) disposal. This study aims to assess the economic and environmental impact of the increase in HW generated before and during the pandemic in an Italian Hospital. Methods Data from 2016 to 2019 and 2020 to 2021 was retrieved from Risk Management department. Per capita and per days-of-stay waste quantity were calculated for the hospital inpatient wards and medical service areas (anatomical pathology, laboratories, radiology, nuclear medicine). Linear regression models assessed the epidemiological impact of COVID, and LOESS analysis modeled the relationship between infectious HW generation and the percentage of COVID-related inpatient days. Average weight of HW per patient was used to estimate the monetary value of CO2 produced. Results Preliminary results show that the inpatient days related to COVID nonlinearly influenced the infectious HW generated by wards. PPE usage increased in every context, and the proportion of COVID-related bed-days ranged from 2% to 12% in low-incidence months to 17% to 31% during acute phases. Pre-COVID CO2 production weighted 487 kg per patient and cost 1705€ per-capita, whereas during the pandemic it amounted to 768 kg per patient and cost 2688€ per capita which resulted in a significant increase of 983€ per patient. Conclusions In light of the results, HW disposal is an urgent issue that should be addressed by policy makers when implementing new monitoring systems for hospitals. A more adequate disposal of HW could substantially contribute in reducing air pollution and concurrently reduce the economic impact health systems due to the coronavirus pandemic. Key messages The COVID-19 pandemic has brought an increase in hospital waste generation. The improvement of HW disposal monitoring system should be considered to avoid reaching critical levels in the near future.


Background:
The rise in extreme heat periods is a major public health challenge of climate change and the World Health Organization therefore recommends the implementation of heat health action plans (HHAPs).In Germany, HHAPs are not implemented in a comprehensive manner nor nationwide.Public health authorities have been identified as key actors with regards to heat and health.This study aims at assessing the role of public health services in the implementation of HHAPs in Germany.Methods: First, a review of the scientific and grey literature on the role of public health services in heat adaptation in Europe was conducted.Second, a policy document analysis of the legislation of Germany's federal states for public health services and their potential role in the implementation of HHAPs was carried out.Finally, semi-structured interviews with selected experts from multiple sectors at the local, federal and national level on their perception of the role of public health services in the implementation of HHAPs in Germany were undertaken.

Results:
Preliminary findings show that the legal framework for public health services in the different federal states addresses environmental health and civil protection to varying extents, but that climate change-specific health risks are barely mentioned.The expert interviews revealed perceived barriers for the public health services to implement HHAPs, notably with regards to personnel (e.g.competencies, time), organizational structures (e.g.financial resources, administrative structures, legal mandates) and competing other tasks (e.g.COVID-19 response).Facilitators included motivated individuals, funding opportunities for cross-sectoral collaboration and political support.

Conclusions:
The role of public health services in HHAP implementation in Germany varies widely between the different geographic settings and is influenced by several factors at the individual, organizational and political level.

Key messages:
Public health services can play an important role in heat adaptation, for example through coordinating the implementation of heat health action plans.
Strong legal frameworks, sufficient organizational structures and well-trained personnel are important preconditions for an effective response by public health services to climate change challenges.

Background:
Personal protection equipment (PPE) use in hospitals has consistently increased due to the Sars-Cov-2 outbreak, in wards repurposed for Covid-19 patients and wards that kept their usual activity.This increase influenced an environmental emergency in terms of health waste (HW) disposal.This study aims to assess the economic and environmental impact of the increase in HW generated before and during the pandemic in an Italian Hospital.

Methods:
Data from 2016 to 2019 and 2020 to 2021 was retrieved from Risk Management department.Per capita and per days-of-stay waste quantity were calculated for the hospital inpatient wards and medical service areas (anatomical pathology, laboratories, radiology, nuclear medicine).Linear regression models assessed the epidemiological impact of COVID, and LOESS analysis modeled the relationship between infectious HW generation and the percentage of COVID-related inpatient days.Average weight of HW per patient was used to estimate the monetary value of CO2 produced.

Results:
Preliminary results show that the inpatient days related to COVID nonlinearly influenced the infectious HW generated by wards.PPE usage increased in every context, and the proportion of COVID-related bed-days ranged from 2% to 12% in low-incidence months to 17% to 31% during acute phases.Pre-COVID CO2 production weighted 487 kg per patient and cost 1705E per-capita, whereas during the pandemic it amounted to 768 kg per patient and cost 2688E per capita which resulted in a significant increase of 983E per patient.

Conclusions:
In light of the results, HW disposal is an urgent issue that should be addressed by policy makers when implementing new monitoring systems for hospitals.A more adequate disposal of HW could substantially contribute in reducing air pollution and concurrently reduce the economic impact health systems due to the coronavirus pandemic.

Key messages:
The COVID-19 pandemic has brought an increase in hospital waste generation.
The improvement of HW disposal monitoring system should be considered to avoid reaching critical levels in the near future.
Abstract citation ID: ckac130.072Burned area mapping using satellite data -a tool for monitoring effects on environment

Results:
We provide burned area maps generated with an implementation of BCMA over two sites in Romania: Ostroveni -Dolj county and Domogled -Mehedinti county, based on acquisitions from July 2020.

Conclusions:
This model provides a fast and reliable tool for detection of burned areas regardless of the landscape and vegetation that could help stakeholders to react and make a proper intervention.Our study highlights the meaningful implications of using this tool to track crop fields burning and to organize large scale awareness campaigns around sustainable crop residues management with positive impact on environment, human health, and agriculture.Further government agencies' positions regarding using satellite monitoring of burning vegetables might be crucial.

Key messages:
Satellite imagery is a valuable source of information for environment monitoring.More strategies are need to bring health and environment sustainability to the center of the climate change and to deliver information to the policy makers.
a multi-step algorithm that uses a pretrained Gaussian Naive-Bayes classifier to map burned crop fields, named BCMA (Burned Crop Mapping Algorithm), using Copernicus Sentinel-2 acquisitions.BCMA can be trained and extended to recognize other user-defined burned areas and it can be used to produce burned crop fields maps at a global scale in near-real-time at high resolution.We focused on two restrained geographical areas where burned areas were signalized in local press as massive burning vegetation events.
issue for global climate change mitigation efforts.This practice is linked with air quality impairment, water contamination, soil degradation, fauna destruction.Chronic exposure to a high level of air pollution may cause permanent health injuries such as the development of lung diseases.The intentional burning of crop residues is a well-known practice across Romania even it is restricted by law.Methods:We propose a generic software model capable of detecting burned areas based on a time series of multi-spectral optical images together with Analyzing the relationship between FiS and other determinants of health like CC may be helpful for sustainable solutions in such a world where we are talking on ''our planet, our health'' motto.Example given in this study is the relationship between the country values/rankings of the ''Global Food Security Index (GFSI)'' and the ''Climate Change Performance Index (CCPI)''.GFSI defines the FS situation and CCPI defines countries' response to CC.
Results: Countries' CCPI and GFSI values do not show a linear relationship.For example, Norway, as a country at the top of the Human Development Index (HDI) ranking list has both high CCPI and GFSI values.On the other hand, although USA and Canada have low CCPI, both have good GFSI values.Sub dimensions of the indicators may also vary across countries.15th European Public Health Conference 2022