Environmental challenges from the increasing medical waste since SARS outbreak

Medical waste is a special class of hazardous pollutants. Improper treatment would cause secondary environmental pollution, especially when responding to public health emergencies. However, there are relatively few researches on the generation of medical waste, and there is a lack of basic understanding of its spatial-temporal heterogeneity. The outbreak of SARS in 2002 is a turning point in China's medical system reform. We estimated the production of medical waste and pollutants on a provincial scale in China from 2002 to 2018, using the data of medical statistics. Moreover, we forecasted the trend of medical waste in China until 2030, using a combination of environmental pressure model (STIRPAT) and time series model (ARIMA). We found that with the development of China's medical system and economy (such as the increase in personal income and popularization of universal health care), the number of seeking medical treatment rapidly increase led to explosive growth in medical waste (similar to 240%) and pollutants (similar to 260%), and large hospitals are the major sources. By 2030, the production of medical waste would still increase by more than 50% compared with 2018 even there is no the pandemic due to the huge population. The production of medical waste in the eastern region was higher than that in the west under the influence of higher population and GDP, while the per capita medical waste was only affected by household consumption level which had no regional characteristic. Additionally, Hg loads from medical waste are more than twice as high as that from discharged wastewater in some regions, which are facing great control pressures. In the future, when planning for medical waste disposal, policymakers shall increase the disposal facilities based on population and promote mobile treatment equipment to improve efficiency, increase the number of beds in medical institutions rather than building more hospitals, and strengthen basic research on the environmental impact. (C) 2020 Elsevier Ltd. All rights reserved.