# Life Cycle Assessment of Medical Waste Management: Case Study for Istanbul
## 1 Introduction  
Medical wastes are generated by various healthcare institutions such as hospitals, laboratories, clinics, research centers, and blood banks [1, 2]. Of these wastes, 85% are considered general and non-hazardous. However, the remaining 15% is hazardous to both human health and the environment because it includes infectious agents, sharp objects, heavy metals, pressurized containers, radioactive and pathological materials, and pharmaceutical products [3, 4, 5]. With the global population projected to increase by approximately 2 billion over the next three decades, coupled with enhanced access to healthcare facilities, medical waste production is expected to rise correspondingly [6, 7, 8]. Additionally, the COVID-19 pandemic significantly impacted the volume of medical waste generated. On average, hospitals in developed countries produced 0.5 kg of hazardous waste per hospital per day, while those in developing countries generated about 0.2 kg. However, during thepandemic, this amount surged to as much as 3.4 kg per person per day [5; 8; 9]. Between 2017 and 2022, Turkey experienced steady population growth, rising from 80,810,525 to 85,279,553 individuals. This demographic increase has correlated with a continuous rise in medical waste, escalating from 98,729 tons to 130,401 tons over the same period. Notably, medical waste saw a significant surge during the COVID-19 pandemic, increasing from 109,478 tons to 135,869 tons [10; 11]. The amount of waste produced has significantly increased in recent years due to population growth, increased consumption, and industrialization [12], leading to the implementation of regulations aimed at reducing its detrimental influences on environmental and human health. The Ministry of Environment, Urbanization, and Climate Change is responsible for enforcing regulations related to waste management in Turkiye. Waste management policies and legislation have been developed with consideration of the European Union harmonization process. The Waste Management Legislation encompasses numerous regulations designed to monitor and control different categories of wastes, such as municipal solid waste, medical waste, packaging waste, etc. Furthermore, the National Action Plan for Waste Management 2023 was published in 2016 [13]. According to Environmental Law No. 2872, responsibility for waste management has been assigned to municipalities. In Turkiye, medical waste is regulated under the \"Regulation on the Control of Medical Wastes\", published in Official Gazette No. 29959 on 25 January 2017 [14]. The definition of medical waste in the Medical Waste Control Regulation is \"infectious waste, pathological waste and sharp-edged waste originating from health institutions\". However, in Annex-2 of the same regulation, wastes are divided into four main categories under the title of \"classification of waste originating from health institutions\":  
* Domestic waste: general waste and packaging waste. * Medical waste: infectious waste, pathological waste, and sharp-edged waste. * Hazardous waste. * Radioactive waste. According to this regulation, the waste producer must collect medical, hazardous, non-hazardous, packaging, and municipal waste and other waste separately at the source without mixing them with each other. Several studies on medical waste management worldwide have been published in the available literature. The environmental impact of hospital waste disposal in Arizona was investigated, and waste segregation at the generation point and waste minimization were emphasized [15]. The relationship between the amount of waste generated from hospitals and healthcare institutions and the population was estimated using data from 2000 to 2017 to improve medical waste management in Istanbul [16]. The study recommended waste segregation and minimization strategies as the trend in medical waste generation increases with future population growth. Ref.