## 2 Materials and Methods
### Collection and Transportation of Biomedical Waste  
The biomedical waste management system implemented in Kocaeli city includes the disposal of all biomedical wastes originating from all public hospitals, private hospitals, dialysis centers, family health centers, laboratories and district municipalities within the borders of the municipality. Biomedical wastes, excluding pathological and hazardous wastes, generated in the boundaries of Kocaeli city and district municipalities are collected and sterilized at the biomedical waste sterilization facility within the scope of national biomedical waste regulation and then disposed in the solid waste landfill. Biomedical waste amounts from the public hospitals, private hospitals, dialysis centers, family health centers and laboratories in the study area are given in Table 1.  
\begin{table}
\begin{tabular}{l c c c} \hline \hline \multirow{2}{*}{**Health Centers**} & \multirow{2}{*}{**Number of Beds**} & \
\begin{tabular}{c} **Biomedical Waste** \\ **Amount (kg)** \\ \end{tabular} &
\begin{tabular}{c} **Biomedical Waste Per** \\ **Bed (kg/bed.year)** \\ \end{tabular} \\ \hline Gebze Faith & 326 & 112,777 & 1.033 \\ Danca Farabi & 350 & 130,433 & 1.039 \\ Kocaeli Public & 335 & 137,765 & 1.119 \\ Lmit Seka & 305 & 99,950 & 1.235 \\ Golcuk Necati Celik & 175 & 60,835 & 0.984 \\ Kandira M. Kazim Dinc & 52 & 19,131 & 1.044 \\ Koríe & 52 & 17,973 & 1.105 \\ Karamursel & 45 & 20,942 & 1.038 \\ Dilovasi & 25 & 12,586 & 1.398 \\ Anadolu Saghdi Merkezi & 201 & 134,297 & 1.994 \\ VM Biomedicalpark & 121 & 75,681 & 2.006 \\ Cihan & 120 & 41,534 & 1.878 \\ Gebze Biomedicalpark & 118 & 69,980 & 1.039 \\ Yuzyl & 112 & 57,551 & 1.781 \\ Akademi & 110 & 34,321 & 1.543 \\ Konak & 107 & 30,329 & 0.937 \\ Medar Golcuk & 101 & 15,870 & 0.851 \\ Koríe Marmara & 79 & 30,264 & 0.472 \\ Kocaeli Private & 75 & 27,906 & 1.150 \\ Ackbadem & 61 & 32,700 & 1.117 \\ Gebze Merkez & 56 & 34,487 & 1.610 \\ Gebze Medar & 75 & 39,507 & 1.849 \\ Romatem Physical & & & \\ Therapy and & 27 & 1937 & 1.582 \\ Rehabilitation (FTR) & & & \\ Hospital Park Daries & 20 & 8898 & 0.215 \\ Cagin Goz & 25 & 1972 & 1.336 \\ Dunya Goz & 11 & 2062 & 0.237 \\ Kocaeli University & 727 & 358,451 & 1.481 \\
**Total** & **3811** & **1,610,139** & **Average = 1.19** \\ \hline \hline \end{tabular}
\end{table}
Table 1: Amounts of biomedical waste generated in Kocaeli city in 2019.  
Figure 1: Location map of the study region [19].  
In the study region, biomedical wastes are accumulated separately, where they occur, without being mixed with other wastes. Sharps, needles, infectious wastes, hazardous wastes and pathological wastes are collected in appropriate containers, which are compatible with the waste. The collected biomedical waste is first taken to the temporary biomedical waste storage of the health institution and then delivered to the biomedical waste collection vehicle. Once the biomedical waste is brought to the disposal site, the sharps, needles and infectious wastes are subjected to sterilization, while the pathological wastes and hazardous wastes are incinerated at the hazardous waste incineration plant located near the sterilization plant. The biomedical waste management system used in this study is given in Figure 2.