# Life Cycle Assessment of Medical Waste Management: Case Study for Istanbul
## 1 Introduction
[17] emphasized waste separation at the source and suggested the sterilization and incineration of sharp and infectious materials for comprehensive medical waste management in southern Iran. A cross-sectional questionnaire was administered to healthcare workers in a public teaching hospital in Ghana to identify the types and quantities of waste generated and to assess current medical waste management practices. The study recommended segregating infectious waste from solid waste at the source and implementing measures to mitigate air pollutants emitted from incineration [18]. Ref. [19] presented the relationship between effective medical waste management and the United Nations Sustainable Development Goals by emphasizing the former's role in reducing environmental pollution. Nevertheless, further improvements in medical waste management strategies and integrated solutions are required, particularly from a circular economy perspective. Circular hospital waste management is supported by [4], which evaluated combined steam sterilization and gasification in Australia. The common processes for treating medical waste are steam sterilization, incineration, and landfilling. Inadequate management of medical waste could lead to serious environmental issues, including the release of infectious materials into the environment, water pollution by landfill leachate, and the emission of dangerous gases [20]. Therefore, sustainable medical waste management, including collection, segregation, transportation, and disposal, has become critical to avoid the spread of infectious diseases in humans [1,21]. Furthermore, factors such as the amount of waste, waste minimization, and environmental emissions should be considered in medical waste management [22]. There are various decision-making methodologies to determine the waste management system that performs best in terms of the environment and human health. Life cycle assessment (LCA) is an effective standardized method used to evaluate the environmental impacts of a product, a process, or a service from production to disposal. In support of life cycle assessment in waste management, the environmental benefits and burdens of the packaging waste management system were evaluated via an LCA [23], which compared the packaging waste management system with two hypothetical scenarios: one where all packaging waste was transferred for incineration and another where it was sent to landfill. The study revealed that the current packaging waste management system presented better environmental performance. Recently, studies have focused on conducting LCA for medical waste management. The application of LCA in medical waste disposal was highlighted in the study of [24], and the mitigation of the amount of hospital waste generated, the separation of infectious waste from domestic waste, and the use of incineration as a disposal method were emphasized. Ref. [25] compared two different medical waste disposal technologies, incineration and steam autoclave sterilization followed by landfill, by using LCA. The waste disposal alternative, incineration with 30% energy recovery, presented the lowest environmental influence. In another study, LCA was used for medical waste management, assessing the disinfection performance of three different methods followed by landfill: microwave, autoclave, and lime. The results showed that the microwave disinfection technique had the least environmental impact [26]. Most studies in the medical waste management field conduct questionnaires to identify the amount of medical waste generated and the disposal technologies used in healthcare facilities. However, a limited number of studies evaluate the influence of medical waste disposal on environmental and human health, and some of them focus on alternative treatments or only a particular type of medical waste, such as infectious waste, etc.