## 1 Introduction
### Greenhouse Gas Emissions  
Global greenhouse gas (GHG) emissions have grown since pre-industrial periods, with a 70% increase between 1970 and 2004 [14]. Since pre-industrial times, increased greenhouse gas emissions from human activities have caused a significant increase in the atmospheric greenhouse gas concentrations. Between 1970 and 2004, global emissions of CO\({}_{2}\), CH\({}_{4}\), N\({}_{2}\)O, hydrofluorocarbons (HFCs), perfluorocarbons (PFCs) and sulphur hexafluoride (SF6), described by their global warming potential (GWP), have increasedby 70% from 28.7 to 49 Giga ton (Gt) CO\({}_{2}\)-eq. CO\({}_{2}\) emissions grew by approximately 80% between 1970 and 2004, representing 77% of the total greenhouse gas emissions in 2004. Between 1970 and 2004, the greatest growth in global greenhouse gas emissions came from the energy supply sector, with an increase of 145%. The Intergovernmental Panel on Climate Change (IPCC) predicts that global greenhouse gas emissions will continue to increase over the next few decades [14]. However, IPCC also estimates that studies have demonstrated a significant economic potential for reducing global greenhouse gas emissions over the next decades that could balance the projected growth of global emissions or reduce emissions below current levels. GHG emissions will then need to peak and decline to stabilize greenhouse gas concentrations in the atmosphere. The lower the level of stabilization, the faster this peak and drop will have to occur. Reduction efforts over the next two to thirty years will have a major impact on opportunities to reach lower levels of stability.  
The generation, transportation and disposal practices of wastes potentially generate greenhouse gas emissions [15]. Total GHG emissions resulting from waste management activities in the world are about 1.3 GtCO\({}_{2}\)-e, corresponding to about 2.8 percent of total GHG emissions [14]. Approximately, 3.3% of total greenhouse gas emissions originate from waste management activities in Turkey [16]. The total greenhouse gas emissions of Kocaeli city for 2016 were calculated as 25.1 million tons of CO\({}_{2}\)-e. Of the total greenhouse gas emission, 65.3% of total emissions were from fixed sources, 17.4% from industrial processes, 15.0% from transportation, 1.4% from land use and 0.9% from waste management [17]. The collection, transportation and transfer of waste is not included in waste management activities, but in the estimation of mobile greenhouse gas resources (cars, trucks) [17]. The units of GHG emissions are converted into CO\({}_{2}\) equivalency (CO\({}_{2}\)-e) in order to better identify and evaluate GHG emissions. Another term commonly used to describe GHG emissions is called global warming factor (GWF). The GWF identifies the amount of GHG emissions generated per ton of biomedical waste collected, transported and sterilized. GWF used in this study is based on a 100-year time period as reported in the recent IPCC assessment report [18]. In the literature, there is no study that investigated the GHG emissions from biomedical waste collection and treatment systems in the city of Kocaeli, Turkey. This study had two main objectives. The first objective was to verify if efficient biomedical waste treatment can occur under standard operating parameters in steam treatment systems in the city of Kocaeli, Turkey. The second objective was to investigate the greenhouse gas (GHG) emissions generated during the transportation and treatment of biomedical waste.