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      Compromising situation of India’s bio-medical waste incineration units during pandemic outbreak of COVID-19: associated environmental-health impacts and mitigation measures

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          Abstract

          COVID-19 induced pandemic situations have put the bio-medical waste (BMW) management system, of the world, to test. Sudden influx, of COVID-infected patients, in health-care facilities, has increased the generation of yellow category BMW (Y-BMW) and put substantial burden on the BMW-incineration units of India. This study presents the compromising situation of the BMW-incineration units of India, in the wake of COVID-19 pandemic, from 21 st March, 2020 to 31 st August, 2020. This analysis revealed that on an average each COVID-infected patient in India generates approximately 3.41 kg/d of BMW and average proportion of Y-BMW in it is 50.44%. Further, it was observed that on 13 th July, 2020, the total Y-BMW, generated by both the normal and COVID-infected patients, fully utilized the BMW-incineration capacity of India. Also, it was made evident that, during the study period, BMW-incineration emitted several pollutants and their concentration was in the order: NO x > CO >SO x > PM > HCl > Cd > Pb > Hg > PCBs > Ni > Cr > Be > As. Subsequently, life time cancer risk assessment depicted that with hazard quotient >10 -6, Cd may induce carcinogenic health impacts on both the adults and children of India. Therefore, to mitigate the environmental-health impacts associated with the incineration of BMW, evaluation of various options, viz., alternative technologies, substitution of raw materials and separate treatment of specific wastes, was also done. It is expected that the findings of this study may encourage the global auditory comprising scientific community and authorities to adopt alternate BMW-management strategies during the pandemic.

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          Stability of SARS-CoV-2 in different environmental conditions

          We previously reported the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in different clinical samples. 1 This virus can be detected on different surfaces in a contaminated site. 2 Here, we report the stability of SARS-CoV-2 in different environmental conditions. We first measured the stability of SARS-CoV-2 at different temperatures. SARS-CoV-2 in virus transport medium (final concentration ∼6·8 log unit of 50% tissue culture infectious dose [TCID50] per mL) was incubated for up to 14 days and then tested for its infectivity (appendix p 1). The virus is highly stable at 4°C, but sensitive to heat. At 4°C, there was only around a 0·7 log-unit reduction of infectious titre on day 14. With the incubation temperature increased to 70°C, the time for virus inactivation was reduced to 5 mins. We further investigated the stability of this virus on different surfaces. Briefly, a 5 μL droplet of virus culture (∼7·8 log unit of TCID50 per mL) was pipetted on a surface (appendix p 1; ∼cm2 per piece) and left at room temperature (22°C) with a relative humidity of around 65%. The inoculated objects retrieved at desired time-points were immediately soaked with 200 μL of virus transport medium for 30 mins to elute the virus. Therefore, this recovery of virus does not necessarily reflect the potential to pick up the virus from casual contact. No infectious virus could be recovered from printing and tissue papers after a 3-hour incubation, whereas no infectious virus could be detected from treated wood and cloth on day 2. By contrast, SARS-CoV-2 was more stable on smooth surfaces. No infectious virus could be detected from treated smooth surfaces on day 4 (glass and banknote) or day 7 (stainless steel and plastic). Strikingly, a detectable level of infectious virus could still be present on the outer layer of a surgical mask on day 7 (∼0·1% of the original inoculum). Interestingly, a biphasic decay of infectious SARS-CoV-2 could be found in samples recovered from these smooth surfaces (appendix pp 2–7). 39 representative non-infectious samples tested positive by RT-PCR 3 (data not shown), showing that non-infectious viruses could still be recovered by the eluents. We also tested the virucidal effects of disinfectants by adding 15 μL of SARS-CoV-2 culture (∼7·8 log unit of TCID50 per mL) to 135 μL of various disinfectants at working concentration (appendix p 1). With the exception of a 5-min incubation with hand soap, no infectious virus could be detected after a 5-min incubation at room temperature (22°C). Additionally, we also found that SARS-CoV-2 is extremely stable in a wide range of pH values at room temperature (pH 3–10; appendix p 1). Overall, SARS-CoV-2 can be highly stable in a favourable environment, 4 but it is also susceptible to standard disinfection methods.
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            Association between short-term exposure to air pollution and COVID-19 infection: Evidence from China

            The novel coronavirus pneumonia, namely COVID-19, has become a global public health problem. Previous studies have found that air pollution is a risk factor for respiratory infection by carrying microorganisms and affecting body's immunity. This study aimed to explore the relationship between ambient air pollutants and the infection caused by the novel coronavirus. Daily confirmed cases, air pollution concentration and meteorological variables in 120 cities were obtained from January 23, 2020 to February 29, 2020 in China. We applied a generalized additive model to investigate the associations of six air pollutants (PM2.5, PM10, SO2, CO, NO2 and O3) with COVID-19 confirmed cases. We observed significantly positive associations of PM2.5, PM10, NO2 and O3 in the last two weeks with newly COVID-19 confirmed cases. A 10-μg/m3 increase (lag0–14) in PM2.5, PM10, NO2, and O3 was associated with a 2.24% (95% CI: 1.02 to 3.46), 1.76% (95% CI: 0.89 to 2.63), 6.94% (95% CI: 2.38 to 11.51), and 4.76% (95% CI: 1.99 to 7.52) increase in the daily counts of confirmed cases, respectively. However, a 10-μg/m3 increase (lag0–14) in SO2 was associated with a 7.79% decrease (95% CI: −14.57 to −1.01) in COVID-19 confirmed cases. Our results indicate that there is a significant relationship between air pollution and COVID-19 infection, which could partially explain the effect of national lockdown and provide implications for the control and prevention of this novel disease.
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              Disinfection technology of hospital wastes and wastewater: Suggestions for disinfection strategy during coronavirus Disease 2019 (COVID-19) pandemic in China

              Hospitals are important sources of pollutants resulted from diagnostic, laboratory and research activities as well as medicine excretion by patients, which include active component of drugs and metabolite, chemicals, residues of pharmaceuticals, radioactive markers, iodinated contrast media, etc. The discharge of hospital wastes and wastewater, especially those without appropriate treatment would expose the public in danger of infection. In particular, under the Coronavirus Disease 2019 (COVID-19) pandemic context in China, it is of great significance to reduce the health risks to the public and environment. In this study, technologies of different types of hospital wastes and wastewater disinfection have been summarized. Liquid chlorine, sodium hypochlorite, chlorine dioxide, ozone, and ultraviolet irradiation disinfection are commonly used for hospital wastewater disinfection. While incineration, chemical disinfection, and physical disinfection are commonly used for hospital wastes disinfection. In addition, considering the characteristics of various hospital wastes, the classification and selection of corresponding disinfection technologies are discussed. On this basis, this study provides scientific suggestions for management, technology selection, and operation of hospital wastes and wastewater disinfection in China, which is of great significance for development of national disinfection strategy for hospital wastes and wastewater during COVID-19 pandemic.
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                Author and article information

                Journal
                Environ Pollut
                Environ Pollut
                Environmental Pollution (Barking, Essex : 1987)
                Elsevier Ltd.
                0269-7491
                1873-6424
                8 February 2021
                8 February 2021
                : 116621
                Affiliations
                [1 ]Department of Civil Engineering, Punjab Engineering College, Chandigarh 160012, India
                [2 ]Assistant Project Officer, State Project Management Unit, Punjab Pollution Control Board, Ludhiana 141001, India
                [3 ]Department of Civil Engineering, Shaheed Bhagat Singh State Technical Campus, Ferozepur 152004, India
                [4 ]Department of Civil Engineering, Chandigarh University, Gharuan 140413, India
                Author notes
                []Corresponding author.
                Article
                S0269-7491(21)00199-8 116621
                10.1016/j.envpol.2021.116621
                7869633
                33592442
                cb6317f8-594e-4c36-85b1-43f36e90cfa4
                © 2021 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 2 October 2020
                : 25 January 2021
                : 27 January 2021
                Categories
                Article

                General environmental science
                covid-19,bio-medical waste,incineration,health risk assessment,alternative technology,heavy metals

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