Evaluation of potentially toxic elements and pharmaceutical compounds in leachate and exhaust air from non-incineration medical waste treatment devices

This study assessed the health risks and toxicity of compounds found in the leachate and exhaust air of non-incineration devices used for hospital waste management. Specifically, it measured the levels of potentially toxic elements and pharmaceutical compounds in two disinfection waste treatment devices-hydroclave with shredder (device A) and autoclave without shredder (device B)-at a hospital in Tehran, Iran. Sampling occurred from October 2022 to March 2023. potentially toxic elements were analyzed using Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES), while cytotoxicity was evaluated with an ELISA reader.The results indicated that the exhaust air from device A contained high concentrations of barium (9.80 ± 1.60 µg/m³), zinc (8.60 ± 2.25 µg/m³), and chromium (8.45 ± 2.30 µg/m³). In contrast, barium and zinc were the most abundant potentially toxic elements in device B. Analysis of the leachate from device A showed that nickel and arsenic had the lowest concentrations, while barium, chromium, and zinc had the highest. Additionally, Leachate analysis from Device A also revealed high levels of barium, chromium, and zinc, while nickel and arsenic were found at lower concentrations. Significant concentrations of pharmaceutical compounds, such as azithromycin, ciprofloxacin, diclofenac, and naproxen, were detected in the effluent from both devices, with higher concentrations in Device A, indicating improper segregation and inadequate management of pharmaceutical waste. This underscores the urgent need for continuous training, supervision, and monitoring in pharmaceutical waste management. Cytotoxicity analyses showed that particulate matter and leachate from Device A had a more pronounced negative impact on human cell lines (HepG2 and A549) compared to Device B. Health risk assessments using Monte Carlo simulations indicated that the carcinogenic risks from potentially toxic elements (PTEs) in Device A, particularly arsenic and chromium, exceeded the permissible limits set by the USEPA, while Device B posed significantly lower risks. These findings highlight the importance of educating hospital staff on proper waste segregation, continuous monitoring, and implementing advanced waste management protocols to protect public health and the environment.