Social Life Cycle Assessment of Healthcare Waste Supply Chains

Abstract Along with the growth of the healthcare waste (HCW) sector, the significance of properly managed waste generated in medical institutions has also grown, both to protect public health and to ensure sustainability. While recent research, including studies driven by the COVID-19 pandemic, has highlighted the technological, economic and environmental dimensions of the infectious HCW (iHCW) supply chain, the social aspects remain underexplored. These social factors, often identified as behavioural barriers, hinder the effective deployment and adoption of iHCW even when circular economy-based approaches are environmentally and economically viable. This study applies a Social Life Cycle Assessment (S-LCA) to two iHCW management supply chains in Latvia: (1) University Hospital → thermal treatment plant → landfill disposal and (2) Regional Hospital → chemical treatment plant → energy recovery. The S-LCA methodology follows the United Nations Environment Programme/Society of Environmental Toxicology and Chemistry (UNEP/SETAC) guidelines, with data collected through interviews and structured across 5 categories, 6 subcategories and 82 indicators. The results of the S-LCA demonstrate that waste management companies dealing with HCW have high socially responsibility rates (average score 75 %), mainly due to high requirements set nationally for all waste management companies to qualify for participation in the tender procedures (ISO 9001, ISO 14001, ISO 45001, ISO 50001). In contrast, hospitals, as government- or municipality-funded entities, possess well-structured documentation and formal commitments in areas aligned with national priorities, such sub-categories as forced labour and child labour, equal opportunities and non-discrimination. From the perspective of social hotspots identified throughout the supply chains, the lowest performance was noted in subcategories such as “Poverty alleviation” (aggregated weighted score 43 %), “Education provided in the local community” (54 %), “Corruption” (57 %) and “Local employment” (58 %). This trend of social hotspots is not exclusive to the iHCW supply chains; it largely mirrors the wider national context and the waste management sector as a whole.