I
nte
rna
t
io
na
l J
o
urna
l o
f
P
u
bli
c
H
ea
lt
h Science
(
I
J
P
H
S)
Vo
l.
5
,
No
.
3
,
Sep
tem
b
er
201
6
,
p
p
.
2
4
7
~
2
5
1
I
SS
N:
2252
-
8806
247
J
o
ur
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ttp
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spita
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uchs
in M
a
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us
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In
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a
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tec
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n
ic,
He
a
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M
in
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stries
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In
d
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Art
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nfo
AB
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A
r
ticle
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to
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y:
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J
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1
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R
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T
h
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a
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so
m
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th
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risk
s
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s
p
it
a
l
w
a
ste
d
isp
o
sa
l.
T
h
e
f
irst
g
ro
u
p
is
th
e
p
a
ti
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ts
w
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it
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.
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is
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m
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.
T
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se
c
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it
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m
p
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d
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c
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tac
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w
it
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p
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‟s
a
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ts
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n
d
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in
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e
ir
d
a
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y
d
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s.
T
h
e
th
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g
ro
u
p
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th
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v
isit
o
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o
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th
o
se
w
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a
c
c
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m
p
a
n
y
th
e
p
a
ti
e
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ts
;
th
e
ir
risk
is
b
ig
a
s
we
ll
.
T
h
e
las
t
g
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u
p
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th
e
so
c
iet
y
,
p
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p
le w
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wa
ste
sip
o
sa
l
is
d
o
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e
in
a
p
p
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o
p
r
iate
ly
.
It
c
a
u
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s th
e
d
e
c
re
a
s
e
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n
v
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tal
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ty
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,
h
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a
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sp
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b
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m
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sp
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In
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,
th
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tal
p
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wa
ste
w
h
ich
,
if
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p
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a
.
Jo
g
ja
h
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it
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a
s
In
c
i
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e
ra
to
r,
th
u
s
sim
p
li
fy
in
g
th
e
m
a
n
a
g
e
m
e
n
t
su
c
h
w
a
ste
.
Th
e
w
a
ste
m
a
n
a
g
e
m
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t
in
c
l
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e
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,
p
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d
u
re
s
a
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d
p
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m
a
k
in
g
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d
to
b
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x
p
lo
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d
t
o
in
v
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stig
a
te
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p
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f
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m
a
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a
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m
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t
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f
Jo
g
ja h
o
sp
it
a
l
.
K
ey
w
o
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d
:
Ho
s
p
ital
Ma
n
ag
e
m
e
n
t
So
lid
w
as
te
T
r
ea
tm
en
t
Co
p
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rig
h
t
©
2
0
1
6
In
stit
u
te o
f
A
d
v
a
n
c
e
d
E
n
g
i
n
e
e
rin
g
a
n
d
S
c
ien
c
e
.
Al
l
rig
h
ts
re
se
rv
e
d
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
Ag
u
s
S
u
w
ar
n
i
,
Hea
lth
P
o
l
y
tec
h
n
ic
,
Hea
lth
Mi
n
is
tr
ies
,
I
n
d
o
n
esia
.
E
m
ail:
m
m
3
1
1
0
8
6
@
g
m
ail.
co
m
1.
I
NT
RO
D
UCT
I
O
N
Ho
s
p
ital
as
a
m
ea
n
s
o
f
h
ea
lt
h
,
a
p
lace
f
o
r
p
atien
ts
o
r
h
ea
lth
p
eo
p
le,
m
a
y
b
e
th
e
v
u
ln
er
ab
l
e
p
lace
to
s
p
r
ea
d
d
is
ea
s
e,
an
d
to
co
n
ta
m
i
n
ate
th
e
e
n
v
ir
o
n
m
en
t
a
n
d
h
ea
lth
p
r
o
b
le
m
s
[
1
]
.
E
n
v
ir
o
n
m
e
n
tal
Hea
lt
h
Ma
n
ag
e
m
e
n
t
is
r
ec
e
n
tl
y
co
n
s
id
er
ed
n
o
t
as
a
co
n
s
u
m
ti
v
e
p
ar
t,
b
u
t
a
s
et
o
f
s
tag
e
s
a
n
d
s
t
r
ateg
ies
o
f
h
o
s
p
ital
m
a
m
ag
e
m
e
n
t
to
d
ev
elo
p
its
ca
p
ac
it
y
in
m
a
n
a
g
i
n
g
h
o
s
p
ital
en
v
ir
o
n
m
e
n
t
to
g
i
v
e
d
ir
ec
t
o
r
in
d
ir
ec
t
b
en
ef
i
ts
to
th
e
s
er
v
ice
q
u
a
lit
y
i
n
a
w
h
o
le
.
E
n
v
ir
o
n
m
e
n
tal
Hea
lt
h
Ma
n
a
g
e
m
en
t
h
as
co
m
p
lica
ted
p
r
o
b
le
m
s
i
n
.
On
e
o
f
t
h
e
m
is
t
h
e
w
as
te
p
r
o
b
le
m
w
h
ich
clo
s
el
y
r
elate
s
to
Go
v
er
n
m
en
t
L
a
w
s
.
Ho
s
p
ital
as
o
n
e
o
f
t
h
e
b
ig
g
es
t
w
as
te
-
p
r
o
d
u
ce
r
s
is
p
o
ten
tiall
y
ca
u
s
e
en
v
ir
o
n
m
en
ta
l
p
o
llu
t
io
n
to
t
h
e
s
u
r
r
o
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n
d
in
g
,
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d
w
ill
l
ik
e
l
y
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i
v
e
lo
s
s
to
t
h
e
s
o
ciet
y
a
n
d
th
e
h
o
s
p
ita
l its
el
f
[
2
]
.
T
h
er
e
ar
e
s
o
m
e
g
r
o
u
p
s
w
h
o
m
a
y
g
e
t
t
h
e
r
is
k
s
o
f
h
o
s
p
ital
w
a
s
te
d
i
s
p
o
s
al.
T
h
e
f
ir
s
t
g
r
o
u
p
is
t
h
e
p
atien
ts
w
h
o
co
m
e
to
h
o
s
p
ital
t
o
g
et
cu
r
e
an
d
ca
r
e.
I
t
is
th
e
m
o
s
t
v
u
l
n
er
ab
le
g
r
o
u
p
.
T
h
e
s
ec
o
n
d
is
h
o
s
p
ital
‟
s
e
m
p
lo
y
ee
s
w
h
o
h
av
e
d
ir
ec
t
co
n
tact
w
it
h
th
e
p
atien
t
s
as
m
ai
n
illn
e
s
s
‟
s
a
g
en
t
s
o
n
d
o
in
g
t
h
e
ir
d
aily
d
u
tie
s
.
T
h
e
th
ir
d
g
r
o
u
p
is
th
e
v
i
s
ito
r
o
r
th
o
s
e
w
h
o
ac
co
m
p
a
n
y
t
h
e
p
atien
ts
;
t
h
e
ir
r
is
k
i
s
b
ig
as
w
e
ll.
T
h
e
last
g
r
o
u
p
is
t
h
e
s
o
ciet
y
,
p
eo
p
le
w
h
o
liv
e
n
ea
r
th
e
h
o
s
p
ita
l,
ev
e
n
w
h
e
n
t
h
e
waste
s
ip
o
s
al
is
d
o
n
e
i
n
ap
p
r
o
p
r
i
atel
y
.
I
t
ca
u
s
es
t
h
e
d
ec
r
ea
s
e
o
f
en
v
ir
o
n
m
e
n
tal
q
u
a
lit
y
w
h
ic
h
lead
s
to
th
e
d
ec
li
n
e
o
f
h
ea
lt
h
q
u
alit
y
i
n
th
e
ar
ea
.
Hen
ce
,
h
o
s
p
ital
h
as
a
r
esp
o
n
s
ib
ilit
y
to
m
a
n
ag
e
th
e
d
is
p
o
s
al
p
r
o
ce
s
s
o
f
w
a
s
te
co
r
r
ec
tl
y
a
n
d
ap
p
r
o
p
r
iately
b
y
co
n
d
u
cti
n
g
s
a
n
itat
io
n
p
r
o
g
r
am
s
in
h
o
s
p
ital
[
3
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8806
I
J
P
HS
Vo
l.
5
,
No
.
3
,
Sep
tem
b
er
20
1
6
:
2
4
7
–
2
5
1
248
2.
RE
S
E
ARCH
M
E
T
H
O
D
T
h
e
r
esear
ch
is
a
q
u
alitativ
e
d
escr
ip
tiv
e
o
n
e
w
ith
t
h
e
p
r
i
m
ar
y
o
b
j
ec
tiv
e
to
f
ig
u
r
e
o
u
t
r
ea
l
co
n
d
itio
n
an
d
d
escr
ip
tio
n
o
f
it
o
b
j
ec
tiv
ely
[
4
]
.
I
t
is
a
ca
s
e
s
tu
d
y
a
s
a
m
o
r
e
s
u
itab
le
s
tr
ateg
y
f
o
r
th
e
q
u
esti
o
n
s
o
f
how
an
d
w
h
y
w
h
e
n
t
h
e
r
esear
c
h
er
h
a
s
a
litt
le
c
h
an
ce
to
co
n
tr
o
l th
e
o
b
s
er
v
ed
ev
e
n
t
s
,
an
d
w
h
e
n
th
e
f
o
cu
s
o
f
th
e
r
e
s
ea
r
ch
is
a
co
n
te
m
p
o
r
ar
y
p
h
e
n
o
m
e
n
a
in
r
ea
l lif
e
[
5
]
.
3.
RE
SU
L
T
S
A
ND
AN
AL
Y
SI
S
3
.
1
.
P
ro
ce
s
s
o
f
s
o
lid
w
a
s
t
e
m
a
na
g
e
m
ent
3
.
1
.
1
.
T
re
a
t
m
e
nt
pro
ce
s
s
o
f
m
edic
a
l so
lid
w
a
s
t
e
Fig
u
r
e
1
tells
th
e
tr
ea
t
m
e
n
t p
r
o
ce
s
s
o
f
m
ed
ical
s
o
lid
w
a
s
te
b
y
P
P
L
at
J
o
g
j
a
Ho
s
p
ital
.
Fig
u
r
e
1
.
T
h
e
tr
ea
tm
e
n
t
p
r
o
ce
s
s
o
f
m
ed
ical
s
o
lid
w
aste
d
o
n
e
b
y
P
P
L
at
J
o
g
j
a
h
o
s
p
ital
Descr
ip
tio
n
o
f
s
o
lid
m
ed
ical
w
a
s
te
tr
ea
t
m
e
n
t
p
r
o
ce
s
s
Ho
s
p
i
tal
J
o
g
j
a
is
alm
o
s
t
th
e
s
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m
e
with
[
6
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4
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Rec
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m
o
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th
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s
a
m
e
w
i
th
r
esear
ch
[
1
6
]
,
th
at
t
h
e
w
a
s
te
co
llectio
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a
n
d
tr
an
s
p
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Or
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[
3
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,
ex
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ip
m
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n
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R
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[
1
7
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t
h
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p
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ld
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tak
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ased
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„
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,
r
eu
s
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r
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v
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d
d
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[
1
8
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.
Ho
s
p
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w
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s
h
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y
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w
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en
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w
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s
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n
itatio
n
to
b
e
s
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ld
to
w
a
s
te
co
llecto
r
s
[
1
9
]
.
T
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e
p
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n
tag
e
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f
m
a
ter
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r
ec
y
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led
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to
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p
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d
is
p
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[
2
0
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.
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g
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e
m
o
n
e
y
f
o
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th
e
Ho
s
p
ital Y
o
g
y
a
k
ar
ta.
3
.
3
.
A
m
o
un
t
o
f
w
a
s
t
e
in Co
m
bu
s
t
io
n
Her
e
is
th
e
a
m
o
u
n
t
o
f
w
a
s
te
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m
b
u
s
ted
o
n
i
n
ci
n
er
ato
r
b
ased
o
n
th
e
d
ata
o
f
E
n
v
ir
o
n
m
en
tal
Hea
lt
h
is
tallatio
n
at
J
o
g
j
a
Ho
s
p
ital
[
T
ab
le
1
]
.
T
ab
le
1.
T
h
e
am
o
u
n
t o
f
Me
d
ical
an
d
N
on
-
m
ed
ical
So
lid
W
as
te
at
J
o
g
j
a
Ho
s
p
ital
M
e
d
i
cal
N
o
n
-
me
d
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cal
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mo
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n
t
5
0
0
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3
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3
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o
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D
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L
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g
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h
D
L
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k
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r
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*
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o
u
r
ce
: E
n
v
ir
o
n
m
e
n
tal
He
alth
I
s
talla
tio
n
at
J
o
g
j
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Ho
s
p
ital
W
ell
-
d
esi
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n
ed
in
ci
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er
ato
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h
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s
to
b
u
r
n
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te
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v
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t
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est
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n
t
h
e
f
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r
m
o
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h
a
n
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m
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s
t
b
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itted
w
it
h
a
s
cr
u
b
b
er
to
tr
ap
to
x
ic
air
p
o
llu
tan
ts
th
at
ar
e
r
elea
s
e
d
[
2
1
]
.
[
2
2
]
s
tates
t
h
at
if
w
as
te
w
er
e
d
is
p
o
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o
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w
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(
s
till
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to
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ch
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m
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,
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t
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[
2
2
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s
tates
th
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w
h
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ch
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p
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elo
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8
0
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°
C
,
t
h
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s
m
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n
s
m
o
k
e
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r
in
th
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f
o
r
m
o
f
p
ar
ticles.
M.
A
li
a
n
d
C.
Ku
ro
iw
a
s
u
g
g
e
s
ts
th
a
t
p
r
iv
ate
o
r
g
a
n
izatio
n
s
i
n
v
o
l
v
e
d
in
w
aste
co
llect
io
n
d
ev
elo
p
in
g
h
ea
lt
h
o
v
er
ti
m
e,
th
e
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ee
d
an
d
d
em
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n
d
.
So
m
e
h
o
s
p
itals
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n
T
h
ailan
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av
e
b
ee
n
d
eleg
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m
an
a
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m
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p
ain
h
o
u
s
e
w
as
te
to
p
r
iv
ate
o
r
g
an
iza
tio
n
s
[
2
3
]
.
W
o
r
k
er
s
co
llect
g
ar
b
ag
e
at
a
ce
r
tain
p
o
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n
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t
h
en
s
ep
ar
ated
an
d
f
i
n
all
y
t
r
an
s
p
o
r
ted
to
th
e
ex
ter
m
i
n
atio
n
Ho
s
p
ita
l p
ar
tn
er
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
P
HS
I
SS
N:
2252
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8806
S
o
lid
W
a
s
te
Ma
n
a
g
eme
n
t in
H
o
s
p
ita
l J
o
g
ja
(
Mu
ch
s
in
Ma
u
la
n
a
)
251
4.
CO
NCLU
SI
O
N
T
h
e
tr
ea
tm
e
n
t
p
r
o
ce
s
s
o
f
s
o
lid
w
aste
at
J
o
g
j
a
Ho
s
p
ital
c
ar
r
ies
o
u
t
th
e
ef
f
ec
ti
v
e
s
ta
g
e
s
,
s
p
ec
if
i
c
p
h
ases
a
n
d
s
h
o
r
t
ter
m
p
r
o
ce
s
s
.
I
t
p
r
ev
en
ts
w
aste
ac
c
u
m
u
l
atio
n
as
w
ell
as
av
o
id
i
n
g
il
ln
ess
.
T
h
e
tr
ea
tm
e
n
t
p
r
o
ce
s
s
o
f
n
o
n
-
m
ed
ical
s
o
lid
w
a
s
te
at
J
o
g
j
a
H
o
s
p
ital
ap
p
lie
s
d
if
f
er
e
n
t
s
ta
g
es
as
s
o
m
e
te
m
p
o
r
ar
y
w
a
s
te
b
ask
e
t
at
th
e
h
o
s
p
ital
h
a
v
e
alr
ea
d
y
ca
teg
o
r
ized
it
i
n
to
p
ap
er
,
p
last
ic
o
r
g
la
s
s
w
aste.
R
ec
y
cli
n
g
p
r
o
ce
s
s
at
J
o
g
j
a
Ho
s
p
ital
h
as
n
o
t
b
ee
n
co
n
s
id
er
ed
ef
f
ec
ti
v
e
as
n
o
n
-
m
ed
ical
w
a
s
te
s
ell
in
g
s
h
o
u
ld
g
iv
e
ad
d
i
tio
n
al
i
n
co
m
e
to
th
e
h
o
s
p
ital.
RE
F
E
R
E
NC
E
S
[1
]
In
d
o
n
e
sia
n
M
i
n
istry
o
f
He
a
lt
h
,
No
m
o
r:
1
2
0
4
/M
ENKES
/
S
K/X/2
0
0
4
,
“
T
e
r
m
s
o
f
En
v
iro
n
m
e
n
tal
He
a
lt
h
Ho
sp
it
a
l
,
”
Ja
k
a
rta
,
Dirjen
P
P
M
&
P
L
De
p
k
e
s
RI
,
2
0
0
4
.
[2
]
A
d
isa
s
m
it
o
,
“
En
v
iro
n
m
e
n
tal
A
u
d
it
Ho
sp
i
tals
,”
Ja
k
a
rta,
Ra
ja
G
ra
p
in
d
o
P
e
rsa
d
a
,
2
0
0
8
.
[3
]
W
HO
,
“
M
a
n
a
g
e
m
e
n
t
o
f
Was
tes
F
ro
m
He
a
lt
h
-
Ca
re
A
c
ti
v
it
ies
,”
Ce
tak
a
n
P
e
rtam
a
,
Ja
k
a
rta,
EG
C
,
2
0
0
5
.
[4
]
S.
No
t
o
a
tm
o
d
jo
,
“
He
a
lt
h
Re
se
a
rc
h
M
e
th
o
d
o
l
o
g
y
,”
C
e
tak
a
n
Ke
ti
g
a
,
Ja
k
a
rta,
P
T
Rin
e
k
a
Cip
t
a
,
2
0
0
5
.
[5
]
R.
K.
Yin
,
“
Ca
se
S
tu
d
y
Re
se
a
rc
h
:
De
sig
n
a
n
d
M
e
t
o
d
s
,”
Ce
tak
a
n
Ke
se
m
b
il
a
n
,
Ja
k
a
rta,
D
e
v
isi
P
e
rg
u
ru
a
n
T
in
g
g
i
Ra
ja
w
a
li
P
e
rs
,
2
0
0
9
.
[6
]
B.
A
la
m
s
y
a
h
,
“
W
a
ste
M
a
n
a
g
e
m
e
n
t
in
H
o
sp
it
a
ls
P
u
p
u
k
Ka
lt
im
Bo
n
tan
g
to
G
e
t
En
v
iro
n
m
e
n
tal
Qu
a
li
ty
S
tan
d
a
rd
s
,”
T
e
sis
, U
ND
IP
,
S
e
m
a
ra
n
g
,
200
7
.
[7
]
L
.
C.
S
.
Ra
o
,
W
.
C.
R.
Ra
n
y
a
l,
L
.
C.
S
.
Bh
a
ti
a
,
L
.
C.
V
.
S
h
a
r
m
a
,
L
,
“
Bio
m
e
d
ica
l
Was
te
M
a
n
a
g
e
m
e
n
t:
A
n
In
f
ra
stru
c
tu
ra
l
S
u
rv
e
y
o
f
Ho
sp
i
tals
,”
Co
n
tem
p
o
ra
ry
Iss
u
e
,
M
JA
F
I
,
v
o
l.
60
,
p
p
.
3
7
9
-
3
8
2
,
2
0
0
4
.
[8
]
J.
I.
Blen
k
h
a
rn
,
“
P
o
ten
ti
a
l
c
o
m
p
ro
m
ise
o
f
h
o
s
p
it
a
l
h
y
g
ien
e
b
y
c
li
n
ica
l
wa
ste
c
a
rts
,”
J
o
u
rn
a
l
o
f
H
o
s
p
it
a
l
In
fec
ti
o
n
,
v
ol
.
6
3
,
p
p
.
4
2
3
e
4
2
7
,
2
0
0
6
.
[9
]
G
.
V
.
P
a
ti
l
a
n
d
K.
P
o
k
h
re
l,
“
Bio
m
e
d
ica
l
S
o
li
d
W
a
ste
M
a
n
a
g
e
m
e
n
t
in
a
n
I
n
d
ian
H
o
s
p
it
a
l:
a
C
a
se
S
t
u
d
y
,
”
J
o
u
rn
a
l
o
f
W
a
ste
M
a
n
a
g
e
me
n
t
,
v
o
l.
25
,
p
p
.
592
–
5
9
9
,
2
0
0
4
.
[1
0
]
M.
A
s
k
a
rian
,
M
.
V
a
k
il
i,
G
.
K
a
b
ir,
“
Re
su
lt
o
f
Ho
sp
it
a
l
W
a
ste
S
u
rv
e
y
in
P
riv
a
te
H
o
sp
it
a
ls
in
F
a
rs
P
r
o
v
in
c
e
,
Ira
n
,”
J
o
u
rn
a
l
o
f
W
a
ste
M
a
n
a
g
e
me
n
t
,
v
ol
.
24
,
p
p
.
3
4
7
-
3
5
2
,
2
0
0
3
.
[1
1
]
M.
Ka
ra
m
o
u
z
,
B.
Zah
ra
ie,
R.
Ke
ra
c
h
ian
,
N.
Ja
a
fa
rz
a
d
e
h
,
N.
M
a
h
jo
u
ri,
“
De
v
e
lo
p
in
g
a
m
a
s
ter
p
lan
f
o
r
h
o
sp
it
a
l
so
li
d
w
a
ste
m
a
n
a
g
e
m
e
n
t:
A
c
a
se
stu
d
y
,”
El
se
v
ier
,
2
0
0
6
.
[1
2
]
B.
Co
r
o
n
e
l,
P
.
Du
ro
se
ll
e
y
,
H.
Be
h
ry
,
J.
F
.
M
o
sk
o
v
tch
e
n
k
o
,
J.
F
re
n
e
y
y
,
“
In
situ
d
e
c
o
n
tam
in
a
ti
o
n
o
f
m
e
d
ica
l
w
a
ste
s
u
sin
g
o
x
id
a
ti
v
e
a
g
e
n
ts:
a
1
6
-
m
o
n
t
h
stu
d
y
in
a
p
o
ly
v
a
len
t
in
ten
siv
e
c
a
re
u
n
it
,”
J
o
u
rn
a
l
o
f
Ho
s
p
it
a
l
In
f
e
c
ti
o
n
,
v
ol
.
50
,
pp.
2
0
7
±2
1
2
,
2
0
0
2
.
[1
3
]
M.
A
li
a
n
d
K
.
C
h
u
s
h
i
,
“
S
tatu
s
a
n
d
C
h
a
ll
e
n
g
g
e
s
Ho
sp
it
a
l
S
o
l
id
W
a
ste
M
a
n
a
g
e
m
e
n
t:
Ca
se
S
tu
d
ie
s
F
ro
m
T
h
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ter
Cy
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.
11
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p
.
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5
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7
,
2
0
0
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.
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