“…Safe management of medical waste can be extremely expensive, but in the United States, up to 85% of waste from hospitals does not need to be treated as infectious according to regulatory definitions (WHO, 2018). Physical waste audits in which components are measured can unveil issues in waste segregation, Almuneef and Memish, 2003;Diehl et al, 1992;Fasola et al, 2008;Garcia, 1999;Gunther, 2013, 2016;Mosquera et al, 2014;Nandwani, 2010;Reed et al, 2013 Educational programmes 11 (34%) Almuneef and Memish, 2003;Denny et al, 2019;Dietrich et al, 2004;Fraifeld et al, 2021;Hames, 2013;Nandwani, 2010;Reed et al, 2013;Soroceanu et al, 2011;Tisdall et al, 2019;Tudor, 2008;Zafar and Butler, 2000 Operational procedure changes 8 (25%) Debita et al, 2017;De Sousa et al, 2014;Diehl et al, 1992;Fasola et al, 2008;Grimmond and Reiner, 2012;Kron et al, 2021;Makofsky and Cone, 1993;Reed et al, 2013 Waste sorting changes 8 (25%) Diehl et al, 1992;Francis et al,1997;Moreira and Gunther, 2013;Lawlor, 2014;Mosquera et al, 2014;Debita et al, 2017;McGain et al, 2015;Fraifeld et al, 2021 Lean/Six Sigma/total quality management 4 (13%) Askarian et al, 2010;Furukawa et al, 2016a…”