Sheikh N, Maheshwari C. Measures against disposable masks: a potential source of environmental and biological pollution. HPHR. 2021;48.
Contaminated disposable masks are potential hazards to the hygiene and environment. There is increased demand, and in turn, the production of PPEs and masks has also scaled up. But due to the lack of awareness and integrated strategy for the proper disposal of these masks they might be a cause of rising health and environmental issues in the upcoming time. People lack awareness regarding the number of times each mask can be used, how to sanitize and reuse the mask, and the proper disposal of a contaminated mask. In addition, the concerned authorities lack efficient strategies to diminish the use of non-biodegradable material to minimize plastic waste, creating awareness among people to dispose of the masks properly and design efficient strategies to cope with the plastic waste. Due to which these COVID-19 masks can be a potential source of the spread of the virus and increase of plastic waste. This is a review article pertaining to details from the recent researches and articles in regards to the prevalent issues and solutions in respect of the current pandemic. The best approach is to educate the masses to reduce contaminated waste along with proper decontamination and disposal of dreg.
The increased demand for PPE and disposal poses two major problems to deal with, firstly, the general public not properly disposing of the masks, secondly the inappropriate nationwide management of proper plastic disposal and reduction of plastic waste. In turn, leading to the spread of viral infection through the contaminated masks, in addition to adding up to the plastic accumulation. Disposable Masks were generally used by Health care workers as a precaution against air-borne diseases. Since the emergence of the SARS pandemic in 2019, numerous measures and SOPs were imposed to restrain the spread of the COVID-19 virus. Social distancing, isolations, quarantine, good hygiene, and masking were some of the measures primarily suggested by WHO (, which were imposed by Governments in almost every affected country. After the outbreak masks are now widely used by the general public as the most effective mean against the spread of infection, as suggested by the researchers ( according to the July 2020 database, masks used in only a few Asian countries were counted to be 2,228,170,832 and solely Pakistan used about 61,762,860 masks daily at the acceptance rate of 80% (. But what we are overshadowing is the harm in wake of this pandemic. Due to this increase in usage, depletion of the stocks of masks and PPE surged (Missoni, Armocida et al. 2020). As a result of this demand, the production of masks also scaled up. For instance, in China, the production of disposable masks increased to 14.8 million, as of February 2020 (Aragaw 2020, Fadare and Okoffo 2020). The use of masks was further necessitated as expected when the lockdowns were limited due to the economic crisis. According to Japanese METI, over 600 million orders of masks per month were scored as of April 2020 (Aragaw 2020). More so, between 2016-2020, the annual rate of PPE rose in the global market by 65% from $40 billion to $58 billion (Singh, Tang et al. 2020). It is expected that this rate of need might not even decrease post-pandemic. The unfortunate effects of this waste produced in turn are ineluctable.
Plastic-induced solid waste pollution has always been a concern for environmentalists and researchers. As a non-biodegradable toxin, it poses a great danger to the lifecycle and food web (. The question is how to cater to these situations. This increased availability and use of masks require a proper plan for its disposal as well as awareness regarding how the contaminated masks should be reused, handled and, discarded. Structured monitoring and awareness by the government or authorities for the disposal should be made to combat the explosion of global environmental pollution. In this order, awareness must be created among the general public regarding proper disposal. Along with that, Illegal dumping and recycling must be banned. Reusable masks must be introduced and promoted.
This is a review article whose theme is the repercussions of inappropriate disposal of used PPE. Giving the prospect of the hazards of the contaminated plastic waste over populations, animals and, the environment in the context of the coronavirus pandemic. This study, by choosing to perform a narrative review, considered the need to map what had been produced up to that point about the theme of waste disposal under COVID-19, since this phenomenon is recent and growing, and there is no restriction regarding the type of publication since the presence of publications derived from original research is still scarce. Narrative reviews do not have explicit and systematic criteria for the search and analysis of the evidence, and its data sources may or may not be predetermined or specific. There were no limitations for this research, such as type of study, year, and language of the publication, since this is a recent context, with little pieces of researches carried out.
Due to the lack of awareness among the public about the proper disposal of used masks and inefficient central waste management systems, contaminated masks and PPE are creating serious environmental and hygiene issues (Silva, Prata et al. 2020). Plastic can itself propagate invasive pathogens and when it is in the form of a contaminated mask it becomes more hazardous (Naik, Naik et al. 2019). Laypersons, especially the impoverished are observed reusing the masks (Song, Pan et al. 2020). People find used masks dispersed and use them anyhow to follow protocols. Sometimes people are even observed sharing masks that some friend or relative has already used, due to a lack of knowledge about usage and disposal. As general mass lacks the understanding of the correct manner of discarding waste, contaminated masks are seen lying on grounds, roads, parks, sittings, and clinics. 94% of people have reported seeing PPE in their community regularly. This not only makes the place look inappropriate but also spoils the environment. Nobody wants to be touched by a mask that had shielded someone’s potentially virus-laden breath. Local roadside vendors who sell the masks, touch the masks with bare hands, more so people who are buying these masks also touch them while selecting and spoil them. These when used by other people can be a potential source of transmission of the corona. As the pandemic surged the panic buying of PPE also increased dramatically, ultimately bringing out tons of plastic waste (. According to a report, only 15 countries of Africa have reportedly produced 586,833,053 wasted masks i.e. two masks daily per capita (. Asia throws 1.8 billion facemasks daily and China takes out 702 million masks daily which is the highest quantity globally (. Due to the lack of awareness among the public about the proper disposal of used masks and inefficient central waste management systems, these masks are creating some serious environmental and hygiene issues (Silva, Prata et al. 2020).
They clog pipes, and streets and also jam the machinery, mainly in the municipal system (. Plastic disposable masks are made up of polypropylene, polyurethane, polyacrylonitrile, polyesters, etc. being indestructible this waste poses a great environmental challenge adding plastic to the territory and water bodies (Abbasi, Khalil et al. 2020). This intoxicates aquatic and territorial lives in turn disturbing food webs. Moreover, the addition of plastic particles in human consumption, when a human eats plastic contaminated seafood, can create human diseases too (Stafford and Jones 2019). Some proven pathologies are metabolic, endocrine, fertility, and digestive disorders (Wright and Kelly 2017). Much known is the fact that plastic is devastating as it takes thousands of years to degrade. When burnt, plastics release environmental toxins, in turn adding to the air pollution. Escalated amount of facemasks and medical waste in the environment, thereby warrants the urgent prevention and control of this huge plastic waste.
As masks are the potent source of the spread of the virus, the community habitats and public areas should be carefully monitored to reduce pandemic-related risks. There must be proper collection and disposal of waste for which proper management must be undertaken. Due to increased waste, the Irish government raised funds for ring-fencing to tackle illegal dumping (. Garbage collectors should not collect waste, because not only it is dangerous for the spread among the pickers but also to the general population when recycled and reused inappropriately. Awareness to people must be given not to add COVID contaminated waste to the household trash as it is not incinerated or treated efficiently by the municipal plants assigned to treat household waste. Specially labeled trash cans must be used for contaminated masks and PPE.
This is necessary to prevent the infection and prevent the stealing of the mask for reuse and resale.
This method is being followed in Thailand (. When discarding the used masks, always dispose of them in closed leak-proof bags (. India uses paper bags for disposal (. Awareness through mass media and reforms among people with Feasible guidelines should be put forward to halt the spread. Community-wide guidance to tell people that reusable facemasks are better can help to reduce plastic waste (, Washable masks must be worn when possible. Moreover, new projects related to organic and degradable masks should be channelized (. The reusable masks for example from ten tree usable masks, ultra by blue introduced salvage hemp, others made organic masks, biodegradable material must be promoted (. People must be taught to disinfect masks before reusing or discarding them, for instance, a simple method to inactivate virus-contaminated medical masks without affecting their filterability is by heating with a hairdryer for 30min (. Even after all the preventive measures are taken the fact is that disposable masks are part of medical safety protocols and this use cannot be excluded. So they must be efficiently disposed of. The process must include pretreatment, segregation, safe storage, delivery, collection, transport, and disposal. The methods for plastic disposal include incineration, sand landfills, or chemical-physical treatments. The major technique preferred for plastic disinfection and disposal is incineration, which is a biologically safe and suitable method to destroy the traces of virus with a high furnace temperature of 1100° for 3 minutes. (. China is using the method of a rotary kiln at 850° (. If land-fill is the option, the waste must be pretreated by autoclaving, chemical-physical, or biological methods to halt the spread of infection. (. US-based convention of trans bonding movement of hazardous waste and disposal has urged members to treat the waste of COVID-19 as urgent public service to minimize possible impacts.
Moreover, UVGI, MGS, and microwave-generated steam are thought to be efficacious sterilization methods (Paul, Gupta et al. 2020, Zhao, Zhang et al. 2020). The method of landfill is being used in India, Bangladesh, Malaysia, etc. as the common management option (. Once the waste is treated, then the proper burial must be done in rural and remote areas. Manifestly, Japan is using melting, steam, sterilization, shredding, and eventually landfill as the course of action. Alas, all these techniques increase the microplastic in the environment, so alternate approaches to this must be used. To reduce the net micro plastic reserve over the earth a productive idea of thermolysis of solid plastic into liquid fuel can be undertaken (. Making building material out of properly disinfected waste is another proposition (. These methods can act as the long-term plan for the huge plastic waste which is expected to be produced for a long time.
The repression of environmental pollution intensified with pandemic and authorities need to make coping strategies and policies for proper disposal. Critical thinking is required to evaluate and reduce this rising issue regarding plastic waste. The masks used for protection themselves can be the cause of infection transmission. There must be a proper awareness program regarding the usage of biodegradable masks, proper disposal of contaminated masks. Or if people are reusing masks, they must be educated on how to sterilize masks (Vernez, Save et al. 2020). The harms that this plastic pollution is causing are underrated due to the enormous industrial growth and economic interest. Secondly banning masks is the least preferred option, as it is an effective measure against the spread of the virus.
There must be a coordinated international strategy for this. Proper disposal or effective techniques to decontaminate and reuse these masks are a better way to reduce the harm of such big waste (Lee, Bong et al. 2020). Furthermore, an effective plan of action must be designed to cope be increasing plastic waste over the planet.
Abbasi, S. A., et al. (2020). “Extensive use of face masks during COVID-19 pandemic: (micro-) plastic pollution and potential health concerns in the Arabian Peninsula.” Saudi Journal of Biological Sciences 27 (12): 3181-3186.
Aragaw, T. A. (2020). “Surgical face masks as a potential source for microplastic pollution in the COVID-19 scenario.” Marine Pollution Bulletin 159: 111517.
Benson, N. U., et al. (2021). “COVID pollution: impact of COVID-19 pandemic on global plastic waste footprint.” Heliyon 7 (2): e06343.
Eikenberry, S. E., et al. (2020). “To mask or not to mask: Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic.” Infectious Disease Modelling 5: 293-308.
Fadare, O. O. and E. D. Okoffo (2020). “Covid-19 face masks: A potential source of microplastic fibers in the environment.” The Science of the total environment 737: 140279.
Jirawattanasomkul, T., et al. (2021). “Fibre-Reinforced Polymer Made from Plastic Straw for Concrete Confinement: An Alternative Method of Managing Plastic Waste from the COVID-19 Pandemic.” Engineering Journal 25 (3): 1-14.
Klemeš, J. J., et al. (2020). “Minimising the present and future plastic waste, energy and environmental footprints related to COVID-19.” Renewable and Sustainable Energy Reviews 127: 109883.
Lee, J., et al. (2020). “Fast and easy disinfection of coronavirus-contaminated face masks using ozone gas produced by a dielectric barrier discharge plasma generator.” medRxiv.
Missoni, E., et al. (2020). “Face Masks For All And All For Face Masks in the COVID-19 pandemic: community level production to face the global shortage and shorten the epidemic.” Disaster Medicine and Public Health Preparedness: 1-5.
Mueller, A. V., et al. (2020). “Quantitative method for comparative assessment of particle removal efficiency of fabric masks as alternatives to standard surgical masks for ppe.” Matter 3 (3): 950-962.
Naik, R. K., et al. (2019). “Microplastics in ballast water as an emerging source and vector for harmful chemicals, antibiotics, metals, bacterial pathogens and HAB species: A potential risk to the marine environment and human health.” Marine Pollution Bulletin 149: 110525.
Organization, W. H. (2020). Risk communication and community engagement readiness and response to coronavirus disease (COVID-19): interim guidance, 19 March 2020, World Health Organization.
Panda, A. K., et al. (2010). “Thermolysis of waste plastics to liquid fuel: A suitable method for plastic waste management and manufacture of value added products—A world prospective.” Renewable and Sustainable Energy Reviews 14 (1): 233-248.
Paul, D., et al. (2020). “Exploring options for reprocessing of N95 Filtering Facepiece Respirators (N95-FFRs) amidst COVID-19 pandemic: A systematic review.” PloS one 15 (11): e0242474.
Prata, J. C., et al. (2020). “COVID-19 pandemic repercussions on the use and management of plastics.” Environmental science & technology 54 (13): 7760-7765.
Provencher, J., et al. (2019). “Assessing plastic debris in aquatic food webs: what we know and don’t know about uptake and trophic transfer.” Environmental Reviews 27 (3): 304-317.
Sangkham, S. (2020). “Face mask and medical waste disposal during the novel COVID-19 pandemic in Asia.” Case Studies in Chemical and Environmental Engineering 2: 100052.
Sarkodie, S. A. and P. A. Owusu (2021). “Impact of COVID-19 pandemic on waste management.” Environment, development and sustainability 23 (5): 7951-7960.
Scalvenzi, M., et al. (2020). “Community Knowledge About the Use, Reuse, Disinfection and Disposal of Masks and Filtering Facepiece Respirators: Results of a Study Conducted in a Dermatology Clinic at the University of Naples in Italy.” Journal of community health: 1-8.
Selvaranjan, K., et al. (2021). “Environmental challenges induced by extensive use of face masks during COVID-19: A review and potential solutions.” Environmental Challenges: 100039.
Silva, A. L. P., et al. (2020). “Increased plastic pollution due to COVID-19 pandemic: Challenges and recommendations.” Chemical Engineering Journal: 126683.
Singh, N., et al. (2020). “Environmentally sustainable management of used personal protective equipment.” Environmental science & technology 54 (14): 8500-8502.
Song, W., et al. (2020). “Heat inactivating and reusing of virus-contaminated disposable medical mask.” medRxiv.
Stafford, R. and P. J. Jones (2019). “Viewpoint–Ocean plastic pollution: A convenient but distracting truth?” Marine policy 103: 187-191.
Torkashvand, J., et al. (2021). “Municipal solid waste management during COVID-19 pandemic: a comparison between the current activities and guidelines.” Journal of Environmental Health Science and Engineering: 1-7.
Vanapalli, K. R., et al. (2021). “Challenges and strategies for effective plastic waste management during and post COVID-19 pandemic.” Science of The Total Environment 750: 141514.
Vernez, D., et al. (2020). “Reusability of filtering facepiece respirators after decontamination through drying and germicidal UV irradiation.” BMJ global health 5 (10): e003110.
Wright, S. L. and F. J. Kelly (2017). “Plastic and human health: a micro issue?” Environmental science & technology 51 (12): 6634-6647.
Zhao, Z., et al. (2020). “Germicidal ultraviolet light does not damage or impede performance of N95 masks upon multiple uses.” Environmental Science & Technology Letters 7 (8): 600-605.
Nayab Sheikh is a final year MBBS student at Karachi Medical and Dental College, Karachi.
Chanchal Maheshwari is third year MBBS student at Karachi Medical and Dental College, Karachi.