New Report | Assessment of the Cytotoxic Waste Management in Western Balkan Countries

ISWA is proud to announce our Working Group on Healthcare Waste (WGHCW)'s newest report exploring the management of cytotoxic waste in Western Balkan Countries.

17 Jun 2020 -


Click here for FULL REPORT


To celebrate the release of this report and to help waste professionals understand more on the subject, we are excited to invite you to an online discussion about the publication.


Cytotoxic Wastes in Western Balkan Countries: Challenges, Roadblocks, and Solutions
Tuesday, July 7th 2020 - 3:00 PM (CEST)


Summary of Report

This assessment provides a status report on the Cytotoxic waste management in Western Balkan (WB) countries through utilization of data provided from the International Solid Waste Associations with a focus on National Member countries. For the purpose of the Project, a Questionnaire was developed in order to collect reliable information from the institutions that are generating cytotoxic waste.

WB Countries account for nearly 18 million citizens. It is estimated that around 50000 patients per year are treated with chemotherapy and that approximately 100 tons of hazardous cytotoxic waste is generated throughout the process. Sustainable healthcare waste management presents significant challenges in the countries in transition because of the versatility of hazardous properties. The challenges are mainly related with achieving the necessary standards especially in management of hazardous healthcare waste streams that are generated in smaller rates than the infectious waste but requires very expensive handling and treatment technologies.

In line with collected data, all WB countries have already established similar healthcare waste management systems, in accordance with WHO guidelines and EU directives. Due to the fact of absence of specific treatment technology, the countries are faced with serious issues of not regularly collecting the waste, long term temporary storage and difficulties exporting the waste to countries that poses adequate treatment technologies. These issues can lead to improper storage, treatment and potentially illegal disposal of the cytotoxic waste and increasing the risk toward the public and environment as well.

One of the main findings of this report is the willingness for cooperation among the WB countries healthcare systems and institutions in areas such as special investigations and analysis, scientific programs, continuous professional development, transfer of knowledge and practices on various healthcare topics.

The listed recommendations are excellent example on tracing the path for establishing a regional approach for managing of hazardous cytotoxic waste that could serve as a template for international application which could subsequently be utilized elsewhere.


This is an initiative by the Working Group on Healthcare Waste with support from the ISWA Scientific and Technical Committee.


Authors: Viktor Hristov and Dr Slobodanka Pavlovic

Advisory Experts: Dr. Anne Woolridge,  Edward Krisiunas,  Omar Fern√°ndez Sanfrancisco

Project Coordinator: Jennifer MacDonald

Contributors: Zoran Obradovic HWM Zrenjanin, Serbia,  Daniela Dameska Nelepa MaSWA, Skopje Macedonia,  Zeljko  Aleksic    HWM  Banja  Luka,  RS,  Bosnia,  Dr.  Goran  Vijuc  SeSWA,  Novi  Sad,  Serbia,  Bojana Tot SeSWA, Novi Sad, Serbia,  Dragisa Marjanovic BaSWA, Sarajevo, Bosnia and Herzegovina, MSc. Malenka Vujosevic, Podgorica, Montenegro,  Dr. Mihail Kochubovski, Skopje, Macedonia,   Dr  Nikola  Vasev,  Skopje,  Macedonia,   Marijana  Lutovska  Head  Nurse,  Skopje,  Macedonia,  Irena Jareva HWM Skopje, Macedonia,  Darko Blinkov, Skopje, Macedonia,  Enis Tela, Tirana, Albania,  Lendita Sopa, Pristina, Kosovo,  Enver Tasi, Pristina, Kosovo



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