Integrated Environmental Assessment of Medical Waste Management in the Kingdom of Bahrain
Round 1
Reviewer 1 Report
This study was focused on assess the increasing generation rate of MW and its management related to medical waste in Bahrain. It deserves for publication in the Sustainability after minor revision. A few suggestions are listed as follows:
1. Need to further highlight the significance of the study.
2. Specific measures need to be defined for medical waste for a more sustainable future.
Author Response
This study was focused on assess the increasing generation rate of MW and its management related to medical waste in Bahrain. It deserves for publication in the Sustainability after minor revision. A few suggestions are listed as follows:
Response: We thank the reviewer for his positive comments of the paper and have incorporated the suggestions as detailed hereunder;
- Need to further highlight the significance of the study.
Response: One section in the revised manuscript is created (section 4) that focuses on the significance of the study. It is hoped that the contents included will serve the purpose.
- Specific measures need to be defined for medical waste for a more sustainable future.
Response: At the end of the manuscript the section “Conclusion” has been modified with “Conclusions and Recommendations”. Wherein some measures have been proposed for sustainable future in terms of judicious management of MW.
Reviewer 2 Report
The article Integrated Environmental Assessment of Medical Waste Management in the Kingdom of Bahrain addresses the important and topical topic of medical waste management, especially considering the ever-increasing amount of waste generated. The strengths of the article are: a description of the state of the economy in Bahrain, an analysis of policies of medical waste and the presentation of future forecasts and proposals for the management of this waste. The content of the article will be of interest to readers. However, prior to publication, authors should make the changes indicated below:
· Introduction - The background on medical waste management is not exhaustive. Please add more information about what categories of medical waste are generated and what their exact properties are. This is very important, because the properties of waste determine the use of an appropriate method of their transformation. Please also pay attention to the limitations and obstacles in the management of medical waste. Some medical waste is not recyclable and can only be thermally treated. Authors can also mention in the introduction other waste treatment methods than pyrolysis, incineration, gasification, and carbonization.
The reviewer believes that adding more references will contribute to improving the quality of the article. Sample publications:
https://doi.org/10.1007/s11356-021-16727-9,
https://doi.org/10.1007/s11356-022-20740-x,
https://doi.org/10.1007/s11356-022-19018-z,
https://doi.org/10.22097/eeer.2022.300132.1214,
https://doi.org/10.1007/s10163-022-01428-3,
https://doi.org/10.2298/VSP200521072S.
· Figure 1 needs improvement - very poor quality.
· Equation 1 should be done using Equation editor.
· Figure 2- In the opinion of the reviewer, the graph would look better if the authors changed the graph type to scatter plot with lines.
· Figure captions – please end each figure caption with a dot.
· Section 3.1 describes the increase in the amount of medical waste generated. The causes and types of waste were well diagnosed. However, there is no comparison of the upward trend and waste characteristics with other countries or regions. Please add a discussion to the information provided.
· Line 324 – use subscript at CO2.
Comments for author File: 
Comments.pdf
Author Response
The article Integrated Environmental Assessment of Medical Waste Management in the Kingdom of Bahrain addresses the important and topical topic of medical waste management, especially considering the ever-increasing amount of waste generated. The strengths of the article are: a description of the state of the economy in Bahrain, an analysis of policies of medical waste and the presentation of future forecasts and proposals for the management of this waste. The content of the article will be of interest to readers. However, prior to publication, authors should make the changes indicated below:
- Introduction - The background on medical waste management is not exhaustive. Please add more information about what categories of medical waste are generated and what their exact properties are.
Response: Categories of MW with exact properties are described, In line 31-41
This is very important, because the properties of waste determine the use of an appropriate method of their transformation. Please also pay attention to the limitations and obstacles in the management of medical waste. Some medical waste is not recyclable and can only be thermally treated.
Response: Some specific obstacles and limitations in sustainable management are outlined in the text as suggested, line 307-311.
Authors can also mention in the introduction other waste treatment methods than pyrolysis, incineration, gasification, and carbonization.
Response: Several treatment methods are briefly described in the text, being highlighted in the main test.
The reviewer believes that adding more references will contribute to improving the quality of the article. Sample publications:
Response: We thank the reviewer for suggesting valuable works, most of the articles were helpful in improving the quality of the article. Most of them have been included in the list and useful information from the same have been incorporated in the revised version.
- Figure 1 needs improvement - very poor quality.
Response: Figure 1, has been changed and its quality has been improved as suggested.
- Equation 1 should be done using Equation editor.
Response: Equation Editor used for the Equation as suggested.
- Figure 2- In the opinion of the reviewer, the graph would look better if the authors changed the graph type to scatter plot with lines.
Response: Figure/plot changed to stattered plot with lines as suggested.
- Figure captions – please end each figure caption with a dot.
Response: All the figures captions are ended up with a dot.
- Section 3.1 describes the increase in the amount of medical waste generated. The causes and types of waste were well diagnosed. However, there is no comparison of the upward trend and waste characteristics with other countries or regions. Please add a discussion to the information provided.
Response: One of the suggested references deals with same issue and has been included for making a comparison with a representative country.
- Line 324 – use subscript at CO2.
Response: Corrected as suggested with thanks.
We are thankful to the reviewer for his input and time which improved tremendously the quality of the article.
Reviewer 3 Report
It is not clear what you want to achieve with the article, what the consequences of your research would be. Do you want to change the waste management policy in the country? If yes, how? Do you want to change the medical waste management system? If so, you didn't suggest a specific way.
Author Response
It is not clear what you want to achieve with the article, what the consequences of your research would be. Do you want to change the waste management policy in the country? If yes, how?
Response: Proper management of medical waste is possible if different sector shoulder the responsibility in true spirits. Because, MW is not handled by a single body, there are several dealing hands in this respect. The study found that most of the existing policies address the impact of the MW issues, but the policies are lacking in tackling the drivers and pressures. Therefore this study recommends forming the policies in a way to tackle the roots of the issue, focusing on the drivers and pressure of increasing medical waste and its mismanagement and the proposed actions to be taken for efficient medical waste management (section 3.5, line 355 in the revised version).
Do you want to change the medical waste management system? If so, you didn't suggest a specific way.
Response: No, but some actions are suggested for improving the existing practices. For instance, a sustainable scenario is suggested; for increasing the quantity of medical waste to go for segregation. For the issue of medical waste treatment to adopt alternative technology, which needs further studies for the best technology, as shown in section 3.4, Table 2. In addition, some recommendations are provided in section
We hope the reviewer will agree with the changes and modifications, in case of further suggestions we would be glad to improve the article as much as we can. We are thankful to him for having a critical look at the manuscript.
Round 2
Reviewer 3 Report
Conclusions can be bulleted according to main conclusions to make them more clear.
