Staff Attitudes Toward Healthcare Waste Separation: An Exploratory Survey from a Triple-Bottom-Line Perspective

Julia Nike Sturm; Mark Berneburg; Bernadett Kurz; Dennis Niebel

doi:10.3390/healthcare14080975

journal article Open Access Apr 08, 2026

Staff Attitudes Toward Healthcare Waste Separation: An Exploratory Survey from a Triple-Bottom-Line Perspective

Julia Nike Sturm

Mark Berneburg

Bernadett Kurz

Dennis Niebel

Healthcare Vol. 14 No. 8 pp. 975 · MDPI AG

View at Publisher Save 10.3390/healthcare14080975

Abstract

Background: In 2022, the German healthcare system generated 400,000 tons of waste. Reducing this number could lower greenhouse gas emissions. The waste management plan at the University Medical Center Regensburg, and those of other comparable German facilities, require that glass, cardboard/paper, residual waste, and other non-hazardous materials are collected separately. Objectives: To assess the personal interest, proficiency, opinion, and awareness of waste management among German dermatology staff to develop customized, resource-saving process optimization and training programs. Methods: An online cross-sectional survey was conducted among German dermatology healthcare professionals between 27 February and 4 October 2024. Out of the 100 responses, 84 were complete and subsequently analyzed. Respondents included staff at dermatology wards, outpatient units, and private practices. Data were analyzed descriptively; comparisons were made between clinics and outpatient units, and correlations were identified among the items. Results: Most respondents perceived the amount of waste generated during wound dressing changes as high; more than 60% expressed an interest in receiving further training on sustainability and waste reduction. Although many respondents reported having a good understanding of waste separation, they identified time pressure and stress as the two main obstacles to consistent implementation. Higher self-reported knowledge did not correspond with greater confidence in recycling as an effective waste reduction measure. Conclusions: The findings suggest a discrepancy between awareness and practice regarding sustainable waste management in dermatology. Combining structural and organizational measures with targeted training and workflow optimization could promote more sustainable clinical practices.

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References

29

[1]

Rummler, T., Jaron, A., and Neubauer, A. (2026, March 19). Abfallvermeidungsprogramm des Bundes Unter Beteiligung der Länder. Available online: https://www.bundesumweltministerium.de/download/abfallvermeidungsprogramm-des-bundes-unter-beteiligung-der-laender-fortschreibung-wertschaetzen-statt-wegwerfen.

[2]

Publications Office of the European Union (2008). Directive 2008/98/EC of the European Parliament and of the Council of 19 November 2008 on Waste and Repealing Certain Directives, Publications Office of the European Union.

[3]

Statistisches Bundesamt (2026, March 19). Abfallwirtschaft: Kurzübersicht Abfallbilanz—Zeitreihe: Abfallbilanzen 2012–2023. Available online: https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Umwelt/Abfallwirtschaft/Tabellen/liste-abfallbilanz-kurzuebersicht.html.

[4]

Bundesministerium der Justiz (2012). Kreislaufwirtschaftsgesetz: KrWG, Bundesministerium der Justiz.

[5]

World Health Organization (2026, March 19). Health-Care Waste. Available online: https://www.who.int/news-room/fact-sheets/detail/health-care-waste.

[6]

World Health Organization (2014). Safe Management of Wastes from Health-Care Activities: A Practical Guide, World Health Organization. [2nd ed.].

[7]

Statistisches Bundesamt Deutschland—GENESIS (2026, March 19). 32111-0002: Abfallentsorgung: Deutschland, Jahre, Abfallarten. Available online: https://www-genesis.destatis.de/datenbank/online/statistic/32111/table/32111-0002.

[8]

Karliner, J., Slotterback, S., Boyd, R., Ashby, B., and Steele, K. (2026, March 19). Health Care Climate Footprint Report: How the Health Sector Contributes to the Global Climate Crisis and Opportunities for Action. Available online: https://global.noharm.org/resources/health-care-climate-footprint-report.

[9]

Spruell "The carbon footprint of healthcare settings: A systematic review" J. Adv. Nurs. (2023) 10.1111/jan.15671

[10]

Silva "Carbon Footprint Analysis of an Outpatient Dermatology Practice at an Academic Medical Center" JAMA Dermatol. (2025) 10.1001/jamadermatol.2024.5669

[11]

Niebel "Environmental Impact of Dermatology and Action Towards It: A Narrative Review" Int. J. Dermatol. (2025) 10.1111/ijd.17810

[12]

Niebel "Treibhausgasäquivalente und Nutzwasserverbrauch durch dermatologische Produktprobenverpackungen" Dermatologie (2024) 10.1007/s00105-024-05392-x

[13]

Aboueid "Barriers and enablers to implementing environmentally sustainable practices in healthcare: A scoping review and proposed roadmap" Healthc. Manag. Forum (2023) 10.1177/08404704231183601

[14]

Hartung, S., and Wihofszky, P. (2024). Gesundheit und Nachhaltigkeit: Klimawandel und Auswirkungen auf Gesundheit aus Medizinischer Sicht, Springer. 10.1007/978-3-662-68278-4

[15]

Bartol, A., and Herkommer, E. (2026, March 19). Der Aktuelle Begriff: Nachhaltigkeit. Available online: https://webarchiv.bundestag.de/archive/2006/0202/bic/analysen/2004/.

[16]

Zarei "ChecKAP: A Checklist for Reporting a Knowledge, Attitude, and Practice (KAP) Study" Asian Pac. J. Cancer Prev. (2024) 10.31557/apjcp.2024.25.7.2573

[17]

Recycling behaviour in healthcare: waste handling at work

Joachim Vogt, Katia R.A. Nunes

Ergonomics 2014 10.1080/00140139.2014.887786

[18]

Udayanga, L., Sahana, L., Perera, A., Ranasinghe, K., and Ranathunge, T. (2023). Knowledge, perceptions and practices on healthcare waste management and associated occupational health hazards among healthcare professionals in the Colombo District, Sri Lanka: A cross-sectional study. Front. Public Health, 11. 10.3389/fpubh.2023.1215648

[19]

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

Rachel C. Shelton, Brittany Rhoades Cooper, Shannon Wiltsey Stirman

Annual Review of Public Health 2018 10.1146/annurev-publhealth-040617-014731

[20]

"Perceptions and concerns about sustainable healthcare of nursing students trained in sustainability and health: A cohort study" Nurse Educ. Pract. (2022) 10.1016/j.nepr.2022.103489

[21]

Musa "Assessment of Nurses’ Practice and Potential Barriers Regarding the Medical Waste Management at Hamad Medical Corporation in Qatar: A Cross-Sectional Study" Cureus (2020)

[22]

Linder, N., Rosenthal, S., Sörqvist, P., and Barthel, S. (2021). Internal and External Factors’ Influence on Recycling: Insights From a Laboratory Experiment With Observed Behavior. Front. Psychol., 12. 10.3389/fpsyg.2021.699410

[23]

World Health Organization (2026, March 19). Operational Framework for Building Climate Resilient Health Systems. Available online: https://www.who.int/publications/i/item/9789241565073.

[24]

Sharma "Regulated Medical Waste Reduction in the Dermatology Clinic" Dermatol. Ther. (2024) 10.1007/s13555-024-01279-w

[25]

Systematic review of the application of the plan–do–study–act method to improve quality in healthcare

Michael J Taylor, Chris McNicholas, Chris Nicolay et al.

BMJ Quality & Safety 2014 10.1136/bmjqs-2013-001862

[26]

Social Desirability Bias in Dietary Self-Report May Compromise the Validity of Dietary Intake Measures

James R Hébert, LYNN CLEMOW, Lori Pbert et al.

International Journal of Epidemiology 1995 10.1093/ije/24.2.389

[27]

Evaluation of methods used for estimating content validity

Enas Almanasreh, Rebekah Moles, Timothy F. Chen

Research in Social and Administrative Pharmacy 2019 10.1016/j.sapharm.2018.03.066

[28]

Tan "Measuring social desirability bias: Do the full and short versions of the Marlowe-Crowne Social Desirability scale matter?" J. Empir. Res. Hum. Res. Ethics (2022) 10.1177/15562646211046091

[29]

Moshagen "Reducing socially desirable responses in epidemiologic surveys: An extension of the randomized-response technique" Epidemiology (2010) 10.1097/ede.0b013e3181d61dbc

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Details

Published: Apr 08, 2026
Vol/Issue: 14(8)
Pages: 975
License: View

Authors

J

Julia Nike Sturm

Department of Dermatology, University Medical Center Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany

M

Mark Berneburg

Department of Dermatology, University Medical Center Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany

B

Bernadett Kurz

Department of Dermatology, University Medical Center Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany

D

Dennis Niebel

Department of Dermatology, University Medical Center Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany; Heinz-Werner-Seifert-Institut, Trierer Str. 70-72, 53115 Bonn, Germany

Cite This Article

Julia Nike Sturm, Mark Berneburg, Bernadett Kurz, et al. (2026). Staff Attitudes Toward Healthcare Waste Separation: An Exploratory Survey from a Triple-Bottom-Line Perspective. Healthcare, 14(8), 975. https://doi.org/10.3390/healthcare14080975

Staff Attitudes Toward Healthcare Waste Separation: An Exploratory Survey from a Triple-Bottom-Line Perspective

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