What happens to trash after disposal? The management and processing of discarded items is often opaque and taken for granted, but an understanding of hospital waste streams is important for radiology departments and hospital systems for economic, regulatory, and environmental reasons. In this paper, we discuss the numerous waste pathways including general, hazardous, pharmaceutical, radioactive, and electronic waste as well as sustainable waste streams including laundry services, composting, and recycling. Costs, regulatory issues, and environmental considerations associated with each pathway are reviewed. We also describe radiology's specific contributions to each waste stream as well as variations in department practices, tips for optimal use, and future research investigations that could impact waste volume. Healthcare garbage disposal pathways will only increase in importance as our healthcare needs and systems continue to grow, and waste optimization efforts yield benefits to operation costs, environmental ecosystems, and human health.
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