New integrated approaches based on MC-HFLTS for healthcare waste treatment technology selection

Selecting the most appropriate healthcare waste treatment technology (HCWTT) is an uncertain and complex decision-making problem because there exist more than one alternative and many conflicting qualitative and quantitative criteria. However, the use of fuzzy and comparative values, instead of specific crisp values, provides more accurate results, so that the alternatives may be evaluated in accordance with hesitant human nature. The purpose of this paper is to select the best HCWTT using a hesitant fuzzy linguistic term set (HFLTS).

Five main criteria were identified for HCWTT selection, such as economic, social, environmental, technical and ergonomic criteria. In total, 19 sub-criteria were examined, and the hierarchy of the criteria was formed. The criteria weights were determined using the multi-criteria hesitant fuzzy linguistic term set (MC-HFLTS). The selection processes of incineration (A₁), steam sterilization (A₂), microwave (A₃) and landfill (A₄) alternatives were carried out using the multi-attributive ideal-real comparative analysis (MAIRCA) and multi-attributive border approximation area comparison (MABAC) methods. In the comparative analyses, Vise Kriterijumska Optimizacija I Kompromisno Resenje (VIKOR) and technique for order preference by similarity to an ideal solution (TOPSIS) methods were used.

The comparison of the results of the MABAC and MAIRCA methods with the results of VIKOR and TOPSIS methods indicated that A₂ (steam sterilization) alternative was the best one and produced the same ranking of the technology alternatives (A₂ > A₃ > A₁ > A₄). As a result, the study concluded that these methods can be successfully used for HCWTT selection problems.

To the best of the authors’ knowledge, MC-HFLTS has not been used to select HCWTT in the existing literature. For the first time, MC-HFLTS&MAIRCA and MC-HFLTS&MABAC approaches were used in order to choose the best treatment method for healthcare waste under the effect of multiple conflicting hierarchical criteria. It has been provided that MABAC and MAIRCA select alternative choices by taking into consideration the hierarchical criteria. Unlike other studies, this study also considered ergonomic criteria that are important for people working during the process of using the treatment technology.