en عمومى General Systematic Review Article <p></p> <div style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="line-height:150%"><span new="" roman="" times="">Operating room waste management is a critical challenge in healthcare systems, playing a decisive role in preventing healthcare-associated infections (HAIs), protecting the health of staff and patients, and reducing environmental impacts. In recent years, the increasing volume of surgical procedures, widespread use of disposable items, and infection control requirements have led to a significant rise in the generation of infectious and hazardous waste in operating rooms. From an environmental health engineering perspective, sustainable waste management extends beyond safe disposal to include source reduction, proper segregation, volume minimization, targeted recycling, selection of appropriate and environmentally sound treatment technologies, and optimization of the life cycle of consumable materials. This critical review aims to systematically analyze published scientific evidence without time restriction up to 2025, focusing on sustainable operating room waste management strategies with particular emphasis on their role in preventing HAIs. Findings indicate that poor waste segregation, suboptimal use of single-use protective equipment, and sole reliance on costly treatment technologies not only increase economic and environmental burdens but may also exacerbate the risk of pathogen transmission. In contrast, integrating environmental health engineering principles with infection control programs, staff training, process redesign, and the adoption of innovative, low-impact technologies have been proposed as effective and sustainable strategies. This critical review underscores the necessity of policy revision and a shift from a reactive to a preventive, system-oriented approach in operating room waste management.</span></span></span></span></div> Hospital waste management, Operating room, Environmental health engineering, Sustainability, Prevention of healthcare-associated infections 14 25 http://jrhms.thums.ac.ir/browse.php?a_code=A-10-186-5&slc_lang=en&sid=1 Hossein Farash Khayalo 10031947532846001914 10031947532846001914 No Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Abbas Aabbasnia 10031947532846001915 10031947532846001915 Yes Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Mojtaba Yeganeh 10031947532846001916 10031947532846001916 No Environmental Health Engineering Research Center, Iran University of Medical Sciences, Tehran, Iran Erfan Rajabi 10031947532846001917 10031947532846001917 No Student Research Committee, School of Paramedical Sciences, Iran University of Medical Sciences, Tehran, Iran Seyed Abolfazl Hosseini 10031947532846001918 10031947532846001918 No Student Research Committee, School of Paramedical Sciences, Iran University of Medical Sciences, Tehran, Iran Bahador Pourdel 10031947532846001919 10031947532846001919 No Student Research Committee, School of Paramedical Sciences, Iran University of Medical Sciences, Tehran, Iran Edris Bazrafshan 10031947532846001920 10031947532846001920 No Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran