Of the hospitals surveyed, 93.3% provided training for staff at some point, while only 20% of the hospitals had ongoing training and education. The survey indicated that training programs regarding medical waste management for doctors, nurses and technicians were limited in Nanjing. Birpinar et al. (2008) reported that, in Istanbul, 98% of hospitals organize courses for their collection personnel, and healthcare services organize training programs regarding
medical waste management for doctors, nurses, and technicians; almost 63% of healthcare services organize courses
at least once a month, while 31% organize courses at least twice a year. Askarian et al. (2004) reported that 60% of hospitals in Iran provided some training for cleansing staff; however, newly hired waste management personnel were not trained properly. Abdulla et al. (2008) reported that 29% of the hospitals in northern Jordan had not provided training to doctors and other personnel regarding medical waste management and the related hazards; 57% of hospitals provided limited training for support staff (maintenance engineers, cleaning workers). In developed countries, such as the USA, there are effective training programs and educational plans related to medical waste management for all staff (Askarian et al., 2004).