Medical care is vital for our life and health, but the waste generated from medical activities represents a real problem of living nature and human world. Improper management of waste generated in health care facilities causes a direct health impact on the community, the health care workers and on the environment.
Every day, relatively large amount of potentially infectious and hazardous waste is generated in the health care hospitals and facilities around the world. Indiscriminate disposal of BMW or hospital waste and exposure to such waste possess serious threat to environment and to human health that requires specific treatment and management prior to its final disposal.
Definition of bio-medical waste
According to Bio-medical Waste (Management and Handling) Rules of India "Any waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals.
Bio-Medical waste consists of:
- Human anatomical waste like tissues, organs and body parts.
- Animal wastes generated during research from veterinary hospitals.
- Microbiology and biotechnology wastes.
- Waste sharps like hypodermic needles, syringes, scalpels and broken glass.
- Discarded medicines and cytotoxic drugs.
- Soiled waste such as dressing, bandages, plaster casts, material contaminated with blood, tubes and catheters.
- Liquid waste from any of the infected areas.
- Incineration ash and other chemical wastes.
Hazards associated with poor health care waste management
Proper disposal of biomedical waste is of paramount importance because of its infectious and hazardous characteristics. Improper disposal can result in the following:
- Injuries from sharps to all categories of health care personnel and waste handlers.
- Increase risk of infections to medical, nursing and other hospital staff.
- Poor infection control can lead to nosocomial infections in patients particularly HIV, Hepatitis B & C.
- Increase in risk associated with hazardous chemicals and drugs being handled by persons handling wastes.
- Poor waste management encourages unscrupulous persons to recycle disposables and disposed drugs for repacking and reselling.
- Development of resistant strains of microorganisms.
Quantum of waste that is generated
- By a HospitalThe quantum of waste that is generated in India is estimated to be 1-2 kg per bed per day in a hospital and 600 gm per day per bed in a general practioner's clinic. As per government data, 85% of the hospital waste is non-hazardous, 15% is infectious/hazardous.
- e.g. a 100 bedded hospital will generate 100 - 200 kgs of hospital waste/day.All India basis
Total bio-medical waste generation in the country is 484 tonnes Per Day (TPD) from 1,68,869 healthcare facilities (HCF), out of which 447 TPD is treated.
Bio-Medical Waste Management Rules, 2016
The major salient features of BMW Management Rules, 2016 include the following:-
- The ambit of the rules has been expanded to include vaccination camps, blood donation camps, surgical camps or any other healthcare activity;
- Phase-out the use of chlorinated plastic bags, gloves and blood bags within two years;
- Pre-treatment of the laboratory waste, microbiological waste, blood samples and blood bags through disinfection or sterilisation on-site in the manner as prescribed by WHO or NACO;
- Provide training to all its health care workers and immunise all health workers regularly;
- Establish a Bar-Code System for bags or containers containing bio-medical waste for disposal;
- Report major accidents;
- Existing incinerators to achieve the standards for retention time in secondary chamber and Dioxin and Furans within two years;
- Bio-medical waste has been classified in to 4 categories instead 10 to improve the segregation of waste at source;
- Procedure to get authorization simplified. Automatic authorization for bedded hospitals has been announced. The validity of authorization synchronised with validity of consent orders for Bedded HCFs. One time Authorisation for Non-bedded HCFs;
- The new rules prescribe more stringent standards for incinerator to reduce the emission of pollutants in environment;
- Inclusion of emissions limits for Dioxin and furans;
- State Government to provide land for setting up common bio-medical waste treatment and disposal facility;
- No occupier shall establish on-site treatment and disposal facility, if a service of `common bio-medical waste treatment facility is available at a distance of seventy-five kilometer; and
- Operator of a common bio-medical waste treatment and disposal facility to ensure the timely collection of bio-medical waste from the HCFs and assist the HCFs in conduct of training.
Major changes in new rules
Under the new regime, the coverage has increased and also provides for pre-treatment of lab waste, blood samples, etc. It mandates bar code system for proper control. It has simplified categorisation and authorisation. Thus, it will make a big difference to clean India Mission.
Scientific disposal of Biomedical Waste through segregation, collection and treatment in an environmentally sound manner minimizes the adverse impact on health workers and on the environment.
The hospitals are required to put in place the mechanisms for effective disposal either directly or through common biomedical waste treatment and disposal facilities.
The hospitals servicing 1000 patients or more per month are required to obtain authorisation and segregate biomedical waste in to 10 categories, pack five colour backs for disposal.
The segregation of waste at source is the key step and reduction, reuse and recycling should be considered in proper perspectives. The challenge before us, therefore, is to scientifically manage growing quantities of biomedical waste that go beyond past practices. If we want to protect our environment and health of community we must sensitize ourselves to this important issue not only in the interest of health managers but also in the interest of community.