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Hospital and bio-medical waste management is one of the most important health aspects of the government. Bio-medical waste can be a huge health issue. It is reported that only 15% of the total health care activities (infectious, toxic and radio-active) is considered hazardous and focus attention is required for sanitising such activities.

What is hospital waste? It refers to all biological or non-biological waste that is discarded and not intended for further use. Bio-medical waste, on the other hand, refers to waste which is generated during diagnosis, treatment or immunisation of human beings or animals or in research activities.

One example will clarify the matter. A report published in 2018 by the World Health Organisation (WHO) observed that every year an estimated 16 billion injections were administered world-wide but not all of the needles and syringes were disposed properly. The report also observed the harmful methods of management of waste. Open burning and incineration of health-care wastes can, under some circumstances, result in emission of dioxins, furans and particulate matter. Measures to ensure the safe and environmentally sound management of healthcare waste can prevent adverse health and environmental impact including the unintended release of chemical or biological hazards, including drug-resistant microorganisms into the environment.

Bio-medical Waste Management Rules, 2016 and Amendment, 2018

These rules shall apply to all persons who generate, collect, receive, store, transport, treat, dispose or handle bio-waste in any form. The policy is to immunise all healthcare workers and others involved in handling of bio-medical waste for protection against diseases including Hepatitis B and Tetanus which are likely to be transmitted by handling of bio-waste.

Role of Pollution Control Board

The Pollution Control Board has made some convenient rules for segregation, collection, treatment, processing and disposal of biomedical wastes. There are several categories like yellow, red, white and blue. In the yellow category the included items are - human and animal anatomical waste that is human or animal tissues, organs, body parts, solid waste, expired or discarded medicines, chemical waste, chemical liquid waste, discarded linen and mattress and micro-biological, bio-technological waste and also clinical laboratory waste. Similarly, in the red category contaminated waste generated from disposable items such as tubing bottles, etc. are included. The white category relates to waste (used or discarded) sharps including metal items like needles, syringe with fixed needles, scalpels and blades. The blue category is related to items like broken, discarded or contaminated glassware and metallic body implants.

The Bureau of Indian Standards has fixed certain standard rules pertaining to waste bags and the method of using it. Waste management has many methodological steps. These are segregation, collection of bio-medical waste and transportation and storage of waste. This category can be divided into two parts - intramural transport involving the movement of waste bags inside the healthcare facility premises and the second is extramural transport which relates to movement of waste for offsite treatment or disposals. The last stage is treatment and disposal.

Waste management: reasons for failure

The study of WHO has identified certain reasons for failure of waste management. It has identified that lack of awareness about the health hazards related to healthcare waste, inadequate training in proper waste management and absence of waste management and disposal systems as the main factors. In many cases, insufficient financial and human resources and low priority are also responsible.

The task ahead

The management of healthcare waste requires increased attention. The WHO has suggested some key elements in improving the system. They include promoting practices that reduce the volume of waste generated, proper waste segregation and proper supervision of waste transmission. The government needs to take initiatives to create awareness. This will be a long term process. Common people should be protected. It should be noted that the government of a country must have commitment and support for universal, long-term improvement of its waste management system. At the same time, immediate action can be taken locally.