The waste generated in hospitals, healthcare centers, and laboratories is very harmful for our environment. The pathogens present in it, if not disposed of properly can affect the environment at worst. Medical waste includes both organic and inorganic waste. On average a hospital bed generates one KG of biomedical waste per day out of which 10% to 15% is infectious, 5% is hazardous and the rest are general waste.
According to a WHO report, hepatitis B virus can survive in medical waste for eight days. Disposable syringes should be used with a sense of security. It may be used and repacked as new syringes by the mafias, which are involved in medical waste trafficking.
Unmediated and unhealed syringes may be used in hospitals and can cause cross-infection. Plastic constitutes a major chunk of medical waste.
The use of plastic and medical equipment is now growing at 6% per annum. Even though plastic reduces the possibility of transmission of infection within the hospital, it damages the environment. An act was passed by the Ministry of Environment and Forest in 1986 and notified the biomedical waste (Management and handling rules) in June 1998. The act defines any waste generated during the diagnosis, treatment and immunization of human beings or animals or in research activities as a biomedical waste.
There are two types of medical waste, hazardous and non-hazardous waste.
Non Hazardous biomedical waste
It comes mostly from administrative and housekeeping functions of the healthcare as establishments and may also include waste generated during maintenance of healthcare premises.
It is very dangerous for the environment, and it creates a variety of health risks to humans.
Hazardous waste is further divided into different categories such as:
i. Human anatomical waste recharges human tissues, organs, and body parts including blood and other body fluids.
ii. Animal waste such as animal tissues, organs, body part carcasses, Bleeding parts, fluids, blood, and experimental animals used in research and waste generated by veterinary hospitals are in the category of medical waste.
Microbiology and biotechnology waste such as waste from laboratory cultures, stop or specimens of microorganisms, live or attenuated vaccines, and human and infectious agents from research and diagnostic laboratories.
Medical Waste like sharp needles, syringes, blades, glass, etc may also cause punctures and cuts including both used and unused sharps.
Medical waste which includes discarded Medicines and cytotoxic drugs also includes waste of outdated contaminated and discarded medicines.
Spoiled waste items contaminated with blood and body fluids include cotton dressings, solid plaster cast, liners, and other materials contaminated with blood.
Solid waste generated from disposable items other than waste sharps such as tubings, intravenous sets etc.
Liquid waste generated from laboratory and washing, cleaning housekeeping, and disinfecting activities.
All these hazardous waste can lead to serious environmental issues. Therefore, there are biomedical waste management rules made which were first implemented in July 1998 and subsequently revised in 2011. However, the latest amendment in biomedical management rules was done in 2016. If there is a failure in complying with the rules, action as per provisions of environmental protection act 1986 will take place. It includes imprisonment for a period of five years or a fine of Rs 1,00,00 or both.
In accordance with these rules, it is the duty of every person to take all steps in premises of medical institutions. They should ensure that waste generated is handled without any adverse effect on human health as well as the environment.
Steps of Biomedical waste management according to the law
Segregation- The biomedical waste shall be segregated into colored containers or bags at the point of generation. The waste is divided in accordance with the schedule prior to its storage, transportation, treatment, and disposal. There are separate bins for different types of medical wastes, black containers or bags including paper cardboards, rappers etc.
Yellow containers are generally kept for human tissues, organs, body parts, experimental animals, and Items contaminated with blood’s body fluids like dressings, cotton swabs etc. Red bins are generally used for waste generated from disposable items such as tubings, bottles, urine bags, syringes, needles etc. Blue Bins are used for discarded contaminated glasses medicines side to toxic waste metallic waste etc.
Collection and storage- Waste bags and containers should be removed daily from wards/OPD’s or even more frequently if needed in operation theaters, ICUs, and labor rooms. It is important to ensure that waste bags/containers are properly sealed and labeled. This waste may be temporarily stored at the central storage area of the hospital and from there it may be sent in bulk to the site of final disposal within 48 hours.
Transportation- The biomedical waste must be transported with care and in closed containers. Manual handling of the west bank should be minimized to reduce the risk of needle prick injuries and infections. Vehicles used for transportation of BMW must have the biohazard symbol and these vehicles should not be used for any other purposes.
Treatment and disposal
Municipal waste- general waste specially contents of the black bags is sent to municipal waste bins
Deep burial- human organs and animal waste should be sent for deep burial.
Autoclave and microwave- contamination from microorganisms can be contained by using this process before the disposal of medical waste
Shredding-Contends of red containers should be treated with chemical disinfectants like sodium hypochlorite and then be shredded and sent for recycling
Incineration-Contents of yellow bags percent for Incineration and incineration ash can be sent for landfills.
General rules of related to biomedical waste
-All medical professionals must be aware of biomedical waste management and handling rules.
-Every healthcare institution must have an all paneled training programme for all categories of staff.
-Biomedical waste should be segregated by a generator of the waste and at the site of generation.
-All should adopt universal precautions while handling the biomedical waste