A Review on Biomedical Waste Management

Background: Health care institutions and hospitals generate biomedical waste which can introduce various infections and injuries to the healthcare workers, patients and harm the surrounding environment. For proper management of biomedical waste Government of India has introduced the biomedical waste management and Handling rules in 1998, unfortunately health care workers awareness regarding biomedical waste segregation, handling and management is minimal hence, the study addresses the issues related to it.Methods: This cross sectional study was conducted in the month of July 2016 among health care workers at Malabar Medical College Hospital and Research Centre, Calicut, India. A pre-tested, semi-structured questionnaire was used to elicit the various information like collection, segregation and disposal of biomedical waste.Results: 567 health care workers were interviewed.44.3% (251) opined correctly that biomedical waste should not be kept more than 48 hours at hospital settings. 61.6% (349) opined waste sharps should be disposed in white/blue puncture proof containers.89.6% (508) knew about HIV, hepatitis B and hepatitis C are common infections transmitted due to improper biomedical waste management. 60.5% (345) and 61% (346) opined that human anatomical waste and pads, cottons, dressings should be disposed in yellow bags, respectively. 70.7% (401) were fully immunised against hepatitis B. 29.8% (169) had received training on biomedical waste management.Conclusions: Knowledge regarding biomedical waste disposal among nursing staff is satisfactory compared to other health care workers, adequate training among health care workers can improve the biomedical waste management and handling practices at hospital settings.

With a population of 1.4 billion, biomedical waste (BMW) management in India has always been a challenge, which has increased many folds during the coronavirus pandemic. BMW contains hazardous and infectious material and therefore it is important that the personnel involved in the management and disposal of BMW have adequate and up-to-date information/awareness. Collection, carriage, and final disposal of BMW is both critical and challenging at the same time. Healthcare waste contains potentially harmful microorganisms, which can infect hospital professionals, patients, health workers and the public. The Government had laid down ‘BMW (Management and Handling) Rules, in 1998’; ‘BMW (Management and Handling Rules 2011)’; ‘BMW Management Rules, 2016 and BMW (Amendment) Rules, 2018’. Several studies have highlighted that the knowledge about BMW management and its disposal is limited among the healthcare personnel and that the practice is not satisfactory in India. The exploratory research design was utilised for this study with the help of primary data collected through a questionnaire along with the information available from official websites. The present findings reveal that BMW generation has increased by 80.07%, and the workload of BMW management has increased by 72.07% along with 71.43% surge in turnover during the coronavirus pandemic. These findings are in accordance with the recent literature underscoring the urgent need for a congenial environment, with up-to-date information/awareness of BMW and implementation of proper safety regulations to protect the personnel directly involved in BMW management.

Rules and management of biomedical waste at Vivekananda Polyclinic: A case study

Background: Inadequate and inappropriate knowledge regarding disposal of Bio-Medical Waste may have serious health consequences to those who handle it as well as can have a deleterious impact on the environment. The objective of the study was to assess the knowledge, attitude and practices about the various aspects of bio-medical waste (BMW) management among private practitioners of Poonamallee taluk, ChennaiMethods: A community based cross-sectional study was conducted to assess the Knowledge, Attitude and Practices about the various aspects of Bio-Medical Waste (BMW) management among private practitioners of Poonamallee taluk, Chennai. The sample size was calculated as 171. Data was collected using a structured interview schedule among all private practitioners including dentists. Data was entered and analyzed by using IBM SPSS software Version 21. Results: 78.3% private practitioners were found to have adequate knowledge about the biomedical waste management rules. 76% private practitioners had knowledge regarding segregation of waste at source. 56.7% of practitioners segregated the BMW into different categories at source level and disposed in specified color coded containers. Conclusions: The importance of training regarding biomedical waste management needs emphasis; lack of proper and complete knowledge about biomedical waste management impacts practices of appropriate waste disposal.

This study investigated the environmental and health risks associated with biomedical waste in CHUB, Huye District, Rwanda. In the majority of countries across the world, the preservation of the environment and public health depends on the proper biomedical waste collection and disposal. It has been reported that the management of biomedical wastes results in needless deaths of individuals each year. The study had four objectives: (1) To assess the biomedical waste generation and disposal practices across all departments at CHUB;(2) To investigate the implementation and enforcement of biomedical waste management regulations ;(3) To assess the risks related to biomedical waste to humans and the environment.; and (4) To find out the level of knowledge among healthcare workers on biomedical waste management. With a cross-sectional study design survey and observation methods, data were collected from clinical service of inpatient departments, and the study population was 196 health workers. The WHO rapid assessment tool for waste management and water sanitation was adapted and used. The results of this study showed a great amount of biomedical waste are well segregated (92%), and color coding is respected during biomedical wastes collection and disposal (100%) but a significant part of biomedical liquid wastes are disposed of directly to hand-wash sink water evacuation (14%). Significant cases of needle stick injuries were also observed (21%) and internal regulations and protocols on biomedical waste management are available in most clinical services. The study recommends that regular training of health professionals in biomedical waste management, including transport and disposal essentials, connect remaining clinical departments to the specialized pit dedicated to biomedical liquid wastes to avoid any risk of direct contamination or environmental contamination; and documentation on the type of biomedical waste generated in all clinical services is an important point to be improved. Keywords: Biomedical wastes, Environmental risk, Waste segregation, Color-coding System, Infection Prevention Control, Environmental risks, University Teaching Hospital of Butare

Background: The hierarchies of Bio-Medical Waste (BMW) is largely based on the concept of the “3Rs”, namely reduces, reuse and recycle, and broadly relates to the sustainable practice of resources. The objectives of the study were to assess the Bio-Medical Waste (BMW) Management operating system in a multispecialty hospital and discuss the situation in terms of newly introduced BMW Rules 2016.Methods: A hospital based cross-sectional study was carried out by collecting data by means of independent surveys involving on-ground operating system of BMW management across different wards, outpatient departments, emergency departments, intensive care units and laboratories in the hospital.Results: The hospital was following Bio Medical Waste (Management and Handling) Draft rules, 2011 in the management of BMW. All the wastes were categorized into 8 categories as per 2011 draft rules. Efficient waste segregation, collection, storage, transport and waste treatment were followed as per norms with regular training of all health care workers under the close supervision and monitoring by dedicated BMW management committee. The hospital was registered for BMW management and renewal was being carried out every three years.Conclusions: It can be concluded that the hospital had an efficient and a well-organized BMW management system in place that was even conforming to the latest BMW Management Rules 2016 to some extent. Moreover, the hospital could upgrade the techniques of BMW management as per the newly introduced latest guidelines. As far as the categorization of BMW is concerned, it has to be changed accordingly to the new rules. Needless to say, a regular training and monitoring of BMW Management at all hospitals is the need of the hour and has a long way to go for environmental and human health.

The disposal of biomedical wastes have been studied at various hospitals like, Krishnarajendra Hospital, Mission Hospital, J.S.S. Hospital, Basappa Memorial Hospital, Apollo Hospital and Vikram Hospital for the period of six months by analyzing the procurement lists. Various issues like quantities and proportions of different categories of wastes handling, treatment and disposal methods have been examined. The process of segregation, collection, transport, storage and final disposal methods of infectious and non-infectious wastes have also been observed. One way analysis of variance test has been carried out to determine the possible interrelationship between the wastes originating from different departments of different hospitals. The proper disposal methods have not been employed in K.R. Hospital followed by J.S.S. Hospital and Mission Hospitals when compared to other hospitals. In addition, the differences in the infrastructure were examined and the consequences for waste segregation and disposal methods were also discussed under economic and ecological aspects. For this existing problem, proposed systems of bio-medical waste management are described to improve the disposal practices. A waste management strategy has also been proposed. Key words: Environment, hospitals, bio-medical wastes, disposal, infectious wastes, non infectious wastes, solid wastes.

Healthcare encompasses the trinity of teaching, research, and patient care that necessitates the proper management of biomedical waste (BMW) generated during these activities. In recent years, with the rise in public and private healthcare establishments, India is likely to generate about 775.5 tons of medical waste per day by 2022. A joint study conducted by industry body The Associated Chambers of Commerce and Industry of India and Velocity suggests that medical waste is expected to grow at a compounded annual growth rate of about 7%. The seemingly endless stream of BMW has become a topic of global concern and implications. It is not only the subject of humanitarian concern but it has far-reaching effects on the environment also. BMW is a potential health hazard to the healthcare workers, public, and flora and fauna of the area. The Environment Protection Act 1986, the BMW (Management and Handling) Rules in July 1998, subsequently revised in 2011, and now the “BMW Management Rules, 2016” are an attestation to the commitment of the Government of India to ensure safe and proper disposal of allopathy and nonallopathy (Ayurveda, Siddha, Unani, or Homeopathy) BMW. The present BMW guidelines are based on the guiding principles of the World Health Organization, The Basel Convention on Hazardous Waste (1989), The Bamako Convention (1991), The Stockholm Convention on Persistent Organic Pollutants (2001), and The Minamata Convention on Mercury (2013). Despite our two-decade-old history of implementing BMW management guidelines, there have been innumerable incidents of mismanagement of BMW. The Hepatitis Outbreak in Modassa, Gujarat (India), 2009 is one of the major episodes that drew attention to the issue of unsatisfactory BMW management in the country. “Safe and effective management of waste is not only a legal necessity but also a social responsibility. Lack of awareness, commitment, concern, and cost factor are some of the reasons for unsatisfactory management of BMW.” By definition, waste generated during dental care is a subset of hazardous BMW, thus making dental institutions and dentists liable for the management of the waste generated. It includes infectious wastes and noninfectious toxic wastes (mercury, silver amalgam, heavy metal scraps, X-ray processing waste, acrylic resin scraps, wasted metal alloys, metal dust, porcelain, plaster of Paris, gypsum, and other chemical wastes). All of these wastes if not handled properly can pose a serious threat to humans as well as environment. Thus, there is an equally overarching need for the management of dental waste from dental care establishments. Considering the Indian scenario, major issue related to the current BMW management is lack of satisfactory implementation of BMW management guidelines. Data from the Government of India site indicate that the total BMW generated in the country is 484 tons per day (TPD) from 168,869 HCFs. Unfortunately, only 447 TPD is treated, and 37 TPD is left untreated, necessitating an urgent need to take action for strengthening the existing system capacity, increase the funding and commitment toward safe disposal of BMW. In recent years, the monitoring bodies, viz., State Pollution Control Board and Central Pollution Control Board, have formed monitoring bodies to plan out a strategy to manage the quantum of BMW generated all over the country. A country like India that has strode in expansion of health sector in recent decades, attention should be drawn to BMW management strategies that are affordable, sustainable, and adaptable to local conditions so that the wastes generated should not harm the healthy.

<div><p><em>Biomedical waste management is receiving larger attention because of recent regulations of the biomedical Wastes (Management & Handling Rules, 1998). Inadequate management of biomedical waste may be associated with risks to healthcare employees, patients, communities and their environment. The current study was conducted to assess the quantities and proportions of different constituents of wastes, their handling, treatment and disposal way in numerous health-cares. In this research, we try to elaborate and discuss the of Bio-medical waste management procedure of Ujjain city. Various health care units were surveyed using a modified survey form for waste management. This form was obtained from the world Health Organization (WHO), with the aim of assessing the processing systems for biomedical waste disposal. Hazards related to poor biomedical waste management and shortcomings in the existing system were identified. The development of waste management policies, plans, and protocols are suggested, in addition to establishing training programs on correct waste management for all healthcare workers.</em></p></div>

Background: The World Health Organization biomedical waste guidelines of 2004 emphasizes the importance of the “human factor” over technology and equipment. Housekeeping staff members are directly involved in the collection, transport, and disposal of biomedical waste and are at high risk of acquiring infections. At the same time, they are usually unskilled, uneducated, and have little to no knowledge about the segregation and disposal of biomedical waste, which further compounds their health risk. Objective: To assess the awareness and practices regarding biomedical waste management in housekeeping staff of a tertiary care hospital. Subjects and Methods: A cross-sectional study was conducted among 100 housekeeping staff members of a tertiary teaching hospital in Pune, Maharashtra, from February to April 2022. A semi-structured, pretested questionnaire was used for data collection. Knowledge of the study participants was scored on a scale of 0–10 and the median score of all the study participants was taken as a cutoff for determining good and poor knowledge. The data were entered into MS Excel 2010 and analyzed using IBM SPSS software 16-trial version. The Chi-square test was used as a test of significance. Results: In the present study, 73% of study participants had good knowledge regarding biomedical waste management. All the participants (100%) were following appropriate practices regarding biomedical waste management. Age and experience were found to be significantly associated with knowledge regarding biomedical waste management (P < 0.05). Conclusion: There is a gap in the knowledge regarding biomedical waste management among the study subjects which needs to be addressed through repeated and diligent training exercises.

Biomedical waste is the waste that is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining there to, or in the production or testing of biological components. The Biomedical waste treatment and disposal are to be done very carefully, as it is infectious in nature. The present study has been initiated to assess the Biomedical Waste generation and management in Odisha state, India, with the objective to conduct a detailed survey of different Health Care Units (HCUs) and also to record and assess the current scenario of the state Bio-Medical Waste generation & management conducted through primary data analysis via questionnaires and physical quantification methods and secondary data analysis in health care units of all 30 districts of Odisha. As per the field study carried out during the period, there were 1545 bedded and 9408 non-bedded HCUs, which together produced an approximate quantity of 4368 MT/annum of BMW. Around 828 MT/annum (19%) of the total biomedical waste so generated was treated by the existing Common Biomedical Waste Treatment Facilities (CBWTFs) functioning in the state, while the remaining 81% of this waste needs to be attended and treated. The study proposes the need for installing four new CBWTFs in different locations of the state in order to treat the larger portion of the unattended biomedical waste and also reveals the lack of proper BMW management systems and awareness regarding biomedical waste management in various HCUs.

Chapter 23 - Chemical methods for the treatment of biomedical hazardous waste

Background: Biomedical waste (BMW) is generated in every health facility, which if not disposed off properly poses a risk for health and environment. Handling, segregation, mutilation, disinfection, storage, transportation and final disposal are vital steps for safe and scientific management of biomedical waste in any establishment. The objective were to assess the biomedical waste management (BMWM) practices and knowledge regarding BMWM in a tertiary care hospital.Methods: A descriptive study was carried out in the tertiary care hospital during July and August 2014. Hospital waste management practices were observed by making visits to the waste collection sites at different sites of the hospital and for assessment of knowledge regarding waste management a total of 113 health care personnel were interviewed.Results: The overall mean score for “Condition of waste receptacles” was 44.3%. The mean score for segregation of waste was 77%, for mutilation of recyclable waste the mean score was 88% and the disinfection mean score was 72%. There were some good practices observed like presence of posters regarding disposal of BMW in most places, availability of gloves, masks etc. to the workers collecting BMW .There was no separate route for transport of biomedical waste. The knowledge regarding BMWM was not satisfactory among the participants and scope of improvement is there.Conclusions: While there were some good practices observed, there were inconsistencies observed regarding BMWM in the hospital.

Medical waste is infectious, contain toxic chemicals and pose contamination risks to both people and also the environment in primary health care centers. In the present study, we assessed the knowledge, attitude and practices of health care providers about biomedical waste management in primary health care centers PHCC in Erbil district center, Kurdistan Iraq. Using a self-administered questionnaire, we collected data on biomedical waste management from samples of health care providers (HCP) in 25 health centers in the Erbil district center. Based on results, total knowledge, and attitude and practice scores on a 34 questions was prepared related to Knowledge, attitude and practice. Total 687 HCP participated in study and largest proportion of the sample (40.9%) were aged 41-50 years, more than half (58.4%) were females, nurses constituted 41.5% of the sample, 39.9% were diploma certificate holders, The majority of the sample had more than 10 years of experience, but only 10.8% 74 of them had received training about biomedical waste management. Almost all the participants had no strong knowledge about biomedical waste (BMW) management, and very little (less than 10%) had moderate knowledge. More than 90% of the sample had no information about the weakest and strong microbes resistant to antiseptics, the majority 525 (76.4) have little knowledge about importance to taking the vaccination hepatitis B and C to prevent from BMW hazardous, the majority (93.3%) of the participants believe that safe disposal of BMW is extremely important to prevent infection transmission, more than two thirds (69.9%) of the participants always dispose sharps in puncture proof container. Conducting of appropriate training on how to dealing with biomedical waste is essential to develop safe practices among HCP.

INTRODUCTION: Biomedical Waste is defined as any waste, which is generated during the diagnosis, treatment or immunisation of human beings or animals or in research activities pertaining thereto or in the production or testing of biological products. Healthcare workers are one of the main contributors to the healthcare waste management process. AIM: The study aimed to assess the level of awareness and attitude regarding biomedical waste management policy and practices among health care workers at Bareilly International University, Bareilly, India. MATERIALS AND METHOD: A cross-sectional study was conducted using a questionnaire with closed-ended questions which was distributed to 150 medical, 154 dental and 100 Class IV employees at Bareilly International University, India. The responses in the questionnaire were used to assess their knowledge of biomedical waste disposal. The responses were evaluated, and each participant's percentage of correct and incorrect responses for each question was calculated. RESULTS: The results indicated that all healthcare professionals had a low degree of knowledge and awareness regarding the risks associated with biomedical waste formation, legal requirements, and management. Only 11 (7.14%) dental interns had excellent knowledge about biomedical waste generation and legislation while 5 (3.33%) medical interns had extremely poor knowledge about it. Only 4 (4%) Class IV employees had an excellent awareness of biomedical waste management practices. Only 34 (22.08%) dental interns had an excellent level of knowledge of needle-stick injuries among health care personnel. CONCLUSION: It was concluded that health care professionals have a low degree of knowledge and awareness regarding the risks of biomedical waste generation, laws, and management at Bareilly International University, India hence there is a requirement for regular monitoring and training at all levels of healthcare.