Assessment of biomedical waste management of a multispeciality hospital in the light of new BMW rules 2016: what has changed from the past?

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

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.

Healthcare is undoubtedly an inevitable facet of human existence. The very functioning of a healthcare establishment generates waste which in turn needs to be effectively managed. Bio-Medical Waste is defined as any waste produced during the diagnosis, testing, treatment, research or production of biological materials by either animals or humankind. The present study was done to access whether Government hospitals in the district Srinagar of the Union territory of Jammu and Kashmir are functioning in gross violation of the existing Bio-Medical Waste (Management and Handling) Rules, thereby posing dangers to in-patients, visitors and the public at large and whether The Bio-Medical Waste (Management and Handling) Rules suffer from certain basic shortcomings due to which they have become ineffective in protecting the environment generally and the health of the people in particular. The study revealed a gross violation of Bio-Medical Waste (Management and Handling) Rules. A judicious balance between environment protection and Bio-Medical Waste Management is the need of the hour.

Healthcare is undoubtedly an inevitable facet of human existence. The very functioning of a healthcare establishment generates waste which in turn needs to be effectively managed. Bio-Medical Waste is defined as any waste produced during the diagnosis, testing, treatment, research or production of biological materials by either animals or humankind. The present study was done to access whether Government hospitals in the district Srinagar of the Union territory of Jammu and Kashmir are functioning in gross violation of the existing Bio-Medical Waste (Management and Handling) Rules, thereby posing dangers to in-patients, visitors and the public at large and whether The Bio-Medical Waste (Management and Handling) Rules suffer from certain basic shortcomings due to which they have become ineffective in protecting the environment generally and the health of the people in particular. The study revealed a gross violation of Bio-Medical Waste (Management and Handling) Rules. A judicious balance between environment protection and Bio-Medical Waste Management is the need of the hour.

Improper waste management practices are a serious problem that involves not only the hospital staff but society at large. To improve biomedical waste (BMW) management, it is important to evaluate the current practices in BMW management (BMWM), identify the gaps, and address them. With this backdrop, this research was done to assess the awareness of BMW management practices among the healthcare professionals in a teaching hospital. This is a hospital-based observational study with assessment of 112 doctors, 230 nurses, and 158 waste handlers. The healthcare workers (HCW) were evaluated regarding awareness, and different practices of BMWM with a self-structured questionnaire. An overall score of ≥50% in each section was considered satisfactory regarding awareness and practices for BMWM. Data were analyzed statistically using SPSS Ver.21 software. Regarding the awareness on various aspects of BMWM, doctors had maximum level of awareness at 68.6% (60.0% – 77.2%), followed by nurses at 69.3% (63.3%-75.3%) and waste handlers at 55.9% (48.2% – 63.6%). Overall nurses showed maximum awareness of existing practices at 74.0% followed by doctors at 70.2% and waste handlers were at 53.8%. To optimize BMWM, it is important to raise awareness on best practices while evaluating the current practices. Gaps in knowledge and skills need to be identified and closed. Ongoing information, education and communication for health care professionals are pivotal in improving BMWM practices.

Introduction: Biomedical waste generated during healthcare activities poses serious risks to public health and the environment when not handled safely. Despite the implementation of the Biomedical Waste (Management and Handling) Rules in India, gaps in awareness and compliance remain evident across healthcare settings. Knowledge and adherence to biomedical waste management protocols are especially crucial for allied health science students, who form an integral part of the future healthcare workforce. Assessing their understanding and attitude toward safe waste management practices is essential for strengthening infection control and ensuring environmentally responsible healthcare delivery. Aims: The study aimed to determine the knowledge on biomedical waste generation, health hazards and legislation, Awareness on BMW Management Practices, Attitude towards BMW Management and Needle-Stick Injury Awareness among first year allied health science students. Methods: A descriptive cross-sectional study was conducted among 102 first year allied health students selected through convenience sampling. Data were collected using structured questionare comprising 35 closed ended questions under four categories: biomedical waste generation, health hazards and legislation, Awareness on BMW Management Practices, Attitude towards BMW Management and Needle-Stick Injury Awareness. Results: Of the 102 participants, 52.9% exhibited good knowledge and 44.1% showed intermediate awareness of biomedical waste creation, risks, and legislation. The majority of respondents (50%) had intermediate understanding of biological waste management techniques, with good awareness coming in close (42.2%). 70.6% of pupils demonstrated a modest attitude towards safe waste-handling procedures, according to attitude and behaviour assessments. 62.7% of respondents demonstrated good awareness of needlestick injuries. There were significant association found between the course of study and awareness of needlestick injuries (*p = 0.010) and between the course of study and knowledge level (*p= 0.034). Other demographic factors did not exhibit statistical significance. Conclusion: This study revealed that the first year allied health science students possess moderate level of knowledge and attitude towards Biomedical Waste management. Practical compliance and safe waste handling behavior remain insufficient. This demonstrates that students need structured educational intervention and regular training to strengthen the biomedical waste management practices.

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.

Challenges and actions to the environmental management of Bio-Medical Waste during COVID-19 pandemic in India

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.

Background: Infection control is a major component in health care practices. The health care team while providing services of curative, promotive or preventive, inevitably create waste and also cause injury which may be hazardous to health. Poor waste management practices pose a huge risk to the health of public, patients, professionals and also contribute to environmental degradation. Nurses as the part of health care personnel is expected to have proper knowledge, practice, and 6 capacity to guide others for waste collection, management, and proper handling techniques. Method: A descriptive study was conducted to assess the knowledge of nurses on biomedical waste Management, spillage management and to determine needle stick injury among 210 registered nurses working in various wards of selected hospital. The convenient sampling technique was used to select the subjects. Baseline proforma and structured knowledge questionnaire was used to collect the data and data was analyzed using descriptive and inferential statistics. Result: In this study it has been found that the majority of staff nurses (78.6%) had good level of knowledge, 18.1% had very good level of knowledge and 3.33% had satisfactory level of knowledge on Biomedical Waste and Spillage Management and Needle Stick Injury. Conclusion: The findings of the study have shown that majority of staff nurses have good level of knowledge on Biomedical Waste and Spillage Management and Needle Stick Injury.

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.

<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>

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.

The city of Sikasso is facing an alarming situation regarding the management of biomedical waste, caused by the multiplication of private health facilities. As a result, biomedical waste is often found in neighborhood dumps and sometimes mixed into household waste containers of certain public structures, whose contents are then sent to the public landfill. This situation poses a major risk to both human health and the environment of the city. The objective of this work is to carry out a comparative study on the modes of biomedical waste management between the private and public sectors (Clinics and CSCOMs), and to propose concrete recommendations for more effective, sustainable, and safe management of biomedical solid waste in Sikasso. The adopted methodology consisted of a literature review, followed by field surveys through questionnaires on biomedical solid waste management. The sample was exhaustive, covering all health facilities in the city of Sikasso, including 12 CSCOMs, 8 Clinics, and the CSREF. The study results revealed that 90.5% of facilities practice waste sorting at the source, 14.3% of private clinics have not appointed a person responsible for waste management, 85.7% of facilities have manuals on waste management procedures, and 37.5% of clinics do not practice waste transportation to specialized facilities ensured by GIEs as a disposal method and do not have an anatomical waste pit. To address the environmental and health problems generated by this waste, health centers, especially private clinics, must comply with biomedical waste management standards, and the municipal authorities must become more involved in the management of private facilities.