Biomedical waste generation at Ayurveda hospitals in South Asia: A mini review of the composition, quantities and characteristics.

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Ayurveda hospitals generate biomedical wastes (BMW). However, details on composition, quantities and characteristics are very scarce, details which are important to formulate a proper waste management plan for subsequent implementation and continual improvement. Therefore, this article presents a mini review of the composition, quantities and characteristics of BMW generated from Ayurveda hospitals. Additionally, this article presents some best possible treatment and disposal procedures. Most of the information was gleaned from peer-reviewed journals, although some information was collected by the author and from grey literature available to the author; 70-99% (by wet weight) of the solid waste is non-hazardous; biodegradables contributing to 44-60% by wet weight due to more used Kizhi (medicinal bags for fomentation) and other medicinal/pharmaceutical wastes (excluding waste medicated oils, which is 12-15% of the liquid medicinal waste stream and are not readily biodegradable) largely derived from plants. The hazardous waste component includes infectious wastes, sharps, blood as pathological wastes (from Raktamoksha - bloodletting), heavy metal containing pharmaceutical wastes, chemical wastes and heavy metal rich wastes. Quantities of infectious wastes followed by sharps and blood form a major portion of hazardous wastes. Most of the infectious waste material contaminated with blood or other body fluids and sharps from Raktamoksha are very similar (appearance, moisture content and bulk density) to what is generated from hospitals practicing Western medicine. However, hospital-specific waste studies are required in future to better understand the sources, areas of generation, types, quantities and characteristics of BMW, and hence to formulate more accurate waste management plans.