By Anuprerna Bijarnia, Anshu Priya and Harshita Raj
Biomedical waste (BMW) is any solid or liquid waste, as well as its container and any intermediate product, generated during the treatment, diagnosis, or immunisation of humans and animals, or in related research activities, or in the manufacturing or testing of biologicals. Approximately 85% of the waste generated by health-care activities is non-hazardous, but the remaining is considered hazardous. Medical care is vital for our lives and well-being. However, because there is a high risk of disease or pathogen transfer, the waste generated by medical activities can be hazardous and even fatal.
via AIHMS
Biomedical waste differs from regular trash or general waste, as well as other sorts of chemical, universal, or industrial waste. Biomedical waste must be properly disposed of and separated. Used
bandages and dressings, human or animal tissues, sharps such as injections, needles, and broken glass, and human anatomical waste such as wasted blood, body fluids, and body parts are all
examples of infectious waste.
Sources of Biomedical Waste
Hospitals:- They are a huge source of biomedical waste as they have to deal with many surgeries daily and the patients who are affected by any virus or disease.
Nursing homes:- A nursing home always has a qualified nurse on-site to provide medical care.
Veterinarians:- They are the doctors of the animal world. They use their skills to evaluate patients, make diagnoses and treat a wide range of conditions. They use a lot of equipment that becomes ‘sharps’ waste. This includes syringe, needles as well as razor, blades, scalpels etc..
Clinic of dentists:- As in old style dental filling, dentists use mercury amalgam. But now they rarely use mercury but dentists still deal with mercury waste when old fillings or teeth are removed. They also produce waste cotton or plastic or any other material which may be contaminated with body fluids or blood.
Laboratories:- A laboratory is a facility that provides equipment for experimental study in science or for testing and analysis of any research. In a lab many pieces of equipment are used like microscope, universal testing machine, centrifuges, bioreactor, etc.
Effects Of Biomedical Waste on Environment and Humans
via Daniels Health
When biomedical waste is dumped in bodies of water, it is frequently absorbed by plants and
consumed by marine creatures which further contaminates the food chain. Inadequate biomedical
waste incineration releases contaminants into the air and leaves an ash residue. Incineration of high metal content heavy materials can release harmful components into the environment, causing respiratory illness. Headaches, dizziness, and nausea can result from exposure to radioactive waste. Sharp garbage including body fluids in landfills and hospital wards can cause skin infections, cholera, typhoid, and tetanus, among other diseases. The open burning of medical wastes can cause the release of dioxins and furans, which can cause mental and respiratory disorders. Wastes containing cytotoxic drugs that are used in cancer treatments are mutagenic and carcinogenic.
via gmch.gov.in
Increase in Biomedical Waste during Covid-19 Pandemic
As a result of the Covid-19 pandemic, a large amount of biomedical waste has been generated. Over 1.3 billion used syringes, needles, test kits, and over a hundred million discarded glass vials are among the waste that must be properly disposed of. The outbreak resulted in a 102.2 percent rise in waste generation in both private and public hospitals. Littering of masks and gloves by citizens is one of the major concerns. In addition to the hospital waste, taking care of the sick at home has led to production of infectious waste. Proper management of medical waste is a necessity due to its potential to generate infection. The elements included in waste management are waste segregation, storage, transportation, disinfection and final disposal.
via NDTV
Some of the new guidelines issued by CPCB (central pollution control board) for effective management of waste are as follows:
Use of colour-coded bins for onsite segregation and the usage of double-layered bags in the COVID-19 isolation areas.
There should be additional and temporary bins for disposable PPEs, gloves and masks and separate containers for reusable materials
The faeces from the confirmed COVID-19 positive patient should be collected in a diaper and segregated as the yellow category BMW or it can be collected in a pan and flushed in the toilet, following which the toilet should be disinfected in adherence to the SOPs.
There should be dedicated vehicles for the transportation of BMW, and it should be sanitised after every trip and the waste should be disposed within 24h.
The workers involved in the handling of wastewater treatment should be protected with PPE. The utilisation of treated water from the STP can be avoided during the pandemic.
Acts and Policies in Management of Biomedical Waste
In June 2007, at a World Health Organization (WHO) meeting in Geneva, basic principles for attaining safe and sustainable health-care waste management were developed. All stakeholders involved in financing and supporting health-care operations have a moral and legal obligation to safeguard the safety of others, and hence should contribute to the expense of BMW's appropriate management. Furthermore, it is the manufacturer's responsibility to create environmentally friendly medical gadgets in order to assure their safe disposal. WHO emphasised that the government should set aside funds to develop, promote, and maintain an effective health-care waste management system. These include novel and ingenious methods/devices to reduce the bulk and toxicity of health-care waste.
Policies for BMW Management in India
The erstwhile Ministry of Environment and Forests of the Government of India issued the first BMW
guidelines in July 1998. The BMW problem in India was exacerbated by the existence of scavengers who sort open, unprotected health-care debris for recycling without gloves, masks, or shoes, and second, syringe reuse without proper sterilising. In the years 2000, 2003, and 2011, the BMW 1998 rules were amended. These new laws have broadened the scope of coverage, simplified the authorization process, and improved segregation, transportation, and disposal procedures to reduce pollution.
via Times of India
Salient Features of Biomedical Waste Rules -
The rules' scope was broadened to include a variety of health camps, such as vaccination and blood donation camps.
Liquid waste to be separated at source by pre-treatment before mixing with other liquid waste.
The BMW disposal register is to be maintained daily and updated monthly on the website.
The segregation, packaging, transportation, and storage of BMW have been improved.
The Ministry of Environment, Forest, and Climate change will monitor the implementation of rules yearly. In addition, every 6 months, this committee shall submit its report to the State Pollution Control Board.
Measures to Reduce BMW at Individual Level
Biomedical waste management was already a big challenge before COVID, and now it’s an even
bigger one. Segregation of solid waste is still done in three streams, the same as before – dry, wet
and sanitary. In case of home quarantine, waste should be segregated into the three streams as
usual.
Masks, gloves and other COVID waste should be segregated as reject/sanitary waste.
Club the dry waste and sanitary waste together and keep them in yellow (non-chlorinated) bags. These bags would be collected by regular waste collectors, who would then hand it over to an authorised vendor who runs a CBWTF (Common Bio-medical Waste Treatment and Disposal Facility).
Wet waste should be stored separately and handed over to waste collectors/pourakarmikas as usual. Alternatively, you can compost the wet waste at home itself.
The yellow non-chlorinated bags for storing dry and sanitary waste are to be provided by the BBMP.
Following are a few highlights relevant to residential settings:
Biomedical Waste Management Rules, 2016, identify the following as yellow-category biomedical
waste:
Human and animal anatomical waste, soiled waste (contaminated with blood, body fluids, dressings, plaster casts, cotton swabs, etc), contaminated linen, mattresses and bedding. In the context of COVID, any disposable material (plates, cups, etc) used by patients should also be considered as biomedical waste.
Contaminated general plastic waste too should be disposed of in non-chlorinated bags.
For practical purposes, BBMP has decided to treat all dry and sanitary waste from COVID-positive houses as biomedical waste, to be segregated in yellow bags and disposed of only by authorised vendors. All waste collectors and handlers, including pourakarmikas and CBWTF staff, should have appropriate PPE.
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