Biomedical waste management: Safety of health care workers handling the waste is paramount

Biomedical waste includes human and animal anatomical waste, treatment apparatus like needles, syringes and other materials used in health care facilities in the course of treatment and research.  This waste is generated during diagnosis, treatment or immunization in hospitals, nursing homes, pathological laboratories, blood bank, etc.

Tonnes of biomedical waste are produced by hospitals every day. An estimated 1-2 kg of waste per bed in a hospital and 600 gm of waste per bed in a clinic is generated every day.

Segregation is the key to waste management and should be done at the source of generation of biomedical waste e.g. all patient care activity areas, diagnostic services areas, operation theaters, labor rooms, treatment rooms etc.

Only 15% of this waste is hazardous and poses a threat to human health and the remaining is non-hazardous. However, when hazardous waste is not segregated at the source of generation and mixed with nonhazardous waste, then 100% waste becomes hazardous. This then exposes the health care workers who handle the waste, including all those who come into contact with it, to major health risks. These risks include AIDS (acquired immune deficiency syndrome), Hepatitis B and C, GI infections, respiratory infections, blood stream infections, skin infections, effects of radioactive substances etc.

Scientific disposal of biomedical waste through segregation, collection and treatment in an environmentally sound manner is therefore essential.

However, the proper management of biomedical waste is not just about their safe disposal; it also involves the safety of health care workers who handle the waste.

“Handling” in relation to biomedical waste includes the generation, sorting, segregation, collection, use, storage, packaging, loading, transportation, unloading, processing, treatment, destruction, conversion, or offering for sale, transfer, disposal of such waste.

Safe disposal of biomedical waste is now mandated by the law in India and all health care establishments generating biomedical waste are required to abide by the “Biomedical Waste Management Rules, 2016”.

In accordance with these rules, it is the duty of every “occupier” i.e. a person who has administrative control over the institution and the premises generating biomedical waste, to take all necessary steps to ensure that biomedical waste is handled without any adverse effect to human health and the environment and in accordance with these rules.

“(g) provide training to all its health care workers and others, involved in handling of bio medical waste at the time of induction and thereafter at least once every year and the details of training programmes conducted, number of personnel trained and number of personnel not undergone any training shall be provided in the Annual Report;

(h) immunise all its health care workers and others, involved in handling of bio-medical waste for protection against diseases including Hepatitis B and Tetanus that are likely to be transmitted by handling of bio-medical waste, in the manner as prescribed in the National Immunisation Policy or the guidelines of the Ministry of Health and Family Welfare issued from time to time”

The BMWM Rules 2016 have also defined the duties of the “operator” of a common biomedical waste treatment and disposal facility. An operator is a person who owns or controls a Common Bio-medical Waste Treatment Facility for the collection, reception, storage, transport, treatment, disposal or any other form of handling of biomedical waste.

The Operator is required to:

“(a) take all necessary steps to ensure that the bio-medical waste collected from the occupier is transported, handled, stored, treated and disposed of, without any adverse effect to the human health and the environment, in accordance with these rules and guidelines issued by the Central Government or, as the case may be, the central pollution control board from time to time;

(g) undertake appropriate medical examination at the time of induction and at least once in a year and immunise all its workers involved in handling of bio-medical waste for protection against diseases, including Hepatitis B and Tetanus, that are likely to be transmitted while handling bio-medical waste and maintain the records for the same;

(h) ensure occupational safety of all its workers involved in handling of bio-medical waste by providing appropriate and adequate personal protective equipment;”

(Source: Biomedical Waste Management Rules, 2016, Ministry of Environment, Forest and Climate Change, Govt. of India)

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA