ABSTRACTS
NEGATIVE IMPACT OF BIOMEDICAL WASTE ON THE ENVIRONMENT AND
ISSUES IN EXISTING DISPOSAL SYSTEMS
The whole amount of waste produced by health-care activities constitute about 85% is
general, non-hazardous waste. The left over 15% is considered to be hazardous material
waste which may be contagious, toxic and radioactive. This paper put forth the negative
impact of biomedical waste on water, soil, air quality, and the environment. Hospitals and
health-care centers, medical industries produce larger amount of biomedical waste in an
instinctive manner. Improper management of waste by these organizations causes actual
environmental problems and is hazardous to human health. Inattention to biomedical waste
management contributes to environmental pollution, illness in humans and animals, and
diminishes the natural as well as financial resources. Moreover, biomedical waste has many
hazardous compounds such as dioxin and furan, which must be controlled and managed
through implementing programs and policies based on sustainable development. It poses
severe health hazard to the hospital staffs, rag-pickers, municipal workers and the
community. Finally, this paper can be considered to be a guide for future studies in
biomedical waste identification, handling, and disposal needs so that better management
protocols are put into practice.
EFFECTS OF BIOMEDICAL WASTE DURING AND POST COVID SCENARIO – A
REVIEW
Appropriate biomedical waste management has become a prime concern worldwide in the
pandemic era of COVID-19 as it affects the environment and living organisms up to a great
extent. Biomedical Waste (BMW) poses various health and environmental hazards. Hence, it
should be handled with the utmost care and disposed off safely. The sudden outbreak of the virus
led to an exponential rise in the quantity of biomedical waste. Furthermore, the poor
infrastructure and lack of human resources have aggravated this situation. Although, World
Health Organization and other public health and environmental societies formulate different
guidelines for the disposal machinery of BMW but the proper implementation of those rules in
public sectors is very difficult. In this situation, the sudden prevalence of pandemic like,
COVID-19 further worsens such conditions. Huge disposition of medical wastes during COVID-
19 detection, treatment, and precautionary measures not only increases the risk of reoccurrence
of infection but puts us also in front of a huge challenge of efficient management of these BMW.
In this respect, this paper focus on an overview of BMW, existing BMW management, probable
consequences of COVID-19 pandemic on the waste management system, and future
perspectives. The review paper also summarizes better management practices for the wastes
including optimizing the decision process, infrastructure, upgrading treatment methods and other
activities related with the biological disasters like COVID-19. For biomedical waste
management, thermal treatment of waste can be an alternative, as it can generate energy along
with reducing waste volume by 80–95%.
POLICY DECISIONS FOR DISPOSAL OF BIOMEDICAL WASTES
Evidence from different parts of India show that the knowledge on BMW disposal among health-
care personnel is less, and the practice of the same is not satisfactory. Strict implementation of
the rules laid down is necessary and is the need of the hour. Waste is now considered as an
important resource and critical component of the circular economy. India is facing a major waste
management challenge. Apart from organized waste management through the urban local bodies,
informal unorganized waste management sector provides employment opportunities to around a
million people in the country. Use of municipal waste to produce energy is being practiced by
some local municipalities. However, many of waste to energy plants in India have been
unsuccessful due to low calorific value of the waste and its non-segregation at the source. The
waste generated from healthcare facilities in India is also of serious concern to community health
and environment due to improper management practices and poor or non-compliance of rules.
India is also implementing the extended producer responsibility (EPR) policy which sets the
responsibility of the producer of a product beyond conventional sales to its post-consumer or
end-of-life (EOL) stage thus leading to a circular economy. This paper aims at providing
sustainable alternatives for proper disposal of these wastes. This is accompanied by examination
of relevant judicial decisions. Since there are a plethora of policies, cases and laws, some of
which have lapsed, the paper focuses upon certain select policies, laws and rules which are
currently being implemented and are proposed to be implemented in the near future.
Bio-medical waste (BMW) disposal is a very important but challenging task. Health-care
waste
contains potentially harmful microorganisms, which can infect hospital patients, health workers,
and
the general public. Exposure to hazardous health-care waste can result in disease or injury. The
Government of India has been laying down rules, namely, Bio-Medical Waste (Management
and
Handling) Rules, in 1998, The draft of Bio-Medical Waste (Management and Handling Rules
2011,),
and recently Bio-Medical Waste Management Rules, 2016. Evidence from different parts of
India
show that the knowledge on BMW disposal among health-care personnel is low, and the
practice
of the same is not satisfactory. Strict implementation of the rules laid down is necessary and is
the
need of the hour
Bio-medical waste (BMW) disposal is a very important but challenging task. Health-care
waste
contains potentially harmful microorganisms, which can infect hospital patients, health workers,
and
the general public. Exposure to hazardous health-care waste can result in disease or injury. The
Government of India has been laying down rules, namely, Bio-Medical Waste (Management
and
Handling) Rules, in 1998, The draft of Bio-Medical Waste (Management and Handling Rules
2011,),
and recently Bio-Medical Waste Management Rules, 2016. Evidence from different parts of
India
show that the knowledge on BMW disposal among health-care personnel is low, and the
practice
of the same is not satisfactory. Strict implementation of the rules laid down is necessary and is
the
need of the hour
CHALLENGES ON ECOSYSTEM BASED ON THE INCREMENTAL BIOMEDICAL
WASTES
Purchasing environmentally sustainable medical devices and consumables is a worthwhile goal,
but the realities of achieving this are challenging and require a better evidence base or, at the
very least, further thinking and nuanced guidance. It is imperative for all countries to adopt
environmentally sustainable management of medical waste to prevent catastrophic stockpiling of
infectious waste during and after pandemics. The persons handling Health-Care Waste (HCW)
are at immediate risk, followed by persons residing near HCW dumping/processing areas and the
general public. Infectious HCW is a major threat to the health of humans and animals as it has
the potential to spread various infectious diseases to the human and animal population. Due to
the uncontrolled use of disposable non-biodegradable materials by healthcare systems and their
processing or lack of it, the HCW has emerged as one of the major sources of environmental
pollution including the emission of the significant amount of greenhouse gases, which stands
from 3 to 10% of total emissions of nations. HCW also leads to leaching chemicals, heavy metals
like Pb, Cd, Cr, radioactive substances, and even generating carcinogens like dioxin in the
environment contaminating air, soil, and water in general and especially in areas surrounding
HCW dumping or processing affecting health and quality of life of not only of humans but co-
habiting flora and fauna in those areas. Thus, the HCW is becoming one of the major sources of
environmental pollution and collectively contributing to the problem of global warming. This
paper focuses on sources, types, and various environmental and health hazards related to HCW,
its global environmental impact and management strategies for minimum effects with an eco-
friendly and sustainable approach. Some of the critical observations of this article are also
expected to offer momentum for enhancing national disaster preparedness in future.
Additionally, we present an outline for future studies on medical waste generation rate and
various socioeconomic and environmental parameters that should be investigated in future work
to promulgate an inventory of the database for sustainable management of medical/HCW.
ADMINISTRATION OF MEDICAL WASTES IN HOSPITALS BASED ON THE
CLASSIFICATION CATALOGUE
Many nations struggle with the collection, separation, and disposal of medical waste. However,
extra caution is required to avoid the risk of injury, cross-contamination, and infection; thus,
healthcare workers and individuals responsible for waste management must follow the
mandatory safety procedures. Medical waste is very serious and needs to be disposed of
properly, but this can be difficult without knowing what kind of waste you have. In this paper, a
classification of the various types and categories of medical waste and its treatment methods are
discussed. There are generally 4 different kinds of medical waste: infectious, hazardous,
radioactive, and general. Medical waste is a source of generation of hazardous biomedical waste.
Medical waste generation and disposal is an important aspect, especially in countries with poor
hygiene and high population. Medical centers including hospitals, clinics, and places where
diagnosis and treatment are conducted generate wastes that are highly hazardous and put people
under risk of fatal diseases. Policies should be framed to avoid spread of infections by providing
specification for handling waste for generation, segregation, collection, storage, transportation,
and treatment. Awareness should be created at all levels of society through various means of
communication and education, so that the risks of spreading the health hazards could be
minimized. This manuscript deals with medical waste, principles of waste management program,
categories of health-care waste, parameters to be monitored in health-care waste, finances to be
managed, and national plans for health-care waste.
INCINERATION TECHNIQUES FOR BOIMEDICAL WASTES
The increase in healthcare provisions has lead to massive increase in generation of biomedical
wastes. Inefficient handling of Health Care Wastes in a hospital environment poses a severe
threat to workers, patients, waste handlers and the general human community due to possibility
of transmission of pathogens. Hence, a sound biomedical waste management practice is needed
to avoid any potential issues. In general, a sound waste management technique involves
appropriate planning including collection, segregation, storage, treatment and disposal
procedures and adequate training of the workers involved in the process. Incineration is one of
the most widely used techniques for disposal of biomedical wastes. The process involves burning
of the waste at very high elevated temperatures (15000°C) under controlled operating conditions
in a chamber known as incinerator. The end products generated are carbon dioxide and water
with ash as residual material. Incineration of biomedical wastes is the preferred option in many
areas. Wastes from hospitals are frequently incinerated on site, but current air pollution limits are
difficult to comply with in small incinerators. The major benefits of incineration are that it
is quick, easy, and simple. It effectively removes the waste entirely, and safely removes any
microorganisms. However, when burning hazardous materials, emissions can be particularly
dangerous. Some states prefer for waste disposal companies to look towards incineration as their
first choice, but materials must be reviewed and determined as safe to burn. Our findings indicate
that incineration is the best waste disposal technique among the available alternatives. Even if
the dataset indicates ‘incineration’ is the best method, we must not forget about the
environmental concerns arising from this method. The problems arising from incineration and
the methods used to deal with them are summarized. This paper presents an in-depth analysis of
design aspects of the incineration chamber.
INTEGRATED STRATEGIES (TECHNICAL AND NON-TECHNICAL) IN HEALTH-
CARE WASTE MANAGEMENT
Integrated waste management is a relatively newer conception in the field of waste management
that optimizes many of the former waste management practices and integrates new dimensions of
waste management strategies. The concept, integrated waste management, involves both the
technical and non-technical components of waste management; where waste treatment plant set-
up, technological advancement, chemical treatment, etc. are components of technical attributes
of integrated waste management and policy adoption, awareness campaigns, etc. are part of non-
technical components of integrated waste management. Nowadays, integrated waste
management is a promising field of waste management, as adoption of certain technologies
cannot solve the waste-related issues sustainably, unless other suitable non-technical
measurements are not adopted simultaneously. However, as the extent of integrated waste
management strategies is expanding day by day, the complexity involved with smooth
implementation of integrated waste management strategies is also increasing gradually causing
an urgent need to design a sustainable framework of effective integrated waste management
strategies. Successful implementation of integrated waste management strategies, therefore,
requires integration of multiple stakeholders from different fields. Integrated waste management
strategies can be significantly beneficial and impactful in multiple ways comparing with the
outcomes of traditional isolated initiatives of waste management. Thus, integrated waste
management strategies can have multiple benefits as well as, it can multiply the usual benefit of
any waste management strategy. An effective waste management strategy involves balance
between waste generation and waste disposal. Raising public awareness about waste, involving
local governments, and improving legislation have all contributed to the development of the best
waste management strategy. As a result, the need of the hour is to identify knowledge gaps and
establish a strong regulatory framework for developing a more holistic approach to waste
reduction and waste energy recovery.
CHALLENGES IN CIRCULAR ECONOMY ADOPTION FOR SUSTAINABLE
DEVELOPMENT IN MEDICAL WASTE MANAGEMENT
Many countries are promoting Circular Economy (CE) practices in the manufacturing and
service sectors. Medical waste management has traditionally relied upon a linear economy for
many years and requires conversion to CE. The reason for transitioning towards CE can be
attributed to various ecological and economic drawbacks of the linear economy. Excessive
production and dumping of wastes are polluting our environment. Moreover, scarcity of raw
materials and growing demand increases the price of goods, eventually affecting global markets.
However, only a few studies deliberate the challenges while implementing CE in the medical
waste industry. This paper presents the potential challenges for the implementation of CE in
medical waste management. This research covers the major challenges in adopting the CE across
medical waste management and will benefit organizations in adopting CE practices for
sustainable development. In addition, the limitations and future scope of the study are conversed.
This study can further be improved by addressing the challenges while implementing the
solutions mentioned in this study. The comprehensive review depicts existing, and emerging
waste management approaches to form a CE by processing the waste efficiently and fuelling a
sustainable development movement. The cradle-to-cradle approach in CE, national solid waste
compliances/legislation, key initiatives taken by the Governments, and the influence of industry
and legal framework on CE were also discussed. The work will facilitate policy and decision-
makers to include CE in the Indian Solid Waste Management sector.
EXPLORING THE AWARENESS LEVEL (KNOWLEDGE AND PRACTICES)
ABOUT BIOMEDICAL WASTE MANAGEMENT AMONG HEALTHCARE
PERSONNEL
The aim of the present study was to assess awareness regarding biomedical waste management
as well as knowledge of effective recycling and reuse of materials among healthcare personnel.
This study aims to investigate the awareness level of biomedical waste management in
healthcare facilities, and their perception among hospital waste management team, doctors,
nurses, lab technicians and waste handlers in India. The study has been conducted through a
questionnaire survey followed by the descriptive statistical analysis method. It was surprising
that only 40% hospitals had any kind of waste treatment & disposal facility onsite, only 10%
hospitals were using the latest technology and 60% hospitals shred the biomedical waste before
disposal. To improve biomedical waste management, it is important to evaluate the current
practices in BMW management, identify the gaps, and address them. This study is therefore
conducted to assess the knowledge, attitude and practices in BMW management among health
care workers. It is concluded that there was a lack of awareness about the biomedical waste
generation, legislation and management among healthcare personnel, and they all needed regular
audits and training programs at all levels, and a proper management starting from waste
generation to its disposal at sites. To optimize BMW management, 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. Considering the current
deficiencies among employees, BMW training courses should be held continuously and
regularly, and the content of the programs should be updated according to the emergencies.
EMERGING TECHNOLOGIES IN BIOMEDICAL WASTE TREATMENT AND
DISPOSAL
Healthcare waste disposal includes a multitude of disposal methods, including incineration, land
filling and chemical treatments. The aim of this paper was to examine the current HCW disposal
methods in place and the harmful effects they have on the environment and on public health. The
present study has been conducted at the district health care facility of a town in India to
understand the characteristics of biomedical waste, category wise generation rate, segregation,
labeling, and handling, treatment and disposal methods for residue. An attempt has also been
made to minimizing the risk of infection and lowering the stress of the treatment on less green
techniques like incineration. Owing to the recent developments the clinics, hospitals, medical
colleges, nursing homes, medical laboratories and research centres have sprung not only in
metros but even in small towns and villages. Since it is not feasible to build treatment facility in
every hospital, biomedical wastes need to be transported to zonal treatment facility, which may
be located far away from the health care facilities. Biomedical waste, however, can be rendered
safe and unobjectionable, aesthetically and environmentally, if health care facility managers
implement the requirements and recommendations of several codes of practice and technical
advice, which are simple and inexpensive. Studies are required to consider more reliable
assessment methods for treatment technologies. This work can serve educators, researchers, as
well as all the medical staff from nurses to doctors and volunteers who tirelessly contribute to the
society in keeping people away from many diseases including the current global pandemic
outbreak due to severe acute respiratory syndrome corona virus 2 through the best and most
sustainable practices in medical waste management.
