J. Int.

Environmental Application & Science,

Vol. 4 (1): 65-78 (2009)

Management of Biomedical Waste in India and Other Countries: A Review

B. Ramesh Babu*, A.K. Parande, R. Rajalakshmi, P. Suriyakala, M. Volga
Central Electrochemical Research Institute, Karaikudi630006, Tamilnadu, India
Received July 29, 2008; Accepted March 16, 2009

Abstract: The objective of this study is (i) to summarize the rules for management
and handling of biomedical wastes, (ii) to give the definition, categories of
biomedical wastes, suggested storage containers including colour-coding and
treatment options, (iii) mainly to highlight the effects of biomedical waste in the
environment such as air, land, radioactive pollution and (iv) disposal of wastes,
regulation and recommendations. Health-care waste management in several countries
including India is receiving greater attention due to stringent regulations. The waste
generation rate ranges between 0.5 and 2.0 kg bed-1day-1. The solid waste from the
hospitals consists of bandages, linen and other infectious waste (30-35%), plastics (710%), disposable syringes (0.3-0.5%), glass (3-5%) and other general wastes
including food (40-45%). Several survey works carried out by various research
organizations by (Government and Non government and private sectors) have been
discussed and reviewed in this paper.
Keywords: Data management, emissions, biomedical wastes, hazardous waste,
health-care establishment, regulations, waste-management plan, waste disposal.

Introduction
Bio-medical waste means any waste generated during diagnosis, treatment or immunization of
human beings or animals. Management of healthcare waste is an integral part of infection control and
hygiene programs in healthcare settings. These settings are a major contributor to community-acquired
infection, as they produce large amounts of biomedical waste. Biomedical waste can be categorized
based on the risk of causing injury and/or infection during handling and disposal. Wastes targeted for
precautions during handling and disposal include sharps (needles or scalpel blades), pathological
wastes (anatomical body parts, microbiology cultures and blood samples) and infectious wastes (items
contaminated with body fluids and discharges such as dressing, catheters and I.V. lines). Other wastes
generated in healthcare settings include radioactive wastes, mercury containing instruments and
polyvinyl chloride (PVC) plastics. These are among the most environmentally sensitive by-products of
healthcare (Askarain et al., 2004; Remy, 2001). WHO stated that 85% of hospital wastes are actually
non-hazardous, around 10% are infectious and around 5% are non-infectious but hazardous wastes. In
the USA, about 15% of hospital waste is regulated as infectious waste. In India this could range from
15% to 35% depending on the total amount of waste generated (Glenn & Garwal, 1999; Anonymous,
1998; Chitnis et al., 2005)
The management of bio-medical waste is still in its infancy all over the world. There is a lot of
confusion with the problems among the generators, operators, decision-makers and the general
community about the safe management of bio-medical waste. The reason may be a lack of awareness.
Hence resource material on the environment for hospital administrators, surgeons, doctors, nurses,
paramedical staff and waste retrievers, is the need of the hour (Almuneef & Memish, 2003; Acharya &
Meeta, 2000).
Sources of Bio-Medical Waste
While urban solid waste has attracted the attention of town planners, environmental activists and
civic administrators, there is yet lack of concern for some special sources of waste and its
management. One such waste is bio-medical waste generated primarily from health care
establishments, including hospitals, nursing homes, veterinary hospitals, clinics and general
* Corresponding: E-mail: akbabu_2001@yahoo.com, Tel:+91-4565-227555, Fax:+91-4565-227779

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J. Int. Environmental Application & Science,

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practitioners, dispensaries, blood banks, animal houses and research institutes. The other sources of
biomedical waste are the following:
Households,
Industries, education institutes and research centres,
Blood banks and clinical laboratories,
Health care establishments (for humans and animals): (Anonymous, 2000; Chitnis et al., 2000).
The sector generates all the types of waste listed under the bio-medical waste are shown in Figure 1.

Primary source
Hospitals, nursing
homes, veterinary
hospitals, clinics,
dispensaries, blood

Other sources
Households,
Industries, education
institutes and research
centers

Figure 1. Source of biomedical wastes (The Gazette of India, 1998)

Categories of biomedical wastes
Categories of biomedical wastes are given in Table 1.
Table 1. Categories of biomedical wastes
Category
1
2

Source of waste
Human Anatomical Waste (human tissues, organs, body parts)
Animal Waste (animal tissues, organs, body parts, carcasses, bleeding parts,
fluid, blood and experimental animals used in research, waste generated by
veterinary hospitals, colleges, discharge from hospitals, animal houses)
Microbiology & Biotechnology Waste (wastes from laboratory cultures, stocks
or specimens of micro-organisms live or attenuated vaccines, human and animal
cell culture used in research and industrial laboratories, wastes from production
of biological, toxins, dishes and devices used for transfer of cultures)

4
Waste Sharps(needles, syringes, scalpels, blades, glass, etc. that may cause
puncture and unused sharps)
5

Discarded Medicines & Cytotoxic drugs (wastes comprising of outdated,

contaminated and discarded medicines)
Soiled Waste (items contaminated with blood and body fluids including cotton,
dressings, soiled plaster casts, lines, beddings, other material contaminated with
blood.

7
Solid Waste (wastes generated from disposable items other than waste sharps
such as tabbing, catheters, intravenous sets etc.)
8

9
10

Liquid Waste(waste generated from laboratory and washing, cleaning, housekeeping and disinfecting activities)
Incineration Ash (ash from incineration of any bio-medical waste)
Chemical Waste (chemicals used in production of biological, chemicals used in
disinfection, as insecticides, etc.)

Source: Biomedical wastes (Management and Handling Rules, 1998)

66

Treatment and Disposal

Incineration /deep burial
Incineration /deep burial

Local autoclaving /
microwaving incineration
Disinfection (chemical
treatment /autoclaving/
microwaving and mutilation/
shredding
Incineration /destruction and
drugs disposal in secured
landfills
Incineration autoclaving/
microwaving
Disinfection by chemical
treatment autoclaving/
microwaving and mutilation/
shredding
Disinfection by chemical
treatment and discharge into
drains
Disposal in municipal landfill
Chemical treatment and
discharge into drains for
liquids and secured landfill
for solids.

J. Int. Environmental Application & Science,

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Effects of biomedical waste

The improper management in bio-medical waste causes stern environmental problems that
causes to air, water and land pollution. The pollutants that cause damage can be classified into
biological, chemical and radioactive. There are several legislations and guidelines in India concerning
environmental problems, which can be addressed. The classification of radioactive waste generated as
part of bio-medical waste is covered. Some of the effects of pollution on air, radio activities, land,
health and hazards are discussed (Sadhu and Singh 2003; www.ipaiindia.org/files/2007.pdf).
Air Pollution
Air pollution can be caused in both indoors and outdoors atmosphere. Biomedical waste that
generated by air pollution are been classified in three types namely-Biological, Chemical and
radioactive (http://kspcb. kar.nic.in/BMW).
In-door air pollution
Pathogens present in the waste can enter and remain in the air for a long period in the form of
spores or as pathogens Segregation of waste, pre-treatment at source etc., can also reduce this problem
to a great extent. Sterilizing the rooms will also help in checking the indoor air pollution due to
biological (Askarian et al 2004b; Baveja et al 2000). The indoor air pollution caused due to the above
chemicals from poor ventilation can cause diseases like Sick Building Syndrome (SBS). Proper
building design and well-maintained air conditioners can reduce the SBS. Chemicals should be
utilized as per prescribed norms. Over use of chemicals should be avoided (Bdour 2004, Saurabh &
Ram 2006).
Out-door air pollution
Outdoor air pollution can be caused by pathogens. The biomedical waste without pre-treatment
if transported outside the institution, or if it is dumped in open areas, pathogens can enter into the
atmosphere. Chemical pollutants that cause outdoor air pollution have two major sources-open
burning and incinerators. Open burning of bio-medical waste is the most harmful practice. When
inhaled can cause respiratory diseases. Certain organic gases such as dioxins and furans are
carcinogenic (Burd 2005). The design parameters and maintenance of such treatment and disposal
technology should be as per the prescribed standards (Bdour 2004).
Radioactive emissions
Research and radio-immunoassay activities may generate small quantities of radioactive gas.
Gaseous radioactive material should be evacuated directly to the outside. The use of such device
requires maintenance of the trap and monitoring of the off-gas (Malviga 1999).
Water Pollution
The liquid waste generated when let into sewers can also lead to water pollution if not treated
properly (Rao, 1995; Rao & Garg, 1994). Water pollution can alter parameters such as pH, BOD, DO,
COD, etc. There are instances where dioxins are reported from water bodies near incinerator plants.
Dioxins enter the water body from the air (Chitins et al, 2000; Ravikant et al, 2002; Saini & Dadhwal
1995)
Radioactive effluent
Radioactive waste in liquid form can come from chemical or biological research, from body
organ imaging, from decontamination of radioactive spills, from patients urine and from scintillation
liquids used in radioimmunoassay. Under normal circumstances, urine and faeces can be handled as no
radioactive waste so long as the patients room is routinely monitored for radioactive contamination
(Patil & Pokhrel, 2004; Shah et al, 2001).
Land Pollution
Soil pollution from bio-medical waste is caused due to infectious waste, discarded medicines,
chemicals used in treatment and ash and other waste generated during treatment processes. Heavy

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J. Int. Environmental Application & Science,

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metals such as cadmium, lead, mercury etc., which are present in the waste will get absorbed by plants
and can then enter the food chain. Nitrates and phosphates present in leachates from landfills are also
pollutants. Excessive amounts of trace nutrient elements and other elements including heavy metals in
soil are harmful to crops and are also harmful to animals and human beings (Mehta 1998). The
permissible limits of some elements in soil for plants are presented in the Table 2. Minimizing the
waste and proper treatment before disposal on land are the only ways of reducing this kind of pollution
(Silva et al 2005). The waste generated from various countries is given in Table 3.
Table 2. Comparison of treatment technologies for medical wastes
Treatment
Systems

Autoclave

Description

Hydroclave

Microwave

Incinerator

Chemical

Steam
Steam sterilization,
sterilisation
(indirect heating)
(Direct heating) simultaneous
shredding and
dehydration

Microwave
heating of preshredded waste

High
temperature
waste
incineration

Mixing preground waste

with chemicals,
such as chlorine

Sterilization
efficacy

Medium

Medium

Medium

High (total
destruction of
microorganisms)

Dependent on
chlorine strength
and dispersment
through the waste

Capital cost

Low

Low

High

High

Moderate

Operating cost Low

Low

High

High

Low

Operator
maintenance
skills

Low skill level Low skill level

required
required

Automated, but
highly complex
and high level
maintenance skill
required

High level
operator and
maintenance
skills required

High level
required for
chemical control
and grinder

Air emissions

Odorous but
non-toxic

Somewhat odorous
but non-toxic

Somewhat
odorous but nontoxic

Can be highly
toxic

Some chlorine
emissions

Water
emissions

Odorous, may
contain live
microorganisms

Odorous but sterile

Negligible

None

None

Treated waste
characteristics

Wet waste, all

material
recognizable

Dehydrated,
shredded waste,
unrecognizable
material

Shredded but wet

waste

Mostly ash, may Shredded wet

contain toxic
waste, containing
substances
chemicals used as
disinfectants

Table 3 Amount and composition of hospital waste generated

(a) Amount
Country
U. K.
U.S.A.
France
Spain
India

Quantity (kg/bed/day)
2.5
4.5
2.5
3.0
1.5

(b) Hazardous/non-hazardous
Hazardous
a) Hazardous but non-infective
b) Hazardous and infective
Non-hazardous

15%
5%
10%
85%

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(c) Composition
By weight
Plastic

14%

Dry cellublostic solid

Wet cellublostic solid

45%
18%
20%

Combustible

Non-combustible
Source: http://isebindia.com/95_99/99-07-2.html

Health hazards
According to the WHO, the global life expectancy is increasing year after year. However, deaths
due to infectious disease are increasing. A study conducted by the WHO in 1996, reveals that more
than 50,000 people die everyday from infectious diseases. One of major causes for the increase in
infectious diseases is improper waste management. List of infections and diseases documented to have
spread through bio-medical waste. Tuberculosis, pneumonia, diarrhoeal diseases, tetanus, whooping
cough etc., are other common diseases spread due to improper waste management (Chitins et al, 2002;
Chitins et al, 2003; Tudor et al, 2005; Marinkovic et al, 2005).
Occupational health hazards
Occupational health concerns exist for janitorial and laundry workers, nurses, emergency medical
personnel, and refuse workers. Injuries from sharps and exposure to harmful chemical waste and
radioactive waste also cause health hazards to employees in institutions generating bio-medical waste.
Proper management of waste can solve the problem of occupational hazards to a large extent (Patil &
Shekar, 2001).
Hazards to the general public
The general publics health can also be adversely affected by bio-medical waste. Improper
practices such as dumping of bio-medical waste in municipal dustbins, open spaces, water bodies etc.,
leads to the spread of diseases. Emissions from incinerators and open burning also lead to exposure to
harmful gases which can cause cancer and respiratory diseases (Manohar et al, 1998; Da silva et al,
2005).
Plastic waste can choke animals, which scavenge on openly dumped waste. Injuries from sharps
are common feature-affecting animals. Harmful chemicals such as dioxins and furans can cause
serious health hazards to animals and birds. Certain heavy metals can affect the reproductive health of
the animals (Code & Christic, 1999).
2. Environmental management system
The EMS is a broad framework aimed at providing effective direction for an institution in
response to the changing external and internal factors. Waste system of the hospital was studied by
(Das et al, 2001; CPHEE 1998; Kelkar, 1998; Kela et al, 2000). Figure 2 shows the waste
management flow chart and process flow chart of the existing indicated the sequence from generation
of waste to its final disposal. Figure 3 shows the interference of the points and data (Jaswal & Jaswal
2000). Colour coding and type of container for disposal of biomedical wastes is given in Table 4
Biomedical waste solutions specialize are in three categories namely:

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J. Int. Environmental Application & Science,

External
Govt. Rules

Method
PT wheel chair
used for transport

Vol. 4 (1): 65-78 (2009)

No segregation
Identification

Environment hazard
waste

All wastes thrown

In garbage bins

No identification of
wastes

Incinerator not working

Low priority
Lack of attitude

No plastic bags
Inadequate
Containers

Ignorance

Machine and
Materials

Waste not important

Man

*(Source: Das et al, 2001), Containment (Anonymous, 1998), Disposal (Ndiaye et al, 2003), Info nugget
2003)

Figure 2. Waste management flow chart*

Table 4. Type of container and colour code for collection of bio-medical waste
Category

Waste class

Type of container

Colour

1.

Human anatomical waste

Plastic

Yellow

2.

Animal waste

-do-

-do-

3.

Microbiology and Biotechnology waste

-do-

Yellow/Red

4.

Waste sharp

Plastic bag puncture

proof containers

Blue/White Translucent

5.

Discarded medicines and Cytotoxic

waste

Plastic bags

Black

6.

Solid (biomedical waste)

-do-

Yellow

7.

Solid (plastic)

Plastic bag puncture

proof containers

Blue/White Translucent

8.

Incineration waste

Plastic bag

Black

-do-

-do-

9.
Chemical waste (solid)
Source: http://isebindia.com/95_99/99-07-2.html

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START

Waste generated

Are waste segregated?

D

Stop
Yes
No
Waste collected in containers

Different colour
containers for
category

Yes

Stop

No
Disposal of wastes

Stop

Yes
No
Wastes dumped in garbage bin

Is incinerator ok?
No
Wastes disposed
indiscriminately

Stop

Figure 3. A process flow chart of the existing waste system of the hospital management of the
infectious waste is crucial in todays health care arena (Saurabh, & Ram, 2006)

Disposal methods
Different methods are used for the disposal of bio medical waste and are discussed below:
Incineration:
It is a controlled combustion process where waste is completely oxidized and harmful microorganisms
present in it are destroyed/denatured under high temperature. An article regarding plasma pyrolysis of
medical waste was reported by Neema and Gareshprasad (2002). The authors stated that the operating
cost of the system would be Indian Rupees 13 per kilogramme (kg), and the energy recovered would
cost Indian Rupees 8 per kg; thus the net cost would be Rs 7 per kg. Amount and composition of

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hospital waste generated are in Table 5. Incineration is popular in countries such as Japan where land
is a scarce resource, as they do not consume as much area as a landfill. Sweden has been a leader in
using the energy generated from incineration over the past 20 years. Denmark also extensively uses
waste-to-energy incineration in localised combined heat and power facilities supporting district
heating schemes (Gupta, 1998).
Table 5. Machinery requirements for Common Waste Treatment Facility
1

Incinerators

2 numbers

Auto Claves

One

Microwave equipment

(Optional)

Shredders

2 nos

Chimney

30 M

Effluent Treatment Plant

Vehicle Washing Equipments

Water pumps, Storage, Air Compressors

Generator for Electricity

Source: http://mpcb.mah.nic.in

Autoclaving: Autoclaving is a low-heat thermal process where steam is brought into direct contact
with waste in a controlled manner and for sufficient duration to disinfect the wastes. For ease and
safety in operation, the system should be horizontal type and exclusively designed for the treatment of
bio-medical waste. For optimum results, pre-vacuum based system be preferred against the gravity
type system. It shall have tamper-proof control panel with efficient display and recording devices for
critical parameters such as time, temperature, pressure, date and batch number etc (NEERI 1995,
Bacini & Brunner, 1991; Pruss et al, 1999).
Microwaving, microbial inactivation occurs as a result of the thermal effect of electromagnetic
radiation spectrum lying between the frequencies 300 and 300,000 MHz. Microwave heating is an
inter-molecular heating process. The heating occurs inside the waste material in the presence of steam
(Pruthvish et al, 1998).
Hydroclaving is similar to that of autoclaving except that the waste is subjected to indirect heating by
applying steam in the outer jacket. The waste is continuously tumbled in the chamber during the
process.
Shredder: Shredding is a process by which waste are deshaped or cut into smaller pieces so as
to make the wastes unrecognizable. It helps in prevention of reuse of bio-medical waste and also acts
as identifier that the wastes have been disinfected and are safe to dispose off. A shredder is to be used
for shredding in bio-medical waste with minimum requirements (Singh & Sharma 1996; Shah et al,
2001; Rasheed et al, 2005).

Standards for treatment and disposal of bio-medical wastes

Standards for incinerators
All incinerators shall meet the following operating and emission standards
A. Operating Standards
1. Combustion efficiency (CE) shall be at least 99.00%.
2. The Combustion efficiency is computed as follows:

C.E =

%CO 2
100
%CO 2 + %CO

3. The temperature of the primary chamber shall be 800o 50o C.

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4. The secondary chamber gas residence time shall be at least I (one) second at 1050o 50o C,
with minimum 3% Oxygen in the stack gas.
B. Emission Standards
The emission standards are given in Table 6.
Table 6. EPA Emission limits for new hospital/medical/infectious waste incinerators
POLLUTANT
Particulate Matter
Carbon Monoxide
Dioxins/Furans
Hydrogen Chloride or 99% reduction
or 99% reduction
Sulphur Dioxide
Nitrogen Oxides
Lead
Cadmium
Mercury

Small
69 mg/dscm
40 ppmv
125 ng/dscm total or
2.3 ng/dscm TEQ
15 ppmv or 99%
reduction
55 ppmv
250 ppmv
1.2 mg/dscm or 70%
reduction
0.16 mg/dscm or
65% reduction
0.55 mg/dscm or
85% reduction

EMISSION LIMITS
Medium
34 mg/dscm
40 ppmv
25 ng/dscm total or
0.6 ng/dscm TEQ
15 ppmv or 99%
reduction
55 ppmv
250 ppmv
0.07 mg/dscm or
98% reduction
0.04 mg/dscm or
90% reduction
0.55 mg/dscm or
85% reduction

Large
34 mg/dscm
40 ppmv
25 ng/dscm total or
0.6 ng/dscm TEQ\
15 ppmv or 99%
reduction
55 ppmv
250 ppmv
0.07 mg/dscm or
98% reduction
0.04 mg/dscm or
90 % reduction
0.55 mg/dscm or
85% reduction

mg = milligrams, dscm = dry standard cubic meter, ppmv = parts per million by volume ng = nanograms, TEQ = toxic
equivalent; Capacities: small=less than or equal to 200 lbs/hr; medium=greater than 200 lbs/hr to 500 lbs/hr; large=greater
than 500 lbs/hr.

Standard for liquid waste:

Table 7. shows the effluent generated from the hospital should conform to the following limits
Table 7. Emission standards waste incinerators
S. No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17

Contaminant
Total Particulate
Carbon Monoxide
Sulphur Dioxide
Nitrogen Oxides (NOx as NO2)
Hydrogen Chloride
Hydrogen Fluoride
Total Hydrocarbons (as Methane CH4)
Arsenic
Cadmium
Chromium
Lead
Mercury
Chlorophenols
Chlorobenzenes
Polycyclicaromatic Hydrocarbons
Polychlorinated Biphenyls
Total PCDDs & PCDFs Opacity

Limit
20 mg/m3
55 mg/m3
180 mg/m3
380 mg/m3
50 mg/m3 or 90% removal
4 mg/m3
32 mg/m3
4 g/m3
100 g/m3
10 g/m3
50 g/m3
200 g/m3
1 g/m3
1 g/m3
5 g/m3
1 g/m3
0.5 ng/m3 5%

Source: (Machala et al, 2007)

Common Biomedical treatment Facilities

Tables 8 and 9 show the machinery requirements for Common Waste Treatment Facility.

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Table 8. Effluent generated from hospital

Parameters
pH
Suspended solids
Oil and grease
BOD
COD

Permissible limits
6.3-9.0
100 mg/L
10 mg/L
30 mg/L
250 mg/L

Source: Srivasta, 2000

Table 9. Design and Operation Requirements for Biomedical Waste Incinerators and Emission
Control Systems
S.No.
1
2
3

Parameter
Incinerator
Minimum Incineration
Temperature
Minimum Residence
Time

Primary Air (Underfire)

5
6

Secondary Air (Overfire)

Overfire Air Injector
Design
Auxiliary Burner
Capacity

8
9
10
11
12
13

14

Oxygen Level at the

Incinerator Outlet
Turndown Restrictions
Maximum CO Level
Combustion Efficiency
Emission Control
Systems
Flue Gas Temperature at
Inlet or Outlet of
Emission Control Device
(2)
Opacity

Incinerator Type Modular

(Excess Air and Starved Air)

Incinerator Type Mass Burn

1000 degrees C at fully mixed

height
1 second after final secondary air
injection ports

1000 degrees C determined by an

overall design review
1 second calculated from the point
where most of the combustion has
been completed and the incineration
temperature fully developed
Use multiple plenums with individual
air flow control

Utilize multi-port injection to

minimize waste distribution
difficulties
Up to 80% of total air required (1)
That required for penetration and
coverage of furnace cross-section
Secondary burner 60% of total
rated heat capacity, and that
required to meet start-up and partload temperatures
6 to 12%

At least 40% of total air required

That required for penetration and
coverage of furnace cross-section
60% of total output, and that required
to meet start-up and part-load
temperatures
6 to 12%

80 to 110% of designed capacity

55 mg/m3 @ 11% (4-h rolling
average)
99.9% (8-h rolling average)

80 to 110% of designed capacity

55 mg/m3 @ 11% (4-h rolling average)

Not to exceed 140 degrees C

Not to exceed 140 degrees C

Less than 5%

Less than 5%

99.9% (8-h rolling average)

Common Biomedical treatment Facilities are setup for the treatment and disposal of Biomedical
Wastes generated in a number of health care facilities. They are likely to be more economical
than individual waste treatment facilities. Resources can be utilized optimally in case of
common Facilities (Anonymous, 1997; Ranyal, 2000; http://www.cpcb.nic.in).
Present Scenario:
Waste management is one of the important public health measures. If we go into the historical
background, before discovery of bacteria as cause of disease, the principle focus of preventive
medicine and public health has been on sanitation. The provision of potable water, disposal of odor
from sewage and refuse were considered the important factors in Prevention of epidemics. The
current status of practice in India is given in Figure 4.
The vehicles transporting the wastes to the facility shall be designed exactly as per the standards
of Bureau of Indian Standards (Anonymous, 2005). They should also be labelled with symbols meant

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for hazardous wastes. The common Treatment facilities should comply with all the emission and
effluent standards of the pollution control Board (Anonymous, 2005).
Biomedical waste in Delhi, India
With increasing awareness in general populations regarding hazards of hospital waste, public
interest, litigations were filed against erring officials. Some landmark decisions to streamline hospital
waste
management
have
been
made
in
the
recent
time
(http://health.delhigovt.nic.in/Health/files/bio.html)
All health care institutions are required to handle biomedical waste in a specified manner.
Delhi is generating approximately 6500 metric tons of waste out of which 65 tons are Biomedical
Waste. The Government hospitals and major private hospitals have their own arrangement for
treatment of biomedical waste (Anonymous, 1998, Gayathri and Kamala P, 2005, Saurabh G, Ram
B, 2006)
Infectious liquid waste

Waste Generators
(Hospitals, Nursing
home, Clinics)
Septic tanks
open drains

Solid
SolidSolid
waste

Collection
(technical + nontechnical)

* Overflowing
drains
* Poor sanitary
conditions

Sorting (segregation)

Recycling (at source)

Status
Collected in open
bins without
disinfection
* No segregation
* No labeling of bins
* No colour coding of bins
* Sorting of used disposables
without disinfection
Used plastic and glass
Intravenous Bowles
infections sets, sharps,
syringes and sold to third

party
Transportation

* Manually
transported
* No safety
precaution

Recycling of
clinical waste
by rag picker

Municipal bins

Onsite disposal

Open
burning

Municipal dump yard

Recycling of disposal clinical waste by rag

pickers/ unsafe disposal/ unaesthetic
conditions/ odour/ nuisance/ ground water
pollution

*Air Pollution
* Toxic ash

*(Source: Saurabh & Ram , 2006)

Figure 4. Current status of medical waste disposal in Lucknow, India

75

* Disposal on road or
open pits
* No fencing to keep
rag pickers away
* Health impact

J. Int. Environmental Application & Science,

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Conclusions
Proper management of Bio medical waste is a concern that has been recognized by both
government agencies and the Non government organizations. Several hazards and toxic materials
containing should be disposed off with proper take and care. Inadequate and inefficient segregation
and transportation system may cause severe problem to the society hence implementing of protective
measures, written policies all of these factors contribute to increased risk of exposure of staff, patients
and the community to biomedical hazards. In order to accelerate the rate at which proper processing
and management methods are designed, timely regulatory and legislative policies and procedures are
needed. To properly separate, process and isolation of wastes, they must be well-characterized, which
is challenging. Safe and effective management of bio medical waste is not only a legal necessity but
also a social responsibility. Lack of concern in persons working in that area, less motivation,
awareness and cost factor are some of the problems faced in the proper hospital waste management.
Proper surveys of waste management procedures in various practices are needed. Clearly there is a
need for education as to the hazards associated with improper waste disposal. An effective
communication strategy is imperative keeping in view the low awareness level among different
category of staff in the health care establishments regarding biomedical waste management. One
important direction for future research would be to project the flows of bio medical waste worldwide
and quantitatively and qualitatively assess.

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