To protect human health and the environment, the Ministry of Environment and Forests had notified the Bio-Medical Waste (Management and Handling) Rules, 1998 under the Environment (Protection) Act, 1986 (29 of 1986) and later notified Bio-medical Waste Management Rules, 2016.
The guidelines have also been prepared to enable each hospital to create conditions for waste management in terms of segregation, collection, transportation, treatment and disposal of hospital waste. This has become a topic of enormous concern due to the massive amount of biomedical waste generated every year. Biomedical waste management means any waste which is generated during diagnosis, treatment or immunisation of human beings or animals or in research activities.
Universal problem
Biomedical waste is a universal problem. In the course of daily operation of medical activities, mass immunisation campaigns and even in emergency situations, good health-care waste management (HCWM) is crucial to prevent the exposure of healthcare workers, patients, waste handlers and the community to infections, toxic effects and injuries. Setting up waste treatment facilities can also be a costly affair for individual hospitals or nursing homes.
As India’s premier public sector medical institution which sets the standards in rendering quality patient care for other hospitals to emulate, All India Institute of Medical Sciences, Delhi, is uniquely poised to show the way in biomedical waste management management for the rest of the health sector. Its guidelines are a commitment in that direction.
As per records, AIIMS, Delhi, has 2,478 inpatient beds, with nearly 3 million outpatient visits a year (8,000-10,000 a day), with as many attendants, posing an enormous challenge to housekeeping. Incorporating the staff (both regular and contractual) strength of 14,000 and visitors, the total daily footfall at AIIMS reaches to nearly 50,000.
AIIMS Delhi produced 24,000 kg of yellow waste, 23,500 kg of plastic and rubber waste, 500 kg of sharp and 26,200 kg of glass waste making a total of 74,500 kg a month, or nearly 2,500 kg per day in 2018. According to Bio-medical Waste Management Rules, 2016, proper handling and disposal of such waste is a must and failure to comply will result a penal action including imprisonment of five years or a fine of ₹1 lakh or both. Recycling and reuse of biomedical waste along with proper disposal calls for immediate attention of both private and government hospitals.
Infection risks
Disposing of the waste consumes approximately 10-20 per cent of the average facility's operating budget annually. The majority of healthcare facility staff is involved in waste production and management in some capacity. Just as healthcare waste passes through many hands, from patient to practitioner, to procurement and disposal staff, the risk of infection from contaminated waste passes along in each step. The broader context here is that India generates 9.46 million tonnes of plastic waste annually out of which 40 per cent plastic waste goes uncollected. India generates around three million tonnes of medical waste every year and the amount is expected to grow at 8 per cent annually. Industrial waste, sewage and agricultural waste pollute water, soil and air. It can also be dangerous to human beings and environment. Similarly, hospitals and other health care facilities generate lots of waste which can transmit infections.
Guidelines have been issued with respect to enforcing the ban on identified forms of single use plastics.
The Plastic Waste Management Amendment Rules, 2021, prohibit manufacture, import, stocking, distribution, sale and use of plastic carry bags having thickness less than 75 microns, and having thickness less than 120 microns with effect from December 31, 2022.
With respect to both biomedical waste and single use plastic, the Centre has suggested the way forward:
* It has constituted an advisory committee for the respective States to review implementation of bio-medical waste management;
* Capacity building workshops are being organised for MSME units to provide them technical assistance for manufacturing of alternatives to banned single use plastic items with the involvement of CPCB/SPCBs/PCCs along with Ministry of Small Micro and Medium Enterprises and Central Institute of Petrochemicals Engineering (CIPET) and their State centres. Provisions have also been made to support such enterprises in transitioning away from banned single use plastics;
* For effective enforcement of ban on identified single use plastic items from this month, national and State level control rooms will be set up and special enforcement teams will be formed for checking illegal manufacture, import, stocking, distribution, sale and use of banned single use plastic items. States/UTs have been asked to set up border check points to stop inter-State movement of any banned single use plastic items.
A holistic approach to dealing with plastic waste, biomedical or in other forms, is underway, but it calls for participation by the citizenry in this effort.
The writer is Assistant Director, IES, Ministry of Rural Development and former Administrative Officer, AIIMS Delhi