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bio-medical waste

bio-medical waste

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Published by faridkhan

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Categories:Topics, Art & Design
Published by: faridkhan on Oct 02, 2010
Copyright:Attribution Non-commercial


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Medical care is vital for our life, health and well being. But the wastegenerated from medical activities can be hazardous, toxic and even lethal becauseof their high potential for diseases transmission. The hazardous and toxic parts of waste from health care establishments comprising infectious, bio-medical andradio-active material as well as sharps (hypodermic needles, knives, scalpels etc.)constitute a grave risk, if these are not properly treated/disposed or is allowed toget mixed with other municipal waste.
Its propensity to encourage growth of various pathogen and vectors and its ability to contaminate other non-hazardous/non-toxic municipal waste jeopardises the efforts undertaken foroverall municipal waste management.
The rag pickers and waste workers areoften worst affected, because unknowingly or unwittingly, they rummage throughall kinds of poisonous material while trying to salvage items which they can sellfor reuse. At the same time, this kind of illegal and unethical reuse can beextremely dangerous and even fatal. Diseases like cholera, plague, tuberculosis,hepatitis (especially HBV), AIDS (HIV), diphtheria etc. in either epidemic or evenendemic form, pose grave public health risks. Unfortunately, in the absence of reliable and extensive data, it is difficult to quantify the dimension of the problemor even the extent and variety of the risk involved.With a judicious planning and management, however, the risk can beconsiderably reduced. Studies have shown that about three fourth of the totalwaste generated in health care establishments is non-hazardous and non-toxic.Some estimates put the infectious waste at 15% and other hazardous waste at 5%.Therefore with a rigorous regime of segregation at source, the problem can bereduced proportionately. Similarly, with better planning and management, notonly the waste generation is reduced, but overall expenditure on wastemanagement can be controlled. Institutional/Organisational set up, training andmotivation are given great importance these days. Proper training of health careestablishment personnel at all levels coupled with sustained motivation canimprove the situation considerably.
The rules framed by the Ministry of Environment and Forests (MoEF),Govt. of India, known as
‘Bio-medical Waste (Management and Handling)Rules, 1998,’
notified on 20
July 1998, provides uniform guidelines and code of practice for the whole nation. It is clearly mentioned in this rule that the
(a person who has control over the concerned institution / premises) of an institution generating bio-medical waste (e.g., hospital, nursing home, clinic,dispensary, veterinary institution, animal house, pathological laboratory, bloodbank etc.)
shall be responsible for taking necessary steps to ensure that suchwaste is handled without any adverse effect to human health and theenvironment.Definition :
‘Bio-medical waste’ means any solid and/or liquid waste includingits container and any intermediate product, which is generated during thediagnosis, treatment or immunisation of human beings or animals or in researchpertaining thereto or in the production or testing thereof.The physico-chemical and biological nature of these components, theirtoxicity and potential hazard are different, necessitating different methods / options for their treatment / disposal. In Schedule I of the Bio-medical Waste(Management and Handling) Rules, 1998 (Annexure II), therefore, the wasteoriginating from different kinds of such establishments, has been categorised into10 different categories (as mentioned in the box below) and their treatment anddisposal options have been indicated.
Components of Bio-medical waste
(i) human anatomical waste (tissues, organs, body parts etc.),(ii) animal waste (as above, generated during research/experimentation, from veterinary hospitals etc.),(iii) microbiology and biotechnology waste, such as, laboratory cultures, micro-organisms,human and animal cell cultures, toxins etc.,(iv) waste sharps, such as, hypodermic needles, syringes, scalpels, broken glass etc.,(v) discarded medicines and cyto-toxic drugs(vi) soiled waste, such as dressing, bandages, plaster casts, material contaminated with blood etc.,(vii) solid waste (disposable items like tubes, catheters etc. excluding sharps),(viii) liquid waste generated from any of the infected areas,(ix) incineration ash,(x) chemical waste.
Health hazards associated with poormanagement of Bio-medical waste
 (i) Injury from sharps to staff and waste handlers associated with the health careestablishment.(ii) Hospital Acquired Infection(HAI)(Nosocomial) of patients due to spread of infection.(iii) Risk of infection outside the hospital for waste handlers/scavengers and eventuallygeneral public.(iv) Occupational risk associated with hazardous chemicals, drugs etc.(v) Unauthorised repackaging and sale of disposable items and unused / date expired drugs.The environmental hazards are mentioned at 7.4.2.
7.1.1 Linkage of Bio-medical Waste Management with Municipal WasteManagement
At present, the role of the civic body with respect to the management of bio-medical waste is not clearly defined, leading to confusion and laxity fromeither side.
Since majority of the health care establishments are located within themunicipal area, their waste management naturally has a close linkagewith the municipal system. At the same time, the civic authority isresponsible for public health in the whole of the municipal area. Therefore,the health care establishments must have a clear understanding with themunicipality regarding sharing of responsibilities associated with this issue.
Studies have shown that about three fourth of the total hospital waste is nothazardous / infected (provided strict segregation is practised) and can evenbe taken care of by the municipal waste management system, e.g., wastegenerated at the hospital kitchen or garden, the office or packaging materialfrom the store etc.
Such practices of strict and careful segregation would reduce the load andthe cost of management of the actually hazardous and infected bio-medicalwaste (collection, transportation, treatment and disposal).

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