Bio Medical Waste

 

  • Definition: Biomedical waste is defined as human and animal anatomical waste, treatment apparatus like needles, syringes and other materials used in health care facilities in the process of treatment and research.
    • Covid-19 related Biomedical waste includes: personal protective equipment (PPE), gloves, face masks, head cover, plastic coverall, hazmat suit, syringes among other gears and medical equipment used by both healthcare providers and patients.
  • Hazardous Waste: Biomedical waste is a biologically and chemically hazardous waste containing biological and microbiological contamination.
    • It has the potential of spreading various types of diseases.
    • The covid related biomedical waste contains various medicines that are toxic in nature.

 

Key Points

  • Central Level: The Central Pollution Control Board (CPCB) to ensure strict compliance of biomedical waste management rules and scientific disposal of the waste.
  • State Level: The Chief Secretaries of all the States/UTs to oversee compliance and ensure that authorisation is secured by every health care facility in their respective jurisdiction and also there is adherence to the norms.
  • District Level: The District Magistrates in accordance with the District Environmental Plans.
  • Groundwater Contamination: While permitting deep burials, it may be ensured that groundwater contamination does not take place.
  • Segregation: Ensure that hazardous bio-medical waste is not mixed with the general waste.
  • Frequent Violation of Rules: The direction came as a result of regular fines being imposed on various healthcare facilities and biomedical waste treatment facilities
  • Earlier Observation: The segregation of Covid-­19 biomedical waste from general garbage is a must to avoid further contamination adversely affecting public health.

 

Bio-Medical Waste Management Rules, 2016

  • Definition: Biomedical waste is defined as human and animal anatomical waste, treatment apparatus like needles, syringes and other materials used in health care facilities in the process of treatment and research.
    • Objective: The objective of the rules is to properly manage the per day bio-medical waste from Healthcare Facilities (HCFs) across the country.
  • Ambit: The ambit of the rules has been expanded to include vaccination camps, blood donation camps, surgical camps or any other healthcare activity.
  • Phase Out: Chlorinated plastic bags, gloves and blood bags has been phased out within two years starting from March 2016.
  • Pre-treatment: Pre-treatment of the laboratory waste, microbiological waste, blood samples and blood bags through disinfection or sterilisation on-site in the manner prescribed by the World Health Organization (WHO) or by the National AIDS Control Organisation (NACO).
  • Categorisation: Bio-medical waste has been classified into 4 categories instead of the earlier 10 categories to improve the segregation of waste at source.
  • Stringent Standards for Pollutants: The rules prescribe more stringent standards for incinerators to reduce the emission of pollutants in the environment.
  • Role of State Government: The State Government provides the land for setting up common bio-medical waste treatment and disposal facility.es

 

Concerns:

    • Pandemic: The pandemic has presented a challenge in terms of capacity to scientifically dispose of generated waste and a challenge for civic authorities in charge of its collection and disposal.
    • Poor Compliance: States are not following the CPCB guidelines on Covid-19 related waste. In some states, improper segregation of waste has been reported from Covid-19 facilities and quarantine homes.
    • Non Segregation: The non-­segregation of waste results in the incineration of contaminated plastics producing toxic gases and adding to air pollution.
    • Increase in Waste: The rise in residential biomedical waste and its collection without adhering to safety protocols could also trigger a surge in caseload.
    • Health of Workers Associated: Without proper scientific management of such waste, it can potentially affect patients and can affect the concerned workers and professionals. Discarded masks and gloves risk the lives of thousands of sanitation workers who work often without any protection or training to handle such hazardous material.

Suggestions:

  • Proper Segregation: Left-over food, disposable plates, glasses, used masks, tissues, toiletries, etc used by Covid-19 patients should be put in yellow-coloured bags, while used gloves should be put in red bags and sent for sterilisation and recycling at the CBWTFs. Where waste is not going to incinerators, deep burial systems should be properly maintained as per protocols taking all due precautions to prevent harm to the environment. A deep burial system involves burying biomedical waste in 2-meter-deep ditches and covering them with a layer of lime and soil.
  • Awareness Campaign: Initiatives like conducting an appropriate programme on Doordarshan, All India Radio and other media platforms to create mass awareness about the correct disposal of biomedical waste.
  • Creating Infrastructure: The government should set up recycling plants across the country (as envisaged under the Smart cities project) under the Public-Private Partnership (PPP) Model.
  • Coherency in Rules: The Centre should form a national protocol combining the Biomedical Waste Management Rules, 2016 with the guidelines on Extended Producer Responsibility (EPR) for producers of plastic.
  • Innovation: Incentivise start-ups and Small and Medium Enterprises (SMEs) offering solutions for waste segregation and treatment.
  • Monitoring: There should be constant and regular monitoring by the central and state PCBs, Health Departments in the states/UTs and by the high-level task team at Central level with further coordination by CPCB.
Basel Convention
  • Adopted on March 22, 1989 by the Conference of Plenipotentiaries in Basel, Switzerland, the “Basel Convention on the Control of Trans-boundary Movements of Hazardous Wastes and their Disposal”, generally known as the Basel Convention, came into force in 1992.
    • It is an international treaty that aims to reduce the movement of hazardous waste between countries.
  • It particularly focuses on preventing transfer of hazardous waste from developed to less developed countries.
    • It provides for cooperation between the parties, including exchange of information on issues relevant to the implementation of the Convention.
  • India is a member of the Basel Convention.
    • It ratified the convention in June 1992 and brought it into force on 22nd September 1992.
    • However, India has not ratified the Basel ban amendment.
    • Adopted by the parties in the Basel Convention in 1995, the amendment prohibits all export of hazardous wastes, including electronic wastes and obsolete ships from 29 wealthiest countries of the Organization of Economic Cooperation and Development (OECD) to non-OECD countries.
Challenges in Biomedical Waste Management
  • Major Waste Generated at Home: The Covid related biomedical waste is generated not just in the hospitals but also at homes. Only 20% of the patients had to go to hospital.
    • 80% of Covid patients are recuperating/have recuperated at home. They are generating the biomedical waste at the places where it can not be treated properly. There is no proper facility for the management of the biomedical waste generated at home; it is being dumped in the ordinary municipal waste.
  • Issues with Local Hospitals: Although India has the facility of managing this high amount of waste but because a large amount of this waste is being generated at homes and at provincial and local level hospitals, the waste is getting mismanaged.
    • These local hospitals are not as updated in facilities and infrastructure and hence, don’t have proper biomedical waste management facilities.
  • Municipal Workers at Risk: As such a large amount of covid waste is being generated at home, it makes the municipal workers the frontline workers too.
    • Data shows that these workers too have been impacted extensively amid the pandemic, a lot of them have died too.
    • There is a common perception that the virus must have been transmitted by respiratory droplets, aerosols or by touching an infected surface. However, there is less attention given to the poor management of the biomedical waste, a large number of people, specially the municipality workers getting infected due to coming in contact with the waste disposed of in the open.
  • Lack of Awareness: People are also not aware of how to segregate the waste at source and this is a bigger concern.
  • Issue with the Waste Management Rules: The legal provisions for the same are designed to tackle biomedical waste at hospitals only.
    • They do not provide any information about how to manage such waste at home or any place other than hospitals.
  • Unequal Distribution of CBWTF: India has about 200 Common Biomedical Waste Treatment Facilities (CBWTF) across the country but they are located only in a few cities/districts like Mumbai or in Delhi.
    • However, in far off corners of the country, there is no such treatment facility at all.
    • Maharashtra had the highest number of such facilities (29) followed by Karnataka (26) and Gujarat (20). Kerala, which had witnessed the highest rate of daily generation, had only one CBWTF.
  • Lack of Accurate Data: The CPCB, during the first wave of the pandemic, was very quick in providing clear guidelines and a mobile app for collecting data on biomedical waste generation.
    • But with the occurrence of the second wave, the impact is so bad that the hospitals are not even able to upload any data now.
    • Also, considering the fact that the second wave has hit India in a worse way, the covid related biomedical waste generated should have been a lot more than 250 tons (probably around 500 tons) as in the first wave the daily biomedical waste generation was 200 tons.

 

NGT raises concern over COVID-19 bio-medical waste disposal

 What’s the concern now?

There are concerns regarding unscientific disposal of bio-medical waste by unauthorised healthcare facilities.

Only 1.1 lakh out of 2.7 lakh healthcare facilities are authorised under the Bio-medical Waste Management Rules, 2016 so far.

 What has the tribunal said?

  1. There are gaps in compliance of the Bio Medical Waste Management Rules, 2016 which are applicable to the disposal of the bio-medical waste generated out of handling a viral disease.
  2. The State PCBS/PCCS have to make serious efforts to bridge the gap to mitigate possible risk in terms of unscientific disposal of bio-medical waste and enforce rule of law.
  3. There is need for revision of the guidelines for ‘Handling, Treatment and Disposal of Waste Generated during Treatment, Diagnosis, Quarantine of COVID-19 Patients’ issued by the Central Pollution Control Board (CPCB) recently.

Need of the hour:

  1. All aspects of scientific disposal of liquid and solid waste management should be taken care of not only at institution level but also at individual levels, such as manner of disposal of used Personal Protection Equipment (PPE), used bags, gloves, goggles, without the same getting mixed with other municipal solid waste causing contamination.
  2. The effectiveness of the monitoring mechanism, including securing information should be reviewed by way of electronic manifest system from the handlers of such waste and its online reporting by the State PCBS or PCCS by developing necessary software.
  3. There is the need to create awareness by special awareness programmes, organising training in concerned local bodies, health departments, providing workers handling COVID-19 waste with adequate protective gear, adequate coordination with media and other concerned regulatory authorities.

Salient features of BMW Management Rules, 2016:

  1. The ambit of the rules has been expanded to include vaccination camps, blood donation camps, surgical camps or any other healthcare activity.
  2. It calls for Phase-out the use of chlorinated plastic bags, gloves and blood bags within two years.
  3. It calls for Pre-treatment of the laboratory waste, microbiological waste, blood samples and blood bags through disinfection or sterilisation on-site.
  4. It seeks to Provide training to all its health care workers and immunise all health workers regularly.
  5. It seeks to Establish a Bar-Code System for bags or containers containing bio-medical waste for disposal.
  6. As per the rules, Bio-medical waste has been classified in to 4 categories instead 10 to improve the segregation of waste at source.
  7. As per the rules, State Government shall provide land for setting up common bio-medical waste treatment and disposal facility.

 

Way Forward

  • Judiciously Managing the Waste: The potential of biomedical waste of spreading a disease through the environment, largely by polluting water, is extremely high.
    • The biomedical waste generated should be collected and treated properly and must not be allowed to reach the water bodies as then it will be a problem too big to handle.
    • The biomedical waste generated should either be incinerated or gasified.
    • Along with managing the biomedical waste generated, nature should also be taken care of. The waste must be managed so judiciously so that it does not contribute to climate change or trigger any other harm.
  • Role of State Agencies: The state agencies responsible for providing the data to higher authorities have to play a crucial part in ensuring that data is not missed and no wrong data is forwarded to the CPCB.
  • Awareness Among People: The waste segregation and management is done by the state agencies by colour coding like the red coloured container means that the biomedical waste is highly hazardous.
    • So the people must also be aware about these color codings as they represent the hazard level of each biomedical waste.
    • If people will have knowledge about such basic things then they will be more cautious about keeping themselves away from such hazardous waste.
    • People must also understand that even if they are not infected, they should not put their masks and gloves in the same municipal bins that they have; waste segregation is a must.
    • People have to follow the SOPs generated by not just the WHO but other various health agencies to control the infection.
  • SOPs for Waste Management at Home: The CPCB shall come out with SOPs for managing biomedical waste at home for rural as well as urban communities.
    • While burning biomedical waste is not an option in urban areas as the pollution levels are already high, burning biomedical waste in pits can be a possible way of managing waste in the village areas.

 

PRACTICE QUESTIONS

1)

https://www.insightsonindia.com/2021/05/08/biomedical-waste-generation-during-covid-times-has-added-to-the-concerns-of-heath-management-in-light-of-the-situation-enumerate-the-issues-related-to-biomedical-waste-generation-and-suggest-measure/

2)

https://www.insightsonindia.com/2021/05/12/discuss-the-emerging-issues-in-biomedical-waste-management-due-to-covid-19-what-will-be-the-challenges-in-waste-management-before-the-world-owing-to-it/

 

 

3)

https://www.insightsonindia.com/2015/10/21/7-write-a-critical-note-on-bio-medical-waste-management-in-india-and-its-impact-on-population-health/

4)

https://www.insightsonindia.com/2020/06/23/india-is-on-the-brink-of-a-covid-induced-waste-crisis-discuss-the-concerns-associated-with-biomedical-waste-crisis-facing-the-country/