Transcript several interconnected ambitions are motivating the Indian

Bio Medical Waste: Planning and
Management
Dr.Vaibhav Goel Bhartiya
Subharti Law School
Swami Vivekanand Subharti University Meerut
What are the minimum
requirements for health?
• Availability
public health care facilities must exist in sufficient quantity. At a
minimum, this includes safe drinking water, adequate sanitation,
hospitals and clinics, trained medical personnel receiving domestically
competitive salaries, and essential drugs
• Accessibility
health care must be physically and economically affordable. It
must be provided to all on a non-discriminatory basis. Information on
how to obtain services must be freely available.
• Acceptability
all health facilities must be respectful of medical ethics, and they
must be culturally appropriate
• Quality
health facilities, goods, and services must be scientifically and
medically appropriate and of good quality. At a minimum, this requires
skilled medical personnel, scientifically approved and unexpired drugs
and hospital equipment, safe water and adequate nutrition (within the
facility)
Bio medical waste
• waste means ‘res derilicta’ (or the abandoned
object) corresponds to the concept of “ throw away”
culture.
• Bio-medical waste is a term coming into common
usage to replace what had been referred to as
pathological or infectious wastes and to include
additional related waste streams.
• Bio-Medical Waste" means any waste, which is
generated during the diagnosis, treatment or
immunization of human beings or animals or in
research activities pertaining thereto or in the
production or testing of biological. It includes
infectious and non-infectious waste. Infectious
waste includes pathological waste, cotton,
dressing, used needles, syringes, scalpels, blades,
glass, etc., and non-infectious waste includes
general waste from the kitchen / canteen,
packaging material including radioactive wastes,
mercury containing instruments, PVC plastics ”
• In true sense and in the manner we understand biomedical hazards in modern time had been arisen in
USA during 1970s period.
The eye opening
incidences had been occurred at the East Coast of
the USA where medical waste mixed with the
municipal waste stream had found including
syringes and bandages were washed up on beaches
in the East Coast of the USA.
• A Report on Alternative Treatment and Non-Burn Disposal Practices, A WHO
publication Pg. 4.
See, www.searo.who.int/LinkFiles/SDE_SDE_mgmt-biomedical-framework.pdf.
• It is estimated that Delhi produces 7,000 metric
tones of waste every day. Biomedical waste
generated by 1,700 healthcare establishments is
80,880 kg of waste per day in Delhi only.
As per Indian Express.com. feb08, 10 available at,
http://www.w3c.org/TR/1999/REC-html40119991224/loose.dtd accessed on 27.12.2010.
Why special planning for Bio Medical Waste
• First, the Bio-medical waste itself is the different
kind of waste and cannot be treated and manage on
the same footing as other waste materials are! The
other waste material which is not useful may not be
as dangerous as the Bio-medical waste.
• Secondly, the Bio-medical waste is vulnerable and
contagious and the person coming in contact may
get infected due to it. Thus the contagious and
infectious nature of the bio-medical waste itself
reveals the danger of mismanagement
Continued…
• Thirdly, the Bio-medical waste cannot be destroyed
as easily as the other waste can be destroyed. The
products used for medical treatment of human body
are made up of such material which cannot be
decomposed easily. Again the bacteria, virus, fungus
or any biological infectious micro-organisms are
resistant to different normal process of
immunization by heating, boiling and dumping.
These micro-organisms are capable of surviving
years together unless destroyed thought specific
treatment.
• Lastly, as the micro-organism of diseases carries
by Bio-medical wastes may infect to even healthy
human being respective of his resistance power, age
or even the area.
• Therefore, handling, disposal and destruction of
hazardous waste including Bio-medical waste has
become task of top-priority for the urban
societies and improper disposal of such waste
material has become one of the biggest challenge
for present developed and developing nation.
Effects of Bio-medical
• 1. Infection.
• 2. Genotoxicity and Cytotoxicity
• 3. Chemical toxicity
• 4. Radioactivity hazards.
• 5. Physical injuries
• 6. Public sensitivity.
There are two main types of risks associated with
biomedical waste.
• Foremost is the risk to health, due to infection or injury,
particularly health care workers involved in handling of
biomedical waste.
• The second types of risk are an environmental risk, if there
is no proper disposal of biomedical waste. This can lead to
pollution of water, air and soil resulting in long-term
exposure of the population which may lead to server
adverse health effects due to poisoning The risk to water can
be due to heavy metals, such as mercury, silver or expired
pharmaceuticals
for
disposal
• Unscientific disposal of health care waste may lead
to the transmission of communicable diseases
such as gastro-enteric infections, respiratory
infections, spreading through air, water and direct
human contact with the blood and infectious body
fluids. These could be responsible for transmission
of Hepatitis B, C, E and AIDS within the
community. Diseases are spread by improper
treatment and disposal of waste.
Indian Legislation on the issue
• 1989 the Government of India, in exercise of powers
conferred under Section 6, 8 and 25 of the
Environment Protection Act, 1986 formulated the
Hazardous Waste (management & Handling) Rules,
1989 but hospital waste is not covered in this.
• It is only in 1995 the legislative response came out
when government had taken the feedback from the
public on Bio-medical Waste after issuing a draft
because of Basel.
• Biomedical Waste (Management & Handling) Rules,
1998" (BMW Mgt) in short) in July 1998 has been
finally notified.
• In accordance with the rules, every hospital
generating BMW Mgt needs to set up requisite
BMW treatment facilities on site or ensure requisite
treatment of waste at common treatment facility.
Paschim Banga Khet Mazdoor Samity and others v. State of West
Bengal and another, AIR 1996 SC 2426
and in W.L Wadhera vs. Union of India
• All hospitals with 50 beds and above should install
either their own incinerator or an equally effective
alternative method before 30th November 1996.
• The incinerator or the alternative method should be
installed with a necessary pollution control
mechanism conforming to the standard laid down by
Central Pollution Control Board (CPCB).
• Hazardous medical waste should be segregated at
source of generation and disinfected before final
disposal.
Bio-medical waste generation & disposal :Problems
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– Improper waste management: The waste management of the primary health care institution is
negligence on their part and which raise the bio-medical waste
scatter on the road or in public space, which harm to animal as
well as environment.
– Lack of proper knowledge: There is lacking of proper knowledge to disposal of the biomedical waste and proper management so it raise to BMW
– Cost of disposal: There is cost of bio-medical waste on the hospital Authority so
they neglect on there part and small clinic are not offered that
cost.
– Absence of any heavy punishment: There is no any provision in law to give heavy punishment to the
violence that rule and very light punishment are mention
Some of the object of BMW Rules
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•
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•
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Health and safety of the nurses staff
Management of Waste in Health Care Institution
Prevent Transfusion of diseases and deficiencies
Proper Disposal of Bio-medical Waste
To prevent injury to the health care workers
To prevent general exposure cytotoxic, genotoxic
and chemical
• Get seriousness about Bio-Medical Waste
• Punishment or penalty provided to violating the rule
of BMW to the occupier or the operator.
• Maintain the record the bio-medical waste (end of
year 31st of December and display at 31st of March
of every year. )
• But after the empirical study I came across that no
where rules have been followed properly.
• Health care unites are transmitting the same rules of
1998 as amended in 2000 on their web site or
otherwise but working practically on that.
• Hence the problem of Bio medical waste increasing
with the development of technologies and procedure
of disease eradication.
Suggestions
• It is utmost necessary to have ample literature (in reach)
on the bio-medical waste management
• It is also necessary to have the linkage between various
institutions, organization and governmental bodies
working in bio-medical waste management
• While granting the permission to the hospitals, norms
shall be developed so that at the initial stage the hospital
may have infrastructure for bio-medical waste management
at their site
• There is urgent need to have more numbers of disposal
sites in the metro cities.
• It is further recommended that through there is not need of
any modification or alteration in the present piece of
legislation, but its effective execution is urgently
warranted which is possible through Public
Participation only
•
•
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It is further recommended that the bio-medical
waste hazards shall also be looked from the
“Health” jurisprudence. At the present the
judicial decisions are focusing only on the
“environmental” aspects in its decisions. But
bio-medical waste not only has the impact on
“environment” but also on the Health of an
individual and community health as well.
Management.
The increasing participation from the NGOs,
international institutions, local bodies,
voluntary organizations shall be given priority so
that the policy execution burden may be shared
and distributed upto larger extend.
Monitory Guarantee may be imposed on Hospitals
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