Infectious waste that can be solids, liquids and waste from the laboratory are termed as biomedical wastes. Biomedical waste, also called clinical waste, is the by-product of hospitals, nursing homes, research laboratories etc. The main outlet of biomedical waste is a biological source [1].

HISTORY:

Year | Event

• Late 1980s | Many used syringes were washed up on the beaches of the East Coast in the US. This event gave rise to the Biomedical Waste Management Law.
• After 1990s | India invested in biomedical waste management [2]

STATISTICS:

1. The number of small and private hospitals and nursing homes in India exceeds 15,000 (excluding clinics & pathological laboratories).

2. The amount of medical waste generated in India each year is approximately 3 million tonnes; it would be increasing at an annual rate of 8%.

3. Only Maharashtra, Karnataka and Tamil Nadu are taking pro-active steps in disposing biomedical waste [3].


TYPES:

1. Human anatomical waste

2. Animal waste- consists of animal tissues, organs, animals used for research purposes and the generation of waste from hospitals, animal houses etc.

3. Biotechnological waste- consists of laboratory waste (cell cultures both human and animal, infectious agents) and also from industries, waste products as and when biologicals, devices etc. are produced.

4. Waste sharps- Used and unused needles, glass etc. that can give rise to bruises and cuts; also drugs that are cytotoxic in nature and beyond their expiry date.

5. Solid waste- Dressings, beddings etc. contaminated due to body fluids and blood; also the waste that comes when catheters and intravenous sets are disposed off.

6. Liquid waste- Activities such as washing, disinfecting etc that produces waste products.

7. Chemical waste- Chemicals that come together to constitute biologicals and those used for the purpose of disinfection [4].

METHODS FOR DISPOSING BIOMEDICAL WASTE:

The basic methods for treating and disposing of biomedical waste are Incineration, Autoclaving, Mechanical/Chemical Disinfection, Microwave and Irradiation.

1. Incineration: Biomedical waste burned in a regulated manner specifically in a medical waste incinerator is known as incineration. The advantages of this method are reduction in the waste volume, waste sterilization & removing the requirement of sorting out the waste prior to treatment. The disadvantage of this method is the pollution caused due to generation of smoke, as the entire biomedical waste is 20% plastic. Toxic gases such as dioxins and furans are released when the incineration process is underway. The disposal of waste from incineration can be done in a landfill. This process covers pathological waste as well. Slowly but surely, the regulation of waste from incinerators has increased along with the cost of incineration.

2. Autoclaves: Utilization of autoclaves is mainly for destroying microorganisms found in biomedical waste before it goes into a landfill. Shredding of the biomedical waste after being treated in an autoclave is very important for it to be disposed off with the general waste. Pathological waste is not treated in autoclaves as radioactive material can be present in it; aerosols can be formed after the commencement of the process and it becomes airborne on opening of the instrument [5].
In steam sterilization almost all the pathogens are killed except for the microorganism that gives rise to Creutzfeldt-Jakob disease (a degenerative disease of the brain) [6].

3. Chemical disinfection: In the treatment of either liquid or semi-liquid biomedical waste, the concerned authorities can use chlorine, quaternary ammonium and phenolic compounds. The excess use of quaternary ammonium compounds is harmful to marine life [6].

VARIOUS COUNTRIES AND THE MEASURES UNDERTAKEN BY THEM TO MANAGE BIOMEDICAL WASTE:

1. In India:
The Bio-Medical Waste (Management and Handling) Rules, 2011 under the Environment (Protection) Act, 1986 by the Ministry of Environment and Forests (MoEF), Government of India [7].

2. In the UK:
- The Hazardous Waste (England and Wales) Regulations, 2009 [8].
- Guidance on the safe management of healthcare waste, 2013 by Department of Health [9].

3. In Sri Lanka:
The National Solid Waste Management Strategy (NSWMS), 2007 for a 10-year time period. Its focus is on two aspects- Management of Municipal solid waste and biomedical waste [10].

4. In China:
- The legislation that initiated action in managing medical waste in China is the Regulation on the Control of Medical Waste.
- Administrative Punishment Measures for the Medical Waste Management, 2004.
- National Hazardous Waste and Medical Waste Treatment Facility Construction Plan, 2004 [11].


OUTSTANDING WORK IN MANAGEMENT OF BIOMEDICAL WASTE:

1. Enviro-Vigil: NGO based in Thane, Enviro-Vigil, has taken along with it all the healthcare units under Thane Municipal Corporation and those from Vasai, Virar, Mira Road etc for proper management of biomedical waste from the last 31/2 years. Dentists and general practitioners have also started contributing to this set-up. The facility gathers biomedical waste from pharmaceutical companies and medical research laboratories. People are being taught to dispose off their own biomedical waste at the domestic level. The NGO is also planning to gather waste from slaughter houses any time soon. It has set a benchmark for 'Zero Bio-Medical Waste' in Thane city. Enviro-Vigil has been given the ISO 9001-2000 certificate from DNV of Netherlands [12].

2. King George Medical University, Lucknow: The King George Medical University has been given a Special Recognition Award by the United Nations Development Program (UNDP) and the World Health Organization. It has become a regional benchmark for the last 2.5 years in the efficient management of biomedical waste. KGMU's mission is supported by Global Environment Facility and an NGO, Healthcare without Harm [13].


REFERENCES:

1. http://en.wikipedia.org/wiki/Biomedical_waste

2. Anura A. Bio-Medical Waste Management. Website:
http://www.slideshare.net/budhendra/bio-medical-waste-management-131

3. http://cpreec.org/pubbook-biomedical.htm

4. http://www.iasri.res.in/agridata/02data%5Cchapter%202%5Cdb2002tb2_12.htm

5. http://www.wastemed.com/treatment.htm

6. http://www.ehow.com/list_7505802_biomedical-waste-disposal-methods.html

7. http://moef.nic.in/downloads/public-information/salient-features-draft-bmwmh.pdf

8. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/218704/haz-waste-regs-guide.pdf

9. https://www.gov.uk/government/publications/guidance-on-the-safe-management-of-healthcare-waste

10. http://www.unep.org/ietc/Portals/136/Other%20documents/NWMS/Presentation%20-%20Sri%20Lanka.pdf

11. http://www.wilsoncenter.org/publication/waste-mismanagement-chinas-struggle-medical-trash

12. http://wgbis.ces.iisc.ernet.in/biodiversity/sahyadri_enews/newsletter/issue24/article3.htm

13. http://www.undp.org/content/india/en/home/presscenter/pressreleases/
2013/03/05/lucknow-hospital-earns-global-recognition-for-sound-bio-medical-waste-management-systems/




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