International Journal of Science and Research (IJSR)

ISSN (Online): 2319-7064

Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438

Biomedical Waste Management: Need of Today

A Review
Dr. Manika Barar1, Arpita Kulkhestha2
1
Department of Chemistry, SIMT College, Meerut, India
2
Department of Chemistry, Jiwaji University, Gwalior, India

Abstract: Medical care is vital for our life and health, but the waste generated from medical activities represents a real problem of
living nature and human world. Improper management of waste generated in health care facilities causes a direct health impact. The
present review article deals with the basic issues as definition, categories, problems relating to biomedical waste and procedure of
handling and disposal method of Biomedical Waste Management. It also intends to create awareness amongst the personnel involved in
health care unit.

Keywords: Biomedical waste, Treatment process, health hazardous.

1. Introduction bins or even worse, out in the open. Such irresponsible

dumping has been promoting unauthorized reuse of medical
All human activities produce waste. We all know that such waste by the rag pickers for some years now. If we want to
waste may be dangerous and needs safe disposal. Industrial protect our environment and health of community we must
waste, sewage and agricultural waste pollute water, soil and sensitize our selves to this important issue not only in the
air. It can also be dangerous to human beings and interest of health managers but also in the interest of
environment. Similarly, hospitals and other health care community.[4] Surveys carried out by various agencies show
facilities generate lots of waste which can transmit that the health care establishments in India are not giving
infections, particularly HIV, Hepatitis B & C and Tetanus, to due attention to their waste management. After the
the people who handle it or come in contact with notification of the Bio-medical Waste (Handling and
it.Biomedical waste management has recently emerged as an Management) Rules, 1998, these establishments are slowly
issue of major concern not only to hospitals, nursing home streamlining the process of waste segregation, collection,
authorities but also to the environment. The proper treatment, and disposal. Many of the larger hospitals have
management of biomedical waste has become a worldwide either installed the treatment facilities or are in the process
humanitarian topic today. Although hazards of poor of doing so.[5]
management of biomedical waste have aroused the concern
world over, especially in the light of its far-reaching effects Bio Medical waste consists
on human, health and the environment. [1]
 Human anatomical waste like tissues, organs and body
Hospital waste is a potential health hazard to the health care parts
workers, public and flora and fauna of the area. The  Animal wastes generated during research from veterinary
problems of the waste disposal in the hospitals and other hospitals
health-care institutions have become issues of increasing  Microbiology and biotechnology wastes
concern. Most countries of the world, especially the  Waste sharps like hypodermic needles, syringes, scalpels
developing nations, are facing the grim situation arising out and broken glass
of environmental pollution due to pathological waste arising  Discarded medicines and cytotoxic drugs
from increasing populations and the consequent rapid  Soiled waste such as dressing, bandages, plaster casts,
growth in the number of health care centres. India is no material contaminated with blood, tubes and catheters
exception to this and it is estimated that there are more than  Liquid waste from any of the infected areas
15,000 small and private hospitals and nursing homes in the  Incineration ash and other chemical wastes
country. This is apart from clinics and pathological labs,
which also generate sizeable amounts of medical waste.[2] Classification of Bio-Medical Waste- The World Health
Organization (WHO) has classified medical waste into eight
India generates around three million tonnes of medical categories:
wastes every year and the amount is expected to grow at  General Waste
eight per cent annually. Creating large dumping grounds and  Pathological
incinerators is the first step and some progressive states such
 Radioactive
as Maharashtra, Karnataka and Tamil Nadu are making
 Chemical
efforts despite opposition.Barring a few large private
hospitals in metros, none of the other smaller hospitals and  Infectious to potentially infectious waste
nursing homes have any effective system to safely dispose  Sharps
of their wastes. With no care or caution, these health  Pharmaceuticals
establishments have been dumping waste in local municipal  Pressurized containers

Volume 4 Issue 2, February 2015

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Paper ID: SUB151659 2417
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 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064
Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438
Sources of Biomedical Waste- Hospitals produce waste, 5. Biological processes - Using biological enzymes for
which is increasing over the years in its amount and type. treating medical waste. It is claimed that biological reactions
The hospital waste, in addition to the risk for patients and will not only decontaminate the waste but also cause the
personnel who handle them also poses a threat to public destruction of all the organic constituents so that only
health and environment.[3] plastics, glass, and other inert will remain in the residues.[8]

Major Sources 2. Processing Process of the Waste-

 Govt. hospitals/private hospitals/nursing homes/
dispensaries. 1. Incineration
 Primary health centers.  Incinerators should be suitably designed to achieve the
 Medical colleges and research centers/ paramedic emission limits.
services.  Wastes to be incinerated shall not be chemically treated
 Veterinary colleges and animal research centers. with any chlorinated disinfectants.
 Blood banks/mortuaries/autopsy centers.  Toxic metals in the incineration ash shall be limited
 Biotechnology institutions. within the regulatory quantities
 Production units.  Only low sulphur fuel like Diesel shall be used as fuel in
the incinerator.
Minor Sources
 Physicians/ dentists’ clinics 2. Autoclaving- The autoclave should be dedicated for the
 Animal houses/slaughter houses. purpose of disinfecting and treating biomedical waste.
 Blood donation camps. A. When operating a gravity flow autoclave, medical waste
 Vaccination centers. shall be subjected to:
 Acupuncturists/psychiatric clinics/cosmetic piercing.  A temperature of not less than 121 oC and pressure of
 Funeral services. about 15 pounds per square inch (psi) for an autoclave
 Institutions for disabled persons residence time of not less than 60 minutes; or
 A temperature of not less than 135 oC and a pressure of
Treatment of Biomedical waste - There are mainly five 31 psi for an autoclave residence time of not less than 45
technology options available for the treatment of Bio- minutes; or
Medical Waste or still under research can be grouped as[7,3]-  A temperature of not less than 149 oC and a pressure of
1. Chemical processes 52 psi for an autoclave residence time of not less than 30
2. Thermal processes minutes.
3. Mechanical processes B. When operating a vacuum autoclave, medical waste shall
4. Irradiation processes be subjected to a minimum of one per vacuum pulse to
5. Biological processes purge the autoclave of all air. The waste shall be
subjected to the following :
1. Chemical processes - These processes use chemical that  A temperature of not less than 121 oC and a pressure of
act as disinfectants. Sodium hypochlorit, dissolved chlorine 15 psi per an autoclave residence time of not less than 45
dioxide, peracetic acid, hydrogen peroxide, dry inorganic minutes; or
chemical and ozone are examples of such chemical. Most  temperature of not less than 135 oC and a pressure of 31
chemical processes are water-intensive and require psi for an autoclave residence time of not less than 30
neutralizing agents. minutes; or Medical waste shall not be considered
properly treated unless the time, temperature and
2. Thermal processes - These processes utilise heat to pressure indicate stipulated limits. If for any reason, these
disinfect. Depending on the temperature they operate it is were not reached, the entire load of medical waste must
been grouped into two categories, which are Low-heat be autoclaved again until the proper temperature,
systems and High-heat systems. Low-heat systems (operates pressure and residence time were achieved.
between 93-177°C) use steam, hot water, or electromagnetic
radiation to heat and decontaminate the waste. 3. Microwaving
 Microwave treatment shall not be used for cytotoxic,
3. Mechanical processes- These processes are used to hazardous or radioactive wastes, contaminated animal
change the physical form or characteristics of the waste carcasses, body parts and large metal items.
either to facilitate waste handling or to process the waste in  The microwave system shall comply with the efficacy
conjunction with other treatment steps. The two primary tests/routine tests
mechanical processes are-  The microwave should completely and consistently kill
a) Compaction - used to reduce the volume of the waste . bacteria and other pathogenic organism that is ensured by
b) Shredding - used to destroy plastic and paper waste to the approved biological indicator at the maximum design
prevent their reuse. Only the disinfected waste can be used capacity of each microwave unit.
in a shredder.
4. Deep Burial
4. Irradiation processes- Exposes wastes to ultraviolet or  A pit or trench should be dug about 2 m deep. It should
ionizing radiation in an enclosed chamber. These systems be half filled with waste, and then covered with lime
require post shredding to render the waste unrecognizable.

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Paper ID: SUB151659 2418
Licensed Under Creative Commons Attribution CC BY
 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064
Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438
within 50 cm of the surface, before filling the rest of the Standard For Liquid Waste- The effluent generated from
pit with soil. the hospitals must confirm to the following[11]:
 It must be ensured that animals do not have access to
burial sites. Parameter Permissible limit
 Covers of galvanised iron/wire meshes may be used. pH 6.5 – 9.0
 On each occasion, when wastes are added to the pit, a Suspended
solids 100 mg/l
layer of 10cm of soil be added to cover the wastes.
Oil and grease 10 mg/l
 Burial must be performed under close and dedicated
BOD 30 mg/l
supervision. COD 250 mg/l
 The site should be relatively impermeable and no shallow Bioassay test 90% survival of fish after 96 hours in 100% effluent
well should be close to the site.
 The pits should be distant from habitation, and sited so as Waste minimization: Waste minimization is an important
to ensure that no contamination occurs of any surface first step in managing wastes safely, responsibly and in a
water or ground water. cost effective manner. This management step makes use of
 The area should not be prone to flooding or erosion. reducing, reusing and recycling principles. There are many
 The location of the site will be authorized by the possible routes to minimize the amount of both general
prescribed authority. waste and biomedical wastes within the health care or
 The institution shall maintain a record of all pits for deep related facility. Alternative technologies for biomedical
burial. waste minimization (e.g., microwave treatment; hammer
mill) have been investigated and are not considered to be
5. Disposal of Sharps practical. Some of the principles of waste minimization are
listed below and will be developed further in the long-term
Sharps are discarded needles and lancets that have been used strategy. [9]
in animal or human patient care/ treatment or in medical,
research, or industrial laboratories. Sharps include items Health hazards- According to the WHO, the global life
such as hypodermic needles, syringes, dental carpules, and expectancy is increasing year after year. However, deaths
scalpel blades. Please note that certain exemptions apply to due to infectious disease are also increasing. A study
farmers. conducted by the WHO reveals that more than 50,000
 Blades and needles waste after disinfection should be people die everyday from infectious diseases. One of the
disposed in circular or rectangular pits. causes for the increase in infectious diseases is improper
 Such pits can be dug and lined with brick, masonry, or waste management. Blood, body fluids and body secretions
concrete rings. which are constituents of bio-medical waste harbour most of
 The pit should be covered with a heavy concrete slab, the viruses, bacteria and parasites that cause infection.
which is penetrated by a galvanized steel pipe projecting
about 1.5 m above the slab, within internal diameter of This passes via a number of human contacts, all of whom are
upto 20 mm. potential ‘recipients’ of the infection. Human
 When the pipe is full it can be sealed completely after Immunodeficiency Virus (HIV) and hepatitis viruses
another has been prepared. spearhead an extensive list of infections and diseases
documented to have spread through bio-medical waste.
3. Radioactive waste from medical Tuberculosis, pneumonia, diarrhea diseases, tetanus,
whooping cough etc., are other common diseases spread due
establishments to improper waste management. [8,12]
 It may be stored under carefully controlled conditions
until the level of radioactivity is so low that they may be A. Occupational health hazards
treated as other waste. The health hazards due to improper waste management can
 Special care is needed when old equipment containing affect
radioactive source is being discarded.  The occupants in institutions and spread in the vicinity of
 Expert advice should be taken into account. the institutions
 People happened to be in contact with the institution like
Mercury control - Wastes containing Mercury due to laundry workers, nurses, emergency medical personnel,
breakage of thermometer and other measuring equipment and refuse workers.
need to be given  Risks of infections outside hospital for waste handlers,
 Proper attention should be given to the collection of the scavengers and (eventually) the general public.
spilled mercury, its storage and sending of the same back  Risks associated with hazardous chemicals, drugs, being
to the manufacturers. handled by persons handling wastes at all levels.
 Must take all measures to ensure that the spilled mercury  Injuries from sharps and exposure to harmful chemical
does not become part of biomedical wastes . waste and radioactive waste also cause health hazards to
 Waste containing equal to or more than 50 ppm of employees.
mercury is a hazardous waste and the concerned
generators of the wastes including the health care units are B.Hazards to the general public
required to dispose the waste as per the norms. The general public’s health can also be adversely affected by
bio-medical waste.

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Paper ID: SUB151659 2419
Licensed Under Creative Commons Attribution CC BY
 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064
Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438
 Improper practices such as dumping of bio-medical waste  Either judicial powers should be given to the management
in municipal dustbins, open spaces, water bodies etc., board or special court should be established in the matters
leads to the spread of diseases. of environment pollution for imposing fines and awarding
 Emissions from incinerators and open burning also lead to damages etc.
exposure to harmful gases which can cause cancer and  There is biomedical waste label on waste carry bags and
respiratory diseases. waste carry trolley and also poster has put on the wall
 Exposure to radioactive waste in the waste stream can also adjacent to the bins (waste) giving details about the type
cause serious health hazards. of waste that has to dispose in the baggage as per
 An often-ignored area is the increase of in-home biomedical waste management rule. Carry bags also have
healthcare activities. An increase in the number of the biohazard symbol on them.[6]
diabetics who inject themselves with insulin, home nurses
taking care of terminally ill patients etc., all generate bio- 5. Conclusion
medical waste, which can cause health hazards.
The problem of bio-medical waste disposal in the hospitals
4. Recommendations and other healthcare establishments has become an issue of
increasing concern, prompting hospital administration to
 Every hospital should have special boxes to use as dustbin seek new ways of scientific, safe and cost effective
for bio-medical waste. management of the waste, and keeping their personnel
 Bio-medical waste should not be mixed with other waste informed about the advances in this area. The proper
of Municipal Corporation. management of biomedical waste has become a worldwide
 Bio-medical waste Management Board can be established humanitarian topic today. Although hazards of poor
in each District. management of biomedical waste have aroused the concern
world over, especially in the light of its far-reaching effects
on human, health and the environment.

Volume 4 Issue 2, February 2015

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Paper ID: SUB151659 2420
Licensed Under Creative Commons Attribution CC BY
 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064
Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438
References
[1] Mandal S. K. and Dutta J. , Integrated Bio-Medical
Waste Management Plan for Patna City, Institute of
Town Planners, India Journal 6-2: 01-25 (2009).
[2] Singh V. P., Biswas G., and Sharma, J. J., Biomedical
Waste Management - An Emerging Concern in
Indian Hospitals Indian, Journal of Forensic Medicine
& Toxicology, Vol. 1, No. 1. (2007-12).
[3] Hem Chandra, Hospital Waste an Environmental
Hazard and Its Management, (1999).
[4] Govt. of India, Ministry of Environment and Forests
Gazette notification No 460 dated July 27, New Delhi:
1998: 10-20
[5] Glenn, Mc.R & Garwal, R. Clinical waste in
Developing Countries. An analysis with a Case Study
of India, and a Critique of the BasleTWG Guidelines
(1999)
[6] The Bio Medical Waste (Management and Handling)
Rules, (1998).
[7] Bekir Onursal, Health Care Waste Management in
India. The world Bank (2003).
[8] https://www.gov.uk/healthcare-waste
[9] http://www.who.int/csr/resources/publications/standard
precautions/en/
[10] "Guidance on Closed Containers". Environmental
Protection Agency. Retrieved 15 May 2013.
[11] "Disposal of Medical Waste". Press Information
Bureau. 25 July 2014. Retrieved 25 July 2014.
[12] Shalini Sharma* and S.V.S.Chauhan, Assessment of
bio-medical waste management in three apex
Government hospitals of Agra, Journal of
Environmental Biology, 29(2), p. p 159-162 (2008)

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