The generation of waste, whether it be from households, offices, vehicles, hospitals, restaurants, etc. is an inevitable process as it is a byproduct of development. This waste over time can be extremely harmful to the environment and if mismanaged, it can be even more harmful to humans and other life on earth.
Biomedical waste is defined as “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 Biologicals”. Biomedical waste management has been an issue of concern even before the AIDS pandemic. Despite the guidelines being in effect since 1998 in India, Biomedical waste management has garnered more importance in the wake of the COVID-19 pandemic. Wearing masks, shields, and Personal Protective Equipment (PPE) have to be constantly replaced which can lead to increased amounts of waste.
MedPiper Technologies and Journomed had conducted a Webinar on 27th August, 2021 where the speaker Mr. Fareed Uddin Syed discussed at length the ways biomedical waste is segregated and managed by the respective authorities. Mr. Fareed Uddin Syed is a Senior Advisor for Quality Assurance and Improvement, Quality Heath Consultants (QHC), Expert in Hospital Planning and Biomedical Waste Management at NRMC, India. He also stressed the necessity for efficient biomedical waste management during the time of COVID-19 where large amounts of waste are generated.
Around 80-85% of the total waste generated from a hospital is considered as general non-infectious waste. However, the insufficient management of this waste can render it infectious. The remaining 15-20% is hazardous and infectious in nature and should be handled with a lot of precaution. The Central Pollution Control Board (CPCB) has put forth some guidelines on how infectious waste should be categorised and the methods of disposal required for each of them. These guidelines were revised recently in August 2020, keeping the COVID-19 pandemic in mind.
Mr. Syed spoke about how infectious waste is categorised based on its nature and toxicity into four colors:
- Yellow: The waste in the Yellow category consists of Human Anatomical waste, Animal Anatomical Waste, Soiled Waste (contaminated with blood and other bodily fluids), expired or discarded medicine, chemical liquid and solid waste, discarded bedding contaminated with body fluids, Microbiological, Biochemical and any kind of Clinical Laboratory waste. Such waste is segregated and stored in non-chlorinated bags that are yellow in color. Primary disposal methods include incineration, deep burial, or plasma pyrolysis. Sterilisation by Autoclaving followed by shredding or mutilation can also be done. Chemical sterilisation treatment is not to be done. With regards to COVID-19, cloth masks, linen. PPEs like Triple Layer Mask, N-95 Mask, Head Cover, Shoe Cover, Non-Plastic Apron or Semi Plastic Cover-All, Swab Stick, Used Tissue Paper, Cotton. Handkerchief, Used Toiletries, Bandages, Plaster Caste, Blood Bag, Apron Pad or Diaper, etc. are included in this category.
- Red: This category mostly consists of contaminated recyclable waste such as tubing, bottles, catheters, urine bags, syringes (without needles and fixed needle syringes) and vacutainers and gloves are also included. Red non-chlorinated bags should be used for storage and segregation. Autoclaving and microwaving are the best methods of sterilisation followed by shredding and mutilation (using specific kinds of scissors) to ensure that these materials are not reused. The treated waste should be sent to registered or authorized recyclers or for energy recovery or plastics to diesel or fuel oil or for road making. The COVID-19 waste generated includes: Recyclable Plastic and Rubber PPEs such as Hazmat Suit, Latex or Nitrile Gloves, Plastic Vials, Viral Transport Media, Eppendorf Tubes, Vaccutainers, Plastic Cryovial Pipette Tips, Syringes, Tubings, Catheter, etc. to be disposed of after Pre-Treatment (Autoclaving)
- White: This category encompasses waste sharps including metals, needles, syringes with fixed needles, scalpels, blades, or any other contaminated sharp object that may cause puncture and cuts. These should be segregated into white translucent leak-proof and tamper-proof containers which should have the biohazard symbols on it. Autoclaving and Dry Heat sterilization followed by mutilation is the desirable method of disposal.
- Blue: Broken glassware and metallic body implants belong to the blue category. Plastic blur-colored leak-proof and tamper-proof containers are used for storage and segregation. This waste can be sterilised using chemicals like Sodium Hypochlorite solution and it can be sent for recycling.
Mr. Syed also spoke about the responsibilities that the necessary authorities and urban local bodies should undertake while handling and disposing of the various hospital waste which includes:
- To ensure that the biomedical waste generated during the treatment of COVID-19 Patients is collected in the designated storage bags and containers
- The segregated waste is stored in a separate area in the dedicated collection room and handed over to the Common Bio-Medical Waste Treatment Facility (CBWTF) vehicle
- To ensure that the non-chlorinated red and yellow plastic bags are double layered especially from COVID-19 isolation wards
- The biomedical waste from COVID-19 and isolation wards is transported in a separate trolley marked “COVID-19” with the biohazard to the dedicated collection room
- The dedicated trolley, bins, containers are disinfected with 1-2% Sodium Hypochlorite Solution daily
The COVID-19 pandemic continues to plague the world in more ways than one. Uncontrolled amounts of waste are generated from various isolation centres, quarantine care centres, households and hospitals and it will put a large strain on the healthcare sector and damage the environment if not handled carefully. Thus reinstating the importance of proper management of biomedical waste.