Hospital Waste Management: A Requirement

In a country like India, heaps of litter is taken to dump sites. Mostly the waste ends up on

road sides and empty plots. Untreated waste bears an economic cost for residents of the

locality and is also an environmental hazard. Increasing pollution leading to environmental

changes and economic cost related to waste in terms of health hazards and negative impact on

infrastructure have changed the authorities view it.

Hospital waste management is a formal discipline and does occupy a critical place in the

management of healthcare sector. The management of hospital waste requires its removal and

disposal from the healthcare establishments as hygienically and economically as possible by

methods that all stages minimises the risk to public health and to environment. Hospital waste

management is an important process that must be dealt with diligently. The management of

hazardous waste material requires specific knowledge and regulations and it must be carried

out by specialists in the field. Though waste management is a relatively new phenomenon, it

has caught the attention of the Government. Today the term waste management covers collecting,

sorting, processing, recycling and reusing materials that would otherwise be considered as

useless.

Hospital waste refers to all waste, biologic or non biologic that is discarded and not

intended for further use. Medical waste is a subset of hospital waste; it refers to the

material generated as result of diagnosis, treatment or immunisation of patients and

associated biomedical research. Biomedical waste is generated in hospitals, research

institutions, healthcare teaching institutions, clinics, laboratories, blood banks, animal

houses and veterinary institutions. Hospital waste management means the management of waste

produced by hospitals using techniques that will check the spread of diseases. A variety of

methods are used by the medical facilities to dispose their wastes including burning burial,

entombing, selling, dumping and removal by municipal bins. In developing countries, awareness

regarding hospital waste management in terms of its segregation, collection, storage,

transportation and disposal is lacking. In those countries waste disposal practice was found

to be quite unsafe and both clinical and non clinical wastes were found to be thrown together.

The management of hospital waste poses a major problem in most of the countries. In recent

years medical waste disposal has posed even more difficulties with the appearance of

disposable needles, syringes and other similar items. There are several categories of hospital

wastes according to their weight density and constituents. The World Health Organization has

classified medical waste into different categories which are infectious, sharps, pathological,

pharmaceutical and radioactive. There are several categories of infectious waste like human

tissues and body parts, animal carcasses, syringes, blades, saws, drugs, vomits, urine,

chemicals and fluid from laboratories. Infectious healthcare waste is major cause of HIV/AIDS,

Hepatitis B and C viral infections. These viruses are generally transmitted through injuries

from needles and sharp objects which are contaminated with human blood. In some countries

contaminated disposable needles are often scavenged, repackaged, sold and reused without

sterilization. Such malpractices are associated with serious health implications due to

transmission of infectious disease. There are numerous other diseases which could be

transmitted by contact with healthcare wastes. These are urinary tract infections, wound

infections, bacteremia and skin infections. Healthcare waste disposal in each country depends

upon a number of factors including sensitization level of the health managers as well as other

professionals existing local legislation and available resources.

Hospitals are socially obliged to maintain a clean environment and dispose medical waste in

order to prevent pollution and infections within and near the hospital. Every hospital should

have its waste management team that will cover responsibilities, plan, collection,

segregation, transportation, storage, disposable methods, containers and their colour coding,

waste minimization techniques, protective clothing etc. Further that heavy penalty shall be

imposed on the institutions found to be negligent.

Hospital waste water is a source of environmental pollution and health risks. Hospital waste

water is loaded with pathogenic microorganism, heavy metals, disinfectants, detergents,

solvents, pharmaceuticals and others. Uncontrolled discharge in most of the hospitals enhances

the eco toxicological risk for environment and toxic or infectious risk for humans. With

reference to hospital waste management, institutional strengthening to develop, implement and

enforce regulations on hospital waste management is needed. Sensitisation, motivation

campaigns and technical courses among professionals, technicians and sanitary workers should

be carried out; so that they identify themselves with responsibilities.

There is not enough information on medical waste management technologies and its impact on

public health and environment. Practice of proper medical waste disposal and management is

also inadequate. There is need for raising awareness about medical waste and its related

issues. The need for healthcare waste management planning should be highlighted to facilitate

the implementation of necessary measures to improve the present healthcare waste management

situation.

- By Dr. Gitartha Roymedhi