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COVID CHAOS: RE-EVALUATING INDIA’S BIOMEDICAL WASTE MANAGEMENT

The environment has been a subject of focus for a long time, but legal systems worldwide have strived to safeguard the environment wherever it is essential. Medical care is indispensable for life.

INTRODUCTION

The environment has been a subject of focus for a long time, but legal systems worldwide have strived to safeguard the environment wherever it is essential. Medical care is indispensable for life. However, it produces a considerable amount of waste that is dangerous for the environment and human survival. The medical facilities produce a range of waste materials, including sharps, cotton, needles, gloves, banned medications, and fluid waste[1]. Dealing with the biomedical waste has led to an array of persistent problems. Consequently, under the Environmental Protection Act of 1986, Bio-medical waste management rules were outlined in 1998[2]. Again, in 2016, the Government of India introduced new biomedical waste management rules, which aimed at strengthening the collection, treatment, and disposal of biomedical waste.

DEFINITION OF BIOMEDICAL WASTE

Biomedical Waste (hereinafter BMW) refers to any waste produced during the diagnosis, treatment, or immunization of people or animals, as well as during biological research or health camps[3]. Everyone who produces, gathers, stores, transports, receives, treats, disposes of, or handles biomedical waste in any way is affected. Around 75% and 90% of all BMW is categorised as non-hazardous[4] or general health care waste. The rest 10%-25% of BMW[5] is regarded as dangerous and poses multiple threats to humans and the environment. It could be solid or liquid. Biomedical waste differs from household and commercial waste, and it entails serious hazards compared to other kinds of waste. The primary biomedical waste generators are clinics, labs, facilities, dental and medical centres, bio-research centres, and veterinary clinics.[6]

Disposal Procedures for BMW

BMW must be segregated to ensure the proper disposal and to minimize health risks. Each category poses a distinct risk. Sharps can cause injuries[7], radioactive waste can emit harmful radiation[8], chemical or genotoxic waste can be toxic or carcinogenic[9] and infectious waste can spread diseases. This segregation can protect human health and the environment from potential harm.

Medical supplies must be disposed of properly because they could be infected with pathogens and harmful bacteria. Diverse methods are used to handle different types of biomedical waste. The predominant method is autoclaving, which applies steam sterilization to effectively and economically destroy germs; it is appropriate for nearly 90% of items before being discarded in a landfill. Another method is Incineration, which drastically lowers waste’s volume and solid mass but necessitates proper emission control. Chemical sterilization is another approach. After solid waste is crushed, chemical sterilization, which frequently employs chlorine, treats the liquid waste. An additional method is microwaving. Waste can be effectively eliminated through microwave treatment, which reduces its volume, conserves energy, and is suitable for specific types of biomedical waste, though not all. Recycling, as a method, involves converting specific medical waste materials, such as office paper, cardboard, aluminium, steel cans, glass bottles, and plastic containers, into reusable products. This process reduces waste and promotes sustainability by repurposing materials that would otherwise end up in landfills. Moreover, the land disposal method is used for hazardous waste. It requires careful monitoring to prevent contamination, with sanitary landfills being the safer option due to controlled dumping in isolated areas.

Regulation and Compliance of Biomedical Waste

The management of biomedical waste differs from that of municipal waste[10]. Ministry of Environment, Forests, and Climate Change has directed that the Central Pollution Control Board (hereinafter CPCB) be the supreme body responsible for BMW management initiatives of the entire nation[11]. Every State has its own State Pollution Control Board (hereinafter SPCB), which checks and controls BMW actions within the State and reports findings to the CPCB. The country has a particular policy for the location, isolation, storage, and disposition of BMW under the rules outlined in the BMW Management Rules of 2016. The country has numerous instances of non-adherence to the abovementioned rules despite the strict liabilities. The annual report of CPCB for 2018-19 shows that 23,942 Health Care Facilities (hereinafter HCF) violated the BMW rules 2016, and 18210 HCFs were warned for infractions. According to the survey, there are enormous amounts of BMW generated every day, and 13% of HCFs have violated the BMW rules[12]. These statistics highlight the inadequate quality of biomedical care and executives in India.

Biomedical waste (BMW) has dramatically increased globally due to the COVID-19 pandemic, presenting serious challenges for waste management agencies. Any waste resulting from patient isolation, diagnosis, treatment, quarantine, and home care was referred to as COVID-19 waste during the pandemic[13]. If bodily fluids or secretions from COVID-19 patients were present, solid waste was deemed contagious; otherwise, it was disposed of per the Solid Waste Management Rules of 2016. Fear of infection led to less waste recycling, and, in certain circumstances, an outright ban on recycling was imposed. Furthermore, the amount of waste generated by households increased, which resulted in the abandonment of waste segregation and recycling systems.

As seen by the first outbreak in Wuhan, China, when BMW output increased from 50 tons per day to 247 tonnes per day[14], the pandemic made management of it more difficult. Given the high COVID-19 cases, India has seen a significant rise in biomedical waste. In July, the Central Pollution Control Board (CPCB) reported to the National Green Tribunal that India produced 101 metric tonnes (M.T.) of BMW connected to COVID-19 daily on top of the usual 609 MT.[15]. In 2019, the diagnosis and treatment of patients resulted in an extra daily rise of 146 tons following the commencement of COVID-19[16]. India produced 28,747.91 tonnes of BMW between June 2020 and December 2021,[17] in addition to 45,308 tonnes of COVID-19 biomedical waste in 2020[18]. According to this data, the pandemic has caused a notable increase in the output of biomedical waste in India. This exemplifies the pressing need for proper waste management measures to address the spike.

Thus, the COVID-19 pandemic has created novel difficulties for India’s biomedical waste management system. The information emphasizes the need for better waste management procedures and infrastructure to minimize the negative effects of rising biomedical waste on the environment and public health.

IMPACT OF COVID-19 PANDEMIC ON BIOMEDICAL WASTE IN INDIA

In 2016, the government published new rules called the Biomedical Waste Management Rules of 2016, which supervened the old ones of 1998. Biomedical Waste Management Rules of 2016 provide the fundamental base for biomedical waste control in India. Significant regulations such as waste categorization, treatment methods, storage requirements, and waste handler responsibilities are outlined in these rules. Although they aim to protect the environment and public health and advance sustainable waste management techniques, it is important to recognize their limitations, particularly in light of the COVID-19 pandemic. The regulations served as a reliable guide for properly disposing of biomedical waste resulting from the treatment, diagnosis, and isolation of COVID-19 patients during the COVID-19 crisis. Per these regulations, the Central Pollution Control Board released supplementary guidelines[19] to address the unique difficulties brought about by the pandemic, such as properly handling waste from isolation units and sample collection sites. However, despite these efforts, the shortcomings of the legislation were exposed when the volume of biomedical waste outgrew the capacity of the system.

For instance, there were concrete issues with waste disposal because the rules did not sufficiently account for the volume of waste generated during the pandemic[20]. Problems, including treatment facility capacity, poor segregation procedures, and waste disposal delays, brought attention to the dire requirement for stronger and more flexible laws.

In summary, even though the Biomedical Waste Management Rules of 2016 offer a legal framework for waste management, they are ineffective at handling unanticipated problems like the COVID-19 pandemic. A critical examination shows that the legislation has to be improved and revised to better prepare it to deal with public health emergencies in the future. Refining infrastructure, encouraging cooperation among stakeholders, and revitalizing enforcement mechanisms are critical measures in making biomedical waste management procedures in India more resilient.

CONCLUSION

Upon examining the development of biomedical waste management in India under the auspices of the Biomedical Waste Management Rules of 2016, we recognize both achievements and challenges. These rules establish the underlying structure for waste categorization, treatment techniques, and waste handler responsibilities. However, the start of the global COVID-19 pandemic revealed the shortcomings of this legislation, especially when it came to dealing with the increase in biomedical waste. Although the legislation offered a starting point for handling COVID-19 waste, logistical and enforcement issues surfaced, which uncovered the weaknesses in the system’s capacity for adaptation.

The pandemic made it clear how urgent it is to improve and amend current laws, highlighting the necessity of having more foresight and agility in the face of developing public health emergencies. Enhancing infrastructure, promoting collaboration among stakeholders, and improving enforcement mechanisms are important to strengthen the robustness of biomedical waste management procedures in India.

Author(s) Name: Raheeq Assad (Central University of Kashmir)

References:

[1] Getasew Mitiku and others, ‘Biomedical waste management practices and associated factors among health care workers in the era of the covid-19 pandemic at metropolitan city private hospitals, Amhara region, Ethiopia, 2020’ (2022) 17(4) PloS one  <www.ncbi.nlm.nih.gov/pmc/articles/PMC8985930/> accessed 6 June 2024.

[2] Biomedical waste management rules of 1998.

[3] Priya Datta, Gursimran Kaur Mohi and Jagdish Chander, ‘Biomedical waste management in India: Critical appraisal’ (2018) 10(1) Journal of laboratory physicians 6-14 <www.ncbi.nlm.nih.gov/pmc/articles/PMC5784295/> accessed 6 June 2024.

[4] Pravinraj S, Darshana Zala and Janakiram M, ‘Knowledge, Attitude and Practice of Biomedical Waste Management Among Doctors and Nurses During the COVID-19 Pandemic in Puducherry: A Cross-Sectional Study’ [2023] Cureus  <http://dx.doi.org/10.7759/cureus.51290> accessed 10 June 2024.

[5] Gurpreet Singh Bhalla, Kuntal Bandyopadhyay, and Kavita Sahai, ‘Keeping in pace with the new Biomedical Waste Management Rules: What we need to know!’ (2019) 75(3) Medical Journal Armed Forces India 240, 240-245 <http://dx.doi.org/10.1016/j.mjafi.2018.12.003> accessed 10 June 2024.

[6] Anand M Dixit and others, ‘Assessment of Biomedical Waste Management in Health Facilities of Uttar Pradesh: An Observational Study’ [2021] Cureus  <http://dx.doi.org/10.7759/cureus.20098> accessed 10 June 2024.

[7] Parvin Lakbala, Farbood Ebadi Azar and Hajeb Kamali, ‘Needlestick and sharps injuries among housekeeping workers in hospitals of Shiraz, Iran’ (2012) 5(1) BMC Research Notes <http://dx.doi.org/10.1186/1756-0500-5-276> accessed 11 June 2024.

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[9] Leila Ghasemi and others, ‘Evaluate the types and amount of genotoxic waste in Tehran University of Medical Science’s hospitals’ (2018) 16(2) Journal of Environmental Health Science and Engineering 171, 171-179 <http://dx.doi.org/10.1007/s40201-018-0305-7> accessed 11 June 2024.

[10] Bhargavi N Kulkarni and V Anantharama, ‘Repercussions of COVID-19 pandemic on municipal solid waste management: Challenges and opportunities’ (2020) 743 Science of The Total Environment 140693,  <http://dx.doi.org/10.1016/j.scitotenv.2020.140693> accessed 10 June 2024.

[11] Sharad Chand and others, ‘Updates on biomedical waste management during COVID-19: The Indian scenario’ (2021) 11 Clinical Epidemiology and Global Health 100715,  <http://dx.doi.org/10.1016/j.cegh.2021.100715> accessed 10 June 2024.

[12] Central Pollution Control Board Annual Report 2018/2019. Ministry of Environment, Forest, and Climate Change (2019) 1-160.

[13] Shefali, ‘Generation, types and impacts of biomedical waste during COVID-19: Indian context’ (2023) 38(4) Environmental analysis, health and toxicology  <www.ncbi.nlm.nih.gov/pmc/articles/PMC10834080/> accessed 6 June 2024.

[14] Malini R Capoor and Annapurna Parida, ‘Biomedical Waste and Solid Waste Management in the Time of COVID-19: A Comprehensive Review of the National and International Scenario and Guidelines’ (2021) 13(02) Journal of Laboratory Physicians 175-182 <http://dx.doi.org/10.1055/s-0041-1729132> accessed 10 June 2024.

[15] Consolidated Status Report in the matter of O.A. NO. 72 of 2020 In re: Scientific Disposal of Bio-Medical Waste arising from Covid-19 treatment – Compliance of BMWM Rules, 2016 before Hon’ble National Green Tribunal, Principle Bench, New Delhi.

[16] Shivani Kumar, ‘World Environment Day: India produced 45,308 tonnes of Covid-19 biomedical waste in previous year’ (Hindustan Times, 5 June 2021)  <www.hindustantimes.com/india-news/world-environment-day-india-produced-45-308-tonnes-of-covid-19-biomedical-waste-in-previous-one-year-101622862552910.html> accessed 11 June 2024.

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[18] cf Kumar (n 16) para 3

[19] ‘COVID-19 Waste Management’ (https://cpcb.nic.in/covid-waste-management/, 26 Apr. 2023).

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