10 Impact of Biomedical Waste Management System …
239
Statistical Analysis of BMW Management Systems
BMW management is solely dependent on various steps of handling wastes including
collection, segregation, transportation, treatment and final disposal of waste. Therefore, District Level Health Survey (DLHS) has been recorded to get recommendations
based on biomedical waste management systems in accordance with Annual Health
Survey (AHS). The DLHS-4 was conducted in 30 states and Union Territories (UTs)
comprising of nine states (AHS) and 21 states were non-AHS states preceded by
DLHS-1 (1998–1999), DLHS-2 (2002–2003) and DLHS-3 (2008–2009) [5]. Therefore, statistical survey analysis can be conducted at district levels and city levels to
collect the ideas and recommendations from public and hospital managements to
arrive at the best BMW management system to protect human health and environment. Generally, survey analysis was conducted on the following parameters such
as, role of segregations of waste-coloured bins/bags (yellow, red, blue, white and
black) having cytotoxic symbols, biohazard symbol, usage of huge plastic container
for needles and syringes, treatment and disposal methods adopted in waste management such as autoclave, microwave, chemical disinfectant, shredder, incinerator, deep
burial pit, Sharp pit and usage of Personal Protection Equipment (PPE) aids.
10.2 Biomedical Waste Management System in India
and Other Countries
10.2.1 History and Development of Biomedical Waste
Management System (BWMS)
The first BMW rules were introduced by the government of India (G.S.R. 343(E),
S.O. 630 (E)) dated 20 July 1998. This act describes the segregations of wastes into
10 categories which are found to be a difficult task for the scavengers/housekeeper
staff to sort out different kinds of biomedical wastes without having prior knowledge
about its infectious risks. The major drawback of this act was, the scavengers were
found to get exposed to infectious waste with no gloves, masks and used syringes
without sterilization. Before this act, there was only general environmental act (The
Environment (Protection) Act, 1986).
Later on, International Clinical Epidemiology Network (2002–2004) reframed
the BMW setup as 1
0 , 2
0 & 3
0 Healthcare facility (HCF) among 20 states of India.
They found that there is no incredible BMW System for 82%, 60% and 54% of
1
0 , 2
0 & 3
0 HCF units in India [6]. More specifically, it was reposted that around
240 peoples were infected with Hepatitis B due to the reuse of unsterilized syringes
(Gujarat). After this incidence, India made necessary action to improve the already
existing regulatory acts for better management of biomedical waste. Further, minor
modifications of 1998 BMWM rules were proposed on 2000, 2003 & 2011. Again
in 2016, the Ministry of Environment and forest climate change has introduced
239
Statistical Analysis of BMW Management Systems
BMW management is solely dependent on various steps of handling wastes including
collection, segregation, transportation, treatment and final disposal of waste. Therefore, District Level Health Survey (DLHS) has been recorded to get recommendations
based on biomedical waste management systems in accordance with Annual Health
Survey (AHS). The DLHS-4 was conducted in 30 states and Union Territories (UTs)
comprising of nine states (AHS) and 21 states were non-AHS states preceded by
DLHS-1 (1998–1999), DLHS-2 (2002–2003) and DLHS-3 (2008–2009) [5]. Therefore, statistical survey analysis can be conducted at district levels and city levels to
collect the ideas and recommendations from public and hospital managements to
arrive at the best BMW management system to protect human health and environment. Generally, survey analysis was conducted on the following parameters such
as, role of segregations of waste-coloured bins/bags (yellow, red, blue, white and
black) having cytotoxic symbols, biohazard symbol, usage of huge plastic container
for needles and syringes, treatment and disposal methods adopted in waste management such as autoclave, microwave, chemical disinfectant, shredder, incinerator, deep
burial pit, Sharp pit and usage of Personal Protection Equipment (PPE) aids.
10.2 Biomedical Waste Management System in India
and Other Countries
10.2.1 History and Development of Biomedical Waste
Management System (BWMS)
The first BMW rules were introduced by the government of India (G.S.R. 343(E),
S.O. 630 (E)) dated 20 July 1998. This act describes the segregations of wastes into
10 categories which are found to be a difficult task for the scavengers/housekeeper
staff to sort out different kinds of biomedical wastes without having prior knowledge
about its infectious risks. The major drawback of this act was, the scavengers were
found to get exposed to infectious waste with no gloves, masks and used syringes
without sterilization. Before this act, there was only general environmental act (The
Environment (Protection) Act, 1986).
Later on, International Clinical Epidemiology Network (2002–2004) reframed
the BMW setup as 1
0 , 2
0 & 3
0 Healthcare facility (HCF) among 20 states of India.
They found that there is no incredible BMW System for 82%, 60% and 54% of
1
0 , 2
0 & 3
0 HCF units in India [6]. More specifically, it was reposted that around
240 peoples were infected with Hepatitis B due to the reuse of unsterilized syringes
(Gujarat). After this incidence, India made necessary action to improve the already
existing regulatory acts for better management of biomedical waste. Further, minor
modifications of 1998 BMWM rules were proposed on 2000, 2003 & 2011. Again
in 2016, the Ministry of Environment and forest climate change has introduced