268
R. Majumdar
at the right moment. Infectious diseases are propagated from the healthcare wastes
through several different pathways, such as—(a) through the exposure of an uninfected individual to the infected droplets that might be present in the medical swabs,
absorbent gauze clothes and other surgical disposable products (e.g. needles and
syringes, scalpel blades, lancets, blood spill clean-up materials, disposable suture
sets and biopsy forceps); (b) through the exposure to the body-fluid specimens (e.g.
blood, saliva and nasal secretions) of an infected vector [37]; (c) through the exposure
of an uninfected host to the urine, faeces and vomitus (containing fluid blood) from
the infected vector; and in some cases, (d) through the exposure to the carcasses that
are suspected of being contaminated with infectious agents [38].
The safe and sustainable management of biomedical waste (BMW) is a major
social and legal responsibility of the community as a whole, and it revolves around
two main principles, (a) reduction in the volume of biomedical waste generation
and (b) recovery and recycling of the waste to the maximum extent possible [39].
Furthermore, it is also important to contain and segregate the biomedical waste separately from other waste at the point of generation. As per the ‘Biomedical Waste
Guidelines’ it is mandatory to place the solid biomedical waste in securely tied red
bags, and to place the loaded bags in well maintained secondary containers that are
rigid, leak resistant, clean and fitted with tight covers [38]. However, owing to the
lack of cautious monitoring from the governing bodies, such as the pollution control
board (PCB) [40], as well as, the inadequacies of the healthcare facilities (HCF) in
terms of the manpower and infrastructure [41], biomedical waste is often disposed
in an improper fashion leading to multiple environmental and health hazards [42].
During the times of overland flash floods, the dormant as well as active infectious
particulates from the inappropriately disposed biomedical waste can enter into the
stormwater run-offs, which may eventually end up in the urban waterbodies. Additionally, while flowing through the large canals and open drains, the infected wastewater may transmit serious illness to any population that may form direct contact with
the stream. In case of contagious diseases, such a transmission would be a matter of
grave concern, as it has the potential to trigger a community spread through interpersonal contacts. Moreover, the sewers of the healthcare establishments, where the
patients suffering from highly contagious diseases, such as cholera and typhoid are
treated, are bound to receive contaminated wastewater. Such infected wastewater
streams can trigger a massive outbreak of disease within the urban communities,
if it is allowed to get discharged into the regular UWW streams without proper
disinfection and necessary precautions [11].
It is worth highlighting that the concentrated sewage sludge, largely composed of
organic matter and nutrient-laden organic solids [23], being an end product of municipal wastewater treatment process contains the pathogenic microorganisms that are
the critical constituents to remain active in the sludge. Among these microorganisms, a number of pathogenic bacteria are both human pathogenic and zoonotic,
i.e. they can potentially infect both humans, as well as, animals. Additionally, these
organisms have been found to exhibit strong adaptability to suit their survival in
the changing environment [43]. Modified bacterial strains can be quite stubborn and
relatively resistant to commonly employed sludge stabilization techniques, making
R. Majumdar
at the right moment. Infectious diseases are propagated from the healthcare wastes
through several different pathways, such as—(a) through the exposure of an uninfected individual to the infected droplets that might be present in the medical swabs,
absorbent gauze clothes and other surgical disposable products (e.g. needles and
syringes, scalpel blades, lancets, blood spill clean-up materials, disposable suture
sets and biopsy forceps); (b) through the exposure to the body-fluid specimens (e.g.
blood, saliva and nasal secretions) of an infected vector [37]; (c) through the exposure
of an uninfected host to the urine, faeces and vomitus (containing fluid blood) from
the infected vector; and in some cases, (d) through the exposure to the carcasses that
are suspected of being contaminated with infectious agents [38].
The safe and sustainable management of biomedical waste (BMW) is a major
social and legal responsibility of the community as a whole, and it revolves around
two main principles, (a) reduction in the volume of biomedical waste generation
and (b) recovery and recycling of the waste to the maximum extent possible [39].
Furthermore, it is also important to contain and segregate the biomedical waste separately from other waste at the point of generation. As per the ‘Biomedical Waste
Guidelines’ it is mandatory to place the solid biomedical waste in securely tied red
bags, and to place the loaded bags in well maintained secondary containers that are
rigid, leak resistant, clean and fitted with tight covers [38]. However, owing to the
lack of cautious monitoring from the governing bodies, such as the pollution control
board (PCB) [40], as well as, the inadequacies of the healthcare facilities (HCF) in
terms of the manpower and infrastructure [41], biomedical waste is often disposed
in an improper fashion leading to multiple environmental and health hazards [42].
During the times of overland flash floods, the dormant as well as active infectious
particulates from the inappropriately disposed biomedical waste can enter into the
stormwater run-offs, which may eventually end up in the urban waterbodies. Additionally, while flowing through the large canals and open drains, the infected wastewater may transmit serious illness to any population that may form direct contact with
the stream. In case of contagious diseases, such a transmission would be a matter of
grave concern, as it has the potential to trigger a community spread through interpersonal contacts. Moreover, the sewers of the healthcare establishments, where the
patients suffering from highly contagious diseases, such as cholera and typhoid are
treated, are bound to receive contaminated wastewater. Such infected wastewater
streams can trigger a massive outbreak of disease within the urban communities,
if it is allowed to get discharged into the regular UWW streams without proper
disinfection and necessary precautions [11].
It is worth highlighting that the concentrated sewage sludge, largely composed of
organic matter and nutrient-laden organic solids [23], being an end product of municipal wastewater treatment process contains the pathogenic microorganisms that are
the critical constituents to remain active in the sludge. Among these microorganisms, a number of pathogenic bacteria are both human pathogenic and zoonotic,
i.e. they can potentially infect both humans, as well as, animals. Additionally, these
organisms have been found to exhibit strong adaptability to suit their survival in
the changing environment [43]. Modified bacterial strains can be quite stubborn and
relatively resistant to commonly employed sludge stabilization techniques, making