98% of domestic biomedical waste mixed with solid waste

Most households in Bengaluru dispose unwrapped sanitary napkins, soiled diapers, syringes, blood-soaked cotton and stained medical gauges into the dry waste bin on a regular basis.

Little do we comprehend that these small quantities of waste has turned out to be one of the big environmental threats. Biomedical waste generated from houses is among the major contributors to biomedical waste in the state, according to experts. The total quantity is so high that the experts believe it is posing more challenges than the biomedical waste generated by hospitals and clinics. The lack of data on the waste the domestic sector generates worsens the situation.

Home healthcare

With the home healthcare sector growing at a rapid pace in several cities including Bengaluru, the supplies used in individual households have also increased over the years. However, little is being done to segregate this while collecting domestic waste, explain experts.

Seshi Reddy, assistant general manager (operations), Medicare Environmental Management Private Limited, a company that handles biomedical waste, said that the amount of waste generated from the households is far higher than the amount generated in hospitals and medical facilities. Reddy said that a recent study conducted by the Bruhat Bengaluru Mahanagara Palike (BBMP) indicates that the amount of waste generated in the domestic sector is close to four times that of the waste generated by hospitals in the city.

“About 98% of the waste generated in households is incinerable waste. For the other 2%, we need to focus on segregation as per the categories specified by the pollution control board. About 98% of the domestic biomedical waste gets mixed with municipal waste,” he said.

In 2014, BBMP conducted a pilot project to have biomedical waste collected in a separate bin. It was tried in Yelahanka and the West Zone covering about 12 lakh families. However, the efforts have remained unsuccessful.

Officials in the Karnataka State Pollution Control Board (KSPCB) explained that while the quantities are too small to be collected on an everyday basis, people find it difficult to store it in the houses as it emanates foul odour.

In addition, the biomedical waste management rules do not consider sanitary pads and diapers as biomedical waste, though they are contaminated by human secretion.

Yet another aspect that lacks clarity is the missing guidelines for use of incinerators. “There is a certain temperature at which the napkins ought to be burnt. The incinerators should function at 400-500 degrees temperature. If these do not function as per standards, harmful chemicals such as dioxins are released,” said A Ramesh, a senior official with the KSPCB.

Dr H Sudarshan Ballal, medical director, Manipal Hospitals, said that it was certainly important to treat any blood-stained product as biomedical waste. “However, it would be very tough to have this segregated into the biomedical waste category as it is used throughout the country. In most countries, its thrown off as solid waste,” he said.

Dr Murali S, chief, medical services, Manipal Hospitals said, “The first step in handling biomedical waste is segregation. The waste is collected in four different categories at the source. This is later collected on an everyday basis by government-approved agencies or common biomedical treatment units. The liquid waste is treated in effluent treatment plants.”

Dr Ranganath T S, secretary, Karnataka Association for Community Health said, “Under the Swachh Bharat Mission, there is a Kayakalpa programme in every hospital. This is to ensure that cleanliness is maintained. As part of the same, even biomedical waste is given attention. There are district quality assurance officers in each of the districts. It is their task to train staff nurses and group D staff at government hospitals besides the medical staff. The trained staff segregate waste at source and it is sent to treatment facilities or units.”

Even as several disposables are used at Ayurvedic, Unani and Homoeopathy treatment centres in the state, they refuse to acknowledge that any biomedical waste is being generated here. Massage centres and clinics use cotton and other disposables while treating patients, but most of this waste is considered solid waste.

A senior official from the KSPCB said that the board has no control over this. “They visit our office seeking certificates. They say they can sign an undertaking that no injections or surgical procedures would be carried out there. However, it is a known fact that Ayush doctors sometimes do conduct surgical procedures and administer injections,” said the official.

The board is contemplating to set up a meeting with the Indian Medical Association to have doctors adhere to the guidelines.

The process

Dr Suman G, associate professor, community medicine, M S Ramaiah Memorial Hospital, said that the hospital ensures that an overseeing team monitors the segregation and discarding of waste.

“The staff training happens on a regular basis. The idea is to educate all on segregation. We have a system in place to track the waste. The waste collected in plastic bags is weighed and a barcode is used. If there are complaints from the processing unit about segregation, we can trace back to where the fault has occurred. By weighing the waste, we know the amount it has generated,” she added.

Dr Madan Gaekwad, former president, Private Hospitals and Nursing Homes Association, said that even as most of the large-sector hospitals have been following it, the challenge is for the smaller institutes. “All the big hospitals have sewage and effluent treatment plants, while smaller hospitals find it difficult to have one due to space constraints,” he said.

Speaking on condition of anonymity, another private hospital representative said that smaller clinics and establishments with less than 30 beds release sewage without treating it. “Pricing is an issue when it comes to waste disposal. For smaller establishments, since quantities generated is less, the waste management companies quote is a big sum,” said a practitioner.