Author: Umang Dudeja,
IMS Unison Univ, Dehradun
Biomedical waste is any waste containing infectious materials. It can also include waste related to the production of visually appearing biomedical waste from medical and laboratory sources ( e.g. packaging, unused bands, kits for infusion, etc.) and research lab waste that is primarily restricted from environmental release containing bio-molecules and/or agencies. Due to the possibility of contamination and their inclination to cause injury in cases where they are not properly contained and disposed of, the discontinuation sharps are regarded as biomedical waste whether they are contaminated.
Biomedical residues can be solid or liquid. Examples of infectious waste include the disposal of blood, blood splitting, undesirable plant species and microbiological inventories, identifiable body parts (in particular because of amputation), other human or animal tissues, used bandages and clothing, discarded gloves, other supplies of body fluid and laboratory waste showing features described. Shafts include potentially contaminated needles, scalpels, lancets, and other tools penetrating the skin.
The number of people infected with the corona virus disease (COVID-19) is steadily increasing worldwide. In these circumstances, waste management is of extreme importance, including hazardous, medical and household waste. Many types of additional medical and hazardous waste are generated during the viral outbreak including infected masks, gloves, syringes, samples, and other protective equipment, drain bags, urine bags, body fluid or blood-soaked tissue/cotton, empty ampoules, etc. When mixed, medical waste and household waste may harm the health of the community and the environment as a whole. Unprotected waste management could have unforeseen effects on human health and the environment and is therefore essential for the safe treatment and disposal of such waste.
RISK TO HUMAN LIFE
Disposal of this waste is an environmental issue since medical waste is classified as infectious or organically hazardous and may lead to the propagation of infectious diseases. The most frequent danger to humans is the infection that affects other living organisms in the area. Daily waste exposure (landfill) results in the accumulation of noxious substances or microbes in the body of the person.
A 1990 report from the United States Country Agency for Toxic Substances and Disease Register concluded that biomedical waste generated in the traditional healthcare environment will not adversely affect the general public. However, they found that the biomedical waste can pose an injury and exposure risk for doctors, nurses and sanitary workers through occupational contact with medical waste. Furthermore, medical waste, such as needles that are illicitly used outside health centres, or biomedical wastes that are produced through home health care is available to the general public.
Although exact figures are premature, the generation of medical waste has increased six times over before COVID-19 by some estimates. According to the reports of the South China Morning Post, 240 tonnes of medical waste per day (about the mass of a blue adult whale) were dealt with during Wuhan's outbreak in comparison with 40 tonnes earlier. There is a lack of exact information on the issue in the Indian scenario, but conservative estimates are a grim image. As reported in the joint report by the Associated Commerce and Industry Chambers of India (Assocham) and Velocity, in 2018, the total quantities of medical waste produced in India (in 2018) are at 550 TPD and the figures are expected to grow close to the 775.5 TPD in 2022. Given these figures, and besides, waste from the COVID-19 crisis will become more difficult in the coming months.
To protect the environment, the general public and workers, particularly health care and sanitation staff at risk of being exposed to biomedical waste as an occupational risk, it is necessary to properly manage and dispose of biomedical waste. The steps in biomedical waste management include production, build-up, handling, storage, processing, transport and disposal. Developing and implementing a national waste management policy will help improve biomedical waste management in a country's health facilities.
India has specific regulations on biomedical waste, but the Covid-19 presented the country with an unforeseen amount of biomedical waste. It is a unique challenge. In April, the Central Pollution Control Board (CPCB) issued a detailed guideline on the handling of biomedical waste (BMW) with a special mobile app to track its collection and disposal last week to highlight this new challenge in treating waste as the newest coronavirus can potentially survive for several hours per day in the environment.
It specified scientific means of collecting, transportation and disposing of waste and requested that the State Boards / Committee on Pollution Control comply with it while following the whole process. The guidelines are categorised as yellow for highly infectious waste at medical establishments, in quarantine camps and households, in the home, the sample-gathering centre, laboratories, insulation facilities as well as the common biomedical waste treatment facility (CBWTF) for handling COVID-19-related Biomedical Waste.
The world faces a new challenge to eliminate masks, gloves and personal protective equipment during the COVID-19 crisis already to combat pollution generated by single-use plastics and by other non-biodegradable materials.
Environmentalists say that EPIs, masks or gloves are predominantly made from plastics. During ongoing health crises, it creates unexpected environmental impacts that make a great many people silent, invisible health risk.
The need to provide these people with healthcare and services will also continue to grow as the worldwide population continues. Besides the additional pressure to ensure that people are fit and healthy, the pressure to ensure that medical products are disposed of in ways that are both safe and healthy and environmentally friendly will also increase. Currently, medical waste is being disposed off and dumped.
Medical waste, from used needles, syringes to soil dressing, body parts, samples of the diagnostics of blood, chemicals, pharmaceuticals, medical devices and radioactive materials, is defined by the World Health Organization (WHO). It estimates that there is worldwide use of 16 billion injections but many of them have been misallocated.
Soumya Dutta, an environmental expert, says the government must take action today to ensure a sustainable green recovery. Our health and industry governance must also react quickly, install toxic gas absorption filters and take all necessary measures for safe disposal of enormous amounts of biomedical waste.
Since most of our hospitals do not have specialised filters to remove them. This poses a silent, invisible health risk to many people who live around these incinerators and could eventually develop cancer and other diseases over the coming years.
INDIA ON COVID-19
India has established its guidelines for safe disposal of biomedical waste produced during processing, diagnosis and quarantine in patients with COVID-19 by the Central Pollution Control Board, India.
It should be noted that India was one of the first countries in this direction to take a proactive step. The CPCB guidelines provide a range of steps for the safe disposal of COVID-19 patient wastes, sample Collection Centers and COVID-19 suspected patients' laboratories and quarantine camps/home-care facilities. The Guidelines also outline the duties of CBDF, State Pollution Control Boards and Urban Local Authorities.
The key actions mandated for various stakeholders include:
● Specific colour coded containers / bags in shelters and maintenance of adequate waste segregation, according to Biomedical Waste Management Rules, 2016.
● Double-layered bags for collection of COVID-19 isolation ware waste (using two bags) to ensure null leaks.
● Dedicated / marked waste and temporary waste storage areas prior to the transfer to approved staff for priority treatment and immediate disposal by the Common Bio-Medical Waste Treatment Facility (CBWTF).
● Maintain separate records of COVID-19 insulation stations generated waste.
● Disinfecting container / trolley container internal and external surfaces used for COVID-19 waste storage with 1 percent sodium hypochlorite solution per day.
● COVID-19 ward reporting and COVID ICU ward reportable to SPCBs in the area as well as to the respective CBWTFs.
● Biomedical waste dedicated sanitation workers to collect and transfer COVID-19 waste in a timely way into a temporary waste disposal area.
● Generally produced solid waste from quarantine centres to be transferred by Urban Local Body (ULBs) to waste collector.
● Dispose of COVID-19 waste on receipt by the Common Facility for Biomedical Waste Treatment (CBWTF). In accordance with the 2016 Bio-medical Waste Management Rules, CBWTF may use any of those methods allowed. This includes incineration, plasma pyrolysis, autoclaving, micro-giving, chemical disinfection, etc.
NEW CHALLENGES IN WASTE MANAGEMENT
During an outbreak, many other types of medical and dangerous waste, including infected masks, handgrips and other protective devices and a higher volume of non-infected items of the same nature, are generated. Recent airborne transmission reports have led to recommendations that masks be used in public areas. Effective waste management can minimise unforeseen health or environmental consequences. Appropriate identification, collection, separation, storage, transport, treatment and disposal and important related aspects, including disinfection, protection of personnel and formation, are required for effective management in biomedical and health-care waste.
The plastic waste suddenly increased in volume, particularly in products used in the protection of individuals and health care, is one of the many adverse consequences of the COVID-19 pandemic. The environmental problems are linked to the product life cycles and can be measured using the metrics (PF and PWF), which are highlighted by this paper. The destruction of residual pathogens for the safe disposal of this waste is a crucial priority. The rush to rapidly build capacity to cope with the crisis is likely to lead to a decrease in consideration of long-term sustainability issues without emphasis. By taking several key points into account, risk can be avoided:
● Disrupting the COVID-19 pandemic can lead, in a way the outbreak presents an unusual opportunity for modern product systems to shift towards a more lasting future path.
● PF and PWF metrics can become effective policy-making and public engagement tools. It provides an effective way to communicate abstract burdens for use by non-specialists in numerical form.
● Contingency plans should be continuously developed and adjusted to address plastics' future and waste management in various critical situations.
 https://www.intechopen.com/books/current-topics-in-public-health/health-care-waste-management-public-health-benefits-and-the-need-for-effective-environmental-regulat  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1519619/  https://www.scmp.com/news/china/society/article/3065049/coronavirus-china-struggling-deal-mountain-medical-waste-created  https://www.downtoearth.org.in/blog/health/biomedical-waste-management-in-india-still-a-looming-concern-63896  https://www.senseandsustainability.net/2017/09/29/dumped-medical-waste-hazardous-to-the-environment/  https://www.investindia.gov.in/team-india-blogs/bio-medical-waste-management-during-covid-19  https://www.nature.com/articles/d41586-020-02058-1