Biomedical Waste Management Status in Two Hospitals of Gulbarga City, Karnataka… ·...

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WSN 31 (2016) 82-110 EISSN 2392-2192

Biomedical Waste Management Status in Two Hospitals of Gulbarga City, Karnataka, India

Jadesh V. Murli1,a, K. S. Kavya2,b, D. S. Shivkumar2,c

1Assistant Professor, Department of P.G. Studies and Research in Zoology, Gulbarga University,

Kalburgi, 585106, Karnataka, India

2Department of P.G. Studies and Research in Zoology, Gulbarga University,

Kalburgi, 585106, Karnataka, India

a-cE-mail address: [email protected] , [email protected] , [email protected]

ABSTRACT

The proper management of biomedical waste has become a worldwide humanitarian topic

today. Although hazards of poor management of biomedical waste have aroused the concern

worldwide over, especially in the light of its far –reaching effects on human, health and the

environment. Now it is well established fact that there are many adverse and harmful effects to the

environment including human being which are caused by the “HOSPITAL WASTE” generated during

the patient care. Hospital waste is a potential health hazards to the care workers, public, flora, fauna of

the area. The problems of the waste disposal in the hospitals and other health care institutions have

become issues of increasing concerns. This research article is to survey the practice of biomedical

waste such as collection, storage, transportation, and disposal along with the amount of biomedical

waste generated in two Hospitals of Gulbarga. The proper management methods have been employed

in Government hospital. In Basaveshwara hospital there is no proper segregation of waste at the source

of generation and all the wards don’t contain all the liners. In both the hospitals waste collected and

disposed daily. It is highly desirable for a Hospital Administrator to know the weak points in the chain

of waste management so that these could be addressed appropriately. Keeping this in view, the present

study was conducted to assess generation and management of biomedical waste in Government

General Hospital and Basaveshwara Hospital.

World Scientific News 31 (2016) 82-110

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Keywords: Biomedical waste; Hospital; Management and Handling Rules; 1998; Collection and

Transportation of wastes; WHO; Liners; Infection and non- infectious wastes

1. INTRODUCTION

According to Baveja etlal, (2000), hospitals are health institutions providing patient care

establishments to look after the public health. This may defectively be clean, healthy

environment for their employees and the community. In the process of health care, waste is

generated which usually includes sharps, human tissues or body parts and other infectious

materials. (Baveja etal., 2000), also referred to as “Hospital Solid Waste” and “Biomedical

Solid Waste”, according to Monohar etal. (1998).

According to Biomedical Waste (Management and Handling) Rules, 1998 of India,

“any waste which is generated during the diagnosis, treatment or immunization of human

beings or animals or in research activities pertaining therefore or in the production or testing

of biological. The Government of India (Notification, 1998) specifies that Hospital Waste

Management is part of hospital hygiene and maintenance activities, which are mainly

engineering functions, such as collection, transportation, operation/treatment of processing,

systems and disposal of waste. However, initial segregation and storage activities are the

direct responsibility of nursing personnel who are engaged in the hospital. If the infectious

component gets mixed with the general non-infectious waste, the entire mass becomes

potentially infectious, (Info Nugget, 2003).

According to WHO (2005), medical waste refers to hazardous waste materials generated

by health care activities, including a broad range of materials. From used needles and syringes

to soiled dressing, body parts diagnostic samples, blood, chemicals, pharmaceuticals, medical

devices and radioactivity materials.

Glenn and Garwal (1999) reported that, according to WHO 85% of the hospital wastes

ate actually non-hazardous, whereas 10% are infectious and 5% are non-infectious but they

are include in hazardous wastes- about 15% to 35% of Hospitals waste is regulated as

infectious waste. The range is dependent on the total amount of waste generated.

Though hospital waste contains 10% infectious waste which is not properly disposed off

pose a great health risk to the public. (Askarian et al, 2004). Furthermore, improper waste

management can lead to environment pollution: water, air, soil, unpleasant smells can foster

the growth and multiplication of insects, rodents and worms and may lead to transmission of

diseases like typhoid, Cholera, Human Immunodeficiency Virus (HIV), and Hepatitis B and

C. (Abdulla et al. 2008).

Though as many as 40 pathogens have been documented to be transmitted by BMW

(Collins et al., 1987) its well documented propensity to cause transmission of 3 pathogens

namely Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C

Virus(HCV) makes it essential that due care is exercised while handling and disposing (Pruss

A. et al., 1999). In 2001, Remy et al, reported that waste generated in the process of health

care are composed of variety of wastes including hypodermic needles, scalpels, blades,

surgical cottons, gloves, bandages, clothes, discarded medicine and body fluids, human tissue

and organs, chemicals etc., other wastes generated in healthcare settings include radioactive

wastes, mercury containing instruments, PVC plastics etc.


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These are the most environmentally sensitive healthcare by products and needs a greater

attention which has to be monitored.

Disposal of bio-medical wastes has emerged as a major problem in India. The public is

increasingly concerned over improper disposal of hazardous wastes and biomedical waste are

still handled and disposed together with domestic wastes, thus creating a great health risk to

both the public and the environment. In present study attempt has been made to assess the

practice of biomedical waste namely – collection, storage, transportation, and disposal along

with the amount of generated biomedical waste in two hospitals of Gulbarga.

2. THE STUDY AREA

Gulbarga city is situated on Bombay Chennai section of the central Railway and is at a

distance from 646 km, from Bangalore, the capital city of Karnataka. The city is situated at a

latitude of 17º19’ N and longitude of 76º54’ E. It has a general slope of North - west to South-

East.

3. ETHICAL CLEARANCE

Ethical clearance from institutes ethics committee and permission from Medical

Superintendent to collect data from various patient care areas was taken before the study; the

study was approved by Department of P.G. Studies and Research in Zoology, Gulbarga

University, Gulbarga, and Karnataka, India in 2013.

4. ASSESSMENT OF OPERATING PROCEDURES

Informal discussion with various hospital functionaries were carried out. Common

regional facility for final disposal of infectious waste was also studied wastes generated in

two hospitals were weighed during a week for each hospital.

5. QUANTITATIVE DETERMINATION OF WASTE

The following steps were involved in the determination of the biomedical waste

generated from different places in the study centre:

i. Solid waste of both types, infectious and non- infectious was weighed individually on

suspension spring scale (±10 g) with the assistance of the staff and the weight was

recorded

ii. Each color coded bin or liner ment for collection of particular waste in each block was

weighed and recorded.

iii. The quantities of infectious and non-infectious west were recorded in each block of

each liner for 7 days and all the data was compiled to represent the average values.

iv. The supporting staff of each block was briefed over denature of assistance and support

that was needed in determining the quantity of wastes during the study period.


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v. The available medical facilities in the hospital are given blow in the Table 1

(Government General Hospital) and Table 2 (Basaveshwara Hospital) and Figure 1

shows the study area.

Table 1. Facility available at Government General Hospital.

Sl. No. NAME OF WARDS

1. Causality

2. Minor OT

3. Psychiatry ward

4. Injection room (male and female)

5. Orphan baby ward

6. Burn's ward

7. Maternity ward and PPC ward

8. General Ward

9. Post Operative ward (a)

10. Post operative ward (b)

11. First floor major O.T

12. Male orthopedic ward

13. Male surgical ward

14. Male surgical septic ward

15. Female orthopedic ward

16. Male medical ward

17. Nutritionary rehabilitation centre

18. Pediatric ward

19. Female surgical ward

20. Special room (1,2,3,4)

21. Cardiac IICU

22. Eye and cardiac ward

23. Labor room

24. Antenatal ward


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25. ANC ward

26. PNC ward

27. Emergency ward

28. Blood bank

29. Medical OPD

30. RNTCTP Centre

31. Pediatric ward

32. Dental OPD

33. Dermatitis, skin and SID OPD

34. Department of radiology

35. Surgical OPD

36. Laboratory

37. Orthopedic OPD

38. Psychiatry OPD

39. ARV room

40. ENT OPD

41. Eye OPD

42. NICU

43. Gyaenic OPD

Table 2. Facility available in the Basaveshwara Hospital.

Sl. No. NAME OF THE WARD

1. Causality

2. Acute medical care

3. Trauma care

4. Blood bank

5. Washing and sterilization

6. Infection lab and serology lab


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7. Bleeding room

8. X-ray

9. Orthopedic OPD

10. Surgical OPD

11. Skin and UDL OPD

12. Medical OPD

13. ENT OPD

14. ENT Major OT

15. Eye ward

16. Eye female ward

17. Eye male ward

18. Male skin ward

19. Female skin ward

20. Chest and TB (Female)

21. Chest and TB (Male)

22. Special room (13)

23. Common collection centre

24. Pathology lab

25. Microbiology lab

26. Male Ortho ward (A, B C Unit)

27. SICU

28. MICU

29. ICCU

30. RNTCP Centre

31. Dialysis unit

32. Female ortho ward (A,B C unit)

33. male Ortho ward

34. Orthopedic O.T

35. PICU

36. Neuro ICU

37. Isolation ward


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38. Surgery OT

39. Post operative ward

40. Obstetric ward

41. NICU

42. Obstetrics and gynecology Operation theaters

43. Labor room

44. Surgical ward (A, B, C)

45. Male surgical ward

46. Female Surgical Ward

47. Female skin ward

48. Pediatrics ward

49. Female medical ward

50. Male medical ward (A,B)

51. Female dressing room

52. Male dressing room

53. Oncology OPD

54. Eye OPD

55. Department of DVL (Dermatology, Venerology

and Leprosy)

56. CT Scan centre

57. Magnetic resonance imaging (MRI)

58. MRI-x-ray

59. Ultrasonography

60. Mammography and color Doppler

61. Gynecology OPD

62. Obstetrics OPD

63. Pediatric OPD

64. Psychiatry ward

65. Pediatric OPD


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Figure 1. Study area.

Government General

Hospital

Basaveshwar Hospital


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5. 1. Qualitative analysis of biomedical waste: The bio-medical waste generated in the

hospital was observed to be infectious and non-infectious waste.

Infectious waste includes-

i. Infected plastics – catheters, canulos, syringes, gloves, blood bags, tubes, bottles,

and other infected plastics , microbiological waste from pathological laboratory

and waste generated from disposable items other than sharps, etc,. These wastes

should be collected in red color plastic liner or bin.

ii. Infectious waste – human anatomical waste, microbiological waste from

pathological laboratory, items contaminated with blood and body fluids. These

wastes should be collected in yellow color plastic liner.

iii. Infected glass whole and broken glass, test tubes, ampoules, vials and sample

bottles, should be collected in blue liner.

Non- infectious waste includes

iv. Chemical waste- insecticides, disinfectants fumigants, chemical containers,

cytotoxic waste, incinerator ash, expired medicines and other chemicals. This

waste should be collected in black liner.

v. Non- infected recyclable waste- Disposable cups, plastic, card board, metal

containers, paper, non- infectious plastics and other recyclables. Non-infected

recyclable waste should be collected in white.

vi. Non-infected Biodegradable waste includes- left –over food items, vegetables and

fruit peels, egg shells, meat, fish and other biodegradables. These should be

collected in Green containers. [According to Bio-medical Waste (Management and handling) Rules, 1998]

Our main object of qualitative analysis of biomedical waste in both the hospital was

whether they are following these segregation rules at the source of waste generation or not.

Our observation of Government Hospital waste segregation is summarized in Table number 3.

It shows that whether the segregation is done properly according to the rules (Management

and Handling) Rules, 1998 or not.

Out of 43 wards except male surgical septic ward, in remaining all wards there was a

proper segregation wastes at the source of generation.

And observation of Basaveshwara Hospital about segregation was summarized in Table

number 4. Out of 65 wards in 44 wards they are not following the segregation rules. In

remaining 21 wards there is a proper segregation of waste at the source of generation.

And the Table number 5 shows the KAP (Knowledge-Awareness-Practice) of

Government General hospital staff. This shows that all the hospital staff has the knowledge

about segregation of waste at the source of information in the prescribed liner. And they are

following and practicing it regularly.

From the Table number 5 it is clear that all the staff members of Basaveshwara Hospital

have Knowledge and positive attitude towards the waste segregation. The practice of

segregation is only about 32.31%. In both the hospitals, hospital staff members aware about

Management and Handling Rules, 1998.


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6. QUANTITATIVE ANALYSIS OF BIOMEDICAL WASTE

Each color coded bin or liner ment for collection of particular waste in each block was

weighed and recorded for 7 days to get average value. Table number 6 shows the average

quantity of waste in Kg/day of each liner in each block of Government General Hospital.

The total amount of average infectious and no- infectious waste per day is 181.42 Kg.

The infectious waste per day was 61.51 Kg. (This is the weight of waste present in yellow and

red liner). Remaining waste was non-infectious.

Table number 7 shows that average amount of waste generated per day in each ward of

Basaveshwara Hospital. The total amount of average waste generated per day was 132.6 Kg.

out of 132.6 kg infectious waste was 76.7 kg (Waste present in Yellow and red liner).

In both the hospitals infectious waste generated per day was more. If this is not

segregated properly or mixed and transported with non- infectious waste it will lead to great

health risk to both the public and the environment. From the Table number 4, it is clear that in

Basaveshwara hospital most of the wards don’t contain the liners prescribed for particular

type of waste collection and they dumped all the wastes in one common bin.

Table 3. Segregation of waste in Government General Hospital.

Sl. No. NAME OF WARDS PROPER SEGREGATION

(YES/NO)

1. Causality YES

2. Minor OT YES

3. Psychiatry ward YES

4. Injection room (male and female) YES

5. Orphan baby ward YES

6. Burn's ward YES

7. Maternity ward and PPC ward YES

8. General Ward YES

9. Post Operative ward (a) YES

10. Post operative ward (b) YES

11. First floor major O.T YES

12. Male orthopedic ward YES

13. Male surgical ward YES

14. Male surgical septic ward NO BIN

15. Female orthopedic ward YES


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16. Male medical ward YES

17. Nutritionary rehabilitation centre YES

18. Pediatric ward YES

19. Female surgical ward YES

20. Special room (1,2,3,4) YES

21. Cardiac IICU YES

22. Eye and cardiac ward YES

23. Labor room YES

24. Antenatal ward YES

25. ANC ward YES

26. PNC ward YES

27. Emergency ward YES

28. Blood bank YES

29. Medical OPD YES

30. RNTCTP Centre YES

31. Pediatric ward YES

32. Dental OPD YES

33. Dermatitis, skin and SID OPD YES

34. Department of radiology YES

35. Surgical OPD YES

36. Laboratory YES

37. Orthopedic OPD YES

38. Psychiatry OPD YES

39. ARV room YES

40. ENT OPD YES

41. Eye OPD YES

42. NICU YES

43. Gyaenic OPD YES


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Table 4. Segregation of waste in Basveshwar Hospital.

Sl. No. NAME OF THE WARD PROPER SEGREGATION

(YES /NO)

1. Causality Yes

2. Acute medical care Yes

3. Trauma care Yes

4. Blood bank No

5. Washing and sterilization No

6. Infection lab and serology lab No

7. Bleeding room No

8. X-ray No

9. Orthopedic OPD No

10. Surgical OPD No

11. Skin and UDL OPD No

12. Medical OPD No

13. ENT OPD No

14. ENT Major OT No

15. Eye ward No

16. Eye female ward No

17. Eye male ward No

18. Male skin ward No

19. Female skin ward No

20. Chest and TB (Female) No

21. Chest and TB (Male) No

22. Special room (13) No

23. Common collection centre No

24. Pathology lab No

25. Microbiology lab No

26. Male Ortho ward (A, B C Unit) No

27. SICU No

28. MICU Yes

29. ICCU Yes

30. RNTCP Centre Yes

31. Dialysis unit Yes

32. Female ortho ward (A,B C unit) Yes


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33. male Ortho ward No

34. Orthopedic O.T No

35. PICU No

36. Neuro ICU Yes

37. Isolation ward Yes

38. Surgery OT Yes

39. Post operative ward Yes

40. Obstetric ward No

41. NICU Yes

42. Obstetrics and gynecology Operation

theaters Yes

43. Labor room Yes

44. Surgical ward (A, B, C) Yes

45. Male surgical ward Yes

46. Female Surgical Ward Yes

47. Female skin ward No

48. Pediatrics ward No

49. Female medical ward No

50. Male medical ward (A,B) No

51. Female dressing room No

52. Male dressing room No

53. Oncology OPD No

54. Eye OPD No

55. Department of DVL (Dermatology,

Venerology and Leprosy) No

56. CT Scan centre No

57. Magnetic resonance imaging (MRI) No

58. MRI-x-ray No

59. Ultrasonography No

60. Mammography and color doppler No

61. Gynecology OPD Yes

62. Obstetrics OPD No

63. Pediatric OPD Yes

64. Psychiatry ward No

65. Pediatric OPD Yes


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Table 5. Quantification of Bio- Waste in Government General Hospital.

Sl. No. Name of

Wards

Average Quantity of Waste in kg per day Total

Number

of Beds

Average

Number of

patients

per day Black Yellow White Blue Red Green

1 Causality Empty 0.15 1 2 3 No bin 3 2

2 Minor OT Empty 0.15 1 Empty 2 No bin 1 -

3 Psychiatry

ward Empty Empty 2 2 1 3 10 1

4

Injection room

(male and

female)

No bin 0.25 1 No bin 1 No bin 2 -

5 Orphan baby

ward No bin No bin Empty No bin No bin No bin 5 3

6 Burn's ward 1 0.85 3 1 3 No bin 18 16

7

Maternity

ward and PPC

ward

0.05 0.5 5 5 1 No bin 38 26

8 General Ward No bin Empty 1 No bin No bin No bin 8 6

9

Poast

Operative

ward (a)

No bin 0.5 1 1 2 3 20 18

10 Post operative

ward (b) No bin 0.5 1 2 1 4 22 16

11 First floor

major O.T 5 1 1 2 2 No bin 7 4

12

Male

orthopedic

ward

2 1 1 3 2 No bin 18 12

13 Male surgical

ward 0.07 2 1 2 3 No bin 20 18

14 Male surgical

septic ward No bins No Bin No bin No bin No bin No bin 5 4

15

Female

orthopedic

ward

No bin 1 1 1 1 2 19 15

16 Male medical

ward No bin 0.05 No bin 0.5 0.1 No bin 20 18

17

Nutritionary

rehabilitation

centre

0.05 1 0.5 1 1 1 10 3


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Sl. No. Name of

Wards


Number

of Beds

Average

Number of

patients


18 Pediatric ward No bin 0.1 0.07 2 1 2 12 8

19 Female

surgical ward No bin 1 0.25 2 1 No bin 22 20

20 Special room

(1,2,3,4) No bin No bin No bin 0.35 0.78 1 32 8

21 Cardiac IICU No bin 0.2 0.25 2 0.07 0.07 6 4

22 Eye and

cardiac ward No bin 3 No bin No bin No bin No bin 9 3

23 Labor room 0.06 0.25 1 2 2 No bin 5 5

24 Antenatal

ward No bin No bin 2 2 0.75 1 4 3

25 ANC ward 0.02 0.6 0.25 2 1 4 15 13

26 PNC ward 0.02 0.6 4 2 1 4 20 16

27 Emergency

ward 0.05 1 2 3 1 3 39 34

28 Blood bank Empty 0.25 0.05 0.75 0.25 0.5 0 -

29 Medical OPD No bin No bin 0.075 No bin No bin No bin 1 -

30 RNTCTP

Centre Empty 0.06 1 0.08 0.44 No bin 1 -

31 Pediatric ward Empty Empty 0.25 1 1 No bin 1 -

32 Dental OPD Empty 0.75 Empty 1 1 No bin 1 -

33

Dermatitis,

skin and SID

OPD

0.002 Empty No bin Empty Empty No bin 1 -

34 Department of

radiology 1 No Bins Empty Empty No bin No bin 0 -

35 Surgical OPD Empty Empty 1 1 Empty Empty 1 -

36 Laboratory No bin 0.125 Empty 0.25 1 No bin 0 -

37 Orthopedic

OPD No bin Empty Empty No bin 1 No bin 1 -

38 Psychiatry

OPD No bin Empty No bin 0.015 No bin No bin 1 -


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Sl. No. Name of

Wards


Number

of Beds

Average

Number of

patients


39 ARV room No bin Empty 0.25 0.75 1 Empty 1 -

40 ENT OPD Empty 0.2 0.25 No bin 1 No bin 1 -

41 Eye OPD Empty 0.025 0.05 0.075 1 No bin 1 --

42 NICU No bin 3 4 No bin No bin No bin 6 4

43 Gyaenic OPD Empty 0.01 0.015 0.015 2 No bin 1 -

9.322 20.12 37.26 44.785 41.39 28.57 408 280

[Date of Quantification from 17-03-213 to 23-03-2013]

(Some blocks have not opened during our study period and in some blocks staff members are not allowed to

enter so we kept those boxes empty)

Table 6. Quantification of Bio Waste in Basaveshwara Hospital.

Sl.

No. Name of Wards

Average Quantity of Waste in Kg/per day Total

Number

of Beds

Average

Number

of

Patients


1 Causality No Bin 1 1 No Bin 2 No Bin 3 -

2 Acute medical

care No Bin 2 2 3 4 No Bin 23 20

3 Trauma care No Bin 0.35 3 2 2 No Bin - -

4 Blood bank 2 1 No Bin No Bin 2 No Bin 14 12

5 Washing and

sterilization No Bin 4 No Bin No Bin No Bin No Bin 14 12

6

Infection lab

and serology

lab

No Bin No Bin No Bin No Bin No Bin No Bin - -

7 Bleeding room No Bin No Bin No Bin No Bin No Bin No Bin - -

8 X-ray No Bin No Bin No Bin No Bin No Bin No Bin - -

9 Orthopedic

OPD

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin - -

10 Surgical OPD Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin -


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Sl.

No. Name of Wards


Number

of Beds

Average

Number

of

Patients


11 Skin and UDL

OPD

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin - -

12 Medical OPD Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin - -

13 ENT OPD Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin - -

14 ENT Major OT No Bin 0.35 1 1 4 Common

dustbin 17 5

15 Eye ward 3 0.45 No Bin Empty 1 Common

dustbin 12 6

16 Eye female

ward No Bin No Bin No Bin No Bin No Bin No Bin 28

No

patient

17 Eye male ward No Bin No Bin No Bin No Bin No Bin No Bin 11 No

patient

18 Male skin ward No Bin No Bin No Bin No Bin No Bin No Bin 21 No

patient

19 Female skin

ward No Bin No Bin No Bin No Bin No Bin No Bin 17

No

patient

20 Chest and TB

(Female) No Bin No Bin No Bin No Bin No Bin No Bin 12

No

patient

21 Chest and TB

(Male) No Bin No Bin No Bin No Bin No Bin No Bin 18

No

patient

22 Special room

(13) 1 0.55 No Bin No Bin 5 No Bin 13 11

23 Common

collection centre 2 1 No Bin No Bin 0.50 1 - -

24 Pathology lab Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin

Common

dustbin - -

25 Microbiology

lab No Bin No Bin No Bin 1 1 No Bin - -

26

Male Ortho

ward (A, B C

Unit)

Empty 0.3 No Bin No Bin 2 No Bin 51 48

27 SICU No Bin Empty No Bin 0.4 0.6 No Bin 17 11

28 MICU No Bin No Bin No Bin No Bin No Bin No Bin 17 14

29 ICCU 1 2 No Bin 2 2 No Bin 9 8

30 RNTCP Centre No Bin No Bin No Bin No Bin No Bin No Bin 14 14

31 Dialysis unit No Bin 2 No Bin No Bin 1 No Bin 13 No

patient

32

Female ortho

ward (A,B C

unit)

No Bin 2 0.25 0.15 2 No Bin 39 18

33 male Ortho

ward No Bin No Bin No Bin No Bin No Bin No Bin 9 6

34 Orthopedic O.T No Bin 1 No Bin 1 1 No Bin - -


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Sl.

No. Name of Wards


Number

of Beds

Average

Number

of

Patients


35 PICU No Bin No Bin No Bin No Bin No Bin No Bin 21 20

36 Neuro ICU Empty Empty Empty Empty Empty No Bin 8 No

patient

37 Isolation ward No Bin No Bin No Bin No Bin No Bin No Bin 4 3

38 Surgery OT No Bin 1 No Bin No Bin 1 No Bin - -

39 Post operative

ward No Bin 0.35 No Bin No Bin 2 No Bin 6 4

40 Obstetric ward No Bin No Bin No Bin No Bin No Bin No Bin 16 14

41 NICU No Bin 1 No Bin No Bin 1 1 11 9

42

Obstetrics and

gynecology

Operation

theaters

No Bin 0.25 No Bin No Bin 1 0.35 5 4

43 Labor room 1 6 No Bin No Bin 1 No Bin 5 4

44 Surgical ward

(A, B, C) 1 1 No Bin No Bin 1 No Bin 21 20

45 Male surgical

ward 1 2 1 2 1 2 23 20

46 Female Surgical

Ward 2 1 3 4 2 3 39 21

47 Female skin

ward

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- No

patient

48 Pediatrics ward

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

17 15

49 Female medical

ward

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

14 13

50 Male medical

ward (A,B)

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

16 12

51 Female dressing

room

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- -

52 Male dressing

room

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- --

53 Oncology OPD

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- -

54 Eye OPD

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- -


-100-

Sl.

No. Name of Wards


Number

of Beds

Average

Number

of

Patients


55

Department of

DVL

(Dermatology,

Venerology and

Leprosy)

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- -

56 CT Scan centre

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- -

57

Magnetic

resonance

imaging (MRI)

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- -

58 MRI-x-ray

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- -

59 Ultrasonography

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- -

60

Mammography

and color

doppler

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

One

common

dustbin

- -

61 Gynecology

OPD No Bin 1 No Bin No Bin 1 1 - -

62 Obstetrics OPD No Bin Empty No Bin No Bin Empty Empty - -

63 Pediatric OPD No Bin 1 0.25 No Bin Empty 0.5 - -

64 Psychiatry ward Common

dustbin

Common

dustbin 2

Common

dustbin

Common

dustbin

Common

dustbin - -

65 Pediatric OPD No Bin 1 2 1 2 No Bin 10 8

14 33.6 15.5 17.55 43.1 8.85 588 352

[Date of Quantification from 24-04-2013 to 29-04-201

(Some blocks have not opened during our study period and in some blocks staff members are not allowed to

enter so we kept those boxes empty)

Table 7. Awareness regarding Bio-medical waste (Management and Handling) Rules,

1998 in the hospitals.

Sl. No. Designation

Aware (A) / Not Aware (NA)

Name of the Hospitals

Government

Hospital

Basaveshwara

Hospital


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1 Doctor

(specialist) A A

2 Doctor

(Resident) A A

3 GDMO A A

4 Nurse A A

5 Technician A A

6 Pharmacist A A

7 Ward boy A A

8 Peon A A

9 Ayahs A A

10 Sweeper A A

11 Clerk and other

Staff A A

Table 8. KAP (Knowledge – Awareness – Practice) to determine the existing levels of information,

training, practices in the Hospitals.

Sal.

No. Designation

Knowledge

(Yes/No)

Attitude

(Positive /

Negative)

Practice

(Yes / No)

Go

ver

nm

ent

Ho

spit

al

Bas

ves

hw

ar

Ho

spit

al

Go

ver

nm

ent

Ho

spit

al

Bas

ves

hw

ar

Ho

spit

al

Go

ver

nm

ent

Ho

spit

al

Bas

ves

hw

ar

Ho

spit

al

1 Doctor

(specialist) Y Y + + Y Y

2 Doctor

(Resident) Y Y + + Y Y

3 GDMO Y Y + + Y Y


-102-

4 Nurse Y Y + + Y N

5 Technician Y Y + + Y N

6 Pharmacist Y Y + + Y Y

7 Ward boy Y Y + + Y Y

8 Peon Y Y + + Y Y

9 Ayahs Y Y + + Y Y

10 Sweeper Y Y + + Y Y

11 Clerk and

other Staff Y Y + + Y Y

Figure 2. Shows the average amount of the infectious and non-infectious waste in both

the Hospitals per day.

[The wastes present in Red and yellow is considered as infectious waste]

0

5

10

15

20

25

30

35

40

45

GOVERNMENT HOSPITAL

BASVESHWAR HOSPITAL


-103-

QUANTIFICATION OF BIOWASTES IN HOSPITALS

PICTURE SHOWING LINERS IN THE FEMALE

SURGICAL WARD-GOVERNMENT GENERAL

HOSPITAL

INFORMATION ABOUT SEGREGATION OF

WASTES IN PRESCRIBRD LINER IS PASTED ON

THE WALL OF WARD FOR THE AWARNESS -IN

GOVRNMENT GENERAL HOSPITAL

LINERS IN BURNS WARD-GOVERNMENT GENERAL

HOSPITAL


-104-

ALLUMINIUM BOX FOR THE COLLECTION

OF SHARP NEEDLES AND SYRINGES-

GOVERNMENT GENERAL HOSPITAL

WASTE DUMPED IN THE HOSPITAL

CAMPUS- GOVERNMENT GENERAL

HOSPITAL

COLLECTION OF WASTES FROM THE WARDS- GOVERNMENT

GENERAL HOSPITAL


-105-

CHAMP VEHICLE MENT FOR CARRING BIO MEDICAL WASTE IN GULBARGA AT


BIO WASTE IN THE CHAMP VEHICLE –DIFFERENT TYPES OF WASTES ARE KEPT IN DIFFERENT COMPARTMENT S.


-106-

PICTURES SHOWING THE BURNING OF WASTES BEHIND THE HOSPITAL CAMPUS-


COLLECTYED BIO WASTS IN BASAWESWAR HOSPITAL REDAY FOR

DISPOSAL


-107-

LINERS IN ICCU OF BASAVESHWAR HOSPITAL INFORMATION ABOUT SEGREGATION OF

WASTES IN PRESCRIBRD LINER IS PASTED ON

THE WALL OF WARD FOR THE AWARNESS -IN

IMPROPER DUMPING OF WASTES IN YELLOW LINER PRESCRIBED FOR THE COLLECTION OF INFECTIOUS

ANATOMICAL WASTE- IN WARD OF BASAWESWAR HOSPITAL


-108-

Figure 3. Picture showing waste management status of two Hospitals.

IMPROPEDR DUMPING OF WASTE IN WARD

SEPARATE DEPARTMENT MENT FOR THE

DISPOSAL AND REUSE OF WASTE

ALUMINIUM BOX FOR THE COLLECTION

OF NEEDLES AND SYRINGES


-109-

7. CONCLUSIONS

7. 1. Government General Hospital

In Government, general hospital except two wards each ward and OPD contains color

bins and there is proper segregation (at the point of generation in the prescribed color bins),

collection and transportation of the generated waste in the hospital regularly. And all nurses,

ayahs, workers doing it properly and regularly. But the people those are coming for the

treatment without any care throwing the food wastes, papers, plastics in the hospital campus.

In the government hospital response was very good and 98% of hospital staff doing the

segregation satisfactorily. The wastes from labor room, O.T., and other body parts and

anatomical wastes they either burn it or deep buried behind the hospital.

7. 2. Basaveshwara Hospital

32.31% of waste generated in Hospital segregated properly. All the wards don’t contain

all the liners most of the wards contain mainly three liners that is red, yellow, green. Some

wards contain red, yellow and black and sometimes the wastes are not dumped in the correct

liner. The wastes are collected and disposed daily. The nurses, ayahs and workers have the

knowledge about the segregation of wastes

Medical wastes should be classified according to their source, typology and risk factors

associated with their handling, storage and ultimate disposal. The segregation of waste at

source is the key step and reduction, reuse and recycling should be considered in proper

perspective. We need to consider innovative and radical measures to clean up the distressing

picture of lack of civic concern on the part of hospitals and slackness in government

implementation of bare minimum of rules, as waste generation particularly biomedical waste

imposes increasing direct and indirect costs on society. The challenge before us, therefore, is

to scientifically manage growing quantities of biomedical waste that go beyond past practices.

If we want to protect our environment and health of community we must sensitize ourselves

to this important issue not only in the interest of heath managers but also in the interest of

community.

ACKNOWLEDGEMENT

Sincere thanks to the all Hospital staff for their kind co-operation during the course of study. The authors are

also express gratitude to the Institution for the technical assistance in carrying out this work.

References

[1] I. Remy, Great Western Pacific Coastal Post (2001).

[2] G. Baveja, S. Muralidhar, P. Aggarwal, Hospital Today (2000) 485-486.

[3] D. Manohar, P.R. Redd, B. Kotaih, Ind. J. Environ (1998) 319-326.

[4] Notification: Bio-medical waste (Management and Handling) Rules, Ministry of

Environment and Forestry, New Delhi (1998).

[5] Info Nugget, Government of India, Press Information Bureau (2003).


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[6] WHO, Waste Management (2005), 568-569.

[7] F. Abdulla, H.A. Qdais, A. Rabi, Waste Manage, (2008) 450-458.

[8] M. Askarian, M. Vakili, G. Kabir, Waste Manage (2004) 347-352.

[9] A. Pruss, E. Cirouit, P. Rushbrook, WHO (1999) 2-46.

[10] C.H. Colins, D.A. Kennedy, J Appl Bacteriol (1987) 385-402.

( Received 16 November 2015; accepted 01 December 2015 )

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