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INTRODUCTION

Hospital Waste Management means the management of waste produced by

hospitals using such techniques that will help to check the spread of

diseases through it.

The management of waste poses to be a major problem in most of the

countries, especially hospital waste. It is an ongoing problem for many

countries. In recent years, medical waste disposal has posed even more

difficulties with the appearance of disposable needles, syringes, and other

similar items. Pakistan is also facing this problem. Around 250,000 tonnes

of medical waste is annually produced from all sorts of health care

facilities in the country. This type of waste has a bad affect on the

environment by contaminating the land, air and water resources.

According to a report, 15 tonnes of waste is produced daily in Punjab. The

rate of generation is 1.8 kilograms per day per bed. The province houses

250 hospitals with a total capacity of 41,000 beds.

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OBJECTIVES OF THE STUDY

To study about various steps involved in waste disposal

management

To study about how the waste disposal management

helpful to organisation

To study about employees opinion in waste disposal

management

To study about various drawbacks of waste disposal

management system

LIMITATIONS

Time is a major limiting factor.

During working hours its difficult to collect answers.

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REVIEW OF LITERATURE

Different Types

Hospital wastes are categorised according to their weight, density and

constituents. The World Health Organisation (WHO) has classified

medical waste into different categories. These are:

Infectious: material-containing pathogens in sufficient concentrations or

quantities that, if exposed, can cause diseases. This includes waste from

surgery and autopsies on patients with infectious diseases;

Sharps: disposable needles, syringes, saws, blades, broken glasses, nails or

any other item that could cause a cut; Pathological: tissues, organs, body

parts, human flesh, fetuses, blood and body fluids;

Pharmaceuticals: drugs and chemicals that are returned from wards,

spilled, outdated, contaminated, or are no longer required;

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Radioactive: solids, liquids and gaseous waste contaminated with

radioactive substances used in diagnosis and treatment of diseases like

toxic goiter; and Others: waste from the offices, kitchens, rooms, including

bed linen, utensils, paper, etc.

Guidelines

There are Guidelines for Hospital Waste Management In Pakistan since

1998 prepared by the Environmental Health Unit, of the Ministry of

Health, Government of Pakistan, giving detailed information and covering

all aspects of safe hospital waste management in the country, including the

risk associated with the waste, formation of a waste management team in

hospitals, their responsibilities, plan, collection, segregation,

transportation, storage, disposal methods, containers, and their color

coding, waste minimisation techniques, protective clothing, etc.

Improper disposal

Hospitals and public health care units are supposed to safeguard the health

of the community. However, the waste produced by the medical care

centers if disposed of improperly, can pose an even greater threat than the

original diseases themselves.

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There are no systematic approaches to medical waste disposal. Hospital

wastes are simply mixed with the municipal waste in collecting bins at

roadsides and disposed off similarly. Some waste is simply buried without

any appropriate measure. The reality is that while all the equipment

necessary to ensure the proper management of hospital waste probably

exists, the main problem is that the staff fails to prepare and implement an

effective disposable policy.

How does hospital waste affect us?

If hospital waste is not managed properly it proves to be harmful to the

environment. It not only poses a threat to the employees working in the

hospital, but also to the people surrounding that area.

Infectious waste can cause diseases like Hepatitis A & B, AIDS, Typhoid,

Boils, etc.

People pick up used syringes from the hospital waste and sell them. Many

drug addicts also reuse the syringes that can cause AIDS and other

dangerous and contagious diseases. If a syringe, previously used by an

AIDS patient, is reused, it can affect the person using it. So, the hospital

staff should dispose off the syringes properly, by cutting the needles of the

syringes with the help of a cutter, so that the needle ca not be reused.

When waste containing plastics are burnt, Dioxin is produced, which can

cause Cancer, birth defects, decreased psychomotor ability, hearing

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defects, cognitive defects and behavioral alternations in infants.

Flies also sit on the uncovered piles of rotting garbage. This promotes

mechanical transmissions of fatal diseases like Diarrhea, Dysentery,

Typhoid, Hepatitis and Cholera. Under moist conditions, mosquitoes

transmit many types of infections, like Malaria and Yellow fever.

Similarly, dogs, cats and rats also transmit a variety of diseases, including

Plague and Flea born fever, as they mostly live in and around the refuse. A

high tendency of contracting intestinal, parasitic and skin diseases is found

in workers engaged in collecting refuse.

Solution

Some steps should be taken for the minimisation of hospital waste. Before

any clear improvement can be made in medical waste management,

consistent and scientifically based definitions must be established as to

what is meant by medical waste and its components, and what the goals

are. Plans and policies should be laid down for this purpose. Then the

waste should be segregated. Imposing segregated practices within hospitals

to separate biological and chemical hazardous waste will result in a clean

solid waste stream, which can be recycled easily. If proper segregation is

achieved through training, clear standards, and tough enforcement, then

resources can be turned to the management of the small portion of the

waste stream needing special treatment.

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New emphasis should be put on the reduction of waste, workers' safety

should be ensured through education, training and proper personal

protective equipment.

Incinerators: a solution or a threat?

Incineration has been the treatment method of choice for medical waste for

two important reasons. First, incineration has always been thought to be

the best method of eliminating any infectious organisms that are present in

medical waste. Second, incineration has been economical for hospitals

because it substantially reduces the volume to be disposed of in a landfill.

Waste disposal costs have historically been based on the volume to be

disposed. Both of these assumptions behind medical waste incineration are

no longer able to support objective scrutiny. Waste is burnt at very high

temperatures, that produce emissions full of acidic gases, heavy metals,

toxic organisms and dioxins. There is a lot of ash produced by an

incinerator as well.

Incinerators for medical and municipal waste have been linked to severe

public health threats and pollution. The combination of intense public

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opposition to incineration and increasingly strict environmental pollution

regulation has forced the closure or cancellation of many incinerators in

industrialised countries.

Incinerators are fast becoming an obsolete technology in many developed

countries as they are moving towards safer and more economical

alternative approaches to medical and municipal waste management.

As a result, many incinerator companies are targeting overseas markets

where people are not yet aware of the serious health and environmental

threats associated with incineration or the many advantages of alternatives.

Incinerator companies are now targeting Asia, Africa, and Latin America

to sell their toxic technology. Researchers came to the conclusion that

Dioxin, as well as mercury and other toxic substances, are emitted when

waste is burnt in an incinerator. Dioxin and related chlorinated organic

compounds are extremely potent toxic substances that produce a

remarkable variety of adverse effects in human and animals at extremely

low doses.

Mercury is also bio-accumulative and is toxic to the kidneys and nervous

system. Readily converted to its organic form in the environment, mercury

interferes with normal brain development.

Techniques to be used

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Various alternative technologies for incineration are available at hospitals

in many developed countries. As these techniques are either too

complicated or very expensive, they are not being used in Pakistan.

Though, these techniques should also be applied here,, for proper waste

disposal.

Steam Autoclaving

Steam Autoclaving is the most widely used and most efficient alternative

medical-waste-treatment technology. Most available autoclaves are

designed to handle both biohazard and normal hospital wastes

simultaneously. However, they cannot treat pathological animal wastes,

chemotherapy wastes, and low level radioactive wastes. These wastes have

to be treated separately.

Medical waste autoclaves usually jointly operate with a shredder, and a

compactor(to minimise the waste volume).

In autoclaves, the effects of heat from saturated steam and increased

pressure decontaminate medical waste by inactivating and destroying

microorganisms.

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There are two types of autoclaves, gravity displacement and pre-vacuum.

Those designed for medical waste are mostly pre-vacuum.

Chemical Treatment

In chemical treatment systems, an anti-microbial chemical, such as sodium

hypochlorite, chlorine dioxide, or peracetic acid, decontaminates the

medical waste. Most chemical treatment systems, currently in use, operate

at ambient temperature.

Microwave Radiation

In Microwave Radiation, medical waste enters the system by batch or

continuous mode, where it is wetted with steam or water and heated by

microwave radiation at de-contaminating temperatures.

Other Thermal Systems

Some systems use a combination of infrared radiation and forced hot-air

convection to treat the waste. The waste then is compacted, preparing it for

landfill. Other systems use gamma radiation to heat the waste to

disinfecting temperatures. A portion of the solid residue obtained is

recycled, while the remainder is disposed. Several other thermal systems

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currently under development use steam, oil, electricity or some form of

radiation as their source of heat.

Disposal of Pathological waste

As mentioned above, Pathological waste (body parts, research animals,

etc.) cannot be disposed off by autoclaving. For disposal of such waste,

either Crematoria (burning of the body) or burial should be performed.

Training

The hospital staff should be trained in such a manner that they help in

disposing off the waste properly.

INDUSTRY PROFILE

Recently, much has been said about the healthcare industry in India and its

growth. And rightly so; the industry has been gathering steam and making

people take notice of its massive growth. Last year, Dr. Prathap C. Reddy,

Apollo Hospitals group founder-chairman said in Bangalore that the overall

industry will show speedy signs of growth mainly because of increase in life

expectancy, higher income levels, greater reach of health insurance, and

growing lifestyle-related diseases. In fact, it is already a million-dollar

industry that is currently undergoing a rapid expansion phase with 12

percent CGPA (cumulative growth per annum) since 2008. By 2020, the

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sector will accumulate Rs.1.3 trillion (Rs.12,60,000 crore) in revenues.

Government initiatives and public-private partnerships will help create

better opportunities for nurses, paramedics, emergency medical technicians

and specialized doctors across the country, Dr Reddy said.

According to the Investment Commission of India, the market size of

hospitals and nursing homes will grow at 20% every year & projected to

stand at Rs. 54,000 crore. Medical equipment on the other hand will be

somewhere close to Rs. 9,000 crore with 15 per cent growth; clinical lab

diagnostics with Rs.4,500 crore - a clear 30 per cent increase. In addition to

this, imaging diagnostics will be another money-spinning business standing

at Rs.4,500 crore (30 per cent growth). Other services including training and

education, aesthetics and weight loss, and retail pharmacy will stand at Rs.

9,000 crore.

Theres also been an influx of medical tourism, educational services, and

leisure tourism in India which is likely to build up in the coming years

drawing an additional $6-50 billion in revenue and producing close to 10-48

million direct and indirect jobs by 2020.

Investments in Healthcare

Global Ratings agency Fitch recently said that "India's healthcare sector will

continue to witness investments in 2012 but at a slow pace, driven by a wide

gap between the demand for, and supply of, healthcare services," Fitch

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Ratings said in its annual report '2012 Outlook: India Health Care'. It further

added: "This (slow growth) is due to below-par healthcare infrastructure,

especially in Tier II and Tier III cities, increasing lifestyle-related health

problems, changing demographics, rising disposable income and insurance

penetration, and increasing government support and medical tourism."

"The sector will continue to offer investment opportunities in increasing bed

capacity, ancillary industries like medical technologies and diagnostics in

Tier II and Tier III cities, while specialty services like cardiology,

neurology, joint replacements etc, are likely to attract most of the

investments in bigger cities," the report said.

Rise of the Insurance Industry

The Insurance segment is worth $3 billion (Rs 15,000 crore) as of now.

Health insurance is growing at 20% and will reach around $13 billion by

2020. So, it is growing at a faster rate than the healthcare industry but, even

with that growth, you are talking about a funding gap of over $200 billion.

The gap in rupees crore is so significant that the Indian government will

have a serious issue in terms of financing healthcare says Mr. Antony

Jacob, CEO, Apollo Munich Health Insurance.

Competing with other Industries

The healthcare segment is moving ahead on the same line as the

pharmaceutical or the software industries here. Like manufacturing, this

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segment also has the power to be the engine of the countrys economy.

Thanks to this, many foreign companies will continue to invest in it in the

years ahead.

The Path Ahead

Already, Indias economy is flourishing and the middle class is getting

stronger with more disposable income to spend on healthcare services. The

Government of India too is in the midst of constantly developing all

inclusive policies on healthcare that aim to reinforce the sector a high

number of infrastructures and advance medical equipment solutions have

been infused in the sector. In the years ahead, the sector holds greater

potential and promise.

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HOSPITAL PROFILE

Hospital information

Adarsha Hospital was inaugurated on 12/10/2005 by His Holiness Shri Shri

Shri Vibhudesha Theertha Swamiji of Sri Admar Matt, Udupi. Hospital is

situated in the heart of the city very near to KSRTC Bus-stand. Hospital

situated in cool noiseless and homely environment with ample parking

facility. Hospital is an advanced secondary health care centre started with

the main intention of providing comprehensive quality health care with

compassion to all the sanctions of society and is very economical in all

respects.

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Hospital is having 100 beds with good spacious well ventilated rooms and

enjoyable south west breez. Multiple out-patient departments with specious

waiting hall and all the diagnostic modalities.

India is facing epidemic Diabetes and it is having maximum number of

diabetic patients in the world. By the year 2025 India is burdened with more

than 60 million diabetics. Thus India is called as the capital city of Diabetis.

Hence the cardiac problems also. To face this emerging cardio diabetic

epidemic we dedicated this hospital for Cardio diabetes to face this

challenge we are planning to train various medical and paramedical peronals

conducting numerous free camps across the region with public awareness

programs in hospital and through Medias.

To give comprehensive quality health care the hospital management has

taken utmost care to appoint various staff and resident Doctors who are in

the hospital around the clock. Super specialists from different places are

visiting the hospital to impart quality health care. Hospital is having an ISO

9001-2008 certification for its standard.

Departments:

Internal Medicine

Comprehensive Diabetic Care

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Orthopaedics

General Surgery

Obstetrics & Gynaecology

Paediatrics and Neonatology

Ophthalmology

ENT

Dental Surgery

Radio Diagnosis

Skin & STD

Physiotherapy

Super specialty departments:

Interventional Cardiology

Neuro Surgery

Neurology

Gastroenterology

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Urology

Medical Oncology

Rheumatology

Nephrology

Endocrinology

Plastic Surgery

Diabetic Foot care

Facilities

In-patient

(Platinum, Delux, Special, Semispecial and General wards with A/C &

without A/C)

Out-patient

3 Well equipped Operation

C arm system with Laporoscopic instruments

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Labour theatre

Medical, Surgical and Neonatal Critical Care Units (25 Beds)

Microscopic Eye and Ear surgeries

Ventilators and Haemodialysis unit

Trauma care centre

300MA & 60MA portable X ray with digirtal CR system

Treadmill test

Thoshiba Spiral CT scan

Cardiac Catheterisation Laboratory (Cath Lab)

Video Endoscopy and Colonoscopy facility

Ultrasound scanning, Echo Cardiography and Doppler studies

Fully computerized laboratory with Nano Lab

Leica 40 operating Neuro Microscope & ENT micro scopes

Feotal Doppler, baby warmer and Phototherapy

Multipara monitors, NIBPS, SPO2 monitors, Cardiac monitors, infusion and

syringe pumps

24 hours Ambulance service with Cardiac care.

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RESEARCH METHODOLOGY

Research methodology is a way to solve the research problems. It may be

understood as a science of studying how research in done scientifically.

Primary and secondary data were made use at along with the data collection.

Data collections are done through interviews, questionnaire, interview

schedule, observation, magazines, booklet and internet.

Source of Data

Data is coming from primary and secondary data collection

methods.

Primary data;

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Primary data those which are freshly collected from the first and

their happen to be original in character. Primary datas are collected by

using interview schedules, questioners, interview, observation and by

conducting interview with the people (customer)

Secondary data;

Secondary data are which have been already been ready like

magazines, booklet, prospectus etc.. The secondary data is collected also

through journals, websites etc

Sample frame

Sample frame refers to the place from where the sampling has

been drawn.

Size of sample

It refers to the number of items to be selected from the

population. Here in the project the size of is 10.

Research Design

The research design used here is descriptive design.

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Sampling

The sampling technique here is convenient sampling.

TOOLS FOR ANALYSIS

The technique used for analysis and interpretation is percentage analysis

pictures, graphical representation like bar diagram, pie diagram, columns,

graphs, cylinder chart, cone diagram and doughnut.

Percentage Analysis

The researcher has used percentage analysis

No of respondents

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Percentage = * 100

Total No of Sample taken

Period of Study

The study is conducted during the academic year 2012- 2013

DATA ANALYSIS AND INTERPRETATION

TABLE NO 1

No of beds in the hospital

Criteria No of

Respondents

Percentage of

RespondentsLess than 50 0 0

50 100 0 0

100 200 100 100

Above 200 0 0

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Total 100 100

INTERPRETATION

From the above table it is clear that the hospital is having 100 to 200 beds.

GRAPH NO 1

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TABLE NO 2

Number of beds occupied per day

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Criteria No ofRespondents

Percentage ofRespondents

0 25 10 10

25 50 10 10

50 75 70 70

75 100 10 10

Total 100 100

INTERPRETATION

From the above table it is clear that the majority have the opinion that there

are 50 to 75 patients in a day.

GRAPH NO 2

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TABLE NO 3

No of staffs in the hospital in a shift

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Criteria No ofRespondents

Percentage ofRespondents

0 25 10 10

25 50 10 10

More than 50 70 70

Total 100 100

INTERPRETATION

From the above table it is inferred that there is 25 to 50 staffs are working in

the hospital in a shift.

GRAPH NO 3

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TABLE NO 4

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Do department generating dangerous wastes have satellite accumulation

areas?

Criteria No on

Respondents

Percentage of

Respondents

Yes 100 100

No 0 0

Total 100 100

INTERPRETATION

From the above table it is clear that there are satellite accumulation areas for

dangerous wastes.

GRAPH NO 4

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TABLE NO 5

Are the collection areas properly and clearly identified and labelled

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Criteria No onRespondents

Percentage ofRespondents

Yes 100 100

No 0 0

Total 100 100

INTERPRETATION

From the above table it is clear that the collection areas are clearly and

properly labelled and identified.

GRAPH NO 5

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TABLE NO 6

Does your hospital have a centralized collection area for dangerous wastes?

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Criteria No of Respondents

Percentage ofRespondents

Yes 0 0

No 100 100

Total 100 100

INTERPRETATION

From the above table it is clear that the hospital does not have any

centralised collection of dangerous wastes.

GRAPH NO 6

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TABLE NO 7

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Is all the waste containers properly labelled with the type of dangerous

waste and accumulation start date?

Criteria No of

Respondents

Percentage of

RespondentsYes 30 30

No 30 30

Sometimes 40 40

Total 100 100

INTERPRETATION

From the above table it is clear that majority of the respondents have the

opinion that the waste containers are not properly labelled.

GRAPH NO 7

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TABLE NO 8

Are all hazardous waste containers maintained in good condition?

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Criteria No of

Respondents

Percentage of

Respondents

Yes 25 25

No 50 50

Sometimes 25 25

Total 100 100

INTERPRETATION

From the above table it is clear that the respondents have the opinion that the

waste containers are not maintained in good condition.

GRAPH NO 8

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TABLE NO 9

Do the staffs who handle waste receive hazardous waste management

training

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Criteria No of

Respondents

Percentage of

Respondents

Yes 20 20

No 80 80

Total 100 100

INTERPRETATION

From the above table it is interpreted that majority of the staff doesnt get

any training for handling hazardous waste.

GRAPH NO 9

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TABLE NO 10

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Does the hospital keep the log of amounts of dangerous waste generated per

month?

Criteria No of

Respondents

Percentage of

respondents

Yes 20 20

No 35 35

Sometimes 45 45

Total 100 100

INTERPRETATION

From the above table it is clear that the hospital is not maintaining the log of

amount of dangerous waste generated per month regularly.

GRAPH NO 10

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TABLE NO 11

Do you have a contingency plan with a copy filed at your local fire

department?

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Criteria No of

Respondents

Percentage of

Respondents

Yes 0 0

No 100 100

Total 100 100

INTERPRETATION

From the above table it is clear that the hospital is not maintaining the

records of contingency plan.

GRAPH NO 11

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TABLE NO 12

Do you have emergency response numbers posted near telephone?

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Criteria No of

Respondents

Percentage of

Respondents

Yes 100 100

No 0 0

Total 100 100

GRAPH NO 12

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TABLE NO 13

Does your management ensure that medical wastes are labelled and

managed, properly segregated from dangerous wastes & solid wastes.

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Criteria No of

Respondents

Percentage of

respondents

Yes 10 10

No 50 50

Sometimes 40 40

Total 100 100

INTERPRETATION

From the above table it is interpreted that the majority have the opinion that

management does not ensure that medical wastes are labelled and managed

properly segregated from dangerous wastes & solid wastes.

GRAPH NO 13

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TABLE NO 14

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Are sharps segregated from other wastes and kept in puncture resistant

biomedical waste containers?

Criteria No of

Respondents

Percentage of

respondents

Yes 18 18

No 40 40

Sometimes 42 42

Total 100 100

From the above table it is clear that majority of the respondents have the

opinion that the sharps are not segregated from other wastes and kept in

puncture resistant biomedical waste containers regularly.

GRAPH NO 14

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TABLE NO 15

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Are all bio medical waste containers labelled bio medical waste

Criteria No of

Respondents

Percentage of

respondents

Yes 0 0

No 100 100

Total 100 100

INTERPRETATION

From the above table it is identified that the bio medical waste containers are

not labelled properly.

GRAPH NO 15

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TABLE NO 16

Does your waste water discharges to

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Criteria No of

Respondents

Percentage of

respondents

Sewer 0 0

Septic tank 100 100

Surface water 0 0

Total 100 100

INTERPRETATION

From the above table it is clear that the waste water is discharged to septic

tank system.

GRAPH NO 16

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TABLE NO 17

Have you sampled your waste water?

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Criteria No of

Respondents

Percentage of

respondents

Yes 68 68

No 0 0

Sometimes 32 32

Total 100 100

INTERPRETATION

From the above table it is clear that the hospital has done sampling for the

waste water.

GRAPH NO 17

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TABLE NO 18

What will be the interval for sampling waste water?

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Criteria No of

Respondents

Percentage of

respondents

Once in a

month

0 0

Quarterly 28 28

Half yearly 46 46

Yearly 26 26

Total 100 100

INTERPRETATION

From the above table it is clear that majority have the opinion that the

interval for sampling is half yearly.

GRAPH NO 18

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TABLE NO 19

Is there periodic maintenance of treatment plant?

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Criteria No of

Respondents

Percentage of

respondents

Yes 100 100

No 0 0

Total 100 100

GRAPH NO 19

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2. There is satellite accumulation centre for dangerous wastes

3. The collection areas are clearly and properly labelled

4. Majority have the opinion that the hospital does not have a centralised

collection area

5. Majority have the opinion that the waste containers are not labelled

properly

6. Majority said that hazardous waste containers are not maintained in

good condition

7. About 80% of the respondents does not received the training

8. The hospital does not have a contingency plan

9. The emergency response information is posted near telephone

10.The management ensures the collection and segregation of waste only

to a limit.

11.Sharps are not separated regularly

12.Biomedical waste containers are not labelled properly

13.The waste water is discharged to septic tank system

14.The sampling of waste water is done half yearly

15.There is periodic maintenance of treatment plant

SUGGESTIONS

1. Try to provide centralised collection area for hazardous waste

2. Try to maintain the labelling of waste containers in good condition

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3. Try to maintain the hazardous waste containers in good condition

4. Provide training for handling of hazardous waste management to all

employees

5. Try to keep a log of amount of waste generated per day

6. Try to maintain a contingency plan

7. Label all biomedical waste containers properly

8. Separate and keep sharps in puncture resistant bags

CONCLUSION

If the overall goal of waste management is to prevent disease transmission

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from waste products, therefore the emphasis should be placed on the

"Management" aspect of the process and not on the "technological fix"

which is expensive diversion rather than an effective solution. Technology

should fit the situation and work in the management system to achieve the

final goal as part of the overall system, not as a replacement for the system.

Technology choices should be made to meet local needs and conditions.

National standards for operating acceptable treatment technologies should

be set which should match the international standards practiced in the

developed countries.

BIBLIOGRAPHY

Books

Shishir Basarkar, Hospital waste management

Mohd. Faizal Khan, Medical waste managemnt

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C. R. Kothari, Research Methodology

Websites

www.google.com

www.who.int/topics/medical_waste/en.

https://fortress.wa.gov/ecy/publications

APPENDIX

1. Number of beds?

65

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Less than 50 50 to 100 100 to 200 Above

200

2. Average number of beds occupied per day?

0 to 25 25 to 50 50 to 75 75 to 100

3. Number of staff

0 to 25 25 to 50 More than 50

4. Do departments generating dangerous wastes have satellite

accumulation areas?

Yes No

5. Are the collection/satellite areas properly and clearly identified and

labelled?

Yes No

6. Does your hospital have a centralized collection area for dangerous

waste?

Yes No

7. Are all waste containers properly labelled with the type of dangerous

waste and accumulation start date?

Yes No Sometimes

8. Are all hazardous waste containers maintained in good condition?

Yes No Sometimes

9. Do staff who handle waste receive hazardous waste management

training?

Yes No

10.Does your department keep a log of the amounts of dangerous waste

generated per month?

Yes No Sometimes

11.Do you have a contingency plan with a copy filed at your local fire

department?

Yes No

12.Do you have emergency response information posted near a

telephone?

Yes No

13.Does your management ensure that medical wastes are labelled and

managed properly, segregated from dangerous wastes and solid

wastes?

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Yes No Sometimes

14.Are sharps segregated from other wastes and kept in puncture-

resistant biomedical waste containers?

Yes No Sometimes

15.Are all biomedical waste containers labelled biomedical waste?

Yes No

16.Does your wastewater discharge to:

Sewer Septic system Surface water

17.Have you sampled your wastewater discharge?

Yes No Sometimes

18.What will be the interval for sampling waste water?

Once in a month Quarterly Half Yearly

Yearly

19. Is there periodic maintenance of treatment plant?

Yes No