Bio Medical Waste Management & Hygiene in Healthcare Environment

Suggested citation for future researches
Sreejith A., (2008), Hygiene and Biomedical Waste Management Plan for Healthcare Environmental Setting: A Study
with Special Focus on Kerala, India. Hygiene Standard Institute (HSI), Trivandrum, India.
HYGIENE AND BIOMEDICAL WASTE

MANAGEMENT PLAN FOR HEALTHCARE
ENVIRONMENTAL SETTING: A STUDY WITH
SPECIAL FOCUS ON KERALA, INDIA
Research report prepared for
Hygiene Standard Institute

by
SREEJITH A.
HSI-ASIA
Email: info@ internationalhygiene.org
www.internationalhygiene.org
Trivandrum
2008
© Sreejith A., Environmental Policy Researcher, Trivandrum, Kerala, India.

Tel: +91-9447583751, Email:sreejiagriman@gmail.com
CONTENTS
LIST OF TABLES
LIST OF FIGURES
LIST OF APPENDICES
Chapter Title Page No.
1 INTRODUCTION
2 REVIEW OF RELATED LITERATURE
3 METHODOLOGY
4 RESULTS AND ANALYSIS
5 CONCLUSIONS AND SUGGESTIONS
BIBLIOGRAPHY
APPENDICES
ACKNOWLEDGEMENTS

LIST OF TABLES
Table No. Page
Title
No.
2.1 Colour coding and type of container for disposal
of biomedical wastes
2.2 Colour coding system – segregation
2.3 Categories of biomedical waste

LIST OF FIGURES
Figure Page
Title
No. No.
4.1 Male to Female Ratio of respondents
4.2 Distribution of different age group of respondents
4.3 Years of working of the respondents
4.4 Percentages of occurrences of accidents related to
clinical wastes
4.5 Distribution of scope of work of respondents
4.6 Awareness towards the definition of biomedical
waste
4.7 Awareness towards the handling of accidents related
to biomedical waste
4.8 Response to the adherence of management to
standard procedures
4.9 Awareness of the risk exposed to the respondents
themselves
4.10 Awareness of the risk exposed to others
4.11 Familiarity of the respondents towards the
management plan
4.12 Ability of the respondents to identify types of
biomedical wastes
4.13 Ability of respondents to segregate, contain and label
the biomedical waste
4.14 Awareness of the respondents towards the storage
facility
4.15 Awareness of the respondents to record keeping
4.16 Awareness of the effects of clinical wastes to the
environment

LIST OF APPENDICES
Appendix No. Title
I Survey form
II Questionnaire form
III Photographs

Sreejith A., (2008), Hygiene and Biomedical Waste Management Plan for Healthcare Environmental Setting: A Study with
Special Focus on Kerala, India. Hygiene Standard Institute (HSI), Trivandrum, India.
ABSTRACT
Issues of improving the management of biomedical wastes are receiving
increasing attention throughout the world since healthcare institutions
generate tons of biomedical waste each year. The waste generated has
been increasing due to the use of disposable materials and development in
medicine production. Hazardous and Toxic Materials (HTM) Office Board
of Public Works, Los Angles (1995) estimated that around 15 percent of
hospital waste is contaminated with infectious agents potentially
hazardous to human health such as hepatitis and human
immunodeficiency virus (HIV) and to the environment. As these changes
have been gradual and waste disposal was not previously perceived as a
major concern, the response of the hospital field has been largely
piecemeal and uncoordinated. Not only solid waste is considered as a
major problem in many developing countries but other wastes such as
wastewater and air pollution are also becoming serious problems. Due to
the lack of investment and infrastructure, in some cases, wastewater
discharged from hospitals often runs directly into nearby water bodies.
Improperly discharged wastes to sewers will generate wastewater
potentially dangerous to handlers. Moreover, most hospital incinerators
were never designed for the disposal of large quantities of waste and
consequently have become overloaded, causing air pollution in

surrounding areas. Poor waste management practices pose a huge risk to
the health of the public, patients, professionals and contribute to
environmental degradation
In the present study an attempt is made to determine awareness about
Biomedical waste management policy, practices and to assess attitude
towards it and to develop a Hygiene & Biomedical Waste Management
Plan for Healthcare Environmental Setting with special focus to Kerala
State in the Indian union.
Review of the literature and studies which are related to the topic under
study was done on studies related to the problems specific to the impaired
healthcare waste management as well as studies related to hygiene and
biomedical waste management in healthcare environmental setting.
The method adopted for the present study was survey method. The data
collection was done through survey form, questionnaire, informal
interviews and site visits by the investigator. The collected data were
statistically analysed.
From the analysis of the collected data, it was found that the management
components are well in place. However there are some fields that need
attention such as record keeping. The awareness towards the effects of
biomedical wastes on environment if improperly handled is strong.
During the site visits, photo documentation was done on various aspects

of biomedical waste management methods followed by healthcare
institutions. These photographs revealed that unscientific biomedical
waste management techniques are followed at various levels of
segregation, treatment, transport and disposal. The present study
developed a hygiene and biomedical management plan for effective
infection control as well as for proper record maintenance of hospitals in
Kerala.
The study concludes that the biomedical waste management practices
followed in majority of healthcare institutions in Kerala is unscientific.
However, there are a smaller minority of healthcare institutions which
practice the most sound biomedical waste management methods. Training
and awareness programmes are lacking in many of the cases which needs
to be looked into. A further study on this topic is suggested on the
incineration and the air pollution control measures to avoid the
contamination from the incinerator from being exposed to the
environment. A study on the awareness of the public towards the
biomedical waste management also can be carried out. The awareness
level may vary from person to person depending on the education
background. Further study can be carried out to compare the management
system of a government hospital and private hospital.

Chapter 1
INTRODUCTION
1.1 INTRODUCTION
Over the years there have been tremendous advancements in the
health care system. However it is ironic that the health care settings,
which restore and maintain community health, are also threatening
their well-being. Poor waste management practices pose a huge risk to
the health of the public, patients, professionals and contribute to
environmental degradation (Joseph and Krishnan 2004). It is reported
that for the first time the Biomedical waste management issue was
discussed at a meeting convened by the World Health Organisation
regional office for Europe at Bergen, Norway in 1983. The seriousness
of the issue was brought to limelight during the “beach wash- ups” of
summer 1988. Investigation carried out by the Environment Protection
Agency (EPA) of USA in this regard culminated in the passing of
Medical Waste Tracking Act (MWTA), November 1988. With the
passage of time the problem has evolved as a global humanitarian
issue. In our country, this issue has attracted the attention of the
Honourable Supreme Court of India and guidelines has been issued
.The Biomedical waste (Management and handling) Rules 1998 lay

down clear methods for disposal of biomedical waste, defined as “any
waste generated during the diagnosis, treatment or immunisation of
human beings or animals or in research activities used in the
production or testing of biologicals.” Pollution control boards of every
state have been given the task of authorising and implementing the
rules.
Issues of improving the management of hospital wastes are receiving
increasing attention throughout the world since hospitals generate tons
of medical waste each year. The waste generated has been increasing
due to the use of disposable materials and development in medicine
production. Hazardous and Toxic Materials (HTM) Office Board of
Public Works, Los Angles (1995) estimated that around 15 percent of
hospital waste is contaminated with infectious agents potentially
hazardous to human health such as hepatitis and human
immunodeficiency virus (HIV) and to the environment. As these
changes have been gradual and waste disposal was not previously
perceived as a major concern, the response of the hospital field has
been largely piecemeal and uncoordinated (Wangsaatmaja S., 1997).
Not only solid waste is considered as a major problem in many
developing countries but other wastes such as wastewater and air
pollution are also becoming serious problems. Due to the lack of
10

investment and infrastructure, in some cases, wastewater discharged
from hospitals often runs directly into nearby water bodies (Nelson et
al., 1993). Improperly discharged wastes to sewers will generate
wastewater potentially dangerous to handlers. Moreover, most
hospital incinerators were never designed for the disposal of large
quantities of waste and consequently have become overloaded, causing
air pollution in surrounding areas.
In the present study an attempt is made to determine awareness about
Biomedical waste management policy, practices and to assess attitude
towards it and to develop a Hygiene & Biomedical Waste Management
Plan for Healthcare Environmental Setting with special focus to Kerala
State in the Indian union.
1.2 NEED AND SIGNIFICANCE
Treatment and disposal of biomedical wastes generated from hospitals
should be done as per the Biomedical Waste (Management and
Handling) Rules, 1998. It is the responsibility of waste generator to
treat and dispose of the biomedical waste. Whereas local governments
have to assist the hospitals, if they come forward for establishment of a
Common Treatment Facility, by identifying suitable land, it is the
responsibility of the local bodies to treat and dispose the non
11

biomedical waste (general waste) and treated biomedical waste
generated in the healthcare institutions. The Kerala State Pollution
Control Board (PCB) is the prescribed authority to implement
Biomedical Waste (Management and Handling) Rules in the state.
As per 1991 Census, Kerala has the highest number of hospitals (26%)
in India. The Report on Private Medical Institutions in Kerala
published by the Department of Economics and Statistics (1995) shows
that there are about 12618 private medical institutions for all systems of
medicines combined and it is roughly estimated that the solid and
liquid waste generation per hospital bed is 1.3 to 2.0 kg and 450 litres
respectively. About 85% waste generated in hospitals is general waste
and can be handled as other solid wastes. The remaining 15%
constitutes infectious and toxic wastes. More often than not, the
general wastes in hospitals and biomedical wastes are allowed to mix
thereby rendering the general waste also toxic and hazardous.
(Economic Review, Kerala, 2004).
1.2.1 Current Issues in Management of Health Care Waste
There are two main issues at present:
• The 1998 legislation by the Govt. of India and
• Implementation of the same at individual healthcare
establishment level as well as whole town / city level.
12

The legislation has fulfilled a long standing necessity. Now this sector
has got clear cut guidelines which should be able to initiate a uniform
standard of practice through out the country. It would be necessary to
implement proper biomedical waste management system for each and
every hospital, nursing home, pathological laboratory etc.
Comprehensive management system for each and every health care
establishment has to be planned for optimal techno-economic viability.
At the same time the final disposal for the whole town must not be lost
sight of. Since there are a large number of small and medium health
care establishments, common treatment and disposal facilities are
essential.
1.2.2 Legal Aspects and Environmental Concern
Indiscriminate disposal of infected and hazardous waste from
hospitals, nursing homes and pathological laboratories has led to
significant degradation of the environment, leading to spread of
diseases and putting the people to great risk from certain highly
contagious and transmission prone disease vectors. This has given rise
to considerable environmental concern.
The first standard on the subject to be brought out in India was by the
Bureau of Indian Standards (BIS), IS 12625 : 1989, entitled ‘Solid
Wastes-Hospitals-Guidelines for Management’ but it was unable to
13

bring any improvement in the situation. In this scenario, the present
study assumes great significance.
1.2.3 Biomedical Waste (Management and Handling) Rules, 1998
The Central Govt. has notified these rules on 20th July, 1998 in exercise
of section 6, 8 and 25 of the Environment (Protection) Act, 1986. Prior
to that, the draft rules were gazetted on 16th October, 1997 and Public
suggestion/comments were invited within 60 days. These suggestions
were considered before finalising the rules.
1.2.4 Scope and application of the Rules
These rules apply to all those who generate, collect, receive, store,
transport, treat, dispose or handle biomedical waste in any form.
According to these rules, it shall be the duty of every occupier of an
institution generating biomedical waste, which includes hospitals,
nursing homes, clinics, dispensaries, veterinary institution, animal
houses, pathology laboratories, blood banks etc., to take all steps to
ensure that such wastes are handled without any adverse effect to
human health and the environment. They have to either set up their
own facility within the time frame or ensure requisite treatment at a
common waste treatment facility or any other waste treatment facility.
Every occupier of an institution, which is generating, collecting,
receiving, storing, transporting, treating, disposing and/or handling
14

biomedical waste in any other manner, except such occupier of clinics,
dispensaries, pathological laboratories, blood banks etc., which provide
treatment/service to less than 1000 (one thousand) patients per month
shall make an application in prescribed form to the prescribed
authority for grant of authorisation to carry on the work. Whenever an
accident occurs concerning biomedical waste, it has to be reported to
this authority. Each State and Union Territory (UT) Government shall
be required to establish a prescribed authority for this purpose. The
respective governments would also constitute advisory committees to
advise the Governments with respect to implementation of these rules.
The occupier or operator can also appeal against any order of the
authority if they feel aggrieved to such other authority as the Govt. of
the State/UT may think fit to constitute.
1.2.5 Environmental Concern
The following are the main environmental concerns with respect to
improper disposal of biomedical waste management:
• Spread of infection and disease through vectors (fly,
mosquito, insects etc.) which affect the in -house as well as
surrounding population.
15

• Spread of infection through contact/injury among
medical/non-medical personnel and sweepers/rag pickers,
especially from the sharps (needles, blades etc.).
• Spread of infection through unauthorised recycling of
disposable items such as hypodermic needles, tubes, blades,
bottles etc.
• Reaction due to use of discarded medicines.
• Toxic emissions from defective/inefficient incinerators.
• Indiscriminate disposal of incinerator ash / residues.
1.2.6 Healthcare Associated Infection
According to Wenzel R.P. (1997), management of health-care waste is
an integral part of hospital hygiene and infection control. Health-care
waste should be considered as a reservoir of pathogenic
microorganisms, which can cause contamination and give rise to
infection. If waste is inadequately managed, these microorganisms can
be transmitted by direct contact, in the air, or by a variety of vectors.
Infectious waste contributes in this way to the risk of nosocomial
infections, putting the health of hospital personnel and patients, at risk.
Healthcare associated infections (HCAIs) are preventable. As per the
findings of Hygiene Standard Institute (2007) improved compliance to
hygiene has been shown to reduce the number of infection outbreaks in
16

health care facilities, transmission of antimicrobial resistant organisms
(e.g. Methicillin-resistant Staphylococcus aureus (MRSA)) and overall
infection rates. Despite evidence of the benefit of hygiene, health care
workers’ compliance with good hand hygiene remains universally low-
40 percent to 50 percent (Hygiene Standard Institute, 2007). Reasons for
low compliance rates are complex and can be attributed to the
existence of numerous individual, work group and institutional
barriers, which makes it difficult to enhance and sustain compliance.
As a result of these barriers, few projects have demonstrated sustained
improvement in compliance with hand hygiene guidelines and a
reduction in HCAIs rates.
1.3 STATEMENT OF THE PROBLEM
The study is entitled ‘HYGIENE AND BIOMEDICAL WASTE
MANAGEMENT PLAN FOR HEALTHCARE ENVIRONMENTAL
SETTING: A STUDY WITH SPECIAL FOCUS ON KERALA, INDIA’.
1.4 DEFINITION OF KEY TERMS
‘Hygiene’ can generally refer to a whole range of measures, which
protect health and well-being and improve the quality of life. Hygiene
refers to practices associated with ensuring good health and
cleanliness. In broader, scientific terms hygiene is the maintenance of
health and healthy living. Hygiene ranges from personal hygiene,
17

through domestic up to occupational hygiene and public health
(Hygiene Standard Institute, 2007).
‘Biomedical waste’ means any solid and/or liquid waste including its
container and any intermediate product, which is generated during the
diagnosis, treatment or immunisation of human beings or animals or in
research pertaining thereto or in the production or testing thereof.
(Biomedical Waste (Management and Handling) Rules, 1998).
1.5 HYPOTHESES
1. Only a very few healthcare personnel have proper awareness
regarding Biomedical waste management policy and practices.
2. Healthcare personnel will show positive attitude towards
biomedical waste management policy and practices.
3. The development and implementation of a Hygiene &
Biomedical Waste Management Plan for Healthcare
Environmental Setting will reduce the rate of spread of
healthcare associated infections.
1.6 OBJECTIVES
1. To determine the awareness of healthcare personnel regarding
Biomedical waste management policy and practices.
2. To assess attitude towards biomedical waste management
policy and practices.
18

3. To develop a Hygiene & Biomedical Waste Management Plan
for Healthcare Environmental Setting with special focus to
Kerala State in the Indian union.
1.7 METHODOLOGY IN BRIEF
An anonymous survey form and questionnaire (Appendix I and II)
were developed after literature search and review. The survey form
and questionnaire were designed to suite six categories of personnel
associated with health care settings, i.e Doctors, House surgeons,
Students (Final year), Nurses, Paramedical and Auxiliary Staff. Pilot
survey was carried out by distributing the survey form and
questionnaire to fifty personnel from all the six categories. Validity and
reliability were ascertained.
The period of study was from August 2007 to February 2008. The pre-
tested anonymous survey form and questionnaire were distributed to
personnel from all the above six categories in Kerala. Informal
consultations with healthcare personnel were also done. Health care
settings covered included Medical college hospitals, Dental college
hospitals, General hospitals, Private hospitals, Community health
centres, Primary health centres, Laboratories, Dental clinics and
Veterinary hospital. The respondents were asked to indicate their
views on biomedical waste management policy, practices and their
19

attitude related to the issue. Opportunity was also given to give details
regarding certain questions asked.
To document biomedical waste management practices, photographs
were taken. All data management and analysis were carried out using
Microsoft Excel.
1.7.1 Method adopted
The normative survey method was adopted for the study, as it was
found to be the most appropriate method for collecting data.
1.7.2 Sample selected for the study
For the present study, a representative sample from 20 healthcare
institutions of Kerala state was selected. The sample size was 488
which included 198 males and 290 females. The mean age of the
sample was 35. Health care settings covered included one medical
college hospital, one dental college hospital, two private hospitals, two
community health centers, three primary health centers, five
laboratories, five dental clinics and a veterinary hospital.
1.7.3 Tools used for the study
The data for the present study were collected using the Survey form
and Questionnaire on hygiene and biomedical waste management
prepared by the investigator.
1.7.4 Statistical technique used for the study
20

The statistical technique used for the analysis of the collected data was
Estimation of simple percentage.
1.8 SCOPE OF THE STUDY
The present study attempts to determine awareness of healthcare
personnel towards Biomedical waste management policy and practices
and to assess their attitude towards it. The study also tries to develop a
Hygiene & Biomedical Waste Management Plan for Healthcare
Environmental Setting with special focus to Kerala. A representative
sample of 488 healthcare personnel from 20 healthcare institutions of
Kerala state was selected for the study. The study will be useful in
assessing the awareness level and attitude of healthcare personnel
towards biomedical waste management policy and practices and in
providing training programmes for improving the same. The study
will also help in developing a Hygiene and biomedical waste
management plan which in turn will help in reducing the spread of
healthcare associated infections.
1.9 LIMITATIONS OF THE STUDY
Despite the efforts made by the investigator to make the study as
precise and objective as possible, certain limitations have crept into the
study and the investigator was able to identify them.
21

1. The study was conducted on a sample selected from healthcare
institutions of three districts of Kerala viz.,
Thiruvananthapuram, Idukki and Kozhikode. Extending the
study to other districts in Kerala was not possible due to the
limited time at the disposal of the investigator. More generalised
results would have been obtained from the study if a large
sample from more districts was used.
2. The study concentrated on issues related to biomedical waste
management only. The study can be further expanded by
focusing on issues related to Hygiene, Environment, Sanitation,
Safety and Health.
1.10 FORMAT OF THE REPORT
The study is reported in five chapters, the following being the details.
Chapter 1: INTRODUCTION
This chapter contains all the relevant sectors and details
pertinent to the area under investigation.
Chapter 2: REVIEW OF RELATED LITERATURE
Presents the review of related literature and studies
pertaining to the study undertaken.
22

Chapter 3: METHODOLOGY
Gives a detailed description of the method adopted for the
study, tools used for the study, the sample taken,
administration of the tools and an account of the statistical
techniques used for analysing the data obtained from the
study.
Chapter 4: RESULTS AND ANALYSIS
Concerned with the analysis of the data followed by the
results of the study.
Chapter 5: CONCLUSIONS AND SUGGESTIONS
Summarises the study in retrospect. The important findings
and a few recommendations for further research are
presented.
The report is followed by Bibliography and Appendices pertaining to
the study.
23

BIBLIOGRAPHY
1. Anthony, L. (2006). Potential risks and hazards of not implementing
a proper clinical waste management system. Waste Management
Conference and Exhibition, 2006.
2. Barr, D. (1960). Encyclopaedia of Educational Research. New York:

Mac Millan Company.
3. Bdour, B. Altrabsheh, Hadadin, N. and Al-Shareif, M. (2006).
Assessment of medical waste management processes: A case study of
the northern part of Jordan. Waste Management.
4. Best, J. W. (1950). Research in Education. New Jersey: Prentice
Hall Inc.
5. Best, J. W. and Kahn, J. V. (1996). Research in Education (7th

edition). New Delhi: Prentice Hall of India Pvt. Ltd.
6. Blenkharn, J. I. (2005). Medical waste management in the south
of Brazil. Waste Management.
7. Collins, C. H. (1991). Treatment and disposal of clinical and
laboratory waste. Medical Laboratory Sciences.
8. Economic Review, Kerala 2005.
24

9. Hazardous and Toxic Materials (HTM) Office Board of Public
Works, Los Angeles, 1995, Fact Sheet: Medical Waste
Management, Enviro Search, Los Angeles, USA.
10. Hillway, T. (1969). Research Design- Handbook of Educational
Research. Boston: Houghton-Mifflin Company.
11. Hygiene Standard Institute (HSI) (2007).
http://www.internationalhygiene.org/
12. Ibrahim, Z. B. (2005). Management and Disposal of Clinical Waste
(Case Study: Hospital Kebangasaan Malaysia). Universiti Teknologi
Malaysia.
13. Joseph, J. and Krishnan, A., (2004). Hospital waste management in
the union territory of Pondicherry- An exploration.
www.pon.nic.in/citizen/science/ppcc-new/joe.pdf
14. Lavelle, P. (1998). How Hazardous Is Hospital Waste? World
Wastes.
15. Martin, C. (2006). Best Management Practices for Hospital Wastes.
Hospital and Clinical Wastes Reduction and Management
Conference.
25

16. Ministry of Environment & Forests, GOI. (1998). Biomedical waste
laws and regulations.
http://envfor.nic.in/legis/hsm/biomed.html
17. Mouly, G. J. (1963). The Science of Educational Research. New
Delhi: Eurasia Publishing House.
18. Nelson, D., Chistie, K., Snelling, J., and Scott, P., (1993). Trends in
Medical Waste Management in Asia, Enviro Search International
Inc., Utah, USA.
19. Office of Solid Waste RCRA Hazardous Waste (2004). e-Manifest
Roadmap conference proceedings. US Environmental Protection
Agency.
20. Reinhardt, P. A. and Gordon, J. G. (1991). Infectious and Medical
Waste Management. Lewis Publishers.
21. Tsakona, M., Anagnostopoulou, E. and Gidarakos, E. (2006).
Hospital waste management and toxicity evaluation: A case study.
Waste Management.
22. Turkman, B. W. (1978). Conducting Educational Research (2nd
edition). New York: Harcourt Brace Jovanovich Inc.
23. Turnberg, W. L. (1996). Biohazardous Waste: Risk Assessment,
Policy, and Management. John Wiley & Sons Inc.
26

24. U.S. Environmental Protection Agency (1991). Medical Waste
Management and Disposal. Noyes Data Corporation.
25. Walker, R. (1989). Doing Research- A Handbook for Teachers. Great
Britain: Cambridge University Press.
26. Wangsaatmaja, S. (1997). Environmental action plan for a hospital.
Thesis submitted for the degree of Master of Engineering at
Asian Institute of Technology School of Environment, Resources
and Development Bangkok, Thailand.
27. Wenzel, R. P. (1997). Prevention and control of nosocomial
infections, 3rd ed. Baltimore, MD, Williams & Wilkins.
27


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Suggested citation for future researches

HYGIENE AND BIOMEDICAL WASTE

Research report prepared for

Hygiene Standard Institute

Email: info@ internationalhygiene.org

© Sreejith A., Environmental Policy Researcher, Trivandrum, Kerala, India.

Chapter Title Page No.

2 REVIEW OF RELATED LITERATURE

4 RESULTS AND ANALYSIS

5 CONCLUSIONS AND SUGGESTIONS

© Sreejith A., Environmental Policy Researcher, Trivandrum, Kerala, India.

2.1 Colour coding and type of container for disposal

2.2 Colour coding system – segregation

2.3 Categories of biomedical waste

© Sreejith A., Environmental Policy Researcher, Trivandrum, Kerala, India.

© Sreejith A., Environmental Policy Researcher, Trivandrum, Kerala, India.

Appendix No. Title

© Sreejith A., Environmental Policy Researcher, Trivandrum, Kerala, India.

Issues of improving the management of biomedical wastes are receiving

increasing attention throughout the world since healthcare institutions

been increasing due to the use of disposable materials and development in

medicine production. Hazardous and Toxic Materials (HTM) Office Board

of Public Works, Los Angles (1995) estimated that around 15 percent of

hospital waste is contaminated with infectious agents potentially

hazardous to human health such as hepatitis and human

immunodeficiency virus (HIV) and to the environment. As these changes

piecemeal and uncoordinated. Not only solid waste is considered as a

major problem in many developing countries but other wastes such as

the lack of investment and infrastructure, in some cases, wastewater

Improperly discharged wastes to sewers will generate wastewater

potentially dangerous to handlers. Moreover, most hospital incinerators

consequently have become overloaded, causing air pollution in

© Sreejith A., Environmental Policy Researcher, Trivandrum, Kerala, India.

surrounding areas. Poor waste management practices pose a huge risk to

the health of the public, patients, professionals and contribute to

In the present study an attempt is made to determine awareness about

Biomedical waste management policy, practices and to assess attitude

towards it and to develop a Hygiene & Biomedical Waste Management

Plan for Healthcare Environmental Setting with special focus to Kerala

State in the Indian union.

healthcare waste management as well as studies related to hygiene and

biomedical waste management in healthcare environmental setting.

collection was done through survey form, questionnaire, informal

attention such as record keeping. The awareness towards the effects of

biomedical wastes on environment if improperly handled is strong.

© Sreejith A., Environmental Policy Researcher, Trivandrum, Kerala, India.

of biomedical waste management methods followed by healthcare

institutions. These photographs revealed that unscientific biomedical

waste management techniques are followed at various levels of

segregation, treatment, transport and disposal. The present study

developed a hygiene and biomedical management plan for effective

infection control as well as for proper record maintenance of hospitals in

The study concludes that the biomedical waste management practices

followed in majority of healthcare institutions in Kerala is unscientific.

However, there are a smaller minority of healthcare institutions which

practice the most sound biomedical waste management methods. Training

to be looked into. A further study on this topic is suggested on the

incineration and the air pollution control measures to avoid the

contamination from the incinerator from being exposed to the

environment. A study on the awareness of the public towards the

biomedical waste management also can be carried out. The awareness

level may vary from person to person depending on the education

background. Further study can be carried out to compare the management

system of a government hospital and private hospital.

Bio Medical Waste Management & Hygiene in Healthcare Environment

Bio Medical Waste Management & Hygiene in Healthcare Environment