Biomedical waste management: Flout the rules and face imprisonment

M3 India Newsdesk Sep 14, 2017

Indian health-care sector is growing at a tremendous rate with a total of 169913 health care facilities having bed strength of 1786108.

It is estimated that a total of 495.30 tonnes of medical waste is generated each day by these healthcare facilities. Although the Bio-medical Waste Management Rules have existed in the country for 19 years staff awareness levels are still low along with poor implementation strategy. 60–70% of facilities show average awareness, while only 10% of facilities show very good awareness levels.

Bio-Medical Waste Management Rule Update

India formulated the Rules on Bio-medical Waste in 1998 and they were called Bio-medical Waste (Management & Handling) Rules 1998. The rules have been revised and amended and are now called the Bio-medical Waste Management Rules, 2016, notified by the Ministry of Environment, Forest and Climate Change.

These rules apply to all persons who generate, collect, receive, store, transport, treat, dispose, or handle bio medical waste in any form including hospitals, nursing homes, clinics, dispensaries, veterinary institutions, animal houses, pathological laboratories, blood banks, Ayush hospitals, clinical establishments, research or educational institutions, health camps, medical or surgical camps, vaccination camps, blood donation camps, first aid rooms of schools, forensic laboratories and research labs.

Summary of Bio-Medical Waste Management Rules, 2016

The rules are divided into various sections depending upon the responsible person. As far as practising doctors or hospitals are concerned, following rules summarise their role in the management of biomedical waste.

Duties of the Occupier (person having administrative control over the place that generates bio-medical waste)

Ensure proper handling of the bio-medical waste without any adverse effect to human health and the environment and in accordance with the rules
Provide safe, ventilated and secured location for storage of segregated biomedical waste in coloured bags or containers with no secondary handling, and transport of biomedical waste to common treatment facility for the appropriate treatment and disposal
Pre-treat the laboratory waste, microbiological waste, blood samples and blood bags through disinfection or sterilisation as prescribed by the World Health Organisation (WHO) or National AIDs Control Organisation (NACO) guidelines before sending it to the common bio-medical waste treatment facility for final disposal
Do not out use of chlorinated plastic bags, gloves and blood bags within two years from the date of publication of these rules (28th March, 2016)
Follow the rules and regulations of respective waste management guidelines to dispose of solid waste other than bio-medical waste
Do not mix treated bio-medical waste with municipal solid waste
Train all health care workers and others at the time of induction and thereafter at least once every year and provide the details of training programmes conducted, number of personnel trained and number of personnel not undergone any training in the Annual Report
Immunise all health care workers against transmittable diseases including Hepatitis B and Tetanus etc. according to the National Immunisation Policy or the guidelines of the Ministry of Health and Family Welfare
Establish a Bar- Code System for bags or containers containing bio-medical waste within one year from the date of the notification of these rules
Segregate liquid chemical waste at source and ensure its pre-treatment or neutralisation prior to mixing with other effluents
Treat and dispose of liquid waste in accordance with the Water (Prevention and Control of Pollution) Act, 1974 ( 6 of 1974)
Ensure occupational safety of all its health care workers by giving them appropriate and adequate personal protective equipment
Regularly conduct health check-up and maintain records about health status of all healthcare workers starting from induction, followed by at least once in a year
Keep a well-maintained and updated bio-medical waste management register on daily basis
Display the monthly record bio-medical waste management record on its website in accordance with the rules
Report any major accidents including accidents caused by fire hazards, blasts during handling of biomedical waste and the remedial action taken and the records relevant to it, (including nil report) in Form I to the prescribed authority and also along with the annual report
All the health care facilities shall make own website within two years from the date of notification of these rules and make available the annual report on its web-site
Inform the authority if the operator of a facility does not collect the bio-medical waste within the intended time or as per the agreed time
Review and monitor the activities related to bio-medical waste management through a committee and this committee should meet once in every six months and the record of the minutes of the meetings of this committee shall be submitted along with the annual report to the prescribed authority
Healthcare establishments having less than thirty beds shall designate a qualified person to review and monitor the activities relating to bio-medical waste management within that establishment and submit the annual report
Maintain all record for operation of incineration, hydro or autoclaving etc., for a period of five years
Existing incinerators should meet the standards for treatment and disposal of bio-medical waste as specified in Schedule II for retention time in secondary chamber and Dioxin and Furans within two years from the date of this notification
Some other rules related to practicing doctors or hospitals from other sections of the rule book
Occupier (doctor or hospital administration) is not allowed to establish on-site treatment and disposal facility, if a service of ` common biomedical waste treatment facility is available at a distance of seventy-five kilometre
But if the service of the common bio-medical waste treatment facility is not available, the Occupiers shall set up requisite biomedical waste treatment equipment like incinerator, autoclave or microwave, shredder prior to commencement of its operation, as per the authorisation given by the prescribed authority
Use of new technologies for the treatment of bio medical waste other than those listed in Schedule I require submission of a request to the Central Government for laying down the standards or operating parameters.
Disposal by deep burial is permitted only in rural or remote areas where there is no access to common bio-medical waste treatment facility. This will be carried out with prior approval from the prescribed authority and as per the Standards specified in Schedule-III. The deep burial facility shall be located as per the provisions and guidelines issued by Central Pollution Control Board from time to time.

Violation of Rules

In case of any violation of the rules, health-care facilities and CBWTFs are liable to take action under section 5 and section 15 of the Environment Protection Act.

The violation, in respect of each such failure or contravention, be punishable with imprisonment for a term which may extend to five years with fine which may extend to one lakh rupees, or with both, and in case the failure or contravention continues, with additional fine which may extend to five thousand rupees for every day during which such failure or contravention continues after the conviction for the first such failure or contravention.

If the failure or contravention continues beyond a period of one year after the date of conviction, the offender shall be punishable with imprisonment for a term which may extend to seven years.

Source:

Gazette Notification. Government Of India Ministry Of Environment, Forest And Climate Change. March 2016.
WHO ; Report on health-care waste management status in countries of the South-East Asia Region.2017.

Only Doctors with an M3 India account can read this article. Sign up for free or login with your existing account.

4 reasons why Doctors love M3 India

Exclusive Write-ups & Webinars by KOLs
Daily Quiz by specialty
Paid Market Research Surveys
Case discussions, News & Journals' summaries

Sign-up / Log In