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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.
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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 bio- medical 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
World Scientific News 31 (2016) 82-110
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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
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 -
World Scientific News 31 (2016) 82-110
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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
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
per day Black Yellow White Blue Red Green
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 -
World Scientific News 31 (2016) 82-110
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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
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 - -
World Scientific News 31 (2016) 82-110
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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
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
- -
World Scientific News 31 (2016) 82-110
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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
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
World Scientific News 31 (2016) 82-110
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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
World Scientific News 31 (2016) 82-110
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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
World Scientific News 31 (2016) 82-110
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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
World Scientific News 31 (2016) 82-110
-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
World Scientific News 31 (2016) 82-110
-105-
CHAMP VEHICLE MENT FOR CARRING BIO MEDICAL WASTE IN GULBARGA AT
GOVERNMENT GENERAL HOSPITAL
BIO WASTE IN THE CHAMP VEHICLE –DIFFERENT TYPES OF WASTES ARE KEPT IN DIFFERENT COMPARTMENT S.
World Scientific News 31 (2016) 82-110
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PICTURES SHOWING THE BURNING OF WASTES BEHIND THE HOSPITAL CAMPUS-
GOVERNMENT GENERAL HOSPITAL
COLLECTYED BIO WASTS IN BASAWESWAR HOSPITAL REDAY FOR
DISPOSAL
World Scientific News 31 (2016) 82-110
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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
World Scientific News 31 (2016) 82-110
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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
World Scientific News 31 (2016) 82-110
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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).
World Scientific News 31 (2016) 82-110
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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.
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[10] C.H. Colins, D.A. Kennedy, J Appl Bacteriol (1987) 385-402.
( Received 16 November 2015; accepted 01 December 2015 )