Received : 27.7.2002; Accepted : 20.6.2003.
Biomedical Waste Management : An Infrastructural
Survey of Hospitals
Lt Col SKM Rao*, Wg Cdr RK Ranyal+, Lt Col SS Bhatia#, Lt Col VR Sharma** Abtract
Background : The Ministry of Environment & Forests notified the Biomedical Waste (management & handling) Rules, 1998" (BMW Mgt) in July 1998. In accordance with the rules, every hospital generating BMW needs to set up requisite BMW treatment facilities on site or ensure requisite treatment of waste at common treatment facility. No untreated BMW shall be kept stored beyond a period of 48 hours. The cost of construction, operation and maintenance of system for managing BMW represents a significant part of overall budget of a hospital if the BMW rules have to be implemented in their true spirit. Two types of costs are required to be incurred by hospitals for BMW Mgt, internal and external. Internal cost is the cost for segregation, mutilation, disinfection, internal storage and transportation including hidden cost of protective equipment. External costs are off site transportation, treatment and final disposal.
Methods : A study of hospitals was carried out from various sectors like Govt, Private, Charitable institutions etc. to assess the infrastructural requirement for BMW Mgt. Cost was worked out for a hospital where all the infrastructure as per each and every requirement of BMW rules had been implemented and then it was compared with other hospitals where hospitals have made compromises on each stage of BMW Mgt.
Results : Capital cost incurred by benchmarked hospital of 1047 beds was Rs.3 lakh 59 thousand excluding cost of incinerator and hospital is incurring Rs. 656/- per day as recurring expenditure. Pune city has common regional facility for BMW final disposal. Facility is charging Rs.20 per kg of infectious waste. As on Dec 2001 there were 400 institutions including nursing homes, labs and blood banks which were registered.
Conclusion : After analyzing the results of study it was felt that there is an urgent need to standardize the infrastructural requirement so that hospitals following BMW rules strictly do not suffer additional costs. MJAFI 2004; 60 : 379-382
Key Words : Biomedical waste; Cost; Hospital; Infrastructure Introduction
Hospital is one of the complex institutions which is
frequented by people from every walk of life in the
society without any distinction between age, sex, race
and religion. This is over and above the normal inhabitants
of hospital i.e patients and staff. All of them produce
waste which is increasing in its amount and type due to
advances in scientific knowledge and is creating its
impact . The hospital waste, in addition to the risk for
patients and personnel who handle these wastes poses
a threat to public health and environment . Keeping
in view inappropriate biomedical waste management,
the Ministry of Environment and Forests notified the
“Biomedical Waste (management and handling) Rules,
1998” in July 1998. In accordance with these Rules (Rule
4), it is the duty of every “occupier” i.e a person who
has the control over the institution and or its premises,
to take all steps to ensure that waste generated is
handled without any adverse effect to human health and
environment. The hospitals, nursing homes, clinic,
dispensary, animal house, pathological lab etc., are
therefore required to set in place the biological waste
treatment facilities. It is however not incumbent that
every institution has to have its own waste treatment...