Biomedical waste issues come under focus

Meena Janardhan

New guidelines have been issued by the Central Pollution Control Board (CPCB) in India for handling, treatment and safe disposal of biomedical waste generated during treatment, diagnosis and quarantine of patients confirmed or suspected to have the coronavirus disease (COVID-19).

These guidelines have been drawn up after consulting experts, hospital authorities, and waste collection companies. Though India already had Bio-Medical Waste Management Rules, 2016, the CPCB guidelines were released to ensure that the waste generated specifically during testing of people and treatment of COVID-19 patients is disposed of in a scientific manner.

The CPCB has stated that these guidelines need to be followed by all stakeholders including isolation wards, quarantine centers, sample collection centers, laboratories, urban local bodies, and the Common Bio-medical Waste Treatment and Disposal Facilities (CBWTFs), in addition to the existing biomedical waste management rules.

It also specified that these guidelines are based on current knowledge of COVID-19 and existing practices in the management of infectious waste generated in hospitals while treating viral and other contagious diseases and would be updated if needed.

Meanwhile, as far as the state pollution control boards are concerned, the guidelines said they shall maintain separate records of COVID-19 treatment wards, quarantine centers, quarantined homes in respective states.

Biomedical waste, according to the existing biomedical waste rules, is any waste that is generated during the diagnosis, treatment or immunization of human beings, animals or research activities etc. It could include human tissues, items contaminated with blood, body fluids like dressings, plaster casts, cotton swabs, beddings contaminated with blood or body fluid, blood bags, needles, syringes, or any other contaminated sharp object.

The World Health Organization categorizes sharps, human tissue, fluids, and contaminated supplies as “biohazardous,” and non-contaminated equipment and animal tissue as “general medical waste.”

The guidelines stress that for isolation wards where COVID-19 patients are kept, in addition to rules regarding biomedical waste, as a precaution, double-layered bags (two bags) “should be used for the collection of waste to ensure adequate strength and no-leaks.”The guidelines seek a separate record of waste generated from COVID-19 isolation wards.

The CPCB suggested similar steps for the sample collection centres and laboratories for COVID-19 suspected patients. The pollution watchdog said opening or operation of COVID-19 ward, sample collection centres and laboratories should also be intimated to the State Pollution Control Boards (SPCBs).

Pointing out that even though a low quantity of biomedical waste is expected to be generated at the quarantine facilities and during home care for suspected COVID-19 patients, the guidelines insist that they still need to follow strict steps to ensure safe handling and disposal of waste.

It added that while the routine solid waste generated from quarantine centres can be treated and disposed of as per the solid waste management rules 2016, “biomedical waste generated should be collected separately in yellow coloured bags and bins.”

Quarantine camps/centers need to inform the CBWTF operator as and when the waste is generated so that waste can be collected for treatment and disposal at the facility. A CBWTF is a set up where biomedical waste generated from member health care facilities is imparted necessary treatment to reduce adverse effects that this waste may pose on human health and environment

“Urban local bodies should engage the CBWTFs to pick up such waste either directly from such quarantined houses or from identified collection points,” said the guidelines, and that in case of home-care for suspected patients, biomedical waste should be collected separately in yellow bags (yellow coloured, non-chlorinated plastic bags) and handed over to authorized waste collectors engaged by local bodies.

For the CBWTFs that will be disposing of this waste, the CPCB asked them to maintain a separate record for collection, treatment and disposal of COVID-19 waste. It asked them to report to the state pollution control boards about receiving waste from COVID-19 isolation wards, quarantine camps, quarantined homes and testing centres.

The guidelines further said that the CBWTF operators “shall ensure regular sanitization of workers involved in handling and collection of biomedical waste and that they should be provided with adequate personal protective equipment including three-layer masks, splash-proof aprons/gowns, nitrile gloves, gumboots and safety goggles.”

The pollution watchdog recommended that COVID-19 waste should be disposed of immediately upon receipt at facilities and emphasized that they should not allow “any worker showing symptoms of illness to work at the facility.”It has also directed the facilities to use dedicated vehicles to collect COVID-19 ward waste and asked them to sanitize such vehicles after every trip.