14.1 BIO-MEDICAL WASTE MANAGEMENT

14.1.1 Implementation of Bio-medical Rules in Kolkata

The Eastern Zone Office of the Central Pollution Control Board carried out bio-medical waste management study in 9 hospitals in Kolkata having bed capacity more than 500. During the study it was observed that there was barely any biomedical waste segregation as per the Biomedical Waste Rules. No pre-treatment is given to the wastes. Salient observations of the study are as follows:

• The needle cutting kits for the syringes are hardly used.
• None of the hospitals have incinerator and biomedical wastes are disposed at Dhapa by Calcutta Municipal Corporation.
• No pre-treatment is given to biomedical waste.
• There is no provision to quantify the waste.
• There is no regular lifting of biomedical waste from the hospitals.

Hospital Waste

• The Calcutta Municipal Corporation uses vats for carrying the waste from the hospitals. These vats overflow with wastes.
• The waste collection areas do not have sealed enclosures, as a result ragpickers and animals and birds spread the waste.
• Biomedical wastes are hoarded within the wards in some of the hospitals.
• Almost all of the hospitals are providing human placenta to a pharmaceutical unit.
• The colour scheme adopted by hospitals (black and pink) have little value, as their use is dependent on their availability in the hospital store.
• The thickness of polythene bags is not proper, as they rupture easily.
• The liquid wastes from operation theatres goes to municipal sewer without any pretreatment.

14.1.2 Biomedical Waste Management in Allahabad, Uttar Pradesh

Allahabad is an important religious and historical city in Uttar Pradesh. As per the inventorisation carried out the city has about 36 Government/Government aided hospitals, 180 private nursing homes, about 300 pathological laboratories, 3 veterinary hospitals, 16 community health centres and 4 blood banks. Total bed capacity in private hospitals is 2,600 and in Government hospitals is 2,850.

Only 4 hospitals - Swaroop Rani, Jeewan Jyoti, Nazarath and Kamla Nehru Memorial Hospital - are equipped with incinerators. Among these only Kamla Nehru Memorial Hospital has functional incinerator. The general practice is to mix infectious wastes with garbage and finally disposed of to outskirts of the city at Phaphamau and Kareli. Many hospitals were found storing the infectious wastes along with other wastes for more than 3 days. A large number of pathological laboratories discharge infectious effluents directly into sewer. Veterinary hospitals dispose animal tissues, body parts and bleeding parts openly on roadside.

At present 25 nursing homes dispose of their un-segregated waste on open land near Jhusi. Under this scheme, unsegreagated waste is being lifted from nursing home and transported to open land for disposal. The cow dung and soil is spread over it. The waste is allowed to disintegrate over a period of time. No leachate collection system is provided.

The average waste generation/bed is 250 gram/day, therefore having a bed capacity of 5450, the city of Allahabad generates 1.3 MT/day of biomedical waste, which deserves segregation followed by prescribed treatment and safe disposal.

Recently, Allahabad Nagar Nigam has allotted a land to Allahabad Nursing Home Association for installation of Common Treatment Facilities for small nursing homes. Allahabad Nursing Home Association is in process to contract the management and handling of biomedical waste to private party.

14.1.3 Biomedical Waste Management in Gujarat and Maharastra

There are 8 hospitals in Gujarat having more than 500 beds. Information for these hospitals related to biomedical waste management was collected through a questionnaire.

In Maharastra, out of the 25 hospitals having bed capacity of more than 500, only 9 hospitals responded to the questionnaire. In addition to these hospitals, 7 hospitals were also visited to verify the implementation of Biomedical waste Rules.

The wastewater generated from Mayo Hospital, Nagpur; Acharya Vinoba Bhave Hospital, Wardha; and SSG Hospital, Vadodara were collected and analysed.

14.1.4 Workshop on Bio-Medical Waste Management

A workshop on bio-medical waste management was organized by CPCB Zonal Office Kanpur jointly with UPPCB at Lucknow during month of December 2000. The objectives of the workshop were (i) to increase awareness about rules, regulation and procedures (ii) to discuss various treatment options for waste generated which can help in guiding in technology selection for waste treatment (iii) to discuss the status of Bio-medical Waste at few selected cities in UP and to formulate an action plan for major cities in UP (iv) to present related cases studies to motivate the hospitals. Altogether 80 delegates from Nagar Nigam, Nursing Home Association, Medical establishments and NGOs concerned to respective cities/towns including Regional Officers of UP Pollution Control Board, participated in the workshop. The faculties were invited from reputed medical institutions, NGOs and representatives from reputed equipment manufacturers of the hospital waste treatment.

The following major recommendations were made in the workshop:

• To organize follow up meetings at regional levels by all regional offices UPPCB in association with CPCB and to prepare a definite action preferably in different phases. Active attention is required to be paid at all KAVAL towns (Kanpur, Allahbad, Varanasi, Agra and Lucknow) in UP.
• To organize training at regional levels for doctors/nurses/safaiwala engaged in collection/segregation and management of bio-medical waste.
• CPCB and concerned regional offices of UPPCB will pursue with Nagar Nigam/ Nagar Palika.
• Mayor Lucknow Nagar Nigam has agreed to convene a meeting of 11 Mayors and MNAs of all-important towns.
• The segregation as prescribed in the management is too complicated. It should have been started with simpler system.

Achievements of the workshop

Kanpur

• Organized meeting with the Hon'ble Mayor, Mukhya Nagar Adhikari of Kanpur Nagar Nigam; representatives of major hospitals, medical association, ICDP, Indian Medical association and UPPCB, wherein the following decisions were taken;
• Formation of local committee
• Development of common facility in Kanpur
• Free allotment of land for common treatment by Nagar Nigam
• Review meeting by Nagar Nigam in near future

Allahabad

• Constantly pursuing with Allahabad Nagar Nigam and Regional Office of UPPCB for organization of Regional level meeting. Also participated in meeting organized at Regional Office of UPPCB wherein following decisions were taken:
• Constitution of local committee of nursing home association that will look after options of treatment for small nursing homes.
• Pursuing with Regional Office of UPPCB for development of common facility for small nursing homes.
• Allahabad Nagar Nigam will allot the required land to local committee for common treatment.

14.2 WEB-SITE AND SOFTWARE DEVELOPMENT

14.2.1 Up-gradation of CPCB Web-site

The web-site of CPCB has been continuously upgraded and updated. During the year, information on recognised environmental laboratories, report of High Power Committee on Hazardous Waste Management, report on Tajmahal case, Newsletters of CPCB (Parivesh), training programmes under Zoning Atlas Programme and ambient noise levels on Deepawali day in Delhi have been added. Besides information on air and water quality, industrial pollution along the rivers and lakes, pollution control in 17 categories of industries and weekly and daily air quality data for Delhi have been updated. A project on redesigning of web-site has also been initiated.

14.2.2 Development of Software

A software has been developed for compilation and easy and quick retrieval of the information on the inspections carried out under Environmental Surveillance. In addition, a software has also been developed for issuing computerised slips to visitors.