Stack emission monitoring carried out in the incinerators installed at 32 major hospitals in Delhi. The observations are as follows:

• Emission of particulate matter is being exceeded by more than 5 to 50 times of the permissible limit

• Air pollution control devices have not been installed with incinerators

• A few hospitals are still using single chamber incinerator, while others do not attain prescribed temperature in primary or secondary chambers

• Segregation of bio-medical wastes has not been paid adequate attention by hospitals

Inventory of bio-medical waste in the cities of Vadodara, Nagpur, Wardha and Nasik has been completed. It was observed that except SSG hospital, Vadodara, no other hospital has provided incinerator as per the guidelines. The methods adopted for the disposal of hospital wastes by most of the hospitals were found to be inadequate.

A study was conducted in nine government run hospitals in Kolkata, having bed capacity exceeding 500, to ascertain the status of the biomedical waste management.

Spore Testing Methodology for Efficiency Testing of Autoclaves

With the intensive development of health care, there has been mushroom growth of hospitals and nursing homes. Growth has eventually boosted generation of quantum of medical wastes from hospitals and nursing homes. Safe disposal of infectious hospital wastes is a matter of serious concern. The Bio medical Waste (Management and Handling) Rules, 1998 notified by Govt. of India, have stipulated rules for proper collection, storage, transportation, treatment and disposal of bio-medical waste. As per Biomedical Waste Rules, 1998, the hospitals have to install treatment facilities like autoclaves, incinerators etc. for treatment of bio-medical wastes generated from their premises. To ensure safe treatment and disposal of infectious hospital waste, these treatment facilities should operate at designed efficiency level.

A project has been initiated by the Central Pollution Control Board to develop spore testing methodology for efficiency testing of autoclaves used for hospital waste treatment. The major objectives of the project are:

• To standardise the spore testing methodology for assessment of the efficiency of autoclaves used in hospital waste treatment.

• In-situ assessment of the efficiency of autoclaves installed at various hospitals within NCT-Delhi using biological indicator.

Standardisation of spore testing methodology has been undertaken using Bacillus stereothermophilus as biological indicator for efficiency testing of autoclaves used for hospital waste treatment. Standardised methodology has been field tested at various autoclaves installed at hospitals within NCT-Delhi for their efficiency testing. The observations and findings of field testing are presented below.

Efficiency testing/validation of hospital autoclaves in NCT-Delhi by spore testing methodology

S.  No.	Autoclave Location	Sampling Month	Location inside Autoclave	Observations	Efficiency/  Validation
1.	Autoclave - I Mangolpuri	July, 1999	From inner wall towards door, placed spore strips in 6 tubes in bags for efficiency testing.	Turbidity developed in two tubes (5 & 6)	Partially satisfactory/ Unsatisfactory
2.	Autoclave - I Mangolpuri	October, 1999	Exposed spore strips in 8 tubes in bags inside autoclave	No turbidity developed in any tube.	Satisfactory
3.	Autoclave - II   Sarita Vihar	February, 2000	Exposed spore strips in 5 tubes in bags inside autoclave	No turbidity developed in any tube.	Satisfactory
4.	Autoclave - III   Jehangirpuri	February, 2000	Exposed spore strips in 5 tubes in bags inside autoclave	No turbidity developed in any tube.	Satisfactory
5.	Autoclave - IV   Delhi Gate	February, 2000	Exposed spore strips in 5 tubes in bags inside autoclave	No turbidity developed in any tube.	Satisfactory

The results indicate that the Bio-medical waste treatment autoclaves installed at the hospitals are satisfactory with respect to sterilization of bio-medical waste undertaken at these autoclaves.

Bio-Medical Waste Management in Lucknow

In Lucknow city, there are total 25 Govt. hospitals, 125 registered Private nursing homes, 75 un-registered Private Nursing homes, about 500 Private Clinics and 250 Pathological Laboratories spread all over the city. There are also 243 Govt. Dispensaries and private clinics that are running in rural areas. In general, average per bed bio-medical waste generation in Lucknow ranges between 240 - 824 gm/bed/day. The maximum bio-medical waste generation was estimated to be 3.7 MT/ day. The salient findings of a study undertaken by CPCB are:

• None of hospitals are following any waste management scheme;
• Incinerator at SGPGI was found in operational condition, while other incinerators are completely non- functional;
• Municipal Corporation has installed an incinerator of capacity 75 Kg/hr to treat medical waste being generated from various hospitals but it remains non-functional; and
• Bio- medical waste is being mixed with other non- infectious or domestic solid waste

Workshop on Bio-Medical Waste Management

A joint workshop was organised with the UP Pollution Control Board on December 02, 2000 at Lucknow. The Workshop was attended by representatives of Nagar Nigam from all major and a few minor towns, representatives from IMA, Nursing Home Associations, major hospitals, medical and management experts across the entire state of UP. The major recommendations of the workshop are given below:

• To organise follow-up meetings at regional levels by all regional offices of UPPCB in association with CPCB and prepare a definite action plan preferably in phases;
• To organise training at regional levels for doctors/nurses/ safaiwalas engaged in generation/segregation and management of bio- medical waste;
• CPCB and concerned regional offices of UPPCB will pursue with Nagar Nigam/ Nagar Palikas and Medical Association including concerned agencies to ensure development and management of facilities; and
• Persuasion for land from development authority, siting of common management facility, organisation of awareness programme with various organisation for speedy implementation of the rules.