CSE welcomes new rules on bio-medical waste management, recommends stringent monitoring to ensure compliance

March 31, 2016

  • Centre for Science and Environment (CSE) welcomes new notification of Bio-medical Waste Management Rules, 2016, by environment ministry. 

  • Rules needed for patient safety and protection of environment in the backdrop of mushrooming of hospitals and clinics.

  • Next step: ensure strict implementation of the Rules by ensuring segregation of waste into infected and non-infected components.

  • Strict monitoring of hospitals and waste treatment facilities, imposing penalties, making hospitals responsible for waste management - some of the measures that need to be taken. 

New Delhi, March 31, 2016: Centre for Science and Environment (CSE) has welcomed the new notification of Bio-medical Waste Management Rules, 2016, by the Union ministry of environment, forests and climate change (MoEFCC). This is a significant step forward, says CSE, as the existing rules of 1998 have been revamped, with the major change coming in the reduction in waste categorization from the existing 10 categories to only four. 

It is estimated that 484 tonnes of bio-medical waste is generated every day in India; out of this, 447 tonnes are treated. The rest of the waste enters the environment. Since this waste contains infectious pathogens, it needs to be ensured that the waste is treated and disposed of properly.

The new notification is believed to be simpler for hospitals as according to them, a reduction in waste categorization will minimize the confusion faced by waste-handlers and other healthcare workers who handle bio-medical waste directly.

CSE has found the new rules to be comprehensive, that clearly define the roles of all stakeholders, waste-generators and waste treatment facility operators, local authorities, state governments and pollution control boards. It is important to get the rules implemented at the earliest.

The key highlights of the new notification

  1. The new rule mandates a bar code system for bags and containers containing bio-medical waste, which is a good move as this will restrict the entry of waste in the illegal recycling market. It will also be beneficial to rag-pickers and people dealing with infected solid plastic waste and working in the recycling industries, respectively.

  2. The purview of the new rules has been expanded to include vaccination camps, blood donation camps, surgical camps and other healthcare activities

  3. The new rules have reduced the categorization of waste from 10 to four. This will ease the waste segregation process at the source of generation 

  4. A ministry statement said that under the new rules, bedded hospitals will get automatic authorisation while there would be a one-time authorisation for non-bedded hospitals. 

  5. New Rules mandate pre-treatment of lab waste, blood samples, laboratory waste, microbiological waste and blood bags through disinfection or sterilisation on-site in the manner as prescribed by WHO or NACO. 

  6. Under the new Rules, use of chlorinated plastic bags, gloves and blood bags will be phased out within two years. This will be a good step if implemented within the stipulated time of two years as burning of chlorinated plastics often leads to emission of dioxin-furan, a Persistent Organic Pollutant (PoP) that has the potential to cause reproductive and developmental problems, damage to the immune system, interfere with hormones and also cause cancer.  

  7. The new Rules ask for training and regular immunization of all healthcare workers. It needs delineation of proper responsibility of the stakeholders else the issue does not get addressed

Next steps: scale up the action
CSE, while welcoming the move, says this legal mandate must be accompanied with implementation. CSE’s visits to medical facilities have revealed shocking facts on the current handling and disposal practices of bio-medical waste which raises serious doubts on the government estimate of 92 per cent compliance level.

Besides hospitals and clinics, waste is generated at places such as blood donation camps, vaccination camps and so on. Therefore, the move of including these camps into the ambit of medical waste is a good decision. However, an action plan needs to be designed on how to monitor these camps and the waste they generate. 

Hospitals and Common Bio Medical Waste Treatment Facility (CBWTF) in Delhi and many other cities across India have shown good examples of managing the waste. In India, there are around 198 CBWTFs, while 28 new facilities are coming up. All these are handling and managing wastes in a sustainable manner. The new notification is expected to give an impetus to bio-medical waste management practices.

The way forward
• All CBWTFs will have to ensure operational standards are notified for running incinerators.

Hospitals will need to phase out use of chlorinated plastic bags, gloves and blood bags within two years from the date of notification of these Rules. A CSE analysis said being a signatory to the Stockholm Convention, India may benefit from the phasing out of chlorinated plastic bags, gloves and blood bags, as most of the time these items end up in incinerators, causing huge emission of dioxin and furans. 

• Hospitals have been asked to provide training to all their health care workers and others involved in the handling of bio-medical waste at the time of induction and, thereafter, at least once every year and also reporting on the details of training programmes conducted, number of personnel trained and those who do not undergo training in the Annual Report;

• Hospitals have been asked to immunise all their health care workers and others involved in the handling of bio-medical waste for protection against diseases including Hepatitis B and Tetanus

• CBWTF operators need to come up with bar coding and global positioning system for handling of bio-medical waste within one year.

 

For further information, please contact Souparno Banerjee, souparno@cseindia.org, 99108 64339.