Kerala Disposal Of Hospital Waste

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Abstract

 

The studies were done in the state of Kerala, India. Government hospitals in urban and rural were covered. Information on [a] Rules for the awareness of bio-medical waste management, [b] Trainings undergone, [c] Colour coding, Sharps like needle, scalpel blades management, segregation, waste management in common facilities & disposal. Bio-medical Waste Management Rules awareness in hospitals of the Urban and rural areas, Segregation & colour codes usages.

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Key Word: IMAGE, Kerala bio-waste, waste management, Squanders, Government, colour codes.

 

Introduction

 

Is it not unexpected that the human services conveyance framework, which is set up to defend the soundness of the general population and fix them on the off chance that they endure any ailment, itself turns into a wellspring of contamination spreading ailment. Amid the procedure of conveyance, medicinal services establishments/offices create distinctive sorts of irresistible and additionally risky bio-therapeutic waste that presents colossal hazard to patients, social insurance suppliers, stealing cloth pickers, and the network everywhere, if its transfer isn’t extensively and experimentally overseen. The risks of presentation to bio-therapeutic waste can go from gastro enteric, respiratory, and skin contaminations to all the more lethal illnesses, for example, HIV/AIDS, and Hepatitis. Bio-restorative waste is likewise a wellspring of defilement of land and water sources if not rendered innocuous before its entombment ashore or transfer in water. Besides, biomedical waste transmits destructive gases, which prompts barometrical contamination, when treated open consuming or consuming in incinerators. These outflows can cause respiratory and skin sicknesses or considerably malignancy, if prudent conventions are overlooked. The Government of India issued the primary draft rules for transfer of bio-medicinal squanders in June 1995 (Ministry of Environment and Forests 1995).

 

In spite of ordering all doctor’s facilities with at least 50 beds to introduce nearby incinerators, the draft rules were for the most part blamed for overlooking worldwide patterns (Agarwal 1998). Periodic legal pushing, and continued exercises by non-administrative associations prompted the issue of Bio-restorative Waste (Management and Handling) Rules by the Government of India in July 1998 (Ministry of Environment and Forests 1998). It secured basic issues (isolation, transportation, and transfer) for advancing efficient logical administration of bio-medicinal waste among human services establishments/offices and people in the nation.

 

The Indian Medical AssociationKerala State Branch has responded to the call of transfer of waste by setting up a Common Biomedical Waste Treatment and Disposal Facility at Palakkad as per the arrangement of the Biomedical Waste (Management and Handling) Rules 1998 and with the endorsement of Kerala State Pollution Control Board. Indian Medical Association, Kerala State Branch, set up IMAGE, a cutting edge Common Biomedical Waste Treatment and Disposal Facility at Palakkad and it was charged on fourteenth December 2003. Picture was considered and propelled to help human services suppliers to defeat the difficulties presented by the obligations set down in the Biomedical Waste (Management and Handling) Rules 1998.

 

Objectives

 

The study aims to know the information of healthcare provider institutions or facilities of government, in urban & rural areas in Kerala state in respect of:

 

  1. Bio-medical Waste (Management and Handling)
  2. Training on management of bio-medical waste
  3. Segregation and disposal of bio-medical waste

Department of Health Services

 

Sl.No.        District        General Hospital        District Hospitals        Specialty        TBC        Taluk Hospitals        CHC        24 X 7 PHC        PHC        Others        Total        FW Sub- Centers

                                W&C        MHC        TB        LEP        Others        Total                                                                

1        Trivandrum        2        2        2        1        1        0        1        5        1        6        23        6        64        9        118        483

2        Kollam        0        1        1        0        1        0        0        2        2        8        17        6        52        1        89        418

3        Pathanamthitta        2        1        0        0        0        0        0        0        1        4        12        5        38        1        64        260

4        Alappuzha        1        1        1        0        1        1        1        4        1        7        16        17        42        1        90        366

5        Kottayam        4        0        0        0        0        0        1        1        2        3        19        12        43        0        84        339

6        Idukki        0        1        0        0        0        0        0        0        1        4        14        11        31        2        64        307

7        Ernakulam        2        1        1        0        0        0        0        1        1        11        22        34        42        1        115        410

8        Thrissur        2        1        0        1        0        1        0        2        1        6        24        11        68        3        118        472

9        Palakkad        0        1        1        0        0        0        1        2        1        6        19        11        65        9        114        504

10        Malappuram        1        3        0        0        0        0        0        0        2        6        20        20        66        6        124        578

11        Kozhikode        1        1        1        1        0        1        0        3        1        7        16        6        57        0        92        402

12        Wayanad        1        1        0        0        0        0        0        0        1        2        9        8        14        5        41        204

13        Kannur        1        1        1        0        0        0        0        1        1        7        11        13        70        3        108        413

14        Kasragod        1        1        0        0        0        0        0        0        1        2        9        10        30        3        57        247

Total        18        16        8        3        3        3        4        21        17        79        231        170        682        44        1278        5403

 

Source: dhs.kerala.gov.in

 

Total = 5403 (Government Health centres throughout Kerala)

 

Sorting & Treatment Methods used

 

Colour coding        Type of container and waste category        Treatment options

Yellow        Plastic bag

1Human anatomical waste

2Animal waste

3Microbiology & biotechnology waste

6Solid wastes (contaminated with blood)        Incineration, deep burial

Red        Disinfected container/plastic bag

3Microbiology and biotechnology waste

6Solid wastes which are contaminated with blood

7Solid waste from disposable items like tubing’s        Autoclaving, microwaving, chemical treatment

Blue/white translucent        Plastic bag/puncture proof container

4Waste sharps (which may cause puncture)

7Solid wastes from disposable items        Autoclaving, microwaving, chemical treatment & destruction, shredding

Black        Plastic bag

5Discarded medicines and cytotoxic drugs

9Incineration ash

10Chemical waste (solid)        Disposal in secured landfill

 

Hospital Waste (Categorised)

 

Wastes which are evidently safe

 

Wastes which can transmit contamination

 

The primary class of squanders is primarily pressing materials, kitchen squanders, rubbish and other residential sorts of squanders. These squanders can securely go into the metropolitan waste framework; care should, nonetheless, be taken to transport them rapidly and painstakingly to the city transfer locales.

 

The second one consists of: –

  1. Obsessive squanders, including tissues, and body parts that are evacuated amid medical procedure or post-mortem examination.
  2. Societies and supplies of irresistible operators and partner organic including societies from therapeutic and neurotic labs, antibodies and so on.
  3. Squander human blood and results of blood including serum, plasma, and other blood parts.
  4. Sharps that have been utilized in patient consideration including hypodermic needles, syringes, pipettes, broken glass, and surgical blade cutting edges, blood vials, needles with joined tubing.
  5. Squanders from post-mortem that were in contact with irresistible specialists, including ruined dressing, wipes, wraps, tubes, waste sets, under cushions, and careful gloves.
  6. Lab squanders from restorative or obsessive research, for example, slides, expendable gloves, lab coats and cook’s garments.
  7. Dialysis squanders that were in contact with the blood of patients experiencing hemodialysis, including polluted expendable gear and supplies, for example, tubing channels, dispensable sheets and towels.
  8. Disposed of restorative gear and parts that were in contact with irresistible specialists.
  9. Organic waste and disposed of materials polluted with blood, discharge, exudates or emission from individuals.

 

Dangers from Hospital squanders

 

Plausible wellbeing perils from these squanders and their ill-advised transfer can be the transmission of the accompanying illnesses like, AIDS, hepatitis B, most basic bacterial diseases including cholera, looseness of the bowels and typhoid, torment, tuberculosis and numerous parasitic contaminations.

 

Magnitude of the Hospital squander in Kerala

 

Based on the quantity of clinics and accessible beds, a provisional gauge of the quantum of squanders created is landed at 1, 30,000 the aggregate number of beds.

 

The amount of irresistible squanders created per bed, every day is figured at 2kg. Along these lines, the doctor’s facilities in the state created in excess of 260 tons of irresistible squanders each day or 95,000 tons yearly.

 

The Present Scenario

 

In the event that there is much else lethal than the potential risk caused by irresistible healing center squanders, it was the absence of worry about the threat. The clinical squanders were being nourished into the city squanders framework by all the administration and private doctor’s facilities, specialist’s counseling rooms, centers and research centers till 2003. Squander transfer frameworks were woefully deficient or non-existent in many healing facilities. The perilous squanders dumped into landfills by the healing facilities brought about land and ground water contamination. The laborers taking care of these squanders were themselves willfully ignorant of the peril of these dangerous body squanders. The medicinal services specialists in the doctor’s facilities were frequently deficiently secured due to the absence of proper defensive attire and gear. Once more, there are the general population who run ‘casual’ reusing administration and accordingly, presenting themselves to the risks. They scrounge through the losses for plastic, cardboard and tin. There are likewise examples when the disposed of expendable syringes and needles returned to the shops pressed as new.

 

An Agenda for activity

 

It is more secure to burn all of waste. It is a perfect objective. Be that as it may, to give incinerators to every single healing facility is implausible both financially and naturally. A pragmatic transfer technique, to limit dangers, can be worked economically that don’t present long haul risks. The general procedure can be:

 

  1. For all time limiting contact with waste by patients and their relatives, other faculty and populace possibly influenced; for this reason, plastic packs and canisters ought to be given to every one of the wards in the healing centers. The laborers dealing with these squanders must be furnished with defensive articles of clothing, for example, coats and gloves.
  2. Mindfulness and training programs for restorative and lay people to notify them of the conceivable risks presented by the unseemly and reckless treatment of medicinal waste. This must incorporate introduction and proceeding with instruction projects and preparing though wellbeing couldn’t care less laborers.
  3. To impart the significance of following and transfer of irresistible squanders in healing facilities not just in the psyches of the medicinal work force yet doctor’s facility managers and the legislature.
  4. Therefore the venture “IMAGE” was started by Indian Medical Association, Kerala.

 

IMAGE (IMA Goes Eco-friendly)

 

The undertaking “IMAGE”IMA Goes Eco-friendly was started in 2000 to help Government and Private Hospitals in Kerala to oversee and arrange the dangerous squanders created in their premises. An office was set up in the Headquarters of IMA in Trivandrum. Consistent correspondence with the administrations of all clinics in Kerala was started. Gatherings were composed all over Kerala by IMA through which the requirement for legitimate waste administration was advanced. The help of the Kerala State Pollution Control Board (KSPCB was extremely useful. Part Secretary Indulal, Engineer, Vijayabhas and others helped in starting this procedure. The arrangement was to begin five Central Waste Management Plants in Keralatwo sections of land of grounds for each with an incinerator, autoclave, shredder, and a profluent treatment plant.

 

A plot was obtained in Parippally close Kollam and the proposition was endorsed by Kerala State PCB. In any case, because of the restriction from neighborhood individuals, it must be racked. The equivalent happened to the plans in Kannur. At long last, the present site was situated close Kanjikode, Palakkad. With the endorsement of the Pollution Control Board, Municipal Corporation and so on., the Plant was begun with one incinerator, one autoclave, shredder, ETP, and so on. Awareness training programs for Hospitals in Waste Segregation was begun. Shading Bags and Bins were provided to all doctor’s facilities with essential guidelines, publications and so on. Providers for every one of these things were reached. Healing centers were asked for to give needle destroyers in every single fundamental area. A private association, GJ Multiclave was chosen for gathering of squanders and the task of the Plant. This was arranged as a typical office for the whole State and a Co-agent Project where the healing facilities should pay an Affiliation Fee and a for each bed for each day expense for waste gathering and transfer. The gauge for such a Project was 1 crore to begin with including the expense of the land, building, Incinerator, Autoclave, Shredder, ETP and so forth. This was to take into account >10,000 beds. Along these lines the Affiliation expense was chosen as 1000 for every bed and the treatment charges at 3.50 per bed every day.

 

Before long with the activity of the IMA and the PCB, a few healing facilities were made to join the undertaking. Obviously, there were complaints from numerous fronts. Hippies bringing specialists from to the extent USA against burning, foe associations exhorting better treatment plants, and so on. Be that as it may, IMAGE endure and is making a colossal net benefit for IMA separated from undertaking a helpful movement. In the interim, an investigation was directed to discover the squanders made by the doctor’s facilities, facilities, dental centers, demonstrative focuses in the whole Kollam locale. From the present information accessible from IMAGE reports, it demonstrates that just about 60% of the doctor’s facilities, and so forth are subsidiary to IMAGE. Just two or three doctor’s facilities have their very own waste treatment plants. While IMAGE has been a win to the degree to which it has been actualized, there is have to take it further, to spread mindfulness about the requirement for bio-medicinal waste administration and broaden the office for all clinics in Kerala.

 

Conclusion:

 

Medical squanders are very perilous and put individuals under danger of deadly ailments. The comprehension of medicinal waste administration and control methods is vital. In this paper, starting materials on the meaning of medical waste, medicinal waste administration administrative, the dangers of introduction, waste administration systems & control procedures are displayed.

 

Reference:

  1. Factura, H., Bettendorf, T., Buzie, C., Pieplow, H., Reckin, J., & Otterpohl, R. (2010). Terra Preta sanitation: re-discovered from an ancient Amazonian civilisation“integrating sanitation, bio-waste management and agriculture. Water Science and Technology, 61(10), 2673-2679.
  2. Kishore, J., Goel, P., Sagar, B., & Joshi, T. K. (2000). Awareness about biomedical waste management and infection control among dentists of a teaching hospital in New Delhi, India. Indian journal of dental research: official publication of Indian Society for Dental Research, 11(4), 157-161.
  3. Hanumantha Rao, P. (2008). Report: Hospital waste management”awareness and practices: a study of three states in India. Waste management & research, 26(3), 297-303.
  4. Chaerul, M., Tanaka, M., & Shekdar, A. V. (2008). A system dynamics approach for hospital waste management. Waste management, 28(2), 442-449.
  5. Tsakona, M., Anagnostopoulou, E., & Gidarakos, E. (2007). Hospital waste management and toxicity evaluation: a case study. Waste management, 27(7), 912-920.
  6. Ashalakshmi, K. S., & Arunachalam, P. (2010). Solid Waste Management: A Case Study of Arppukara Grama Panchayat Of Kottayam District, Kerala (India). Journal of Global Economy, 6(1), 33.

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