Syeda AB Jan
Biomedical waste, often linked to hospitals, is generated across a diverse array of settings, from sprawling medical complexes to small clinics and even households providing home-based care. The nature and volume of this waste vary significantly depending on the facility and the medical procedures performed. Improper handling of biomedical waste can pose severe risks to human health and the environment, making it critical to understand its sources and composition. In this article, we delve into the primary and secondary sources of biomedical waste, explore its key components, and highlight the potential dangers some of these waste types present.
Biomedical waste originates from a wide range of healthcare and related activities, which can be categorized into primary and secondary sources. Each source contributes uniquely to the volume and type of waste generated, reflecting the diversity of healthcare practices. Primary sources are typically large-scale facilities or institutions where medical procedures are performed routinely, generating significant quantities of waste. Large hospitals, such as Apollo Hospitals in India or Johns Hopkins Hospital in the United States, perform complex surgeries, diagnostics, and treatments daily. These facilities generate substantial amounts of waste, including surgical tissues, used syringes, and contaminated dressings. For instance, during a single cardiac surgery, a hospital may produce anatomical waste like excised tissues, blood-soaked swabs, and disposable surgical tools. Maternity hospitals, like Fernandez Hospital in Hyderabad, specialize in childbirth and neonatal care, producing waste such as placentas, umbilical cords, and blood-contaminated materials from delivery rooms. Medical and veterinary colleges, such as AIIMS (All India Institute of Medical Sciences) or veterinary schools conducting animal research, generate waste from dissections, autopsies, and laboratory experiments. For example, a veterinary college might produce animal carcasses and tissues from experiments on rodents or larger animals. Blood banks, such as those operated by the Red Cross, handle blood donations and testing, generating waste like contaminated needles, blood bags, and test tubes. Pathology labs, which analyze samples for diseases, produce waste such as used slides, pipettes, and culture plates potentially contaminated with pathogens. Animal houses in pharmaceutical industries, like those at Pfizer or Novartis, use animals for drug testing, resulting in waste like animal carcasses, bedding materials, and tissues. For instance, a lab testing a new cancer drug on mice may generate significant pathological waste daily.
Secondary sources are smaller or less specialized facilities that still contribute to biomedical waste, often in lower volumes but with equal significance in terms of risk. Dental practices, such as SmileCare Dental in Mumbai, generate waste like extracted teeth, blood-soaked gauze, and used syringes from local anesthesia administration. Rural primary healthcare centers (PHCs) in countries like India provide basic medical care, vaccinations, and minor procedures, producing waste such as used needles, cotton swabs, and expired medicines. Temporary blood donation camps, like those organized by NGOs during community drives, generate waste including used lancets, blood bags, and swabs. For example, a Red Cross blood donation camp might discard hundreds of used needles in a single day. Facilities practicing Ayurveda, Yoga, Unani, Siddha, and Homeopathy, such as those under India’s AYUSH Ministry, produce waste like herbal residues, used acupuncture needles, and contaminated dressings. With the rise of home healthcare services, such as those provided by companies like Portea Medical, waste like used insulin syringes, wound dressings, and IV tubing is generated in households. For instance, a diabetic patient administering daily insulin injections at home contributes to biomedical waste through discarded needles and syringes. Factories with on-site clinics or universities with health centers generate waste from minor treatments, vaccinations, or first aid, such as used bandages and alcohol swabs. The type and quantity of biomedical waste depend on the facility’s size, specialization, and patient load. For example, a large hospital performing organ transplants will generate more complex waste than a rural PHC administering vaccines.
Biomedical waste is broadly classified into two categories: hazardous and infectious waste, and non-infectious or general waste. Infectious waste, which poses the greatest risk, is further divided into four major categories, each with distinct characteristics and examples. The first category, though constituting only 10-15% of total hospital waste, is the most hazardous due to its potential to transmit viral, bacterial, fungal, or parasitic diseases. It encompasses body parts, organs, and tissues removed during medical procedures. For example, during an appendectomy at a hospital like Fortis, the excised appendix is considered anatomical waste. Similarly, a tumor removed during cancer surgery or an amputated limb from a trauma case falls into this category. Placentas from childbirth, such as those discarded after deliveries at a maternity hospital, and aborted fetuses are also included. Blood-soaked dressings, cotton swabs, and hospital gowns used during surgeries or wound care are common examples. For instance, during a cesarean section, blood-soaked sponges and drapes are generated in large quantities. Research labs, such as those at the Indian Institute of Science, produce animal carcasses and tissues from experiments. For example, a lab studying neurodegenerative diseases might generate brain tissue samples from rats, classified as pathological waste.
Plastic waste accounts for 25-30% of biomedical waste and is critical due to its widespread use in healthcare. Made from materials like polypropylene, HDPE, and PVC, plastic items are valued for their sterility, strength, and flexibility. Disposable syringes used for vaccinations or IV sets for administering fluids, such as those used in chemotherapy at Tata Memorial Hospital, are common plastic waste. Patients undergoing dialysis at a center like Apollo Dialysis Clinics generate waste like dialysis tubing and blood bags. Surgical gloves and endotracheal tubes used in intensive care units, such as those at Max Healthcare, add to the plastic waste stream. While these items are essential for infection control, their disposal poses challenges due to their volume and potential contamination.
Sharps are objects capable of causing punctures or cuts and are highly hazardous due to their potential to transmit infections like HIV or hepatitis. Used needles from insulin injections or vaccinations, such as those discarded at a community health camp, are common sharps. Surgical scalpels used in procedures like orthopedic surgeries at AIIMS or blades from minor procedures in clinics contribute to this category. Proper handling and disposal of sharps are critical to prevent injuries and infections among healthcare workers and waste handlers.
Glass waste includes broken or discarded items like medicine vials and ampoules, except those contaminated with cytotoxic drugs. A pathology lab testing blood samples may discard glass vials containing residual blood, while a clinic administering vaccines may generate empty ampoules. Glass slides used in microscopy or test tubes from diagnostic labs, such as those at Dr. Lal PathLabs, are common glass waste.
The hazardous nature of biomedical waste, particularly infectious and sharp waste, poses significant risks. For instance, improper disposal of needles can lead to needlestick injuries, potentially transmitting diseases like hepatitis B. Similarly, untreated anatomical waste can spread pathogens if not incinerated or disposed of properly. Plastic waste, if not segregated, can clog landfills or release toxic chemicals when incinerated improperly.
Biomedical waste is a complex issue that extends far beyond hospitals, encompassing a wide range of sources from large medical institutions to home-based care. Understanding its sources—primary facilities like hospitals and secondary ones like dental clinics—and its composition, including anatomical, plastic, sharps, and glass waste, is crucial for effective management. By recognizing the diversity of biomedical waste and its associated risks, stakeholders can implement better segregation, treatment, and disposal practices to protect public health and the environment. Proper waste management systems, adherence to regulations, and increased awareness are essential to mitigate the dangers posed by this critical byproduct of healthcare.
