Rules and management of biomedical waste at Vivekananda Polyclinic: a case study.

Hospitals and other healthcare establishments have a "duty of care" for the environment and for public health, and have particular responsibilities in relation to the waste they produce (i.e., biomedical waste). Negligence, in terms of biomedical waste management, significantly contributes to polluting the environment, affects the health of human beings, and depletes natural and financial resources. In India, in view of the serious situation of biomedical waste management, the Ministry of Environment and Forests, within the Government of India, ratified the Biomedical Waste (Management and Handling) Rules, in July 1998. The present paper provides a brief description of the biomedical waste (Management and Handling) Rules 1998, and the current biomedical waste management practices in one of the premier healthcare establishments of Lucknow, the Vivekananda Polyclinic. The objective in undertaking this study was to analyse the biomedical waste management system, including policy, practice (i.e., storage, collection, transportation and disposal), and compliance with the standards prescribed under the regulatory framework. The analysis consisted of interviews with medical authorities, doctors, and paramedical staff involved in the management of the biomedical wastes in the Polyclinic. Other important stakeholders that were consulted and interviewed included environmental engineers (looking after the Biomedical Waste Cell) of the State Pollution Control Board, and randomly selected patients and visitors to the Polyclinic. A general survey of the facilities of the Polyclinic was undertaken to ascertain the efficacy of the implemented measures. The waste was quantified based on random samples collected from each ward. It was found that, although the Polyclinic in general abides by the prescribed regulations for the treatment and disposal of biomedical waste, there is a need to further build the capacity of the Polyclinic and its staff in terms of providing state-of-the-art facilities and on-going training in order to develop a model biomedical waste management system in the Polyclinic. There is also a need to create awareness among all other stakeholders about the importance of biomedical waste management and related regulations. Furthermore, healthcare waste management should go beyond data compilation, enforcement of regulations, and acquisition of better equipment. It should be supported through appropriate education, training, and the commitment of the healthcare staff and management and healthcare managers within an effective policy and legislative framework.