ABSTRACT
Introduction The World Health Organization (WHO) Regional Office for Europe convened a meeting on hospital waste management at Bergen, Norway in 1983, which was the first international forum to discuss the issue of biomedical waste (BMW) management. With expansion of health infrastructure in the country, BMW in India is also on the rise. In this background, the purpose of the present chapter is two-fold: (a) to highlight the environmental impacts related to BMW and the need to manage these wastes, and (b) to estimate the costs of managing BMW in a metropolitan city using a case study of Chennai. The indiscriminate disposal of BMW attracted the attention of the Supreme Court of India, which has from time to time issued instructions regarding the environmentally sound management of solid and hazardous wastes. The Ministry of Environment and Forest, Government of India (GoI) brought out the BioMedical Waste (Management and Handling) Rules in 1998 (BMW Rules),1 which is the primary instrument for regulating BMW in India. The quantity of BMW generated varies depending on the hospital policies and practices and the type of care being provided. The quantity of the BMW generated in developed countries varies from 1-5 kg/bed/day while the corresponding figure for developing countries is around 1-2 kg/bed/day (Yadav 2001). According to a WHO report, while approximately 85 per cent of hospital wastes are non hazardous, 10 per cent are infectious and the remaining 5 per cent are non infectious but hazardous (Yadav 2001). In India, generation of municipal solid waste (MSW), industrial hazardous waste and BMW has been increasing due to population growth, economic growth, life style changes and urbanization, etc. BMW is among the most hazardous types of waste and could pose human health risks as it is contaminated with disease carrying pathogens. Therefore, it is essential to implement safe and reliable methods for handling it. However, there are costs involved in BMW handling and disposal. Under the current framework, private collectors transport and dispose wastes from private hospitals while public hospitals dump the waste in the municipal landfills. A substantial amount of BMW is also dumped into the MSW collection points (dustbins) from where rag pickers collect and sell reusable materials.
