Essay on Biomedical Waste | Waste Management

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Essay on Biomedical Waste

Essay Contents:

1. Essay on the Introduction to Biomedical Waste
2. Essay on the Classification and Categories of Biomedical Waste
3. Essay on the Routes of Transmission of Disease by Biomedical Waste
4. Essay on the Effect of Biomedical Waste on Human
5. Essay on the Impact of Biomedical Infectious Waste
6. Essay on the Personal Protective Devices Used to Control Diseases in Hospital
7. Essay on the Protective Measures to Reduce Biomedical Waste

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Essay # 1. Introduction to Biomedical Waste:

It is the waste generated by healthcare establishments, research facilities and laboratories.

Waste may be generated during:

i. Diagnosis, treatment of a disease and immunization for diseases

ii. Associated biomedical research, and

iii. Production and testing of biologicals.

Broadly, the biomedical waste is generated in the hospitals, nursing homes, clinics, pathology/microbiology laboratories, blood banks, anima houses and veterinary institutes. Such a waste can also be generated at home if the health care is being provided there to a patient (e.g. dialysis, insulin injections, dressing material, etc.)

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Essay # 2. Classification and Categories of Biomedical Waste:

Approximately 85% of the biomedical waste is innocuous and as harmless as any other municipal waste. The remaining 15%, however, differs from other waste in that it can be injurious to human or animal health and deleterious to the environment. It must be remembered that if both these types are mixed together, then the whole lot becomes harmful.

The hazardous hospital waste may further be classified into the following categories:

1. Infectious

2. Injurious

3. Cytotoxic

4. Chemical.

1. Infectious Waste:

Infectious waste has potential to contain pathogens (bacteria, viruses, parasites or fungi) in concentration and quantity sufficient to cause diseases in susceptible individuals.

The waste that has been in contact with a patient suffering from an infectious disease carries with it the microorganisms that can transmit the disease to other person(s).

Some of the diseases that may be transmitted this way are:

i. Hepatitis A, B, C, D and E

ii. Gastroenteritis, typhoid fever

iii. Tuberculosis

iv. Postoperative wound infection

v. Skin and blood infections, and

vi. AIDS, etc.

The infectious waste category includes:

i. Waste from surgery on patients and autopsy on dead bodies with infectious diseases (e.g. tissues and materials or equipment that has been in contact with blood and/or other infected body fluids).

ii. Waste from infected patients in isolation words (e.g. excreta, dressings from infected or surgical wounds, clothes heavily soiled with human blood or other body fluids).

iii. Waste that has been in contact with infected patients undergoing hemodialysis (e.g. dialysis equipment such as tubing and filters, disposable towels, gowns, aprons, gloves and laboratory coats).

iv. Cultures and stocks of infectious agents from laboratories.

v. Any other instruments or materials that have been in contact with the infected persons or animals.

2. Injurious Waste:

This is the hazard of sharp biomedical waste that could cause cuts or puncture wounds, including needles, hypodermic needles, scalpels and other blades, knives, infusion sets, saws, broken glass, ampoules and nails. Whether or not such items are infected, these are usually considered as highly hazardous healthcare waste.

The objects listed above are liable to cause injury and the associated complications.

The sharp biomedical waste may also be infectious and can transmit following infectious diseases:

i. Tetanus

ii. AIDS

iii. Hepatitis

iv. Septicemia

v. Wound infection.

3. Cytotoxic Waste:

Certain drugs or other substances can injure the cell (structural and functional unit of the body). Cytotoxic waste includes the contaminated materials from drug preparation and administration, such as syringes, needles gauges, vials and packaging, outdated and expired drugs, excess (leftover) solutions and drugs returned from the wards. It also includes potentially hazardous amounts of the administered cytotoxic drugs or their metabolites which should be considered genotoxic for at least 48 hours and sometimes up to one week after drug administration.

Notable among these are:

i. Anticancer drugs

ii. Strong acids and alkalies

iii. Concentrated phenyls

iv. Radioactive material.

The cytotoxic agents can produce the following effects:

i. Immunosuppression

ii. Anemia

iii. Thrombocytopenia

iv. Ulcers

v. Cancer

vi. Fetal abnormalities

vii. Genetic abnormalities leading to various diseases.

4. Chemical Waste:

Hazardous chemicals are usually the by-products of laboratory waste and other substances which include:

i. Chemotherapy waste

ii. Photographic chemicals

iii. Formaldehyde and other disinfectants

iv. Heavy metals (e.g. mercury)

v. Residential anesthetic gases

vi. Other toxins and corrosives

vii. Radioactive chemicals

viii. Dyes

ix. Insecticides (e.g. DDT).

Chemical waste consists of discarded solid, liquid and gaseous chemicals, for example, from diagnostic, experimental work and from cleaning, housekeeping and disinfecting procedures.

Chemical waste from healthcare facilities may be hazardous or nonhazardous. Chemical waste can cause corrosion, poisoning, skin diseases, cancer, etc.

The chemical waste is considered hazardous if it is:

i. Toxic

ii. Corrosive

iii. Flammable

iv. Reactive (explosive, water reactive, shock sensitive)

v. Genotoxic (e.g. cytotoxic drugs).

It may also be harmful to the sewage bacteria if discarded without prior treatment.

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Essay # 3. Routes of Transmission of Disease by Biomedical Waste:

i. Inhalation (breathing)

ii. Ingestion

iii. Contamination of wounds

iv. Absorption from cutaneous and mucous membranes

v. Injury causing breach in continuity of surface followed by infection.

Diseases Associated with Biomedical Waste:

i. AIDS

ii. Hepatitis

iii. Gastroenteritis, typhoid fever

iv. Skin infections

v. Septicemia

vi. Tuberculosis

vii. Tetanus

viii. Cancer

ix. Genetic/fetal abnormalities.

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Essay # 4. Effect of Biomedical Waste on Human:

The biomedical waste can adversely affect several categories of people. As such, anyone (including general public) can be affected. However, those associated with a healthcare establishment (hospital, nursing home, etc.) are at a greater risk.

Following categories of individuals can easily become a victim of hazards of biomedical waste:

i. Medical doctors, nurses, compounders, dressers, OT assistants, lab assistants, ward boys, ayah, sweepers, biomedical waste handlers, etc.

ii. Patients in healthcare establishments or those receiving home care.

iii. Visitors/attendants to healthcare establishments or attendants at home.

iv. Workers in support services allied to healthcare establishments, such as laundries, waste handling and transportation.

v. Rag-pickers.

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Essay # 5. Impact of Biomedical Infectious Waste:

According to World Health Organization (WHO) (1999), with regard to life-threatening virus infections such as HIV/AIDS and hepatitis B and C, healthcare workers, particularly nurses, are at greatest risk of infection through injuries from contaminated sharps (largely hypodermic needles).

Some Facts:

i. In 1992, eight cases of HIV were recognized as occupational infections in France. In two of them transmission took place through wounds in waste handlers.

ii. In June 1994, out of 39 cases of HIV infection in USA, 34 reportedly occurred from an injury through the sharp biomedical waste. Four resulted from exposure of skin or mucous membrane to infected blood.

iii. By June 1996, the number of cumulative recognized cases of occupational HIV infection had risen to 51 in USA and all of them were nurses, doctors or laboratory assistants.

iv. It is estimated that in USA, approximately 86,000 to 160,000 healthcare workers are injured annually by sharp biomedical waste. Out of these about 164 to 323 persons develop hepatitis B infection subsequently.

v. It is estimated that in Japan the risk of HIV and hepatitis B infection after hypodermic needle puncture is 0.3 and 3% respectively.

vi. Nearly 66% of the rag pickers in India suffer from an injury (or wound) because of biomedical waste.

vii. A hospital housekeeper in the USA developed staphylococcal bacteremia and endocarditis after a needle injury.

viii. Thota et al (2014) observed that “Everyone wins, when the environmental health is respected and safe guarded”. In many developing countries, the proper disposal of infectious waste is a growing problem and if it is not managed in a sustained way, it will make the situation worse. Every concerned health personnel are expected to have proper knowledge, practice, and capacity to guide others for waste collection, proper handling techniques, and management. Dentists are encouraged to follow best management practices when disposing hazardous wastes. All the dental personnel as required to undergo continuing training program on biomedical waste management.

ix. Yadav M has stated that as biomedical waste is the major source of dioxin production during incineration, which is generally the cause of incurable cancers, the Medical ethics dictate that prevention must be carried out as we all are bound by Hippocratic Oath.

x. Mathur P et al observed that the biomedical Waste scattered in and around the hospitals, invites flies, insects, rodents, cats and dogs that are responsible for the spread of communication disease like plague and rabies. Rag pickers in the hospital, sorting out the garbage are at a risk of getting tetanus and HN infections. The recycling of disposable syringes, needles, I/V sets and other article like glass bottles without proper sterilization are responsible for hepatitis, HIV, and other viral diseases.

It should be clear by now that anyone can be affected by the hazards of biomedical waste. Members of the medical profession are especially vulnerable to the same. Therefore, each of us needs to observe certain safely measures while handling biomedical waste to protect ourselves as well as others from hazards of exposure to the same. Use of safety measures is very easy and convenient. These measures may be quite effective if used properly.

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Essay # 6. Personal Protective Devices Used to Control Diseases in Hospital:

Important protective devices are:

1. Gloves:

They are meant to protect hands. They also help in prevention of disease transmission from one person to another.

Proper uses of gloves involve the following:

Wear them while:

i. Doing an invasive procedure

ii. Dressing a patient

iii. Handling blood or body fluids, and

iv. Dealing with sharps and chemicals.

Wash your hands with soap and water before and after using gloves.

After wearing gloves, one should not touch anything other than the work for which the gloves are worn.

Ideally, gloves should be changed after serving or examining each patient. If, however, this is not feasible, then the hands (with the gloves on) should be dipped in 1% hypochlorite solution for one minute and then only the next patient should be examined.

Ensure a proper disposal of used gloves. Put the gloves in 1% sodium hypochlorite solution for a period of 30 minutes, cut them to alter the original shape and then throw them in the red waste bag.

Thick layered gloves are used by the waste handlers while handling biomedical waste.

2. Cap, Mask/Face Mask and Gown:

All these devices are meant to protect the body.

Their proper use involves the following:

i. Wear the mask in such a way that it covers the mouth and the nose. If it is soiled with blood/body fluid, it should be discarded and replaced immediately.

ii. Apron/Gown should cover the body from neck to knees.

iii. Wear all these gears whenever blood/body fluid is likely to spill over.

iv. Wear them during all surgical procedures including while delivering a baby (childbirth).

v. Wear at least cap and mask while working in wards.

vi. For cleaning, dip them in 1% hypochlorite solution for 30 minutes and then wash thoroughly with soap and water. After drying, these should be autoclaved.

3. Gumboots with Thick Sole:

These should be used while working in the operation theaters and labor rooms. These prevent injury (and thus the transmission of disease) from spilled material and sharp biomedical waste. This precaution is a must for those working at incinerator and Land fill sitres.

4. Eye Glasses/Protective Goggles:

Goggles (or plain glasses) should be worn while performing dental surgery, orthopedic surgery and if the patient is known to be HIV/ Hepatitis B positive. Eye glasses/protective goggles must be worn by biomedical waste handlers.

5. Shield:

One must wear a protective shield while working in a radiation prone environment (e.g. Radiology and Radiotherapy departments). It protects from radiation hazards. Persons working in the radiology department should also wear a dosimeter to estimate the quantum of exposure to radiation.

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Essay # 7. Protective Measures to Reduce Biomedical Waste:

i. All employees of the hospital, including biomedical waste handlers, must be vaccinated against Tetanus and Hepatitis B.

ii. Extreme care must be taken while handling needles and other sharps, since most sharp injuries occur between the points of their use and disposal.

iii. Sharps should not be left casually on counter tops, food trays, beds, etc. as it can result to grievous injury.

iv. Clipping, bending or breaking the glass and needles with hands must not be practiced as this can cause accidental injuries.

v. Sharps should be segregated at the site of generation and thereafter placed in a puncture proof container.

vi. All disposable items must be dipped in 1% hypochlorite solution for at least half an hour to ensure disinfection.

vii. Exposure to radiation should be avoided as much as possible.

viii. All universal precautions are to be taken while dealing with HIV positive or hepatitis B positive cases.

The precautions are:

a. Always wear double gloves while dealing with these patients.

b. Wear cap, mask and apron.

c. In operation theater (OT), goggles/glasses must be worn.

d. The transfer of instruments in the OT should not be from hand to hand between a nurse and doctor or vice versa. Instead, a tray or bowl should be used during transfer of instruments. Do not hold the instruments from pointed/sharp end.

e. First aid box and emergency medicines should be available in the treatment areas.

Measures to be Observed if an Accident Occurs:

Extreme care should be taken while dealing with the sharps. In case, an injury due to (infected) sharps or broken glass takes place, clean the wound immediately, first with saline and then with spirit or povidone iodine. Consult a doctor. Dressing of the wound may be required. An injection of tetanus toxoid (TT) is advisable.

If an injurious solution is spilled on the body, remove the soiled clothes and wash the part thoroughly with plenty of water. Apply nonirritant antiseptic cream and immediately report to a doctor. In case of spillage in eyes, wash with water and avoid rubbing. See a doctor as early as possible.

Rag Pickers:

Rag pickers usually collect disposable items (like syringes, IV sets, blood bags, urine bags, etc.) from the biomedical waste. There is a possibility that these items are repacked and sold. People are tempted to buy them due to a very low cost. However, all these items can transmit the diseases to the users.

As per law, this unauthorized recycling is a crime as it can be fatal to human life. While economic plight of rag pickers deserves a thoughtful consideration on humanitarian grounds, yet they cannot be allowed to continue this trade for the sake of their own health as well as of others. Illegal recycling by all the persons must be strictly curbed.

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