Indian Society of Hospital Waste Management

There are two things going wrong in the consideration of environmental protection. One is compartmentalization and the second in the consideration of waste to energy concept. Whenever one discusses the issue related to Bio-med waste management, or the issue of Solid waste management one tends to consider these aspects separately. It is well known that these two aspects cannot be considered separately. Bio-Med waste if not taken care can pollute the whole of the solid waste and transfer infectivity to the whole of the Municipal Solid Waste, after which all the waste must be considered infected and treated as such. Similarly whenever one considers environmental protection, pollution to the aquifer and the air requires to be taken into consideration. Isolated consideration cannot lead to comprehensive solutions.

By and large people are engaging themselves in considering the concept of “waste to energy” only in the sphere of regeneration of energy from the waste, or perhaps gas for further generation of energy, or the compacted waste to used as fuel. But all these would require some machinery thus creating end products requiring management as waste. Some of the gadgets required may be non-eco-friendly, like electricity generating plants etc. The thought process has to be applied to converting the waste to manure status as well, so that the earth’s energy is retained and can be used to re-plough the saved energy in the energy chain of the nature. That is why propagating the idea to convert the waste to manure, or such like end products of waste treatment should be given priority.

" Increase in the incidence of HIV and HVB & C is in proportion to the numbers of plastic syringe growth. Could this have a proportionate phenomenon? If so is this the time to think to go back to the glass syringe era?"

"Disposal of infected waste generated by small hospitals or nursing homes still remains an enigma. Is carting the waste to a Common Area Facility, the answer? For carting, a special van, preferably an air-conditioned van will be required. The waste is also likely to remain in the nursing homes premises for twelve to sixteen hours, depending on the turn around time. More the number of vehicles engaged to reduce the turn around time, more will be the total running cost. At the same time, the waste remaining on the premises for twelve to sixteen hours would provide enough opportunity to the microbes to multiply and perhaps mutate, thus defeating the very purpose of preventing spread of hospital acquired infection.

Small hospitals and nursing homes cannot be expected to have their own system, since that would not be cost-effective. If the aim of treating the biomedical waste at the earliest is to be achieved the answer is a mobile system, frequenting various locations at regular intervals. This would require a conceptual approach, as to design a vehicle housing non-polluting and eco-friendly equipments (multi option). Theoretically it is possible to have such vehicles having it’s own power or power drawn from predetermined outlets.

Sole energy for sustenance of living in the world is the solar energy. Burning reduces the matter to gaseous form, thus requiring the cycle of fixation of energy all over again. Instead, it the matter is not burnt but converted to configuration as close to the nature as possible then its assimilation in the energy-chain becomes that much easier and simpler.

Should we then incinerate all materials or only the minimum essentially required?

Positive health?

As per WHO definition health is when there is absence of disease does not identify absence of pollutants in the body or in the mind. We know of infirmity and positive health is complete physical and psychological, well being. The fact is that today a human being carries about 240 chemicals more than he carried in the 1920s. These chemicals are not useful like lead is not useful to the body in any way. These chemicals only cause harmful effects.

Should not therefore the definition of positive health be revised as “a state of health where there is complete absence of diseases and infirmity, a feeling of physical and mental well being, and complete absence of chemical, physiological or psychological pollutants.”

Right to live?

Right to live is a fundamental right in the constitution. Should this be related to any state of living or a healthy living? Like an underfed child suffering from malnutrition has the right of life? A body, which is full of pollutants like lead, arsenic etc can be labeled as enjoying the right of life?

9th Mar 2002.
Contributed by
Air Marshal LK Verma
views from readers are welcome.

"Bacterial mutation leads to more virulent type of the same strain. This happens because the bacterial species acquires additional properties or adapts itself according to the changed environment. Procreation is one of the basic instincts of any living species. So changes in the surrounding environment forces living species to acquire new properties making it possible for that species to survive and reproduce in the changed environment. In other words there is a process of adaptation leading to altered behaviour.

Can a process be developed by which the more virulent type of the microbes be converted to less virulent type -at least the ones which have caused havoc after having changed their properties such as virus causing AIDS which is a mutated virus from the otherwise non-pathogenic simian immunodeficiency virus(SIDS).

Many Health Care Providers might have either established or in the process of establishing Common Area Facility (CAF) for storage of hospital waste before final disposal. Segregation and disinfection/sterilization of the infected waste might not have carried out before the waste is carted to the CAF. Under these circumstances infected waste would be in the hospital premises for any length of time up to 24 hours depending upon the routine followed in the respectine health care facilities. If the hospitals have contracted the responsibility of the CAF to some agencies, the Health Care Providers might not seriously consider safe storage or proper disinfection/sterilization of the infected waste. Under such circumstances, nosocomial infection might have already occurred before the waste is carted to the CAF from the points of generation. In such a scenario, the conversion of infected waste to non-harmful waste does not take place, thereby the spread of nososcomial and hospital acquired infection do not get curbed. At the same time if all Health Care Providers are expected to have a comprehensive waste management system on site, it may not be cost effective and perhaps not eco-friendly.

Please send your comments, suggestions etc to the Secretary Surgeon Commodore
P. Sivadas at psivadas@hotmail.com (Interesting, constructive and thought provoking correspondence will appear at this site for general information and further deliberations with an ultimate goal of achieving proper disposal of infected waste from the hospital)