Biomedical waste management rules across country

• The National Green Tribunal has pointed out a huge lack of compliance of biomedical waste management rules across the country.
• The tribunal has asked for the implementation of the framework, which emphasizes on strict adherence to the norms related to the maintenance, storage, and movement of Biomedical Waste Treatment.

What is Biomedical Waste?

Biomedical waste/hospital waste is any kind of waste containing infectious materials.  It may also include waste associated with the generation of biomedical waste that visually appears to be of medical.

• Hospital waste: It refers to all waste, biological or non‐ biological that is discarded and not intended for further use.
• Bio-medical waste: It means any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biological and including categories mentioned in Schedule I, of the BMW rules, 2016.

Biomedical waste consists of-

• Human anatomical waste like tissues, organs and body parts
• Animal wastes generated during research from veterinary hospitals
• Microbiology and biotechnology wastes
• Waste sharps like hypodermic needles, syringes, scalpels and broken glass
• Discarded medicines and cytotoxic drugs
• Soiled waste such as dressing, bandages, plaster casts, material contaminated with blood, tubes and catheters
• Liquid waste from any of the infected areas
• Incineration ash and other chemical wastes

How is biomedical waste treated in India?

• Autoclaving: The process of autoclaving involves steam sterilization. Instead of incineration, which can be expensive, autoclaving simply introduces very hot steam for a determined amount of time. 
• Incineration: The major benefits of incineration are that it is quick, easy, and simple. It effectively removes the waste entirely and safely removes any microorganisms. 
• Chemicals disinfection: When it comes to liquid waste, a common biomedical waste disposal method can be chemical disinfection. Chlorine is a regular choice for this process, and is introduced to the liquid waste in order to kill microorganisms and pathogens. 
• Microwaving: Microwave technology can also disinfect wastes. Wastes are first placed into a shredder. This wastes are mixed with water and internally heated that neutralizes present biologicals.
• Irradiation: This method involves waste sterilization by exposing waste to cobalt sources. Cobalt emits gamma rays that kill all the microbes in wastes.
• Shredding: It is a process by which waste are deshaped or cut into smaller pieces so as to make the wastes unrecognizable. It helps in prevention of reuse of bio-medical waste and also acts as identifier that the wastes have been disinfected and are safe to dispose-off.

Who deals with biomedical wastes in India?

• Central Pollution Control Board: The CPCB has been following up with all SPCBs/PCCs to ensure effective management of biomedical waste in States/UTs.
• National Green Tribunal (NGT): The NGT has been stringent on the application of the BMW 2016.
• Common Bio-Medical Waste Treatment and Disposal Facilities (CBWTDF): There are now over 200 licensed CBWTDF or Common Treatment Facility (CTF) in India.

Salient Features of Biomedical Waste Rules, 2016

• Compulsory pre-treatment: The method of sterilization/disinfection should be in accordance with National AIDS Control Organization (NACO) or WHO.
• Phasing out plastic use: The use of chlorinated plastic bags, gloves, blood bags, etc. should be gradually stopped and this phasing out should be within 2 years from the date of notification of these rules
• Safe disposal of Liquid waste: They need to be separated at source by pre-treatment before mixing with other liquid waste
• Incineration guidelines: The existing incinerator should be upgraded/modified to achieve the new standard within 2 years from the date of this notification

Color coding of Biomedical wastes in India

As per Bio-medical Waste Management Rules, 2016, Bio-medical waste is required to be segregated in following color coded waste categories-

• Red Bag: Syringes (without needles), soiled gloves, catheters, IV tubes etc. should be all disposed of in a red coloured bag, which will later be incinerated.
• Yellow Bag: All dressings, bandages and cotton swabs with body fluids, blood bags, human anatomical waste, body parts are to be discarded in yellow bags.
• Cardboard box with blue marking: Glass vials, ampules, other glass ware is to be discarded in a cardboard box with a blue marking/sticker.
• White Puncture Proof Container (PPC): Needles, sharps, blades are disposed of in a white translucent puncture proof container.
• Black Bags:  These are to be used for non-bio-medical waste. In a hospital setup, this includes stationary, vegetable and fruit peels, leftovers, packaging including that from medicines, disposable caps, disposable masks, disposable shoe-covers, disposable tea cups, cartons, sweeping dust, kitchen waste etc.

International Agreement and Conventions

There are three international agreements and conventions which are particularly pertinent in BMWM. These are-

1. Basel Convention on Hazardous Waste: It is the most inclusive global environmental treaty on hazardous and other wastes. It has 170 member countries, and its objectives are to protect human health and the environment against the adverse effects resulting from the generation, management, and disposal of hazardous wastes, specifically clinical wastes from health care in hospitals, health centers, and clinics.
2. Stockholm Convention on POPs: It is a global treaty to protect human health and the environment from POPs (POPs – dioxins and furans). POPs are toxic chemicals that accumulate in the fatty tissue of living organisms and cause damage. These chemicals are formed by medical waste incinerators and other combustion processes. It deals with BEP including source reduction, segregation, resource recovery and recycling, training, and proper collection and transport.
3. Minamata Convention on Mercury: It is a global treaty to protect human health and the environment from the adverse effects of mercury. On October 10, 2014, in Japan, more than 90 nations signed the first new global convention on environment and health. This treaty includes the phasing out of certain medical equipment in health-care services, including mercury-containing medical items such as thermometers and blood pressure device.

Environmental impacts of Biomedical Wastes

Improper management of health care waste can have both direct and indirect health consequences for health personnel, community members and on the environment.

• Toxin emissions: The most serious effect that biomedical waste has on our seas is the discharge of poisons into the waters that could then be consumed by ocean life creatures.
• Food chain contamination: Toxins would interject into the food chain and eventually reach humans who consume sea creatures. 
• Plastic pollution: 85% of disposable plastic materials make up all medical equipment.
• Groundwater Contamination: Deep burials of biomedical wastes may result in groundwater contamination.

 

Challenges in India

• Increase in waste: In a highly populous country like India, there is a rise in residential biomedical waste and its collection without adhering to safety protocols could also trigger a surge in caseload.
• Poor Compliance of BMW rules: States are not following the CPCB guidelines.
• Non-segregation: In some states, improper segregation of waste has been reported.
• Improper disposal: The non-segregation of waste results in the incineration of contaminated plastics producing toxic gases and adding to air pollution.
• Lack of infrastructure: Currently, in India, there are only 198 CBMWTF in operation and 28 are under construction.  .
• No alternative to incineration: During incineration and post-combustion cooling, waste components dissociate and recombine forming new particles.

Why addressing this is important?

• Preventing another pandemic: The COVID pandemic was the outcome of virus leak from Wuhan.
• Uncontrolled outcomes: This has presented a challenge in terms of the capacity to scientifically dispose of generated waste and a challenge for civic authorities in charge of its collection and disposal.
• Hazard to healthcare personnel: Without proper scientific management of such waste, it can potentially affect patients and can affect the concerned workers and professionals.

Way forward

• Multi-stakeholder involvement: Proper management of Bio medical waste is a concern that has been recognized by both government agencies and the NGOs.
• Stringent regulatory push: In order to accelerate the rate at which proper processing and management methods are designed, timely regulatory and legislative policies and procedures are needed.
• Raising awareness: An effective communication strategy is imperative keeping in view the low awareness level among different categories of staff in the healthcare establishments regarding biomedical waste management.
• Infrastructure push: The centre and states in liaison should set up recycling plants across the country as envisaged under the Smart cities project.
• Proper collection: To properly separate, process and isolation of wastes, they must be well-characterized, which is challenging.
• Safe disposal: Several hazards and toxic materials containing should be disposed-off with proper take and care.

Conclusion

• Safe and effective management of biomedical waste is not only a lawful obligation but also a civil duty.
• The current BMWM 2016 rules are an improvement over earlier rules in terms of improved segregation, transportation, and disposal methods, to decrease environmental pollution and ensure the safety of the staff, patients, and public.

India digitize UIP

After the success of the Co-WIN platform, the government has now replicated it to set up an electronic registry for routine vaccinations. Named U-WIN, the programme to digitise India’s Universal Immunisation Programme (UIP) has been launched in a pilot mode in two districts of each state and Union Territory.

More about U-WIN

1. The platform will be used to register and vaccinate every pregnant woman, record her delivery outcome, register every newborn delivery, administer birth doses and all vaccination events thereafter.
2. The platform that replicates Co-WIN, which has served as the “digital backbone” for India’s COVID-19 vaccination programme, was launched in 65 districts.
3. The U-WIN is going to be the single source of information for immunisation services, updating vaccination status, delivery outcome, planning of RI sessions and reports like antigen-wise coverage, etc.
4. There will be digital registrations of all pregnant women and newborns for individualised tracking for vaccination, reminders for upcoming doses and follow-up of dropouts.
5. Healthcare workers and programme managers will be able to generate real-time data of routine immunisation sessions and vaccination coverage for better planning and vaccine distribution.
6. For pregnant women and children, vaccine acknowledgement and immunisation card linked to ABHA ID (Ayushman Bharat Heath Account) will be generated and all states and districts can access a common database to track and vaccinate beneficiaries.
7. Besides, through the platform citizens can check nearby ongoing routine immunisation sessions, and book appointments.
8. All states and UTs have been sensitised on U-WIN functionalities and objectives for the pilot in 65 districts and staff and healthcare workers have been trained on all modules of U-WIN.
9. With this the entire vaccination system including records will get digitised, easing the tracking of beneficiaries.
10. Vaccination records under UIPare being maintained manually as of now. So this will do away with the hassle of keeping a physical record. It will enable the digitisation of session planning, and updating vaccination status on a real-time basis.

Centre sets up panels against online platforms

The Centre has notified the formation of three grievance appellate committees that will address users’ complaints against social media and other internet-based platforms, including being empowered to oversee and revoke content moderation-related decisions taken by these platforms.

Three GACs and their composition

1. According to the notification, issued late 27 January 2023 night, each of the three grievances appellate committees (GACs) will have a chairperson, two whole-time members from different government entities, and retired senior executives from the industry for a term of three years from the date of assumption of office.
2. The first panel will be chaired by the chief executive officer of the Indian Cyber Crime Coordination Centre under the Ministry of Home Affairs.
3. The second panel will be chaired by the joint secretary in charge of the Policy and Administration Division in the Ministry of Information and Broadcasting.
4. The third panel will be chaired by Kavita Bhatia, a senior scientist at the Ministry of Electronics and IT.

The role of the panels

1. In October last year, the government notified that it will start the process of selecting GACs amid criticism from civil society activists, who had raised concerns about the government’s involvement in the appeals process.
2. The government had initially said that it would be open to social media companies setting up a self regulatory body provided that it found the body’s functioning satisfactory.
3. GACs can also seek assistance from people who may have adequate expertise and experience in a subject matter while dealing with users’ appeals.
4. The GACs will adopt an “online dispute resolution mechanism” where the entire appeal process, from its filing to the final decision, will be done online.
5. Social media companies will also have to compile every order passed by the GACs and report them on their respective websites.
6. Keeping in view the transition period required for the intermediaries as per their requests and technical requirement, the GACs’ online platform will be operational from 1 March 2023.

‘Green comet’ appearing close to Earth

Appearing near Earth after nearly 50,000 years and next estimated to come close to us after as many years, it might be possible to see a recently discovered green comet. The comet is estimated to come closest to Earth around 2 February 2023. Termed the C/2022 E3 (ZTF), the comet was named to refer to those who first spotted it – astronomers using the wide-field survey camera at the Zwicky Transient Facility (ZTF) in the US, in March 2022.

What is the ‘green comet’?

1. After approaching the sun in the middle of January, it is now moving away from it, along its own orbit.
2. The orbit indicates it comes from the edge of our solar system, a distant reservoir of comets we call the Oort cloud.”
3. The Oort cloud is thought to be a big, spherical region of outer space enveloping our sun, consisting of innumerable small objects, such as comets and asteroids.
4. NASA terms it “the most distant region of our solar system” and “Home of the Comets”.
5. The green comet could be at a distance of 2.5 light minutes from Earth, meaning a “mere” 27 million miles.

Why is it green in colour?

1. Comets are frozen rocky or gas-filled objects that are remnants of the formation of the solar system.
2. Due to their composition, characteristics and the path they move in, they tend to leave a light “behind them”. Here, the comet itself is green (called the head of the comet) and emits a whitish light behind it (often called the tail of the comet).
3. Just like other bodies in space, comets also have orbits. They are sometimes pulled in close to the sun because of the sun’s gravity acting on them.
4. As they orbit near the Sun, “They heat up and spew gases and dust into a glowing head that can be larger than a planet”.
5. The remains of dust following this burning up, from a distance, look like a trail of light to humans on Earth. Comets, therefore, have often been seen giving out blue or whiteish light, or even green.
6. In this case, the green glow “is thought to arise from the presence of diatomic carbon – pairs of carbon atoms that are bound together – in the head of the comet.
7. The molecule emits green light when excited by the ultraviolet rays in solar radiation,” The Guardian reported.

Managing Water Quality of Lake Victoria

One of the largest lakes in the world, Lake Victoria, has been suffering from a variety of unsustainable human activities over the last five decades. Delhi-based non-profit Centre for Science and Environment and National Environment Management Council (NEMC), Tanzania have jointly released a report on managing its water quality.

About Lake Victoria:

• Lake Victoria and its flora and fauna support the livelihoods of about 45 million people.
• The ecologically unique water body is shared by three countries — Tanzania (51 per cent), Uganda (44 per cent) and Kenya (5 per cent).
• Africa’s largest lake by area, the world’s largest tropical lake, and the world’s second-largest freshwater lake by surface area after Lake Superior in North America.
• Occupies a shallow depression in Africa.
• The lake was renamed after Queen Victoria by the explorer John Hanning Speke, the first Briton to document it in 1858, while on an expedition with Richard Francis Burton

Findings & Suggestions of the Report

• Identified Mwanza city as a hotspot, contributing a substantial pollution load in the form of industrial effluents, domestic sewage and dumping of solid waste.
• It also recognised two rivers — the Mirongo and the Nyashishi — as the major water bodies carrying domestic and industrial pollution loads, respectively.
• Results of the sampling exercise showed substantial pollutant load in the rivers, which may be getting discharged in the lake.
• The water from the Nyashishi is extensively used for agricultural purposes before it meets the lake.
  • The focus on the Nyashishi should now be doubled as any pollutant in the river, along with affecting the water quality of Lake Victoria, may also adversely impact crops and human health.