ESSENCE - International Journal for Environmental Rehabilitation and Conservation
Angmo & Rampal/VIII [2] 2017/88 – 94
Volume VIII [2] 2017 [88 – 94]
Awareness status of Biomedical waste management at Sonam Norbu Memorial
Govt District Hospital Leh-Ladakh
Angmo, Sonam and Rampal, Raj Kumar
Received: March 30, 2017  Accepted: June 30, 2017  Online: December 31, 2017
Abstract
In present study attempt has been made to
assess the awareness status regarding
biomedical waste generation and management
at Sonam Norbu Memorial Govt District
Hospital Leh-Ladakh by interview and
questionnaire method. The survey was
conducted in hospital using specific
questionnaire of 17 questions among doctors,
healthcare staff and paramedical students. The
analysis of Awareness status of Biomedical
waste and management among Doctors,
Healthcare staff and Students at study area
revealed that all the surveyed respondents
were not fully awared about the biomedical
waste management rules as per BMWM 2016.
Keywords: Analysis | Awareness
Respondent | BMWM 2016
For Correspondence:
Department of Environmental Sciences, University of
Jammu, Jammu, J & K, India
Email: sonamangmo111@rediffmail.com
[ISSN 0975 - 6272]
[www.essence-journal.com]
Introduction
Bio-Medical waste mean any waste, included
in the ten categories mentioned in schedule I
of BMW rule 1998, which is generated in
color coding bin mention in schedule II during
the diagnosis, treatment or immunization of
human being or animals or in research
activities pertaining or in the production or
testing of biological organism (Bio-Medical
Waste Rules 1998 of India, MOEF 20 July
1998).
As per rules (BMW Rule 2016) "Bio-medical
waste" means any waste, which is generated
during the diagnosis, treatment or
immunization of human beings or animals or
research activities pertaining thereto or in the
| production or testing of biological or in health
camps, including the categories mentioned in
Schedule appended to these Biomedical waste
pose hazard due to infectivity as well as
toxicity. Biomedical waste differs from other
types of hazardous waste, such as industrial
waste.
Hospitals are one of the complex institutions
which are frequently visited by people from
society without any distinction between sex,
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 Angmo & Rampal/VIII [2] 2017/88 – 94
age, race and religion. Biomedical waste is a
heterogeneous mixture, which is very difficult
to manage as such. A major issue related to
present biomedical waste management is that
many hospitals dispose off their waste in an
improper, biohazard and indiscriminate
manner which contribute to spread of serious
diseases. There is lot of confusion with the
problem among the generator, operator,
decision maker and the general community for
the safe management of biomedical waste.
Almuneef and Memish (2003).
According to Rashid et al., 2005 most of
studied hospitals in Karachi have not proper
waste storage area. Hospital waste was
disposed of with municipal waste in PHC
clinic of Gaza Governorate where
municipality truck collect hospital waste and
municipal waste together (Massrouje 2001).
Exposure to medical waste can result in
diseases or injury due to the risk of sharps
injury and bloodstained body fluid (BBF)
exposure in medical waste (Shiferaw et al.,
2012). Till July 1998 there was no rule for
proper waste disposal. Most of the hospitals
were disposing off their wastes along with
general waste. For prevention of these
improper practices, the Govt of India has
made a rule know as Biomedical waste
(Management &Handling) rule 1998 under
Environment (Protection) Act 1986. Under
this rule the Govt. has given specific
guidelines for management of biomedical
waste. Advances and increasing number of
health care units has increased the generation
of Biomedical Waste (BMW) which has
posed a huge risk to the health of the public,
patients and professionals thereby
contributing to environmental degradation
(Narang et al., 2012).
The ministry of Environment & Forest and
climate change amended the BMW
management rule 1998 as a BMW
management rule 2016 which has come to
force on 28 march 2016. These rule should
apply to all persons who generate, collect,
receive, store, transport, treat, dispose or
handle biomedical waste in any form
including Hospital, nursing home, clinics,
dispensaries, veterinary institution, animal
home, pathological lab, blood bank, Ayush
hospital, clinical establishment, research or
education institution, health camp, medical or
surgical camp, vaccination camp, blood
donation camp, first aid room of school,
forensic, laboratories, and research lab. These
rule shall not be applicable to radioactive
waste as covered under the provision of the
atomic energy act 1962, hazardous waste
covered under the manufacture storage and
import of hazardous chemical 1989, solid
waste covered under the municipal solid waste
management and handling rule 2000, lead acid
batteries management and handling rule 2001,
waste covered under the e-waste 2011. The
part I of schedule I consist of Biomedical
waste categories and their segregation,
collection, treatment, processing and disposal
option. (Gazette of India, extraordinary, part
II, section 3, subsection(i) 2016.
Material and Method The survey was
conducted in hospital using following
questionnaire of 17 questions among 20
doctors, 30 healthcare staff and 30
paramedical students
Questionnaire on Awareness Status Survey of
Biomedical Waste Generation and
Management at (Sonam Norbu Memorial
Hospital Leh-Ladakh)
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Name …………………. c. glass ware

Designation…………. d. all
Q10. How many times does the collection of
waste take place in hospital?
Q1. Do you know whether the hospital
have a waste treatment equipment? (Yes/No) a. 1
b. 3
Q2. Does hospital provide any training
c. 4
related to biomedical waste? (Yes/No)
d. 2
Q3. Where the hospital waste
Q11. What are the main purpose of different
incinerated? (Onsite/Offsite)
color coding bin in hospital? (tick)
Q4. Who should be responsible for
a. Segregation of waste
management of waste?
b. Only for dumping of waste
a. Doctors b. Nurses c. Patients d.
Q12. Which of the following waste are put
Attendants e. All of them.
in blue bin?
Q5. Which of the following biomedical
a. Broken glass
management rules are followed in this
b. Tubing, Iv set
hospital?
c. Bandages
a. BWM 1998
d. None
b. BWM 2016
Q13. Is Blood bag put in Yellow bin
c. Both
(yes/No?)
d. None
Is Urine bag put in Red bin (yes/No)
Q6. How hospital staffs aware its patients
about Biomedical waste? Q14. Name three Non-biodegradable waste
generated in this hospital.
………………………………………………
………………………………………………
Q7. Where the segregation of infectious
and non- infectious take place? Q15. What are the biodegradable waste
a. At source of generatio generated in this hospital?
b. After collection ………………………………………………
Q8. How many categories are there in Q16. Biomedical waste management rule
BWM 2016? 2016 are applicable to …(Tick)

a. 4 a. Person who generate

b. 5 b. Person who collect
c. 3 c. Person who transport
d. 6 d. All

Q9. Which of the following waste are put Q17. Which of the following waste are
in yellow bin? thrown in white bin?

a. Soiled waste a. Sharp/needle

b. Sharps/blade b. Cotton

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 Angmo & Rampal/VIII [2] 2017/88 – 94

c. Broken glass d. Human tissue/organ

Observations and Discussion

S.no Awareness related question % age frequency % age frequency of % age frequency
of Doctors Health care staff (ANM, Staff of respondent/
respondent nurse, Pharmacist, Dental student
n=20 assistant) n=30
n=30
1 Knowledge of waste treatment equipment in
hospital 100 70 82
a)Yes 0 30 18
b)No
2 Practice of training related to management of
biomedical waste
Yes 100 86 80
No 0 14 20
3 Incineration of biomedical waste on site
Yes 25 7 10
No 75 93 90
4 Responsibility for management of waste lies
with
Nurses 0 5 30
Patient 0 0 0
All of them 100 95 70
5 Biomedical waste is management by
BMW1998
35 44 54
BMW2016
10 10 26
Both
25 26 20
No answer
30 20 0
6 Awareness of patient by hospital staff is
through
Awareness programme 30 22 15
Display chart 25 14 20
No answer 15 54 25
Announcement speaker 30 10 40
7 Segregation of infectious and non infectious
waste
At source of generation 75 50 66
After collection 25 50 34
8 Biomedical waste Categories in BMW 2016
4 30 57 50
5 20 33 25
No answer 50 10 25
9 Biomedical waste put in yellow bin
Soiled waste 90 86 72
No answer 10 14 28
10 Collection of waste in hospital is done
Once 75 65 80
twice 20 15 5
thrice 5 20 15
11 Purpose of using different color coding bin
in hospital is
For Segregation of waste 100 85 100
Only for dumping of waste 0 15 0

12 Biomedical waste put in blue bin

Broken glass 55 54 44
Tubing, Iv 30 16 46
No answer 15 30 10
13 Blood bag put in yellow bin as per BMW
2016
Yes 5 34 50
No 95 66 50

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14 Non-biodegradable waste in hospital

Glassware, needles
Needles, syringes 50 30 40
Plastic glassware 35 24 25
no answer 10 36 15
5 10 20

15 Biodegradable waste in hospital

Placenta, urine 30 12 24
Anatomical waste 35 25 36
No answer 10 35 20
Human tissue 25 28 20

16 Biomedical waste management rule 2016 is

applicable to
5 0 20
Person who generate 0 5 20
Person who collect 95 95 60
All
17 Waste thrown in white bin
Sharp/needle 70 50 46
No answer 30 50 54
Table 1: Awareness status of biomedical waste and its management at study area

The 100% of Doctors, 70% of healthcare staff
and 82% of students were observed to be
aware about waste treatment equipment in the
hospital. 100% of doctors, 86% of healthcare
staff and 80% of students were of the view that
practices of training related to management of
biomedical waste management are carried out
from time to time. 25% of doctors 7% of
healthcare staff and 10% of students reported
that incineration of biomedical waste is done
onsite. 100% of doctors, 95% of healthcare
staff and 70% of students reported that
responsibilities of management of waste lies
with nurses as well patients. 35% of doctors
44% of healthcare staff and 54% of students
were of the view that biomedical waste in
hospital is managed by biomedical waste
management 1998. 10% of doctors 10% of
healthcare staff and 26% of the students
opined that BMW is managed by BMWM rule
2016. Whereas 25% of doctors, 26% of
healthcare staff and 20% of students were of
the view that BMW in hospital is managed by
both BMWM rule 1998 and BMWM rule
2016. As per 30% of doctors, 22% of
healthcare staff, 15% students the patients in
the hospital are aware through awareness
programme whereas 25% of doctors 14% of
healthcare staff and 20% students were of
view that awareness of patients is carried
through display of charts. Only 30% of
doctors 10% of healthcare staff and 40% of
students were of view that awareness of
patients is carried through announcements on
speaker. 75% of doctors 50% of healthcare
staff and 66% students reported that
segregation of infectious and non-infectious
waste is done at source of generation whereas
25% of doctors, 50% of health care staff and
34% of students reported that segregation of
infectious and noninfectious waste is done
after collection of waste. Only 30 % of
doctors, 57 % of healthcare staff and 50% of
students rightly responded that in BMW 2016
there are 4 categories. 90% of doctors, 86%
healthcare staff 72% of students rightly
responded that soiled waste is put in yellow
bin. As per 75% of doctors 65 % of healthcare
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staff and 80% of students collection of waste
in hospital done once a day as per 20% of
doctors 15% of health care staff and 5% of
students collection of waste done twice a day
and only 5% of doctors 20% of health care
staff and 15% of students reported that
collection of waste is done thrice a day .All
the doctors and students responded but 85%
of healthcare staff were view that different
color dust bin in the hospital are used for the
segregation of waste. Only 5% of doctors
34% of healthcare staff and 55% of students
rightly responded that blood bags are put in
yellow bin as per biomedical waste
management rule 2016. As per 95% of
doctors, 95% of healthcare and 60% of
students BMWM rule is applicable to all that
is person who generate and person who
collects. As per 70 %of doctors 50% of
healthcare staff and 46% of students sharps
and needles are put in white bin.
The analysis of Awareness status of
Biomedical waste and its management among
Doctors, Healthcare staff and students at study
area reveal that all the respondent were not
fully awared about the biomedical waste
management as per BMW 2016 Nagarrajan et
al. (2005) also observed significant gap in the
Knowledge, Attitudes and Practices of the
consultant, resident and scientist with regard
to BMW disposal They recommended subject
intensive training program to increase
awareness and practices in the people. Pandit
et al. (2005) in a cross-sectional study of 30
hospitals from Sabarkantha district, Gujarat
observed that was an immediate and an urgent
need to train and educate all doctor and the
staff to adopt effective waste management
practices. Gupta and Shantmanu(2016)
crossectional study among 89 with
predesigned semi structural questionnaire
they concluded that there was lack of
knowledge regarding management of
biomedical waste among health worker.
Recommendation
 Biomedical waste management related
topics should be put in syllabus of
paramedical students of this hospital.
 Good quality type of non- chlorinated
gloves should be provided to sweeper
and boomer.
 Incinerator should be set up at area
away from market and residential area
because gases releases from incinerator
are carcinogenic in nature.
 Seminar/awareness campaigns should
be conducted to aware the peoples.
 There should be a separate landfill for
treated biomedical waste so as to avoid
mixing of municipal waste with treated
hospital waste.
 Health staff as well as attendant of
patient should be fully aware to
management of biomedical waste
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