The world is witnessing rapid advancement in healthcare. As a consequence, the amount of biomedical waste generated globally is growing at an exponential rate. However, management of the biomedical waste (BMW) still remains a difficult challenge. Mismanagement of BMW has alarming and life-threatening ramifications to human health and the environment. Key steps of BMW management are waste segregation, collection, treatment, and safe disposal. Leading international health organisations emphasise segregation at source as an important focus point to improve BMW management. In this chapter, the authors will study a BMW management network in an Indian healthcare facility. The different steps of BMW management will be analytically modelled and simulated. The importance of segregation at source will be investigated and a post-segregation policy with a penalty framework will also be suggested. The authors also conduct numerical experiments to test their model and suggestions. This computational study establishes the importance of accuracy in segregation to improve efficiency of BMW management.
TopIntroduction
The healthcare industry is facing a global challenge of managing biomedical waste produced during medical procedures. Biomedical waste comprises of hazardous, infectious, and/or radio-active substances which require to be disposed of safely. Improper treatment of biomedical waste has dangerous and life-threating consequences to human health and the environment. According to the estimations by the World Health Organisation (WHO), every year 5.2 million people, including 4 million children, lose their lives due to erroneous management of medical waste (Rahman et al. 2020). Reports of dangerous levels of air, water and soil pollution have surfaced recently and are directly linked to the failures of waste management (Pandey & Dwivedi 2016, WHO 2018, Kumar & Prakash 2020).
Overall management of waste of any type broadly involves the process of collection, segregation, treatment and safe disposal. Waste management of any form is in itself a complicated and critical process. In addition, the treatment of biomedical waste involves further challenges. The steps of segregation and treatment of the biomedical waste require higher precision since they are more layered, complex and time consuming. There is less room for error in the overall management of medical waste because of the presence of hazardous substances. Moreover, the increasing volumes of biomedical waste levels further pose an alarming threat. In India, approximately 619 tonnes of biomedical waste is generated every day, of which only 544 tonnes is processed and disposed of. Around 74 tonnes of biomedical waste is dumped in unknown and remote locations. Several Indian states report significant amounts of disparity in biomedical waste generation and treatment (Saxena et al. 2022).
The disparity between waste generation and treatment arises because of improper management of biomedical waste. There is inaccuracy in the implementation of waste management steps of collection, segregation, treatment and disposal. According to the Indian Ministry of Environment and Forest, around 28 percent of biomedical waste is left untreated. In other words, only a two-third of the total biomedical waste is treated and the rest is getting mixed with general waste (Economic Times, 2017). There are dire and dangerous consequences of mixing general waste with biomedical waste comprising used syringes, contaminated swabs, expired drugs and anatomical waste. Untreated biomedical waste is not only contaminating but pathogenic as well. A study conducted by an Environment Support Group (ESG) for a treatment plant in Mavallipura, Bengaluru found evidence of hazardous waste in landfills. The study revealed heavy metals being released from landfills to water bodies. They reported how heavy metals are rarely found in municipal waste but are prominent in hazardous waste from Hospitals or industries. They also reported conversation with local garbage-collecting workers who confirmed picking up garbage bags with used syringes, swabs and other biomedical waste (Deccan Herald, 2018).
Several studies report that one of the major reasons behind mismanagement of biomedical waste is lack of strict legal frameworks (Yong et al. 2016). However, India’s Biomedical Waste Management Rules 2016 are considered to be a landmark rulebook for management for biomedical waste. It is not only comprehensive and exhaustive but it has been simplified and easy-to-read as well (Singhal, 2017). However, despite advances in legal framework, there is a significant gap between biomedical waste generation and treatment. This happens because the implementation of the BMW Rules still need a lot of improvement. A key area of enhancing overall management of BMW is improving segregation of biomedical waste. Focus on better segregation of biomedical waste should be top priority for medical policymakers. Efficient segregation not only reduces mixing and contamination of waste, it could also reduce operational cost of waste treatment. Duong, 2023 report cost savings of about $100,000 just by doing appropriate segregation of waste.