India’s biomedical waste management is governed by stringent laws aimed at ensuring the safe handling, treatment, and disposal of waste generated by healthcare facilities. These regulations are designed to mitigate health and environmental risks while encouraging sustainable practices. Drawing inspiration from European guidelines, healthcare providers are urged to minimize waste generation, phase out incineration, work towards a toxic-free future, and ensure the safety of waste management personnel.
However, recent developments highlight ongoing challenges in implementation. In a case before the National Green Tribunal (NGT), Kerala faced criticism for its inaction on biomedical waste dumping along its border in Tamil Nadu. Such incidents underscore the urgent need for stricter enforcement of biomedical waste management laws to protect public health and the environment. This article will delve into the issues surrounding the handling of biomedical waste, examining the current regulatory framework, challenges in enforcement, and the need for sustainable practices to address the growing concerns in this critical area.
Recent Case Overview
The National Green Tribunal (NGT) took suo moto cognizance of the issue and expressed serious concerns regarding Kerala’s handling of the illegal dumping of biomedical waste into Tamil Nadu. The tribunal questioned whether Kerala authorities might be colluding with the alleged offenders and directed the state’s environment department secretary to provide a comprehensive report on the matter. Additionally, it instructed Tamil Nadu to strengthen border monitoring by forming a dedicated task force to oversee vehicular movements. The tribunal criticized Kerala’s report as vague and insufficient, noting it lacked details about the quantity of waste cleared from the affected border villages in Tamil Nadu’s Tirunelveli district.
The Kerala State Pollution Control Board (KSPCB) reported issuing a show-cause notice in December 2024, to three entities—Regional Cancer Centre, Credence Multispecialty Family Hospital, and Leela Kovalam Resort out of which only Credence Hospital defended itself, stating that it had entrusted its biomedical waste to IMAGE (Indian Medical Association Goes Eco-friendly), Kerala’s sole authorized waste management agency. The rest failed to respond and the KSPCB also did not take any further action. The tribunal expressed concern over IMAGE’s alleged involvement in violations and it also noted that the agency participated in an important meeting chaired by Kerala’s Secretary, despite being an alleged violator.
The tribunal also suggested the state consider agreements with authorized waste management agencies in Tamil Nadu and Karnataka instead of solely relying on IMAGE to ensure better accountability. It also emphasized that merely issuing show-cause notices was insufficient and urged authorities to adopt comprehensive measures, including temporarily halting operations of violators, such as holiday resorts, until investigations are completed.
The bench also highlighted delays by the Central Pollution Control Board (CPCB) in finalizing standard operating procedures (SOPs) for biomedical waste management, despite previous directives to draft guidelines to prevent inter-state dumping. The tribunal urged the CPCB to expedite the process. Meanwhile, Tamil Nadu reported additional incidents of waste dumping, including human excreta, in Kanniyakumari. In response, the tribunal called for swift action on the issue and adjourned the proceedings to a later date.
Regulatory Framework Governing Biomedical Waste
The Biomedical Waste Management Rules, 2016(Replacing the Biomedical Waste (Management and Handling) Rules of 1998), were introduced to oversee the proper handling, management, and disposal of biomedical waste produced by healthcare facilities, research institutions, and laboratories in India. These rules aim to mitigate the negative impacts of biomedical waste on public health, the environment, and ecosystems.
These rules apply to all healthcare establishments, research institutions, laboratories, blood banks, veterinary institutions, and other facilities involved in generating, handling, or disposing of biomedical waste. The rules categorize healthcare facility-generated biomedical waste into four color-coded groups to ensure proper segregation and disposal. The Yellow Category includes waste from microbiological and biotechnological laboratories, anatomical waste, and discarded medicines. The Red Category covers infectious waste such as blood-soaked items, human anatomical waste, and sharps like needles and syringes. The White Category pertains to solid waste like tubing, catheters, and items contaminated with blood or body fluids. Lastly, the Blue Category addresses waste from materials like glassware, plastics, and metallic implants. This categorization is critical for the proper segregation, handling, and disposal of biomedical waste, as each type requires specific treatment and disposal methods.
The rules mandate the segregation of biomedical waste at its source into color-coded bags or containers corresponding to the waste category. These containers must be properly packaged and labelled according to prescribed guidelines to ensure safe handling, transportation, and disposal.
Specific requirements are outlined for the storage and transportation of biomedical waste. Facilities must use leak-proof, puncture-resistant containers and vehicles designed for the secure transport of biomedical waste. Healthcare establishments are required to store waste in designated areas and ensure that it is transported to authorized treatment and disposal facilities within the stipulated time frame.
The rules outline specific treatment and disposal methods for different categories of biomedical waste, including incineration, autoclaving, microwaving, chemical treatment, and deep burial. Healthcare establishments are obligated to treat and dispose of biomedical waste strictly according to these prescribed methods and must maintain detailed records of all waste treatment and disposal activities.
The rules mandate that all healthcare establishments obtain authorization from the respective state pollution control board for generating, handling, and disposing of biomedical waste. Additionally, establishments are required to maintain records of their biomedical waste management practices and submit annual reports to the state pollution control board.
To ensure compliance, the rules provide for regular monitoring and inspections of healthcare establishments by designated authorities. Non-compliance with the prescribed standards and guidelines can result in severe penalties, including fines, imprisonment, and the cancellation of authorization. These measures aim to enforce accountability and uphold the safe and effective management of biomedical waste.
Persistent Challenges
The implementation of the Biomedical Waste Management Rules continues to face several challenges. A significant issue is the lack of awareness and training among healthcare professionals and waste handlers, leading to improper handling, segregation, and disposal practices that put public health and the environment at risk. Limited infrastructure and resources further hinder compliance, with many establishments still lacking access to authorized disposal facilities and specialized equipment for safe waste management.
Many healthcare facilities lack the manpower and resources and hence fail to meet prescribed standards. Regular inspections and enforcement are difficult. Coordination among healthcare stakeholders, laws, and agencies is also lacking which hinders effective rule implementation. Hence, compliance also becomes a perpetual issue.
Improving the implementation of Biomedical Waste Management Rules requires enhanced awareness and training through regular workshops for healthcare professionals, waste handlers, and administrative staff, alongside incorporating waste management education into medical and paramedical curricula. Strengthening infrastructure by establishing more authorized disposal facilities, especially in rural areas, is vital, as is increasing inspections and enforcing stricter penalties for violations. Public awareness campaigns and community engagement can promote accountability, while GPS-enabled tracking systems for waste transport can ensure transparency and prevent illegal dumping, fostering a comprehensive and compliant waste management system.
The unregulated informal waste disposal sector continues to pose significant risks, requiring stronger enforcement, awareness efforts, and integration into the formal system. The recent case highlights the need for robust enforcement of biomedical waste management laws.
Conclusion
The NGT’s directive to the CPCB in O.A. No.312 of 2024(SZ) underscores the need for a consistent framework to prevent inter-state dumping, which remains a challenge due to poor coordination and monitoring. Improper disposal of biomedical waste poses serious health risks, contaminating soil, water, and ecosystems, while affecting communities’ well-being. This incident calls for greater inter-state cooperation and a comprehensive overhaul of biomedical waste management practices. Strengthening regulatory bodies will ensure sustainable, efficient management, safeguarding public health and the environment.
