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Home Biomedical Waste Management

Biomedical Waste Management

MANAGEMENT
TOPIC: BIOMEDICAL WASTE
F.Y. B.M.S.
INDEX
|SR. NO. |TOPIC |pg. no. |
|1 |An Overview of Biomedical Waste Management |3 |
|2 |Biodegradable & Non-degradable Wastes |6 |
|3 |Hazards associated with Poor Health Care Waste Management |7 |
|4 |Persons at risk of the hazards of medical procedures |8 |
|5 |Rules & regulations governing the disposal of Biomedical Waste |9 |
|6 |The different Hospital Waste categories |10 |
|7 |The concept of Biosafety |11 |
|8 |Disposal of Biomedical Waste |15 |
|9 |Legal aspects related to Biomedical Waste Management |16 |
|10 |Mumbai Scenario |23 |
|11 |BIBLIOGRAPHY |27 |
AN OVERVIEW OF BIOMEDICAL WASTE MANAGEMENT
A hospital produces many types of waste material. Housekeeping activity
generates considerable amount of trash, and the visitors and others bring with them
food and other materials which must in some way be disposed off. In addition to the
waste that is produced in all resident buildings, hospital generate pathological waste
viz. blood soaked dressings, carcasses and similar waste. These waste materials must
be suitably disposed of immediately lest they purify, emit foul smells, act as a source of
infection and disease, and become a public health hazard. While in developing countries
most of the public health problems are due to industrialization, in developing countries
many of the public health problems are also related to defective sewage and waste
disposal.
Many of our hospitals neither have a satisfactory waste disposal system nor a
waste management and disposal policy. The disposal of waste is exclusively entrusted
to the junior most staff from the housekeeping department without any supervision, and
even pathological wastes are observed to be disposed off in the available open ground
around hospitals with scant regard to aesthetic and hygiene considerations.

Waste can be defined as any discarded unwanted residual matter arising from the
hospitals or activities related to the hospitals. Disposal covers the total process of
collecting, handling, packing, storage, transportation and final treatment of wastes.
VOLUME
In a study of patterns of wastes in Indian cities, the quantity of refuge varied from
0.48 to 0.06 kg per capita per day with total compostable matter varying from 30 to 40
percent. The quantum of domestic waste in advanced countries is six to ten times more.
So far as hospitals in advanced countries are considered, the average refuge in
hospitals in Denmark and West Germany is 3kg per bed per day. The quantum and
types of waste reflects the life style of the society, and this fact must be borne in mind
in the planning or waste disposal in hospital.
On an average, the volume of total solid waste in hospitals in India is estimated to
range between 1kg and 3 kg per day on a per bed basis. In a teaching hospital of 700
beds soiled waste averaged 1.5 kg per bed per day. It is estimated that about 0.25 kg
out of this comprises of food waste. In a study carried out in the family wing of a large
hospital, he composition of wastes was bandages, gauze and cottonwood waste 34.1%,
coal ash 31.6%, foliage 13.5 5, food waste 11.5 %, trash5.1 %, biological waste 2.3%
and glass, bottles, etc. 1.8 %.
A 1988 study of AIIMS revealed that 67.5% waste originated from wards, 13.4 %
from OPD and 19.1 % from the service area.
Waste management is generally not given the importance it deserves, because the
intrinsic value of the waste materials as an object of further utility has not been
recognized. The net result is that a hospital tries to cut the expenditure involved in
waste disposal by meager allotment of resources. A clean hospital and good
housekeeping have a direct effect on the health, comfort and morale of patients, visitors
and hospital personnel alike. Cleanliness radiates a cheer and a well-kept hospital would
give the public a feeling of confidence.
INTRODUCTION
Biomedical Wastes
Biomedical wastes are defined as waste that is generated during the diagnosis,
treatment or immunization of human beings or animals, or in research activities
pertaining thereto, or in the production of biological.
Biodegradable and Non Biodegradable Wastes
Biodegradable waste means any waste that is capable of undergoing anaerobic or
aerobic decomposition, such as food and garden waste, and paper and paperboard. It
also includes waste from households, which because of its nature and composition is
similar to biodegradable waste from households.
Non biodegradable wastes are the wastes that cannot be decomposed by bacteria
e.g. plastics, bottles and tins.
Quantum of Waste That Is Generated By A Hospital
The quantum of waste that is generated in India is estimated to be 1-2 kg per bed
per day in a hospital and 600 gm per day per bed in a general practioners clinic. E.g. a
100 bedded hospital will generate 100 200 kgs of hospital waste/day. It is estimated
that only 5 10% of this comprises of hazardous/infectious waste (5 10kgs/day)
Hazards Associated With Poor Health Care Waste Management
Proper disposal of biomedical waste is of paramount importance because of its
infectious and hazardous characteristics. Improper disposal can result in the following:
1. Organic portion ferments and attracts fly breeding.
2. Injuries from sharps to all categories of health care personnel and waste
handlers.

3. Increase risk of infections to medical, nursing and other hospital staff.

4. Injuries from sharps to health workers and waste handlers.
5. Poor infection control can lead to nosocomial infections in patients particularly
HIV, Hepatitis B & C.
6. Increase in risk associated with hazardous chemicals and drugs being handled
by persons handling wastes.
7. Poor waste management encourages unscrupulous persons to recycle
disposables and disposed drugs for repacking and reselling.
8. Development of resistant strains of microorganisms.
Persons at Risk of the Hazards of Medical Procedures Depending on the type of
procedures, the persons at risk and mode of transmission in some common medical
procedures are:
|Procedure |Person at risk |Mode of Transmission |
|Collection of blood samples |Patient Health worker |Contaminated needle, gloves,
Skin puncture by needle |
| | |or container, |
| | |Contamination of hands by blood |
|Transfer of specimens (within |Laboratory personnel |Contamination of exterior of
specimen container, |
|laboratory) | |Broken container, |
| | |Splash of specimen |
|HIV serology and virology |Laboratory personnel |Skin puncture, splash of
specimen, |
| | |Broken specimen container, Perforated gloves |
|Cleaning and Maintenance |Laboratory Personnel Supporting |Skin puncture or
contamination, Splashes, |
| |staff |Contaminated work surface |
|Waste Disposal |Laboratory Personnel Support |Contact with contaminated waste |
| |Staff |Puncture wounds and cuts |
| |Transport worker | |
|Shipment of specimens |Transport worker |Broker or leaking specimen, containers
and packages |
| |Postal worker | |
RULES AND REGULATIONS GOVERNING THE DISPOSAL OF THESE WASTES
The Government of India has promulgated the Biomedical Waste (Management and
Handling) Rules 1998. They are applicable to all persons who generate, collect, receive,
store, transport, treat, dispose or handle biomedical wastes. This includes hospitals,
nursing homes, clinics, dispensaries, veterinary institutions, animal houses, pathological
laboratories and blood banks.
RESPONSIBILITIES OF HEALTH CARE INSTITUTIONS REGARDING BIOMEDICAL WASTE
MANAGEMENT
It is mandatory for such institutions to:
? Set up biomedical waste treatment facilities like incinerators, autoclave and
microwave systems for treatment of the wastes
? Make an application to the concerned authorities for grant of authorization
? Submit a report regarding information about the categories and quantities of
biomedical wastes handled during the preceding year by 31 Jan every year
? Maintain records about the generation, collection, reception, storage,
transportation, treatment, disposal and/or any form of handling bio medical waste
? Report immediately any accident to the prescribed authority

THE DIFFERENT HOSPITAL WASTE CATEGORIES

the following table shows the different categories of hospital waste and their
treatment of disposal.
|Category |Type of Waste |Treatment and Disposal Options |
|Category 1 |Human Anatomical Waste (Human tissues, organs, body |
Incineration/Deep Burial |
| |parts) | |
|Category 2 |Animal waste (Animal tissues, organs, body parts, |Incineration/Deep
Burial |
| |carcasses, bleeding parts, blood and experimental | |
| |animals used in research) | |
|Category 3 |Microbiology and biotechnology waste(waste from lab |Local
Autoclaving/ Microwaving/ Incineration |
| |culture, specimens from microorganisms, vaccines, cell | |
| |cultures, toxins, dishes, devices used to transfer | |
| |cultures) | |
|Category 4 |Waste Sharps (Needles, Syringes, scalpels, blades, |Chemical
Disinfection Autoclaving/ Microwaving, |
| |glass) |Mutilation and Shredding |
|Category 5 |Discarded medicines and Cytotoxic drugs (outdated, |
Incineration/Destruction and disposal in land fills |
| |contaminated, discarded drugs) | |
|Category 6 |Soiled waste (contaminated with blood and body fluids |Autoclaving/
Microwaving/ Incineration |
| |including cotton, dressings, soiled plasters, linen) | |
|Category
7
|Solid
waste
(tubes,
catheters,
IV
sets)
|Chemical
Disinfection/Autoclaving/ Microwaving, |
| | |Mutilation and Shredding |
|Category 8 |Liquid waste (Waste generated from laboratory and |Disinfection by
chemical treatment and discharge |
| |washing, cleaning, disinfection) |into the drains |
|Category 9 |Incineration ash |Land fills |
|Category 10 |Chemical waste |Chemical disinfection and discharge into the drains
|
THE CONCEPT OF BIOSAFETY
Biosafety is essentially a preventive concept and consists of wide variety of safety
precautions that are to be undertaken, either singly or in combination, depending on the
type of hazard by all medical, nursing and paramedical workers as well as by patients,
attendants, ancillary staff and administrators in a hospital.
CONCEPT OF DISINFECTION AND STERILIZATION
Disinfection and sterilization are important procedures in biosafety. Disinfection
refers to procedures which reduce the number of microorganisms on an object or
surface but not the complete destruction of all microorganism or spores. Sterilization on
the other hand, refers to procedures, which would remove all microorganisms, including
spores, from an object. Sterilization is undertaken either by dry heat (for 2 hours at
1700C in an electric oven method of choice for glass ware and sharps) or by various
forms of moist heat (i.e. boiling in water for an effective contact time of 20 min or steam
sterilization in an autoclave at 15 lb/sq inch at 1210C for 20 min)
DISINFECTANTS
COMMONLY
USED
FOR
DISINFECTION
OF
MATERIALS
CONTAMINATED WITH BLOOD AND BODY FLUIDS

High level disinfectants like chlorine releasing compounds are used for disinfecting
materials contaminated with blood and blood products. The recommended dilutions for
these compounds are given as follows:
|Name of Disinfectant |Available chlorine |Required chlorine |Required chlorine |
Amount of disinfectant to be |
| | | |Contact period |dissolved in 1 ltr of water |
|Sodium hypochlorite |5% |0.5% |30 min |100 ml |
|Calcium hypochlorite |70% |0.5% |30 min |7.0 gm |
|Na OCl powder |- |0.5% |30 min |8.5 gm |
|Na Dichloro isocyanurate (NaDCC) tablets|60% |0.5% |30 min |4 tabs |
|Chloramine |25% |0.5% |30 min |20 gm |
METHODS OF DISINFECTION OF COMMONLY USED HOSPITAL ARTICLES:
|General use items |Disinfection |
|Bath water |Add savlon when necessary |
|Bed pans |Wash with hot water and dry |
| |Disinfect with phenol after use by infected patients Autoclave |
|Bowls |Wash with hot water and keep dry |
| |Autoclave |
|Crockery, Cutlery |Wash with hot water/detergent and keep dry |
|Floors |Vacuum clean; No use of broom |
|Furnitures |Damp dust with detergent/phenol/2% Lysol |
|Mattresses/Pillows |Use water impermeable cover |
| |Wash cover with detergent and keep dry |
| |Disinfect with phenol/2%lysol |
|Trolley tops |Wipe with warm water and detergent to remove dust and keep dry |
|Thermometers |Wash with warm water/detergent and keep dry |
|Endoscopes/ Arthroscopes/ Laparoscopes/ Fiberoptic Endoscopes |Immerse in2%
Cidex solution |
| |Use latex gloves, eye protection plastic covering mask while handling |
| |Alternatively, use ethylene oxide sterilization |
|Endotracheal suction catheter |Should be disposable |
|Endotracheal tubes |Recycled after cleaning and autoclaving |
|Ambu Bags |Ideally heat disinfect |
| |Immerse in 2% glutaraldehyde and wash with sterile distilled water to |
| |reduce respiratory irritation |
|Oxygen delivery face mask |Wash and dry |
| |Use 70% isopropyl alcohol to remove mucus |
|Suction drainage bottles |Ideally autoclave |
|Ventilatory circuits, respiratory equipment in |Heat disinfection for 800 F for 30
min |
|Neonatal/Pediatric unit |Autoclave |
| |Ethylene oxide sterilization |
|Incubators |Clean thoroughly with warm water / soap |
| |Use 70% isopropyl alcohol |
|Humidifiers |Empty daily refill with sterile water |
| |Disinfect when contaminated with 1% Na hypochlorite |
| |Autoclave |
|Urinary Catheter |Should be disposable |
STERILIZATION METHODS FOR COMMON HOSPITAL INSTRUMENTS

Before instruments are cleaned and sent for sterilization they should be disinfected
for 30 minutes.
Methods of sterilization- table
| |Dry Heat |Autoclave |Ethylene oxide |2% Glutaraldehyde |Formaline |Gamma
radiation |
|Gloves |- |YES |- |- |- |YES |
|Plastic Syringe |- |- |YES |- |- |- |
|Glass Syringe |- |YES |- |- |- |- |
|Needles |- |- |- |- |- |- |
|Endoscopic instruments |- |- |- |YES |YES |- |
|Suction tubes |- |- |- |YES |- |- |
|Suction bottles |- |YES |YES |YES |YES |YES |
|Cautery cable |- |- |YES |YES |YES |YES |
|Cautery points |- |- |- |YES |YES |YES |
|Laryngoscopes |- |- |- |YES |YES |YES |
|Endotracheal tubes |- |- |YES |YES |YES |YES |
|Catheters |- |- |YES |YES |YES |YES |
|Cath Lab Material |- |- |YES |YES |- |YES |
|Blanket |YES |- |- |- |- |- |
|Mattresses |YES |- |- |- |- |- |
|Suturing Material |YES |- |- |YES |- |YES |
DISPOSAL OF BIOMEDICAL WASTE
During the disposal of biomedical waste there are certain colour codes which are to
be followed for the proper disposal and to sort out different types of biomedical waste .
they are as follows:
|Colour coding |Type of Container |Waste Category |Treatment options |
|Yellow |Plastic Bags |Human and animal wastes, Microbial and |Incineration/ Deep
Burial |
| | |Biological wastes and soiled wastes | |
| | |(Cat 1,2,3 and 6) | |
|Red |Disinfected container/ Plastic |Microbiological and Biological wastes, |
Autoclave/ Microwave/ Chemical |
| |bags |Soiled wastes, Solid wastes |Treatment) |
| | |(Cat 3,6,7) | |
|Blue/ White/ Transparent |Plastic bag, Puncture proof |Waste sharps and solid
waste |Autoclave/ Microwave/ Chemical |
| |container |( Cat 4 &7) |Treatment Destruction and |
| | | |Shredding |
|Black |Plastic bag |Discarded medicines, Cytotoxic drugs, |Disposal in secured land
fills |
| | |Incineration ash and chemical waste | |
| | |(Cat 5,9 & 10) | |
|Green |Plastic Container |General waste such as office waste, food |Disposed in
secured landfills |
| | |waste & garden waste | |
Due to such classification and sorting the biomedical waste in such a manner it
becomes very easy during the disposal of the biomedical waste. If such kind of
classification is avoided, it may result into improper disposal methods followed by
environmental imbalances.

For e.g. The human and animal waste is generally packed into yellow bags and
sent for incineration and deep burial. If such classification is avoided and instead of
packing human and animal waste in yellow bags, the third category waste i.e. waste
sharps and solid wastes are sent for incineration and deep burial it may cause a very
serious environmental problem.
LEGAL ASPECTS RELATED TO BIOMEDICAL WASTE MANAGEMENT
Now moving on to the legal aspects related to the disposal and the treatment of
biomedical waste management we come across the following issues.
Management of hospital waste became an issue of concern only in 1980s, when
mass hysteria was generated in the United States on noticing hospital waste floating
along east coast beaches and children playing with used syringes. This led to enactment
of the medical waste-tracking Act of 1988, which required the US Environment
Protection Agency (EPA) to identify alternatives (non regulatory) approach to medical
waste management.
Some public interest litigations (PILs) filed in different states in India, put constant
pressure on the government for a law governing healthcare waste management
(HCWM). The Ministry of Environment and Forests had issued first draft notification on
24th April 1995.
The second one followed in October 1997 and ultimately after public and expert
scrutiny, biomedical waste management and handling rules were promulgated on 20th
July 1998. Due to criticism and feedback from healthcare institutions, two amendments
were issued on March 6, 2000 and June 2, 2000. In the year 2003, guidelines for
common biomedical waste treatment facility (CBWTF) and guidelines for design and
construction of biomedical waste incinerator were also published by Central Pollution
Control Board S (CPCB) national legislations. The guidelines establish legal controls and
permit the national agency responsible for the implementation.
The law has to be complemented by a policy document and technical guidelines.
There should be a clear description of responsibilities before the law is enacted. It is the
responsibility of the government to create a framework for the safe management of
healthcare wastes and to ensure that healthcare facility managers take their share of
responsibility to manage wastes safely.
There are some international agreements and regulatory principles, which form a
basis for HCWM rules at national level:
(a) The Basel convention signed by more than 100 countries, concerns transboundary movements of hazardous waste. It is also applicable to healthcare waste.
(b) The polluter pays principle implies that all producers of waste are legally and
financially responsible for the safe and environmentally sound disposal of the waste
they produce.
(c) The precautionary principle is a key principle governing health and safety
protection.
(d) The duty of care principle stipulates that any person handling or managing
hazardous substances or related equipment is ethically responsible for using the utmost
care in the task.
(e) The proximity principle recommends that treatment and disposal of hazardous
waste take place at the closest possible location to its source. Keeping in mind the
importance of the subject, a study was carried out with the following objectives:
(a) To analyze the regulatory and legal framework available for healthcare waste
management (HCWM) in our country.
(b) To analyze the problems of regulators, healthcare institutions and CBWTF
operator.

(c) To recommend measures to fill the gaps in the law and overcome the hurdles in
implementation of BMW rules.
A study was conducted in the city of Pune regarding this. The methodology
adapted for this study:(a) Interviews of regulators and users i.e representatives of pollution control board,
waste management officers of healthcare institutions, managing director of Image India
(CBWTF operator) were conducted.
(b) Comparison of existing legal framework and guidelines for HCWM in India with
regulatory framework of other countries such as the US, the UK and South East Asian
countries.
(c) Spot study of various healthcare institutes in Pune and visit to CBWTF site.
The new guidelines for CBWTF cover details of how much land is required
(minimum 1 acre), coverage area (150 Km/10000 beds), treatment equipment,
infrastructure setup, record keeping, collection and transportation of BMW, disposal of
treated BMW, cost to be charged by CBWTF operator and setting up and operating
CBWTF.
Guidelines for BMW incinerator contain specifications for APCD (air pollution control
device) ie, high-pressure venturi scrubber system. The Maharashtra Pollution Control
Board (MPCB), which has a regional office at Pune, its advisory committee of board
consisting of secretary, Pune Municipal Corporation (PMC), health officer and
representatives of hospitals and nursing homes of Pune. The MPCB permitted Image
India to set up CBWTF in consultation with local body i.e. PMC in the year 2000. Notices
were issued in all local newspapers advising all healthcare institutes of Pune to avail of
the facility. Initial licensing/authorisation of healthcare institutes for waste generation
and disposal was done by the MPCB.
Periodic checks are carried out on CBWTF for adherence to statutory norms. The
MPCB can only issue notice to healthcare institutes for non-adherence of norms. The
MPCB has no punitive powers of its own. Due to shortage of staff, HCWM becomes a
non-priority area as Pune has a huge industrial area. Monitoring is based on complaints
from citizens, local bodies and NGOs. However, all the complaints received by MPCB
were from CBWTF who informs board of violations in his own interest. CBWTF operator is
checked once in six months by special equipment. The MPCB is not issuing permission
for new incinerators and in fact has ordered to close down incinerator in one reputed
hospital for not conforming to the norms.
Image India operates CBWTF in Pune with three oil-fired incinerators with a
common chimney, catering to 70-80 per cent of healthcare institutes in Pune (6000
beds approximately). It charges Rs 2 per bed per day to these healthcare institutes. It
gets its incinerator ash tested by government-approved lab and the report is forwarded
to MPCB. It also forwards monthly certificate of following norms, details of waste.
It is also acting as a virtual watchdog for Pune as far as BMW is concerned in his
own interest. It has started charging from Rs 20/ Kg of infectious waste to compulsory
Rs 2/- per bed per day as hospitals were disposing off infectious waste clandestinely.
They claim to have 170 collection points all over the city; however, observation did not
confirm the same. They have two dedicated and specially designed vehicles for BMW
collection. Image India also has an authority to return unsegregated waste from any
healthcare institute and inform SPCB and notice an issue to it.
The PMC collects all the general waste from healthcare institutes. It acts as
guarantor for healthcare institutes in Pune in terms of ensuring payment to CBWTF. It
has provided land on lease for 30 years to CBWTF as per agreement. Initial licensing at
the rate of Rs 1000/- per HCE was carried out and renewal will be done every 3 years.

PMC took strict action of filing FIR against one of the hospitals that defied all notices
issued by MPCB and medical superintendent was arrested.
Health care institutes cost of BMW treatment is too high. There is no concession
offered to small waste generators. They also face difficulty due to limited pick up points
as well as long storage time up to seven days or so. Central facility for recyclable waste
as well as non-burn techniques does not exist.
If shredder, autoclave as well as microwave is installed centrally then the entire
hazardous waste of HCE can be taken care of. Segregation mistakes are very common
by employees leading to rechecking of yellow bags and re-segregation has to be carried
out which exposes employees to injuries and infections.
There are no incentives offered to hospitals that are law abiders in terms of capital
costs as well as operational costs. Many hospitals continue to take short cuts in terms of
colour coding, use of bags, use of disinfectant et cetera, workers safety is not taken into
consideration/not given due importance in terms of provision of personal protective
equipment and immunization.
RECOMMENDATIONS
1. Biohazard bag specifications like plastic bags should be specified (minimum
gauze of 225 microns for high risk waste and 100 microns for low risk waste). Standard
for tensile strength to determine its resistance to tearing should also be specified.
2. Prescribed authority should be able to enforce rules.
3. Medical waste transfer station should be introduced to overcome problems of
lifting infectious waste from all the healthcare organizations within 48 hours in big cities.
Bigger hospitals that are now acting as regular pick up points can in fact become
medical waste transfer stations for small waste generators. As per CAG report of 2001,
the waste from hospitals in New Delhi was not lifted for three to 58 days. Medical waste
tracking in terms of infrastructure like computers, bar coding of biomedical bags and
record keeping should be specified.
4. Medical waste reduction plan and progress report should become an inherent
part of the rules. Rules also should specify the targets to be achieved by institutes in
terms of waste reduction. Hazardous waste like mercury, plastic, batteries, organic
solvents, formaldehyde et cetera should be specifically monitored.
5. Record keeping of tracking documents, treatment of waste records should be
kept for three years and record of burial sites should be kept permanently.
6. Administrative penalty for violating the rules, not applying for authorization,
operating without permit should be standardized throughout India.
7. There is a need to specify the court where cases for violation of rules can be
heard and penalty awarded.
8. Community/ public should be allowed to access the records, specially where
community interest is involved.
9. BMW rules should include occupational health and safety regulation for hospitals
and legal clauses, for hospitals who do not abide by the rules.
10. Judicial review of any order also should be specified other than appellate
authority.
11. Subsidies/ soft loans / tax exemptions should be provided to healthcare
institutes /CBWTF operator for technological innovations, waste recycling equipment
and final disposal facilities.
12. Fine/penalties charged under the rules should find their way to a national
health care waste management fund from which subsidies can be granted to law
abiding health care institutes.

13. It is also desirable to create a separate body (Waste Management Board) for
managing all solid wastes including BMW at the national level which has the authority to
solve issues related to waste management.
Mumbai Scenario
Demographic Profile Mumbai
Once a cluster of seven islands Colaba, Mazgaon, Old Womans Island, Wadala,
Mahim, Parel and Sion-Matunga- Mumbai has over the years become one island, partly
by silting action of the sea and partly by the human agency. Originally, home to the kolis
(fisher folk), the city is today the capital of Maharashtra and the financial capital of
India. Mumbai, the commercial pulse of India and forefront of Indias development in
business, also has the busiest international airport and seaport in the country. The glory
of the city is well described in its history. There were major changes in the
administrative set up of Mumbai after the 1981 census. For all administrative purposes
the district is divided into 24 Wards, but the 88 sections within these Wards remain
same. The population of Mumbai in 1872 was only 6,44,400. As on March 1, 2001, the
city had a population totalling 119,14,398. Although it has the strongest and the most
diversified economy of any of Indias metropolitan cities and higher levels of income and
lower incidence of poverty with very high literacy rate, Mumbai continues to have
serious infrastructure deficits. This is mainly in terms of housing and water supply. In
2001, the population of Mumbais suburbs was more than 2.5 times of that of Mumbai,
indicating a shift from the city to the suburbs or South Mumbai to North Mumbai. An
overview of the decadal population growth is shown in Table 1.
Table 1: Population Data in Municipal Corporations of Mumbai Urban Agglomeration
|Sr. No | Constituents | 1971 Million | 1981 | 1991 | 2001 |
| | | |Million |Million |Million |
|
| Total | Gr. Mumbai UA | 6.59 | 9.42 | 12.59 | 16.36 |
|
| 1 | Gr. Mumbai | 5.97 | 8.24 | 9.92 | 11.91 |
|
| a. | Mumbai Suburb | 2.90 | 4.95 | 6.75 | 8.58 |
|
| b. | Mumbai Dist. | 3.07 | 3.28 | 3.17 | 3.32 |
|
| 2 | Thane | 0.20 | 0.43 | 0.80 | 1.26 |
|
| 3 | Kalyan | 0.23 | 0.44 | 1.01 | 1.19 |
| |-Dombivilli | | | | |
|
| 4 | Ulhasnagar | 0.16 | 0.27 | 0.36 | 0.47 |
|
| 5 | Mira Bhayander | 0.01 | 0.02 | 0.17 | 0.52 |
|
| 6 | Navi Mumbai | | | 0.30 | 0.70 |
|
The growing population also continually places a constant pressure on the health
care delivery system. Planners, since 1950, have suggested decentralisation as one of
the solutions.

Congruent with the population distribution trend is the health care delivery
mechanism. An overview of the number of hospital beds shown in Table 2 indicates a
higher concentration in the South Mumbai tapering down towards the suburbs.
Table 2: Number of Hospital beds in Mumbai
|City Zone |Population |Existing Beds |
| |2001 census | |
|The City (Ward A-G) |3.32 |21,874 |
|Western Suburbs |5.09 |10,504 |
|(Wards H,K.P,R) | | |
|Eastern Suburbs |3.49 |8,084 |
|(Wards L,M,N,S,T) | | |
|Mumbai City Total |11.91 |40,422 |
The city, catering to a population of nearly 13 million with a concentration of more
than 16,000 persons per sq. km, proudly includes approximately 1,100 health-care
institutions, 47 blood banks, 26 eye banks, 262 family welfare centres, 13 centres for
blind and disabled, 179 health centres, 308 pathological labs, 64 spastic centres, 663
vaccination centers, 108 CT scan & USG centres, 15 angiography centers, 12 MRI
centers and 4 Gamma cameras all constantly increasing. This can easily be witnessed
with the upcoming hospitals all over the city right from LH Hiranandani Hospital, Godrej
Memorial Hospital, Wockhardt Hospital and so on. This pressure of ever-increasing
health care has also led to an obvious increase in the biomedical waste generated by
them. Adding to its current problem of managing solid waste, the Municipal Corporation
of Greater Mumbai (MCGM) has to also handle this very technical issue of regulating
biomedical waste which is a potential biohazard and capable of transmitting infection.
Of the total amount of almost 7,000tonnes of waste generated by the city, almost
25tonnes is estimated to be medical waste.
BIBLIOGRAPHY
1. www.bcpt.org.in
2. www.env.gov.jp
3. www.wikipedia.com
4. Principles Of Hospital Administration And Planning-By B.M. Sakharkar
5. www.Managementparadise.com
ACKNOWLEDGEMENT
We would like to thank Prof. Manoj Devne for giving us an opportunity to express
our views and ideas on the topic as well as helping us improve our knowledge in
Environmental Management subject.
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