International Academic Journal of Law

ISSN Print: 2709-9482 | ISSN Online: 2709-9490

Frequency: Monthly
Language: English
Origin: Kenya
Website: https://www.iarconsortium.org/journal-info/iajl
Research Article
Biomedical Waste Management and Law- A Study of the Government
Hospitals of District Srinagar in the Union Territory of Jammu And
Kashmir, India
Article History Abstract: Healthcare is undoubtedly an inevitable facet of human existence. The
very functioning of a healthcare establishment generates waste which in turn
Received: 20.04.2022
needs to be effectively managed. Bio-Medical Waste is defined as any waste
Revision: 28.04.2022
produced during the diagnosis, testing, treatment, research or production of
Accepted: 03.05.2022
biological materials by either animals or humankind. The present study was done
Published: 10.05.2022
to access whether Government hospitals in the district Srinagar of the Union
Author Details territory of Jammu and Kashmir are functioning in gross violation of the existing
Sufaya Bashir Bio-Medical Waste (Management and Handling) Rules, thereby posing dangers to
Authors Affiliations in-patients, visitors and the public at large and whether The Bio-Medical Waste
Department of Law, University of Kashmir, (Management and Handling) Rules suffer from certain basic shortcomings due to
Srinagar, India which they have become ineffective in protecting the environment generally and
Corresponding Author* the health of the people in particular. The study revealed a gross violation of Bio-
Sufaya Bashir Medical Waste (Management and Handling) Rules. A judicious balance between
environment protection and Bio-Medical Waste Management is the need of the
How to Cite the Article: hour.
Sufaya Bashir. (2022). Biomedical Waste
Management and Law- A Study of the Government Keywords: Biomedical waste, legal regulations, judiciary, segregation.
Hospitals of District Srinagar in the Union Territory .
of Jammu And Kashmir, India. Int Aca. J Law, 3(3),
1-6 INTRODUCTION
Copyright @ 2022: This is an open-access article Over the years there have been tremendous advancements in the
distributed under the terms of the Creative
Commons Attribution license which permits healthcare system. However it is ironic that the healthcare settings, which
restore and maintain community health, are also threatening their well-
unrestricted use, distribution, and reproduction
in any medium for non commercial use being. Poor waste management practices pose a huge risk to the health of
(NonCommercial, or CC-BY-NC) provided the the public, patients, professionals and contribute to environmental
original author and source are credited.
degradation. 1 Bio-Medical Waste is defined as any waste fabricated
during the diagnosis, testing, treatment, research or production of
biological materials by either animals or mankind. Such waste has the potential to be hazardous to human health if it is
left unregulated. It originates from Bio-Medical Waste facilities, such as hospitals, clinics, nursing homes, laboratories,
funeral homes, dentist offices, veterinarian or physician complexes, medical transporters (e.g., ambulances) and storage
and treatment facilities for biological entities since they all produce Bio-Medical Waste. It contains human body parts,
tissues and organs as well as animal body parts, carcasses, excreted bodily wastes, parts containing blood and wastes
generated at veterinary hospitals. Besides, microbiology and biotechnology cultivate Bio-Medical Waste in the form of
laboratory cultures, live or non-live vaccines, and human and animal cell cultures used during research.

Items that come into contact with biological-waste functions are also considered Bio-Medical Waste originators.
Needles, syringes, blades, scalpels, blood stained material or cotton balls and dirtied plasters are a few such examples.
Discarded medicines, used tubing and catheters, chemicals used for disinfection purposes and any waste that is a
consequence of laboratory upkeep are all instigators of Bio-Medical Waste as well.

In the area of pollution, the management of wastes is a perennial agenda and of these wastes, the Bio-Medical Waste
is a special kind of waste. The infectious nature of the Bio-Medical Waste itself reveals the danger of its mismanagement.
Bio-Medical Waste (also popularly called healthcare waste or hospital waste) is a by-product of healthcare and includes
sharps, non-sharps, blood, body parts, chemicals, pharmaceuticals, medical devices and radioactive materials. Generation
of Bio-Medical Waste in sizeable quantities, depending upon the number of patients and the nature of activity, is an
unavoidable side effect of healthcare delivery systems which primarily and predominantly takes within its fold processes
like diagnosis, treatment, surgical intervention, post-operative care, rehabilitative care, clinical research, clinical trials
etc. The objectives of the study are to analyze the existing rules and regulations pertaining to the management and

1
J. Joseph and A. Krishnan, “Hospital waste management in the union territory of Pondicherry – An exploration” 155
JHI 260 (2004).

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Sufaya Bashir, Int Aca. J Law; Vol-3, Iss-3 (May-Jun-2022): 1-6
handling of Bio-Medical Wastes for their efficacy, especially in the context of enforcement and feasibility and to analyze
the problem of Bio-Medical Waste Management in government hospitals in district Srinagar and investigate the
adequacy of law and efficacy of administrative agencies in effective handling and proper disposal of Bio-Medical
Wastes.

Study Area
For the present study ten hospitals were selected which have different characteristics in terms of their size, treatment
technology and the type of patients catered, from district Srinagar of the Union Territory of J&K which constitutes the
universe of the health care institutions visited. The ten major hospitals are S.M.S.H, L.D Hospital, Bone and Joint
Hospital Barzullah, G.B Pant Children hospital, Chest Disease Hospital, Government Psychiatric Diseases Hospital,
Sher-i-Kashmir Institute of Medical Sciences, SKIMS Medical College, JLNMH, and Gousia Hospital.

MATERIAL AND METHODS

Research Methodology adopted for accomplishment of this work is partly doctrinal, and partly empirical. The nature
of study is both to review the existing literature on the subject and will also involve empirical data collection. The
doctrinal part involves review of literature (Books, journals), laws, judicial pronouncements, surveys conducted, e-
resources etc. It may also take into consideration all the data collected from secondary and tertiary resources. Thus, on
one side it explores the present legal frame work on the topic from the perspective of writings, judicial decisions and
relevant statutes and other relevant material collected from the primary and secondary sources. On the other hand, for the
purpose of empirical study a questionnaire has been administered to purposive random stratified representative sample
of:

 Personnel in Occupiers : At the level of the Occupier, the researcher identified certain categories and numbers of
personnel associated with different healthcare settings, i.e. ten Medical Superintendents, thirty Doctors, thirty
Nursing Staff and thirty Auxiliary staff (supporting staff), totaling in all 100. Having obtained the sample of
healthcare settings, a questionnaire was designed to suit these categories referred to above which developed after
literature survey and review. The said questionnaire was distributed to the identified personnel from amongst the
sample of Occupiers, after a pilot survey.
 Enforcement Authorities: The prescribed authority under the rules is the Jammu and Kashmir State Pollution
Control Board and it is entrusted with a very big role in the effective monitoring of the rules. This study involved
interviewing the officials of the Jammu and Kashmir State Pollution Control Board. Besides, this study identified
ten officials Jammu and Kashmir State Pollution Control Board of different ranks, involved in the
implementation of the BWM Rules. A questionnaire designed to suit these officials, developed on the basis of the
problem of mismanagement Bio-Medical Waste was distributed. In addition, informal interviews were conducted
with a few of these officials in order to deviate from the structured context of the questionnaire distributed to
them.

RESULTS AND DISCUSSION

The information collected through the questionnaire and interview from the respondents has been processed and
analyzed for testing the hypothesis. The collected data is analyzed below:
1. The quantity of waste generated in ten major hospitals of Srinagar per day is 5760.25 kilograms, which has
drastically increased over the years. Despite of such large quantities of biomedical waste only Sher-I-Kashmir
Institute of Medical Sciences is having the incineration facility and the other hospitals if having facility is non-
functional.
2. In a majority of the areas of this study, the scene is dismal and calls for serious and immediate amelioration. It was
found by the researcher that knowledge and awareness of biomedical waste (M&H) Rules among the respondents is
negligible, 90% of respondents failed to answer the name of rules applicable to hospital waste, it means that the
Government has not done enough to sensitize the personnel who are employed in healthcare establishments that
generate Bio-Medical Wastes. Less than half (48%) of the respondents reported that their healthcare settings
followed a waste management plan that too small a percentage in an area of risk-prone environment. It was found
that a good number of respondents were not aware of the job responsibilities associated with BMW which is again a
major concern.
3. It was found by the researcher that vast majority (70%) of the respondents were not even aware that authorization
given by the Jammu and Kashmir State Pollution Control Board which reflects the starting point of the disconnection
in the system between the prescribed authority under the rules and the Occupiers.
4. It was found by the researcher that only two hospitals are having their own official websites in contravention of
Rule 4 (P) of Biomedical wastes Management Rules which provides that all health care facilities shall have their
own website within 2 years from the date of notification of these rules, for the purpose of uploading Annual Bio-
Medical waste report. It was also found that no hospital has uploaded the annual report of BMW on their official

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website as envisaged by Rule 13 (4) of BMW rules. It was again observed that vast majorities (90% of Occupiers
have not submitted the annual report to the SPCB and even greater majorities do not maintain any records and
hence there is very little information related to the generation, collection, reception, storage, transportation,
treatment, disposal and/or any form of handling of Bio-Medical Waste . Further, no accidents have been reported
until today in prescribed format to the prescribed authority. In respect of mandatory annual reporting, meant to be
furnished to the prescribed authority by 30 June annually, only one hospital had submitted such reports since last two
years. The Jammu and Kashmir State Pollution Control Board has not undertaken any measures due to non-receipt of
such reports even though CPCB has to be compulsorily intimated on or before 31 July of every year, which shall
have further send this information to Ministry of Environment, forest and climate change on, or before 31 August
every year.
5. The methods of treatment and disposal of Bio-Medical Wastes are the main aspects of these Rules. Schedule I has
laid down the categories of wastes and their methods of treatment while the scientific standards for operating
technical instruments like incinerators, autoclaves and microwaves are prescribed in Schedule II. For abiding by
Schedule I, which prescribes the various ways by which treatment of Bio-Medical Wastes must be undertaken, the
Occupier must possess certain specified facilities like autoclaves or microwaves. However, majority of the Occupiers
did not even possess autoclaves. As for the other mandatory facilities required to treat Bio-Medical Wastes as per the
rules, it was found by the researcher only one hospital is having incineration facility to dispose of the BMW and rest
of the hospital transports the waste to Common Biomedical Waste Treatment Facility which are also only two in
Kashmir Division, which implies failure of government and authorities to establish waste disposal plants taking into
the consideration the quantum of waste generated by health care establishments.
6. Segregation, packaging, transportation and storage are equally important in the management and handling of Bio-
Medical Waste. Segregation is the first step and it is clearly prescribed that Bio-Medical Waste should not be mixed
with other wastes. In the rules laid down for segregation, Schedule I prescribes a certain type of container with a
particular color coding to be adopted and Schedule IV prescribes the symbols to be used on such containers
However, alarming amounts (80%) of Occupiers were not able to match the waste type with its color which clearly
indicates failure of occupiers in segregating the waste. Though the respondents were aware of the fact that
segregation is important but when seen practically hardly any segregation was done according to the Rules. Not only
sanitation staff and nurses but also doctors were also unable to match the codes. It was found that in some health care
establishments the BMW is collected through authorized waste collection. However, it was also observed by the
researcher many occupiers burn the BMW in open and it was found that unsegregated waste remains scattered in the
open, which is easily accessible to rag pickers and animals.
7. Labelling must be done for Bio-Medical Waste containers or bags in accordance with Schedule IV of the BWM
Rules. The symbols for depicting biohazard and cytotoxic wastes are provided in the BWM Rules. However, it was
found that 49% of respondents were not aware of the labelling of infectious waste with Biohazard symbols.
8. It was found as per the data collected from the respondents that less than 48% of occupiers maintain a register for
biomedical waste
9. As far as the findings drawn on Employee Education and Suitability are concerned, of the three aspects, viz. whether
the respondent has undergone any training programme on hospital waste management; whether the hospital provides
annual education on waste management for an employee and whether the concerned respondent would like to attend
a programme on hospital waste management, the first two aspects again show a poor level of employee education
since a very large segment (80%) of respondents have not undergone any training on waste management and an
equally large number (80%) reported that their healthcare setting does not have any annual education programme on
waste management. There is however, some consolation in observing that a majority of them was interested in
attending a programme on Bio-Medical Waste Management and it shows their willingness to contribute to a hygienic
environment in their healthcare establishments.
10. It was found that only 74% of respondents were provided protective equipment’s and the rest were without any
protective gears, which again is violation of Rule 4(l) of BMW rules 2016. It was also found annual checkup of
respondents was also limited to a specific percentage. The main stakeholders that is the sanitary staff who handles
and carries BMW before it is transported to Common Biomedical Waste Treatment Facility are not checked annually
for the probable effects of BMW, which violates rule 4(m) of the BMW rules 2016.

Bio-Medical Waste Regulation and Management: A Critical Overview

Having completed a detailed evaluation of Bio-Medical Waste Management in the District Srinagar of the Union
Territory of Jammu and Kashmir in the light of the BWM Rules, the findings of which are detailed above, a critical
evaluation of the BWM rules themselves is also necessary in the context of the hypothesis postulated in this study. For
this purpose, the content of the relevant rules have been examined and the need for having such rules in their existing
form, has been ascertained, giving reasons for the same.
 According to BMW Rules 2018 waste is categorized in four categories however, such classification is not
comprehensive as for example there is no special attention on pharmaceutical waste being a form of biomedical

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waste. On the contrary, in developed countries such as U.S. there are special guidelines on pharmaceutical waste
management wherein detailed classification of pharmaceutical waste is mentioned along with disposal methods.
 According to BMW Rules 2018 Biomedical waste means any waste which is generated during the diagnosis,
treatment or immunization of human being or animals or research activities pertaining there to or in production or
testing of biological or in health camps including categories mentioned in schedule I. However, it does not
necessarily comprise certain wastes such as those produced during manufacture of pharmaceuticals, processing of
drug products or excipients. The disposal method stated for outdated, contaminated and discarded medicines as per
current guidelines for biomedical waste includes incineration, destruction and drugs disposal in secured landfills, this
seems satisfactory at hospital level however there is no rule-specifying disposal of expired or discarded medicines at
household level.
 The methods provided for the disposal of BMW in the Rules of 2018 like incineration, autoclaving though no doubt
are efficient methods for the disposal of BMW but in a hospital environment, technologies like those of incineration
fail because untrained staff runs them. The incinerator should be used at its optimum level otherwise; the waste may
not be treated properly. In most of the surveys carried out, incinerators run at temperatures lower than those specified
in the rules and due to this poor operation and maintenance, these incinerators do not destroy the waste, need a lot of
fuel to run, and are often out of order. When every hospital uses an incinerator, it is underutilized since the amount
of infectious waste of a single hospital is not sufficient for the optimum use of the machine, thereby leading
improper treatment of Bio-Medical Waste. Therefore, overall, it is not feasible for every hospital to use an
incinerator and it is preferable to have centralized incinerators instead.
 BMW Rules 2018 provides that it shall be the duty of occupier not to give treated biomedical waste with municipal
solid waste however; there are no means to distinguish with an absolute precision between the two types of wastes.
A small carelessness of throwing a syringe or a needle contaminated by infectious waste will pose great danger as
the waste, which is assumed non-biomedical solid waste could in fact be infectious waste as a result. Therefore, this
Rule is not at all feasible as utmost care is required while segregating and findings reveal that the required standard
of care is not present. Hence this Rule requires reconsideration to ensure the objectives of segregation since, as of
now, segregation of the Bio-Medical Waste into specific categories of Bio-Medical Waste and storage in different
color-coded containers is not being implemented to an appreciable extent.
 There is a specific direction in the Rules that the maximum permissible period of storage of untreated Bio-Medical
Waste is 48 hours. The question here is as to how the authorities ensure compliance with this rule when there is no
technology to test this period of 48 hours in respect of such wastes. The authorities also do not have any designated
officials to undertake surprise inspections in this regard. Apparently, the only way left for the authorities is to rely on
the statement of the hospital staff, which speaks of the weakness of this Rule.
 The Rules mention that the Central or the relevant State or Union territory Pollution Control Boards as the prescribed
authority. However, these Boards are already over-stressed because of lack of infrastructure, labor and technical
power to implement the existing legislative requirements. New responsibilities of this kind have certainly put added
pressure on Boards and in turn have resulted in poor implementation. An analysis of the Rules vis-à-vis their
implementation portrays the total lack of preparedness on the part of the State of Jammu and Kashmir, in terms of
both infrastructure and skill.
 The law relating to Bio-Medical Waste Management should play an important role in curbing the menace of
mismanagement and the bio-medical Rules have to face to such challenges in order to strengthen regulation. The fear
of punishment for contravention of the Rules seems illusory and meaningless as much enforcement of penal
provisions under the Environment (Protection) Act, 1986 has not been done. In view of this, regulation of bio-
medical waste presents significant challenges. The scenario of Bio-Medical Waste demands better management. The
present rules appear ineffective to manage the volumes of Bio-Medical Waste. Law has stumbled in performing its
duty, much of attribute from the lack of proper implementation mechanism. Time has come to act seriously and
implement the rules effectively. Greater commitment is required on the part of the Government looking into the
magnitude of the problem. The regulatory body should be strengthened. There is certainly a need to re-look at the
rules. Taking into consideration the above findings and shortcomings of the BMW Management Rules 2018, it is
submitted that both the hypothesis stands proved i.e.
1. Government hospitals in Srinagar function in gross violation of the existing Bio-Medical Waste (Management
and Handling) Rules, thereby posing dangers to in-patients, visitors and the public at large.
2. The Bio-Medical Waste Management Rules, suffer from certain basic shortcomings due to which they have
become ineffective in protecting the environment generally and health of the people in particular.

CONCLUSION
To sum up, the solution of environmental pollution on Bio-Medical Waste Management solicits concerted multi-
disciplinary endeavors. Therefore, proper environmental health requires the co-operation and service of public health and
medical professionalism apart from educating people about the menace. As far as policy and legal framework, the
relevant provisions should provide for the respective standards, formalities and procedures to be complied by all people
concerned. However, it is crucial to understand that despite enunciation of law dealing with pertinent standards,

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formalities and procedures as detailed above, unless appropriate efforts are made to translate the same into action, law
will remain more on paper; an act of futility, when it comes to achieving the contemplated objective in practice. This is
the precise reason why, appropriately structured and customized strategies need to be identified for the purpose of
meaningful implementation of the Law.

One such strategy is the effective dissemination of provisions of law among those who are either directly or indirectly
obligated under the Act for its proper implementation. Inclusion of Bio-Medical Waste Management component in the
curriculum of medical, dental and nursing courses will contribute towards improvement. The environmental issue is
slowly gaining ground in the Indian society. This is because environmental problems affect each individual thus resulting
in substantial awareness at all levels. The younger generation must be entrusted with this task since they are the future of
the country. The Bio-Medical Waste Management is certainly an environmental issue and therefore, proper training must
be given to the people, who will be directly responsible for its management. Therefore, it is important to include Bio-
Medical Waste Management in the curriculum of courses above referred. This is because doctors, dental surgeons and
nurses are directly responsible for the supervision and handling of the Bio-Medical Waste and they are directly handling
such waste in their routine jobs.

Educating the public about the potential hazards about Bio-Medical Waste is also very important. The cooperation of
the people is necessary to ensure proper treatment of Bio-Medical Waste. The education of the public should begin in the
hospitals, where nurses, who regularly come in contact with the patients, can educate them about Bio-Medical Waste
especially diabetic patients, who regularly use insulin injections and then simply throw the infected injections in the
dustbin. However, the most important category that must receive education is the private clinics, medical testing centers
and small hospitals, which individually generate wastes in smaller quantities but cumulatively, the waste generation is
substantial and significant.

It is time that hospitals and other medical institutions realized the importance of managing and treating Bio-Medical
Waste in a safe and non-hazardous manner that can prevent the spread of pathogens and microbial infections into our
environment and society. The State of Jammu and Kashmir needs to wake up to this problem as quickly as possible and
confront it with courage and determination. This requires greater investment in the healthcare technology to improve the
quality of its management systems. However, what it first needs is awareness about the magnitude of this problem.
Awareness can be brought about by NGOs who are aware and have the capability to educate others. The Government of
Jammu and Kashmir in this regard can offer financial help to these NGOs to carry out the necessary awareness and
training operations required by the hospitals. The corporate sector too can contribute a great deal by developing
innovative technologies and manufacturing environment friendly products.

It is the ethical and social responsibility of healthcare professionals to control the process of disposal of dangerous
wastes of hospital. It is the duty of the State, Legislators, Healthcare establishments and the public to make sure that
environmentally acceptable Bio-Medical Waste disposal is introduced and implemented effectively. Though it is the
moral duty of medical professionals to see that hazardous wastes are systematically processed and disposed, it is the duty
of the Union Territory of the Jammu and Kashmir to introduce effective legal machinery for the purpose.

It can therefore be stated that social regulation can be achieved through the establishment of norms of conduct and the
creation of required legal machinery along with accompanying empowerment on the authority. Law serves as one of the
key instruments of such social regulation. Therefore, it is essential for developing a legal frame work on the management
of Bio-Medical Waste and implementation of the same thought an effective medium for sustainable development. This
needs an integrative character highlighting consensus planning, policy and procedure which are not considered inimical
to the social norms. Therefore, a judicious balance between environment protection and Bio-Medical Waste Management
is the need of the hour.

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