Biomedical Waste: From Neglect to Regulation

The rise of HIV/AIDS and the 'Syringe Tide' of 1987 paved the way for global recognition of the biohazard threat and the need for regulation.

In the early days of healthcare, little attention was paid to the proper disposal of medical waste. Infectious materials, sharps, and other hazardous waste were often mixed with general waste, posing significant risks to both healthcare workers and the environment. The lack of awareness and regulations led to sporadic and unsafe practices.

However, during the 1980s, the rise of HIV/AIDS and other serious health concerns brought the issue into sharper focus. It is reported that, for the first time, the topic of medical waste management was discussed at a meeting convened by the World Health Organization’s regional office for Europe in Bergen, Norway, in 1983.

The ‘Syringe Tide’ episode of 1987, described in last week’s article, further heightened concerns. This incident underlined the urgent need for specialised medical waste management services and appropriate regulations.

In the United States, the Medical Waste Tracking Act of 1988 categorised waste from hospitals as hazardous and required institutions to follow systematic guidelines for handling and disposal. As a result, a new industry of medical waste service providers emerged, offering comprehensive solutions for waste collection, transportation, treatment, and disposal.

The ‘Syringe Tide’ disaster also sent shockwaves across Europe and other Western countries. Eventually, stringent rules and regulations were introduced to govern the handling, transport from the source of generation, treatment, and disposal of medical waste.

Introduction of legislation for managing medical waste in India

In India, the first case of HIV was reported in 1986. At the time, there were no specific rules or regulations to manage medical waste. Due to the absence of legislation and a general lack of awareness among policymakers and other stakeholders, medical waste was not treated as hazardous. It was routinely mixed with general municipal solid waste and dumped in landfills or open dumping grounds.

To compound the growing burden of municipal and hospital waste, disposable plastic items were introduced into the healthcare sector in the 1970s. These items quickly gained popularity due to their convenience and durability. By the 1980s and 1990s, the use of disposable plastic items in hospitals had significantly increased, driven by the broader adoption of plastics in both daily life and medical practice.

The wake-up call: Dr B.L. Wadhera vs Union of India

In the 1990s, several NGOs and individuals in Delhi began drawing attention to the issue of unregulated medical waste management. In 1995, Dr B.L. Wadhera filed a writ petition in the Hon. Supreme Court of India, highlighting the neglected problem of medical waste disposal in Delhi. The petition pointed out that the government had failed to recognise the hazardous impact of openly dumped medical waste on public health and had not classified it appropriately as hazardous waste.

As a result, the Hon. Supreme Court directed the Government of India to appoint a committee of experts and develop a clear legislative framework for the classification and proper management of medical waste. This landmark judgement exposed major regulatory gaps and set the wheels in motion for the creation of medical waste management legislation in India. More on this in my next article. Till then, have a good weekend!

(The writer is an environmentalist.)