BIO- MEDICAL WASTE MANAGEMENT
ABSTRACT
Biomedical waste is any kind of waste containing infectious (or potentially
infectious) materials. It may also include waste associated with
the generation of biomedical waste that visually appears to be of medical or
laboratory origin (e.g., packaging, unused bandages, infusion kits, etc.), as
well research laboratory waste containing bio molecules or organisms that are
restricted from environmental release. As detailed below , discarded sharps are
considered biomedical waste whether they are contaminated or not, due to the
possibility of being contaminated with blood and their propensity to cause
injury when not properly contained and disposed of. Biomedical waste is a type
of bio waste.
Biomedical waste may be solid or liquid. Examples of infectious
waste include discarded blood, sharps, unwanted microbiological cultures and
stocks, identifiable body parts (including those as a result of amputation),
other human or animal tissue, used bandages and dressings, discarded gloves,
other medical supplies that may have been in contact with blood and body
fluids, and laboratory waste that exhibits the characteristics described above.
Waste sharps include potentially contaminated used (and unused discarded)
needles, scalpels, lancets and other devices capable of penetrating skin.
INTRODUCTION
Biomedical waste management has recently
emerged as an issue of major concern not only to hospitals, nursing home
authorities but also to the environmental and law enforcement agencies, media
and the general public. Biomedical waste is forming approximately 1 to 2
percent of the total municipal solid waste stream. Some of these wastes are
potential threat to the human health and environment. Composition and quantity
of biomedical wastes generated differ not only from country to country but also
within the country. Health care facilities viz. laboratories, clinics, nursing
homes, medical, dental, and veterinary hospitals, generate a waste stream
varied in its composition. Among these facilities the hospitals contribute
maximum wastes. The greatest risk of biomedical waste is from the infectious
and sharp components of the waste because health care workers (HCW) and people
associated with handling waste are often getting needle prick injuries and can
contract HIV or AIDS, Hepatitis B and C. Risks in hospitals or health
care settings are very high. Because of these concerns about biomedical waste
generated at national and international level, the Union Ministry of
Environment and Forest, Government of India has notified ‘Biomedical Waste (Management
and Handling) Rules,1998’ under the provision of Environment
(Protection) Act, 1986. However, it has been observed that biomedical
waste management is a complex and one has to go further in the intricacy of
management and attitude of the health workers.
DEFINITION
According to Biomedical
Waste (Management and Handling) Rules, 1998 of India “Any
waste which is generated
during the diagnosis, treatment or immunization of human beings or animals or
in research activities pertaining thereto or in the production or testing of
bio logical. The Government of India (notification, 1998) specifies that
Hospital Waste Management is a part of hospital hygiene and maintenance
activities. This involves management of range of activities, which are mainly engineering
functions, such as collection, transportation, operation or treatment of
processing systems, and disposal of wastes. One of India’s major achievements has
been to change the attitudes of the operators of health care facilities to
incorporate good HCW management practices in their daily operations and to
purchase on-site waste management services from the private sector. World
Health Organization states that 85% of hospital wastes are actually
non-hazardous, whereas 10% are infectious and 5% are non-infectious but they
are included in hazardous wastes. About 15% to 35% of Hospital waste is
regulated as infectious waste. This range is dependent on the total amount of
waste generated
Classification of Bio Medical Waste
The World Health Organization (WHO) has classified medical waste
into eight categories:
·
General Waste
·
Pathological
·
Radioactive
·
Chemical
·
Infectious to potentially infectious waste
·
Sharps
·
Pharmaceuticals
·
Pressurized containers
Effect of Hazardous sites
Bio hazardous waste, also known as
infectious or biomedical waste, is any waste that contains infectious materials
or potentially infectious substances such as blood. Of particular concern are
sharps such as scalpel blades, needles, glass pipettes, or any other waste
material that may cause an injury during handling.
Bio hazardous waste must be handled
according to strict federal, state and local regulations. Mishandled biohazard
waste poses a threat not only to healthcare professionals, patients, and local
community members , it also poses a significant threat to the environment.
Wildlife and Pharmaceuticals - Biohazard waste that is not disposed
of properly can end up in lakes, parks, and other wildlife refuges where birds
and fauna live. Wildlife are very curious about pharmaceuticals. It is thought
they are attracted to the scent or color of pills and liquid medicine. This
curiosity results in digestion of medication, which can injure or even kill the
animal.
Groundwater
Contamination - Much thought and effort has been taken to
ensure landfills are built to protect the earth around them. Most are built
with a special lining so nearby soil and groundwater cannot
The
historical Srinagar city is the summer capital
of Jammu And Kashmir State, surrounded by
hills on east and north eastern side
longitude. Altitude of Srinagar varies from
1580 m in the low lying vicinity of
River Jhelum and 1620m on the eastern
hill slopes with an average elevation of
about 1586m above mean sea level (Bates,
2005). The city lies on both side
of river Jhelum, which swirls through the
heart of the Srinagar city. For the present study
two hospitals were selected which have different
characteristics in terms of their size,
treatment technology and the type of patients
catered. The two study stations were: Sheri
Kashmir Institute of Medical Sciences (SKIMS), Soura
It is a tertiary care hospital, catering
to the average socio-economic class of
people and provides a total of 600 beds. Shri
Maharaja Hari Singh Hospital (SMHS), Karan Nagar It is
a teaching hospital associated to Government
Medical College, Srinagar and is the biggest
general hospital in terms of bed capacity.
become contaminated. Mishandled biohazard waste can compromise
even the best landfill design. Syringes and other sharp objects can easily rip
the lining. As rain falls, contaminants in the landfill can seep out to the
exterior soil, and the groundwater become toxic.
Radioactive Pollution - In order to
accurately diagnose patients, doctors must sometimes use radioactive tools.
When disposed of improperly, radioactivity can enter landfills and other areas.
These substances emit particles that are dangerous to people. Excessive
exposure to radioactivity can result in serious diseases.
Airborne Pollutants - Certain
medical waste can be destroyed by incineration. But, if not ignited properly,
pollutants can move through the air. Airborne pollutants can be worse than
land-based types because they can spread far and wide and quickly.
Biohazard waste
poses serious risks and must be handled and disposed of properly.
Everyone working
in the healthcare industry has a responsibility to handle these materials
correctly and speak up if they see others ignoring safety measure and
regulations.
How to manage biomedical waste
Ø
Use only disposable syringes
etc
Ø
Bandages,
cotton and other blood stained materials should not be thrown with general
garbage.
Ø
Use black plastic bags to dispose biomedical wastes.
Ø
Keep trash out
of reach of small children and infants.
Ø
Diapers,
Sanitary napkins etc.
STUDY AREA
Biomedical waste management
is receiving greater attention due to recent regulations of the Biomedical
Wastes (Management & Handling Rules, 1998). Inadequate management of
biomedical waste can be associated with risks to healthcare workers, patients,
communities and their environment. The present study was conducted to assess
the quantities and proportions of different constituents of wastes, their
handling, treatment and disposal methods in different health-care settings.
Various health care units were surveyed using a modified survey questionnaire
for waste management. This questionnaire was obtained from the World Health Organization
(WHO), with the aim of assessing he processing systems for biomedical waste
disposal. Hazards associated with poor biomedical waste management and
shortcomings in the existing system were identified. The development of waste
management policies, plans, and protocols are recommended, in addition to
establishing training programs on proper waste management for all healthcare
workers.
Surveys carried out by various agencies show
that health care establishments in India are not giving due attention to their
waste management. The need for treating BMW was not taken up as a serious issue
till the late 90’s. However, the initiatives taken up led to the formulation of
the ‘Bio-medical Waste – Handling and Management Rules – 1998’ which was
amended in 2000 by the MEF and taken forward by the Central Pollution Control
Board. After the notification of the Bio-medical Waste (Handling and
Management) Rules, 1998, these establishments are gradually streamlining the
process of waste segregation, collection, treatment, and disposal. Many of the
larger non hospitals have either installed the treatment facilities or in the
process of doing so while entrepreneurs have set up centralized waste treatment
facilities.
Primary Data Source:
Status
of biomedical waste in Uttar Pradesh
Balrampur
Hospital:
To address the biomedical waste
problem the ‘Biomedical Waste Management Rules, 2000’ have recently been
adopted in the State of Uttar Pradesh. Regulators and regulated are both in the
process of evolving strategies and action plans to implement this regulation
and to address the fact that cur-rently there are no incinerators in Uttar
Pradesh for treating biomedical waste. Given the early stage of public
attention to this issue, the information base currently available with the
Government Department of Health or the Uttar
Pradesh Pollution Control Board (UPPCB) do not throw much light on the nature
and extent of the problem.
Based on the number of hospital
beds, Table 1 gives an estimate of the quantities of waste generated in each
district. The total quantity of biomedical waste for Uttar Pradesh is estimated
as 20.76 tonnes per day. As UPPCB is in the proc-ess of generating an inventory
of all categories of biomedical
|
|
Hospitals
|
Generation of
|
Hospitals with
|
Generation of
|
Hospitals
|
Generation of
|
Hospitals
|
Generation of
|
|
|
|
infectious
|
infectious
|
with > 50
|
infectious
|
infectious
|
|
|
Area
|
with > 500
|
> 200 and
|
with < 50
|
|
|
waste per day
|
waste per day
|
and < 199
|
waste per day
|
waste per day
|
|
|
|
beds
|
< 499 beds
|
beds
|
|
|
|
(kg)
|
(kg)
|
beds
|
(kg)
|
(kg)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Ghaziabad
|
1
|
125
|
1
|
87.5
|
11
|
344
|
34
|
2125
|
|
|
Noida
|
0
|
0
|
1
|
87.5
|
14
|
437.5
|
5
|
31
|
|
|
Kanpur
|
1
|
125
|
7
|
612.5
|
18
|
562.5
|
136
|
850
|
|
|
Jhansi
|
1
|
125
|
1
|
87.5
|
9
|
281
|
3
|
19
|
|
|
Allahabad
|
1
|
125
|
4
|
350
|
14
|
437.5
|
175
|
1094
|
|
|
Meerut
|
2
|
250
|
2
|
175
|
11
|
344
|
193
|
1206
|
|
|
Agra
|
2
|
250
|
1
|
87.5
|
16
|
500
|
47
|
294
|
|
|
Aligarh
|
2
|
250
|
4
|
350
|
2
|
62.5
|
58
|
362.5
|
|
|
Mathura
|
0
|
0
|
1
|
87..5
|
7
|
219
|
37
|
231
|
|
|
Lucknow
|
5
|
625
|
6
|
525
|
13
|
406
|
246
|
1537.5
|
|
|
Bareilly
|
0
|
0
|
4
|
350
|
37
|
1156
|
174
|
1087.5
|
|
|
Gorakhpur
|
1
|
125
|
2
|
175
|
2
|
62.5
|
54
|
337.5
|
|
|
Faridabad
|
0
|
0
|
1
|
87.5
|
6
|
187.5
|
32
|
200
|
|
|
Raibarelly
|
0
|
0
|
2
|
175
|
4
|
125
|
57
|
356
|
|
|
Varanasi
|
1
|
125
|
1
|
87.5
|
6
|
187.5
|
28
|
175
|
|
|
Muradabad
|
0
|
0
|
2
|
175
|
5
|
156
|
109
|
681
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
|
17
|
2125
|
40
|
3412.5
|
175
|
5468.5
|
1388
|
10587
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Average
per
|
|
125
|
|
85
|
|
31.0
|
|
8.0
|
|
|
hospital
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Assumptions:
|
|
|
|
|
|
|
|
|
|
average number of beds for hospitals with <
50 beds is 25.
average number of beds for hospitals with 50 to
199 beds is 125.
average number of beds for hospitals with 200
to 499 is 350.
average number of beds for hospitals with
>500 beds is 500.
average waste generation factor is 250/bed per
day for infectious biomedical waste (CPCB 2000).
Status
of hospital’s compliance to biomedical rules in Uttar Pradesh
|
Bed capacity
|
Number
of
|
Hospitals having own or
common
|
Hospital having approval
for disposal
|
|
|
hospitals
|
incinerating facility
|
of biomedical wastes
|
|
|
|
|
|
|
|
|
|
|
|
500 or more than 500 bed capacity
|
17
|
8
|
3
|
|
|
More than 200 but less than 500 bed capacity
|
38
|
13
|
3
|
|
|
Less than 50 and less than 200 bed capacity
|
180
|
33
|
2
|
|
|
Less than 50 bed capacity
|
1389
|
290
|
4
|
|
|
|
|
|
|
|
|
Total
|
1624
|
344
|
12
|
|
|
|
|
|
|
|
|
Allergy
|
Dental and oral health
|
Homeopathy
|
Orthopaedics
|
Radiology
|
|
Anti rabies
|
Emergency
|
Leprosy
|
Ophthalmology
|
Urology
|
|
Andrology
|
Ear, nose & throat
|
Neurosurgery
|
Paediatrics
|
Ultrasonography
|
|
Blood bank
|
General medicine
|
Nephrology
|
Pathology-with the computerized
|
Video endoscope
|
|
Burn and plastic surgery
|
General surgery
|
Neurology
|
autoanalyser
|
Vaccination
|
|
Cardiology
|
|
|
Physiotherapy
|
X-ray
|
|
Chest and isolation
|
|
|
Psychiatric
|
|
:
Characteristics of biomedical waste generated at Balrampur Hospital.
|
Waste type
|
Components
|
Moisture content (%)
|
Heat value (kcal/kg)
|
|
|
|
|
|
|
Anatomical
|
Human tissue
|
70–90
|
50–800
|
|
Kitchen
|
Food, peelings
|
70
|
1400
|
|
Clinical
|
Bandages, gauze
|
0–30
|
3600–4500
|
|
Paper
|
Packings, boxes
|
0–10
|
4700
|
|
Cotton
|
Personal effects
|
0–10
|
4700
|
|
Plastics
|
PET, LDPE, HDPE items
|
0–1
|
9000–11000
|
MEDICAL WASTE MANAGEMENT IN THE BALRAMPUR
HOSPITAL
The present study noted that there
is no proper system for the collection and disposal of biomedical waste in the
Bal-rampur Hospital. The collection of infectious and non-infec-tious wastes is
done by a team of two waste collectors; one pulls the hand-driven trolley and
the other collects mixed waste from each ward. The waste is piled in a corner
of the hospital and often burned inside the premises or otherwise it ends up in
the municipal waste that is collected or dumped in
nearby areas. The hospital administration
spends 76 000 rupees (approximately US$ 1700) per year for the waste
manage-ment in the hospital.
In general the health conditions of
rag pickers are very poor. They also face problems with scavenging animals and
dogs in addition to being socially ostracized. The recycling of con-taminated
materials further spreads the contamination through several resource chains in
various commercial and domestic activities in the city, increasing the risk of
disease and con-tamination. The burning of waste releases toxic fumes into the
atmosphere and causes smoke nuisance (Figure 3).
ROOM-WISE
GENERATION OF HOSPITAL WASTE
Biomedical wastes are generated in
various departments, wards and laboratories of the hospital. The surgical ward,
emergency facility, out-patient department, out-patient department for women
and orthopedic department all generate major quan-tities of solid waste. Hence,
the quantities of different catego-ries of waste have to be estimated by
discussions, interviews and by physical checks. An estimated quantity of 50–70 kg/day is generated from
these places. The details are given in the Table 6.
Table 6 shows that the highest value
of 15–20 kg/day of biomedical waste is generated from ward no. 7 (out-patient
department for women) followed by surgical ward, plaster room, emergency
out-patient department, ward no. 2 (dress-ing room), pathology laboratory, orthopaedic
department and ward no. 3 (accidental dressing). The average quantity of waste
generation in the hospital is 0.5 kg/bed per day. Thus, the total waste
generation for Balrampur Hospital with a capacity of 656 beds is 328 kg/day.
Waste generated per day.
|
Name of ward
|
Quantity of waste (kg/day)
|
|
|
|
|
Ward no. 7 (out-patient department for women)
|
15–20
|
|
Surgical ward
|
10–15
|
|
Plaster room
|
8–10
|
|
Emergency out-patient department
|
5–10
|
|
Ward no. 2 (dressing room)
|
5
|
|
Pathology laboratory
|
3–5
|
|
Orthopaedic department
|
2–3
|
|
Ward no. 3 (accident dressing)
|
2
|
|
|
|
|
Total
|
50–70
|
|
|
|
EXISTING WASTE DISPOSAL
PRACTICES IN BALRAMPUR HOSPITAL
The Balrampur Hospital does not
practice segregation of infectious and non-infectious waste. There is no
mechanism for waste segregation. The waste from wards, which include used
cotton, dressing materials, blood, bottles, PVC drip sets, needles, syringes
and their covers, are thrown on the floor by the doctors, nurses and attendants
alike. These wastes are
spread all around, swept to a remote
corner or under the stairs. There are huge waste piles in Balrampur Hospital,
usually located on the roadside. These waste piles are frequented by rag
packers, who collect the recyclable items such as plastics and polythene. The waste piles are
constantly visited by nat-ural scavengers (e.g. cows, dogs, pigs,
micro-organisms, mice, rats). The garbage is usually thrown in the open and
loaded on to the trucks of the municipal corporation.
DISPOSAL OF HUMAN PARTS AND
ORGANS FROM THE HOSPITAL
Amputated human parts such as limbs,
organs surgically removed or residual pieces of intestines and bowel are either
packed in bags or PVC jars, preserved in formaldehyde and transported to
pathology labs for further studies. When these organs are not useful and are
not considered for pathological studies, they are thrown in the waste pile or
disposed of in the municipal garbage.
DISPOSALS FROM PATHOLOGY,
MICROBIOLOGY, ANATOMY, BIOCHEMISTRY AND PHARMACOLOGY DEPARTMENTS
Office wastes and other general
garbage are mostly collected in bins and disposed of in garbage pits or burned
in the open. The remnants of human organs preserved in formaldehyde for
pathological examination are subsequently buried in the backyard of the
department at least 3 feet under the ground. Unused blood specimens, sera, full
bottles of expired blood after intermittently practiced chemical disinfection
are washed down the drains and are mixed with the sewage. Glass culture plates,
pipettes, enzyme-linked immunosorbent assay plates and other contaminated
bacteriological and virological material are either chemically disinfected or
auto-claved. The glass items are washed and reused.
METHODOLOGY
This study investigated
medical waste practices used by hospitals in Oregon, Washington, and Idaho,
which includes the majority of hospitals in the U.S. Environmental Protection
Agency's (EPA) Region 10. During the fall of 1993, 225 hospitals were surveyed
with a response rate of 72.5%. The results reported here focus on infectious
waste segregation practices, medical waste treatment and disposal practices,
and the operating status of hospital incinerators in these three states.
Hospitals were provided a definition of medical waste in the survey, but were
queried about how they define infectious waste. The results implied that there
was no consensus about which agency or organization's definition of infectious
waste should be used in their waste management programs. Confusion around the
definition of infectious waste may also have contributed to the finding that
almost half of the hospitals are not segregating infectious waste from other
medical waste. The most frequently used practice of treating and disposing of
medical waste was the use of private haulers that transport medical waste to
treatment facilities (61.5%). The next most frequently reported techniques were
pouring into municipal sewage (46.6%), depositing in landfills (41.6%), and
autoclaving (32.3%). Other methods adopted by hospitals included
Electro-Thermal-Deactivation (ETD), hydropulping, microwaving, and grinding
before pouring into the municipal sewer. Hospitals were asked to identify all
methods they used in the treatment and disposal of medical waste. Percentages,
therefore, add up to greater than 100% because the majority chose more than one
method. Hospitals in Oregon and Washington used microwaving and ETD methods to
treat medical waste, while those in Idaho did not. No hospitals in any of the
states reported using irradiation as a treatment technique. Most hospitals in
Oregon and Washington no longer operate their incinerators due to more
stringent regulations regarding air pollution emissions. Hospitals in Idaho, however, were still operating
incinerators in the absence of state regulations specific to these types of
facilities.
Medical wastes are highly hazardous
and put people under risk of fatal diseases. The understanding of medical waste
management and control techniques is important. In this paper, introductory
materials on the definition of medical waste, medical waste management
regulatory acts, the risks of exposure, medical waste management procedures and
control techniques are presented.
RESUILT
AND DISCUSSION
The
important inferences regarding the various
components of the waste management hierarchy
like segregation, packaging, storage, collection,
transportation and disposal were drawn and
then the framework of compliance was assessed.
Barring SKIMS, the waste was not
segregated at source as prescribed in the
Biomedical Waste Management Rules, 1998 Due
to poor segregation practices, the general
waste gets mixed up with the infectious
waste. Hospitals were using uncovered plastic
bins for waste collection provided with
same kind of color coded labelled polybags.
Polybags were not sealed properly and its integrity
was found not to be preserved. In SMHS
hospital, waste sharps were contained without
being subjected to disinfection in open
trays or in any of the bins. While
in SKIMS, sharps were disinfected properly and
finally incinerated. Waste storage area at
SKIMS was of a size appropriate to
the quantities of waste produced but did
not have secured bins to eliminate the
possibility of access to the waste by
rodents, flies, or other natural scavengers.
The waste was placed in an open area
before disposal at SMHS hospital, so it
was easily accessible to unauthorized personnel
and animals. The transportation of waste to
the storage site was done manually in
SMHS hospital, while in SKIMS trolleys and pipeline
system (Chute) was employed. Biomedical waste was
autoclaved and incinerated (Type Brick Kiln;
capacity 125 kg/hr) onsite, at SKIMS. Ash
so obtained was buried in onsite ash pits,
neither lined from below nor sealed above.
Liquid waste was treated in the treatment
plant and flushed into the sewers .
SMHS hospital treats its biomedical waste
at Common Biomedical Waste Treatment Facility (CBWTF),
Lassipora Pulwama, Kashmir, while the liquid
waste was flushed directly into the River Jhelum.
CONCLUSION
Health-care services in rural or urban
settings inevitably generate wastes that may be hazardous to health or have
harmful environmental effects. Some of them, such as sharps, cultures from
medical laboratories or infected blood, carry a higher potential for infection
and injury than any other type of wastes. The absence of or improper management
measures to prevent exposure to hazardous health-care waste (HCW) results in
important health risks to the general public, in- and outpatients as well as
the medical and ancillary staff. Furthermore, improper treatment or disposal of
HCW, such as open-air burning, can constitute a significant source of pollution
to the environment through the release of substances such as dioxins, furans or
mercury. (153) Safe management of HCW is a key issue to control and reduce
nosocomial infections inside a hospital and to ensure that the environment
outside is well protected. The current practices encountered in most of the
Sub-Saharan countries of Africa do not comply with the international
requirements to guaranty a safe and environmentally sound management of HCW:
the full spectrum of health-care waste management (HCWM) practices are found in
the health-care facilities (HCFs), from the most hazardous ones where no
segregation system is applied and the waste is simply dumped in the backyard to
safer procedures where the waste is segregated and the part considered as
hazardous is incinerated separately. To significantly improve the current
situation, the Governments of most of the Sub-Saharan countries of Africa must
develop a medium and long-term national strategy that should become an integral
feature of the HCFs. This strategy should reflect the integrated effort that is
necessary to set-up safe and environmentally sound HCWM practices. In
particular, a special attention should be paid to the following points: ƒ At
each administrative level, clear institutional and individual responsibilities
should be established. Moreover, specific monitoringand
administrative procedures should be set-up and adequate resources allocated to
ensure a proper management of the HCW; Adequate awareness and training program
for health officers and planners, hospital administrators, medical staff and
environmental health officers should be developed; Appropriate,
environmental-friendly and affordable technologies should be selected for the
treatment and the disposal of HCW, taking into consideration both technical and
financial resources available in the country. (154) In many Sub-Saharan
countries, the lack of resources in the health sector tends to affect
negatively the way HCW is managed. Furthermore, for a given country, the
situation can differ significantly from one region to the other depending on
the resources (financial, human and material) locally available. Under these
adverse circumstances, planning remains a key issue. It requires the definition
of a strategy that takes into account the given constraints and opportunities,
appropriate allocation of resources, clear formulation of objectives, practical
indicators of achievement and a well structured timeframe.
Medical wastes should be
classified according to their source, typology and risk factors associated with
their handling, storage and ultimate disposal. The segregation of waste at
source is the key step and reduction, reuse and recycling should be considered
in proper perspectives. We need to consider innovative and radical measures to
clean up the distressing picture of lack of civic concern on the part of
hospitals and slackness in government implementation of bare minimum of rules,
as waste generation particularly biomedical waste imposes increasing direct and
indirect costs on society. The challenge before us, therefore, is to
scientifically manage growing quantities of biomedical waste that go beyond
past practices.
Hope you find this article helpful. Do share your views and comments.
Thanks a ton!!
