Syringes found by the waterfront TN's capital defy biomedical waste disposal rules

A conservancy worker was collecting garbage in Chrompet. Just as he was managing some 'household waste' collected from a clinic in the neighbourhood, a syringe pricked his finger. The worker expressed that he couldn't bend his finger as it seemed to have been numbed by a few traces of anaesthetic still present. He informed his head, and the doctor from the clinic was warned. They were told to dispose of biomedical waste as per the rules.

This, however, is not one incident in Chennai. Improper disposal of bio-medical waste is widespread, and activists in the city are seriously concerned about the implications. A social activist is horrified at the indiscriminate dumping of biomedical waste near Vandalur, which he has found for the fourth consecutive time in as many months. Sites like Thiruneermalai, Injambakkam, Chembarambakkam, Kundrathur, Anakaputhur, Vandalur and Nazarethpet are a few where medical waste is often dumped in bold defiance of rules.

Startled by the trend, the activist has taken it upon himself to analyse some of the suburban localities and has been doing it for a few months. He locates the spots where biomedical waste is dumped - often around landfills and water bodies and then takes the necessary measures to report violations.

Rules defied

The Biomedical Waste Management (BWM) Rules, 2016 state that the bio-medical waste producer (healthcare facilities) and the operator of the common biomedical waste treatment and disposal facility (CBMWTF) are responsible for the safe disposal and handling of such waste in any location. It enlists many norms for safe disposal measures of hazardous waste.

The licensed healthcare facilities must segregate the waste and sign up with the CBMWTF for the transport, collection, treatment and scientific disposal of biomedical waste. The acceptance for such waste disposal is given by the Tamil Nadu Pollution Control Board (TNPCB).

Communication with several stakeholders concluded how the rules are being defied on the ground in Tamil Nadu’s capital city.

Rule: As per the norms, soiled objects contaminated with blood or body fluids such as plaster casts, dressings, cotton swabs and bags having discarded or residual blood and blood components must be segregated in yellow coloured non-chlorinated plastic bags. Also, pharmaceuticals waste such as antibiotics, cytotoxic drugs and all objects contaminated with cytotoxic drugs, along with plastic or glass ampules and vials, must be packed in yellow-coloured non-chlorinated containers or bags. The norms also enlist treatment alternatives.

Reality: Syringes, surgical gloves, blood-smeared cotton and expired medicines are spotted discarded indiscriminately near landfills and water bodies.

Rule: The State Health Department must guarantee the implementation of the regulations in all healthcare occupiers and facilities. TNPCB is liable to analyse the compliance of several norms and conditions. Moreover, the TNPCB must take action against CBMWTF or healthcare facilities that defy segregation rules.

Reality: The lack of effective implementation has resulted in uncontrolled illegalities in ways of biomedical waste disposal in Chennai. TNPCB officials find it challenging to monitor every facility considering how healthcare companies have flourished over the past several years. An activist has observed that action taken against the violators has been inadequate and poor. When officials examine the site after they file a complaint, they inquire about the whereabouts of the wrong-doers rather than investigating themselves. The activist stated that he hasn't seen them punishing violators so far.

Rule: The duties of the healthcare facilities include guaranteeing that biomedical waste is not mixed with MSW at the source. Biomedical waste produced in households during healthcare activities must be segregated according to these rules and handed over in distinctive bags or containers to municipal waste collectors.

Reality: A few practitioners violate this rule, so the burden falls on the conservancy workers. A TNPCB official hinted at the remote possibility of producing biomedical waste from households using dialysis syringes or tools at home. He also indicated that there were odds that these would get mixed with household waste while handing over to conservancy workers from local bodies. To solve this, Greater Chennai Corporation (GCC) is building domestic HW collection centres in 15 areas and incinerators in many parts of the city in around 4-5 months.

Inquired about the household's current disposal method of biomedical waste, the Chief Engineer at GCC said that, for now, they transport such segregated waste to hospitals for incineration. Municipal treatment facilities are likely to be available soon. Handling of biomedical waste shall be channelised once the private contractor takes up garbage disposal, which may happen quickly. The official stated that one incinerator is available in Manali, and 6-7 more tenders are passed.

But, there are serious arguments against incinerators. Many experts state that incinerating biomedical waste emits hazardous particles into the air. Heavy metals, nitrogen oxide, particulates and dioxin are some unhealthy gases emitted into the atmosphere while burning. Exposure to these gases can result in neurological disorders, cancer and damage to the respiratory system.

Even otherwise, in the way that indiscriminate dumping of such waste happens, there is an impact on the environment that is usually forgotten. A senior researcher expressed that the bacteria and other microorganisms in the waste pollute the water bodies and harm the user. Plastic biomedical waste like injections, saline bottles and tubes, when disposed of in landfills, emits heavy metals and volatile organic compounds over time into the atmosphere, and many studies are verifying the same.

Insufficient facilities and way ahead

Although incidents of irregular disposal have been reported to the specific authorities, dumping resumes unabated in Chennai. Experts attribute it to insufficient treatment centres and consistent rules enforcement.

As per the BWM Rules, 2016, at least one CBMWTF must be sited within the specific state on UT to handler healthcare units located at a radial distance of 75 km. But, in a coverage area where there are less than 10,000 beds within a radial distance of 75 km, the existing CBMWTF in the locality might also be permitted to handle the healthcare units located within a radius of 150 km of its location, given the biomedical waste produced is treated, collected, treated and disposed of within two days as stated under these norms.

In TN, there are 11 treatment centres, and two out of them handle Chennai and nearby districts. A social activist raised a flag on the total number and considered it insufficient.

As per him, two treatment facilities for three districts with about 1,100 clinics and hospitals don't meet the demand. Apart from that, the waste has to be disposed of within two days.

Because of the unavailability of extra treatment plants and the need to transport them within 48 hours, haphazard disposal of biomedical waste is being done in the city. There have also been chances of reselling used medical tools, accelerating health issues' risk.

Another activist strongly suggests increasing the count of treatment facilities in Tamil Nadu. Comparing the state with other Indian states, he expressed that this city and state lack in treating biomedical waste. States like Maharashtra, Karnataka and Kerala have more than 20 centres.