To assess the knowledge, attitude and practices in biomedical waste management among health care workers in dedicated COVID hospital in Bangalore

Navigating Challenges in Biomedical Waste Management in India: A Narrative Review

Biomedical waste management (BMWM) in India poses significant challenges that demand thorough examination and strategic interventions. As the country's healthcare sector expands rapidly, proper management of biomedical waste becomes increasingly critical to safeguarding public health and environmental integrity. Biomedical waste, encompassing industrial waste, hospital waste, and waste from other healthcare facilities, poses a heightened risk of infection and injury compared to any other form of waste. A lack of understanding regarding safe medical waste disposal practices can be hazardous to one's health as well as the environment. To improve waste management practices in the country, we can suggest effective strategies and recommendations by developing a deeper understanding of the current situation. To manage medical waste effectively, healthcare professionals must be knowledgeable about and have experience with this process. This evaluation study provides a comprehensive overview of current BMWM methods in India, shedding light on the benefits, drawbacks, challenges, and areas for improvement in the healthcare waste management system. Several important facets of BMWM were highlighted by the literature research, including waste segregation, treatment techniques, and disposal options, as well as compliance and regulatory frameworks.

Knowledge, attitude, and perceived practice of sanitary workers on healthcare waste management: A descriptive cross-sectional study in Dodoma region,Tanzania

Introduction

Healthcare facilities produce a variety of trash that, if handled improperly, could endanger the environment, the health of patients and clients, healthcare personnel, and the general public. Health staff have been given training on infection control and healthcare waste management. It is not apparent whether similar initiatives are taken for sanitary personnel, though. By evaluating sanitary workers' knowledge, attitudes, and practices about healthcare waste treatment in the Dodoma region of Tanzania, this study sought to clarify the situation.

Methods

From March to August 2022 in Dodoma, Tanzania, a descriptive cross-sectional study using a quantitative methodology was conducted on 156 randomly chosen sanitary workers. The primary data collection instruments were structured questionnaires that were conducted by interviewers and a trash checklist that the research team created. Statistical Package for Social Sciences computer software was used to conduct a descriptive analysis of the data with a 95% confidence level and a 5% level of significance.

Results

The average age was 28 ± 6.2 years, and there were 74.4% females. Of all of the health institutions under study, 78.4% of the generated medical waste was non-infectious, whereas 21.6% of it was infectious. The share of non-infectious and infectious healthcare waste created by regional referral hospitals was 43.5% and 13.2%, respectively. While 67.8% of sanitary workers believed that handling healthcare waste was not their problem and 63.6% of sanitary workers actually displayed subpar practices of handling healthcare waste, 74.4% of sanitary workers had low understanding about handling healthcare waste. Their procedures for handling medical waste were substantially influenced by the kind of healthcare facility, sex, education, job experience, knowledge, and attitude (p < 0.05).

Conclusion

Sanitary staff members had limited understanding and thought they were less concerned with gathering, moving, and storing medical waste. To provide the highest level of health safety, national health policy and facility-based interventions must support and fund participatory waste management training that is tailored to the sociodemographic profiles of sanitary employees.

Knowledge, Attitude and Practice of Personnel Involved in Bio Medical Waste Handling about COVID-19 & Its Bio-Medical Waste Management: A Descriptive Analysis

Background: The COVID-19 pandemic has led to an increased amount of biomedical waste, worsening the already strained biomedical waste management system in India. As biomedical waste handlers are the core of biomedical waste handling, their knowledge, attitude, and practices regarding sorting, segregation, transport, and storage of the waste are of prime concern. This study aims to evaluate the knowledge, attitude and practices of personnel involved in biomedical waste handling about COVID-19 and its biomedical waste management at All India Institute of Medical Sciences Mangalagiri. Design: Cross-sectional survey. Setting: AIIMS Mangalagiri and common bio-medical waste treatment facility at Guntur. Participants- Personnel involved in bio-medical waste handling Methodology: The study enrolled a total of 139 participants from December 2020 to January 2021. A convenient sampling technique was used and a questionnaire was administered by face-to-face interview. Results: The study showed that half of the participants had favorable knowledge about bio-medical waste management (average score 5.08 and range 1-9). Two-thirds of the respondents felt that handling COVID-19 waste is necessary to contain the infection. Conversely, the practices regarding COVID-19 and its biomedical waste management were not in conformity with attitudes and knowledge. Fewer participants knew the exact sequence of donning (15.80%) and doffing (31.70%). Majority of participants (72.7%) desired a hands-on training for handling biomedical waste. Conclusion: Participants have good knowledge and attitudes regarding COVID-19 bio-medical waste management, but are not adhering to it. This explains the need for comprehensive training programs for all those involved in bio-medical waste management of COVID-19.

Biomedical waste disposal practices among healthcare workers during COVID-19 pandemic in secondary and tertiary care facilities of Tamil Nadu

Purpose

The ongoing COVID-19 crisis has drastically changed the practice of biomedical waste (BMW) generation and management. Studies venturing into the facility level preparedness at various levels of healthcare delivery during pandemic situation is the need of the hour. Hence, we did this study to assess the BMW disposal practices amongst secondary and tertiary health facilities during COVID-19 pandemic in Tamil Nadu.

Materials and methods

This cross-sectional survey was conducted amongst doctors, nurses and allied healthcare staffs across various departments in 18 public health facilities across six districts of Tamil Nadu. Multivariable logistic regression analysis was done based on the random-intercept model to assess the determinants of BMW disposal practices. The effect size was reported as adjusted odds ratio (aOR) with 95% confidence interval (CI).

Results

In total, 2593 BMW disposal observations were made. During nearly three-fourth of the observations (73%), the BMW was disposed of appropriately. Nurses (aOR ​= ​1.54; 95%CI: 1.06–2.23) and doctors (aOR ​= ​1.60; 95%CI: 1.05–2.45), healthcare workers in Paediatrics department (aOR ​= ​1.77; 95%CI: 1.13–2.76), healthcare workers in inpatient department (aOR ​= ​2.77; 95%CI: 1.95–3.94) and injection outpatient department (aOR ​= ​2.69; 95%CI: 1.59–4.47) had significantly better odds of having appropriate BMW disposal practices.

Conclusion

Our study shows that nearly during three-fourth of the observations, healthcare workers performed appropriate BMW disposal practices. However, measures should be taken to achieve 100% compliance by healthcare workers especially the target groups identified in our study by allocating appropriate resources and periodically monitor the BMW disposal practices.

Knowledge, attitude and practice towards bio-medical waste management among healthcare workers: a northern Saudi study

Background

Health care workers (HCWs) involved in day-to-day care and other healthcare activities play a significant role in biomedical waste (BMW) management. The World Health Organization stated some of the causes for the failure of BMW management, namely, lack of awareness of the health hazards related to BMW and inadequate trained HCWs in BMW management. The present study assessed knowledge, attitude, and practice (KAP) towards BMW management among the HCWs in northern Saudi Arabia.

Methodology

The present study assessed KAP through a self-administered and validated questionnaire. Using a multistage probability sampling method, 384 HCWs from different healthcare facilities participated in this survey. We performed binomial logistic regression analysis to find association between KAP subscales and sociodemographic characteristics. Spearman's correlation test was performed to find the strength and direction of correlation (rho) between KAP scores.

Results

Of the population studied, high knowledge, attitude, and practice scores were found in 47.1%, 65.1%, and 49.5% of the HCWs, respectively. The present study found that knowledge score was significantly higher among the age group from 30 to 39 years (ref: age less than 30 years: AOR = 2.25, 95% CI [1.05-4.85], p = 0.04) and non- Saudi nationals (ref: Saudi: AOR = 2.84, 95% CI [1.63-4.94], p < 0.001) The attitude score towards BMW management was significantly lower among the HCWs working in tertiary care settings (ref: PHC: AOR = 0.38, 95% CI [0.12-0.69], p = 0.01). Regarding the practice score, the male categories had a significantly higher score (ref: female: AOR = 1.82, 95% CI [1.19 -2.99], p = 0.02), while pharmacist (ref: physicians: AOR = 0.39, 95% CI [0.18-0.58], p = 0.02) and lab technicians (ref: physicians: AOR = 0.31, 95% CI [0.11-0.53], p = 0.02) had a significant lower practice score. The test results revealed a weak positive correlation of knowledge with the attitude scores (rho = 0.249, p = 0.001), and a moderately strong positive correlation was found between attitude and practice scores (rho = 0.432, p = 0.001).

Conclusion

This study suggests that a regular training program for the HCWs on BMW management is necessary through symposiums, role play, interactive lectures, and other feasible training methods. Furthermore, a multicentric prospective exploratory study is to be conducted in other regions of the KSA to understand the region-specific training needs of HCWs.

Challenges and measures during management of mounting biomedical waste in COVID-19 pandemic: an Indian approach

BACKGROUND

During coronavirus pandemic, an unpredictable pile of biomedical waste (BMW) gathers at the top. India produces 710 tonnes of biomedical waste daily. The contribution of COVID-19 related biomedical waste was 126 tonnes per day in first wave of the pandemic. BMW's rapid growth is putting a strain on current waste management facilities, especially in developing countries. A sudden boost in biomedical waste needs rapid and proper segregation and disposal methods to avoid future consequences.

MAIN BODY OF THE ABSTRACT

From literatures and statistical data available on Central Pollution Control Board (CPCB) it shows that India lags behind in large-scale sorting, collection, careful storage, transfer and disposal of bio waste. India has its own guidelines set by the CPCB to ensure the safe disposal of biomedical waste during diagnosis, treatment and quarantine of COVID-19 patients. Although there are strict guidelines for bio-waste management, many hospitals in the process of implementing them often dispose of waste in inappropriate, chaotic and indiscriminate ways due to negligence or laziness. Often, due to poor separation practices, hospital waste is mixed with general waste, resulting in harmful overall waste flow. Waste disposal handlers are not safe due to their exposure to various health risks and inadequate training in waste management. The present review sheds light on guidelines, measures, and challenges related to biomedical waste management.

SHORT CONCLUSION

Improper waste separation leads to improper waste disposal. Waste generation and management issues are causing daily problems as they have a profound impact on the dramatically changing global environment, including air, water and soil pollution. In addition, BMW's daily production and its processing are inversely proportional. This situation suggests that India will soon be drowning in its own garbage. The focus of this review is on the generation and disposal of biomedical waste. Based on a review of the literature, this evaluation provides a comparative picture of the current status of waste generation, national waste management strategies, and some measures to contribute to waste management and avoid future disasters.