IoT in Hospital Solid Waste Generation and Management

Introduction: Biomedical waste (BMW) management is crucial for mitigating environmental and human health risks. Conventional methods, which include segregation, collection, transportation, and disposal, often fail to address the growing volumes of waste and the associated hazards. Aim: This article examines existing regional and worldwide practices, trends, challenges and the way forward in BMW management. Methodology: Peer-reviewed publications, conference papers, systematic reviews, and reports published in English that were searched using databases such as PubMed and Google Scholar were among the sources of information that were been synthesized in this review. Search terms included waste management, medical waste management, smart bins, AI, machine learning, and IoT. Results: Globally, disparities in BMW management practices persist, influenced by socio-economic conditions, regulatory frameworks, and resource availability. Developing regions often lack adequate infrastructure, leading to improper waste segregation, unsafe transportation, and open dumping, thereby exacerbating health and environmental risks. With approximately 75–90 percent of BMW being non-hazardous and the remainder requiring specialized handling, technological advancements. In India, for instance, it generates 1.5–2 kg of waste per bed daily, with an additional surge during the COVID 19 pandemic. Conclusion: Emerging AI-enabled solutions, such as smart bins, real-time monitoring, route optimisation, and blockchain technologies, demonstrate the potential to enhance efficiency, safety, and sustainability in BMW management. From Waste to Smart Transformations, AI-driven biomedical waste management has become a critical necessity at the global and regional levels, underscoring the urgent need for further extensive research in this field.

Background: The hierarchies of Bio-Medical Waste (BMW) is largely based on the concept of the “3Rs”, namely reduces, reuse and recycle, and broadly relates to the sustainable practice of resources. The objectives of the study were to assess the Bio-Medical Waste (BMW) Management operating system in a multispecialty hospital and discuss the situation in terms of newly introduced BMW Rules 2016.Methods: A hospital based cross-sectional study was carried out by collecting data by means of independent surveys involving on-ground operating system of BMW management across different wards, outpatient departments, emergency departments, intensive care units and laboratories in the hospital.Results: The hospital was following Bio Medical Waste (Management and Handling) Draft rules, 2011 in the management of BMW. All the wastes were categorized into 8 categories as per 2011 draft rules. Efficient waste segregation, collection, storage, transport and waste treatment were followed as per norms with regular training of all health care workers under the close supervision and monitoring by dedicated BMW management committee. The hospital was registered for BMW management and renewal was being carried out every three years.Conclusions: It can be concluded that the hospital had an efficient and a well-organized BMW management system in place that was even conforming to the latest BMW Management Rules 2016 to some extent. Moreover, the hospital could upgrade the techniques of BMW management as per the newly introduced latest guidelines. As far as the categorization of BMW is concerned, it has to be changed accordingly to the new rules. Needless to say, a regular training and monitoring of BMW Management at all hospitals is the need of the hour and has a long way to go for environmental and human health.

INTRODUCTION: Biomedical Waste is defined as any waste, which is generated during the diagnosis, treatment or immunisation of human beings or animals or in research activities pertaining thereto or in the production or testing of biological products. Healthcare workers are one of the main contributors to the healthcare waste management process. AIM: The study aimed to assess the level of awareness and attitude regarding biomedical waste management policy and practices among health care workers at Bareilly International University, Bareilly, India. MATERIALS AND METHOD: A cross-sectional study was conducted using a questionnaire with closed-ended questions which was distributed to 150 medical, 154 dental and 100 Class IV employees at Bareilly International University, India. The responses in the questionnaire were used to assess their knowledge of biomedical waste disposal. The responses were evaluated, and each participant's percentage of correct and incorrect responses for each question was calculated. RESULTS: The results indicated that all healthcare professionals had a low degree of knowledge and awareness regarding the risks associated with biomedical waste formation, legal requirements, and management. Only 11 (7.14%) dental interns had excellent knowledge about biomedical waste generation and legislation while 5 (3.33%) medical interns had extremely poor knowledge about it. Only 4 (4%) Class IV employees had an excellent awareness of biomedical waste management practices. Only 34 (22.08%) dental interns had an excellent level of knowledge of needle-stick injuries among health care personnel. CONCLUSION: It was concluded that health care professionals have a low degree of knowledge and awareness regarding the risks of biomedical waste generation, laws, and management at Bareilly International University, India hence there is a requirement for regular monitoring and training at all levels of healthcare.

Background: Inadequate and inappropriate knowledge regarding disposal of Bio-Medical Waste may have serious health consequences to those who handle it as well as can have a deleterious impact on the environment. The objective of the study was to assess the knowledge, attitude and practices about the various aspects of bio-medical waste (BMW) management among private practitioners of Poonamallee taluk, ChennaiMethods: A community based cross-sectional study was conducted to assess the Knowledge, Attitude and Practices about the various aspects of Bio-Medical Waste (BMW) management among private practitioners of Poonamallee taluk, Chennai. The sample size was calculated as 171. Data was collected using a structured interview schedule among all private practitioners including dentists. Data was entered and analyzed by using IBM SPSS software Version 21. Results: 78.3% private practitioners were found to have adequate knowledge about the biomedical waste management rules. 76% private practitioners had knowledge regarding segregation of waste at source. 56.7% of practitioners segregated the BMW into different categories at source level and disposed in specified color coded containers. Conclusions: The importance of training regarding biomedical waste management needs emphasis; lack of proper and complete knowledge about biomedical waste management impacts practices of appropriate waste disposal.

Background: Dental waste is a subset of hazardous biomedical (BM) waste. It has been observed that most of the dental health facilities, the guidelines for proper management of dental waste are not adopted and not up to the prescribed standard. Aim: The aim of this study is to assess the knowledge, awareness, and attitude/behavior of BM waste generation, hazards, and legislation among the study subjects using self-structured questionnaire. Methodology: A cross-sectional study was conducted in 337 practicing dentists in Bengaluru city for the past 2 months. A self-structured questionnaire was used to obtain required data. The questionnaire was divided into three sections. The first section of the questionnaire contained questions regarding knowledge of BM waste generation, hazards, and legislation, whereas the second section contained questions regarding the level of awareness on BM waste management practice, and the third section contained questions regarding attitude/behavior toward BM waste. Results: Of 337 (100%) study participants, 176 (52.2%) were males and 161 (47.8%) were females. Among 337 (100%) study participants, more than three-fourth, i.e., 291 (88.4%) knew about BM waste generation and legislation, whereas 23 (6.8%) each did not know and were not aware of it. Conclusion: There is a good level of knowledge and awareness about BM waste generation hazards, legislation, and management among health care personnel in Bengaluru city. Regular monitoring and training are still required at all levels, and there is a need for continuing dental education on dental waste management practices to these dental practitioners.

Introduction: Hospitals are the centers of cure and also of infectious waste generation. Improper waste management can be a threat to public health and environment. Staff that provide healthcare ought to be aware of the proper handling and the system of management. Aim: The aim of the study was to determine knowledge, attitude and practices towards BioMedical Waste (BMW) management among health care professionals, private practitioners and post graduate students in davangere, karnataka. Method: A cross-sectional study was conducted using a questionnaire with closed-ended questions. It was distributed to 458 health care workers including dental and medical post graduates, staff and private practioners. The questionnaire was used to assess their knowledge of biomedical waste disposal. The results were expressed as a number and percentage of respondents for each question. Descriptive tests and Chi square tests were used to perform the statistical analysis. Results: Around 540 questionnaires were distributed of which 458 were returned and analyzed. It was seen that though 91.70% of the participants were aware of the BMW generation and legislation however over 60% were still unaware regarding the correct color coding system. About 13.6% of participants were not vaccinated for HBV infection and only 65.9% of the study subjects were correctly able to identify the symbol for biohazard. Conclusion : It can be concluded from the present study that proper training and education regarding the BMW management is a must and needs to start at a much earlier level during the graduation of the healthcare workers so that it can be put into practice at the earliest.

Community health centers are the frontliners of healthcare services which in its activities produces medical waste and non-medical waste both in solid and liquid form. This waste needs to be managed in accordance with existing regulations where environmental management must be carried out systematically and sustainably. Regarding the management of Covid-19 medical waste in the health facilities of North Toraja Regency, this study aims to determine the management process, management constraints and compare the management of wastewater and hazardous and toxic solid medical waste generated from handling Covid-19 patients at hospitals and health centers in Toraja Regency. North. The research method used is descriptive research method with case study design. Data collection techniques are carried out by observations, interviews, and documentation of secondary data. The results show that the management of hazardous and toxic solid medical waste water and waste for Covid-19 patients in private hospitals leaves the processing to third parties and government hospitals destroy solid hazardous medical waste with incinerators, while at community health center the wastewater is directly discharged into water bodies and medical hazardous waste. handed over to a third party. The process of treating waste water and hazardous and toxic solid medical waste for Covid-19 patients at the health facilities of North Toraja Regency has not been in accordance with the guidelines issued by the Indonesian Ministry of Health. The main obstacle in processing solid medical waste water and hazardous waste for Covid-19 patients at the health facilities of North Toraja Regency is the lacking of operational costs and delays in disbursing operational costs. Government-owned hospitals were found to be slow to comply the Covid-19 Health Facilities Waste Management Guidelines issued by the Ministry of Health of the Republic of Indonesia.

Introduction:Healthcare facilities generate medical waste, also known as healthcare waste or health facility waste, during the healthcare delivery process, which is improperly managed as a result of underfunded healthcare systems, poor training, and lack of awareness of policies and legislation on handling medical waste as well as do not have national guidelines in place to adhere to the correct disposal of such wastage in developing countries like Ethiopia.Objectives:To estimate the healthcare waste generation rate among selected public hospitals in eastern Ethiopia.Methods:A cross-sectional study design was conducted in eight public in eastern Ethiopia from 1st June 2023 to 30th July 2023. The “Bed-Patient-healthcare wastes” model was used to estimate the healthcare waste generation rate based on WHO and empirical evidence. HCW generation rate = No of (Inpatients (Inpts) + Outpatients (Outpts))/day*0.53 kg/day. Meanwhile, general (GW), infectious (IW), pharmaceutical (PW), sharps (SW), and pathological (PtW) are computed as follows: GW = No. of (Inpt + Oupt)/day*0.53 kg/day and IW, PW, SW, and PtW = No. of Inpts/day*0.53 kg/day. In contrast, for hazardous and non-hazardous healthcare wastes, No of HCWs/day*0.8 and no. of HCWs/day*0.2 were utilized, and Key informant interviews and field observational were also applied. Descriptive analysis such as percentage, mean, and standard deviation were presented.Result:According to the current assessment, 105.1-142.8 kg/day healthcare waste was generated from outpatient and 167.3-244.2 kg/day from inpatients of public hospitals. From these, the Mean ± SD of daily healthcare waste generation rate estimated by non-hazardous and hazardous waste were 164.6 ± 80.9 kg/patients/day and 41.2 ± 20.2 kg/patients/day, respectively. In daily generation, the mean and standard deviations (Mean ± SD) of general wastes, infections waste, pharmaceutical wastes, sharp wastes, and pathological waste/patient were 62% (521.9), 23% (194.8), 4% (35.4), 2% (17.7), and 9% (70.9), respectively.Conclusion:The current assessment concluded that a large volume of healthcare waste is generated from selected public hospitals, which were not effectively segregated, separated at the source, and haven’t conventional or standard treatment. As a result, the study advised that regional and global collaboration in hospital waste and wastewater management be encouraged.

Background: Biomedical waste includes waste products generated from medical procedures within healthcare centers, research facilities, diagnostic laboratories, and treatment procedures, immunization process of humans as well as animals from the production and testing of biological substances. Management and disposal of biomedical waste should be done using safe as well as proper methods. These methods should be known as well as practiced by all healthcare professionals for reducing transmission of different infections and prevention of different types of health as well as environment-associated hazards. Aim: The aim of the present study was to analyze knowledge, awareness, and practice of the management of generated biomedical waste among dental undergraduate students in India. Materials and Methods: This randomized cross-sectional study was carried out on a total of 450 dental undergraduate students after obtaining the institutional ethical committee clearance. The questionnaire included details of sociodemographic characteristics (age, gender, religion, and caste), knowledge, awareness, and attitude regarding handling as well as management of biomedical waste in healthcare settings. Data collection was done for a period of 1 month. Results and Observations: On assessing knowledge regarding the generation of biomedical waste along with legislation, it was observed that only 10.19% of dentistry students had an excellent level of knowledge regarding generation as well as legislation concerned with biomedical waste, whereas only 2.03% of undergraduate dental students possessed an extremely poor level of knowledge. On analyzing awareness concerning practices of waste regulation and management, it was observed that only 6% of dental undergraduate students had “excellent” level of knowledge concerning the practice of biomedical waste management. On analyzing the attitude of dental students toward the management of biomedical, it was observed that 29.1% possessed a poor attitude regarding the issue of proper biomedical waste management. Conclusion: In the present study, it was observed that the majority of dental students pursuing undergraduate courses did not have adequate knowledge, attitude, and awareness regarding the practice of adequate biomedical waste management and disposal.

Background: During the health-care delivery process, healthcare establishments generate hazardous bio-medical wastes (BMWs) which need for appropriate handling and management to prevent environmental and public health hazard. Different healthcare professionals should have adequate knowledge, attitudes, and practices with respect to BMW management. Honorable Supreme Court of India had led down the guidelines on BMW (Management and Handling) Rules in 1998, which was amended in 2016 by the Environment ministry.Objective: To assess knowledge, attitude, and practices regarding BMW management among the resident doctors and nursing staff in a tertiary care specialty teaching hospital as per new BMW Management Rules, 2016.Study Design: This was an institution based cross-sectional study.Methods: Predesigned, pretested, structured questionnaires were administered on fifty resident doctors and fifty nursing staff of the hospital with their prior consent. Data were analyzed using SPSS-25. Chi-square test and independent-sample t-test were applied for the analysis.Results: Both groups had adequate and comparable knowledge about BMW management. The nursing group had significantly more favorable attitude and adequate practice in comparison to resident doctors (P = 0.0001). There was lack of adequate training in both the groups significantly more in resident doctors. Regarding practices, resident doctors had more inadequate practice regarding handling, segregation, disposal, reporting, and record maintenance of BMW than nursing staff.Conclusion: Nursing staff have a better attitude and good practice than the resident doctors about BMW management. There should be a regular training program regarding BMW management for both the cadres of health-care workers.

Biomedical waste management and treatment is one of the critical process for organizations (HCF and CBMWTF) because if not handled properly would lead to hazardous effects like mass infection. Bio-Medical Waste (Management and Handling) Rules, 1998 was published vide notification number S. O. 630 (E) dated the 20th July, 1998, by the Government of India.[4]. 60 per cent of secondary care and 54 per cent of tertiary care health facilities were in the RED category i.e. absence of a credible BMW management system in place or ones requiring major improvement. [5] Amount of Biomedical waste generated every year is more than 8% as compared to previous per year. [6] Efforts are being taken to automate waste management by introducing wireless systems. Segregation plans are proposed in order to maximize the recycling of waste and proper handling of non-recyclable waste. That classification would not sustain in wide variety of wastes such as biomedical waste. Hence this type of waste is treated differently. Therefore, such a waste has its own management unit. This study goes over current followed practices that are undertaken by countries and also studies various available technologies to automate such processes and carefully handling biohazardous waste automatically.

Background: The quantum of waste generated from medical care and activities is a global matter of concern. Improper management of biomedical waste has a grave health impact on the community, health care professionals and the environment. It is mandatory by law that every medical organization that generates waste should have a system, process and resources in place for segregating biomedical waste within the organization for proper disposal. The present articles deals with understanding the various costs associated in biomedical waste management process which will help the health care organization to prioritize their spending and focus on areas that require spending to achieve compliance in process of biomedical waste management.Material and methods: Descriptive cross sectional study was carried out, to study the compliance of biomedical waste management at three different hospitals with respect to Bio-Medical Waste (Management & Handling) Rules, 2011. A retrospective study was conducted to analyze cost data for a 1-year time period. Cost involved in BMW management was analyzed and classified as capital and recurring costs. The study was undertaken in Udupi taluk, taluk comprises of 11 hospitals (1 Government and 10 private hospitals), the hospitals were selected using convenient sampling as taking permission to conduct the study was difficult. Only three hospitals permitted to carry out the study.Results: Compliance was found to be better in accredited hospital than non-accredited hospital. This could be attributed to strict adherence to standard operating procedures and Regular training of staff. Cost involved in BMW management was analyzed as capital and recurring costs. Since most of the hospital outsource final disposal, Capital costs are significantly less compared to recurring costs. Among the recurring costs, maximum expenditure is on Consumables like color- coded bags. Cost per bed per day for handling BMW was calculated and it was found to be higher in smaller hospitals.Conclusion: Cost of biomedical waste management forms a significant part of hospital expenses. We analyzed both the capital costs and the operating costs and it was found that operating costs had a bigger impact on the hospital bottom line. The costs were found to be higher in the smaller hospitals. The larger hospital would be procuring items in higher volumes, which would enable them to bargain for a lower cost. If the government or the common biomedical waste management facility can provide color- coded bags to hospitals at a uniform pricing irrespective of the bed strength, it would enable them to bring down the operating costs significantly.

Safe and sustainable sanitation is necessary for human health and productivity. Human civilization is linked to waste creation. Municipal solid waste, hazardous waste, sewage, sludge, bio medical waste, agricultural and industrial waste, and commercial waste are all examples of waste. High-polluting industries, hospitals, medical centres, and nursing homes are the principal sources of hazardous waste. However, the management of biomedical waste has become a major challenge in the 21st century due to the rapid development of medical and health care facilities, the increase in the world's population, and the corresponding rise in consumption. Because biomedical waste has the potential to seriously harm both the environment and human life, it warrants special care. Worldwide, the production of biomedical waste is becoming more and more significant, particularly in poorer nations. Regulations governing the handling of biomedical waste have a significant impact on how governments, businesses, and communities behave globally. They offer the legal framework for the collection, appropriate separation, processing, treatment, and environmentally responsible disposal of biomedical wastes. However, there can be significant differences between nations in the way these laws are drafted, applied, and modified. There is a significant risk of infection and injury from biomedical waste. There could be serious consequences for public health from improper garbage management. The environment and human health are at risk when biomedical waste management is not understood. On March 28, 2016, the Government of India issued the Biomedical Waste Management Rule, 2016, in exercise of the authority granted under the Environment (Protection) Act, 1986, to manage the biomedical waste generated. Treatment and disposal of biomedical waste through Common Biomedical Waste Treatment Facilities (CBWTFs) is necessary as per BMWM Rules, 2016. Against this backdrop, present paper purports to examine knowledge, attitude and practices of biomedical waste management among health care and sanitation personnel in selected districts of Haryana. The paper is based mainly on primary data.

Biomedical waste management in Ayurveda hospitals – current practices and future prospectives

Composition and production rate of pharmaceutical and chemical waste from Xanthi General Hospital in Greece