Review Overcoming challenges due to enhanced biomedical waste generation during COVID-19 pandemic

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Review Overcoming challenges due to enhanced biomedical waste generation during COVID-19 pandemic


Biomedical wastes (BMWs) are potentially infectious to the environment and health. They are co-dependent and accumulative during the ongoing coronavirus disease-2019(COVID-19) pandemic. In India the standard treatment processes of BMWs are incineration, autoclaving, shredding, and deep burial; however, incineration and autoclaving are the leading techniques applied by many treatment providers. These conventional treatment methods have several drawbacks in terms of energy, cost, and emission. But the actual problem for the treatment providers is the huge and non-uniform flow of the BMWs during the pandemic. The existing treatment methods are lacking flexibility for the non-uniform flow. The Government of India has provisionally approved some new techniques like plasma pyrolysis, sharp/needle blaster, and PIWS-3000 technologies on a trial basis. But they are all found to be inadequate in the pandemic. Therefore, there is an absolute requirement to micromanage the BMWs based on certain parameters for the possible COVID-19 like pandemic in the future. Segregation is a major step of the BMW management. Its guideline may be shuffled as segregation at the entry points followed by collection instead of the existing system of the collection followed by segregation. Other steps like transportation, location of treatment facilities, upgradation of the existing treatment facilities, and new technologies can solve the challenges up to a certain extent. Technologies like microwave treatment, alkaline hydrolysis, steam sterilization, biological treatment, catalytic solar disinfection, and nanotechnology have a lot of scopes for the treatment of BMWs. Hi-tech approaches in handling and transportation are found to be fruitful in the initial steps of BMW management. End products of the treated BMWs can be potentially fabricated for the application in the built environment. Some policies need to be re-evaluated by the health care facilities or government administrations for efficient BMW management.

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Biomedical wastes

COVID-19 pandemic

Treatment facilities


Upgrading conventional techniques

1. Introduction

Civilization, technological advances, and resources consumption are necessary for the development of a country, but they have entitled an unintended negative impact on the urban environment. Presently India is grappling with different issues of the higher volume of diverse wastes. The waste disposal technologies and their methodology have impacted different local and global environmental establishments. During the ongoing novel COVID-19 pandemic, the generation of BMWs at different COVID-19 treatment facilities is increased by many folds due to the new guidelines for their handling, treatment, and disposal implemented by the Central Pollution Control Board(CPCB), Government of India, New Delhi (CPCB, 2020). As per the guidelines, leftover food of patients and disposables like surgical masks, gloves, bib, roll, sheets, wrappers of medicine/syringes, used water bottles, food plates, and semisolid gels are coming under the umbrella of BMW (Hasija et al., 2022Sarkodie and Owusu, 2021). These additional inclusions result in the generation of huge BMW during the pandemic (Chowdhury et al., 2022). Their daily generation rate has increased from 500 to 750 g per bed before the pandemic to 2500–4000 g per bed during the pandemic. The rate of BMW generated per day is 609tons, and further addition of 164tons per day of COVID-19 related BMWs, including the waste generated from different quarantine homes (Sharma et al., 2020). In India, the amount of BMW was 56898tons from June 2020 to June 2021. Further, the non-uniform flow of the COVID-19 related wastes has confused the BMW quantity evaluation and their management (Richter et al., 2021). The BMWs have assumed an increasing significance in its management and handling procedure due to the statutory demand of different medical administrations of the Government of India. Lacking proper BMW management creates health risks in public, patients, healthcare personnel, and the environment (Nema et al., 2011). The management procedure includes quantity assessment, types, preliminary handling, transportation, treatment, and final disposal of the BMWs (Sharma et al., 2020). So far, the proper management of the categorical wastes has imposed more responsibilities on the medical administrators (Shammi et al., 2022). However, the BMWs can be managed with the application of proper technology to reduce the headache of the medical establishments (Saxena and Srivastava, 2011). For example, about 50% rise in the BMWs has attributed to the food wastes from different COVID-19 hospitals and isolation centers which are non-hazardous and effectively segregated at the source. Therefore, the segregation of BMWs at the entry points is one of the major steps for their management (Dehal et al., 2021). Similarly, upgradation of the current treatment and disposal techniques and development of the new technologies combined with the implementation of some new rules and policies give the ray of light for overcoming the challenges due to the huge BMW generated during the pandemic (Agrawal et al., 2021Ara et al., 2022Kumar et al., 2021Mohan et al., 2022). The present review article summarizes the pros and cons of different existing BMW treatment techniques and future perspectives for the overall BMW management.

2. BMW generation in India during pandemic

According to the CPCB reports from the year 2007 to 2019, there was a steady increase in the amount of BMW generation per day, as shown in Fig. 1 (CPCB, 2020). In 2008, the BMW generation rate was only 410tons per day. In the next ten years, the value increased up to 619tons per day. India has set up different BMW treatment facilities in its states and union territories with a treatment capacity of 800tons per day (Dehal et al., 2021). Fig. 1 shows that the daily generation of BMWs was much less than the treatment capacity; however, 100% treatment was unable to achieve. This may be due to inadequacy in implementing the BMW management policies or incompetent treatment facilities. Fig. 2 shows the percentage of BMWs treated during the above period. The percentage of treatment increased from 2007 to 2011 and remained stationary up to 2016. After 2016 it again decreased steadily up to 2019. This decrease in the treatment percentage needs an urgent evaluation based on the policy-making and environmental impact assessment. During the pandemic, the daily BMW generation rate has suddenly increased up to 850tons per day (Chand et al., 2021). This increased BMW generation rate is the consequence of the sudden increase of the COVID-19 patients and the additional guidelines set up by the CPCB. The COVID-19 related BMWs generation rate is given in Fig. 3, which mimics the pattern of COVID-19 positive cases in India. The sudden increase in the amount of BMWs during the pandemic has turned out to be extremely harsh for the treatment providers and medical administrators. Therefore, there is an absolute requirement to micromanage the BMWs based on certain parameters for the possible COVID-19 like pandemic in the future (Goswami et al., 2021Punčochář et al., 2012).

Fig. 1