Lahore: 30 pathological labs violating waste management rules

[Naveed Yaseen]

By Ali Raza
AS many as 30 pathological laboratories, including those operating in top hospitals of the provincial metropolis, are spreading contagious diseases by violating the Hospital Waste Management Rules (HWMR) 2005.

The Environment Protection Department (EPD) Punjab on Friday launched a massive crackdown on pathological laboratories violating the Hospital Waste Management Rules 2005 meant to regulate disposal of clinical and pathological waste as well as medical equipment such as syringes, blood bags etc. The operation was launched on the directions of EPD Secretary Sajjad Saleem.

EPD sources said that on Friday, eight teams consisting of officials of the EPD and the City District Government Lahore were constituted to visit pathological laboratories to check compliance of HWMR 2005. Sources said teams were directed to check pathological laboratories in big and renowned hospitals in the city, which are mostly in private sector.

On Friday, teams raided various hospitals and private pathological laboratories in the City and found ten laboratories in Allama Iqbal Town violating the rules.

The situation was not different on Jail Road where a large number of private hospitals and pathological laboratories are located. A large number of patients daily visit these hospitals and laboratories but do not know that they may get an infectious disease by only giving a sample of their blood.

Several pathological laboratories operating in the surroundings of Mayo Hospital were also raided and at least four were found disposing of clinical and pathological waste in violation of the HWMR 2005.

On Shalimar Link Road, the EPD and CDGL teams found three pathological laboratories violating the HWMR 2005.

Naseemur Rehman, a senior EPD official said in August 2005, the Federal Ministry of Environment notified Hospital Waste Management Rules and majority of the government hospitals had enforced these rules. He said hospital waste includes infectious material containing pathogens in sufficient concentrations or quantities that, if exposed to humans, can cause diseases. This includes waste from surgery and autopsies on patients with infectious diseases. Other types of wastes are sharps such as disposable needles, syringes, saws, blades, broken glasses, nails or any other item that could cause a cut, tissues, organs, body parts, human flesh, foetuses, blood, body fluids, drugs, chemicals, solids, liquids and gaseous waste contaminated with radioactive substances used in diagnosis and treatment of diseases such as toxic goiter.

He said the EPD started the campaign because there were reports that in most of the private hospitals, clinics and pathological labs especially in middle and poor localities were violating hospital waste management rules.

He said under the Hospital Waste Management Rules, 2005, hazardous waste must be separated from non-hazardous waste at wards, operation theatre, laboratory or any other room in the hospital where waste is generated.

He said the rules clearly mention that all disposable material and medical equipment such as syringes, needles, plastic bottles, drips, blood bags, etc shall be cut or broken so that they can not be used again. He said the above mentioned hospitals were not following this condition. He said according to rules, sharps must be placed in metal or high density plastic containers resistant to penetration and leakage but no such containers or boxes were being used by majority of pathology labs in the City. These containers must be coloured yellow and marked “Danger! Contaminated Sharps” but most of the private hospitals, clinics and labs did not follow this rule.

The HWMR 2005 clearly stated that the chemical waste and waste with high content of mercury or cadmium shall not be incinerated, but shall be placed in chemical resistant containers and sent to specialized treatment facilities. Radioactive waste, which has to be stored to allow decay to background level, shall be placed in waste bags, in a large yellow container or drums. The container or drum shall be labelled showing the radio nuclide’s activity on a given date and the period of storage required and marked “Radioactive Waste” with the radiation symbol. No such arrangement is seen in most of the private hospitals, clinics and pathological labs.

About waste collection, the rules said sanitary staff and sweepers shall, when handling waste, must wear protective clothing at all times including face masks, industrial aprons, leg protectors, industrial boots and disposable or heavy duty gloves. The rules said all waste bags must be labelled before removal, indicating the point of production and contents and after removing a waste bag from a container, it must be cleaned properly.

In most cases, hospital waste is simply mixed with municipal waste in bins at roadsides and disposed off similarly. Some waste is simply buried without any safety measures. Disposable syringes and needles are also not disposed off properly. Many patients, who routinely use syringes at home, also do not know how to dispose them properly. They just throw them in a dustbin or other similar places, because they think that these practices are inexpensive, safe, and easy.

Naseemur Rehman said that the standard practice of hospital waste disposal is dumping it in CDGL containers. He said when waste containing plastics are burnt, dioxin is produced, which can cause cancer, birth defects, decreased psychomotor ability, hearing defects, cognitive defects and behavioural alternations in infants.

He said flies sit on the uncovered piles of rotting garbage. This promotes mechanical transmissions of fatal diseases such as diarrhoea, dysentery, typhoid, hepatitis and cholera. Under moist conditions, mosquitoes transmit many types of infections such as malaria and yellow fever. Similarly, dogs, cats and rats also transmit a variety of diseases, including plague and flea-born fever as they mostly live in and around the refuse. A high tendency of contracting intestinal, parasitic and skin diseases is found in workers engaged in collecting refuse, he maintained.

About the possible action against the above mentioned hospitals or those who would be found guilty of not enforcing the HWMR 2005, he said report on every hospital or lab, which was checked had been sent to the EPD secretary. He said a notice under the environmental would be issued to these hospitals. He said later a second reminder would also be served on hospitals and labs not complying with the directions of the department after which their case would be send to the Environmental Tribunals for legal action. He said the EPD will expand the campaign and it will be spread to all over Punjab in the coming days.

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