PESHAWAR, April 30: Public sector health care institutions have yet to develop a proper framework for safe disposal of hospital waste, in accordance with the Environmental Protection Act, 1997, health officials told Dawn.

Rules of Hospital Waste Management of 2000 drawn under the Environmental Protection Act, 1997, call for the formation of hospital waste management to ensure that waste was properly disposed off within 24 hours.

The rules say that the hospital waste management team under the medical superintendents, with pharmacist, engineer, infection control officer, heads of all departments, senior nurses, radiology officer, waste management officer as its members is to be formed with a view to ensure timely disposal of the hospital waste.

The act also provides for the formation of an advisory committee to be headed by health secretary, which shall periodically review the implementation of rules and recommend amendments and also recommend adoption of such policy measures, plans and projects as it may consider necessary for the effective management of hospital waste in the province.

According to rules, each hospital shall apply to the federal or provincial environmental agency for grant of licences in accordance with the provision of Hazardous Substance Rules, 2000. Such bodies are yet be formed. In their absence a polluted environment in the hospitals exists.

A doctor who had been working on the hospital waste management for the last two years said that an estimated 2,800kg of waste was generated by the three teaching hospitals of the city in one day.

According to a rough estimate, one kilogramme of waste was generated by one bed that included hazardous materials which needed proper disposal, but lack of the required infrastructure has increased the risks for the people, the doctor added.

Khyber Teaching Hospital (KTH), Lady Reading Hospital (LRH) and Hayatabad Medical Complex (HMC) had installed incinerators about two years back with each costing Rs3.2 million, but due to lack of proper management, these incinerators are of little use, given the fact that hospitals' waste was still handled by the sweepers.

Since the installation of the incinerators, there has never been an impact assessment nor a monitoring system in place. Initially, the idea was that an impact assessment of the incinerators would be conducted periodically and if found feasible, incinerators would be installed in other hospitals of the province.

Nevertheless, all three dual chambers incinerators had the proper combustion capacity of the hospital waste at 3,000 Celsius. The hospital waste that includes kitchen and infectious waste, bio-waste, pharmaceutical, chemical and radio active waste and sharps needed proper collection, transportation and disposal.

"Unfortunately, the waste is not properly disposed off, owing to the inability of the hospitals' managements, who never accorded priority to it," said a doctor. The incinerators during combustion omit toxic fumes, putting at risk the people of getting TB, chest, gastro-intestinal and skin infections.

The health professionals as well as relatives of the patients also faced the risk of getting infected with hepatitis B & C and HIV/AIDS, because they frequently come in contact with sharps, such as blades and needles.

"Some elements do not want the use of incinerators, because they have been earning good amount from selling the used syringes to be re-cycled," said a doctor. The problem becomes more alarming when the dust-bins at the hospitals aren't emptied for several days.