A WHO fact sheet says that among the total waste that gets generated in healthcare, 80% is general waste. The remaining 20% of the waste is by far hazardous and can be toxic, radioactive and infectious in nature. There is limited clarity on the disposal mechanism for the hazardous waste and in particular, radioactive waste. It is meaningful to realize that when radioactive substances are used for treatment health, a proper mechanism is needed to dispose of the used matter in the correct manner.
Radioactivity is a phenomenon where matter is emitted through elements and spontaneous radiation takes place. It does not get altered by electricity, heat or other forces and remains unchangeable. The disposal of radioactive waste needs to be followed very meticulously and needs to be disposed of properly with standard protocols in place. The current situation of radioactive waste disposal is vague and is largely dependent on how the hospital concerned perceives it. Available documents suggest in no simpler terms that India is a dumping ground for the world’s e-waste.
In one report, the figures obtained from a major Indian port from April 2009 to December 2009 found used computer parts in plenty, including outdated cathode ray tube monitors with hazardous amount of lead which came from parts of the Middle East, Finland and South Asia. That apart, 5761 used and old printers were imported from different destinations, including the US. Other major computer parts included 2868 assorted CPUs, 2156 assorted motherboards, 3750 hard disks and many more.
This data only serves to remind us of the persistent negligence that India has been giving to prioritize permanent removal of e-waste. In this context, radioactive waste can then be read as a tip of the iceberg problem of sort. The policy should focus on the ways in which segregation of radioactive waste can be carried about, the treatment method that needs to be employed for its safe disposal.
The policy should address the many facets of radioactive waste. How should radioactive waste be collected on-site to the disposal centre? What should be the competence and training of the handlers of radioactive waste? What must be done if external contamination takes place while storing the radioactive waste? What mechanisms are needed to protect the waste without any leakages taking place? What checks and balances should be put in place? Who should be the regulatory authority to keep a constant check on such pointers?
India remains ignorant and in need of a national policy on radioactive hospital waste management. It is imperative to create concrete policies to avoid the spread of infection through waste, prevent the misuse of radioactive waste which can spell chemical and biological disasters in the form of dirty bombs if in the wrong hands. Policies should have a direction for handling the radioactive waste and this should be handled only with people trained in the field. Capacity building exercises should to be taken up across the country to train the workers handling this waste so that it is disposed of with quality control standards and not dumped with other e-waste. There should to be clear guidelines for segregation, collection, storage, transportation and treatment. Disaster management authorities should be the nodal agency for conducting regulatory checks at all hospitals using radioactive waste.
Radioactive waste can be either natural and artificial. However, it remains a source of exposure to human beings through different routes. The channels though which radioactive waste can be harmful are through ingestion & inhalation of radioactive substances through the air that one breathes or through the food consumed. Much of the impact depends on the magnitude of exposure upon the individual concerned. From a policy perspective, safeguarding human interest before commercial interest will need to be tightened to the hilt. Parts of, or the whole body can be affected, leading to cancers of different forms.
The policy should encompass a dedicated insurance scheme for health-workers handling these substances and provide them with adequate social security. Increased awareness must be generated among health workers with substances that have a high “potential hazard index“ which is noted in terms of the nuclide availability which includes the half life and the permissible annual intake.
Radioactive waste management in India is fairly nascent given the other burgeoning priorities confronting the nation. But it needs more attention.