Hospitals are health institutions providing patient care services. It is the duty of hospitals and health care establishments to look after the public health. This may directly be through patient care or indirectly by ensuring a clean, healthy environment for their employees and the community. In the process of health care, waste is generated which usually includes sharps, human tissues or body parts and other infectious materials (Baveja et al., 2000), also referred to as ‘‘Hospital Solid Waste’’ and ‘‘Bio-medical Solid Waste’’ (Manohar et al., 1998).

The Government of India (Notification, 1998) speci-fies that Hospital Waste Management is part of hospital hygiene and maintenance activities. This involves management of a range of activities, which are mainly engineering functions, such as collection, transportation, operation/treatment of processing systems, and disposal of waste. However, initial segregation and storage activities are the direct responsibility of nursing personnel who are engaged in the hospital. If the infectious component gets mixed with the general non-infectious waste, the entire mass becomes potentially infectious (Info Nugget, 2003). Before the notification of Bio-Medical Solid Waste (Management and Handling) Rules 1998, waste from houses, streets, shops, offices, industries and hospitals was the responsibility of municipal or governmental authorities, but now it has become mandatory for hospitals, clinics, other medical institutions and veterinary institutions to dispose of bio-medical solid waste as per the Law. The onus lies on hospitals and other health care institutions to ensure that there are no adverse health and environmental consequences as a result of their waste handling, treatment and disposalactivities.

The actual biomedical waste management situation in the democratic developing country like India is grim. Lakshmi (2003), in the leading national newspaper of the country, reports that even though there are Rules stipulating the method of safe disposal of Bio-medical Waste (BMW), hospital waste generated by Government Hospitals is still largely being dumped in the open, waiting to be collected along with general waste. According to World Health Organization (Biomedical Wastes, 2004) the human element is more important than the technology alone. Almost any system require treatment and disposal that is operated by well-trained and well-motivated staff provides more protection for staff, patients and the community, than an expensive or sophisticated system that is managed by staff who do not understand the risks and the importance of their contribution (Biomedical Wastes, 2004). The study conducted by the Central Pollution Control Board (CPCB), an apex pollution monitoring body on incinerators in Delhi Hospitals, concludes that the incinerators were found to spew a high level of deadly residues and toxic emissions such as cancer-causing dioxins and furans besides chemicals which cause neonatal abnormalities, reproductive and skin disorders, endocrine disruption and suppression of the immune system, reports Krishna of The Independent Media Center India (2004). He also notes that there is also even prevalence of reuse/recycling of biomedical waste being practiced due to: (i) lucrative monetary returns, and (ii) lack of awareness about the problems associated with biomedical wastes. The crux to all of this may be due to a lack of awareness and appreciation amongst medical staff and residents, as well as the public; inadequate existing facilities, and lack of strict enforcement of the Rules in light of the enormous population of the country. Biomedical waste management is a special case wherein the hazards and risks exist not just for the generators and operators but also for the general community (Sandhu and Singh, 2003). There are about 1.6 million health care workers at approximately 27,500 health care facilities in India (Shah et al., 2001). Waste management has become a critical issue as it poses potential health risks and damage to the environment, which has taken a central place in the national health policy and is attracting a considerable international interest. India participated in the United Nations Conference on the Human Environment held at Stockholm in June, 1972, where decisions were taken to take appropriate steps for the protection and improvement of human environment. Therefore, the Environment (Protection) Act 1986 (EPA) was formed under the Ministry of Environment and Forests, which is the most comprehensive Act on the Indian Statute Book relating to Environment Protection (Jaswal and Jaswal, 2000). It is general legislation for the Protection of Environment, enacted under article 253 of the Constitution, which came in force on 19th November 1986. In July 1998, the Government of India Environment (Protection) Act 1986 (Rule 29 of 1986) issued a Notification on Biomedical Waste (Management and Handling), Rules 1998, indicating the Rules for the Management and Handling of bio-medical solid waste. It defines ‘‘Biomedical waste’’ as any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals, and including categories mentioned in Schedule I (1998). Looking into the existing scenario of biomedical waste management in the country it was thought to undertake a study to: (i) assess the human factor in handling and treatment of clinical waste, i.e., to study the existing modus operandi and its compliance with the Standard Procedures of the Biomedical Waste Management Rules as per EPA 1986 and (ii) quantitatively determine the amount of non-infectious and infectious waste in various blocks of a recently built, multi-speciality, high-technology hospital known for its most advanced diagnostic and surgical specialities. The study lasted a period of 3 months.