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ORIGINAL RESEARCH  
Year : 2020  |  Volume : 31  |  Issue : 1  |  Page : 26-30
Assessment of knowledge and awareness about biomedical waste management among health care personnel in a tertiary care dental facility in Delhi


1 Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
2 Department of Prosthodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
3 Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India

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Date of Submission28-Jun-2018
Date of Decision22-Jul-2018
Date of Acceptance06-Aug-2018
Date of Web Publication02-Apr-2020
 

   Abstract 


Aim: The study was conducted to assess knowledge and awareness of biomedical waste management (BMWM) among undergraduate students, residents, and nursing staff in a tertiary care dental facility in Delhi. Materials and Methods: A questionnaire survey (using ten close ended questions) was conducted regarding various aspects of BMWM among undergraduate students, residents, and nursing staff in a tertiary care dental facility. In each group, scores were determined depending upon the correct responses, the participants marked. The data were compiled and subjected to statistical analysis. Results: Only 33.3% undergraduate students gave over 70% correct answers as compared to nursing staff (100%) and residents (62.2%). Undergraduate students showed various lacunae in terms of knowledge regarding BMWM. The difference between the knowledge of the 3 groups i.e., nursing staff, residents, and undergraduate students was statistically significant (P = 0.001). Residents exhibited better awareness regarding BMWM as compared to undergraduate students (P = 0.003). Conclusion: The pertinence of the issue of BMWM and lack of adequate preparation of the trainee dentists at undergraduate level reflects the urgent need to fill the lacunae in the dental undergraduate curriculum.

Keywords: Attitude, awareness, biomedical waste management

How to cite this article:
Choudhary M, Verma M, Ghosh S, Dhillon JK. Assessment of knowledge and awareness about biomedical waste management among health care personnel in a tertiary care dental facility in Delhi. Indian J Dent Res 2020;31:26-30

How to cite this URL:
Choudhary M, Verma M, Ghosh S, Dhillon JK. Assessment of knowledge and awareness about biomedical waste management among health care personnel in a tertiary care dental facility in Delhi. Indian J Dent Res [serial online] 2020 [cited 2021 May 10];31:26-30. Available from: https://www.ijdr.in/text.asp?2020/31/1/26/281818



   Introduction Top


Biomedical waste (BMW) has been defined as “any waste that is generated during diagnosis, treatment or immunization of human beings or animals, in the research activities pertaining to or in the production or testing of biological and includes categories mentioned in schedule I of the Government of India's Biomedical Waste (Management and handling) rules 1998” [1],[2]

Approximately, 10–25% waste derived from health care facilities is considered to be hazardous and carries a higher potential for infection than any other type of waste.[3] It is estimated that about 0.33 million tonnes of BMW are generated in India alone.[4]

Dental waste is a subset of hazardous BMW. It is generated during various procedures and includes cotton, latex, glass, sharps, human body parts, and fluids (such as teeth, tissue, blood, etc.), dental materials and chemicals.[5]

Dental waste is further classified into non-risk waste and risk waste. Risk waste is infectious waste and hazardous. Infectious waste contains a large variety of pathogens. Hazardous waste contains metals that are toxic and non-degradable once they reach environment e.g., silver, lead, mercury, x-ray solutions, etc.[6]

Presently with the increase in demand for dental care, there has been an exponential growth of dental institutions and dental care centers in India, which in turn led to an increase in the amount of BMW generation in these centers.[6]

Hence, it is important to have proper storage and disposal of such BMW material according to rules and act.[3]

The absence of proper waste management, lack of awareness about the health hazards from BMW, insufficient financial and human resources, and poor control of waste disposal are the most critical problems connected with healthcare waste. The hazardous impact of medical waste on public and environment is enhanced manifold if adequate and appropriate handling of these wastes is not adopted.

However, a study was conducted to assess the knowledge and awareness of important aspects of BMW management (BMWM) among health care professionals in a tertiary care dental hospital in Delhi.

Aims and objectives

To assess knowledge, awareness and important aspects of BMWM among undergraduate students, residents, and nursing staff in a tertiary care dental facility in Delhi


   Materials and Methods Top


A cross-sectional study was carried out among the undergraduate students, residents, and Nursing Staff of a dental institution in New Delhi. A total of N = 95 participants were included by simple random sampling. The study was carried out for period of 3 months from December 2017 to February 2018.

A specially designed questionnaire consisting of ten close ended questions was prepared that consisted of basic awareness and knowledge related to latest BMW act was prepared. The questionnaire was administered to each participant. [Table 1] shows the questionnaire which was given to the participants. The responses were categorized as correct, incorrect, and not answered. The response was marked out of ten for each participant, one mark for correct answer (hence, maximum score that could be obtained per participant was 10). Mean score was calculated, hence, in each participant group, by calculating the mean obtained from scores of individual in each group.
Table 1: The questionnaire

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The data were compiled and subjected to statistical analysis.


   Results Top


A total of 95 participants were included in the study. [Table 2] shows the distribution of participants in the study. [Table 3] shows the distribution of the responses among the above 3 categories.
Table 2: Frequency distribution in each group

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Table 3: The distribution of the responses among the above three categories

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The mean score obtained by each group are depicted in [Table 4]. It was observed that Group 1, i. e., Nursing staff showed the highest score with undergraduate students (Group 3) scoring the lowest. Approximately, 60% (57) participants scored 70% and above. Only 33.3% undergraduate students (Group 3) scored over 70% correct answers as compared to nursing staff (100%) and residents (62.2%). The lowest scores were seen in Group 3, and the highest average scores were observed in Group 1.
Table 4: Mean scores in each group

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On comparing the 3 groups using analysis of variance (ANOVA), it was observed that there was significant difference between the mean scores of the 3 groups. (P = 0.001) as shown in [Table 5].
Table 5: Comparison between the groups using analysis of variance

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Application of post-hoc test (Bonferroni), showed a significant difference between scores of groups individually between Group 1 and Group 2 (P = 0.001); Group 2 and Group 3 (P = 0.003); and Group 1 and Group 3 (P = 0.001) as shown in [Table 6]. [Table 7] shows various P values derived at after applying Pearson Chi-square test with respect to individual questions among various groups.
Table 6: Post-hoc Bonferroni comparison for all the groups

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Table 7: P values derived at after applying Pearson Chi-square test with respect to individual questions among various groups

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   Discussion Top


Hazards of improper management of BMW have resulted in increased concern for management of same throughout the world. Considering its deleterious effects on human health and ecosystem, several studies especially from developing countries have been documented in the literature showing inadequacy of knowledge and indigent attitude among health care workers regarding BMW.[7]

The present study aimed at determining the BMW awareness of various groups of professionals who are involved in dental health care.

Considering BMW is not included in the curriculum of the dental study in India, the questionnaire pertaining to BMW was kept at a basic level.

Further, nursing staff (Group 1) and residents (Group 2) scored better as compared to undergraduate students (Group 3). In addition, nursing staff had a better score as compared to the residents' group that was siginificantly better than the undergraduate group.

There was a significant difference between the scores obtained between the 3 groups. The results are in agreement in the previous studies by Mathur et al.[8] and Kapoor et al.[9] Similarly, when comparing the scores of residents with undergraduate students, the former had a significantly higher score. These findings were supported by study by Sanjeev et al.[3] This observation may be because of the fact that, BMWM is not included formally in traditional dental curriculum. One can conclude that undergraduate students need substantial clinical exposure to learn these protocols. One can also deduce that residents who have been working in the clinics for a longer time might be more sensitized to BMWM.

There was no significant difference between scores in various groups in questions 1, 2, 5, 7, 9, and 10. Hence, it could be deduced that all the groups had answered in similar pattern. Out of these, questions 1, 2, 5, 7, and 10 were related to very basics of BMWM that dealt with definition, basic cardinal principles, aims, objectives, and basic understanding of the BMWM. Considering the Institute is a NABH accredited teaching hospital, standards of BMWM remains priority for this Institute for necessary legal and environment clearances.

The results are in consonance with the study of Saini et al.[10] and Rudraswamy et al.[11] Both the above mentioned studies were conducted among dental students and dental staff, respectively and indicated that the above groups had good awareness and perception level regarding BMWM.

In questions pertaining to pre-treatment of BMW; 3 and 6; it could be appreciated that nursing staff fared better than residents and undergraduate students. Further, the difference was statistically significant too. This could be attributed to the fact that they are directly involved in that process as compared to the other groups and are responsible toward the pre-treatment.

In aspects pertaining to sharp management, nursing staff fared better than undergraduate students did. Logically, students are exposed to clinical environment in the 3rd and 4th year of curriculum, and it could be deduced that sensitization with respect to this aspect necessarily takes some more time as compared to nursing staff who are directly involved in patient care. These results are similar to that of Pawar and Patil.[4]

With respect to a question related to Mercury, all the groups responded well, and there was no significant difference in between the various groups. Regarding disposal of mercury, multiple studies have shown variable results regarding the awareness among health care workers about how the remaining mercury should be handled and further its disposal.[6]

Regarding upgradation of BMWM rules, nursing staff scored significantly higher than other groups. This emphasizes the need for inclusion of education about policies and rules of BMWM in the dental curriculum.

Although BMWM is a matter of legislation, which are regularly amended, various studies have shown different levels of awareness of such laws. Study by Sudhir et al.[12] showed that 22.3% did not know about such laws. Study by Kishore et al.[13] showed 64.1% respondents were not aware of BMW related laws.

The present study was conducted on varied groups in a tertiary dental hospital setup, and a closed ended questionnaire was used. The study had an added benefit as questions were formatted for analysis and response rate, and there by it prevents recall bias.

Further, all the participants in the study belonged to same workplace, and hence, they followed similar guidelines and BMWM protocol. The present study was conducted in a small group and subjects. There is need for more research and more data for evidence base for future decision-making.


   Conclusion Top


The study revealed that there is high awareness about BMWM among nursing staff, which was more than residents and undergraduate students. Only 33.3% undergraduate students scored over 70% correct answers as compared to nursing staff (100%) and residents (62.2%). There is a definite need for more awareness among dentists' group regarding the subject. This could be improved if BMWM could be included in the graduate dental curriculum and regular continuing education program are conducted.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Government of India, Ministry of Environment and Forests. Bio-Medical Waste (Management and Handling) Rules. Gazette of India; 1998.  Back to cited text no. 1
    
2.
Government of India, Ministry of Health and Family Welfare. National Guidelines on BMW (Management and Handling) Rules. Government of India, Ministry of Health and Family Welfare; 1998.  Back to cited text no. 2
    
3.
Sanjeev R, Suneesh K, Subramaniam R, Prashant PS, Meera G. Knowledge, attitude and practices about BMWM among dental health care personnel in dental colleges in Kothamangalam: A cross-sectional study. Health Sci 2014;1:JS001I.  Back to cited text no. 3
    
4.
Pawar PA, Patil TS. Knowledge, practice and attitude of dental care waste management among Pvt. dent practitioners in Latur city. Int Dent J Stud Res 2017;5:80-4.  Back to cited text no. 4
    
5.
Sharma A, Sharma V, Sharma S, Singh P. Awareness of biomedical waste management among health care personnel in Jaipur, India. Oral Health Dent Manag 2013;12:32-40.  Back to cited text no. 5
    
6.
Bansal M, Vashisth S, Gupta N. Knowledge, awareness and practices of dental care waste management among private dental practitioners in tricity (Chandigarh, Panchkula and Mohali). J Int Soc Prev Community Dent 2013;3:72-6.  Back to cited text no. 6
    
7.
Ranjan R, Pathak R, Singh DK, Jalaluddin M, Kore SA, Kore AR, et al. Awareness about biomedical waste management and knowledge of effective recycling of dental materials among dental students. J Int Soc Prev Community Dent 2016;6:474-9.  Back to cited text no. 7
    
8.
Mathur V, Dwivedi S, Hassan M, Misra R. Knowledge, attitude, and practices about biomedical waste management among healthcare personnel: A cross-sectional study. Indian J Community Med 2011;36:143-5.  Back to cited text no. 8
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9.
Kapoor D, Nirola A, Kapoor V, Gambhir RS. Knowledge and awareness regarding biomedical waste management in dental teaching institutions in India – A systematic review. J Clin Exp Dent 2014;6:e419-24.  Back to cited text no. 9
    
10.
Saini R, Pithon MM, Singh HK, Popoff DV. Knowledge of BMWM among the students of rural dental college, Maharashtra, India. Int J Exp Dent Sci 2013;2:24-6.  Back to cited text no. 10
    
11.
Rudraswamy S, Sampath N, Doggalli N. Staff's attitude regarding hospital waste management in the dental college hospitals of Bangalore city, India. Indian J Occup Environ Med 2012;16:75-8.  Back to cited text no. 11
[PUBMED]  [Full text]  
12.
Sudhir KM, Chandu GN, Prashant GM, Nagendra J, Shafiulla M, SubbaReddy VV. Awareness and practices about dental health care waste management among dentists of Davangere city, Karnataka. J Indian Assoc Public Health Dent 2006;8:44-50.  Back to cited text no. 12
    
13.
Kishore J, Goel P, Sagar B, Joshi TK. Awareness about biomedical waste management and infection control among dentists of a teaching hospital in New Delhi, India. Indian J Dent Res 2000;11:157-61.  Back to cited text no. 13
    

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Correspondence Address:
Meera Choudhary
Maulana Azad Institute of Dental Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijdr.IJDR_528_18

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