Assessment of Biomedical Waste Management Practices and Risk Perception Among Healthcare Workers in South India

Introduction Inefficient biomedical waste (BMW) management in healthcare settings can expose patients, workers, and the environment to significant risks. This study aimed to assess BMW segregation practices, occupational risk perception, training exposure, and sharps injury incidence among healthcare workers (HCWs) across multiple tertiary care hospitals in South India. Methods A cross-sectional observational study was conducted over six months across four randomly selected tertiary care teaching hospitals in Chennai, Tamil Nadu. A total of 356 healthcare workers comprising 84 (23.6%) doctors, 186 (52.2%) nurses, and 86 (24.2%) housekeeping staff were selected using stratified random sampling. Data were collected via a pre-validated, structured questionnaire (55 items), on-site observations, and semi-structured interviews. Risk perception was measured using a five-point Likert scale, and a simplified infection risk model adapted from the UK Environmental Agency was applied. Data were analyzed using SPSS version 26.0 (IBM Corp., Armonk, NY, USA), employing chi-square tests and one-way ANOVA. Results Overall, 257 (72.1%) of participants demonstrated correct knowledge of BMW segregation protocols, with highest accuracy among nurses (142, 76.3%) and lowest among doctors (53, 63%). Field observations revealed inconsistent compliance, particularly in high-volume areas. Risk perception was highest for environmental contamination (mean score: 4.30) and waste worker exposure (4.08), but significantly lower for patients and visitors. A total of 41 sharps injuries were reported, with underreporting observed among doctors. Training participation varied significantly across roles: only 26 (31%) doctors were trained compared to 138 (74.2%) nurses and 76 (88.3%) housekeeping staff. Training was strongly associated with both risk perception and segregation accuracy (p < 0.05). Conclusion This multi-center study highlights critical gaps in BMW knowledge, risk perception, and training, particularly among doctors. Despite awareness, compliance remains inconsistent, underscoring the need for mandatory training, improved monitoring, and institution-wide reinforcement of biomedical waste protocols to reduce health and environmental hazards.