Background: WHO defines a safe injection as 'one that does not harm the recipient, does not expose the healthcare worker to any avoidable risks and does not result in any waste that is dangerous to the community. Breaks in safe injection practices coupled with overuse of injections may expose the recipients, healthcare workers or the community to several harms including life-threatening infections. Unsafe injections can transmit bacterial, viral (HBV, HCV and HIV) and parasitic (malaria) infections. Bio-medical waste (BMW) is defined 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. Approximately 75-90% of the bio-medical waste is non-hazardous and as harmless as any other municipal waste. The remaining 10-25% is hazardous and can be injurious to humans or animals and deleterious to environment. Sharps which include needles are hazardous type of waste and need proper disposal at the site of generation. The Bio Medical Waste Management Rules (2018) should be used as a reference and followed carefully for sharps management.

Material and Methods: Cross sectional observational study conducted among 152 waste handlers in various health care settings of Kashmir valley over a period of six months. A validity tested questionnaire was used to gather information. Results are summarised and presented in the form of tables and chi (x2) test was used for test of association with statistical significance set at p-value of less than 0.05.

Results: In this study out of 152 waste handlers, majority (71.1%) of waste handlers were male. 78.4% belonged to the age group of 31-50 years. All the waste handlers were illiterate. Only a small percentage (3.9%) was trained in waste handling. In 40.1% of the facilities protective measures for waste handlers in the form of only latex gloves was available. Only 23.7% of these waste handlers had received Hepatitis B vaccine. Out of these 58.3% had received three doses, 30.6% two doses and 11.1% one dose of the vaccine. Majority (86.2%) of the waste handlers carried waste bags by hand while only 13.8% used Lorries. In only 6.6% of waste handlers needles were seen piercing out of the waste bags. 98.7% of waste handlers were not aware about different colors of polybags and their purpose. In 48% of the cases separate polybags were used for disposal. 23.7% of the waste handlers had received a needle stick injury in last 6months while waste collection.

Conclusion: None of the waste handlers were wearing protective gear. PPE in the form of only latex gloves were available in 40.1% of the facilities. Waste handlers were not using protective gear; their knowledge about waste handling was poor and were not following BMW rules for waste management.