Assessment of Knowledge, Attitude and Practices related to Biomedical Waste Management among Undergraduate Students: A Questionnaire-based study Dr. Aditi Tiwari 1, Dr. Madhu Sweta Jain 2 , Dr. Ananya C. Tripathi 3 Ritika Tiwari 4 tiwariaditi2000@gmail.com 1 ,madhuswetajain@gmail.com 2 , ananyaat550@gmail.com 3 , ritikatiwari172@gmail.com 4 Abstract— Background: To ascertain Knowledge, Attitude and Practices of Orthodontic Undergraduate students (I/II/III) regarding biomedical waste management protocol and to compare Knowledge, Attitude and Practices of Undergraduate Dental Students Aim of Study: To assess Knowledge, Attitude and Practices related to Biomedical Waste Management among Undergraduate Dental Students. Methods and Materials: ▪ A self-designed English language questionnaire were used for this study. 20 questions were formulated to assess the knowledge, attitude this constraint is acknowledged as a methodological limitation for subsequent analyses. A single duplicated personal identifier was detected, but examination of time-stamps and response patterns confirmed that it represented two distinct submissions; therefore, all 207 records were retained for analysis in accordance with the a-priori plan (complete-case approach). The survey collected a total of 207 responses, with all questionnaires being fully completed. Only one instance of a duplicate identifier was detected, accounting for 0.5% of the responses. There was no item-level missing data reported in the survey. However, demographic variables such as age, gender, academic year, city, and state were not captured in the survey due to their exclusion from the Google Form used for data collection. As a result, demographic distribution could not be reported. Overall, the survey demonstrated a high completion rate and minimal data quality issues. Key point: Although the sample size is robust for a single-centre KAP survey, the absence of demographic data limits subgroup comparisons (e.g., year-wise or gender-wise differences). All subsequent statistical tests therefore treat the cohort as a single analytic group unless otherwise stated. Knowledge Domain Results A total of 14 knowledge items (Q 6 – Q 19) were scored for every respondent (maximum = 14). Composite score: mean ± SD = 9.17 ± 1.74 (median = 9; IQR = 8–10; range = 5–13).Only 9.7 % (n = 20) achieved ≥12/14, while 6.3 % (n = 13) scored ≤6/14, indicating substantial heterogeneity in factual mastery. Table 2: Item-wise performance Correct responses for each knowledge item (N = 207) Item Correct n Correct % 95 % CI Wax bag colour 157 75.8 70.0–81.7 Applicator-tip bag 138 66.7 60.2–73.1 Debonded-bracket bag 160 77.3 71.6–83.0 Cotton-salivation bag 171 82.6 77.4–87.8 Yellow-bag treatment 185 89.4 85.2–93.6 Bag symbol 27 13.0 9.0–17.9 BMWM disinfectant (1 % NaOCl) 175 84.5 79.4–89.0 Working-model disposal 117 56.5 49.7–63.2 Hawley-appliance bag 4 1.9 0.5–4.8 E-chain bag 144 69.6 63.2–75.5 Fixed-appliance disposal 183 88.4 83.8–92.4 LA syringe & needle protocol 135 65.2 58.6–71.4 Mini-implant disposal 133 64.3 57.6–70.6 Yellow-bag thickness 170 82.1 76.8–87.3 Results: Highest accuracy (≥80 %): yellow-bag treatment, BMWM disinfectant concentration, cotton-salivation bag selection, fixed-appliance disposal procedure, and minimum bag thickness.Lowest accuracy (<60 %): biohazard symbol identification (13 %), working-model disposal (56 %), and Hawley-appliance bag choice (1.9 %). Interpretation: While foundational concepts such as bag colour coding and chemical disinfection were well-understood, critical gaps persist in recognizing regulatory symbols and the specific disposal route for acrylic appliances—areas that warrant targeted instructional reinforcement. Attitude Domain A total of 207 completed records were analyzed for the five attitude items (Q 1 – Q 5). Response distributions are detailed in Table 3 and summarized below. Awareness of colour-coded disposal protocol (Q 1). Only 7.7 % of students felt completely aware of the colour-bag system, while the dominant category was partially aware (76.3 %), underscoring a sizeable knowledge gap in a fundamental safety requirement. Knowledge of the local
Tiwari et al. (Sun,) studied this question.