Updated Guidelines on Biomedical

Waste Management
 Bio Medical Waste
Any waste which is generated during the diagnosis, treatment or
immunization of human beings, animals or in research
activities,production and testing of biologicals
Infectious waste 10%
+
Hazards Waste 5%
 Government of India
• Bio medical Waste Management and Handling rules in July 1998
• Bio Medical waste Management Rules 2016

28th March, 2016

Applicable to all the Health Care establishments

Application of BMW Rules, 2016
• Apply to all persons who generate, collect, receive, store, transport, treat, dispose, or
handle bio medical waste

 Hospitals  Clinical establishments

 Nursing homes  Research or Educational institutions
 Clinics  Health camps
 Dispensaries  Medical or surgical camps
 Veterinary institutions  Vaccination camps
 Animal houses  Blood donation camps
 Pathological laboratories  First aid rooms of schools
 Blood banks  Forensic laboratories
 AYUSH hospitals  Research labs
 Legal Implications
• The occupier or operator shall be liable for action under
section 5 and section 15
• Imprisonment up to 5 years or penalty up to Rupees one
lakh or both in case of violation

Hospital INCINERATOR
BMW Rules 2016 Does Not Apply To
 Solid wastes from community
 Radioactive wastes
 Hazardous chemicals
 Lead acid batteries
 E- Waste
 Hazardous / Genetically engineered Microbes
 Trans boundary movement of wastes
 Occupier
• Agreement copy with Operator (CBMWTF)
• Obtain Authorization
• Obtain consent to operate Air and Water

From State Pollution Control Board

Segregation at Place of Generation
 Color Codes for
segregations

Yellow White

Blue
Red

14
Schedule 1- categories and their segregation, collection, treatment, processing and disposal options

(a)Human Anatomical Waste: Human tissues, organs, body

parts and fetus
Yellow colored
(b)Animal Anatomical Waste :Experimental animal
carcasses, body parts, organs, tissues, including the waste non-chlorinated
generated from animals used in experiments or testing plastic bags
(c)Soiled Waste: Items contaminated with blood, body fluids
like dressings, plaster casts, cotton swabs and bags containing
residual or discarded blood and blood components.

Incineration or Plasma Pyrolysis or deep burial* In absence of above

facilities, autoclaving or micro-waving/hydro calving followed by
shredding or
mutilation or combination of sterilization and shredding. Treated waste to
be sent for energy recovery.
Challenge with Amputated Body Parts
Schedule 1- categories and their segregation, collection, treatment, processing and disposal
options
Yellow
(d) Expired or coloured
Discarded Medicines: non-
Pharmaceutical waste like chlorinated
antibiotics, cytotoxic drugs plastic
including all items contaminated bags or Expired `cytotoxic drugs and items
with cytotoxic drugs along containers contaminated with cytotoxic drugs to be
with glass or plastic ampoules, returned back to the manufacturer or supplier
vials etc. for incineration at temperature
>1200 0C or to common bio-medical waste
treatment facility or hazardous waste treatment,
storage and disposal facility for incineration at
>1200 0C Or
Encapsulation or Plasma Pyrolysis at
>1200 0C.
All other discarded medicines shall
be either sent back to manufacturer or disposed
by incineration.
 (g) Discarded linen,
mattresses, beddings
contaminated with
blood or body fluid. Non-chlorinated
yellow plastic Non- chlorinated chemical
bags or suitable disinfection followed by
packing material incineration or Plasma
Pyrolysis

(h) Microbiology, Biotechnology

and other clinical laboratory
waste: Blood bags, Laboratory
cultures, stocks or specimens of Autoclave safe
plastic bags Pre-treat to sterilize with
microorganisms,
live or attenuated vaccines, or containers nonchlorinated chemicals
on-site as per National
human and animal cell cultures
AIDS Control Organization
used in research, industrial
or World Health
laboratories, production of
Organization guidelines
biological, residual toxins, dishes
thereafter for Incineration.
and devices used for cultures.
Contaminated Waste Red coloured
(Recyclable) non-
(a) Wastes generated chlorinated
from disposable items such as plastic bags or
tubing, bottles, intravenous tubes containers
and sets, catheters, urine bags,
syringes (without needles and fixed
needle syringes) and vaccutainers
with their needles cut) and gloves

Autoclaving or hydroclaving followed by

shredding or mutilation or combination of
sterilization and shredding. Treated waste to
be sent to registered or
authorized recyclers or for energy recovery or
plastics to diesel or fuel oil or for road
making, whichever is possible.
Plastic waste should not be sent to landfill
sites.
 Challenges with plastic waste
 Plastic bottles should be numbered and entries
maintained in separate registers
 Weighed and documented
 Handed over to CTF
 Puncture proof,
Leak proof,
Waste sharps
tamper proof
Including
containers
Metals:
Needles, syringes
with fixed
needles, needles from needle tip

STAY Sharp
cutter or burner, scalpels,
blades, or any other Autoclaving or Dry Heat Sterilization

BE Safe
contaminated sharp object that followed by shredding or mutilation or
may cause puncture and cuts. encapsulation in metal container or
This includes both used, cement concrete; combination of
discarded and contaminated shredding cum autoclaving; and sent fo r
metal sharps final disposal to iron foundries (having
consent to operate from the State
Pollution Control Boards or Pollution
Control Committees) or sanitary
landfill or designated concrete waste
sharp pit.
aa…………… HUB
……… CUTTER
Glassware:
Broken or discarded Puncture proof,
and contaminated glass Leak proof,
including medicine vials tamper proof
and ampoules except containers
those contaminated with
cytotoxic wastes &
Metallic Body Implants

Disinfection (by soaking the washed

glass waste after cleaning with
detergent and Sodium Hypochlorite
treatment) or through autoclaving or
microwaving or hydro claving and
then sent for recycling.
Bio Medical Waste Flow Chart
Designated storage
Occupiers
Occupiers In house
(institution point in
(institution Segregation as per Hospital
generating bio- Schedule I of BMW
generating bio- premises
medical waste) rules 2016
medical waste)
Handover &collection
by CWTF Vehicle
( Temp controlled
Waste Water to as Specified)
Effluent Operator
treatment plant)

REUSE Unloading & stored

at CWTF as
specified
Treatment (
Incinerator,
Autoclave, Disposal (Recycle
Shredding, & Landfills )
Hydroclave, Plasma
25
pyrolysis
Liquid waste from Hospitals
& Non-Bedded Establishment
Transport from Wards/OP

Bags once tied should not be re-opened

Bio Medical Waste Weighing and
Documentation
Transported to CTF by
Operator
 Bio Medical Waste Management Rules 2016 Amendments
(16/03/2018)
• Annual report made available on website within two
years (15-03- 2020)
• Phase out chlorinated plastic bags & gloves (excluding
blood bags) by 27-03-2019
• Bar-coding on bags by 27-03-2019
• Blue: Puncture proof, leak proof container or box with blue
coloured marking
 Bio Medical Waste Management Rules 2019 Amendments
(20/02/2019)
• Maintain Register – update on day to day basis
• Display monthly record on website
• Annual report made available on website within two years
(15-03- 2020)
• Health Care Facilities having less than ten beds shall have to
comply with the output discharge standard for liquid waste
by 31st December, 2019
 Bio Medical Waste --- Covid-19 CPCB
18/04/2020, 20/06/2020
• Colour coded bins (with foot operated lid)
• Double layered bags (using 2 bags)
• Collect and store separately
• Separate vehicle for collection and transport
• Mandatory Labelling as “COVID-19 Waste”
• Maintain separate records COVID wards
• Use dedicated trolleys and collection bins labelled COVID-19
• Inner and outer surface of bins disinfected with 1% sodium
hypochlorite solution daily
 Bio Medical Waste --- Covid-19
• Report opening of COVID ward to State Pollution Control
Board, Common Bio Medical Waste Treatment Facility
(CBWTF)
• Register in CPCB mobile application namely
“COVID19BWM”
• Depute dedicated sanitation workers separately
• Provide training
• ETP water is not to be recycled
• Collect used PPEs such as goggles, face-shield, splash proof apron,
Plastic Coverall, Hazmet suit, nitrile gloves into
Red bag
• Collect used mask (including Triple layer mask, N95 mask etc.), head
cover/cap, shoe-cover, disposable linen Gown, non-plastic or semi-plastic
coverall in Yellow bag
• Items like left over food, disposable plates, glass, used masks, used
tissues, used toiletries, etc. used by COVID-19 patient shall become
solid general waste and shall be segregated in green bag
 COVID 19 BIOMEDICAL WASTE MANAGEMENT GUIDELINE
 Double layered bags should be used for collection of waste
 Biomedical waste from COVID-19 wards, should be labelled as “COVID-19 Waste”
 Collect and store biomedical waste from COVID-19 wards separately
 The (inner and outer) surface of containers/bins/trolleys used for storage of COVID-19 waste should be disinfected with 1% sodium
hypochlorite solution daily.

YELLOW RED BLUE WHITE GENERAL WASTE -

GREEN
• Triple Layer Mask, • Goggles, • Broken /Empty • Needles • Fruit Peel Offs,
• N95 Mask, • Face-shield, Glass Medicine • Stylet (Venflon) • Discarded Papers,
• Head Cover/Cap, • Splash Proof Apron, Ampoules And • Insulin Syringe With • Left-over Food,
• Shoe-cover, • Plastic Coverall, Vials Fixed Needles • Disposable Food Plates
• Disposable Linen Gown, • Hazmet Suit, • Empty Juice Bottles Or
• Non-plastic Or Semi- • Nitrile Gloves Tetra Packs,
plastic Coverall • Used Water Bottles,
• Diapers From Positive
Patients
• Biomedical waste generated from Quarantine Camps /

Quarantine-Home / Home-care would be treated as ‘domestic

hazardous waste’ disposed as Bio Medical Waste.