Bio-Medical Waste Management 2016

Bio-MedicalWaste
Management
Dr. Shubhangi Kshirsagar
Assistant professor
Department of Swasthavritta &Yoga

Bio-Medical Waste Management
Rules, 2016
 First published in 1998.
 Revisions in 2011 and 2016 (March)
 Focus is on Collection, Segregation,
Transport, Processing, Treatment and
Disposal in Environmentally sound
manner.
2

Definition
1.According to Bio-Medical Waste (Management and
handling) Rules, 1998 of India, "Bio-medical waste"
means any waste, which is generated during -
 Diagnosis or
 Treatment or
 Immunization of human-beings or animals or
 Research activities or
 in the production or
 Testing of biological or
 Health camps
 including the categories mentioned in Schedule 1.
3

BMW Rules 1998 BMW Rules 2016
Occupier with more than
1000beds required to obtain
authorization
Every occupier generating
BMW, including health camps ,
AYUSH requires to obtain
authorization.
Operator duties are absent Duties of operator are listed
BMW is divided in 10
categories
BMW is divided in 4
categories
Rules restricted to more than
1000 beds.
Treatment and disposal of
BMW made mandatory for all.
No format for annual report Format for annual report
4

 Between 75 to 90 per cent of the waste
produced by the health-care providers is
non-risk or "general" health-care waste,
comparable to domestic waste
 Remaining 10-25 % health care waste –
hazardous & may create variety of
health risk
5

Sources of hospital care waste
 Hospitals
 Nursing Homes
 Clinics
 Dispensaries
 PHCs
 Mortuaries
 Slaughter houses
 Animal Houses
 Pathological Laboratories
 Medical Research or
Educational Institutions
 Health Camps Medical
or Surgical Camps
 Vaccination Centres
 Research organizations
 Biotechnology
institutions
 Blood Banks
6

Types of waste
1. Human anatomical waste - human tissues, organs,
body parts, foetus below the viability
2. Animal waste - animal tissues, organs, body parts,
carcasses, bleeding parts, fluids, blood and experimental
animals used in research, waste generated by veterinary
hospitals colleges, discharge from hospital, animal house.
3. Soiled waste - Items contaminated with blood and fluids
including cotton, dressings, soiled plaster casts, linen,
beddings, other material contaminated with blood 7

4. Discarded medicines or expired medicine –
pharmaceutical waste like antibiotics, cytotoxic drugs etc.
5. Chemical waste - Chemicals used in production of
biological and used or discarded disinfection.
6. Chemical liquid waste - waste generated due to use of
chemicals in production of biological and used or discarded
disinfectant, liquid from laboratory and floor washing,
cleaning, house-keeping and disinfecting activities
8

7. Discarded linen, mattresses, beddings contaminated
with blood or body fluids.
8. Microbiology and biotechnology waste - waste from
laboratory cultures, stocks or specimens of micro-
organisms, vaccines, human and animals used in cell
cultures.
9

9. Contaminated wastes ( Recyclable) – waste
generated from disposable items ex. Tubing,
bottles, intravenous tubes and sets, catheters,
urine bags, gloves.
10

10. Waste sharps including metals - needles,
syringes, scalpels, blades, glass, etc.,that may cause
puncture and cuts. (used and unused sharps)
11

11. a. Glassware – broken or discarded and
contaminated glass including medicine vials
and ampoules except those contaminated
with cytotoxic drugs.
b. Metallic body implants
12

Health hazards of biomedical waste
Exposure to hazardous health-care waste can
result in disease or injury, because –
• It contains toxic or hazardous chemicals or
pharmaceuticals
• It contains sharps
• It is genotoxic
• It is radioactive
13

The main groups at risk are –
• Medical doctors
• Nurses
• Health-care auxiliaries
• Hospital maintenance personnel
• Patients in health-care establishments
• Visitors to health-care establishments
• Workers
14

Hazards of health care waste
1. Hazards from Infectious waste & Sharps
 Pathogens from infectious waste enter human body
through puncture, cut or abrasion; through mucus
membrane by inhalation or by ingestion.
ex. HIV, Hepatitis B & C
2. Hazards from radio-active waste
It can be ranges from headache, dizziness & vomiting
to much more serious problems.
15

3.Hazards from Chemical and pharmaceutical Waste
 They are toxic, genotoxic, corrosive, flammable,
reactive, explosive, shock sensitive.
 Although present in small quantity, they may
cause intoxication, either by acute or chronic
exposure, and injuries, including burns
Ex. Disinfectant – used in large quantities.
4. Public sensitivity
Sensitive to visual impact ( particularly anatomical
waste) 16

Treatment & Disposal
Methods for Health
Care waste
17

Treatment & Disposal methods for
health care waste
1. Incineration
2. Chemical disinfection
3. Wet and dry thermal treatment
4. Microwave irradiation
5. Land disposal
a. Open dump
b. Sanitary landfill
6. Inertization
18

1. Incineration
 High temp dry oxidation process
 Reduces organic & combustible waste to
inorganic incombustible matter.
 Significant reduction in weight & volume
 Selected for those waste which can not be
recycled, reused or disposed off in land site.
 No need of pre-treatment
19

Characteristic of waste suitable for
Incineration
 Low heating volume
Above 2000kcal/kg for single chamber
Above 3000kcal/kg – for Pyrolytic double
chamber
 Content of Combustible matter >60%
 Content of Non-combustible matter below 5%
 Non-combustible fine below 20%
 Moisture below 30%
20

Waste type not to be incinerated
 Pressurized gas cylinders
 Large amount of reactive chemical waste
 Silver salts & photographic & radiographic
waste
 Halogenated plastic such as PVC
 Waste with high mercury or cadmium content
ex. broken thermometers, used batteries
 Sealed ampoules or ampoules containing
heavy metals
21

Types of Incinerators
1. Double chambered pyrolytic incinerator – to
burn infectious health care waste.
2. Single chamber furnaces – should be used
only if pyrolytic incinerators are not
affordable
3. Rotary kilns – operating at high temp,
capable of causing decomposition of
genotoxic substances & heat resistant
chemicals
22

Incinerator
Dr. Shubhangi Kshirsagar 23

2. Chemical disinfection
 Chemicals are added to the waste, to kill or
inactivate pathogen (Waste + chemical),
which results in disinfection.
 It is suitable for treating liquid waste such as
blood urine, stool or hospital sewage.
24

3.Wet & dry thermal treatment
1. Wet thermal treatment (steam disinfection)
 It is based on exposure of shredded
infectious waste to high temp, high pressure
steam
 Based on autoclave sterilization.
 It is inappropriate for the treatment of
anatomical waste & animal carcasses,
chemical & pharmaceutical waste.
25

3.Wet & dry thermal treatment
2. Screw feed technology
 Non burn, dry thermal disinfection process
 Waste is shredded & heated in a rotating auger.
 Waste is reduced by – 80% in volume & 20-35%
in weight.
 It is suitable for treating infectious waste &
sharp, but not used to pathological, cytotoxic
or radioactive waste
26

4. Microwave irradiation
 Most microorganism are destroyed by the
action of microwave of a frequency of about
2450MHz & wavelength of 12.24nm.
 The water contained within the waste is rapidly
heated by the microwave & the infectious
component are destroyed by heat conduction.
27

sss
28

5. Land disposal
a. Open dump
 Health care waste should not be disposed on
or around open dumps.
 Risk to people or animals who are coming
into contact with infectious pathogens.
29

b. Sanitary landfill
Advantage over open dumps are -
1. Geological isolation of waste from the
environment
2. Appropriate engineering preparation before
the site is ready to accept waste
3. Staff present on site to control operation
4. Organized deposit & daily coverage of waste
30

Sanitary landfill
31

Sanitary landfill
32

6. Inertization
 It involves mixing waste with cement and
other substances before disposal, to minimize
the risk of toxic substance contained in the
waste migrating into the surface water or
ground water.
 Proportion of mixture –
Pharmaceutical waste 65%
Lime 15%
Cement 15%
Water 5% 33

Bio-Medical Waste
Management
Rules, 2016
Schedule I
34

35
Category Type of waste Type of bags or
container
Treatment
Yellow Human anatomical
waste
Yellow
Colored non-
chlorinated
plastic bags
 Incineration or
 Plasma Pyrolysis
or
 Deep burial
Animal anatomical
waste
Soiled waste – items
contaminated with
blood, body fluids
like dressings, cotton
swab
Incineration/Plasm
a Pyrolysis / Deep
burial
 Micro-waving/
hydrowaving
Expired & Discarded
Medicines with
Cytotoxic drugs
Yellow
Coloured non-
chlorinated
plastic bags/
containers
Inc. >12000/Send
back to
manufacturer,
Encapsulation or
plasma pyrolysis

Category Type of Waste Type of bags or
container
Treatment
Yellow Chemical waste Yellow
Colored containers/
non- chlorinated
plastic bags
Inc./Plasma
Pyrolysis/
Encapsulation
Chemical Liquid waste Separate collection
system leading to
effluent treatment
system
Resource
Recovery;
Pretreatment;
discharge
Discarded/contaminate
d linen, mattresses etc.
Yellow Colored non-
chlorinated plastic bags/
suitable packing
materssssial
Non-chlor.
Chemical
disinfection
followed by
inc./ Plasma
Pyrolysis
Microbiology & Autoclave safe plastic Inc. (after lab
36

37
Category Type of waste Category Treatment
Red Contaminated/
RecyclableWaste
Red Colored non-
chlorinated plastic
bags/ containers
Autoclave/ hydroclaving/
Microwaving followed
by shredding or
mutilation,
Sterilization + shredding
White Waste Sharps
including metals
White/ translucent
(puncture proof,
leak proof tamper
proof container)
Autoclave or dry heat
sterilization followed by
Shredding; landfill
Blue Glassware
(expect
Cytotoxic
contaminated),
Metallic Body
Implants
Blue Cardboard
boxes
Disinfection/autoclave/
hydroclaving/
microwaving; recycling

Bio-Medical Waste Management
Rules, 2016
38
Category Type of container
Yellow Non chlorinated plastic bag,Autoclave
safe plastic bags or containers
Red Non chlorinated plastic bags or
containers
White(Translucent) Puncture proof, Leak proof, tamper
proof containers
Blue Cardboard boxes with blue colored
marking

Duties of Operator
 Ensure BMW collected from occupier is transported, handled, stored,
treated and disposed of without any adverse effects.
 Ensure timely collection of biomedical waste from occupier.
 Establish bar coding and global positioning system for handling of BMW
within one year.
 Provide training to all workers.
 Undertake appropriate medical examination at the time of induction and
at least once a year.
 Immunize workers against hepatitis B and tetanus.
 Report major accident.
 Maintain a log book of its treatment equipment.
 Display details of authorization, treatment, annual report on its website.
 Supply non chlorinated plastic coloured bags to occupier.
 Ensure collection of BMW on holidays also.
 Maintain all records for five years.
 Ensure occupational safety of workers.
41

Duties of Occupier
 Ensure BMW handled without any adverse effects.
 Make provision of safe, ventilated, secured location for storage of segregated
waste in coloured bags
 Ensure bar code system for BMW bags
 Provide training to all workers.
 Ensure occupational safety of workers.
 Not to give treated BMW with muncipal solid waste
 Ensure segregation of liquid chemical waste at source
 Ensure treatment & disposal of liquid chemical waste in accordance with water
 Dispose of solid waste in accordance with the provision of respective waste
management rules
 Maintain & update on day to day basis BMW registerand display the monthly
record on website
 Report major accident.
 Immunize workers against hepatitis B and tetanus.
 Display annual report on its website
42

Biohazard symbol Cytotoxic hazard
symbol
43

Thank you !
44

Bio-Medical Waste Management 2016

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