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![Biomedical Waste
Management and Handling Rules, 1998
[Amended in 2000]
• These rules apply to all persons who generate, collect,
receive, store, transport, treat, dispose or handle bio-
medical waste in any form. All Institutions generating
BMW must take all steps to ensure that such waste is
handled without any adverse effect to human health and
the environment](https://image.slidesharecdn.com/biomedicalwastemanagement-150714045219-lva1-app6891/75/Biomedical-waste-management-23-2048.jpg)
![Annual report
To be submitted to the prescribed authority
by 31 January every year
Name of the occupier with Address
Categories of waste generated and Quantity
[monthly average] basis:
Name of treatment facility with Address
Category-wise quantity of waste treated
Mode of treatment with details:
Any other information](https://image.slidesharecdn.com/biomedicalwastemanagement-150714045219-lva1-app6891/75/Biomedical-waste-management-58-2048.jpg)
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Biomedical waste management
- 1. Biomedical Waste Management Presenting by….. DayanaJose & Divya George. 2nd MHA, JMC
- 2. Definition Biomedical waste meansany waste materials which is generated during diagnosis, treatment, surgery or immunization of human beings or animals or research activities pertaining there to or in production of biologicals. -WHO
- 3. Aims of biomedicalwaste management • To prevent transmission of diseases • To prevent injuries • To prevent general exposure to harmful effects of biomedical wastes • To ensure environmental hygiene
- 4. Classification of healthcare wastes Hazardous wastes 10-20% Non-hazardous wastes 75-90% Infectious 15-18% • Sharps • Non-sharps • Plastic disposables • Liquid wastes Healthcare wastes • Radioactive wastes • Chemical wastes • Cytotoxic wastes • Pressurized containers
- 5. Proportion of differentwastes in hospitals 80% 15% 1%3%1% General wastes Patho&infectious wastes Sharp Wastes Chemical wastes Radio&Cytotoxic
- 6. Sources of Biomedicalwastes • Government hospitals • Private hospitals • Nursing homes • Dentist / physicians clinics • Dispensaries • PHC • R&D establishments • Training centers • Mortuaries • Blood bank, collection centers, laboratories • Animal houses, slaughter houses
- 7. Persons at risk •Medical doctors • Nurses • Nursing assistances • Dressers • Compounders • OT assistances • Ward boys • Sweepers • Patients • Visitors • Workers in support services • Rag pickers
- 8. Biomedical waste statistics DevelopedCountries- 1-5 kg/bed/day, with variations among countries. In India- 1-2 kg/bed/day with variation among Govt. and Private establishments. Approximately 506.74 tons/ day wastes generated Out of which only 57% waste undergoes proper disposal
- 10. Need of BMWManagement in Hospitals???
- 11. Hazardous health care wastecan result in 1. Infection 2. Genotoxicity and Cytotoxicity 3. Chemical toxicity 4. Radioactivity hazards. 5. Physical injuries 6. Public sensitivity.
- 12. Infection routes oPuncture oAbrasion oCut inthe skin oThrough mucous membranes o By inhalation and ingestion.
- 13. Most Common Infections 1. Gastro enteric through faeces and/or vomit e.g. Salmonella, Vibrio Cholera, Helminthes ,Hepatitis A 2. Respiratory through inhaled secretions e.g. Mycobacterium tuberculosis; Measles virus; Streptococcus pneumoniae 3.Ocular infections through eye secretions e.g. Herpes virus, 4. Skin infection through pus e.g. Streptococcus spp , 5. Meningitis through Cerebrospinal fluid e.g. Neisseria meningitides 6. Blood borne diseases AIDS , Septicaemia and bacteraemia ,Viral Hepatitis B & C 7. Hemorrhagic fevers through body fluids Lassa, Ebola and Marburg viruses
- 14. Genotoxicity and Cytotoxicity •Irritant to skin and eyes e.g. alkylating agent, intercalating agent • Carcinogenic and Mutagenic e.g. Secondary neoplasia due to chemotherapy
- 15. Chemical Toxicity • Manydrugs are hazardous • May cause intoxication , burns, poisoning on exposure
- 16. Radioactivity Hazards • Radioactivewaste exposure may cause headache, dizziness, vomiting, genotoxicity and tissue damage
- 17. Physical injuries • Sharps •Chemicals • Explosive agents
- 18. Waste with highcontent of heavy metals
- 19. Pressurized containers GAS CARTRIDGES GASCYLINDERS 19 AIROSOL
- 20. Waste Sharps eg:Needles Human anatomical waste Discarded medicines Solid waste eg: cotton swabs
- 21. How did BMWcome into Existence • In the late 1980’s • Items such as used syringes washed up on several East Coast beaches USA • Concern about HIV and HBV virus infection • Lead to development of Biomedical Waste Management Law in USA. • However in India the seriousness about the management came into lime light only after 1990’s
- 22. Legislation • Recognizing thedeadliest nature of the Bio-Medical Waste, the Government and Pollution Control Boards under the guidelines of Ministry of Environment and Forests(MOEF). • MOEF have promptly designed and issued guidelines to the hospitals to ensure a proper and safe disposal of bio-medical waste • BIO-MEDICAL WASTE Management & Handling Rule came into effect in 1998. • Provides uniform guidelines and code of practice for Bio- medical waste management.
- 23. Biomedical Waste Management andHandling Rules, 1998 [Amended in 2000] • These rules apply to all persons who generate, collect, receive, store, transport, treat, dispose or handle bio- medical waste in any form. All Institutions generating BMW must take all steps to ensure that such waste is handled without any adverse effect to human health and the environment
- 24. Penalties as perrules • The PENALTIES are as specified in Environment (Protection) Act 1986. • Imprisonment for upto five years with fine upto one lakh rupees, or both. • In case the failure additional fine upto five thousand rupees for every day.
- 25. Bio-Medical Waste FlowChart )
- 26. Categories of BiomedicalWaste Schedule as per WHO Standard WASTE CATEGO RY TYPE OF WASTE TREATMENT AND DISPOSAL OPTION Category No. 1 Human Anatomical Waste (Human tissues, organs, body parts) Incineration/ deep burial Category No. 2 Animal Waste (Animal tissues, organs, body parts, carcasses, bleeding parts, fluid, blood and experimental animals used in research, waste generated by veterinary hospitals and colleges, discharge from hospitals, animal houses) Incineration / deep burial Category No. 3 Microbiology & Biotechnology Waste (Wastes from laboratory cultures, stocks or specimen of live micro organisms or attenuated vaccines, human and animal cell cultures used in research and infectious agents from research and industrial laboratories, wastes from production of biologicals, toxins and devices used for transfer of cultures) Local autoclaving/ microwaving / incineration
- 27. Category No. 4Waste Sharps (Needles, syringes, scalpels, blades, glass, etc. that may cause puncture and cuts. This includes both used and unused sharps) Disinfecting (chemical treatment@@ / autoclaving / microwaving and mutilation / shredding Category No. 5 Discarded Medicine and Cytotoxic drugs (Wastes) comprising of outdated, contaminated and discarded medicines Incineration@ / destruction and drugs disposal in secured landfills Category No. 6 Soiled Waste (Items contaminated with body fluids including cotton, dressings, soiled plaster casts, lines, bedding and other materials contaminated with blood.) Incineration@ / autoclaving / microwaving Category No. 7 Solid Waste (Waste generated from disposable items other than the waste sharps such as tubing, catheters, intravenous sets, etc.) Disinfecting by chemical treatment@@ / autoclaving / microwaving and mutilation / shredding#
- 28. Category No. 8Liquid Waste (Waste generated from the laboratory and washing, cleaning, house keeping and disinfecting activities) Disinfecting by chemical treatment@@ and discharge into drains Category No. 9 Incineration Ash (Ash from incineration of any biomedical waste) Disposal in municipal landfill Category No. 10 Chemical Waste (Chemicals used in production of biologicals, chemicals used in disinfecting, as insecticides, etc.) Chemical treatment and discharge into drains for liquids and secured landfill for solids.
- 29. Colour Waste Treatment YellowHuman & Animal anatomical waste / Micro-biology waste and soiled cotton/dressings/linen/beddings etc. Incineration/DB Red Tubings, Catheters, IV sets. Autocl/microwav/ chemical treatment Blue / White Waste sharps ( Needles, Syringes, Scalpels, blades etc. ) Autocl/microwav/ chemical treatment/destru ction/shredding Black Discarded medicines/ cytotoxic drugs, Incineration ash, Chemical waste. Disposal in land fields
- 30. 1. Survey ofwaste generated 2. Reduction at source . 3. Segregation of hospital waste. 4. Collection & Categorization of waste. 5. Storage of waste. 6. Transportation of waste. 7. Treatment of waste.
- 31. Source Reduction • SourceReduction - ways to lessen the amount of material • Segregation - keeping noninfectious waste out of the infectious waste stream • Minimization - reduce or eliminate waste at the source • Engineering controls - methods to reduce quantity of waste(smaller containers)
- 32. Steps to ManageHazardous Wastes before Disposal 1. Know what hazards you have. 2. Purchase smallest quantity needed, and don’t purchase hazardous materials if safe alternative exists 3. Limit use and access to trained persons with personal protective gear 4. Use Engineering Controls such as Ventilation, Hoods etc. 5. Get Rid of Unnecessary Stuff
- 33. 6. Label ofHazard Warnings toxic biohazard inflammable corrosiveRadiation Gas bottle explosive Health danger
- 34. 7. Communicate aboutWork -place Hazards • Job description • Posters on doors • Labels on hazards • Give feedback on use of PPE and disposal in evaluation • Role model safe use and disposal • Contact point who is responsible
- 35. 8.Label for bio-medicalwaste containers/bags
- 36. Segregation of waste Atthe point of generation In a color coded leak-proof container Container should bear 'Biohazard' symbol and appropriate wording Container should never be completely filled
- 39. Wastes requiring pretreatmentbefore disposal Microbiological waste Method: Autoclaving Final disposal as a general waste- Black Bag
- 40. Pretreatment before disposalCont… Tubes used for serum separation, centrifugation of samples, preparation of dilutions etc. Any other contaminated plastic wares Method: Chemical Disinfection using Sodium hypochloride Final Disposal- Blue bag
- 41. Waste disposed withoutpretreatment Yellow bag Contaminated gloves; latex & plastic(Uncontaminated – general waste) Contaminated tissue /blotting papers Contaminated cotton Human tissue/organs White sharp disposal container Broken glass, pipettes, broken test tubes, Needles, razor blade, scalpel
- 42. Attention !! Do notallow the containers to overfill Arrange containers near the operation area at accessible distance Ensure that the disposed item is inside the container and not hanging at the edge
- 43. PACKAGING & LABELING •Bags 3/4th filled should be tied • Be supervised Name of Ward • Date of Packaging • Destination (Treatment Site) • Bio Hazard/Cytotoxic Symbol • Weighing & Recording • Separate Register and Weighing Machine • Daily recording is mandatory
- 45.
- 46. Collection, transportation, storage (withinthe hospital) Waste collected and stored in thick non-corrosive disposable plastic bags or containers of specific colour code. The waste in bags or containers should be stored in a separate area, room, or building of a size appropriate to the quantities of waste produced and the frequency of collection. Health care waste should be transported within the hospital or other facility by means of hand cart wheeled trolley
- 47. Label for transportof bio-medical waste containers/bags • Date of generation ................... • Waste category No ....... • Waste class…………… • Waste description…………. • Sender's Name & Address……….. Contact Person………….. • Receiver's Name & Address……… Contact Person………….. • In case of emergency please contact, Name & address………. Label shall be non-washable and prominently visible.
- 48. Transportation Transportation of BMWcan be divided into internal and external transportation. .
- 50. Safe Transportation REGISTERED, AUTHORIZED,BMW TRANSPORTERS
- 51. Do you havea bio-spill kit? Container of undiluted household bleach Several pairs of gloves Safety glasses Absorbent material Biohazardous waste (autoclave) bags Dust pan & scoop or tongs for broken glass Place in a labeled bag or bucket and keep in areas where biohazards are used
- 52. Disposal methods ofbio-medical wastes • Incineration • Chemical disinfection • Autoclave • Encapsulation • Microwave • Shredder • Plasma pyrolysis • Deep burial In kerala, IMAGE ( Indian Medical Association Goes Eco- Friendly) is the external agency managing final disposal of hospital wastes…
- 53. Indian medical associationgoes eco-friendly Indian Medical Association, Kerala State Branch, established IMAGE, Biomedical Waste Treatment and Disposal Facility at Palakkad and it was commissioned on the 14th December 2003. IMAGE was conceived and launched to support healthcare providers to overcome the challenges posed by the responsibilities laid down in the Biomedical Waste (Management and Handling).
- 54. Office Bearers: • IMAGEis guided by a team of professional doctors, elected from among the members of I.M.A Kerala State Branch, dedicating their knowledge in the field of medicine and the hazards posed by bio medical waste. • The Supreme Court judgment in December 2002 to dispose the medical waste within 48 hours of generation forced doctors engaged with IMA in Kerala chapter to find out a solution.
- 57. Accident reporting 1. Dateand time of accident: 2. Sequence of events leading to accident 3. The waste involved in accident : 4. Assessment of the effects of the accidents on human health and the environment,. 5. Emergency measures taken 6. Steps taken to alleviate the effects of accidents 7. Steps taken to prevent the recurrence of such an accident
- 58. Annual report Tobe submitted to the prescribed authority by 31 January every year Name of the occupier with Address Categories of waste generated and Quantity [monthly average] basis: Name of treatment facility with Address Category-wise quantity of waste treated Mode of treatment with details: Any other information
- 59. Staff safety • Propertraining • Personal protective clothing and equipment • Immunization • Post-exposure prophylaxis • Medical surveillance • Personal hygiene
- 60. Responsibility Infection control iseveryone's business. You are not only protecting yourself, but also those around you……