Biomedical waste managment

BIOMEDICAL WASTEBIOMEDICAL WASTE
MANAGEMENTMANAGEMENT
PRATEEK JANAGAL (99)
KAJAL (60)

What is Biomedical Waste?What is Biomedical Waste?
Bio-medical waste" means any waste, which is generated during the
diagnosis, treatment or immunisation of human beings or animals or in
research activities pertaining thereto or in the production or testing of
biologicals, and including categories mentioned in Schedule I;
Specific to hospitals Bio-medical waste is defined as waste that is
generated during the diagnosis, treatment or immunization of human
beings and are contaminated with patient’s body fluids (such as syringes,
needles, ampoules ,organs and body parts, placenta, dressings,
disposables plastics and microbiological wastes).

BIOMEDICAL WASTE INCLUDES
Needles Discarded medicines
Human anatomical waste Solid waste eg: cotton swabs

Who’s at Risk ?
• Doctors and nurses
• Patients
• Hospital support staff
• Waste collection and disposal staff
• General public and
• the Environment

Health hazards of BMW
Type of wasteType of waste Health hazardHealth hazard
Human / AnimalHuman / Animal
waste/ Soiledwaste/ Soiled
wastewaste
HIV,HBV,HCV, cholera,HIV,HBV,HCV, cholera,
salmonellosis, rabies, leptospirosis,salmonellosis, rabies, leptospirosis,
anthrax,TB, pneumonia, septicemiaanthrax,TB, pneumonia, septicemia
SharpsSharps HIV, HBV, HCV, InjuriesHIV, HBV, HCV, Injuries
Cytotoxic/Cytotoxic/
radioactive wasteradioactive waste
Cancer, genetic mutation, birthCancer, genetic mutation, birth
defectdefect
Chemical wasteChemical waste Poisonings, dermatitis, conjunctivitis,Poisonings, dermatitis, conjunctivitis,
bronchitisbronchitis

NEED FOR BMW MANAGMENT
 Nosocomial infections to patients from poor infection
control practices and poor waste management.
 Drugs which have been disposed of, being repacked and
sold off to unsuspecting buyers.
 Risk of air, water and soil pollution directly due to waste,
or due to defective incineration emissions and ash.
 Risk of infection outside hospital for waste handlers and
scavengers, other peoples.

India :India :Extent of the problemExtent of the problem
CPCB,April,2011 dataCPCB,April,2011 data
>95,000 hospitals and healthcare facilities in India .
4.2 lakh kg of biomedical waste is generated on a daily basis.
Three million tonnes of medical wastes generated every year.
Expected to grow 8% annually.
2,91,983 kg/day BMW is disposed. which means that almost
28% of the wastes is left untreated and not disposed finding its
way in dumps or water bodies and re-enters our system.
Karnataka tops the chart with 62,241 kg/day of BMW.
 Only 179 CTF to treat the BMW in the country.



BIOMEDICAL RULES 1998
The Government of India as under Section 6,8 and 25
of the Environment (Protection) Act,1986, has made
the Biomedical Wastes (Management & Handling)
Rules, 1998.
The rules are applicable to every institution
generating biomedical waste which includes hospitals,
nursing homes, clinic, dispensary, veterinary
institutions, animal houses, laboratory, blood bank.
The rules are applicable to all persons who generate,
collect, receive, store, transport, treat, dispose, or
handle bio medical waste in any form.

BIOMEDICAL WASTE(MANAGEMENT & HANDLING)BIOMEDICAL WASTE(MANAGEMENT & HANDLING)
RULES by Govt. of India, 1998RULES by Govt. of India, 1998
Revised in 2011Revised in 2011
Now known as BMW Rules, 2011Now known as BMW Rules, 2011
2011 1998
Every occupiergenerating BMW,
irrespective of the quantumof wastes
comes under the BMWRules and
requires to obtain authorisation
Occupiers with more than 1000 beds
required to obtain authorisation
Duties of the operatorlisted Operatorduties absent
Treatment and disposal of BMWmade
mandatory forall the HCEs
Rules restricted to HCEs with more
than 1000 beds
A format forannual report added with
the Rules
No format forAnnual Report
FormVI i.e. the report of the operator
on HCEs not handing overthe BMW
added to the Rules
FormVI absent

Setting up BMW treatment facility
Occupier set up FOLLOWING treatment facilities,prior to
commencement of its operation which are--
AUTOCLAVE HYDROCLAVE INCINERATOR MICROWAVE SHREDDER

Bio Medical Wastes Destruction byBio Medical Wastes Destruction by
Double Chambered IncineratorDouble Chambered Incinerator

Incinerator Ash DisposalIncinerator Ash Disposal

Health waste CharacterizationHealth waste Characterization
Hospital waste
Non Hazardous
(≈ 75-90%)
Hazardous waste
(≈ 10-25%)
Infectious
Others
( Radioactive,
Cytotoxic )

WASTEWASTE
CATEGORYCATEGORY
WASTE TYPEWASTE TYPE TREATMENT & DISPOSALTREATMENT & DISPOSAL
CategoryCategory
11
Human Anatomical waste (human tissues,Human Anatomical waste (human tissues,
organs, body partsorgans, body parts
Incineration/deep burialIncineration/deep burial
CategoryCategory
22
Animal Waste: Animal tissues, organs, bodyAnimal Waste: Animal tissues, organs, body
parts, bleeding parts, fluid, blood andparts, bleeding parts, fluid, blood and
experimental animals used in research etcexperimental animals used in research etc
Incineration/deep burialIncineration/deep burial
CategoryCategory
33
Microbiology & Biotechnology Wastes: WastesMicrobiology & Biotechnology Wastes: Wastes
from clinical samples, pathology, biochemistry,from clinical samples, pathology, biochemistry,
hematology, blood bank, laboratory cultures,hematology, blood bank, laboratory cultures,
etcetc
LocalLocal
autoclaving/microwaving/autoclaving/microwaving/
IncinerationIncineration
SCHEDULE I: CATEGORIES OF BIO-MEDICAL WASTE

WASTEWASTE
CATEGORYCATEGORY
CategoryCategory
No. 4No. 4
Waste Sharps (needles, glass syringesWaste Sharps (needles, glass syringes
scalpels ,blades, etc.) that may causescalpels ,blades, etc.) that may cause
puncture and cuts(Includes both usedpuncture and cuts(Includes both used
and unused sharps).and unused sharps).
Disinfection (chemicalDisinfection (chemical
treatment / destruction oftreatment / destruction of
needle by tip cutter,needle by tip cutter,
autoclaving/microwave andautoclaving/microwave and
mutilation/shreddingmutilation/shredding
CategoryCategory
No. 5No. 5
Discarded Medicines & CytotoxicDiscarded Medicines & Cytotoxic
drugs (Wastes comprising of outdated,drugs (Wastes comprising of outdated,
contaminated and discardedcontaminated and discarded
medicines)medicines)
Disposal in secured landfillsDisposal in secured landfills
or Incinerationor Incineration
CategoryCategory
No. 6No. 6
Soiled Waste (Items contaminated withSoiled Waste (Items contaminated with
blood, & body fluids including cotton,blood, & body fluids including cotton,
dressings, soiled plaster casts, linens,dressings, soiled plaster casts, linens,
beddings, other material contaminatedbeddings, other material contaminated
with blood)with blood)
Incineration/autoclaving/Incineration/autoclaving/
microwavingmicrowaving

WASTEWASTE
CATEGORYCATEGORY
CategoryCategory
No.7No.7
Infectious Solid Waste (wasteInfectious Solid Waste (waste
generated from disposablegenerated from disposable
items other than the wasteitems other than the waste
sharps such as tubing's, handsharps such as tubing's, hand
gloves, saline bottles with IVgloves, saline bottles with IV
tubes, catheters, glass,tubes, catheters, glass,
intravenous sets etc.intravenous sets etc.
Disinfection by chemicalDisinfection by chemical
Treatment /Treatment /
autoclavingautoclaving
/Microwaving followed/Microwaving followed
by mutilation /by mutilation /
shreddingshredding
CategoryCategory
No.8No.8
Liquid waste( waste generatedLiquid waste( waste generated
from laboratory and washings ,from laboratory and washings ,
cleaning, house keeping andcleaning, house keeping and
disinfecting activities)disinfecting activities)
Chemical treatment andChemical treatment and
discharge into drains fordischarge into drains for
liquids and securedliquids and secured
landfill for solidslandfill for solids

WASTEWASTE
CATEGORYCATEGORY
CategoryCategory
No.9No.9
Incineration ash (ash fromIncineration ash (ash from
incineration from anyincineration from any
biomedical waste)biomedical waste)
Disposal in municipalDisposal in municipal
landfilllandfill
CategoryCategory
No.10No.10
Chemicals used in productionChemicals used in production
of biologicals, chemicals used inof biologicals, chemicals used in
disinfection as insecticides etcdisinfection as insecticides etc
Chemical treatment andChemical treatment and
discharge into drains fordischarge into drains for
liquids and securedliquids and secured

Schedule-IISchedule-II
Colour coding and Type of Containers forColour coding and Type of Containers for
Different Biomedical WastesDifferent Biomedical Wastes
ColourColour
codingcoding
Type ofType of
containercontainer
WasteWaste
categorycategory
Treatment /Treatment /
DisposalDisposal
Non chlorinatedNon chlorinated
Plastic BagsPlastic Bags
Incineration/Incineration/
Deep BurrialDeep Burrial
plastic bag /plastic bag /
puncture proofpuncture proof
Container forContainer for
sharpssharps
Chemical Treatment /Chemical Treatment /
Autoclaving /Autoclaving /
Microwaving and followedMicrowaving and followed
by Mutilation & shreddingby Mutilation & shredding
and disposal in landfills orand disposal in landfills or
disposal of recyclabledisposal of recyclable
wastewaste
Plastic Bags /Plastic Bags /
ContainersContainers
Chemical TreatmentChemical Treatment
and discharge into drainsand discharge into drains
for liquids and securedfor liquids and secured
Plastic BagsPlastic Bags
5,9,10(solid)5,9,10(solid) Disposed as per the
Municipal Solid Waste

KITCHEN WASTE/FOOD
PAPER/
plastic
WRAPPERS
Outer packing/
Cardboard
General/Kitchen
waste
For Noninfectious
Solid waste
such as
Management of hospital waste

Bandages
Humananatomical
waste-placenta
Swab stick-
decontaminated
WASTE DISPOSAL
SWABS
Dressing
Animal waste
Discarded
medicine/cytotoxic
drugs
YELLOW BIN
(Category 1,2, 3,6)
used for

RED BINDrains
Plastic culture
plates & tubes
I/V sets
Urine bag
WASTE DISPOSAL
All infectious waste
sharp, non
sharp & sharps
plastic waste
Category 3, 6, 7
Pathology waste

Personnel safety devicesPersonnel safety devices
The use of protective gears should be made mandatory forThe use of protective gears should be made mandatory for
all the personnel handling waste.all the personnel handling waste.

StorageStorage
In an area away from general traffic and accessible
only to authorized personnel
DO NOT store for more than 48 hours
If for any reason it becomes necessary to store the
waste beyond such period take measures to ensure
that the waste does not adversely affect human
health and environment

TransportTransport
 Transport by wheeled
trolleys/containers /carts only in
vehicles authorized for the
purpose
 They should be
 Easy to load and unload
 No sharp edges
 Easy to clean
 Disinfect daily
 Trolleys ,Wheelbarrows:
covered

Transportation and StorageTransportation and Storage
 If a container is transported
from the premises where bio-
medical waste is generated to
any waste treatment facility
outside the premises, the
container shall, apart from
the label prescribed in
Schedule III, also carry
information prescribed in
Schedule IV.

BMW management committeeBMW management committee
 Head of the hospital : chairman
 Waste Mx officer (dev. and implementation plan)
Members:
 HOD’s of all department
 Nursing superintendent,
 Head nurse,
 Sanitary inspector
 Chief pharmacist,
 Radiation officer
 Supply officer,
 financial officer

Hand WashingHand Washing
 Handwashing is the single most
effective way to stop the spread of
disease.
 Gloves do not replace handwashing.
Hand sanitizer may be used if no visible
soiling is present.It can also be used
when the water is out of service.
 Inspect your hands each time they are
washed. Only use hospital approved
soaps and lotions

ConclusionConclusion
Bio-medical waste programme cannot be
successfully implemented without the
willingness, self-motivation, and co-operation
from all sections of employees of any health
care setting.
If we want to protect our environment and
health of community we must sensitize our
selves to this important issue not only in the
interest of health managers but also in the
interest of community.

Biomedical waste managment

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