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Hazards Associated with Hospital
Waste
1. Hazards from infectious waste and sharps:
 Pathogens in infectious waste may enter into the
human body through a puncture, abrasion or cut in the
skin.
 Potential health care effects are:
 AIDS
 Gastro enteric infections
 Blood stream infections

 Hepatitis B and C
 Respiratory infections
 Skin infections
2. Hazards from chemical and pharmaceutical
waste:
 Many of the chemicals and pharmaceuticals used in
health care establishment are toxic, genotoxic,
corrosive, flammable, reactive, explosive(or)shock
sensitive.

 The exposure is inhalation of dust (or) aerosols,
absorption through the skin, ingestion of food
accidentally contaminated with cytotoxic drugs,
chemicals or wastes
4. Hazards from radioactive waste:
 Headache, dizziness and vomit.
 More serious problems occur by it.
 It also affects genetic material.

Decontamination of Hospital
Waste
1. Disposable items such as gloves, syringes, I.V
bottles, catheters are punctured/mutilated.
2. Disposable syringes, needles to be cut by
syringe cutter.
3. Chemical decontamination by
a) Bleach (10gms bleach in 1 lit. water).
b) Hypochlorite east 1%4 Deep burial Dilution
of chlorine releasing compounds.
4. Deep burial Dilution of chlorine releasing
compounds.

SEGREGATION, TRANSPORTATION
AND DISPOSAL OF WASTE

SEGREGATION, TRANSPORTATION
AND DISPOSAL OF WASTE
 Segregation means separating the waste into
different streams and the aims to keep the harmful
and infected material separate from the harmless and
non-contagious waste.
 For this purpose, use of specially colored dustbin and
plastic bags is mandatory.
 Certain procedures and facts should be kept in mind
during the collection and segregation of biomedical
waste.

WASTE CATEGORY 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,)
Incineration /
deep burial
Category No. 3 Microbiology & Biotechnology Waste (Wastes from
laboratory cultures, stocks or specimen of live
microorganisms, human and animal cell cultures used in
research and infectious agents from research and
industrial laboratories, wastes from production of
biological, toxins and devices used for transfer of cultures)
Local
autoclaving/
microwaving /
incineration

Category 4 Waste 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 5 Discarded Medicine and Cytotoxic drugs
(Wastes comprising of outdated,
contaminated and discarded medicines)
Incineration / destruction and
drugs disposal in secured
landfills
Category 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 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

Category No. 8
Liquid Waste (Waste generated from the
laboratory and washing, cleaning,
housekeeping 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 biological, chemicals used in
disinfecting, as insecticides, etc.)
Chemical treatment
and discharge into
drains for liquids
and secured landfill
for solids.

Note:
 Color coding of waste categories with multiple treatment
options, shall be selected depending on treatment option
chosen, which are specified.
 Waste collection bags for waste types needing incineration
shall not be made of chlorinated plastics.
 Categories 8 and 10 (liquid) do not require
containers/bags.
 Category 3 if disinfected locally need not be put in
containers/bags.

COLOR CODING &
SEGREGATION OF WASTE

COLOUR
CODING
TYPES OF WASTE
TREATMENT
OPTIONS/ METHODS
OF DISPOSAL
BLACK BAG
YELLOW
BAG
RED BAG
BLUE/WHITE
PUNCTURE
PROOF CAN
General Uninfected waste
-Office papers, paper cups, tissue paper
-Kitchen waste
Soiled infected waste
-Human tissues, organs and body parts,
-Items contaminated with blood and body
fluids of patients known to be HIV/HBV/HCV
positive discarded cytotoxic medicines
Infectious plastic waste
-Disposable items like infected IV tubings
-Rubber catheters, hyles tubes
-Cannulas, gloves and cut syringes
Sharps
Needles, syringes, scalpels, blades etc.
Disposal in secured
landfill
Incineration
Autoclaving/
microwaving
Chemical treatment/
destruction autoclaving

TRANSPORTATION AND DISPOSAL
OF WASTE
 Ideally as soon as a bag is full, it should be tied, labeled
and sent to the settle of final disposal. However, it may not
be practical to make frequent trips to the site of disposal
just with a few bags, full of waste.
 In this situation, the hospital waste may be temporarily
stored at a central area in the hospital and from there it
may be sent in bulk to the site of final disposal once or
twice a day.

 Some important precautions regarding transportation and
storage of biomedical waste are:
 Before taking the bag away, ensure that it is properly tied
and labeled and there is no possible of spillage.
 Person handling the waste bags should not touch the items
of public use.
 A covered, biohazards symbolized hand cart may be used to
transport the waste to the central storage area of the
hospital

 Don't throw the bags haphazardly as this may tear them
apart and the waste may spill out.
 A full time person should be posted at the central site of
storage for regular receiving and dispatching the waste.
 As per rules, biomedical waste cannot be stored for more
than 24 to 48 hrs.
 Always use closed transportation from the site of central
storage to final disposal site.

DISPOSAL TECHNIQUES
Disposal of hospital waste may be done by different
techniques.
1. Chemical Disinfection:
 Solid waste as plastic, rubber and metallic item, IV sets,
blood bags, gloves catheters, urobag, needles,etc. must
be disinfected before they are sent to final disposal (land
fill).
 Chemical disinfection is also most appropriate method to

treat the liquid waste such as blood, urine stools or
hospital sewage.
2. Thermal Measures (wet and dry):
 In this method, shredded infectious waste is exposed to
high pressure steam like autoclaving.
 It dries 80% liquid of waste and waste is reduced to 20-30%
in weight.
 Adequately trained operators or technicians are needed
for autoclaving techniques operation.

3. Microwave Irradiation:
 This technique is also effective (like auto calving/
hyroclaving) in sterilizing the infected, disposable waste.
 Most microorganisms are destroyed by the action of
microwaves,
4. Incineration:
 Incineration is a high temperature, dry oxidation process
that reduces organic and combustible waste to an
inorganic in combustible matter.

 It also reduces the volume and weight of the waste.
 It is usually related to the waste that cannot be reused,
recycled or disposed of by a land fill treatment
 Generally, three kinds of incinerations are there:
a. Single Chamber Furnaces: These are simple and
cheapest units.
b. Double Chamber Pyrolytic Incinerators: Most suitable
and commonly care waste in first pyrolytic chamber,

waste is destroyed through an oxygen deficient, medium
temperature, combustion process. This produces solid
ashes and gases.
c. Rotary Kiln: It comprises a rotating oven and a post-
combustion chamber. It is specially used to burn chemical
wastes (including cytotoxic drugs and pharmaceuticals).

Waste to be Incinerated
Human materials
 Laboratory wastes
Animal wastes
Dressing Materials

Wastes not to be Incinerated
 Pressurized gas containers
 Large amount of reactive chemical waste.
 Radiographic/photographic waste
 Halogenated plastics such as (polyvinyl chloride)
 Waste with the mercury or cadmium (such as
thermometers)
 Sealed ampoules / ampoules containing heavy
metals

5. Inertization:
 In this process cement and other substances are mixed
with waste before disposal.
 Mixing of cement etc. reduces the risk of migrating toxic
substances into surface water or ground water.
 After making homogenous mixture, cubes are prepared at
site, then transported to final disposal site.

6. Landfill:
 Besides incineration, land fill is the second important
choice for final disposal of biomedical waste.
 It is quite effective, provided practice appropriately, open
dumping of health care waste is not recommended due to
reasons of acute pollution problems, fires, higher risk of
disease transmission and open access to scavengers and
animals.
 So, a sanitary landfill observing certain rules is acceptable
choice for biomedical waste, particularly in developing
countries like India

Some guidelines for Sanitary Landfill are:
 A specific designated place with authoritative
permission.
 Site away from the residential areas/ water
sources.
 Appropriate engineering preparation
 Easy transportation facilities
 Daily coverage of waste.
 Constant supervision.

NURSES ROLE AND RESPONSIBILITIES IN
BIOMEDICAL WASTE MANAGEMENT
 Disinfect the waste so that it is no longer a source of
pathogenic organisms.
 Reduce the bulk in order to reduce requirements for
storage and transportation.
 Make the waste unrecognizable for aesthetic reasons.
 Make recyclable items unusable. For example, cutting up
syringes and damaging the needles.

 Recycling infectious plastic wastes can be
considered only after adequate
disinfection/sterilization.eg glass, paper,
corrugated cardboard, aluminum, x-ray films,
reclaimed silver from x-ray film, plastic(non-
infectious components).
 Disposable items, such as gloves, syringes should be
mutilated after use to prevent illegal packing and
reuse
 These types of containers should be available at
each point, namely for general wastes, infected
non sharp waste, and infected sharp waste.

 Needles, syringes, and other sharp instruments and
objects should be placed in a puncture-resistant
plastic/metal container at the work station.
 Needles, syringes may also be hydroclaved/autoclaved
or chemically disinfected and disposed.
 Alternatively, sharp waste may be transported to a
central site for treatment and containers may be
reused, but only after cleaning and disinfecting.
 40% of needle-prick injuries are a result of reheating.
Therefore, do not recap the waste.

 Reusable glass syringes and needles-aspirate with
hypochloric solution and immerse in a flat tray for
20 minutes. Rinse with water several times.
 Chemical disinfection prior to disposal is required
for sharps, disposable infections, plastic/rubber,
infectious glassware, and blood and body fluids.
 Change the chemical solution frequently, or at
least once a day
 Always handle, waste with gloves and masks. Apron
and boots must be used if splashing is expected.

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