infection management and environment protection

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BIO MEDICAL WASTE MANAGEMENT

Objectives

• Minimise environmental threat and publichealth risk

• Minimise hospital acquired diseases to themedical staff and health care personnelwho handle these wastes at generationpoint

• Stop recycling of disposable syringes,saline, I.V. fluid bottles, picked up by ragpickers and are recycled back into themarket without any disinfection

Manoj Kumar Sharma, Lab Tech, MSF

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• Doctors and nurses

• Patients

• Hospital support staff

• Waste collection and disposal staff

• General public

• Environment

Who’s at Risk ?

Who is responsible for Waste management

Doctors

Nurses

Technicians

Other staffs like ward boys

Logistics

The Bio-medical waste should besegregated as per categories applicable.

Manoj Kumar Sharma, Lab Tech, MSF

STEPS FOR BIO-MEDICAL WASTE MANAGEMENT

• Waste generator is responsible for

The steps that should be followed are:

• Segregation

• Collection and Storage

• Transportation

• Treatment and Disposal 5

How segregation of wastes is to be done?

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Black Bucket - General waste (non infectious)

Red Bucket - Infectious plastic waste like saline bottles, syringes, catheters, etc

Yellow Bucket - Anatomical and Soiled waste.

White (Puncture Proof Container) - Metal and Glass sharp waste like broken vials, needles etc

Do’s1. Always segregate waste at source of generation

2. Segregate infectious waste into:a. Sharps (Metal and Glass sharps) like needles, blades, lancets,broken ampoules, vials, slides in white puncture proofcontainer

b. Solid wastes (Infectious plastic waste) like syringes, tubing,catheters etc to be disposed in red plastic bins/bags

c. Anatomical waste (placenta, body parts) and soiled waste(Items contaminated with blood, and body fluids including cotton,dressings, soiled plaster casts, lines, beddings, other materialcontaminated with blood) in yellow plastic bins/bags

d. Non-infectious (General) waste like waste similar to householdwaste including packaging material, cartons, fruit and vegetablepeels, syringe and needle wrappers, medicine covers in blackplastic bins and bags

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Don’ts

Never mix infectious and non-infectious waste atsource of generation, during waste collection,waste storage, waste transportation or duringfinal disposal of waste.

Points to remember:-• Bins should be located at all points of waste

generation

• No infectious waste should be stored beyond48 hours 8

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COLLECTION AND STORAGE OF WASTEDo’s

• Always collect the waste in covered bins

• Fill the bins up to the 3/4th level

• Clean the bins regularly with soap and

water/disinfect the bins regularly

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Don’ts

• Never overfill the bins

• Never mix infectious and non-infectious

waste in the same bin

• Never store waste beyond 48 hrs

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TRANSPORTATION OF WASTE Do’s

1. Always carry/transport the waste inclosed containers

2. Use dedicated waste collectionbins/trolleys/wheel barrows fortransporting waste

3. Transport waste through a pre-definedroute within the health care facility

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Don’ts

1. Never transport the waste in open

containers or bags, it may spill and lead

to spread of infections

2. Never transport waste through crowdedareas

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TREATMENT AND DISPOSAL OF BIO-MEDICAL WASTE

• All sharp waste (Metal and Glass sharp waste) - Disinfected in their

puncture proof containers and should be disposed off in the sharps pit.

• Infected organic waste (Body/Body parts) and soiled waste (Items

contaminated with blood, and body fluids including cotton, dressings, soiled

plaster casts, lines, beddings, other material contaminated with blood)-

Should be taken to the onsite deep burial pits and covered with a layer of

lime and soil or Incinerated.

• Infected recyclables such as plastics waste - Should be first cut and then

put in the Red Bucket. It is disinfected using bleach solution (in a

disinfection tank) and then shred. It is then sent for recycling or stored for

deferred recycling.

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General Waste

• Non-infected organic waste such as kitchen waste and leaf

fallings have to be put in a compost pit, which is to be located

within the premises. Standard composting methods such as

mixing the waste with leaf fallings and soil should be adopted.

Manure will be available and this should be used for the garden.

• Recyclable material such as packaging material, recyclable

plastic and paper should be sold to authorized recyclers. Plastic

should be shredded and disinfected before disposal. Care must

be taken to ensure that the recyclable waste is not infected and

also that it be kept separate from infectious waste at all times.17

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CHEMICAL DISINFECTION

Ensure the following points while chemical disinfection:-

• That the used product is treated prior to disposal.

• Treatment should be with a solution of 1% BleachingPowder (10 Gm bleaching powder in 1 liter of water)

• The waste should be submerged in this solution for an hour

• Infected waste shall not be kept for more than 48 hours andso disinfection process shall be done every day.

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SITE OF CHEMICAL DISINFECTION

• Sharp waste – Disinfectant be placed in the PPC

• Plastic waste – Disinfection be carried out in tumbler (Sub

centre) and disinfection tank (CHC/DH)

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HANDLING MERCURY SPILLS

• Never touch mercury with bare hands as mercury isabsorbed quickly though the skin.

• Remove all jewellery while dealing with mercury asmercury combines with gold, silver and other metals.

• Clear the area around the spill.

• Wear all the protective gear

• Contain the spread of mercury and use two hardcardboard sheets to gather all the mercury.

• Use a syringe to suck up mercury

• Pour contents of the syringe into the plastic/ glasscontainer with 5 to 10 ml of water.

• Put sealing tap, if used in the plastic/glass container.

• Put the used syringe in a separate plastic container forfurther use.

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• At least two pairs of latex gloves (Mercury passesthrough a single pair of latex gloves)

• Face mask

• Protection for the eyes

• Sealing tape

• 10 c.c. syringe

• Covered plastic/glass container with water

Mercury containment kit

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• Mercury can be stored indefinitely in this condition, but the

hospital should seek out a government approved and

licensed hazardous waste disposal firm or mercury

recycler, which can handle mercury.

• Mercury collected in this manner can be cleaned and

reused in the new equipment

Storage and disposal of mercury waste

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HANDLING LIQUID WASTE SPILLS

Liquid waste is any blood, body fluid, pus, any discharge

from wounds or liquid chemicals

• Clean the liquid waste spill by adding equal or more

quantity of bleaching powder solution and leave the

area for 30 minutes

• Wipe the area with a swab/cloth

• Discard the swab/cloth after cleaning the area into the

Yellow bucket. 24

DISPOSAL OF DISINFECTANTDo’s

• Always dilute the disinfectant before disposal into drains

• Wear personal protective gears while handling

disinfectants

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• Never dispose the chemicals, disinfectants without diluting

them

• Never use expired chemicals or disinfectants. Send them

back to the stores

DISPOSAL OF DISINFECTANTDont’s

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Questions and answers