bio medical waste management

BIOMEDICAL WASTEBIOMEDICAL WASTE MANAGEMENTMANAGEMENT

08-05-200908-05-2009 BIO-MEDICAL WASTE MANAGEMENTBIO-MEDICAL WASTE MANAGEMENT 22

ABBREVATIONS USEDABBREVATIONS USED::BIOMEDICAL WASTE MANAGEMENTBIOMEDICAL WASTE MANAGEMENT : : BMW MgtBMW MgtMANAGEMENTMANAGEMENT : Mgt : Mgt


CONTENTS :CONTENTS :1.1. DEFINITIONDEFINITION2.2. NECESSITYNECESSITY3.3. COMPONENTS COMPONENTS 4.4. TYPESTYPES5.5. STEPS IN WASTE MANAGEMENTSTEPS IN WASTE MANAGEMENT6.6. BIOMEDICAL WASTE Mgt PROCESSBIOMEDICAL WASTE Mgt PROCESS7.7. COST OF BMW MgtCOST OF BMW Mgt8.8. WASTE TREATMENT AND DISPOSALWASTE TREATMENT AND DISPOSAL9.9. OCCUPATIONAL HAZARDS AND SAFETY MEASURESOCCUPATIONAL HAZARDS AND SAFETY MEASURES10.10. INDIAN SCENARIOINDIAN SCENARIO11.11. CONCLUSIONSCONCLUSIONS12.12. RECOMMENDATIONS AND FOLLOW UPRECOMMENDATIONS AND FOLLOW UP13.13. REFERENCESREFERENCES


DEFINITION:DEFINITION: BIOMEDICAL WASTEBIOMEDICAL WASTE means any solid ,liquid means any solid ,liquid

waste including its container and any waste including its container and any intermediate product , which is generated during intermediate product , which is generated during the diagnosis, treatment or immunization of the diagnosis, treatment or immunization of human begins or animals or in research human begins or animals or in research pertaining thereto or in the production or testing pertaining thereto or in the production or testing thereof. thereof.


NECESSITYNECESSITY:: Biomedical waste must be properly Biomedical waste must be properly

managed to protect the general public , managed to protect the general public , specifically healthcare and sanitation specifically healthcare and sanitation workers who are regularly exposed to workers who are regularly exposed to biomedical waste as an occupational biomedical waste as an occupational hazard.hazard.


COMPONENTS OF BIOMEDICAL WASTE:COMPONENTS OF BIOMEDICAL WASTE:

1.Human anatomical waste (tissues ,organs, body 1.Human anatomical waste (tissues ,organs, body parts);parts);

2.Animal waste (as above, generated during 2.Animal waste (as above, generated during research or experimentation , from veterinary research or experimentation , from veterinary hospitals etc.);hospitals etc.);

3.Microbiology and biotechnology waste, such as, 3.Microbiology and biotechnology waste, such as, laboratory cultures ,micro-organisms, human laboratory cultures ,micro-organisms, human and animal cell cultures , toxins etc.;and animal cell cultures , toxins etc.;

4.Waste sharps ,such as , syringes ,scalpels, 4.Waste sharps ,such as , syringes ,scalpels, broken glass;broken glass;

5.Discarded medicines;5.Discarded medicines;


6.Soiled waste , such as dressing, bandages, 6.Soiled waste , such as dressing, bandages, plaster casts ,material contaminated with blood plaster casts ,material contaminated with blood etc ;etc ;

7.Solid waste (disposable items like tubes etc)7.Solid waste (disposable items like tubes etc)8.Liquid waste generated from any of the infected 8.Liquid waste generated from any of the infected

areas;areas;9.Incineration ash;9.Incineration ash;10.Chemical waste.10.Chemical waste.


BIOMEDICAL WASTE:BIOMEDICAL WASTE:


TYPES OF BIOMEDICAL WASTETYPES OF BIOMEDICAL WASTE : :


STEPS IN WASTE MANAGEMENTSTEPS IN WASTE MANAGEMENT : :

Waste surveyWaste survey :determines the point of :determines the point of generation, the type of waste at each generation, the type of waste at each point and level of generation.point and level of generation.

Waste segregationWaste segregation : consists of : consists of placing different types of wastes in placing different types of wastes in different containers at the point of different containers at the point of generation.generation.


Waste accumulation and storageWaste accumulation and storage : occurs : occurs between the point of waste generation and site between the point of waste generation and site of waste treatment and disposal.of waste treatment and disposal.

Waste transportationWaste transportation : when medical waste : when medical waste is not treated on site, untreated waste must be is not treated on site, untreated waste must be transported from the generation facility to transported from the generation facility to another site for treatment and disposal.another site for treatment and disposal.


Waste treatmentWaste treatment : is mainly required to : is mainly required to disinfect or decontaminate the waste, right disinfect or decontaminate the waste, right at the source so that it is no longer the at the source so that it is no longer the source of pathogenic organisms.source of pathogenic organisms.

Waste disposalWaste disposal : vary in their capabilities, : vary in their capabilities, cost, availability to generation and impact cost, availability to generation and impact on the environment.on the environment.


AREA – WISE FREQUENCY OF AREA – WISE FREQUENCY OF WASTE SURVEY :WASTE SURVEY :

Wards (each one of them) Wards (each one of them) Each shift Each shift Out patients departmentOut patients department Each shift Each shift Operation theatreOperation theatre Each operation / surgical procedure Each operation / surgical procedure Intensive care unitIntensive care unit Each shift Each shift Emergency unitEmergency unit Each shift Each shift Dialysis unit Dialysis unit Each procedure Each procedure Radiation unit Radiation unit Each procedure Each procedure LaboratoriesLaboratories (pathological , biochemical Each shift(pathological , biochemical Each shift Pharmacy)Pharmacy) chemist’ dispensation unitchemist’ dispensation unit Once a day Once a day Kitchen Kitchen Twice, after every meal Twice, after every meal Administrative unit and central storeAdministrative unit and central store Once a day Once a day Surrounding premises and garden once a daySurrounding premises and garden once a day


BIOMEDICAL WASTE BIOMEDICAL WASTE MANAGEMENT PROCESS :MANAGEMENT PROCESS :

Handling, segregation, mutilation, disinfection, Handling, segregation, mutilation, disinfection, storagestorage, , transportation and final disposaltransportation and final disposal are are vital steps for safe and scientific management of vital steps for safe and scientific management of biomedical waste in any establishment.biomedical waste in any establishment.

The key to minimization and effective The key to minimization and effective management of bio-medical waste is management of bio-medical waste is SEGREGATION (separation) AND SEGREGATION (separation) AND IDENTIFICATION OF WASTE by sorting them IDENTIFICATION OF WASTE by sorting them into COLOUR CODED plastic bags or into COLOUR CODED plastic bags or containers.containers.


COLOUR CODING- BIOMEDICAL WASTE COLOUR CODING- BIOMEDICAL WASTE (MANAGEMENT AND HANDLING ) RULES,1998 (MANAGEMENT AND HANDLING ) RULES,1998

(SCHEDULE II) :(SCHEDULE II) :

COLOURCOLOUR CODINGCODING

TYPE OFTYPE OF CONTAINERCONTAINER

WASTE WASTE CATEGORIESCATEGORIES

YELLOWYELLOW Plastic bags Plastic bags Cat 1 human Cat 1 human anatomical waste, anatomical waste, Cat 2 animal waste,Cat 2 animal waste,Cat 3 microbiology Cat 3 microbiology waste,waste,Cat 6 soiled waste.Cat 6 soiled waste.

REDRED Disinfected Disinfected container container Plastic bags Plastic bags

Cat 3 microbiological Cat 3 microbiological Cat 6 soiled Cat 6 soiled Cat 7 solid wasteCat 7 solid waste(Waste IV tubes (Waste IV tubes catheters, etc.)catheters, etc.)


BLUE/ WHITEBLUE/ WHITE Plastic Plastic bag/puncture bag/puncture proof containersproof containers

Cat 4 waste sharpsCat 4 waste sharpsCat 7 plastic Cat 7 plastic disposable disposable tubings,etc.tubings,etc.

BLACKBLACK Plastic Plastic bag/puncture bag/puncture proof containersproof containers

Cat 5 discarded Cat 5 discarded medicinesmedicinesCat 9 incineration ash Cat 9 incineration ash Cat 10 chemical wasteCat 10 chemical waste


COST OF BIOMEDICAL WASTE COST OF BIOMEDICAL WASTE MANAGEMENT :MANAGEMENT :

Two types of costs are required to be incurred by Two types of costs are required to be incurred by hospitals for BMW Mgt, hospitals for BMW Mgt, internalinternal and and externalexternal. .

Internal costInternal cost includes cost for segregation, mutilation, includes cost for segregation, mutilation, disinfection, internal storage and transportation including disinfection, internal storage and transportation including hidden cost of protective equipment.hidden cost of protective equipment.

External costExternal cost involves off site transport of waste, involves off site transport of waste, treatment and final disposal.treatment and final disposal.

Govt. of India in its pilot project for hospital waste mgt in Govt. of India in its pilot project for hospital waste mgt in Govt. hospitals has estimated Rs.85 lakhs as capital cost Govt. hospitals has estimated Rs.85 lakhs as capital cost in 1000 bedded super specialty teaching hospital which in 1000 bedded super specialty teaching hospital which includes on site final disposal of BMW.includes on site final disposal of BMW.


WASTE TREATMENT AND WASTE TREATMENT AND DISPOSAL :DISPOSAL :

1.1. INCINERATIONINCINERATION : : High temperature High temperature thermal process employing combustion thermal process employing combustion of the waste under controlled condition of the waste under controlled condition for converting them into inert material for converting them into inert material and gases.and gases.


TYPES OF INCINERATIONTYPES OF INCINERATION:: Double-chamber pyrolytic incinerators

specially designed to burn infectious health-care waste.

Single-chamber furnaces with static grate, used only if pyrolytic incinerators are not affordable.

Rotary kilns operating at high temperature, capable of causing decomposition of genotoxic substances and heat-resistant chemicals.


2. DISINFECTION:

CHEMICAL DISINFECTIONCHEMICAL DISINFECTION : Recommended for liquid : Recommended for liquid wastes as well as chemical wastes involving the use of wastes as well as chemical wastes involving the use of at least 1% hypochlorite solution with other equivalent at least 1% hypochlorite solution with other equivalent reagents like phenolic compounds, iodine etc. for a reagents like phenolic compounds, iodine etc. for a minimum contact period of 30 minutes.minimum contact period of 30 minutes.

THERMAL DISINFECTION: generally used for treating solid waste.


3. 3. AUTOCLAVE TREATMENTAUTOCLAVE TREATMENT : A l : A low ow heat process in which steam is brought heat process in which steam is brought into direct contact with the waste material into direct contact with the waste material for duration sufficient to disinfect the for duration sufficient to disinfect the material.material.

4. 4. HYDROCLAVE TREATMENTHYDROCLAVE TREATMENT : Steam : Steam sterilization process which can treat the sterilization process which can treat the same waste as the autoclave plus the same waste as the autoclave plus the waste sharps.waste sharps.


5. 5. MICROWAVE TREATMENTMICROWAVE TREATMENT : : A wet A wet thermal disinfection process in which the thermal disinfection process in which the microwave heats the targeted material microwave heats the targeted material from inside out, providing a high level of from inside out, providing a high level of disinfection.disinfection.


6.LAND FILLING6.LAND FILLING : : Open dumps : not recommendedSanitary landfills : Disposing of certain

types of health-care waste (infectious waste and small quantities of pharmaceutical waste) in sanitary landfills is acceptable.


OCCUPATIONAL HAZARDS AND OCCUPATIONAL HAZARDS AND SAFETY MEASURES :SAFETY MEASURES :

Occupational hazardsOccupational hazards : :

1.1. Contact with infected material like Contact with infected material like pathological waste, used gloves etc.pathological waste, used gloves etc.

2.2. Contact with stool, urine, blood, pus etc., Contact with stool, urine, blood, pus etc., of the patients during cleaning job.of the patients during cleaning job.

3.3. Accidental cut or punctures from infected Accidental cut or punctures from infected sharps such as scalpels, knives etc.sharps such as scalpels, knives etc.


Safety measuresSafety measures : : Clear directives in the form of a notice to Clear directives in the form of a notice to

be displayed in all the concerned areas.be displayed in all the concerned areas. Sterilization of all equipments and their Sterilization of all equipments and their

issue accordingly.issue accordingly. Provision of disinfectant, soap etc., of the Provision of disinfectant, soap etc., of the

right quality and clean towels / tissue right quality and clean towels / tissue paper. paper.


IMPORTANT PRECAUTIONSIMPORTANT PRECAUTIONS : :

Never transfer sharps directly from person to person

Never recap the needles


Do not inhale chemicals directly. Use always mask.

Never overload bins used for storing Bio Medical Waste


Keep away sharps medicines from children

Never transfer sharp directly


DISPLAY OF THE BIO-HAZARDOUS SYMBOL AND DISPLAY OF THE BIO-HAZARDOUS SYMBOL AND THE TYPES OF WASTE TO BE PUT IN EACH THE TYPES OF WASTE TO BE PUT IN EACH

CONTAINER AS PER SCHEDULE-II :CONTAINER AS PER SCHEDULE-II :


INDIAN SCENARIO :INDIAN SCENARIO : Legislation: Bio-Medical Waste Regulations 1998 • Classified in ten categories; • Color coding and types of containers for different categories and

their corresponding treatment & disposal option with standards. Generation: 0.33 million tons/year Prevalent Practice : • Poorly managed incinerators;……..or back yard burners? • Open burial pits posing a threat to public; • Sharps collected/reused without cleaning or sterilization.

After a Sristi’s (NGO) intervention in 1997, Court directed CentralPollution Control Board to emphasize on non-burn technology


CONCLUSIONS CONCLUSIONS :: Safe and effective management of waste is not only a legal Safe and effective management of waste is not only a legal

necessity but also a social responsibility.necessity but also a social responsibility.

Lack of concern, motivation, awareness and cost are some of the Lack of concern, motivation, awareness and cost are some of the problems faced in the proper biomedical waste management.problems faced in the proper biomedical waste management.

Clearly there is a need for education as to the hazards associated Clearly there is a need for education as to the hazards associated with the improper waste disposal.with the improper waste disposal.

A LESSER amount of biomedical waste means a lesser burden A LESSER amount of biomedical waste means a lesser burden on waste disposal work, cost saving and a more efficient disposal on waste disposal work, cost saving and a more efficient disposal system.system.

Hence, health care providers should always try to reduce the Hence, health care providers should always try to reduce the waste generation in day to day work in the clinic or at the hospital.waste generation in day to day work in the clinic or at the hospital.


RECOMMENDATIONS AND RECOMMENDATIONS AND FOLLOW UPFOLLOW UP : :

All health care facilities generating Bio-medical waste shall strictly ensure segregation, color coding and other provisions of Bio-medical waste (Management & Handling) rules, 1998 and amendments thereof.

Incinerators, which do not confirm to the design and emission norms as per rules, must be modified and air pollution control system may be retrofitted to minimize the emission level.


The operator should ensure proper operation and management (O&M) of incinerator through attainment of required temperature in both the chambers, regular operation of the incinerator, proper maintenance of the logbook and storage of the waste in isolated area, plastic incineration should not be undertaken


Proper training and personal safety equipment / accessories should be provided to waste handling staff.

Records of waste generation, treatment and Records of waste generation, treatment and disposal should be maintained by the hospital.disposal should be maintained by the hospital.

Various regulatory agencies, hospitals, medical Various regulatory agencies, hospitals, medical association and municipal corporation should association and municipal corporation should work together for proper management of Bio-work together for proper management of Bio-medical waste in the cities / towns.medical waste in the cities / towns.


REFERENCES :REFERENCES :

Veda Hegde, Kulkarni RD , Ajantha GS – Veda Hegde, Kulkarni RD , Ajantha GS – Biomedical waste management.Biomedical waste management.

Biomedical WasteBiomedical Waste – Wikipedia , the free – Wikipedia , the free encyclopedia .encyclopedia .

Biomedical Waste Management : An Biomedical Waste Management : An infrastructural survey of hospitalsinfrastructural survey of hospitals – Lt col SKM – Lt col SKM Rao , Wg Cdr RK Ranyal , Lt Col SS Bhatia , Lt Rao , Wg Cdr RK Ranyal , Lt Col SS Bhatia , Lt Col VR Sharma .Col VR Sharma .


GLOBAL JOURNAL OF HEALTH SCIENCEGLOBAL JOURNAL OF HEALTH SCIENCE : : K.V.Radha, K.Kalivani, R.Lavanya.K.V.Radha, K.Kalivani, R.Lavanya.Department of chemical engineering,Department of chemical engineering,Anna University, Chennai.Anna University, Chennai.

HEALTH CARE WASTE MANAGEMENT IN HEALTH CARE WASTE MANAGEMENT IN SOUTH ASIA: SOUTH ASIA:

C.VisvanathanEnvironmental Engineering & Management ProgramAsian Institute of Technology,Thailand.

bio medical waste management

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waste disposal

waste segregation

waste transportation

animal waste

soiled waste

type of waste

microbiology waste

liquid waste