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BIO-MEDICALWANAGEMENT
M
T
S
A
E
Contents: Bio-Medical Waste Management
1 . I n t r o d u c t i o n 2.Types Of Bio-medical w aste
3.
Effects of Bio-medical waste4.Collection and treat ment of Bio -medical w aste5.Case Study: INHS
KAYLYANI Hospital6 . C o n l u s i o n
INTRODUCTION
All over the country, unsegregated and untreated biomedicalwaste is being indiscriminately discarded into municipal
bins, dump sites, onroadsides, in water bodies or is being incompletely and improperly burnt inthe open. All this is
leading to rapid proliferation and spreading of infectious,dangerous and fatal communicable diseases like hepatitis, AIDS
and severaltypes of cancers. In urban and rural areas alike, incidence and prevalence of several such human diseases has
increased and the per capita medicalexpenditure has also gone high several folds. Although, yet to be proven,morbidity or
illness amongst both urban and rural dwellers has increasedalbeit for different reasons.The Ministry of Environment and
Forests, Govt. of India has notified theBiomedical Waste (Management and Handling) rules 1998 with
subsequentamendments (June 2nd 2000 and September 2003). However, only 5-10% of institutions in the country have
implemented the Rules or are following themat present.Unfortunately, some western countries, in the garb of managing
theirbiomedical wastes, are adding to our problems by exporting their wastes topoorer countries.The improper handling,
treatment, storage, transport and disposal of wastecan lead to serious problems like:- The entire waste from a healthcare
establishment, which includes non-infectious as well as infectious waste, if unsegregated and untreated is mixedwith the
rest of the waste in a healthcare establishment, will convert the entirenon infectious general waste (75-80%) also into
infectious waste.- The indiscriminate disposal of sharps within and outside institutions leadingto occupational hazards
like needle stick injuries, cuts, and infections amonghospital employees, municipal workers and ragpickers.-Injuries due
to the sharp especially among ragpickers and hospital /municipal workers increases the incidence of Hepatitis B, C, E and
HIVamong these groups who transmit these diseases to others in the communityand also succumb to such fatal diseases.-
The problem with medical waste lies in the fact that it is not handled andtreated according to its type, which leads to
hazardous working conditions for
hospital personnel and exorbitant investment in technology that creates moreproblems.Hospital waste is generated during
the diagnosis, treatment, orimmunization of human beings or animals or in research activities in thesefields or in the
production or testing of biologicals. It may include wastes likesharps, soiled waste, disposables, anatomical waste,
cultures, discardedmedicines, chemical wastes, etc. These are in the form of disposable syringes,swabs, bandages, body
fluids, human excreta, etc. This waste is highlyinfectious and can be a serious threat to human health if not managed in
ascientific and discriminate manner. It has been roughly estimated that of the 4kg of waste generated in a hospital at least
1 kg would be infected.- Undestroyed needles and syringes being circulated back to Recycling,through unscrupulous

3. traders who employ the poor and the destitute tocollect such waste for repackaging and selling in the market.- Reuse of
disposable like syringes, needles, catheters, IV and dialysis sets arecausing spread of infection from healthcare
establishments to the generalcommunity.- Disposal of hospital waste and veterinary hospital waste in municipaldumpsite
resulting in animals especially cows feeding on the blood soakedcotton and plastics, and this in turn leading to diseases
like bovinetuberculosis which through milk can infect humans.- The indiscriminate dumping of untreated hospital waste
in municipal binsincreasing the possibility of survival, proliferation and mutation of pathogenic microbial population in
the municipal waste. This leads toepidemics and increased incidence and prevalence of communicable diseasesin the
community.- Incidence and prevalence of diseases like AIDS, Hepatitis B&C tuberculosisand other infectious diseases
increasing due to inappropriate use, storage,treatment, transport and disposal of biomedical waste.- Chances of vectors
like cats, rats, mosquitoes, files and stray dogs gettinginfected or becoming carriers which also spread diseases in the
community.
Bio-medical waste:
―Bio-Medical Waste‖ is any waste,which is generated during the diagnosis, treatment or immunization of human beings
or animals. These wastes are also generated during researchactivities or in the production or testing of biological
material.Redefining it scientifically, Biomedical waste is defined as ―any solid, fluid orliquid waste, including its container
and any intermediate product, which isgenerated during its diagnosis, treatment or immunization of human beingsor
animals, in research pertaining thereto, or in the production or testing of biological and the animal wastes from slaughter
houses or any other likeestablishments.‖―Any waste that is generated in the diagnosis, treatment or immunization of
human beings or animals, in research pertaining thereto, or in the productionor testing of biologicals.‖Infectious wastes
are those biomedical wastes which contain sufficientpopulation of infectious agents that are capable of causing and
spreadinginfections among people, livestock and vectors. Infectious wastes includehuman tissues, anatomical waste,
organs, body parts, placenta, animal waste(tissue / cell cultures), any pathological / surgical waste, microbiology
andbiotechnology waste (cultures, stocks, specimens of micro-organism, live orattenuated vaccines, etc.), cytological,
pathological wastes, solid waste (swabs,bandages, mops, any item contaminated with blood or body fluids),
infectedsyringes, needles, other sharps, glass, rubber, metal, plastic disposables andother such wastes.Cytotoxic
substances, as the word suggests are toxic to cells and are oftenanti-neoplastic which inhibit cell growth and
multiplication. These drugswhen come in contact with normal cells can damage them and cause severedisability or even
death of those affected. These drugs could be present in thewaste generated from the treatment of cancer patients or from
other work related to testing and control of cancerous cells.
Infected plastics are those biomedical plastics which have been used foradministering patient care or for performing
related activities and maycontain blood or body fluids or are suspected to contain infectious agents insufficient number
which may lead to infections among other humans oranimals. These generally include IV tubes / bottles, tubings, gloves,
aprons,blood bags / urine bags, disposable drains, disposable plastic containers,endo-tracheal tubes, microbiology and
biotechnology waste and otherlaboratory waste.As regards its type and composition, most hospital waste is similar
tohousehold waste and can be disposed of in the same way. In addition to this,however, hospitals generate certain special
types of waste which should not behandled by domestic refuse collection services, because of the risk of infection,because
they are hazardous in other ways, or for ethical reasons.Such waste must be collected separately at the places where it is
generated,and disposed of in specially approved plants, e.g., incinerators. Hence, typesof hospital waste may be classified
according to the disposal methodsappropriate for them, as follows:
TYPES OF

4. BIO-MEDICALW A
T
S
:
E
Type A: Waste which does not require any special treatment.This is the waste produced by the hospital administration, the
cleaningservice, the kitchens, stores and workshops. It can be disposed of in the sameway as household waste.Type B:
Waste with which special precautions must be taken to preventinfection in the hospital.This is usually taken to include all
waste from inpatient and casualty wardsand doctors' practices, e.g. used dressings, disposable linen and
packagingmaterials.It only constitutes a risk for patients with weakened defences while it is stillinside the hospital. Once it
has been removed from the wards it can behandled by the local domestic refuse collection service.
Type C: Waste which must be disposed of in a particular way to preventinfection.This is waste from isolation wards for
patients with infectious diseases; fromdialysis wards and laboratories, in particular those for
microbiologicalinvestigations, which contains pathogens of dangerous infectious diseases, e.g.tuberculosis, hepatitis
infectious diarrhoeal diseases and which constitutes areal risk of infection when disposing of this waste. It includes
needles andsharp objects coated with blood, or disposable items contaminated with stool.Type D: Parts of human bodies:
limbs, organs etc.This waste originates in pathology, surgical, gynecological and obstetricdepartments. It has to be
disposed of separately, not to prevent infection butfor ethical reasons.Type E: Other waste.Hospitals provide a service, and
hence have infrastructures which can alsogenerate hazardous waste products, e. 9. chemical residues from laboratories,as
well as inflammable, explosible, toxic or radioactive waste, which must bedisposed of in accordance with statutory
provisions.
SHARPS HANDLING AND DISPOSAL:
Sharps consist of needles, syringes, scalpels, blades, glass etc., whichhave the capability to injure by piercing the skin. As
these sharps are used inpatient care, there is every chance that infection can spread through this typeof injury. Nurses
can get a sharp injury before and after using a sharp on apatient. Further, sharps discarded without any special
containment orsegregation can injure and transmit disease to those who collect waste(including safai karamcharis,
municipal sweepers and ragpickers). Therehave been reports that waste collected from the hospitals are resold,
thiscreates an additional occupational and community health hazard.
PLASCTICS IN HELTHCARE
Hospitals use plastics because they fear a spread of infection throughthe use of reusable medical equipment. Thus, plastic
use has grown withincreasing concern for infection control. However, there have been caseswhere even with the use of
plastics there has been a spread of infection inwards. Nurses complained of nosocomial infections in wards even
thoughdisposable equipment was used — they related it to improper waste disposalof disposable equipment within the
wards.PVC is a thermoplastic, with approximately 40 percent of its content beingadditives. Plasticisers are added to make
PVC flexible and transparent.

5. Medical equipment made from PVC:
B l o o d
b a g s B r e a t h i n g
t u b e s Feeding tubes Pressure monitor tubesCatheters Drip chamberIV Containers
Parts of a syringeIV Components LabwareInhalation masks Dialysis tubes
MEDICAL
W SE
AT
INCINERATION
Incineration is a complex technology that is used to burn waste. Theproblem of medical waste is one of disinfecting the
waste and not of destroying it. With the increased use of disposables in medicine, the amountof plastic going for
incineration has increased manifold. The burning of plastics, especially in unregulated incinerators, creates a new set of
chemicaltoxins, some of which, are super toxins even in extremely small quantities.Incineration thus converts a biological
problem into a chemical one.
MERCURY:AHEALTHHAZARD
Sources of Mercury in hospitals:
1. Thermometers2. Blood pressure cuffs
3. Feeding tubes4. Dilators and batteries5. Dental amalgam6. Used in laboratory chemicals like Zenkers solution and
histologicalfixatives.
GLUTARALDEHYDE/ CIDEX
Glutaraldehyde is a colourless, oily liquid, which is also commonly availableas a clear, colourless, aqueous solution. It is a
powerful, cold disinfectant, usedwidely in the health services for high-level disinfection of medical instrumentsand
supplies and available with trade names such as: Cidex, Totacide, andAsep.Glutaraldehyde is a widely used disinfectant
and a sterilizing agent(commonly available in 1 percent and 2 percent solutions) in medical anddental settings. It is used
in embalming (25% solution), as an intermediateand fixative for tissue-fixing in electron microscopy (20 percent, 50
percentand 99 percent solutions) and in X-ray films.
RADIOACTIVE WASTE
Radiations are used for wide variety applications in research, industry,medicine, manufacturing, agriculture, consumer
goods and services. Thecommon concern is that in all these uses, care must be taken to ensure thateveryone is protected
from the potential hazards of radiation.
EFFECTS OFBIO-MEDICALW T
S
A
E
SHARPS HANDLING AND DISPOSAL
Sharps consist of needles, syringes, scalpels, blades, glass etc., whichhave the capability to injure by piercing the skin. As
these sharps are used inpatient care, there is every chance that infection can spread through this typeof injury. Nurses
can get a sharp injury before and after using a sharp on apatient. Further, sharps discarded without any special
containment orsegregation can injure and transmit disease to those who collect waste(including safai karamcharis,
municipal sweepers and ragpickers). Therehave been reports that waste collected from the hospitals are resold,
thiscreates an additional occupational and community health hazard.
MEDICAL WASTE INCINERATION
Acid gases include nitrogen oxide, which has been shown to cause acidrain formation and affect the respiratory and
cardiovascular system. As largeamounts of plastic are incinerated hydrochloric acid is produced. This acidattacks the
respiratory system, skin, eyes and lungs with side effects such ascoughing, nausea and vomiting.Heavy metals are released
during incineration of medical waste. Mercury,when incinerated, vaporizes and spreads easily in the environment. Lead
andcadmium present in the plastics also accumulates in the ash.Acute and chronic exposure to lead can cause metabolic,
neurological andneuro-psychological disorders. It has been associated with decreasedintelligence and impaired
neurobehavioral development in children.Cadmium has been identified as a carcinogen and is linked to toxic effects
onreproduction, development, liver and nervous system.
PLASCTICS IN HELTHCARE
Disposal of PVC via incineration leads to the formation of dioxin andfurans. Dioxin and furans are nwanted by-products
of incineration withcarcinogenic and endocrine-disrupting properties. They are toxic at levels aslow as 0.006 picograms
per Kg of body weight.
MERCURYHEALTHHAZARD:
When products containing mercury are incinerated, the mercurybecomes airborne and eventually settles in waterbodies
from, where via bio-magnification in the food chain and bioaccumulation, it reaches humans. If itis flushed, it enters
waterbodies directly, and if it is thrown in bins it couldenter the body of animals via skin or inhalation, or permeate into
the groundcausing soil and groundwater poisoning. This metalaccumulates in the muscle tissues.Three major types of
mercury are found in the environment – methylmercury, mercury (zero), mercury (two). Out of these, methyl mercury is
themost toxic; it bio accumulates and has the capability to interfere with celldivision and cross the placental barrier. It
also binds to DNA and interfereswith the copying of chromosomes and production of proteins. Pregnantwomen and
children are most vulnerable to the effects of mercury. The
Minamata disaster in Japan is an example of mercury-poisoning via bio-magnification and bioaccumulation. Mercury
exposure can lead topneumonitis, bronchitis, muscle tremors, irritability, personality changes,gingivitis and forms of
nerve damage

6. GLUTARALDEHYDE/ CIDEX
Aqueous solution is not flammable. However, after the waterevaporates the remaining material will burn. During a fire,
toxicdecomposition products such as carbon monoxide and carbon dioxide can begenerated.
RADIOACTIVE WASTE
Accidents due to improper disposal of nuclear therapeutic materialfrom unsafe operation of x-ray apparatus, improper
handling of radio-isotopic solutions like spills and left over doses, or inadequate control of radiotherapy have been
reported world over with a large number of personssuffering from the results of exposure. In Brazil while moving, a
radiotherapyinstitute a left over sealed radiotherapy source resulted in an exposure to 249people of whom several either
died or suffered severe health problemsInternational atomic Energy Agency, 1988). In a similar incidence four peopledied
from acute radiation syndrome and 28 suffered serious radiation burns(Brazil, 1988)
Collection andTet e tf i-
ramnoBo
MedicalWaste
The fight against hospital infection demands the cooperation of allthose employed in the hospital: doctors, technicians,
nursing and cleaningstaff. This is why one of the most urgent tasks is to convince, train andmonitor the personnel
responsible for refuse disposal. Unless they areconvinced of the need, trained and monitored, all efforts to improve
thesituation will be doomed to failure.Hospital waste should always be collected in disposable containers whichsatisfy the
following requirements: they must be moisture-resistant and non-transparent; sellable in such a way as to prevent egress
of micro-organisms;safe to transport; and colour-coded to distinguish them from household refusebags. The waste must
be collected in such containers at the point where it isgenerated, and removed from the wards daily without being sorted
ortransferred to other containers. The containers must be carefully sealed.Generally, plastic bags are used for Type B and
C waste, and plastic bucketsfor Type D waste. The material these disposable containers are made of mustbe appropriate
for the next treatment stage. If the waste is subsequentlyincinerated, for example, combustible materials with a low level
of toxicitymust be used; if it is heat-disinfected the materials must be steam-permeable.This requirement also applies,
incidentalIy, to all disposable items purchasedby hospitals.
The waste must be transported to a central incineration plant outside thehospital in specially designed vehicles which do
not compress it. The interiorof the vehicle body must be easy to clean and it must be adequately ventilated.Generally
speaking, hospital waste should be burnt in appropriateincinerators: this is a recognized, proven method for disposing of
all hospitalwaste. There are many different incineration systems available on the markettoday. Basically, an incineration
plant should satisfy the followingrequirements:• it should burn dry, wet and organic waste completely.• glass, plastics and
metals contained in the waste should not impair thefunction of the plant in any way.The combustion process should be
fully automated, and exhaust gasesshould be within the statutory limits even if there are considerable differencesin the
calorific values of the waste.It should have an automatically closing charging sluice to prevent operatingpersonnel from
coming into contact with the combustion chamber.Plants which satisfy these requirements are now available in all
sizes.Alternatively, Type C waste can be disinfected and subsequently disposed of as household refuse, or, in special cases,
removed to guarded sanitary landfillsand immediately covered. Type D waste can be interred in an appropriatemanner in
cemeteries.A variety of methods, chemical and physical, can be used for disinfection. Todisinfect waste, however, only
thermal systems in which the waste is steam-treated at temperatures above 105°C have so far proved
successful.Disinfection in pressure-resistant installations involves approximately thesame amount of work as incineration,
but has the disadvantage that it is notpossible to check visually whether the treatment has been a complete success.With
incineration this is of course possible. For this reason incineration is tobe preferred in countries which have no trained
inspection personnel.There are also devices on the market which shred waste and then disinfect itwith liquid chemicals.
These devices are only suitable for small quantities,
mostly prone to breakdowns, and there is no guarantee that the disinfectantfluid will reach all the waste. They are not
suitable for handling all the wastegenerated by a hospital.
SHARPS HANDLING AND DISPOSAL:
-
Make needle reuse impossible:
Auto disable syringes, like Solo Shotdevice, cannot be used more than once and therefore cannot carry infectionfrom one
patient to another.
-
Take the sharp out of sharps waste:
Needle removers ―de-fang‖syringes, immediately removing the needles after injection and isolating themin secure
containers. The syringe cannot be reused, and there’s no risk of accidental needle sticks.
-
Keep needles away from vulnerable hands
:
Special stickproof containers capture used needles and other medical waste until they can bedestroyed. PATH is working
to increase access to these ―safety boxes,‖identifying low-cost options and making them available for all types of
injections.

7. Using a needle cutter/destroyer:
1. Place used needle in the cutter/destroyer.2. Cut/destroy the needle and the nozzle of syringe in the destroyer/cutter.3.
Separate syringe’s barrel and plunger and put in liquid disinfectant.4. After every shift empty the contents of needle
container/destroyer intoliquid disinfectant, removethrough pouring out contents through a sieve.
MEDICAL WASTE INCINERATION
Due to poor operation and maintenance, these incinerators do notdestroy the waste, need a lot of fuel to run, and are often
out of order. There isa lot of difference between the theory and practice of incinerator operation.This is true around the
world. The problem of medical waste needs asystematic approach, with investments in training of staff, segregation,
wasteminimisation and safe technologies, as also centralised facilities. Merelyinvesting in unsafe incinerators cannot solve
it.
PLASCTICS IN HELTH CARE
Do’s and Don’ts:
Ensure
1. That the used product is mutilated.2. That the used product is treated prior to disposal.3. Segregation
Do not
1. Reuse plastic equipment.2. Mix plastic equipment with other waste.3. Burn plastic waste.
Alternatives to mercury based instruments
Digital instruments are available as substitutes to the mercury containinginstruments. Costs: The cost of the blood
pressure instruments ranges fromRs 2000 to 7000 and the cost of thermometers ranges from Rs 200 to 300
Why are the alternative technologies better ?
These less harmful, non-toxic substitutes pose no environmental or healthhazards and last for a longer duration. The life
span of the mercuryinstruments, on the other hand, is short because of their fragility. Eventhough the initial investment
cost of the alternative technologies is high, theassets associated with them are lifelong.
GLUTARALDEHYDE/ CIDEX
Identify All Usage Locations:
All departments that use glutaraldehyde mustbe identified and included in the safety program. Eliminate as many
usagelocations as possible and centralize usage to minimize the number of employees involved with the handling of
glutaraldehyde
Monitor Exposure Levels
: Measurement of glutaraldehyde exposure levelsmust be conducted in all usage locations.
Training
: An in-depth education and training program should be conductedfor all employees who work with hazardous chemicals.
Use Personal Protective Equipment
: All employees who work withglutaraldehyde must be provided appropriate personal protective equipment.This
equipment includes proper eye/face protection, chemical protectivegloves, and protective clothing.
Engineering controls
: Rooms in which glutaraldehyde is used should have aminimum of 10 air exchange rates per hour.General room
ventilation: A neutralizing agent will, over time, chemicallyinactivate the glutaraldehyde
SAFETY MEASURES:
A chain is as strong as the weakest link in it, thus, not even one person in thehospital should be missed while training is
given. The entire staff is involvedin waste management at some point or the other, including administrators,stores
personnel and other, seemingly uninvolved, departments. To ensurethat the waste is carried responsibly from cradle to
grave, and to see that allthe material required for waste management is available to the staff, it isimportant to involve
everyone, including:• Doctors• Administrators• Nurses• Technicians• Ward Boys and safai karamcharis
INFECTION CONTROL
1. Universal Precautions:
All the healthcare workers being exposed directlyor indirectly to infectious diseases must take Universal Precautions to
reducethe chance of spread of infection.
2. Sterilization and cleaning
: Ensure that the hospital has adequateprocedures for the routine, cleaning, and disinfection of environmentalsurfaces,
beds, bed rails, bedside equipment, and other frequently touchedsurfaces, and ensure that these procedures are being
followed. Routinemicrobiology tests for air and water contamination should be carried out inall parts of the hospital.
Sterilize and disinfect instruments that enter tissue,or through which blood flows, before and after use. Sterilize devices or
itemsthat touchintact mucus membranes. In all the autoclave cycles, spore strips need to beplaced to check the efficacy of
the machine. Recommended chemicaldisinfectants should be used for the storage of instruments and fumigation of rooms.
All the rooms must have proper ventilation.
3. Managing Body Fluid Spillages
: Urine, Vomit & Faeces : All spillages of body fluids (urine, vomit or faeces) should be dealt with immediately.
Gloves(ideally disposable) should be worn, spillage should bemopped up with absorbent toilet tissue or paper towels: this
should bedisposed of into the waste bin meant for soiled waste. Pour 10 percenthypochlorite solution and leave it for 15
min. Clean the area with a swab. Forspillages outside (e.g. in the playground) sluice the area with water. Do notforget to
wash the gloves and then wash your hands after you have taken thegloves off.

8. 4. Patient Placement
: A separate room is important to preventdirect/indirect contact transmission when the patient is with highlytransmissible
microorganisms, or the patient has poor hygienic habits.
5. Immunization programmes
: Since hospital personnel are at risk of exposure to preventable diseases, maintenance of immunity is an
essential.Optimal use of immunizing agents will not only safeguard the health of personnel but also protect patients from
becoming infected by personnel. Themost efficient use of vaccines withhigh risk groups is to immunize personnelbefore
they enter high-risk situations.
HANDLE MERCURY WITH CARE:
-NEVER TOUCH MERCURY WITH BARE HANDS.-WEAR ALL PROTECTIVE GEARS.-GATHER MERCURY USING STIFF
PAPER AND SUCK IT IN THESYRINGE WITHOUT THE NEEDLE
-POUR CONTENTS OF THE SYRINGE IN A BOTTLE CONTAININGWTR AE-PUT SCOTCH TAPE AROUND THE BOTTLE KEEP THE
SYRINGEFOR FURTHER USE
RADIOACTIVE WASTE
Facilities and procedures described in the rules:
(a) Collection:
It is mandatory to mention the facilities available e.g.polythene lined waste bins for collection of solid wastes, and
corrosionresistant cardboards or delay tanks for collection of liquid wastes.
(b) Transfer:
it is important to state the type of container employed duringtransfer of waste/sourcese.g. cardboards, sturdy polythene
bags, radio-graphy camera
(d) Disposal:
Identify the disposal methods for solid, liquid and gaseouswastes briefly such as for:i). Solids: Burial pits, municipal
dumping site or waste management agencye.g. BRIT etc.ii). Liquids: Sanitary sewerage system, soak-pit, waste
management agencyetc.iii). Gaseous wastes: Incineration facility, fume hood etc.
Safety Clothing
:
A set of safety clothing and equipment for waste handlerswas identified and provided. It included cap, eye protection
goggles, mask,apron, gloves and boots. Disposable caps and masks were used. Gloves andaprons selected were of
nonpermeable material to prevent contact with blood& body fluids. However gloves selected were malleable enough to
permitfinger movement.Handling, segregation, mutilation, disinfection, storage, transportation andfinal disposal are vital
steps for safeand scientific management of biomedial
waste in any establishment. The key to minimisation and effectivemanagement of biomedical waste is segregation
(separation) andidentification of the waste. The most appropriate way of identifying thecategories of biomedical waste is
by sorting the waste into colour codedplastic bags or containers.
C SSU Y. .. AYNOIA
AET D IH LAI S L
NK
. S HP
: T
Strategy:
1. Already existing bins were used.2. Hard plastic bins were purchased instead of cheap alternatives or pedalbins, as the
hospital,going by their experience, wanted to go in for bins which would last longer.3. Initially, changing of bags was done
on a regular basis. In case of infectiousand plastic waste, bags were changed once a day, and for general waste, bagswere
changed twice daily. The cost of this exercise was coming to almost Rs.100 daily. The hospital has now decided to
experiment with plastic reductionin its waste stream. Thus, only the infectious waste bags are replaced daily,the bags
meant for disinfected plastics and general waste are retained till thebag remains intact and clean.4. The plastic bags
purchased by the hospital are cheaper alternatives to theexpensive bags available.5. The hospital purchased extra stock in
addition to its present needs, as donefor other items, to prevent any slack in the system.6. To minimize the use of chemical
disinfectant in the wards, two bins havebeen provided, one for disinfection of plastics and one for disinfected
plastics.After each shift, or when the bin with disinfectant is full, the contents aretransferred to the other bin (min.
residence period of any item in disinfectantis 2hrs)
Strategy adopted:
1. To reduce the load of plastics, the hospital is planning to go in for clothlining. This would cost them 1-2 Rs. / bag.2.
Microbiological studies in the hospital’s laboratory have shown that 10%bleach is effective for two days, thus a new
solution is prepared everyalternate day.
CONCLUSION
Inadequate waste collection, handling and disposal promotesthe spread of infection in hospitals is and can thus
undermine doctors' effortsto heal their patients. Moreover, it can cause infection outside the hospital. Soproper disposal
of hospital waste is in everyone's interest.To achieve this, clear guidelines must be issued; organizational measures
arenecessary; hospital personnel must be trained, convinced of the need forappropriate disposal method and monitored,
waste must be collected indisposable containers at the place where it is generated and transportedwithout being

9. transferred or compacted. Special waste must be burned inincinerators which are technologically up to date.Health
workers shouldn’t have to be afraid that saving another’s life willendanger their own. Nor should communities pay for
better health care withmedical waste they aren’t yet able to manage.Hospital waste management should be with a view to
minimize risk tohealthcare workers, and cause minimum damage to the environment
1.
CONCLUSION
Inadequate waste collection, handling and disposal promotesthe spread of infection in hospitals is and can thus
undermine doctors' effortsto heal their patients. Moreover, it can cause infection outside the hospital. Soproper disposal
of hospital waste is in everyone's interest.To achieve this, clear guidelines must be issued; organizational measures
arenecessary; hospital personnel must be trained, convinced of the need forappropriate disposal method and monitored,
waste must be collected indisposable containers at the place where it is generated and transportedwithout being
transferred or compacted. Special waste must be burned inincinerators which are technologically up to date.Health
workers shouldn’t have to be afraid that saving another’s life willendanger their own. Nor should communities pay for
better health care withmedical waste they aren’t yet able to manage.Hospital waste management should be with a view to
minimize risk tohealthcare workers, and cause minimum damage to the environment
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14. Upload a Document
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