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1
BIO MEDICAL WASTE
MANAGEMENT
Submitted by:-Prajwal M A
2
CONTENTS
• Introduction
• Sources
• Classification
• Categories
• Transportation
• Treatment
• Case study
• Summary
• Reference
INTRODUCTION
• Since beginning, the hospitals are known for the treatment of sick persons but we
are unaware about the adverse effects of the garbage generated by them on human
body and environment.
• Until recently, medical waste management was not generally considered as issue.
• In 1980s and 1990s - HIV and Hepatitis B led to questions about potential risks.
• Thus, hospital waste generation become a prime concern due to its risk factor to
the health of patients, hospital staff and to the general population.
3
What is Bio Medical waste???
Bio medical waste means any waste, which is generated during the diagnosis,
treatment or immunization of human beings or animals or in research activities.
 Biomedical waste (BMW) is generated in hospitals, research institutions, health care
teaching institutes, clinics, laboratories, blood banks and veterinary institutes.
 It has been estimated that up to 85% to 90% of the waste generated is non-
infectious.
 Remaining 10% to 20% of waste is hazardous and infectious.
4
SOURCES OF BIO MEDICAL WASTE
Categorized as Major and Minor sources according to the quantities produced.
5
CLASSIFICATION OF BIOMEDICAL WASTE
 85-90% of the biomedical waste is non- hazardous.
 Remaining 10-15% is hazardous and can be injurious to humans or animals
and to environment.
6
BIO MEDICAL WASTE CATEGORIZATION
Bio medical waste are categorized according to “Bio medical waste management rules
2016” schedule 1.
Waste
category
Waste class and Description Treatment and
Disposal
No 1 Human Anatomical Wastes.
(Human tissues, organs, waste body parts) Incineration / Deep burial.
No 2 Animal Wastes
( animal tissue, organs, body, animals used in research, waste generated by
veterinary hospitals)
Incineration / Deep burial.
No 3 Microbiology & Biotechnology Waste
(Wastes from laboratory, cultures or specimens of micro-organisms, human
and animal cell culture used in research).
Local Autoclaving /
microwaving/incineration.
No 4
Waste Sharps
(Needles, syringes, scalpels, blades, glass, etc that are capable of causing
puncture and cuts.).
Autoclaving /
microwaving/incineration.
7
No 5
Discarded Medicines
(Wastes comprising contaminated and discarded medicines). Incineration or destruction and
disposal in landfills.
No 6
Soiled Wastes
( soiled cotton, dressings, plaster casts, beddings, material
contaminated with blood).
Incineration or
autoclaving/microwaving.
No 7
Solid Waste
(Wastes generated from disposable items such as tubeings, catheters,
intravenous sets etc.)
Autoclaving/microwaving.
No 8
Liquid Waste
(from laboratory and washing, cleaning,
house-keeping and disinfecting activities)
Disinfection by chemical
treatment and discharge into
drains.
No 9
Incineration Ash
(ash from incineration of any bio-medical waste) Disposal in municipal landfill.
No 10
Chemical Waste
(Chemicals used in production of biologicals, chemicals
used in disinfection, as insecticides, etc.)
Disinfection by chemical
Treatment.
8
Segregation and Colour coding for Bio medical waste
Bio medical wastes are colourized as:
 BLACK (non- infected waste).
 YELLOW (anatomical waste).
 RED (Solid infected waste).
 BLUE (Infected plastics).
 WHITE (Sharps).
9
TRANSPORTATION AND STORAGE
Temporarily stored at the central storage area of the hospital and from there sent to the site of final
disposal once or twice a day depending upon the quantity of waste .
During transportation following points should be taken care:
• Check that waste bags/containers are properly sealed and labeled.
• Bags should not be filled completely, so that bags can be picked up by the neck for handling.
• At a time only one bag should be lifted.
• Manual handling should be minimized to reduce the risk of needle prick injury and infection.
• BMW should be kept only in a specified storage area.
• After removal of the bag, clean the container including the lid with an appropriate disinfectant.
• Waste bags should be transported in a covered wheeled containers or large bins. No untreated
bio‐medical waste shall stored beyond 48 hours.
10
Fig. Covered wheeled containers
• Waste is transported to the site of final disposal in a closed motor vehicle (truck,
tractor‐trolley etc.). It prevents spillage of waste on the way.
• Vehicles used for transport of BMW must have the “Bio Hazard symbol” and
these vehicles should not be used for any other purpose.
11
Fig. Bio hazard symbol on vehicles.
Treatment And Disposal Techniques For Bio Medical Waste
The methods are:
 Autoclaving.
 Incineration.
 Gas/Vapor Sterilization.
 Chemical Disinfection.
 Deep Burial.
12
Autoclave
• Closed chambers that apply both heat and pressure, and sometimes steam to
sterilize medical equipment.
• Used to destroy microorganisms that may be present in medical waste before
disposal into landfill.
• Small autoclaves are used for sterilizing reusable medical instruments while large
autoclaves used to treat large quantity medical waste.
• It is most effective with material such as plastics, metal pans, bottles, and flasks.
• High-density polyethylene and polypropylene plastic should not be used.
13
Fig. Autoclaves
14
Incineration
• Incineration is a waste treatment process which convert Bio medical waste into ash by
employing combustion process under controlled condition.
• The main purpose is to reduce the waste volume and destruction of dangerous substances.
• It has strong benefits for the treatment of certain waste such as clinical wastes and
certain hazardous wastes where pathogens and toxins can be destroyed by high temperatures.
• Incinerators can be oil fired or electrically powered.
• Waste should be less moisture as less than 30%.
Advantage of Incineration:
• No Pre treatment is required.
• Suitable for low heating volume.
Disadvantages of Incineration:
• Large capital and operating cost.
15
Fig. Incinerator
16
Gas/vapor sterilization
• It is the process of destroying all microorganisms and pathogenic products using gaseous or vapour
chemicals.
• Ethylene oxide is the gas most often used.
• It is highly explosive and flammable in the presence of air, but these hazards are reduced by
diluting with CO2.
• It is usually heated to a temperature of 54°C.
Chemical disinfection
• It is the preferred treatment for liquid infectious wastes.
• It involves the use of chemical agents such as chlorine.
• There are a number of factors that should be considered regarding the usage, including:
The type of wastes, degree of contamination, type of disinfectant used , its concentration, quantity,
contact time.
Advantage:
• Best for liquid waste.
• Useful for pharmaceutical , chemical and other infectious waste.
Disadvantages:
• Disinfectants may themselves be hazardous to operators.
• Needs trained operators.
17
Deep Burial
• Decomposing human and animal anatomical waste.
• To avoid recycling of sharps, their burial in safe pit is an effective and economical disposal method.
Deep burial should have the following specifications:
• A Pit should be dug about 2 meter deep.
• It is half filled with waste, then covered with lime ,before filling the pit with soil.
• Covers of wire meshes may be used to avoid animal entry.
• On each occasion, when wastes are added to the pit, a layer of 10 cm of soil shall be added to over the
wastes.
Fig. Deep burial
18
HEALTH HAZARD FROM BIO MEDICAL WASTE
• The improper management of bio-medical waste causes serious environmental problems in
terms of air, water and land pollution.
• Air Pollution can be caused in both indoors and outdoors.
• Indoor air pollutants like pathogens present in the waste cause pollution.
• Outdoor air pollution have two major sources- open burning and incinerators.
• Waste which is dumped into lakes and water bodies, can cause severe water pollution.
• Harmful chemicals present in bio-medical waste such as heavy metals can also cause water
pollution.
• Land Pollution is caused by the final disposal of all bio-medical waste.
• Open dumping of bio-medical waste is the greatest cause for land pollution.
LEGISLATIVE ASPECT IN RELATION TO BIO MEDICAL
WASTE
Various central legislation related to biomedical waste management in India are as follows:
• The Biomedical waste(management and handling) rules,1998.
 The water (prevention and control of pollution) Act, 1974.
 The Air (prevention and control of pollution) Act, 1981.
 The hazardous waste(management and handling) rules,1998.
 Municipal Solid waste (management and handling) rules, 2000.
 The Biomedical waste(management and handling) rules Amendment ,2000 and 2003.
 The Bio-medical Waste (Management and Handling) Rules, 2011.
19
20
CASE STUDY
Anu, S., Ranjitha , A,B., Yaseen , M.,(2016), carried out a research study on “Hospital waste generation
and management – a case study for major hospitals of Davanagere”., volume: 03 issue: 06.
Study area
Two major hospitals of Davanagere city. They are:
• S . S. Institute of medical science and research centre(Private hospital)- Estd. 2004
• Chigateri district hospital(Govt. hospital)- Estd.1961
Methodology
• Hospital wise waste collection data is obtained from the District Administration.
• Data collection is made by visiting personally to major hospitals in the city.
• An attempt is made to suggest the best management practice which can adopted in hospitals as
well as by a district administration.
Results and Discussions
• The hospitals has separate waste Management staff.
• They follow the guidelines of central pollution control board for handling Hospital waste according
to BM waste Handling rules 1998 using different color coding bins for segregation.
21
Detailed Description of S.S Hospital and Chigateri dist. hospital
Type of Hospital General and super specialty
Total number of bed 750
Patient usage 315
Total quantity of waste generated
per day
500-600 kg/day
Infectious waste per day 200-250 kg/day
General waste per day 300-350 kg/day
Water supply per capita demand
( no. of beds exceeding 100)
450 ltrs/bed/day
Total quantity of liquid waste
generated
450*750*85*1.3/100 = 372937.5
ltrs/day
Segregation at source Yes
Type of collection Regular ( within 48 hrs)
Time of collection 8 to 12 am
General(Govt. hospital)
950
450 - 515
550- 700kg/day
200 – 350kg/day
300 – 450 kg/day
450 lts/bed/day
450*950*85*1.3/100=472387.5ltrs/day
Yes
Regular (within 48 hrs)
8 – 12am
22
Proposed Common hospital waste incinerator
Conclusion
• The total quantity of waste generated from S.S. Hospital is 500 - 600 kg/day. and C.G Hospital is 550 -
700 kg/day .
• From S.S. Hospital about 200 - 250 kg/day of waste is incinerable. From C.G Hospital about 200 - 350
kg/day of waste is incinerable.
• To treat the above waste generated a common biomedical waste incinerator of 200 kg/ hr is proposed to
treat the incinerable waste effectively from both the major hospitals. Best management practices are
suggested for effective hospital waste management.
23
SUMMARY
• Hospital Management must understand the gravity of the issue and they must be able to differentiate
between hospital waste and general waste.
• They must ensure proper identification, segregation at the source of generation, collection in prescribed
coloured containers, safe transportation, appropriate treatment and safe disposal of Bio-Medical Waste.
• They should provide health education and training to handle the Bio-Medical Waste.
• Safe and effective management of biomedical waste is not only a legal necessity but also a social
responsibility.
• Effective implementation of rules by surprise visits and inspection by authorities must be carried out.
• Legislative aspect in relation to bio medical waste must be followed.
• BMW Management Board must be established in each district.
24
THANK YOU

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Biomedical waste managment

  • 2. 2 CONTENTS • Introduction • Sources • Classification • Categories • Transportation • Treatment • Case study • Summary • Reference
  • 3. INTRODUCTION • Since beginning, the hospitals are known for the treatment of sick persons but we are unaware about the adverse effects of the garbage generated by them on human body and environment. • Until recently, medical waste management was not generally considered as issue. • In 1980s and 1990s - HIV and Hepatitis B led to questions about potential risks. • Thus, hospital waste generation become a prime concern due to its risk factor to the health of patients, hospital staff and to the general population. 3
  • 4. What is Bio Medical waste??? Bio medical waste means any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities.  Biomedical waste (BMW) is generated in hospitals, research institutions, health care teaching institutes, clinics, laboratories, blood banks and veterinary institutes.  It has been estimated that up to 85% to 90% of the waste generated is non- infectious.  Remaining 10% to 20% of waste is hazardous and infectious. 4
  • 5. SOURCES OF BIO MEDICAL WASTE Categorized as Major and Minor sources according to the quantities produced. 5
  • 6. CLASSIFICATION OF BIOMEDICAL WASTE  85-90% of the biomedical waste is non- hazardous.  Remaining 10-15% is hazardous and can be injurious to humans or animals and to environment. 6
  • 7. BIO MEDICAL WASTE CATEGORIZATION Bio medical waste are categorized according to “Bio medical waste management rules 2016” schedule 1. Waste category Waste class and Description Treatment and Disposal No 1 Human Anatomical Wastes. (Human tissues, organs, waste body parts) Incineration / Deep burial. No 2 Animal Wastes ( animal tissue, organs, body, animals used in research, waste generated by veterinary hospitals) Incineration / Deep burial. No 3 Microbiology & Biotechnology Waste (Wastes from laboratory, cultures or specimens of micro-organisms, human and animal cell culture used in research). Local Autoclaving / microwaving/incineration. No 4 Waste Sharps (Needles, syringes, scalpels, blades, glass, etc that are capable of causing puncture and cuts.). Autoclaving / microwaving/incineration. 7
  • 8. No 5 Discarded Medicines (Wastes comprising contaminated and discarded medicines). Incineration or destruction and disposal in landfills. No 6 Soiled Wastes ( soiled cotton, dressings, plaster casts, beddings, material contaminated with blood). Incineration or autoclaving/microwaving. No 7 Solid Waste (Wastes generated from disposable items such as tubeings, catheters, intravenous sets etc.) Autoclaving/microwaving. No 8 Liquid Waste (from laboratory and washing, cleaning, house-keeping and disinfecting activities) Disinfection by chemical treatment and discharge into drains. No 9 Incineration Ash (ash from incineration of any bio-medical waste) Disposal in municipal landfill. No 10 Chemical Waste (Chemicals used in production of biologicals, chemicals used in disinfection, as insecticides, etc.) Disinfection by chemical Treatment. 8
  • 9. Segregation and Colour coding for Bio medical waste Bio medical wastes are colourized as:  BLACK (non- infected waste).  YELLOW (anatomical waste).  RED (Solid infected waste).  BLUE (Infected plastics).  WHITE (Sharps). 9
  • 10. TRANSPORTATION AND STORAGE Temporarily stored at the central storage area of the hospital and from there sent to the site of final disposal once or twice a day depending upon the quantity of waste . During transportation following points should be taken care: • Check that waste bags/containers are properly sealed and labeled. • Bags should not be filled completely, so that bags can be picked up by the neck for handling. • At a time only one bag should be lifted. • Manual handling should be minimized to reduce the risk of needle prick injury and infection. • BMW should be kept only in a specified storage area. • After removal of the bag, clean the container including the lid with an appropriate disinfectant. • Waste bags should be transported in a covered wheeled containers or large bins. No untreated bio‐medical waste shall stored beyond 48 hours. 10
  • 11. Fig. Covered wheeled containers • Waste is transported to the site of final disposal in a closed motor vehicle (truck, tractor‐trolley etc.). It prevents spillage of waste on the way. • Vehicles used for transport of BMW must have the “Bio Hazard symbol” and these vehicles should not be used for any other purpose. 11
  • 12. Fig. Bio hazard symbol on vehicles. Treatment And Disposal Techniques For Bio Medical Waste The methods are:  Autoclaving.  Incineration.  Gas/Vapor Sterilization.  Chemical Disinfection.  Deep Burial. 12
  • 13. Autoclave • Closed chambers that apply both heat and pressure, and sometimes steam to sterilize medical equipment. • Used to destroy microorganisms that may be present in medical waste before disposal into landfill. • Small autoclaves are used for sterilizing reusable medical instruments while large autoclaves used to treat large quantity medical waste. • It is most effective with material such as plastics, metal pans, bottles, and flasks. • High-density polyethylene and polypropylene plastic should not be used. 13
  • 15. Incineration • Incineration is a waste treatment process which convert Bio medical waste into ash by employing combustion process under controlled condition. • The main purpose is to reduce the waste volume and destruction of dangerous substances. • It has strong benefits for the treatment of certain waste such as clinical wastes and certain hazardous wastes where pathogens and toxins can be destroyed by high temperatures. • Incinerators can be oil fired or electrically powered. • Waste should be less moisture as less than 30%. Advantage of Incineration: • No Pre treatment is required. • Suitable for low heating volume. Disadvantages of Incineration: • Large capital and operating cost. 15 Fig. Incinerator
  • 16. 16 Gas/vapor sterilization • It is the process of destroying all microorganisms and pathogenic products using gaseous or vapour chemicals. • Ethylene oxide is the gas most often used. • It is highly explosive and flammable in the presence of air, but these hazards are reduced by diluting with CO2. • It is usually heated to a temperature of 54°C. Chemical disinfection • It is the preferred treatment for liquid infectious wastes. • It involves the use of chemical agents such as chlorine. • There are a number of factors that should be considered regarding the usage, including: The type of wastes, degree of contamination, type of disinfectant used , its concentration, quantity, contact time. Advantage: • Best for liquid waste. • Useful for pharmaceutical , chemical and other infectious waste. Disadvantages: • Disinfectants may themselves be hazardous to operators. • Needs trained operators.
  • 17. 17 Deep Burial • Decomposing human and animal anatomical waste. • To avoid recycling of sharps, their burial in safe pit is an effective and economical disposal method. Deep burial should have the following specifications: • A Pit should be dug about 2 meter deep. • It is half filled with waste, then covered with lime ,before filling the pit with soil. • Covers of wire meshes may be used to avoid animal entry. • On each occasion, when wastes are added to the pit, a layer of 10 cm of soil shall be added to over the wastes. Fig. Deep burial
  • 18. 18 HEALTH HAZARD FROM BIO MEDICAL WASTE • The improper management of bio-medical waste causes serious environmental problems in terms of air, water and land pollution. • Air Pollution can be caused in both indoors and outdoors. • Indoor air pollutants like pathogens present in the waste cause pollution. • Outdoor air pollution have two major sources- open burning and incinerators. • Waste which is dumped into lakes and water bodies, can cause severe water pollution. • Harmful chemicals present in bio-medical waste such as heavy metals can also cause water pollution. • Land Pollution is caused by the final disposal of all bio-medical waste. • Open dumping of bio-medical waste is the greatest cause for land pollution.
  • 19. LEGISLATIVE ASPECT IN RELATION TO BIO MEDICAL WASTE Various central legislation related to biomedical waste management in India are as follows: • The Biomedical waste(management and handling) rules,1998.  The water (prevention and control of pollution) Act, 1974.  The Air (prevention and control of pollution) Act, 1981.  The hazardous waste(management and handling) rules,1998.  Municipal Solid waste (management and handling) rules, 2000.  The Biomedical waste(management and handling) rules Amendment ,2000 and 2003.  The Bio-medical Waste (Management and Handling) Rules, 2011. 19
  • 20. 20 CASE STUDY Anu, S., Ranjitha , A,B., Yaseen , M.,(2016), carried out a research study on “Hospital waste generation and management – a case study for major hospitals of Davanagere”., volume: 03 issue: 06. Study area Two major hospitals of Davanagere city. They are: • S . S. Institute of medical science and research centre(Private hospital)- Estd. 2004 • Chigateri district hospital(Govt. hospital)- Estd.1961 Methodology • Hospital wise waste collection data is obtained from the District Administration. • Data collection is made by visiting personally to major hospitals in the city. • An attempt is made to suggest the best management practice which can adopted in hospitals as well as by a district administration. Results and Discussions • The hospitals has separate waste Management staff. • They follow the guidelines of central pollution control board for handling Hospital waste according to BM waste Handling rules 1998 using different color coding bins for segregation.
  • 21. 21 Detailed Description of S.S Hospital and Chigateri dist. hospital Type of Hospital General and super specialty Total number of bed 750 Patient usage 315 Total quantity of waste generated per day 500-600 kg/day Infectious waste per day 200-250 kg/day General waste per day 300-350 kg/day Water supply per capita demand ( no. of beds exceeding 100) 450 ltrs/bed/day Total quantity of liquid waste generated 450*750*85*1.3/100 = 372937.5 ltrs/day Segregation at source Yes Type of collection Regular ( within 48 hrs) Time of collection 8 to 12 am General(Govt. hospital) 950 450 - 515 550- 700kg/day 200 – 350kg/day 300 – 450 kg/day 450 lts/bed/day 450*950*85*1.3/100=472387.5ltrs/day Yes Regular (within 48 hrs) 8 – 12am
  • 22. 22 Proposed Common hospital waste incinerator Conclusion • The total quantity of waste generated from S.S. Hospital is 500 - 600 kg/day. and C.G Hospital is 550 - 700 kg/day . • From S.S. Hospital about 200 - 250 kg/day of waste is incinerable. From C.G Hospital about 200 - 350 kg/day of waste is incinerable. • To treat the above waste generated a common biomedical waste incinerator of 200 kg/ hr is proposed to treat the incinerable waste effectively from both the major hospitals. Best management practices are suggested for effective hospital waste management.
  • 23. 23 SUMMARY • Hospital Management must understand the gravity of the issue and they must be able to differentiate between hospital waste and general waste. • They must ensure proper identification, segregation at the source of generation, collection in prescribed coloured containers, safe transportation, appropriate treatment and safe disposal of Bio-Medical Waste. • They should provide health education and training to handle the Bio-Medical Waste. • Safe and effective management of biomedical waste is not only a legal necessity but also a social responsibility. • Effective implementation of rules by surprise visits and inspection by authorities must be carried out. • Legislative aspect in relation to bio medical waste must be followed. • BMW Management Board must be established in each district.