India is likely to generate about 775.5 tons of medical wast per day by 2020, from the current level of 550.9 tons per day growing at CAGR about 7%. Safe and effective management of waste is not only a legal necessity but also a social responsibility.

1. BIO-MEDICAL
WASTE
MANAGEMENT
PRESENTED BY: J.G
SAMBAD
IKDRC COLLEGE OF NURSING

2. INTRODUCTION
BIO-MEDICAL WASTEBIO-MEDICAL WASTE
Waste generated in The diagnosis,
treatment or immunization of human
beings or animals, in research or in the
production or testing of biological
products.
It also includes waste coming out of
medical treatment given at home.
HAZARDOUS WASTEHAZARDOUS WASTE
Any waste with a potential to pose a threat
to human health & life

3. CLASSIFICATION OF BMW
NON-HAZARDOUS HAZARDOUS
( 80% ) ( 20% )
 INFECTIOUS OTHER HAZARDOUS
 ( 15% ) ( 5% ) (injurious)
Non sharp - Radioactive
Sharp - Broken Glasswares
Plastic Dispos - Press Containers
Liquid - Chemical, cytotoxic
- Incineration ash

4. MIXED HOSPITAL WASTE BEFORE
PROJECT

5. PERSONS AT RISK

6. Government of India, first enacted an
environment (Protection) act in 1986
notified the rules for the management
& handling of bio-medical waste in July,
1998
As per these rules it is duty of occupier of….
hospital, Nursing home, clinic, dispensary,
Veterinary institute, animal house, blood
bank & pathological laboratory to take all
steps to ensure that BMW is handled without
adverse effect to human health &
environment
RULES FOR
BMW

7. AS PER NOTIFIED RULES………
 BMW is not to be mixed with other
wastes
 BMW should be segregated in specified
Container / bag at the site of generation
 Each container has to be specifically
labeled
 Transportation of such waste has to be
done in specified vehicle only
 Untreated BMW is not to be stored
beyond a period of 48 hours

8. OBJECTIVES OF HWM
Keeping the waste secured &
preventing the access to
unauthorized persons
Initiate awareness campaigns about
the potential hazard of medical waste
within the health care setup &
community
Decontaminate / disinfect the
infectious component of the waste at
the site of

9. SCHEDULES
I. Categories of BMW
II.Color coding and type of container for
disposal of BMW
III.Labels for BMW containers / bags
IV.Labels for transport of BMW bags
V. Standards for treatment and disposal of
BMW
VI.Schedule for waste treatment facilities
like incinerator / autoclave / microwave
systems.

16. Discarded
Medicines

26. TREATMENT OF HOSPITAL
WASTE
General waste
The 85% of the waste generated in the hospital
belongs to this category. The, safe disposal of
this waste is the responsibility of the local
authority.
Bio –hazardous waste: 15% of hospital waste
 Deep burial: The waste under category 1
and 2 only can be accorded deep burial and
only in cities having less than 5 lakh
populations.

27. Autoclave and microwave treatment :
Standards for the autoclaving and microwaving are
also mentioned in the Biomedical waste
(Management and Handling) Rules 1998. All
equipment installed/shared should meet these
specifications. The waste under category 3,4,6,7
can be treated by these techniques. Standards for
the autoclaving are also laid down.
 Shredding: The plastic (IV bottles, IV sets,
syringes, catheters etc.), sharps (needles, blades,
glass etc) should be shredded but only after
chemical treatment/microwaving/autoclaving.
Needle destroyers can be used for disposal of
needles directly without chemical treatment.

28. Secured landfill: The incinerator ash, discarded
medicines, cytotoxic substances and solid chemical
waste should be treated by this option.
Incineration: The incinerator should be installed
and made operational as per specification under the
BMW rules 1998 and a certificate may be taken from
CPCB/State Pollution Control Board and emission
levels etc should be defined. In case of small
hospitals, facilities can be shared. The waste under
category 1,2,3,5,6 can be incinerated depending
upon the local policies of the hospital and feasibility.
The polythene bags made of chlorinated plastics
should not be incinerated.
I

35. RATIONALE OF HOSPITAL WASTE
MANAGEMENT
Injuries from sharps leading to infection to all categories
of hospital personnel and waste handler.
Nosocomial infections in patients from poor infection
control practices and poor waste management.
Risk of infection outside hospital for waste handlers and
scavengers and at time general public living in the
vicinity of hospitals.
Risk associated with hazardous chemicals, drugs to
persons handling wastes at all levels.
"Disposable" being repacked and sold by unscrupulous
elements without even being washed.
Drugs which have been disposed of, being repacked and
sold off to unsuspecting buyers.
Risk of air, water and soil pollution directly due to waste,
or due to defective incineration emissions and ash

40. MANAGEMENT AND
ADMINISTRATION
Heads of each hospital will have to take authorization
for generation of waste from appropriate authorities as
notified by the concerned State/U.T. Government, well in
time and to get it renewed as per time schedule laid down
in the rules.
 Each hospital should constitute a hospital waste
management committee, chaired by the head of the
Institute and having wide representation from all major
departments. This committee should be responsible for
making Hospital specific action plan for hospital waste
management and its supervision, monitoring and
implementation. The annual reports, accident reports, as
required under BMW rules should be submitted to the
concerned authorities as per BMW rules format.

41. COORDINATION BETWEEN,
HOSPITAL AND OUTSIDE
AGENCIES
Municipal authority :
Co-ordination with Pollution Control Boards:
To search for cost effective and environmental
friendly technology for treatment of bio-medical
and hazardous waste
Development of non-PVC plastics as a
substitute for plastic which is used in the
manufacture of disposable items.

42. HOW TO MINIMIZE HOSPITAL WASTE?
As far as possible purchase reusable
Items made of glass and metal
 Select non-PVC plastics
 Strengthen sterilization procedures
 Adopt procedures & policy for
BMW segregation
 Establish effective & sound recycling
policy (authorized manufacturer)
 Special effort to recycle chemical waste
Be good as gold--buy green

43. NURSE’S ROLE AND
RESPONCIBILITY IN BMW
MANAGEMENT
Nurses are responsible and accountable for
professional behaviour. This involves the application
of the nursing process and cooperation with other
concerned authorities within the legislation
affecting the practice of nursing.
The accountability of nurse should be in accordance
with the profession’s code of ethics and practice
and within the context of the policies of the
employing agency. It should also comply with the
customs and values of the society in which the
nursing care rendered. The following guidelines
should be followed for effective BMW management.

44. Continue…….
Disinfectant the waste so that it is no longer
a source of pathogenic organisms.
Reduce the bulk in order to reduce
requirement for storage and transportation.
Make the waste unrecognisable for aesthetic
reasons
Make recyclable items unusable, for
example, cutting up syringes and damage
the needles.
Recycling infectious plastic waste can be
considered only after adequate
disinfection/sterilization.
Disposal items, such as gloves, syringes,
and the like, should be mutilated after use to
prevent illegal packing and reuse.

45. Continue……
Code coding of bags should be done as per
regulation.
Needles, syringes and other sharp
instruments and objects should be placed in
a puncture–resistant plastic/ metal
container at the workstation.
Alternatively, sharp waste may be
transported to a central site for treatment
and container may be reused, but after
cleaning and disinfecting.
 50% of needle stick injuries are as a result
of reheating. Therefore, do not recap the
waste.
Chemical disinfectant prior to disposal is
required for sharp, disposal infectious
plastic/rubber, and infectious glassware and
blood fluids by 1% hypochlorite or
equivalent disinfectant. Always ensure that
the right concentration of the disinfectant is
used.

46. Continue…….
Ensure that all surfaces come in contact
with the chemical. Contact time should
be at least 30 minutes
Change the chemical solution frequently,
or at least once a day.
Always handle the waste with gloves and
masks, apron and boots must be used if
splashing is expected.
Use sharp decontaminating units made
up of solid plastic puncture-proof
material on the outside and inner
perforated container with handles filled
with one third hypochlorite solution.

47. KEY MESSAGES
1. Adhere strictly to Bio-Medical Waste
(BMW) Management guidelines
2. Always use protective gears
3. Immunize yourself (HBV and TT)
4. Never take short cuts in segregation,
collection, transportation or disposal of
waste

48. Thank you.
Discard waste safely
to save your
environment