1. BIOMEDICAL WASTE MANAGEMENT IN
VIROLOGY
MODERATOR
DR. MINI P. SINGH
SPEAKER
MANMOHAN MISHRA
Msc. Virology
08-01-2014

2. Biomedical Waste Management in
news

3. Definition
"Health care waste" – The waste generated
as a result of
• Diagnosis, treatment, or immunization of human
beings or animals
• Research pertaining to the above activities
• Production or testing of biologicals & categories

4. Areas where wastes generated in our
department

Tissue culture lab


Routine diagnostic lab
Genomics lab
Hepatitis lab

Influenza lab


5. Laboratory Waste material
Syringe, needles, blood, serum,
Tips, Elisa plate, Reagents,
Lancets, slides, gauze pieces,
Plastic tubes, plastic bottles,
Test tubes, glass bottles,
Iimmersion oil, stains, saline bottles,
cell medium, culture vial bottle flask,
PPE, mask, MCT, Kit boxes, storage vials, urine, VTM containing
nasopharyngeal swab, CSF samples, membrane filters, antibiotics,
genomics reagent, wooden stick , papers, gloves, egg inoculation waste
Viral load tray

6. HAZARDS
•
Laboratory Staff

8. HAZARD FROM SHARPS
WHO in 2000
Injections with contaminated syringes caused
• 21 million HBV- 32% of all new infections
• 2 million HCV- 40% of all new infections
• 260 000 HIV - 5% of all new infections
One needle-stick injury from a needle used on an infected patient
30%HBV
1.8%HCV (recently updated 3%)
0.3%HIV

9. Quantity of waste generated in PGIMER Chandigarh
Total waste – 804.25 Kg/day
Type of waste
Kg/day
Human Anatomical Waste
5.5
Animal Waste
1.33
Microbiology & Biotechnology
waste
13.5
Waste Sharps
104.9
Soiled Waste
(cotton, dressings, soiled plaster
casts, beddings)
533.65
Solid Waste
(tubing, catheters, intravenous
sets )
135.87

10. Classification of BMW
BMW
Potential toxic waste:
A) Radioactive: solid,
A)Dressings &infectious
D) contaminateSwabs
Potentially with blood, liquid, gases used for
Non- hazardous or
materials: Tissues for
body organ imaging,
Hazardous (10-25%)
A) Biodegradable: virologicalfluids.
general waste (75-90%) pus, body processing,
tumor localisation &
Peels of fruits &B) placenta, tumors, organs treatment
Laboratory wastes
vegetable skin, or limbs i.e removed
including samples,
during surgeryof
B) Chemical: Toxic,
culture stocks
Infectious ( 15-18%)
corrosive, inflammable,
infectious infected
B) Non
E) Potentiallyviruses, lab
glassware & in diagnostic reactive
Biodegradable: animals usedplasticware
Wrapping foils, or research studies
C) Pharmaceutical: (5-7%)
C) Instruments used in
Other hazardous
patient care
plastic bags, F) Pathological : endoscopes, Surplus stock, spillage
or contamination is
ultrasound probes,
papers
waste:Autopsy & Biopsy
syringes, needles,sharps detected or expiry date
is over


11. Biomedical waste management rule, 1998
Schedule I
Categories of biomedical waste:
a. No chemical pretreatment before incineration
Chlorinated plastics shall not be incinerated
The physico-chemical
b. Deep burial – towns, rural areas
biological nature
c. Chemicaltoxicity potential hazard are solution
treatment - 1% hypochlorite different
categorised into 10 different categories
d.Multilation / shredding must be such that it prevents unauthorized
reuse

12. Categories of BMW
CATEGORY
TYPE OF WASTE
TREATMENT &
DISPOSAL
Category 1
Human anatomical wastes
Incineration/ deep
burial
Category 2
Animal wastes
Incineration/ deep
burial
Category 3
Microbiology & biotechnology
waste
Local autoclaving/
microwaving/incineratio
n
Category 4
Waste sharps like needles,
syringes, scalpels, blades, glass
etc
Disinfection
(Chemical/autoclaving/
micro waving &
mutilation/shredding)
Category 5
Discarded Medicines & cytotoxic
drugs
Incineration/destruction
& disposal in land fills

13. CATEGORY
TYPE OF WASTE
TREATMENT &
DISPOSAL
Category 6
Soiled wastes
Items contaminated with blood,
body fluids including cotton,
dressings etc
Incineration,
autoclaving,microwaving
Category 7
Solid wastes like catheters, IV sets
etc.
Disinfection by chemical
treatment/autoclaving/mi
cro waving and
mutilation & shredding
Category 8
Liquid wastes
Laboratory, blood banks, hospitals,
house etc.
Disinfection by chemicals
and discharge into drains
Category 9
Incineration ash
Disposal in municipal
land fills
Category 10
Chemical wastes
Chemical treatment &
discharge into drains for
liquid and secured land
fills for solids.

14. Segregation
•Basic separation of different categories of waste generated at
source and thereby reducing the risks as well as cost of handling
and disposal.
•The most crucial step in BMW mgmt.
•Effective segregation alone can ensure effective bio-medical
waste management.
• The BMWs must be segregated in accordance to guidelines
schedule 1 of BMW Rules, 1998

15. Plastic bag
Non chlorinated
“For incineration
only”

16. Plastic bag
“For autoclaving
only”
Puncture proof
“For sharps only”

19. Schedule II
Color coding & type of container for disposal of biomedical waste

20. Color coding shall be selected depending on treatment option
chosen, as in Schedule 1
Waste collection bags for incineration shall not be made of
chlorinated plastics
Category 8 do not require containers/bags
Category 3 if disinfected locally need not be put in
Containers/bags

21. Schedule III
Different labels for bio-medical waste containers
and bags shall be required for identification and safe handling
Waste
Label should be non-washable & prominently visible

22. Schedule IV
Label for transport of bio-medical
waste containers /bags

23. Schedule V
Standards for treatment and disposal of
Bio-medical wastes

24. Schedule VI
Schedule for waste treatment facilities like incinerator/
autoclave / microwave system

25. BIOMEDICAL WASTE HANDLING
•Segregation
•Collection
•Storage
•Transportation

26. Collection
•Sanitation staff to collect waste during morning and
afternoon (at least daily)
•Supervision by staff nurse & sanitation supervisor
•Weighed & documented in register
•Replaced immediately with new bags of same type &
garbage bin cleaned with disinfectant regularly

27. Collectors must wear
protective materials
Content of container
should not exceed three
quarter of its capacity
Tie neck tightly
Hold bag from neck

28. •Collection of sharp medical waste under maximum
precaution
•If there is spillage of waste from container
(Accidental/Damage of bin)
gently collect waste into a bin
soak area with 2% Lysol solution for 30 minutes
wash and wipe
•Radioactive waste collected when activity decays to a
safe level

29. Storage

Holding of biomedical waste for a certain period of
time, then sent for treatment & disposal

30. Stored in areas of generation for a
period varying from 2 to 12 hrs
Central storage located within
establishment
Area marked with “CAUTION :
BIOHAZARDOUS WASTE STORAGE
AREA – UNAUTHORIZED PERSONS
KEEP OUT”
Away from patient rooms, operation
theatres, laboratories or any public
access areas

31. On site transport (intramural/internal)
Transport within establishment
Wheeled trolleys, containers or carts
300-500 litres capacity
120-200 litres capacity

32. Radio Frequency Identification
(RFID) tags for monitoring trolley
movement
Easy to load & unload
No sharp edges (prevents damage
to waste bags)
Easy to clean (disinfected daily)
Workers immunized & have
personal protective equipment
Heavy duty gloves
Coveralls
Thick soled boots
Leg protectors

33. Routing
Quickest or shortest possible route
Route laid out from farthest point of transfer station & as
collection progresses towards collection storage area
After departure further handling discouraged

34. Off site transport(extramural/ external)
Closed motor vehicle (truck,
tractor-trolley)
Vehicle used only for transport of
waste
Bio-Hazard symbol
Leak proof body & capable of
locking
Separate cabins for driver/staff &
biomedical waste containers

35. STANDARDS FOR TREATMENT & DISPOSAL OF BIO-MEDICAL
WASTES
Incinerator
Autoclave
Liquid waste
Microwaving
Deep Burial

36. All incinerators shall meet the following operating and
emission standards
•Operating Standards
•Combustion efficiency (CE) shall be at least 99.00%
•The Combustion efficiency is computed as follows:
•The temperature of the primary chamber shall be 800±50 ºc
•The secondary chamber gas residence time shall be at least
(one) second at 1050±50 ºC ,with minimum 3% Oxygen in the
stack gas.

37. •Emission Standards
S.
Parameters
No.
Concentration
mg/Nm3 at
(12% CO2
correction)
1.
Particulate matter
150
2.
Nitrogen Oxides
450
3.
HCl
50
4.
Minimum stack height shall
be 30 meters above ground
5.
Volatile organic compounds in
ash not be more than 0.01%

38. •Suitably designed pollution control devices
•Wastes to be incinerated – NO chlorinated disinfectants
•Chlorinated plastics shall not be incinerated
•Toxic metals in inceration ash
•Only low sulphur fuel like Diesel shall be used as fuel in the
incinerator.

39. STANDARDS FOR WASTE AUTOCLAVING
The autoclave: dedicated for the purposes of Disinfecting and
treating bio-medical waste
1)When operating a gravity flow autoclave
Temperature
(˚ c)
Pressure
(psi)
residence time
(min)
121
15
60
135
31
45
149
52
30

40. 2) When operating a vacuum autoclave:
- minimum of Validation test
one pre-vacuum pulse to purge
the Autoclave have:
Each autoclave shallof all air
Spore testing:
- The waste shall be subjected to the following :
Graphic or computer recording devices automatically and
Biological indicator
Temperature
Pressure
residence
continuously monitor
(˚ c) stearothermophilus spores
(psi)
Bacillus
record dates, time of day
1x10 4 spores/ml
load identification number
(min)
121
45
Routine Test 15
operating parameters
A chemical indicator strip/tape
135
31
31
time

41. STANDARDS FOR LIQUID WASTE
Bio-assay test 90% survival of fish after 96 hours in 100%
effluent
hospitals connected with sewers without terminal sewage
treatment plant
not connected to public sewers
For discharge into public sewers with terminal facilities, the
general standards as notified under the Environment Protection Act,
1986

42. STANDARDS OF MICRO WAVING
Microwave treatment shall not be used for:
cytotoxic, hazardous or radioactive wastes
contaminated animal carcasses, body parts
large metal items
Bacillus subtilis spores strips with at least 1 x 104 spores/ml
The microwave should completely and consistently kill the
bacteria and other pathogenic organisms
ensured by approved biological indicator at the maximum
design capacity of each microwave unit

43. STANDARDS FOR DEEP BURIAL
A pit or trench should be dug about 2 meters
deep
It should be half filled with waste, then covered
with lime within 50 cm of the surface, before
filing the rest of the pit with soil
animals do not have any access to burial sites
Covers of galvanised iron/wire meshes

44. On each occasion, when wastes are added to the pit, a
layer of 10 cm of soil shall be added to cover the wastes
distant from habitation
Burial must be performed under close and dedicated
supervision
The area should not be prone to flooding or
erosion
The deep burial site should be relatively impermeable
and no shallow well should be close to the site
The location authorised by the prescribed
authority
The institution shall maintain a record of all
pits for deep burial.

46. Needle destroyer
Needles Mutilated (cut) by
needle destroyer &
chemically disinfected (by
dipping in 1% hypochlorite
solution for 30min)
Syringe barrel separated from
plunger before disinfection

47. PPE
• After removing PPE into white transparent autoclavable bag it is
tied & then autoclaved & discarded
or
• PPE discarded to yellow bag & then sent for incineration

48. ETBR Gel Discarding
• ETBR is carcinogenic hence glove must be worn to
dicard in white transparent autoclave containing 1%
Sodium hypochlorite
Vol 1: 4 i.e. 1 vol of gel + 4 vol. of Sodium hypochlorite
& kept for 30-45 min
• autoclaved after removing the disinfectant & autoclaved
then discarded

49. Tips
Tips discrded in red bucket containig 1% NaOCl
for 30-45 min and then discarded.

50. Sodium Hypochlorite
•Commercially available 4% sodium hypochlorite
• 1% NaOCl can be prepared by diluting 1 vol 4% NaOCL in to 3 vol
of tap water
Formula= Conc of the comm. Available NaOCL -1
Desired Conc.
EX : for 1% from 4 % = 4 – 1/1 = 3 vol
•
•For making 1 Bucket i.e Suppose 15 litre capacity
1/3rd should be filled red & Blue Bucket
So, for that 10 litre should be made
2.5 litre 4% NaOCL + 7.5 litre Tap water

52. Plasma Prolysis System

53. Process
The temperature of the plasma reaction determines the structure of
A plasma and uses an inert
theplasma torch forming gas. gas such as steam.
The electrodes copper or tungsten to hafnium or zirconium, of the
This can be optimized to minimize ballast contents composed along
with alloys.
byproducts of oxidation: CO2, N, H2O, etc..
A these conditions molecular dissociation can occur by breaking
At strong electric current under high voltage passes between the two
electrodes as an electric
down molecular bonds. arc.
Pressurized elemental ionized passing in a gaseous phase.
The resultinginert gas is components are through the plasma created
by the arc.
Complex molecules are separated into individual atoms.
The torch's temperature ranges from 4,000 to 25,000 °F
Molecular dissociation using plasma is referred to as (2,200 to
13,900 °C).
"plasma pyrolysis."

54. http://www.tifac.org.in/do/hgt/case/plasma.htm

56. The machine is steam heated to a
Technical features of ECODAS
temperature of 138°C and pressure is increased to 3.8 bars.
Medical waste is loaded from the top of the machine into a
The fully equipped and online-controlled process has a cycle
chamber automated at the bottom with
time of duty minutes, depending upon the size of plant and the
a heavy40-60 shredder.
amount of waste. Sterile fragments (8 log10 reduction) are
discharged from the bottom some unbreakable objects, off
If the medical waste containsof the machine and disposedlikein the
environment landfill site.
metal parts, the shredder stops automatically, and the chamber is
not opened until waste is sterilized by
The original volume of falls is gravity into 80%.
steam. Shredded wastewasteby reduced by the lower chamber.
ECODAS (a) T2000 model: fully-automatic model (b) Heavy-duty shredder cuts
(www.ecodas.com)

60. Technology:
A rotating oven & post combustion chamber , specifically used to
burn chemically waste
Incineration temp: 1200-1600⁰ C, decomposes even persistent
chemicals like polychrobiphenyls ( PCBS)
Capacity: 0.5 to 3 tonns /hr
Use: Infectious wastes, all chemical & pharmaceutical cytotoxic waste
Contraindications: Radioactive waste, Pressurized containers, wastes
with heavy metals

62. Thermal Hydroclave
Principle: Sterilization by
saturated steam under pressure
with agitation & fragmentation
Technique: 121-132⁰C, 15-20 psi,
15-30 mins
Advantage:
better steam penetration
Dries up the waste
85% volume reduction
a) loading
b) Heat up &
fragmentation
c) Sterilization period
D) De-pressurization
and De-hydration
E) Unloading

63. Electro-Thermal Deactivation (ETD) is a
process that employs a dielectric oven where low frequency radio waves are used
to generate a high strength electrical field.
Medical waste passing through this dielectric oven absorbs the energy in the field,
and heats very rapidly. This heat kills all potential pathogens and renders the
waste non-infectious. The waste is also shredded to reduce volume by up to 89%.

64. THANK YOU