management of bio medical waste in the hospitals of lucknow

1. Management
Of Bio Medical
Waste

2. What is Bio-medical waste
?? Definition
 Any solid, fluid or liquid waste, including its container and any
intermediate product, which is generated during the diagnosis,
treatment or immunization of human beings or animals, in
research pertaining thereto, or in the production or testing of
biological and the animal waste from slaughter houses or any
other like establishments.
Generated from
 Waste generated by health care facility
 Research facility
 Laboratories
Hazardous health care waste
 85% waste is non infectious
 10% are infectious
 5% are hazardous

3. Two type of hazardous Bio
medical waste
 Non hazardous: Approximately 75-90% of the
biomedical waste is non-hazardous and as
harmless as any other municipal waste. (E.G,
Plastic, Glass, Cardboared, etc)
 Hazardous waste:10-25% is hazardous and
can be injurious to humans or animals and
deleterious to environment. It is important to
realise that if both these types are mixed
together then the whole waste becomes
harmful.
Bio Hazard Symbol

4. Types Of Biomedical Waste
Options Waste Category
Category No. 1 Human Anatomical Waste
Category No. 2 Animal Waste
Category No. 3 Microbiology & Biotechnology
Waste
Category No. 4 Waste Sharps
Category No. 5 Discarded Medicines and Cytoxic
drugs
Category No. 6 Solid Waste
Category No. 7 Solid Waste
Category No. 8 Liquid Waste
Category No. 9 Incineration Ash
Category No. 10 Chemical Waste
Options Waste Category Treatment & Disposal
Category No. 1 Human Anatomical Waste Incineration / deep burial
Category No. 2 Animal Waste Incineration / deep burial
Category No. 3 Microbiology & Biotechnology
Waste
Local autoclaving / microwaving
/ incineration
Category No. 4 Waste Sharps Disinfection by chemical
treatment / autoclaving /
microwaving and mutilation /
shredding
Category No. 5 Discarded Medicines and Cytoxic
drugs
Incineration / destruction and
drugs disposal in secured landfills
Category No. 6 Solid Waste Incineration / autoclaving /
microwaving
Category No. 7 Solid Waste( generated by
disposal items)
Disinfection by chemical
treatment / autoclaving /
microwaving and mutilation /
shredding
Category No. 8 Liquid Waste Disinfection by chemical
treatment and discharge into
drains.
Category No. 9 Incineration Ash Disposal in municipal landfill
Category No. 10 Chemical Waste Chemical treatment and
discharge into drains for liquids
and secured land for solids

5. Categories Examples
Components Examples
Human Anatomical Waste Tissues, organs, body parts
Animal Waste Generated during research/experimentation, from veterinary
hospitals
Microbiology &
Biotechnology Waste
Laboratory cultures, micro-organisms, human and animal
cell cultures, toxins
Waste Sharps Hypodermic Needles, Syringes, Scalpels, Broken Glass
Discarded Medicines and
Cytoxic drugs
Barium Enema, X-Rays, Cancer Chemotherapy, Tar-Based
Products
Solid Waste Dressing, bandages, plaster casts, material contaminated
with blood
Liquid Waste Generated from any of the infected areas
Chemical Waste Alcohol, Sulphuric Acid, Chlorine Powder, Glutaraldehyde,
Picric Acid, Fertiliser, Ammonia

6. Non-Infectious
waste, 80%
Pathological
and Infectious
waste, 15%
Chemical and
Pharmaceutical
waste, 3%
Sharps,
1%
Radioactive,
Cytotoxic and
heavy metals,
1%
Bio-Medical Wastes
percentage

7. CLASSIFICATION OF HOSPITAL
WASTE
Non-
Hazardous
Waste
Bio-degradable
Non bio-
degradable
Potentially
Infectious
Waste
Dressings,
swabs,
laboratory
wastes,
instruments
used in patient
care..
Potentially
Toxic Waste
Radioactive
Chemical
Pharmaceutical

8. Hospital Waste

9. Pharmaceutical Waste

10. Chemical waste
Lab reagents

11. Radioactive Waste

12. Developed Countries- 1-5 kg/bed/day, with variations
among countries.
In India- 1-2 kg/bed/day with variation among
Govt. and Private establishments.
* 80 percent waste generated in a hospital is non
hazardous and can be dealt with normal domestic
waste management system.
* 15 percent pathological & infectious waste.
* 3 percent chemical & pharmaceutical waste.
* 1 percent sharps.
* 1 percent radioactive, cytotoxic and heavy metals.

13. According to my survey research
In SGPGI- 100 Kg of bio medical waste/day
In Globe Medicare - 50 Kg of bio medical
waste/day
In Kamakhya Hospital-10-15 Kg of bio medical
waste/day
In Brajraj Hospital-50 Kg of bio medical
waste/day

14. COLOR
CODE
TYPE OF CONTAINER WASTE
CATEGORY
TREATMENT
OPTIONS
Yellow Plastic bags 1, 2, 3 and 6 Incineration/deep burial
Red Disinfected container/plastic
bag
3, 6 & 7 Autoclaving/Micro
Waving/Chemical
treatment
Blue/white
transparent
Plastic bags/puncture proof
container
4 & 7 Autoclaving/Micro
waving/chemical
treatment, Destruction &
shredding
Black Plastic bag 5, & 9, AND
10 (SOLID)
Disposal in secured land
fills

19. Principles of Control of Hazards of
Biomedical Waste in Health Care
Establishments
* Each institution should develop its own bio waste management
policy and ensure that the health care workers are adequately
trained to handle biological waste.
* Measures such as universal safety precautions, hand washing
and proper segregation of waste material should be
encouraged.
* Rationale patient management policy should be followed
and admissions restricted to those for whom it is felt
absolutely necessary.
* Proper house-keeping is essential and the hospital premises
should be kept clean and well-ventilated.
* Use of disinfectants should be rationalized.

20. Two types of Disposing bio medical
waste
Thermal technology
 It Uses Heat To Decontaminate Instruments
And Equipment And The Temperatures In
This Process May Rise To Extremely High
Levels.
 Most Of The Microbes Are Destroyed At
Temperatures Below 100°c.
1. Autoclave
2. Incinerator

21. - Here vacuum pumps are utilized to
evacuate the air in the chamber of
autoclave and steam under pressure
is pushed in, which is able to
penetrate the waste material more
thoroughly. This technology thus
reduces the cycle time to 30 - 60
minutes and the temperatures
attained are 132°C.
-where air is pushed out of the
autoclave by steam under pressure.
This system operates at
temperatures of 121°C and has a
cycle time of approximately
60 - 90 minutes.

22. - Incineration is a high heat system
process of burning combustible
Solids at very high temperature in a
furnace.
- It employs combustion of waste
material in stages, followed by
cleaning of the flue gas through a
number of pollution control devices.
- The end product is devoid of
infectious organisms and organic
compounds of waste, which is
aesthetically acceptable.
- Based on the type of fuel
consumed the division could be-
● Conventional incinerator using
wood/charcoal
● Electrical incinerator
● Oil fired incinerator using
electricity and diesel oil

23. Mechanical Technology
1. Compaction: Compacting is carried out by a
hydraulic ram against a hard surface.
2. Grinding / Shredding: Waste material is broken
down into smaller particles under negative pressure to
avoid any spillage outside the chamber.
3. Pulverization: Waste is mixed with large volume of
water and bleach solution. The waste is torn to shreds
and then fed to an ultra high speed hammer mill with
large spin blades which pulverize the matter into small,
safe particles.

24. Final Disposal Methods
General Non Hazardous Waste Secured Landfills
Liquid Wastes Chemical Disinfectant Neutralization With Reagent,
And Discharged Into The Sewerage System.
Human Anatomical Wastes Incinerated And Sent To Landfill Sites.
Sharps Needles Can Be Cut By Needle Cutter And Contained
In 1% Bleach Solution, And Sent To Landfill For Disposal.
Microbiology Waste Autoclave/Microwave/Incineration Landfill Disposal.
Infectious Solid Waste Autoclave/Microwave/Incineration Landfill Disposal.
Radioactive Waste The Solid Wastes Are Disposed By Concentration And
Storage, While Liquids By Dilution And Dispersal
Pressurized Containers Disposed Off With General Waste In Secured Landfills.
General Non Hazardous Waste Secured Landfills
Liquid Wastes Chemical Disinfectant Neutralization With Reagent,
And Discharged Into The Sewerage System.
Human Anatomical Wastes Incinerated And Sent To Landfill Sites.
Sharps Needles Can Be Cut By Needle Cutter And Contained
In 1% Bleach Solution, And Sent To Landfill For Disposal.
Microbiology Waste Autoclave/Microwave/Incineration Landfill Disposal.
Infectious Solid Waste Autoclave/Microwave/Incineration Landfill Disposal.
Radioactive Waste The Solid Wastes Are Disposed By Concentration And
Storage, While Liquids By Dilution And Dispersal
Pressurized Containers Disposed Off With General Waste In Secured Landfills.
General Non Hazardous Waste Secured Landfills

25. UNDER ENVIRONMENT PROTECTION ACT,
1998
BIO-MEDICAL WASTE (Management & handling) RULES 1998
1st Amendment Rules vide S.O.201(E) Dated
06/03/2000
2ndAmendment Rules vide S.O.1069(E) Dated
17/09/2003
Generation/Collection/Reception/Storage
Transportation
Treatment/Disposal
 or any other form of handling.

26. Role Of Doctors, Nurses, Lab
Technicians.
 Do not dispose dressings in patients
 bin / Ask for disposal bags.
 Ensure all the plastics and gloves are cut and put into bleach
solution.
 Ensure all used injections are cut using needle cutters.
 Ensure compliance of this scheme during ward visits
 Help patients understand the scheme.
 Media plates to be put in separate
 bleach solution.

27. DON’TS
 Put the waste indiscriminately.
 Put wrong bags in bin. (Adhere to color code.)
 Fill the bags till neck. (Waste would otherwise spill
over.)
 Handle waste without protective clothing.
 Drag the bags after removal. (Bags can burst and
the site could be repulsive.)
 Never recap the needle. (Never re-use needle
without disinfection)
 Mix non infectious waste with infectious waste.