Post on 15-Jul-2015
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BIO-MEDICALWASTE
MANAGEMENT
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Definition : Acc to bio medical waste rules ,1998 of India “ bio-medical waste” means any waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining there to or in the production or testing of bio medicals.
Any unwanted residual material which cannot be discharged directly, or after suitable treatment can be discharged in the atmosphere or to a receiving water source, or used for landfill is waste. (Wilson, 1981)
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Hospital waste: refers to all waste, biological or non biological, that is discarded and is not intended for further use
Medical waste: refers to materials generated as a result of patient diagnoses, treatment, immunization of human beings or animals
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Infectious waste: are the portion of medical waste that could transmit an ‘infectious disease’.
Pathological waste : waste removed during surgery/ autopsy or other medical procedures including human tissues, organs, body parts, body fluids and specimens along their containers.
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Reduce the impact waste management . Reduction in the incidence of infection and
accidental injuries to hospital staff. Cost-effective disposal of hospital waste.
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GLOBALLY- Developed countries generate 1 to 5 kg/bed/day
Developing countries: meager data, but figures are lower. 1-2kg/pt./day
WHO Report: 85% non hazardous waste : 10% infective waste
: 5% non-infectious but hazardous. (Chemical, pharmaceutical and radioactive)
INDIA:-No national level study - local or regional level study shows
hospitals generate roughly 1-2 kg/bed/day
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The Ministry of Environment and Forest has drafted certain rules in exercise of powers conferred by sections 6,8 and 25 of the environment (protection) act, 1986
The Gazette of India extraordinary , part II –section 3- subsection (ii)
On 20th July 19989
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WASTE CATEGORY
TYPE OF WASTETREATMENT AND
DISPOSAL OPTION
Category No. 1Human Anatomical Waste (Human tissues, organs, body parts)
Incineration@ / deep burial*
Category No. 2
Animal Waste(Animal tissues, organs, body parts, carcasses, bleeding parts, fluid, blood and experimental animals used in research, waste generated by veterinary hospitals and colleges, discharge from hospitals, animal houses)
Incineration@ / deep burial*
Category No. 3
Microbiology & Biotechnology Waste (Wastes from laboratory cultures, stocks or specimen of live micro organisms or attenuated vaccines, human and animal cell cultures used in research and infectious agents from research and industrial laboratories, wastes from production of biologicals, toxins and devices used for transfer of cultures)
Local autoclaving/ microwaving / incineration@
CATEGORIES OF BIOMEDICAL WASTE SCHEDULE – I
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Category No. 4
Waste Sharps (Needles, syringes, scalpels, blades, glass, etc. that may cause puncture and cuts. This includes both used and unused sharps)
Disinfecting (chemical treatment@@ / autoclaving / microwaving and mutilation / shredding##
Category No. 5
Discarded Medicine and Cytotoxic drugs (Wastes comprising of outdated, contaminated and discarded medicines)
Incineration@ / destruction and drugs disposal in secured landfills
Category No. 6
Soiled Waste (Items contaminated with body fluids including cotton, dressings, soiled plaster casts, lines, bedding and other materials contaminated with blood.)
Incineration@ / autoclaving / microwaving
Category No. 7
Solid Waste (Waste generated from disposable items other than the waste sharps such as tubing, catheters, intravenous sets, etc.)
Disinfecting by chemical treatment@@ / autoclaving / microwaving and mutilation / shredding# #
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Category No. 8
Liquid Waste (Waste generated from the laboratory and washing, cleaning, house keeping and disinfecting activities)
Disinfecting by chemical treatment@@ and discharge into drains
Category No. 9Incineration Ash (Ash from incineration of any biomedical waste)
Disposal in municipal landfill
Category No.10
Chemical Waste (Chemicals used in production of biologicals, chemicals used in disinfecting, as insecticides, etc.)
Chemical treatment @@ and discharge into drains for liquids and secured landfill for solids.
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Waste categoryWaste category Infectious Infectious
wastewaste
Pathological Pathological wastewaste
Description And ExamplesDescription And Examples• Lab culturesLab cultures• Waste from isolation Waste from isolation
wardswards• Tissues(swabs)Tissues(swabs)• Materials/equipments of Materials/equipments of
infected patientsinfected patients• ExcretaExcreta• Human tissues/fluidsHuman tissues/fluids• Body partsBody parts• Blood or body fluidsBlood or body fluids 14
Pathological waste
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Blood bags found in the municipal waste stream in violation of rules for such waste. 16
Sharp wasteSharp waste
Pharmaceutical Pharmaceutical wastewaste
Genotoxic Genotoxic wastewaste
• NeedlesNeedles• Infusion SetsInfusion Sets• ScalpelsScalpels• Knives Blades Knives Blades • Broken GlassBroken Glass• Expired PharmaceuticalsExpired Pharmaceuticals• Contaminated Contaminated
PharmaceuticalsPharmaceuticals• Banned PharmaceuticalsBanned Pharmaceuticals• Waste Containing Cytotoxic Waste Containing Cytotoxic
Drugs(often Used In Cancer Drugs(often Used In Cancer Theraphy)Theraphy)
• Genotoxic ChemicalsGenotoxic Chemicals17
Pharmaceutical Waste
Sharp Waste 18
Chemical Chemical wastewaste
Waste with Waste with high content high content of heavy of heavy metals metals
Pressurized Pressurized containerscontainers
Radioactive Radioactive wastewaste
• Lab reagentsLab reagents• Film developerFilm developer• Expired disinfectantsExpired disinfectants• Expired solventsExpired solvents• BatteriesBatteries• Broken thermometersBroken thermometers• Blood pressure guages etcBlood pressure guages etc• Gas cylindersGas cylinders• Gas catridgesGas catridges• Aerosol cansAerosol cans• Radiotherapy/lab research liquidsRadiotherapy/lab research liquids• Contaminated glass wares, Contaminated glass wares,
packages, absorbent paperspackages, absorbent papers19
Cytotoxic drugs
Lab reagents
Genotoxic waste
Chemical waste
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Waste with high content of heavy metals
Worn out batteries
Blood pressure guages 21
Radioactive waste
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Government/private hospitals Nursing homes Physician/dentist office or clinic Dispensaries Primary health care centers Medical research and training centers animal./slaughter houses labs/research organizations Vaccinating centers Bio tech institutions/production units
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1. Know what hazards you have
2. Purchase smallest quantity needed, and don’t purchase hazardous materials if safe alternative exists
**Use mercury-free thermometers
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3. Limit use and access to trained persons with personal protective gear
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Don’t accumulate unneeded products Don’t let peroxides and oxidising agents turn
into bombs
Photo of bomb robot called into hospital to dispose of picric acid.
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Examples of hazard labels:
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Job description Posters on doors Labels on hazards Give feedback on use of PPE
and disposal in evaluation Role model safe use and
disposal Contact point who is
responsible
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Slide 33
Separate sharps and infectious waste where they are used ◦ This prevents injuries that can occur when people
sort the trash after it is disposed Janitors can reinforce separation of sharps
waste disposal by reporting sharps in garbage to Hospital Infection Control Committee members
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Treatment and Disposal
Methods of Hospital Waste
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Waste minimization & recycling of waste Identification of points of generation of waste Waste segregation at source Compiling the inventory of waste Waste treatment (disinfection etc.) at the site Waste collection and transportation, on-site and off-
site Waste treatment , on-site & off the site Final disposal of waste Occupational safety Continuous monitoring of the system Training of the staff.
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TREATMENT/DITREATMENT/DISPOSAL SPOSAL METHODMETHOD
ADVANTAGESADVANTAGES DISADVANTAGESDISADVANTAGES
Rotary kilnRotary kiln Adequate –all infect waste most Chemical wastePharmaceutical waste
High investment and operating costs
Pyrolytic Pyrolytic incinerationincineration
Adequate –all infect wasteMost pharmaceutical wasteChemical waste
Incomplete destruction of cytotoxicsRelative high investment
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ROTARY KILN PYROLYTIC INCINERATOR
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Single-chamber incinerator
Good dis infection efficiencyDrastic reduction of wt & volume of wasteResidues disposed in landfillsNo need of high trained operatorsLow investment/operating cost
Significant emissions of atmos pollutantsNeed for periodic removal of slag &sootInefficient in destroying thermally resistant chem /drugs
Drum/ brick incinerator
Drastic reduction of wt &volume of wasteVery low investment & operation
Massive emission of black smoke, ash toxic flue gas
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Chemical Chemical disinfectiondisinfection
Highly efficient disinfection under good operating conditionsChemical disinfectants are relatively inexpensive
Requires highly qualified technicians for operating of the processUses hazardous substances that requires comprehensive safety measures
Wet Wet thermal thermal treatmenttreatment
Environmentally soundRelatively low investment/operating costs
Shredders are subject to frequent breakdowns Poor functioning42
CHEMICAL DISINFECTION
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WET THERMAL TREATMENT
Off-site wet thermal (or "steam autoclave") treatment facility
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Operating requires qualified techniciansInadequate for anatomical, pharmaceutical,chemical waste ,waste that is not steam permeable
Micro- Micro- wave wave irradiationirradiation
Good disinfection efficiency under appropriate conditionsDrastic reduction in waste volumeEnvironmentally sound
High investment& operating costsPotential operation Maintenance problems
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MICROWAVE IRRADIATION
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Encapsulation SimpleLow costSafe
Not recommended for non sharp infectious waste
Safe buryingSafe burying Low costRelatively safe if access to site is restricted
Safe only if access to site is limited and certain precautions are taken
inertisationinertisation Relatively inexpensive
Not applicable to infectious waste
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ENCAPSULATION
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Inertisation, Immobilisation
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Biomedical waste (management &handling) rule 1998, prescribed by The Ministry of Environment and Forests, Govt of India, came into force on 20th July 1998. This rule applies to those who generate, collect, receive, store, dispose, treat or handle bio medical waste in any manner.Thus bio medical waste should be segregated into containers/bags at the point of generation of waste. ThusColour Coding & type of containers used for disposal of waste is came into existence which is shown as follows
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Colour Colour codingcoding
Type of Type of containercontainer
Waste categoryWaste category Treatment Treatment optionsoptions
YellowYellow Plastic bagPlastic bag Human anatomical Human anatomical wastewasteAnimal wasteAnimal wasteMicrobiology &biotech Microbiology &biotech waste,waste,solid wastesolid waste
Incineration/Incineration/deep burialdeep burial
RedRed Dis infected Dis infected container/placontainer/plastic bagstic bag
Micro&biotech wasteMicro&biotech wasteSolid wasteSolid wasteSolid wasteSolid waste
AutoclavingAutoclavingMicrowavingMicrowavingChem RxChem Rx
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Black Plastic bagPlastic bag Discarded Discarded medicinesmedicinesCytotoxic Cytotoxic drugsdrugsIncineration Incineration ashashchemicalschemicals
Disposal in Disposal in secured landfillssecured landfills
Blue/white translucent
Plastic bag
Puncture proof container
Sharp wasteSolid waste
AutoclavingMicrowavingChem RxDestruction/shredding 52
• Thus refuse disposal cannot be solved without public education.• Individual participation is required.• Municipality and government should pay importance to disposal of waste economically.• Thus educating and motivating oneself first is important and then preach others about it.• Start disposing waste first from within your home, then outside home, then neighborhood ,then your street, your area ,city and then the nation and the world.
• Lets make this world a better place to live in.
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HCRW Management.ppt 7/03Slide 54
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