Post on 10-Feb-2017
Occupational Health Risks of
Biomedical Waste Management
– An overview
by
Dr. Vidhya Venugopal
Professor Department of Environmental Health Engineering
Sri Ramachandra University Porur, Chennai - 600 116
In India- 1-2 kg/bed/day with variation among Govt. and Private establishments.
Approximately 506.74 tons/ day wastes generated
Out of which only 57% waste undergoes proper disposal
Biomedical waste Statistics
Categories of Bio-Medical Wastes
Cytotoxic drugs
Genotoxic waste
Chemical waste
Pharmaceutical Waste
Sharp Waste
Waste with high content of heavy metals
Worn out batteries
Blood pressure guages 6
Radioactive waste
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OCCUPATIONAL HAZARD Who is at risk?
Health-care & house-keeping personnel,
waste workers
Doctors, nurses and technicians
Waste recyclers and rag pickers
Visitors
In- and out-patients
General public
Real time Statistics
Sharps (Annual injury rate)
House-keeping personnel & nurses - 10-20/1000
Cleaning dept. and waste handlers - 180/1000
Needle stick injuries
Risk of Hepatitis B – ROT = 6-30%.
Risk of HIV infection – Avg. TR = 0.3% (3/1000)
TYPES OF OCCUPATIONAL HAZARDS
Physical
Chemical
Biological
Ionising/non-ionising radiation
Psychosocial
Ergonomical
From Hazard to Disease
EXPOSURE UPTAKE EFFECT DISEASE
H A
Z
A
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Occupational
Environmental Environmental
Exposure Assessment Health Surveillance
OCCUPATIONAL HAZARDS (Physical)
Types:
Noise, Vibration, Radiation, Heat, Physical
injuries, Lifting heavy objects
EFFECT:
Hearing loss, nervous problems, backache,
physical disability, heat exhaustion, Musculo skeletal disorders, genetic damage, cancers etc.,
OCCUPATIONAL HAZARDS (Chemical)
SOURCE: Chemical cleaners, sterilizers, anaesthetic chemicals, expired pharmaceuticals, gluteraldehye, latex, Mercury, heavy metals, volatiles and plastics.
EFFECT: Irritation to sensory organs, headaches, nausea, vomiting, systemic illnesses, Neurological and GI disorders, cardiovascular disorders, immune dysfunction, reproductive & personality disorders, disability and possibly death
OCCUPATIONAL HAZARDS (Ergonomical)
SOURCE:
Repetitive motions, awkward postures,
twisting, ergonomically unfriendly working
conditions, bending and lifting weights
EFFECT:
Osteoarthritis of wrist, epicondylitis elbow,
back pain, low back pain, shoulder
tightening (temporary and permanent)
OCCUPATIONAL HAZARDS (Radiation)
SOURCE:
Radiotracer in therapy, cancer treatment,
radiopharmaceutical waste, waste from
radio medical procedures, discarded laser
equipments
EFFECTS:
Burns, Radiation sickness, cataract,
reduction in blood cells, Chromosomal
aberrations, tumours, skin erthyrema/
cancers, sterility.
OCCUPATIONAL HAZARDS (Biological)
SOURCE:
Bioaerosols, body fluids, soiled linen, bandages sharps, needle stick, Biowaste
EFFECT:
H1N1, Hepatitis B, HIV, Infections due to other pathogens, Common infections, compromised immune system due to repeated exposures, disability and/or death in acute cases.
OCCUPATIONAL HAZARDS (Psychosocial)
SOURCE:
Fatigue, Workload demand, Problematic
interpersonal relationships, Limited career
opportunities, poor remuneration, Monotony of
the job, Stress due to fear, Poor/limited training
in BMW.
EFFECT:
Personality disorders, low self-esteem, Anxiety,
low motivation, imbalanced work-life balance,
Depression, alcohol/drug abuse, Violence
Laws of Biomedical Waste Management
On 20th July 1998
Ministry of Environment and Forests (MoEF),
Govt. of India, Framed a rule known as ‘Bio-
medical Waste (Management and
Handling) Rules, 1998,’
Provides uniform guidelines and code of
practice for Bio-medical waste management.
Government initiatives……
SAFETY/PRECAUTIONERY
MEASURES
VULNERABLE POPULATION
Pregnant Women
Work group above 45yrs
Disabled or with previous illness.
With respiratory illnesses
High exposures
Hazard Control Principles
Hierarchy of Controls
Source Controls
Substitution
Enclosure or Isolation
Adequate Safety Program
Audits
Pathway Controls
Housekeeping
Distance
Continuous Area Monitoring
Reduce exposure
Receiver (Worker) Controls
Training & Education
Rotation
Enclosure of Worker
Personal Protective Devices
Strong org. policies
SPILLAGE
3 MAJOR TYPES OF SPILLAGE
BLOOD SPILLAGE
MERCURY SPILLAGE
CHEMICAL SPILLAGE
PRECAUTION S FROM BLOOD
SPILLAGE
Wear Personal Protective Equipment
Mark the area.
Add 5%sodium hypo chlorite to the
spillage and keep it for 10-15 minutes.
Collect the spillage using waste cloth
or cotton.
MERCURY SPILLAGE
Wear personal protective Equipment
With the help of two cardboard pad,
collect the spillage and with an ink filler
absorb mercury
It is then transferred to a water filled
container.
It is then transferred to a seal proof bag
and taken to clinical pharmacist
DO NOT BROOM OR VACCUM
No take home Mercury
CHEMICAL SPILLAGE
Whenever a chemical spillage occurs, remove
contaminated clothing.
Flush eyes/skin with water at least for 15-30
mins. Use soap for cleaning.
Protect yourself and remove injured persons
(if any) to fresh air.
Notify concerned personnel
If flammable vapors are involved, do not
operate electrical switches.
Do not touch the spill without PPE.
If unknown chemical evacuate room and
wait for spill team
OTHER TIPS FOR BASIC OSH
Safe Hand washing Techniques
Personal hygiene and habits
Never eat, drink or apply cosmetics in the work area
Avoid touching your face, mouth or eyes
Never suck pens or chew pencils
Separate area for eating and drinking
Visual remainders of hazards
Do’s and Don’ts pictorial
Hand
Washing
Pictorial Labels with Agent, Concentration &
Hazard Warnings
Examples of hazard labels:
Communicate about Workplace Hazards
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
Successful prevention requires:
Information on the causal relationship between risk factor and health outcome,
Knowledge of the mechanism of action of hazardous factors and conditions,
Knowledge of how the causal relationship can be broken,
Resources and tools for the implementation of measures,
Political, managerial and target group support for a preventive programme.
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Preventive health (OEH)
Ground reality I - Risk Assessment
Ground reality II- Risk perception
Let the waste of the “sick” not contaminate the
lives of “The Healthy”
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