BIOMEDICAL WASTE MANAGEMENT

Dr. Hemali ParmarMBBS, MD (Microbiology)

Tutor MicrobiologyBaroda Medical College, Gujarat

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OBJECTIVES Classification of bio medical waste (various waste

categories) Segregation of waste (colour coding system for

waste disposal) Pre treatment & decontamination Final disposal General safety practices to be used in the

laboratory (standard work precautions) Importance of hand washing Spill management

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INTRODUCTION OF WASTE MANAGEMENT Hospital waste is a potential reservoir

of pathogenic micro-organisms. Decontamination of waste and their

ultimate disposal are closely interrelated.

Laboratory wastes are of different category.

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CLASSIFICATION OF WASTE To streamline over all handling of hospital waste, it has been

classified into several categories. Each laboratory should have a working estimate of non-

hazardous and hazardous waste produced there on day-to-day basis.

The waste segregation with an ultimate aim of safe handling and disposal has been classified into various categories.

They have been given colour coding for collection i.e. in a specified container only a specified type of waste should be collected.

Segregation at the point of generation of waste must be in accordance with this colour coding. Categories waste segregation and collection is a mandatory legal requirement.

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CONT… The table in next slides comes as

product of schedule I of Rule 4 and 7 of Bio-medical waste (Management and handling) Rules 2011.

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CONT…

Categoryno.

Waste category Disposal 

1 Human Anatomical Waste(human tissues, organs, body parts) Incineration@@

2

Animal waste(animal tissue, organs, body parts, carcasses, bleeding parts, fluid, blood and experimental animals used in research, waste generated by veterinary hospitals/ colleges, discharge from hospitals, animal house)

Incineration@@

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Categoryno.

Waste category Disposal 

3

Microbiology & Biotechnology waste and other laboratory waste(wastes from clinical samples, pathology, biochemistry, haematology, blood bank, laboratory cultures, stock or specimen of microorganisms, live or attenuated vaccines, human and animal cell culture used in research and infectious agents from research and industrial laboratories, waste from production of biological toxins, dishes and devices used for transfer of cultures)

Disinfection at source by chemical treatment@ or by autoclaving/microwaving followed by mutilation/shredding## and after treatment final disposal in secured landfill or disposal of recyclable wastes (plastic or glass) through registered or authorized recyclers

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CONT…Category

no.

Waste category Disposal 

4

Waste sharps(needles, glass syringes or syringes with fixed needles, scalpels, blades, glass etc. that may cause puncture and cuts. This includes both used and unused sharps)

Disinfection by chemical treatment@ or destruction by needle and tip cutters, autoclaving or microwaving followed by mutilation or shredding##, whichever is applicable and final disposal through authorized CBWTF or disposal in secured landfill or designated concrete waste sharp pit

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Discarded medicines and cytotoxic drugs(wastes comprising of outdated, contaminated and discarded medicines)

Disposal in secure landfill or incineration@@

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CONT…Category

no.

Waste category Disposal 

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Soiled waste(Items contaminated with blood, and body fluids including cotton, dressings, soiled plaster casts, linen, beddings, other material contaminated with blood)

Incineration@@

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Infectious solid waste(Wastes generated from disposable items other than the waste sharps such as tubings, hand gloves, saline bottles with IV tubes, catheters, glass, intravenous sets etc.)

Disinfection by chemical treatment@ or autoclaving or microwaving followed by mutilation or shredding## and after treatment final disposal through registered or authorized recyclers

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CONT…Category

no.

Waste category Disposal 

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Chemical waste(Chemical used in production of biologicals,chemicals used in disinfection, as insecticides, etc.)

Chemical treatment@ and discharge into drains meeting the norms notified under these rules and solid disposal in secured landfill

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CONT… @ Chemical treatment using at least 1% hypochlorite solution or

any other equivalent chemical reagent. It must be ensure that chemical treatment ensures disinfection.

## Mutilation/shredding must be such so as to prevent unauthorized reuse.

@@ There will be no chemical pre-treatment before incineration. Chlorinated plastics/bags shall not be incinerated.

Liquid waste generated from laboratory, washing, cleaning, housekeeping and disinfecting activities shall be treated so as to meet the discharge standards stipulated under these rules.

Incineration ash (ash from incineration of any biomedical waste) shall be disposed through secured landfill, if toxic or hazardous constituents are present beyond the prescribed limits as given in hazardous waste (Management, Handling and Transboundary Movement) Rules, 2008.

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SEGREGATION OF WASTE Colour coding and type of container for disposal of

bio medical wastes:Colour

CodingType of container to

be used Waste category number Treatment options as per schedule I

Yellow Non-chlorinated plastic bags Category 1,2,5,6 Incineration

Red

Non-chlorinated plastic bags/puncture proof container for sharps

Category 3,4,7 (4-waste sharps) (in the earlier Rules, soiled waste are for red colour)

As per schedule I (Rule 7)

Blue Non-chlorinated plastic bags container

Category 8 (chemical waste)

As per schedule I (Rule 7)

Black Non-chlorinated plastic bags Municipal waste Disposal in Municipal

dump sites

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CONT… • Waste collection bags for waste types needing

incineration shall not be made of chlorinated plastics.

• Category 3 if disinfected locally need not be put in containers / non-chlorinated plastic bags.

• The municipal waste such as office waste (like paper waste), kitchen waste, food waste and other non infectious waste shall be stored in black coloured containers/bags and shall be disposed of in accordance with Municipal Solid Waste(Management and Handling) Rules 2000.

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GENERAL GUIDELINES1. Segregate waste into the prescribed categories at the point

of generation.2. Colour coded bags are used as per international norms.3. All waste is decontaminated (chemically/autoclaving) at the

laboratory before final disposal.4. Segregation is done at the site of the generation of the

waste in different colour coding bags.5. Non infected materials like wrappers, papers etc - Black

colour plastic bag6. Waste sharps (Needles, broken glass tubes, Scalpels,

Scissors etc.) - Blue colour puncture proof container.7. Infected Soiled wastes (Linen, Aprons, gauge pieces, Cotton)

- Yellow colour plastic bags.8. Infected plastic waste (culture plates, syringes, serum vials,

swab sticks, micro tips etc) Red colour plastic bags.

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EXERCISE:- Sharp????? RED Culture plate????? RED Gloves????? RED Expired drug?????? YELLOW Urine sample????? RED

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EXERCISE Plain vacuttainer????? RED Cotton???? YELLOW Chemical???? BLUE Kit box & plastic wrapper????? BLACK Dead mice???? YELLOW Liquid waste?????? GENERAL DRAIN

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PRE-TREATMENT & DECONTAMINATION Each blood sample is handled carefully and discarded after serum

separation by in discarding container of 1% hypochlorite. Used micro tips are discarded in containers of freshly prepared 1 %

hypochlorite lying on working benches. They are autoclaved and disposed in Red bags in hospital waste. Remains of kits reagents are discarded by autoclaving and disposed in

Red bags in hospital waste. All the cotton swabs used as tops are discarded in yellow bags and

sent for disposal in hospital waste. All the used gloves are cut and discarded in discarding container of 1

% Na. hypochlorite. They are autoclaved and discarded in red bag. After the end of each days work, discarding container is autoclaved

(121°C x ½ hours).

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DECONTAMINATION AND DISPOSAL OF SHARPS

After use, needles and syringes should be locally destroyed/ cut by a needle destroyer and these should be collected in a rigid container preferably immersed in1% freshly prepared sodium hypochlorite solution till disposal.

Locate sharps disposal containers close to the point of use e.g. in patient room, on the medicine trolley and in the treatment room etc.

Dispose used sharps in a puncture resistant container into the blue bag.

Prevent overflow by sending sharps disposal containers for autoclaving and shredding when they are three quarters full.

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FINAL DISPOSAL The black bags and waste therein is

dispensed along with other municipal waste.

The bio-medical waste is collected and disposed off.

All the waste generated in the department is sent to common waste collection site after decontamination.

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POLICY FOR SAFETY IN THE LABORATORY Employees themselves for their own

protection are responsible for adhering to all biosafety guidelines and regulations set out by the laboratory management as well as demonstrate competency in laboratory safety techniques

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STANDARD WORK PRECAUTIONS Standard work precautions refer to the precautions

consistently used on the presumption that all blood and body fluids are potentially infectious for blood borne pathogens.

Similarly, all instruments and other equipment that come in contact with blood are assumed to be potentially infectious and must be properly handled, cleaned, sterilized/ disinfected or safely disposed off.

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STANDARD WORK PRECAUTIONS Hand washing with soap & water Barrier protection. For example effective use of

gloves, gowns, masks, goggles, foot cover, etc. Safe handling of sharp items and prevention of

accidents with sharps Safe handling of specimens (blood etc.) during

collection, processing and transport Safe handling of spills of blood Safe waste disposal Immunization with hepatitis B vaccine

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CONT…

Take protective measures Ensure proper use of gloves Dispose infectious waste in appropriate container Gowns should be closed in front (neck to knees)

and with cuffed sleeves Hand washing before & after work

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CONT… Do not touch eyes, nose, mouth or any uncovered

body parts, telephone receiver, door handles, tap with gloved hands

Do not interchange equipment between laboratories Do not open laboratory doors with gloved hands Do not wear open shoes Do not eat or drink in laboratory Do not smoke in laboratory

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HAND WASHING

Hand washing is the best defense against all pathogens

Wash hands after handling all materials known or suspected to be contaminated

Good hand washing = 15 seconds with running water, soap, and friction

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CONT…

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SHARPS SAFETY

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SPLASHES TO THE EYE

Flush the eye for 5 minutes with normal

saline (for microorganisms)

Flush at least for 15 minutes (for chemicals)

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COMMONLY USED DISINFECTANTS IN THE LABORATORY

Ethyl alcohol (70%) Gluteraldehyde (2%) Sodium hypochlorite solution (1%, 4%) Povidone iodine (pvi) 10%

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MANAGEMENT OF SPILLS• Put absorbent material down on spillage area• Flood with available concentrated sodium hypochlorite

solution upon & around the spill and leave for 30 minutes

• Place the absorbent material in the biohazard bag meant for infectious waste

• Reapply the disinfectant solution to all exposed surfaces• Thorough wash of the area with soap and water

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SUMMARY Bio medical waste categories are

reduced from 10 to 8. Change in color coding system Do’s & Don’t’s of bio safety measures Hand washing steps Spill management

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THANK YOU