Biomedical Waste Management-by Satish Sinha
-
Upload
chaitanya-gawade -
Category
Documents
-
view
218 -
download
0
Transcript of Biomedical Waste Management-by Satish Sinha
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
1/30
Bio-Medical WasteManagement
Satish Sinha
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
2/30
History of medical waste• Medical Waste Tracking Act in
US
• I Draft Rules in India–1995• Final Rules in 1998,
a!end!ents and 5 guidelines
• "#$luti$n $f Rules and
%ractices t&r$ug& 'ati$nal"()eriences
• 'ati$nal *uidelines $n +MW,*uidelines $n Incinerati$n,
TFs, I!!uni-ati$n Waste andMercur.
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
3/30
Various networks'*/s
• 0ealt& are Wit&$ut 0ar!
0W02In3ecti$n safet.4
• SI*' Safe In3ecti$n *l$al'et6$rk2
Anti7incinerati$n4 • *AIA *l$al Anti Incinerat$r
Alliance2
Mercur.
• er$ Mercur.
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
4/30
Stockholm Convention onPersistent OrganicPollutants
• an internati$nal
en#ir$n!ental treat. • ai!s t$ eli!inate $r restrict
t&e )r$ducti$n and use $f)ersistent $rganic )$llutants
%/%s2• entered int$ f$rce $n 1: Ma.
;;< 6it& rati=cati$n . 18and 1>8 signat$ries
http://en.wikipedia.org/wiki/Environmental_lawhttp://en.wikipedia.org/wiki/Treatyhttp://en.wikipedia.org/wiki/Persistent_Organic_Pollutanthttp://en.wikipedia.org/wiki/Ratificationhttp://en.wikipedia.org/wiki/Ratificationhttp://en.wikipedia.org/wiki/Persistent_Organic_Pollutanthttp://en.wikipedia.org/wiki/Treatyhttp://en.wikipedia.org/wiki/Environmental_law
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
5/30
Basel Convention
• $ntr$l $f Tran $undar.M$#e!ent $f 0a-ard$us
Wastes and T&eir Dis)$sal
• Mini!i-e &a-ard$us 6aste
generati$n and dis)$se itnearest t$ t&e )$int $fgenerati$n
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
6/30
nvironmental!egulations
• "n#ir$n!ent %r$tecti$n Act, 198>
• +MW Rules 1998
• Munici)al Waste Manage!ent and 0andling2
Rules, ;;;• At$!ic "nerg. Act
• 0a-ard$us Wastes Manage!ent ? 0andling2Rules, 1989
• "7Waste Rules
• +atteries M?02 Rules ;;1
• Manufacture, St$rage and I!)$rt $f0a-ard$us &e!icals rules, 1989
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
7/30
Patient safety and Bio-medical waste
management
• In ;; W$rld 0ealt& asse!l., )asseda res$luti$n calling !e!er states t$
6$rk f$r safet. $f %atients
• In /ct ;;
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
8/30
Priority areas for Patient safety
• Safe clinical )ractices and &and&.giene
• Safe Surgical )ractices
• +l$$d Safet.• Safe In3ecti$ns %ractices
• 0ealt& are Waste Manage!entRules and guidelines are a#ailale ut
i!)le!entati$n is #er. )$$r Back $ftraining $r )$$r training is als$ a fact$r It&as n$t een gi#en t&e due )ri$rit. . !$st$f t&e states and dedicated udget isreCuired All states s&$uld f$cus $n t&is
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
9/30
Health care associated infections
• $!)licate et6een 571; $f ad!issi$ns inacute care &$s)itals in
industriali-ed c$untries
• It is esti!ated t&at t&isrisk is u) t$ ; ti!es
&ig&er in de#el$)ing 6$rld
• At an. gi#en ti!e, 1< !illi$n)e$)le 6$rld6ide suEer fr$! 0AI,and at least 5; $f 0AI are
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
10/30
"nsafe in#ections
• India c$ntriutes t$ 57; $f t&egl$al in3ecti$ns W0/, 19992
• Annual in3ecti$n usage G – >illi$n, $f t&is nearl. t6$7t&irds>9in3ecti$ns2 unsafe India B"' Stud.;;7;<
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
11/30
Why $ollow "niversal
Precautions• T&e )re#alence rate $f l$$d $rn
disease7 0e)atitis + 8H1;;;, 0I:H1;;; 'A/ 1992
• DiEicult t$ test eac& )atient
• 'SI and $t&er s&ar) in3uries aret&e ke. anadian &ealt& issue,aEecting :;;;; )e$)le )er .earand c$sting ar$und d$llar 1
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
12/30
What is this concernfor%
• Infecti$us 6aste s$lid and liCuid2
• S&ar)s 6aste
• .t$t$(ic 6aste
• %&ar!aceutical 6aste
• Radi$acti#e 6aste
• &e!icals and disinfectants
• %ressurised c$ntainers
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
13/30
BMW !ules and &ey'ctors
• '$ti=ed in 1998
• $nce)t $f %%% !$del
•
Identi=ed tec&n$l$gies andstandards
• %+
•
S%+• De)art!ent $f 0ealt&
Headline of presentation to come here (on slide master)
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
14/30
&now your waste
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
15/30
Waste (reatment ) *is+osal System
Category Waste category (reatment
Category 1 Human anatomicalwaste
Inc/burial
Category 2 Animal waste Inc/burial
Category 3 icrobiology !biotechnology waste
Inc/alternate
Category " #aste sharps $isinfection !autocla%ing/microwa%ing/shredding ! mutilation
Category & $iscarded medicines'
cytotoic drugs
Inc/landll
Category * !+
,olid waste Autocla%ing'microwa%ing !mutilation for category +
Category - .iuid waste $isinfection
Category 0 Incineration ash .andll
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
16/30
Schedule ,,
Colourcoding
(y+e ofContainer ,
WasteCategory
(reatmento+tions as
+er Schedule,
ellow lastic bag Human' animal'microbiology'soiled waste
Incineration/deepburial
4ed $isinfectedcontainer/ plasticbag
icrobiology'solid ! soiledwaste
Autocla%ing/icrowa%ing/Chemical 5reatment
6lue/#hitetranslucent
lasticbag/punctureproofcontainer/,harps6laster
#aste sharps !solid waste
Autocla%ing/icrowa%ing/Chemical 5reatment !destruction/shredding
6lac7 lastic bag $iscardedmedicine' $isposal insecured landll
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
17/30
Bio-medical waste andtechnology
• Tec&n$l$g. is $nl. a fracti$n $f t&e
s$luti$n• Ma3$r c$!)$nents $f 6aste
!anage!ent are4
o Segregation of waste
o
Waste minimisationo Reducing use of hazardous substances
or processes
o Waste Audit
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
18/30
'++roved treatment
methods
• Aut$cla#e
• &e!ical disinfecti$n
• 0.dr$cla#e
• Micr$6a#e
• Incinerati$n
• An. $t&er tec&n$l$g. after %+ a))r$#al
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
19/30
,n house management of
waste• 1Sur#e.
Meeting 6it& t&e &eads $f all t&e de)art!ents
F$r!ing a 6aste !anage!ent c$!!ittee
Suggest eCui)!ent )r$cure!ent
:F$r!al training f$r all t&e nursing staE
8I!)le!enting t&e s.ste! t&r$ug&$ut t&e
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
20/30
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
21/30
Of site management of
waste-Centralied $acilitiesDraft Guidelines on Common facilities-
• Treatment facilities- 90% non-burn, 10% waste- burn
• Limits incineration to Categories 1&2• tleast 1 !m from residential areas" cce#table in
industrial area
• $ne o#erator allowed to cater u#to 10,000 beds,situated witin 10 'm radius
• (egregation is te role of generator) o#erator can re#ortmi*ing of waste to te #rescribed autorit+
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
22/30
2006 2008 2009
HCF Total Number of Healthcare facilities 73975 129511
Number of HCFs linke to CTFs ! o"n facilit# 3$001 11*-
Number of facilities "here "aste is not bein%treate
3997$ 13$31
&ercenta%e of total facilities "ith no t#'e oftreatment mechanism
5$( 10(
)aste *io+meical "aste %enerate !a# 319$53 k%s $13500, "1"0&*8
*io+meical "aste treate !a# 1$3952 k%s 295270 291983
*io+meical "aste not treate !a#+ 175501 k%s 113719
Percentage of Bio-medical waste untreated/day
55% 28%
-ncinerator Total incinerators in the countr# $36 5$7
-ncinerators "ith .&C/s 207 250
-ncinerators "ithout .&C/s 229 297
Total Number of Violations 244!2 !"#"$
&' issued ()ow cause notices !48*8
Medical 6aste in India4 ;;>7;;9
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
23/30
Hurdles in
,m+lementation Issues $f a)acit.
B$6 )ri$rit.
Res$urce All$cati$n Fi(ed Mindset
In3ecti$n safet., c&e!ical safet. and 6aste !anage!ent issues .et t$ =nds)ace in de#el$)!ent )lanning
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
24/30
At t&e S%+ le#el
a)acit. and res$urce
M$nit$ring and c$ntr$l
Trans)arenc. $f )r$cesses 0ierarc&. $f c$ntr$l
Inde)endent audits
A6areness $f c$!!unit. Increasing $utreac& $f centrali-ed
facilit. t$ rural areas
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
25/30
't the Hos+ital level
Mindset issues
In#$l#e!ent $f seni$r!anage!ent
Res$urce a#ailailit. and)ri$ritising
*$#ern!ent 0$s)itals iggest
defaulters a)acit. +uilding
I!)le!entati$n $ttlenecks
Res)$nsiilit. =(ing
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
26/30
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
27/30
Way $orward
Res$urce all$cati$n f$r 6aste!anage!ent
Maintaining a )$$l $f trainers at l$ckHdistrict le#els Stake&$lders in#$l#e!ent Inc$r)$rati$n int$ curricula $f !edical,
nursing and )ara!edical c$lleges U) gradati$n t$ latest de#el$)!ents in+MW !anage!ent
Waste !ini!i-ati$ns )$lic.
A))r$)riate tec&n$l$g. selecti$n 7
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
28/30
merging ,ssues
Mercur. First !ercur. d$cu!entati$n in
&ealt&care in ;;
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
29/30
merging ,ssues
In3ecti$n Safet. Increased attenti$n . &$s)itals
Fines $n unattended needles '$ t$ reca))ing
Re)$rting $f needle stick in3ur. and
f$ll$6 u)
&e!ical Safet.
M$nit$red use $f *lutaralde&.de,f$r!alde& de en-ene c t$t$(ic
-
8/16/2019 Biomedical Waste Management-by Satish Sinha
30/30
(hank .ou
Toxics Link-2, ung#ura .*t"
/ew Deli 11001
011-22003, 220411
www.toxicslink.org