Professional Documents
Culture Documents
Trainer Guide
Trainer Guide
On
Bio-Medical Waste
Management & Handling
Best Practices
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permission.
Disclaimer of USAID - The data / information expressed in this booklet necessarily does not reflect the views of
USAID/ US Government
The Health and Family Welfare Department, Government of Tamil Nadu through the
Tamil Nadu Health Systems Project (TNHSP) is committed to provide effective health care
services to the community through all the primary health centres, secondary care hospitals
and tertiary teaching hospitals in the State of Tamil Nadu. The project has pioneered various
initiatives to increase the quality of care in public hospitals of the state.
The health care facilities in the state has always the risk of spreading the infections
through the blood, body fluids, secretions and excretions of infectious patients to the
general population and the health care service providers if it is not controlled effectively.
TNHSP in collaboration with Tamil Nadu State Aids Control Society (TANSACS), Tamil
Nadu Pollution Control Board (TNPCB), State Health Society (NRHM) and AIDS Prevention
And Control Project (APAC-VHS) supported by USAID has initiated capacity building of health
care service providers in the state to implement Bio Medical Waste Management in seven
Government Medical College Hospitals & four Private Medical College Hospitals in the state.
This project is termed as PUSH (Project for Upgrading Safety in Health Care) and aims at
training 150 health care providers as Trainers in Bio Medical Waste management. They in
turn would be entrusted the responsibility of training 40,000 health care providers in the
state within a span of two years. I wish to thank the financial & technical support of APAC-
VHS – USAID and the consultant Becton & Dickinson, India appointed for this project. I wish
this capacity building exercise a great success and hope that the learning be transformed
into practice & thereby bring a great reduction in hospital acquired infections.
Bio-waste management and practice of universal work precautions in health care facilities is
critical for quality health care delivery. With increasing number of health facilities having to
manage ICTC and ART services focusing on HIV testing and other infections it is mandatory
that infection control and bio-waste management techniques are reinforced, using available
state of the art technology and capacity-building of health task-force. This will eventually
contribute to decreasing the disease burden in community as well as well-being of health
care providers at all levels.
Biomedical waste if improperly managed, places health care workers, sanitation workers,
and the general public at risk of contracting dangerous diseases as twenty percent of the
medical waste is considered hazardous and/or infectious. Therefore it is critical to have an
Infection Control and Waste Management plan for the state.
The broad objective of proposed biomedical waste management plan is to ensure the
efficient and sustainable management of potentially harmful waste generated from
healthcare facilities, which helps in prevention, care and treatment of HIV/AIDS.
This initiative of capacity building of the 11 regional training centers on BMW would help in
strengthening the state health system in hospital infection control. The cascading training
would help in training about 40,000 health care providers in the state on infection control
and thereby help in reducing the overall incidence of hospital acquired infections.
AIDS Prevention And Control Project (APAC- VHS- USAID) is happy to have supported this
initiative of the Tamilnadu Health systems project & Tamilnadu State AIDS control Society
and we express our solidarity in the fight against the HIV epidemic.
Healthcare providers, regulatory bodies and patients too, are beginning to focus on
improving healthcare safety.
There are several drivers for this – patient education and awareness, litigation, competition,
corporate governance, medical tourism and need for accreditation, ability and willingness to
pay for better quality, and the realization that the “down stream” costs of “poor quality /
safety” more than justify the costs of improving safety.
We have seen in recent times, several initiatives start off in India, in which BD is playing a
key role - National Initiative of Patient Safety – started by Minister of Health, GOI – in which
BD is the Knowledge partner, and a program to build awareness around unsafe injections,
working with IAP and Min. of Health.
BD sees “Safety” holistically – “Total Safety for Patients, Health care workers and
Community”.
We believe that the constraint in improving safety, is NOT lack of awareness about “What
should be done” - everyone in healthcare delivery has access to the best standards like JCI,
NABH and CDC. The constraint lies in the “”How” to achieve those standards, the inertia
around current practices and the infrastructure constraints.
While training on “what” and “how” is a necessary step in the journey, BD has developed a
structured, comprehensive 12 month program – Safe-I Risk Reduction Program – to help
hospitals develop their own organizational capabilities like HICC, setting up protocols and
policies based on global best practices, surveillance systems, continuous education on
medication delivery practices, formation of Infusion teams to cascade the training down to
impact bed-side practices.
TN has once again showed why it is called one of the progressive states in India – by the
vision of creating 11 Centers of Excellence in Biomedical Waste Management, and we are
proud to have been chosen by TNHSP to conceptualize this training program basis an
assessment of current reality, and to conduct the entire training program, which will finally
cover all healthcare professionals and workers across the state of Tamil Nadu.
We wish you all success in making this PROJECT PUSH a reality, and ensuring that Tamil
Nadu gets recognized as THE best in Bio Medical Waste management practices.
Rajnish Rohatgi,
Director
B.D. India Pvt. Ltd
BMW(M&H):Training module and hand-out Trainer’s Guide 6
Page
Program purpose
1. Agenda…………………………………………………………….......10
2. Module overview…………………………………………………..11
3. Implementation advice………………………………………….12
4. Resources……………………………………………………………….12
5. Instructions…………………………………………………………….12
6. Bin-it and Win-it……………………………………………………..13
7. KBC Quiz…………………………………………………………………13
8. Advance preparation……………………………………………..13
9. Target Audience………………………………………………….…13
10. Session Overview……………………………………………………14
11. Session 1……..………………………………………………………...15
12. Session 2………………………………………………………………..29
13. Session 3………………………………………………………………..36
14. Session 4…………………………………………………………………43
15. Session 5…………………………………………………………………54
16. Session 6…………………………………………………………………64
10 min Video
15 min Break
1 hour Lunch
Module overview
BMW(M&H):Training module and hand-out Trainer’s Guide10
Page
1. Session 1
Definition of BMW
BMW (M&H) Rules, 1998
Classification of Hospital Waste
Types of BMW
Lifecycle of BMW
Movement of BMW
Risks associated with BMW
2. Session 2
Categories of BMW
Colour codes for BMW
Good segregation practices
3. Session 3
Which waste is infected
Methods of disinfection of BMW
Autoclave
Microwave
Chemical methods
Sodium hypochlorite
Bleaching Powder
Disinfection Protocols
4. Session 4
Storage of BMW in wards, CSA, CTF
Transportation of BMW
Labeling
Weighing
Record Maintenance
Vehicle for transport
5. Session 5
Methods of disposal of waste
Deep burial pit
Sharps pits
Secured landfill
Liquid waste & its management
Effluent Treatment Plant (ETP)
Standards of Hospital Effluent
6. Session 6
Mercury spillage
Handling mercury spills
RA waste
Handling RA waste
Precautions
Safety of healthcare workers
Surveillance
Post exposure Prophylaxis
Degree of exposure
Implementation advice
Instructions
Arrange the colour coded bins in a straight line next to each other.
Make a mark 5 to 7 feet away colour coded bins. Place the box
containing the soft balls, each with a sticker of a bio-medical waste
generated in the hospital. Select one member of the audience. The
member is given exactly one minute to take out one soft ball at a
time and to throw it into the appropriate colour coded bin. Award
one point to every soft ball which falls into the CORRECT colour
coded bin.
KBC Quiz
Select one member of the audience and bring him/ her to the front
of the group. Let him be seated on the ‘hot-seat’. Using the slide set
on KBC (Kaun Banega Crorepati quiz) display the questions and
await their answers and ‘lock’ the same. Involve the audience only
after the selected member’s answer has been ‘locked’.
Advance preparation
Target audience
Session Overview:
BMW(M&H):Training module and hand-out Trainer’s Guide13
Page
Resources required
Steps Time Activity/ Methodology Content
10
1 min Group interaction Welcome Message & introduction
10
2 min Video presentation Oru Nodi Podhum video LCD/overhead projector, speakers
10
3 min Group interaction Interactive session based on video LCD/overhead projector, flip charts
Biomedical waste its importance &
4 1 hour Trainer presentation risks LCD/overhead projector, flip charts
15
5 min Trainer presentation Lifecycle of waste LCD/overhead projector, flip charts
30 Need for Segregation & colour
6 min Trainer presentation coding LCD/overhead projector, flip charts
30
7 min Trainer presentation Importance of Disinfection LCD/overhead projector, flip charts
20
8 min Energiser activity Fun activity on segregation Colour bins, soft balls, stop-watch
30
9 min Trainer presentation Transport and storage LCD/overhead projector, flip charts
30
10 min Trainer presentation Treatment and disposal. LCD/overhead projector, flip charts
30 Management of other hazardous
11 min Trainer presentation waste LCD/overhead projector, flip charts
15 KBC quiz slide set, LCD/overhead
12 min Energiser activity KBC quiz projector
Surveillance / Record maintenance
13 1 hour Trainer presentation / HCW safety LCD/overhead projector, flip charts
30 In-house practice Hospital Tour - identifying best
14 min observation practices Guide for hospital visit
Trainer’s Notes:
Trainer’s Notes:
Briefly state the objective of the PUSH in the following
manner:
Trainer’s Notes:
Briefly mention the different sections that will be
covered in the training module
Slide 4
Slide 5
Trainer’s Notes:
Briefly state the broad objectives of the training
module as mentioned in the slide.
Trainer’s Notes:
Trainer’s Notes:
The objective of this slide is to simplify the definition
of BMW mentioned in the previous slide.
Trainer’s Notes:
Before explaining about the content of the
slides, give a brief background about how in
India (like in the other countries) medical
waste was considered a part of the municipal
waste till the BMW (M&H) Rules of 1998
After mentioning the first two points of the
slide, emphasise more on the last point where
proper management of BMW is a statutory
requirement that is MANDATED BY LAW.
Avoid using words like mandatory and
statutory while addressing audiences whose
language skills may not be advanced.
Slide 10
Trainer’s Notes:
The objective of this slide is to instil into each one of
the participants, the importance of being aware of
BMW.
Trainer’s notes:
This slide depicts the end objective of the entire gamut
of BMW(M&H) rules, which is to ensure the safety of
humans and the environment.
Trainer’s Notes:
Using your laser pen, point out to the
quantity of waste that is generated in Indian
hospitals everyday on a per-bed basis. Please
keep in mind that there are other studies
which mention slightly different numbers as
well.
There are also variations in the amount of
waste generated in the government and the
private hospitals.
Before explaining about the classification of
hospital waste, mention that NOT ALL WASTE
GENERATED IN THE HOSPITAL IS BIO-MEDICAL
WASTE. In fact, most of the waste (80%) is
general waste.
While mentioning about the classification of
BMW emphasise that not all BMW is
infectious waste. Pharmaceutical waste and
Slide 13
Trainer Notes:
Contaminated wastes are those wastes which are
contaminated with blood and/or other body fluids.
Trainer’s Notes:
Trainer’s Notes:
This slide shows the different types of BMW
GENERATED ONLY IN THE LAB like culture plates, slides
after examination and liquid waste.
Trainer’s Notes:
Trainer’s note:
This slide gives the outline of the entire
lifecycle of BMW
Using your laser pen, point out to all the
different stages mentioned in the slide
Give an example of a particular type of BMW
like an I.V. tubing (or) give an example of a
particular ward and ask the audience to give
their opinion of what has to ideally happen in
every stage of the lifecycle
Once the audience has completed the task of
creating an imaginary sequence, ask them
whether these practices are being carried on
in the hospital premises diligently
Slide 22
Trainer’s note:
All the stages of BMW lifecycle are NOT
completed inside the hospital. Even within
the hospital, there are different areas which
are involved in the entire lifecycle
The objective of this slide is to give a broad
picture of the movement of BMW across the
different areas
Emphasis has to be made towards proper
segregation and disinfection since a gap early
in this lifecycle (where the healthcare
professionals are involved) would lead to a
failure downstream.
Slide 23
Trainer’s note:
Involve audience by asking these interactive
questions.
Trainer’s note:
Now that the audience is aware to an extent about the
lifecycle of BMW and its movement across different
areas, they should also realise that this would be a
risky affair if recommended guidelines are not
followed
Trainer’s Notes:
Point out to all the types of BMW mentioned
in the slide and emphasize on the high
number of the types of BMW that is risky
‘Risky’ as a term refers to the fact that the
BMW could cause an infection or is highly
likely to cause a ill-effect on the health of the
affected individual
Selected members of the audience could be asked to
enumerate the reasons why they think a particular
waste is risky?
Slide 26
Trainer’s Notes:
In this slide, first point out to the pictures
which highlight the different unsafe practices
in BMW Management and Handling.
Give examples for each of these unsafe
practices like improper collection of needles,
reuse of syringes and improper disposal of
waste in the surroundings respectively.
Now move to the impact of these unsafe
practices which would be injuries (like needle
stick injuries), infections like Hep-B, HIV and
toxic effects like release of dioxins which are
carcinogenic released due to incomplete
incineration
These risks will be discussed in the following
slides
Trainer’s Notes:
This slide should be a follow up of the explanation in
the previous slide.
Percutaneous injury refers to any injury on
the skin with a needle or any other sharps
‘Contact’ refers to contact of blood or other
body fluids which might contaminate the bio-
medical waste
Trainer’s note:
Mention that these diseases are of major concern to
us as HCW.
Slide 29
Trainer’s Notes:
Talk about viruses-only a brief overview of this list.
Emphasize on the long list, and what we know & talk
commonly are only 3 of these 33, which means that
there is lot more that could be transmitted via
occupational exposures.
Trainer’s note:
Trainer’s Notes:
Point out to the incidence rates mentioned in the
slide. To give a clearer picture, mention that for every
100 persons infected with Hep B positive needles, 30
would be infected. Similarly 1.8 would be positive for
HCV but in the case of HIV it would be 3 cases for
every 1000 NSIs.
Trainer’s note:
Explain the iceberg analogy and mention that what we
know is only the tip.
Slide 34
Trainer’s note:
Trainer’s note:
Trainer’s Notes:
Which professionals in the hospital are at most risk,
highlight the most affected are Nurses & Physicians,
followed by technicians.
Slide 37
Trainer’s Notes:
The objective of this slide is to portray the
high number of individuals who are exposed
to a risk at any given time.
But the fact remains that anyone can be
exposed to the risk of improper management
and handling at any step of the lifecycle of
BMW.
Slide 38
Trainers Notes:-
In the lifecycle of BMW managements, all the
steps are very very important.
However the most important step is the
segregation
can anyone explain why?
Slide 42
Trainers Notes:-
Slide already discussed.
Remind about the lifecycle of waste
Trainers notes:-
let us see the definition of segregation
again repeating that the most important step
in the lifecycle of BMW management is……..
Slide 44
Trainers Notes:-
what all do you think the hazards of improper
segregation and hence the mixing of the
waste is?
Point out at each one of the point and
carefully read them with explanation of the
points
Mixing of infectious and non infectious waste
makes the whole waste infectious.EMPHASIZE
this…
Slide 45
Trainers Notes:-
We are all again and again stressing on the
importance of segregation, but we want to
segregate waste according to what?
What are the guidelines?
All Biomedical wastes are divided into 10
categories by the central pollution control
board.
Lets quickly go through them….
Trainers Notes:-
Point out at each one of the pictures on the
slide and gives examples
1- human body parts or anatomical wastes
2- Animal and their tissues used at various
places like labs
3- All the laboratory wastes like live cultures
4- All forms of sharps like needles, scalpels,
glass,etc
5- All the discarded and expired medications and
the cytotoxic drugs
Slide 47
Trainers Notes:-
6- all the soiled or blood and bodyfluid
contaminated waste like plasters and
bandages soiled with blood.
7- Solid contaminated wastes like iv sets, plastic
tubings, IV bottles,etc
8- All liquids and chemicals used for cleaning
and like the detergents used in cleaning the
floors
9- Incineration ash derived from burning of the
wastes.
10- Solid and liquid chemicals like hypochlorite,
formalin and other chemicals
Slide 48
Trainers Notes:-
Point out at each one of the colours on the
slide with attention on each of the categories
These colours tell us the exact segregation
and the bins they are to be discarded in
Yellow-1,2
Blue- 4
Red- 3,6 &7
Black- 5, 9 & 10
Trainers Notes:-
Trainers Notes:-
So how does colour coding help in
segregation?
Point out at the points one by one and explain
Standardizing the practices so that the
understanding is uniform and hence the
compliance
We can decide on where the bag has to be
sent (incineration/autoclaving,etc) just
looking at the colour coding and without
having to open each of the bins to check the
content. Imagine what would have happened
without the coding…the bin/bag would have
had to be opened every time we wanted to
discard any waste
Thus with colour coding, a uniform practice
guideline can be laid down
Slide 51
Trainers Note:-
Here is the first of the colour coded bins with
what all is to be discarded in it.
They include all the human anatomical wastes
and body parts and all forms of animal wastes
used in the laboratories for various purpose
like research, vaccine production, etc
Slide 53
Trainers Notes:-
This slide show’s the colour coded blue bin
and the category of wastes that shall be
segregated into this blue coloured bin.
Enumerate all the examples of category 4
(sharps) to avoid all confusion.
All glass also are in this category as they are
potential sharps.
Use pointer to show the pictures on the slide
projected
The needles shall be destroyed in a needle
burner before discarding.
The needles shall be then put in the blue twin
bin which contains freshly prepared 1%
sodium hypochlorite.
Trainers Notes:-
This slide shows the color coded black bin and
the category of wastes that shall be
segregated into this black colored bin.
The categories of waste which are discarded
into this bin are category 5, cat 10 and cat 9.
(use the pointer to show each category and
enumerate the examples in each category)
Trainers Notes:-
Trainers Notes:-
Again stress on the fact that, of all steps
in the lifecycle of BMW management, the
most important is segregation. If
segregation is improper, the 20%
hazardous will contaminate the
remaining 80% of nonhazardous . Thus
100% of hospital waste becomes
hazardous.
Thus good segregation will also save on
the cost to the hospital as disposal of
hazardous waste is the costliest and it
shall be limited to 20%.
Also the HCW, especially the BMW
worker can be safe from injuries due to
sharps entering the wrong bag and thus
giving him/her a fatal NSI.
Slide 58
SESSION 3
Slide 60
Trainers Notes:-
What is disinfection?
How is it different from sterilisation?
Trainers Notes:-
We have seen generation of waste, the
segregation and its importance. Now lets
proceed to the next step in the cycle which is
‘Disinfection’.
Slide 62
Trainers Notes:-
Trainers Notes:-
This slide in a glimpse shows the various
categories of waste in the hospital which need
disinfection.
Enumerate the categories and correlate them
with the colour coded bins with the help of
demonstration tools
Trainers Notes:-
Enumerate each of the waste.
Ask if any participant is from the lab services
and ask him the type of wastes in his/her
clinical area
Then ask his/her understanding of why the
wastes are hazardous for the benefit of other
participants.
Explain the concept of live vaccines-i.e. they
contain live microorganisms or weakened
microorganisms.
Culture in the lab is the process of growing-
isolating and identifying the microorganisms
responsible of causing disease. There are
various equipments used for this purpose like
petridishes, testtubes, etc
Slide 65
Trainers Notes:-
Enumerate all examples with explanation of
scalpels, razors and how glass is sharp
(breakage)
Slide 66
Trainers Notes:-
Soiled in this context means any material
contaminated with patient blood or body
fluid. This could be fresh(wet) or old (dried).
Enumerate the examples
Throw a question as to where the sanitary pads would
go ??
Ask them where they dispose their cotton swabs in the
phlebotomy rooms?(which colored bags)?
Trainers Notes:-
These are items like IV sets, cvcs, and other
catheters.
Ask them how they dispose these items at
present
Ask them if used iv sets are contaminated and
why, (explain the concept of backflow and
negative pressure and hence they do not need
to be visibly blood stained to be
contaminated
Use pointers to point the items.Emphasize
saline pouches.
Slide 68
Trainers Notes:-
What are all the liquid wastes in the
hospitals?
Use flip charts to enumerate all the liquid
wastes from the hospitals
Try assigning them to the clinical areas they
are used in
Assign on the flip charts the method of
disposal of these wastes
Try to probe if these wastes are infectious are
hazardous? and reasons to why they think
this .
Tentative answers:- phenol, hypochlorite, formalin,
soap, bleach, other decontaminating agents.
Slide 69
Trainers Notes:-
Biologicals are materials used to prepare and grow
microorganisms, eg:- media used in the laboratories,
nutrient broth, glucose broth, etc
Trainers Notes:-
First ask whether recapping prevents sharps
injury and if it is considered a good practice?
We all know that recapping is not a good
practice and still we do it intentionally or
unintentionally.
Another problem is that we leave the needle
unattended, also wrong because it may harm
someone else.
How will you realise that the needle which
was left unattended was contaminated or
not?
Hence the best practices are……as given on
slides.
Ask them how they decontaminate the needles, if they
do?
How long do they immerse in the disinfectant
solution?
When and how they prepare the solution? Keep
sweets for the answers to increase participation.
Trainers Notes:-
Now we know the difference between
disinfection and sterilization.
We also know that we have to segregate and
then decontaminate the BMW
Now let us see the different ways in which
disinfection of waste is done
Autoclaving---in which steam under high
pressure is used to disinfect
Microwave--- in which materials are shredded
& soaked in water, water is then heated to
disinfect.
Chemical Method
These are chemicals like sodium hypochlorite
or bleach, used for disinfection
They also kill the infectious organisms by
multiple mechanisms
The commonest concentration required
for disinfection is 1% sodium
hypochlorite.
Trainers Notes:-
This is one of the commonest used processes
It is also efficient and reliable
Slide 73
Trainers Notes:-
Also is another physical method of
disinfection
Slide 74
Trainers Notes:-
In this method we can use different types of
chemicals are used as mentioned below
They require no special equipments and can
be used for most BMW disinfection
Trainers Notes:-
The commonest and most reliable chemical
used for disinfection is sodium hypochlorite
There are various concentrations which are
used for disinfection of various BMWs
As shown 1% is the most commonest in use
dilution which we use in the hospitals for
disinfection
The commonest form in which this solution is
available is in 5% concentration, to be diluted
just before use
Slide 76
Trainers Notes:-
It is very important that the solution is to be
freshly prepared, because when kept after
preparation, the solution begins loosing
chlorine and hence the ability to disinfect also
Also, more the contaminant load, more will
be the disinfectant required. Therefore
heavily soaked material require a 10 %
concentration
It corrodes some metals and hence plastic
containers are preferred for keeping the
freshly prepared hypochlorite solution
Minimum contact time required is 30
minutes.
Slide 77
Trainers Notes:-
Here are the disinfection protocols for a few
common waste materials.
Ask the participants that in their setup, what
is the concentration used for these items?
Are they different or the same concentration
is used uniformly?
SESSION 4
Trainers Notes:-
Ask the participants what all steps we have covered till
now and next is what?
Slide 81
Trainers Notes:-
After disinfection we all keep the waste in our
wards for some time till the waste transport
worker comes to transport it
Lets see the important points in the this
storage of the waste
Slide 82
Trainers Notes:-
There is storage of waste at different places
and for different amount of time which is ….
Trainers Notes:-
This shows the flow pattern of the BMW
along with the temporary storage areas
Point and read each of the blocks and a brief
explanation for each
Slide 84
Trainers Notes:-
Note how each of the bins have a poster on
segregation above on the wall.
Also note the type of gloves used by the workers
Trainers Notes:-
The central storage area should be away from
the public traffic
It should be closed and secured area under
lock and key
No animals, rodents or pests should be
allowed to enter the area
The entry to the facility should be dedicated
The area should be dry and clean with no
spillage or stray materials lying on the floor
The area should have separate areas for
different colour coded bins storage
It should have a functional weighing scale for
weighing the waste and recording before it
leaves the hospital facility
The worker incharge of this facility should be
vaccinated.
Slide 86
Slide 87
Trainers Notes:-
Continue with the points of CSA
Trainers Notes:-
Trainers Notes:-
Point the CTF and say that once the waste
arrives there it should ideally be disposed in
24 - 48 hrs.
Trainers Notes:-
Now summarize each of the steps of lifecycle
of the waste we have seen till now.
Slide 91
Trainers Notes:-
Use the pointer as you revise these steps in
the lifecycle and stop at transportation
Slide 92
Trainers Notes:-
The waste has to be transported at multiple
levels from the point of generation to the CSA
and from the CSA to the CTF.
These BMW, most of them are hazardous and
hence precautions have to be taken during
the transport
Lets see what these NOT to be forgotten
points are during this multistep transport of
the BMW.
Point the points at the bottom of the slide and
read out loud to stress on the importance.
Trainers Notes:-
Ask the participants to name the symbol and where all
it should be used in the hospital and outside.
Slide 94Slide 95
Trainer’s Notes:-
1) Briefly discuss about the Transportation of BMW
from the wards to CSA.
2) Talk for a few minutes about the best practices to
be followed while transporting BMW to CSA
All the bags should be labelled and secured
the bags should not be more than 3/4ths
full
designated trolleys should be used for
transportation
grade IV workers transporting the waste should
wear appropriate PPE
Trainer’s Notes:-
Trainer’s Notes:-
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Trainer’s Notes
Talk about the key personnel entrusted
with the task of record maintenance
Trainer’s Notes:-
Speak for a few minutes on the best
practices to be followed During Transport
of BMW
Talk about the dangers of mixing BMW
And steps to prevent spillage
Slide 102
Trainer’s Notes:-
Here more details on the trolleys used for
transport of BMW are discussed
Trainer’s Notes:-
Speak about the vehicles used for
transporting BMW from CSA to CTF
Trainer’s Notes:-
Trainer’s Notes:-
Trainer’s Notes
Trainers Notes:-
Introduce the new slide which deals about
Slide 108
Trainers Notes:-
Talk for a few minutes about the
advantages of proper record keeping
Trainers Notes:-
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Continuation of previous slide
Trainers Notes:-
Introduce the technology Autoclave
Briefly discuss about the process and
the advantages.
Slide 124
Trainers Notes:-
Introduce the Technology Shredding
Trainers Notes:-
Talk for a few minutes about deep burial pit.
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SESSION 6
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Introduce the next slide PEP
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How is it transmitted?
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Define surveillance.
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