MANUAL ON WASTE MANAGEMENT IN THE HOSPITAL: I. Introduction An old saying says “Cleanliness is next to Godliness”.

The essence of this was aptly captured by Dravidians, who in 5000 BC gave due emphasis to immaculate town pla nning and safe and effective sewerage systems who got rid of all solid and liqui d wastes generated by the pollution. They were indeed the pioneers as far as sci entific waste management is concerned ; which is borne out from excavation of Mo hanje-Dora and Harapa. The modern hospitals and health care institutions includi ng research centres use a wide variety of drugs including antibiotics, cytotoxic s, corrosive chemicals, radio active substances, which ultimately become part of hospital waste. The advent of disposables in the hospitals has brought in its w ake, attendant, ills i.e. inappropriate recycling, unauthorised and illegal re-u se and increase in the quantum of waste. All round technological progress has le ad to increased availability of health related consumer goods, which have the pr opensity for production of increased wastes. The issue of improper Hospital Wast e Management in India was first highlighted in a writ petition in the Hon’ble Supr eme Court; and subsequently, pursuant to the directives of the court, the Minist ry of Environment and Forests, Govt. of India notified the Bio-Medical Waste (Ma nagement and Handlings) Rules on 27th July 98; under the provisions of Environme nt Act 1986. These rules have been framed to regulate the disposal of various ca tegories of Bio-Medical Waste as envisaged therein; so as to ensure the safety o f the staff, patients, public and the environment. The Govt. Medical College Jam mu is a referral, tertiary care hospital. It has many associated hospitals like Govt. Medical College Hospital Jammu, SMGS Hospital, Dental Hospital, Psychiatry Disease Hospital and Chest Disease Hospital. The GMC Hospital is biggest of all , with bed strength of 850 beds. It has the clinical specialities like Medicine, Surgery, Orthopaedics, Eye, Radiodiagnosis, Radiotherapy and Anaesthesiology. T he para/non-clinical specialities which provide support to the hospital are Anat omy, Physiology, Pharmacology, SPM, Blood Bank, Pathology, Microbiology, Forensi c Medicine and Biochemistry. The indoor complex of the hospital has 1 to 15 ward s (Surgery, Medicine, Eye, Ortho & RT). The specialised nursing care units like ICU, CCU, dialysis Unit, spinal and burn ward etc. are also available. The hospi tal has 11 major operation theatres and 4 minor operation theatres. The major op eration theatres are in a separate OT complexes like Main Surgical OT, Ortho OT, Eye OT and Emergency OT. The separate Out patient department (OPDs) for Medicin e, Surgery, Orthopaedics, Eye, Radiotherapy, Physiotherapy and Electro Medical D iagnosis Deptt. (including facilities for ECG, EEG, TMT, Endoscopic procedures e tc.) are also available. Almost 1000 patients (average) attend these OPD every d ay. The Emergency Department of the hospital runs round the clock with almost mo re than 400 patients attending the Casualty of the hospital every day. The facil ities of emergency lab. X-Ray, ultrasound, ECG, CT Scan and Blood Bank are avail able 24 hours in the emergency. An emergency indoor ward, post operative recover y ward, emergency OT complex and disaster ward is also attached to the casualty. The OPD Labs. (Pathology/Microbiology/Biochemistry) are also separately located near the OPD blocks for the benefit of OPD patients. The separate Blood Bank an d the Immunisation Section (Antirabic) is also available. The hospital has its o wn CSSD, Laundry, Kitchen, Mortuary and hospital stores. These activities genera te a lot of waste which should be managed properly with care. II. WASTE MANAGEME NT POLICY The Bio-Medical Waste Management policy at GMC has been framed to meet the following broad objectives :–

(b) Health hazar ds associated with improper hospital waste management: A number of hazards and r isks are associated with this viz. including its container a nd any intermediate product. the policy statement aims to provi de for a system for management of all potentially infectious and hazardous waste s in accordance with the Bio-Medical Waste (Management and Handling) Rules 1998. drugs. * Risks associated with hazardous chemicals. in research pertaining thereto. especially due to imperfe ct treatment and faulty disposal methods. (ii) Defining the various categories of waste being generated in the hospital/health care institution. III. NEED FOR BIO-MEDICAL WASTE MANAGEMENT (a) (Statutory) Legal Obligation : I n accordance with the provisions of the Bio-Medical Waste (Management and Handli ng) Rules 1998.” (c) Clinical Waste : Is defined as “any waste coming out o f medical care provided in hospitals or other medical care establishments. being handled by persons handl ing wastes at all levels.” (b) Medical Waste : Is a term used to des cribe “any waste that is generated in the diagnosis. or in the production or testing of biologicals. and (eventually) the general public. IV. deadline for GMC was 31st December’ 1999. * Injuries from sharps to all categories of h ospital personnel and waste handlers. biological or non-biological that is generated from a hospital. by which the rules must be conformed with.” (d) Hospital Waste : Refers to all waste . or i n the production or testing of biologicals and the animal waste from slaughter h ouses or any other like establishments. so that each category is treated in a suitable manner to render it harmless. (a) Bio-Medical Wast e : May be defined as “any solid. and is not int ended for further use. treatment or immunisation of human beings or animals. organ. * Risks of infections outside h ospitals for waste handlers. which is generated during its diagnosis. bo dy parts. * Nosocomial infections in patients from p oor infection control and poor waste management. water and soil pollution. fluid or liquid waste. failing which legal action can be initiated. body fluids and specimens along with their containers. POLICY STATEMENT Summing up. (vi) Changing the use patterns from single usage to multiple usage wh enever possible. in research pertaining thereto. (iv) Identifying and utilising proper “treatment technolog y” depending upon the category of waste. (e) Pathological Waste : Is defined as “waste removed durin g surgery/autopsy or other medical procedures including human tissues. (v) Creating a system where all categorie s of personnel are not only responsible. but also accountable for proper waste m anagement.(i) Changing an age old “mind set” and attitude through knowledge and training. treatment or immunisation of human beings or animals. DEFINITIONS It is important to know the definitions so as to be able to understand the categ orisation and other steps of waste management subsequently. but d oes not include waste generated at home. scavengers. c) Environmental hazards : Improper hospital waste man agement also results in air. (iii) Segregation and collection of various categories of was te in separate containers.” .

Plastics afte r disinfection and shredding. dishes a nd devices used for transfer of cultures) Category No. X-ray film. documents. it may be solid. if concentration and virulence of pathogenic organisms is sufficiently high.3 Microbiology & Biotechnology waste (waste from laboratory cultures . that may cause puncture and cuts. other types of waste generated in hospitals are : (h) Radioactive Waste : Which includes waste contaminated with radionucli des. V. (g) Hazardous Waste : Refers to that portion of Bio-Medical Waste which has a potential to cause hazards to health an d life of human beings. glass. floor swe epings and also includes kitchen waste. fluid. 4 Waste Sharps (needles. 9 Incinerati on Ash Category No. 7 Solid Waste Category No. (j) General Waste : Includes general d omestic type waste from offices. housekeeping and disinfecting activities) (ash from incineration of any bio-medical waste) Ch emical Waste (chemicals used in production of biologicals. This i ncludes both used and unused sharps). syringes. organs. as insecticides. In addition. bleeding pa rts. (i) Pressurized Waste : Include compressed gas cylinders. animals houses) Category No. metal cans. 5 Discarded Medicines (waste comprising of outdated contaminated an d discarded medicines) Category No. solid linen. reclaimed silver from X-ray developing solution. dressings. stores. and body fluids including cotton. in-vitro imaging and other therapeutic pro cedures. cleaning. body Wastes parts) Catego ry No. catheters.(f) Infectious Waste : Refers to that portion of Bio-Medical Waste which may tra nsmit viral. discharge from hospitals. (k) Recyclable Waste : Includes the foll owing: Glass after cleaning and disinfection.2 Animal Wastes (animal tissues. other material contaminated with blood) (Wastes generated from dispo sable items other than the waste sharps such as tubings. body parts carcasses. These are generated from in-vitro analysis of body fluids and tissues.) (waste generated from laboratory and washing. letters. chemicals used in dis infection. toxins. human and animal cell culture used in research and infectious agents from research and industrial laboratories.10 VI. etc. waste from production of biologicals. blood and experimental animals used in research. blades. liquid or gaseous waste. bacterial or parasitic diseases. 8 Liquid Waste Category No. corrugated cardboard. etc. CATEGORISATION OF BIO-MEDICAL WASTES Bio-Medical waste have been categorised into ten different categories as mention ed in the table below :– OPTION WASTE CATEGORY WASTE CONTENT Category No.) Category No. cardboard containers. stocks or specimens of m i c r o organisms live or attenuated vaccines.1 Human Anatomical (human tissues. intravenous sets etc. scalpels. linen . Category No. HOSPITAL WASTE MANAGEMENT COMMITTEE . 6 Solid Waste (items contaminated with blood . organs. plaster casts. aerosol cans and disposable compressed gas containers. catering areas. beddings. alumi nium. waste generated by veterinary hospitals. public areas. paper. comprisin g of newspapers.

Treatment GMC-as per Bioroom. (A) Generation of Wastes : The following table dep icts wastes generated at GMC Hospitals :– Type (i) Non-Hazardous (General) Site of Generation Office. Administration. VII. Conversely small errors at this stage can create lot of subsequent problems. (B) Segregation of Wastes : Segregat ion or the separation of different types (categories) of waste by sorting at the point of generation. It is now universally accepted that segregation is the responsibility of the gener ator of wastes . Cashier. Rest ro oms Hostels. of was tes are generated per bed per day which gives an idea about the tremendous volum e of waste generated on a day to day basis. has been considered as the “key” for the entire process as it allows special attention to be given to the relatively small quantities of infec tions and hazardous waste. etc. MRI rooms and various followup clinics * Quantum of Wastes : Studies carried out have indicated that about 2 Kg. C T Scan. clinical departments. All laboratories. The responsibilities of the various categories of the staff involved in the generation. treatment and disposal of wastes is formulated and impl emented by this committee. pathology and microbiology departments and has powers to take decisions on all matters relate d to Bio-Medical Waste Management in the respective hospitals. nursing station. thus reducing the risks and cost of waste management. Pantries in wards. OPERATIONAL ASPECTS The practical operational aspects regarding proper management of Bio-Medical Was tes has been described under each step starting with the generation and ending w ith final disposal of wastes. Kitchen Cafeteria. Billing. Rules Operation theatres. Dialysis and Endoscopy rooms. Minor OTs. Stores. Disposal by Muni cipal/ Civic Authorities (ii) Hazardous (Infectious and toxic) Wards.A Hospital Waste Management Committee has been established in each of the associ ated hospitals with a view to improve and streamline Hospital Waste Management a nd for proper implementation of Bio-Medical Waste Management Rules’ 98. under the chairmanship of the Medical Superintendents. This smaller core group is responsible for implementation of these rules. Pharm acology OPDs’ Injection rooms and procedure rooms. Medical Waste Isolation ro oms. It is a broad based committee with representative from hospital administration. Blood Bank Pharmacy and Medical Stores. Intensive Care Units and post operative recovery room. Residential areas. tra nsportation. collection. collection.

which should be changed at least once times. II. nurses and paramedics. and it becomes a truly Herculean ta sk to segregate or sort out various categories. once they have been mixed up. in reality. and put the syringe in the solution. However. *She shoul d ensure that twice in a day these are replaced by the centralised gang and sign in the register. doctors. nurse or para-medical personnel. to des troy the needle. Wards – Treatment Room *Colour coded *Sister I/C should ensure that and sl uice room (yellow.i. Blood Banks stroyer and put in *Colour coded *Officer Incharge of the lab/unit (yellow. * Factors affecting segregation at source: (i) Hospital policy and procedures (ii) Motivation and training of “generators” i. containers lined with capacity are present lined wit h priate colour appropriately coloured polythene polythene bags bags. *Colour coded *She should ensure that punct ure (yellow. the doctor. and at both these places. RESPONSIBILITY medical staff should be puncture proof container. (iii) Facilities provided for segregation * Proposed system for segregation: SITECONTA INER I. and to ensure that the polythene bags black) medium sized are regularly replaced and sent bins lined wi th for treatment/disposal coloured polythene bags *Electrical/manual *Clinical & Para Clinical staff needle deshould segregate the waste generated at source app ropriate container . *Doctors / nurses and parainstructed to use the same. this job is always relegated to the sanitation staff. blue and proof container contains 1% Sod black) large size bins Hyp ochlorite in a day. with 1% Hypochlorite sol.e. two large black) large size bins (w ith cover) of hundred ltrs. Laboratories and Sample Co llection centres incl. – Bathroom and *Only black coloured Toilets bags bins lined by b lack polythene bags – Nursing station *Needle destroyer *Sister I/C should ensure that the (electric / manual) equipment is functional at all *Puncture proof In c ase of fault she should inform containers (double bin) the Officer I/C to get it replaced.e.

4-Waste Sharps i. need not to be put into bags) Category No. dressings. blood and experimental animals used in research. 6-Solid Waste i.e. waste generated by vet erinary hospitals. Puncture Inscription on bag “For autoclaving Ca tegory No. 3-Micro biology & Biotechnology Wastes i. TABLE: COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF BIO-MEDICAL WASTES Co lour Coding Identification Waste Category & Constituents Treatment Option Yellow colour Plastic bag withCategory No.Incineration polythene inscription “for mical Wastes i. & black Supervisor/Sister I/c to ensure that these are present. animal houses. “Cytotoxic” all animals tissues. *Electrical/manual *Sharps like needles to be desneedle destroyer troyed by usin g the destroyer. body parts carcasses bleeding parts . that may cause punture & cuts. other material contaminated with blood except plastics. Category No. 2-Animal Wast es i. bags of different incinerat ion only” organs. soiled plaster cas ts. 1-Human Anato. discharge from hospitals. scalpels.e. stocks or s pecimens of micro-organisms live or attenuated vaccines. Autoall needles. human and animalcell cu lture used in research and infectious agents from research and industrial labora tories.III.e. and body fluids including cotton. syringes. Operation theatres and Intensive Care Unit *Colour coded medium or large sized bags (depending upon quantity of waste gener ated) with coloured polythene bags-yellow. HyHypochlorite WHAT GOES WHERE ? – A GUIDE po chlorite solution. fluid.e. Blue colour polythene bags of diffclaving erent sizes in bl ue coloured bins/ bols of “Biodrums. linen. wastes from laboratory cultures. all items contamin ated with blood. beddings. (If disinfected locally. proof container with 1% Sod. polythene bags are chang ed regularly. *Clinical and Para Clinical staff to segregate the waste generated at source and put in appropriate container. body parts which are gesizes in yellow coalong with symbol nerat ed in patient care areas lourd bins/drums “Biohazard” and Category No. (This includes both used a nd hazard” and Cytounused sharps) . organs.e. blades only” with symglass etc. wastes from production of biologicals. toxins. *Puncture proof con*Syringes to be put in puncture ainter with 1% Sod. all human tissues. dis posables and sharps.

after which it is transported for treatment and disposal by the sanitation staff of centralised gang. etc.e. proof container a ll wastes generated from disshould be inscriposable items (other than the waste bed. all chemicals used in pro duction of biological used in disinfection. the coloured polythene bags should be replaced and the garbage bin should be cleaned with disinfectant regu larly. after which it is sent for treatment and disposal . 9-Incineration Ash i.e. (D) Storage of Waste : Storage refers to the holding of Bio-Medical Waste for a certain period of time. catheters. there is a l ag period of two to three hours. Subsequently. (should be returned back to medical stores for fur ther disposal) Category No.e.proof container toxic”. – The proce ss of collection should be documented in a register. Puncture Category No. * Operational Aspects: – From these sites the sanitatio n staff from the centralised gang will collect the waste during morning and afte rnoon. All General Wa stes Civil Authorities treatment would NOTE : Autoclave facility not available in the hospital so the waste after chemi cal be put in yellow bins.Discarded Secure Medicine s and Cytotoxic drugs land fill i. 10-Chemical Waste i. waste is stored in the areas of generation (as mentioned in table 1) for a n interim period varying from two to twelve hours. (sh ould be cut into smaller pieces with the help of scissors) Black colour No inscr iption plastic bags of different sizes Category No. all wastes comprising of outdated. 5. only” intravenous sets etc. as insecticides. attendants or visitors. 7-Solid Waste i. There is a need to be vigilant so that intermixing of different categories of waste is no t done inadvertently by the patients. During this period it is the responsibility of the clinical and para-medical staff to c heck that there is proper segregation and no subsequent recycling of disposables and other items. At GMC Hosp ital. It is the responsibility of the sanitation staff and security staff to en sure that rag pickers and other unscrupulous elements do not gain entry and sort out the waste for “recycling” purposes.e. during which the waste is “stored” opposite the mor tuary. In other words it means the duration of time wastes are kept at the site of ge neration and transit till the point of treatment and final disposal. during transportation of the waste. . The containers for collection should be strategically located at all points of generation as menti oned in the earlier table. “For sharps sharps) such as tubings. contamin ated and discarded medicines. ash from incineration of any Bio-Medical Waste Category No. under supervision of the staff nurse and sanitation supervisor. (C) Collection of Waste : Collection of Bio-Medical Wastes should be done as per rules in colour coded plastic bags as mentioned in the earlier table. (E) Transportation of Waste : Transportatio n of Bio-Medical Waste can be divided into intramural (internal) and extra mural (external) transportation.

The general waste (in black polythene bags) should be deposited at the municipal dumps. opposite the mortuar y adjacent to the incinerator site. the waste collected in blue bags will be transported to the site of autoclaving and shredding for treatment. adjacent to the generator room. disposable and paper containers for t ea/coffee etc. the sanitation staff sh ould obtain a proper receipt.* Intramural (internal) transport : The sanitation staff from the centralised ga ng will be responsible for transporting the different coloured polythene bags in garbage bins from the sluice room. The functioning of the autoclave and shredder including the number of cycles per day will be maintained in a log tabl e and periodically monitored by engineers as per J&K PCB norms. It is the responsibility of the supervisor to ensure that rag pickers and other unwan ted elements do not rummage through the waste for re-using of disposables and pl astics. These general wastes should be put into black co loured polythene bags and are deposited at the municipal dump opposite to the mo rtuary. The functioning of the incinerator and the number of cycles operated per day should be documented in a log book. * Incineration : The waste collected in yellow coloured bag s is transported to the site of incineration. it is the responsibility of the h ospital security(Police/contractor) to ensure that rag pickers are not allowed e ntry into the dumps. The ash produced by incineration should b e sent for secure land filling. These bags will be transported in the vehicle by the Municipa lity authorities.. and comprises of paper. the waste will be taken through main ramp in covered trollies to the ground floor. peels of fruits. prior to autoclaving and shredding. outer cover or wrapping of disposable items l ike syringes. * Autoclaving and Shredding : Once the autoclave facility is installed in the hospital. After the waste (in yellow colou red bags) is deposited in the custody of the supervisor. and it is his/her responsibility to get the res pective trolleys/carts cleaned and disinfected. and fr om there to the area near the incinerator/mortuary. Regular monitoring of the process shoul d be carried out by the engineers as per J&K Pollution Control Board norms and f eed back provided to officer incharge. Th e incinerator is maintained on contract basis by the Engineering services depart ment and is manned by a supervisor and workers. The Sanitation Officer is responsible for proper co-ordination b etween municipal authorities and GMC. card boards boxes. It is subsequently collected by the local municipal authorities for disp osal every day. From all the floors and wings. left over food articles. This waste is non toxic and non infectious. (F) Treatment and Disposal of Hospi tal Waste : * Civic Authorities : Most of the waste (about 80%-90%) generated in the hospital is general waste which is similar to the waste generated in house and offices. However. * Extramural (external) transpor t : This will be required only for the general waste collected in the black colo ured plastic bags. The process of deposition of the waste for autoclaving and shredding will also be documente d and a register will be maintained for the same. needles sets etc. The supervisor will ensure tha t rag pickers and other unwanted persons do not gain access to the waste stored there. and the entire process should be documented. . The request will be made to the Municipal authorities to send the vehicle once in day without any failure. nursing station and treatment room of each w ard on push carts and garbage trollies. Any spillage or leakage should be reported t o Sanitation Inspector Incharge.

and with the nursing staff in case of routine cleaning. As the “occupier”. therapeutic processes in Radiotherapy Depa rtment. Gaseous ra dioactive waste can be diluted through dispersal in the outside atmosphere. VIII.” 3. GMC Hospital He has the overall responsibility for the form ulation and implementation of guidelines for hospital waste management and has t o ensure that waste is handled without any advance effect to human health and en vironment. He is also responsible for submitting an annual report in Form II to the J&K Pollu tion Control Board (prescribed authority) by 31st January regarding information about categories and quantities of Bio-Medical Wastes handled during the previou s year. Nursing Professionals and Sanitation Profe ssionals. vials. Pathology wi ll make one Faculty Member responsible for supervision of segregation in their a rea of activities. he is responsible for applying for grant of authorisat ion (in Form I) to the prescribed authority i. To hold meeting of the Hospital Waste Management Committee and form ulate the detailed plan of action in regard to segregation. absorbent paper. To ensure the circulation of enough copies of Bio-Medical Waste Rules and guidelines for implementation of the same in Clinical Departments.e. tumour localisation. Blood Bank. 4. urine and faeces can be handled as non-radioactive waste so long as the room is routinely monitored for radioactive contamination. and then discharged into drai ns/sewers where it is taken care of by the principle of dilution and dispersal. syringes. 2. Lab Services.e. To conduct training programmes for Medical Professionals. 5. Responsibility of chemical waste should be with the persons/staff using the chemicals and generating the waste. Each Clinical Department (Unit). Concen tration and storage under strict supervision in a large drum/container till it h as decayed is principally used. collection. * Liq uid and Chemical Wastes : These wastes should be disinfected by chemical treatme nt using at least 1% sodium hypochlorite solution. To procure the items req uired in this regard and make them available in all patient care areas. To conduct “Awareness Programme”: Clinical combined/grand round will be held for making the Faculty and the Residents awar e of the “Biomedical Waste (Management & Handling) Rules’ 98. The responsibility for proper disposal of liquid wastes lies with the sanitation supervisor in case of weekly “gang” cleaning of indoor patient care areas. protective clothing etc. J&K Pollution Control Board. . These applications of radioactive materials generate some solid radioact ive waste i.ROLE OF PERSONNEL INVOLVED IN WASTE MANAGEMENT The following paras outline the roles and responsibilities of the various personnel in confirmation to the B io-Medical Waste Management (management and handling) Rules 1998:(A) Role of Med ical Superintendent. storage and transport of waste from all the patient care areas. Microbiology. (B) Function s of Hospital Waste Management Committee 1.* Radioactive Waste : Radioactive wastes are generated during the process of bod y organ imaging. Unde r normal circumstances. The radioactive material in liquid form (includi ng patients urine) are generally diluted and dispersed in the sewers. He is answerable to the higher authorities in the Ministry. The responsibilities of the individual professionals wi ll be highlighted in these guidelines.

e.6. trained in hospital waste m anagement. resident doctors. IX TRAINING ON HOSPITAL WASTE MANAGEMENT In order to be able to comprehend and implement the Bio-Medical Waste (Management and Han dling) Rules’ 1998. patient and their attendants. Regular in-service train ing and evaluation of the sanitation attendants will be carried out by him. In each and every OT the sa me instruction of supervision will be followed and one Sister Incharge will be r esponsible. storage. He will attend the Hospital Waste Management Committee meetings and will ensure the training of the staff posted under him.e. doctors. He will be responsible for accident reporting in Form III t o the prescribed authority. paramedics and group-D staff. hospital and sanitation atten dants. He will be the mem ber of the Hospital Waste Management Committee. He will be responsible for monit oring the programme from time to time at various levels i. It sh ould definitely include the following : (i) Awareness of different categories of waste and potential hazard (ii) Waste minimization. With regard to the departments which generate radioactive w aste one of the consultants should be designated as Radiation protection officer and he will be responsible for implementation of the necessary guidelines. Units/ Deptts. They will be responsible for the formulation and implementation of waste management procedures for their departments in conformity with the general guid elines issued by administration. Before the training is carried out the training needs t o be identified content varied accordingly. transportation and treatment including disposal. and will liaise with the Officer Incharge of waste management for adm inistrative support. (D) Role of concerned Heads/Incharge of Labs. She will conduct surprise rounds and wil l review and evaluate the various aspects of scientific hospital waste managemen t at all levels from generation and segregation to final disposal. (F) Role of I/c Sanitation Inspector The Incharge Sanitation Inspec tor will be responsible for the implementation. It should be interactive and should include awareness sessions. collection. reduction in use of disposa bles . monitoring and evaluation of hos pital waste management from collection and storage of hospital waste to its fina l disposal. Floor wise one Nursing Sister (Nursing Supervisor) will be responsible for su pervision of segregation in the wards of each floor. paramedical staff. generation. (E) Role of Matron The Matron will designate one of the senior administrative level deputies as Sister Incharge of Hospital Waste Management. nurses. it is mandatory to provide training to all categories of staff i. He w ill also provides feed back information to Officer Incharge Waste Management in case of accidents and spills. canteen staff. operation of Bio-Medical Was te treatment facilities. Infection Control Officer and Matron. She will also attend the meetings of Hospital Waste Management Committee on behalf of the Mat ron and co-ordinate the training of nurses on Hospital Waste Management with adm inistration. segrega tion. who will be responsibl e for close monitoring of the activity. demonstrations and behavioural science inputs. He w ill be responsible for circulation of all policy decisions and the hospital wast e management manual. nurses. They will also be responsible for getting all s taff. (C) Role of Officer Incharge of Waste Management The Officer Incharg e of waste management will be incharge of implementation and will liaise with th e Heads of Departments.

9. A holistic view. 8. Anand R. 1995 . 14. of I ndia. Jan. Do incinerate blo od soaked dressings/body parts etc. Gazette of India Extraordinary. Hospital Waste Mana gement. Huisman J. 7. 38 W. IIRD and Shristi 1998. 1983 . Management of Waste from Hospitals and other health care establishments. 1985 .J. Suess M. 1998.(iii) Segregation policy (iv) Proper and safe handling of sharps (v) Use of prot ective gear (vi) Colour coding of containers (vii) Appropriate treatment of wast e (viii) Management of spills and accidents (ix) Occupational health. Hospital Waste Manag ement–A holistic approach. 3. Manag ement of Hospital Waste. 6. (c) B lue (inner perforated) – Sharps/needles. Module on Hospital Waste Management by Sulabh Internat ional Institute of Health and Hygience. New Delhi. Report of high power committee on Urban based Waste Management. 4. Sarma R.C. *(1) . Do use syringe and needle destroyer. 7.H. Legal and administrative requirements in management of Hazardous Waste. 2. 7983. 6. Problems in community wast e management. 35-47. Hospital Waste Management . Do immunise all waste handlers. Do transport through covered trolleys/wheel barrows. Do decontaminate all sharps and plasti c waste by chemical/autoclave. 10.K.. Mathur S. Euro Report and Studies No . Geneva 1969. Govt. Points to remember for Waste Management in the Hospital 1. plastic aprons. Draft Bio-medical wastes (Management a nd Handling) rules 1998. Proceedings of National Workshop as Management of hospi tl waste.. Jain T. 1996 7(2). (b) Black – Garbage for dumping in municipal bin. 3. Journal of Academy of Hospital Administration. 55-7. Do provide protective we ar (mask. Basu R. 4. 9. Do segregate waste at point of generation to : (a) Infection (b) Non-Infectious/Garbage (c) Sharps/ Needles. gum boots to transporters and handlers. 16-18 Jaipur. 10. 5. No.W. WHO Regional Publication No. Do collect waste in color coded containers/bags : (a) Yello – Infectio us waste for incineration. Issues involved in Hospital Waste Management : an experience fro m a large teaching Institution. gloves. . Aggarwal R. Book published by Department of Hospital administration. New Delhi. Journal of Academy of hospital Administration. Planning Commission. References : 1. Public Health Paper.. 1-61. Do cover waste collection containers. Satpathy 1998 edition. 8. Part II Section 3 Sub-s ection (ii) dated 27th July. J uly 1995.K. 2. 5. S.P.. 97 WHO. Do shred plastic waste (cul all tubings into p ieces by scissors).O. 25-35 .N. AIIMS. 1998 Jul y 1(2). 1998 Apr.

Do ensure all surfaces come in contact with chemical (including lumen). Do change chemical solutions frequently (wit h every shift). Don’t chemically treat incinerable waste. . 7. Do let the con tact time be atleast 30 minutes. 3. Don’t throw sharps in the trash or into non-puncture proof containers. Do handle with gloves and mask. Do apply to sharp or infectd plastic waste.Dont’s for handing and Disposal of Hospital Waste 1. Don’t mix the infectious with n on-infectious waste. Do use 1% hypochlo rite or equivalent disinfectant. Don’t allow unauthorised pe rsons access to waste collection/storage areas. 4. 7. 4. Don’t incinerate plastic waste. Don’t fi ll the waste container more than 3/4th of capacity. 2. 2. Don’t recap the needle or bend or break needles by hand. 5. 5. 6. Don’t use open buckets for infe ctious waste or sharps. 3. Proper concentration is essential. Wear appron and boots if spla shing is expected. Do’s and Dont’s for Chemica l Treatment 1. 6.