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WALCHAND INSTITUTE OF TECHNOLOGY SOLAPUR

A
PROJECT REPORT
On
BIOMEDICAL WASTE MANAGEMENT….
(IMPACTS AND CHALLAGES)
SUBMITTED BY:-
Ms. KOKARE JYOTSNA (41)
Ms. KATEWAL VARSHA (38)
Ms. JADHAV SHWETA (28)
Ms. RAJMANE SHILWANTI (59)

DURING THE PERIOD


2020-21
UNDER THE GUIDANCE OF
PROF. P.V.DHANSHETTI

DEPARTMENT OF CIVIL ENGINEERING


WALCHAND INSTITUTE OF TECHONOLOGY
SOLAPUR – 413006
(Accredited by National Board of Accreditation, New Delhi
Winner of ‘National Award for Best Industry – Linked Institute’ from
AICTE &CII – 2013, 2014 and 2018)

2020-2021

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WALCHAND INSTITUTE OF TECHNOLOGY SOLAPUR

A
PROJECT REPORT
On
BIOMEDICAL WASTE MANAGEMENT….
(IMPACTS AND CHALLAGES)
SUBMITTED BY:-
Ms. KOKARE JYOTSNA (41)
Ms. KATEWAL VARSHA (38)
Ms. JADHAV SHWETA (28)
Ms. RAJMANE SHILWANTI (59)

CLASS: T.Y.(CIVIL)
DURING THE PERIOD
2020-21
UNDER THE GUIDANCE OF
PROF. P.V.DHANSHETTI

DEPARTMENT OF CIVIL ENGINEERING


WALCHAND INSTITUTE OF TECHONOLOGY
SOLAPUR – 413006
(Accredited by National Board of Accreditation, New Delhi
Winner of ‘National Award for Best Industry – Linked Institute’ from
AICTE &CII – 2013, 2014 and 2018)

2020-2021

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CERTIFICATE
This is to Certify that the seminar entitled “ Biomedical waste management ….(impact
and challenges) ” is Completed by the following of T.Y. (CIVIL) Class in satisfactory
manner Under my Guidance.

SUBMITTED BY :-
Ms. KOKARE JYOTSNA (41)
Ms. KATEWAL VARSHA (38)
Ms. JADHAV SHWETA (28)
Ms. RAJMANE SHILWANTI (59)
The Seminar is found to be complete in partial Fulfilment for the Award of the Degree of
Bachelor of Civil Engineering of Solapur University, Solapur.

Prof. P.V.DHANSHETTI Dr. S.S.PATIL Dr. S.A.HALKUDE

(GUIDE) (HEAD) (PRINCIPAL)

DEPARTMENT OF CIVIL ENGINEERING


WALCHAND INSTITUTE OF TECHONOLOGY
SOLAPUR – 413006
(Accredited by National Board of Accreditation, New Delhi
Winner of ‘National Award for Best Industry – Linked Institute’ from
AICTE &CII – 2013, 2014 and 2018)
2020-2021

ACKOWLEDGEMENT

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Acknowledgment is not not mere formality as is the usual notation.It is the only way through
which we can connote our deep and profound gratitude to the person who directly contribute
to the work .This project is itself an acknowledgement to the intensity ,drive and technical
competency of many individuals who have contributed to it.

We take excellent opportunity to express our deep sense of gratitude to Civil Engineering
Department and our guide Prof. P.V.DHANSHETTI under whose valuable guidance this
project has been completed. We are indented to our honorary principal Dr. S.A.HALKUDE who
has been constant source of motivation and co-operation in bringing this project in very short
time, We also thank to our HOD Dr. S.S.PATIL also other staff member of civil
engineering department for providing necessary facilities and valuable information for
completion of our project work.

Name of Student Roll No


Shweta jadhav 28
Shilwanti rajmane 59
Varsha katewal 38
Joytsna kokare 41

Date :-
Place :-

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Index
Chapter Topic

abstract

List of figs

List of tables
1. Introduction
2. Litrature rewiew

3. Biomedical waste management data

4. Advanced techniques and methods


for disposal

conclusion

references

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ABSTRCT

According to the WHO, the global life expectancy is increasing year after year.
However, deaths due to infectious diseases are increasing. A study conducted by
the WHO reveals that more than 50,000 people die every day from infectious
diseases.

One of the causes for the increase in infectious diseases is improper waste
management. Blood, body fluids and body secretions which -are constituents of
bio-medical waste harbour most of the viruses, bacteria and parasites that cause
infection.

This passes via a number of human contacts, all of whom are potential ‘recipients’
of the infection. Human Immunodeficiency Virus (HIV) and hepatitis virus
spearhead an extensive list of infections and diseases documented to have spread
through bio-medical waste. Tuberculosis, pneumonia, diarrhoea diseases, tetanus,
whooping cough etc., are other common diseases which spread due to improper
waste management.

Waste minimization is an important first step in managing wastes safely,


responsibly and in a cost effective manner. This management step makes use of
reducing, reusing and recycling principles. There are many possible routes to
minimize the amount of both general waste and biomedical waste within the health
care or related facility.

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CHAPTER ONE
INTRODUCTION
BIO-MEDICAL WASTE:
The waste generated form healthcare facilities referred also as healthcare waste, hospital waste
and infectious waste includes all types of waste generated by healthcare establishments, research
facilities and laboratories in addition to hospitals and clinics including waste generated by blood
banks. Hospitals in general, generate waste at an average rate of 1 Kg/bed/day. A small
percentage of this waste is toxic and harmful not only to the staff and patients but also to the
general public at large. The improper management of Bio-medical waste causes serious
environmental problems in terms of air, water and land pollution. A study conducted by the
World Health Organization in 1996, reveals that more than 50,000 people die every day from
infectious diseases in the whole world. The situation has not improved yet. One of the reasons
for the increase in infectious diseases is the improper waste management.

Definition of Biomedical Waste:


 Bio-Medical Waste (BMW) refers to any waste, which is generated during the diagnosis,
treatment or Immunization of human beings or animals or in research activities pertaining
thereto or in the production or testing of biological and including categories mentioned in
Schedule I of the Bio-Medical Waste (Management and Handling) Rules, 1998.
 Bio-Medical waste means any solid or liquid waste including its container and any
intermediate product, which is generated during diagnosis, treatment ,immunization of
human being and animals or in research or in production and testing.

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Classification of biomedical waste:

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Table 1: Bio-medical waste rule


Schedule Content
Schedule I Classification of bio-medical waste in various categories
Schedule II Colour coding and type of containers to be used for each category of
biomedical waste
Schedule III Proforma of labels to be used on containers/bag.
Schedule IV Proforma of labels for transport of waste containers/bag.
Schedule V Standards for treatment and disposal of waste
Schedule VI Deadlines for creation of waste treatment facillities

Table 2 – Waste categories: their treatment and disposal methods Option Treatment & Disposal
Waste
Option Treatment & Disposal Waste Category

Category No. 1 Incineration /deep burial Human Anatomical Waste


Category No. 2 Incineration /deep burial Animal Waste

Category No. 3 Local autoclaving/ microwaving/ Microbiology & Biotechnology


incineration waste

Category No. 4 Disinfections(chemical Waste Sharps


treatment/autoclaving/microwaving &
mutilation shredding

Category No. 5 Incineration / destruction & drugs Discarded Medicines and


disposal in secured landfills Cytotoxic drugs

Category No. 6 Incineration, autoclaving/microwaving Solid Waste (Items


contaminated with blood and
body fluids

Category No. 7 Disinfections by chemical treatment Solid Waste (waste generated


autoclaving/microwaving& mutilation from disposable items
shredding

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Category No. 8 Disinfections by chemical treatment Liquid Waste


and discharge into drain

Category No. 9 Disposal in municipal landfill Incineration Ash

Category No. 10 Chemical treatment & discharge into Chemical Waste


drain for liquid & secured landfill for
solids

Table 3 - Color coding-biomedical waste (management and handling) rules, 1998 (Schedule II)

Color Coding Type of Containers Waste Category Treatment Options


as per Schedule 1
Yellow Plastic bag 1,2,3,6 Incineration/deep
burial
Red Disinfected 3,6,7 Autoclaving/Micro
Container/ Plastic bag waving/ Chemical
Treatment
Blue/White Plastic bag/puncture 4,7 Autoclaving/Micro
translucent proof container waving/ chemical
treatment and
destruction/shredding
Black Plastic bag 5,9,10 (Solid) Disposal in secured
landfill

Table 4 – Showing final disposal method adopted by the hospital according to the type of waste
generated

Type of Wastes Site of Generation Final Disposal By

Non-Hazardous (General) Office, Kitchen, Cafeteria, Municipal Authorities


Billing, Administration,
Cashier, Rest rooms, Pantries
in wards, Stores, etc
Hazardous (Infectious and Wards, Treatment, room, Common biomedical waste
toxic) nursing station, Isolation rooms, treatment facility (Private
Operation theatres, Intensive Waste Management
Care Units and post operative Company.
recovery room, Minor OTs,
Blood Bank Pharmacy and
Medical Stores, All laboratories,
Pharmacology OPDs’ Injection
rooms

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Disposal of biomedical Wastes


Incineration

It is economically attractive to dispose of infectious health-care waste in municipal incinerators if these


are located reasonably close to hospitals. As the heating value of health-care waste is signifificantly
higher than that of domestic refuse, the introduction of relatively small quantities of health-care waste
will not affect the operation of a municipal incinerator. Municipal incinerators are usually of a double-
chamber design, with an operating temperature of 800°C in the first combustion chamber and gas
combustion in the second chamber at temperatures of, typically, 1000–1200°C.

Waste that should not be incinerated:

• Pressurized containers. Explosion may occur and cause damage to the equipment.

• Halogenated plastics (e.g. PVC). Exhaust gases contain hydrogen chloride and may contain dioxins.

• Wastes with high content of heavy metals (e.g. thermometers, batteries). Incineration will cause
emission of toxic metals (e.g. lead, cadmium, mercury) into the atmosphere.

Medical Waste Incinerators - Hospital Waste Incinerator

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Autoclaving:

Autoclaving is an effificient wet thermal disinfection process. Typically, autoclaves are used in hospitals for
the sterilization of reusable medical equipment. They allow for the treatment of only limited quantities of
waste and are therefore commonly used only for highly infectious waste, such as microbial cultures or sharps.
It is recommended that all general hospitals, even those with limited resources, be equipped with autoclaves.

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Shredding

Shredding is carried out to avoid re-entry of contaminated plastic and glass items to market.
Figure 6.14 shows shredding process under progress. The shredded plastic and glass can then be
reprocessed for manufacture of new items.

Shredding machine

Microwaving

Microwave treatment should not be used for cytotoxic, hazardous or radioactive wastes, contaminated
animal carcasses, body parts and large metal items. Presence of metal leads to sparkling and possibly
health hazards. The microwaving demands comparatively higher investment and proper segregation of
waste..

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Landfilling

It is a another method of final disposal of biomedical waste. It a municipality or medical authority


geniunly lacks the means to treat the waste before disposal, sanitary landfill observing certain standards
can be as an acceptable choice especially in developing country.

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CHAPTER TWO
LITERATURE REVIEW

CASE STUDY ONE:


HOSPITAL WASTE MANAGEMENT (International Research Journal of Engineering and
Technology)
ABSTRACT
The hospital wastes are the waste produced from hospitals, nursing homes, dental clinics, surgery
centers, personal healthcare’s etc. These type of waste is different from the other types of waste
like household waste, industries waste and municipal wastes etc. and consists of the following
types of waste like sharps waste, clinical laboratory, human anatomical waste, discarded and
expired medicines etc. the hospital waste causes the direct as well as indirect impact on human
being, animals and environment too. Due to this situation proper handling and disposal of waste
is necessary. To overcome this situation the ministry of environment and forest published
guidelines on the Biomedical Waste (Management and Handling) Rules, 1998 in India for the
minimization of hospital waste quantity. The actual situation of hospital waste management in
India is extricable because the hospital waste is dumped on the municipal landfill sites along
with the other soiled waste. The main focus of this study is on the evolution of hospital waste
generated quantity and the practices adopted for safe collection and disposal of waste in the
environment. The overall waste is being segregated in different color coded containers/bags
before the disposal according to the Biomedical Waste (Management and Handling) Rules, 1998.
These wastes are to be treated and disposed off in the common treatment facilities. The
incinerator ashes and other soiled waste generated in these treatment plants is disposed off in the
municipal landfill sites.
INTRODUCTION
Hospitals are the essential waste generation sites. Every department in the hospitals produces
different kinds of waste like healthcare waste, household waste, industries waste and household
wastes.
A Healthcare wastes consist of bacterial, toxic, cytotoxic waste, expired nuclear and
pharmaceutical wastes and sharps waste etc. Other wastes products produced from healthcare are
not dangerous and include prescription boxes, packaging of medicals and food items and offices
wastes.
The hospital waste management is not only the responsibility of hospital administrations but
also the hospital employees too. The process of hospital waste management should began with
the generation of wastes at sites followed by the process of segregation and handling of waste the
waste is segregated in different color coded containers with the symbol of biohazard. The
distribution and transportation of hospital waste should be done by the special vehicles which are
covered fully. The transportation vehicles transported this hospital waste to the final disposal
sites. For the proper handling and management of this waste the workers should be properly
qualified.

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According to the Biomedical Waste (Management and Handling) Rules, 1998 of India “Any
waste which is generated during diagnosis, treatment or immunization of human beings, animals
or in research activities pertaining there to or in the production and testing of biologicals.
The Government of India Notification, 1998 specify that Hospital Waste Management is the
integral part of hospitals hygiene and maintenance activities. This involves the management of
the limits of activities like collection, transportation, operation or treatment of processing
systems, and disposal of wastes. With the references to the literatures keeping in mind the
objective of the present study is the quantitative analysis with respect to its physical
characteristics of the waste generated in hospitals.
CONCLUSION
The focus on this study is on the practices related to the hospital waste collection, segregation,
transfer and transportation, and final disposal of the waste as per the Biomedical Waste
(Management and Handling) Rules, 1998in our country especially for the metropolitan cities.
Based on the results the wastes are collected in different bags which are color coded and these
bags sent to the common treatment facilities for their treatment and disposal. The treatment
facilities consists the equipments like autoclaves, shredders and incinerators etc. The air
pollution control devices are also provided for the control and emission of the particulates
matter, NOX, SOX, etc.
CASE STUDY TWO:
Impact of Biomedical Waste on City Environment: Case Study of Pune, India.{ IOSR Journal of
Applied Chemistry (IOSR-JAC)}
ABSTRACT
Indian cities are facing problem of Biomedical waste management in the wake of urban
development. The number of healthcare facilities is increasing day by day resulting in large-scale
generation of bio medical waste. It has been observed that inadequate disposal of biomedical
waste is creating highly unhygienic environment and posing serious heath threat for inhabitants.
Present paper discusses the issue of biomedical waste management from a wider perspective
with special emphasis on chemical waste which is one of the most hazardous wastes in present
context. Various types of biomedical waste with reference to generation, handling and disposal
practices are presented. It includes study and analysis of the parameters which affect the quality
of environment to explore their impact on city environments. The current practices of handling
such waste is presented based on a study conducted in city of Pune, which is the second largest
city in the state of Maharashtra, India. It is aimed to put forth the importance of adequate
handling and treatment of biomedical waste with reference to healthy and hygienic living
environment for inhabitants to live in.
INTRODUCTION
Some 25% of biomedical waste is hazardous which adversely affect city environment allover the
world particularly developing countries are most at risk due to poor waste management.
Healthcare facilities in an urban area are designed as a place for patients for diagnosis, analysis
and treatment of medical problems. It houses a number of complex activities where generation of
solid waste is unavoidable. This solid waste referred as “healthcare waste“ which include all

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waste, biological or non-biological that is discarded and will never be used again [1,2]. Medical
waste can be classified in three groups: medical waste, infectious waste and domestic waste.
“Medical waste” refers to materials accumulated as a result of patient diagnosis, treatment or
immunization of patients. “Infectious waste” refers to the portion of medical waste that is in
contact with a patient who has infectious disease and it is capable of producing an infectious
disease. Majority of cases medical waste is considered to be infectious waste, if medical waste
and other waste are not collected separately. If all waste is mixed then the hospital waste is
presumed to be infectious waste. Of the total amount of waste generated by health-care activities,
about 80% is general waste. The remaining 20% is considered hazardous material that may be
infectious, toxic or radioactive (fig.1). Every year an estimated 16 000 million injections are
administered worldwide, but not all of the needles and syringes are properly disposed of
afterwards.
Health-care waste contains potentially harmful microorganisms which can infect hospital
patients, health-care workers and the general public. Health-care waste includes all the waste
generated by health-care establishments, research facilities, and laboratories. In addition, it
includes the waste originating from “minor” or “scattered” sources--such as that produced in the
course of health care undertaken in the home (dialysis, insulin injections, etc.).
Infectious waste is material suspected to contain pathogens (bacteria, viruses, parasites or fungi)
in sufficient concentration or quantity to cause disease in susceptible hosts. This category
includes waste contaminated with blood or other body fluids, cultures and stocks of infectious
agents from laboratory work, waste from infected patients in isolation wards; dressings,
bandages and other material contaminated with blood or other body fluids which is Infectious
because it contains bacteria, viruses, parasites or fungi. Sharps are the Hhypodermic, intravenous
or other needles; auto-disable syringes; syringes with attached needles; infusion sets; scalpels;
pipettes; knives; blades; broken glass. Pathological waste contains human tissues, organs or
fluids; body parts; unused blood products. Chemical Waste containing chemical substances (e.g.
laboratory reagents; film developer; disinfectants that are expired or no longer needed; solvents;
waste with high content of heavy metals, e.g. batteries; broken thermometers and blood pressure
gauges). Pharmaceuticals that are expired or no longer needed; items contaminated by or
containing pharmaceuticals; cytotoxic waste containing substances with genotoxic properties
waste containing cytostatic drugs (often used in cancer therapy) genotoxic chemicals).
Radioactive: Waste containing radioactive substances (e.g. unused liquids from radiotherapy or
laboratory research; contaminated glassware, packages, or absorbent paper; urine and excreta
from patients treated or tested with unsealed radionuclides; sealed sources.
Generation of waste depends on numerous factors such as type of healthcare facility,
specialization, proportion of reusable items employed in hospital, and proportion of patients
treated on a day-care basis. Hospitals and clinics are the only one source of infectious waste
generation which is heterogeneous mixtures composed of general refuse, laboratory and
pharmaceutical chemicals and their containers, and pathological wastes. As a result, some
infectious wastes do not separate from general waste and may pose a threat to the environment.
CONCLUSION
Traditionally, hospital wastes have been disposed of with the municipal wastes in landfills. However,
since the late 1980’s, the spreading trend of immunodeficiency virus (HIV), hepatitis B virus (HBV) and

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other agents associated with blood bone diseases has raised public awareness and concerns of the
disposition of medical waste. As a result, medical waste is required to be treated in a special way and
not to be mixed with municipal waste. Proper medical waste management requires special treatment of
medical waste such as incineration or hazardous waste landfill facilities [12]. Former studies have shown
that the best available technology for disposing of medical waste is incineration. Infectious waste should
go into yellow leak-proof plastic bags or containers. Bags and containers for infectious waste should be
marked with the international infectious substance symbol Chemical waste consists of discarded solid,
liquid, and gaseous chemicals, for example from diagnostic and experimental work and from cleaning,
housekeeping, and disinfecting procedures. Pharmaceutical waste includes expired, unused, spilt, and
contaminated pharmaceutical products, drugs, vaccines, and sera that are no longer required and need
to be disposed of appropriately. Small amounts of chemical or pharmaceutical waste may be collected
together with infectious waste. Large quantities of chemical waste should be packed in chemical-
resistant containers. The identity of the chemicals should be clearly marked on the containers:
hazardous chemical wastes of different types should never be mixed. The proper collection of hospital
waste will reduce the volume of infectious wastes and consequently the cost of treatment. Considering
the scale of biomedical waste generated in Indian cities like Pune is imperative to take this issue at top
most priority basis. Adequate biomedical waste management is the solution to safeguard city
environment and provide a healthy, hygienic living environments for the city dwellers.

CASE STUDY THREE:

A Case Study of Biomedical Waste Management in Hospitals ( global journal of health science).

ABSTRACT
Biomedical waste management is receiving greater attention due to recent regulations of the
Biomedical Wastes (Management & Handling Rules, 1998). Inadequate management of
biomedical waste can be associated with risks to healthcare workers, patients, communities and
their environment. The present study was conducted to assess the quantities and proportions of
different constituents of wastes, their handling, treatment and disposal methods in different
health-care settings. Various health care units were surveyed using a modified survey
questionnaire for waste management. This questionnaire was obtained from the World Health
Organization (WHO), with the aim of assessing the processing systems for biomedical waste
disposal. Hazards associated with poor biomedical waste management and shortcomings in the
existing system were identified. The development of waste management policies, plans, and
protocols are recommended, in addition to establishing training programs on proper waste
management for all healthcare workers.
INTRODUCTION
The recent developments in healthcare units are precisely made for the prevention and protection
of community health. Sophisticated instruments have come into existence in various operations
for disease treatment. Such improvement and advances in scientific knowledge has resulted in
per capita per patient generation of wastes in health care units. Waste generated in the process of
health care are composed of variety of wastes including hypodermic needles, scalpels, blades,
surgical cottons, gloves, bandages, clothes, discarded medicine and body fluids, human tissues
and organs, chemicals etc., Other wastes generated in healthcare settings include radioactive
wastes, mercury containing instruments, PVC plastics etc., These are the most environmentally

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sensitive healthcare by products and needs a greater attention which has to be monitored ( Remy,
2001).
World Health Organization states that 85% of hospital wastes are actually non-hazardous,
whereas 10% are infectious and 5% are non-infectious but they are included in hazardous wastes.
About 15% to 35% of Hospital waste is regulated as infectious waste. This range is dependent on
the total amount of waste generated (Glenn and Garwal, 1999).These wastes now threatens the
public since, the health care foundations are situated in heart of city and therefore medical waste,
if not properly managed can cause dangerous infection and posses a potential threat to the
surrounding environment, persons handling it and to the public. Health and environmental
effects, uncertainty regarding regulations and negative perceptions by waste handles are some
important concerns in health care waste management in a country (Freeman, 1998). Globally
this issue has been seriously considered and appropriate waste management systems are being
developed and installed. A number of difficulties are being faced at many places in
implementation of this plan in practice. The waste disposal is governed by the Government
agencies and regulations including private organizations.
At present, there is no available information that describes the actual practice of handling the
health care waste products. The proposed hospital waste management plan is consistent with the
biomedical waste (management and handling) (second Amendment) Rules, 2000, Ministry of
environment and forests. As a result this study aims to assess the biomedical waste handling and
treatment in different health care settings.
CONCLUSION
The premier hospital is severely lacking in actions to dispose of its waste and uphold its statutory
responsibilities. This is due to the lack of education, awareness and trained personnel to manage
the waste in the hospital, as well as the paucity of the funds available to proper waste
management system. The results of the study demonstrate the need for strict enforcement of legal
provisions and a better environmental management system for the disposal of biomedical waste
in hospitals as well as other healthcare establishments. A policy needs to be formulated based on
‘reduce, recover, reuse and dispose’. The study concludes that healthcare waste management
should go beyond data compilation, enforcement of regulations and acquisition of better
equipment. It should be supported through appropriate education, training and the commitment
of the healthcare staff, management and healthcare managers within an effective policy and
legislative framework.
CASE STUDY FOUR:
Bio-Medical Waste Management – A Case Study of Bhopal City ( Nature Environment and
Pollution Technology An International Quarterly Scientific Journal ).
ABSTRACT
The waste produced in the course of healthcare activities carries a higher potential of infection
and injury than any other type of waste. The present scenario of bio-medical waste (BMW)
management in Indian hospitals is grim. However, there is an emerging concern regarding bio-
medical waste management, particularly as a result of notification of Bio-medical Waste
(Management and Handling) Rules, 1998 which makes it mandatory for the healthcare

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establishments to ensure that such waste is handled without any adverse effect to human health
and environment. Proper handling, treatment and disposal of bio-medical wastes are important
elements of healthcare office infection control programme. Correct procedure will help protect
healthcare workers, patients and the local community. This article also discusses about various
types of wastes, their management and the status of bio-medical waste generated in Bhopal city.
INTRODUCTION
Bio-medical waste is any waste, which is generated during diagnosis, treatment or immunization
of human beings or animals or in research activities pertaining to or in the production or testing
of biologicals and categories mentioned in schedule 1 of Bio-medical Waste (Management and
Handling 1998) Rules. Biologicals is any preparation made from organisms or microorganisms
or product of metabolism and biochemical reactions intended for use in the diagnosis,
immunization or the treatment of human beings or animals or in research activities pertaining
thereto.
CONCLUSION
Safe and effective management of waste is not only a legal necessity but also a social
responsibility. Lack of concern, motivation, awareness and cost factors are some of the problems
faced in the proper hospital waste management. Proper surveys of waste management procedures
are needed. Clearly, there is a need for education as to the hazards associated with improper
waste disposal. Lack of apathy to the concept of waste management is a major stymie to the
practice of waste disposal. An effective communication strategy is imperative keeping in view
the low awareness level among different categories of staff in healthcare establishments
regarding biomedical waste management. Proper collection and segregation of bio-medical waste
are important. At the same time, the quantity of waste generated is equally important. A lesser
amount of bio-medical waste means a lesser burden on waste disposal work, cost-saving and a
more efficient waste disposal system. Hence, healthcare providers should always try to reduce
the waste generation in day-to-day work in the clinic or at the hospital.

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CHAPTER THREE
BIOMEDICAL WASTE IN MAHARASHTRA

 BEFORE PANDEMIC = 62.4 TONNES PER DAY BIOMEDICAL WASTE


 IN-PANDEMIC = 90.6 TONNES PER DAY BIOMEDICAL WASTE
 ACCORDING TO MPCB (MAHARASHTRA POLLUTION CONTROL BOARD) ON
AN AVERAGE IN PANDEMIC BIOMEDICAL WASTE IS INCREASED BY 80 TO
90 PERCENT

BIOMEDICAL WASTE

 INDIA roughly produces 2kg/bed/day biomedical waste.

 As indicated by the Ministry of Environment and Forest (MOEF) net age of


BMW in India is 4,05,702 kg/day, out of which just 2,91,983 kg/day is disposed.

 Before COVID-19 episode, an administration or a private emergency clinic would


ordinarily deliver 500g of biomedical waste per bed, every day.

 Presently that number has gone up to between 2.5 to 4 kg per bed, every day

 Delhi creates 27 tons of non-COVID biomedical waste and as much as 11 tones of


COVID-19 related waste each day, as per CPCB;

 Mumbai has been producing 9 tones of COVID-19 waste and 6 tones of non-
COVID biomedical waste each day, BMC. ( Brihanmumbai Municipal
Corporation) estimates.

 BEFORE PANDEMIC RESULT OF BIOMEDIAL WASTE IN MAHARASHTRA


Table 5: YEARLY BIOMEDICAL WASTE GENERATED IN KG PER DAY

SR.NO. YEAR BIOMEDICAL


WASTE IN KG PER
DAY

1. 2014 53,385kg

2. 2015 62,740kg

3. 2016 71,511kg

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BIOMEDICAL WASTE IN MUMBAI CITY

 In Maharashtra most Biomedical waste generated in Mumbai city.

 Before COVID-19 biomedical waste generated in Mumbai is 12,000 to 14,000 kg


per day.

 In March, when the first case was reported in the city, 3.28 lakh kg biomedical
waste was generated with an average of 11,230 kg daily.

 While in April it was 12,675 kg.

 In may it increased to 17,631kg.

 In June it is increased by 22,023 kg per day.

 According to the data, about 82 tone of biomedical waste and municipal solid
waste (MSW) are generated daily from COVID care centres and quarantine areas
like sealed buildings and containment zones.

 Data shows that K-west ward (Andheri, Jogeshwari) and M-west (Chembur) ward
generates a maximum of 9000 kg BMW and MSW each ward, following 6000 kg
in p-north (Malad).

DAILY AVG. COVID-19 WASTE GANERATED IN MUMBAI (KG)


3304.1
APRIL
446.7

7169.4
MAY
815.3

8318.3
JUNE
1760.9

9225.1
UPTO JULLY
2840.4

0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000

COVID WASTE FROM CONTAINMENT ZONE COVID WASTE FROM HOSPITALS

BIOMEDICAL WASTE IN THANE CITY

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 In Thane approximately, 525 to 625 kgs biomedical waste is generated from


private hospitals, nursing homes and medical practitioners daily.

 Apart from this, 200 k biomedical waste is generated by government hospitals.

 Thane city has 225 private hospitals including nursing homes and the corporations
major hospital Chhatrapati Shivaji, four maternity homes and 16 health care
centers. There are 1200 medical practitioners.

 According to the survey it was found that per patient per bed 150mgm of
biomedical waste is generated.

 while the 1,800 plus medical organisations in the city generate over two tonnes of
hazardous biomedical waste on a daily basis, as much as 600 kg or 30 percent of
toxic waste is not segregated properly according to the data.

BIOMEDICAL WASTE IN PUNE CITY

 Before COVID-19 biomedical waste generated in Pune is 12,000 kg per day.

 In COVID-19 pandemic the biomedical waste increased to 3,000 kg per day.

 That is in COVID -19 the biomedical waste is 15,000 kg per day .

 According to survey in Pune 19 blood banks, 461 pathology laboratories, 4260


dispensaries, 32 COVID care centres and 32 other healthcare establishments in
Pune.
BIOMEDICAL WASTE TOP CITIES
Table 6: BIOMEDICAL WASTE GENERATED IN VARIOUS CITIES WITH
COMAPRISON OF WASTE BEFORE COVID-19 AND IN COVID-19
PANDEMIC

SR. NAME OF BEFORE IN


CITY COVID-19 COVID-19
NO. BMW IN BMW IN
KG/DAY KG/DAY

1. MUMBAI 12000 22,023kg/d


to14000kg/d ay
ay

2. PUNE 12,000 15,000


kg/day kg/day

3. NAGPUR 10,000kg/da 14,000

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y kg/day

4. NASHIK 8,000 kg/day 11,000


kg/day

5. AURANGAB 7,000kg/day 10,000


AD kg/day

6. KOLHAPUR 4,000kg/day 7,000


kg/day

Indian households’ ineffective waste management is putting sanitation workers at


risk of Covid-19

Sanitation workers and rag pickers are at risk from handling unmarked medical waste emerging
from homes where Covid-19 patients are quarantined, medical experts and waste management
specialists warned. Discarded masks, gloves and tissues could be potential sources for the spread
of this highly contagious virus, they said.
Recent reports have illustrated the dangers of dumping medical waste related to the treatment
and containment of the virus.
 In Pune, face masks dumped by users in household garbage were being collected
by rag pickers, The Indian Express reported on March 23. “There is no
mechanism for collection and disposal of masks and medical waste generated by

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more than 2,000 people under home-quarantine across the district for having a
travel history or showing Covid-19 symptoms,” the report said.
 In Thane, a man was caught putting over 100,000 used face masks out to dry so
that he could resell them in the market, the Times of India reported on March 12.
 A heap of medical waste was found lying in the open in Delhi’s Sharan Vihar
area, The Indian Express reported on April 1. Discarded face masks, tunics,
gowns, caps and syringes were found in the dump.
Challenges are varied depending on generators of waste, type and quantity of waste, destinations,
processes and worker safety.
The novel corona virus gets transmitted through direct touch and contaminated surfaces and
objects, according to a government document on the use of personal protective equipment.
Sanitary staff involved in cleaning frequently-touched surfaces and linen is at moderate risk and
are supposed to use N-95 masks and gloves.
Adherence to the basic rules of waste segregation is still low in India. Waste generators are
supposed to segregate the waste at source and then hand it over to the authorized waste pickers
or collectors, according to the Solid Waste Management Rules 2016. But there have been
instances where households and societies do not comply with these rules.
There is even more limited awareness about the need for separate disposal of biomedical waste
generated by households, as we explain later. Waste management systems will need to now
include more specific Covid-19 related rules, experts told us.
As many as 5,734 Covid-19 cases have been reported in India, as of 3 pm on April 9, according
to Corona virus Monitor, a Health Check database. While 473 patients have recovered, 166 have
died. As of 9 pm on April 7, India had tested 114,015 samples. Of these, 4,616 individuals were
confirmed positive, data from the Indian Council of Medical Research shows. Each patient is
tested multiple times.

Challenge #1: Where does the waste originate?

The first challenge is to re-define the classification of waste generators during COVID-19. One
must look at the general population including slums and informal settlements, people in home
quarantines – both from people with mild symptoms and asymptomatic – waste from places post
contact tracing, people in quarantine camps at the borders and other areas, COVID clusters,
people in hospitals, general hospitals, diagnostic labs and street waste.  But this classification
only focuses on known infected cases and the non-affected population’s singular focus on
protecting themselves. 

“Now is the time to ensure unified colour-coded system”

Street waste is another huge challenge in itself – not only is it mixed; it does pose a huge risk, if
there is waste that has been contaminated. Shankar adds, “Hypothetically, I am playing out a
scenario, if a COVID-19 carrier throws a wrapper on the ground, say at a playground, and a child
comes in contact accidentally, and carries it home, embraces his mother, etc then the entire chain

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is affected. Yes, I understand that this is not possible now in a lockdown, but how long will the
lockdown continue? And this could also be a waste worker who touches it. The prospects are
scary. We need to be aware and cautious than sorry.”

Challenge #2: Rise in biomedical waste

The second challenge is the rise in biomedical waste from hospitals, along with an increase in
disposal of personal protective equipment (PPE) by the general public. As witnessed by China, in
Wuhan, where the novel corona virus first emerged, the biomedical waste being generated was
so high that the government had to deploy mobile waste treatment facilities and construct a new
medical waste treatment plant. 

Challenge #3: Mapping households to waste service providers

The third urgent challenge is inter-departmental coordination to map households and waste
services, based on generators mentioned above. This needs to be digitally mapped. 

Challenge #4: Waste worker awareness and safety

The fourth challenge is around worker awareness and safety. The waste workers need to be
trained on how to handle waste, new instructions must be provided on how to handle waste from
specific generators who have been in home quarantine, and to handle the influx of PPE disposed
of from households. 

“Waste workers need clear instructions on how to handle waste from those in
home quarantine”

The government must distribute PPE to all workers, including instructions on how to clean and
when to dispose and where to seek supplies when the PPE is torn. At a special sitting of the
Karnataka High Court on March 30, the Court directed the State to provide safety equipment to
every sanitation worker in Karnataka and provide breakfast and transport facilities during the
lockdown.  Can the Karnataka Essential Services Maintenance Act, 2015, be used to protect
waste workers – both registered and informal?

There is need for a separate vehicle to collect these waste based on types of generators. But the
problem arises when the worker has to also collect from the general population, along with those
quarantined or asymptomatic.  What happens when the garbage falls from a torn bag, how do the
workers handle that? Should the waste from these households be double-bagged in plastic, which
is banned in Karnataka, or should it be wrapped in newspaper? 

Challenge #5: Where does the waste go?


The fifth challenge are the waste destinations – guidelines, processes, data and penalty. What are
the guidelines on handling tissues or gloves mixed with dry waste? Should the entire lot be

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treated as contaminated, even if one of the houses has an asymptomatic person? This is in
relation to the staying power of the virus on different surfaces.
What about the biomedical facilities themselves? How equipped are they to handle the waste?
Has there been any preparedness, audit to check the capacity? How can data be tracked and
compared? What are the provisions for dumping of COVID waste? 
When downstream waste processing plants are shut.

Challenge #6: sixth challenge


The sixth challenge is reverse supply chain logistics. While waste is being collected, it only gets
accumulated in destinations, as the rest of the downstream recycling and processing operations
are shut down. What are the solutions, then? Can the entire value chain from collection,
recovery, recycling be treated as essential services?

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 z

Storage of Medical Waste AT DOMESTIC LEVEL….

Labelling

Labelling for external communication

These labels are warnings to employees and the public about the type of waste in the container.
Your local jurisdiction may have rules about warning labels that must be affixed to storage

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containers. Even if there are no legal requirements, best practices call for warnings that
indicate the nature of the hazard. For infectious, pathological, and most regulated medical
waste, the medical waste symbol can be employed. If you buy bags and containers
designed for medical waste, these often come with the medical waste symbol on it.

Labelling for internal use

Well-run facilities require their employees to put labels on waste bags and containers for tracking
purposes. It is not different from an inventory management system. Employees (either those who
generate the waste or waste technicians) should apply a label with the date, type of waste, and
point of generation. Doctors, dental, and veterinary offices are usually small enough to not do
this, but any hospital should. The weight of the waste should be recorded. This information will
be useful in the long run for identifying problems in cross-contamination among waste streams
and mistakes in segregation.

I’m afraid my customers will be scared off if they see a sign saying “medical
waste”.

The point of the sign is to alert people to a possible hazard. So it should be a little scary. It
doesn’t have to scare customers away if you keep the waste store where customers do not
normally go (which you should, anyway).

Bags

The marketplace is full of vendors that sell bags for medical waste. Just look in a directory of
industrial supplies or an internet search. For the most part there are no (or few) government
regulations on these (containers for sharps are another matter.) The vendors may brag their bags
are thick and resist punctures. Some bags are labelled with the biohazard symbol and some are
coloured. Some manufacturers sell both the trash can (specifically labelled for medical waste)
and the plastic (or canvas) bag that goes with it. Many manufacturers make medical waste bags
red, and some waste management plans specify that there customers use red bags. You might
hear of “red bag waste”. You might think this designation has a legal meaning, but it doesn’t.
There is no rule that says your infectious or pathological waste must be put in a red bag, although
most industrial hygienists and sanitation engineers probably prefer a red bag, all other things
being equal.

The best practice for most facilities is to buy these dedicated medical waste bags. Could you just
use general purpose garbage bags? In a pinch you could and these will work for most medical
waste items, provided you don’t overfill them. But in general you want to keep medical waste in
containers labelled medical waste, and it is worth paying a little more to get bags and bins
already labelled.

Waste bags should be filled to no more than three quarters full. At that point they should be
closed for collection. Don’t staple the bag closed. Either use a twisty, or, if the bag comes ready

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to self-seal, employ that. Keep spare bags in areas where waste is collected in bags, so
employees are not tempted to overfill any one bag.

Bags come in sizes from sandwich size to as big as 55-gal drums (a standard drum size in
industry.) The World Health Organization recommends infectious waste bags be a minimum of
70 µm in thickness (ISO 7765 2004). It is easy to find bags thicker than that.

One disadvantage of bags shows up when autoclave treatment is used. To ensure the waste is
heated adequately, the bags must be opened to allow the steam in. When bagged waste is to be
incinerated, this is not a concern, as the bags themselves are combustible. However, some plastic
bags may melt in the autoclave, producing a mess. To avoid this, test bags in the autoclave with
no waste. Bag suppliers might be able to specify a temperature the plastic will stand up to.

Containers

More sturdy containers are employed to hold large quantities of waste. You can buy these from
many retailers and there are no "official" requirements for them. If a legal dispute arises, the
court will look at whether the waste manager exercised due care. Containers, bins, barrels for
medical waste can be made from various materials (plastic, steel, aluminum). Colors should
conform with whatever scheme you have set for your facility.

Large containers should be lockable, especially if they are going to be outdoors or in an area
where a lot of customers or non-professionals frequent.

One mistake facility managers make is assuming that the container a material was delivered in
when it is purchased is acceptable as a waste container for the same material. Once the material
becomes a waste, it is subject to different rules and regulations. The in-bound shipping container
will probably not suffice as a storage or out-bound shipping container.

If you have a waste removal service, they might be able to provide containers. Considering the
low cost of the containers compared to what they charge, they really should do so if they want
you as a regular customer. They may also have containers that fit with their hand trucks or other
mechanical transport means.

Rubbermaid makes these convenient containers with foot pedals. We do not endorse them (or
any other products), but be aware that they are many potential containers.

Dumpsters

You don’t want to put regulated waste in dumpsters, which are not built tight enough to keep out
rain and vermin. Outdoor dumpsters are okay for municipal solid waste, but regulated waste
(hazardous, radioactive, biological) should be kept in tight containers and indoors.

Sharps containers

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These containers are designed to prevent people from being by used needles, scalpels, and
lancets. Sharps containers are generally made of thick plastic, and have a door that opens so the
user can insert the sharp into the container. When the door is closed, the sharp is dropped down
into the main chamber of the container. The container functions much like a standard post office
mailbox, in that the user cannot reach the sharps inside the container via the door.

Sharps containers are found in hospitals, clinics, medical practices, and can also be used by
private individuals who use sharps in the home, such as diabetics who require regular injections
of insulin. For home users, a sharps container is provided by a private disposal company. When
the individual fills the container, the container is then mailed to the disposal company for
disinfection and destruction prior to disposal.

Keeping the Waste On Site

Storage rooms should have locks and be away from the public and most building occupants.
Ideally they should be indoors, but any outdoor storage should be fenced to keep away animals
and humans.

State regulations often dictate the maximum amount of time that medical waste can be stored
prior to treatment. For example, in the state of New York, storage of regulated medical waste is
limited to seven days. Medical waste must be stored separately from standard waste, without
possibility of the two waste types mixing. All reusable storage containers must be disinfected
after they have been emptied, unless they employ a disposable liner that is removed with the
waste.

Workplace safety rules apply medical facilities, and waste managers must worry about employee
safety. There are cases of workers getting sick from contact with waste.

The International Committee of the Red Cross (ICRC) recommends storage time for infectious
waste not exceed 72 hours in winter and 48 hours in summer in temperature climate zones. In hot
climates, the recommended limits are 48 hours in the cooler season and 24 hours in the warmer
season. If refrigerated storage is available, hold times can go up to a week, per the ICRC.

The ICRC recommends criteria for storage areas. While this does not have the force of law, they
are good guidelines and should help you with regulators:

1. Area should be closed, and access must be restricted to authorized persons only
2. Waste storage area must be separate from food store; Area should be covered and
sheltered from the sun
3. Flooring must be waterproof with good drainage
4. Must be easy to clean
5. Must be protected from rodents, birds and other animals; Must allow easy access for on-
site and off-site means of transport
6. Should be well lighted

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7. Should be big enough to sort waste if possible and to allow physical separation of
different categories of waste. Ideally, it should have some physical barriers to prevent
mixing of wastes of different categories
8. Should be close to any on-site treatment
9. Compartmented (so that the various types of waste can be sorted)
10. Should have eye-washed and other PPE
11. Should be near wash basins
12. The entrance must be marked with a sign to discourage people from entering unless they
need to be there and warning of hazards.

ICRC publication on medical waste.

You might hear the words containment and confinement used when describing storage areas. For
all practical purposes they mean the same thing when it comes to design of storage facilities for
medical waste.

The Difference between Storage and Disposal

The patent literature describes many disposal containers for medical waste. These are actually
storage containers for temporary isolation of the waste from human workers. (Disposal refers to
long-term and presumably permanent resting place for waste.) Storage is of concern to the waste
manager, too, and vendors provide a wide variety of options for containers. Your state
government still might have something to say about storage but the containers on the market
usually are acceptable to them.

Operating procedures for your business should specify the maximum time you intend to store
waste on site. If you know how fast your waste is generated and how often it gets taken off-site
you will be able to determine the volume and type of storage needed.

Design of storage systems

Large operations often have small collection bins spread around the facility. For instance, a
complex of doctors’ offices may have containers in each examination room, with a regular
schedule of transferring this waste to a larger storage unit.

The placement of the storage units is an element in the overall design of the waste management
process. Factors that must be weighed:

1. Number of storage units at a given facility (fewer is better to reduce risk of release)
2. Distance between generation of waste and storage unit (less distance is better – many
operating rooms have units so doctors and nurses can put tissue in units without moving
long distances.)
3. Size of storage units.
4. Air flows in locations.
5. Ergonomics

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6. Traffic patterns (people, vehicles) nearby


7. When storing liquid chemicals, the storage area should have a sump for spill collection.
8. Odour control

CHAPTER FOUR
NEW TECHNOLOGIES FOR TREATMENT OF BIO-MEDICAL
WASTE

Central Pollution Control Board (CPCB) have granted conditional or provisional approval to new
technologies (other than notified under BMW Rules) for treatment of biomedical waste , under
the BMW Rules as under:

1. Plasma Pyrolysis
2. Waste Sharps Dry Heat Sterilization and Encapsulation.
3. Shredding Cum Chemical Disinfection (Static / Mobile)

 PLASMA PYROLYSIS TECHNOLOGY:

Plasma pyrolysis is treatment technology can be adopted for treatment and disposal of
bio- medical waste similar to the incineration can be achieved . In case of plasma
pyrolysis , biomedical waste is treated at high temperature under controlled condition to
form gases like methane , hydrogen and carbon monoxide which are subjected to
combustion (oxidation) in secondary chamber . In the plasma pyrolysis process waste is
converted into small clinker which can be disposed I secured lanfills.
CPCB granted provisional approval to the plasma pyrolysis.

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WASTE SHARPS DRY HEAT STERILIZATION AND


ENCAPSULATION

This technology based on dry heat sterilization especially for treatment of waste category
waste sharps . Approval to this technology is accorded by CPCB under the bio-medical
waste (Management and handling ) rules. This technology equipment is canister before
used for collection of waste sharps and canister after treatment.

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SHREDDING CUM CHEMICAL DISINFECTION OF BIO-MEDICAL


WASTE (STATIC/MOBILE)

This technology is based on shredding followed by chemical disinfection of biomedical


waste . This is a non-burn technology in which biomedical waste is shredded beyond
recognition and sterilized so as to make it suitable for disposal along with municipal solid
waste. This technology approved by CPCB.

1.Static unit
2.Mobile unit

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 IN INDIA THE PRICE OF WASTE SHREDDER RS.1.50 LAKH/UNIT.


 MEDICAL WASTE SHREDDER RS 55,000/PIECE.
 BIO-MEDICAL WASTE SHREDDING MACHINE RS 1.10 LAKH/UNIT
 BIO-MEDICAL WASTE SHREDDER MACHINE RS. 1 LAKH/UNIT.

AMB ECOSTERYL – MODEL 75


 AMB Ecosteryl serial 75 is cutting edge technology in hospital waste disposal nowdays.
It has a 20kW four shaft shreeder designed for processing of sharps and prickly ,
syringes , needles and waste drums that hold up to 60L
 Capacity : up to 75 - 100 kg/hr (120 lbs/hr)

RDD MODEL 150:

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This technology is constructed in german . The medical sector with its


requirements for sterilization and disinfection of the hospital waste has been in
our primary focus.

The working cycle is 30 min


Steam consumption is 5 kg
Electricity consumption is 0,5 Kwh

MODEL MWM SERIES – MOBILE MEDICAL WASTE


TREATMENT STATION :
Mobile solutions for medical waste treatment and disposal : Mobile medical waste
treatment station , MWM series , caters to many other customized demands , such
as in military field hospital , emergency situations such as nature disaster and
epidemic diseases .
1. The most important application is Emergencies and customized demands.
2. The capacity of effective loading volume : 150L and 700L .
3. Microbial inactivation: 99.9999%
4. Its advantage is Easy , safe, efficiency and environmental – friendly
5. Steam generator and power generator

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MOBILE MWM SERIES ECHNOLOGY USED IN AMERICA


The steam sterilization technology is going mainstream

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CONCLUSION

The absence of waste management, lack of awareness about the health


hazards, insufficient financial and human resources and poor control of waste
disposal are the most common problems connected with health care wastes. An
essential issue is the clear attribution of responsibility of appropriate handling and
disposal of waste .According to the ‘polluter pays’ principal, this responsibility lies
with the waste producer ,usually being the health-care provider , or the
establishments involved in related activities .We need innovative and radial
measures to clean up the distressing picture of lack of civic concern on the part of
hospitals and slackness in government implementation of bare of minimum of rules
,as waste generation particularly biomedical waste imposes increasing direct and
indirect costs on society. The challenge before us therefore , is to scientifically
manage growing quantities of biomedical waste that go beyond past practices . If
we want to protect our environment and health of community we must sensitize
ourselves to this important issue not only in the interest of health managers but also
interest of community.

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REFERENCES
I. www.irjet.net
II. www.nswai.com
III. www.researchgate.net
IV. www.neptjournal.com
V.

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