Biomedical waste

management

SUNIL KUMAR. P ST.JOHN'S

MEDICAL COLLEGE ,
13-10-2018 BANGALORE 1
Definition
Waste generated during the
diagnosis, testing, treatment,
research or production of
biological products for
humans or animals (WHO)

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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

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MEDICAL COLLEGE ,
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Classification of Bio-Medical Waste
The World Health Organization (WHO) has
classified medical waste into eight
categories:
1. General Waste
2. Pathological
3. Radioactive
4. Chemical
5. Infectious to potentially infectious waste
6. Sharps
7. Pharmaceuticals
8. Pressurized containers SUNIL KUMAR. P ST.JOHN'S
MEDICAL COLLEGE ,
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MEDICAL COLLEGE ,
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 Sources of Bio-Medical Waste
Major Sources Minor sources

Hospitals  Clinics
Labs  Dental clinics
Research  Home care
centers  Cosmetic clinics
Animal research  Paramedics
Blood banks  Funeral services
Nursing homes  Institutions
Mortuaries
Autopsy centers 13-10-2018
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Problems relating to biomedical
waste
A major issue-- some hospitals are
disposing of waste in a haphazard,
improper and indiscriminate manner.
 Lack of segregation practices, results in
mixing of hospital wastes with general
waste making the whole waste stream
hazardous.
 Inappropriate segregation ultimately
results in an incorrect method of waste
disposal. SUNIL KUMAR. P ST.JOHN'S
MEDICAL COLLEGE ,
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Inadequate Bio-Medical waste management thus will cause
 environmental pollution,
 unpleasant smell,
 growth and multiplication of vectors like insects, rodents and
worms and may lead to the transmission of diseases like
typhoid, cholera, hepatitis and AIDS through injuries from
syringes and needles which are contaminated
 Various communicable diseases, which spread through water,
sweat, blood, body fluids and contaminated organs, are
important to be prevented.
 The Bio Medical Waste scattered in and around the hospitals
invites flies, insects, rodents, cats and dogs that are responsible
for the spread of communication disease like plague and rabies.
 Rag pickers in the hospital, sorting out the garbage are at a risk
of getting tetanus.

SUNIL KUMAR. P ST.JOHN'S

MEDICAL COLLEGE ,
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 Hazardous health care
waste can result in
1. Infection

2. Genotoxicity and Cytotoxicity

3. Chemical toxicity

4. Radioactivity hazards.

5. Physical injuries

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6. Public sensitivity. 13-10-2018
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Need of biomedical waste management
in hospitals
reasons due to which there is great need of management of
hospitals waste such as:
 Injuries from sharps leading to infection to all categories of
hospital personnel and waste handler.
 nosocomial infections in patients from poor infection control
practices and poor waste management.
 Risk of infection outside hospital for waste handlers and
scavengers and at time general public living in the vicinity
of hospitals.
 Risk associated with hazardous chemicals, drugs to persons
handling wastes at all levels.
 “Disposable” being repacked and sold by unscrupulous
elements without even being washed.
 Drugs which have been disposed of, being repacked and
sold off to unsuspecting buyers.
 Risk of air, water and soil pollution directly due to waste, or
due to defective incineration emissions and ash.

SUNIL KUMAR. P ST.JOHN'S

MEDICAL COLLEGE ,
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 SUNIL KUMAR. P ST.JOHN'S
MEDICAL COLLEGE ,
13-10-2018 BANGALORE 12
 SUNIL KUMAR. P ST.JOHN'S
MEDICAL COLLEGE ,
13-10-2018 BANGALORE 13
Biomedical Waste Management
Process
The hospital waste like body parts, organs, tissues,
blood and body fluids along with soiled linen, cotton,
bandage and plaster casts from infected and
contaminated areas are very essential to be properly
collected, segregated, stored, transported, treated
and disposed of in safe manner to prevent nosocomial
or hospital acquired infection.
 Waste collection
 Segregation
 Transportation and storage
 Treatment & Disposal
 Transport to final disposal site
 Final disposal
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Segregation of biomedical
waste
 Segregation of waste is the first step.
 This would ensure
◦ that infectious wastes do not get mixed with non-
infectious wastes
◦ Only a small fraction of waste generated by health care
institutions is actually infectious or hazardous. It is
estimated that 80-85% is non-infectious, 10% is
infectious and 5 % is hazardous.
◦ Segregation of waste into infected or contaminated waste
and non-infected waste is mandatory and is a
prerequisite for safe and hygienic waste management.
 Segregation at source
◦ makes it easier to prevent spread of infection, help it
easier to choose among the options of disposal, and
◦ can reduce the load on the waste treatment system and
prevent injuries.
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 SUNIL KUMAR. P ST.JOHN'S
MEDICAL COLLEGE ,
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 Colour Type Waste Treatment Options as
Coding of Container Category per Schedule 1
s

Yellow Plastic bag 1,2,3,6 Incineration/deep burial

Red Disinfected 3,6,7 Autoclaving/Micro

Container/ waving/ Chemical
Plastic bag Treatment

Blue/ White Plastic 4,7 Autoclaving/Micro

translucent bag/puncture waving/ chemical
proof container treatment and
destruction/shredding

Black Plastic bag 5,9,10 (Solid) Disposal in secured

landfill

SUNIL KUMAR. P ST.JOHN'S

MEDICAL COLLEGE ,
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 SUNIL KUMAR. P ST.JOHN'S
MEDICAL COLLEGE ,
13-10-2018 BANGALORE 18
 SUNIL KUMAR. P ST.JOHN'S
MEDICAL COLLEGE ,
13-10-2018 BANGALORE 19
LABEL FOR BIO-MEDICAL WASTE
CONTAINERS/BAGS

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MEDICAL COLLEGE ,
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Transportation
 Untreated biomedical waste shall be transported only in
specially designed vehicles.
 The waste should be transported for treatment either in
trolleys or in covered wheelbarrows.
 Manual loading should be avoided as far as possible.
 The bags / container containing biomedical wastes should
be tied/ lidded before transportation.
 Before transporting the bag containing biomedical wastes,
it should be accompanied with a signed document by
Nurse/ Doctor mentioning date, shift, quantity and
destination.
 Special vehicles must be used so as to prevent access to,
and direct contact with, the waste by the transportation
operators, the scavengers and the public.
 The transport containers should be properly enclosed.
 The effects of traffic accidents should be considered in the
design, and the driver must be trained in the procedures
he must follow in case of an accidental spillage.
 It should also be possible to wash the interior of the
containers thoroughly SUNIL KUMAR. P ST.JOHN'S
MEDICAL COLLEGE ,
13-10-2018 BANGALORE 21
Personnel safety devices
 The use of protective gears should be made mandatory for all the
personnel handling waste.
 Gloves:
◦ Heavy-duty rubber gloves
◦ This should be bright yellow in colour. After handling the waste, the gloves
should be washed twice.
◦ The gloves should be washed after every use with carbolic soap and a
disinfectant.
◦ The size should fit the operator.
 Aprons, gowns, suits or other apparels:
◦ Apparel is worn to prevent contamination of clothing and protect skin.
 Masks:
◦ Various types of masks, goggles, and face shields are worn alone or in
combination, to provide a protective barrier. It is mandatory for personnel
working in the incinerator chamber to wear a mask covering both nose and
mouth, preferably a gas mask with filters.
 Boots:
◦ Leg coverings, boots or shoe-covers provide greater protection to the skin
when splashes or large quantities of infected waste have to be handled. The
boots should be rubber-soled and anti-skid type. They should cover the leg
up to the ankle.

SUNIL KUMAR. P ST.JOHN'S

MEDICAL COLLEGE ,
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Biomedical Waste Treatment and
Disposal
Incineration Technology
 This is a high temperature thermal process employing
combustion of the waste under controlled condition for
converting them into inert material and gases. Incinerators
can be oil fired or electrically powered or a combination
thereof.
 Broadly, three types of incinerators are used for hospital
waste:
 multiple hearth type, rotary kiln and controlled air types.
Non-IncinerationTechnology
 Non-incineration treatment includes four basic processes:
thermal, chemical, irradiative, and biological. The majority
of non-incineration technologies employ the thermal and
chemical processes. The main purpose of the treatment
technology is to decontaminate waste by destroying
pathogens.

SUNIL KUMAR. P ST.JOHN'S

MEDICAL COLLEGE ,
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 Autoclaving
The process involves using steam at high
temperatures.
◦ These are also of three types: Gravity type, Pre-
vacuum type and Autoclave treatment has been
recommended for microbiology and biotechnology
waste, waste sharps, soiled and solid wastes.
◦ This technology renders certain categories
(mentioned in the rules) of bio-medical waste
innocuous and unrecognizable so that the treated
residue can be land filled.
 Microwave Irradiation
◦ The microwave is based on the principle of
generation of high frequency waves.
◦ These waves cause the particles within the waste
material to vibrate, generating heat.
◦ This heat generated from within kills all COLLEGE
pathogens.
SUNIL KUMAR. P ST.JOHN'S
MEDICAL ,
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 Chemical Methods
◦ 1 % hypochlorite solution can be used for chemical
disinfection
 Plasma Pyrolysis
◦ Plasma pyrolysis is a state-of-the-art technology for
safe disposal of medical waste.
◦ It is an environment-friendly technology, which
converts organic waste into commercially useful by
products.
◦ The intense heat generated by the plasma enables
it to dispose all types of waste including municipal
solid waste, biomedical waste and hazardous waste
in a safe and reliable manner. Medical waste is
pyrolysed into CO, H2, and hydrocarbons when it
comes in contact with the plasma-arc. These gases
are burned and produce a high temperature
(around 1200oC).9

SUNIL KUMAR. P ST.JOHN'S

MEDICAL COLLEGE ,
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MEDICAL COLLEGE ,
13-10-2018 BANGALORE 26
Benefits of Biomedical Waste
Management
 Cleaner and healthier surroundings.
 Reduction in the incidence of hospital acquired and
general infections.
 Reduction in the cost of infection control within the
hospital.
 Reduction in the possibility of disease and death due
to reuse and repackaging of infectious disposables.
 Low incidence of community and occupational health
hazards.
 Reduction in the cost of waste management and
generation of revenue through appropriate treatment
and disposal of waste.
 Improved image of the healthcare establishment and
increase the quality of life.

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MEDICAL COLLEGE ,
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CONCLUSION
 Medical wastes should be classified according to
their source, typology and risk factors associated
with their handling, storage and ultimate
disposal.
 The segregation of waste at source is the key
step and reduction, reuse and recycling should
be considered in proper perspectives.
 scientifically manage growing quantities of
biomedical waste that go beyond past practices.
 Proper disposal of the waste.
 If we want to protect our environment and
health of community we must sensitize our
selves to this important issue not only in the
interest of health managers but also in the
interest of community.
SUNIL KUMAR. P ST.JOHN'S
MEDICAL COLLEGE ,
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 SUNIL KUMAR. P ST.JOHN'S
MEDICAL COLLEGE ,
13-10-2018 BANGALORE 29
Healthy community
Healthy environment
Healthy you
Healthy me

Wake up
Lets follow the rules and
protect ourselves and our
loved ones

Let the wastes of the sick not

contaminate the lives of the
healthy.

SUNIL KUMAR. P ST.JOHN'S

MEDICAL COLLEGE ,
13-10-2018 BANGALORE 30