See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/362103944

Liquid Waste Management

Conference Paper · July 2022

CITATIONS READS

0 6,958

1 author:

Priyanka Verma
Central Council for Research in Unani Medicine
22 PUBLICATIONS   93 CITATIONS   

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Optomechanics View project

All content following this page was uploaded by Priyanka Verma on 19 July 2022.

The user has requested enhancement of the downloaded file.

 ISSN: 2231-3834 (Online)
Research & Reviews: A Journal of
ISSN: 2349-1264 (Print)

Toxicology Volume 11, Issue 3, 2021

DOI (Journal): 10.37591/RRJoT
STM JOURNALS
http://medicaljournals.stmjournals.in/index.php/RRJoT/index

Review RRJoT

Liquid Waste Management

Priyanka Verma*

Abstract
Liquid waste is an emerging problem in this world, because of its ability to enter watersheds, pollute
ground and drinking water when improperly handled and disposed. Diseases like cholera, plague,
tuberculosis hepatitis as well as diphtheria are very common in places where untreated waste is
reused and can be extremely dangerous over the period of time. Which can give public health risks as
well as a major problem for healthcare facilities. About 90% of wastewater which is produced
globally from the hospital care facility remains untreated but there is increase in untreated
wastewater in irrigation due to scarcity of water. So proper steps should be taken to discard untreated
and wastewater to keep safe and to avoid contamination of the table water.

Keywords: Liquid waste management, Effluent treatment Plant, Wastewater treatment plant.

INTRODUCTION
Hospital and health care facility provide patient care services during which certain amount of waste
like cotton swabs, discarded syringes and unused specimens etc. are produced which are collectively
called as Biomedical waste. This can be either solid or liquid, which is generated during the diagnosis
and need to be disposed off safely and effectively [1]. Bio waste in health care facility should be
properly managed, if not will impact the society and natural environment.

WHO stated 85%responsibility of municipal or government authorities in liquid waste management

but in 1988 Government of India has implemented the Biomedical waste management and handling
rules, 1988 which specifies that the hospital waste management is a part of hospital hygiene and
maintenance activities such as collection, transportation, treatment, operation of processing systems
and appropriate disposal of waste is a liability for the hospital management [2]. The implementation
of the biomedical waste management and handling rules 1998 is made mandatory for hospitals, clinics
and other medical institutions.

LIQUID BIOMEDICAL WASTE

Liquid waste give serious threat to human health and environment because of their ability to enter
watersheds, pollute ground and drinking water when improperly handled and disposed. Illegal and
unethical reuse of this untreated waste, can be extremely dangerous and even fatal in causing diseases
like cholera, plague, tuberculosis, hepatitis B,
diphtheria etc. in either epidemic or even in
*Author for Correspondence
Priyanka Verma endemic form, which can pose grave public health
E-mail: biochemistpriyanka@gmail.com risks and consequences and this is a major problem
Research Officer, Department of Biochemistry, Regional
for healthcare facilities, their employees and the
Research Institute of Unani Medicine, New Delhi, India community at a large [3].
Received Date: October 22, 2021
Accepted Date: December 01, 2021 Wastewater is not similar to sewage for the
Published Date: December 20, 2021 former is any water that has been adversely
Citation: Priyanka Verma. Liquid Waste Management.
affected in quality by anthropogenic influence and
Research & Reviews: A Journal of Toxicology. 2021; 11(3): comprises liquid waste either discharged from
18–24p. health care facilities or from domestic residences.

© STM Journals 2021. All Rights Reserved 18

Liquid Waste Management Priyanka Verma

Types of Liquid Waste

The liquid waste generated from Hospital care facility is of the following type which includes:
• Infectious waste i.e. blood and body fluids, laboratory waste (cultures of infectious agents,
cultures from laboratories, biological discarded vaccines, culture dishes and devices.)
• Hazardous chemical which includes formaldehyde (obtained from pathology labs, autopsy,
dialysis, embalming), Mercury (broken thermometers, sphygmanometers, dental amalgams),
solvents (Pathology and embalming), Radioactive isotopes.
• Pharmaceutical liquid waste (which includes discarded, unused, expired medicines).
• Photographic chemicals (i.e. fixer and developer)
• Waste from cleaning and washing water channelled into the drain.

Hazards and Challenges of Liquid Bio medical waste

Most existing systems and technologies being used in handling liquid biomedical waste are failing
to address the problem of effective management of liquid waste. Like pouring biomedical liquid waste
in drain which can pose higher infection threat to medical staff due to chances of spilling, splashing,
and aerosolizing. Untreated liquid waste is a threat to the society or community. The wastewater
treatment plants can be additional source of release of methane gas into the atmosphere, which
requires capture, destruction or utilisation to reduce the possibility for reducing greenhouse gas
emissions. Almost 90% of the waste water produced from the hospital care facility remains untreated
and is a major cause of water pollution in low income countries. Besides there is increase in the use of
his intreated wastewater for irrigation due to the scarce water resources.

Segregation and Management of Liquid Waste

Biomedical and waste management handling rules 1998 state that liquid and chemical waste
produced should be properly treated before it is discarded into public sewer system. It should be pre-
treated before it id discarded as well as neutralised and then can be flushed into the sewage system
while the chemical waste need to be first neutralized with appropriate reagents before been flushed
into the sewer. Thus, it is seen that liquid waste management includes.

Thus it can be said that liquid waste management includes practices which prevent discharge of
untreated pollutants to the drainage system or to water bodies to avoid disposal of non hazardous
liquid wastes. Therefore these wastes are first segregated and stored in leak proof containers and then
disinfected or neutralised with approved chemical decontamination at the site of generation [3]. These
containers are labelled with biohazard symbol. If the waste require transport before decontamination,
then it is advised to be stored in a twin bin containers. This twin bin containers consists of primary
and secondary containers, in this primary container is placed into secondary one to avoid spillage and
leakage during transport. Secondary container is labelled with biohazard symbol denoting presence of
biomedical waste.

Disposal Procedures for Infectious Liquid Waste

Sanitary Sewer Disposal Methods
This type of system is used for the disposal for certain liquid wastes, it not only checks the leaks
but reduces the disposal cost [4]. Disinfection is done chemically prior to its disposal to eliminate
microorganisms or microbial load.

Chemical treatment uses 1% sodium hypochlorite solution with a minimum contact for 30 mins or
it is done with other standard disinfectants e.g., 10–14 gms of bleaching powder in 1 Litreswater, 4%
formaldehyde, 70% ethanol, 70% isopropyl alcohol, 6% hydrogen peroxide, 2.5% povidone iodine.

Disinfection of culture media is totally different from the usual disinfection, because of high
microbial load and rich protein content rigorous disinfection is required, where inactivation will be
done by 5.23% sodium hypochlorite in a 1:10 dilution and should be left for minimum of 8 hours and

© STM Journals 2021. All Rights Reserved 19

Research & Reviews: A Journal of Toxicology
Volume 11, Issue 3
ISSN: 2231-3834 (Online), ISSN: 2349-1264 (Print)

finally disposed into sanitary sewer which is followed by flushing with a lot of cold water for a
minimum period of 10 mins. Sodium hypochlorite which is also called as bleach is having a broad
spectrum disinfectant which is effective for enveloped virus like HIV, HBV, HSV, vegetative bacteria
which includes Pseudomonas, staphylococcus and salmonella, fungi like Candida, mycobacterium and
non enveloped virus should be stored between 50 and 70 F. Household undiluted bleach has a shelf
life ranging from 6 months to 1 year from the date of manufacturing, it undergoes degradation of 20%
per year until a total degration of salt and water.

Guidelines for Pouring Biomedical Liquid Waste down the Sanitary Sewer
• Microbial biohaardous liquid waste, should be necessarily autoclaved and finally put down into
the sewer system.
• Hospital workers should wear protective equipments which normally include lab coat, gloves
and safety glasses to protect from spillage and aerosols generated from disposal.
• Two different basins should be used one to wash their hands and the other for pouring
biomedical liquid waste which is disinfected in order to avoid splashing.
• Proper inactivation time should be documented by the lab supervisor in the official log book.
Supervisor has the responsibility to document every event in log book regarding bleach
addition. Any waste lacking this is considered to be violation of the approved inactivation
process. Such a log book must be kept for a minimum of 3 years and finally be handed to the
safety officer for long term retention.
• Supervisor should have proper knowledge about chlorine inactivation like microbial cell culture
plates should be disinfected for hours to days. In charge should have judgment regarding
chlorine inactivation like inactivation of microbial cell culture plates by disinfectants require
hours to days, as the protein levels are high microbial culture wastes should be treated for at
least 8 hours to allow the bleach to kill the microbes and time of exposure and its recording will
ensure adequate killing time.
• Microorganisms like legionella is readily transmitted in humans by aerosols, they can’t be
inactivated by the bleach exposure, therefore can infect the worker, so they need to be
autoclaved, therefore during transportation to the autoclave site they should be tightly packed to
prevent aerosolization of legionella [5, 6].

Placing Directly in the Biohazardous Waste Bin

In this liquid waste is directly placed in red or yellow bio hazardous container which depends on
the treatment to be given by the health care facility. Yellow biohazard bin is used when the hospital
care facility had incinerator on the other hand in facilities without incinerators here liquid waste is
placed directly to red bin which is further autoclaved. It takes normally 45 to 90 mins at 250 F for
sterilizing liquid waste and autoclave pressure should be 15 psi.

Liquid waste Solidification

This involves adding of powdered solidifying agent to the liquid waste containers which turns the
liquid content into gelatinous solid mass after 5 to 10 mins, thus eliminates the need to transport the
biohazard fluids in a liquid form. The solidification can be disposed of as red bag waste. Here
microencapsulation technology is used in which liquid waste is converted to solid waste, it used dry
granular super absorbent polymers that can retain large volume of liquids. Some solidifiers also
include sanitising agents like chlorine or glutaraldehyde which help in disinfection before
solidification is done [7]. These absorbent polymers can absorb fluids up to 300 times having there
volume expansion to less than 1% which therefore reduced the water based spills along with the
transport cost by around 50%.

There are many disadvantages as well linked to this system, the canisters become too heavy after
solidification, besides this the hospital has to check for the landfill operators to dump the solidified
waste. The effectiveness of these powders have not been tested on the body fluids so there actions are
questionable as well as these powders add more pollutants to the landfills.

© STM Journals 2021. All Rights Reserved 20

Liquid Waste Management Priyanka Verma

Closed Disposal Systems

By and large, the majority of hospitals and other healthcare facilities either pour the treated or
untreated liquid waste down the drain, dispose of full or partially filled containers of liquid waste,
intact as red bag waste or it is solidified which is further disposed in either red or yellow bag if the
state in which the facility is available consider it as legal. Nowadays fluid waste are designed in such
a way that they use closed disposal system, they dispose fluid waste down in the sewer with very
minimal contact with the humans. Many of them are attached to the vacuum system that directly
empties the canisters into the sewer therefore reducing exposure risk.

There are many drawbacks associated with the closed disposal system which includes big capital
investment as well as such system requires labour activities like someone to collect, process,
maintaining of log book, clean, disinfect, collect and then finally redistribute them. Maintenance of
these canisters should also be taken care of when repair is needed [8].

Hospital Care Facility without any Available Options

There are many hospitals without any biowaste facility in order to reduce health hazards following
measures should be followed in order to lower the contamination [9]. Cases suffering from enteric
diseases should be isolated in separate wars, there excreta is collected in separate buckets and treated
chemically, which is very important in cases of Cholera outbreak. Chemicals as well as
pharmaceuticals should not be discharged directly in sewer and should be disinfected chemically with
sodium hypochlorite, chlorine gas or dioxide as well as sewage from these establishments should not
be used for agriculture, drinking or any other purpose.

Chemically Hazardous Liquid Waste Disposal

Chemicals that form hazardous waste are formaldehyde, solvents like xylene, acetonitrile, acetone,
ethanol, isopropanol, Toluene, methanol, ethyl acetate which are basically obtained from pathology
lab as well as from embalming procedures. Mercury coming from the broken thermometers is also a
threat to the society. Formalin when produced in large quantites are incinerated for disposal [10].
Mostly radioactive waste is generated from department of nuclear medicine and they can be retained
until they have decayed to non hazardous materials and thereafter can be transported for disposal.

Waste Disposal Techniques of Radioactive Isotopes Depends upon the Level of Radiations
Geological Disposal
Here radioactive waste is buried without having intention to retrieve the waste. There are some
liquids which are disposed by using the process of nitrification which uses high radiation as well as
attention is given so that liquid does not leach out during burial [11].

Natural Transmutation or Decay

It is nothing but conversion of one radioactive element into more stable element over a period of
time spontaneously. Very high energy is needed to cause changes in the nuclear structure of the
elements.

Reuse of waste
Reprocessing spent fuels rods can potentially recover 96% of the uranium for use in new fuel rods.
Mercury is most of the time generated from dental amalgams as well as broken thermometer in
hospital care facilities. Mercury is a powerful neurotoxin, therefore great care is taken to protect
people from its exposure. Even small quantity of mercury spill lead to mercury poisoning particularly
in children. That’s why it is advised to find better alternatives for mercury devices.

Guide to Cleaning up a Small Mercury Spill

• Evacuate area- remove everyone from the area that has been contaminated with mercury spills
and shut the door. Turn off interior interior ventilation system to avoid dispersing of mercury
vapour [12].

© STM Journals 2021. All Rights Reserved 21

Research & Reviews: A Journal of Toxicology
Volume 11, Issue 3
ISSN: 2231-3834 (Online), ISSN: 2349-1264 (Print)

• Put on face mask- in order to prevent breathing of mercury vapour.

• Put on old clothes- so that they can be discarded if they become contaminated with mercury.
• Remove jewellery- so that the mercury can’t combine (Amalgamate) with the previous metals.
• Wear rubber/latex/nitrile gloves- to avoid absorption through the skin. Place all broken objects
in a zip lock bag. Secure the bag and label it as contaminated with mercury.
• Locate mercury beads- small and hard to see small beads can be located with the flashlight
when held it at a low angle close to the floor in a darkened room which reveals glistering beads
of mercury.
• Use eye dropper and sticky tape- use an eyedropper or syringe to draw up the mercury beads
and carefully transfer the mercury into an unbreakable plastic container with an airtight lid
containing 5-10 ml of water. Place the container in the zip lock bag. Powdered sulphur or zinc
powder when put over mercury spills form a coloured compound which can be visualised
easily.
• Leak proof bag- place all the materials used during the clean up, including gloves, into a leak,
proof plastic bag or container, Seal and label it.
• Final disposal – contact the local hospital manager responsible for toxic clean up and proper
disposal to ensure that all mercury contaminated wastes now secured in labelled bags is dealt
with in accordance with national legislation.
• Outside ventilation- keep the area ventilated to the outside (with windows open and ventilation
running) for at least 24 hrs after the successful clean up. Still if there are symptoms of sickness,
medical attention should be contacted immediately.

Pharmaceutical Liquid Waste Disposal

Pharmaceutical liquid waste are the largest waste which are produced by the hospitals, if found in
small amounts they can be easily diluted with water and discharged to the sewers. It can be
transported to the secured land fill or it can be returned to the supplier and if the waste is in small
amounts it can be incinerated. It has been found that around 250 million pounds of drugs are flushed
into the sewage system each year in USA.

Disposal Procedures for Photographic Liquid Waste

Often temporary storage is done for the disposal of photographic liquid waste, for this often 25 L
containers are used. Care should be taken regarding its storage, handling and movement of the liquid
photogenic waste. Silver which is one of the heavy metal found in the universe, which when found in
concentration exceeding 5 ppm is considered as hazardous as per resource conservation and recovery
act (RCRA). Silver recovery units are installed which removes most of the silver before it is disposed
off

WATER TREATMENT PLANT

Liquid waste generated from places like operation theatre, labour rooms, lab, laundry, canteen and
toilet is firstly segregated and treated with disinfectant and then finally poured into common drainage
facility. This waste produced could lead to infections and if the discard is done in local bodies like
lakes and rivers it will be hazardous. To avoid this biomedical waste guidelines 1998 has to be
followed, as well as hospital should make their own Effluent treatment plant so that waste water can
be reused eventually. Hospitals not having effluent treatment plant here waste water is first chemically
treated and then released into common sewage facility which is further connected to local municipal
water treatment facilities. BOD and COD tests can measure organic, inorganic or microbial contents
inside the waste water. BOD measures the oxygen demand of biodegradable pollutants while COD
measures oxygen demand of oxidizable pollutants.

High BOD in waste water indicates excess amount of organic carbon which have higher polluting
capacity. Waste water should follow permissible limits before discarding it, waste [13] water should
remove majority of contaminant and produce effluent that is suitable for disposal to the natural

© STM Journals 2021. All Rights Reserved 22

Liquid Waste Management Priyanka Verma

environment. Hospitals which have their own effluent treatment plant follow three stage treatment i.e.
primary, secondary and tertiary [14].

Primary Treatment
In this sewage is stopped in a basin, in which the settled as well as floating material is removed and
the remaining liquid is subjected to secondary treatment. By this treatment BOD and COD levels
comes down to 25% of its initial levels.

Secondary Treatment
It removes dissolved and suspended biological matter and is performed by indigenous, water borne
microorganisms. Secondary treatment uses microbial degradation, aerobic or anaerobic which help in
reduction of organic compounds. This primary and secondary treatment reduces BOD by 80 to 90%.
Suspended solids which settled down as slurry called as sludge. The treated fluid then undergoes
tertiary treatment which remains 95% of the pollutants from the waste water.

Tertiary Treatment
In this chemicals are used to remove inorganic compounds and pathogens. This is the final stage of
treatment. In this the effluent is mixed with sodium hypochlorite, which is followed by passing
through dual media filter (DMF) and then activated carbon filter (ACF) where sand, anthracite and
activated carbon are used as filtration media [15].

Legal Aspects of Liquid Waste Management

Disposal of infected and hazardous waste which comes from hospitals, nursing homes as well as
laboratories has been a threat to the environment which lead to the spreading of the disease putting the
environment to risk and transmission of prone disease. So it is the duty of health care facility which
includes hospitals, nursing homes, clinics, dispensaries, veterinary institutions, animal houses,
pathology and biochemistry lab, blood banks etc., steps should be taken to reduce adverse effect to the
human health and environment. Each state as well as union territory should establish a authority for
this purpose.

CONCLUSION
The area of liquid waste management is grossly neglected, even existing technologies and practices
cannot take care. Safe handling of biomedical waste is a matter of serious concern for the authorities
as this waste which is produced by medical activities is hazardous and toxic in character; it can be
lethal as well because of their high potential for diseases transmission. Because of lack of awareness
there is a urgent need to educate people by providing them educational material for better
understanding of hospital waste management.

REFERENCES
1. Park K. Hospital waste Management parks. Textbook of Preventive and social Medicine. 18 th
edition, New Delhi.M/s Banarsidas Bhanot Publications, 2005. p 595-8.
2. The Gazette of India Biomedical wastes (Management and Handling) Rules 1998.Extraordinary
Part II Section 3–Sub Section (ii) pp. 10-20. India: Ministry of Environment and Forests,
Government of India. Notification dated 2nd July 1998.
3. Blenkham JI.Standards of clinical waste management in UK hospitals. J Hosp Infect 2006;62(3):
300-3.
4. NIUA. Urban Scenario of India. Avaialable online from: https://www.niua.org/urban-scenario-of-
india.
5. Patil AD. Shekdar AV. Health care waste management in India. J Environ. Manager 2001; 63:
211-20.
6. UNC. Environment, Health and Safety. Biological Waste Disposal Policy. Available online at:
https://ehs.unc.edu/biological/policy/

© STM Journals 2021. All Rights Reserved 23

 Research & Reviews: A Journal of Toxicology
Volume 11, Issue 3
ISSN: 2231-3834 (Online), ISSN: 2349-1264 (Print)

7. Spill Control Technologies Ltd. Liquid Waste Solidifier. Available online at: https://store-
f2b01.mybigcommerce.com/liquid-waste-solidifier-lws-2lbs/
8. Manfred Hoffmann Baumaschinen Industrieservice. Available online at:
https://www.baumaschinen-hoffmann.de/.
9. Singh IB, Sharma RK. Hospital waste disposal system and technology. J Acad Hosp Abm 1996:
8-9(2-1):33-9.
10. UC San Diego. Blink.How to Identify, Label, Package and Dispose of Biohazardous and Medical
Waste. Available Online at: https://blink.ucsd.edu/safety/research-lab/hazardous-waste/disposal-
guidance/medical/dispose.html
11. Sailing H. Radioactive Waste Management. 2nd ed, New York.Taylor and Francis: 2002.
12. EPA. United States Environmental Protection Agency. Storing, Transporting and Disposing of
Mercury. https://www.epa.gov/mercury/storing-transporting-and-disposing-mercury
13. Ministry of Environment, Forest and Climate Change, Government of India. Available online at:
https://moef.gov.in/en/division/environment-divisions/hazardous-substances-management-
hsm/introduction/
14. Kadam A, Ozaa G, Nemadea P, Dutta S, Shankar H. Municipal wastewater treatment using novel
constructed soil filter system. Chemosphere 2008; 71(5): 1975-81.
15. Nemade PD, Kadam AM, Shankar HS. Wastewater renovation using constructed soil filter (CSF).
A novel approach J Hazard Mater 2009; 170(2-3): 657-65.

© STM Journals 2021. All Rights Reserved 24

View publication stats