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SEMINAR ON

HOSPITAL WASTE MANAGEMENT

GUIDED BY DR. N .C RAO DR. MOHIT DR. SHAILJA DR. ABHISHEK DR. SHIKHA

SUBMITTED BY: SAKSHI SINDWANI BDS INTERN

g. dictated by the needs of expanding population. waste from surgery. Hospital waste is a potential health hazard to the health care workers. increasing land and water pollution lead to increasing possibility of catching many diseases. Hydrochloric acid etc. Dioxin. kitchen waste. organ. A modern hospital is a complex. e. culture and stocks of infectious agents from laboratories. Air pollution due to emission of hazardous gases by incinerator such as Furan. paper. (2) (3) . The last century witnessed the rapid mushrooming of hospital in the public and private sector. waste originating from infectious patients. the hospitals are known for the treatment of sick persons but we are unaware about the adverse effects of the garbage and filth generated by them on human body and environment.g. Since beginning. plastics. transfusion transmitted diseases. Hospital acquired infection. public and flora and fauna of the area. ultimately. Pathological waste: Consists of tissue. Classification of hospital waste (1) General waste: Largely composed of domestic or house hold type waste. have compelled the authorities to think seriously about hospital waste and the diseases transmitted through improper disposal of hospital waste. rising incidence of Hepatitis B. a place to serve the patient. It is hazardous waste. wrappers.Hospital Waste An Environmental Hazard and Its Management Hospital is a place of almighty. discarded and not intended for further use in the hospital. The advent and acceptance of "disposable" has made the generation of hospital waste a significant factor in current scenario. hospital waste. It is non-hazardous to human beings.e. human foetuses. It is hazardous e. All these products consumed in the hospital leave some unusable leftovers i. Now it is a well established fact that there are many adverse and harmful effects to the environment including human beings which are caused by the "Hospital waste" generated during the patient care. the Central Government had to intervene for enforcing proper handling and disposal of hospital waste and an act was passed in July 1996 and a bio-medical waste (handling and management) rule was introduced in 1998. What is hospital waste Hospital waste refers to all waste generated. blood and body fluid. Infectious waste: The wastes which contain pathogens in sufficient concentration or quantity that could cause diseases. This problem has now become a serious threat for the public health and. multidisciplinary system which consumes thousands of items for delivery of medical care and is a part of physical environment. packaging material. and HIV. body part.

needles. and gaseous waste that is contaminated with radionucleides generated from in-vitro analysis of body tissues and fluid.g. Pharmaceutical waste: This includes pharmaceutical products. house keeping. a cut or puncture of skin e.A.5 4. liquid and gaseous chemicals e. liquid. scalpels. or contaminated. cleaning. broken glass. in-vivo body organ imaging and tumour localization and therapeutic procedures. France Spain India Quantity (kg/bed/day) 2. U. and disinfecting product.0 1.5 2. have been spilled.5 3.S.5 (b) Hazardous/non-hazardous Hazardous a) Hazardous but non-infective b) Hazardous and infective Non-hazardous (c) Composition By weight Combustible Noncombustible Plastic Dry cellublostic solid Wet cellublostic solid 14% 45% 18% 20% 15% 5% 10% 85% .g. Chemical waste: This comprises discarded solid.(4) Sharps: Waste materials which could cause the person handling it. (5) (6) (7) Amount and composition of hospital waste generated (a) Amount Country U. drugs. saws. and chemicals that have been returned from wards. are outdated. Radioactive waste: It includes solid. blades. nail. K.

But when hazardous waste is not segregated at the source of generation and mixed with non hazardous waste. in research pertaining thereto.Biomedical waste Any solid. not the complete.e. then 100% waste becomes hazardous. which is generated during the diagnosis. The question then arises that what is the need or rationale for spending so much resources in terms of money. All biomedical waste are hazardous. including it's container and any intermediate product. or in the production or testing of biological and the animal waste from slaughter houses or any other similar establishment. or due to defective incineration emissions and ash. man power. nosocomial infections in patients from poor infection control practices and poor waste management. risk associated with hazardous chemicals. 1. Segregation of waste . fluid and liquid or liquid waste. "disposable" being repacked and sold by unscrupulous elements without even being washed. treatment or immunisation of human being or animals. In fact only 15% of hospital waste i. "Biomedical waste" is hazardous. notified under the Environment Protection Act by the Ministry of Environment and Forest (Government of India).ll categories of hospital personnel and waste handler. In hospital it comprises of 15% of total hospital waste. risk of infection outside hospital for waste handlers and scavengers and at time general public living in the vicinity of hospitals. drugs to persons handling wastes at all levels. drugs which have been disposed of. • • • • • • Approach for hospital waste management Based on Bio-medical Waste (Management and Handling) Rules 1998. material and machine for management of hospital waste ? The reasons are: • injuries from sharps leading to infection to a. Rationale of hospital waste management Hospital waste management is a part of hospital hygiene and maintenance activities. water and soil pollution directly due to waste. risk of air. being repacked and sold off to unsuspecting buyers.

At ordinary room temperature the collected waste should not be stored for more than 24 hours. diagnostic services areas. 2. 6. labour rooms.Segregation is the essence of waste management and should be done at the source of generation of Bio-medical waste e. doctors. The biomedical waste should be segregated as per categories mentioned in the rules. all patient care activity areas. Transportation Within hospital. nurses. 5.g. technicians etc. Separate time should be earmarked for transportation of bio-medical waste to reduce chances of it's mixing with general waste.e. treatment rooms etc. Category Waste class 1. waste routes must be designated to avoid the passage of waste through patient care areas. Desiccated wheeled containers. (medical and paramedical personnel). Trolleys or carts should be thoroughly cleaned and disinfected in the event of any spillage. The responsibility of segregation should be with the generator of biomedical waste i. trolleys or carts should be used to transport the waste/plastic bags to the site of storage/ treatment. 3. remains secured during transportation. Type of container and colour code for collection of bio-medical waste. Collection of bio-medical waste Collection of bio-medical waste should be done as per Bio-medical waste (Management and Handling) Rules. Human anatomical waste Animal waste Microbiology and Biotechnology waste Waste sharp Type of container Plastic -do-doColour Yellow -doYellow/Red Plastic bag punctureBlue/White proof containers Translucent Black Yellow Discarded medicinesPlastic bags and Cytotoxic waste Solid (biomedical waste)-doSolid (plastic) Incineration waste Plastic bag punctureBlue/White proof containers Translucent Plastic bag Black -do- Chemical waste (solid) -do- 3. The wheeled containers should be so designed that the waste can be easily loaded. 2. 9. 7. 4. does not have any sharp . 8. operation theatres.

glass etc) should be shredded but only after chemical treatment/microwaving/autoclaving. safe disposal of this waste is the responsibility of the local authority. Needle destroyers can be used for disposal of needles directly without chemical treatment. discarded medicines. Secured landfill:: The incinerator ash.4. Incineration: it is a high temperature dry oxidation process which converts organic and combustible matters into inorganic and • • .6.1 General waste The 85% of the waste generated in the hospital belongs to this category. Hazardous biomedical waste needing transport to a long distance should be kept in containers and should have proper labels. IV sets. to reduce the volume of the waste.edges and is easy to clean and disinfect.).2 bio-medical waste: 15% of hospital waste • Deep burial: The waste under category 1 and 2 only can be accorded deep burial and only in cities having less than 5 lakh population. make waste unrecognizable for aesthetic reasons. The waste under category 3. lined internally with stainless steel or aluminium to provide smooth and impervious surface which can be cleaned. 4. The transport is done through desiccated vehicles specially constructed for the purpose having fully enclosed body. The drivers compartment should be separated from the load compartment with a bulkhead. cytotoxic substances and solid chemical waste should be treated by this option. • • Shredding: The plastic (IV bottles. Standards for the autoclaving are also laid down. Treatment of hospital waste Treatment of waste is required: • • • • to disinfect the waste so that it is no longer the source of infection. All equipment installed/shared should meet these specifications. blades. 4. Autoclave and microwave treatment Standards for the autoclaving and microwaving are also mentioned in the Biomedical waste (Management and Handling) Rules 1998. The. catheters etc. The load compartment should be provided with roof vents for ventilation. 4.7 can be treated by these techniques. make recycled items unusable. syringes. sharps (needles.

However. The waste under category 1. The ash is mostly formed by the inorganic constituents of the waste. In some cases.6 can be incinerated depending upon the local policies of the hospital and feasibility. and may take the form of solid lumps or particulates carried by the flue gas. Incineration may also be implemented without energy and materials recovery. correct colour of the bag needs to be used. In several countries.incombustible matters. Plasma arc gasification. • It may be noted that there are options available for disposal of certain category of waste. the heat generated by incineration can be used to generate electric power. incinerators built just a few decades ago often did not include a materials separation to remove hazardous. flue gas. pyrolysisand anaerobic digestion. depending on .[1] Incineration and other high temperature waste treatment systems are described as "thermal treatment". and heat. Incineration of waste materials converts the waste into ash. Incineration with energy recovery is one of several waste-to-energy (WtE) technologies such as gasification. The flue gases must be cleaned of gaseous and particulate pollutants before they are dispersed into theatmosphere. Incinerators reduce the solid mass of the original waste by 80–85% and the volume (already compressed somewhat in garbage trucks) by 95-96 %.5. it may be noted that depending upon the option chosen. In some countries. Most of these facilities did not generate electricity. Temptature being used in this process is 1100 – 1300 degree centigrade The incinerator should be installed and made operational as per specification under the BMW rules 1998 and a certificate may be taken from CPCB/State Pollution Control Board and emission levels etc should be defined. The polythene bags made of chlorinated plastics should not be incinerated. The individual hospital can choose the best option depending upon the facilities available and its financial resources. facilities can be shared.3. bulky orrecyclable materials before combustion. These facilities tended to risk the health of the plant workers and the local environment due to inadequate levels of gas cleaning and combustion process control. there are still concerns from experts and local communities about the environmental impact of incinerators (see arguments against incineration).2. Incineration is a waste treatment process that involves the combustion of organic substances contained in waste materials. In case of small hospitals.

Incineration has particularly strong benefits for the treatment of certain waste types in niche areas such as clinical wastes and certainhazardous wastes where pathogens and toxins can be destroyed by high temperatures. 5. collectors and other handlers are aware of the nature and risk of the waste. It should be ensured that: drivers. Germany and France.2 • • • • . In many countries. provided regarding the procedures to be adopted in the event of spillage/ accidents. waste incineration produced 4. albeit with a significant energy cost. in localised combined heat and power facilities supportingdistrict heating schemes. the Netherlands. Waste combustion is particularly popular in countries such as Japan where land is a scarce resource. Garbage trucks often reduce the volume of waste in a built-in compressor before delivery to the incinerator. In 2005. Safety measures 5. workers are protected by vaccination against tetanus and hepatitis B.composition and degree of recovery of materials such as metals from the ash for recycling. simpler waste compaction is a common practice for compaction at landfills. written instructions. protective gears provided and instructions regarding their use are given. which cannot be routed to a conventional wastewater treatment plant. Examples include chemical multi-product plants with diverse toxic or very toxic wastewater streams.8 % of the electricity consumption and 13. the volume of the uncompressed garbage can be reduced by approximately 70%[citation needed] by using a stationary steel compressor. Denmark and Sweden have been leaders in using the energy generated from incineration for more than a century.7 % of the total domestic heat consumption in Denmark. 5. at landfills. in particular Luxembourg.1 All the generators of bio--medical waste should adopt universal precautions and appropriate safety measures while doing therapeutic and diagnostic activities and also while handling the bio-medical waste. it significantly reduces the necessary volume for disposal. This means that while incineration does not completely replace landfilling. A number of other European countries rely heavily on incineration for handling municipal waste. Alternatively.

.Conclusion – I hereby conclude my seminar that as we know there are many adverse affects to the environment and human being caused by hospital waste generated during patient care so it is our soul duty to correctly and adequately dissipate all the biomedical waste products generated during or after patient care.