BIOSAFETY AND WASTE MANAGEMENT

 Medical laboratories primarily process and perform testing on

human specimens to provide results and interpretation for
individual patient management, infection control, and public
health purposes.

 Any clinical specimen potentially contains biological agents,

such as viruses, bacteria, fungi, or parasites.

 It is therefore essential to ensure biological safety in the medical

laboratory to prevent laboratory-acquired infections by
laboratory staff and dissemination of any infectious agent from
the laboratory.
 In other words the application of safety precautions to
reduce the risk of a laboratory worker to a potentially
infectious microorganism is called Biosafety.

 It also involves limiting the contamination of the

laboratory environment and the community.
 Biosafety includes the protective measures against the risks of
contamination with pathogen germs in the laboratories that
handle pathogens, or stock or manipulate potentially
contaminated products, or perform microbiological tests for
medical or scientific research purposes, as well as the means of
protecting the environment and the human collectivities against
hazard contaminations.
 It is different from that of biosecurity, which
refers to the sum of measures designed to
protect workers, environment and population
against the loss, theft, use and release in the
environment of pathogenic biological agents.
BIOSAFETY AND BIOSECURITY

 Biosafety includes the protective measures against the risk of contamination

with pathogens germs in the laboratories that handle pathogens or perform
microbial test

 for medical or scientific research purposes, as well as means of protecting the

environment and humans against hazard contaminations.

 It is different from biosecurity which refers to the sum of measures designed

to protect workers ,environment and population against the loss, use and
release in the environment of pathogenic biological agents.
 Micro-organisms have generally been categorised into four Risk Groups, and
medical laboratories are classified into four Biosafety Levels (BSLs).

 Each BSL has designated requirements in terms of architectural features

and ventilation, safety equipment such as biological safety cabinets, use of
personal protective equipment, and adoption of safe microbiological practices
by qualified and trained personnel.
 Biosafety level guidelines recognize
that facility design is important in
providing a barrier to protect persons
working in the facility as well as those
in the community.

 An accidental release of certain

airborne infectious agents could be
catastrophic.
To assist in planning and managing a laboratory, the
CDC described facility designs based on functions in
handling infectious agents.

Basic Laboratory
The first design, known as the basic laboratory,
provides general space in which work is done with
viable biosafety level 1 agents

Containment Laboratory
The containment laboratory has special engineering
features that make it possible for laboratory
personnel to handle aerosolized hazardous materials
(eg, Mycobacterium tuberculosis) without
endangering themselves.
 PRACTICES TO BIOSAFETY

 Limited access to lab when work is in progress

 Daily decontamination
 Mechanical pipetting
 Lab coats, safety glasses and gloves required
 Red bags and sharps containers required.
 Biohazards signs posted at the lab enterance
 Label all equipment (incubators, freezers, etc)
 TC room-negative air flow(air flow from low to high hazard “pressure mapping”)
 Documentation training
 Baseline serology or pre-vaccination may be required
 Required foot activated hand washing sink and controls
 Hygienic practices (no smoking, eating, applying cosmetics, lip balm, contacts
with phones, decontaminate lab-bench before and after work, wash hands after
procedures)
 SOP’s/manual on biosafety, and biosafety officer made available.
 PATHOLOGICAL WASTE MANAGEMENT
Human anatomical waste is usually generated in
operation theatres but a number of specimens are
sent to the pathology department for diagnosis.
Hence it is a liability of the laboratory to dispose
the tissues as biomedical waste.

Pathological waste (human tissue or fluids) is

defined as any waste removed during surgery,
autopsy or other medical procedures including
human tissues, organs, body parts, body fliud and
specimen along their container.
 .

 According to WHO report 85% of the hospital are non harzardous, 10% are
effective ( hence harzardous), and 5% are non infectious but hazardous (
chemical, pharmaceutical and radioactive).
 (WHO, 2010)
PATHOLOGICAL WASTE MANAGEMENT CONTN
 Accordingto a WHO report, 85% of the hospital
wastes are non-hazardous, 10% are infective
(hence harzadous), and 5% are non-infectious but
hazardous (chemical, pharmaceutical and
radioactive).
 Categories/ Classification of Pathological waste

 Biomedical waste in histopathology unit can be grouped into

two. Infectious and Non-infectious waste.

 Or non-hazardous waste (which includes bio-degradables and

non-biodegradables), potentially infectious waste (which
includes dressings, swab, laboratory waste, and instruments
used in patient care) and potentially toxic waste (radioactive,
chemicals and pharmaceutical)

•
Non-infectious waste from the pathology department are
mostly in form of stationary and printed materials, packing
material cartons, paper, and plastics as the case may.

Although it is encouraged and it has been a practice to collect

and send the waste paper once a week to central stores for
shredding and it could be sold for recycling.

The non-infectious waste needs to be segregated at source to

prevent mix up with the infectious waste. Improper segregation
will unnecessary increase the load of infectious waste.
 Liquid and Chemical waste: Liquid waste generated from
laboratory washing, cleaning and disinfecting activities has to be
disinfected by chemical treatment before discharging in drain.

 However, it is not practical to disinfect huge volumes of liquid

waste Instead, the practice of disinfection for blood containers is a
better approach.

 Ten categories of infectious biomedical waste have been described

in [Table - 1] shown below
CATEGORIES AND CLASSIFICATIONS OF PATHOLOGICAL WASTE
CONTN
 Principles of waste Management
I. Identification of points of generation of waste
II. Waste minimization and recycling of waste
III.Waste segregation at source
IV.Waste treatment (disinfection etc) at site
V. Waste collection and transportation, on-site and off-site
VI.Waste treatment, on-site and off-site
VII.Final disposal of waste
VIII.Occupational safety
IX.Continuous monitoring of the system
X. Training of staff.
 Steps for effective management of Pathological waste

1. Survey of waste generated

Differentiate the type of waste
Quantity of the waste generated
Determine the points of generation and types of waste generated at
each point
Determine the level of generation and disinfection within the lab

2. Segregation of waste
It refers to the basic separation of different category of waste generated
at source and thereby reducing the risk as well as cost of handling disposal
Segregation is the most crucial step in histology waste management.
Effective segregation alone can ensure effective waste management
The bins and bags should carry the biohazard symbol indicating the
nature of waste to the scientist, patient or public. Labels should be non-
washable and prominently visible.
3. Collection and categorization of waste
The collection of Pathological wastes involves different types of containers
The containers should be placed in such a way that 100% collection is
achieved
Sharps must always be kept in puncture proof containers to avoid injuries
and infection to the waste handlers and the waste should be handled properly by
using universal precautions to prevent any kind of infection.

4. Storage of waste
Once collection occurs then the Pathological waste is stored in proper
place. Segregated waste of different categories need to be collected in identifiable
containers.
The duration of storage should not exceed 8-10hours at most 24 hours
Each container should be clearly labelled to show where it is kept.
5. Transportation of waste

 Transportation devices include trolleys, wheelbarrows etc

 Manual loading should be avoided as far as possible
 Containers should be tied properly before transportation
 Container should be accompanied with a signed document by the clinician mentioning date,
shift, quantity and designation.

6. Treatment of waste: the main objectives of treatment are disinfecting and

decontaminating the waste and also volume reduction. 5 ways of treating Pathological waste
include:

 Incineration: typically for pathological waste and never for plastics

 Thermal (autoclaving) typically for sharps waste and infectious waste. Never for pathological
waste.
 Irradiation: typically for sharps waste and infectious waste. Never for pathological waste
 Chemical: typically for chemical waste and liquid waste (e.g generated from histopathology
laboratory stains or cleaning agents)
 Biological (enzymes): though not fully developed and rarely used technology for medical waste
disposal.
 CONCLUSION
Safe and effective management of bio-medical waste is not only a legal necessity but also a social
responsibility and as such, Pathological waste management cannot successfully be implemented without
the willingness, devotion, self-motivation, cooperation and participation of all sections of employees of
any health care establishment.

Proper Pathological Waste management is the responsibility of the ‘generators of waste’ and it is our
moral duty to take care of the waste so that ourselves, our staff members and the community at large is
protected from the risks of hazards of biomedical waste.

The need for the continuous professional training of the staff and for the establishment of individual and
collective responsibilities for preventing biosafety incidents and trespassing biosecurity rules in correlation
with the medical laboratory should as well be emphasized.
 RECOMMENDATION

All concerned, and organizations should:

I. Promote sound health care waste management in their advocacy
II. Develop innovative solutions to reduce the volume and toxicity of the waste they produce and associated with
their products. (Histopathology specimens could be washed with water to remove formalin and then sent in yellow
polythene bags to central common facility for incineration.)
III. Ensure that global health strategies and programs take into account health-care waste management.
IV. Continuous safety training for staff and regular external assessments of laboratories were recommended as possible
measures to improve the biosafety standards of pathology departments.
V. Government should: Allocate a budget to cover the costs of establishment and maintenance of sound health-care waste
management systems. And Implement and monitor sound health-care waste management systems, support capacity
building, and ensure worker and community health.
VI. A procurement of a “tissue-digester” Tissue remains resulting from such processing can often be disposed of via a
sanitary sewer system or taken to an incinerator
Pathological waste should be packaged into variety of containers/ bags. After the refuse are picked it should
be taken to an incinerator where it is safely disposed of.

When waste is accumulated or stored up for a long time to form large quantities of tissue samples there is an
option of on-site disposal via “tissue-digester” this appliance is commonly used by laboratories that receive
large quantities of tissue samples.

A tissue digester works like a pressure cooker, helping significantly reduce the volume of the pathological
waste, as well as deactivate stubborn infectious agents. Tissue remains resulting from such processing can
often be disposed of via a sanitary sewer system or treated as bioharzardous waste.