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BIO MEDICAL WASTE MANAGEMEN

INTRODUCTION
 Medical profession – a really humble one has come under
close scrutiny of environment conscious people and
lawmakers since last two-three years
 Management of waste generated during diagnosis,
treatment or immunization of human bodies or animals or
research activities has never been an integral part of the
health care program.
 We were never aware that this waste is potentially
hazardous and pose a serious threat to human health, if not
managed properly. But, since notification of Bio-Medical
Waste (Management & Handling) Rules, 1998, the issue is
perhaps the most talked – about one among medical
professionals.
 It is now compulsory for every medical professional that
the waste generated by their activities is properly
segregated, collected, treated and disposed.
ABOUT S S Medical
Systems
INTRODUCTION
 A company of young and energetic entrepreneurs working
with zeal in the field of medical equipments for more than 10
years with a vision of supporting and being a part of
development that is sustainable to our environment.
 Placed as one of the leading companies in the region
providing high quality services in Medical Equipments to the
best of client's satisfaction.
 Posses a well - developed design office with Computer
Center and Laboratory -cum-R&D Center to carry out any job
in environmental engineering.
WASTE CHARACTERIZATION
 It is very important to identify biomedical waste from
other solid waste in order to minimize quantity of bio-
medical waste requiring disposal as stipulated in the rules.

Also it is important that bio-medical waste is segregated


and categorized into groups which are amenable to
specific treatment / disposal methods.

As per Bio-Medical Waste (Management & Handling) Rule


1998, the Bio Medical Waste has been grouped in to
categories shown in Schedule-I ahead.
WASTE
QUANTIFICATION
According to WHO report, around 55 % of the Biomedical
Wastes are actually non - hazardous wastes, around 10 %
are infectious wastes and around 5 % are non infectious
but hazardous.
WASTE QUANTIFICATION

Sr. City   Average Quantity of Bio


No. medical Waste
gm/bed/day
1. Kanpur :  
325
 

2. Bhopal : 376
 

3. Surat : 250-300
 
HIGHLIGHTS OF BIO
MEDICAL
WASTE (M&H)
This Rules were RULES,
notified on 1998
20 July, 1998
th
and are called
Bio Medical Waste (M&H) Rules, 1998. Some of the
highlights of these rules are given here.

 DUTY OF OCCUPIER :
 
It is duty of every occupier under these rules to handle
that bio medical waste generated as per guidelines in
these rules so as not to cause any adverse impact to
human health or environment.

   TREATMENT AND DISPOSAL OF BIO MEDICAL


 
WASTE :
Bio Medical Waste shall be treated and disposed in
accordance with Schedule-I given below here.
SCHEDULE – I
CATEGORIES OF BIO-MEDICAL
WASTE
 PRESCRIBED AUTHORITY
UPPCB, on receipt of From-I (prescribed form for application of
authorization), shall process the application and grant or renew
the authorization,
 AUTHORISATION
Every occupier of an organization on intimation shall make an
application in Form I to the prescribed authority (UPPCB) for
grant of authorization which is given for three months.
 ANNUAL REPORT
Every occupier is required to submit an annual report in
prescribed Form-II by 31st January every year giving information
about categories and quantities of biomedical waste handled
during the preceding year.
 ANNUAL REPORT
Every authorized person shall maintain records related to the
generation, collection, reception, storage, transportation,
treatment and disposal which shall be subject to investigation
and verification by UPPCB.
WHAT DO THE RULES PRESCRIBE?
 Segregation, Packaging, Transportation & Storage
1) Bio-medical waste shall not be mixed with other
wastes.
2) Bio-medical waste shall be segregated into
containers/bags at the point of generation in
accordance with Schedule II prior to its storage,
transportation, treatment and disposal.
3) If a container is transported from the premises where
bio-medical waste is generated to any waste treatment
facility outside the premises, the container shall, apart
from the label prescribed in Schedule III, also carry
information prescribed in Scheduled IV.
4) Notwithstanding anything contained in the Motor -
Vehicles Act, 1998, or rules thereunder untreated
bio - medical waste shall be transported only in such
vehicle as may be authorised for the purpose by the
competent authority as specified by the government.
WHAT DO THE RULES PRESCRIBE?
 Segregation, Packaging, Transportation & Storage

5) No untreated bio - medical waste shall be kept stored


beyond a period of 48 hours:
Provided that if for any reason it becomes necessary to
store the waste beyond such period, the authorised
person must take permission of the prescribed
authority and take measures to ensure that the waste
does not adversely affect human health and the
environment.
CHEDULE – I
ATEGORIES OF BIO-MEDICAL WASTE
  Waste Category Treatment & Disposal
Option
 

Category No. 1 Human Anatomical Waste  


(human tissues, organs, body parts) Incineration@ / deep burial*

Category No. 2 Animal Waste  


(animal tissues, organs, body parts Incineration@ / deep burial*
carcasses, bleeding parts, fluid, blood and
experimental animals used in research,
waste generated by veterinary hospitals
colleges, discharge from hospitals animal
houses)

Category No. 3 Microbiology & Biotechnology Waste  


(wastes from laboratory cultures, stocks or Local autoclaving/micro
specimens of micro-organism live or waving/
attenuated vaccines, human and animal cell incineration@
culture used in research and infectious
agents from research and industrial
laboratories, wastes from production of
biological toxins, dishes and levices used for
transfer of cultures)
Category No. 4 Waste Sharps  
(needles, syringes, scalpels, blades, glass, Disinfections (chemical
etc. that may cause puncture and cuts. This treatment)@@ /autoclaving/
included both used and unused sharps) micro-waving and
multination/shredding##
CHEDULE – I
ATEGORIES OF BIO-MEDICAL WASTE
Category No. 5 Discarded Medical and Cytotoxic  
drugs Incineration@/destruction
(wastes comprising or outdated, drugs disposal in secured
contaminated and discarded landfills
medicines)
 
Category No. 6 Solid Waste  
(Items contaminated with blood, and Incineration@/autoclaving/
body, fluids including cotton, dressings, Micro waving
soiled plaster casts, lines beddings,
other material contaminated with blood)

Category No. 7 Solid Waste  


(wastes generated from disposable Disinfections by chemical
items other than the waste sharps such treatment@@
as tubings, catheters, in travenous sets Autoclaving/micro waving
etc.) and
multination/shredding ##

Category No. 8 Liquid Waste  


(waste generated from laboratory and Disinfections by chemical
washing, cleaning, house keeping and treatment@@ and
disinfecting activities discharge into drains
ATEGORIES OF BIO-MEDICAL WASTE
SCHEDULE – II

COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF BIO MEDICAL


WASTES
Colour Type of Waste Treatment options as
  Coding Container Category per Schedule I
   

Yellow Plastic Bag Cat.1, Cat. 2, and Incineration / deep burial


Cat.3, Cat.6
 

Red Disinfected Cat. 3, Cat. 6, Autoclaving/Microwaving


container/plastic and Cat.7 Chemical Treatment
bag  

Blue/White Plastic Cat. 4, Cat. 7, Autoclaving/Microwaving


translucent bag/puncture proof   Chemical Treatment and
container   destruction/shredding
 
Black Plastic Bag Cat. 5 and Cat. 9 Disposal in secured
Cat. 10. (Solid) landfill
 
Notes :
 
1. Colour coding of waste categories with multiple treatment options as
define in Schedule – I, shall be selected depending on treatment option
chosen, which shall be as specified in Schedule – I.

2. Waste collection bags for waste types needing incineration shall not be
made of chlorinated plastics.

3. Categories 8 and 10 (liquid) do not require containers/bags.

4. Category 3 if disinfected locally need not be put in containers/bags


CHEDULE – I
ATEGORIES OF BIO-MEDICAL WASTE
Category No. 9 Incineration Ash  
(ash from incineration of any bio- Disposal in municipal
medical waste) landfill

Category No.10 Chemical Waste  


(chemical used in production of Chemical treatment and
biological, chemicals used in discharge into drains for
disinfections, as insecticides, etc) liquids and secured
landfill for solids

Chemicals treatment using at least 1 % hypo chloride


solution or any other equivalent chemical reagent. It
must ensured that chemical treatment ensures
disinfections. 

Multination/shredding must be such so as to prevent


unauthorized reuse

There will be no chemical pretreatment before


incineration. Chlorinated plastics shall not be
incinerated.
Deep burial shall be an option available only in towns
with population less than five lakhs and in rural areas.
SCHEDULE – I
CATEGORIES OF BIO-MEDICAL
WASTE
The facility required to be set up in time frame as given in Schedule below.
SCHEDULE – IV
 
SCHEDULE FOR WASTE MANAGEMENT FACILITIES LIKE
INCINERATOR/ AUTOCLAVE/MICROWAVE SYSTEM

A. Hospital and nursing homes in towns By 30th June, 2000 or


with population of 30 lakhs and above earlier
 
B. Hospitals and nursing homes in towns  
with population of below 30 lakhs -
 
  a) With 500 beds and above By 30th June, 2000 or
  earlier
  b) With 200 beds and above but less By 31st December, 2000
than 500 beds. or earlier
  c)  With 50 beds and above but less By 31st December, 2001
than 200 beds or earlier
  d)  With less than 50 beds  By 31st December, 2002
  or earlier
C. All other institutions generating bio-  By 31st December, 2002
medical waste not included in A and B or earlier
above  
TREATMENT OF BIO MEDICAL
WASTE
There are five broad categories of
medical waste treatment technologies :
1. Mechanical Process – Shredding & Compaction

2. Thermal Process - Autoclave

Hydroclave

Incinerator

Microwave

Plasma Pyrolysis

3. Chemical Process - Disinfections

4. Irradiation Process - Electron Treatment

5. Biological Process
 
Table : Comparison of Treatment Technologies for Medical Wastes

Treatment Autoclave Hydro lave Microwave Incinerato Chemical


Systems r
   

Description Steam  Steam  Microwave  High  Mixing pre-


Sterilization  Sterilization  heating (pre  temperature  ground 
(Direct  (Indirect  shredding of  waste  waste with 
heating) heating  waste done  incineration chemicals 
simultaneous  in few  such as 
shredding and  causes) chlorine 
dehydration) 
 
Sterilization  Medium Medium Medium High (total  Dependent 
Efficacy destruction  on chlorine 
of micro- strength 
organisms) and 
discernment 
through the 
waste 
Capital Cost Medium Medium Medium High Moderate
 
 

Operating Cost Low Low Low High Low


 
 
Table : Comparison of Treatment Technologies for Medical Wastes
Treatment Autoclave Hydroclave Microwave Incinerato Chemical
Systems r
 

 
Operation/ Low skill  Low skill level  Automated,  High level  High level 
level  required but highly  operation  required for 
required complex  and  chemical 
and high  maintenanc control and 
Maintenance  level  e skills  grinder
Skills maintenanc required
e skill   
required
Air Emissions  Odorous but  Odorous but  Odorous but  Can be  Some 
non-toxic non-toxic non-toxic highly toxic chlorine 
emissions
 

Water  Odorous,  Odorous but  Negligible None None


Emissions may contain  sterile
live micro-
organism

Treated waste  Wet waste,  Dehydrated,  Wet waste  Mostly ash,  Shredded 


characteristic all material  shredded  (may be  may contain  wet 
recognizable waste,  shredded) toxic  containing 
unrecognizabl substances chemicals 
e material used as 
disinfectants 
DETAILS OF THE FACILITY
 TOTAL AREA OF PLOT 2400 SQ.MT.
 Different facilities :
1. Security cabin. 12. Incineration ash
storage yard.
2. Weigh bridge. 13. Shredded waste
storage yard.
3. Office. 14. Parking for
collection
vehicles.
4. Laboratory. 15. Shower area.
5. Store for spares. 16. Diesel storage
tank.
6. Incinerator shed. 17. Chimney
7. Autoclave shed. 18. Fire hydrant &
Incinerable waste storage area. fire safety
9. Autoclavable waste storage area.
10. Boiler room
11. Supervisors room equipment.
DETAILS OF THE FACILITY
LAYOUT PLAN
DETAILS OF THE FACILITY
PLAN OF SHED
DETAILS OF THE FACILITY
ELEVATION
DETAILS OF THE FACILITY
AUTOCLAVE

 Capacity of autoclave 1215 Liters. (900 mm x


900 mm x 1500 mm).

 Expected to sterilize approximately 125 kg/hr


of waste.

 Type of autoclave “High Pressure High


Vacuum”.

 Material of construction.
Stainless steel for chamber, Jacket, Door,
Outer cover, Piping, stand, Carriage & Trolley.
DETAILS OF THE FACILITY
AUTOCLAVE
 Operation
With the autoclave in loading position, the bags are
loaded manually in the chamber. The system design
ensures that the bags do not stick to the autoclave
chamber even at high temperatures.
The doors are then shut and the sterilization cycle is
initiated. The first phase of the process is a steam –
vacuum pulsing to ensure total air removal and effective
penetration of steam. Steam is subsequently injected to
raise the temperature of the load to 1390C. This is an
over – kill approach which results in total destruction of
Bacillus Stearothermophilus. After the sterilization
phase the steam is vented out and the steam is passed
through a condenser where it is condensed to water.
DETAILS OF THE FACILITY

OPERATION OF AUTOCLAVE
DETAILS OF THE FACILITY
AUTOCLAVE
 Equipment Construction
The chamber is fabricated from high quality
stainless steel with superior hygiene argon
welding. The autoclave is provided with
automatic pressure lock sliding safety doors.
The autoclave piping is fabricated from
stainless steel and is provided with automatic
valves. All accessories like vacuum pump,
compressor, air and condensate treatment
system are part of the equipment.
DETAILS OF THE FACILITY
AUTOCLAVE
 SAFETY FEATURES
The autoclaves are designed with special doors to
prevent opening in pressurized condition. Secondly the
process is controlled by a computer where the
parameters are programmed and can not be changed by
the operator. The system has been designed such that
the load can not be discharged unless the required
vacuum, pressure, temperature and time have been
achieved. Thirdly high temperature/pressure alarms and
automatic pressure relief devices are incorporated for
maximum operator safety.
The system also incorporates special treatment devices
for processing the condensate which is produced when
the steam condenses upon contact with the chamber
and contaminated waste.
DETAILS OF THE FACILITY
AUTOCLAVE
 SAFETY FEATURES
The system decontaminates the air drawn out of the
chamber during the pre-vacuum stage. This prevents
any exposure risks for the operator working in the
Waste Disposal Facility.
 CONTROL SYSTEM
The Autoclaving System is equipped with
microprocessor controlled process management
system. The system ensures the desired process
repeatability and accuracy for effective and efficient
sterilization.
The process management system is provided with a
user friendly communication interface. This keeps the
operator informed what the machine is doing at any
point during its operation.
DETAILS OF THE FACILITY
AUTOCLAVE
 CONTROL SYSTEM
The communication interface also helps the operator to
ensure that the machine is set properly to perform its
various functions.
The system is also equipped with a printer for printing
the key process parameters time, temperature,
pressure and vacuum for every sterilization process
using a dot – matrix printer. At the end every batch the
printout is removed and stored in a file maintained at
the facility to establish process effectiveness.
DETAILS OF THE FACILITY
SHREDDER
 Capacity : 200 kg.hr.
 Cutting chamber size: 680 mm x 350 mm x 220 mm
 Motor HP : 15 HP
 No. of Blades : 32 (16 + 16 on each shaft)
 Salient Features:
 Combine hook / shear blades
Knives are constructed from non – corrosive, high alloy
heat treated steel for extra long life. The application
and product characteristics determine the blade design
(blade width, No. of hooks, hook reach).the positioning
of the blades within the cutting chamber is also
adjustable to obtain the optimum “rip – shear” action
and end product size.
DETAILS OF THE FACILITY
SHREDDER
 Auto Reverse System
For the ultimate safety of the shredder or
specially design electronic device is
incorporated. In case of over load of the drive
motor or jamming of the shredder, the safety
system acts instantly to achieve.
- Tripping of the drive motor.
- Reversing the direction of the drive motor for
a set duration.
- Shut off the drive of the motor and give an
audio – visual alarm.
DETAILS OF THE FACILITY
SHREDDER
 Interlock to avoid Aerosolizing
Shredder operation is interlocked with the in
feed hopper door & the unloading door. The
doors are provided with proper gaskets and
clamping devices. Thus there is a no
possibility of “AEROSOLIZING”. Opening of
any one door will “shut – off” the shredder
instantly.
 Low Noise and Non Ballistic
Low speed, high torque shredders operate at
low noise levels without creating any dust and
flying particles.
DETAILS OF THE FACILITY
INCINERATOR
 Capacity : 100 kg/hr.
 Fuel: CNG/LDO (Duel Fired)
 Type of burner Operation: Automatic
 Operating hours: continuous
 Residence time of gases in
Secondary chamber: 1 sec.
 Stack height: 30 m.
 Stack top Diameter: 250 mm
 Two distinct chamber with separate burners
DETAILS OF THE FACILITY
INCINERATOR
 Temperature
Primary Chamber: 6500C
Secondary Chamber: 10500C
 SS Scrubber with 5% caustic solution as
scrubbing media
DETAILS OF THE FACILITY

INCINERATOR
 Interlock:
 Primary and secondary burner operates on ON
- OFF basis depending on temperature set for
the chamber
 The limit switch on charging door trips the
primary burner when the door opens.
 Venturi outlet temperature high trips I.D. fan,
F.D. fan and burners.
 I.D. fan failure trips F.D. fan and burners.
DETAILS OF THE FACILITY
INCINERATOR
FEATURES OF CONTRACT
Estimated quantity of Bio Medical waste – 2200 kg/day ()
CHARACTERISTICS OF BIO – MEDICAL WASTE

Category Sr. No. Type of Waste Proportion


No.
3 1 Micro & Biotech 1%
waste
4 2 Waste Sharps 7%

6 3 Infected Solid 10%


waste
1 4 Human Anatomical 15%
waste
7 5 Soiled waste 67%
FEATURES OF CONTRACT
Total investment to set up the facility to be made by KGMU.
Land (maximum up to 4000 sq. mt.) shall be provided at
KGMU site by The University.
Facility to be developed by S S Medical Systems within 4-6
months.
All fixed assets to be transferred to KGMU at the end of
contract period, if contract is not extended.
Total facility to be in strict adherence to BMW (M & H) Rules.
Transportation of BMW from designated points up to facility is
to be carried out by S S Medical Systems.
FEATURES OF CONTRACT
Liabilities of waste from receipt of waste rests with
S S Medical Systems.
Collection & transportation of waste as per BMW
(M & H) Rules.
Total cost of operation of facility to be borne by S S
Medical Systems.
Treated biomedical waste shall be disposed at
Sanitary Landfill Site of LMC, for which no charges
shall be paid to LMC by S S Medical Systems.
DETAILS OF COLLECTION SYSTEM
 Waste to be collected from points designated by
KGMU.

 It is responsibility of waste generators to deposit the


waste at the designated points.

 Waste receivers shall receive the waste, record the


weight and issue a receipt of BMW.

 BMW received at collection centers shall be picked


up and transported by S S Medical Systems vehicle
duly labeled as per BMW ( M & H ) rules.
DETAILS OF COLLECTION SYSTEM

 To match with receiving schedule pick up


vehicle will
start collection at 1:00 pm and complete
collection at 9:00 pm, so that the waste
collected at the collection centers shall be
transferred to facility on same day.

 Treatment of BMW shall start at 5:30 pm in


the evening.
SCHEME FOR K.G.M.U.

 The total capacity of facility being developed by S S


Medical Systems is 100 Kgs./Hr. from KGMU in
collaboration with M/d Alfatherm Ltd., New Delhi. The
facility has a large spare capacity.
Under this scheme :
Under this scheme, the facility shall have capacity for
management of bio-medical waste generated in whole of
KGMU. Bio-medical waste in each center shall be
collected at one place (local collection center) and than
transported to the facility developed by S S Medical
Systems. Treatment and disposal of bio-medical waste
shall be carried out by S S Medical Systems as per
applicable rules and regulations.
SCHEME FOR K.G.M.U.

 S S Medical Systems shall issue manifest to each


dept./ward for quantity of bio-medical waste accepted
by S S Medical Systems for submission to prescribed
authority. S S Medical Systems shall also issue a
Membership Certificate to all the members for legal
compliance with bio-medical waste management rules.
S S Medical Systems will also assist in development of
local collection system up to local collection center
SUMMARY
 We at S S Medical Systems are working with a
vision establishing biomedical waste treatment
facility which will be one of the best in India.

The operation of facility will be in strict


adherence to Biomedical waste (M & H) Rules
1998.

Together with UPPCB we intend to be part of


the movement towards total compliance to
these rules in KGMU.