BIO MEDICAL WASTE

MANAGEMENT
 PHYSICIAN
ADD YEARS TO LIFE &
ADD LIFE TO YEARS
OF THE PATIENTS
DOCTORS -- SAVIOURS OF MANKIND
HOSPITALS – TEMPLES OF HEALING
MEDICAL PROFESSION -- NOBLE
DOCTORS ARE GUIDED BY ETHICS
BUT GOVERNED BY LAW
ACCOUNTABLE TO THE PATIENT
ANSWERABLE TO THE COMMUNITY
 NOSO COMIAL INFECTIONS
HOSPITAL ACQUIRED INFECTIONS
PROPER DISPOSAL
OF HOSPITAL WASTE
– SOCIAL RESPONSIBILITY
 POLLUTION CONTROL BOARD
HOSPITAL as INDUSTRY
TIIC
LOAN
 HOSPITALS
CLASSIFIED UNDER
OBNOXIOUS & HAZARDOUS INDUSTRY
 CATEGORY
HOSPITALS, Mines, Cements, Fertilizers &
Chemicals, Distilleries, Tanneries

Hotels, Cinema Theatre, Lime Kilns,

Stone Crushing unit

NIL – No toxic substance, No effluent, No

fugitive emissions, No use of fuel
 HON’BLE SUPREME COURT OF INDIA

Writ Petition No 888 of 1996

Public Interest Litigation
Mrs. Almitra H. Patel vs. Union of India
 Pathetic Situation of Solid Waste Management Practices
 Obligatory function of Urban Local Bodies
 Resulting in problems of Health & Sanitation
 No solution in sight.
Hon’ble Supreme Court after several hearings, constituted a committee
 INTERIM REPORT OF THE COMMITTEE
Domestic / Trade Waste
Construction Waste
Industrial Waste
Infectious & Hospital Waste.
 Adverse impact on Human Health.
 Grossly neglected.
 Do not discharge their duties for safe disposale.
 Infectious waste & sharps get mixed up with Domestic Waste.
 Incinerators in certain Hospitals only – Often single chamber
not affectively functioning.
 Ministry of Environment, Govt. of India to issue mandatory
instructions to rectify with a time frame.
 Tamilnadu Pollution Control Board
O/o District Environment Engineer,
TN Pollution Control Board
Proc. No. DEE/TNPC Bd/TLR/BMW/INV/2001 Dated

Sub : TNPC Board – Hazardous Substance Management –

Failure to install Bio Medical Waste Treatment and disposal
facility within the stipulated time schedule – Show Cause
Notice – issued.

Ref : The Bio Medical Waste (M & H) Rules 1998 as

amended in 2000 notified under the Environment
(Protection) Act 1986.
Hence you are directed to show cause within fifteen
days from the date of receipt of this notice so as to why
penal for an offence punishable under Section 15 of
Environment (Protection) Act, 1986 should not be
initiated against you for not having complied with and
contravening the said provisions of the Bio Medical
Waste (Management & Handing) Rules 1998 as
amended in 2000 and also to issue direction for
closure of the unit and stoppage of power supply
etc., under Section (5) of the Environment
(Protection) Act, 1986.
DISTRICT ENVIRONMENTAL ENGINEER

Tamilnadu Pollution Control Board.

 SCHEDULE VI (see rule 5)
SCHEDULE FOR WASTE TREATMENT FACILITIES
LIKE INCINERATOR / AUTOCLAVE / MICROWAVE SYSTEM
A.Hospitals and Nursing Homes in towns with population of 30
lakhs and above 30th June 2000 or earlier
B. Hospitals and Nursing Homes in towns 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 than 500 beds
by 31st December, 2000 or earlier
(c) with 50 beds and above but less than 200 beds
by 31st December, 2001 or earlier
(d) with less than 50 beds by 31st December, 2002 or earlier
C. All other institutions generating bio-medical waste not
included in A and B above by 31st December, 2002 or earlier
CLASSIFICATION OF BMW
CAT-1Human anatomical CAT-2 Animal waste
waste CAT-4 Waste sharps
CAT-3 Microbiology &
Biotechnology waste
CAT-5 Discarded
medicines and cytotoxic
drugs
CAT-6 soiled waste CAT-7 Solid waste
CAT-8 Liquid waste CAT-9 Incineration
CAT-10 Chemical waste ash
 BIO MEDICAL WASTE MANAGEMENT
PROGRAMME PLANNING
1. Willingness
2. Self Motivation
3. Investments – Person, Place, Financial
4. Identifying Nodal Person – ICC – BMWM Committee.
5. Waste Survey
6. Evaluation of Existing Practice
7. Training
8. Implementing Segregation
9. Reporting and Feed Back
10. Review after one year.
 HOSPITAL WASTES

Non Infectious Infectious

Biodegradable Non Biodegradable Non Sharps Sharps

Solids Liquids

Incinerable Non Incinerable

(Autoclave, Microwave)
 SCHEDULE – 1 (See Rule 5)
CATEGORIES OF BIO MEDICAL WASTE
OPTION WASTE CATEGORY TREATMENT & DISPOSAL
Category No. 1 Human Anatomical Waste Incineration / deep burial

Category No. 2 Animal Waste Incineration / deep burial

Category No. 3 Microbiology & Biotechnology Local autoclaving / microwaving /

Waste incineration
Category No. 4 Waste Sharps Disinfection by chemical treatmet /
atoclaving / microwaving and
mutilation / shredding
Category No. 5 Discarded Medicines and Incineration / destruction and
Cytotoxic drugs drugs disposal in secured landfills
Category No. 6 Solid Waste Incineration / autoclaving /
microwaving
Category No. 7 Solid Waste Disinfection by chemical treatment
/ autoclaving / microwaving and
mutilation / shredding
Category No. 8 Liquid Waste Disinfection by chemical treatment
and discharge into drains.
Category No. 9 Incineration Ash Disposal in municipal landfill

Category No. 10 Chemical Waste Chemical treatment and discharge

into drains for liquids and secured
land for solids
 SCHEDULE – II (See Rule 6)
COLOUR CODING AND TYPE OF CONTAINER
FOR DISPOSAL OF BIOMEDICAL WASTES

COLOUR TYPE OF WASTE TREATMENT OPTIONS

CODING CONTAINER CATEGORY as per Schedule I
Yellow Plastic Bag Cat.. 1, 2, 3 Incineration / deep
and 6 burial
Red Disinfected Cat. 3, 6, and 7 Autoclaving /
container / Microwaving / Chemical
Plastic Bag Treatment
Blue / White Plastic Bag / Cat. 4, Cat. 7 Autoclaving /
Translucent puncture proof Microwaving / Chemical
container treatment and
destruction shredding
Black Plastic Bag Cat. 5, 9 and Disposal in secured
10 (Solid) landfill
 SEGREGATION OF WASTE

RED BAG OR CONTANIER

No
Sharps
PLASTIC WASTE In this
IV Sets
Tubings bag
Blood & Urine bags
Syringes
SEGREGATION OF WASTE
YELLOW
BAG OR CONTAINER

No
INFECTIOUS WASTE Plastics
Soiled bandages
Dressings In this
Cotton Swabs bag
Sanitary Pads
 SEGREGATION OF WASTE

Needles and Ampoules

to be put
in the separate
puncture proof bin provided
Proper segregation scheme
 Reduces the risk of infecting wokers
 Reduces the cost of treatment of waste
 Reduce the risk of infecting the
community at large
 Recycle waste that is non infectious
 Reuse wherever possible
SEGREGATION OF WASTE
Beware! Remember not to mix
any infectious waste with non
infectious waste,it will make
the whole heap infectious
special situations
Giving injections/immunizations
Collecting blood samples
Surgery Special /invasive procedure
Labor room/deliveries
Examining patients
Laboratory work
Collecting soiled linen
Cleaning spittoons
Disposing off waste.
 DOCTORS

Do not dispose dressings in patients bin / Ask for

disposal bags.
Ensure all the plastics and gloves are cut and put
into bleach solution.
Ensure all used injections are cut using needle
cutters.
Ensure compliance of this scheme during ward
visits
 NURSES

 Put cut gloves and plastic in bleach solution.

 Put all other infectious waste, such as pathological

waste, bandages, dressings, cotton etc… in yellow bin.

 Always cut needles with the needle cutter and

disinfect with bleach solution.

 All sharps to be put in needle cutter container.

 Help patients understand the scheme.

 LAB TECHNICIANS

 Use gloves during all tests.

 Reusable items to be soaked in bleach and heated at
high a temperature.
 Media plates to be put in separate bleach solution.
 Cut gloves, syringes to be put in red coloured bin with
bleach.
 Needles to be cut with needle cutter and disinfected with
bleach.
 Sharps to be put in needle cutter container.
 WARDS BOYS / AYYAS

 Cut all tubes.

 Cut all gloves.

 Check if waste in bleach in only plastic or

glass. If not, report to the supervisor.

 Help patients understand the scheme

DO’S
 Segregate waste as per category
 Put waste in correct bin wiz. Plastic/rubber waste in Red,
Anatomical soiled waste in Yellow, Non-infectious general waste
in Black and Sharps in Blue Puncture Proof Container. Ensure
colour bags of the same colour as bins.
 Ensure that the plastic bag has bio-hazard symbol and label.
 Remove plastic bags when ¾ full, tie the bags properly. Ensure
bag is properly tied / sealed to avoid spilling.
 Remove bags by Wheel Barrows only to the waste storage site.
 Cut the needle (disposable) before throwing it.
 Wear protective gear while handling waste.
 Always snipe the IV bottle, cut the IV sets, and fingers of gloves
before throwing it in the bin or sending it back to the store.
 Always keep your record book on waste activity up to date.
 DON’TS
 Put the waste indiscriminately.
 Put wrong bags in bin. (Adhere to colour code.)
 Fill the bags till neck. (Waste would otherwise spill
over.)
 Handle waste without protective clothing.
 Drag the bags after removal. (Bags can burst and the
site could be repulsive.)
 Never recap the needle. (Never re-use needle without
disinfection)
 Mix non infectious waste with infectious waste.
TREATMENT AND
DISINFECTION OF WASTE
 Infectious waste must be disinfected
before disposal
 Disinfection should be used even if
sterilization facilities are available.
 Sterilization results in destruction of all
forms of microbial life including spores
 Disinfection results in destruction of
specific pathogenic micro organisms
Methods of disinfection
 Thermal: Steam or dry
heat.e.g..Autoclave
 Irradiation and ultraviolet: small metal
and glass items,hospital and laboratory
supplies.
 Microwave: For liquids,non metallic
objects,bio hazardous waste
Contd…..
 Filtration:for heat sensitive
pharmaceutical and biological waste.
 Chemical: wastes such as disposables
 Chemical disinfectants used for
inactivating HIV are ethanol 70%,2-
propanol 70%,Povidone iodine
2.5%,Formal dehyde 4%,
Glutaraldehyde 2%, and hydrogen
peroxide 6%.
Chemical Hazardous waste
 Solvents
 Chemotherapy waste
 Photographic chemicals
 Formaldehyde waste
 Radioactive waste
 Heavy metals used in instruments
 Toxics and corrosives
 Waste anaesthetic gases
 Minimization of wastes,careful
segregation,recycling and safe disposal of
wastes that cannot be recycled.
BIN CLEARANCE
 The bins must be emptied every shift or
at least twice a day when the bags are
3/4th full.
 Sweeper must seal the bag properly
 Waste moved in wheelbarrows and
trolleys
 Institute should plan timings of waste
collection and transportation
 No mixing of the waste while
transporting to the waste storage site.
Waste storage site
 A secure,lockable waste storage site
 Room with well ventilation,secure
 Ease in terms of handling to the operator and
for treatment,on or off site.
 Site needs to be marked with warning signs
and the biohazard symbol.
 Waste evacuated within 24 hrs
 No untreated waste can be stored beyond 48
hrs
 No access to unauthorized persons.
 OUT HOUSE MANAGEMENT

Role of Common Facilitator

 To collect Bio Medical Waste from Individual Hospital every
day.
 To transport in closed container Van safely to the Treatment
plant.
 To erect common offsite BMWM Treatment facility in
accordance with the standard prescribe BMWM Rules and .
 To dispose various categories of Bio Medical Waste by
approved techniques.
 To train the individual hospitals staffs regarding BMWM
Record keeping and
monitoring
 A good record keeping system has a
three tiered structure.
 In charge’s of all departments
generating waste
 Health/sanitary in charge
 Waste management officer
 Monthly compilation needs to be done
which helps annual reports submission.
 MEMORANDUM OF UNDERSTANDING
BETWEEN IMA & G.J. MULTI CLAVE INDIA (P) Ltd

Tariff agreed – Rs. 2.50 per bed per day on the basis of
declared bed strength of Health Care Establishment.

Comparison of Tariff -- Per bed and Per kg of Waste

(Average Bio Medical Waste Per Bed Per Day - 400 gms)
For a Hospital of 30 Beds with average occupancy of 20 Beds
Bio Medical Waste Generated 20 x 400 gms = 8Kg
Amount to be given 8 x Rs. 9 = Rs. 72/-.
(Bio Medical Waste from OP, Casualty & OT to be added)
Amount to be given per bed 30 x Rs. 2.50 = Rs. 75/-
(Bio Medical Waste from OP, Casualty & OT included)
Sustaining waste
management programme

 On going education and training

 Quality assurance
 Sharing responsibility
 Motivation and commitment
 Patronage to reduce-recycle-usage
 Let us prove that we are
ECO FRIENDLY
To make others shed their hostility and
become
MEDICO FRIENDLY