Professional Documents
Culture Documents
Dr Shazia Shams
Lecturer ,
PHI, Nagpur
Why manage Hospital Waste?
Dr Shazia Shams
Purpose of Infection Management and Environment Plan
(IMEP)
Inappropriate
disinfection
Dr Shazia Shams
Waste generated in the hospital
Dr Shazia Shams
Untidy Hospital
Dr Shazia Shams
Mixing of Biomedical waste with General Waste
Dr Shazia Shams
Unhygienic labour room
Dr Shazia Shams
Patient Safety
Dr Shazia Shams
Open Disposal
of Placenta –
Invitation to
Dogs
Dr Shazia Shams
What is Biomedical Waste ?
Dr Shazia Shams
Definition of Biomedical Waste
Biomedical waste has been defined as “any waste, which is
generated during the diagnosis, treatment or immunization
of human beings or animals or in research activities
pertaining thereto or in the production or testing of
biologicals” as per Biomedical waste (management &
handling rules) 1998.
Dr Shazia Shams
Definition of Biomedical Waste
Biomedical waste has been defined as “any waste, which is
generated during the diagnosis, treatment or immunization
of human beings or animals or in research activities
pertaining thereto or in the production or testing of
biological or in health camps, including the categories
mentioned in Schedule I appended to these Rules” as per
Biomedical Waste Rules 2016.
Dr Shazia Shams
Dr Shazia Shams
Biomedical waste rules 2016
Gazetted on 28th March 2016
Major Changes –
Small facilities less than thirty beds may designate a qualified person to
review and monitor the activities relating to bio-medical waste
management Dr Shazia Shams
Biomedical waste rules 2016
Bar Code System for bags & containers (after 28th March 2017)
Treatment & disposal of Liquid waste in accordance with the water (Prevention
& control of Pollution) 1974
Autoclaving/Micro-
Plastic Bag waving/ Chemical
Blue/ White /puncture-proof Cat. 4, Cat. 7 Treatment &
Translucent containers Destruction /
shredding
Disposal in secured
Black Plastic Bag Categories 5, 9, 10
landfill.
Dr Shazia Shams
Categories of Waste: Schedule I
(BMW Rules 2016)
Category Type of Waste Bag/ Container Treatment/ Disposal
Dr Shazia Shams
Categories of Waste: Schedule I (BMW Rules
2016)
Category Type of Waste Bag/ Container Treatment/ Disposal
Red Contaminated Red Coloured non- Autoclave/ Microwave/
Waste (Recyclable) chlorinated plastic Hydroclave followed by
shredding or mutilation
or combination
White SHARPS including Puncture Proof/ Leak Proof/ Autoclave/ Dry Heat
Metals Tamper proof Sterilisation or
shredding or Mutilation
or Encapsulation or
designated concrete
sharp pit
Segregation Collection
Transport Disposal
Dr Shazia Shams
Segregation
Different types of waste should be
collected separately
Should be done at point of generation
Different coloured bins are to be used
Segregation ensures occupational and
health safety
Segregation also reduces the cost of
treatment and disposal
Dr Shazia Shams
SCHEDULE III
(See rule 8 (4))
LABEL FOR TRANSPORTING BIO-MEDICAL WASTE BAGS OR
CONTAINERS
Day ............Month ..............
Year ...........
Date of generation ...................
Waste category No ........
Waste quantity…………
Sender's Name and Address Receiver's Name and Address:
Phone No ........ Phone No ...............
Fax No ............... Fax No .................
Contact Person ........Contact Person .........
In case of emergency please contact :
Name and Address :
Phone No.
Note : Label shall be non-washable and prominently visible.
Dr Shazia Shams
TRANSPORTATION
WITHIN HOSPITAL
of Waste
Storage
No untreated
●
●
Dr Shazia Shams
Who is at risk for sharps injuries?
Any worker who may come in
contact with contaminated
sharps is at risk, including
nurses, ANMs, lab workers,
doctors and waste handlers.
Dr Shazia Shams
Categories of staff exposed to Needle stick Injuries
Staff prone to needle-stick Relative % of
injuries injuries
Staff nurses 34.6%
Interns 15.7%
Residents 11.7%
Trainee nurses 8.5%
Technical Staff 6%
Workers responsible for waste 19%
management / cleaning
Others 4.5%
Dr Shazia Shams
ESTIMATED RISK OF INFECTION FOLLOWING A
NEEDLESTICK FROM AN INFECTED SOURCE-PATIENT
35% 30%
30%
25%
20%
15%
10%
5% 3%
0.30%
0%
Hepatitis B Virus Hepatitis C Virus HIV
Source: Needlestick injuries studies among healthcare workers
Dr Shazia Shams
Unsafe Injection Practices
Reuse
Wrong Technique
Unhygienic Practices
Waste Management Mechanism
Outcome
o Short Term – Abscess Formation, Skin Rashes,
Irritation, Pain, Disabilities
o Long Term – HIV, HCV & HBV(33%)
Why Re use
Lack of Awareness
Altruism – Limited number of syringes, many patients
in need
Economic Reasons – Financial Gains
What are some of the incorrect practices that
have resulted in transmission of disease?
Objective:
Decontamination
Cleaning
Sterilization or HLD
Storage.
sterilization
Autoclaved instruments are kept in clean area
Dr Shazia Shams
Symptoms of Mercury poisoning
Impairment of peripheral vision
Disturbance of sensations
Lack of coordination of movements
Impairment of speech or hearing
Skin rashes
Mood swings & mental disturbance
Abnormal brain development
Dr Shazia Shams
MANAGING MERCURY SPILL
Dr Shazia Shams
Mercury Spill Management
Remove all jewellery (mercury binds with the metal)
Put on rubber or latex gloves
Pickup broken glass and place in a glass container with 5 to10 ml of water
Use syringe for sucking the mercury droplets. Locate any remaining mercury with
the flash light; the beads will reflect the light making them easier to locate.
Seal the glass container and label as “mercury waste” and place in a safe corner.
Place all materials used in the clean-up, including gloves, in a trash bag.
Seal the trash bag with tape and label as “mercury waste”.
Wash the area with mercury neutralizing agents like 20% calcium sulphide or
sodium thiosulphate solution (if the chemicals are available).
Wash your hands, face, and any other areas of your body exposed to the mercury.
Keep the room well ventilated.
CBMWTSDF
(Common Bio-Medical Waste Treatment, Storage and Disposal Facility)
Why Required –
Every individual occupier cannot provide their
own facility.
Easier to concentrate on vigilance of Central
facility.
Ensure adequate treatment and disposal of BMW.
CBMWTSDF
Dr Shazia Shams
Central biomedical waste disposal facility
CWTF Sharp pit
Dr Shazia Shams
Spill Management
Blood And Body Fluids Spill Management
Dr Shazia Shams
CWTF:
Incinerator Effluent Treatment Plant
Dr Shazia Shams
STANDARDS:TREATMENT, DISPOSAL: Sch II
Standards for Incinerators
Standards for waste autoclaving:
Standards for liquid waste:
Standards for plasma pyrolysis
Standards of microwaving
Standards for deep burial
Standards for efficacy of chemical disinfection
Standards for dry heat sterilization
Dr Shazia Shams
FORMS:
FORM – I (See rule 10): APPLICATION FOR AUTHORISATION
REPORTING
FORM –V (See rule 10)
Grant: 90 days
Dr Shazia Shams
Annual report
Maintenance of records:
Dr Shazia Shams
Accident reporting:
Major accident: intimate immediately: prescribed
authority: within 24 h remedial steps
Dr Shazia Shams
Conclusions: Highlights BMWM, rules 2016
Ambit of the rules
Hazardous , MO, radioactive: different Acts
Duties: Occupier, CBWTF, Authority
No categorization
Deep burial, CBWTF exempted: remote, defense
Stds: Non chlorinated bags: barcode, GPS Vehicle
Standards of equipments, effluent, pits, parameter
Recycling: authorized recyclers
Sustainable, eco friendly, green technologies, waste to
energy
Dr Shazia Shams
Bio-Medical Waste Management (Amendment)
Rules March 16, 2018
Original provision Amended provision
Rule ( 4c) -It shall be the duty of It shall be the duty of every occupier
every occupier to pre-treat the to pre-treat the laboratory waste,
laboratory waste, microbiological microbiological waste, blood
waste, blood samples and blood samples and blood bags through
bags through disinfection or disinfection or sterilization on-site in
sterilization on-site in the manner the manner as prescribed by the
as prescribed by the World Health World Health Organization (WHO)
Organization (WHO) or National guidelines on Safe management of
wastes from health care activities
AIDs Control Organization
and WHO Blue Book, 2014 and
(NACO) guidelines and then sent
then sent to the Common bio-
to the common bio-medical waste
medical waste treatment facility
treatment facility for final disposal for final disposal.
Original provision Amended provision
Rule 4 (p) -It shall be the duty of It shall be the duty of all the health
every occupier to make available care facilities (any number of beds)
the annual report on its web-site and shall make available the annual
all the health care facilities shall report on its web-site within a
make own website within two years period of two years from the date
from the date of notification of of publication of Bio-Medical
these rules. Waste Management (Amendment)
Rules, 2018
Rule 5 (c) -It shall be the duty of It shall be the duty of every operator
every operator of a common bio- of a common bio-medical waste
medical waste treatment and treatment and disposal facility to
disposal facility to establish bar establish bar coding and global
coding and global positioning positioning system for handling of
system for handling of bio- medical bio- medical waste in accordance
waste within one year with the guidelines issued by the
Central Pollution Control Board by
27th March, 2019
Original provision Amended provision
Rule 7(8) -Every occupier shall Every occupier shall phase out use
phase out use of non-chlorinated of chlorinated plastic bags within
plastic bags within two years from two years from the date of
the date of publication of these publication of these rules and after
rules and after two years from such two years from such publication of
publication of these rules, the these rules, the chlorinated plastic
chlorinated plastic bags shall not be bags shall not be used for storing
used for storing and transporting of and transporting of bio-medical
bio-medical waste and the occupier waste and the occupier or operator
or operator of a common bio- of a common bio-medical waste
medical waste treatment facility treatment facility shall not dispose
shall not dispose of such plastics by of such plastics by incineration and
incineration and the bags used for the bags used for storing and
storing and transporting biomedical transporting biomedical waste shall
waste shall be in compliance with be in compliance with the Bureau
the Bureau of Indian Standards. Till of Indian Standards. Till the
the Standards are published, the Standards are published, the carry
carry bags shall be as per the Plastic bags shall be as per the Plastic
Waste Management Rules, 2011. Waste Management Rules, 2016.
Original provision Amended provision
Along with the changes in the Rules, amendments have also been made to
Schedule I, II and III and the format for submission of the annual report
information on bio-medical waste management has been inserted as Form
IVA.
The Amendment Rules have come into force from March 16, 2018.
[G.S.R. 234 (E)]
URL: http://www.egazette.nic.in/WriteReadData/2018/183847.pdf
.
अिधसूचना 19 फरवरी, 2019
1) These rules may be called the Bio-Medical Waste
Management (Amendment) Rules, 2019.
2. In the Bio-Medical Waste Management Rules,
2016 (herein after referred to as the said rules), in
rule 4,-
(i) For clause (n), the following clause, shall be
substituted, namely:- “(n) ,in case of all bedded health
care units, maintain and update on day to day basis the
bio-medical waste management register and display
the monthly record on its website according to the bio-
medical waste generated in terms of category and
colour coding as specified in Schedule I;”;
(ii) For clause (p), the following clause shall be substituted,
namely:- “(p) ,in case of all bedded health care facilities (any
number of beds), make available the annual report on its
web-site within a period of two years from the date of
publication of the Bio-Medical Waste Management
(Amendment) Rules, 2018
Dr Shazia Shams
Thank You