BIOMEDICAL WASTE MANAGEMENT

BY SHARIQ ANSARI

as defined by the Bio-Medical Waste ( Management and Handling ) Rules.1998 It includes any waste which is generated during the diagnosis. ACCORDING TO BIOMEDICAL WASTE RULES. and including categories mentioned in Schedule 1 .WHAT IS BIO-MEDICAL WASTE ? Bio . treatment or immunisation of human beings or animals or in any research activities pertaining thereto or in the production or testing of biologicals. is generated during the diagnosis. . treatment or immunization of human beings or animals or in any research activities pertaining thereto or in the production or testing of biologicals . 1998.Medical waste is Any waste which.

Laboratories and Blood Banks.infectious waste forms nearly 90% of the waste generated by a hospital. Operation Theatres. .SOURCES OF BIO-MEDICAL WASTE: ‡ ‡ ‡ ‡ ‡ ‡ ‡ Hospitals Diagnostic Centers Laboratories Blood Banks Nursing Homes Clinics Veterinary Hospitals and Clinics Non . The remaining 10% comprises of infectious waste and is generated in all the Wards. Intensive Care Units.

Non-Infectious Waste . ii. Infectious Waste.CLASSIFICATION OF HOSPITAL WASTE A. Bio-Hazardous Waste (25%) I. Non-Hazardous Waste (75%) B.

BIO-MEDICAL WASTE: MANAGEMENT ISSUES ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ The implementation of Bio-Waste regulation is unsatisfactory. An incorrect method of waste disposal A bag not securely tied results in scattering of Bio-Medical waste Most importantly there is no mechanism to ensure that all waste collected and segregated . In some hospitals there is no proper training of the employees in hazardous materials management and waste minimization aspects. Additional hazard includes recycling of disposables without even being washed. Lack of segregation practices. There is no mechanism for ensuring waste treatment within prescribed time limits. reaches its final destination without any pilferage. Usage of same wheel barrow for transportation of all categories of waste is also a cause of infection spreading. .

disinfection. transportation and final disposal are vital steps for safe and scientific management of BMW in any establishment . Schedule II contains the Colour coding and the type of container for disposal of different Bio Medical waste categories ‡ ‡ ‡ ‡ . mutilation. 1998 ‡ Keeping in view inappropriate Bio-Medical waste management. it is the duty of every occupier i. In accordance with these Rules . 1998 in July 1998. Handling. segregation.e. a person who has the control over the institution and or its premises. storage.BIO-MEDICAL WASTE RULES. to take all steps to ensure that waste generated is handled without any adverse effect to human health and environment. Schedule I of the Bio-Medical rules contains the categories of Bio-Medical Waste . the Ministry of Environment and Forests notified the Bio-Medical Waste (management and handling) Rules.

6 No. Incineration Autoclaving/Microwavig.2 No. Disinfection Disinfection by chemical treatment & discharge into drains Disposal in Municipal Landfill Chemical treatment and discharge into drains for liquids and secured landfill for solids. 3 No. Incineration Autoclaving/Microwavig.SCHEDULE I OF THE BIO-MEDICAL RULES WASTE CATEGORY S No.VJ Incineration /Deep Burial. 1 No. 7 No.10 Chemical Waste . 8 No. 9 TYPE OF WASTE Human Anatomical Waste Animal waste Microbiology & Biotechnology Waste Waste Sharps Discarded Medicine and Cytotoxic drugs Soiled Waste Solid Waste Liquid Waste Incineration Ash TREATMENT AND DISPOSAL OPTION VIncineration /Deep Burial. No. 4 No. 5 No. Disinfection Incineration /Dest and drugs disp in secured landfills.

OF THE BIO-MEDICAL RULES Color Coding Type of Container Waste Category Treatment options as per Schedule I Yellow Plastic bag Disinfected container/ plastic bag Cat.3.6.SCHEDULE II.4 and Cat.6 Cat.3 Incineration/ deep burial and Cat. and Cat.1. and Cat.9. Cat.10 (solid) Black . Cat.5.7 container Plastic bag Cat.7 Autoclaving/Micro waving/ Chemical Treatment Autoclaving/Micro waving/ Chemical Treatment and destruction/ shredding Disposal in secured landfill Red Blue/ White Translucent AA Plastic Bag/ puncture proof Cat.Cat.2. Cat.

STEPS INVOVLED IN BIOMEDICAL WASTE MANAGEMENT Waste survey waste minimization waste segregation & safe storage waste treatment & handling waste transportation waste disposal .

A surveys helps in evaluating both the type & quality of waste generated in hospital. E. Determine the points of generation & type of waste generated of each point.WASTE SURVEY Waste survey is important component of the waste management scheme. Differentiate the type of waste. Quantify the waste generated. AIM : A. D. C. B. To find out the type of disposal carried out . Determine the level of generation & disinfection in the hospital.

Recycling is a good environmental practice. needles and other plastics. Recycled plastic material can be used for nonfood grade applications. Provides an opportunity for recycling certain components of medical waste like plastics after proper and thorough disinfection. Reduces the cost of treatment and disposal (80 per cent of a hospital s waste is general waste. Prevents illegally reuse of certain components of medical waste like used syringes. provided it is not contaminated with other infectious waste) .‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ SEGREGATION HELPS IN: Segregation reduces the amount of waste needs special handling and treatment Effective segregation process prevents the mixture of medical waste like sharps with the general municipal waste. Of the general waste. the biodegradable waste can be composted within the hospital premises and can be used for gardening purposes. which does not require special treatment. which can also double as a revenue generating activity.

The standard technologies being utilised in the country for treatment and disposal of biomedical waste are · Microwave · Autoclave · Incineration . that is highly infectious and hazardous.OVERVIEW OF TECHNOLOGY USED FOR BIO-MEDICAL WASTE TREATMENT AND DISPOSAL As bio-medical is a specialised class of waste. there are specific technologies are required to treat and dispose the waste.

2. One of the most common occurrences while dealing with Bio-Medical Waste is the spillage and leakage of waste. 3. . Precautions should also be taken to ensure that the general public do not breathe in this air. Other precautions to be kept in mind are the same as those followed in the rest of the hospital. Spill Protocol is therefore essential for any hospital. 4. This refers to the measures that have to be taken to contain and decontaminate the accident site. No reagents should be sucked into the pipette with the mouth. The surface containing the spill has to be mopped up with a swab soaked in disinfectant and then the swab should be put in the infectious waste bin. Laboratories should be well ventilated so as to ensure that personnel do not breathe in contaminated air.EMERGENCY SITUATIONS: Accidents should be avoided and therefore have systems to deal with emergency situations should be developed. This should include the following: 1.

Define management policies for waste management.Evalute the present scenario this entails preaudit and auditing of hospital wastes. .PRIMARY STEPS OF EFFECTIVE HEALTH CARE WASTE MANAGEMENT 1.Preparation of job chart for hospital waste management. costs & policies yearly. 4. Evaluate technical procedures. Asses all cost associated with waste management. 5. 2. 6. 3. Train the trainers & employers.

HEALTH HAZARDS ASSOCIATED WITH POOR HOSPITAL WASTE MANAGEMENT Injuries from sharps to all categories of hospital personal (HIV & HBV) Nosocomical infection in patient from poor infection control & poor hospital waste management. III. All the health workers put on heavy duty gloves while dealing with infectious waste especially sharps. d) Risks associated with hazardous chemicals. food trays or beds as grievous injuries can result. c) Risk of infection outside hospital for waste handlers. IV. scavengers & eventually the general public. PRECAUTION : I. drugs being handled by persons handling wastes at levels and e) Disposable-recycled. Sharp should not be left casually on counter tops. In situation when recapping is unavoidable. The single handed method be utilized. II. Recapping needles should discouraged. All the health workers employed in/ outside the hospital must be vaccinated against hepatitis B. a) b) .repacked & sold may be non noticeable.

who form a part of the community. A community can therefore do the following to ensure a higher level of health:  Communities should strive to ensure that awareness programmes should be conducted in their areas through residents associations on the issue.  Communities should remain vigilant and should promptly report breach in proper bio-medical waste practices by any hospital to the pollution control board.  Communities should ensure medical practitioners having clinics in their localities do not dispose off their waste in the municipal waste stream. Patients. the community has a very important role to play in ensuring that the hospital practices the prescribed procedures for treating bio-medical waste. constantly utilise services of healthcare institutions and hence they also share the responsibility of ensuring that these institutions do not pollute the community. but arrange to send it to the 6 facility.COMMUNITYS ROLE IN BIO-MEDICAL WASTE MANAGEMENT: While management of bio-medical waste is primarily the responsibility of medical institutions and those who actually generate this waste. .

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