BIO MEDICAL WASTE

MANAGEMENT

Submitted by:-Prajwal M A

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CONTENTS
• Introduction
• Sources
• Classification
• Categories
• Transportation
• Treatment
• Case study
• Summary
• Reference

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 INTRODUCTION
• Since beginning, the hospitals are known for the treatment of sick persons but we
are unaware about the adverse effects of the garbage generated by them on human
body and environment.
• Until recently, medical waste management was not generally considered as issue.
• In 1980s and 1990s - HIV and Hepatitis B led to questions about potential risks.
• Thus, hospital waste generation become a prime concern due to its risk factor to
the health of patients, hospital staff and to the general population.

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What is Bio Medical waste???
Bio medical waste means any waste, which is generated during the diagnosis,
treatment or immunization of human beings or animals or in research activities.

 Biomedical waste (BMW) is generated in hospitals, research institutions, health care

teaching institutes, clinics, laboratories, blood banks and veterinary institutes.
 It has been estimated that up to 85% to 90% of the waste generated is non-
infectious.
 Remaining 10% to 20% of waste is hazardous and infectious.

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SOURCES OF BIO MEDICAL WASTE
Categorized as Major and Minor sources according to the quantities produced.

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CLASSIFICATION OF BIOMEDICAL WASTE
 85-90% of the biomedical waste is non- hazardous.
 Remaining 10-15% is hazardous and can be injurious to humans or animals
and to environment.

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BIO MEDICAL WASTE CATEGORIZATION
Bio medical waste are categorized according to “Bio medical waste management rules
2016” schedule 1.
Waste Waste class and Description Treatment and
category Disposal
     
Human Anatomical Wastes.  
No 1 Incineration / Deep burial.
(Human tissues, organs, waste body parts)
 
    
Animal Wastes  
No 2 Incineration / Deep burial.
( animal tissue, organs, body, animals used in research, waste generated by  
veterinary hospitals)  
      

Microbiology & Biotechnology Waste Local Autoclaving /

No 3
(Wastes from laboratory, cultures or specimens of micro-organisms, human microwaving/incineration.
and animal cell culture used in research).
  Waste Sharps  

(Needles, syringes, scalpels, blades, glass, etc that are capable of causing Autoclaving /
No 4
puncture and cuts.). microwaving/incineration.
 

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    Discarded Medicines
No 5 (Wastes comprising contaminated and discarded medicines). Incineration or destruction and
disposal in landfills.
     Soiled Wastes   

No 6 ( soiled cotton, dressings, plaster casts, beddings, material Incineration or

contaminated with blood). autoclaving/microwaving.
 
   Solid
Waste  

  (Wastes generated from disposable items such as tubeings, catheters, Autoclaving/microwaving. 

 
No 7 intravenous sets etc.)  
  Liquid Waste
No 8 (from laboratory and washing, cleaning, Disinfection by chemical
house-keeping and disinfecting activities) treatment and discharge into
drains.
 

  Incineration Ash
No 9 (ash from incineration of any bio-medical waste) Disposal in municipal landfill.
  Chemical Waste
No 10 (Chemicals used in production of biologicals, chemicals Disinfection by chemical
used in disinfection, as insecticides, etc.) Treatment.

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Segregation and Colour coding for Bio medical waste
Bio medical wastes are colourized as:
 BLACK (non- infected waste).  BLUE (Infected plastics).
 YELLOW (anatomical waste).  WHITE (Sharps).
 RED (Solid infected waste).

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TRANSPORTATION AND STORAGE
Temporarily stored at the central storage area of the hospital and from there sent to the site of
final disposal once or twice a day depending upon the quantity of waste .

During transportation following points should be taken care:

• Check that waste bags/containers are properly sealed and labeled.
• Bags should not be filled completely, so that bags can be picked up by the neck for handling.
• At a time only one bag should be lifted.
• Manual handling should be minimized to reduce the risk of needle prick injury and infection.
• BMW should be kept only in a specified storage area.
• After removal of the bag, clean the container including the lid with an appropriate disinfectant.
• Waste bags should be transported in a covered wheeled containers or large bins. No untreated
bio‐medical waste shall stored beyond 48 hours.

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 Fig. Covered wheeled containers

• Waste is transported to the site of final disposal in a closed motor vehicle (truck,
tractor‐trolley etc.). It prevents spillage of waste on the way.
• Vehicles used for transport of BMW must have the “Bio Hazard symbol” and
these vehicles should not be used for any other purpose.

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 Fig. Bio hazard symbol on vehicles.

Treatment And Disposal Techniques For Bio Medical Waste

The methods are:
 Autoclaving.  Chemical Disinfection.
 Incineration.  Deep Burial.
 Gas/Vapor Sterilization.

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Autoclave
• Closed chambers that apply both heat and pressure, and sometimes steam to
sterilize medical equipment.
• Used to destroy microorganisms that may be present in medical waste before
disposal into landfill.
• Small autoclaves are used for sterilizing reusable medical instruments while
large autoclaves used to treat large quantity medical waste.
• It is most effective with material such as plastics, metal pans, bottles, and flasks.
• High-density polyethylene and polypropylene plastic should not be used.

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Fig. Autoclaves

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Incineration
• Incineration is a waste treatment process which convert Bio medical waste into ash by
employing combustion process under controlled condition.
• The main purpose is to reduce the waste volume and destruction of dangerous substances.
• It has strong benefits for the treatment of certain waste such as clinical wastes and
certain hazardous wastes where pathogens and toxins can be destroyed by high temperatures.
• Incinerators can be oil fired or electrically powered.
• Waste should be less moisture as less than 30%.
Advantage of Incineration:
• No Pre treatment is required.
• Suitable for low heating volume.
Disadvantages of Incineration:
• Large capital and operating cost.

Fig. Incinerator

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Gas/vapor sterilization
• It is the process of destroying all microorganisms and pathogenic products using gaseous or vapour
chemicals.
• Ethylene oxide is the gas most often used.
• It is highly explosive and flammable in the presence of air, but these hazards are reduced by
diluting with CO2.
• It is usually heated to a temperature of 54°C. 
Chemical disinfection
• It is the preferred treatment for liquid infectious wastes.
• It involves the use of chemical agents such as chlorine.
• There are a number of factors that should be considered regarding the usage, including:
The type of wastes, degree of contamination, type of disinfectant used , its concentration, quantity,
contact time.
Advantage:
• Best for liquid waste.
• Useful for pharmaceutical , chemical and other infectious waste.
Disadvantages:
• Disinfectants may themselves be hazardous to operators.
• Needs trained operators.

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Deep Burial
• Decomposing human and animal anatomical waste.
• To avoid recycling of sharps, their burial in safe pit is an effective and economical disposal method.
Deep burial should have the following specifications:
• A Pit should be dug about 2 meter deep.
• It is half filled with waste, then covered with lime ,before filling the pit with soil.
• Covers of wire meshes may be used to avoid animal entry.
• On each occasion, when wastes are added to the pit, a layer of 10 cm of soil shall be added to over the
wastes.

Fig. Deep burial

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HEALTH HAZARD FROM BIO MEDICAL WASTE
• The improper management of bio-medical waste causes serious environmental problems in
terms of air, water and land pollution.
• Air Pollution can be caused in both indoors and outdoors.
• Indoor air pollutants like pathogens present in the waste cause pollution.
• Outdoor air pollution have two major sources- open burning and incinerators.
• Waste which is dumped into lakes and water bodies, can cause severe water pollution.
• Harmful chemicals present in bio-medical waste such as heavy metals can also cause water
pollution.
• Land Pollution is caused by the final disposal of all bio-medical waste.
• Open dumping of bio-medical waste is the greatest cause for land pollution.

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 LEGISLATIVE ASPECT IN RELATION TO BIO MEDICAL
WASTE
Various central legislation related to biomedical waste management in India are as follows:
• The Biomedical waste(management and handling) rules,1998.
 The water (prevention and control of pollution) Act, 1974.
 The Air (prevention and control of pollution) Act, 1981.
 The hazardous waste(management and handling) rules,1998.
 Municipal Solid waste (management and handling) rules, 2000.
 The Biomedical waste(management and handling) rules Amendment ,2000 and 2003.
 The Bio-medical Waste (Management and Handling) Rules, 2011.

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 CASE STUDY
Anu, S., Ranjitha , A,B., Yaseen , M.,(2016), carried out a research study on “Hospital waste
generation and management – a case study for major hospitals of Davanagere”., volume: 03 issue: 06.
Study area
Two major hospitals of Davanagere city. They are:
• S . S. Institute of medical science and research centre(Private hospital)- Estd. 2004
• Chigateri district hospital(Govt. hospital)- Estd.1961
Methodology
• Hospital wise waste collection data is obtained from the District Administration.
• Data collection is made by visiting personally to major hospitals in the city.
• An attempt is made to suggest the best management practice which can adopted in hospitals as
well as by a district administration.
Results and Discussions
• The hospitals has separate waste Management staff.
• They follow the guidelines of central pollution control board for handling Hospital waste according
to BM waste Handling rules 1998 using different color coding bins for segregation.

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Detailed Description of S.S Hospital and Chigateri dist. hospital
Type of Hospital General and super specialty General(Govt. hospital)
Total number of bed 750 950
Patient usage 315 450 - 515
Total quantity of waste generated 500-600 kg/day 550- 700kg/day
per day
Infectious waste per day 200-250 kg/day 200 – 350kg/day

General waste per day 300-350 kg/day 300 – 450 kg/day

Water supply per capita demand 450 ltrs/bed/day 450 lts/bed/day
( no. of beds exceeding 100)
Total quantity of liquid waste 450*750*85*1.3/100 = 372937.5 450*950*85*1.3/100=472387.5ltrs/day

generated ltrs/day
Yes
Segregation at source Yes
Regular (within 48 hrs)
Type of collection Regular ( within 48 hrs)
8 – 12am
Time of collection 8 to 12 am

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Proposed Common hospital waste incinerator

Conclusion
• The total quantity of waste generated from S.S. Hospital is 500 - 600 kg/day. and C.G Hospital is 550
-700 kg/day .
• From S.S. Hospital about 200 - 250 kg/day of waste is incinerable. From C.G Hospital about 200 -
350 kg/day of waste is incinerable.
• To treat the above waste generated a common biomedical waste incinerator of 200 kg/ hr is proposed
to treat the incinerable waste effectively from both the major hospitals. Best management practices are
suggested for effective hospital waste management.

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 SUMMARY
• Hospital Management must understand the gravity of the issue and they must be able to differentiate
between hospital waste and general waste.
• They must ensure proper identification, segregation at the source of generation, collection in prescribed
coloured containers, safe transportation, appropriate treatment and safe disposal of Bio-Medical Waste.
• They should provide health education and training to handle the Bio-Medical Waste.
• Safe and effective management of biomedical waste is not only a legal necessity but also a social
responsibility.
• Effective implementation of rules by surprise visits and inspection by authorities must be carried out.
• Legislative aspect in relation to bio medical waste must be followed.
• BMW Management Board must be established in each district.

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THANK YOU

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