BIOMEDICAL WASTE

MANAGEMENT
PANDEY ARPIT
 Introduction
 History
 Definitions
 Types of wastes
 Waste management Biomedical waste
management
 Conclusion
 References
 INTRODUCTION

Medical and dental care is vital in our life.

Biomedical waste - emerged as an issue of
concern.
Biomedical waste is the real problem for the
MAN,COMMUNITY,ENVIRONMENT
Safe, scientific, cost-effective method for
biomedical waste management - need of hour.
 HISTORY

 In the late 1980’s

• Items such as used syringes washed up on several East
Coast beaches USA
• HIV and HPV virus infection
• Lead to development of Biomedical Waste Management
Law inUSA.
 However in India the seriousness about the management
came into lime light only after 1990's.
 WHO has estimated that
• In 2000
• Injections with contaminated
syringes caused:
• 21 million hepatitis B virus (HBV)
infections (32% of all new infections);
• Two million hepatitis C virus
(HCV) infections (40% of all new
infections);
• 260 000 HIV infections (5% of all
new)
Laws of Biomedical Waste Management

On 204 July 1998

• Ministry of Environment and Forests
(MoEF), Govt. of India, Framed a rule
known as Bio-medical Waste
(Management and Handling) Rules, 1998.
• Provides uniform guidelines and code of
practice for Bio-medical waste
management.
 BIOMEDICAL RULES 1998
• The Government of India as contemplated under Section 6,8 and 25 of the
Environment (Protection) Act, 1986, has made the Biomedical Wastes
(Management & Handling) Rules, 1998.

• The rules are applicable to every institution generating biomedical waste

which includes hospitals, nursing homes, clinic, dispensary, veterinary
institutions, animal houses, laboratory, blood bank.
•The rules are applicable to all persons who generate, collect, receive, store,
transport, treat, dispose, or handle bio medical waste in any form.
 DEFINITIONS
• Acc to bio medical waste rules, 1998 of India
“ bio-medical waste" means any waste which is generated
during the diagnosis, treatment or immunization of
human beings or animals or in research activities
pertaining there to or in the production or testing of bio
medicals.
Hospital waste: refers to all waste, biological or non
biological, that is discarded and is not intended for further
use.
Medical waste: refers to materials generated as a result of
patient diagnoses, treatment, immunization of human
beings or animals.
 Infectious waste: are the portion of medical waste that could
transmit an 'infectious disease’.

Pathological waste: waste removed during surgery/ autopsy or

other medical procedures including human tissues, organs, body
parts, body fluids and specimens along their containers.
Health Care Waste: means all the waste generated
byHospital establishments, research facilities, and
laboratories. In addition, it includes the waste originating
from "minor" or scattered sources such as that produced in
the course of health care undertaken in the home (dialysis,
insulin injections, etc.)
 Types Of WATES
Garbage (food wastes)
Rubbish (paper , plastics)

SOLID
Demolition Products(bricks)
Sewage treatment residue

WASTE LIQUID

Dead animals
Manure and discarded
material
GASEOUS
• Sewage
• Waste water from a community containing solid and liquid
excreta, derived from houses streets and factories.

• Sullage
• Waste water which does not contain human excreta.
Categories of Bio-Medical Wastes

Non – Infection
Waste 80%
Pathological &
infectious waste
15%

Chemical & pharmaceutical

waste 3%

Radioactive, Sharps 1%
cytotoxic & heavy metals 1%
BIOMEDICAL WASTE MANAGEMENT
 Waste Treatment and
S,No
category Waste Type
disposal
 Waste Treatment and
S,No Waste Type
category disposal
 Waste
S,No Waste Type Treatment and
category
disposal
COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF
BIOMEDICAL WASTE
 STAGES OF
MANAGEMENT
OF BMW
A) Segregation & Collection
B) Safe transportation & storage
C) Treatment & Disposal Of BMW
 Segregation & Collection

Waste should be segregated and collected at the site of

generation itself.

Segregation of waste denotes the separation of waste into

various specified categories as per its nature .
Use of plastic bags makes the transportation easier, it prevents the spillage and the waste remains
outside the view of others. This also keeps the original containers clean.The plastic bags are not to
be reused.

When bag or container, as the case may be, is three fourth full, it should be sealed by tying it. The
disposable sharps container should be sealed by tape. All bags or containers must be labeled which
shall be non washable/prominently visible
 Safe transportation & storage

While transporting the waste to the central storage area certain rules must
be followed:
1. Check that waste bags/containers are properly and effectively sealed.
2. Waste bag is properly labeled.
3. Bags should be picked up by the neck and placed, so that bags can be
picked up by the neck again for further handling. Hand should not be
put under the bag. At a time only one bag should be lifted.
4. Manual handling of waste bags should be minimized to reduce the risk of needle prick injury and infection.
Avoid close contact between body and bag container.

5. Waste bag or container should not be thrown or dropped.

6.After removal of the bag, clean the container including lid with an appropriate disinfectant.

7.Bags or containers containing the waste should be transported in covered wheeled containers or large bins
in covered trolleys dedicated for this purpose.The bags and containers should be replaced by fresh
bag/container.

Bio- medical waste storage areas must be separate from general waste storage sites and should have clear
signs indicating "For Biomedical Waste only.
8. In case, a lift is to be used during
transportation of biomedical waste it should be
designed and reserved for this purpose only.
CENTRAL STORAGE
 The central storage area should be ideally situated on the ground floor and
near the rear entrance. This will make the transportation of waste to the
site of final disposal easier.
 The central storage area should be big enough to store the required
number of waste bags at a time. There should be sufficient storage capacity
to store at least two day's waste.
 It should have a good flooring, light, ventilation and water supply. There
should be special drain to discharge the washing, which should go to the
sewer.
 A full time storekeeper should be responsible to receive and dispatch the
waste and maintain proper records.
Unauthorized people should not be able to
enter the storage area.

An accidental spillage should beproperly

attended.

As per rules, biomedical waste cannot be

stored for more than 24 to 48 hours.

Refrigerated storage room (cold rooms) can

be considered where wasteshave to be
stored in bulk for over 48 hour
 TRANSPORT TO THE FINAL DISPOSAL

 Transportation from the health care establishment to the site of

final disposal should preferably be done in a motor vehicle, as
these sites are likely to be situated at a distance from the
hospital.
 Closed transportation in these motor vehicles (truck, tractor,
trolley, etc) is desirable as it prevents the spillage on the way.
 All these vehicle must have the biohazard symbol and they
should not be used for any other purpose.
 Proper servicing is a must regular basis.
Temporary storage of biomedical waste may also be
needed at the site of final disposal. It should have all
characteristics similar to that described for the central
storage area of the hospital.
 Treatment is a term used for those processes that modify the waste in someway
before it is finally disposed off.
 According to the draft Biomedical (Management and Handling) R 1995.....
 Treatment means: "a method, technique, or process designed to change
thephysical, chemical or biological characteristics or composition of any
biomedicalwaste so as to render such waste non-hazardous to health and
environment".
 The primary aim of treatment is to disinfect or decontaminate the waste
toeliminate the pathogens before it reaches the site of its final disposal.
Five technology options for treatment

 Incineration

 Chemical disinfection
 Wet and dry thermal treatment
1. Wet thermal treatment
2. Screw-feed technology

 Micro wave irradiation

 Land disposal
1. Municipal disposal sites
2. Sanitary landfills

 Inertization
INCINERATION
 Incineration is the complete destruction of
materials to their inertconstituents by a process of
combustion.

 Safe way of disposal.

 There is reduction of volume and weight by

approximately--- 95%
Types of incinerators:
•Double-chamber pyrolytic incinerators: designed to burn infectious
health-care waste.
•Single-chamber furnaces with static grate, used only if pyrolytic
incinerators are not affordable.

•Rotary kilns operating at high temperatures, capable of causing

decomposition of genotoxic substances and heat-resistant
chemicals.foot.com
Characteristics of the waste suitable for incineration are:
a) Low heating volume-above 2000 Kcal/kg for single-chamber
incinerators, and above 3500 Kcal/kg for pyrolytic double-
chamber incinerators
b) Content of combustible matter above 60%
c) Content of non-combustible solids below 5 %
d) Content of non-combustible fines below 20 %
e) Moisture content below 30%
 CHEMICAL TREATMENT
 Plastic, rubber and metallic items (like IV sets, blood bags, gloves, catheters,
syringes and needles must be chemically disinfected before they are sent for
final disposal (landfill).

 Chemical disinfection can be done in following steps:

1. Mutilate the syringes and needles with a needle destroyer.Cut all other
plastic/rubber item with the help of scissors (so that they cannot be reused)
2. Make 1 per cent hypochlorite solution (fresh everyday) by dissolving 10
gms of this powder (approx 2 spoonfuls) in 1 litre of water in a plastic
bucket.fopt.com
3. Keep another, smaller bucket with perforations inside the main bucket (having the solution).
Put all the items that are to be disinfected inside the perforated bucket and keep well- dipped for
about 30-60 minutes

.4. After 30 to 60 minutes take out the disinfected items and put them in a proper waste bag.
Sharps should be first kept in a tough cardboard box then only put in the plastic bag so as to
avoid damage to the bags.

5. Change the solution every 12 hours.Commonly used - Sodium hypochlorite solution, Cresol,
Savlon, Bleaching powder
Wet and dry thermal treatment
Wet thermal treatment:
• Based on exposure of shredded infectious waste to high temperature, high pressure steam.
•Similar to the autoclave sterilization process.
•Inappropriate for the treatment of anatomical waste and animal carcasses.
•Will not efficiently treat chemical and pharmaceutical waste.

Screw-feed technology
Screw-feed technology is the basis of a non-burn, dry, thermal disinfection process in which
waste is shredded and heated in a rotating auger.
•The waste is reduced by 80% in volume and by 20-35 % in weight.
•Suitable for treating infectious waste and sharps.
•Should not be used to process pathological, cytotoxic or radioactive waste.
Microwave irradiation
• Most microorganisms are destroyed by the action of microwave of a frequency of about
2450 MHZ and a wavelength of 12.24 cm.
• The water contained within the waste is rapidly heated by the microwave and the
infectious components are destroyed by heat conduction.
• The efficiency should be checked routinely through bacteriological and virological tests

STANDARDS OF MICROWAVE

•Not be used for cytotoxic, hazardous,/radioactive wastes, contaminated animal carcasses,

body parts, & large metal items.
Disposal means placing the biomedical waste in its final resting
place
According to the draft Biomedical Waste (Management
andHandling) Rules, 1995.
Disposal means : "burial, discharge, deposit, dumping, land filling
or placing on land of any biomedical waste"
Two types of disposal:- 1) Land open dumps.
2) Sanitary landfills.

Health-care waste should not be deposited on or around open dumps.

Advantages of sanitary landfill over open dumps:
Geological isolation
Appropriate engineering preparation of the site.
Staff present on site to control operations,
Organized deposit and daily coverage of waste.
Sanitary landfills

• It is another choice for final disposal of biomedical waste and it can be quite
effective if practiced appropriately.
• While open dumping of biomedical waste cannot be recommended for the
reasons of acute pollution problems, fires, higher risk of disease transmission
and open access to scavengers and animals.

Some essential elements for design and operation of a sanitary landfill are given
below:

• 1. A specifically designated place should only be used for the landfill.

2. The site should preferably be away from the residential areas.
3. Location should be such that vehicles carrying waste can easily approach it in all
weathers.
4. The area should be under constant supervision and security control.Unauthorized
entry must be strictly prohibited.
5. It should not be in the vicinity of a drinking water source as pollution may result.
6. The site should be divided into various manageable phases and all of them should
be adequately prepared before the actual and fill starts.
7. The site should be so organized that the waste can be spread, compacted and
covered daily.
8. A final cover should be constructed to prevent the rain water infiltration when each
phase of landfill is completed. A temporary cover should be provided if rains are
expected in between and before the site is completed.
9. Waste should be buried as rapidly as possible so as to minimize the exposure to
humans or animals.
Inertization
•The process of "Inertization" involves mixing waste with cement and
other substances before disposal.

proportion of the mixture :

•65% pharmaceutical waste, 15 % lime, 15% cement and 5 % water.

The purpose of treatment of biomedical waste
 To reduce or eliminate pathogens so that they no longer pose a hazard to persons
exposed to it
 It changes the physical appearance of waste to make it unrecognizable so that it is
not aesthetically offensive or frightening.
 It also reduces the bulk volume of waste to reduce requirements forstorage and
transport.
 It makes recyclable items unusable so that unauthorized reuse is prevented.

 To reduce the cost and handling time

 CONCLUSION
Safe and effective management of biomedical waste is not only a legalnecessity but also a
Social Responsibility.

Bio-Medical Waste Management cannot successfully be implemented without the

willingness, devotion, self-motivation, cooperation and participation of all sections of
employees of any health care establishment.

If we want to protect our environment and health of the community we must see ourselves to
this important issue not only in the interest of health managers but also in the interest of
community.
 REFERENCES

• Textbook of preventive and social medicines -Park- Ed 21

• Text of essential of preventive and community dentistry -
Soben Peter - Ed 5
• "Infection Control & Management of Hazardous Materials
for Dental Team “ Chris H Miller Charles John Palonik