Waste generated during the diagnosis, testing, treatment, research or production of biological products for humans or animals

1. BIO MEDICAL WASTE
MANAGEMENT
Dr.Rahul.K.R
Guided by,
Dr.Jyothilal. K, HOD,
Dr.Vandana Rani (Associate prof),
Dept. of Swasthavritta.

2. INTRODUCTION
 Medical care – vital in our life and health.
 BMW -emerged as issue of concern world over.
 BMW real problem for
MAN, COMMUNITY,& ENVIRONMENT
 Safe scientific cost effective methods of BMW
management is needed.
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3. NEED OF WASTE MANAGEMENT
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4. DEFINITION:
Waste generated during the diagnosis,
testing, treatment, research or
production of biological products for
humans or animals (WHO).
 “Bio Medical waste” is 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.
(Act to BMW 1998 Govt of India)
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5. BIO MEDICAL WASTE STATISTICS
 Developed Countries- 1-5 kg/bed/day, with variations
among countries.
In India-
• 1-2 kg/bed/day with variation among
Govt. and Private establishments.
• Approximately 506.74 tons/ day wastes generated
• Out of which only 57% waste undergoes proper disposal
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6. LEGISLATIVE FRAMEWORK
Bio medical waste (Management and
Handling)Rules was passed on 28th July 1998.
Amended in 2000
The rules define the Administrative Medical
Officers of healthcare facilities as biomedical
waste ‘generators’ and fix responsibility on
them for developing an effective waste
disposal mechanism for the waste their
facilities generate.
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7. These rules apply to all persons who generate,
collect, receive, store, transport, treat, dispose or
handle bio-medical waste in any form. All
Institutions generating BMW must take all steps to
ensure that such waste is handled without any
adverse effect to human health and the
environment.
The PENALTIES are as specified in Environment
(Protection) Act 1986.
• Imprisonment for upto five years with fine upto one
lakh rupees, or both.
• In case the failure additional fine upto five thousand
rupees for every day.
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8. SOURCES OF HEALTHCARE WASTE
Govt. Hospitals
Private Hospitals
Nursing Homes
Physician’s office/clinic
Dentist’s office/clinic
Dispensaries
Medical research and training establishments
Mortuaries
Blood bank and collection centers.
Animal houses etc……..
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9. WHO estimates
85% of hospital waste is non-hazardous
10% is infectious
5% is non-infectious.
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10. Non-Infectious
waste, 85%
Pathological
and Infectious
waste, 10%
Chemical and
Pharmaceutical
waste 3%Sharps, 1%
Radioactive,
Cytotoxic and
heavy metals,
1%
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11. CLASSIFICATION OF HEALTH CARE WASTE
Waste category Description
1.Infectious waste Waste suspected to contain
pathogens.Eg;laboratory
cultures,materials or equipments that
have been in contact with the infected
patients.
2.Pathological waste Human tissues or fluids, body parts,
fetus.
3.Sharps Eg; needles, scalpel, knives, blade,
broken glass etc.
4.Pharmaceutical waste Waste containing pharmaceuticals
that are expired or no longer needed,
items contaminated by or containing
pharmaceuticals (Box/Bottle)
Cont…
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12. CONT…
Waste category Description
5.Genotoxic waste Waste containing chemical agents
such as laboratory reagents, film
developer, disinfectants, drugs used in
chemotherapy, etc.
6.Wastes with heavy metal content Batteries, broken thermometres,blood
pressure gauges etc.
7.Pressurised containers
Gas cylinders, gas cartridges, aerosol
cans etc.
8.Radio active wastes Waste containing radioactive
substances.Eg;unused liquids from
radiotherapy or laboratory research.
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13. HOSPITAL WASTE MANAGEMENT STRATEGIES
1. Survey of waste generated
2. Reduction at source .
3. Segregation of hospital waste.
4. Collection & Categorization of waste.
5. Storage of waste.
6. Transportation of waste.
7. Treatment of waste.
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14. BIO-MEDICAL WASTE FLOW CHART
In House Segregation
(Collection, Segregation Packing
in Color Coded Poly Bags)
Common Storage Point
At
Hospitals
Transportation
(Approved Special Vehicle)
Unloading and Temp
Storage at CBWTF
Treatment
(Incineration, Autoclaving
and Shredding)
Disposal
( Recycling & Landfill)
Waste Water
to TP
Re Use
Generator
(HOSPITALS)

15. CATEGORIES OF BIOMEDICAL WASTE IN INDIA
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WASTE CATEGORY TYPE OF WASTE TREATMENT/DISPOSAL
Category no.1 Human Anatomical
Waste
Incineration/deep burial
Category no.2 Animal waste Incineration/deep burial
Category no.3 Microbiology and
biotechnology waste
Local autoclaving/
microwaving/
incineration
Category no.4 Waste sharps Disinfection/autoclaving/
microwaving
Category no.5 Discarded medicine and
cytotoxic drugs
Incineration/ destruction
and drugs disposal in
secured land fill
Cont…

16. CONT.… CATEGORIES OF BIOMEDICAL WASTE IN
INDIA
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WASTE CATEGORY TYPE OF WASTE TREATMENT/DISPOSAL
Category no.6 Solid waste
(Items contaminated with
blood fluids including
cotton, dressing, solid
plaster casts)
Incineration/autoclaving/
microwaving
Category no.7 Solid waste
(Wastes from disposable
items such as catheters,
tubing, IV sets)
Disinfection by chemical
treatment/autoclaving/
microwaving / shredding.
Category no.8 Liquid waste
(Wastes from laboratory,
washing, cleaning, house
keeping etc.)
Disinfection by chemical
treatment and discharge
into drainage systems.
Category no.9 Incineration ash Disposal in municipal
landfill
Category no.10 Chemical waste
(chemicals used in
disinfection/ as
insecticide
Chemical treatment and
discharge into drainage
for liquid and secured
landfill for solids.

17. COLOR CODING OF CONTAINER
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COLOR CODE TYPE OF
CONTAINER
WASTE
CATEGORY
TREATMENT
OPTIONS
Yellow Plastic bags 1, 2, 3 and 6 Incineration
Red Disinfected
container/plastic
bag
3, 6 & 7 Autoclaving/Micro
Waving/Chemical
treatment
Blue/white transparent Plastic
bags/puncture proof
container
4 & 7 Autoclaving/Micro
waving/chemical
treatment,
Destruction &
shredding
Black Plastic bag 5, & 9, and
10 (SOLID)
Disposal in secured
land fills

18. 19

19. 20
LABEL FOR BIO-MEDICAL WASTE
CONTAINERS/BAGS

20. COLLECTION, TRANSPORTATION, STORAGE
 Waste collected and stored in thick non-corrosive
disposable plastic bags or containers of specific colour
code.
 The waste in bags or containers should be stored in a
separate area, room, or building (not more than 48hrs)
of a size appropriate to the quantities of waste
produced and the frequency of collection.
 Health care waste should be transported within the
hospital or other facility by means of hand cart
wheeled trolley .
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21. COLLECTION, TRANSPORTATION,
STORAGE (WITHIN THE HOSPITAL)
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22. SAFE TRANSPORTATION IN A REGISTERED,
AUTHORIZED, BMW TRANSPORTERS
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23. BIO-SPILL KIT
 Container of undiluted household bleach
 Several pairs of gloves
 Safety glasses
 Absorbent material
 Bio hazardous waste (autoclave) bags
 Dust pan & scoop or tongs for broken glass
Place in a labeled bag or bucket and keep in areas where
biohazards are handled.

24. TREATMENT AND DISPOSAL TECHNOLOGIES
Incinerators
Chemical disinfection
Wet and dry thermal treatment
Deep burial or land filling
Recycling
Worm composting
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Newer Technologies
 Micro wave irradiation
 Plasma torch technology
 Gamma irradiation
 Hydroclave
 Pyrolator
 Electron beaming

25. INCINERATION
Burning the waste in simple kiln up to1000ºC
Organic and combustible waste is changed
to inorganic and incombustible and finally
to fly ash.
Ash is collected in thick puncture proof bags
and stored for periodic dump into
community landfill.
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26. TYPES OF INCINERATOR
 DOUBLE CHAMBER PYROLITIC
 SINGLE CHAMBER FURNACES
 ROTARY KILN
It involves
preparation(segregation)
Waste charging
Waste combustion
Treatment of emission through control
Handling of incineration ash. 27

27. DOUBLE CHAMBER PYROLITIC
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28. SINGLE CHAMBER FURNACES
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29. ROTARY KILN
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30. 31

31. CHEMICAL DISINFECTION
Destruction of most of pathogens from liquids.
By using chemical disinfectants such as
bleaching powder, glutaraldehyde, alcohols
or quaternary ammonium compounds.
Best for treating liquid wastes such as
blood,urine,stools or hospital sewage.
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32. 33

33. WET THERMAL TREATING(AUTOCLAVE)
The infectious wastes are steam
heated at specified temperature and
pressure for specific period of time.
Decontamination occurs when steam
penetrates the waste.
Autoclaves which functions within
specified range of temperature,
pressure etc is used. 34

34. 35

35. DRY THERMAL TREATMENT (SCREW FEED
TECHNOLOGY)
Waste is treated in a rotating auger.
Waste is reduced by 80% in volume and 20-
30% in weight.
Suitable for treating infectious wastes and
sharps.
Not used to process pathological,
cytotoxic, or radioactive waste. 36

36. DEEP BURIAL
Wastes belonging to category 1,3,6
collected in yellow containers are
disposed by this method.
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37. LAND FILLING
Land filling means disposal of residual solid wastes
on land in a facility designed with protective
measures against pollution of ground water,
surface water, air and ground.
Sanitary landfills are specially constructed for
disposal of nonbiodegradable infectious hospital
wastes.
It should have an impermeable clay and pebble
base.
Stored earth for covering at the end of each
disposal operation.
Frequent spray of insecticide is done.
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38. WORM COMPOSTING
Biodegradable general waste from areas like
kitchen, dining places, cafeteria which mostly
contain organic wastes, peelings of vegetables
etc collected in white containers with black
stripes are disposed off.
Rectangular pit of 1 m deep bound by brick
wall is built.
A few 100 earthworms are introduced to earth
bed on which waste is dumped and some
water sprinkled daily.
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39. MICROWAVING
•Heat is generated inside equipment
during bombardment of EM waves
into the retaining molecules of waste.
•Waste should have some water
content to enhance molecular
mobility.
•Highly efficient
•30-40% weight reduction.
•Minimal environmental pollution and
occupational risk.
•Cost effective.
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40. PLASMA TORCH TECHNOLOGY
It consists of a flame at about 2,200 to 13,900 °C
It takes various types of garbage and vaporizes
into 4th state of matter ,plasma (plasma pyrolysis).
It reduces thrash that otherwise would fill up
landfills.
It can dispose bio hazardous wastes safely.
It is extremely costly and needs a complex set up.
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41. HYDROCLAVE
An advanced autoclave method for treating
infectious waste, utilizing steam, but much faster
and with much heat penetration.
It is a double walled cylindrical vessel mounted
horizontally.
The vessel is fitted with a mixing arm that rotates
slowly inside vessel.
It totally sterilizes the waste.
complete dehydration of waste ,reduces volume
by 70%.
Very low operating cost.
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42. WASTE SHARP
 They are needles, syringes, scalpels, blades, broken glass
capable of causing injuries or introducing infection.
 Their segregation reduces the chances of injury.
 Final disposal is done by mutilation.
 Must be collected at the point of generation, in a leak-
proof and puncture-resistant container.
 Containers must bear the international biohazard
symbol and appropriate wording.
 Containers should never be completely filled, nor filled
above the full line indicated on box. 43

43. PLASTIC WASTE
 Plastics being non biodegradable remain in the soil for
more than 1000 yrs contaminating the soil and
surrounding water bodies.
 Collection and reuse of disposable plastics without
adequate treatment will result in spread of infections.
 Improper burning leads to release of toxic gases like
Sulphur dioxides, hydrochlorides etc which are potent
carcinogens.
cont….
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44. CONT…..
PLASTIC WASTE
Use of plastic should be minimized.
Plastics should be properly disinfected.
They are better managed by non
burning technologies.
Microwaves, autoclaves, hydroclaves,
chemical disinfection are most suited.
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45. Most of the waste produced during Ayurveda
treatments can be managed by the above
mentioned processes like incineration, land filling,
chemical disinfection etc.
Used oil is the main challenge for the disposal as
when they are disposed on soil or water resources
produces many adverse effects to the ecosystem.
 Used oils can be used as fuel in incinerators.
 They can be recycled by chemical processes like
bleaching. 46

46. CONCLUSION
 Refuse disposal cannot be solved without public education.
 Individual participation is required.
 Municipality and government should pay importance to
disposal of waste economically.
 Personal protective equipment (PPE) does not replace
procedures and techniques.
 Thus educating and motivating oneself first is important
and then preach others about it.
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