Bio medical waste

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1. Bio-Medical Waste Management By : Dr. DEEPAK KUMAR

2. Let the waste of the “sick” not contaminate the lives of “The Healthy”

3. WASTES ?????????? Wastes Solid waste Household waste Industrial waste Biomed.waste or hospital waste Liquid Waste Gaseous Waste Waste is any substance which is discarded after primary use, or it is worthless, defective and of no use.

4. What is bio-medical waste ???? On 20 th July 1998 Exercising powers : section 6,8,25 of environmental protection act 1986 which runs under Ministry of Environment and Forests ( MoEF ), Govt. of India, Framed a rule known as ‘Bio-medical Waste (Management and Handling) Rules, 1998 ,’ According to this rule ‘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 of testing of biological”

5. Biomedical waste Statistics Developed Countries- 1-5 kg/bed/day, with variations among countries. In India- (Bangalore) ½-4 kg/bed/day in Govt . Hospitals ½-2 kg/bed/day in private Hospitals ½-1 kg/bed/day in Nursing Homes Approximately 40 tons/ day wastes generated Out of which only 30% waste undergoes proper disposal . (by national environmental engineer research institute 1997)

6. Categories of Bio-Medical Wastes

7. Categories Of biomedical Wastes in India WASTE CATEGORY TYPE OF WASTE Category No. 1 Human Anatomical Waste (Human tissues, organs ,body parts) Category No. 2 Animal Waste (Animals tissues, organs, fluids, blood ) Category No. 3 Microbiology & Biotechnology Waste( Laboratory cultures, micro-organisms, human and animal cell cultures, toxins) Category No. 4 Waste Sharp(needles , syringes, scalpels, broken glass, etc ) Category No. 5 Discarded Medicine and Cytotoxic drugs(outdated ,contaminated & discarded medicines)

8. cont … Category No. 6 Soiled Waste(contaminated with blood & fluids ,including cotton, dressing, plaster etc) Category No. 7 Solid Waste(except sharp)tubings,catheter,iv sets etc) Category No. 8 Liquid Waste( from lab,washing,cleaning,house keeping and disinfection ) Category No. 9 Incineration Ash(ash from incineration of bmw ) Category No.10 Chemical Waste(chemical used in disinfection,as insecticide,etc )

9. The exposure to hazardous health care waste can result in Infection Geno toxicity and Cytotoxicity   Chemical toxicity   Radioactivity hazards.  Public sensitivity.

10. Infection The infectious agents enter in he body through Puncture, Abrasion, Cut in the skin; Through mucous membranes; By inhalation and ingestion.

11. Most Common Infections 1. Gastro enteric through faeces and/or vomit e.g. Salmonella, Vibrio Cholera, Helminthes Hepatitis A 2. Respiratory through inhaled secretions e.g. Mycobacterium tuberculosis; measles virus; streptococcus pneumonae 3.Ocular infections through eye secretions e.g. Herpes virus , 4 . Skin infection through pus e.g. Streptococcus spp , 5 . Meningitis through Cerebrospinal fluid e.g. neisseria meningitides ,

12. 6 . Blood borne diseases AIDS Septicaemia and  bacteraemia Viral Hepatitis B & C 7 . Hemorrhagic fevers through body fluids Ebola

13. Genotoxicity and Cytotoxicity Irritant to skin and eyes E.g. alkylating agent, intercalating agent Carcinogenic and Mutagenic e.g . Secondary neoplasia due to chemotherapy Chemical Toxicity Many drugs are hazardous May cause intoxication , burns, poisoning on exposure

14. Radioactivity Hazards Radioactive waste exposure may cause headache, dizziness, vomiting, genotoxicity and tissue damage Public sensitivity Visual impact of the anatomical waste, recognizable body parts

15. Schedules under bmw (handling rule)1998 1- Categories Of BMW, Treatment & Disposal 2- Color Coding & Type Of Container 3- Label For BMW Container 4- Label For Transport Of BMW Container 5- Standers For Treatment & Disposal

16. Treatment and disposal technologies for healthcare waste Category Waste Type Treatment and Disposal Method Category 1 Human Wastes (Tissues, organs, body parts Incineration £ / deep burial Category 2 Animal Waste Incineration £/ deep burial Category 3 Microbiology and Biotechnology waste Autoclave/microwave/incineration £ Category 4 Sharps Disinfection (chemical treatment)@+/autoclaving/microwaving and mutilation shredding Category 5 Discarded Medicines and Cytotoxic Drugs Incineration@/ destruction and drugs disposal in secured landfills

17. Cont.. Category Waste Type Treatment and Disposal Method Category 6 Contaminated solid waste Incineration@/autoclaving / microwaving Category 7 Solid waste (disposable items other than sharps) Disinfection by chemical treatment@@ microwaving/autoclaving & mutilation shredding ## Category 8 Liquid waste (generated from laboratory washing, cleaning, housekeeping and disinfecting activity) Disinfection by chemical treatment@@ and discharge into the drains Category 9 Incineration ash Disposal in secured landfill Category10 Chemical Wastes Chemical Treatment@@ and discharge in to drain for liquids and secured landfill for solids

18. @@Chemical Treatment Using At Least 1% Hcl Solution Or Any Other Equipment Chemical Reagent.It Must Be Ensures Dis Infection. ## Mutilation/Shredding Must Be Such So As To Prevent Unauthorized Reuse. @ There Will Be No Chemical Pre-treatment Before Incineration.Chlorinated Plastic Shall Not Be Incinerated. £ Deep Burial Shall Be An Option Available Only In Towns With Population Less Than 5 Lakhs And In Rural Areas.

19. COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF BIOMEDICAL WASTES COLOUR CODING TYPE OF CONTAINER WASTE CATEGORY TREATMENT OPTIONS as per Schedule I Yellow Plastic Bag Cat.. 1, 2, 3 and 6 Incineration / deep burial Red Disinfected container / Plastic Bag Cat. 3, 6, and 7 Autoclaving / Microwaving / Chemical Treatment Blue / White Translucent Plastic Bag / puncture proof container Cat. 4, Cat. 7 Autoclaving / Microwaving / Chemical treatment and destruction shredding Black Plastic Bag Cat. 5, 9 and 10 (Solid) Disposal in secured landfill

20. 1.COLOUR CODING OF WASTE CATAGORIES WITH MULTIPLE TREATMENT OPTIONS AS DEFINED IN SCHEDULE ,SHALL BE SELECTED DEPENDING ON THE TREATMENT OPTION CHOSEN,WHICH SHALL BE AS SPECIFIED IN SCHEDULE I. 2.WASTE COLLECTION BAGS FOR WASTE TYPES NEEDING INCINERATION SHALL NOT BE MADE OF CHLORINATED PLASTICS. 3.CATAGORIES 8 & 10(LIQUID) DO NOT REQUIRE CONTAINER/BAGS. 4.CATAGORY 3 IF DISINFECTED LOCALLY NEED NOT BE IN CONTAINER/BAGS.

21. 8/31/2015 23 Needle Destroyer

22. Incineration Incineration Is A High Temperature Dry Oxidation Process,that Reduces Organic And Combustible Waste To In Organic Incombustible Matter And Results In A Very Significant Reduction Of Waste-volume And Weight.The Process Is Usually Selected O Treat Wastes That Cannot Be Recycled,reused Or Disposed Off In A Land Fill Site. Type Of Incinerators: Double-chamber Pyrolytic Sinlgle -chamber Pyrolytic Rotatry Kilns Tempeture In Incinerator: Primary Chamber: 800ºc ± 50ºc Secondary Chamber: 1050ºc ± 50ºc

23. General Schematic

24. Wastes Storage Pre-processing/blending Incineration Flue Gas Pollution Control Ash Stabilization Landfill Effluent POTW

25. CHARACTERISTIC OF WASTES SUITABLE FOR INCINERATION ; LOW HEATING VOLUME COMBUSTIBLE MATTER >60% NON-COMBUSTIBLE SOLIDS <5% NON-COMBUSTIBLE FINES <20% MOISTURE CONTENTENT <30% WASTE TYPES NOT TO BE INCINERRATED PRESURIZED GAS CONTAINERS REACTIVE CHEMICAL WASTES SILVER/RADIOGRAPHIC/PHOTOGRAPHIC WASTE HALOGENATED PLASTICS(PVC) WASTES WITH HIGH MURCURY/CADMIUM CONTENT

26. Chemical process Disinfectants: A Disinfectant Is A Chemical Agent, which Destroys Or Inhibits Growth Of Pathogenic Micro-organism In The Non- sporing Or Vegetative State. Disinfectants Are Applied To Inanimate Objects & Material Such As Instruments And Surfaces To Control And Prevent Infection. Antiseptics: An Antiseptic Is A Type Of Disinfectant, which Destroys Or Inhibits Growth Of Micro-organisms On Living Tissues Without Causing Injurious Effects When Applied To Surface Of Body Or To Expose Tissues.

27. Wet and dry THERMAL PROCESS HEAT DISINFECTION : Boiling For 20 Min Useful For Pre Treatment Of Sharps & Plastic Waste HOT AIR OVEN : Causes Sterilization & Mutilation At 160 ºc Used For Glassware And Powders AUTOCLAVE : Steam Sterilization Under Pressure Is A Low Heat Thermal Process Waste is subjected to 121 ºC or 135 ºC

28. HYDROCLAVE : Steam –Sterilization Under Pressure Causes Fragmentation Of Wastes Waste Is Subjected To 121 ºc Or 132 ºc MICROWAVE : Volumetric Heating For Microbial Hazardous Waste Using Frequency Of 2450 MHz And Wavelength 112.24nm Waste Destruction Occurs By Heat Conduction PLASMA ARC : Ionized Gas At High Temperature Causes Gasification And Molecular Dissociation Of Organic Wastes Waste Is Subjected To 2000 ºc

29. Land disposal Compacting : reducing size and volume of waste (useful for genral non hazardous waste) Shredding: breaking the material into smaller pieces by grinding /cutting/granulation Landfill: oldest method of waste disposal Encapsulation :filling containers with waste adding an immobilizing material (plastic foam/ bituminous sand/cement mortar/clay material) and sealing containers

30. inertization Process: Mixing Biomedical Waste With Cement & Other Substance Before Disposal,so As To Minimise Risk Of Toxic Substances Contained In Waste To Contaminate Ground/Surface Water. Inertization Is Especially Suitable For Pharmaceuticals & For Incineration Ashes With High Metal Constant. A Typical Compoition Of Mixture Is: 65% Pharmaceutical Waste 15% Lime 15% Cement 5% Water

31. Conclusion Thus refuse disposal cannot be solved without public education. Individual participation is required. Municipality and government should pay importance to disposal of waste economically. Thus educating and motivating oneself first is important and then preach others about it.

32. बीमारियों को आस पास न पाले कूड़ा कचरा कूड़ेदान में हीं डाले।