Bio medical waste management

Bio-Medical Waste Management for II year MBBS CBME students

1. Bio-Medical Waste Management/ hospital waste management Dr V S Vatkar Associate Professor Microbiology Department D Y Patil Medical College, Kolhapur

2. Definition According to Biomedical Waste Rule, 2016 of India BIOMEDICAL WASTE is defined as : wastes generated during the laboratory diagnosis, treatment or immunization of humans or animals or Research activities or in the production of biologicals . Quantity of solid waste generated in hospitals varies from ½ kg to 2 kg/bed in government hospitals, private hospitals or nursing homes

3. Waste generated in hospitals General waste (80%): majority of waste falls in this category and can be disposed with usual domestic & urban management system. Pathological & Infectious waste (15%): produce maximum hazards. Pathogens present In infectious waste cause infections in health care workers through inhalation, ingestion or direct skin contact. Chemical or Pharmaceutical waste (3%): chemicals e g Disinfectants & pharmaceutical wastes : TOXIC, GENOTOXIC, CORROSIVE, INFLAMMABLE, EXPLOSIVE or SHOCK Sensitive

4. Sharp waste(1%): needle stick & other sharps, capable of transmitting blood borne infections like HIV, HBV, HCV etc. Less than 1% waste: cytotoxic drugs, radioactive waste, broken thermometers & used batteries.

5. Biomedical waste: Global issue today: creating pollution of environment Dreaded effects on human health: infectious material waste generated from the hospitals can spread infections in the community Low awareness about the rules of bio-medical waste

6. Population at risk Health care providers i.e. Doctors, hospital workers Lab. Workers Morticians Waste handlers Laundry workers GENERAL POPULATION

7. Hazards due to Hosp. waste Environmental hazards like : Toxic emissions – carbon, sulphur , dioxins, etc Defective incineration: improper waste residues which contaminate the soil and water Spread of antibiotic resistance

8. Most laboratory acquired infections : HIV, HBV, Brucella spp , Mycobacterium tuberculosis, Bacillus anthracis , Shigella spp , Francisella tularensis etc

9. Categories of biomedical waste According to new rule in 2016 : eight categories Older one (1998): ten categories Category I: Human Anatomical waste Category II: Animal waste Category III: Microbiological & biotechnology & other laboratory waste Category IV: Sharps like needles, scalpel etc Category V: Discarded medicines & cytotoxic drugs Category VI: Soiled waste Category VII: Infectious solid waste Category VIII: Chemical waste

10. Bio-medical waste and technology Technology is only a fraction of the solution. Major components of waste management are: Segregation of waste Waste minimization Reducing use of hazardous substances or processes Waste Audit

11. Black bags White bags Yellow bags Blue bags Red bags

12. Transport of BMW

13. Biomedical waste management

14. incineration Method of choice for disposal of biomedical waste High temperature dry oxidation process : reduces organic & combustible waste to non-organic & non-combustible matter Significant reduction of waste volume & weight

15. Waste that cannot be reduced, recycled or disposed off in a landfill site Eg a) human & animal anatomical waste b) microbiological waste c) solid non-plastic waste Incineration : not be done for pressurized gas containers Reactive chemicals Halogenated plastic (PVC) Heavy metal waste: mercury, silver salts, radiographic waste, broken thermometers

16. Incineration

17. autoclave Steam comes in direct contact with the waste in a controlled manner for sufficient time (steam under pressure : condensation of steam to release LATENT heat) Easy & safe to operate Microbiological waste : preferable method for treatment

18. Autoclave: 2 types are used : Gravity autoclave Prevaccum autoclave

19. Chemical disinfectants Sodium hypochlorite (1-2%): added to waste to kill or inactivate pathogens More suitable for liquid waste: blood, urine, stool & hospital sewage Solid waste: microbiological cultures, sharps etc

20. shredder Plastic waste like used syringes are cut into small pieces. Helps to prevent reuse of biomedical waste. This waste is disinfected and safe to dispose off

21. Plastic waste

22. Hydroclaving - An expanded technology of autoclaving: steam does not come in direct contact with waste. volume reduction of waste much more than autoclaving All items including pathological waste is treated with this method Time 1hr

23. Hydroclaving machine

24. Plasma torch Very costly High temperature is used 2200-13,900 o C Adv.is that there is no need of waste segregation

25. Plasma torch

26. microwaving Microbial inactivation : thermal effect of electromagnetic radiation Radiation spectrum: 300 and 30,000 MHz Intermolecular heating process Heating takes place inside the waste material in presence of steam

27. Waste disposal It includes 3 techniques : . Land filling . Deep burial . Sewage

28. Land filling Deep burial Sewage treatment

29. encapsulation Filling the containers with waste, adding immobilizing material in it & seal the container Cubic boxes made up of metal : three quarters filled with sharps or chemicals or pharmaceutical waste then filled with material such as plastic foam, cement mortar or clay material

30. Metallic drums

31. inertization Mixing of waste with cement and substances before disposal to minimize the risk of contamination of ground water or surfaces with toxic substances present in waste

32. Legal aspects The important legislations and policy documents about hospital waste disposal : Hazardous waste rules ,1989 BMW rules, 1998,Govt.of India, Ministry of Environments and forests, New Delhi, 20 july,1998 notification .

33. Biomedical waste rule 2016 No overlapping between categories and colour code bags Upgrade the incinerator with two chambers Cytotoxic drugs : collected in yellow bags, previously they were collected in black bags Use of bar codes: implement within two years Newer methods for disposal like encapsulation, inertization, plasma torch etc Disposing facility: if outsourced should be available within 75 Km Recycling biomedical waste.

34. THANK YOU