Bio medical waste management

Biomedical waste Management - by Dr.Sujatha Sathananthan

1. Bio Medical Waste Management Dr.S.Sujatha MD.,DPH., Assistant Professor, Department of Community Medicine Chengalpattu Medical College

2. Synopsis Definition Objective Health Hazard Classification Of Health Care Waste Sources Of Health Care Waste Bio Medical Waste (Management) Rules 2016 Categories And Colour Coding Methods Of Disposal 27 April 2018 2 Chengalpattu Medical College

3. Definition 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 thereto or in the production or testing of biological. Source- Bio-Medical Waste Management Rules, 2016 27 April 2018 3 Chengalpattu Medical College

4. Objectives To minimize the production/generation of infective waste. Recycle the waste after treating to the extent possible. Treat the waste by safe and environment friendly/acceptable methods. Adequate care in handling to prevent healthcare-associated infections. Safety precautions during handling the BMW. 27 April 2018 4 Chengalpattu Medical College

5. Health Hazards HIV/AIDS Hepatitis B and C Tuberculosis Diarrhoeal diseases Pneumonias Health Care Associated Infections 27 April 2018 5 Chengalpattu Medical College

6. Persons At Risk 27 April 2018 Chengalpattu Medical College

7. Label For Bio-medical Waste Containers/Bags Cytotoxic Hazard Symbol Handle With Care Note : Label shall be non-washable and prominently visible . Biohazard Symbol 27 April 2018 Chengalpattu Medical College

8. Health Care waste 27 April 2018 8 Chengalpattu Medical College

9. Sources of Health Care Waste Government hospitals Private hospitals Nursing homes Physician's office/clinics Dentist's office/clinics Dispensaries Primary health centres Medical research and training establishments Mortuaries Blood banks and collection centres Animal houses Slaughter houses Laboratories Research organizations Vaccinating centres Bio-technology institutions/production units 27 April 2018 Chengalpattu Medical College

10. Classification of Health Care Waste 1. Infectious waste :- Waste suspected to contain pathogens. E.g . laboratory cultures; waste from isolation wards; tissues (swabs), materials, or equipment's that have been in contact with infected patients . 2. Pathological waste :- Human tissues or fluids e.g. body parts ; blood and other body fluids, foetuses. 27 April 2018 10 Chengalpattu Medical College

11. Classification of Health Care Waste 3 . Sharps :- Sharp waste e.g. needles, infusion sets, scalpels, knives, blades, broken glass etc . 4. Pharmaceutical waste :- Waste containing pharmaceuticals. E.g. pharmaceuticals that are expired or no longer needed, items contaminated by or containing pharmaceuticals (bottles. boxes) 27 April 2018 11 Chengalpattu Medical College

12. Classification of Health Care Waste 5. Genotoxic waste :- Waste containing substances with genotoxic properties e.g. waste containing cytostatic drugs(often used in cancer therapy), genotoxic chemicals Chemical waste :- Waste containing chemical substances. e .g. laboratory reagents, film developer, disinfectants that are expired or no longer needed, solvents. 12 27 April 2018 Chengalpattu Medical College

13. Classification of Health Care Waste 7 . Wastes with high content of heavy metals :- E.g. Batteries, broken thermometers, blood-pressure gauges etc. 8 . Pressurized containers :- E.g Gas cylinders, gas cartridges , aerosol cans. 27 April 2018 13 Chengalpattu Medical College

14. Classification of Health Care Waste Radioactive waste :- Waste containing radioactive substances E.g. unused liquids from radiotherapy or laboratory research, contaminated glassware and packages . 27 April 2018 14 Chengalpattu Medical College

15. Bio Medical Waste (Management)Rules 2016 The MoE,F&CC has notified the new BMW (M) Rules, 2016 on 28 TH March 2016. Under the Environment (Protection) Act, 1986 Replaced the earlier Rules (1998) and the amendments thereof. 4 categories Yellow,Red,Blue and White 27 April 2018 15 Chengalpattu Medical College

16. Bio Medical Waste (Management)Rules 2016 No occupier shall establish on-site treatment and disposal facility, if a service of ` common BMW treatment facility is available at a distance of 75 km. Untreated waste shall not be stored beyond a period of forty – eight hours . Household generated BMW. T he onsite pretreatment of laboratory waste, microbiological waste, blood samples and blood bags as per the guidelines of WHO or NACO. 27 April 2018 16 Chengalpattu Medical College

17. Bio Medical Waste (Management)Rules 2016 Phase out use of chlorinated plastic bags, gloves and blood bags within two years from the date of notification of these rules All plastic bags shall be as per BIS standards (Bureau of Indian Standards). Immunise with Hepatitis B and Tetanus Vaccination to be certified & Documented Personal P rotective Equipments 27 April 2018 17 Chengalpattu Medical College

18. Category Biomedical waste Treatment/Disposal Yellow Human Anatomical waste Incineration / Plasma Pyrolysis /deep burial Animal waste Incineration/ Plasma Pyrolysis / deep burial Soiled Waste Incineration / Plasma Pyrolysis / deep burial Expired or Discarded Medicines Incineration at temperature >1200 C/ Plasma Pyrolysis Chemical Waste Disposed of by incineration or Plasma Pyrolysis or Encapsulation in hazardous waste treatment, storage and disposal facility. 27 April 2018 18 Chengalpattu Medical College

19. Category Biomedical waste Treatment/Disposal Yellow Chemical Liquid Waste. The chemical liquid waste shall be pre-treated before mixing with other wastewater. ETP (Effluent Treatment Plant) Discarded linen, mattresses, beddings contaminated with blood or body fluid. Non- chlorinated chemical disinfection followed by incineration or Plasma Pyrolysis or for energy recovery. Microbiology, Biotechnology and other clinical laboratory waste. Pre-treat to sterilize with non-chlorinated Chemicals:- Incineration 27 April 2018 Chengalpattu Medical College

20. Category Biomedical waste Treatment/Disposal Red Contaminated Waste (Recyclable) Tubing, bottles, intravenous tubes and sets, catheters, urine bags, syringes (without needles) Autoclaving or micro-waving Sent to registered or authorized recyclers or for energy recovery or plastics to diesel or fuel oil or for road making, whichever is possible. 27 April 2018 20 Chengalpattu Medical College

21. Category Biomedical waste Treatment/Disposal White Translucent Puncture proof, Leak proof, tamper proof containers. Waste sharps including Metals. Autoclaving or Dry Heat Sterilization Shredding 27 April 2018 Chengalpattu Medical College

22. Safe Handling of Sharps Wear Gloves Needles should never be recapped Use needle hub cutter Syringe hub should be cut and disposed in red plastic bin Needle stick injuries to be reported, Documented, if needed Post Exposure Prophylaxis (PEP) to be taken 27 April 2018 22 Chengalpattu Medical College

23. aa…………………… HUB CUTTER 27 April 2018 23 Chengalpattu Medical College

24. Category Biomedical waste Treatment/Disposal Blue Cardboard boxes with blue colored marking Glassware Disinfection / autoclaving or Microwaving Recycling. Metallic Body Implants 27 April 2018 Chengalpattu Medical College

25. Remember.. Expired / Cytotoxic /Discarded- un opened vials- Yellow Broken/ Discarded-(other than cytotoxic waste) opened vial- Blue 27 April 2018 25 Chengalpattu Medical College

26. Bags once tied should not be re-opened 27 April 2018 26 Chengalpattu Medical College

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29. Trolley 27 April 2018 29 Chengalpattu Medical College

30. Bio Medical Waste Weighing and Documentation 27 April 2018 30 Chengalpattu Medical College

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32. Common Storage Area Safe ventilated, secure location No secondary handling No scattering or spillage by animals Impermeable layers Easy washable Defined road Colour painting to each category . 27 April 2018 32 Chengalpattu Medical College

33. Monitoring and Record Maintenance for Bio Medical Waste Five types of Register 1. Register for Daily Collection at Source 2. Register for source wise collection for the day 3. Monthly consolidated Register 4. Register for needle stick injuries 5. Plastic infusion bottle/cans register 27 April 2018 33 Chengalpattu Medical College

34. Blood Spills Ensure that the gloves are used before Handling. Cover the spill with absorbent cotton or cloth. Discard this cloth in to the yellow bin. Disinfect the surface with 1% Sodium Hypochlorite Solution / 5 % Phenol for 30 minutes. Cover the disinfectant area with absorbent cotton or cloth. Discard this cloth in to the yellow bin Finally, use the normal mop . 27 April 2018 34 Chengalpattu Medical College

35. Mercury Spills Open all the windows immediately. All the heaters and air conditioners should be switched off. Vaccum cleaner and Broom should not be used Remove all the jewels and watches. Ensure that the gloves, safety goggles, N 95 mask are fitted on, before handling. 27 April 2018 35 Chengalpattu Medical College

36. Mercury Spills Spilled mercury should be collected with the cardboard and sucked with the syringes or use mercury spill kit. Empty the syringes with mercury in a container with water. It should be labelled as mercury waste and stored in a Separate place in Stores. All the mercury spill surfaces should be decontaminated with 10 % sodium- thiosulfate solution 27 April 2018 36 Chengalpattu Medical College

37. Sputum Cups Ensure that the gloves are fitted on before Handling. Remove the lid from the sputum cups. Place the sputum cup with its lid opened into a container which contains 5% Phenol Solution or Phenolic compound diluted to 5% and keep it for 12 hours. The cups and lid should be fully immersed in solution. After 12 hours lift the disinfected sputum cups from the container and transit to Red bins intended for plastic waste. Solution is drained into the collection system. 27 April 2018 37 Chengalpattu Medical College

38. Summary 4 categories Segregate the waste. Use personal protection device while handling the waste. Ensure Universal Health Precautions Training and immunization of health care workers. 27 April 2018 Chengalpattu Medical College

39. LET THE WASTES OF “ THE SICK” NOT CONTAMINATE THE LIVES OF “ THE HEALTHY”……. 27 April 2018 39 Chengalpattu Medical College