Bio Medical Waste Management

Describes the segregation, storage and transportation of Bio Medical Waste in hospitals

1. Biomedical Waste Management
(Segregation, Storage and Transportation)Dr. Latha Venkatesan
Principal
Apollo college of Nursing
Chennai
Dr. Latha Venkatesan
Principal
Apollo college of Nursing
Chennai

2. Hospital Waste Or Biomedical Waste
Any waste generated during health care, diagnosis,
treatment, Immunization, research, testing or related
procedures on Human beings or animals conducted in
hospitals, clinics, Laboratories or similar establishments
Dr.Latha Venkatesan

3. Bio medical waste consists of
•Human anatomical waste like tissues, organs and body
parts
•Animal wastes generated during research from
veterinary hospitals
•Microbiology and biotechnology wastes
•Waste sharps like hypodermic needles, syringes,
scalpels and broken glass
•Discarded medicines and cytotoxic drugs
•Soiled waste such as dressing, bandages, plaster casts,
material contaminated with blood, tubes and catheters
•Liquid waste from any of the infected areas
•Incineration ash and other chemical wastes
Dr.Latha Venkatesan

4. What is the quantum of waste that is
generated by a hospital?
•The quantum of waste that is generated in India
is estimated to be 1-2 kg per bed per day in a
hospital and 600 gm per day per bed in a
general practitioner’s clinic. e.g. a 100 bedded
hospital will generate 100 – 200 kgs of hospital
waste/day.
•It is estimated that only 5 – 10% of this
comprises of hazardous/infectious waste (5 –
10kgs/day)
Dr.Latha Venkatesan

5. Waste generated in the hospital
Dr.Latha Venkatesan
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Biomedical waste (15 – 20%)
 Infectious waste – 15%
 Non infectious but hazardous – 5%

6. Dr.Latha Venkatesan

7. Hospital waste management programme
•Identification of waste types
•Segregation of waste
•Transport & storage of waste
•Proper disposal of waste
•Implementation of contingency plans
•Identify the need for use of personal
protective equipment
Dr.Latha Venkatesan

8. Segregation
•Segregation refers to the basic separation of different
categories of waste generated at source and thereby
reducing the risks as well as cost of handling and
disposal.
• Segregation is the most crucial step in bio-medical
waste management.
•Effective segregation alone can ensure effective bio-
medical waste management.
•The BMWs must be segregated in accordance to
guidelines laid down under schedule 1 of BMW Rules,
2016.
Dr.Latha Venkatesan

9. Identify the suitable bins to dispose
these wastes
Dr.Latha Venkatesan

10. Benefits of segregation
•Segregation reduces the amount of waste needs special
handling and treatment
•Effective segregation process prevents the mixture of
medical waste like sharps with the general municipal
waste.
•Prevents illegally reuse of certain components of medical
waste like used syringes, needles and other plastics.
•Provides an opportunity for recycling certain components
of medical waste like plastics after proper and thorough
disinfection.
Dr.Latha Venkatesan

11. •Recycled plastic material can be used for non-food
grade applications.
•Of the general waste, the biodegradable waste can be
composted within the hospital premises and can be used
for gardening purposes.
•Recycling is a good environmental practice, which can
also double as a revenue generating activity.
•Reduces the cost of treatment and disposal (80 per cent
of a hospital’s waste is general waste, which does not
require special treatment, provided it is not contaminated
with other infectious waste.
Dr.Latha Venkatesan

12. Dr.Latha Venkatesan

13. Major differences between
BMW Rules – 1998 & 2016
Dr.Latha Venkatesan

14. Dr.Latha Venkatesan

15. Dr.Latha Venkatesan

16. Categories Of Bio Medical Waste (India)
Dr.Latha Venkatesan

17. Segregation of Waste
Segregation should happen at source, with proper segregation
protocols to
–Reduce the risk of infecting workers
–Reduce costs of treatment of waste
–Reduce the risk of infecting the community at large
–Recycle waste that is non-infectious
Dr.Latha Venkatesan

18. How to Segregate ?
•The type, placement and size of the container is usually
ascertained on the waste stream in that area
•Bins should be of the same color as for segregation
•All bins must be lined with bags of same colour and
must also have the Biohazard symbol
Dr.Latha Venkatesan

19. Handling infectious waste
•Minimum handling
•Segregation should be done at source
•Transfer and repeated handling should be avoided
•Infectious waste should never be mixed with non-
infectious waste
•All bags having international bio-hazard symbol should
be tied securely and labelled
Dr.Latha Venkatesan

20. Handling waste
•When to change or remove bag from the bin
- Bags must be replaced when three fourth full or twice
a day
- In case of theatre, it may be good to replace the bag
after every procedure
- The bag must be securely tied and labelled
•Do not mix any infectious waste with non-
infectious waste
Dr.Latha Venkatesan

21. Dr.Latha Venkatesan

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1)Yellow cover in
yellow bin
2)Red cover in red bin
3)White puncture
proof container
4)Card board box
with blue marking
Dr.Latha Venkatesan

23. Yellow – Soiled Waste, Tissues, Microbiology and Laboratory Waste,
Cytotoxic Drugs
Dr.Latha Venkatesan

24. Dr.Latha Venkatesan
Red – Gloves, Plastic tubing, Catheters, bags, IV fluid bottles,
syringes, vacutainers

25. Cardboard box with blue marking
Dr.Latha Venkatesan
Glass bottles
Vials
Ampoules
Metallic implants
Blue
marking

26. Puncture Proof Container - Sharps
Dr.Latha Venkatesan

27. Handling sharps
•Sharps are generated in almost all departments
–Theatres, labs, injection rooms, wards…etc
•Cause cut or puncture
•Most injuries occur between the point of use and disposal
•Segregate sharps from rest of the waste at the point of
generation
•Clipping, bending, recapping or breaking of needles must
not be practiced
Dr.Latha Venkatesan

28. DO’S
•Do minimize use of injections
•Do segregate infectious sharps waste
•Do collect in a white transparent container
•Do train & educate all categories of staff in proper
segregation & handling of waste
•Do use hub cutters & needle destroyers
•Do use authorized persons/agencies to handle/dispose
the needles
Dr.Latha Venkatesan
Handling sharps

29. Do nots
•Don’t throw sharps in the trash/ non puncture proof
containers
•Don’t recap the needle
•Don’t disconnect the needle from syringe by hand
•Don’t use open buckets for infectious waste /sharps
Dr.Latha Venkatesan
Handling sharps

30. Needle Puller Hub cutter
Point of use DevicesPoint of use Devices
Needle Pullers & Hub CutterNeedle Pullers & Hub Cutter
Dr.Latha Venkatesan

31. Portable
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Current industry standard is
1 quart flat top….
Visibility, with clear high top… Helps
prevent overfill, helps user identify
hazards.
Functionality, with easy to use temporary
closure for security between uses.
Accommodation, with handle for safe
transport of filled collector……added
volume & height accommodates larger,
bulkier safety needle devices.

32. Dr.Latha Venkatesan

33. Liquid waste
Liquid waste should be treated with 1% sodium
hypochlorite for 30 minutes and
Should be flushed in to the sewer which goes to the
effluent treatment system (ETP)
Dr.Latha Venkatesan

34. Major Considerations
Dr.Latha Venkatesan
Generation
Monitoring &
Record
Maintenance
Storage
Segregation
Treatment & Disposal
Transportation

35. Collection of BMW
•The collection of biomedical waste involves use
of different types of container from various
sources of biomedical wastes like Operation
Theatre, laboratory, wards, kitchen, corridor etc.
The containers/ bins should be placed in such a
way that 100 % collection is achieved.
• Sharps must always be kept in puncture-proof
containers to avoid injuries and infection to the
workers handling them.
Dr.Latha Venkatesan

36. Transportation within the hospital
•Containers: puncture proof, leak proof,
•Bags: sturdy, properly tied
•Transport trolleys: designated & timely
•Staff protection: provided with protective clothing and
other items
•Never put hands in a bag. Manual loading should be
avoided as far as for as possible.
•Before transporting the bag containing BMWs, it should
be accompanied with a signed document by Nurse/
Doctor mentioning date, shift, quantity and destination.
Dr.Latha Venkatesan

37. BMW waste collection & Transport

38. Dr.Latha Venkatesan

39. Dr.Latha Venkatesan

40. Waste storage
•Closed covered area
•Away from the normal passages
•Easily accessible for transportation
•Radioactive waste special containers/
special treatment and disposal
Dr.Latha Venkatesan

41. Dr.Latha Venkatesan
Storage
•Once collection occurs then biomedical waste is stored in a proper place.
•Segregated wastes of different categories need to be collected in
identifiable containers.
•The duration of storage should not exceed for 8-10 hrs in big hospitals
(more than 250 bedded) and 24 hrs in nursing homes.
•Each container may be clearly labelled to show the ward or room where it
is kept. The reason for this labelling is that it may be necessary to trace the
waste back to its source.
•Besides this, storage area should be marked with a caution sign.

42. Dr.Latha Venkatesan
Transportation from hospital to treatment
facility
Special vehicles must be used so as to prevent access to,
and direct contact with, the waste by the transportation
operators, the scavengers and the public.
The transport containers should be properly enclosed.
The effects of traffic accidents should be considered in the
design, and the driver must be trained in the procedures he
must follow in case of an accidental spillage.
It should also be possible to wash the interior of the
containers thoroughly.

43. Dr.Latha Venkatesan

44. Transportation
Dr.Latha Venkatesan

45. Contd…
Dr.Latha Venkatesan

46. Dr.Latha Venkatesan

47. Personal protective equipments
Dr.Latha Venkatesan

48. Shadowing
•From hospital to treatment facility
•To monitor over loading, spillage and
diversification of BMW.
Dr.Latha Venkatesan

49. FAQ
•Should we use the same colour code for bins or can we
choose?
•Each bed should have bins or common in wards?
•The bin and liner should be same colour or bin alone is
enough?
•What should be the size of the bin?
•Washing of bins
•How long we can store the BMW in wards/in central
storage area? Who will check appropriate disposal?
•Diversification during tranportation
Dr.Latha Venkatesan

50. Proper Disposal Of
Hospital Waste –
Every One’s Responsibility
Dr.Latha Venkatesan

51. Dr.Latha Venkatesan

52. Dr.Latha Venkatesan

53. Hands that heal should never harm nor get
harmed