Bio-Medical Waste Management 2016

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1. Bio-Medical Waste
Management
Dr. Shubhangi Kshirsagar
Assistant professor
Department of Swasthavritta & Yoga

2. Bio-Medical Waste Management
Rules, 2016
Firstpublishedin1998.
Revisionsin2011and2016(March)
FocusisonCollection,Segregation,
Transport,Processing,Treatmentand
DisposalinEnvironmentallysound
manner.
2Dr. Shubhangi Kshirsagar

3. Definition
1.AccordingtoBio-MedicalWaste(Managementand
handling)Rules,1998ofIndia,"Bio-medicalwaste"
meansanywaste,whichisgeneratedduring-
Diagnosisor
Treatmentor
Immunizationofhuman-beingsoranimalsor
Researchactivitiesor
intheproductionor
Testingofbiologicalor
Healthcamps
includingthecategoriesmentionedinSchedule1.
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4. BMW Rules1998 BMW Rules2016
Occupier withmore than
1000beds required to obtain
authorization
Every occupiergenerating
BMW, including health camps ,
AYUSH requires to obtain
authorization.
Operator duties are absentDuties of operatorare listed
BMW is divided in 10
categories
BMW is divided in 4
categories
Rules restricted to more than
1000 beds.
Treatment and disposal of
BMW made mandatoryfor all.
No format for annual report Format for annual report
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5. Between 75 to 90 per cent of the waste
produced by the health-care providers is
non-risk or "general" health-care waste,
comparable to domestic waste
Remaining 10-25 % health care waste –
hazardous & may create variety of
health risk
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6. Sources of hospital care waste
Hospitals
Nursing Homes
Clinics
Dispensaries
PHCs
Mortuaries
Slaughter houses
Animal Houses
Pathological Laboratories
Medical Research or
Educational Institutions
Health Camps Medical
or Surgical Camps
Vaccination Centres
Research organizations
Biotechnology
institutions
Blood Banks
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7. Types of waste
1.Humananatomicalwaste-humantissues,organs,
bodyparts,foetusbelowtheviability
2.Animalwaste-animaltissues,organs,bodyparts,
carcasses,bleedingparts,fluids,bloodandexperimental
animalsusedinresearch,wastegeneratedbyveterinary
hospitalscolleges,dischargefromhospital,animalhouse.
3.Soiledwaste-Itemscontaminatedwithbloodandfluids
includingcotton,dressings,soiledplastercasts,linen,
beddings,othermaterialcontaminatedwithblood
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8. 4.Discardedmedicinesorexpiredmedicine–
pharmaceuticalwastelikeantibiotics,cytotoxicdrugsetc.
5.Chemicalwaste-Chemicalsusedinproductionof
biologicalandusedordiscardeddisinfection.
6.Chemicalliquidwaste-wastegeneratedduetouseof
chemicalsinproductionofbiologicalandusedordiscarded
disinfectant,liquidfromlaboratoryandfloorwashing,
cleaning,house-keepinganddisinfectingactivities
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9. 7.Discardedlinen,mattresses,beddingscontaminated
withbloodorbodyfluids.
8.Microbiologyandbiotechnologywaste-wastefrom
laboratorycultures,stocksorspecimensofmicro-
organisms,vaccines,humanandanimalsusedincell
cultures.
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10. 9.Contaminatedwastes(Recyclable)–waste
generatedfromdisposableitemsex.Tubing,
bottles,intravenoustubesandsets,catheters,
urinebags,gloves.
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11. 10.Wastesharpsincludingmetals-needles,
syringes,scalpels,blades,glass,etc.,thatmaycause
punctureandcuts.(usedandunusedsharps)
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12. 11.a.Glassware–brokenordiscardedand
contaminatedglassincludingmedicinevials
andampoulesexceptthosecontaminated
withcytotoxicdrugs.
b.Metallicbodyimplants
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13. Health hazards of biomedical waste
Exposuretohazardoushealth-carewastecan
resultindiseaseorinjury,because–
•Itcontainstoxicorhazardouschemicalsor
pharmaceuticals
•Itcontainssharps
•Itisgenotoxic
•Itisradioactive
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14. The main groups at risk are –
•Medical doctors
•Nurses
•Health-care auxiliaries
•Hospital maintenance personnel
•Patients in health-care establishments
•Visitors to health-care establishments
•Workers
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15. Hazards of health care waste
1.HazardsfromInfectiouswaste&Sharps
Pathogensfrominfectiouswasteenterhumanbody
throughpuncture,cutorabrasion;throughmucus
membranebyinhalationorbyingestion.
ex.HIV,HepatitisB&C
2.Hazardsfromradio-activewaste
Itcanberangesfromheadache,dizziness&vomiting
tomuchmoreseriousproblems.
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16. 3.HazardsfromChemicalandpharmaceuticalWaste
Theyaretoxic,genotoxic,corrosive,flammable,
reactive,explosive,shocksensitive.
Althoughpresentinsmallquantity,theymay
causeintoxication,eitherbyacuteorchronic
exposure,andinjuries,includingburns
Ex.Disinfectant–usedinlargequantities.
4.Publicsensitivity
Sensitivetovisualimpact(particularlyanatomical
waste)
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17. Treatment & Disposal
Methods for Health
Care waste
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18. Treatment & Disposal methods for
health care waste
1.Incineration
2.Chemical disinfection
3.Wet and dry thermal treatment
4.Microwave irradiation
5.Land disposal
a. Open dump
b. Sanitary landfill
6. Inertization
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19. 1. Incineration
Hightempdryoxidationprocess
Reducesorganic&combustiblewasteto
inorganicincombustiblematter.
Significantreductioninweight&volume
Selectedforthosewastewhichcannotbe
recycled,reusedordisposedoffinlandsite.
Noneedofpre-treatment
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20. Characteristic of waste suitable for
Incineration
Lowheatingvolume
Above2000kcal/kgforsinglechamber
Above3000kcal/kg–forPyrolyticdouble
chamber
ContentofCombustiblematter>60%
ContentofNon-combustiblematterbelow5%
Non-combustiblefinebelow20%
Moisturebelow30%
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21. Waste type not to be incinerated
Pressurizedgascylinders
Largeamountofreactivechemicalwaste
Silversalts&photographic&radiographic
waste
HalogenatedplasticsuchasPVC
Wastewithhighmercuryorcadmiumcontent
ex.brokenthermometers,usedbatteries
Sealedampoulesorampoulescontaining
heavymetals
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22. Types of Incinerators
1.Doublechamberedpyrolyticincinerator–to
burninfectioushealthcarewaste.
2.Singlechamberfurnaces–shouldbeused
onlyifpyrolyticincineratorsarenot
affordable
3.Rotarykilns–operatingathightemp,
capableofcausingdecompositionof
genotoxicsubstances&heatresistant
chemicals
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23. Incinerator
Dr. Shubhangi Kshirsagar 23

24. 2. Chemical disinfection
Chemicals are added to the waste, to kill or
inactivate pathogen(Waste + chemical),
which results in disinfection.
It is suitable for treating liquid waste such as
blood urine, stool or hospital sewage.
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25. 3. Wet & dry thermal treatment
1.Wetthermaltreatment(steamdisinfection)
Itisbasedonexposureofshredded
infectiouswastetohightemp,highpressure
steam
Basedonautoclavesterilization.
Itisinappropriateforthetreatmentof
anatomicalwaste&animalcarcasses,
chemical&pharmaceuticalwaste.
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26. 3. Wet & dry thermal treatment
2. Screw feed technology
Nonburn,drythermaldisinfectionprocess
Wasteisshredded&heatedinarotatingauger.
Wasteisreducedby–80%involume&20-35%
inweight.
Itissuitablefortreatinginfectiouswaste&
sharp,butnotusedtopathological,cytotoxic
orradioactivewaste
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27. 4. Microwave irradiation
Mostmicroorganismaredestroyedbythe
actionofmicrowaveofafrequencyofabout
2450MHz&wavelengthof12.24nm.
Thewatercontainedwithinthewasteisrapidly
heatedbythemicrowave&theinfectious
componentaredestroyedbyheatconduction.
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28. sss
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29. 5. Land disposal
a.Opendump
Healthcarewasteshouldnotbedisposedon
oraroundopendumps.
Risktopeopleoranimalswhoarecoming
intocontactwithinfectiouspathogens.
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30. b. Sanitary landfill
Advantage over open dumps are -
1.Geological isolation of waste from the
environment
2.Appropriate engineering preparation before
the site is ready to accept waste
3.Staff present on site to control operation
4.Organized deposit & daily coverage of waste
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31. Sanitary landfill
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32. Sanitary landfill
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33. 6. Inertization
Itinvolvesmixingwastewithcementand
othersubstancesbeforedisposal,tominimize
theriskoftoxicsubstancecontainedinthe
wastemigratingintothesurfacewateror
groundwater.
Proportionofmixture–
Pharmaceutical waste 65%
Lime 15%
Cement 15%
Water 5%
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Dr. ShubhangiKshirsagar

34. Bio-Medical Waste
Management
Rules, 2016
Schedule I
34Dr. Shubhangi Kshirsagar

35. 35
CategoryTypeofwaste Typeofbagsor
container
Treatment
YellowHumananatomical
waste
Yellow
Colorednon-
chlorinated
plasticbags
Incinerationor
PlasmaPyrolysis
or
Deepburial
Animalanatomical
waste
Soiledwaste–items
contaminatedwith
blood,bodyfluids
likedressings,cotton
swab
Incineration/Plasm
aPyrolysis/Deep
burial
Micro-waving/
hydrowaving
Expired&Discarded
Medicines with
Cytotoxicdrugs
Yellow
Colourednon-
chlorinated
plasticbags/
containers
Inc.>1200
0
/Send
back to
manufacturer,
Encapsulationor
plasmapyrolysis
Dr. Shubhangi Kshirsagar

36. Category Type of Waste Typeof bags or
container
Treatment
Yellow Chemical waste Yellow
Colored containers/
non-chlorinated
plastic bags
Inc./Plasma
Pyrolysis/
Encapsulation
Chemical Liquid wasteSeparate collection
system leading to
effluent treatment
system
Resource
Recovery;
Pretreatment;
discharge
Discarded/contaminate
d linen, mattresses etc.
Yellow Colorednon-
chlorinated plastic bags/
suitable packing
materssssial
Non-chlor.
Chemical
disinfection
followed by
inc./ Plasma
Pyrolysis
Microbiology &
biotechnology waste &
Autoclavesafe plastic
bag or containers
Inc. (after lab
pre treatment)
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37. 37
Category Typeof waste Category Treatment
Red Contaminated/
Recyclable Waste
Red Colorednon-
chlorinated plastic
bags/ containers
Autoclave/ hydroclaving/
Microwavingfollowed
by shreddingor
mutilation,
Sterilization + shredding
White Waste Sharps
includingmetals
White/ translucent
(puncture proof,
leak proof tamper
proof container)
Autoclaveor dry heat
sterilization followed by
Shredding; landfill
Blue Glassware
(expect
Cytotoxic
contaminated),
Metallic Body
Implants
Blue Cardboard
boxes
Disinfection/autoclave/
hydroclaving/
microwaving; recycling
Dr. Shubhangi Kshirsagar

38. Bio-Medical Waste Management
Rules, 2016
38
Category Type of container
Yellow Non chlorinated plastic bag, Autoclave
safeplastic bags orcontainers
Red Non chlorinated plastic bags or
containers
White(Translucent)Puncture proof, Leak proof, tamper
proof containers
Blue Cardboard boxes with blue colored
marking
Dr. Shubhangi Kshirsagar

39. Dr. Shubhangi Kshirsagar 39

40. 40Dr. Shubhangi Kshirsagar

41. Duties of Operator
EnsureBMWcollectedfromoccupieristransported,handled,stored,
treatedanddisposedofwithoutanyadverseeffects.
Ensuretimelycollectionofbiomedicalwastefromoccupier.
EstablishbarcodingandglobalpositioningsystemforhandlingofBMW
withinoneyear.
Providetrainingtoallworkers.
Undertakeappropriatemedicalexaminationatthetimeofinductionand
atleastonceayear.
ImmunizeworkersagainsthepatitisBandtetanus.
Reportmajoraccident.
Maintainalogbookofitstreatmentequipment.
Displaydetailsofauthorization,treatment,annualreportonitswebsite.
Supplynonchlorinatedplasticcolouredbagstooccupier.
EnsurecollectionofBMWonholidaysalso.
Maintainallrecordsforfiveyears.
Ensureoccupationalsafetyofworkers.
41Dr. Shubhangi Kshirsagar

42. Duties of Occupier
Ensure BMW handled without any adverse effects.
Make provision of safe, ventilated, secured location for storage of segregated
waste in colouredbags
Ensure bar code system for BMW bags
Provide training to all workers.
Ensure occupational safety of workers.
Not to give treated BMW with muncipalsolid waste
Ensure segregation of liquid chemical waste at source
Ensure treatment & disposal of liquid chemical waste in accordance with water
Dispose of solid waste in accordance with the provision of respective waste
management rules
Maintain & update on day to day basis BMW registeranddisplay the monthly
record on website
Report major accident.
Immunize workers against hepatitis B and tetanus.
Display annual report on its website
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43. Biohazard symbolCytotoxichazard
symbol
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44. Thank you !
44Dr. Shubhangi Kshirsagar