Bio-Medical Waste Management PPT

Bio-Medical Waste Management

1. BIOMEDICAL WASTE ( BMW ) MANAGEMENT Farida Khatun Biomedical Waste (BMW) Management

2. What is BMW? It is defined as “ Any solid and/or liquid waste including its container and any intermediate product, which is generated during the diagnosis, treatment or immunization of human beings or animals”. 2 Biomedical Waste (BMW) Management Farida Khatun

3. HEALTHCARE WASTE CHARACTERIZATION 3 Farida Khatun Biomedical Waste (BMW) Management

4. CLASSIFICATION OF HOSPITAL WASTE 4 Farida Khatun Biomedical Waste (BMW) Management

5. Categories of Persons Exposed to Risk of Infection 5 Farida Khatun Biomedical Waste (BMW) Management

6. Major Difference between BMW Rules 1998 & 2016 1998 2016 1 Occupiers with more than 1000 beds required to obtain Authorization Every occupier generating BMW, Including health camp or ayush requires to obtain authorization 2 Operator duties absent Duties of the operator listed 3 Biomedical waste divided in ten categories Biomedical waste divided in 4 categories 4 Rules restricted to HCEs with more than 1000 beds Treatment and disposal of BMW made mandatory for all the HCEs 5 No format for annual report A format for annual report appended with the rules 6 Schedule I, II, III, IV,V Change of Schedule I, II, III, IV Biomedical Waste (BMW) Management 6 Farida Khatun

7. Duties of Operator To take all necessary steps to ensure that the BMW collected from the occupier is transported , handled, stored, treated & disposed of without any adverse effect to human health & environment. To ensure timely collection of BMW from the health care facilities . To inform the prescribed authority immediately regarding the health care establishments/facilities, which are not handling over the segregated BMW . To provide training of all its workers. Biomedical Waste (BMW) Management 7 Farida Khatun

8. Cont … To undertake appropriate pre-placement & periodic medical examination and immunize all its workers and records for the same. To ensure occupational safety by providing protective equipments . To develop system of reporting of unintended accidents in Form III with annual report even the nil reporting . To maintain a log book of treatment equipment according to weight of batch; categories of waste treated; time; date; duration of treatment cycle & total hours of operation. Biomedical Waste (BMW) Management 8 Farida Khatun

9. Categories of BMW CATEGORY TYPE OF WASTE TREATMENT & DISPOSAL Category 1 Human anatomical wastes Incineration/ deep burial Category 2 Animal wastes Incineration/ deep burial Category 3 Microbiology & biotechnology waste Local autoclaving/ microwaving/incineration Category 4 Waste sharps like needles, syringes, scalpels, blades, glass etc Disinfection (Chemical/autoclaving/micro waving & mutilation/shredding) Category 5 Discarded Medicines & cytotoxic drugs Incineration/destruction & disposal in land fills 9 Farida Khatun Biomedical Waste (BMW) Management

10. CATEGORY TYPE OF WASTE TREATMENT & DISPOSAL Category 6 Soiled wastes Items contaminated with blood, body fluids including cotton, dressings etc Incineration, autoclaving, microwaving Category 7 Solid wastes like catheters, IV sets etc. Disinfection by chemical treatment/autoclaving/micro waving and mutilation & shredding Category 8 Liquid wastes Laboratory, blood banks, hospitals, house etc. Disinfection by chemicals and discharge into drains Category 9 Incineration ash Disposal in municipal land fills Category 10 Chemical wastes Chemical treatment & discharge into drains for liquid and secured land fills for solids. 10 Biomedical Waste (BMW) Management Farida Khatun

11. BMW Rules 1998 COLOR CODE TYPE OF CONTAINER WASTE CATEGORY TREATMENT OPTIONS Yellow Plastic bags 1, 2, 3 and 6 Incineration/deep burial Red Disinfected container/plastic bag 3, 6 & 7 Autoclaving/Micro Waving/Chemical treatment Blue/white transparent Plastic bags/ puncture proof container 4 & 7 Autoclaving/Micro waving/chemical treatment, Destruction & shredding Black Plastic bag 5, 8 & 9 Disposal in secured land fills Biomedical Waste (BMW) Management 11 Farida Khatun

12. BMW Rules 2016 Biomedical Waste (BMW) Management 12 Farida Khatun

13. Health Hazards Biomedical Waste (BMW) Management 13 Farida Khatun

14. 6/26/2019 14

15. Routes of Transmission Biomedical Waste (BMW) Management 15 Farida Khatun

16. Precautions Biomedical Waste (BMW) Management 16 Farida Khatun

17. Environment Legislation The Air (Control of Pollution) Act, prevention and 1981 The Environment (Protection) Act, 1986 The Hazardous Waste (Management & Handling) Rules, 1989 The National Environmental Tribunal Act, 1995 The Biomedical Waste (Management & Handling) Rules, 1998 The Municipal Solid Waste (Management & Handling) Rules, 2000 17 Biomedical Waste (BMW) Management Farida Khatun

18. BIO-MEDICAL WASTE (MANAGEMENT & HANDLING) RULES 1998 BMW Rules have been adopted and notified with the objective to stop the indiscriminate disposal of hospital waste/ bio-medical waste and ensure that such waste is handled without any adverse effect on the human health and environment. PUNITIVE STEPS against DEFAULTERS Involves imprisonment up to five years or penalty up to rupees one lakh or both, in case of continuation the penalty of rupees five thousand per day up to one year and thereafter imprisonment up to 7 years. 18 Biomedical Waste (BMW) Management Farida Khatun

19. Steps for Effective BMW Management Biomedical Waste (BMW) Management 19 Farida Khatun

20. Waste Survey Waste survey is an important component of the waste management scheme. A survey helps in evaluation both the type and quantity of waste generated in hospitals. Aims: Differentiate the types of waste Quantify the waste generated Determine the points of generation & type of waste generated at each point Determine the level of generation & disinfection within the hospital To find out the type of disposal carried out Biomedical Waste (BMW) Management 20 Farida Khatun

21. Steps in the management of hospital waste include: • Generation • Segregation/separation • Collection • Transportation, storage • Treatment • Final disposal Biomedical Waste (BMW) Management 21 Farida Khatun

22. WHO GENERATES BMW? Waste generated by Healthcare facilities Research facilities Laboratories 22 Farida Khatun Biomedical Waste (BMW) Management

23. Biomedical Waste (BMW) Management 23 Farida Khatun

24. 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 , 1998. Biomedical Waste (BMW) Management 24 Farida Khatun

25. Collection Biomedical Waste (BMW) Management 25 The collection of biomedical waste involves use of different types of container . 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. Farida Khatun

26. Storage Biomedical Waste (BMW) Management 26 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 labeled to show the ward or room where it is kept. The reason for this labeling 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. Farida Khatun

27. Transport 27 Biomedical Waste (BMW) Management Farida Khatun

28. Principles of Waste Management Develop a waste management plan that is based on an assessment of the current situation and which minimizes the amount of waste generated Segregate clinical (infectious) waste from nonclinical waste in dedicated containers. Transport waste in dedicated trolleys. Store waste in specified areas with restricted access. Biomedical Waste (BMW) Management 28 Farida Khatun

29. Collect and store sharps in sharps containers. Sharps containers should be made of plastic or metal and have a lid that can be closed. Mark the storage areas with a biohazard symbol Ensure that the carts or trolleys used for the transport of segregated waste collection are not used for any other purpose – they should be cleaned regularly Identify a storage area for waste prior to treatment or being taken to final disposal area. Biomedical Waste (BMW) Management 29 Farida Khatun

30. Handling Devices Trolleys Wheelbarrows Chutes 30 Biomedical Waste (BMW) Management Farida Khatun

31. DO’s & DONT’s Biomedical Waste (BMW) Management 31 Farida Khatun

32. PPE Use appropriate PPE when segregating, packing, transporting, and storing biomedical waste. Biomedical waste should be transported in a closed container. Biomedical Waste (BMW) Management 32 Farida Khatun

33. Proper Disposal of Needles and Sharps Needles and sharps are the commonest mode of transmission of blood-borne pathogens to the healthcare worker Precautions should be taken to prevent injuries by sharp instruments, especially hollow bore needles that have been used for venepuncture or other vascular access procedures. Needles should not be recapped, bent or broken by hand. Disposable needles and other sharps should be disposed immediately after use into puncture-resistant containers which should be located at the site of the procedure. When a needle has to be removed from a syringe, do it with utmost care. Do not overfill a sharps container. Biomedical Waste (BMW) Management 33 Farida Khatun

34. Good Practice for Safe Handling and Disposal of Sharps ALWAYS dispose of your own sharps. NEVER pass used sharps directly from one person to another. During exposure-prone procedures, the risk of injury should be minimized by ensuring that the operator has the best possible visibility; for example, by positioning the patient, adjusting the light source, and controlling bleeding. Protect fingers from injury by using forceps instead of fingers for guiding suturing. NEVER recap, bend or break disposable needles. Directly after use, place needles and syringes in a rigid container until ready for disposal. Locate sharps disposal containers close to the point of use, for example, in patient’s room, on the medicine trolley, and in the treatment room. Biomedical Waste (BMW) Management 34 Farida Khatun

35. Treatment Chemical processes Thermal processes Mechanical processes Irradiation processes Biological processes Biomedical Waste (BMW) Management 35 Farida Khatun

36. 6/26/2019 Biomedical Waste (BMW) Management 36

37. Chemical Processes Biomedical Waste (BMW) Management 37 Farida Khatun

38. Thermal Processes Biomedical Waste (BMW) Management 38 Farida Khatun

39. Mechanical Processes Biomedical Waste (BMW) Management 39 Farida Khatun

40. Irradiation Processes Exposes wastes to ultraviolet or ionizing radiation in an enclosed chamber. These systems require post shredding to render the waste unrecognizable. Biomedical Waste (BMW) Management 40 Farida Khatun

41. Biological Processes Using biological enzymes for treating medical waste. It is claimed that biological reactions will not only decontaminate the waste but also cause the destruction of all the organic constituents so that only plastics, glass, and other inert will remain in the residues. Biomedical Waste (BMW) Management 41 Farida Khatun

42. EMERGENCY RESPONSE PLAN Needle prick, cut, or injury to the handler An accidental spill of BMW inside or outside hospital building. Biomedical Waste (BMW) Management 42 Farida Khatun

43. Conclusion We need innovative and radical measures to clean up the distressing picture of lack of civic concern on the part of hospitals and slackness in government implementation of bare minimum of rules, as waste generation particularly biomedical waste imposes increasing direct and indirect costs on society. The challenge before us is to scientifically manage growing quantities of biomedical waste that go beyond past practices. 43 Farida Khatun Biomedical Waste (BMW) Management