Biomedical Waste (Barna)

Biomedical waste management

1. Dr. Arifa Akram Barna MBBS, MD (Virology) Department of Virology Institute of Epidemiology, Disease Control and Research (IEDCR)

2. Waste Management Waste management refers to the activities connected with the collection and disposal of wastes. Waste management comprises the following activities: Waste collection Waste transportation Waste segregation Waste recycling Waste disposal Waste minimization & control

3. 3 Who’s at Risk ? • Doctors and nurses • Patients • Hospital support staff • Waste collection and disposal staff • General public and • the Environment

4. Biomedical/Microbiological Waste "Bio-medical waste“ means any waste, which is generated during the diagnosis, treatment or immunisation of human beings or animals or in research activities or in the production or testing of biologicals .

5. Types:

6. Steps in BMW management

7. Infectious/contaminated waste A. Non degradable 1. Sharp Hypodermic needles, scalpels, broken lab glassware & Plastic ware, blades 2.Non Sharp Syringes, infusion sets, ELISA plate, ICT, micro centrifuge tube, petri dish, Vacutainer , plastic tube, Pipette tips, mask, gloves B. Degradable Blood , Serum, Plasma, Urine, Stool, Swab, Body fluids, Tissues and organs

8. Management: Segregation- Puncture-proof colour coded container If colour coded container not available then use any beaker/ bucket containing 0.5% hypochlorite solution Processing before disposal Sterilize by Autoclave/ 0.5% hypochlorite solution Transport to the place of disposal Solid-Cleanable trolley Liquid- Bucket with lid Disposal Incineration / Land fill plastic ware, blades

9. Non infectious household waste Tissue paper Management: Segregation- Colour coded container Processing before disposal None Transport to the place of disposal Cleanable trolley Disposal Incineration / Land fill/ Municipal disposal

10. Chemical waste Non-hazardous Management- directly dispose into trash

11. Hazardous if it has at least one of the following properties : corrosive (acids and bases): HCL, NaoH Flammable : alcohol, ether, acetone, acetic acid Oxidizer : conc. H2O2, KMno4, bleach Air or water reactive : zinc dust, magnesium metal Toxic (poisons, carcinogens, mutagens): mercury, formaldehyde, EtBr .

12. Management: keep in a separate, sealable container with labeling of chemical waste dilute strong acid and base into neutral pH and disperse into sewerage system** dilute formalin in water and disperse into sewerage system ethidium bromide in electrophoresis gel- <1%- lab trash >1%- keep in biohazard bag and incinerate

13. Wastes with high content of heavy metal broken thermometers Management: buried in deep landfill

14. Radioactive waste Unused substances from radiotherapy or laboratory research, contaminated glassware, packages or absorbent paper; urine or excreta from patients treated or tested with unsealed radioactive substance Management: Follow individual laboratory’s own system for disposal of radioactive waste

15. Yellow Dustbin & Bags From OT: Amputated Limbs, Placenta, Intestine, Uterus , Ovary etc . From Labs: Live or Attenuated vaccines, Infected Samples and cultures, Culture Plates, Wastes from production of Biologicals , Toxins . MANAGEMENT OF HOSPITAL WASTE

16. Red Dustbin & Bags Cotton pads, Swabs, Gauge Pieces, Dressings, Bandages , Cloths, Bedsheets and Plaster castes Soiled with blood, Pus, Vomits, Sputum and other Body Fluids. MANAGEMENT OF HOSPITAL WASTE

17. Wastes comprising of out dated, contaminated and discarded medicines, solid chemicals used for disinfection in Lab & Hospitals as insecticides Black Dustbin & Bags

18. Blue Dustbins & Bags Needles, Scalples , Blades, Glass ampoules and Syringes etc. that may cause puncture and cuts. This includes both used and unused sharps

19. May also be put for All disposable items like I.V.Sets , S.V.Sets , Venflon , Catheter, I.V.Fluid Bottles Uro -bags , Ryles tube, Drainage Tube and Bags, Empty blood bags and Dialysis and other plastic disposable . A separate Blue Dustbins & Bags

20. Standard Operating Procedure for waste segregation and disposal Procedure A. Non-infectious waste disposal These include papers, packaging boxes, plastic bags and hand paper towels. Dispose these items in black or white polythene bags inserted in 10L plastic buckets without a lid. Remove filled bags and replace them with new ones ready for the following day work.

21. B. Infectious waste disposal [Do not store infectious waste in corridors or stairwells] Seal used tubes, plastic Pasteur pipettes, pipette tips, gloves, cotton, paper towels, specimen containers and cultures for discard in double biohazard bags. Place all infectious waste in designated red, rigid bags placed in step-on lidded waste bins that are clearly labeled with the biohazard symbol. Seal off with tape, when the bags are three-quarter full. Carefully take the sealed bags to the autoclave room and autoclaved. After autoclaving, bio hazard bags containing reusable lab ware are safe to open and clean and take non-reusable waste for incineration.

22. C. Disposal of sharps   Sharps include used needles, surgical knives or broken bottles Do not mix sharps with papers or non-sharps infectious waste Put a properly labeled sharps container in place and used exclusively for the disposal of sharps. Discard used needles immediately into the sharps container. Pick broken glass scattered on the floor with aid of special forceps or swept into a special receptacle and then emptied into the sharps container Autoclave sharps containers when ¾-full and then sent for incineration.

23. Liquid medium and solutions Add to a container of bleach solution Leave for approximately 20 minutes Pour disinfected liquids down the drain. If using any disinfectant other than bleach, which may not be appropriate to pour down the drain, contact Environmental Safety for safe disposal options

24. Contaminated PPE All disposable, contaminated PPE is disposed in a biohazard waste container. Autoclave before final disposal. Decontaminate by submerging the reusable items in 0.5% hypochlorite solution for at least 30 minutes (preferable over night), then autoclave before use.

25. Personnel safety devices The use of protective gears should be made mandatory for all the personnel handling waste.

26. Bio Medical Wastes: Segregate and Pack it right at the point of Generation

27. Storage of waste Holding of biomedical waste for such period of time, at the end of which waste is treated and disposed of. Safe from tampering and access to rag-pickers. Not beyond a period of 48 hours. Biohazard symbol

28. Bio Medical Wastes Collection &Transport

29. CONCLUSION If we want to protect our environment and health of community we must sensitize ourselves to this important issue not only in the interest of health managers but also in the interest of community.