Biomedical Waste collection treatment disposal

Biomedical waste

2. Presentation OutlinePresentation Outline
➢Biomedical waste –An overview
•Definition
•Sources
•Classification
➢Need for BMW Management
•Problems related to Biomedical waste
➢BMW Management legislation
➢BMW process adopted in India
➢BMW management during COVID-19 Pandemic in India
➢Conclusion

3. •Wasteproductwhichis
infectious,hazardous,and
sometimesradioactiveandis
generatedduringthevarious
medicalrelatedactivities
suchasdiagnosis,treatment
andimmunizationisknown
asBiomedicalwaste.
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4. 4

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7. CLASSIFICATION
AccordingtoWHO
•85%ofhospitalwastesareactuallynon-hazardous,
•around10%areinfectiousand
•around5%arenon-infectiousbuthazardouswastes.
•InUSA,about15%ofhospitalwasteisregulatedasinfectiouswaste.In
Indiathiscouldrangefrom15%to35%dependingonthetotalamountof
wastegenerated
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19. Need for BMW management
•In absence of proper segregation, the non infectious waste becomes infectious and poses
environmental threat to the society
•An inappropriate treatment and disposal will spread infectious diseases in society.
•Injuries from sharps leading to infection to all categories of hospital personnel and waste handlers.
•Risk associated with hazardous chemicals and drugs to persons handling wastes
•Risk of infection outside hospital for waste handlers and scavengers
•Risk of spurious drugs due to repacking of disposed off drugs to unsuspecting buyers.
•air, water and soil pollution directly due to waste, or due to defective incineration, emissions and
ash.

22. Existing Scenario of Bio-Medical Waste in India
•Currently, in India, 550.9 tons of Bio-medical waste is
generated daily and is likely to reach about 775.5 tons per
day by 2022 from the current level. (Source: Joint report by Associated
Chambers of Commerce and Industry of India (Assocham) and Velocity in 2018)

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26. Bio-medical Waste Management Rules Framed by
Ministry of Environment and Forest(MoEF), Govt. of
India
•On 20th July 1998,"Bio-medical waste (Management and
Handling) Rules were framed.
•• 1st Amendment on 06-03-2000.
•• 2nd Amendment on 17-09-2003.
•• On 28th March 2016, Under Environment (Protection) Act,
1986, MoEF&CCnotified the new BMW Rules, 2016 and
replaced the earlier Rules(1988). Ammendedin 2018

27. The salient features of Biomedical Waste (Management &
Handling) Rules, 1998 are:
➢The rules were restricted to healthcare facilities with more than 1000 beds
and they are required to obtain authorisation.
➢Biomedical waste was divided into 10 categories as per their treatment
and disposal methods
➢Biomedical waste should be segregated into containers/bags at the point
of generation itself.
➢The containers should be clearly marked with the bio-hazard and
cytotoxic hazard symbol.

28. Salient features of BMW Management Rules, 2016 along with Biomedical
Waste Management (Amendment) Rules, 2018
➢expanded to include vaccination camps, blood donation camps, surgical camps or
any other healthcare activity.
➢Phase-out the use of chlorinated plastic bags, gloves and blood bags (extended to
27
th
March 2019)
➢Pre-treatment of the laboratory waste, microbiological waste, blood samples and
blood bags through disinfection sterilization on-site
➢training to all its health care workers and immunize them for hepatitis B and
Tetanus
➢Establish Bar-Code System for bags or containers

29. Salient features of BMW Management Rules, 2016 along with
BioMedicalWaste Management (Amendment) Rules, 2018
➢No hospital/ healthcare facility (occupier) shall establish on-site treatment
and disposal facility, if a service of “common bio-medical waste treatment
facility’’ (CBMWTF) is available within seventy-five kilometers.
➢ensure timely collection of bio-medical waste
➢Bio-medical waste has been classified into only 4 categories instead of 10
categories as per Biomedical Waste (Management & Handling) Rules,
1998 to improve the segregation of waste at source.

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32. Segregation at Source
Bio Medical Waste Management Rules, 2016 categorises the bio-medical waste
generated from the health care facility into four categories based on the
segregation pathway and colour code.
➢Yellow Category
➢Red Category
➢White Category
➢Blue Category

33. Colour
Coding
Typeofcontainer Wastecategory Treatmentoptions
Yellow PlasticBag HumanAnatomicalWaste/Animal
Waste, Microbiology and
BiotechnologywasteandSoiledwaste
Incineration/DeepBurial
Red Disinfectedcontainer/
plasticbag
MicrobiologyandBiotechnology
wasteandSoiledwaste
Autoclave/Microwave/Chemical
Treatment
Blue PlasticBag/Puncture-proof
container
Broken/ discarded glass-Medicine
vials & ampoules except those
contaminated with cytotoxic wastes.
Metallic Body Implants
Autoclave/Microwave/Chemical
Treatmentanddestruction/
shredding

34. White (or)
Translucent
Plastic Bag/ Puncture-proof
container WastesharpsincludingMetal
sharps-Needles,Syringeswithfixed
needles,Needlesfromneedletip
cutter/burner,Scalpels,Blades
Autoclave/Microwave/ Chemical
Treatment and destruction /
shredding
Black PlasticBag DiscardedMedicines/Cytotoxic
Drugs,Incinerationashand
Chemicalwaste
Disposalinsecuredlandfill

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39. Storage of BMW
• Segregated wastes of different categories needs 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.
•Biomedical Waste & General Waste shall not be mixed.
•Storage time of waste should be as less as possible so that waste storage,
transportation and disposal is done within 48 hours (BMW Management
Rules, 2016)

42. ➢The waste should be transported for treatment either in trolleys or
in covered wheel-barrow.
➢The bags / Containers containing BMWs should be tied/ lidded
before transportation.
➢Before transporting the bag containing BMWs should be
accompanied with a signed document by Nurse/ Doctor mentioning
date, shift, quantity and destination.
➢Final Transport of BMW must be to CBMWTSDF only in
authorized vehicle with appropriate documentation for further
record.

44. Disposal methods
•Incineration
•Autoclave
•Hydroclave
•Microwave
•ETP for Liquid waste
•Deep Burial
•Plasma Pyrolysis
•Waste Sharps Dry heat
sterilization and encapsulation
•Shredding cum Chemical
disinfection

45. Incinerator

49. BMW management of India
288
303
486
501
515
530
0
100
200
300
400
500
600
2013 2014 2015 2016 2017 2018
BMW treated (MT/day)
Year
BMW Treatment in India Treatment & Disposal in metric tonnes/day
Source: CPCB report

50. Common Bio-medical Waste Treatment Facilities
(CBWTFs)/ Private Agencies

52. 93
168
188
179
190
198
191
203
199 198
203
0
50
100
150
200
250
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
No. of CBWTF
Year
Number of CBWTF in India

53. CBWTFs are widely accepted by healthcare facilities and increasing
in its number continuously because of various advantages such as
reduced capital investment,
•reduced cost of treatment,
•no operation & maintenance,
•checks mushrooming of treatment equipment in cities,
•easy implementation by the regulatory bodies etc.

54. During COVID times….
BMW Management Rules, 2016BMW Management Rules, 2016

55. COVIDbiomedicalwaste
Management
GuidelinestohandleCOVID-19biomedicalwasteissuedby
regulatorybodies

58. Guidelines for Handling, Treatment and Disposal of Waste Generated during
Treatment/Diagnosis/ Quarantine of COVID-19 Patients –
Revision 1 dated25/03/2020
Revision 2 dated18/04/2020
Revision 3 dated10/06/2020

60. COVID-19 WASTE MANAGEMENT –DO’S & DON’TS
(Quarantine Camp/Centre or Home-care)
DO’s
•Care takers of COVID-19 patients under home-care
shall store the biomedical waste in yellow coloured
bag provided by Urban Local Body
•Person taking care of suspected or confirmed
(asymptomatic and mild symptomatic) COVID-19
patient at home-care shall handover the yellow bag
to authorized waste collector from urban local body
or common biomedical waste treatment facility
operator.
DON'TS
•Home-care taker shall never mix general waste
with biomedical waste such as used syringes, date
expired or discarded medicines, used
masks/gloves etc.
•Never dispose off used masks of suspected or
confirmed (mild symptomatic or asymptomatic)
COVID-19 patients in bags other than yellow bag.
•Positive or suspected COVID-19 patient shall
never use fabric mask home-made masks, if any.

61. COVID-19 WASTE MANAGEMENT –DO’S & DON’TS
(Quarantine Camp/Centre or Home-care)
•Home-care care-taker may also deposit the yellow
bag at designated deposition centerof ULB.
•General waste from home care or quarantine
centeror quarantine camp shall be handed over as
solid waste to authorized waste collector of Urban
Local Body (ULB -Municipal Corporation /
Municipality).
•Do not leave your used mask within
the reach of others.
•Do not re-use surgical masks or
gloves.
•Quarantine centeror camp or
homecare shall never store
biomedical waste for more than 48
hrs

62. COVID-19 WASTE MANAGEMENT –DO’S & DON’TS
(Quarantine Camp/Centre or Home-care)
•Used masks & gloves from Home quarantine or other
households after keeping aside in paper bag for 72
hours may be cut into pieces prior to disposal to
prevent re-use.
•Person operating quarantine camp or quarantine center
shall contact the CBWTF operator for lifting of
biomedical waste as and when generated.
•Persons operating quarantine camp or quarantine
centeror care-takers of homecare may contact ULB in
case of any difficulty in getting the service.
•Dedicated waste collector of ULB cannot deny
collection of waste from quarantine centre /
quarantine camp / home-care.

65. •BMWM should be a shared teamwork with committed
government backing, good BMW practices followed by both
health-care workers and HCFs, continuous monitoring of
BMW practices, and strong legislature.
•The current BMWM 2016 rules are an improvement over earlier rules
in terms of improved segregation, transportation, and disposal
methods, to decrease environmental pollution and ensure the safety of
the staff, patients, and public.
CONCLUSION

66. •The pillar of BMWM is segregation of waste at source and WR.
•Moreover, more use of non-PVC medical devices and development of
newer novel, eco-friendly systems for disposal of BMW should be
encouraged.
•All participants in BMWM should pledge to guarantee a cleaner and
greener environment.

67. •Are our municipal waste generators, waste collectors and
waste managers aware of the risks they are entering in?
•Are our citizens aware on managing household medical
waste in this COVID-19 situation?
•Are cities ready with their waste management plans?
•Are biomedical waste management firms ready to handle the
extremely hazardous, heaps of biomedical waste our country is
going to generate?

69. References
•MoEFGuidelines
•CPCB guidelines
•Biomedical waste Management Rules (1998)
•Guidelines for Management of Healthcare Waste as per Biomedical Waste Management
Rules, 2016
•WHO guidelines
•ENVIS Newsletter on Biomedical waste management
•Guidelines for Handling, Treatment and Disposal of Waste Generated during
Treatment/Diagnosis/ Quarantine of COVID-19 Patients Revisions 1, 2 and 3 dated 25
th
March 2020, 18
th
April 2020, 10
th
June 2020