Biomedical waste management in blood bank

Biomedical Waste management

1. Biomedical waste management Dr. Hughbert Dkhar Nazareth Hospital Laitumkhrah Shillong

2. Introduction Biomedical waste : Is waste that is either putrescible or potentially infectious. May also include waste associated with the generation of biomedical waste that visually appears to be of medical or laboratory origin (e.g., packaging, unused bandages, infusion kits, etc.), as well research laboratory waste containing bio-molecules or organisms that are restricted from environmental release. Sharps are considered biomedical waste whether they are contaminated or not, due to the possibility of being contaminated with blood and their propensity to cause injury when not properly contained and disposed of. Biomedical waste is a type of biowaste .

3. Introduction At present - most of the hospitals/nursing homes are now equipped with latest instruments for diagnosis and treatment of various diseases. One of the most important aspect associated with hospitals is the generation of wastes and its safe management. Health care institution’s waste contains Human anatomical wastes Blood, body fluid, Disposable syringe, used bandages, surgical gloves, Blood bags/ intravenous tubes etc.

4. Introduction - continue The Bio-medical waste generated from various sources has become a problem and much attention is being given worldwide to find out solution of this problem. The main concern lies with the hospital waste generated from large hospitals/nursing homes as it may pose deleterious effects due to its hazardous nature. Bio-medical wastes, if not handled in a proper way, is a potent source of diseases, like AIDS, Tuberculosis, Hepatitis and other bacterial diseases causing serious threats to human health. Owing to the discussed potential threats this waste needs prime attention for its safe and proper disposal.

5. Definition "Bio-medical waste" means any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining there to or in the production or testing of biologicals .

6. BMW - Types Liquid Semisolid Solid.

7. BMW in general BMW is distinct from normal trash or general waste. It differs from other types of hazardous waste , such as chemical, radioactive, universal or industrial waste . Medical facilities generate waste hazardous chemicals and radioactive materials - Are normally not infectious, they require proper disposal. Some wastes are considered multihazardous , such as tissue samples preserved in formalin.

8. Definition of Occupier "Occupier" means a person who has control over the institution and/or its premises or any institution generating bio-medical waste, which includes : Hospital/Nursing home/Clinic/Dispensary, Veterinary institution/Animal house, Pathological laboratory Blood bank etc.

9. DUTY OF OCCUPIER: It shall be the duty of every occupier to take all steps to ensure that such waste is handled without any adverse effect to human health and the environment. Institution generating bio-medical waste includes Hospital, Nursing home/ Clinic/ Dispensary/ Veterinary institution/ Animal house Pathological laboratory, Blood bank etc.

10. Schedule in BMW Schedule 1 – Categories of Biomedical waste Schedule II – Colour Coding Of the BAGS /BINS Schedule III – Label for BMW Containers/Bags. Schedule IV – Label For Transport Of BMW Containers/Bags. Schedule V – Standards For Treatment And Disposal of BMW. Schedule VI – Schedule For Waste Treatment Facilities Like Incinerator/ Autoclave/ Microwave System.

11. TREATMENT AND DISPOSAL (1) Bio-medical waste shall be treated and disposed of in accordance with Schedule I, and in compliance with the standards prescribed in Schedule V. (2) Every occupier, where required, shall set up in accordance with the time-schedule in Schedule VI, requisite bio-medical waste treatment facilities Like incinerator/ Autoclave/ Microwave system for the treatment of waste, or, Ensure requisite treatment of waste at a common waste treatment facility or any other waste treatment facility.

12. SEGREGATION, PACKAGING, TRANSPORTATION AND STORAGE (1) Bio-medical waste shall not be mixed with other wastes. (2) Bio-medical waste shall be segregated into containers/bags at the point of generation in accordance with Schedule II prior to its storage, transportation, treatment and disposal. (3 )The containers shall be labeled according to Schedule III. (4) If a container is transported from the premises where bio-medical waste is generated to any waste treatment facility outside the premises, the container shall, apart from the label prescribed in Schedule III, also carry information prescribed in Schedule IV.

13. Continue - SEGREGATION, PACKAGING, TRANSPORTATION AND STORAGE (4) Notwithstanding anything contained in the Motor Vehicles Act, 1988, or rules there under, untreated biomedical waste shall be transported only in such vehicle as may be authorized for the purpose by the competent authority as specified by the government. (5) No untreated bio-medical waste shall be kept stored beyond a period of 48 hours Provided that if for any reason it becomes necessary to store the waste beyond such period, the authorized person must take permission of the prescribed authority and take measures to ensure that the waste does not adversely affect human health and the environment.

14. (4) Notwithstanding anything contained in the Motor Vehicles Act, 1988, or rules thereunder , untreated biomedical waste shall be transported only in such vehicle as may be authorised for the purpose by the competent authority as specified by the government. (5) No untreated bio-medical waste shall be kept stored beyond a period of 48 hours Provided that if for any reason it becomes necessary to store the waste beyond such period, the authorised person must take permission of the prescribed authority and take measures to ensure that the waste does not adversely affect human health and the environment.

15. What @@/##/@/* mean? @@ Chemicals treatment using at least 1% hypochlorite solution or any other equivalent chemical reagent. It must be ensured that chemical treatment ensures disinfection. ## Multilation /shredding must be such so as to prevent unauthorised reuse. @ There will be no chemical pretreatment before incineration. Chlorinated plastics shall not be incinerated. * Deep burial shall be an option available only in towns with population less than five lakhs and in rural areas.

16. According to these rules Bio-medical wastes have been categorized under 10 categories and are required to be managed and handled as per prescribed procedures. (Schedule 1)  

17. Schedule 1 – Categories of Biomedical waste Option Waste Category Treatment & Disposal Category No. 1 Human Anatomical Waste (human tissues, organs, body parts) Incineration@/deep burial * Category No. 2 Animal Waste (animal tissues, organs, body parts carcasses, bleeding parts, fluid, blood and experimental animals used in research, waste generated by veterinary hospitals colleges, discharge from hospitals, animal houses) Incineration@/deep burial *

18. Schedule 1 – Categories of Biomedical waste Option Waste Category Treatment & Disposal Category No. 3 Microbiology and Biotechnology Waste (wastes from laboratory cultures, stocks or specimens of micro-organisms live or attenuated vaccines, human and animal cell culture used in research and infectious agents from research and industrial laboratories, wastes from production of biological, toxins, dishes and devices used for transfer of cultures) Local autoclaving/microwaving /incineration@ Category No. 4 Waste sharps (needles, syringes, scalpels, blades, glass, etc. that may cause puncture and cuts. This includes both used and unused sharps) Disinfection (chemical treatment@01/autoclaving/ microwaving and mutilation / shredding##

19. Schedule 1 – Categories of Biomedical waste Option Waste Category Treatment & Disposal Category No. 5 Discarded Medicines and Cytotoxic drugs (wastes comprising of outdated, contaminated and discarded medicines) Incineration@/destruction and drugs disposal in secured landfills Category No. 6 Solid Waste (items contaminated with blood, and body fluids including cotton, dressings, soiled plaster casts, lines, beddings, other material contaminated with blood) Incineration@ autoclaving/ microwaving

20. Schedule 1 – Categories of Biomedical waste Option Waste Category Treatment & Disposal Category No. 7 Solid Waste (wastes generated from disposable items other than the waste sharps such as tubings , catheters, intravenous sets, etc). Disinfection by chemical treatment@@ autoclaving/ microwaving and mutilation/shredding## Category No. 8 Liquid Waste (waste generated from laboratory and washing, cleaning, house-keeping and disinfecting activities) Disinfection by chemical treatment@@ and discharge into drains.

21. Schedule 1 – Categories of Biomedical waste Option Waste Category Treatment & Disposal Category No. 9 Incineration Ash (ash from incineration of any bio-medical waste) Disposal in municipal landfill Category No. 10 Chemical Waste (chemicals used in production of biological, chemicals used in disinfection, as insecticides, etc.) Chemical treatment@@ and discharge into drains for liquids and secured landfill for solids

22. SCHEDULE II COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF BIO-MEDICAL WASTES Colour Coding Type of Container and Waste Category Treatment options as per Schedule I Yellow Plastic bag Cat. 1, Cat. 2, and Cat. 3, Cat. 6. Incineration/deep burial Red Disinfected container/plastic bag Cat. 3, Cat. 6, Cat.7. Autoclaving/Microwaving/ Chemical Treatment Blue/White translucent Plastic bag/puncture proof Cat. 4, Cat. 7. Container Autoclaving/Microwaving/ Chemical Treatment and destruction/shredding Black Plastic bag Cat. 5 and Cat. 9 and Cat. 10. (solid) Disposal in secured landfill

23. Schedule III - Labels

24. Notes : 1. Colour coding of waste categories with multiple treatment options as defined in Schedule I, shall be selected depending on treatment option chosen, which shall be as specified in Schedule I. 2. Waste collection bags for waste types needing incineration shall not be made of chlorinated plastics. 3. Categories 8 and 10 (liquid) do not require containers/bags. 4. Category 3 if disinfected locally need not be put in containers/bags.

25. Example of Waste generated In Laboratory Sl. No Types of waste Category? 1 Cotton balls. 2 Needles/Syringes. 3 Plastic tubings . 4 Culture media with micro-organisms 5 Plastic covers. 6 Disinfectants 7 Blood. 8 Microtips /Pipettes. 9 ELISA wastes 10 Mixer tips(Plastic). 11 House keeping wastes/Cleaning

26. Sl. No Types of waste Category? 1 Cotton balls. 6 2 Needles/Syringes. 4 3 Plastic tubings . 7 4 Culture media with micro-organisms 3 5 Plastic covers. 7 6 Disinfectants 10 7 Blood. 2 8 Microtips /Pipettes. 7 9 ELISA wastes 8 10 Mixer tips(Plastic). 7 11 House keeping wastes/Cleaning 8

27. Waste generated at blood bank Cotton balls (Cat 6) Needles/Syringes (Cat 4) Plastic tubings . (Cat 7) Blood bags. (Cat 7) Plastic covers (Cat 7) Papers Blood (Cat 2) Microtips /Pipettes (Cat 7) ELISA wastes (Cat 8) Mixer tips(Plastic) (Cat 7) House keeping wastes/Cleaning of lab (Cat 8)

28. BMW AND HUMAN RIGHTS Right to Access information. Healthy environment. Safe working environment. To Life and Health.

29. Right to access information To protect themselves from harm (Vaccination). Legislation of BMW. Researchers Regulators Policy makers

30. Right to healthy environment Dumped BMW Waste burning an incineration

31. Effluent treatment plant

32. EFTP

33. Conclusion BMW needs higher priority On going education/awareness

34. reference Read more: Bio-Medical Waste (Management and Handling) Rules, 1998 - Introduction http://www.medindia.net/indian_health_act/bio-medical-waste-rules-1998-introduction.htm#ixzz2I7VCfO3m The Gazatte of India. New Delhi, Wednesday, June 3, 2015/JY AISTHA 13,1937

35. Thank you

36. Biomedical waste may be solid or liquid. Examples of infectious waste include discarded blood , sharps, unwanted microbiological cultures and stocks, identifiable body parts, other human or animal tissue, used bandages and dressings, discarded gloves, other medical supplies that may have been in contact with blood and body fluids, and laboratory waste that exhibits the characteristics described above. Waste sharps include potentially contaminated used (and unused discarded) needles, scalpels , lancets and other devices capable of penetrating skin.

37. Biomedical waste is generated from biological and medical sources and activities, such as the diagnosis, prevention, or treatment of diseases. Common generators (or producers) of biomedical waste include hospitals , health clinics , nursing homes , medical research laboratories , offices of physicians , dentists , and veterinarians , home health care , and funeral homes . In healthcare facilities (i.e., hospitals, clinics, doctors offices, veterinary hospitals and clinical laboratories ), waste with these characteristics may alternatively be called medical or clinical waste.