biomedical waste mangemnt bmw (jasleen).pptx

brief description about biomedical waste managemnt

1. BIOMEDICAL WASTE MANAGEMENT RULES,2016 ( AMENDMENT – MARCH 16, 2018) DR. SANDEEP KAUR Assistant Professor SPM,GGSMCH FDK

2. LEARNING OBJECTIVE At the end of this session , one should be able to learn about: Biomedical waste management and its latest guidelines

3. LESSON PLAN Definition Classification of BMW History Health hazards of health care waste

4. DEFINITION According to biomedical waste (management and handling)rules,1998 of India, Biomedical waste means any waste which is generated during diagnosis, treatment, immunization of human beings or animals or in research activities or in the production or testing of biologicals or in health camps.

5. CLASSIFICATION OF BMW Waste generated from healthcare facility is classified as: Biomedical waste General waste Other waste

6. HISTORY Under the environment protection act,1986, BMWM rules 2016 came into force from 28 th MARCH 2016, superseding biomedical waste ( management and handling ) rules ,1998. Amendments in BMW rules 2016 were done in 2018, 2019. These rules apply to all persons who generate , collect, receive, store, transport, treat , dispose or handle BMW in any form.

7. SOURCES OF BMW Government hospitals Vaccination centres Private hospitals Health camps, Medical camps Nursing homes First aid room of schools Clinics Dispensaries Medical research and training establishments Mortuaries Blood banks and collection centres Animal houses Slaughter houses Laboratories Research organisations

8. WHY BMW MANAGEMENT IS IMPORTANT? WHEN 20 PER OF HOSPITAL INFECTIOUS AND HAZARDOUS WASTE IS MIXED WITH THE OTHER 80per NON INFECTIOUS WASTE , 100per WASTE BECOMES HAZARDOUS AND INFECTIOUS, SO SEGREGATION AT POINT OF SOURCE IS IMPORTANT.

9. HEALTH HAZARDS OF HEALTH CARE WASTE Infections like HIV, Hep B , Hep C Many of chemicals and pharmaceuticals used in HCF are toxic, genotoxic, corrosive, flammable. They may cause intoxication or injuries like burns . Exposure to radioactive waste may lead to symptoms like headache, dizziness, vomiting yo much more serious problems. Exposure may also affect genetic material Apart from health hazards, general public is very sensitive to visual impact of HCF

10. COLOR CODING TYPE OF WASTE EXAMPLE YELLOW Human anatomical waste Animal anatomical waste Soiled waste Expired/discarded medicine Chemical waste Soiled linen, mattress Microbiological waste, biotechnology/ clinical lab. waste Human tissue, fetus , organs Dead experimental animal Plaster cast, cotton contaminated with blood and body fluids Discarded tablets /capsules Discareded chemicals, expired Bedsheets, blankets contaminated with blood and body fluids Culture plates, blood bags RED Contaminated waste ( recyclable) Tubings , i /v set, gloves, catheters, uro bags White translucent box Sharps Needles ,scalpel , knives , i /v needles Blue ( cardboard box with blue taping) Glassware and metallic body implants Broken glass, empty vaccine vials, body implants

11. DUTIES OF AN OCCUPIER RULE 4 To ensure that waste is handled without any adverse effects to human health and environment. Provision of final storage room Pre treatment of lab and microbiological waste and blood bags Phase out use of chlorinated plastic bags, blood bags, gloves Providing training to health care workers and keep record Immunization of health care workers with tetanus and hepatitis B vaccine Establish bar code based software system Pretreatment of liq. Chemical waste before mixing it with domestic liq. Waste.

12. Appropriate and adequate use of PPEs Conduct health checkups of health workers and keep record Display waste management monthly record on HCF’s website Report major accidents in form 1 within 24 hrs Untreated human anatomical waste , animal anatomical waste, soiled waste and biotechnology waste shall not be stored beyond 48hrs. Report to ppcb in case of irregular visits of CBWTF. Proper labelling of containers Formimg BMWM committee and hold atleast bi annual meetings.

13. Daily Maintenance of record by occupier Every authorized person has to maintain records related to generation,collection,reception,storage,transportation,treatment , disposal or any other form of handling of biomedical waste for a period 5 years Waste generated Weight/volume Generation date Disposal Yellow Red White Blue Municipal waste

14. STORAGE OF BMW No untreated biomedical waste should be stored beyond 48 hrs Central waste collection room : Each HCF should ensure a designated central waste collection room situated within its premises, till the waste is picked up and transported for treatment. Its location should be away from public /visitors access. Space allocation should be as per the quantity of waste generated from hospital Space must be sufficient as to store two days of BMW It should be roofed and manned and should be under lock and key. Ramp should be installed , for easy transportation of waste collection trolleys Exhaust fan should be provided for ventilation Adequate provision of water supply adjacent to the storage room

15. TREATMENT AND DISPOSAL OF BMW According to BMWM rules 2016, no HCF shall establish on site treatment and disposal facility for BMW , if a service of CBWTF is available within reach of 75 kilometer of travelling distance of the facility.

16. General waste All the waste other than bio medical waste and which has not been in contact with any hazardous or infectious , chemical or biological secretions and does not include any waste sharps. General waste is further divided into : DRY WASTE N ewspaper , paper, aluminium cans, plastic bottles, aluminium foils , metals , rubber etc WET WASTE ( BIODEGRADABLE) Vegetables, fruits, peels, used tea , flowers etc

17. AUTHORIZATION Means permission granted by SPCB for generation , collection, reception , storage, transportation , treatment and disposal of biomedical waste. Every occupier or operator irrespective of the quantity shall make an application in FORM II for authorization under BMWM RULES and consent under AIR ACT and WATER ACT. Authorization is one time for non bedded occupiers

18. COMMON BMW TREATMENT FACILITIES IN STATE OF PUNJAB m/s medicare environment management , Ludhiana m/s rainbow environments , sas nagar m/s Amritsar environment care system , shri amritasr sahib m/s biomedical treatment plant , pathankot m/s med waste solutions pvt. Ltd. , shri muktsar sahib

19. RATES FOR COLLECTION,TRANSPORTATION AND DISPOSAL OF BMW BY CBWTF S.NO. NO.OF BEDS/ PATIENTS REVISED RATES IN RUPEES 1 OPD/CLINICS/LABS/NURSING HOMES/ HCF’S LESS THAN 10 BEDS RPS 1000 PER MONTH 2 HCF’S 11-20 BEDS RPS 4.20/BED/DAY 3 HCF’S HAVING 21 BEDS AND ABOVE RPS 5.40/ BED / DAY

20. DETAILS TO KEEP FOR FILLING OF ANNUAL REPORT Quantity of general waste on monthly basis Details of on site storage facility ; size and capacity of final storage room Minutes of meeting of BMWM committee No of staff trained and not trained Details of accident If any Liq waste generated and treatment methods Annual report is submitted by the occupier to the prescribed authority in FORM 4 on or before 30 th JUNE of every year , and displayed on the HCF’S website. The record regarding generation, collection, reception, storage, transportation or any handling regarding BMW is kept for a period of 5yrs

21. Labels for biomedical waste

22. BIOMEDICAL WASTE ACCIDENTS AND MANAGEMENT Includes any spill of BMW whether liquid or solid and incidents of needle stick injury These are reported to the prescribed authority ; SPCC in form 1 along with annual report.

23. LIQUID SPILL MANAGEMENT Wear PPE; Mask, gloves, gown , face shield, head cap, safety shoes LIMIT; Put some absorbent material over spilled liquid like old newspaper, tissue paper, gauze piece DISINFECT/NEUTRALIZE; if spilled liquid is potentially infectious like blood, pour a disinfectant like 1per sod. Hypochlorite solution and leave for 30 mins . COLLECT ; spilled liquid along with the disinfectant is mopped up. The mopping should be carried out by working from the least to the most contaminated part and should be put into appropriate waste container. After mopping, cleaning may be done with detergent and water.

24. NEEDLE STICK INJURY All HCW’s and waste handlers must get complete vaccination against HBV and tetanus For prophylactic purpose , 3 doses of HBV vaccine are given at 0,1,and 6 months interval 4 doses of tetanus toxoid are given , 1 dose each at 0,2,12 and 5 years Management ; wash immediately with soap and running water thoroughly Report injury to the supervisor or casualty medical officer to evaluate the injury. NSI form is filled by HIC NURSE and and follow up is done weekly. Management is on case to case basis.

25. NON COMPLIANCE OF RULES Rule 15 of environment protection act 1986 states that; Whosoever fails to aaply or contravenes any of the provisions of the act and the rules, orders and directions to be punishable with imprisonment for a term which may extend to 5 years or with fine which may extend to 1 lakh rupees or both.

26. Summary Bio-medical waste" means any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or research activities pertaining thereto or in the production or testing of biologicals or in health camps. 10 – 25% waste is potentially hazardous. The purpose of treatment of BMW is to reduce the potential hazard posed by biomedical waste, while endeavouring to protect the environment.

27. Yellow – infectious waste Red – recyclable waste White – sharps including metals Blue- glassware and metallic body implants

28. REFERENCES Park K . H0SPITAL WASTE MANAGEMENT . IN: PARKS TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE , 26 TH EDITION. JABALPUR: M/S BANARSIDAS BHANOT PUBLISHERS;2021.P. 883-888 www.ppcb.gov.in www.moef.gov.in biomedical waste manual, 2016

29. Thankyou