Bmw mgmt rules 2016 with amend 2018

Bio-medical Waste Management rules 2016 with amend 2018

1. Bio Medical Waste Management Rules 2016 & (Amendment) Rules, 2018 State Quality Assurance Medical Officer State Quality Improvement Unit Commissionerate of Health Gandhinagar

2. Greek physician Hippocrates "First do no harm"

3. Definition of Biomedical Waste Biomedical waste has been defined as “any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biological or in health camps , including the categories mentioned in Schedule I appended to these Rules ” as per Biomedical Waste Rules 2016.

4. Why BMW Management is Important ? 80% non infectious (kitchen waste, paper) 15% is infectious (dressings, anatomical wastes, blood bags) 5% is non infectious but hazardous,(chemicals, drugs and mercury) When this 20% of the hospital infectious material is mixed with 80% Then all the 100% waste becomes hazardous and infectious, hence segregation should be at source.

5. Biomedical waste rules 2016 Gazetted on 28 th March 2016 Replaces Biomedical Waste (Management & handling) Rules 1998 Major Changes – Scope – also includes Ayush Health Facilities, Vaccination Camps, medical or surgical camp, First-Aid Rooms of Schools, Forensic Labs, etc.

6. SALIENT FEATURES The ambit of the rules has been 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 within two years Pre-treatment of the laboratory waste, microbiological waste, blood samples and blood bags through disinfection or sterilization on-site in the manner as prescribed by WHO or NACO Provide training to all its health care workers and immunize all health workers regularly (Hepatitis B and TT)

7. SALIENT FEATURES Establish a Bar-Code System for bags or containers containing bio-medical waste for disposal Report major accidents Bio-medical waste has been classified in to 4 categories instead 10 to improve the segregation of waste at source Procedure to get authorization simplified . Automatic authorization for bedded hospitals. The validity of authorization synchronized with validity of consent orders for Bedded HCFs. One time Authorization for Non-bedded HCFs Dispose off the waste with in 48 hrs . No healthcare facility shall setup onsite BMW treatment facilities if a CBMWTF exists within 75 kms of distance , to setup if no such facility.

8. Steps for Waste Management

9. Segregation GENERAL REQUIREMENTS Segregation as per the colour coding provided in the BMW Rules, 2016 (Revision 2018). Segregation at the point of generation only. It is the responsibility of the waste generator only. Do not mix general waste generated with the bio medical waste. The work instructions (colour coding) are displayed at appropriate areas of the hospital. 05-03-2019 QI-NHSRC

10. Collection and Storage GENERAL REQUIREMENTS All the bags used for waste collection is need to be sealed once they are full to the 3/4 th of the capacity and transported to the central waste storage area or interim storage areas Collection in the closed covered containers Collection time needs to be fixed for daily pick. General waste must not be collected at the same time or in the same trolley Appropriate PPE i.e . Gum boots, Heavy duty gloves, face masks and eye wear . All the bags needs to be labelled with biohazard or cytotoxic hazard symbol . 05-03-2019 QI-NHSRC

11. Transportation In covered wheel barrow based sturdy trolleys through a route which has low traffic flow of patients and visitors. All the trolleys used for the transportation of the waste must be labelled with bio hazard logo. After every transportation cycle, ensure trolley is washed & dried up . Route of transportation preferably be planned in such a way that ensures: Does not include transportation through high risk areas Supplies and waste are transported through separate routes. Waste is not transported through areas having high traffic of patients and visitors Central Waste collection area can be easy accessed through this route Provide safe transportation of waste to avoiding spillage and scattering of waste 05-03-2019 QI-NHSRC

12. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options No Colour Category of Waste Colour 1 Yellow 2 Red 3 White 4 Blue

13. 05-03-2019 QI-NHSRC

14. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

15. Schedule 1- categories and their segregation, collection, treatment, processing and disposal options Glassware: Broken or discarded and contaminated glass including medicine vials and ampoules except those contaminated with cytotoxic wastes & Metallic Body Implants

16. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

17. Sharp containers Puncture proof, Tamper proof, Leak proof containers!!

18. Schedule 1- WHITE Waste sharps Including Metals: Needles, syringes with fixed needles, needles from needle tip cutter or burner, scalpels, blades, This includes both used, discarded and contaminated metal sharps Autoclaving or Dry Heat Sterilization followed by shredding or mutilation

19. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

20. Schedule 1- red categorY: PLASTICS RECYCLEBLE WASTE (a) Wastes generated from tubing, bottles, intravenous tubes and sets, catheters, urine bags, syringes (without needles and fixed needle syringes ) and gloves Red coloured n o n - chlorin a t ed plastic bags or containers Autoclaving or micro-waving/hydroclaving followed by shredding or mutilation catheters, urine bags, syringes (without needles and fixed needle syringes ) and gloves

21. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

22. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

23. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

24. Schedule I : yellow category: soiled waste Human Anatomical Waste: Human tissues, organs, body parts and fetus Animal Anatomical Waste : Soiled Waste: Items contaminated with blood, body fluids like dressings, plaster casts, cotton swabs and bags containing residual or discarded blood Incineration or Plasma Pyrolysis or deep burial

25. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

26. DRUGS (d) Expired or Discarded Medicines including antibiotics Common bio-medical waste treatment facility : Incineration (d) CYTOTOXIC DRUGS: including all items contaminated with cytotoxic drugs along with glass or plastic ampoules, vials etc.

27. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

28. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

29. CHEMICAL & LIQUID WASTES (g) Chemical Waste: Discarded disinfectants Yellow coloured containers or non-chlorinated plastic bags Disposed of by incineration or Plasma Pyrolysis or Encapsulation in hazardous waste treatment, storage and disposal facility. (h) Chemical Liquid Waste : discarded Formalin, liquid from laboratories and floor washings, cleaning, etc. Separate Collection system leading to effluent treatment system

30. Liquid disinfection unit

31. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

32. Biomedical wastes categories and their segregation, collection, treatment, processing and disposal options

33. Microbiology, Biotechnology and other clinical laboratory waste: Laboratory cultures, stocks or specimens of microorganisms Pre-treat to sterilize with nonchlorinated chemicals on-site as per NACO or World Health Organization LINEN: linen , mattresses, contaminated with blood or body fluid. LABORATORY WASTES & LINEN

34. MONITORING OF IMPLEMENTATION OF THE RULES: ANNUAL REPORT Every occupie r shall submit an annual report to the prescribed authority by 30 th of June every year The prescribed authority shall compile, review, analyze and report to the CPCB by 31 st July every year The CPCB shall submit a report on the same to the MoEFCC by 31 st Augus t every year The Annual reports shall be available on the websites of the occupier, SPCB and the CPCB

35. 2016 Rules Bio Medical Waste Management (Amendment) Rules, 2018 phase out use of chlorinated plastic bags, gloves and blood bags within two years from the date of notification of these rules phase out use of chlorinated plastic bags (excluding blood bags) and gloves by the 27th March, 2019 establish a Bar- Code System for bags or containers containing bio-medical waste to be sent out of the premises or place for any purpose within one year from the date of the notification of these rules; establish a Bar- Code System for bags or containers containing bio-medical waste to be sent out of the premises or place for the further treatment and disposal in accordance with the guidelines issued by the Central Pollution Control Board by 27th March, 2019 make available the annual report on its web-site and all the health care facilities shall make own website within two years from the date of notification of these rules all the health care facilities (any number of beds) shall make available the annual report on its web-site within a period of two years from the date of publication of Bio-Medical Waste Management (Amendment) Rules, 2018

36. 2016 Rules Bio Medical Waste Management (Amendment) Rules, 2018 Annual Report- The prescribed authority shall compile, review and analyse the information received and send this information to the Central Pollution Control Board on or before the 31st July of every year. Annual Report- The prescribed authority shall compile, review and analyse the information received and send this information to Central Pollution Control Board in Form IVA before the 31st July of every year. Yellow waste list Addition of : Routine mask and gown in list Glassware/Metallic Body Implants- Cardboard boxes with blue colored marking Puncture proof and leak proof boxes or containers with blue colored marking Chemical treatment using at least 10% Sodium Hypochlorite Chemical treatment using 1% to 2% shall be substituted

37. Transportation

38. Waste handler with PPE

39. Bio Medical waste storage facility

40. Thanks