Hazards of biomedical waste & its management

1. 23/08/2013 1 HEALTH HAZARDS OF BIOMEDICAL WASTE & ITS MANAGEMENT PRESENTED BY :- DR.NAVIN KUMAR

2. 23/08/2013 2 LET THE WASTE OF THE “SICK” NOT CONTAMINATE THE LIVES OF “THE HEALTHY”. K.park

3. 23/08/2013 3 CONTENTS

4. 23/08/2013 4 DEFINATION: 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 BIO MEDICALS.

5. BIOMEDICAL WASTE 23/08/2013 5 LIQUID

6. HEALTHCARE WASTE CHARACTERIZATION WHO 23/08/2013 6 Biomedical Waste (BMW) Management

7. CLASSIFICATION OF HOSPITAL WASTE 23/08/2013 7 Biomedical Waste (BMW) Management

8. TYPES OF BIOMEDICAL WASTES WASTE CATEGORY TYPE OF WASTE Category No. 1 Human Anatomical Waste Category No. 2 Animal Waste Category No. 3 Microbiology & Biotechnology Waste Category No. 4 Waste Sharps Category No. 5 Discarded Medicine and Cytotoxic drugs Category No. 6 Soiled Waste Category No. 7 Solid Waste Category No. 8 Liquid Waste Category No. 9 Incineration Ash Category No.10 Chemical Waste

9. Chemical waste Waste with high content of heavy metals Pressurized containers Radioactive waste Lab reagents Film developer Expired disinfectants Expired solvents Batteries Broken thermometers Blood pressure guages etc Gas cylinders Gas catridges Aerosol cans Radiotherapy/lab research liquids Contaminated glass wares, packages, absorbent papers 9

10. Sharp waste Pharmaceutical waste Genotoxic waste Needles Infusion Sets Scalpels Knives Blades Broken Glass Expired Pharmaceuticals Contaminated Pharmaceuticals Banned Pharmaceuticals Waste Containing Cytotoxic Drugs(often Used In Cancer Therapy ) Genotoxic Chemicals 10

11. HISTORY OF BIOMEDICAL WASTE  August 13, 1987, prompted expansive closures of numerous  New Jersey  and  New York   beaches due to a “30-mile garbage slick” composed primarily of  medical  and  household wastes because of illegal disposal of the waste private  waste contractors  to dump illegally to avoid high fees. Medical Waste Tracking Act of 1988 (MWTA). 23/08/2013 11

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13. NEED FOR BMW MANAGMENT Nosocomial infections in patients from poor infection control practices and poor waste management. Drugs which have been disposed of, being repacked and sold off to unsuspecting buyers. Risk of air, water and soil pollution directly due to waste, or due to defective incineration emissions and ash. Risk of infection outside hospital for waste handlers and scavengers, other peoples.

14. CATEGORIES OF PERSONS EXPOSED TO RISK OF INFECTION 23/08/2013 14 Biomedical Waste (BMW) Management

15. ROUTES OF TRANSMISSION 23/08/2013 Biomedical Waste (BMW) Management 15

16. PROBLEM ASSOCIATED WITH BMW ORGANISM DISEASES CAUSED RELATED WASTE ITEM VIRUSES  HIV, Hepatitis B, Hepatitis A,C, Arboviruses, Enteroviruses AIDS, Infectious Hepatitis, Infectious Hepatitis, Dengue, Japanese encephalitis, tick-borne fevers, etc. Infected needles, body Fluids, Human excreta, soiled linen, Blood, body fluids. BACTERIA Salmonella typhi, Vibrio cholerae, Clostridium Tetani, Pseudomonas, Streptococcus Typhoid, Cholera, Tetanus Wound infections, septicemia, rheumatic fever, endocarditis, skin and soft tissue infections Human excreta and body fluid in landfills and hospital wards, Sharps such as needles, surgical blades in hospital waste. PARASITES Wucheraria Bancrofti, Plasmodium Cutaneous leishmaniasis, Kala Azar, Malaria Human excreta, blood and body fluids in poorly managed sewage system of hospitals.

17. 23/08/2013 17 WASTE IMPROPER DISPOSAL COLLECTED BY ULB SMALL SCRAP DEALERS (KAWARIWALLAH) RAG PICKERS LANDFILLS OR DUMPING GROUNDS WHOLESALE DEALER OR LARGE SCRAP DEALER RECYCLE FACTORY UNITS CONSUMER

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20. WASTE HIERARCHY PYRAMID 23/08/2013 20

21. BMW 23/08/2013 21

22. OBJECTIVE OF BMW MANAGEMENT TO MINIMIZE THE PRODUCTION/GENERATION OF INFECTIVE WASTE. RECYCLE THE WASTE AFTER TREATING TO THE EXTENT POSSIBLE. TREAT THE WASTE BY SAFE AND ENVIORNMENT FRIENDLY/ACCEPTABLE METHODS. ADEQUATE CARE IN HANDLING TO PREVENT HEALTHCARE-ASSOCIATED INFECTIONS. SEFTY PRECAUTIONS DURING HANDLING THE BMW. 23/08/2013 22

23. COLOUR CODING OF BAGS 23/08/2013 23

24. COLOR CODE TYPE OF CONTAINER WASTE CATEGORY TREATMENT OPTIONS Yellow Plastic bags 1, 2, 3 and 6 Incineration/deep burial Red Disinfected container/plastic bag 3, 6 & 7 Autoclaving/Micro Waving/Chemical treatment Blue/white transparent Plastic bags/ puncture proof container 4 & 7 Autoclaving/Micro waving/chemical treatment, Destruction & shredding Black Plastic bag 5, & 9, AND 10 (SOLID) Disposal in secured land fills 23/08/2013 24 Biomedical Waste (BMW) Management

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30. INSPECTION & RE-SEGREGATION 23/08/2013 30

31. LABEL FOR BIO-MEDICAL WASTE CONTAINERS/BAGS Note : Label shall be non-washable and prominently visible . HANDLE WITH CARE BIOHAZARD CYTOTOXIC BIOHAZARD SYMBOL CYTOTOXIC HAZARD SYMBOL

32. THERMAL PROCESSES 23/08/2013 Biomedical Waste (BMW) Management 32

33. MECHANICAL PROCESSES 23/08/2013 Biomedical Waste (BMW) Management 33

34. INCINERATION 23/08/2013 34

35. BIO MEDICAL WASTES DESTRUCTION BY DOUBLE CHAMBERED INCINERATOR 23/08/2013 35

36. INCINERATOR ASH DISPOSAL 23/08/2013 36

37. AUTOCLAVE 23/08/2013 37

38. BIO MEDICAL PLASTIC WASTES DISINFECTION BY SODIUM HYPOCHLORITE 23/08/2013 38

39. SHARP STORAGE & DISPOSAL

40. LAND DISPOSAL FACILITY FOR CITIES & TOWNS WITH POPULATION LESS THAN 5 LACS

41. BIO MEDICAL WASTE MANAGEMENT IN INDIA THIS RULE APPLIES TO THOSE WHO GENERATE, COLLECT, RECEIVE, STORE, DISPOSE, TREAT OR HANDLE BIO MEDICAL WASTE IN ANY MANNER. BIOMEDICAL WASTE (MANAGEMENT AND HANDLING) RULE 1998, PRESCRIBED BY THE MINISTRY OF ENVIRONMENT AND FORESTS, GOVT OF INDIA, CAME INTO FORCE ON 20TH JULY 1998 . 41

42. THUS BIO MEDICAL WASTE SHOULD BE SEGREGATED INTO CONTAINERS/BAGS AT THE POINT OF GENERATION OF WASTE. 23/08/2013 42

43. UNDER ENVIRONMENT PROTECTION ACT,1998 BIO-MEDICAL WASTE (Management & handling) RULES 1998 1 st Amendment Rules vide S.O.201(E) Dated 06/03/2000 2 nd Amendment Rules vide S.O.1069(E) Dated 17/09/2003 THE AUTHORIZATION IS REQUIRED FOR Generation/Collection/Reception/Storage Transportation Treatment/Disposal or any other form of handling. 23/08/2013 43

44. 44 ENVIRONMENTAL LEGISLATION The Environment (Protection) Act, 1986 The Biomedical Waste (Management & Handling) Rules, 1998 The Municipal Solid Waste (Management & Handling) Rules, 2000 The Hazardous Waste (Management & Handling) Rules, 1989 The National Environmental Tribunal Act, 1995 The Air (Prevention and Control of Pollution) Act, 1981

45. CONCLUSION Thus refuse disposal cannot be solved without public education. Individual participation is required. Municipality and government should pay importance to disposal of waste economically. Thus educating and motivating oneself first is important and then preach others about it. Start disposing waste first from within your home, then outside home, then neighborhood ,then your street, your area ,city and then the nation and the world. Lets make this world a better place to live in . 45