Hospital waste management

Basic about Hospital waste management. It is very helpful for student.

1. Hospital waste management By, Bajarangi lal Chaudhary Ph.D. Scholar

2. Contents Introduction Universal precautions Definition Categories Waste segregation Treatment and disposal Biomedical waste management in India Biomedical waste management program

3. Introduction Adequate management and disposal of waste is essential. Inadequate and inappropriate handling of health care waste may have serious public health consequences and a significant impact on the environment.

4. Waste generated in Hospital The quantity of solid waste generated in hospitals varies from 1/2 to 2 kg/bed in Government hospitals, private hospitals and nursing homes. General waste (80%): Pathological and infectious waste (15%): Chemical and pharmaceutical waste (3%): Sharp waste ( 1%):

5. Situation In India According to the Ministry of Environment and Forests about 4,05,702 kg/ day, of which only 2,91,983 kg/day is properly disposed, which means that almost 28% of the wastes is left untreated and not disposed, finding its way in dumps or water bodies and re-enters our system. Karnataka tops the chart among all the states in generation of biomedical waste.

6. UNIVERSAL PRECAUTIONS 1. Assume that all specimens/patients are potentially infectious. 2. All specimens should be placed in a leak-proof impervious bags for transportation to the laboratory. 3. Use gloves while handling blood and body fluid specimen. 4. Wear laboratory coats or gowns while working in the laboratory.

7. UNIVERSAL PRECAUTIONS 5. Never pipette by mouth. 6. Decontaminate 7. Limit use of needles and syringes 8. Biological safety hoods should be used for laboratory work. 9. All the potentially contaminated materials of the laboratory should be decontaminated before disposal. 10. Always wash hands after completing laboratory work and remove all protective clothings before leaving the laboratory.

8. DEFINITION OF BIOMEDICAL WASTE (BMW) “Biomedical waste” means 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 biologicals .

9. Properties BMW Rule 1998 BMW Rule 2016 No of categories Ten Four Overlapping of categories Yes No Maximum limit for the release of furans Not specified Specified Incinerator May have only one chamber Upgraded to have secondary chamber Chlorinated bags Were used To be phased by out by non chlorinated bags in two years. D/W Biomedical Waste Rule 1998 and 2016

10. Properties BMW Rule 1998 BMW Rule 2016 Cytotoxic drugs Black color back Yellow color bag Use of bar code Not there To be introduced within two years Methods of disposable recommended Incineration, shredding, autoclave, microwaving, sharp pits etc. Newer methods are introduced such as plasma pyrolysis, inrtization and encapsulation. Disposable facility Occupier must have disposable facility No , if outsourcing facility is available within 75km Incineration ash Allowed Not allowed Majority of idea Discarding biomedical waste Recycling of biomedical waste D/W Biomedical Waste Rule 1998 and 2016

11. TREATMENT AND DISPOSAL METHODS 1. Incineration 2. Autoclaving 3. Chemical disinfection 4. Wet and dry thermal treatment 5. Microwave irradiation 6. Inertization

12. Incineration lncineration is a high temperature dry oxidation process that reduces organic and combustible waste into nonorganic incombustible matter, resulting in a very significant reduction of waste volume and weight. Incineration should not be done for: Pressurized gas containers Reactive chemical waste Halogenated plastics such as PVC (polyvinyl chloride) Waste with heavy metals such as mercury, silver salts, radiographic waste, broken thermometers

13. Autoclave

14. Chemical disinfection Chemicals are added to waste to kill or inactivate the pathogens within it results in disinfection rather than sterilization. It is more suitable for liquid waste such as blood, urine, stool and hospital sewage. • However, solid waste, such as microbiological cultures and sharps, etc may be disinfected chemically with certain limitations.

15. Wet and dry thermal treatment Wet thermal treatment or steam disinfection is based on exposure of shredded infectious waste to high temperature, high pressure steam, and is similar to the autoclave sterilization process. It is inappropriate for anatomical waste and animal carcasses.

16. DISPOSAL Landfilling , deep burial and sewage are used for disposal. Infectious waste after treatment can be disposed of by landfilling or deep burial. Liquid waste can be disposed in sewage drains. Besides treatment, incineration is also a method of disposal.

17. BIOMEDICAL WASTE MANAGEMENT IN INDIA It establishes legal control, and permits the national agency responsible for the disposal of health care waste, usually the Ministry of Health, to apply pressure for their implementation. The Ministry of Environment may also be involved.

18. WASTE MANAGEMENT PROGRAM The policies and procedures should be incorporated in the laboratory’s operating manuals. Emphasis should be on waste minimization (by reducing waste, reuse and recycling), proper segregation, and health and safety of the workers. All personnel generating, collecting, transporting and storing infectious waste must be trained under the program.