Huye Isange Rehabilitation Center BIOSAFETY AND BIO SECURITY.pptx

Waste management policy

1. BIOSAFETY AND BIO SECURITY Biosafety versus Biosecurity https://www.rahwayrising.com/robbery-larceny-spike-but-overall-crime-rate-flat/

2. Each facility or lab should adopt its own biosafety guideline that identifies known and potential hazards, and specifies practices and procedures to eliminate or minimize such hazards. International guidelines that define Good Practice (GWP) are divided into the following categories: 1. Access Guidelines (Protected areas, Lab, Nurses’ offices…) 2. Personal Protection Equipment 3. Procedures and Practices Concepts of Biosafety in the Facility, in the Field (in side the facility) and the Laboratory

3. The international biohazard warning symbol must be displayed on the doors of the rooms where micro/macro-organisms of potential harm are handled Only authorized persons should be allowed to enter the laboratory working areas Children should not be authorized or allowed to enter certain areas, such as laboratory working areas . Unless accompanied by a professional Laboratory doors should be kept closed https://www.featurepics.com/online/Staff-Only-Sign-2197216.aspx

4. Personal protective equipment, commonly referred to as "PPE", are equipment worn to minimize exposure to serious workplace injuries and illnesses . These exposures may result from contact with biological, chemical, radiological, physical, electrical, mechanical, or other workplace hazards In the field PPEs are very important The only mitigation measures available are policies, SOPs, practices like Good Work Practices (GWP) and PPE . Substitution, elimination or engineering controls are not available for the field biosafety

5. Hierarchy of Mitigation Selection of PPE will depend on the risk assessment of the work being performed. https://www.osha.gov/shpguidelines/hazard-prevention.html

6. Use of Personal Protective Equipment Wear lab coats/ or work uniform Use appropriate gloves when handling potentially infectious materials Wash hands after and before leaving the laboratory or working area Wear safety glasses to protect the eyes from splashes, impacting objects and sources of artificial ultraviolet radiation. Use respirators , face masks or face shield when e.g cleaning up a spill of infectious material, or in a room with toxic aerosols

7. Handle all human/animal/plant specimen as if potentially hazardous Report accidents and incidents promptly to the immediate supervisor Keep exits and passage ways clear at all times Read all posted signage and job aids Ensure that emergency equipments ( eyewashes, emergency showers and fire extinguishers ) are readily accessible Practice and Procedures (Laboratory, Nurses’ areas)

8. Bio-containment Levels Primary containment  is the container in direct contact with bio-hazardous material I t protects personnel and the immediate laboratory environment from exposure to infectious agents. Secondary containment : is the protection of the environment external to the laboratory from exposure to infectious materials. It entails a combination of facility design and operational practices. Biological Safety Cabinets (BSC)  Biological Safety cabinets  are devices designed to provide effective primary bio-containment in laboratories working with highly infectious agents. The primary purpose of a BSC is to serve as a means to protect the laboratory worker and the surrounding environment from pathogens

9. Standard Work Practices

10. Risk is defined as the likelihood of an undesirable event, involving a specific hazard, that has consequences Hazard is a source that has a potential for causing harm. It is however not a risk without a specific environment or situation What is a Risk?

11. Chain of Infection Reservoir of pathogen Portal of escape Transmission Route of entry/infectious dose Susceptible host Incubation period Illness Risk Assessment Substitution Proper Work Practices Engineering Controls & Protective Equipment Immunization Surveillance

12. Risk and Hazard Communication Establishes systems and policies to manage laboratory and in field biosafety and biosecurity It is Integral in the day-to-day operations of the institution/ organization, both in normal times and times of emergency

13. Risk of Inadequate GWP Increased probability of laboratory injuries / or any practical field area Increased lab pathogen infections Non-compliance of the policies governing universal standard practices can lead to closure of a facility

14. Universal / Standard Precautions Rules of effective practices designed to protect laboratory workers from infection from a range of pathogens Hand washing Personal protective equipment Needle sticks/sharps injury prevention Respiratory hygiene and cough etiquette Environmental cleaning Precautions in transport and processing of biological samples SAFE WASTE DISPOSAL Equipment care-cleaning and disinfection Traffic control in and out of the laboratory or out side the facility

15. Core Requirements: Safety Equipment Safety equipment includes items such as biological safety cabinets and personal protective equipment designed to eliminate or minimize exposures to hazardous biological materials. PPE Gloves Face protections Lab coats and gowns Shoe protection Laboratory Safety Equipment Biosafety Cabinet (BSC) Biological, chemical spill kit Eye wash Pipettes First-Aid Kit

16. Core Requirements - Good Microbiological Practices and Procedures GMPP: Includes both general behaviours, best working practice and technical procedures that should always be observed in the laboratory, animal facility & field and conducted in a standardized way. Best practice - are essential to facilitate safe work practices and control biological risks (Universal standard precautions) e.g. use of barrier protection, masks, hand washing, space decontamination, good waste management, etc.) Technical procedures e.g. Use of validated SOPs Appropriate methods available in proximity to laboratory Personnel training and competence General training on laboratory practices Job specific training and competency assessment Safety and security training NOTE: Refer to WHO Laboratory Biosafety Manual 4th Edition

17. Waste Management Definitions & Classification of Wastes

18. Definition of Terms Decontamination: Reduction of viable biological agents or other hazardous materials on a surface or object(s) to a pre-defined level by chemical and/or physical means. Disinfection: A process to eliminate viable biological agents from items or surfaces for further safe handling or use. Fumigation: Use of a poisonous gas or vapour to remove contamination of a biological agent from a surface, piece of equipment or area. Sterilization: A process that kills and/or removes all biological agents including spores. Waste refers to materials which are produced as end -product or a remainder of process and or procedures within the workplace (Farm, Field, Laboratories, research centres)

19. Why Manage Waste? To protect human, animal health & the environment. To minimize the generation of hazardous waste.

20. Elements of Waste Management Plan Developing a Waste Management Plan Collection of waste Handling of waste - separation, storage and processing at the source Segregation and processing Transfer and transport. Disposal of waste Documentation Personnel responsibility Training (OJTs) Designate a responsible person Conduct a Waste Management survey and invite suggestions Solicit suggestions from workers from the relevant organization Recommend improvements for implementation. Draft the Healthcare waste management plan. Approval and implementation. Review the HealthCare Waste Managment plan.

21. Classification of Wastes Broad Classification of waste Hazardous waste : Waste that is considered to pose inherent risk to human, animal health or environment and therefore needs special management. Non-hazardous waste: - Waste that is considered to pose no inherent risk to human, animal health or environment and therefore needs no special treatment and management.

22. Categories based on Source and Risks Biomedical waste : Any waste which is generated from provision of healthcare or bio-medical research activities. However, not all waste generated in biomedical facilities are hazardous e.g. packaging materials, unused media, saline solutions Cytotoxic /genotoxic waste : are generated during management of cancer therapies. Domestic Waste : Is generated from residential activities or settings. General waste : Is non hazardous waste generated from biomedical facilities (diagnostic & research laboratories, hospitals)

23. Infectious waste : All kind of waste that may transmit infections. Mixed material waste : Are from products containing a mixture of more than one type of hazardous waste or hazardous and non hazardous waste where simple sorting may not be possible or necessary. Municipal solid waste: Waste from household, commerce, administration and service companies that are disposed of through the public waste management system. Radioactive Waste : Any radioactive material that has been, or will be, discarded as of being of no further use. E-Waste – includes discarded e-devices such as TVs, phones, computers, etc.

24. General non-hazardous waste for recycling or reuse e.g paper (constitutes about 80-85% of all waste) Hazardous waste (15-20%) Sharps waste (hypodermic needles, scalpels, knives and broken glass) Infectious waste containing disease transmitting organisms Pathological waste (anatomical tissues/organs) Pharmaceutical/cytotoxic waste from genotoxic or cancer therapies Chemical waste from reagents, solvents or disinfectants Agricultural waste are mostly biodegradable while others such as pesticides are not biodegradable Radioactive waste from radiotherapy, diagnostic & research procedures, or unsealed radionuclides, by-products of nuclear processes

25. Elements of Waste Management https://www.google.com/search?tbm=isch&q=waste+recovery&chips=q:waste+recovery,g_1:energy:7RBoT3cjdnk%3D,online_chips:hierarchy&usg=AI4_-kQjzBN lKToFsogt2f6hzgmLt2xYg&sa=X&ved=0ahUKEwi7sbHM9KHiAhUKz4UKHcXjAYQQ4lYILSgF&biw=1188&bih=566&dpr=1.

26. Waste Minimization The preferred management solution is quite simply not to produce the waste Examples waste minimization source reduction - management & control measures at facility level - stock management of chemicals & pharmaceuticals Waste minimization usually benefits the waste producer Purchase of goods, waste treatment and disposal costs are reduced Liabilities associated with the disposal of hazardous waste are also lower. Minimization as on site waste management saves costs

27. When considering reuse, it is important to make a distinction between different types of products: Single-use devices must not be reused. E.g Syringes and hypodermic needles should not be reused because of the significant chance of exposure. Where there is an option, purchasing a reusable device of similar quality for use is preferable Reuse may involve a combination or all of the following steps: cleaning, decontamination, reconditioning, disinfection and sterilization. Re-usable Containers should be sent to specialized centers for refill. Re-use of plant waste to feed soldier fly larvae to produce animal feeds.

28. Recycling Practiced by a wide range of institutions. From an environmental perspective, recycling is less desirable than reusing a waste item. Recycling reduces costs through reduced disposal costs or payments made by a recycling company for the recovered materials. The non-hazardous portion of waste contains recyclable materials (e.g. paper, cardboard, metal, packaging, tubing, glass).

29. Recovery Refers to converting waste to fuel for generating electricity or for direct heating. OR Is a term used to mean converting waste into new products or composting of organic waste to produce compost for use in agriculture.

30. Treatment/Decontamination Treat to reduce the potential hazard posed by waste, while endeavoring to protect the environment. Chemical method – hypochlorite Mechanical process – shredding, grinding mixing Biological process - composting Emerging Technologies for treatment include; Non burn (wet heat – autoclave & microwave) Biocremation/ resomation /alkaline hydrolysis Effluent decontamination system (EDS) – for treating waste from slaughter houses, post mortem rooms. 31 Autoclave Shredder Open burning Bio cremation - uses water and potassium hydroxide to reduce the body to its basic element of bone & ash Autoclave/shredder

31. Waste Management Process Segregation of waste should be maintained throughout the processes of collection, transport, storage and disposal Segregation Packaging Labeling Handling and storage Transportation Disposal 32

32. Segregation & Labelling 33 Colour coding makes it easier to segregate waste during collection, transport, storage, treatment and disposal. Color provides a visual indication of the potential risk posed by the waste. Segregation is based on potential hazard and disposal route, by the person who generates waste Plant materials - green bin , other non-hazardous kitchen/office waste into black bin , pathological/anatomical waste - red bin , infectious - yellow bin Pharmaceutical - brown Good practice Radioactive waste Vegetative waste General/Non hazardous/ Infectious waste Highly Infectious Poor practice Food/kitchen wast

33. Storage In general, there are four different kinds of waste-storage areas: non-hazardous or general waste, hazardous waste (infectious and sharps waste), chemical and pharmaceutical waste , radioactive waste. Each waste stream generated by a facility should have a storage area. Area to be protected from weather elements and lockable Full waste containers be labelled to help in easy identification of type & source; Closed local storage inside or near the facility may be needed if wastes are not collected frequently; Segregated waste stored separately at holding point 34 Good practice Poor practice - Open air storage

34. Transportation – On Site Color coded transport bins Good practice on PPE What could go wrong? Any truck will do? 35

35. Notes: Transport staff wear adequate PPE; gloves, strong and closed shoes, overalls and masks. Hazardous and non-hazardous waste should always be transported separately - there are three different transport systems Waste transportation trolleys for general waste should be painted black, only be used for non-hazardous waste types and labelled clearly “General waste” or “Non-hazardous waste”. Hazardous waste trolleys should be coloured yellow for infectious waste and should be labelled with an “Infectious waste” sign. Other hazardous waste, such as chemical and pharmaceutical wastes, should be transported separately in boxes to central storage sites. Transportation schedule and route must be established and adhered to. 36

36. Expected Responses Hypochlorite is less toxic and easily diluted in water for disposal down the sewer; Reduce exposure to toxic chemicals by purchasing items that do not generate unnecessary toxicity Waste minimization is achieved by source reduction – stock management, monitoring & control of purchasing 37

37. Chemical Waste Globally harmonized system of classification and labelling of chemicals Types - Cytototoxic - Pharmaceuticals - Heavy metals - Pesticides - Acaricides 38

38. Pharmaceutical Waste Types of pharmaceutical waste - Cytotoxic waste – chemotherapeutic, cytostatic & antineoplastic Pharmaceutical waste – anti-infective, antineoplastic Should be stored in designated quarantine stores Transport separately from other waste streams For disposal; -Return to manufacturers -Burial in sanitary landfill Chemical neutralization -Neutralize with another chemical or dilute in large amounts of water and discharge down sewers 39

39. Infectious & Pathological Waste 40 Biomedical Waste Disposal (Non sharps Waste ) Double bag in yellow or red liners depending on waste stream color code (refer to segregation slide) Affix label Autoclave the materials Dispose by thermal incineration method Biomedical Waste Disposal (Sharps Waste) Segregate in leak and puncture proof sharps container Affix label Storage is in a cool dry place Transport to incineration area for disposal

40. Sharps Waste Management Activity 5 - 3 minutes As the expert, discuss the supplies that you would advise the team to put in place to effectively and safely handle the anticipated waste till disposal Share your thoughts on sticky notes 41

41. Electronic Waste Management Activity 6 ( Handout #07/01 ) - 5 minutes The Owino Uhuru Factory-Mombasa How was the community affected? Which heavy metal was involved in the saga? Discuss and share your thoughts on sticky notes - Type of e-waste - Handling - Disposal 42

42. E-waste Lead and mercury are the main heavy metals that are proven to cause chronic damage to internal organs of humans and animals 43 Disposal Methods of E-Waste Land filling Thermal combustion – incineration Dismantling parts for re-sale Pulverization Shredding Density separation by water

43. Appropriate PPE is a must while handling chemical waste Protocol for safe handling of chemical waste in the field is required Training for personnel is key to safety Use appropriate truck for transport All chemicals must be transported back to station for disposal Field Chemical Waste 44

44. Key Messages Continuous risk assessment is key in waste management Different waste types should be segregated, stored, and disposed according to the risks they present. Minimization of waste production is a key element of waste management plan. Waste management is key to safe and healthy working environment. Proper use of PPE is key to minimizing personal exposure. Effectively tracking waste audit trails, including documentation, segregated storage, and appropriate packaging of the materials are key components of an effective waste management plan. 45

45. References Laboratory biosafety and biosecurity policy guidelines: Health Care Waste management sops, 1st edition, Ministry of Health, GoK , June 2016 National guidelines for safe management of healthcare waste, GoK , 2011 5. Global Biorisk Management Curriculum course Kenya, Ministry of Health, National Infection Prevention and Control Guidelines for Health Care Workers, December 2010. WHO blue book on safe healthcare waste management 2nd edition 2014 National Biosafety Authority (NBA) guidelines 2019 WHO LBM4 Decontamination and Waste Management Monogragh 46

46. @The End @ Thank You!