biomedical waste managment

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BIOMEDICAL WASTE BIOMEDICAL WASTE MANAGEMENT MANAGEMENT PRATEEK JANAGAL (99) KAJAL (60)

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BIOMEDICAL WASTE BIOMEDICAL WASTE MANAGEMENTMANAGEMENT

PRATEEK JANAGAL (99)KAJAL (60)

What is Biomedical Waste?What is Biomedical Waste?Bio-medical waste" means any waste, which is generated during the diagnosis, treatment or immunisation of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals, and including categories mentioned in Schedule I;

Specific to hospitals Bio-medical waste is defined as waste that is generated during the diagnosis, treatment or immunization of human beings and are contaminated with patient’s body fluids (such as syringes, needles, ampoules ,organs and body parts, placenta, dressings, disposables plastics and microbiological wastes).

BIOMEDICAL WASTE INCLUDES

Needles Discarded medicines

Human anatomical waste Solid waste eg: cotton swabs

Who’s at Risk ?

• Doctors and nurses

• Patients

• Hospital support staff

• Waste collection and disposal staff

• General public and

• the Environment

Health hazards of BMW Type of wasteType of waste Health hazardHealth hazardHuman / Animal Human / Animal waste/ Soiled waste/ Soiled wastewaste

HIV,HBV,HCV, cholera, HIV,HBV,HCV, cholera, salmonellosis, rabies, salmonellosis, rabies, leptospirosis, anthrax,TB, leptospirosis, anthrax,TB, pneumonia, septicemiapneumonia, septicemia

SharpsSharps HIV, HBV, HCV, InjuriesHIV, HBV, HCV, InjuriesCytotoxic/ Cytotoxic/ radioactive wasteradioactive waste

Cancer, genetic mutation, birth Cancer, genetic mutation, birth defectdefect

Chemical wasteChemical waste Poisonings, dermatitis, Poisonings, dermatitis, conjunctivitis, bronchitisconjunctivitis, bronchitis

NEED FOR BMW MANAGMENT Nosocomial infections to 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.

India :India :Extent of the problemExtent of the problemCPCB,April,2011 dataCPCB,April,2011 data

>95,000 hospitals and healthcare facilities in India .4.2 lakh kg of biomedical waste is generated on a daily basis.Three million tonnes of medical wastes generated every year. Expected to grow 8% annually.2,91,983 kg/day BMW is 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 with 62,241 kg/day of BMW.  Only 179 CTF to treat the BMW in the country.

BIOMEDICAL RULES 1998The Government of India as under Section 6,8 and 25 of the Environment (Protection) Act,1986, has made the Biomedical Wastes (Management & Handling) Rules, 1998.

The rules are applicable to every institution generating biomedical waste which includes hospitals, nursing homes, clinic, dispensary, veterinary institutions, animal houses, laboratory, blood bank. The rules are applicable to all persons who generate, collect, receive, store, transport, treat, dispose, or handle bio medical waste in any form.

BIOMEDICAL WASTE(MANAGEMENT & HANDLING) BIOMEDICAL WASTE(MANAGEMENT & HANDLING) RULES by Govt. of India, 1998RULES by Govt. of India, 1998

Revised in 2011Revised in 2011Now known as BMW Rules, 2011Now known as BMW Rules, 2011

2011 1998Every occupier generating BMW, irrespective of the quantum of wastes comes under the BMW Rules and requires to obtain authorisation

Occupiers with more than 1000 beds required to obtain authorisation

Duties of the operator listed Operator duties absentTreatment and disposal of BMW made mandatory for all the HCEs

Rules restricted to HCEs with more than 1000 beds

A format for annual report added with the Rules

No format for Annual Report

Form VI i.e. the report of the operator on HCEs not handing over the BMW added to the Rules

Form VI absent

Setting up BMW treatment facilityOccupier set up FOLLOWING treatment facilities,prior to commencement of its operation which are--

AUTOCLAVE HYDROCLAVE INCINERATOR MICROWAVE SHREDDER

Bio Medical Wastes Destruction byBio Medical Wastes Destruction by Double Chambered Incinerator Double Chambered Incinerator

Incinerator Ash DisposalIncinerator Ash Disposal

AutoclaveAutoclave

Health waste CharacterizationHealth waste Characterization

Hospital waste

Non Hazardous(≈ 75-90%)

Hazardous waste(≈ 10-25%)

InfectiousOthers

( Radioactive,Cytotoxic )

WASTEWASTECATEGCATEG

ORYORY

WASTE TYPEWASTE TYPE TREATMENT & DISPOSALTREATMENT & DISPOSAL

Category Category 1 1

Human Anatomical waste (human tissues, Human Anatomical waste (human tissues, organs, body partsorgans, body parts

Incineration/deep burialIncineration/deep burial

Category Category 2 2

Animal Waste: Animal tissues, organs, body Animal Waste: Animal tissues, organs, body parts, bleeding parts, fluid, blood and parts, bleeding parts, fluid, blood and experimental animals used in research etcexperimental animals used in research etc

Incineration/deep burialIncineration/deep burial

Category Category 3 3

Microbiology & Biotechnology Wastes: Wastes Microbiology & Biotechnology Wastes: Wastes from clinical samples, pathology, biochemistry, from clinical samples, pathology, biochemistry, hematology, blood bank, laboratory cultures, hematology, blood bank, laboratory cultures, etcetc

Local Local autoclaving/microwaving/autoclaving/microwaving/IncinerationIncineration

SCHEDULE I: CATEGORIES OF BIO-MEDICAL WASTE

WASTE WASTE CATEGORYCATEGORY

WASTE TYPEWASTE TYPE TREATMENT & DISPOSALTREATMENT & DISPOSAL

Category Category No. 4No. 4

Waste Sharps (needles, glass syringes Waste Sharps (needles, glass syringes scalpels ,blades, etc.) that may cause scalpels ,blades, etc.) that may cause puncture and cuts(Includes both used puncture and cuts(Includes both used and unused sharps).and unused sharps).

Disinfection (chemical Disinfection (chemical treatment / destruction of treatment / destruction of needle by tip cutter, needle by tip cutter, autoclaving/microwave and autoclaving/microwave and mutilation/shreddingmutilation/shredding

Category Category No. 5No. 5

Discarded Medicines & Cytotoxic Discarded Medicines & Cytotoxic drugs (Wastes comprising of outdated, drugs (Wastes comprising of outdated, contaminated and discarded contaminated and discarded medicines)medicines)

Disposal in secured landfills Disposal in secured landfills or Incinerationor Incineration

Category Category No. 6No. 6

Soiled Waste (Items contaminated with Soiled Waste (Items contaminated with blood, & body fluids including cotton, blood, & body fluids including cotton, dressings, soiled plaster casts, linens, dressings, soiled plaster casts, linens, beddings, other material contaminated beddings, other material contaminated with blood)with blood)

Incineration/autoclaving/ Incineration/autoclaving/ microwavingmicrowaving

WASTE WASTE CATEGORYCATEGORY

WASTE TYPEWASTE TYPE TREATMENT & DISPOSALTREATMENT & DISPOSAL

CategoryCategory No.7No.7

Infectious Solid Waste (waste Infectious Solid Waste (waste generated from disposable generated from disposable items other than the waste items other than the waste sharps such as tubing's, hand sharps such as tubing's, hand gloves, saline bottles with IV gloves, saline bottles with IV tubes, catheters, glass, tubes, catheters, glass, intravenous sets etc.intravenous sets etc.

Disinfection by chemical Disinfection by chemical Treatment / Treatment / autoclaving autoclaving /Microwaving followed /Microwaving followed by mutilation / by mutilation / shreddingshredding

Category Category No.8No.8

Liquid waste( waste generated Liquid waste( waste generated from laboratory and washings , from laboratory and washings , cleaning, house keeping and cleaning, house keeping and disinfecting activities)disinfecting activities)

Chemical treatment and Chemical treatment and discharge into drains for discharge into drains for liquids and secured liquids and secured landfill for solidslandfill for solids

WASTE WASTE CATEGORYCATEGORY

WASTE TYPEWASTE TYPE TREATMENT & DISPOSALTREATMENT & DISPOSAL

CategoryCategory No.9No.9

Incineration ash (ash from Incineration ash (ash from incineration from any incineration from any biomedical waste)biomedical waste)

Disposal in municipal Disposal in municipal landfilllandfill

Category Category No.10No.10

Chemicals used in production Chemicals used in production of biologicals, chemicals used in of biologicals, chemicals used in disinfection as insecticides etcdisinfection as insecticides etc

Chemical treatment and Chemical treatment and discharge into drains for discharge into drains for liquids and secured liquids and secured landfill for solidslandfill for solids

Schedule-IISchedule-IIColour coding and Type of Containers forColour coding and Type of Containers for

Different Biomedical WastesDifferent Biomedical Wastes Colour Colour

codingcoding

Type of Type of containercontainer

Waste Waste categocatego

ryryTreatment /Treatment /

Disposal Disposal Non chlorinated Non chlorinated Plastic BagsPlastic Bags

Incineration/Incineration/Deep BurrialDeep Burrial

Non chlorinated Non chlorinated plastic bag / plastic bag / puncture proofpuncture proofContainer for Container for sharps sharps

Chemical Chemical Treatment / Treatment /

Autoclaving / Autoclaving / Microwaving and Microwaving and

followed by followed by Mutilation & Mutilation &

shredding and shredding and disposal in landfills disposal in landfills

or disposal of or disposal of recyclable wasterecyclable waste

Non chlorinated Non chlorinated Plastic Bags /Plastic Bags /ContainersContainers

Chemical Chemical TreatmentTreatment

and discharge into and discharge into drains for liquids drains for liquids

and secured landfill and secured landfill for solidsfor solids

Non chlorinated Non chlorinated Plastic BagsPlastic Bags

5,9,10(solid)5,9,10(solid) Disposed as per the Municipal Solid Waste

Latest

KITCHEN WASTE/FOOD

PAPER/plastic

WRAPPERS

Outer packing/

Cardboard

General/Kitchen

waste

For Noninfectious Solid waste

such as

Management of hospital waste

Bandages

Hum

an a

nato

mic

al

was

te-p

lace

nta

Swab stick-decontaminated

WASTE DISPOSAL

SWABS

Dressing

Animal waste

Discarded medicine/cytotoxic

drugs

YELLOW BIN (Category 1,2, 3,6) used for

RED BINDrains

Plastic culture plates & tubes

I/V sets

Urine bag

WASTE DISPOSAL

All infectious waste sharp, non sharp & sharps plastic waste

Category 3, 6, 7

Pathology waste

Personnel safety devicesPersonnel safety devicesThe use of protective gears should be made The use of protective gears should be made

mandatory for all the personnel handling waste.mandatory for all the personnel handling waste.

StorageStorageIn an area away from general traffic and accessible

only to authorized personnelDO NOT store for more than 48 hours If for any reason it becomes necessary to store the

waste beyond such period take measures to ensure that the waste does not adversely affect human health and environment

TransportTransport Transport by wheeled

trolleys/containers /carts only in vehicles authorized for the purpose

They should be Easy to load and unload No sharp edges Easy to clean

Disinfect daily Trolleys ,Wheelbarrows: covered

Transportation and StorageTransportation and Storage If a container is transported

from the premises where bio-medical waste is generated to any waste treatment facility outside the premises, the container shall, apart from the label prescribed in Schedule III, also carry information prescribed in Schedule IV.

BMW management committeeBMW management committee

Head of the hospital : chairman Waste Mx officer (dev. and implementation plan)Members: HOD’s of all department Nursing superintendent, Head nurse, Sanitary inspector Chief pharmacist, Radiation officer Supply officer, financial officer

Hand WashingHand Washing Handwashing is the single most

effective way to stop the spread of disease.

Gloves do not replace handwashing. Hand sanitizer may be used if no visible soiling is present.It can also be used when the water is out of service.

Inspect your hands each time they are washed. Only use hospital approved soaps and lotions

ConclusionConclusionBio-medical waste programme cannot be

successfully implemented without the willingness, self-motivation, and co-operation from all sections of employees of any health care setting.

If we want to protect our environment and health of community we must sensitize our selves to this important issue not only in the interest of health managers but also in the interest of community.