biomedical waste managment
TRANSCRIPT
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
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
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.