BIOMEDICAL WASTE,DIASTER MANAGEMENT,OCCUPATIONAL

HEALTH,GENETICS,MENTAL HEALTH

Compiled by Dr.karthik

The biomedical waste management and handling rules- 1998Proposed under environmental protection act- 1986[ sec 6,8,25}

Five schedules1--- categories of bmw,treatment and disposal2----color coding and type of container for bmw disposal3----labels of bmw containers/bags4---- labels for transport of bmw containers/bags5---- standards for treatment and disposal of bmw

According to sch 2 – following categories donot require containers for disposal1.Liqiud waste2.Chemical waste3.Microbiological and biotecnological waste

category BMW

1] HUMAN ANATOMICAL WASTE2] ANIMAL WASTE3] MICROBIO/BIOTECHNGY WASTE4] SHARP WASTE5] MEDICINE WASTE/CYTOTOXIC DRUGS6] SOILED WASTE7] SOLID WASTE8] LIQUID WASTE9] INCINERATION ASH10] CHEMICAL WASTE

COLOR CODING [1998]

COLOR CODING[2011]

CATEGORY[1998]

CATEGORY[2011]

YELLOW YELLOW 1,2,3,6 1,2,5,6

RED RED 3,6,7 3,4,7BLUE/WHITE TRANSLUCENT

BLUE 4,7 8

BLACK BLACK 5,9,10 MUNICIPAL WASTE

BIOMEDICAL WASTE MANAGEMENT RULES – 2015

COLOR CODING

CATEGORY

YELLOW 1,2,3,5,6,8WHITE[TRANSLUCENT]

4

RED 7BLUE GLASS[ BROKEN,DISCARDED

Red bags should not be incinerated as they contain cadmiumWaste types not to be incinerated—I. Pressurised gas containersII. Reactive chemical wasteIII. Silver/radiographic/photographic wasteIV. Halogenated plasticsV. Wastes with high mercury/cadmium contentVI. Sealed ampoules ,ampoules with heavy metals

TREATMENT METHODS

Inertization– mixing before disposal to decrease toxic riskMostly for pharma and incerination ash65%- pharma waste15%- lime15%- cement5%- water

Incineration is a high temperature dry oxidation process,doesnot Require pretreatment,disadvantage smoke

Autoclave- 121c to 135cHot air oven– 160c

DISASTER MANAGEMENT

Disaster--- term by colin grantCatastrope with injury or illness to atleast 30 peopleFor every one registed disaster---- 20 unacknowledged emergencies mightHave taken placeWorld disaster reduction day----2nd wed of octoberm.C disease in post diaster phase--- GEPractically most effective stategy post diaster- -- supplying safe drinking waterAnd proper disposal of excretaForemost step in disease prevention--- chlorination of all water bodiesFive stages of a diaster I. Diaster impact and responseII. Stage of health and medical reliefIII.RehabilitationIV. MitigationV. Diaster preparedness

Diaster impact and response----- Search ,rescue and first aidField careTriageTaggingIdentification of dead

Stage of health and medical relief------Primary phase[0-6hrs]- first aid,medical careSecondary follow up phase[6-24hrs]- transportation,sanitation and immunizationTertiary clean up phase[1-60 days]– food,clothing,shelter,rehabilitation,employment

Rehabilitation– water,sanitation,food safety,vector control

TriageUses four colour code system1. Red- highest priority—immediate resuscitaion of limb /life saving

surgery in nxt 6 hrs2. yellow[high priority]– possible resuscitation of limb/live saving

surgery in nxt 24 hrs3.Green – low priority – minor illness4. black– least priority- dead or moribound pts

--- pts with exposure to contaminants should be tagged ---- BLUE triage of three types1] simple triage2]rapid triage-- START3]reverse triage

Bhopal gas tragedy– 3rd sep 1984

Chernobyl explosion- i131,cs 134,cs 137, sr 90- level 7 on international nuclear event scale

Fukushima daichii tragedy– 11 march 2011– i131,cs134,cs137– second diaster with level 7 grade

Genetics

Eugenics – francis galton------improving human hereditary traits by genetic Manipulation----[GENES]Positive eugenics- increase reproduction in genetically advantagedNegative eugenics- lowering fertility of geneticaaly disadvantagedEuthenics – improvement by altering external factors –[environment]Dysgenetics – genetic deterioration in a population relative to their environment

Hardy weinberg lawGenotypes are constant in a population from generation to generation unless specificDisturbing influences are introducedHw law--- genetic equilibrium is basic principle of population geneticsAnd human population is always staticHw law fails in----i. Small and dynamic populationsii. Random matingiii.New mutations,genetic drift,gene flowiv. Assortive matingv. Migarationvi. Natural selection

Mendelian disease inheritance1] autosomal dominent – a) Achondroplasiab) Huntington choreac) Neurofibromatosisd) Familial polyposis colie) Marfans syndromef) Retinoblastomag) Abo blood grp systemh) Hyperlipoproteinemiai) Polycystic kidneyj) Hereditery spherocytosis

2] autosomal recessive-a)Albinismb)Phenylketonuriac) Tay sachs diseased)Alkaptonuriae)Cystic fibrosisf) Galactosemiag)Hemoglobinopathiesh)Maple syrup urine diseasei) Megacolon[hirschsprung disease

Xlinked dominenta)Vit d resistant ricketsb)Blood grp xgc)Familial hypophoshatemia

Xlined recessivea)Hemophilia type a & bb)Ducchennes muscular dystrophyc)Color blindnessd)G6pd deficiencye)Hydrocephalusf) Retinitis pigmentosa

Human genome project

Primary goal- determine the sequence of chemical base pairs which make up dna Began in 1990- james d.watsonEssentially complete genome in april 200322,000 to 23,000 genes in human genome

Mental health

I. Prevalance of neuropsychiatric diseses- 10%

II. Mcc of dalys lost- unipolar depressive disorders

III. Mcc of deaths- alzheimers and other dementias

IV. Mental morbidity in india- 18-20/1000

Intelligent quotientBinet & simon--- first intelligence testsSterns iq test- mental age/chr age x 100WAIS[Wechsler adult intelligence scale

Mean iq is 100 and standard deviation is 15Who categorization of mental retardation

Mental status Iq rangenormal 70 and aboveMild mr 50-69Moderate mr 35-49Severe mr 21-34Profound mr 20 and below