bmwm workshop presentations

Introduction and

Status of Biomedical Waste In Himachal Pradesh

Dr. Sanjay SoodMember Secretary

HP State Pollution Control Board

How Biomedical Waste is defined

Biomedical Waste can be broadly defined as:

“Any waste which is generated during thediagnosis, treatment or immunization of humanbeings or animals or in research activitiespertaining thereto or in the production ortesting of biologicals.”

Hospital Waste isBiomedical Waste

2 November, 2016 3

Biomedical Waste

Non-infectious medical waste

Hazardous waste

Others

medical waste

?

Hospital Waste is not only Biomedical Waste

2 November, 2016 4

Hospital Waste

Common refuse

Biomedical waste

Universal waste

Recyclable waste

Biomedical Waste


Hazardous waste

Others

Regulated medical waste

Characteristics of Hospital waste

• 80% of the waste generated in HCF is non-hazardous andNon-toxic

• BMW generated from medical activities are hazardous,toxic and even lethal

• Possess high potential for diseases transmission• Rag pickers and waste workers are worst affected• 15% is infectious waste and 5% is hazardous waste• Segregation at Source reduces the problem

proportionately• Organizational set up, training and motivation and

compliance to the rules improve the situation considerably

Average composition of Hospital wastein IndiaMaterial Percentage (Wet weight basis %)

General waste 53.5(food waste, sweepings fromhospital premises)

Paper 15.0Rags 15.0Plastics 10.0Glass 4.0Infectious wastes 1.5Metal (sharps etc) 1.0

Source : NEERI.

Introduction about Bio-Medical Waste (Management & Handling) Rules, 1998

BMW (M&H) Rules, 1998 came into force videS.O.630(E), dated 20.7.98 to regulate thebiomedical waste generated from the HealthCare Facilities.

Major Short coming of BMW Rules 1998

• Silent about– the unbeded HCFs and OPDs less than 1000 patient per

month.– Biomedical Waste Storage Point at HCF Level– Segregation of liquid chemical waste at source and its

treatment before mixing with other effluent not covered.– Pre treatment of liquid waste generated from the hospital

• No check during the transportation of the bags orcontainers containing Biomedical waste

• No provision to review and monitor the activities of BMWat HCF level

Introduction about BMWM Rules 2016

• Ministry of Environment, Forest and Climate Change, Govt. ofIndia vide notification GSR. 343(E), dated 28th March, 2016has notified Bio-medical Waste Management Rules, 2016 insupersession of the BMW Rules, 1998

• More emphasis on improve the collection, segregation,processing, treatment and disposal of bio-medical waste inan environmentally sound manner thereby reducing the bio-medical waste generation and its impact on environment.

• These rules shall apply to all persons who generate, collect,receive, store, transport, treat, dispose, or handle bio-medical waste in any form

Issues to be addressed during theWorkshop• BMW Storage point• Segregation/treatment of Liquid Chemical

Waste and Liquid Waste• Use of Non chlorinated bags• Training and workshops• Bar code system• BMW Committee at HCF level• State/district level advisory committee

Status of Biomedical Waste in Himachal Pradesh

Comparison of No of HCfs covered under BMW Rules 1998and to be covered under BMW Rules 2016

Sr. No Name of District No of HCFs coveredunder BMW Rules 1998

No of HCFs to be coveredunder BMW 2016

1 Bilaspur 54 8102 Chamba 35 5253 Kangra 139 20854 Mandi 137 20555 Kullu 59 8856 L & S 19 2857 Sirmour 28 4208 Hamirpur 44 6609 Una 52 780

10 Solan 110 165011 Shimla 77 115512 Kinnaur 10 150

Total 764 11460

0

20

40

60

80

100

120

140

160

Bilaspur Chamba Kangra Mandi Kullu L & S Sirmour Hamirpur Una Solan Shimla Kinnaur

No of HCFs covered under BMW Rules 1998

Status of Bio-Medical Waste generation in Himachal for the year 2015

Name of district No. of HCF’s

Total waste Kg/day

Incinerable waste Kg/day

Deep burial waste Kg/day

Plasticwaste Kg/day

Bilaspur 54 74.9 31.6 27.5 15.9Chamba 35 55.4 21.0 12.1 22.3Kangra 139 391.2 166.9 73.5 150.8Mandi 137 130.6 39.2 51.8 39.6Kullu 59 89.6 28.7 40.6 20.3L&S 19 4.1 0.0 2.5 1.6Sirmour 28 67.6 39.4 6.4 21.8Hamirpur 44 85.4 40.0 4.9 40.7Una 52 106.7 58.0 3.7 45.0Solan 110 749.0 427.0 30.0 321.0Shimla & Kinnaur 87 295.1 138.5 60.7 96.2

Total 764 2050.0 1101.0 149.0 800.0

1101

149

800

Incinerable wasteKg/day

Deep burial wasteKg/day

Plastic waste Kg/day

Status of Biomedical Waste in Himachal Pradesh During the year 2015

Disposal Status

• Through Common Biomedical WasteTreatment Facilities

• Through Captive Incinerators (3 Nos)• Through Deep Burial

CBWTFs in Himachal Pradesh

1. CBWTF at Sandli Arki District Solan:

Covering Area:• Solan, Parwanoo, Baddi, Barotiwala,

Dharampur and Nalagarh area of Solandistrict.

• Shimla town, Rampur of Shimla district.• Nahan, Paonta and Kala Amb area of

Sirmour district

CBWTFs in Himachal Pradesh Cont…

2. CBWTF at Pirdi, District Kullu:Covering:• Bilaspur and Ghumarwin area of

Bilaspur district.• Mandi, Sundernagar, Ner Chowk and

Sarkaghat area of Mandi district.• Kullu and Manali area of Kullu district.

CBWTFs in Himachal Pradesh Cont…

3. BMWT Facility, Pathankot (Punjab):Covering :• Kangra, Palampur, Jawalji, Baijnath, Nurpur, Jassur and

Nagrota area of Kangra district.• Chamba, Kakira and Surgani area of Chamba district.• Hamirpur, Nadaun, Badsar and Bhota area of Hamirpur

district.• Una, Mehatpur, Santokhgarh, Amb and Daulatpur Chowk

area of Una district.

Deep Burial Practices in Himachal

Deep Burial :In rest of the areas where Common BiomedicalWaste Treatment Facilities not available, deepburial practices is being adopted as per theprovisions of BMW rules.

Number of Show Cause Notices issued underBMW Rules January to till date

Sr. No Name of District

No of HCFs Show Cause Notices on non compliance

1 Bilaspur 54 12 Chamba 35 Nil3 Kangra 139 24 Mandi 137 Nil5 Kullu 59 Nil6 L & S 19 Nil7 Sirmour 28 18 Hamirpur 44 39 Una 52 6

10 Solan 110 311 Shimla 77 412 Kinnaur 10 Nil

Total 764 20

1

0

2

0 0 0

1

3

6

3

4

00

1

2

3

4

5

6

7

Bilaspur Chamba Kangra Mandi Kullu L & S Sirmour Hamirpur Una Solan Shimla Kinnaur

Show Cause Notices on non compliance

LetThe Wastes

Of“The Sick”

NOTContaminate

The LivesOf

“The Healthy”

Outcome of the workshopDr. Sanjay Sood

Member SecretaryHP State Pollution Control Board

How Biomedical Waste is defined

Biomedical Waste can be broadly defined as:

“Any waste which is generated during thediagnosis, treatment or immunization of humanbeings or animals or in research activitiespertaining thereto or in the production ortesting of biologicals.”

Hospital Waste isBiomedical Waste

2 November, 2016 27

Biomedical Waste


Hazardous waste

Others

medical waste

?

Hospital Waste is not only Biomedical Waste

2 November, 2016 28

Hospital Waste

Common refuse

Biomedical waste

Universal waste

Recyclable waste

Biomedical Waste


Hazardous waste

Others

Regulated medical waste

Introduction about Hospital waste

• BMW generated from medical activities are hazardous,toxic and even lethal

• Possess high potential for diseases transmission• Rag pickers and waste workers are worst affected• 80% of the waste generated in HCF is non-hazardous and

Non-toxic• 15% is infectious waste and 5% is hazardous waste• Segregation at Source reduces the problem

proportionately• Organizational set up, training and motivation and

compliance to the rules improve the situation considerably

Average composition of Hospital wastein IndiaMaterial Percentage (Wet weight basis %)

General waste 53.5(food waste, sweepings fromhospital premises)

Paper 15.0Rags 15.0Plastics 10.0Glass 4.0Infectious wastes 1.5Metal (sharps etc) 1.0

Source : NEERI.

Introduction about Bio-Medical Waste (Management & Handling) Rules, 1998

BMW (M&H) Rules, 1998 came into force videS.O.630(E), dated 20.7.98 to regulate thebiomedical waste generated from the HealthCare Facilities.

Major Short coming of BMW Rules 1998

• Silent about– the unbeded HCFs and OPDs less than 1000 patient per

month.– Biomedical Waste Storage Point at HCF Level– Segregation of liquid chemical waste at source and its

treatment before mixing with other effluent not covered.– Pre treatment of liquid waste generated from the hospital

• No check during the transportation of the bags orcontainers containing Biomedical waste

• No provision to review and monitor the activities of BMWat HCF level

Bio-medical Waste Management Rules, 2016 -The key highlights:

• The 2016 Regulation have expanded the ambit by including allHCFs, and simplified procedure of getting an authorisation.Non-bedded HCFs will be granted one-time authorisation and incase of bedded HCFs the authorisation now will be synchronisedwith the Consents.

• The new features of Bar Code System for bags and containerscontaining bio-medical waste is expected to eliminate pilferage andrestrict the entry of waste in the illegal recycling market.

• The purview of the new rules has been expanded to includevaccination camps, blood donation camps, surgical camps andother healthcare activities.

• Simplified the categorization. Schedule I & II clubbed. This willease the waste segregation process at the source of generation

Bio-medical Waste Management Rules, 2016 -the key highlights:

• It mandates pre-treatment of liquid waste i.e. lab waste, bloodsamples, microbiological waste and blood bags through disinfectionor sterilisation on-site in the manner as prescribed by WHO orNACO.

• Use of chlorinated plastic bags, gloves and blood bags will bephased out within two years. This will be a good step as burning ofchlorinated plastics often leads to emission of dioxin-furan, aPersistent Organic Pollutant (PoPs).

• The standards for emissions from incinerators have also been mademore stringent.

• Training and regular immunization of all healthcare workers.

Comparison of No of HCfs covered under BMW Rules 1998and to be covered under BMW Rules 2016

Sr. No Name of District No of HCFs coveredunder BMW Rules 1998

No of HCFs to be coveredunder BMW 2016

1 Bilaspur 54 8102 Chamba 35 5253 Kangra 139 20854 Mandi 137 20555 Kullu 59 8856 L & S 19 2857 Sirmour 28 4208 Hamirpur 44 6609 Una 52 780

10 Solan 110 165011 Shimla 77 115512 Kinnaur 10 150

Total 764 11460

• Presentations on the various aspects of theprovisions of previous and new BMW rules bythe following:– Central Pollution Control Board– Health Department– Himachal State Pollution Control Board– Operators of the Transport facilities

Major outcome of the WorkshopIssues Action to be taken by Time Frame

Provision of Biomedical Waste Storage Pointwith in the premises of HCF from whereBiomedical waste handed over to the CBWTF

Health Department Up to 31-03-2017

• Provision for the segregation of liquidchemical waste at source and itstreatment before mixing with other effluent• Pre treatment of liquid waste (LaboratoryWaste, microbiological waste, blood samplesand blood bags) before sending to theCBWTF


Use of Non Chlorinated bags, gloves andblood bags

Health Department Up to 31-03-2018*

Major outcome of the WorkshopIssues Action to be taken by Time Frame

Organisation of Training andworkshops on Biomedical WasteManagement Activities

HealthDepartment, PCBand CBWTFOperators

On going process

Immunisation of Health CareWorkers involved in handling ofBiomedical waste

HealthDepartment

On goingprocess

Bar-code system for the bags orcontainers containing Biomedicalwaste

Operators of CBWTF/Health Department

Up to 31-03-2017*

Major outcome of the WorkshopIssues Action to be taken by Time frame

Establishment of a committee at HCFlevel having more than 30 beds


Constitution of State or District levelAdvisory Committee

State Government Up to 31-03-2017

Revised online application module onHIMXGN for the authorisation underBMW Rules 2016

PCB Up to 31-12-2016

Strengthening of Biomedical wastewing and delegation/re-delegation ofpowers to the officers/officials of theState Board under these Rules

PCB Up to 31-12-2016

In case of Non Violation of above said Rules

• Powers under Section 5 of EPA Act:– The closure, prohibition or regulation of any industry,

operation or process; or– Stoppage or regulation of the supply of electricity or water

or any other service.

• Powers under Section 15 of EPA Act:– Imprisonment for a term which may extend to five years

with fine which may extend to one lakh rupees, or withboth.

LetThe Wastes

Of“The Sick”

NOTContaminate

The LivesOf

“The Healthy”

ISSUES IN IMPLEMENTATION OF BMW MANAGEMENT RULES IN HEALTH CARE FACILITIES

Dr SONAM G. NEGI (OSD)HEALTH SAFETY & REGULATIONDEPT. OF HEALTH GOVT.OF H.P.

BMW MANAGEMENT RULES-2016

Bio-medical waste (BMW)Waste generated during the diagnosis,treatment or immunisation of humanbeings or animals or research activitiespertaining thereto or in the production ortesting of biological or in health camps,including the categories mentioned inSchedule I appended to these rules.

THESE RULES SHALL NOT APPLY TO

• RADIOACTIVE WASTES• HAZARDOUS CHEMICALS• SOLID WASTES• LEAD ACID BATTERIES• HAZARDOUS WASTES• E-WASTE• GENETICALLY ENGINEERED MICRO ORG.

CURRENT SCENARIOBMW MANAGEMENT

STILL A NEGLECTED AREAIMPACTING HUMAN HEALTHADVERSELY.SEGREGATION NOT PROPER AT

GENERATION POINTS.INFECTIOUS WASTE & SHARPS GET

MIXED UP WITH DOMESTIC WASTEAFFECTING POPULATION AT LARGE.

SUGGESTIONS FOR IMPROVEMENT

1. Investment– Person, Place & Finance.

2. Formation of BMW Management Committee.

3. BMW Generation Survey.

4. Evaluation of Existing Practice.

5. Training as per need.

6. SEGREGATION AT THE POINT OF GENERATION .

7. Reporting and Feed Back.

8. Periodical Review & Planning as per requirement.

CATEGORY TYPE OF WASTE TYPE OF BAG OR CONTAINER TO BE USED

TREATMENT AND DISPOSAL OPTIONS

YELLOW

(A) HUMAN ANATOMICAL WASTE:Human tissues, organs,body parts and fetusbelow the viabilityperiod (as per theMedical Termination ofPregnancy Act 1971,amended from time totime).

(B) ANIMAL ANATOMICAL WASTE :Experimental animalcarcasses, body parts,organs, tissues,including the wastegenerated fromanimals used inexperiments or testingin veterinary hospitalsor colleges

YELLOW COLOUREDNON-CHLORINATEDPLASTIC BAGS

INCINERATIONORPLASMA PYROLYSIS ORDEEP BURIAL*

CATEGORY TYPE OF WASTE TYPE OF BAGOR

CONTAINER TO BE USED

TREATMENTAND

DISPOSAL OPTIONS

(C) SOILED WASTE:Items contaminatedwith blood, body fluidslike dressings, plastercasts, cotton swabs and bags containing residualor discarded blood andblood components.

INCINERATIONORPLASMA PYROLYSISORDEEP BURIAL*In absence of above facilities,autoclaving ormicrowaving /hydroclaving

followed by shredding or mutilation or

COMBINATION OFSTERILIZATION AND SHREDDING. TREATED WASTE TO BE SENT FOR ENERGY RECOVERY.

(D) EXPIRED ORDISCARDED MEDICINES:Pharmaceutical wastelike antibiotics,cytotoxic drugsincluding all itemscontaminated withcytotoxic drugs alongwith glass or plasticampoules, vials etc.

Yellow colourednon-chlorinatedplastic bags orcontainers

Expired `cytotoxic drugs and items contaminated with cytotoxic drugs to bereturned back to the manufacturer or supplier for incineration at temperature >1200 0C or to common bio-medical waste treatment facility or hazardous waste treatment, storage and disposal facility for

INCINERATION AT >12000C ORENCAPSULATION OR PLASMA PYROLYSIS AT >12000C.

ALL OTHER DISCARDED MEDICINES SHALL BE EITHER SENT BACK TO MANUFACTURER ORDISPOSED BY INCINERATION.



(e) CHEMICAL WASTE:Chemicals used inproduction of biologicaland used or discardeddisinfectants.

Yellow colouredcontainers ornon-chlorinatedplastic bags

Disposed of by

INCINERATION OR PLASMA PYROLYSIS OR ENCAPSULATION in hazardous waste treatment, storage and disposal facility.

(F) CHEMICAL LIQUIDWASTE :Liquid waste generateddue to use of chemicalsin production ofbiological and used ordiscarded disinfectants,Silver X-ray filmdeveloping liquid,discarded Formalin,infected secretions,aspirated bodyfluids, liquid fromlaboratories and floorwashings, cleaning,house-keeping anddisinfecting activitiesetc.

SEPARATECOLLECTIONSYSTEM LEADINGTO EFFLUENTTREATMENT SYSTEM

After resource recovery, the chemical liquid waste shall be pre-treated before mixing with other wastewater.

THE COMBINED DISCHARGE SHALL CONFORM TO THE DISCHARGE NORMS GIVEN IN SCHEDULE-III.



(G) DISCARDED LINEN,MATTRESSES, BEDDINGSCONTAMINATED WITHBLOOD OR BODY FLUID.

Non-chlorinatedyellow plasticbags or suitablepacking material

Non- chlorinated chemical disinfection followed by incineration or PlazmaPyrolysis or for energy recovery.In absence of above facilities, shredding or mutilation or combination of sterilization and shredding.

TREATED WASTE TO BE SENT FOR ENERGY RECOVERY ORINCINERATION OR PLAZMA PYROLYSIS.



(H) MICROBIOLOGY,BIOTECHNOLOGY ANDOTHER CLINICALLABORATORY WASTE:Blood bags, Laboratorycultures, stocks orspecimens of microorganisms,live orattenuated vaccines,human and animal cellcultures used inresearch, industriallaboratories, productionof biological, residualtoxins, dishes anddevices used forcultures.

Autoclave safeplastic bags orContainers

PRE-TREAT TO STERILIZE WITH NONCHLORINATED CHEMICALS ON-SITE ,AS PER NATIONAL AIDS CONTROL ORGANISATIONORWORLD HEALTH ORGANISATION GUIDELINES .THEREAFTER FOR INCINERATION.



SEGREGATION OF WASTE

INFECTIOUS WASTEHuman/Animal wasteSoiled bandagesDressingsCotton SwabsSanitary Pads

YELLOWBAG OR CONTAINER

No

Plastics

In thisbag

RED CONTAMINATED WASTE(RECYCLABLE)(a) Wastes generatedfrom disposable itemssuch as tubing, bottles,intravenous tubes andsets, catheters, urinebags, syringes (withoutneedles and fixed needlesyringes) andvaccutainers with theirneedles cut) and gloves.

RED COLOUREDNON-CHLORINATEDPLASTIC BAGS ORCONTAINERS

Autoclaving or micro-waving/hydroclaving followed by shredding ormutilation or combination ofsterilization and shredding.

TREATED WASTE TO BE SENT TO REGISTERED ORAUTHORIZED RECYCLERS OR FOR ENERGYRECOVERY OR PLASTICS TO DIESEL OR FUEL OIL OR FOR ROAD MAKING, WHICHEVER ISPOSSIBLE.PLASTIC WASTE SHOULD NOT BE SENT TOLANDFILL SITES.

PLASTIC WASTEIV SetsTubing'sBlood & Urine bagsSyringes


No

Sharps

In this

bag

RED BAG OR CONTANIER

WHITE(TRANSLUCENT)

WASTE SHARPSINCLUDING METALS:Needles, syringes withfixed needles, needlesfrom needle tip cutter orburner, scalpels, blades,or any othercontaminated sharpobject that may causepuncture and cuts. Thisincludes both used,discarded andcontaminated metalsharps

PUNCTURE PROOF,LEAK PROOF,TAMPER PROOFCONTAINERS

Autoclaving or Dry Heat Sterilization followed by shredding or mutilation orencapsulation in metal container or cement concrete; combination of shredding cum autoclaving; and sent for

FINAL DISPOSAL TO IRON FOUNDRIES (HAVING CONSENT TO OPERATE FROM THE STATE POLLUTION CONTROL BOARDS OR POLLUTIONCONTROL COMMITTEES) OR SANITARY LANDFILL OR DESIGNATED CONCRETE WASTE SHARP PIT.


Needles /Sharps in the TRANSPARENT

puncture proof bin/container .

BLUE (A) GLASSWARE:Broken or discarded andcontaminated glassincluding medicine vialsand ampoules exceptthose contaminated withcytotoxic wastes.

CARDBOARD BOXES WITH BLUE COLORED MARKING

DISINFECTION (BY SOAKING THE WASHED GLASS WASTE AFTER CLEANING WITH DETERGENT AND SODIUM HYPOCHLORITETREATMENT) OR AUTOCLAVINGOR MICROWAVINGOR HYDROCLAVING AND THEN SENT FOR RECYCLING.

(B) METALLIC BODYIMPLANTS

CARDBOARDBOXES WITHBLUE COLORED MARKING

-do-

Segregate waste as per category at point of generation .

Put waste in correct bins.

Ensure colour bags of the same colour as bins.

Ensure containers has Bio-hazard symbol.

Remove plastic bags when ¾ full, tie the bags properly.

Ensure bag is properly tied / sealed to avoid spilling.

Ensure spillage free transportation to the storage site.

Cut/mutilate the needles / disposables before disposal.

Wear protective gears while handling BMW. Keep record book on BMW activity up dated.

DO’S

Put wrong bags in wrong bins.

Put the BMW indiscriminately.

Fill the bags till neck.

Handle BMW without PPE.

Drag the bags during transportation

Mix BMW with non infectious wastes

DON’TS

REMEMBERENSURE COMPLIANCE OF BMW

MANAGEMENT RULES,2016 BY :-o SEGREGATION AT SOURCE

o PRE-TREAT BMW (BEFORE DISPOSAL) SO THAT IT BECOMES NON INFECTIVE

o SAFE RECOVERY OF RESOURCES

“Bio-medical Waste

Management Rules 2016”

J. Chandra Babu, M.E ( Envi. Engg.)

Senior Envi. Engineer (Scientist ‘D’ )

Central Pollution Control Board Parivesh Bhawan, East Arjun Nagar

DELHI- 110 032.

M:9868278903

E-mail : [email protected] or

[email protected]

“Intrductory Workshop on

Bio-medical Waste Management Rules, 2016”

National Scenario on

Bio-medical Waste Management ( As per 2014)

National Scenario on BMWM-2014.ppt





“Bio-medical Waste Management

Scenario in the State of H.P”

H.P Scenario on BMWM-2014.ppt




Effects of Improper BMW Management

World Health Organization (WHO), study in 2000, estimated that injections from contaminated syringes caused:

21 million Hepatitis B virus (HBV) infections (32% of all new infections).

Two million Hepatitis C virus (HCV) infections (40% of all new infections); and

atleast 260,000 HIV infections (5% of all new infections).

Bio-medical Waste Management Rules, 2016

Actions shall be taken against

HCFs/CBWTFs for violation of the

provisions

‘Directions’ under Section 5 of ‘The

Environment (P) Act, 1986’ as follows:

Closure, prohibition or regulation of

any operation or process.

Stoppage or regulation of the

electricity or water supply

Closure of the HCFs/CBWTFs.


Actions against HCFs/CBWTF for Violation of the Provisions: Liable for punishment under Section 15 of ‘ The Environment (P) Act, 1986’ which include • Imprisonment up to five years or fine

up to one lakh rupees or both .

• In case of violation continues: additional fine which may extend to five thousand rupees for every day.

• If the contravention continues beyond a period of one year after the first date of contravention, the offender shall be punishable with imprisonment for term which may extend to seven years.

Types of waste generated in HCFs:

Infectious or bio-medical waste

Municipal Solid Waste

Hazardous Waste

Used Lead Acid Batteries

Electrical and Electronic Waste

Hazardous Chemicals

Plastic Waste

Radio Active Waste

Liquid Waste ( from Lab, Laundry etc.,)

Emissions from Boilers, DG Sets etc.,

Environmental

Statutes

1. Water (Prevention and Control of Pollution) Act, 1974. 2. Water (Prevention and Control of Pollution) Cess Act,

1977. 3. Air (Prevention and Control of Pollution) Act, 1981 4. Environment (Protection) Act, 1986- Umbrella Act 5. The Manufacture, Storage and Import of Hazardous

Chemicals Rules, 1989. 6. Hazardous Waste ( Management & Handling) Rules,

1989 replaced by Hazardous and Other Waste (Management and Transboundary Movement) Rules, 2016.

Rules and Notifications

8. The Biomedical Waste (Management and Handling)

Rules, 1998 as amended BMW Rules, 1998.ppt

9. Recycled Plastics Manufacture and Usage Rules, 1999

(and further rules issued in 2016).

10. Municipal Solid Wastes (Management and Handling)

Rules, 2000 and (further rules issued in 2016).

11. The Noise Pollution (Regulation and Control)

(Amendment) Rules, 2000.

12. Batteries (Management and Handling) Rules, 2001 and

further amendments issued from time to time.

13. EIA Notification, 1994 replaced with the EIA Notification,

2006 and further amendments made thereof.

14. e-Waste Management Rules, 2016

BMW Rules, 1998.ppt

BMW Rules, 1998.ppt

BMW Rules, 1998.ppt

BMW Rules, 1998.ppt

BMW Rules, 1998.ppt

BMW Rules, 1998.ppt

BMW Rules, 1998.ppt

Environmental

Statutes

NEW BMWM RULES

Bio-medical Waste Management Rules, 2016 BMWM Rules, 2016 (28.03.2016).docx

May be downloaded from MoEF & CC Website:

http://www.moef.nic.in/sites/default/files/BMW%20Rules,%202016_1.pdf

BMWM Rules, 2016 (28.03.2016).docx

Evolution of BMW Rules in India

CWP filed by Dr BL Wadhera in 1995 in Supreme

Court against Union of India to forthwith stop the

dumping by Civic Authorities of hospital waste of

Safdarjung at Bhalswa dump as the river Yamuna

could be contaminated during rainy season. Plea

upheld & directives issued.

In 1996, Hon’ble Supreme Court’s direction to 50

& above bedded hospitals in Delhi to have

treatment and disposal facilities.

Bio-medical Waste (Management & Handling)

Rules, 1998 notification under Environment

(Protection) Act, 1986.


notified vide GSR 343(E) on 28.03.2016, in supersession of the BMW Rules, 1998

Bio-medical Waste Management Rules 2016 18 Provisions

1. Short Title and Commencement

2. Application

3. Definitions ( from a to p)

4. Duties of the Occupier

5. Duties of the Operator of a CBWTDF

6. Duties of Authorities

7. Treatment and Disposal

8. Segregation, Packing, Transportation and Storage

9. Prescribed Authority

10. Procedure for Authorization

11. Advisory Committee

12. Monitoring of Implementation of the rules in HCFs

13. Annual Report

14. Maintenance of Records

15. Accident Reporting

16. Appeal

17. Site for CBWTDF

18. Liability of the occupier, operator of a facility

04 Schedules

05 Forms


Rule 1. Short Title and Commencement

• These rules may be called the Bio-Medical Waste Management Rules, 2016.

• Came into force with effect from 28.03.2016

Bio-medical Waste Management Rules, 2016 contd…

Rule 2. Application :

These rules shall apply to all persons who

generate, collect, receive, store, transport,

treat, dispose, or handle bio medical

waste in any form including

Hospitals, Nursing Homes, Clinics,

Dispensaries and Ayush hospitals.

Veterinary institutions, animal houses.

Pathological, Forensic and Research

Labs.

Blood Banks.

Research or Educational Institutions.

Camps:-relating to health/medical/

surgical/vaccination or blood donation.

Schools with first aid rooms.

Rule 2: Application contd… (2) These rules shall not apply to the waste as covered

under other regulations such as : a) radioactive wastes - as per provisions of the Atomic

Energy Act, 1962 (33 of 1962); b) hazardous chemicals- as per Manufacture, Storage

and Import of Hazardous Chemicals Rules, 1989 notified under Environment (Protection) Act, 1986;

c) Solid wastes – as per Solid Waste (Management and

Handling) Rules, 2016; d) The Lead Acid Batteries - as per Batteries

(Management and Handling) Rules, 2001 or revised; e) Hazardous wastes – as per Hazardous & Other

Wastes (Management and Transboundary Movement) Rules, 2016;

f) E-waste – as per e-Waste Management Rules, 2016;

and g) hazardous microorganisms, genetically engineered

microorganisms and cells – as per Manufacture, Use, Import, Export and Storage of Hazardous Microorganisms,Genetically Engineered Microorganisms or Cells Rules, 1989 or amendments thereafter;

Rule 3: Main Definitions

Rule 3 (C) : ‘Authorisation’ means permission granted by the prescribed authority (SPCB/PCC) for the generation, collection, reception, storage, transportation, treatment, processing, disposal or any other form of handling of bio-medical waste in accordance with these rules and guidelines issued by the Central Government or Central Pollution Control Board (CPCB) as the case may be;

Rule 3(f): ‘Bio-medical waste’ "bio-medical

waste" means any waste, which is generated during the diagnosis, treatment or immunisation of human beings or animals or research activities pertaining thereto or in the production or testing of biological or in health camps, including the categories mentioned in Schedule-I appended to the BMWM Rules, 2016.

Rule 3: Main Definitions contd…

Rule 3 (g): ‘Bio-medical Waste Treatment and Disposal Facility’ means any facility wherein treatment, disposal of bio-medical waste or processes incidental to such treatment and disposal is carried out, and includes common bio-medical waste treatment facilities; Rule 3 (j):“health care facility” means a place where diagnosis, treatment or immunisation of human beings or animals is provided irrespective of type and size of health treatment system, and research activity pertaining thereto; Rule 3(m): ‘Occupier’ means a person having administrative control over the institution and the premises generating bio-medical waste, which includes a hospital, nursing home, clinic, dispensary, veterinary institution, animal house, pathological laboratory, blood bank, health care facility and clinical establishment, irrespective of their system of medicine and by whatever name they are called.

Rule 3: Main Definitions contd…

Rule 3 (n): ‘Operator of a Common Bio-medical Waste Treatment Facility’ means a person who owns or controls a Common Bio-medical Waste Treatment Facility (CBWTF) for collection, reception, storage, transport, treatment, disposal or any other form of handling of bio-medical waste; Rule 3 (o):“prescribed authority” means the State Pollution Control Board in respect of a State and Pollution Control Committee in respect of an Union Territory;


Rule 4: Duties of the Occupier: To take all necessary steps as per rules

Segregation of waste at source as per Schedule I

and to make a provision for safe and secured

location for storage of segregated BMW.

No secondary handling/pilferage of recyclables/

inadvertent scattering/ spillage and directly

transport waste to treatment facility;

Pre-treat the laboratory waste, microbiological

waste, blood samples and blood bags by

disinfection or sterilization on-site as per WHO

or NACO Guidelines and then for final disposal.

Phase out : use of chlorinated plastic bags,

gloves and blood bags within two years;

Training: To provide training to all its HCWs-at

the time of induction & thereafter atleast once

in a year.

Maintaining records w.r.to the training

programmes and submit along with the Annual Report to SPCB/PCC.

Rule 4: Duties of the Occupier contd…

Immunize all HCWs including Hepatitis

& Tetanus as per NIP or MoH & FW

Bar Code: Establish a Bar-Code System

for bags or containers within one year;

Pre-treatment of Liquid Chemical waste:

Ensure segregation and pre-treatment or

neutralization of liquid chemical waste at

source prior to mixing with other effluent.

Pre-treatment of Liquid Chemical waste

Ensure treatment & disposal of liquid

waste in accordance with Water Act, 1974

Occupational safety: Ensure occupational

safety of HCWs-by providing PPEs.

Health Checks: Conduct health checks to

the HCWs- at the time of induction and

atleast once in a year.

Existing incinerators shall have to achieve

the standards as specified in Schedule II

for retention time in secondary chamber

and Dioxin and Furans within two years.

Rule 4: Duties of the Occupier contd…

Report major accidents including fire in Form I

Form-I, BMWM Rules, 2016.docx) to SPCB/PCC;

Dissemination of Information: Maintain register

and update records on day-to-day basis in respect

of BMW Generation as per Schedule -I & display

monthly record on website as per Schedule. I.

All the HCFs should have own website within 2

years and make available the AR on web-site.

Inform SPCB/PCC immediately in case the CBWTF

does not collect the BMW within the intended time;

Maintain all records for operation of captive

treatment equipment for a period of five years;

Review and monitor the BMW activities- through

existing Committee or by a new Committee.

Committee - meet once in every six months

and submit record of the minutes of the

meetings along with the AR to the SPCB/PCC.

HCF having < 30 no. of beds shall designate a

qualified person to review and monitor.

Form-I, BMWM Rules, 2016.docx












Rule 4: Duties of the Operator of a CBWTFs

• To take all necessary steps as per rules and as per guidelines;

• To ensure timely collection of BMW from the HCFs including on holidays as prescribed under the rules.

• Establish a Bar-Code System and GPS for handling of BMW within one year;

• Inform SPCB/PCC immediately regarding the occupiers which are not handing over the segregated BMW as per BMW Rules;

• To provide training to all its workers-at the time of induction and thereafter atleast once in a year .

• Assist the occupier in training conducted by them for biomedical waste management;

• To undertake appropriate medical examination of the workers at the time of induction and at least once in a year.

• To ensure occupational safety of workers by providing appropriate and adequate PPEs

Rule 4: Duties of the Operator of a CBWTF contd.. To immunise all its workers for protection against diseases, including Hepatitis B and Tetanus and maintain the records; To report major accidents including fire hazards, blasts in Form I to the SPCB/PCC along with the annual report; To maintain a log book for each of its treatment equipment, for a period of five years ; To allow occupier, who are giving waste for treatment to the operator, to see whether the treatment is carried out as per rules; Shall display details of authorisation, treatment, annual report etc. on its web-site; After ensuring treatment of BMW, such as plastics and glass, shall be given to recyclers having valid consent or authorisation or registration from the respective SPCB/PCC; Supply non-chlorinated plastic coloured bags to the occupier on chargeable basis, if required; To upgrade existing incinerators to achieve the standards for retention time in secondary chamber and Dioxin and Furans within two years.


6. Duties of Authorities:-

The Authority specified in column (2) of Schedule-III shall perform the duties as specified in column (3) thereof in accordance with the provisions of these rules.

Schedule -III, BMWM Rules, 2016.docx

Schedule -III-BMWM Rules, 2016.docx

Schedule -III-BMWM Rules, 2016.docx













Bio-medical waste Management Rules, 2016 Rule 7: Treatment and Disposal : (1) Bio-medical waste shall be treated & disposed of by

HCF/CBWTF in accordance with Schedule-ISchedule-I, BMWM Rules, 2016.docx , and as per the standards stipulated under Schedule-II Schedule-II, BMWM Rules, 2016.docx .

(2) Occupier shall hand over only segregated waste as per Schedule-I as well as only pre-treated laboratory and highly infectious Waste to CBWTF for treatment and final disposal: (3) No occupier shall establish on-site treatment and disposal facility, if a service of a CBWTF is available at 75 KM distance. (4) In case where a CBWTF is not available, the Occupiers shall set

up captive Treatment facility prior to commencement of its operation.

(5) Any person/an occupier or operator of a CBWTF intend to use new technologies for treatment of BMW-request the Central Govt. for laying down the standards or operating parameters published in Gazette. (6) Every operator of CBWTF shall set up requisite BMW Treatment equipment, prior to commencement of operation.

Schedule-I, BMWM Rules, 2016.docx












Schedule-II, BMWM Rules, 2016.docx













Rule 7: Treatment and Disposal contd..

(7) Every occupier shall phase out use of chlorinated plastic bags within two years. After two years i.e. from 27.03.2018 onwards

Chlorinated plastic bags shall not be used –by HCF/CBWTF. HCF having captive treatment facility and a CBWTF shall not dispose of such plastics by incineration. The bags used for handling of BMW should be as per BIS Specifications ( to be formulated) till such time as per PWM Rules, 2016 (i.e., = or > 50 µ thick)

(8) After ensuring treatment followed by mutilation or shredding, the recyclable wastes (plastics and glass) shall be given to recyclers having valid authorisation or registration from the respective SPCB/PCC. Such records need to be maintained by the HCF/CBWTF.

(9) The handling and disposal of all the mercury waste and lead waste shall be in accordance with the respective rules and regulations

Bio-medical waste Management Rules, 2016 Rule 8: Segregation, packaging, transportation and storage.- (1) No untreated BMW shall be mixed with

other wastes. (2) The BMW shall be segregated into containers or bags at the point of generation in accordance with Schedule-I prior to its storage, transportation, treatment and disposal. Schedule-I, BMWM Rules, 2016.docx (3) The containers or bags shall be labeled

as specified in Schedule IV. Schedule- IV, BMWM Rules, 2016.docx

(4) Bar code and global positioning system

shall be added by the Occupier and CBWTF within one year time.

(5) The operator of CBWTF shall transport

the BMW from the premises of an occupier to any off-site BMWTF only in the vehicles having label and along with the information as provided in part ‘A’ and part ‘B’ of the Schedule IV.












Schedule-IV, BMWM Rules, 2016.docx












Rule 8: Segregation, packaging, transportation and storage contd…

(6) The Vehicles used for transportation of BMW should be: as per conditions of authorisation issued by SPCB/PCC and registered under Motor Vehicles Act, 1988. (7) Untreated human anatomical

waste, animal anatomical waste, soiled waste and, biotechnology waste shall not be stored beyond a period of 48 hours.

Otherwise, the occupier shall take appropriate measures and inform the prescribed authority along with the reasons for doing so. (8) Microbiology waste and all other clinical laboratory waste shall be pre-treated by sterilisation (Log 6) or disinfection (Log 4) as per the WHO guidelines before giving to the CBWTF.

Bio-medical waste Management Rules, 2016

(9). Prescribed authority:- In States- State Pollution Control Board (SPCB) In UT - Pollution Control Committees (PCC) In case of AFHCEs-DGAFMS The prescribed authorities shall comply with the responsibilities as stipulated in Schedule III of these rules. Schedule -III, BMWM Rules, 2016.docx














(10) Procedure for authorisation.- (1) Every HCF/CBWTF handling BMW, irrespective of waste

generation quantity:

shall make an application in Form II to SPCB/PCC. Form-II, BMWM Rules, 2016.docx SPCB/PCC shall grant the provisional

authorisation in Form III Form-III, BMWM Rules, 2016.docx with validity of authorisation for bedded HCF/a CBWTF synchronised with the validity of the consents, within 90 days.

(2) The authorisation shall be one time for non-bedded occupiers

and the authorization in such cases shall be deemed to have been granted, if not objected by the prescribed authority within 90 days from the date of receipt of duly complete application.

Form-II, BMWM Rules, 2016.docx












Form-III, BMWM Rules, 2016.docx












Procedure for authorisation

(3) In case of refusal of renewal/cancellation/ suspension of authorisation by the SPCB/PCC, reasons shall be recorded in writing: after giving an opportunity of being heard. (4) Every complete application for authorisation shall be disposed of by the prescribed authority within a period of ninety days failing which it shall be deemed that the authorisation is granted under these rules. (4) In case of any change in the bio-medical waste generation, handling, treatment and disposal for which authorisation was earlier granted, the occupier or operator shall submit a fresh application in Form II for modification of the conditions of authorisation.

Bio-medical waste Management Rules, 2016 (11) Advisory Committee.-

(1) Every State Government or Union Territory Administration shall constitute an Advisory Committee under the Chairmanship of respective Health Secretary.

To oversee the implementation of the

rules and to advice the State Government.

The Advisory Committee shall include representatives from:

Departments of Health, Environment,

Urban Development, Animal Husbandry and Veterinary Sciences.

Urban or local bodies or Municipal

Corporation

representatives from IMA, CBWTF and NGO.

(11) Advisory Committee contd…

(2) MoD shall constitute the Advisory Committee (Defence):

Chairman of the Advisory

Committee: DGAFMS Other members of the Committee:

representatives from MoD, MoEF & CC, CPCB, MoH & FW, AFMC or Command Hospital.

(3)The Advisory Committee constituted shall meet at least once in six months and review all matters related to implementation Rules. (4) The MoD may co-opt representatives from the other Govt. and NGOs having expertise in the field of BMW Management.


(12) Monitoring of implementation of the rules in health care facilities.- Every State Government or Union Territory Administration : to monitor compliance to the BMWM Rules by the HCF/CBWTF

Constitute District Level Monitoring Committee (DLMC) in the District under the Chairman of District Collector or District Magistrate or Dy. Commissioner or Add. District Magistrate.

The District Level Monitoring Committee shall submit its report once in six months to the State Advisory Committee and a copy thereof shall also be forwarded to SPCB/PCC concerned for taking further necessary action.

(6) The District Level Monitoring Committee shall comprise of

District Medical Officer (as Member Secretary), Representatives from SPCB/PCC, Public Health Engineering Department, Local bodies or municipal corporation, IMA, CBWTF and registered NGOs working in the field of BMW Management


13. Annual Report:

(1) Every Occupier or Operator of a CBWTFs : Annual Report to be submitted to SPCB/PCC in Form IV by 30 th of June every year;

(2) SPCB/PCC: Shall submit the compiled information to CPCB by 31st of July of every year.

(3) CPCB: CPCB shall compile, review and analyze the information and send alongwith comments or recommendations to the MoEF & CC by 31 th of August of every year.

(4) The Annual Reports shall also be available online on the websites of HCFs, SPCBs and CPCB.


14. Maintenance of records.- Every authorised person shall maintain

records related to handling of BMW for a period of five years, as per BMW Rules.

15. Accident reporting.-

(1) In case of any major accident while

handling BMW, intimate immediately and forward a report within 24 hours in writing regarding the remedial steps taken in Form I.

(2) Information regarding all other accidents and remedial steps taken shall be provided alongwith the annual report.


16. Appeal.- (1) Any person aggrieved by an order of

SPCB/PCC: File an appeal in Form V Form-V, BMWM

Rules, 2016.docx within 30 days from the date of the order to The Secretary (Environment) of the State or UT.

(2) Any person aggrieved by an order of the

DGAFMS File an appeal in Form V within 30 days

from the date of the order to The Secretary, MoEF & CC.

(3) The authority, may entertain the appeal: after expiry of the said period of thirty

days and the appeal shall be disposed of within 90 days from the date of its filing.

Form-V, BMWM Rules, 2016.docx












17. Site for common bio-medical waste treatment and disposal facility.-

(1) the department in the business allocation of land assignment shall be responsible for providing suitable site for setting up of CBWTF in the State or UT .

(2) The selection of site for setting up of CBWTF shall be made in consultation with the SPCB/PCC, other stakeholders and in accordance with guidelines published by the MoEF & CC or CPCB.


18.Liability of the occupier, operator

of a facility.-

(1) The occupier or operator of a CBWTF

shall be liable for all the damages caused

to the environment or the public due to

improper handling of BMW or disposal of

bio-medical waste.

(2) The occupier or operator of a CBWTF

shall be liable for action under Sections 5

and Section 15 of the E (P) Act, 1986 in

case of any violation.


Schedule-I: Schedule-I, BMWM Rules, 2016.docx Biomedical wastes categories and their segregation,

collection, treatment, processing and disposal options Schedule-II: Schedule-II, BMWM Rules, 2016.docx

Standards for Treatment and Disposal of Bio-medical Wastes

Schedule-III: Schedule -III, BMWM Rules, 2016.docx

List of Prescribed Authorities and the Corresponding Duties

Schedule-IV: Schedule-IV, BMWM Rules, 2016.docx

Part A : Label for Bio-medical Waste Containers or Bags

Part B : Label for Transporting Bio-medical Waste Bags or Containers














Schedule-I: Biomedical wastes categories and their segregation,

collection, treatment, processing and disposal options (Part-1)

Category Type of Waste Type of

Bag/Container

to be used

Treatment and

Disposal

Options

Yellow (a) Human Anatomical Waste

(b) Animal Anatomical Waste

(c) Soiled Waste

(d) Expired or Discarded

Medicines

(e) Chemical Waste

(f) Chemical Liquid Waste :

(g) Discarded linen, mattresses,

beddings contaminated with

blood or body fluid.

(h) Pre-treated Microbiology,

Biotechnology and other

clinical laboratory

Yellow coloured

non-chlorinated

plastic bags or

containers or

other suitable

packing material

or as suggested

under the Rules

Incineration

or Plasma

Pyrolysis or

deep burial or

as suggested

under the

Rules.

Schedule –I contd.. Category Type of Waste Type of

Bag/Container

to be used

Treatment and

Disposal Options

Red Contaminated

Waste

(Recyclable)

(a) Wastes

generated from

disposable items

such as tubings,

bottles, intravenous

tubes and sets,

catheters, urine

bags, syringes

(without needles).

Red coloured

non-

chlorinated

plastic bags or

containers

Autoclaving or micro-

waving/ hydroclaving

followed by shredding

or mutilation or

combination of

sterilization and

shredding. Treated

waste to be sent to

registered or authorized

recyclers or for energy

recovery or plastics to

diesel or fuel oil or for

road making, whichever

is possible.

Plastic waste should not

be sent to landfill sites.

Schedule 1 contd… Category Type of Waste Type of

Bag/Containe

r to be used

Treatment and Disposal

Options

White (Transluce

nt)

Waste sharps

including Metals Needles, syringes with fixed needles, needles from needle tip cutter or burner, scalpels, blades, or any other contaminated sharp object that may cause puncture and cuts. This includes both used, discarded and contaminated metal sharps

Puncture proof,

Leak proof,

tamper proof

containers

Autoclaving or Dry Heat

Sterilization followed by shredding

or mutilation or encapsulation in

metal container or cement concrete;

combination of shredding cum

autoclaving; and sent for final

disposal to iron foundries (having

consent to operate from the

SPCB/PCC) or sanitary landfill or

designated concrete waste sharp pit.

Blue Glass Ware (Broken or

discarded and

contaminated glass

including medicine vials

and ampules except those

contaminated with

cytotoxic drugs) and

Metallic Body Implants

Cardboard boxes

with blue colored

marking

Disinfection (by soaking the

washed glass waste after cleaning

with detergent and Sodium

Hypochlorite treatment) or

through autoclaving or

microwaving or hydroclaving

and then sent for recycling


Disposal by deep burial: only in rural or remote areas where there is

no access to CBWTF and as approved by the prescribed authority,

and as per the standards and guidelines issued by CPCB from time

to time.

Plastic bags specification: as per BIS standards ( at present no such

standards), till then Plastic Waste Management Rules , 2016 shall be

applicable

Chemical treatment using at least 10% Sodium Hypochlorite having

30% residual chlorine for 20 minutes or any other equivalent chemical

reagent that should demonstrate reduction efficiency as given in

Schedule- II

Mutilation or shredding must be to an extent to prevent unauthorized

reuse.


Incineration ash: shall be disposed through HWTSDF facility, if toxic

or hazardous constituents are present.

Cytotoxic drug vials shall be sent back to the manufacturer or these

may be sent for incineration at CBWTF or TSDFs or plasma pyrolysis

at temperature >1200 0C.

Chemical Waste: Residual or discarded chemical wastes, used or

discarded disinfectants and chemical sludge can be disposed at HW

TSDF or to the TSDF through CBWTF .

Syringes should be either mutilated, needles should be cut and or stored

in tamper proof, leak proof and puncture proof containers for sharps

storage. Final disposal through a CBWTF or it shall be the

responsibility of the occupier to sterilize and dispose as per BMWM

Rules, 2016

SCHEDULE –II Schedule-II, BMWM Rules, 2016.docx

Standards for Treatment and Disposal of BMW












47

The effluents generated from the hospital or a CBWTF before

discharge into sewers should conform to the following limits :

Note: Sludge from ETP shall be given to CBWTF for incineration or to HW TSDF

Parameter Permissible Limit

pH 6.5 – 9.0

Suspended Solids 100 mg/l

Oil and Grease 10 mg/l

BOD 30 mg/l

COD 250 mg/l

Bio-assay test 90% survival of fish after 96 hours in 100%

effluent

SCHEDULE –II Schedule-II, BMWM Rules, 2016.docx

Standards for Liquid Wsate












48

SCHEDULE IV

(Part-A: LABEL FOR BIO-MEDICAL WASTE

CONTAINERS / BAGS)

Note: Label shall be non – washable and prominently visible

49

SCHEDULE – IV :

Part-B: LABEL FOR TRANSPORTING

BIO-MEDICAL WASTE CONTAINERS/BAGS

Phone No. : Name & Address :

In case of emergency please Contact :

Phone No. :

Telex No. :

Fax No. :

Contact Person :

Phone No.:

Telex No. :

Fax No. :

Contact Person:

Receiver's Name & Address: Sender's Name & Address :

Waste Description :

Day : Month :

Year :

Date of generation :

Waste Category No. :

Waste Class :


Suggested Forms under the BMWM Rules, 2016 Form I: Form-I, BMWM Rules, 2016.docx Accident Reporting Form II: Form-II, BMWM Rules, 2016.docx Application for Authorisation or Renewal of authorisation to be

submitted by the occupier or CBWTF operator Form III: Form-III, BMWM Rules, 2016.docx Authorisation (for Operating a facility for generation, collection,

reception, treatment, storage, transport and disposal of biomedical waste

Form IV: Form-IV, BMWM Rules, 2016.docx Annual Report Format to be submitted by the Occupier or Operator

of a CBWTF to the SPCB/PCC, by 30 th June of every year Form V: Form-V, BMWM Rules, 2016.docx Application for filling appeal against order passed by the

prescribed authority within 30 days.


































Form-IV, BMWM Rules, 2016.docx






















Wrong Practices

observed in HCFs

Mismatch Coloured Bags/Containers

Poor Segregation and the provision

Storing of waste in containers

even after overflowing

Storing of waste not at the

designated areas within the

HCF

Improper Transportation of BMW

Soiled linen left unattended, leading to

spread of infections

Infected items being

sorted from general waste and Transfer of

waste

Infectious waste is being allowed to mix with

the MSW

Open Tub being used for

Disinfection

Segregation and Storing of waste in designated

colour coded containers at source of generation Mixing of food waste with that of the

Infectious Bio-medical Waste

Sorting of infected plastics for reuse Sorting /mutilation of mixed

biomedical waste at the waste

storage area

Handling in person

without PPEs

Mixing of general and healthcare waste and

animals feeding on it

Open Burning of Waste which may lead to

Dioxins and Furans

Common Deficiencies in CBWTFs

Indulged in segregation of waste within CBWTF and Open Burning

Improper Wastewater Treatment Provision / Waste

Sharp Pit/AshStorage Pit

Improper Dg Sets provided as backup ( No Encclosure and the

suitable stack)

Suggested Steps for Effective

Biomedical Waste Management

in HCFs

Components of Bio Medical Waste Management

Transportation

Collection and Safe storage

Segregation at Source

Treatment & Disposal( On-site/Off-site)

Objectives

• Change ‘mindset’ & attitude through knowledge & training

• Defining various categories of BMW generated in HCI

• Proper segregation, collection and transportation

• Identify & utilize proper “treatment technology”

• Creating a system of inter dependence, accountability &

responsibility

• Evolving waste minimization / reduction policies

Waste Management

Committee

Hospital’s Nodal officer

Nursing Superintendent

Sanitary supervisor

Store In charge

Epidemiology Nurse

(Infection Control Nurse)

Policies &

Regulations

Members from other

departments

Medical Director &

Administrative Head

Regular Monitoring

Continuing

Education

Implementation of

the system

Waste Management Committee

( > 30 bedded Hospital)

Segregation at Source, labelling,

Transportation and Storage

HCFs

Categorise Ward –Wise

BM Waste Generation

Identify Ward-Wise BMW

Generation as per Rules

Sequential Steps for BMW Management in HCFs

Identify

Ward-Wise Activity

Quantify Ward-Wise BMW

Generation

Decide: Required Colour coded

containers and the bags with proper

label (Ward-wise)

Segregate at Source of Generation

as per BMWM Rules

Collect and Transport BMW in

closed trolley away from patients to

the temporary storage area

On-site treatment before 48 Hrs or

Hand over to the CBWTF Operator

as per BMWM Rules

Sign Boards with designated colour coded containers and

bags labeled as per BMWM Rules and placed in wards

Segregation at Source

biohazards poster.pdf

biohazards poster.pdf

73

Collection of Bio-medical Waste

• Establish a routine programmes for collection

• Collect ward waste - before every shift

• Waste bags should be sealed properly at source

• All containers/bags labeled as per BMWM Rules, 2016 ( Schedule-IV)

• Filled in designated containers/bags should be immediately replaced with empty containers or bags

• Shift waste to the temporary designated storage area (shift-wise)

74

Labeling : Containers /

Bags

Label should indicate the following:

• Lable in accordance with Schedule –

IV.

• Date of waste generation

• Place of waste generation (e.g. ward

/ establishment)

• Waste category and quantity

• Bar Code/ CBWTF membership

number

Pre-Treat Bio-medical Waste on-site

Pre-treat by disinfection or sterilization on-site as per WHO or NACO Guidelines and then for final disposal of the following waste.

the laboratory waste, microbiological waste, blood samples and blood bags

Transportation of Bio-medical Waste • Engage dedicated House Keeping workers

• For on-site transportation of bio-medical waste:

• Use wheeled and closed trolleys and Easy to load

and unload;

• No sharp edges to avoid damage waste bags or

containers during loading and unloading, easy to

clean;

• Waste should be collected periodically at least

before change of shift;

• No bags should be removed unless labeled;

• Bags should be immediately replaced with a bag

of same colour.

• Specific routes must be planned to avoid exposure

to patients and staff

• Leakages if any during transfer, need to be cleaned

properly and immediately

• Clean and disinfect vehicles/containers in a designated

washing area before use

• Keep a spill cleanup kit in all vehicles used to

transport medical waste.

Requirements of On-site Bio-medical Waste Storage

(prior to the final disposal within 48 hrs)

• Good lighting and ventilation provision

• Cold storage provision (at temperatures below 4 0C ( if waste is required to be stored more than 48 hrs).

• Good drainage provision

• Easy to clean (surfaces preferably glazed/tiled)

• Convenient water supply for daily cleaning and maintenance with disinfectants

• Protected from rodents, insects, birds and unauthorized entry

• Accessible only to the authorized staff

• Secure and lockable

• Washwater to be routed through ETP

Temporary Designated Storage Area of BMW

before Treatment; Away from Patients

Vehicle to be Used for Collection of Waste from Member HCFs

Metal Sharps: Collection, Storage & Disposal

Shredder Needle Destroyers

82

Bio-medical Waste Disposal by Deep Burial

(where no access to CBWTF)

Wastewater Treatment

Waste Water Treatment and Disposal

Waste Water from HCFs

Domestic Sewage

Segregated contaminated

Waste water from wards

Final Disposal in Public Drain or Sewer

Direct Disposal through public sewer or drain

Segregated and treated or

neutralized Liquid Chemical Waste n

Liquid Waste Treatment Facility provided in Karnataka

Liquid Waste Treatment Facility: in Haryana & Delhi

Requisites for CBMWTFs

Cytotoxic Waste

• Cytotoxics, are anti-neoplastic which inhibit cell growth and multiplication.

• If contacted, may damage normal cell and cause severe disability or even death.

• Disposal: Expired `cytotoxic drugs and

items contaminated with cytotoxic drugs

to be returned back to the manufacturer

or supplier for incineration at

temperature >1200 0C or to CBWTF or

HW TSDF for incineration at >12000C

or Encapsulation or Plasma Pyrolysis at

>12000C.

Radioactive Waste

• According to AERB - Atomic Energy Regulatory Board Regulations: radioactive waste must be stored in lead containers until ten times the half life period of the waste is over before disposing.

• Expired radioactive needles, especially cobalt needles used in cancer therapy should be returned for further treatment and disposal in accordance with AERB. Liquid radioactive waste can be discharged into a drain after the half life period is over.

• Low-level radioactive waste resulting from administering radio-pharmaceuticals and performing nuclear medicine procedures and radio-immunology procedures has to be stored and then discharged into drains in accordance with AERB Norms.

Hypo Solution

Hyposolution and Used X-Ray Films generated from X-Ray labs should be sold only to the recyclers registered under Rule 11 of the Hazardous Waste (Management, Handling and Transboundary Movement) Rules, 2008 with the Central Pollution Control Board (CPCB) or registered under Rule 9 of the Hazardous and Other Waste ( Management and Transboundary Movement) Rules, 2016, with the respective SPCB/PCC.

For such recyclers list pl. refer to CPCB website i.e www.cpcb.nic.in

http://www.cpcb.nic.in/







Mercury Waste Management in HCFs

Sources of Hg Waste Generation

Thermometers

Sphygmomanometers

Dental amalgam;

Esophageal dilators,

Cantor and Miller Abbott

Tubes

Barometers

X-Ray Machines

Button Cells and Medical

Batteries

Thimerosal

Laboratory chemicals

Electrical equipment,

fluorescent lamps

Cleaning Solutions

Classification of Mercury Waste: Is it Hazardous Waste

Mercury present as a part of the mercury based

medical instruments :

does not fall under the category of hazardous waste.

When the mercury spillage due to accidental breakage

of mercury based medical instruments or any items

contaminated with mercury:

then classified as ‘Hazardous Waste‘ as per

Scheduled II of the Hazardous Waste and

Other Waste (Management and Transboundary

Movement) Rules, 2016.

Is there mercury

spill

HCF

Wear PPEs

Identify Hg Spill Kit

Clean spill surface area with

10 % Sodium Thio-sulfate Solution

Identify large mercury beads , heap

them using card board and collect

in a plastic bottle half filled with

water and store in a designated area.

Evacuate patients ( if possible)

Mercury Spill Collection Procedure

Allow the room

for 24 hours before re-use

Identify and collect small Hg beads

and store in a plastic bottle half filled

with water

Spray Zinc/Sulphur powder to

identify small Hg beads

Mercury Waste Disposal Options

Store the Collected Hg spill in a designated area

Shift to a Centralized/

Controlled Storage Area

Hand over to the CBWTF

Operator

Return to Mercury

based medical

instrument

manufacturers

Sale or auction

to the authorized

mercury waste

recyclers

(to be encouraged)

Dispose through

HW Treatment

Storage and

Disposal Facility

For fianl disosal

Disposal Options

Guidelines on “Environmentally Sound

Management of Mercury Waste Generated from

HCFs” available at:

http://www.cpcb.nic.in/incini.htm

Mercury Spill Collection.DAT

http://www.cpcb.nic.in/incini.htm

Mercury Spill Collection.DAT

Used Lead Acid Battery Wastes:

• Has to be returned to the manufacturer concerned or to

be disposed off only through the lead acid battery

recyclers registered under the Batteries (Management

and Handling) Rules, 2001 and further amendments

made thereof, with the SPCB/PCC.

E-Waste :

• Has to be returned to the manufacturer concerned or

to be disposed off only through the authorized E-

Waste recyclers under the E-Waste Management

Rules, 2016 .

Fire Protection and Safety Measures

Adequate Fire Protection Equipments: (Smoke

detectors, Water sprinklers, Fire extinguishers,

Sand buckets, Fire alarm, spark arrester etc.)

should be installed

within the HCFs,

at bio-medical waste storage area

Fuel /Chemical storage areas

in accordance with fire safety regulations.

Fire safety aspects: Certificate from ‘fire

department’

Conditions to be imposed in the authorization to

be issued by the SPCBs under the BMW Rules

Other measures: Training & Safety Aspects to the Staff

PERSONAL PROTECTIVE EQUIPMENT (PPEs)

GLOVES MASK GOOGLES

APRON SAFETY SHOES HEAD CAP

Records maintenance and its Submission

(HCF/CBWTF) and to keep in web site within two

years i.e., 27.03.2018.

Maintain records (keep for five years) relating to:

Bio-medical Waste Generation (Ward-wise as

well as Centralized)- for compilation of AR

Pre-treatment of Lab., Microbiology, Blood

Bags and the Blood samples.

Wastes treated and disposed through recyclers

approved by SPCB/PCC.

Waste disposed through CBWTF

Accidents and remedial measures

Immunisation of HC Workers

Trainings organised to the HC Staff

Health status of the workers

Minutes of the meetings of the Committee

Submit annual reports by June 30 th of every

year ( By the HCFs) for the preceding Calendar year .

Periodic Monitoring of Compliance Verification

- Constitute an Internal Surveillance Squad

for assessment of BMW Management

related aspects .

- Assess and review the status of compliance

- Sharing of knowledge

- Initiate steps for improvements

Attention of the Prescribed Authority: Grant of authorisation to all the HCFs irrespective of the no. of patients

treated or quantity of BMW generation;

Phasing out of chlorinated plastic bags, gloves and blood bags within

two years;

Ensuring on-site pre-treatment of laboratory waste, microbiology waste,

blood bags and blood samples by disinfection or sterilization, by HCFs.

Bar code system and GPS establishment, within one year, by the

Occupier or Operator of a CBWTFs whichever is applicable;

Ensuring pre-treatment or neutralization of liquid chemical waste by

HCFs.

The liquid waste treatment and disposal by the HCFs or CBWTF in

accordance with the Water Act, 1974;

Records to be maintained on day to day basis and display the monthly

record including annual report on its website, to be developed within

two years from the date of notification, by the occupier or operator of a

CBWTF and the prescribed authority;

Existing incinerators is required to achieve the standard as specified in

schedule –II for the retention time in secondary chamber and Dioxins

and Furans within two years from the date of notification;

Installation of continuous online monitoring system by the Occupier

and CBWTF for monitoring of the parameters prescribed under the

authorisation granted under the BMWM Rules, 2016 and transmit the

data real time to the servers at SPCB/PCC and CPCB;

Quarterly monitoring of bio-medical waste incinerator stack gaseous

emission, by the occupier and operator of a CBWTF, through a

laboratory approved under the E (P) Act, 1986 and such records

maintained and its submission to the prescribed authority

Constitution of ‘State Level Advisory Committee (SLAC)’ by the

State Government or UT Administration in the respective State or UT

and the activities initiated by the SLAC;

Constitution of the ‘District Level Monitoring Committee (DLMC)’

by the State Government or UT Administration in the respective

State/UT and the activities initiated by the SLAC;

To comply with the responsibilities as per Schedule-III of the Rules.

Bio-medical waste Management Rules, 2016: Recollect

• Wastes other than BMW has to be managed in accordance with the respective rules notified under the E (P) Act, 1986

• BMWM Rules, 2016 are applicable to all generators/ all HCFs and CBWTFs.

• Categories of bio-medical waste is based on 4 colour coding (Yellow, Red, White and Blue)

• Emphasizes segregation of BMW at source of generation.

• Storage of segregated waste in safe location in four colour coded non-chlorinated containers or bags and labeled as per Schedule IV.

• Ensure treatment & disposal of waste such as human, anatomical waste, soiled waste and microbiology waste: within 48 hrs.

• Permits on-site treatment to the HCFs, provided there is no CBWTF within a distance of 75 KMs.

• The Laboratory, microbiology waste, blood samples and blood bags need to be treated by on-site as per WHO or NACO guidelines and then for final disposal.

• Phaseout use of chlorinated plastic bags, gloves and blood bags within 2 years;

• Bar code system to be established by 27.03.2017-within one year.

• To provide training to all its HCW-at the time of induction and thereafter atleast once in a year

Recollect: Bio-medical waste Management Rules, 2016

• All the HCWs need to be immunized as per NIP or MoH & FW Guidelines.

• Health of the HCW has to be ensured by providing adequate PPEs and conduct health checks at the time of induction and once in a year.

• Only trained workers need to be engaged for handling of BMW.

• Suggested Technologies: Incineration, Plasma pyrolysis, Autoclave/Hydroclaving, Dry Heat Sterilization, Microwave, Shredding, Combination of sterilization and shredding, treated plastics for for energy recovery/ recovery of diesel/fuel oil or for road making, Chemical Disinfection (10 % Sodium Hypochlorite Solution), Encapsulation, Ssanitary Landfill or disposal by deep burial (where there is no access to CBWTF)

• Any other technologies requires approval from Central Govt. and same will be notified under the E (P) Act, 1986 with relevant standards.

• HCF/CBWTFs is required to submit the annul report to SPCB/PCC by June 30 th of every year. SPCB to CPCB by 31 July every year.

• Make available the annual report on web-site within 2years and maintain records including operation of treatment equipment for a period of five years.

• In case CBWTF is not collecting the waste within the stipulated time, then HCF has to report immediately to SPCB/PCC.


• Recommend operating standards for incinerator:

Primary : atleast 800 O C; Secondary : atleast 1050 O C

Residence Time : 2 Seconds

Stack emission Standards: Included parameters like

Hg and Dioxins and Furans (0.1 ng TEQ/Nm3)

Stringent Standards : For PM ( 50 mg /Nm3); NOx (400 mg /Nm3 ), HCl (50 mg /Nm3 ), Hg (0.05 mg /Nm3 )

• All the existing incinerator operators (both captive and CBWTF Operators) have to comply with the Dioxins & Furans within two years.

• All the incinerator operators have to install online monitoring systems for the parameters as per SPCB/PCC.

• All the HCFs and CBWTFs have to ensure treatment of liquid waste to comply with discharge limits as per the Rules.

• Responsible authorities for ensuring compliance to the BMW Rules: MoEF, & CC, MoH & FW, MoD, CPCB, SPCBs/PCCs, State Governments/UT Administration, State/UT Health Depts. Local Bodies.

• Local authorities: show suitable site for development of a CBWTF as per CPCB/MoEF&CC guidelines and in consultation with SPCB/PCC.

• Liabilities on Occupier or Operators of CBWTFs for violation of the provisions of BMW Rules (under Section 5 & 15 of E (P) Act, 1986.

Bio-medical Waste Management

Compliance is

possible only when: EKATCCP

Education (92 %)

Knowledge (96 %) Apart from above required is

Attitude (100 %)

Team Work (106 %)

Commitment (125%)

Creativity (132%)

Punishment (139%)

Bio-medical Waste Management

for your patience and

participation.

For further information

please contact by E-mail

[email protected]

(or)

[email protected] Tel. (O) : 011-43102322;

M: 9868278903

Save Earth

Gaps in the implementation of

Biomedical Waste Rules 1998

Praveen SharmaScientific Officer

HP State Pollution Control Board

Best Practices adopted in Himachal Pradesh under BMW Rules

• Fully covered Biomedical Waste StorageArea/Room at IGMC Shimla and to controlthe unauthorized handling and littering of Bio-medical waste this area is under E-surveillance.

• GPS system in the vehicles authorisedtransporters of the bio-medical waste forbetter co-ordination and movement trackingof their vehicles.

Deep Burial Pit

Segregation

Treatment

Internal Transportation

Storage

Gaps in the Implementation of BMW Rules 1998

1. Segregation2. Treatment3. Handling & transportation of BMW with in Hospital4. Storage of Biomedical Waste5. Mixing of Biomedical waste with general waste6. Plastic Waste handling and disposal7. Record Keeping8. Awareness level9. Lack of Co-ordination10. Mismanagement of Black coloured Plastic Bags11. Open Burning of Biomedical Waste along with general waste12. Deep Burial Pits13. Transportation of BMW by the CBWTF Operators

Segregation

In most of the Health Care Facilities colourcoded bins are available for the segregationof biomedical waste as per the requirementof BMW Rules, but there is mixing ofbiomedical waste with general waste.

Treatment

In most of the Health Care Facilities practicesof chemical treatment of Category 4 andCategory 7 are being adopted, but in manycases the syringes were found stored withoutdisinfection and mutilation.

Handling & transportation of BMW with in Hospital:

Generally handling and transportation ofbiomedical waste to final storage point is beingcarried out manually in most of the hospitals.No dedicated trolleys used for the transportation ofbiomedical waste from the point of generation tothe final storage room/point.During internal transportation all colour coded bagsMixed together.

Storage of Biomedical Waste

In most of the Health Care Facilities there isno specified or marked area for the finalstorage of biomedical waste.

At the storage point all type of waste storedtogether

Mixing of Biomedical waste with general waste

In some of the Health Care Facilities, the BioMedical Waste although segregated at thepoint of generation but there was mixing ofthe different categories of biomedical wastewith general waste.

Plastic Waste handling and disposal

In most of the Health Care Facilities, plasticwaste of category 4 and Category 7generated in the hospitals are not beinghanded over to the respective CBWTF and isbeing sold to Kabaris.

Record Keeping

In the most of Health Care facilities, althoughthe records of biomedical waste so generatedare being maintained, however it does notmatch with the record of biomedical wastebeing handed over to the transporter.

Awareness level

Awareness about the biomedical wastehandling rules among medical officers andparamedical staff was adequate, but there isstill need for educating thecontractual/sanitation staff within therespective health care facility for properhandling and disposal of biomedical waste.

Lack of Co-ordination

In most of the Government hospitals, thesanitation work is on contract and there is alack of co-ordination between hospital staffand the contractor, resulting in mixing ofbiomedical waste with the general waste atfinal storage stage, there by defeating thevery purpose of segregation & treatment ofwaste at source.

Mismanagement of Black coloured Plastic Bags

In some of the health care facilities, the blackcoloured polythene bags with insignia of‘biohazard’ are being used for thestorage/transportation of general waste andbeing dumped into the MC dumpers.

Open Burning of Biomedical Waste along with general waste

Practices of open burning of biomedical wastealong with general waste at the backside ofthe health care facilities was observed insome Government as well as Privatehospitals.

Deep Burial Pits

In the deep burial pits all type of biomedicalwaste found mixed with general waste andpractices of burning of this mixed waste isbeing adopted.

Transportation of BMW by the CBWTF Operators

Overloading of the vehicle with biomedicalwaste so collected from the HCFs

Time gap for the collection of biomedicalwaste by the CBWTF operators from the HCFs

bmwm workshop presentations

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