common bio medical waste / hospital waste …indus.org/healthcare/secientific sessions/mr. ch....
TRANSCRIPT
Presentation
on
Common Bio Medical Waste / Hospital Waste Management Operations In India
By
CH.LAKSHMINARAYANA
SMS ENVOCARE LTD.,INDIA
CONTENT OF THE PRESENTATION
1. BIOMEDICAL WASTE:
2. HOSPITAL WASTE:
3. NEED FOR COMMON BIOMEDICAL WASTE MANAGEMENT FACILITIES
4. REGULATORY NORMS FOR BIOMEDICAL WASTE MANAGEMENT IN INDIA
5. INFRASTRUCTURE
6. PROCESS FLOW & OBJECTIVES OF CBMWF
7. OPERATIONS
8. TECHNICAL SPECIFICATIONS OF EQUIPMENTS
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;
• Bio-medical waste treatment facility" means any facility wherein treatment. disposal of bio-medical waste or processes incidental to such treatment or disposal is carried out.
HOSPITAL WASTE
• Medical waste is all waste materials generated at health care facilities, such as hospitals, clinics, physician's offices, dental practices, blood banks, and veterinary hospitals/clinics, as well as medical research facilities and laboratories.
CATEGORIES OF BIO-MEDICAL WASTE
Category No. 1
Human Anatomical Waste:
Human tissues, organs, body parts
Treatment/Disposal: Incineration
Category No. 2
Animal Waste: Animal tissues, organs, body
parts carcasses, bleeding parts, fluid, blood and experimental animals used in research, waste generated by veterinary hospitals, colleges, discharge from hospitals, animal houses
Treatment/Disposal: Incineration
Microbiology &
Biotechnology Waste
Wastes from laboratory cultures,
human and animal cell culture,
infectious agents from research and
industrial laboratories, wastes from
production of biologicals, etc
Treatment/Disposal:
Disinfection at source by Chemical
treatment/ autoclaving /microwaving/after
treatment final disposal at secured land fill
Category No. 3
Waste Sharps: Needles, syringes, scalpels,
blade, glass, etc. that may cause puncture and cuts. This includes both used and unused sharps
Treatment/Disposal: Disinfecting(chemical
treatment/autoclaving/ microwaving and mutilation/ shredding-Sharp Disposal Pits
Category No. 4
Discarded Medicines and
Cytotoxic drugs:
Waste comprising of outdated, contaminated and discarded medicines
Treatment/Disposal:
Incineration@/disposal in secured landfills.
Category No. 5
Soiled Waste:
Items contaminated with blood, and body fluids including cotton, dressings, soiled plaster casts, lines, bedding, other material contaminated with blood)
Treatment/Disposal:
Incineration@
Category No. 6
Solid Waste: Waste generated from
disposal items other than the sharps such a tubings, catheters, intravenous sets etc.
Treatment/Disposal: Disinfecting by chemical
treatment/autoclaving/ microwaving and mutilation/ shredding# #
Category No. 7
Chemical Waste : Chemicals used in
production of Biologicals /chemicals used in disinfection as insecticides.
Treatment/Disposal: Disinfecting by chemical
treatment and discharge into drains.
Category No. 8
NEED FOR COMMON BIOMEDICAL WASTE MANAGEMENT FACILITIES
• This waste can not be mixed with other waste. • Different categories required different treatment • It is infectious waste. • It Can create epidemics
REGULATORY NORMS FOR BIOMEDICAL WASTE MANAGEMENT IN INDIA
Ministry of Environment and Forests has revised the Bio Medical Waste (Management and Handling) Rules promulgated under the Environment Protection Act of 1986. These rules apply to all persons who generate, collect, receive, store, transport, treat, dispose, or handle bio medical waste in any form. The Rules now called the Bio Medical Wastes (Management and Handling) Rules 2011.
INFRASTRUCTURE FOR FACILITY
1. Incinerators
2. Autoclaves
3. Shredders
4. DG set & Power Room
5. Transportation vehicles
6. Intermediate storage sheds
7. Treated waste storage shed
8. Segregation room
9. Site security building
15
10. ADM & laboratory building
11. Treatment equipment room
12. Weigh bridge
13. Effluent treatment plant
14. Vehicle cleaning facility
15. Parking shed
16. Green belt
17. Wash room for workers
18. Work shop
19. Fire & safety
Collection &
Transportation Waste
Receiving Autoclave
Incineration
landfill
Rejects
Yellow Bags
Air Pollution
Control Units
Ash
Stack
Shredder Red Bags
Process Flow Diagram at Facility
Mixed Waste
Sharp Pit
PROJECT- OBJECTIVES
To collect & Transport the Biomedical Waste From Health Care Facilities.
To ensure proper storage of the wastes as per their classification, characterization and compatibility.
To decide the treatment and disposal scheme of wastes as per the regulations
To optimize the treatment and disposal cost by management practices and provide the economical services to the hospitals.
To conduct the public awareness program To Dispose Incinerator Bottom Ash in scientific
manner at Secured Landfills. Pollution Free facility. Saving Natural Resources by recycling systems. To register all the health care facilities as the member
of the CBMWTSDF 17
OPERATIONS
MARKETING
A marketing team shall be responsible for:-
To Register the Health Care Units as Member of facility.
To Visit HCU for trouble shootings.
Take feedback from doctors for quality on services for continual improvements.
Provide necessary training to the hospital staff handling waste at the health care
Units.
Supply barcoded biodegradable bags to track the necessary information and
keep it in records.
Bags shall have the details of the wastes which type of waste can be put in.
To Show the Tele Film On Bio Medical Waste Management.
Distribution of bills at door step and payment collection services
19
RECORD KEEPING
All the records of receipt, treatment and disposal of waste
will be maintained as per the prescribed guidelines
Log book will be maintained for incinerator, autoclave,
shredder etc.
All the records will be maintained in electronic media also.
The master & daily operation data shall be maintained in
software.
Data log sheet shall be maintained at vehicle level.
20
ENCOURAGE SEGREGATION AT SOURCE
Waste will be segregated at source in the color coded bags as
per norms by providing the training & in printed bags by the
HCU.
Sturdy, re-usable, color coded containers will be encouraged
where ever possible.
Waste will be segregated at all patient care activity areas,
diagnostic service areas, operation theatres, labour rooms,
treatment rooms etc.
Provide training to the staff of all HCU’s.
21
SEGREGATION OF HEALTH CARE WASTE
ALL BODY PARTS YELLOW BIN
TRANSPORT VEHCILES AND TROLLEYS
on-site waste collection service will be provided.
Collection schedule will be circulated in advance.
Specially designed collection vehicle will pick up the waste daily
basis.
More frequent collection will be provided for larger
establishments if desired.
Special pack body vehicles for Collection will be provided with
GPS tracking system.
Vehicles will be provided with mobile phones and PPE’S and
TREM card
Every vehicle will be provided with one trained driver and
one helpers, which ensures the safe collection
The collection vehicle reach the facility by evening and the
treatment starts immediately, leaving no chances for
storage.
The incinerable waste (yellow bag) is unloaded near the
incinerator
The autoclave waste (red bag) is unloaded near the
autoclave
TRANSPORT VEHCILES AND TROLLEYS
Transportation Fleet
I
D
Transportation Fleet &
Trolleys
TECHNICAL SPECIFICATIONS OF EQUIPMENTS
29
1. Type & Model "controlled air Oil Fired
Incinerator Model BMW-200
2. Type of Waste Common Bio Medical Waste
3. Burning Capacity 200 kgs/hr.
4. Auxiliary Fuel Diesel
5. Type of Burner Operation Monoblock fully automatic
burners
6. Temperature Primary
Chamber Secondary Chamber
800°C+50°C 1050°C+50°C
DETAILS OF INCINERATOR
INCINERATOR
I
D
PC
C
INCINERATOR
SCC
Recirculation
Pump
V
S
P
a
c
k
B
e
d
I
D
FST
AUTOCLAVE & BABY BOILER
Type of autoclave
Fully automatic horizontal in shape with auto &
manual lock system having high pressure
55Psi/high vacuum 712 mm WC type steam
sterilizer with saturated steam temp, of
150°C.
Capacity 300kg
Material of Construction
of PCC & SCC
The casing will be of S.S. - 316L grade with
Glass wool insulation covered with polished
S.S. with PLC.
Operating System PLC
Baby Boiler Details
Baby boiler: L.D.O./H.S.D. fired PLC regulated
standard company non IBR of 150kg/hr. dry
steam capacity with design temp. &
pressure of 200°C and 9kg/sq.cm
respectively
• operating temperature of 121/134º C and a
working pressure of 1.2/2.1 kg/cm2.
• The unit shall have a single door with
radial locking system.
• The autoclave shall be controlled
with computers.
• The equipment shall be provided with indicators
and recording system for residence time,
temperature and pressure.
AUTOCLAVE
AUTOCLAVE
SHREDDERS
The shaft is made of high strength steel alloys fitted with
cutters having angular way.
Cutters are made of High speed steel which is heat treated to
avoid damage due to sharp, shreded waste, syringes, scalpels,
glass vials, I.V. sets, rubber gloves, plastic materials, etc.
Special Hoppers designed for shredder with Ramp assistance
to push the material in cutting chamber.
Trolley is provided for handling shredded material.
External paneling covers are fitted for operator’s safety.
The shredder is supplied with control unit.
SHREDDERS
Sharp Pit Encapsulation
• The sharp management pit shall
be developed in phase manner.
• This underground pit is
constructed with RCC .
• It is covered from top, provided
with the air ventilation pipe.
• The sharps are disposed in to this
pit for longer period.
• Once the pit is full the new pit
shall be constructed.
SHARP-DISPOSAL PIT
EFFLUENT TREATMENT PLANT
The effluent treatment plant treats the liquid effluent from all
sources like:
Waste water from autoclave sterilization
Liquid waste from shredders
Waste water after disinfecting the transport vehicles
Waste water from scrubber installed in the incinerator
Floor washing etc.
The ETP system shall be designed with zero-discharge process.
It shall have physico-chemical treatment followed by PSF and ACF.
EFFLUENT TREATMENT PLANT
I
D
Bags are not labeled as per BMW rules. The labels should contain all the
details.
Needles should be separated by using needle cutter or burner and to be
given in puncture proof container, these are not being given accordingly.
Anatomical waste is not being given in yellow colour bags in some cases.
Bottles/ sharps/Metal containers are not segregated, this will damage the
refractory.
Gloves/ syringes found in yellow bags without segregation.
some times general waste is coming along with biomedical waste.
Subsequently increasing diesel consumption for incineration.
OBSERVATIONS AT ALL BMW FACILITIES
BMW bags are not packed properly and there are leakages.
Colour coded bags are not being used as prescribed. Yellow bags for
incineration and Red bags for autoclave.
IV sets/IV Bottles/syringes etc. being sold to unauthorized vendors.
OBSERVATIONS AT ALL BMW FACILITIES
,
CLASSIFICATION OF HEALTH CARE WASTE:
Hazardous waste (10-15%)
Non-hazardous waste (70-80%) I
Infectious (15-20%)
Other hazardous (5-7%)
Sources of Bio-Medical Waste
Govt. hospitals ,Private hospitals, Nursing homes
Physicians/Dentist clinics , Dispensaries
PHC Medical research &training establishment, Mortuaries
Blood banks, collection centers , laboratories
Animal houses, slaughter houses.
Conclusion
Prevent and minimize waste generation
Reuse or recycle the waste, to the extent possible.
Treat waste by safe and environmentally sound methods.
Dispose off the final residue by land fill in confined and carefully designed sites.
46
THANK YOU
For Further Information Please Contact:- Ch.Lakshminarayana SMS Envocare Ltd. 20, IT Park | Parsodi |Nagpur |Maharashtra | India Ph +91 -712-6665000 Fax +91-712-6665100 Mb.+91-9922901553 Mail:-lakshminarayana.chimalkonda @smsl.co.in Web:-www.smsenvocare.co.in