Management

Of Bio Medical

Waste

What is Bio-medical waste

??Definition Any solid, fluid or liquid waste, including its container and any

intermediate product, which is generated during the diagnosis,

treatment or immunization of human beings or animals, in

research pertaining thereto, or in the production or testing of

biological and the animal waste from slaughter houses or any

other like establishments.

Generated from Waste generated by health care facility

Research facility

Laboratories

Hazardous health care waste 85% waste is non infectious

10% are infectious

5% are hazardous

Two type of hazardous Bio

medical waste Non hazardous: Approximately 75-90% of the

biomedical waste is non-hazardous and as harmless as any other municipal waste. (E.G, Plastic, Glass, Cardboared, etc)

Hazardous waste:10-25% is hazardous and can be injurious to humans or animals and deleterious to environment. It is important to realise that if both these types are mixed together then the whole waste becomes harmful.

Bio Hazard Symbol

Types Of Biomedical WasteOptions Waste Category

Category No. 1 Human Anatomical Waste

Category No. 2 Animal Waste

Category No. 3 Microbiology & Biotechnology Waste

Category No. 4 Waste Sharps

Category No. 5 Discarded Medicines and Cytoxicdrugs

Category No. 6 Solid Waste

Category No. 7 Solid Waste

Category No. 8 Liquid Waste

Category No. 9 Incineration Ash

Category No. 10 Chemical Waste

Options Waste Category Treatment & Disposal

Category No. 1 Human Anatomical Waste Incineration / deep burial

Category No. 2 Animal Waste Incineration / deep burial

Category No. 3 Microbiology & Biotechnology Waste

Local autoclaving / microwaving / incineration

Category No. 4 Waste Sharps Disinfection by chemical

treatment / autoclaving /

microwaving and mutilation / shredding

Category No. 5 Discarded Medicines and Cytoxicdrugs

Incineration / destruction and drugs disposal in secured landfills

Category No. 6 Solid Waste Incineration / autoclaving / microwaving

Category No. 7 Solid Waste( generated by disposal items)

Disinfection by chemical

treatment / autoclaving /

microwaving and mutilation / shredding

Category No. 8 Liquid Waste Disinfection by chemical

treatment and discharge into drains.

Category No. 9 Incineration Ash Disposal in municipal landfill

Category No. 10 Chemical Waste Chemical treatment and

discharge into drains for liquids and secured land for solids

Categories Examples

Components ExamplesHuman Anatomical Waste Tissues, organs, body parts

Animal Waste Generated during research/experimentation, from veterinary

hospitalsMicrobiology & Biotechnology Waste

Laboratory cultures, micro-organisms, human and animal

cell cultures, toxins

Waste Sharps Hypodermic Needles, Syringes, Scalpels, Broken Glass

Discarded Medicines and Cytoxic drugs

Barium Enema, X-Rays, Cancer Chemotherapy, Tar-Based

Products

Solid Waste Dressing, bandages, plaster casts, material contaminated

with bloodLiquid Waste Generated from any of the infected areas

Chemical Waste Alcohol, Sulphuric Acid, Chlorine Powder, Glutaraldehyde,

Picric Acid, Fertiliser, Ammonia

Non-Infectious waste, 80%

Pathological and Infectious

waste, 15%

Chemical and Pharmaceutical

waste, 3%

Sharps, 1%

Radioactive,Cytotoxic and heavy metals,

1%

Bio-Medical Wastes

percentage

CLASSIFICATION OF HOSPITAL

WASTENon-

Hazardous Waste

Bio-degradable

Non bio-degradable

PotentiallyInfectious

Waste

Dressings, swabs,

laboratory wastes,

instruments used in patient

care..

Potentially Toxic Waste

Radioactive

Chemical

Pharmaceutical

Hospital Waste

Pharmaceutical Waste

Chemical waste

Lab reagents

Radioactive Waste

Developed Countries- 1-5 kg/bed/day, with variations

among countries.

In India- 1-2 kg/bed/day with variation among

Govt. and Private establishments.

* 80 percent waste generated in a hospital is non

hazardous and can be dealt with normal domestic

waste management system.

* 15 percent pathological & infectious waste.

* 3 percent chemical & pharmaceutical waste.

* 1 percent sharps.* 1 percent radioactive, cytotoxic and heavy metals.

According to my survey research

In SGPGI- 100 Kg of bio medical waste/day

In Globe Medicare - 50 Kg of bio medical

waste/day

In Kamakhya Hospital-10-15 Kg of bio medical

waste/day

In Brajraj Hospital-50 Kg of bio medical

waste/day

COLOR

CODE

TYPE OF CONTAINER WASTE

CATEGORY

TREATMENT

OPTIONS

Yellow Plastic bags 1, 2, 3 and 6 Incineration/deep burial

Red Disinfected container/plastic

bag

3, 6 & 7 Autoclaving/Micro

Waving/Chemical

treatment

Blue/white

transparent

Plastic bags/puncture proof

container

4 & 7 Autoclaving/Micro

waving/chemical

treatment, Destruction &

shredding

Black Plastic bag 5, & 9, AND

10 (SOLID)

Disposal in secured land

fills

Principles of Control of Hazards of

Biomedical Waste in Health Care

Establishments

* Each institution should develop its own bio waste management

policy and ensure that the health care workers are adequately

trained to handle biological waste.

* Measures such as universal safety precautions, hand washing

and proper segregation of waste material should be

encouraged.

* Rationale patient management policy should be followed

and admissions restricted to those for whom it is felt

absolutely necessary.

* Proper house-keeping is essential and the hospital premises

should be kept clean and well-ventilated.

* Use of disinfectants should be rationalized.

Two types of Disposing bio medical

wasteThermal technology

It Uses Heat To Decontaminate Instruments

And Equipment And The Temperatures In

This Process May Rise To Extremely High

Levels.

Most Of The Microbes Are Destroyed At

Temperatures Below 100°c.

1. Autoclave

2. Incinerator

- Here vacuum pumps are utilized to

evacuate the air in the chamber of

autoclave and steam under pressure

is pushed in, which is able to

penetrate the waste material more

thoroughly. This technology thus

reduces the cycle time to 30 - 60 minutes and the temperatures

attained are 132°C.

-where air is pushed out of the

autoclave by steam under pressure.

This system operates at

temperatures of 121°C and has a

cycle time of approximately

60 - 90 minutes.

- Incineration is a high heat systemprocess of burning combustible

Solids at very high temperature in a

furnace.

- It employs combustion of waste

material in stages, followed by

cleaning of the flue gas through a

number of pollution control devices.

- The end product is devoid of

infectious organisms and organic

compounds of waste, which is

aesthetically acceptable.

- Based on the type of fuel

consumed the division could be-

● Conventional incinerator using

wood/charcoal

● Electrical incinerator

● Oil fired incinerator using

electricity and diesel oil

Mechanical Technology

1. Compaction: Compacting is carried out by a

hydraulic ram against a hard surface.

2. Grinding / Shredding: Waste material is broken

down into smaller particles under negative pressure to

avoid any spillage outside the chamber.

3. Pulverization: Waste is mixed with large volume of

water and bleach solution. The waste is torn to shreds

and then fed to an ultra high speed hammer mill with

large spin blades which pulverize the matter into small,

safe particles.

Final Disposal MethodsGeneral Non Hazardous Waste Secured Landfills

Liquid Wastes Chemical Disinfectant Neutralization With Reagent,And Discharged Into The Sewerage System.

Human Anatomical Wastes Incinerated And Sent To Landfill Sites.

Sharps Needles Can Be Cut By Needle Cutter And ContainedIn 1% Bleach Solution, And Sent To Landfill For Disposal.

Microbiology Waste Autoclave/Microwave/Incineration Landfill Disposal.

Infectious Solid Waste Autoclave/Microwave/Incineration Landfill Disposal.

Radioactive Waste The Solid Wastes Are Disposed By Concentration AndStorage, While Liquids By Dilution And Dispersal

Pressurized Containers Disposed Off With General Waste In Secured Landfills.

General Non Hazardous Waste Secured Landfills

Liquid Wastes Chemical Disinfectant Neutralization With Reagent,And Discharged Into The Sewerage System.

Human Anatomical Wastes Incinerated And Sent To Landfill Sites.

Sharps Needles Can Be Cut By Needle Cutter And ContainedIn 1% Bleach Solution, And Sent To Landfill For Disposal.

Microbiology Waste Autoclave/Microwave/Incineration Landfill Disposal.

Infectious Solid Waste Autoclave/Microwave/Incineration Landfill Disposal.

Radioactive Waste The Solid Wastes Are Disposed By Concentration AndStorage, While Liquids By Dilution And Dispersal

Pressurized Containers Disposed Off With General Waste In Secured Landfills.

General Non Hazardous Waste Secured Landfills

UNDER ENVIRONMENT PROTECTION ACT,

1998BIO-MEDICAL WASTE (Management & handling) RULES 1998

1st Amendment Rules vide S.O.201(E) Dated 06/03/2000

2ndAmendment Rules vide S.O.1069(E) Dated 17/09/2003

Generation/Collection/Reception/Storage

Transportation

Treatment/Disposal

or any other form of handling.

Role Of Doctors, Nurses, Lab

Technicians.

Do not dispose dressings in patients

bin / Ask for disposal bags.

Ensure all the plastics and gloves are cut and put into bleach

solution.

Ensure all used injections are cut using needle cutters.

Ensure compliance of this scheme during ward visits

Help patients understand the scheme.

Media plates to be put in separate

bleach solution.

DON’TS

Put the waste indiscriminately.

Put wrong bags in bin. (Adhere to color code.)

Fill the bags till neck. (Waste would otherwise spillover.)

Handle waste without protective clothing.

Drag the bags after removal. (Bags can burst andthe site could be repulsive.)

Never recap the needle. (Never re-use needlewithout disinfection)

Mix non infectious waste with infectious waste.