Waste Management Unit

Bio-Medical Waste

Any waste, which is generated during the diagnosis, treatment or immunization of

human beings or animals or in research activities or in the production of testing of

biological. (Bio-Medical Waste (Management and Handling) Rules, 1998 )

As per WHO norms the health-care waste includes all the waste generated by

healthcare establishments, research facilities, and laboratories. In addition, it

includes the waste originating from minor or scattered sources such as that

produced in the course of health care undertaken in the home (dialysis, insulin

injections, etc.)

Burial of waste

Burial should be at least 50 meters from the nearest water source. Burial pit should be 1-2 meters wide and 2-5 meters deep. The bottom of the pit should be at east 1.8 meters above the water table. Erect a fence or a wall around the site to keep out animals. Every time solid medical waste is added to the pit, cover it with 10-30 cm of dirt. When the level of waste reaches to within 30- cm of ground level, fill the pit with dirt,

seal it with concrete, and dig a new pit.

Incineration of solid medical waste Incinerating is

the best option for solid waste disposal, since the

high temperature (1300 C) destroysmicroorganisms and reduces the amount of

waste.

Categories of Bio-Medical Waste as per Bio- Medical Waste

(Management and Handling) Rules 1998

WASTE CATEGORY TYPE OF WASTETREATMENT AND DISPOSAL

OPTION

Category No. 1Human Anatomical Waste (Human tissues,

organs, body parts)Incineration / deep burial

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 and colleges, discharge

from hospitals, animal houses)

Incineration / deep burial

Category No. 3

Microbiology & Biotechnology Waste (Wastes

from laboratory cultures, stocks or specimen of

live micro organisms or attenuated vaccines,

human and animal cell cultures used in

research and infectious agents from research

and industrial laboratories, wastes from

production of biologicals, toxins and devices

used for transfer of cultures)

Local autoclaving/

microwaving / incineration

Category No. 4

Waste Sharps (Needles, syringes, scalpels,

blades, glass, etc. that may cause puncture

and cuts. This includes both used and unused

sharps)

Disinfecting (chemical

treatment@@ / autoclaving /

microwaving and mutilation /

shredding

Category No. 5

Discarded Medicine and Cytotoxic drugs

(Wastes comprising of outdated,

contaminated and discarded medicines)

Incineration@ / destruction and

drugs disposal in secured

landfills

Category No. 6

Soiled Waste (Items contaminated with body

fluids including cotton, dressings, soiled

plaster casts, lines, bedding and other

materials contaminated with blood.)

Incineration@ / autoclaving /

microwaving

Category No. 7

Solid Waste (Waste generated from

disposable items other than the waste sharps

such as tubing, catheters, intravenous sets,

etc.)

Disinfecting by chemical

treatment@@ / autoclaving /

microwaving and mutilation /

shredding

Category No. 8

Liquid Waste (Waste generated from the

laboratory and washing, cleaning, house

keeping and disinfecting activities)

Disinfecting by chemical

treatment@@ and discharge

into drains

Category No. 9Incineration Ash (Ash from incineration of any

biomedical waste)Disposal in municipal landfill

Category No.10

Chemical Waste (Chemicals used in

production of biologicals, chemicals used in

disinfecting, as insecticides, etc.)

Chemical treatment @@ and

discharge into drains for

liquids and secured landfill

for solids.

Colour Coding and Type of Container for disposal

Symbols used for bio-medical waste containers/bags

BIOHAZARD CYTOTOXIC

To plan and design bio-medical waste management unit oneshould know how much and what type of waste is generatedand from which unit.

Is waste minimization possible if so in which unit and for whattype of waste.

What all items and equipment's and their quantities arerequired for managing the waste.

What type of disposal methodology is to be adopted to suit totheir facility.

Ascertain whether common bio-medical waste facility isavailable in the area or not.

Defining route of movement of waste

Unit Wise Generation of Bio- Medical Waste

Unit Waste Generation

Out Patient Soiled Waste,(gauze, bandages etc.), Solid waste (Plastic) andSharps

Injection Room Soiled Waste, Sharps and Solid waste

General Ward Sharps waste, Solid waste and Soiled waste

Labour Room Body part (placenta etc.) ,Sharps waste, Solid waste and Soiled waste

Operation Theatre Body parts, Sharps waste, Solid waste and Soiled waste

Intensive Care Unit Sharps waste, Solid waste, Soiled waste

Casualty/ Emergency Sharps waste, Solid waste and Soiled waste

Laboratory Sharps waste, Solid waste, Soiled waste, Biological (culture / media)

Pharmacy Discarded medicines

Amount and composition of hospital waste generated

Country Quantity (kg/bed/day)U. K. 2.5U.S.A. 4.5France 2.5Spain 3.0India 1.5

Hazardous 15%

a) Hazardous but non-infective 5%

b) Hazardous and infective 10%

Non-hazardous 85%

Waste Management Unit is a designated area of a healthcare facility which is staffed by a multidisciplinary team whose roles include

collection,

transport,

processing,

disposal,

managing and

monitoring

of waste materials generated from the facility.

The Waste Management Unit should have the followingfeatures:

Easily accessible from all functional areas

Accessible from within the unit and externally

Fitted with security fittings such as door locks, keypad/card access,CCTV and motion sensor depending on operational policy

Located away from food and clean storage areas

Not accessible to the public.

The Waste Management Unit should be located on ground level awayfrom publicly accessible areas.

The location should be adjacent to the Dirty Loading Dock for easyaccess by waste collection trucks.

Functional AreasThe Waste Management Unit will include the following Functional Areas:

Enclosed workstation with a workbench, telephone and computer outletto undertake recording and reporting functions; it should have visualcontrol of the waste handling facility

General wet waste holding area

Loading Dock and area with provision

Clinical waste holding rooms

Paper and recyclable materials collection

Clean bin storage area; a variety of bins need to be stored pendingdistribution to the hospital units

The following Functional Areas are optional requirements:

A waste weighing and recording station, which includes a floor leveldigital weighbridge and bar code recorder. This area will be required ifwaste handling policy includes weighing and tracking.

An upright freezer may be required to store tissue pending dispatch forincineration.

A radioactive waste storage

Clinical Waste Storage Clinical waste includes human or animal tissue, blood and body

fluids, pharmaceutical products, syringe, needles, dressings or any other waste which can be hazardous or may cause infection to any person who comes in contact with it.

The three groups of clinical waste include: healthcare wastes which pose as a risk of infection (including

human tissue, sharps, items in contact with body fluids, etc.) healthcare wastes which pose as a chemical hazard pharmaceuticals and medicinally-contaminated wastes which

contain pharmaceutically-active agent (including expired drugs, partially administered medications, vaccines and discarded items used in the handling of pharmaceuticals)

The Clinical Waste Storage is reserved for healthcare clinical waste only.The storage space should be: well-lit and ventilated; adjacent to Dirty Loading Dock; located away from food preparation and general storage areas; located away from routes used by the public; totally enclosed and secure; provided with separate storage areas for sharps receptacles,

anatomical and pharmaceutical waste; sited on a well-drained, impervious surface; readily accessible by authorised staff; kept locked when not in use; secure from entry by animals and free from insect or rodent

infestations; provided with staff washing facilities; clearly marked with warning signs; appropriately drained to a sewer (if approved by local regulations)

Bins and Equipment Washing Bay

A specific area, with adequate drainage, for washing bins and equipment should be located between the dirty and clean storage areas.

Refrigerated Storage

Waste in storage must not create offensive odor to pose as a nuisance tostaff and visitors of the facility. To prevent odor forming in hot weather,clinical & non-clinical waste should be stored in refrigerated storage priorto collection.

Radioactive Waste Storage

Radioactive waste should be handled in a safe manner to ensure that all staff have minimal exposure to radiation.

A Radiation Safety Officer will be responsible for the safe handling, storage and transport of radioactive waste.

Radioactive waste must be stored in leak proof containers in a specifically identified area for the storage of radioactive waste separate from clinical and general waste storage.

The handling, storage and disposal of radioactive materials must comply with requirements of the Radiation Control Act and other relevant local regulations.

General Waste Storage

Waste that are assessed and/or classified as inert or solid waste should bestored in a room separate from clinical waste for collection by outsidecontractors to be sorted, processed and recycled elsewhere

Liquid Waste Storage/ Discharge

Liquid waste that is unsuitable for discharge into a sewer or waterwayssuch as those from laboratory wastes must be contained to preventleakage and stored in abounded area.

Liquid waste may be legally discharged into a sewer or waterways only inaccordance with local sewerage authority requirements.

Functional Relationships The waste handling area will be frequently serviced by site and

contractor's vehicles removing waste in carts and front loading bulk bins.

It is important that adequate traffic access is provided for delivery andremoval of all wastes.

The access roads need to be adequate and turning areas uncongested.

A service lift devoted to materials movement within the hospital is highlyrecommended.

Waste holding/Disposal room should be provided in all FPUs

A Dirty Corridor should be provided for transport of waste which should not be used for transport of clean materials such as food items and general supplies for the facilities.

The Waste Management administration area should be located where visual control of the loading dock can be achieved.

Storage bays for Personal Protective Equipment (PPE) such as heavy duty gloves, safety shoes, protective face visors or goggles should be conveniently located to improve staff compliance thereby avoiding preventable risks.

Building Service Requirements

Building service requirements for the Waste Management Unit will include the following:

The temperature with the waste handling area should be maintained at a temperature that helps control odours; ideally a negative pressure environment should be provided to contain the spread of odours.

Temperature monitor and alarm should be connected to Biomedical Services to alert staff of any malfunction.

Hot and cold water outlets with a hose spray are the minimum requirements to be provided for cleaning waste holding areas and bins as required

Drainage from this area may include disinfectants; therefore liquid wastes may require special treatment prior to discharge.

Walls and floors should be sealed to withstand the frequent wash downs and the floors graded to allow run off.

Lighting should be adequate to allow staff to see clearly especially in waste storage areas and corridors.

Functional Relationship Diagram

Room/Space Qty Area(m2 ) Qty Area(m2 )

Room/Space Qty Area(m2 ) Qty Area(m2 )

National Legislations Governing Waste Management:

The Water (Prevention and Control of Pollution) Act, 1974 (for liquid waste)

The Air (Prevention and Control of Pollution) Act, 1981( for air quality)

The Environment (Protection) Act, 1986

Hazardous Wastes (Management, Handling and Trans boundary (Movement) Rules, 2008 (for

hazardous waste).

The Bio- Medical Wastes (Management and Handling) Rules 1998 (for hospital waste)

The Municipal Solid Wastes (Management and Handling) Rules, 2000 (for domestic municipal

waste)

Battery (Management and Handling) Rules, 2001 (for used batteries waste).

Excerpts from Bio- Medical Waste (Management and Handling) Rules 1998 and as Amended.

The Ministry of Environment and Forest has drafted certain rules in exercise of powers

conferred by sections 6,8 and 25 of the environment (protection) act, 1986.

Policies