A STUDY ON BMW DISPOSAL MANAGEMNT AND RECOMMENDATIONS FOR SAFE DISPOSAL

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PROJECT REPORT
A STUDY ON BIOMEDICAL WASTE DISPOSAL
MANAGEMENT IN SAHARA HOSPITAL AND
RECOMMENDATIONS FOR SAFE DISPOSAL
Project submitted to Sharda University, School of Business
Studies(SBS) building towards the partial award of Masters Degree
in Healthcare and Hospital Administration.
Submitted by
Dr. Rita Singh
ROLL NUMBER--170251146
BATCH-2017-2019
Sharda University , Greater Noida

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DECLARATION
I hereby declare that the Project Report entitled “A STUDY ON
BIOMEDICAL WASTE DISPOSAL MANAGEMENT IN
SAHARA HOSPITAL AND RECOMMENDATIONS FOR SAFE
DISPOSAL” submitted by me to the Department of Business
Management, Sharda University, Greater Noida, is a bonafide work
carried out by me and is original and not submitted to any other
University or Institution for the award of any
Degree/Diploma/Certificate or published any time before.
DATE- SIGNATURE
PLACE- Lucknow NAME- Dr. Rita Singh
ROLL NO-170251146

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SAHARA HOSPITAL
VIRAJ KHAND, GOMTI NAGAR, LUCKNOW – 226010 INDIA
Tel.: 0522-6780001, 6780002, OPD Appt: 0522-6782110
E-mail: hospital@hqsimil.sahara.co.in, Website:www.saharahospitals.com
Ref. No. :………….. Date - ……………
To Whomsoever It May Concern
This is to certify that Dr. Rita Singh student of Master in Hospital and
Healthcare Administration at Sharda University, Greater Noida has successfully
completed her project entitled “A STUDY ON BIOMEDICAL WASTE
DISPOSAL MANAGEMENT IN SAHARA HOSPITAL AND
RECOMMENDATIONS FOR SAFE DISPOSAL” at Sahara Hospital; Lucknow
during internship period from 11/06/.2018 to 25/07/2018.
Wishing her a bright and prosperous future.
DR. MAZHAR HUSAIN
Director Medical Health
Sahara Hospital

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SAHARA HOSPITAL
VIRAJ KHAND, GOMTI NAGAR, LUCKNOW – 226010 INDIA
Tel.: 0522-6780001, 6780002, OPD Appt: 0522-6782110
E-mail: hospital@hqsimil.sahara.co.in, Website:www.saharahospitals.com
Ref. No. :………….. Date - ……………
To Whomsoever It May Concern
This is to certify that Dr. Rita Singh student of Master in Hospital and
Healthcare Administration at Sharda University, Greater Noida has successfully
completed her project entitled “A STUDY ON BIOMEDICAL WASTE
DISPOSAL MANAGEMENT IN SAHARA HOSPITAL AND
RECOMMENDATIONS FOR SAFE DISPOSAL” at Sahara Hospital; Lucknow
during internship period from 11/06/.2018 to 25/07/2018.
Wishing her a bright and prosperous future.
MR.ANIL VIKRAM SINGH
Senior Advisor
Sahara India Parivar

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CERTIFICATION
This is to certify that the Project Report entitled “A STUDY ON
BIOMEDICAL WASTE DISPOSAL MANAGEMENT INSAHARA
HOSPITAL AND RECOMMENDATIONS FORSAFE DISPOSAL”
submitted for the award of Masters Degree in Healthcare and
Hospital Administration. , Lucknow, was carried out by
Dr.Rita Singh under my guidance. This has not been submitted
to any other University or Institution for the award of any
degree/ diploma/certificate.
Signature of the Internal Guide Signature of the Principal
Name: Dr. Richa Panday (with stamp)

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INDUSTRY CERTIFICATE
I write to inform that Dr.Rita Singh was placed from Sharda University for her summer
Internship Project . She started the project entitled “A STUDY ON BIOMEDICAL WASTE
DISPOSAL MANAGEMENT IN SAHARA HOSPITAL AND RECOMMENDATIONS
FOR SAFE DISPOSAL” from 11/06/18 to 25/07/18. She has been innovative in developing the
concepts and working structure for the project , punctual in the implementation at various stages
and sincere in her attempt to complete the task with attention. She has been found to be
pleasant,co-operative and possessed with analytical mind. As a guide , we enjoyed working with
her.
Dr Abha Tandon Ms Manisha Masih
Quality Control Manager Quality Control Manager
Sahara Hospital Sahara Hospital
Dr (Col) Randhir puri
Medical Superintendent
Sahara Hospital

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ABSTRACT
Biomedical waste management is receiving greater attention due to recent
regulations of the Biomedical Wastes (Management & Handling Rules, 1998).
Inadequate management of biomedical waste can be associated with risks to
healthcare workers, patients, communities and their environment.
Interaction of micro– (internal) and macro– (surrounding) environment of human
beings determines the status of health of an individual or of community at–large.
On daily basis, generation and disposal of biomedical wastes has become a
emerging problem not only in India but the world over. These are being produced
during the process of sampling, testing, diagnosis, therapy, immunization and
surgery of humans, animals, and in research experiments. Several categories of
biomedical wastes have been discussed along with steps involved in the
management of biowaste include segregation, storage in containers, labeling,
handling, transport, treatment, disposal and waste minimization. Potential
implications of biomedical wastes include transmission of diseases like Hepatitis
B, C, E, dengue and HIV through contaminated sharps . India generates around
three million tonnes of medical waste every year and the amount is expected to
grow at eight per cent annually. Creating large dumping grounds and incinerators
is the first step and some progressive states such as Maharashtra, Karnataka and
Tamil Nadu are making efforts despite opposition.Barring a few large private
hospitals in metros, none of the other smaller hospitals and nursing homes have
any effective system to safely dispose off their wastes. With no care or caution,
these health establishments have been dumping waste in local municipal bins or
even worse, out in the open. Such irresponsible dumping has been promoting
unauthorized reuse of medical waste by the rag pickers for some years back.

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ACKNOWLEDGEMENT
The success and final outcome of this project required a lot of guidance and
assistance from many people and I am fortunate to have got this all along the
completion of my project work. Whatever I have done is only due to such guidance
and assistance and I would not forget to thank them.
I respect and thank Dr.(Col) Randhir Puri (Medical Superintendent) for giving me
an opportunity to do the project work in Sahara Hospital, Lucknow and I am also
thankful to the hospital staff for providing me the support and guidance which
made me complete the project on time.
I would also like to thank my Industry Supervisors Dr .Abha Tandon (Nodal
Officer, NABH and NABL) and Ms .Manisha Masih (Quality Control Manager)
without whom the project would have been a distant reality. I owe my profound
gratitude to them who took keen interest in my project work and guide all along,
till the completion of my project work by providing all the necessary information.
I would thank Dr. Richa Panday (Mentor Sharda University) for inspiring me
to do internship and couple of projects in Sahara Hospital with full honesty,
punctuality, hard work, and dedication .
I take this opportunity to acknowledge the services provided by Mr Priyank(Front
Office), attendants , receptionists and everyone who collaborated in producing this
work.
I also wish to thank specially my family members, and well-wishers who have
always been supportive in successful completion of my project.
Table of Contents

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S.NO CONTENT PAGE.NO
A). INTRODUCTION 10
1). ABOUT SAHARA HOSPITAL 10
i). HISTORY OF SAHARA HOSPITAL 10
ii). MISSION , VISION , QUALITY POLICY 11
iii). LAYOUT OF HOSPITAL 12
iv). CORE STRENGTH 13
v). SCOPE OF SERVICES 14
vi). SPECIALITIES 16
vii). CERTIFICATIONS 18
viii). STRENGTH OF HOSPITAL 19
2). ABOUT PROJECT 20
i). BIOMEDICAL WASTE 20
ii). CLASSIFICATION OF BMW 21
iii). SOURCES OF BMW 22
iv). CATEGORIES OF BMW 23
v). COLOUR CODING AND TYPE OF CONTAINER 23
vi). LEGAL ASPECT OF BMW 24
vii). TREATMENT OF BMW 25
viii). COLLECTION AND STORAGE OF BMW 31
ix). HEALTH HAZARDS OF BMW 32
B). LITERATURE REVIEW 34
i). CASE STUDIES 34
C). BIBLIOGRAPHY 38

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Introduction
ABOUT SAHARA HOSPITAL-
HISTORY OF SAHARA HOSPITAL:
Sahara Hospital is a tertiary care private hospital in Lucknow, capital city of Uttar
Pradesh state of India. The hospital is a venture of Sahara India Medical Institute
Limited, a subsidiary of Sahara Prime City Limited. Sahara Hospital was the
project of Sahara India Medical Institute Limited, a subsidiary of Sahara Prime
City Limited. It sits on a 27-acre campus at Gomti Nagar , in the neighbourhood
of Lucknow. It was designed by Mumbai-based architect Hafeez Contractor.The
construction contract for the hospital building (set at 490 million (US$7.3 million)
was given to Larsen & Toubro. The total costof the project was 4
billion (US$60 million), which also included costof medical equipment. Rising
80.06 metres (262.7 ft) and 19 floors, it is the tallest building in Lucknow. The
hospital was inaugurated on 12 February 2009 by Chhabi Roy, mother of founder
and chairman of the Sahara India Pariwar Subrata Roy. The hospital is the first
medical centre in Uttar Pradesh to perform a successfulelbow transplant
and endoscopic cervical plate placement. Patients admitted in the 'critical care area'
of hospital can be monitored by the internet protocol cameras. In addition to

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physicians, this remote monitoring facility is provided to the relatives of patients,
so that hygiene and sterility of such areas can be maintained. The first of the three
planned super-specialty hospitals is operational in Lucknow, Uttar Pradesh, India,
presently operating with 378 beds (expandable to 554 beds). Sahara Hospital
Lucknow is poised to become one of the top hospitals in Asia. Sahara Hospital is
expected to place Lucknow on the world map of destinations for healthcare of
global standards. The hospital has specially designed suites for patients and their
families coming from overseas for medical treatment in India, as a cost-effective
and reliable option.
Mission
 The mission of Sahara Hospital is to provide quality healthcare with
compassion efficiency.
 To apply and share new technology
 To Promote an environment in the hospital that facilitates protection of
patient’s rights and commitment towards patient care
 To include preventive healthcare practices in addition to treatment
applications without discrimination of religion, Language, Race and Gender.
Vision
To set a benchmark of excellence in advanced, hi tech multi disciplinary medical
services in Asia, Offering high quality healthcare and tertiary care facilities.
Quality policy
Sahara Hospital is committed to deliver high quality patient care through
applications of latest technology coupled with medical excellence, ensuring safety

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of treatment during patient's stay, promoting and environment of continuous
quality improvement and complying with statutory regulations.
LAYOUT OF THE HOSPITAL
A state-of-the-art, multi-specialty, tertiary care hospital providing world class
facilities with more than 50 specialties and latest generation equipment under one
roof. This hospital is spread on approx. 12.5 acres with approx. 1 million sq. ft.
built up area.
Sahara Hospital got operational in February, 2009 and is currently operating
with 378 beds (including 133 Critical Care beds) and is expandable to 554 beds.
Currently it is running with one of the biggest Critical Care Infrastructure
supported with 8 Ultra Clean Operation Theatres with most advanced technologies
like Portable CT Scan, Cardiac CT Scan and High End Operating Microscopes
with a team of dedicated and renowned clinicians and highly trained paramedics.
Facilities for Radiation Oncology are under process and will be made available in
the near future.
Also, a training facility is being provided at the Sahara College of Nursing &
Paramedical Sciences, which is affiliated to Chhatrapati Shahuji Maharaj Medical
University, Lucknow, recognized by Indian Nursing Council, New Delhi and
approved by U.P. State Medical Faculty and the Govt. of Uttar Pradesh.

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Core Strengths
All ClinicalSpecialties are available under one roof
A Rich Poolof Human Resource
 Highly qualified experienced and skilled Doctors and trained
Paramedical professionals.
 Surgical specialists and Super specialist of all surgical specialties and
medical specialties.
 Round the clock presence of qualified & dedicated staff.
 Nursing college with a constant resource of the most qualified nurses.
Best-in-Class Equipment. delivering the best results
 Specialist to manage poly trauma (24 hours).
 High-end latest generation equipment for OT, ICU’s, Laboratories,
Diagnostics& Rehabilitation.
 Fully equipped approx. 133 Critical care bedded wing.
 State of the art 8 ultra-clean Operation Theatres.
 Internationally designed, equipped with fully automated Central
Sterilization Supply department to achieve desired infection control and
success rate.
The Complete world of Sahara Hospital comprises of:

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SERVICES AT SAHARA HOSPITAL-
 FULL FLEDGED TRAUMA CARE CENTRE:Prompt& integrated
management of Poly trauma & acute strokes with the availability of
Neurosurgery , Neuromedicine, Orthopedic surgery, Plastic &
&reconstructive surgery, cardiothoracic surgery , clinical & invasive
Cardiology, vascular surgery, urology ,ENT surgery ,Gastro surgery, Eye
Surgery , endocrine surgery supported by round the clock services of world
class blood bank & diagnostics .
 The most modern delivery system – “Pneumatic Tube” to achieve efficient
& safe transportation of drugs, pathological samples. First of its kind in
India.
 Cardiac Cath Lab Alluraxperfd10 ceiling suspended-flat panel equipped
with latest generation dynamic flat detector
 1.5 Tesla Ultra fast 16 channel
 Emergency & Trauma Care
 Medical Specialties
 Surgical Specialties
 Investigation Specialties
 Critical care facilities
 Blood bank
 Nutrition & Dietetics
 Physiotherapy
 Alternative Medical Sciences
Diagnostic services are available Round The Clock.
This includes Radiology, Pathology, Endoscopy, and special diagnostic
services,-all located at one place. This also includes latest generation Cardiac
CT, MRI, Cardiac Cath Lab.

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 Ultra fast 64 slice Cardiac CT
 Portable C T SCANS First time in Northern region
 Capsule Endoscopy:-Camera capsule can be easily ingested which takes
thousands of color photos ofthe digestive track.
 Seamless Ultra Clean Operation Theatres as per the International standards
with Laminar Air Flow with dedicated AHUs for each OT.
 Intensive Care Unit Equipped with latest generation equipment and high end
bed side patient monitors for the close monitoring of the patients through
web.
 Mobile Intensive Care Unit (Ambulance) with Latest Generation
Equipments.
 ULTRA MODERN BLOOD BANK FACILITY available round the clock
assuring safe transfusion of high quality blood components.Equipped with
latest generation high end equipment including aphaeresis units for
component donation as well as component separation & storage according to
International Standards.
 Laboratory Sahara Hospital-Curing through Care
 Level III NICU has the state-of-the-art Transport Incubator with ventilator
for transporting sick newborns.
 One of the distinguishing features of Sahara Hospital is the effective
integration of latest Information Technologies and Medical Technologies
 Continuous Renal Replacement Therapy
 World class Entrance lobby with elegant environment.
 Enjoy motherhood -Special Anti Natal Classess
 Thyroid clinic
 Unique surgeries/Treatments/Procedure
 Pioneer centre for Neuro endoscopic Surgeries
 Cardiac Angiography by Non invasive Method. In 5 heart beat Cardiac
Angiography can be Accomplished ensures Minimal Radiation and less dose
of Contrast.
 Facilities for Total Hip and Total knee replacement surgeries arthroscopic
surgery, matching international standards, by trained surgeons.
 Haemato-oncology -Hematological cancers, Lymphomas, Leukemias &
Myelomas. A diverse range of oncological surgeries in the areas of Head &
Neck cancer, Breast cancer, SoftTissue Sarcomas, Gastrointestinal
malignancies and Gynecological cancers.
 Dialysis unit to offer you services of Hemodialysis, Peritoneal Dialysis, and
Bed Side Dialysis with CRRT facility.
 Painless Delivery

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 Cochlear implantation – A cochlear implant can provide normal hearing to
very severely deaf children and adults
SPECIALITIES-
Aesthetic & Cosmetology
Anesthesiology
Clinical Immunology & Rheumatology
Cardiology
Clinical Haematology& Haemato-oncology
• Cardio thoracic Vascular Surgery
• Dental & Maxillofacial Surgery
• Dermatology
• Dietetics & Nutrition
• ENT and Audiological Medicine
• Endocrinology
• Endocrine & Breast Surgery
• Emergency Medicine & Critical Care
• Gastro Medicine
• Gastro Surgery
• General surgery
• Health Promotion & Preventive Medicine
• Internal Medicine
• Interventional Radiology
• Microbiology
• Minimal Invasive & Bariatric surgery
• Neurosurgery;
• Neurology
• Nephrology

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• Orthopedic
• Obstetrics & Gynecology
• Ophthalmology
• Oncology-Surgical & Medical
• Pain management
• Plastic Surgery & Micro vascular surgery
• Pediatrics & Neonatology
• Pediatric Surgery
• Panchkarma
• Psychiatry, Neuropsychiatry & Clinical Psychology
• Physiotherapy & Sports Medicine
• Pulmonology
• Poly Trauma Critical Care
• Pathology
• Radiology
• Rehabilitation Research
• Rheumatology
• Transfusion Medicine
• Urology
• Vascular & Endovascular Surgeon

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CERTIFICATIONS-
The certifications given for Sahara Hospital are NABH, NABL.
NATIONAL ACCREDITATION BOARD FOR HOSPITALS AND
HEALTHCARE PROVIDERS (NABH)-

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NATIONAL ACCREDITATION BOARD FOR TESTINGAND
CALIBRATION LABORATORIES(NABL)
STRENGTH OF THE HOSPITAL:
 The strength is its dedicated, committed and sincere multidisciplinary team
approachof medical, paramedical, non medical personnel and administrators
who are committed to continue to provide the highest quality care .
 The training of staff and research continue to meet the needs of patients.
 Their focus is on patient care and patient safety.
 Working together the staff provides comprehensive diagnosis and
coordinated treatment.
 Proximity of outpatient department with lab facilities and other diagnostics
ensure well coordinated care.

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ABOUT PROJECT-
All human activities producewaste. We all know that suchwaste may be
dangerous and needs safe disposal. Industrial waste, sewage and agricultural
waste, polluted water, soil and air. It can also be dangerous to human beings
and environment. Similarly, hospitals and other health care facilities
generate lot of waste which can transmit infections, particularly HIV,
Hepatitis B & C and Tetanus, to the people who handle it or come in contact
with it.
Definition of Bio-Medical Waste:-
According to Biomedical Waste (Management and Handling) Rules, 1998 of
India – Any waste which is generated during the diagnosis, treatment or
immunization of human beings or animals or in research activities pertaining
thereto or in the production or testing of biological.
The Government of India specifies that Hospital Waste
Management is a part of hospital hygiene and maintenance activities. This
involves management of range of activities, which are mainly engineering
functions, such as collection, transportation, operation or treatment of
processing systems, and disposalof wastes.
Who generates BMW?
A “generator” of BMW is any person who owns or operates a facility that
produces BMW in any quantity. This includes, but is not limited to, the
following: hospitals, skilled nursing facilities, laboratories, physicians,
offices, veterinarians, dental offices, funeral homes, industry, etc.

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World Health Organization states that 85% of hospital wastes are actually
non-hazardous, whereas 10% are’ infectious and 5% are non-infectious but
they are included in hazardous wastes. About 15% to 35% of Hospital waste
is regulated as infectious waste.
Bio-Medical Waste consists of:-
 Human anatomical waste like tissues, organs and bodyparts
 Animal wastes generated during research from veterinary hospitals
 Microbiology and biotechnology wastes
 Waste sharps like hypodermic needles, syringes, scalpels and broken glass.
 Discarded medicines and cytotoxic drugs
 Soiled waste suchas dressing, bandages, plaster casts, material contaminated
with blood, tubes and catheters
 Liquid waste from any of the infected areas and
 Incineration ash and other chemical wastes.
Classification of Bio-Medical Waste:-
The World Health Organization (WHO) has classified medical waste into eight
categories:
1) General Waste
2) Pathological
3) Radioactive
4) Chemical
5) Infectious to potentially infectious waste
6) Sharps
7) Pharmaceuticals and
8) Pressurized containers.

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Sources of Biomedical Waste:-
Hospitals producewaste, which is increasing over the years in its amount
and type. The hospital waste, in addition to the risk for patients and
personnel who handle them also poses a threat to public health and
environment.
Major Sources -
 Govt. hospitals /private hospitals/nursing homes/ dispensaries.
 Primary health centres.
 Medical colleges and research centres/ paramedical services.
 Veterinary colleges and animal research centres.
 Blood banks/mortuaries/autopsy centres.
 Biotechnology institutions.
 Production units.
Minor Sources:
 Physicians/ dentists’ clinics.
 Animal houses/slaughter houses.
 Blood donation camps.
 Vaccination centres.
 Acupuncturists/psychiatric clinics/cosmetic piercing.
 Funeral services.
 Institutions for disabled persons.

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Categories of Bio-Medical Waste:-
Colour Coding & Type of Container:-

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Legal Aspect of Bio-Medical Waste:-
The Central Government, to perform its functions effectively as
contemplated under sections 6, 8, and 25 of the Environment Protection Act,
1986, has made various Rules, Notifications and Orders including the Bio-
medical wastes (Management & Handling) Rules, 1998.A brief summary of
the provisions in Bio-medical wastes (Management & Handling) Rules,
1998 is given below:
 Section 3 establishes the authority of the government to undertake
various steps for protection and improvement of the environment.
 Section 5 provides; for issuance of directions in writing.
 Section 6 empowers the government to make rules.
 Section 8 permits the education of individuals dealing with hazardous
wastes regarding various safety measures.
 Section 10 bestows authority to enter the premises and inspect.
 Section 15 allows the government to take punitive steps against
defaulters. This involves imprisonment up to five years or penalty
upto rupees one lakh or both. In case the default continues, it would
then attract a penalty of rupees five thousand per day up to one year
and thereafter imprisonment up to seven years.
 Section 17 provides for punishment in case of violations by
government departments.
Even after the June, 2000 deadline most of the large hospitals have not
complied with these Rules, as there is no specified authority to monitor the
implementation of these Rules.

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Treatment of Bio-Medical Waste:
I. Chemical Processes:
These processes usechemicals that act as disinfectants. Sodium hypochlorits,
dissolved chlorine dioxide, per-acetic acid, hydrogen peroxide, dry inorganic
chemicals and ozone are examples of such chemicals. Most chemical processes are
water-intensive and require neutralising agents.
II. Thermal Processes:
These processes utilise heat to disinfect. Depending on the temperature they
operate it has been grouped into two categories, which are Low-heat systems and
High-heat systems Low-heat systems (operate between 93-177°C) use steam, hot
water, or electromagnetic radiation to heat and decontaminate the waste.

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 Autoclaving is a low heat thermal process and it uses steam for
disinfection of waste. Autoclaves are of two types depending on the
method they use for removal of air pockets are gravity flow autoclave
and vacuum autoclave.
 Microwaving is a process which disinfects the waste by moist heat
and steam generated by microwave. High-heat systems (operate
between 540-8,300°c) employ combustion and high temperature
plasma to decontaminate and destroy the waste.
 Incinerator & Hydroclaving are high heat systems. Hydroclaving – is
steam treatment with fragmentation and drying of waste.
III. Mechanical Processes:
These processes are used to change the physical form or characteristics of the
waste either to facilitate waste handling or to process the waste in conjunction with
other treatment steps. The two primary mechanical processesare-
 Compaction:-Used to reduce the volume of the waste
 Shredding:-Used to destroy plastic and paper waste to prevent their reuse.
Only the disinfected waste can be used in a shredder.
IV. Irradiation Processes:-
Expose wastes to ultraviolet or ionizing radiation in an enclosed chamber. These
systems require postshredding to render the waste unrecognizable.
V. Biological Processes:

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Using biological enzymes for treating medical waste. It is claimed that biological
reactions will not only decontaminate the waste but will also cause the destruction
of all the organic constituents so that only plastics, glass, and other inert will
remain in the residues.
Points to ponder in processing the waste-
A. Incineration:
 Incinerators should be suitably designed to achieve the emission limits.
 Wastes to be incinerated shall not be chemically treated with any
chlorinated disinfectant.
 Toxic metals in the incineration ash shall be limited within the regulatory
quantities
 Only low sulphur fuel like Diesel shall be used as fuel in the incinerator.
B. Autoclaving:
The autoclave should be dedicated for the purposeof disinfecting and
treating biomedical waste.
1) When operating a gravity flow autoclave, medical waste shall be subjected
to:
 A temperature of not less than 121°C and pressureof about 15 pounds per
square inch (psi) for an autoclave residence time of not less than 60
minutes; or
 A temperature of not less than 135°C and a pressure of 31 psifor an
autoclave residence time of not less than 45 minutes; or
 A temperature of not Less than 149°C and a pressure of 52 psi for an
autoclave residence time of not less than 30 minutes.

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2) When operating a vacuum autoclave, medical waste shall be subjected to a
minimum of one per vacuum pulse to purge the autoclave of all air. The
waste shall be subjected to the following:
 A temperature of not less than 121°C and a pressure of 15 psiper an
autoclave residence time of not less than 45 minutes; or
 Temperature of not less than 135°C and a pressureof 31 psifor an
autoclave residence time of not less than 30 minutes; or Medical waste shall
not be considered properly treated unless the time, temperature and pressure
indicate stipulated limits. If for any reason, these were not reached, the
entire load of medical waste must be autoclaved again until the proper
temperature, pressureand residence time are achieved.
C.Microwaving:-
 Microwave treatment shall not be used for cytotoxic, hazardous or
radioactive wastes, contaminated animal carcasses, bodyparts and large
metal items.
 The microwave system shall comply with the efficacy tests/routine tests
 The microwave should completely and consistently kill bacteria and other
pathogenic organisms that is ensured by the approved biological indicator at
the maximum design capacity of each microwave unit.
D. Deep Burial:
 A pit or trench should be dug about 2 m deep. It should be half filled with
waste, and then covered with lime within 50 cm of the surface, before
filling the rest of the pit with soil.

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 It must be ensured that animals do not have access to burial sites.
 Covers of galvanised iron/wire meshes may be used.
 On each occasion, when wastes are added to the pit, a layer of 10cm of soil
must be added to cover the wastes.
 Burial must be performed under close and dedicated supervision.
 The site should be relatively impermeable and no shallow well should be
close to the site.
 The pits should be distant from habitation, and sited so as to ensure that no
contamination of any surface water or ground water occurs.
 The area should not be prone to flooding or erosion.
 The location of the site must be authorized by the prescribed authority.
 The institution shall maintain a record of all pits for deep burial.
E. Disposal of Sharps:-

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Sharps are discarded needles and lancets that have been used in animal or
human patient care/treatment or in medical, research or industrial
laboratories. Sharps include items such as hypodermic needles, syringes,
dental carpules, and scalpel blades. Please note that certain exemptions
apply to farmers.
 Blades and needles waste after disinfection should be disposed in circular or
rectangular pits.
 Such pits can be dug and lined with brick, masonry, or concrete rings.
 The pit should be covered with a heavy concrete slab, which is penetrated
by a galvanized Steel pipe projecting about 1.5 m above the slab, within
internal diameter of upto 20 mm.
 When the pipe is full it can be sealed completely after another has been
prepared.
F. Radioactive Waste from Medical Establishments:-
 It may be stored under carefully controlled conditions until the level of
radioactivity is so low that they may be treated as other waste.
 Special care is needed when old equipment containing radioactive source is
being discarded.
 Expert advice should be taken into account.
G.Mercury Control:-
Wastes containing Mercury due to breakage of thermometer and other measuring
equipment need to be given-
 Properattention should be given to the collection of the spilt mercury, its
storage and sending of the same back to the manufacturers
 Must take all measures to ensure that the spilt mercury does not become
part of biomedical wastes and

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 Waste containing equal to or more than 50 ppmof mercury is a hazardous
waste and the concerned generators of the wastes including the health care
units are required to disposethe waste as per the norms.
H. Standard for Liquid Waste:-
Collection and Storage of Bio-Medical Waste:-
The collection of biomedical waste involves use of different types of
containers from various sources of biomedical wastes like Operation
Theatres, laboratory’s, wards, kitchens, corridors etc. The containers/ bins
should be placed in such a way that 100 % collection is achieved. Sharps
must always be kept in puncture-proof containers to avoid injuries and
infection to the workers handling them.
 Storage:
 Once collection occurs then biomedical waste is stored in a properplace.
Segregated wastes of different categories need to be collected in identifiable
containers. The duration of storage should not exceed 8-10 hrs in big
hospitals (more than 250 bedded)and 24 hrs in nursing homes.

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 Each container may be clearly labelled to show the ward or room where it is
kept. The reason for this labelling is that it may be necessary to trace the
waste back to its source. Besides this, storage area should be marked with a
caution sign.
Health Hazards of Bio-Medical Waste:-
 According to the WHO, the global life expectancy is increasing year after
year. However, deaths due to infectious diseases are increasing. A study
conducted by the WHO reveals that more than 50,000 people die every day
from infectious diseases.
 One of the causes for the increase in infectious diseases is improper waste
management. Blood, bodyfluids and bodysecretions which -are constituents
of bio-medical waste harbour most of the viruses, bacteria and parasites that
cause infection.
 This passes via a number of human contacts, all of whom are potential
‘recipients’ of the infection. Human Immunodeficiency Virus (HIV) and
hepatitis virus spearhead an extensive list of infections and diseases
documented to have spread through bio-medical waste. Tuberculosis,
pneumonia, diarrhoea diseases, tetanus, whooping cough etc., are other
common diseases which spread due to improper waste management.
A. Occupational Health Hazards:
The health hazards due to improper waste management can affect-
 The occupants in institutions and spread in the vicinity of the institutions
 People who happen to be in contactwith the institution like laundry
workers, nurses, emergency medical personnel, and refuse workers.

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 Risk of infection outside hospital for waste handlers, scavengers and
(eventually) the general public
 Risks associated with hazardous chemicals, drugs, being handled by persons
handling waste at all levels and
 Injuries from sharps and exposure to harmful chemical waste and
radioactive waste also cause health hazards to employees.
B. Hazards to the General Public:-
The general public’s health can also be adversely affected by bio-medical waste.
 Improper practices such as dumping of bio-medical waste in municipal
dustbins, open spaces, water bodies etc., leads to the spread of diseases.
 Emissions from incinerators and open burning also lead to exposure to
harmful gases which can cause cancer and respiratory diseases.
 Exposure to radioactive waste in the waste stream can also cause serious
health hazards.
 An often-ignored area is the increase of in-home healthcare activities. An
increase in the number of diabetics who inject themselves with insulin,
home nurses taking care of terminally ill patients etc., all generate bio-
medical waste, which can cause health hazards.

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LITERATURE REVIEW
A literature review is a text of a scholarly paper, which includes the current
knowledge including substantive findings, as well as theoretical and
methodological contributions to a particular topic. Literature reviews use
secondarysources, and do not report new or original experimental work.
Types of literature review:
Most often associated with academic-oriented literature, such as a thesis,
dissertation or peer reviewed journal article, a literature review usually precedes
the methodology and results section. Literature reviews are also common in a
research proposalor prospectus (the document that is approved before a student
formally begins a dissertation or thesis). Its main goals are to situate the current
study within the bodyof literature and to provide context for the particular reader.
Literature reviews are a staple for research in nearly every academic field.
CASE STUDY-1
A Case Study of BiomedicalWaste Managementin Hospitals
K.V. Radha (Corresponding author)
Department of Chemical Engineering
Anna University, Chennai 600025, India
Tel: 91-44-2220-3545-14 E-mail: radhavel@yahoo.com
K. Kalaivani
Department of Chemical Engineering

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Anna University, Chennai 600025, India
Tel: 91-44-2220-3545-14 E-mail: kalaivani_saran@yahoo.co.in
R. Lavanya
Department of Chemical Engineering,
Anna University, Chennai 600025, India
E-mail: susirajlavan@gmail.com
Abstract
Biomedical waste management is receiving greater attention due to recent
regulations of the Biomedical Wastes(Management & Handling Rules, 1998).
Inadequate management of biomedical waste can be associated with risks to
healthcare workers, patients, communities and their environment. The present
study was conducted to assess the quantities and proportions of different
constituents of wastes, their handling, treatment and disposalmethods in different
health-care settings. Various health care units were surveyed using a modified
survey questionnaire for waste management. This questionnaire was obtained from
the World Health Organization (WHO), with the aim of assessing
the processing systems for biomedical waste disposal. Hazards associated with
poorbiomedical waste management and shortcomings in the existing system were
identified. The development of waste management policies, plans, and
protocols are recommended, in addition to establishing training programs on
properwaste management for all healthcare workers.
Analysis Result
Short comings in the existing system
Medical facilities in urban centers are improving faster than those in the rural areas
due to rapid urbanization. Waste management systems in the urban areas are
already overburdened. Hence, an additional load due to mixing of infectious

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waste from HCUs aggravates the problem. Separate systems for disposalof HCU
waste are available in only a few establishments. The shortcomings in the existing
system are: The segregation of waste in almost all hospitals is not satisfactory.
 Color-coding for various categories of waste is not followed.
 The storage of bio-medical waste is not in isolated area and properhygiene
is not maintained.
 Personal protective equipment and accessories are not provided.
 Most of the hospitals do not have properwaste treatment and disposal
facilities. In the cities where common treatment facilities have come up,
many medical establishments are yet to join the common facility.
 Most of the incinerators are not properly operated and maintained, resulting
in poorperformance.
 Sometimes plastics are also incinerated leading to possible emission of
harmful gases.
 General awareness among the hospital staff regarding bio-medical waste is
lacking.
CASE STUDY-2
BIOMEDICAL WASTE MANAGEMENT
Sandip Chakraborty1, BelamaranahallyVeeregowda2,Leena Gowda2,
Saritha NelamakanahallySannegowda3,RuchiTiwari4, Kuldeep
Dhama5, ShoorVir Singh6
ABSTRACT
Interaction of micro– (internal) and macro– (surrounding) environment of
human beings determines the status of health of an individual or of
community at–large. On daily basis, generation and disposalof biomedical

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wastes has become a emerging problem not only in India but the world
over. These are being produced during the process ofsampling, testing,
diagnosis, therapy, immunization and surgery of humans, animals, and in
research experiments. Several categories of biomedical wastes have been
discussed along with steps involved in the management of biowaste include
segregation, storage in containers, labeling, handling, transport, treatment,
disposaland waste minimization. Potential implications of biomedical
wastes include transmission of diseases like Hepatitis B, C, E, dengue and
HIV through improperly contained contaminated sharps;proliferation and
mutation of pathogenic microbial population in the municipal waste through
dumping of untreated biomedical waste; physical injury and health hazards.
Certain other implications include degradation of the environment
esthetically by careless disposals, having negative effect on public health;
increased risk of nosocomial infections; change of microbial ecology and
spread of antibiotic resistance; increased density of vector population,
resulting in spread of diseases in public. Sensitization and public awareness
is important to protectenvironment and public health globally.

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BIBLIOGRAPHY-
 NABH PDF
 www.wikipedia.com
 www.googleimages.com
 Case Studies
 Researchgate
 www.saharahospital.com