Biomedical Waste management

1. Dr. Hughbert Dkhar
Nazareth Hospital
Laitumkhrah
Shillong

8.  Biomedical waste :
 Is waste that is either putrescible or potentially infectious.
 May also include waste associated with the generation of biomedical
waste that visually appears to be of medical or laboratory origin (e.g.,
packaging, unused bandages, infusion kits, etc.), as well research
laboratory waste containing bio-molecules or organisms that are
restricted from environmental release.
 Sharps are considered biomedical waste whether they are
contaminated or not, due to the possibility of being contaminated
with blood and their propensity to cause injury when not properly
contained and disposed of.
 Biomedical waste is a type of biowaste.

9.  At present - most of the hospitals/nursing
homes are now equipped with latest
instruments for diagnosis and treatment of
various diseases.
 One of the most important aspect associated
with hospitals is the generation of wastes and
its safe management.
 Health care institution’s waste contains
 Human anatomical wastes
 Blood, body fluid,
 Disposable syringe, used bandages, surgical gloves,
 Blood bags/ intravenous tubes etc.

10.  The Bio-medical waste generated from various sources
has become a problem and much attention is being given
worldwide to find out solution of this problem.
 The main concern lies with the hospital waste generated
from large hospitals/nursing homes as it may pose
deleterious effects due to its hazardous nature.
 Bio-medical wastes, if not handled in a proper way, is a
potent source of diseases, like AIDS, Tuberculosis,
Hepatitis and other bacterial diseases causing serious
threats to human health.
 Owing to the discussed potential threats this waste needs
prime attention for its safe and proper disposal.

11. "Bio-medical waste" means any waste,
which is generated during the diagnosis,
treatment or immunization of human
beings or animals or in research activities
pertaining there to or in the production or
testing of biologicals.

12. Liquid
Semisolid
Solid.

13.  BMW is distinct from normal trash or general waste.
 It differs from other types of hazardous waste, such as
chemical, radioactive, universal or industrial waste.
 Medical facilities generate waste hazardous chemicals
and radioactive materials - Are normally not infectious,
they require proper disposal.
 Some wastes are considered multihazardous, such as
tissue samples preserved in formalin.

14.  "Occupier" means a person who has
control over the institution and/or its
premises or any institution generating
bio-medical waste, which includes :
 Hospital/Nursing home/Clinic/Dispensary,
 Veterinary institution/Animal house,
 Pathological laboratory
 Blood bank etc.

15.  It shall be the duty of every occupier to take
all steps to ensure that such waste is handled
without any adverse effect to human health
and the environment.
 Institution generating bio-medical waste
includes
 Hospital,
 Nursing home/ Clinic/ Dispensary/
 Veterinary institution/ Animal house
 Pathological laboratory,
 Blood bank etc.

16.  Schedule 1 – Categories of Biomedical waste
 Schedule II – Colour Coding Of the BAGS /BINS
 Schedule III – Label for BMW Containers/Bags.
 Schedule IV – Label For Transport Of BMW Containers/Bags.
 Schedule V – Standards For Treatment And Disposal of BMW.
 Schedule VI – Schedule For Waste Treatment Facilities Like
Incinerator/ Autoclave/ Microwave System.

17. (1) Bio-medical waste shall be treated and disposed
of in accordance with Schedule I, and in compliance
with the standards prescribed in Schedule V.
 (2) Every occupier, where required, shall set up in
accordance with the time-schedule in Schedule VI,
requisite bio-medical waste treatment facilities
 Like incinerator/ Autoclave/ Microwave system for the
treatment of waste, or,
 Ensure requisite treatment of waste at a common waste
treatment facility or any other waste treatment facility.

18.  (1) Bio-medical waste shall not be mixed with other
wastes.
 (2) Bio-medical waste shall be segregated into
containers/bags at the point of generation in
accordance with Schedule II prior to its storage,
transportation, treatment and disposal.
 (3 )The containers shall be labeled according to
Schedule III.
 (4) If a container is transported from the premises
where bio-medical waste is generated to any waste
treatment facility outside the premises, the container
shall, apart from the label prescribed in Schedule III,
also carry information prescribed in Schedule IV.

19.  (4) Notwithstanding anything contained in the Motor
Vehicles Act, 1988, or rules there under, untreated
biomedical waste shall be transported only in such
vehicle as may be authorized for the purpose by the
competent authority as specified by the government.
 (5) No untreated bio-medical waste shall be kept stored
beyond a period of 48 hours
 Provided that if for any reason it becomes necessary to
store the waste beyond such period, the authorized
person must take permission of the prescribed authority
and take measures to ensure that the waste does not
adversely affect human health and the environment.

20.  (4) Notwithstanding anything contained in the Motor Vehicles
Act, 1988, or rules thereunder, untreated biomedical waste
shall be transported only in such vehicle as may be authorised
for the purpose by the competent authority as specified by the
government.
 (5) No untreated bio-medical waste shall be kept stored
beyond a period of 48 hours
 Provided that if for any reason it becomes necessary to store
the waste beyond such period, the authorised person must
take permission of the prescribed authority and take measures
to ensure that the waste does not adversely affect human
health and the environment.

21.  @@ Chemicals treatment using at least 1% hypochlorite
solution or any other equivalent chemical reagent. It must be
ensured that chemical treatment ensures disinfection.
 ## Multilation/shredding must be such so as to prevent
unauthorised reuse.
 @ There will be no chemical pretreatment before incineration.
Chlorinated plastics shall not be incinerated.
 * Deep burial shall be an option available only in towns with
population less than five lakhs and in rural areas.

22. According to these rules Bio-medical
wastes have been categorized
under 10 categories and
are required to be
managed and
handled as
per prescribed
procedures.
(Schedule 1)

23. Option Waste Category Treatment & Disposal
Category No. 1
Human 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 colleges, discharge from
hospitals, animal houses)
Incineration@/deep
burial*

24. Option Waste Category Treatment & Disposal
Category No. 3
Microbiology and Biotechnology
Waste
(wastes from laboratory cultures,
stocks or specimens of micro-
organisms live or attenuated vaccines,
human and animal cell culture used in
research and infectious agents from
research and industrial laboratories,
wastes from production of biological,
toxins, dishes and devices used for
transfer of cultures)
Local
autoclaving/microwavin
g
/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)
Disinfection (chemical
treatment@01/autoclaving
/ microwaving and
mutilation / shredding##

25. Option Waste Category Treatment & Disposal
Category No. 5
Discarded Medicines and
Cytotoxic drugs
(wastes comprising of outdated,
contaminated and discarded
medicines)
Incineration@/destructi
on and drugs disposal
in secured landfills
Category No. 6
Solid Waste
(items contaminated with blood,
and body fluids including cotton,
dressings, soiled plaster casts,
lines, beddings, other material
contaminated with blood)
Incineration@
autoclaving/
microwaving

26. Option Waste Category Treatment & Disposal
Category No. 7
Solid Waste
(wastes generated from disposable
items other than the waste sharps
such as tubings, catheters,
intravenous sets, etc).
Disinfection by
chemical treatment@@
autoclaving/
microwaving and
mutilation/shredding##
Category No. 8
Liquid Waste
(waste generated from laboratory
and washing, cleaning, house-
keeping and disinfecting activities)
Disinfection by
chemical treatment@@
and discharge into
drains.

27. Option Waste Category Treatment & Disposal
Category No. 9
Incineration Ash
(ash from incineration
of any bio-medical
waste)
Disposal in municipal
landfill
Category No. 10
Chemical Waste
(chemicals used in
production of
biological, chemicals
used in disinfection, as
insecticides, etc.)
Chemical treatment@@
and discharge into drains
for liquids and secured
landfill for solids

28. Colour Coding Type of Container and
Waste Category
Treatment options as per
Schedule I
Yellow Plastic bag Cat. 1,
Cat. 2, and Cat. 3,
Cat. 6.
Incineration/deep burial
Red Disinfected
container/plastic bag
Cat. 3, Cat. 6, Cat.7.
Autoclaving/Microwaving
/ Chemical Treatment
Blue/White translucent Plastic bag/puncture
proof Cat. 4, Cat. 7.
Container
Autoclaving/Microwaving
/ Chemical Treatment and
destruction/shredding
Black Plastic bag Cat. 5 and
Cat. 9 and Cat. 10.
(solid)
Disposal in secured
landfill

31.  Notes:
 1. Colour coding of waste categories with multiple treatment
options as defined in Schedule I, shall be selected depending
on treatment option chosen, which shall be as specified in
Schedule I.
 2. Waste collection bags for waste types needing incineration
shall not be made of chlorinated plastics.
 3. Categories 8 and 10 (liquid) do not require containers/bags.
 4. Category 3 if disinfected locally need not be put in
containers/bags.

35. Sl. No Types of waste Category?
1 Cotton balls.
2 Needles/Syringes.
3 Plastic tubings.
4 Culture media with micro-organisms
5 Plastic covers.
6 Disinfectants
7 Blood.
8 Microtips/Pipettes.
9 ELISA wastes
10 Mixer tips(Plastic).
11 House keeping wastes/Cleaning

36. Sl. No Types of waste Category?
1 Cotton balls. 6
2 Needles/Syringes. 4
3 Plastic tubings. 7
4 Culture media with micro-organisms 3
5 Plastic covers. 7
6 Disinfectants 10
7 Blood. 2
8 Microtips/Pipettes. 7
9 ELISA wastes 8
10 Mixer tips(Plastic). 7
11 House keeping wastes/Cleaning 8

37.  Cotton balls (Cat 6)
 Needles/Syringes (Cat 4)
 Plastic tubings. (Cat 7)
 Blood bags. (Cat 7)
 Plastic covers (Cat 7)
 Papers
 Blood (Cat 2)
 Microtips/Pipettes (Cat 7)
 ELISA wastes (Cat 8)
 Mixer tips(Plastic) (Cat 7)
 House keeping wastes/Cleaning of lab (Cat 8)

40. Right to
 Access information.
 Healthy environment.
 Safe working environment.
 To Life and Health.

41. Right to access information
 To protect themselves from harm (Vaccination).
 Legislation of BMW.
 Researchers
 Regulators
 Policy makers

42. Right to healthy environment
• Dumped BMW
• Waste burning an incineration

48. BMW needs higher priority
On going education/awareness

49. Read more:
 Bio-Medical Waste (Management and Handling) Rules, 1998 - Introduction
http://www.medindia.net/indian_health_act/bio-medical-waste-rules-1998-
introduction.htm#ixzz2I7VCfO3m
The Gazatte of India. New Delhi, Wednesday, June 3, 2015/JY AISTHA 13,1937

52.  Biomedical waste may be solid or liquid. Examples
of infectious waste include discarded blood,
sharps, unwanted microbiological cultures and
stocks, identifiable body parts, other human or
animal tissue, used bandages and dressings,
discarded gloves, other medical supplies that may
have been in contact with blood and body fluids,
and laboratory waste that exhibits the
characteristics described above. Waste sharps
include potentially contaminated used (and unused
discarded) needles, scalpels, lancets and other
devices capable of penetrating skin.

53.  Biomedical waste is generated from biological and
medical sources and activities, such as the
diagnosis, prevention, or treatment of diseases.
Common generators (or producers) of biomedical
waste include hospitals, health clinics, nursing
homes, medical research laboratories, offices of
physicians, dentists, and veterinarians, home
health care, and funeral homes. In healthcare
facilities (i.e., hospitals, clinics, doctors offices,
veterinary hospitals and clinical laboratories),
waste with these characteristics may alternatively
be called medical or clinical waste.