This document discusses biomedical waste management. It begins by defining biomedical waste and classifying it into different categories. It then describes the main features of the BMW Rules 2016 in India, including expanding the scope, phasing out certain materials, requiring training and authorization. The document further discusses the sources, effects and methods of disposal of biomedical waste. It describes how waste should be segregated by category and treated. Finally, it presents results from a study on the knowledge, attitudes and practices of healthcare personnel regarding biomedical waste management in Allahabad, India, finding that doctors, nurses and laboratory technicians had better knowledge than sanitary staff.

1. BIOMEDICAL WASTE MANAGEMENT
Shivani Soni
2nd proff
190

3. Define and classify –
Biomedical waste

4. WAST
ES
Wastes
Solid waste
Household
waste
Industrial
waste
Biomedical
waste or
hospital waste
Liquid
Waste
Gaseo
us
Waste
W
A
S
T
E
S
“Something
which is not
put into proper
usage at a
given time”.

5. BIO-MEDICAL
WASTE: -
Any
wast
e
generated
diagnosis,
treatmen
t
which
is
during the
or
immunization of
human beings or
animals or in research
activitie
s pertaining thereto or
in the production or
testing of biological.

6. Improper:-
Packaging
Segregation
Treatment
and disposal
biomedic
al
of
waste
.
CAUSES

7. CLASSIFICATION OF BIOMEDICAL
WASTE:

8. CLASSIFICATION OF BIOMEDICAL
WASTE:
1. INFECTIOUS
WASTE: waste
to
contai
n
(bacteria
,
parasites, or
Infectious
suspecte
d
pathogen
s
viruses,
fungi)
in
sufficien
t
quantity to cause
diseases in susceptible
hosts.

9. continue…
This category
includes:-
• Cultures and stocks of
infectious agents from
laboratory
work.
from surgery
on with
infectiou
s
• Waste
patient
s
diseas
e.
• Infected animals from
laboratories.

10. Classification continue…
2.PATHOLOGI
CAL WASTE:
bod
y
It consists of
tissues,
parts,
fetuses,
an
d
organ
s,
huma
n
animal
carcasse
s,
blood, and body
fluids.

11. continue…
3. SHARPS:
These are the items that
could cause cuts or
puncture wounds,
including;
Needles,
Scalpel and other blades,
Knives,
Infusion sets,
Saws,

12. Classification continue…
4.PHARMACEUTI
CAL WASTE:
It includesexpired,
unused, spilt, and
contaminated
Pharmaceutical
products,
Drugs,
Vaccines, and sera

13. continue…
5. GENOTOXIC
WASTE: highl
y
• Genotoxic waste is
hazardous and may
have;
Mutagenic,
Teratogenic, or
Carcinogenic
properties.

14. continue…
• It raisesserioussafety
problems,
both inside
hospitals
disposal, and
should
and
after
be
give
n
special attention.
• It includes certain cytostatic
drugs, vomit, urine, or feces
from patients treated with
cytostatic drugs, chemicals,
and radioactive material.

15. Classification continue…
6. CHEMICAL
WASTE:
It consists of
discarded
Solid,
Liquid,
and
Gaseous
chemicals

16. Continue…
Chemical waste may be hazardous or
nonhazardous.
It is considered to be hazardous if it has at least
one of the following properties:
Toxic,
Corrosive (acids of pH < 2 and bases of pH>
12)
Flammable,
Reactive
Genotoxic

17. Classification continue…
7. WASTES WITH HIGH
CONTENT OF HEAVY
METALS:
It represents a subcategory of
hazardous chemical waste, and
is usually highly toxic.
It includes
Batteries,
Broken thermometer,
Blood-pressure gauges.

18. Classification continue…
8. PRESSURIZED
CONTAINERS:
Many types of gas are used in
health care, and are often stored
in pressurized cylinders,
cartridges, and aerosol cans.
Most common gases used in
health care includes:
Anesthetic gases
Ethylene oxide
Oxygen

19. Classification continue…
9. RADIOACTIVE WASTE:
It includes the X- rays, α- and
β- particles, and γ- rays
emitted by radioactive
substances. are
heav
y charged,
and
protons
an
d
• α-
particles,
positively
include
neutrons.
• They have low penetration
power, and are hazardous
to humans mostly when
inhaled or ingested.

20. continue…
• positively charged electrons with significant ability to penetrate
human skin, they affect health through ionization of intracellular
proteins and proteinaceous components.
• γ- Rays, are electromagnetic radiations similar to X- rays but to
• β
-
Particles, are negatively or
shorter
wavelengt
h.
Thei
r
penetrating power is high and
lead shielding is required to
reduce their intensity.

21. DESCRIBE MAIN FEATURES AND
COMPONENTS OF BMW RULES
2016

22. BMW RULES 2016 -
• The ambit of the rules has been expanded to include vaccination camps, blood
donation camps, surgical camps or any other healthcare activity;
• Phase-out the use of chlorinated plastic bags, gloves and blood bags within two
years;
• Pre-treatment of the laboratory waste, microbiological waste, blood samples
and blood bags through disinfection or sterilisation on-site in the manner as
prescribed by WHO or NACO;
• Provide training to all its health care workers and immunise all health workers
regularly;
• Establish a Bar-Code System for bags or containers containing bio-medical waste
for disposal;
• Report major accidents; (g) Existing incinerators to achieve the standards for
retention time in secondary chamber and Dioxin and Furans within two years;
• Bio-medical waste has been classified in to 4 categories instead 10 to improve
the segregation of waste at source;
•

23. •Procedure to get authorisation simplified. Automatic authorisation for bedded
hospitals. The validity of authorization synchronised with validity of consent orders
for Bedded HCFs. One time Authorisation for Non-bedded HCFs;
•The new rules prescribe more stringent standards for incinerator to reduce the
emission of pollutants in environment;
•Inclusion of emissions limits for Dioxin and furans;
•State Government to provide land for setting up common bio-medical waste
treatment and disposal facility;
•No occupier shall establish on-site treatment and disposal facility, if a service of
`common bio-medical waste treatment facility is available at a distance of seventy-
five kilometer.
•Operator of a common bio-medical waste treatment and disposal facility to
ensure the timely collection of bio-medical waste from the HCFs and assist the
HCFs in conduct of training .

24. ENUMERATE CATEGORIES,
SEGREGATION AND DISPOSAL
BIOMEDICAL WASTE

25. SOURCES OF BIOMEDICAL
WASTE: car
e
• It is generated primarily from
health establishments, including
• Hospitals,
• Nursing homes,
• Veterinary hospitals,
• Clinics and general practitioners,
• Dispensaries,
• Blood blanks,
• Animal houses and research institute.

26. Sources continue…
OTHER SOURCES:
1. Households:
 The domestic sector generates biomedical
waste to a small extent which is less than about
0.5% of the total waste generated in a
household.
 The type of biomedical waste generated in a
household are syringes, cotton swabs,
discarded medicines, bandages, plaster,
sanitary napkins, diapers etc.

27. Sources continue…
2. INDUSTRIES, EDUCATION
INSTITUTES AND RESEARCH
CENTERS:
 These also generate bio-
medical waste in
substantial quantities.
 The type of waste
generated from an animal
houses is typically animal
tissues, organs, body
parts, carcasses, body

28. Sources continue…
3. BLOOD
BANKS
AND CLINICAL
LABORATORIES:
Blood banks and
laboratories generate
most of the categories
of biomedical waste.

29. Sources continue…
4.HEALTH
CARE
ESTABLISHME
NTS:
The sources of bio-
medical waste
generated in
health care setting.

30. EFFECTS OF BIOMEDICAL
WASTE: -
The
manageme
nt
imprope
r
of
biomedical waste
causes serious
environmental
problems in terms of
Air,
Water and

31. Effects
continue…
1. AIR POLLUTION:
• Air pollution can be caused in both
indoors
and outdoors. generates
ai
r
• Biomedical waste that
pollution is of three
types-
• Biological,
• Chemical and
• Radioactive.

32. Air pollution continue…
A. Indoor air pollution:-
Hospital Acquired Infections
(Nosocomial infection).
Indoor air pollution can
caused due to:
• Poor ventilation
• The paints, carpet,
furniture, equipment’s,
etc., used in the rooms.
• Use of
chemicals,

33. continue…
can be caused
by
B. Outdoor air
pollution:
 Outdoor air
pollution
pathogens.
 When waste without pretreatment is being
transported outside the institution, or if it is
dumped openly, pathogens can enter the
atmosphere i.e. drinking water, food stuff,
soil etc.

34. Effects
continue…
2. WATER POLLUTION:
• Biomedical waste can cause water pollution. If
the waste is dumped in low- lying areas, or into
lakes and water bodies, can cause severe
water pollution.
• Treatment or disposal option can also cause
water pollution.
• Water pollution can either be caused due to
biological, chemicals or radioactive substances.

35. Effects
continue…
3. LAND POLLUTION:
• Open dumping of biomedical
waste is the greatest cause for
land pollution.
• Soil pollution from bio-medical
waste is caused due to
infectious waste, discarded
medicines, chemicals.
• Heavy metals such as cadmium,
lead, mercury, etc., which are
present in the waste will get
absorbed by plants and can then
enter the food chain.

36. Methods of disposal of bio-
medical waste and their
segregation
WASTE CATEGORY TYPE OF WASTE TREATMENT
AND
DISPOSAL
OPTION
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 and colleges, discharge from
hospitals,)
Incineration@
/ deep burial*
Category
No. 3
Microbiology & Biotechnology Waste (Wastes from
laboratory cultures, stocks or specimen of live
microorganisms, human and animal cell cultures
used in research and infectious agents from
research and industrial laboratories, wastes from
production of biological, toxins and devices used for
transfer of cultures)
Local
autoclaving/
microwaving
/
incineration
@

37. 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# #

38. Category
No. 8
Liquid Waste (Waste
generated from the
laboratory and washing,
cleaning, housekeeping and
disinfecting activities)
Disinfecting
by chemical
treatment@
@ and
discharge
into drains
Category
No. 9
Incineration Ash (Ash
from incineration of any
biomedical waste)
Disposal in
municipal
landfill
Category
No.10
Chemical Waste (Chemicals
used in production of
biological, chemicals used in
disinfecting, as insecticides,
etc.)
Chemical
treatment
@@ and
discharge
into drains for
liquids and
secured

39. DISCUSS MANAGEMENT OF
BIOMEDICAL WASTE AS PER LATEST
BIOMEDICAL WASTE
MANAGEMENT RULES

40. STEPS IN THE
MANAGEMENT OF
BIOMEDICAL WASTE:-
Survey of waste
generated.
Segregation
of hospital
waste.
Collection &
Categorization
of waste.
Storage of
waste.( Not
beyond 48 hrs. )
Transportation
of waste.
Treatment of
waste.

41. COLOR CODING FOR
SEGREGATION OF
BIOMEDICAL WASTE: -
COLOR WASTE
TREATMENT
Yello
w
Human & Animal anatomical
waste / Micro-biology waste and
soiled
cotton/dressings/linen/beddings
etc.
Incineration / Deep
burial
Re
d
Tubing's, Catheters, IV
sets.
Autoclaving /
Microwaving / Chemical
treatment
Blue
/
Whit
e
Waste sharps
( Needles, Syringes, Scalpels,
blades etc.
)
Autoclaving /
Microwaving / Chemical
treatment & Destruction
/ Shredding
Blac
k
Discarded medicines/cytotoxic
drugs,
Incineration ash, Chemical
Disposal in secured
landfill

42. `

44. Bio Medical Waste
Authorisation
BMW waste disposal must be done through scientific disposal techniques that
require the handler to have pre-installed infrastructure and basic knowledge
about the constituents of biomedical waste. The SPCB/PCC assess the
capacity and capabilities of the CBMWTF and HCFs before granting the
authorisation.
MoEF&CC has come up as the nodal monitoring authority for post-authorisation
compliances which was missing in the earlier version of the rules. MoEF&CC
reviews the compliance of Health Care Facilities (HCF) once a year through
state health secretaries, the SPCB and the CPCB. A District Level Monitoring
Committee for districts are also being set up in every state or UT after the
implementation of the 2016 Rules. They submit their monitoring report once
every six months to the State Advisory Committee and the concerned
SPCB/PCC. Any establishment involved in the generation, collection, reception,
storage, transportation, treatment, processing, disposal or any other form of
handling of bio-medical waste needs prior authorisation from the concerned
State Pollution Control Board (SPCB)/ Pollution Control Committee.
Need for Bio medical Waste Authorisation

45. Responsibilities post Biomedical Waste
Authorisation
•Adhering to the segregation, packaging and transport rules as
they are the source of generation and therefore aware of the
potential hazard of the waste.
•HCFs have been made responsible for the prior treatment of
laboratory and microbiological waste, blood samples and blood
bags through disinfection or sterilisation (on-site) in the manner
prescribed by the World Health Organization or National Aids
Control Organisation before discarding it as waste. This
protocol must be followed regardless of whether final treatment
and disposal happen on-site or at a common biomedical waste
treatment facility.

46. Documents Required by BMW Generator/
HCF for Authorisation
•Copy of Aadhar Card
•Copy of Pan card
•Filled in Form- II with the quantity of Four
categories of BMW
•Self-declaration in case Bio-medical waste
is not generated by the HCF.
•Copy of Registration from the State Medical
Council
•Copy of Agreement with Operator of a Bio-
Medical Waste Facility.
•Copy of Authorisation in case of Renewal
•Copy of Noise Monitoring Report, if

47. RESEARCH ARTICLE
A cross-sectional study was conducted among
hospitals (bed capacity >100) of Allahabad city
on “Knowledge, Attitude, and Practices
about Biomedical Waste Management
among Healthcare Personnel”
Medical personnel included were
Doctors (75),
Nurses (60),
Laboratory technicians (78), and
Sanitary staff (70).

48. RESULTS:
• Doctors, nurses, and laboratory technicians
have better knowledge than sanitary staff
regarding biomedical waste management.
• Knowledge regarding the color coding and
waste segregation at source was found to be
better among nurses and laboratory staff as
compared to doctors.
• Regarding practices related to biomedical
waste management, sanitary staff were
ignorant on all the counts.