this is a seminar ppt on biomaterial waste disposal In Prosthodontics

1. BIOMATERIAL WASTE
DISPOSAL
Presented by:
G.Shyni Rani
1st MDS
Prosthodontics Crown&Bridge

2. • CONTENTS
• Introduction
• Definitions
• Sources of biomaterial waste
• Risk groups
• Categories of BMW scheduled as per WHO standards
• Hazards of BMW
• Steps to manage hazardous waste before disposal
• Principles of BMW
• Biomedical waste disposal cycle
• Biomedical waste flow chart
• Color coding for segregation of BMW
• Segregation of solid BMW
• Legislation
• Penalities

3. • Classification of wastes in Dentistry
• The safe disposal of dental waste
• Categories of waste and their method of disposal
• Health and safety regulations regarding sharps injury
• Prosthetic management in HIV patients
• Disposal of facemasks and PPE kits during covid-19
• Disposal of BMW
• Segregation of waste should be observed strictly
• Packaging and labelling
• Packaging and disposal of BMW
• Collection,transportation and storage
• Label for transport of BMW containers
• Transportation
• Safety measures
• Staff safety
• Conclusion
• References

4. INTRODUCTION
• A biomaterial is any matter,surface or construct that interacts
with the biological systems,Such substances can range from
an inert implant to biologically integrated grafts.
• The fist historical use of biomaterials dates to antiquity,when
ancient Egyptians used sutures made from animal sinew
• Biomaterials are materials which are used in medicine and
dentistry to come in contact with living tissues.
• The familiar tooth filling is where most humans first
encounter the biomaterials but increasingly many people rely
on more crirtical implants such as joint replacements,
particularly hips and cardiovascular repairs.

5. • A designed biomaterial should serve its purpose in the
environmentof the living body without affecting the other
bodily organs.
• These biomaterials have embraced biology as basic science
on which they build
• Metal ceramics,plastic,glass and even living cells and tissue
all can be used in creating biomaterials.
• They can be engineered into molded or machined parts
,coatings,fibres,films,moans and fabrics for use in biomedical
products and devices.
• These may include heart and valves ,hipjoint
replacements,dental implants or contact lenses.

7. DEFINITIONS
• Biomaterial:A natural or synthetic material(as a polymer or
metal) that is suitable for introduction into living tissue
especially as a part of a medical device(as an artificial heart
valve or joint or implant)
[Medical definition]
Waste Management:It includes the activities and actions
required to manage waste from its inception to its final
disposal.
Biomedical waste:Biomedical waste is any waste that is
generated as a by-product of healthcare work at doctor’s
surgeries, dentists, hospitals and laboratories. It includes any
material that could come into contact with the body during
diagnosis, research, drug administration or any type of
treatment.

8. Sources of biomaterial waste
• Hospitals,Dental clinics
• Laborateries and research centre
• Mortuary and autopsy centre
• Blood banks
• Nursing homes for the elderly
• Animal research and testing labs

13. CATEGORIES OF BIOMATERIAL WASTE
DISPOSAL SCHEDULE AS PER WHO
STANDARD

16. Hazards of biomaterial waste
• Health-care waste contains potentially harmful
microorganisms that can infect hospital patients, health
workers and the general public. Other potential hazards may
include drug-resistant microorganisms which spread from
health facilities into the environment.
• Adverse health outcomes associated with health care waste
and by-products also include:
• Sharps-inflicted injuries;
• Toxic exposure to pharmaceutical products, in particular,
antibiotics and cytotoxic drugs released into the surrounding
environment, and to substances such as mercury or dioxins,
during the handling or incineration of health care wastes;

17. • Chemical burns arising in the context of disinfection,
sterilization or waste treatment activities;
• Air pollution arising as a result of the release of particulate
matter during medical waste incineration;
• Thermal injuries occurring in conjunction with open burning
and the operation of medical waste incinerators; and
• Radiation burns

19. PROBLEMS ASSOCIATED WITH BMW

20. Principles of Biomaterial Waste Management
• General principles of hygiene and sanitation:Observance of
general principles of hygiene and sanitation such as cleanliness,
good house keeping, adequate supply of safe water, sanitary
facilities and proper ventilation are essential components of a
good bio-medical waste management plan.
• Waste minimization: It is essential that every waste generated
from the hospital should be identified and quantified. Hospitals
should endeavour to reduce waste by controlling inventory,
wastage of consumable items and breakages etc. Waste can also
be minimized by recycling certain waste such as glassware,
plastic material etc after proper cleaning and disinfection.
• Waste segregation: Segregation of waste at source and safe
storage is the key to whole hospital waste management process.
Segregation of various types of wastes into different categories
according to their treatment/disposal options should be done at
the point of generation in colour coded plastic bags/containers as
per schedule II of the gazette notification. The needles and
syringes should be disinfected and mutilated before segregation.

21. • Waste treatment on site: Microbiological and
biotechnology waste being highly infectious should be
treated on site by autoclaving/microwaving/chemical
treatment.
• Waste transportation: The waste should be transported to
kerb collection area in covered container.
• All containers should have biohazard label according to
schedule III of the gazette notification.
• If a container is transported from the premises where
biomedical 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.
• The containers and the vehicles used for transportation of
biomedical waste should not be used for any other purpose.
• Care should be taken to avoid spills.

22. Types of biomaterial waste disposal
• 1.Autoclaving
• The process of autoclaving involves steam sterilization.
Instead of incineration, which can be expensive, autoclaving
simply introduces very hot steam for a determined amount of
time. At the end of the process, microorganisms have been
completely destroyed. This process is particularly effective
because it costs much less than other methods, and doesn’t
present any personal health risks. While some biomedical
waste isn’t able to be disposed of via autoclaving,
around 90% of materials are sanitized this way before being
sent on to a landfill.
• 2. Incineration
• The major benefits of incineration are that it is quick, easy,
and simple. It effectively removes the waste entirely, and
safely removes any microorganisms. However, when burning
hazardous materials, emissions can be particularly dangerous.
Some states prefer for waste disposal companies to look
towards incineration as their first choice, but materials must
be reviewed and determined as safe to burn.

23. • 3. Chemicals
• When it comes to liquid waste, a common biomedical waste
disposal method can be chemical disinfection. Chlorine is a
regular choice for this process, and is introduced to the liquid
waste in order to kill microorganisms and pathogens.
Chemical disposal can also be used for solid wastes, but it is
recommended that they be grinded first to ensure maximum
decontamination. Liquid waste, once decontaminated, is then
disposed into the sewer system.
• 4. Microwaving
• During this process, waste is shredded, mixed with water,
and then internally heated to kill microorganisms and other
harmful elements. One of the main benefits of this process is
the shredding aspect; it lowers the volume of biomedical
waste, and it is reportedly more energy efficient to use this
method than to incinerate. While it can’t be used for all
biomedical wastes, it can be utilized for a good 90% of it,
just like autoclaving.

28. COLOR CODING FOR SEGREGATION OF
BMW DISPOSAL

32. WHY WASTE MANAGEMENT IN
DENTISTRY IS SO IMPORTANT?

33. The wastes generated in Dentistry is broadly
classified as:
• Mercury containing wastes
• Silver containing wastes
• Lead containing wastes
• Impression material wastes
• Titanium based wastes
• Metal based wastes
• Sharps
• Zinc based wastes
• Gypsum based wastes
• Resin based wastes

34. • Ceramic wastes
• Liquid wastes(chemical waste,sterilizing
agents,disinfectionsolution)
• Expired/outdated contaminated Medicines
• Non-hazardous wastes
• Plastic waste

35. WASTES MANAGEMENT
Mercury containing wastes SCRAP AMALGAM:
Premeasured amalgam capsules
Scrap amalgam containers
Amalgam separators
Disposable suction traps
ELEMENTAL MERCURY:
Mercury spill kit
Silver containing wastes Silver recovery/separator unit
Lead containing wastes Lead aprons
Lead foils

36. Metal based waste Base metals of crown and bridge ,CPD and
prefabricated crowns-after disinfection
given back to dental lab for
recasting(recycling)as properties like
hardness etc are not affected when mixed
and used with fresh alloy.
Impression trays(metal)-disinfected and
handed over CWC separately for
recycling,disposable impression
trays(thermoplastic resin with reinforced
fibres)are used
Titanium based waste Dental implants-scrap titanium
Impression materials(used in making dental
impressions)
Rubber based impressions-Sanitary landfill
Impression compound-solid waste after
disinfection
Alginate(left over part after mixing)-to generate
calcium silicate cement through high
temperature calcinations,o it can be segregated

37. Sharps Puncture proof container
Zinc based wastes Disposed as soiled wastes and handed over to
CWC for proper management
Gypsum based wastes Dental casts-regular non-hazards waste and
finally disposed as landfill. Can be disposed
into white lided container.
A study reveals that when 1 ton of ordinary
gypsum is recycled it saves around1000
pounds of black alkali,1 ton of lactic
acid,500kwh of energy.

38. Resin based wastes RPD-Metal part- removed manually and
kept with metal based waste container
Acrylic part-resin based waste container and
should be handed over to CWC fpr proper
management
Ceramic waste Not hazardous to environment but ofcourse it
will utilize the landfill so instead of just
discarding it as regular waste it should be
segregated for recycling
Liquid waste/chemical
wastes/disinfectants/sterilizing agents
Infected body fluid-collected into 10%sodium
hypochlorite solution for 20min & then drained
into sewage.
Chemical waste-first neutralized &drained into
sewage
Disinfectants&sterilizing agents-first
neutralized and then poued into septic system.

39. Expire or outdated medications Handed over to supplier and incinerate at
higher temperature
Non-hazardous waste Re-usable devices for dental procedures are
recommended.
Plastic waste Should not be burned in open or closed
chamber as it produces dioxin and furans
which is bio-accumulative as well as
carcinogenic.
Infected plastic waste-shoul be
autoclaved,shred and given to local vendor for
recycling.
Non-infected plastic-handed over to

40. THE SAFE DISPOSAL OF DENTAL WASTE
• The first and foremost thing a practicing dentist should do is
to dispose of waste materials far from the dental set up to
prevent any contamination.
• This waste can be anything like plastic gloves, water cups,
used napkins, suction tips, etc.
•
After every dental treatment, have a dental assistant properly
clean and disinfect the area.
• This is as important as cleaning the unit because it is very
likely that waste materials will be found thrown on the floor,
which is often overlooked and ignored.
• Using a disinfectant is the right way to make sure no cross-
contamination occurs.

41. • A trash can is surely present in every dental setup, but not all
kinds of waste can be thrown in it directly.
• For example, blood-soaked cotton, suction tips, extracted
teeth, used needles, amalgam fillings containing mercury, etc.
are all hazardous things that need proper waste management
in dentistry.
• Dentists must make sure to use biomedical containers,
double bags, puncture-resistant boxes, and proper recycling
services when it applies.

42. • The ultimate guide to the disposal of waste within the dental
surgery
• CATEGORIES OF WASTE AND THEIR METHOD OF
DIPOSAL
• Hazardous and Non-hazardous wastes must be appropriately
segregated.
• Non-Hazardous waste disposal:
• Firstly,Non-hazardous wastes include offensive waste,non-
cytotoxic,,domestic waste,office waste,x-ray film, and lead fil
and dental plaster casts all of which are disposed in different
ways.

43. • Secondly hazardous wastes which may be infectious include
clinical (soft) waste,sharp waste,sharp waste uncontaminated
withm medicines and sharps waste contaminated with cytotoxic
medicines.
• 1)Soft clinical waste:Orange sacks
• 2)Sharps:Yellow lided rigid containers
• 3)Sharp waste uncontaminated with medicines:Yellow rigid
container with an orange lid.

45. Prosthetic waste management in HIV patients
Sharp items such as needles.scalpel blades Should be placed in puncture resistant
containers marked with biohazard label
Gloves,masks,wipes, paper drapes,surface
covers that are contaminated with body fluids.
Handled with gloved hands and discarded in
sturdy,impervious plastic bags to minimize
human contact.
Blood,disinfectants,sterilants Should be carefully poured into a drain
connected to a sanitary sewer system..
Disposable materials Management

47. Disposal of facemasks and PPE kits during
covid-19

49. Disposable materials Management
N95 respirators and surgical face masks Dry heat pasteurazation at 70 degree
centrigrade fir 1 hr and retained the filtration
efficiency also.
PPE kits Reprocessing of ppe kits

62. CONCLUSION

64. • 1. Wolrd Health Organization. Coronavirus disease 2019 (COVID-19) situation
report -68. Available at: https://www.who.int/docs/default-
source/coronaviruse/situation-reports/ 20200328-sitrep-68-covid-19.pdf.
Accessed March 28, 2020.
• 2. Rio Carlos del, Malani Preeti N. COVID-19—New insights on a rapidly
changing epidemic. JAMA Network. 2020. JAMA Published online February 28,
2020 (Reprinted).
• 3. Nicas M, Nazaroff WW, Hubbard A. Toward understanding the risk of
secondary airborne infection: emission of respirable pathogens. J Occup Environ
Hyg. 2005;2:143–154.
• 4. Loeb M, Dafoe N, Mahony J, et al. Surgical mask vs N95 respirator for
preventing influenza among health care workers: a randomized trial. JAMA.
2009;302:1865– 1871.

65. • 5. Centres for Disease Control and Prevention. Use of cloth face coverings to help slow
the spread of COVID-19. Available at: https://www.cdc.gov/coronavirus/ 2019-
ncov/downloads/DIY-cloth-face-covering-instructions.pdf. Accessed June 15, 2020.
• 6. World Health Organization. Coronavirus disease (COVID-19) advice for the public:
when and how to use masks. Available at: https://www.who.int/emergencies/dis
eases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks.
Accessed June 15, 2020.