Hospital waste management.

1. Hospital waste management
Dr . D. Vanitha
Assistant. Professor
Dept of Community Medicine - SRU1

2. Why Bio-Medical Waste needs Management?
• Needed due to health, Environmental, legal &
aesthetic reasons.
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3. Purpose of waste management
• To protect people who handle waste items from
accidental injury &infection,
• avoid misusing of expiry dated & contaminated drugs
• To prevent spread of infection to local community
• To dispose the hazardous materials safely(toxic
chemicals and radioactive compounds).
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4. What is Bio-Medical Waste?
• Any solid, liquid waste-generated
during diagnosis, treatment
immunization of human beings
or animal.
• includes all waste generated by
health care establishments,
research facilities& laboratories.
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5. Quantity of Waste generation
• Depends up on hospital polices, practices,
hospital specialisation , proportion of usage of
disposable items/reusable items & number of
patients treated per day.
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6. Transmission of infection from wastes
• Through cuts/puncture of skin
• Through mucous membranes-splashing into eyes.
• Inhalation of dust particles & germs
• By ingestion through contaminated fingers, water
food
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7. Who are at more risk?
• Other patients ,Medical & paramedical persons
• Persons who handle the waste material
• Persons involved in cleaning- instruments, floor,
glassware &washing of linen.
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8. Health hazards associated with poor
hospital waste management
• Injuries from sharps
• Nosocomial infection
• Risks of infection outside
hospitals for waste handlers,
scavengers & general public
• Risks associated with
hazardous chemicals
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9. Types of Hospital waste
Hospital waste
Hazardous Non-Hazardous(85%)
Infectious
(10%)
Non-Infectious
(5%)
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10. Hazardous Infectious waste
• Infectious waste contains pathogens (bacteria,
viruses, parasites, or fungi)
• Cultures of infectious agents from lab work
• Waste from surgery & autopsies on patients with
infectious diseases
• Waste from infected patients in wards
• Infected animals from laboratories
• Any other instruments or materials that have been
contaminated by infected persons or animals.
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11. Hazardous non infectious waste
• Chemical and pharmaceutical residues (e.g., expired
drugs and vaccines, disinfectants )
• Cytotoxic waste (drugs used in cancer chemotherapy
• heavy metals waste-mercury - broken thermometer
• Non recyclable&discarded pressurized containers that
are hazardous if burned because they can explode
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12. Non hazardous wastes
• Non contaminated waste include paper, trash,
boxes, bottles, plastic containers and food.
• They can be disposed of by the usual methods
or sent to the local landfill or dumpsite
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13. Steps in the management of
hospital waste
• Generation,
• Segregation/separation,
• Collection,
• Storage,
• Transportation
• Treatment,
• Final disposal
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14. Storage place
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15. Waste
Category
Waste class and
description
Treatment and
disposal systems
1 Human Anatomical
Wastes, Blood &
Body Fluid.
If infectious,
incineration; if not
infectious, then
burial
2 Animal and Slaughter
House Wastes
Disinfections and
burial for solid
treatment and
discharge for fluid
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16. Category No.3 Microbiology &
Biotechnology
Waste
Autoclaving /
micro waving
and incineration
Category No.4 Waste Sharps Disinfection,
shredding and
disposal in
landfill/ recycling
Category No.5 Discarded
Medicines
Incineration and
disposal in
landfills
Category No.6 Soiled Wastes
with blood and
body fluids
If infectious,
incineration; if
non-infectious,
autoclaving/
microwaving/
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17. Category
No.7
Solid waste
from
Disposables
Disinfections by chemical
treatment autoclaving / micro
waving and shredding and
disposal landfill/ recycling for
PVC / Plastic.
Category
No.8
Liquid Wastes
Disinfections by chemical
treatment and discharge into
drains.
Category
No.9
Incineration
ash
Disposal by landfill
Category
No.10
Chemical
Wastes
Chemical treatment and
discharge in drain for liquids and
incineration or land disposal for
solids 17

18. Segregation and safe storage
• Segregation should be done at the point of generation to
avoid mixing of general waste & infectious.
• The infectious waste, even if little is mixed with the other
hospital wastes, the entire waste should be treated as
infectious waste (more expensive and also dangerous)
usage of segregation
• Reduce total treatment cost
• Reduce the impacts of this wastes on the community
• Reduce the chances of infecting health care workers
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19. Biohazard symbol
Colour coding
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20. Colour coding and containers for disposal of
biomedical wastes
Colour
code
container
Waste
category
Treatment
options
yellow
Plastic
bags
Cat 1,2,3,and
6
Incineration /
deep burial
red
Disinfected
container/
Plastic
bags
Cat 3,6 and 7
Autoclaving /
microwaving /
chemical
treatment
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21. Colour
code
container
Waste
category
Treatment options
Blue / white
transparent
Plastic
bags
Cat 4
and 7
Autoclaving/
chemical
treatment,
destruction
&shredding
Black
Plastic
bags
Cat 5 ,9
and 10
Disposal in
secured landfills
Colour coding and containers for disposal of
biomedical wastes
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22. 1.Disease transmission – GIT , Respiratory tract
& Skin infections
2.Toxic hazards by Chemical & Radioactive
wastes
3.Water & Air Pollution
4.Vector breeding and Rodents nuisance
5.Injuries , HIV , Hepatitis B & C by Sharps
6.Public sensitivity
Health hazards
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23. Treatment and disposal technologies
• Incineration
• Chemical disinfection
• Wet and dry thermal treatment
• Microwave irradiation
• Land disposal
• Inertization
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24. Incineration
• High temperature oxidation
process
• Reduces organic and
combustible waste into
inorganic and incombustible
• Reduces the volume of waste
• Method of choice for waste
that cannot be recycled and
reused
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25. Types
• Double chambered pyrolytic incinerators
• Single chamber furnaces
• Rotary kiln operators
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26. Chemical Treatment
• Chemicals are added to waste to kill the
pathogens, result in disinfection.
• liquid waste, such as blood, urine, stools etc
are treated by chemicals like hypochlorite.
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27. Thermal Treatment
• Wet and Dry method.
• WET METHOD / STEAM DISINFECTION
1. Waste is exposed to high temperature and steam
2. Not for anatomical, chemical and pharmaceutical
waste.
• DRY METHOD/ Screw feed technology.
1. Heating in high temperature, without steam.
2. Not for cytotoxic and radioactive waste.
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28. Micro wave
Irradiation
• Waste is treated with
microwave radiation
• Water within the waste is
heated and infectious
components destroyed by
heat conduction
• Frequency – 2450 HZ
• Wave length – 12.24 nm
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29. Land fill
• A special burial pit -prepared
for health care waste only.
• After each waste load, it -
covered with soil layer.
• Access to this disposal area
should be restricted,
• supervision by landfill staff
•easier and thus prevent
scavenging. 29

30. Inertization
• Waste is mixed with other substances before disposal
• Minimise the risk of toxic substances in the waste
migrating to surface water and ground water
• Proportion :
• 65 % waste + 15% lime +15 % cement + 5 % water
• Homogenous mass is formed &cubes/pellets are
produced on site &transported to suitable site.
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31. • Supreme Court, issued instructions regarding
management of Bio-Medical Waste.
• Ministry of Environment and Forests, Government of
India notified the Bio-Medical Waste (Management and
Handling) Rules on 27th July 1998; under the provision of
Environment Protection Act 1986.
• Accordingly all the hospitals (public& private)are bound to
follow these rules to avoid legal actions.
National legislation
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32. In SRU - Red (Category 7) – Autoclaved& shredded –
disposal area
• IV cannulae, IV sets, IV plastic bottles, Syringes
• Gloves, Polythene aprons(disposable)
• ET Tubes
• Urine bags, Blood bags
• Breathing tubes, Feeding tubes
• Central venous catheters
• CAPD catheters and bags
• Microbiological waste in plastic ware
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33. .
In SRU - Yellow (Categories – 1,2,3,6) – Incinerated
• Dressings, cotton
• Body parts, Placenta, Sanitary pads
• disposable Face masks, caps, shoe covers, surgical gowns
• Microbiological waste in glassware
• Outdated blood bags
Green -Paper, food, plastic water bottles, polythene bags
Sharps – needles-collected in non-penetrable plastic boxes
Blue colour bag – to collect empty drug containers – sent
for washing and reused in drug companies
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