Biomedical waste is defined as waste that is generated during the diagnosis , treatment or immunization of human beings and are contaminated with patients body fluids.

1. Biomedical waste
-Ajay Kumar Chaurasiya

2. Biomedical waste
Definition
Biomedical waste is defined as waste that is generated during
the diagnosis , treatment or immunization of human beings and
are contaminated with patients body fluids.(WHO)
Biomedical waste incudes :
Syringes ,needles, ampoules
Organs and body parts
Dressings ,disposable plastics
Microbiological waste.
9/18/2014

3. Aims of biomedical waste managements
To protect the risk of spreading diseases.
To protect health & well being of health care workers & the
community.
To protect injury & potentially fatal infection.
To provide environment friendly waste management
solutions.
To promote the quality & sustainability of the environment.
9/18/2014

4. Sources of biomedical waste
Government hospitals
 Private hospitals
Nursing homes
Physicians/ dentist clinic
Dispensaries
Medical research and training establishments
Blood banks ,collection centers, laboratories
Animal houses, slaughter houses
9/18/2014

5. Classification of Hospital waste
According to WHO guidelines:-
1. Infectious waste
2. Pathological waste
3. Sharps
4. Pharmaceutical waste
5. Genotoxic waste eg. certain cytotoxic or radioactive
waste from oncology & radiotherapy unit
6. Chemical waste
7. Pressurized containers
8. Radioactive waste
9. General waste
9/18/2014

6. NHRC (Nepal) classified health care waste only 3
categories
1. Non-hazardous waste or General waste
2. Hazardous or contaminated waste
3. Sharps (Whether infected or not)

7. Hospital waste
Hospital wastes - considered as hazardous
► A variety of potentially hazardous ingredients : antibiotics,
microorganisms ,Cytotoxic drugs , corrosive chemicals & radioactive
substances -part of hospital waste
Distribution Of hospital waste
WHO Regional office south east Asia NHRC
80 % general waste, 75—90 % Non hazardous or general waste
15 % pathological & infectious waste, 10—25 % as hazardous waste.
1 % sharps,
3 % hazardous ,chemical or pharmaceutical waste &
< 1 % special waste like radioactive
or cytotoxic , pressurized containers
9/18/2014

8. Classification of waste
9/18/2014
Hospital waste
Hazardous Non-hazardous
Potentially
toxic
Infectious biodegradable
Nonbiodegradable
Peels of fruits and vegetables -wrapping foils
-Plastic foils-cytotoxic drugs
-toxic chemicals
-Radioactive
waste

9. • Infectious
9/18/2014
Sharps
Non-sharps
Hypodermic needles with syringes attached
-disposable knives, scalpels, blades, scissors,
forceps
-glass Pasteur pipettes, slides & cover slips
-broken glass, ampoules & vi

10. Non-sharps
• Patient contaminated
9/18/2014
Laboratory
plastics
disposable syringes
-IV sets
Catheters
ET tubes
Non-plastics
-cotton
-gauze
-dressing

11. Laboratory
Specimens:
-blood
-body fluids
-pus
-food samples
-secretions
-excretions
Microbiological lab waste:
-all cultures made from specimen
-all other stock organisms
-used disposable loops, rods,
pipettes
-paper towel & tissues
-disposable gloves & gowns
- Tissues
- Anatomical parts
- Animal carcasses
9/18/2014

12. Categories of persons exposed to risk of infection
Patients attending the health care facilities.
Medical and paramedical person providing health care.
Persons involved in collecting and disposing the waste material.
Those involved in cleaning the instruments, floor surfaces and
washing of glass wares and linen.
9/18/2014

13. Health hazards associated with biomedical waste
management
Injuries from sharps to all categories of hospital persons.(HIV and
HBV)
Nosocomial infection in patient from poor infection control and poor
hospital waste management.
Risk of infections outside hospitals for waste handlers, scavengers and
general public.
Risk associated with hazardous chemicals.
9/18/2014

14. Hospital waste management
The general principle involved in the treatment of hospital waste is that all
infectious or potentially infectious waste must be rendered non infectious before
leaving the hospital.
Whole hospital kept clean & in satisfactory state of hygiene to prevent spread of
infection from patients to patient, health care workers or vice versa.
Prevention of infection outside hospital , careful management of waste from the
point of generation to safe disposable is of paramount importance.
9/18/2014

15. 1. Identification / Categorizing
Also known as Waste survey
Important component of waste management.
Help evaluating both type & quantity of waste.
Determine the points of generation & type of waste
generated each points.
To find out type of disposable carried out.
Determine the type of disinfection needed.
 Appropriate way of identifying biomedical wastes & sorting
them into colored plastic bags or containers
9/18/2014

16. Categories of Bio-medical Wastes
Cate
gory
Type of waste Treatment &
disposable
option
1 Human anatomical wastes(Human
tissues,organs & body parts )
Incineration
/Deep burial
2
Animal wastes(Animal tissues, organs, body
parts, carcasses ,bleeding parts , experimental
animal used research waste by veterinary
hospital)
Incineration
/Deep burial
3
Microbiology & Bio-technology wastes(Waste from
laboratory cultures, stocks or specimens of micro
organisms , live attenuated vaccines, human & animal
cells used in research , waste from biological
production, toxins)
Autoclaving
/Microwaving
/Incineration
9/18/2014

17. Contd…
4
Waste sharps ( Needles, syringes , scalpels,
blades,glass etc capable puncture & cut)
Chemical
(Disinfection)
Autoclaving
5
Discarded medicines & cytotoxic drugs Incineration/
Destruction in
landfills
6
Soiled wastes( items contaminated with blood&
body fluids eg. cotton , dressing)
Incineration /
Autoclaving
9/18/2014

18. Contd..
7
Solid wastes (eg . tubing, catheters , IV
set)
Disinfection by
chemical treament/
Autoclaving
8
Incineration ash Disposable in
municipal land fills
9
Chemical wastes ( used in biological
production, in disinfection)
Chemical treatment
&discharge into
drains for liquid &
secured land fills for
solids.
9/18/2014

19. 2. Handling of wastes
Precautions while dealing infectious wastes:-
Bins & bags labeled with biohazard symbol
personnel involved provided with protective wear & properly trained,
Polythene bags , bins should change when they are ¾ full.
Polythene bags sealed /tied at top whenever transported within or
outside hospital.
Disposables items like gloves ,syringes, IV bottles, catheters
etc. have to be shredded, cut that they not recycled/reused.
Extreme care taken while handling sharps.
9/18/2014

20. Handling of sharps
Put heavy duty glove while dealing sharps.
Sharps should not be left casually on counter tops, food trays or
beds can result injury.
Recapping needles should be discouraged.
Specific color coding should be used with biohazard sign.
Infectious & non infectious kept separately .
Collect sharps in puncture proof containers.
9/18/2014

21. 3. Segregation (Separation)
Biomedical waste must be stored in a secure environment all
the times.
The various types of biomedical waste should be segregated
from each other .
Fluid waste should be contained separately from solid waste.
9/18/2014

22. RED BIN
9/18/2014

23. 9/18/2014

24. YELLOW BIN
9/18/2014

25. 9/18/2014

26. 9/18/2014
BLACK BIN

27. 9/18/2014

28. DISPOSAL OF SHARPS
9/18/2014

29. 9/18/2014

30. 4. Storage & Transportation of wastes
► storage site
 Situated on ground floor near rear entrance.
 Sufficient capacity at least for 2 days.
 With good flooring, light, ventilation , water supply &
drain.
 Full time store keeper must be there.
9/18/2014

31. Transportation of waste
1.Container properly sealed & Labelled .
2. Double Bagging are picked at neck
3. Manual handling better avoided.
4. After removing of bags container must be disinfected.
5. Waste bags should be transported in covered wheeled
container.
6. Vehicles used must be label with biohazard sign.
9/18/2014

32. 7. Yellow bags ( Hazardous waste) & Black bags ( General
waste) collect on separate trolleys while transport.
8. The collection route shall be the most direct from one to the
final collection
9. All vehicles are decontaminated , cleaned & disinfected after
use.
10.Waste should be transported during low patient flow.
9/18/2014

33. Collect yellow bags ( hazardous waste) and black bags (
general waste) on separate trolleys while transport.
9/18/2014

34. Packing & shipping infectious substances
US public health service label requirements
9/18/2014
Etiological agent
Biomedical material
In case of damage
Or leakage
Notify Director CDC
Atlanta,GA
404 -633- 5313

35. 5. Waste treatment
 Chemical Disinfection:
Is required for for plastic, rubber and metallic items before they
are send to final disposal.
1% hypochlorite solution is used.
 Autoclave:
Is effective for microbiology and biotechnology waste.
Microwave irradiation:
also useful in sterilizing the infected disposable waste.
Shredder: For plastic material cut the plastic waste into small
pieces of 1cm size.
9/18/2014

36. 6. DISPOSAL
Incineration
Principle
• It is a high temp ( 800 – 900°C), dry oxidation process which
reduces organic & combustible waste into inorganic , incombustible
matters.
• Incineration is burning of contaminated waste to destroy and kill
micro-organisms.
• Used for the waste that cannot be reused or recycled or disposed in
landfill site.
• Demerits – toxic air emission .
- presence of heavy metal in ash.
9/18/2014

37. Plasma arc technology
• It operates on principle of an electric arc
between two electrodes.
• There is no burning and no formation of ash.
9/18/2014

38. Landfill
1 Open dumps: not recommended.
2. Sanitary landfills:
 Most satisfactory where suitable land is available.
 Adequately compacted & covered with earth soil at the end of
working day.
Points to be remembered for landfill:
1. Site should be away from residental areas or water sources.
2. There should be appropriate engineering preparation.
3. It should have easy transportation facility.
4. Constant supervision is mandatory.
9/18/2014

39. Pits for sharps
• To avoid recycling of sharps their burial in safe pit is an
effective and economical.
• Ideal pit
5 ft. deep circular with 3 ft. Diameter
Slab on top
Pit plastered from inside
9/18/2014

40. Deep burial
9/18/2014

41. Bibliography
Topley and Wilson ‘ microbiology and microbial infection ,vol-
2,4 9th edition
Microbiology and infection control for health processionals-
Gary Lee and Penny Bishop,3rd edition.
Laboratory Biosafety Manual 3rd edition WHO 2004.
www.CDC.gov/biosafety
http//www.who.int/research/en/
http//en.Wikipedia.org/wiki/Biosafety
Handbook of bioterrorism and biodefense-Erik De Clercq and
Earl R Kern
Bailey and Scoot's Diagnostic Microbiology-13 ed
Monica Cheesbrough 2nd Updated part 1& 2.