This presentation summarizes bio-medical waste management practices at a rural hospital in Chhattisgarh, India. It finds that the hospital generates around 887kg of waste per day, of which 200kg requires special handling and disposal methods. Currently, the hospital uses an incinerator to treat 71.6kg of infectious waste per day and landfills the remaining 128.4kg. However, the presentation suggests replacing the incinerator with plasma pyrolysis, a more economical and environmentally friendly waste treatment technology.

1. Presentation on
Bio-Medical Waste Management
Presented by
Avaneesh Kumar Yadav
(M.Tech.-2014EN06)
Civil Engineering Department
Motilal Nehru National Institute of Technology Allahabad, Allahabad

2. Bio-Medical Waste (BMW)
Definition:
As per Bio-Medical Waste (Management and Handling)
Rules, 1998 , “Bio-medical waste is any type of waste
generated during the diagnosis, treatment or immunization of
human beings or animals or in research activities pertaining to
the production of drugs in pharmaceutical companies, animal
waste generated in the veterinary hospitals and also in the
slaughter houses, etc.”
Need for BMW Management:
 If BMW is not segregated at source & allowed to be mixed
with MSW, it may cause dreadful and infectious diseases like
HIV, hepatitis B & C, tuberculosis and other skin and
respiratory ailments.

3.  Unscientific technology like open burning for disposal of
BMW may lead to dangerous levels of emission of gases like
dioxins and furans in the environment, which contain cancer
causing agents.
 Residual ash, if not disposed off in secured landfills, can also
pollute the underground water and contaminate the soil.
 The liquid waste generated when let into sewers can also lead
to surface water pollution if not treated properly.
 Injuries from sharps and exposure to harmful chemical waste
and radioactive waste also cause health hazards to employees
involved in collection and disposal of BMW.
 Plastic waste can choke animals, which scavenge on openly
dumped waste.
 Radioactive waste and heavy metals in liquid form can come
from chemical or biological research and may affect the
reproductive system adversly.

4. Sources Generating Bio-Medical Waste:
Major Sources:
• Govt. hospitals/private hospitals/nursing homes/
dispensaries
• Primary health centers
• Medical colleges and research centers/ paramedic
services
• Veterinary colleges and animal research centers
• Blood banks/mortuaries/autopsy centers
• Biotechnology institutions
• Production units

5. Minor Sources:
• Physicians/ dentists’ clinics
• Animal houses/slaughter houses
• Blood donation camps
• Vaccination centers
• Acupuncturists/psychiatric clinics/cosmetic piercing
• Funeral services
Amount and Composition of hospital waste
generated:
Quantity of BMW:
Country Quantity (kg/bed/day)
U. K. 2.5
U.S.A. 4.5
France 2.5
Spain 3.0
India 1.5

6. Composition of BMW:
Hazardous 15%
a) Hazardous but non-infective 5%
b) Hazardous and infective 10%
Non-hazardous 85%
Composition by weight:
Combustible 80%
(a) Plastic 14%
(b) Dry cellublostic solid 48%
(c)Wet cellublostic solid 18%
Non-combustible 20%

7. Collection of BMW:
 Segregated collection of waste at source is a single most
important step in bio-medical waste management and this
practice results in-
 Waste minimization
 Effective waste management
 Decrease in expenses incurred in managing waste
 Reduce the risk of infection ensuring better healthcare
 Bio-Medical Waste Management Rules 1998 gives the colour
coding that should be used for the various categories of waste-

9. Storage of BMW:
 Immediate treatment and disposal are ideal procedures to
be followed for disposal of bio medical waste.
 Untreated bio medical waste however, can be stored for
not more than 48 hrs.
 If for some reason it becomes necessary to store the waste
beyond such period, permission from the local state
authority must be taken and it must be ensured that it does
not adversely affect human health and the environment.
Treatment of BMW at Source:
 Incineration
 Chemical Disinfection
 Autoclaving
 Shredding
 Microwave Irradiation
 Plasma Pyrolysis

11. Emission Standards for Incineration:
Parameters Conc (mg/N m3 at 12% CO2
correction )
Particulate matter 150
Nitrogen oxides 450
HCL 50
Standards & Requirements for Incineration:
 Minimum height of the stack should be 30 meters above
the ground.
 Above emission limits should be achieved.
 Waste to be incinerated not to be disinfected with
chlorine substance.
 Chlorinated plastics should not be incinerated

12.  Toxic metals in incineration ash should be limited to within
regulatory quantities.
 Only low sulphur fuels like LDO/LSHS to be used as fuel.
Chemical Disinfection:
 High level disinfectants like chlorine releasing compounds are
used for disinfecting materials contaminated with blood and
blood products. The recommended dilutions for these
compounds are given as follows:
Name of Disinfectant Available
chlorine
Required
chlorine
Required
chlorine
Contact period
Amount of
disinfectant to be
dissolved in 1 ltr of
water
Sodium hypochlorite 5% 0.5% 30 min 100 ml
Calcium hypochlorite 70% 0.5% 30 min 7.0 g
NaOCl powder - 0.5% 30 min 8.5 g
Chloramine 25% 0.5% 30 min 20 g

15. Microwave Irradiation
• The microwave is based on the principle of generation of high
frequency waves.
• These waves cause the particles within the waste material to
vibrate, generating heat.
• This heat generated from within kills allpa thogens.
Plasma Pyrolysis
 It is a state-of-the-art technology for safe disposal of
medical waste.
 It is an environment-friendly technology, which converts
organic waste into commercially useful byproducts.

16.  The intense heat generated by the plasma enables it to dispose
all types of waste including municipal solid waste, biomedical
waste and hazardous waste in a safe and reliable manner.
 Medical waste is pyrolysed into CO, H2, and hydrocarbons
when it comes in contact with the plasma-arc.
 These gases are burned and produce a high temperature
(around 1200oC).
Transportation of BMW
 Properly designed carts, trolleys and other wheeled containers
should be used for the transportation of waste inside the
facilities both within the health facility and from the facility to
the final disposal location.
Wheeled containers should be so designed that they have
no sharp edges.
Waste handlers must be provided with uniform, apron, boots,
gloves and masks, and these should be worn when transporting
the waste.

18. Case Study of Bio-Medical Waste of
a Rural Hospital in Chhattisgarh:
• The survey of a medical hospital with 550 beds, 42 wards
and 20 OPDs, attached to a medical college was carried
out during the time period between August-2010 to
October-2010.
• The data collected is tabulated as follows:
(All Units are in Kg/day)

19. TABLE 1: Segregation of bio-medical waste of ground floor
TABLE 2 : Segregation of bio-medical waste of ground floor

20. TABLE 3: Segregation of bio-medical waste of ground floor
TABLE 4: Segregation of bio-medical waste of first floor

21. TABLE 5: Segregation of bio-medical waste of second floor
TABLE 6: Incineration Ash Generated in August 2010

22. TABLE 7: Incineration Ash Generated in August 2010
Average ash generation is normally between 4-5% of the
weight of the waste; as against that we have the ash generation
as 13% which is on higher side.
For Preliminary Planning for waste management
estimation is done on following basis-

23. • 80%- General health care waste.
• 15%-Pathological & infectious waste.
• 1%-sharp waste.
• 3%-Chemical & Pharmacological waste.
• 1%-special waste (Cardio active, cytotoxic, Pressurized
container)
TABLE 8 : Actual waste generated at the hospital
Sr.
No.
Type of
waste
Actual waste
from study in
%
Waste in
Kg
1. General 77.48 687
2. Pathological & Infectious 12.06 107
3. Sharp 2.02 18
4. Chemical pharmacological 5.63 50
5. Special Waste 2.81 25
Total 100 887

24. Summary
 The hospital under study generated 0.58 kg/day.
 Over all capacity of hospital is 550 beds and it generates
around 687 kg per day.
 Over all waste generation of health care center is 887 kg per
day, out of which 200 kg (Refer: Table-8 ) need to be take care
of and need extra precaution for disposal.
 Out of these 200 kg of waste, 71.6 kg went for incineration as
it is highly infectious. Remaining 128.4 kg is disposed through
sanitary landfill disposal method.
 As daily solid waste of hospital generated was in range
between 190 to 230 kg out of which 70 to 115 kg went for the
incineration and rest was put in to their own near-by sanitary
land fill site.
 The domestic waste generated is managed by municipal
disposal system.

25. Disposal System Practiced by the Rural
Medical Hospital:
• The waste from color-coded containers is transported to the
appropriate disposal points.
• No Infectious waste is stored beyond 24 hours.
• Properly designed carts, trolleys and other wheeled containers
are used for the transportation of waste inside the facilities.
• Treatment of sharps is done, i.e. by treating with 1%
hypochlorite solution or any other equivalent chemical
reagent. Shredder is used for disposal of sharp content.
• “Incinex incinerator” (Double chamber pyrolytic incinerator
established in 1981) with capacity of 35 Kg/hr is used by rural
health care institution.
• Fuel: LDO(Diesel) is used whose consumption is around 25 to
27 liters per day.
• Sanitary Land Filling is done at their own land fill site.

26. Suggestions for Advancement:
• In case of failure of current instruments and infrastructure of
waste disposal, the hospital must have alternate plan for safe
transportation of infectious waste to disposal.
• Instead of Incineration, it is suggested to use “Plasma
Pyrolysis” which is new & widely used economical and
environment friendly method.
• Plasma Pyrolysis is smoke free technology for safe disposal of
chlorinated waste.
• It is so compact that it can be installed in a small premises.
• Neither chimney nor foul odour removal system is required in
it.
• Also, it has no dependency on air & moisture unlike
incineration process because it uses plasma torch for heating.

27. CONCLUSION
• The study reveals that the hospital under study incinerates
infectious waste only.
• Considering comparison and applicability of plasma pyrolysis
with incineration, it can be concluded that all wastes i.e.
pathogenic, sharps and infectious except general waste can go
for Plasma Pyrolysis where residue left over would be
negligible with almost no additional cost of treatment and at
the same time it would safeguard the environment.

28. THANK YOU