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Bio-Medical Waste ManagementAnji AnuraSchool of Medical Science and TechnologyIIT Kharagpur
My researchOral CancerIndia accounts for 86% of the worlds oral cancer casesPrevalence of oral cancerRanked 1st among mal...
WASTESWastesSolid wasteHouseholdwasteIndustrialwasteBiomedicalwaste orhospital wasteLiquid Waste Gaseous WasteWASTES“Somet...
What is Bio-medical waste ??Definition– Anything tested or used on an individual, or any trash frombiological experiments ...
History• In the late 1980’s– Items such as used syringes washed up on several EastCoast beaches USA– HIV and HPV virus inf...
WHO has estimated that• in 2000• injections with contaminated syringes caused:• 21 million hepatitis B virus (HBV)infectio...
Laws of Biomedical Waste ManagementOn 20th July 1998• Ministry of Environment and Forests (MoEF), Govt. of India,Framed a ...
Developed Countries- 1-5 kg/bed/day, with variationsamong countries.In India-1-2 kg/bed/day with variation amongGovt. and...
Non-Infectiouswaste, 80%Pathologicaland Infectiouswaste, 15%Chemical andPharmaceuticalwaste, 3%Sharps, 1%Radioactive,Cytot...
• Human anatomical waste• Animal waste• Microbiology andbiotechnology waste• Waste sharps• Liquid waste• Tissues, organs, ...
• Dressing, bandages, plaster casts,material contaminated with blood• Alcohol, Sulphuric acid, chlorinepowder, Glutaraldeh...
Pharmaceutical WasteSharp Waste 12
Cytotoxic drugsLab reagentsGenotoxic wasteChemicalwaste13
Waste with high contentof heavy metalsWorn out batteriesBlood pressure guages 14
GascartridgesGas cylindersAerosol cansPRESSURISEDCONTAINERS15
Radioactive waste16
The exposure to hazardous health care waste canresult in1. Infection2. Genotoxicity and Cytotoxicity3. Chemical toxicity4....
InfectionThe infectious agents enter in he body through Puncture, Abrasion, Cut in the skin; Through mucous membranes;...
Most Common Infections1. Gastro enteric through faeces and/or vomite.g. Salmonella, Vibrio Cholera, HelminthesHepatitis A2...
Most Common Infection Cont.6. Blood borne diseases• AIDS• Septicaemia and bacteraemia• Viral Hepatitis B & C7. Hemorrhagic...
Genotoxicity and CytotoxicityChemical Toxicity• Irritant to skin and eyesE.g. alkylating agent, intercalating agent• Carci...
Radioactivity HazardsPhysical InjuriesRadioactive waste exposure may causeheadache, dizziness, vomiting, genotoxicity and ...
Cat- 1 Human Anatomical WastesCat- 2 Animal Anatomical WastesCat- 3 Microbiology and Biotechnology wastesCat- 4 Waste Shar...
Cat- 6 Sailed WastesCat- 7 Solid WastesCat- 8 Liquid wastesCat- 9 Incineration AshCat- 10 Chemical wastesClassification of...
Pharmaceutical WasteBlood bags found in the municipal waste stream in violation ofrules for such waste. 25
Hospital waste disposal26
27WASTECATEGORYTYPE OF WASTETREATMENT ANDDISPOSAL OPTIONCategory No. 1 Human Anatomical Waste (Human tissues, organs, body...
28Category No. 4Waste Sharps (Needles, syringes, scalpels,blades, glass, etc. that may cause puncture andcuts. This includ...
29Category No. 8Liquid Waste (Waste generated from thelaboratory and washing, cleaning, housekeeping and disinfecting acti...
Color Coding For Segregation ofBMWCOLOR WASTE TREATMENTYellow Human & Animal anatomical waste /Micro-biology waste and soi...
1. Survey of waste generated.2. Segregation of hospital waste.3. Collection & Categorization of waste.4. Storage of waste....
5: Managing Medical Waste Slide 32Steps to Manage Hazardous Wastesbefore Disposal1. Know what hazardsyou have2. Purchase s...
5: Managing Medical Waste Slide 33Steps to Manage Hazardous Wastes(cont..)3. Limit use and accessto trained personswith pe...
5: Managing Medical Waste Slide 344. Use Engineering Controls such as Ventilation,Hoods for Select Hazards
5: Managing Medical Waste Slide 355. Get Rid of Unnecessary Stuff• Don’t accumulate unneeded products• Don’t let peroxides...
5: Managing Medical Waste Slide 366. Label with Agent, Concentration andHazard Warnings• Examples of hazard labels:
5: Managing Medical Waste Slide 377. Communicate about Workplace Hazards• Job description• Posters on doors• Labels on haz...
5: Managing Medical Waste Slide 388. Recycle Products When Possible
Source Reduction• Source Reduction - ways to lessen the amountof material– Segregation - keeping noninfectious waste out o...
Conclusion• Thus refuse disposal cannot be solved without public education.• Individual participation is required.• Munici...
Lets Make This World ABetter Place to Live in.THANK YOU
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Bio medical waste management 13-1

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Bio medical waste management 13-1

  1. 1. Bio-Medical Waste ManagementAnji AnuraSchool of Medical Science and TechnologyIIT Kharagpur
  2. 2. My researchOral CancerIndia accounts for 86% of the worlds oral cancer casesPrevalence of oral cancerRanked 1st among male (12% of all cancerRanked 3rd among female (8% of all cancer) CauseThe habit of betel quid chewing incorporating tobaccoHuman papiloma virus (HPV)HistopathologyDiagnosis ofcancerOral lesionsTissue Biopsy
  3. 3. WASTESWastesSolid wasteHouseholdwasteIndustrialwasteBiomedicalwaste orhospital wasteLiquid Waste Gaseous WasteWASTES“Something which isnot put into properusage at a giventime”.
  4. 4. What is Bio-medical waste ??Definition– Anything tested or used on an individual, or any trash frombiological experiments are medical wasteGenerated from– Waste generated by health care facility– Research facility– LaboratoriesHazardous health care waste– 85% waste is non infectious– 10% are infectious– 5% are hazardous
  5. 5. History• In the late 1980’s– Items such as used syringes washed up on several EastCoast beaches USA– HIV and HPV virus infection– Lead to development of Biomedical Waste ManagementLaw in USA.• However in India the seriousness about the managementcame into lime light only after 1990’s.
  6. 6. WHO has estimated that• in 2000• injections with contaminated syringes caused:• 21 million hepatitis B virus (HBV)infections (32% of all new infections);• Two million hepatitis C virus (HCV)infections (40% of all new infections);• 260 000 HIV infections (5% of all new)
  7. 7. Laws of Biomedical Waste ManagementOn 20th July 1998• Ministry of Environment and Forests (MoEF), Govt. of India,Framed a rule known as ‘Bio-medical Waste (Management andHandling) Rules, 1998,’• Provides uniform guidelines and code of practice for Bio-medical wastemanagement.According to this rule Bio-Medical Waste“Any waste, which is generated during the diagnosis, treatment orimmunization of human beings or animals or in research activitiespertaining there to or in the production of testing of biological”
  8. 8. Developed Countries- 1-5 kg/bed/day, with variationsamong countries.In India-1-2 kg/bed/day with variation amongGovt. and Private establishments.Approximately 506.74 tons/ day wastes generatedOut of which only 57% waste undergoes properdisposalBiomedical waste Statistics
  9. 9. Non-Infectiouswaste, 80%Pathologicaland Infectiouswaste, 15%Chemical andPharmaceuticalwaste, 3%Sharps, 1%Radioactive,Cytotoxic andheavymetals, 1%Categories of Bio-Medical Wastes
  10. 10. • Human anatomical waste• Animal waste• Microbiology andbiotechnology waste• Waste sharps• Liquid waste• Tissues, organs, body parts• Generated duringresearch/experimentation, from veterinary hospitals• Laboratorycultures, micro-organisms, human andanimal cell cultures, toxins• hypodermicneedles, syringes, scalpels, broken glass• Generated from any of theinfected areasComponents of Bio-medical waste
  11. 11. • Dressing, bandages, plaster casts,material contaminated with blood• Alcohol, Sulphuric acid, chlorinepowder, Glutaraldehyde, Picricacid, fertiliser, ammonia• Barium enema, X-rays, Cancerchemotherapy, tar-based products• EtBr, Radioactive components Soiled waste Chemical waste Discarded medicines and cyto-toxic drugs Radioactive Components Incineration ashComponents of Bio-medical waste (Cont…)
  12. 12. Pharmaceutical WasteSharp Waste 12
  13. 13. Cytotoxic drugsLab reagentsGenotoxic wasteChemicalwaste13
  14. 14. Waste with high contentof heavy metalsWorn out batteriesBlood pressure guages 14
  15. 15. GascartridgesGas cylindersAerosol cansPRESSURISEDCONTAINERS15
  16. 16. Radioactive waste16
  17. 17. The exposure to hazardous health care waste canresult in1. Infection2. Genotoxicity and Cytotoxicity3. Chemical toxicity4. Radioactivity hazards.5. Physical injuries6. Public sensitivity.
  18. 18. InfectionThe infectious agents enter in he body through Puncture, Abrasion, Cut in the skin; Through mucous membranes; By inhalation and ingestion.
  19. 19. Most Common Infections1. Gastro enteric through faeces and/or vomite.g. Salmonella, Vibrio Cholera, HelminthesHepatitis A2. Respiratory through inhaled secretionse.g. Mycobacterium tuberculosis; measles virus;streptococcus pneumonae3.Ocular infections through eye secretionse.g. Herpes virus,4. Skin infection through puse.g. Streptococcus spp ,5. Meningitis through Cerebrospinal fluide.g. neisseria meningitides,
  20. 20. Most Common Infection Cont.6. Blood borne diseases• AIDS• Septicaemia and bacteraemia• Viral Hepatitis B & C7. Hemorrhagic fevers through body fluids• Junin, Lassa, Ebola and Marburg viruses
  21. 21. Genotoxicity and CytotoxicityChemical Toxicity• Irritant to skin and eyesE.g. alkylating agent, intercalating agent• Carcinogenic and Mutagenice.g. Secondary neoplasia due to chemotherapy• Many drugs are hazardous• May cause intoxication , burns, poisoning on exposure
  22. 22. Radioactivity HazardsPhysical InjuriesRadioactive waste exposure may causeheadache, dizziness, vomiting, genotoxicity and tissue damageMay result from sharps, chemicals and explosive agentsPublic sensitivityVisual impact of the anatomical waste, recognizablebody parts
  23. 23. Cat- 1 Human Anatomical WastesCat- 2 Animal Anatomical WastesCat- 3 Microbiology and Biotechnology wastesCat- 4 Waste SharpsCat- 5 Discarded medicines and Cytotoxic drugsClassification of Waste Category as perWHO standard
  24. 24. Cat- 6 Sailed WastesCat- 7 Solid WastesCat- 8 Liquid wastesCat- 9 Incineration AshCat- 10 Chemical wastesClassification of Waste Category as perWHO standard cont…
  25. 25. Pharmaceutical WasteBlood bags found in the municipal waste stream in violation ofrules for such waste. 25
  26. 26. Hospital waste disposal26
  27. 27. 27WASTECATEGORYTYPE OF WASTETREATMENT ANDDISPOSAL OPTIONCategory No. 1 Human Anatomical Waste (Human tissues, organs, body parts)Incineration@ / deepburial*Category No. 2Animal Waste(Animal tissues, organs, body parts, carcasses, bleeding parts,fluid, blood and experimental animals used in research, wastegenerated by veterinary hospitals and colleges, discharge fromhospitals, animal houses)Incineration@ / deepburial*Category No. 3Microbiology & Biotechnology Waste (Wastes from laboratorycultures, stocks or specimen of live micro organisms orattenuated vaccines, human and animal cell cultures used inresearch and infectious agents from research and industriallaboratories, wastes from production of biologicals, toxins anddevices used for transfer of cultures)Local autoclaving/microwaving /incineration@Categories of Biomedical Waste Schedule asper WHO Standard
  28. 28. 28Category No. 4Waste Sharps (Needles, syringes, scalpels,blades, glass, etc. that may cause puncture andcuts. This includes both used and unusedsharps)Disinfecting (chemicaltreatment@@ / autoclaving /microwaving and mutilation /shreddingCategory No. 5Discarded Medicine and Cytotoxic drugs(Wastes comprising of outdated, contaminatedand discarded medicines)Incineration@ / destruction anddrugs disposal in securedlandfillsCategory No. 6Soiled Waste (Items contaminated with bodyfluids including cotton, dressings, soiled plastercasts, lines, bedding and other materialscontaminated with blood.)Incineration@ / autoclaving /microwavingCategory No. 7Solid Waste (Waste generated from disposableitems other than the waste sharps such astubing, catheters, intravenous sets, etc.)Disinfecting by chemicaltreatment@@ / autoclaving /microwaving and mutilation /shredding# #Categories of Biomedical Waste Schedule asper WHO standards Cont….
  29. 29. 29Category No. 8Liquid Waste (Waste generated from thelaboratory and washing, cleaning, housekeeping and disinfecting activities)Disinfecting by chemicaltreatment@@ and dischargeinto drainsCategory No. 9Incineration Ash (Ash from incineration ofany biomedical waste)Disposal in municipal landfillCategory No.10Chemical Waste (Chemicals used inproduction of biologicals, chemicals usedin disinfecting, as insecticides, etc.)Chemical treatment @@ anddischarge into drains for liquidsand secured landfill for solids.Categories of Biomedical Waste Schedule asper WHO standards cont….
  30. 30. Color Coding For Segregation ofBMWCOLOR WASTE TREATMENTYellow Human & Animal anatomical waste /Micro-biology waste and soiledcotton/dressings/linen/beddings etc.Incineration / Deep burialRed Tubings, Catheters, IV sets. Autoclaving / Microwaving /Chemical treatmentBlue /WhiteWaste sharps( Needles, Syringes, Scalpels, bladesetc. )Autoclaving / Microwaving /Chemical treatment &Destruction / ShreddingBlack Discarded medicines/cytotoxic drugs,Incineration ash, Chemical waste.Disposal in secured landfill
  31. 31. 1. Survey of waste generated.2. Segregation of hospital waste.3. Collection & Categorization of waste.4. Storage of waste.( Not beyond 48 hrs. )5. Transportation of waste.6. Treatment of waste.
  32. 32. 5: Managing Medical Waste Slide 32Steps to Manage Hazardous Wastesbefore Disposal1. Know what hazardsyou have2. Purchase smallestquantity needed, anddon’t purchasehazardous materials ifsafe alternative exists**Use mercury-free thermometers
  33. 33. 5: Managing Medical Waste Slide 33Steps to Manage Hazardous Wastes(cont..)3. Limit use and accessto trained personswith personalprotective gear
  34. 34. 5: Managing Medical Waste Slide 344. Use Engineering Controls such as Ventilation,Hoods for Select Hazards
  35. 35. 5: Managing Medical Waste Slide 355. Get Rid of Unnecessary Stuff• Don’t accumulate unneeded products• Don’t let peroxides and oxidising agentsturn into bombsPhoto of bomb robot calledinto hospital to dispose ofpicric acid.
  36. 36. 5: Managing Medical Waste Slide 366. Label with Agent, Concentration andHazard Warnings• Examples of hazard labels:
  37. 37. 5: Managing Medical Waste Slide 377. Communicate about Workplace Hazards• Job description• Posters on doors• Labels on hazards• Give feedback on use of PPE anddisposal in evaluation• Role model safe use and disposal• Contact point who is responsible
  38. 38. 5: Managing Medical Waste Slide 388. Recycle Products When Possible
  39. 39. Source Reduction• Source Reduction - ways to lessen the amountof material– Segregation - keeping noninfectious waste out of theinfectious waste stream– Minimization - reduce or eliminate waste at thesource– Engineering controls - methods to reduce quantityof waste(smaller containers)
  40. 40. Conclusion• Thus refuse disposal cannot be solved without public education.• Individual participation is required.• Municipality and government should pay importance to disposalof waste economically.• Thus educating and motivating oneself first is important andthen preach others about it.•
  41. 41. Lets Make This World ABetter Place to Live in.THANK YOU

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