This about bio medical waste management for UG students

1. BIO-MEDICAL WASTE
MANAGEMNET

2. TERMINOLOGIES
• "Biological" means any preparation made from organisms or micro-
organisms or product of metabolism and biochemical reactions
intended for use in the diagnosis, immunization or the treatment of
human beings or animals or in research activities pertaining thereto

3. TERMINOLOGIES
• “Management” includes all steps required to ensure that bio- medical
waste is managed in such a manner as to protect health and
environment against any adverse effects due to handling of such waste

4. HEALTHCARE WASTE
Waste generated from the healthcare facility is classified as:
• Bio Medical Waste
• General Waste
• Other Wastes

5. GENERAL WASTE
• General waste consists of all the waste other than bio-
medical waste and which has not been in contact with
any hazardous or infectious, chemical or biological
secretions and does not includes any waste sharps.

6. GENERAL WASTE
This waste consists of mainly:
• (i) News paper, paper and card boxes (dry waste)
• (ii) Plastic water bottles (dry waste)
• (iii) Aluminum cans of soft drinks (dry waste)
• (iv) Packaging materials (dry waste)
• (v) Food Containers after emptying residual food (dry waste)
• (vi) Organic / Bio-degradable waste - mostly food waste (wet
waste)
• (vii) Construction and Demolition wastes

7. GENERAL WASTE
1. Dry wastes
2. Wet wastes and should be collected separately.
• Quantity of general waste is around 85 % to 90 %
of total waste generated from the facility.
• Such waste is required to be handled as per Solid
Waste Management Rules

8. OTHER WASTES
• It consist of used electronic wastes, used
batteries, and radio-active wastes which are not
covered under biomedical wastes but have to be
disposed as and when such wastes are
generated as per the provisions laid down
under E-Waste

9. INTRODUCTION
• BIO-MEDICAL WASTE :
• Waste generated in the diagnosis,
treatment or immunization of human
beings or animals, in research or in the
production or testing of biological
products.
• It also includes waste coming out of
medical treatment given at home.

10. INTRODUCTION
HAZARDOUS WASTE
• Any waste with a potential to pose a threat to human health &
life

11. SYMBOLS
• Labels shall be non washable
and prominently visible
• Written as HANDLE WITH
CARE

12. CLASSIFICATIONOF BMW

13. CLASSIFICATIONOF BMW
• NON-HAZARDOUS ( 80% )
• HAZARDOUS ( 20% )

14. HAZARDOUS (20%)
INFECTIOUS (15%)
• Non sharp
• Sharp
• Plastic Disposables
• Liquid Wastes
OTHER HAZARDOUS/
INJURIOUS (5% )
• Radioactive waste
• Broken Glass ware
• Pressurized Containers
• Chemical, cytotoxic wastes
• Incineration ash

15. OBJECTIVES OF HWM
• Keeping the waste secured & preventing the access to
unauthorized persons
• Initiate awareness campaigns about the potential hazard of medical
waste within the health care setup & community
• Decontaminate / disinfect the infectious component of the waste at
the site of generation

16. Objectives OF BMW
• To minimize the production/generation of infective waste.
• Recycle the waste after treating to the extent possible.
• Treat the waste by safe and environment friendly/acceptable
methods.
• Adequate care in handling to prevent healthcare- associated
infections.
• Safety precautions during handling the BMW

17. HealthHazards
• HIV/AIDS
• Hepatitis B and C
• Tuberculosis
• Diarrheal diseases
• Pneumonias
• Health Care Associated Infections

19. Sources of HealthCare Waste
MAJOR SOURCES
• Hospitals
• Primary health centers
• Nursing homes
• Medical research centers/Animal.R
• Mortuaries
• Autopsy Centers
• Blood banks and collection centers
• Laboratories
• Research organizations
• Vaccinating centers
MINOR SOURCES
• Physician's office/clinics
• Dentist's office/clinics
• Dispensaries
• Funeral Services
• Cosmetic Clinics
• Bio-technology institutions/production
• Slaughter houses

21. Classification of Health Care Waste
• 1. Infectious waste:- • Waste suspected to contain
pathogens. E.g. laboratory
cultures; waste from isolation
wards; tissues (swabs),
materials, or equipment's that
have been in contact with
infected patients .

22. Classification of Health Care Waste
• 2. Pathological waste:
• 3. Sharps/Sharp waste:
• Human tissues or fluids e.g.
body parts; blood and other
body fluids, fetuses.
• Needles, infusion sets,
scalpels, knives, blades,
broken glass etc.

23. Classification of Health Care Waste
• 4. Pharmaceutical waste:
• 5. Genotoxic waste:
• Waste containing
pharmaceuticals. E.g.
pharmaceuticals that are
expired or no longer needed,
items contaminated by or
containing Waste
• Waste containing substances
with genotoxic properties e.g.
waste containing cytostatic
drugs(often used in cancer
therapy), genotoxic chemicals

24. Classification of Health Care Waste
• 6. Chemical waste:
• Waste containing chemical
substances. e.g. laboratory
reagents, film developer,
disinfectants that are expired
or no longer needed, solvents.

25. Classification of Health Care Waste
• 7. Wastes with high content of
heavy metals:
• 8. Pressurized containers:
• E.g. Batteries, broken
thermometers, blood-pressure
gauges etc.
• Eg Gas cylinders, gas cartridges,
aerosol cans.

26. Classification of Health Care Waste
• 9. Radioactive waste:
• Waste containing radioactive
substances E.g. unused liquids
from radiotherapy or laboratory
research, contaminated
glassware and packages

27. RULES FOR BMW
• Government of India, first enacted an environment (Protection) act in 1986
notified the rules for the management & handling of bio-medical waste in July,
1998
• As per these rules it is duty of occupier of hospital, Nursing home, clinic,
dispensary, Veterinary institute, animal house, blood bank & pathological
laboratory to take all steps to ensure that BMW is handled without adverse
effect to human health & environment

28. Bio-Medical Waste Management Rules
• BMW is not to be mixed with other wastes
• BMW should be segregated in specified
Container / bag at the site of generation
• Each container has to be specifically labeled
• Transportation of such waste has to be done in
specified vehicle only

29. Bio-Medical Waste Management Rules
• Bio-medical waste classified in to 4 categories based on treatment options
• Untreated BMW is not to be stored beyond a period of 48 hours.
• In case for any reason it becomes necessary to store such waste beyond such a period,
the occupier shall take appropriate measures to ensure that the waste does not
adversely affect human health and the environment and inform the SPCB along with the
reasons.

30. Bio-Medical Waste Management Rules
• Immunize with Hepatitis B and Tetanus
• Vaccination to be certified & Documented
• Personal Protective Equipment
• All plastic bags shall be as per BIS standards
(Bureau of Indian Standards).

31. Bio-Medical Waste Management Rules
• No occupier shall establish on-site treatment and disposal facility, if
a service of ` common BMW treatment facility is available at a
distance of 75 km.
• If facility is not available, the Occupiers shall set up requisite bio
medical waste treatment equipment like incinerator, autoclave or
microwave, shredder prior to commencement of its operation, as
per the authorization given by the prescribed authority.

32. Bio-Medical Waste Management Rules
• Pre-treatment of the laboratory waste, microbiological waste, blood
samples and blood bags through disinfection or sterilization on-site in the
manner as prescribed by WHO or NACO;
• Health care facilities (HCF) shall make a provision within the
premises for a safe, ventilated and secured location for
storage of segregated biomedical waste

33. Bio-Medical Waste Management Rules
• Provide training to all its health care workers and others
involved in handling of bio medical waste at the time of
induction and thereafter at least once every year
• Establish a bar-code system for bags or containers containing
bio-medical waste to be sent out of the premises
• Report major accidents including accidents caused by fire
hazards, blasts during handling of bio-medical waste and the
remedial action taken to SPCB

34. Bio-Medical Waste Management Rules
• Disposal by deep burial is permitted only in rural or remote areas
where there is no access to common biomedical waste treatment
facility.
• This will be carried out with prior approval from the prescribed
authority
• The deep burial facility shall be located as per the provisions and
guidelines issued by Central Pollution Control Board from time to

35. Categories of Biomedical Waste
• 1. Yellow Category
• 2. Red Category
• 3. White Category
• 4. Blue Category

36. Categories of Biomedical Waste
CATEGORY
YELLOW
TYPE OF WASTE
• A)Human Anatomical Waste:
• Human tissues, organs, body parts and
fetus below the viability period
• B)Animal Anatomical Waste:
• The waste generated from animals used
in experiments or testing in veterinary
hospitals or colleges or animal houses.

37. Categories of Biomedical Waste
CATEGORY
YELLOW
TYPE OF WASTE
• C)Soiled Waste :Items contaminated with blood, body
fluids like dressings, plaster casts, cotton swabs and
bags containing residual or discarded blood and blood
components.
• D)Pharmaceutical waste: Discarded or Expired
Medicine like antibiotics, cytotoxic drugs including all
items contaminated with cytotoxic drugs along with
glass or plastic ampoules, vials etc.

38. Categories of Biomedical Waste
CATEGORY
YELLOW
TYPE OF WASTE
• E)Chemical Waste: Chemicals
used in production of biological
and used or discarded
disinfectants
• F)Discarded linen, mattresses,
beddings contaminated with
blood or body fluid, routine
mask & gown.

39. Categories of Biomedical Waste
CATEGORY
YELLOW
TYPE OF WASTE
• G)Microbiology, Biotechnology and
other clinical laboratory waste (Pre-
treated):
• Blood bags, Laboratory cultures, stocks or
specimens of microorganisms, live or
attenuated vaccines, human and animal
cell cultures used in research, industrial
laboratories, production of biological,
residual toxins, dishes and devices used for
cultures

40. Categories of Biomedical Waste
CATEGORY
YELLOW
TYPE OF WASTE
• H)Chemical Liquid Waste:
• Liquid waste generated due to use of
chemicals in production of biological
and used or discarded disinfectants,
Silver X - ray film developing liquid,
discarded Formalin, infected
secretions, aspirated body fluids ,
liquid from laboratories an d floor
washings, cleaning, house

41. Categories of Biomedical Waste
CATEGORY
RED
TYPE OF WASTE
• Wastes generated from disposable
items such as tubing, bottles,
intravenous tubes and sets,
catheters, urine bags, syringes
without needles, fixed needle
syringes with their needles cut,
vacutainers and gloves

42. Categories of Biomedical Waste
CATEGORY
WHITE
TYPE OF WASTE
• Waste Sharps including metals:
Needles, syringes with fixed needles,
needles from needle tip cutter or
burner, scalpels, blades, or any other
contaminated sharp object that may
cause puncture and cuts. This includes
both used, discarded and contaminated
metal sharps

43. Categories of Biomedical Waste
CATEGORY
BLUE
TYPE OF WASTE
• Broken or discarded and
contaminated glass including
medicine vials and ampoules
except those contaminated with
cytotoxic wastes. B

48. Bio Medical Waste Collection
Time of Collection
• Collected on daily basis from each ward of the hospital at a fixed
interval of time.
• Multiple collections from wards during the day.
• Collection times should be fixed.
• General waste should not be collected at the same time or in the same
trolley in which bio-medical waste is collected.

49. PACKAGING
• Bags should be filled to no more than three quarters full.
• Once this level is reached ---sealed ready for collection.
• Plastic bags should never be stapled but may be tied or sealed with a plastic tag or
tie.
• Colour coded waste bags and containers should be printed with the bio-hazard
symbol, labelled with details such as date, type of waste, waste quantity, senders
name and receivers details as well as bar coded label to allow them to be tracked till
final disposal.
• Ensure that Bar coded stickers are pasted on each bag

50. INTERIM STORAGE
• Interim storage of bio medical waste is discouraged in the wards
/patient care area and procedures areas such as Operation Theatre.
• If waste is needed to be stored on interim basis in the departments it
must be stored in the dirty utility/sections.
• In absence of dirty utilities/ sections ----must be stored in designated
place away from patient and visitor traffic or low traffic area.
•

51. Common Storage Area
• Safe ventilated, secure location
• No secondary handling
• No scattering or spillage by animals
• Impermeable layers
• Easy washable
• Defined road
• Colour painting to each category

52. In House Transportation of Bio Medical Waste
• Must be done in closed trolleys /
containers preferably fitted with wheels
for easy maneuverability.
• Avoid spillage and scattering of waste

53. TREATMENT
TYPE OF WASTE
Human/Animal
Anatomical Waste
TREATMENT
• No treatment of waste is required to be carried out at the health care facility
except pre-treatment (sterilization) of Yellow (h) category waste by autoclaving/
microwaving/ hydro-claving
• Yellow category waste along with pre-treated waste should be stored in central
storage point and must be handed over to CBWTF.
• It is mandatory for each health care facility that dead fetus waste should be
handed over to CBWTF in yellow bag
• Along with a copy of the official Medical Termination of Pregnancy (MTP)
certificate from the Obstetrician or the Medical Superintendent/ SMO/ CMO of
the HCF.

54. TREATMENT
SOLID WASTE
• No treatment of waste is required to be
carried out at the health care facility.
Waste must be handed over to CBWTF
• Soiled waste should be disposed through
Plasma Pyrolysis unit or in incinerator
• Deep Burial

55. TREATMENT
(d) Expired and Discarded
Medicine
• All the expired and discarded
medicines including cytotoxic
drugs expired `cytotoxic drugs
are either returned back to the
manufacturer or are handed over
to the CBWTF to be disposed of
through incineration at
temperature > 1200oC.

56. TREATMENT
(e) Chemical liquid Waste
• Empty chemical containers with
residual chemicals should be
collected in yellow bags and
handover to CBWTF operator
for final disposal by incineration.

57. • (g) Discarded Linen, Mattresses,
beddings contaminated with
Blood, body fluids, routine mask
and gown.
• The waste mattresses should be
cut into pieces and chemically
disinfected and can be sent to
the CBWTF operator for final
disposal by incineration.

58. • (h) Microbiology, Biotechnology
and Other Clinical Laboratory
Waste
• Pre-treatment by disinfection
before handing over the waste to
CBWTF operator..
• Pre-treatment can be done by
using non-chlorinated chemical
disinfectants like aldehydes,
lime based powders or solutions,
ozone gas, ammonium salts and
phenolic compounds.
• Pretreatment can also be done
by autoclave / microwave

59. RED CATEGORY
• No onsite treatment of Red
category waste is required.
• All such waste is needed to be
sent to CBWTF for final
treatment and disposal

60. RED CATEGORY
HCF having own treatment and
Disposal facility
• All the recyclable waste must be
sterilized using autoclaving
/microwaving followed by
shredding or combination of
sterilization and shredding.

61. White Category
After collection in puncture proof,
leak proof, tamper proof container,
handover the waste to CBWTF
without any alteration or onsite
treatment.

62. Blue Category
• Dispose of the empty glass
bottles by handing over to
CBWTF without any onsite
treatment.
• The residual chemicals in glass
bottle should be collected as
chemical waste in yellow colored
container / bags and over to
CBWTF as yellow(e) waste.

64. BLOOD SPILLS
1.Ensure that the gloves are used before Handling.
2.Cover the spill with absorbent cotton or cloth.
3.Discard this cloth in to the yellow bin.
4.Disinfect the surface with 1% Sodium Hypochlorite Solution / 5 % Phenol
for 30 minutes.

65. BLOOD SPILLS
1.Cover the disinfectant area with absorbent cotton or cloth.
2.Discard this cloth in to the yellow bin
3.Any broken glass that may be contaminated should be removed by
mechanical means such as tongs, forceps, or brush and dustpan, rather
than with the hands and placed in a Sharps container for disposal.
4.Finally, use the normal mop.

66. MERCURY SPILLS
1.Open all the windows immediately.
2.All the heaters and air conditioners should be switched off.
3.Vaccum cleaner and Broom should not be used
4.Remove all the jewels and watches.
5.Ensure that the gloves, safety goggles, N 95 mask are fitted on,
before handling.

67. MERCURY SPILLS
1.Spilled mercury should be collected with the cardboard and sucked
with the syringes or use mercury spill kit.
2.Empty the syringes with mercury in a container with water.
3.It should be labelled as mercury waste and stored in a Separate
place in Stores.
4.All the mercury spill surfaces should be decontaminated with 10 %
sodium-thiosulfate solution / 20% calcium sulphide

68. MERCURY SPILLS
• The equipment used for mercury collection like cardboard, dropper,
adhesive tape, e etc. must be disposed separately. (for chemical waste).
• Seal the trash bag with tape and label as “mercury waste”.
• Wash your hands, face, and any other areas of your body exposed to
the mercury.
• Keep the room well ventilated.
• Method of final disposal of mercury: The mercury shall be disposed
off by handing over to the appropriate agency

69. Monitoring and Record Maintenance for
Bio Medical Waste
• 1. Register for Daily Collection at Source
• 2. Register for source wise collection for the day
• 3. Monthly consolidated Register
• 4. Register for needle stick injuries

70. HOW TO MINIMIZE HOSPITAL WASTE?
1. As far as possible purchase reusable Items made of glass and metal
2. Select non-PVC plastics
3. Strengthen sterilization procedures
4. Adopt procedures & policy for BMW segregation