This PowerPoint presentation is about recently updated guidelines for hospital waste management

1. HOSPITAL WASTE
MANAGEMENT
Dr. Nishant Kumar.

2. Introduction
 Biomedical Waste : It is any waste , which is generated during the
diagnosis ,treatment, or immunization of human- beings or animals or in
research activities pertaining thereto or in the production or in testing of
biologicals.
 Type of hospital waste :
a) General Waste : Constitute 75% to 90% , from administrative and
house keeping functions . This is ‘non risk’ waste.
b) Hazardous waste : Constitute 10-25% and may create variety of
health risk.

3. Source of Health Care Waste
 Government hospital
 Private Hospital
 Nursing Homes
 Physician office
 Dentists offices
 Dispensaries
 Medical research facility
 Primary health centers
 Mortuaries
 Blood banks
 Animal houses
 Slaughter houses

4. Composition of Hospital Waste
80%
15%
3% 1%
Less
than 1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
General waste Pathological & Infectious
Waste
Chemical and Pharmacological
Waste
Sharp Waste Cytotoxic Waste, radioactive
waste, broken thermometer
TYPE OF WASTE
Percentage

5. Health Hazards
Infectious Waste Infection with HIV, Hepatitis B, C.
Infection with bacteria resistant to
antibiotics
Chemical and Pharmaceutical Waste Intoxication ( Acute or Chronic),
Burns
Genotypic Waste Exposure occurs through inhalation
of dust or aerosol , absorption
through skin ,ingestion and
contamination
Radioactive waste Headache, Dizziness and Vomiting
Public sensitivity

6. Treatment and Disposal technologies for
health care waste
Incineration
Chemical
Disinfections
Wet and Dry
Thermal Treatment
Microwave
Irradiation
Land disposal

7. Incineration
 It is a high temperature dry oxidation process, that reduces organic and
combustible waste to inorganic incombustible matter and results in
significant reduction of waste volume and weight.
 It require no pretreatment , provided that certain waste type is not included
.
 Characteristic of waste that is suited for incineration are
 Low heating volume –above 2000 kcal/kg for single chamber
incinerators and above 3500 kcal/Kg for pyrolytic double chamber
incinerators.
 Content with combustible matter more than 60%.
 Content with non combustible matter below 5%.
 Content of non combustible solids below 5%
 Contents of non –combustible fines below 20%
 Contents of moisture below 30%.

8. Incineration (contd.)
 Not to be incinerated
– Pressurized gas containers.
– Large amount of reactive and chemical waste.
– Silver salts and photographic or radiographic wastes.
– Halogenated plastics , such as broken thermometers used batteries and
lead lined wooden panels .
– Sealed ampules or ampules containing heavy metals.

9. Incineration (contd.)
 Types of incinerators
 Double – chamber pyrolytic incinerators –it burns infectious
health care waste.
 Single chamber furnaces with static grates which should be
used only if pyrolytic incinerators are not affordable
 Rotary kilns operating at high temperature capable of
causing decomposition of genotoxic substance and heat
resistant chemicals

10. Chemical Disinfections
 Chemical are added to kill or inactivate the pathogen .
 This method is suited for liquid waste such as blood , urine ,
stools or hospital sewage.
 Solid waste including microbiological cultures , sharps , etc.
may be disinfected chemically with limitations.

11. Wet and Dry thermal treatment
 Wet Thermal Treatment or Steam disinfection : It is based on exposure of
shredded infectious waste to high temperature , high pressure steam and is
similar to the autoclave sterilization process. This process is inappropriate for the
treatment of anatomical waste and animal carcasses, and will not efficiently treat
chemical and pharmaceutical waste.
 Screw feed Technology : It is the basis of a non burn , dry thermal disinfection
process in which waste is shredded and heated in a rotating auger. The waste is
reduced by 80% in volume and by 20 -35% in weight . This process is suitable
for treating infectious waste and sharps , but it should not be used to process
pathological , cytotoxic or radioactive waste.

12. Microwave irradiation
 It destroys most of the organism by action of microwave
frequency of about 2450Mhz and a wavelength of 12.24nm .
The water is rapidly heated by microwave and the infectious
components are destroyed by heat conduction. The efficiency
of the microwave disinfection should be checked routinely
through bacteriological and virological testing.

13. Land Disposal
 They are two type of land disposal
 Open dumps: Not the preferred method of disposal of medical
waste .It poses great risk to people and animal in contact.
 Sanitary Land fills:
 Advantages over open dumps are
 Geological Isolation of waste from environment
 Appropriate engineering preparation before sire is ready to
accept waste
 Staff present on the site to control operations
 Organized deposit and daily coverage of waste

14. Inertization
 It involves mixing waste with cements and other substances
before disposal in order to minimize the risk of toxic substance
contained in the wastes migrating to the surface water or
ground water.
 A typical proportion is 65% pharmaceutical waste , 15% lime ,
15% cement and 5 % water . A homogenous mass is formed
and cubes or pellets are produced on site and then transported
to suitable storage sites.

15. Advantages and Disadvantages
Type of Disposal Advantages Disadvantages
Rotary Kilin Adequate for all infectious waste
, most chemical waste and
pharmaceutical waste
High investment and
operating cost
Pyrolytic incinerators Very high disinfection efficiency.
Adequate for all infections waste
and most pharmaceutical and
chemical waste
Incomplete destruction of
cytotoxic . Relative high
investment and operating
cost
Drum or brick
incinerator
Drastic reduction of weight and
volume
Destroys only 99% of
microorganism . No
destruction of many
chemicals and
pharmaceuticals.

16. Advantage and Disadvantages
Type of Disposal Advantages Disadvantages
Chemical Disinfection Highly efficient disinfection
under good operating
conditions
Requires highly qualified
technician's for operation of
the process
Wet thermal Treatment Environmentally sound Shredders are subject to
frequent breakdown and
poor functioning
Microwave irradiation Good disinfection efficiency
under appropriate
conditions
Relatively high investment
and operating cost
Encapsulation Simple, Low cost and safe No recommended for sharps
Inertization Relative inexpensive Not applicable to infectious
waste
Safe burring Inexpensive Safe only if access to site is
limited

17. Bio Medical Waste Management in India
 Bio medical Waste ( management and handling) Rule 1998 , prescribed by
Ministry of Environment and Forests , Government of India came into
force on 26th July 1998.
 The Rule applies to those who generate , collect , receive , store or handle
bio medical waste in any manner.
 This Act is now superceded by the Bio- Medical Waste management rule
2016, which came into force from 28th March 2016.

18. Biomedical Waste, categories and their segregation
, collection , treatment , processing and disposal
options
Category Type of Waste Type of bag or
Container to be
Used
Treatment and Disposal Options
Yellow
Human anatomical waste
Yellow colored
non –chlorinated
bags
Incineration or plasma pyrolysis
or deep burial*
Animal anatomical waste
Soiled waste – items contaminated
with blood , body fluids like
dressing , plaster casts , cotton
swabs, and bags containing
residual or discarded blood and
blood component's
Same as above, if absent then
autoclaving or microwaving ,
hydroclaving followed by
shredding or mutilation or
combination of sterilization and
shredding . Treated waste to be
send for energy recovery.

19. Category Type of Waste Type of bag or
Container to be Used
Treatment and Disposal
Options
Yellow
Expired or discarded medicines
including all items contaminated
with cytotoxic drugs along with
glass or plastic ampoules vials
Yellow colored non –
chlorinated bags and
containers
a) To be returns back to the
manufactures ,or
b) Suppliers for incineration
at temperature >1200 C or
c) To a common biomedical
waste treatment facility or
d) Hazardous waste
treatment , storage and
disposal facility for
incineration at 1200C or
e) Encapsulation or Plasma
pyrolysis at >1200C
Biomedical Waste, categories and their segregation
, collection , treatment , processing and disposal
options

20. Category Type of Waste Type of bag or
Container to be Used
Treatment and Disposal
Options
Yellow
Chemical Waste- chemical used
in production of biological and
used or discarded disinfectants
Yellow colored
containers or non
chlorinated plastic bags
Disposal by
incineration or plasma
pyrolysis or
Encapsulation in
hazardous waste
treatment , storage and
disposal
Chemical Liquid Waste-Silver X
rays film development liquids,
discarded formalin, infected
secretions , aspirated body fluids
, floor washing cleaning house
keeping activities
Separate collection
system leading to
effluent treatment
plants
After resource recovery
, the chemical liquid
waste shall be pre
treated with other waste
water .
Biomedical Waste, categories and their segregation
, collection , treatment , processing and disposal
options

21. Category Type of Waste Type of bag or
Container to be Used
Treatment and Disposal
Options
Yellow
Discarded Linen ,
mattresses, beddings ,
contaminated with blood
or body fluids
Non –chlorinated
yellow plastic bags
or suitable
materials
Non – Chlorinated
chemical disinfection
followed by incineration or
plasma pyrolysis or for
energy recovery or
shredding or mutilation or
combination of sterilization
and shredding .
Microbiology ,
biotechnology and other
laboratory waste
Autoclave safe
plastic bags or
containers
Pretreatment with non –
chlorinated chemical on
sites followed by
incineration
Biomedical Waste, categories and their segregation
, collection , treatment , processing and disposal
options

22. Category Type of Waste Type of bag or
Container to
be Used
Treatment and Disposal Options
Red
Contaminated waste (Recyclable)-
Waste generated from disposable
items such as tubing's bottles , IV
tubes , sets catheters , urine bags
,syringes (without needles and fixed
needle syringes)and vacutainers with
needles cuts and gloves
Red Colored
non
chlorinated
plastic bags or
containers
Autoclaving or microwaving
/hyrdoclaving followed by
shredding or mutilation or
combination of sterilization and
shredding Treated waste to send
to recyclers or for energy
recovery or plastics to diesel or
fuel oil or for roadmaking .
Plastic waste should not be send
for landfill sites
Biomedical Waste, categories and their segregation ,
collection , treatment , processing and disposal options

23. Category Type of Waste Type of bag or Container
to be Used
Treatment and Disposal
Options
White
Waste sharps
including metals
Puncture proof , leak
proof , tamper proof
containers
Autoclaving or dry heat
sterilization followed by
shredding or mutilation or
encapsulation in metal
containers or cement
concrete or combination
of shredding cum
autoclaving and send for
final disposal in iron
foundaries
Biomedical Waste, categories and their segregation ,
collection , treatment , processing and disposal options

24. Category Type of Waste Type of bag or Container to be
Used
Treatment and Disposal Options
Blue
Glass ware Cardboard boxes with blue
color marking
Disinfection ( by soaking the
washed glass waste after
cleaning with detergent and
sodium hypochlorite treatment )
or through autoclaving or
microwaving or hyrdoclaving
and then send for recycling
Metallic body
implants
Cardboard boxes with blue
colored marking
Biomedical Waste, categories and their segregation ,
collection , treatment , processing and disposal options

25. THANK YOU