1. HOSPITAL WASTE MANAGEMENT
Introduction :
Introduction Biomedical waste - is defined as the waste generated during the diagnosis, treatment or
immunization of human beings or animals or in research activities pertaining there to or in the production of
testing biologicals. Biomedical waste is generated in different departments of the hospital. In health care settings,
about 85% of the waste generated is non hazardous, about 10% is infectious and 5% non infectious but
hazardous waste.
Classification of Hospital waste :
Classification of Hospital waste Non hazardous waste kitchen waste, office waste, wrapping papers and
bouquets, etc. Kitchen waste - left over food , swill , peels and dirty water. Bio-degradabale waste – peels of fruits
and vegetable skin and left over food and other natural kitchen wastes. Non bio-degradable waste - wrappings
foils plastic bags etc. Hazardous wastes potentially infectious waste A. Dressings and swabs contaminated with
blood, pus and body fluids, B. laboratory wastes including laboratory samples, cultures stocks of infectious
agents , laboratory glass ware. C. Instruments used in patient care: these range from diagnostic equipment such
as endoscopes , ultrasound probes , syringes and needles , sharps and other instruments.
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D. Potentially infectious materials , placenta , tissues, tumors ,organs or limbs which are removed during surgery.
E. potentially infected animals used in diagnostic or research studies F. pathological waste- human tissues,
organs, body parts removed during surgery or autopsy or medical procedures and specimens of body fluids.
Potentially toxic waste A. Radioactive – these may be solid , liquids and gases used for analytical procedures,
body organ imaging and tumor localization and treatment. B. Chemical waste - they may be hazardous toxic ,
corrosive, inflammable ,reactive or genotoxic .they require safe disposal which will ensure that human or
environmental problems do not arise during storage, transport, and final disposal. C. Pharamaceutical waste:
surplus stock , spillage , or contamination is detected or expiry date is over.
Laboratory waste material :
Laboratory waste material Sample collection- syringe needle, cotton swabs, lancet Blood bank-
lancet,hypodermic collection needles, plastic tubing , pvc blood bags,slides,guaze pieces , plastic tubes.
Biochemistry- test tubes , glass bottles, plastic tips, autoanalyzer cups ,plastic bottles, chemicals,blood.
Haematology-syringe needles,slides,HB tubes, capillaries,lancet,ESR tubes,chemicals,immersion oil,blood,stains
Bacteriology-syringe and needle,test tubes,glass bottles,saline bottles,plastic bottles,testing
containers,slides,infectious samples,bacteriological medium with growth,culture plates, blood,immersion oil,stains
Serology-syringe and needles,blood,serum,tips,ELISA plate,reagents, Clinical pathology-urine and stool
containers,reagents,slides, filter paper,paper strips,stick wooden,chemical reagents. Histopathology-Human
tissues,organs,formalin,guaze,cotton,chemicals,stains
Categories of Persons exposed to risk of infection :
Categories of Persons exposed to risk of infection Other 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 clearing the instruments , floor surfaces and washing of glass wares and linen. If potentially waste
gets mixed with solid waste from other activities , the entire chain of workers /persons involved in solid disposal.
Health hazards associated with poor hospital waste management :
Health hazards associated with poor hospital waste management A. Injuries from sharps to all categories of
hospital personnel (HIV and HBV). B. Nosocomial infection in patient from poor infection control and poor hospital
waste management C. Risk of infectious outside hospitals for waste handlers , scavengers and eventually the
general public. D. Risks associated with hazardous chemicals , drugs being handled by persons handling wastes
at all levels and E. Disposable – recycled – repacked and sold may be non noticeable . Routes of transmission of
infection from potentially infectious wastes 1.through non – intact skin (preexisting cuts, raw areas) or by cuts and
puncture of the intact skin. 2.Through mucous membranes such as splashing into eyes 3.Inhalation of dust
particles containing germs. 4.By ingestion - through contaminated unwashed hands , contaminated water and
foodstuff. Precaution All the health workers employed in / outside the hospital must be vaccinated against
Hepatitis B All the health care workers put on heavy duty gloves while dealing with infectious waste specially
sharps Sharps should not be left casually on counter tops , food trays or beds as grievous injuries can result
Recapping needles should discouraged .In situation when recapping is unavoidable , the single handed method
be utilized
Primary steps to effective health care waste management :
Primary steps to effective health care waste management Evaluate the present scenario this entails preaudit and
auditing of hospital wastes. Preparation of job charts for hospital waste management. Asses all cost associated
with waste management Define management policies for waste management Train the trainees and employers
Evaluate technical procedures , costs and policies yearly Steps in waste management – waste survey, waste

2. minimization, waste segregation and safe storage and waste treatment and waste handling , waste
transportation, waste disposal.
Waste survey :
Waste survey Waste survey is an important component of the waste management scheme. A survey helps in
evaluating both the type and quantity of waste generated in the hospital AIMS: Differentiate the types of waste
Quantify the waste generated. Determine the points of generation and type of waste generated at each point
Determine the level of generation and disinfection within the hospital. To find out the type of disposal carried out.
SCSM GHS Dr.V.M.M.C. SOLAPURWASTE DISPOSAL SURVEILLANCE :
SCSM GHS Dr.V.M.M.C. SOLAPURWASTE DISPOSAL SURVEILLANCE
Data regarding waste surveillance In our civil hospital :
Data regarding waste surveillance In our civil hospital Generated in your hospital daily :- Total Wt. 75-80 Kg
Maxium soiled waste and sharps produced are in Gyn , Surgery and Medicine wards Many wards do not have
colour coded bags and container(TB and IDH) (Ortho surgery and paed- no container)Those wards which have
such bags and containers but the fact is that the whole waste is thrown into in a big cardboard box
(Sharps+soiled waste+plastics ) and then it is filled in colour bags and transported Only in few wards the sharps
are separated from syringes and the syringes are disinfected with .Na hypochlorite solution before disposal Most
of the wards have needle destroyer but their use is questionable Some say our work load is too much and so it is
not possible to use it(Surgery) it makes irritating noise, Some wards don’t have a needle
destroyer(IDH,TBW,Ortho,Med, CS, ANC,Inj room-OPD) Only in some ward (LR) the sharps are seen to be
separated in separate container through our ward staff say that is done so All the departments agree that the
infectious waste is separated from noninfectious waste but we can see that the whole waste but we can see that
the whole waste is thrown in the same cardboard box There is confusion among staff regarding use of needle
destroyer.
Categories of Biomedical wastes :
Categories of Biomedical wastes
Segregation :
Segregation Biomedical waste should be segregated into bags / containers prior to storage /transport for disposal
and be labeled and carry necessary information as per recommended rules If the infectious waste is mixed with
the entire waste it will be treated as infectious waste. Thus , by segregation a hospital can Reduce total treatment
cost Reduce the impacts of the waste on the community and Reduce the chances of infecting health care
workers
Handling and treating waste material :
Handling and treating waste material Bins with lids lined with polythene bags or inner chamber for bucket should
be used The bins and bags should also be labeled with the biohazard symbol and if required , for the types of
waste they have to be used for. Personnel involved in infectious waste handling should be provided suitable
protective wear and should be properly trained Polythene bags placed in the bins have to be changed with each
shift or when they are ¾ full. Untreated biomedical waste should not be kept stored beyond a period of 48 hrs. In
case of if it becomes necessary to store the biomedical waste to store it beyond a period permission of authority
and must ensure that the waste does not affect human health and environment. Polythene bags carrying waste
have to sealed /tied at the top whenever the waste is being transported within or outside the hospital Infectious
wastes from wards, ICU , OT, OPD and the labs should have a common specific bin allotted for them at the final
point of disposal . This bin should be covered and protected from the public at all times
Chemicals used for disinfection :
Chemicals used for disinfection 1Phenol and related compounds A. crude phenol-in 5%strenth used for mopping
floors and cleaning drains Cresol – 3 to 10 times as powerful as phenol 5 to10% used for disinfection of urine and
faeces Cresol emulsion- cresol and soap eg.lyzol,izol,2% solution of lysol for disinfection of urine or faeces
Chlorhexidine- most useful skin antiseptics.0.5% alcoholic or aqueous solution used as handlotions.cream with
lotions containing 1% recommended for burns. Dettol- 5% used for disinfection of instruments and plastic
equipment contact of at least 15 min.required. 2.Quarternary ammonium compounds A.Cetrimide – cetavolon
used in 1-2% strength b. Savlon- clinical thermometers plastic appliances etc.can be disinfected in savlon in 1 in
6 in spirit Halogens and their compounds A.bleaching powder: 5 % solution suitable for a period of 1 hour Sodium
hypochlorite – 5 % sodium hypochlorite solution use for decontaminating Alcohol- 70% used as skin antiseptic
Formaldehyde gas used for disinfection of rooms.
Needle and syringes :
Needle and syringes Destroy the Needle and separate sharps in plastic box provided and send to pharmacy
stores.
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3. Destroy the syringe hub and collect in separate blue box & send it along with sharps like scalpel blade to
pharmacy store
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Infectious material like biopsy material, organs, blood soiled cotton swabs, tampons and gauze pieces collect in
red bags. Send to Incinerator.
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Plastic IV canulas, catheter etc. ( after burning the needle) are to be mutilated & collected in blue box then send
to pharmacy store& needle to be collected along with sharps.
Liquid waste :
Liquid waste Liquid waste- hospital generates liquid waste – infectious or chemical. to avoid the exposure to the
general public it is necessary that the waste be properly treated. The liquid pathological waste should be treated
with a chemical disinfectant. The solution should be treated with a reagent to neutralize it .This can be flushed
into the sewer system For blood , serum sample and body fluids of laboratory should be collected in red bags
from penicillin bulbs and send it to incinerator. Put empty penicillin bulbs in the sodium hypochlorite solution
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Non biodegradable waste can be disposed off in a municipal bins Non infectious waste material like paper, food
waste, drug cartoons to be collected in black bag and send for Municipal collection.
Non hazardous waste :
Non hazardous waste Disposal of biodegradable waste Kitchen waste can be utilized in different ways according
to the quantity of waste . In large hospitals technologies like biodegradation can be installed . In smaller
establishments , kitchen waste can be composed Kitchen waste or ward waste is collected in green colored
container and put in bio culture pit. The biodegradable waste is comparatively easy to handle. It should be
disposed after its biodegradation which can be accomplished by bio digestion (using bacteria or earthworms or
by pit . After complete decomposition it can be used as biofertilizer.)
Transport :
Transport On site transportation segregated wastes have to be transported within the facility from the point of
generation to the final waste disposal site. All bags should be fastened and small trolleys can be used in large
facilities .Trolleys and carts should be large enough so that the waste is not piled up on them in an unsafe way.
They should be stable to minimize the risk of propping over hazardous waste and even after decontamination
should never be transported with general municipal wastes. Biomedical waste should be collected and deposited
with sanitary inspector upto 11.30 a.m. and send to the incinerator. Waste from surgery wards and hospital wards
should be collected and send to the incinerator by 11.30 a.m. The biomedical waste shall be transported only in
vehicles which may be authorized
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Do not burn any waste in the hospital premises. Keep the Hospital premises clean.
This is the beginning of health :
This is the beginning of health THANK YOU