BIOMEDICAL WASTE MANAGEMENT IN
VIROLOGY

MODERATOR
DR. MINI P. SINGH

SPEAKER
MANMOHAN MISHRA
Msc. Virology
08-01-2014
Biomedical Waste Management in
news
Definition
"Health care waste" – The waste generated
as a result of
• Diagnosis, treatment, or immunization of human

bein...
Areas where wastes generated in our
department


Tissue culture lab




Routine diagnostic lab
Genomics lab
Hepatitis l...
Laboratory Waste material
Syringe, needles, blood, serum,
Tips, Elisa plate, Reagents,
Lancets, slides, gauze pieces,
Plas...
HAZARDS

•

Laboratory Staff
HAZARD FROM SHARPS
WHO in 2000
Injections with contaminated syringes caused

• 21 million HBV- 32% of all new infections
•...
Quantity of waste generated in PGIMER Chandigarh
Total waste – 804.25 Kg/day
Type of waste

Kg/day

Human Anatomical Waste...
Classification of BMW
BMW
Potential toxic waste:
A) Radioactive: solid,
A)Dressings &infectious
D) contaminateSwabs
Potent...
Biomedical waste management rule, 1998
Schedule I
Categories of biomedical waste:
a. No chemical pretreatment before incin...
Categories of BMW
CATEGORY

TYPE OF WASTE

TREATMENT &
DISPOSAL

Category 1

Human anatomical wastes

Incineration/ deep
b...
CATEGORY

TYPE OF WASTE

TREATMENT &
DISPOSAL

Category 6

Soiled wastes
Items contaminated with blood,
body fluids includ...
Segregation
•Basic separation of different categories of waste generated at
source and thereby reducing the risks as well ...
Plastic bag
Non chlorinated
“For incineration
only”
Plastic bag
“For autoclaving
only”
Puncture proof
“For sharps only”
Schedule II
Color coding & type of container for disposal of biomedical waste
Color coding shall be selected depending on treatment option
chosen, as in Schedule 1
Waste collection bags for incinera...
Schedule III
Different labels for bio-medical waste containers
and bags shall be required for identification and safe hand...
Schedule IV
Label for transport of bio-medical
waste containers /bags
Schedule V
Standards for treatment and disposal of
Bio-medical wastes
Schedule VI

Schedule for waste treatment facilities like incinerator/
autoclave / microwave system
BIOMEDICAL WASTE HANDLING
•Segregation
•Collection
•Storage
•Transportation
Collection
•Sanitation staff to collect waste during morning and
afternoon (at least daily)
•Supervision by staff nurse & ...
Collectors must wear
protective materials
Content of container
should not exceed three
quarter of its capacity
Tie neck ti...
•Collection of sharp medical waste under maximum
precaution
•If there is spillage of waste from container
(Accidental/Dama...
Storage


Holding of biomedical waste for a certain period of
time, then sent for treatment & disposal
Stored in areas of generation for a
period varying from 2 to 12 hrs
Central storage located within
establishment
Area mark...
On site transport (intramural/internal)
Transport within establishment
Wheeled trolleys, containers or carts

300-500 litr...
Radio Frequency Identification
(RFID) tags for monitoring trolley
movement
Easy to load & unload
No sharp edges (prevents ...
Routing

Quickest or shortest possible route
Route laid out from farthest point of transfer station & as
collection progre...
Off site transport(extramural/ external)
Closed motor vehicle (truck,
tractor-trolley)
Vehicle used only for transport of
...
STANDARDS FOR TREATMENT & DISPOSAL OF BIO-MEDICAL
WASTES

Incinerator

Autoclave
Liquid waste
Microwaving
Deep Burial
All incinerators shall meet the following operating and
emission standards

•Operating Standards
•Combustion efficiency (C...
•Emission Standards

S.
Parameters
No.

Concentration
mg/Nm3 at
(12% CO2
correction)

1.

Particulate matter

150

2.

Nit...
•Suitably designed pollution control devices
•Wastes to be incinerated – NO chlorinated disinfectants
•Chlorinated plastic...
STANDARDS FOR WASTE AUTOCLAVING

The autoclave: dedicated for the purposes of Disinfecting and
treating bio-medical waste
...
2) When operating a vacuum autoclave:

- minimum of Validation test
one pre-vacuum pulse to purge
the Autoclave have:
Each...
STANDARDS FOR LIQUID WASTE

Bio-assay test 90% survival of fish after 96 hours in 100%
effluent
hospitals connected with...
STANDARDS OF MICRO WAVING

Microwave treatment shall not be used for:
cytotoxic, hazardous or radioactive wastes
contami...
STANDARDS FOR DEEP BURIAL

A pit or trench should be dug about 2 meters
deep
It should be half filled with waste, then c...
On each occasion, when wastes are added to the pit, a
layer of 10 cm of soil shall be added to cover the wastes

distant...
Needle destroyer

Needles Mutilated (cut) by
needle destroyer &
chemically disinfected (by
dipping in 1% hypochlorite
solu...
PPE

• After removing PPE into white transparent autoclavable bag it is
tied & then autoclaved & discarded
or
• PPE discar...
ETBR Gel Discarding
• ETBR is carcinogenic hence glove must be worn to
dicard in white transparent autoclave containing 1%...
Tips

Tips discrded in red bucket containig 1% NaOCl
for 30-45 min and then discarded.
Sodium Hypochlorite
•Commercially available 4% sodium hypochlorite
• 1% NaOCl can be prepared by diluting 1 vol 4% NaOCL i...
Plasma Prolysis System
Process
The temperature of the plasma reaction determines the structure of
A plasma and uses an inert
theplasma torch form...
http://www.tifac.org.in/do/hgt/case/plasma.htm
The machine is steam heated to a
Technical features of ECODAS
temperature of 138°C and pressure is increased to 3.8 bars.
...
Technology:
A rotating oven & post combustion chamber , specifically used to
burn chemically waste

Incineration temp: 120...
Thermal Hydroclave

Principle: Sterilization by
saturated steam under pressure
with agitation & fragmentation
Technique: 1...
Electro-Thermal Deactivation (ETD) is a
process that employs a dielectric oven where low frequency radio waves are used
to...
THANK YOU
Bmw mgmt in virology
Bmw mgmt in virology
Bmw mgmt in virology
Bmw mgmt in virology
Bmw mgmt in virology
Bmw mgmt in virology
Bmw mgmt in virology
Bmw mgmt in virology
Bmw mgmt in virology
Bmw mgmt in virology
Upcoming SlideShare
Loading in …5
×

Bmw mgmt in virology

686 views

Published on

Published in: Business, Technology
3 Comments
0 Likes
Statistics
Notes
  • Be the first to like this

No Downloads
Views
Total views
686
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
19
Comments
3
Likes
0
Embeds 0
No embeds

No notes for slide

Bmw mgmt in virology

  1. 1. BIOMEDICAL WASTE MANAGEMENT IN VIROLOGY MODERATOR DR. MINI P. SINGH SPEAKER MANMOHAN MISHRA Msc. Virology 08-01-2014
  2. 2. Biomedical Waste Management in news
  3. 3. Definition "Health care waste" – The waste generated as a result of • Diagnosis, treatment, or immunization of human beings or animals • Research pertaining to the above activities • Production or testing of biologicals & categories
  4. 4. Areas where wastes generated in our department  Tissue culture lab   Routine diagnostic lab Genomics lab Hepatitis lab  Influenza lab 
  5. 5. Laboratory Waste material Syringe, needles, blood, serum, Tips, Elisa plate, Reagents, Lancets, slides, gauze pieces, Plastic tubes, plastic bottles, Test tubes, glass bottles, Iimmersion oil, stains, saline bottles, cell medium, culture vial bottle flask, PPE, mask, MCT, Kit boxes, storage vials, urine, VTM containing nasopharyngeal swab, CSF samples, membrane filters, antibiotics, genomics reagent, wooden stick , papers, gloves, egg inoculation waste Viral load tray
  6. 6. HAZARDS • Laboratory Staff
  7. 7. HAZARD FROM SHARPS WHO in 2000 Injections with contaminated syringes caused • 21 million HBV- 32% of all new infections • 2 million HCV- 40% of all new infections • 260 000 HIV - 5% of all new infections One needle-stick injury from a needle used on an infected patient 30%HBV 1.8%HCV (recently updated 3%) 0.3%HIV
  8. 8. Quantity of waste generated in PGIMER Chandigarh Total waste – 804.25 Kg/day Type of waste Kg/day Human Anatomical Waste 5.5 Animal Waste 1.33 Microbiology & Biotechnology waste 13.5 Waste Sharps 104.9 Soiled Waste (cotton, dressings, soiled plaster casts, beddings) 533.65 Solid Waste (tubing, catheters, intravenous sets ) 135.87
  9. 9. Classification of BMW BMW Potential toxic waste: A) Radioactive: solid, A)Dressings &infectious D) contaminateSwabs Potentially with blood, liquid, gases used for Non- hazardous or materials: Tissues for body organ imaging, Hazardous (10-25%) A) Biodegradable: virologicalfluids. general waste (75-90%) pus, body processing, tumor localisation & Peels of fruits &B) placenta, tumors, organs treatment Laboratory wastes vegetable skin, or limbs i.e removed including samples, during surgeryof B) Chemical: Toxic, culture stocks Infectious ( 15-18%) corrosive, inflammable, infectious infected B) Non E) Potentiallyviruses, lab glassware & in diagnostic reactive Biodegradable: animals usedplasticware Wrapping foils, or research studies C) Pharmaceutical: (5-7%) C) Instruments used in Other hazardous patient care plastic bags, F) Pathological : endoscopes, Surplus stock, spillage or contamination is ultrasound probes, papers waste:Autopsy & Biopsy syringes, needles,sharps detected or expiry date is over 
  10. 10. Biomedical waste management rule, 1998 Schedule I Categories of biomedical waste: a. No chemical pretreatment before incineration Chlorinated plastics shall not be incinerated The physico-chemical b. Deep burial – towns, rural areas biological nature c. Chemicaltoxicity potential hazard are solution treatment - 1% hypochlorite different categorised into 10 different categories d.Multilation / shredding must be such that it prevents unauthorized reuse
  11. 11. Categories of BMW CATEGORY TYPE OF WASTE TREATMENT & DISPOSAL Category 1 Human anatomical wastes Incineration/ deep burial Category 2 Animal wastes Incineration/ deep burial Category 3 Microbiology & biotechnology waste Local autoclaving/ microwaving/incineratio n Category 4 Waste sharps like needles, syringes, scalpels, blades, glass etc Disinfection (Chemical/autoclaving/ micro waving & mutilation/shredding) Category 5 Discarded Medicines & cytotoxic drugs Incineration/destruction & disposal in land fills
  12. 12. CATEGORY TYPE OF WASTE TREATMENT & DISPOSAL Category 6 Soiled wastes Items contaminated with blood, body fluids including cotton, dressings etc Incineration, autoclaving,microwaving Category 7 Solid wastes like catheters, IV sets etc. Disinfection by chemical treatment/autoclaving/mi cro waving and mutilation & shredding Category 8 Liquid wastes Laboratory, blood banks, hospitals, house etc. Disinfection by chemicals and discharge into drains Category 9 Incineration ash Disposal in municipal land fills Category 10 Chemical wastes Chemical treatment & discharge into drains for liquid and secured land fills for solids.
  13. 13. Segregation •Basic separation of different categories of waste generated at source and thereby reducing the risks as well as cost of handling and disposal. •The most crucial step in BMW mgmt. •Effective segregation alone can ensure effective bio-medical waste management. • The BMWs must be segregated in accordance to guidelines schedule 1 of BMW Rules, 1998
  14. 14. Plastic bag Non chlorinated “For incineration only”
  15. 15. Plastic bag “For autoclaving only” Puncture proof “For sharps only”
  16. 16. Schedule II Color coding & type of container for disposal of biomedical waste
  17. 17. Color coding shall be selected depending on treatment option chosen, as in Schedule 1 Waste collection bags for incineration shall not be made of chlorinated plastics Category 8 do not require containers/bags Category 3 if disinfected locally need not be put in Containers/bags
  18. 18. Schedule III Different labels for bio-medical waste containers and bags shall be required for identification and safe handling Waste Label should be non-washable & prominently visible
  19. 19. Schedule IV Label for transport of bio-medical waste containers /bags
  20. 20. Schedule V Standards for treatment and disposal of Bio-medical wastes
  21. 21. Schedule VI Schedule for waste treatment facilities like incinerator/ autoclave / microwave system
  22. 22. BIOMEDICAL WASTE HANDLING •Segregation •Collection •Storage •Transportation
  23. 23. Collection •Sanitation staff to collect waste during morning and afternoon (at least daily) •Supervision by staff nurse & sanitation supervisor •Weighed & documented in register •Replaced immediately with new bags of same type & garbage bin cleaned with disinfectant regularly
  24. 24. Collectors must wear protective materials Content of container should not exceed three quarter of its capacity Tie neck tightly Hold bag from neck
  25. 25. •Collection of sharp medical waste under maximum precaution •If there is spillage of waste from container (Accidental/Damage of bin) gently collect waste into a bin soak area with 2% Lysol solution for 30 minutes wash and wipe •Radioactive waste collected when activity decays to a safe level
  26. 26. Storage  Holding of biomedical waste for a certain period of time, then sent for treatment & disposal
  27. 27. Stored in areas of generation for a period varying from 2 to 12 hrs Central storage located within establishment Area marked with “CAUTION : BIOHAZARDOUS WASTE STORAGE AREA – UNAUTHORIZED PERSONS KEEP OUT” Away from patient rooms, operation theatres, laboratories or any public access areas
  28. 28. On site transport (intramural/internal) Transport within establishment Wheeled trolleys, containers or carts 300-500 litres capacity 120-200 litres capacity
  29. 29. Radio Frequency Identification (RFID) tags for monitoring trolley movement Easy to load & unload No sharp edges (prevents damage to waste bags) Easy to clean (disinfected daily) Workers immunized & have personal protective equipment Heavy duty gloves Coveralls Thick soled boots Leg protectors
  30. 30. Routing Quickest or shortest possible route Route laid out from farthest point of transfer station & as collection progresses towards collection storage area After departure further handling discouraged
  31. 31. Off site transport(extramural/ external) Closed motor vehicle (truck, tractor-trolley) Vehicle used only for transport of waste Bio-Hazard symbol Leak proof body & capable of locking Separate cabins for driver/staff & biomedical waste containers
  32. 32. STANDARDS FOR TREATMENT & DISPOSAL OF BIO-MEDICAL WASTES Incinerator Autoclave Liquid waste Microwaving Deep Burial
  33. 33. All incinerators shall meet the following operating and emission standards •Operating Standards •Combustion efficiency (CE) shall be at least 99.00% •The Combustion efficiency is computed as follows: •The temperature of the primary chamber shall be 800±50 ºc •The secondary chamber gas residence time shall be at least (one) second at 1050±50 ºC ,with minimum 3% Oxygen in the stack gas.
  34. 34. •Emission Standards S. Parameters No. Concentration mg/Nm3 at (12% CO2 correction) 1. Particulate matter 150 2. Nitrogen Oxides 450 3. HCl 50 4. Minimum stack height shall be 30 meters above ground 5. Volatile organic compounds in ash not be more than 0.01%
  35. 35. •Suitably designed pollution control devices •Wastes to be incinerated – NO chlorinated disinfectants •Chlorinated plastics shall not be incinerated •Toxic metals in inceration ash •Only low sulphur fuel like Diesel shall be used as fuel in the incinerator.
  36. 36. STANDARDS FOR WASTE AUTOCLAVING The autoclave: dedicated for the purposes of Disinfecting and treating bio-medical waste 1)When operating a gravity flow autoclave Temperature (˚ c) Pressure (psi) residence time (min) 121 15 60 135 31 45 149 52 30
  37. 37. 2) When operating a vacuum autoclave: - minimum of Validation test one pre-vacuum pulse to purge the Autoclave have: Each autoclave shallof all air Spore testing: - The waste shall be subjected to the following : Graphic or computer recording devices automatically and Biological indicator Temperature Pressure residence continuously monitor (˚ c) stearothermophilus spores (psi) Bacillus record dates, time of day 1x10 4 spores/ml load identification number (min) 121 45 Routine Test 15 operating parameters A chemical indicator strip/tape 135 31 31 time
  38. 38. STANDARDS FOR LIQUID WASTE Bio-assay test 90% survival of fish after 96 hours in 100% effluent hospitals connected with sewers without terminal sewage treatment plant not connected to public sewers For discharge into public sewers with terminal facilities, the general standards as notified under the Environment Protection Act, 1986
  39. 39. STANDARDS OF MICRO WAVING Microwave treatment shall not be used for: cytotoxic, hazardous or radioactive wastes contaminated animal carcasses, body parts large metal items Bacillus subtilis spores strips with at least 1 x 104 spores/ml The microwave should completely and consistently kill the bacteria and other pathogenic organisms ensured by approved biological indicator at the maximum design capacity of each microwave unit
  40. 40. STANDARDS FOR DEEP BURIAL A pit or trench should be dug about 2 meters deep It should be half filled with waste, then covered with lime within 50 cm of the surface, before filing the rest of the pit with soil animals do not have any access to burial sites Covers of galvanised iron/wire meshes
  41. 41. On each occasion, when wastes are added to the pit, a layer of 10 cm of soil shall be added to cover the wastes distant from habitation Burial must be performed under close and dedicated supervision The area should not be prone to flooding or erosion The deep burial site should be relatively impermeable and no shallow well should be close to the site The location authorised by the prescribed authority The institution shall maintain a record of all pits for deep burial.
  42. 42. Needle destroyer Needles Mutilated (cut) by needle destroyer & chemically disinfected (by dipping in 1% hypochlorite solution for 30min) Syringe barrel separated from plunger before disinfection
  43. 43. PPE • After removing PPE into white transparent autoclavable bag it is tied & then autoclaved & discarded or • PPE discarded to yellow bag & then sent for incineration
  44. 44. ETBR Gel Discarding • ETBR is carcinogenic hence glove must be worn to dicard in white transparent autoclave containing 1% Sodium hypochlorite Vol 1: 4 i.e. 1 vol of gel + 4 vol. of Sodium hypochlorite & kept for 30-45 min • autoclaved after removing the disinfectant & autoclaved then discarded
  45. 45. Tips Tips discrded in red bucket containig 1% NaOCl for 30-45 min and then discarded.
  46. 46. Sodium Hypochlorite •Commercially available 4% sodium hypochlorite • 1% NaOCl can be prepared by diluting 1 vol 4% NaOCL in to 3 vol of tap water Formula= Conc of the comm. Available NaOCL -1 Desired Conc. EX : for 1% from 4 % = 4 – 1/1 = 3 vol • •For making 1 Bucket i.e Suppose 15 litre capacity 1/3rd should be filled red & Blue Bucket So, for that 10 litre should be made 2.5 litre 4% NaOCL + 7.5 litre Tap water
  47. 47. Plasma Prolysis System
  48. 48. Process The temperature of the plasma reaction determines the structure of A plasma and uses an inert theplasma torch forming gas. gas such as steam. The electrodes  copper or tungsten to hafnium or zirconium, of the This can be optimized to minimize ballast contents composed along with  alloys. byproducts of oxidation: CO2, N, H2O, etc.. A these conditions molecular dissociation can occur by breaking At strong electric current under high voltage passes between the two electrodes as an electric down molecular bonds. arc. Pressurized elemental ionized passing in a gaseous phase.  The resultinginert gas is components are through the plasma created by the arc. Complex molecules are separated into individual atoms. The torch's temperature ranges from 4,000 to 25,000 °F Molecular dissociation using plasma is referred to as (2,200 to 13,900 °C). "plasma pyrolysis."
  49. 49. http://www.tifac.org.in/do/hgt/case/plasma.htm
  50. 50. The machine is steam heated to a Technical features of ECODAS temperature of 138°C and pressure is increased to 3.8 bars. Medical waste is loaded from the top of the machine into a The fully equipped and online-controlled process has a cycle chamber automated at the bottom with time of duty minutes, depending upon the size of plant and the a heavy40-60 shredder. amount of waste. Sterile fragments (8 log10 reduction) are discharged from the bottom some unbreakable objects, off If the medical waste containsof the machine and disposedlikein the environment landfill site. metal parts, the shredder stops automatically, and the chamber is not opened until waste is sterilized by The original volume of falls is gravity into 80%. steam. Shredded wastewasteby reduced by the lower chamber. ECODAS (a) T2000 model: fully-automatic model (b) Heavy-duty shredder cuts (www.ecodas.com)
  51. 51. Technology: A rotating oven & post combustion chamber , specifically used to burn chemically waste Incineration temp: 1200-1600⁰ C, decomposes even persistent chemicals like polychrobiphenyls ( PCBS) Capacity: 0.5 to 3 tonns /hr Use: Infectious wastes, all chemical & pharmaceutical cytotoxic waste Contraindications: Radioactive waste, Pressurized containers, wastes with heavy metals
  52. 52. Thermal Hydroclave Principle: Sterilization by saturated steam under pressure with agitation & fragmentation Technique: 121-132⁰C, 15-20 psi, 15-30 mins Advantage: better steam penetration Dries up the waste 85% volume reduction a) loading b) Heat up & fragmentation c) Sterilization period D) De-pressurization and De-hydration E) Unloading
  53. 53. Electro-Thermal Deactivation (ETD) is a process that employs a dielectric oven where low frequency radio waves are used to generate a high strength electrical field. Medical waste passing through this dielectric oven absorbs the energy in the field, and heats very rapidly. This heat kills all potential pathogens and renders the waste non-infectious. The waste is also shredded to reduce volume by up to 89%.
  54. 54. THANK YOU

×