Bio-Medical Waste Managment in regards with New "BIO-MEDICAL WASTE MANAGEMENT RULES 2016"

1. BIOMEDICAL WASTE (BMW) MANAGEMENT
Prepared By
Prashant Fulluke
Elixir Consultancy Services
Mob: 9881381700
prashantfulluke@gmail.com

2. WHAT IS BMW ?
 It is defined as “any waste, which is generated during the
diagnosis, treatment or immunization of human beings or
animals or research activities pertaining thereto or in the
production or testing of biological or in health camps,
including the categories mentioned in Schedule I appended
to BMW rules 2016”
 “Any solid and/or liquid waste including its container and
any intermediate product, which is generated during the
diagnosis, treatment or immunization of human beings or
animals”.
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BiomedicalWaste(BMW)Management

3.  Bio-Medical Waste generated by
 Hospitals
 Nursing Homes
 Clinics
 Dispensaries
 Veterinary Institutes/Animal Houses
 Pathological Laboratories
 Blood Banks/Blood Donation Camps
 Ayush Hospitals
 Clinical Establishment
 Research/Educational Institute/Research Labs
 Health Camps
 Medical or Surgical Camps
 Vaccination Camps
 Blood Donation Camps
 First Aid Rooms of Schools
 Forensic Laboratories
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WHO GENERATES BMW ?
BiomedicalWaste(BMW)Management

4. 4
Bio-
Medical
Waste
75-85%
Non-
infectious
10-15%
Infectious
5-10%
Hazardous
BMW CHARACTERIZATION
BiomedicalWaste(BMW)Management

5. Non-Hazardous Waste
Bio-
degradabl
e
Non bio-
degradabl
e
Potentially Infectious Waste
Dressings,
swabs,
laboratory
wastes,
instrument
s used in
patient
care..
Potentially Toxic
Waste
Radioactive Chemical Pharmaceutical
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CLASSIFICATION OF BMW
BiomedicalWaste(BMW)Management

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CATEGORIES OF PERSONS
EXPOSED TO RISK OF INFECTION
BiomedicalWaste(BMW)Management

7. Risk of HIV &
HBV
Nosociomial
infections
Others..
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HEALTH HAZARDS
BiomedicalWaste(BMW)Management

8. By ingestion
(contaminated
unwashed hands,
contaminated food
stuffs, water etc)
Intact or
non intact
skin,
mucous
membranes
Inhalation of
dust
particles
containing
germs
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ROUTES OF TRANSMISSION
BiomedicalWaste(BMW)Management

9. 11/9/2016
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BiomedicalWaste(BMW)Management

10. Medical, Paramedical & Sanitation
staff should be
vaccinated against Hepatitis B
Using heavy duty gloves especially while
dealing with infectious wastes
Recapping needles should be
discouraged. In case, if unavoidable
single handed method should be used
Segregation of Biomedical Waste & Safe
disposal.
All necessary compliance in accordance with
BMW (Management) Rules 2016 to avoid
unwanted occurrence.
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PRECAUTIONS
BiomedicalWaste(BMW)Management

11.  The Air (Prevention and Control of Pollution) Act, 1981
 The Water (Prevention and Control of Pollution) Act, 1974
 The Environment (Protection) Act, 1986
 The Hazardous Waste (Management & Handling) Rules, 2016
 The National Environmental Tribunal Act, 1995
 The Biomedical Waste (Management) Rules, 2016
 The Municipal Solid Waste (Management & Handling) Rules, 2000
 The E-Waste (Management) Rules, 2016 11
ENVIRONMENT LEGISLATION
BiomedicalWaste(BMW)Management

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KEY FEATURES OF BMW (M) RULES, 2016
 The ambit of the rules has been expanded to include vaccination camps,
blood donation camps, surgical camps or any other healthcare activity.
 Occupier shall take all necessary steps to ensure that bio-medical
waste is handled without any adverse effect to human health and
the environment and in accordance with these rules.
 Make a provision within the premises for a safe, ventilated and
secured location for storage of segregated biomedical waste in
colored bags or containers in the manner as specified.
 Phase-out the use of chlorinated plastic bags, gloves and blood bags
within two years.
 Pretreatment of the laboratory waste, microbiological waste, blood
samples and blood bags through disinfection or sterilization onsite
in the manner as prescribed by WHO or NACO.
 Do not give treated bio-medical waste with municipal solid waste
 Conduct health check up at the time of induction, provide training
to all its health care workers and immunize all health workers at
the time of induction and thereafter at least once every year.
 Report major accidents.
Cont……
BiomedicalWaste(BMW)Management

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 The details of training programmes conducted, number of
personnel trained and number of personnel not undergone any
training shall be provided in the Annual Report.
 Ensure occupational safety of all its health care workers and others
involved in handling of biomedical waste by providing appropriate
and adequate personal protective equipments.
 Establish a Bar Code System for bags or containers containing
biomedical waste for disposal.
 Untreated human anatomical waste, animal anatomical waste,
soiled waste and, biotechnology waste shall not be stored beyond a
period of forty – eight hours:
 Existing incinerators to achieve the standards for retention time in
secondary chamber and Dioxin and Furans within two years.
 Ensure segregation of liquid chemical waste at source and ensure
pre- treatment or neutralization prior to mixing with other effluent
generated from health care facilities.
 Biomedical waste has been classified in to 4 categories instead 10 to
improve the segregation of waste at source.
Cont……
BiomedicalWaste(BMW)Management
KEY FEATURES OF BMW (M) RULES, 2016

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 Procedure to get authorization simplified. Automatic authorization
for bedded hospitals. The validity of authorization synchronized
with validity of consent orders for Bedded HCFs. One time
Authorization for Non-bedded HCFs;
 Operator of a common biomedical waste treatment and disposal facility
to ensure the timely collection of biomedical waste from the HCFs and
assist the HCFs in conduct of training.
 Maintain and update on day to day basis the bio-medical waste
management register and display the monthly record on its website
according to the bio-medical waste generated in terms of category and
colour coding as specified.
 Establish a system to review and monitor the activities related to bio-
medical waste management by forming a committee & maintain the
record.
 Every occupier or operator of common bio-medical waste treatment
facility shall submit an annual report to the prescribed authority in
Form-IV, on or before the 30th June of every year.
 Occupier shall make available the annual report on its web-site and
all the health care facilities shall make own website within two
years.
BiomedicalWaste(BMW)Management
KEY FEATURES OF BMW (M) RULES, 2016

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COLOR
CODE
TYPE OF BAG/
CONTAINER
TYPE OF WASTE TREATMENT OPTIONS
Yellow
Yellow coloured
non-chlorinated
plastic bags
(a) Human Anatomical Waste Incineration or Plasma Pyrolysis
or
deep burial
(b)Animal Anatomical Waste
(c) Soiled Waste:
(d) Expired or Discarded
Medicines:
Returned back to the
manufacturer or supplier for
incineration
(e) Chemical Waste
Disposed of by incineration or
Plasma
Pyrolysis or Encapsulation
Separate
collection
system leading
to effluent
treatment system
(f) Chemical Liquid Waste
Chemical
liquid waste shall be pre-treated
before
mixing with other wastewater
Non-chlorinated
yellow plastic
bags or suitable
packing material
(g) Discarded linen,
mattresses, beddings
contaminated with
blood or body fluid.
Non- chlorinated chemical
disinfection
followed by incineration or
Plazma
Pyrolysis or for energy recovery
Autoclave safe
plastic bags or
containers
(h) Microbiology,
Biotechnology and
other clinical
laboratory waste:
Pre-treat to sterilize with
nonchlorinated
chemicals on-site
CATEGORIES OF BMW
BiomedicalWaste(BMW)Management

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CATEGORIES OF BMW
COLOR
CODE
TYPE OF BAG/
CONTAINER
TYPE OF WASTE TREATMENT OPTIONS
Red
Red coloured
non-chlorinated
plastic bags or
containers
Contaminated Waste
(Recyclable)
Autoclaving or micro-waving/
hydroclaving followed by shredding
or
mutilation or combination of
sterilization and shredding.
Treated
waste to be sent to registered or
authorized recyclers
White
(Translucent)
Puncture proof,
Leak proof,
tamper proof
containers
Waste sharps
including Metals:
Autoclaving or Dry Heat
Sterilization
followed by shredding
Blue
Cardboard boxes
with blue
colored marking
(a) Glassware
Disinfection and then
sent for recycling.(b) Metallic Body
Implants
BiomedicalWaste(BMW)Management

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STEPS FOR EFFECTIVE BMW
MANAGEMENT
BiomedicalWaste(BMW)Management

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WASTE SURVEY
Waste survey is an important component of
the waste management scheme. A survey
helps in evaluation both the type and
quantity of waste generated in hospitals.
Aims:
• Differentiate the types of waste
• Quantify the waste generated
• Determine the points of generation &
type of waste generated at each point
• Determine the level of generation &
disinfection within the hospital
• To find out the type of disposal carried
out
BiomedicalWaste(BMW)Management

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 Segregation refers to the basic separation of different categories of waste
generated at source and thereby reducing the risks as well as cost of
handling and disposal.
 Segregation is the most crucial step in bio-medical waste management.
Effective segregation alone can ensure effective bio-medical waste
management.
 The BMWs must be segregated in accordance to guidelines laid down under
schedule 1 of BMW Rules, 2016.
SEGREGATION
BiomedicalWaste(BMW)Management

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•The collection of biomedical waste involves use of different types of container .
• The containers/ bins should be placed in such a way that 100 % collection is
achieved.
• Sharps must always be kept in puncture-proof containers to avoid injuries
and infection to the workers handling them.
COLLECTION
BiomedicalWaste(BMW)Management

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Once collection occurs then biomedical waste is stored in a proper place.
Segregated wastes of different categories need to be collected in identifiable
containers. The duration of storage should not exceed for 8-10 hrs in big
hospitals (more than 250 bedded) and 24 hrs in nursing homes. Each
container may be clearly labelled to show the ward or room where it is kept.
The reason for this labelling is that it may be necessary to trace the waste
back to its source. Besides this, storage area should be marked with a
caution sign.
STORAGE
BiomedicalWaste(BMW)Management

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TRANSPORT
Final Transport of BMW must be to CBMWTSDF only in authorized
vehicle with appropriate documentation for further record.
BiomedicalWaste(BMW)Management

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BiomedicalWaste(BMW)Management
RECORD KEEPING
 MPCB Consent & Authorization.
 Formation of Committee to Establish a system to review and monitor the
activities related to bio-medical waste management & maintain the record.
 Documents of Tie-up with CBMWTSDF to safe dispose of BMW.
 Record of Pretreatment of BMW & Trade Effluent.
 Records of Training, Health Check up.
 Record of BMW generation & disposal through CBMWTSDF.
 Annual Report.
LABEL FOR BIO_MEDICAL WASTE CONTAINERS or BAGS

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BMW TREATMENT

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BiomedicalWaste(BMW)Management
DUTIES OF HCF’S / COMPLIANCE
 To obtain MPCB Consent & Authorization for it’s activity.
 To take all necessary steps to ensure the appropriate handling of BMW as
per the guidelines of BMW (M) Rules, 2016.
 To make all the provisions of safe segregation, pre-treatment, storage &
transport to CBMWTSDF.
 Pre-treatment of BMW.
 Phase out the chlorinated bags, gloves & blood bags.
 Not to give any BMW to Municipal solid waste unless the solid waste other
than BMW.
 Provide the training to all health care workers, staff at the time of Induction
& thereafter once in year & maintain the record of the same.
 Immunize all its health care workers and others time to time & maintain the record.
 Establish a Bar- Code System for bags or containers containing bio-medical waste
Cont….
It shall be the duty of every Occupier………

26. 26
BiomedicalWaste(BMW)Management
DUTIES OF HCF’S / COMPLIANCE
 Ensure segregation of liquid chemical waste at source and ensure pre-treatment or
neutralization.
 Ensure treatment and disposal of liquid waste before mixing with sewage water.
 Ensure complete treatment of sewage waste water & chlorination before discharge
to drain.
 Ensure occupational safety of all its staff & monitor the same time to time.
 Conduct health check up at the time of induction and at least once in a year for all its
health care workers and maintain the records.
 Maintain and update on day to day basis the bio-medical waste management
register and display the monthly record on its website.
 Report major accidents.
 Prepare the Annual report for the Period of January to December & submit the same
till 30th June.
 Make available the annual report on its web-site.
 Form a committee to establish a system to review and monitor the activities
related to bio-medical waste management & maintain the record.
It shall be the duty of every Occupier………

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BiomedicalWaste(BMW)Management
OUR HELPING HAND
 Consultancy services to obtain MPCB Consent & Authorization.
 Preparation & Submission of Annual Report.
 Plant installation for pre-treatment/treatment of waste water (ETP), full-
fledge treatment of sewage waste water (STP).
 Consultancy services/Annual Contract to
 Pre-treatment of BMW
 Formation of committee & BMW management
 Implementation of Bar code system.
 Systematic procedure for Segregation, storage & final disposal of BMW.
 Training to Health work
 Record keeping of Training, Health check up, Immunization of Health
Care workers & staff, BMW generation & disposal, occupational safety.
 Report major accidents.
Services offer by us………

28. Concluding….
 It is just not the law abide compliance but
the SOCIAL RESPONSIBILITY of every
Health Care Establishment to say…
NO TO HAZARD OF BIOMEDICAL WASTE
 It will only take..
 Proper planning.
 Spread Awareness.
 Involvement everyone.
 Segregation, Pre-treatment at first stage.
 Appropriate Storage
 Timely Disposal.
 All Records…
And………………………….. ALL CLEAN. 28
BiomedicalWaste(BMW)Management

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BiomedicalWaste(BMW)Management