The document discusses bio-medical waste management. It defines bio-medical waste and its categories. It notes that approximately 40 tons of waste is generated daily in India, but only 30% undergoes proper disposal. It outlines the various treatment and disposal methods for different categories of waste, including incineration, autoclaving, chemical treatment, and secured landfilling. Color coding and container requirements are also specified. The risks of exposure to healthcare waste include infections, genotoxicity, chemical toxicity, and radioactivity hazards. Proper waste management requires adherence to government rules and public education.

1. BIO-MEDICAL WASTE
MANAGEMENT
By : Dr. DEEPAK KUMAR

2. Let the waste of the “sick” not
contaminate the lives of “The
Healthy”

3. WASTES ??????????
Wastes
Solid waste
Household
waste
Industrial waste Biomed.waste or
hospital waste
Liquid
Waste
Gaseous
Waste
Waste is any substance
which is discarded after
primary use, or it is
worthless, defective and of
no use.

4. What is bio-medical waste ????
On 20th July 1998
• Exercising powers : section 6,8,25 of environmental protection act 1986
which runs under Ministry of Environment and Forests
(MoEF), Govt. of India, Framed a rule known as ‘Bio-
medical Waste (Management and Handling) Rules, 1998,’
According to this rule ‘Bio-Medical Waste ’’ means
“Any waste, which is 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 of biological”

5. BIOMEDICAL WASTE STATISTICS
Developed Countries- 1-5 kg/bed/day, with variations
among countries.
In India- (Bangalore)
½-4 kg/bed/day in Govt. Hospitals
½-2 kg/bed/day in private Hospitals
½-1 kg/bed/day in Nursing Homes
Approximately 40 tons/ day wastes generated
Out of which only 30% waste undergoes proper disposal .
(by national environmental engineer research institute 1997)

6. CATEGORIES OF BIO-MEDICAL WASTES
80%
15%
3% 1% 0.50%
Sales Non-Infectious waste
Pathological and
Infectious waste
Chemical and
Pharmaceutical waste
sharps
radioactive and cytotoxic
waste

7. Categories Of biomedical
Wastes in India
WASTE CATEGORY
TYPE OF WASTE
Category No. 1
Human Anatomical Waste (Human tissues,
organs ,body parts)
Category No. 2
Animal Waste (Animals tissues, organs,
fluids, blood )
Category No. 3
Microbiology & Biotechnology
Waste(Laboratory cultures, micro-
organisms, human and animal cell cultures,
toxins)
Category No. 4
Waste Sharp(needles, syringes, scalpels,
broken glass, etc)
Category No. 5
Discarded Medicine and Cytotoxic
drugs(outdated ,contaminated & discarded
medicines)

8. cont…
Category No. 6
Soiled Waste(contaminated with blood & fluids
,including cotton, dressing, plaster etc)
Category No. 7
Solid Waste(except sharp)tubings,catheter,iv sets
etc)
Category No. 8
Liquid Waste(from lab,washing,cleaning,house
keeping and disinfection)
Category No. 9
Incineration Ash(ash from incineration of bmw)
Category No.10
Chemical Waste(chemical used in disinfection,as
insecticide,etc)

9. THE EXPOSURE TO HAZARDOUS HEALTH CARE WASTE CAN RESULT IN
1. Infection
2. Geno toxicity and Cytotoxicity
3. Chemical toxicity
4. Radioactivity hazards.
5. Public sensitivity.

10. INFECTION
•The infectious agents enter in he body
through
 Puncture,
 Abrasion,
 Cut in the skin;
 Through mucous membranes;
 By inhalation and ingestion.

11. MOST COMMON INFECTIONS
1. Gastro enteric through faeces and/or vomit
e.g. Salmonella, Vibrio Cholera, Helminthes
Hepatitis A
2. Respiratory through inhaled secretions
e.g. Mycobacterium tuberculosis; measles virus;
streptococcus pneumonae
3.Ocular infections through eye secretions
e.g. Herpes virus,
4. Skin infection through pus
e.g. Streptococcus spp ,
5. Meningitis through Cerebrospinal fluid
e.g. neisseria meningitides,

12. 6. Blood borne diseases
• AIDS
• Septicaemia and bacteraemia
• Viral Hepatitis B & C
7. Hemorrhagic fevers through body fluids
• Ebola

13. Genotoxicity and Cytotoxicity
• Irritant to skin and eyes
E.g. alkylating agent, intercalating agent
• Carcinogenic and Mutagenic
e.g. Secondary neoplasia due to
chemotherapy
Chemical Toxicity
• Many drugs are hazardous
• May cause intoxication , burns, poisoning on
exposure

14. Radioactivity Hazards
Radioactive waste exposure may cause headache, dizziness,
vomiting, genotoxicity and tissue damage
Public sensitivity
Visual impact of the anatomical waste, recognizable body parts

15. SCHEDULES UNDER BMW (HANDLING RULE)1998
•1- Categories Of BMW, Treatment &
Disposal
•2- Color Coding & Type Of Container
•3- Label For BMW Container
•4- Label For Transport Of BMW
Container
•5- Standers For Treatment & Disposal

17. TREATMENT AND DISPOSAL TECHNOLOGIES FOR HEALTHCARE WASTE
Category Waste Type Treatment and Disposal Method
Category 1
Human Wastes (Tissues,
organs, body parts
Incineration £ / deep burial
Category 2 Animal Waste Incineration £/ deep burial
Category 3
Microbiology and
Biotechnology waste
Autoclave/microwave/incin
eration £
Category 4 Sharps
Disinfection (chemical
treatment)@+/autoclaving/
microwaving and
mutilation shredding
Category 5
Discarded Medicines and
Cytotoxic Drugs
Incineration@/ destruction
and drugs disposal in
secured landfills

18. CONT..
Category Waste Type
Treatment and Disposal
Method
Category 6 Contaminated solid waste
Incineration@/autoclaving /
microwaving
Category 7
Solid waste (disposable items
other than sharps)
Disinfection by chemical
treatment@@
microwaving/autoclaving &
mutilation shredding##
Category 8
Liquid waste (generated from
laboratory washing, cleaning,
housekeeping and disinfecting
activity)
Disinfection by chemical
treatment@@ and discharge
into the drains
Category 9 Incineration ash Disposal in secured landfill
Category10 Chemical Wastes
Chemical Treatment@@ and
discharge in to drain for
liquids and secured landfill
for solids

19. @@Chemical Treatment Using At Least 1% Hcl Solution Or
Any Other Equipment Chemical Reagent.It Must Be Ensures Dis
Infection.
## Mutilation/Shredding Must Be Such So As To Prevent
Unauthorized Reuse.
@ There Will Be No Chemical Pre-treatment Before
Incineration.Chlorinated Plastic Shall Not Be Incinerated.
£ Deep Burial Shall Be An Option Available Only In Towns
With Population Less Than 5 Lakhs And In Rural Areas.

20. COLOUR CODING AND TYPE OF CONTAINER
FOR DISPOSAL OF BIOMEDICAL WASTES
COLOUR CODING TYPE OF CONTAINER WASTE CATEGORY TREATMENT OPTIONS as per
Schedule I
Yellow Plastic Bag Cat.. 1, 2, 3 and 6 Incineration / deep burial
Red Disinfected container /
Plastic Bag
Cat. 3, 6, and 7 Autoclaving / Microwaving /
Chemical Treatment
Blue / White
Translucent
Plastic Bag / puncture
proof container
Cat. 4, Cat. 7 Autoclaving / Microwaving /
Chemical treatment and destruction
shredding
Black Plastic Bag Cat. 5, 9 and 10 (Solid) Disposal in secured landfill

21. 1.COLOUR CODING OF WASTE CATAGORIES WITH MULTIPLE
TREATMENT OPTIONS AS DEFINED IN SCHEDULE ,SHALL BE
SELECTED DEPENDING ON THE TREATMENT OPTION
CHOSEN,WHICH SHALL BE AS SPECIFIED IN SCHEDULE I.
2.WASTE COLLECTION BAGS FOR WASTE TYPES NEEDING
INCINERATION SHALL NOT BE MADE OF CHLORINATED
PLASTICS.
3.CATAGORIES 8 & 10(LIQUID) DO NOT REQUIRE
CONTAINER/BAGS.
4.CATAGORY 3 IF DISINFECTED LOCALLY NEED NOT BE IN
CONTAINER/BAGS.

23. NEEDLE DESTROYER

25. INCINERATION
Incineration Is A High Temperature Dry Oxidation Process,that Reduces Organic
And Combustible Waste To In Organic Incombustible Matter And Results In A Very
Significant Reduction Of Waste-volume And Weight.The Process Is Usually
Selected O Treat Wastes That Cannot Be Recycled,reused Or Disposed Off In A
Land Fill Site.
Type Of Incinerators:
Double-chamber Pyrolytic
Sinlgle-chamber Pyrolytic
Rotatry Kilns
Tempeture In Incinerator:
Primary Chamber: 800ºc ± 50ºc
Secondary Chamber: 1050ºc ± 50ºc

26. GENERAL SCHEMATIC

27. Wastes
Storage
Pre-processing/blending
Incineration Flue Gas
Pollution
Control
Ash Stabilization
Landfill
Effluent
POTW

28. CHARACTERISTIC OF WASTES SUITABLE FOR INCINERATION;
• LOW HEATING VOLUME
• COMBUSTIBLE MATTER >60%
• NON-COMBUSTIBLE SOLIDS <5%
• NON-COMBUSTIBLE FINES <20%
• MOISTURE CONTENTENT <30%
WASTE TYPES NOT TO BE INCINERRATED
• PRESURIZED GAS CONTAINERS
• REACTIVE CHEMICAL WASTES
• SILVER/RADIOGRAPHIC/PHOTOGRAPHIC WASTE
• HALOGENATED PLASTICS(PVC)
• WASTES WITH HIGH MURCURY/CADMIUM CONTENT

29. CHEMICAL PROCESS
Disinfectants: A Disinfectant Is A Chemical Agent, which Destroys Or
Inhibits Growth Of Pathogenic Micro-organism In The Non-sporing Or
Vegetative State.
Disinfectants Are Applied To Inanimate Objects & Material Such As
Instruments And Surfaces To Control And Prevent Infection.
Antiseptics: An Antiseptic Is A Type Of Disinfectant, which Destroys Or
Inhibits Growth Of Micro-organisms On Living Tissues Without Causing
Injurious Effects When Applied To Surface Of Body Or To Expose
Tissues.

30. WET AND DRY THERMAL PROCESS
HEAT DISINFECTION : Boiling For 20 Min
Useful For Pre Treatment Of Sharps & Plastic Waste
HOT AIR OVEN: Causes Sterilization & Mutilation At 160ºc
Used For Glassware And Powders
AUTOCLAVE: Steam Sterilization Under Pressure Is A Low Heat
Thermal Process
Waste is subjected to 121ºC or 135ºC

31. • HYDROCLAVE: Steam –Sterilization Under Pressure Causes
Fragmentation Of Wastes
Waste Is Subjected To 121ºc Or 132ºc
• MICROWAVE: Volumetric Heating For Microbial Hazardous Waste
Using Frequency Of 2450 MHz And Wavelength 112.24nm
Waste Destruction Occurs By Heat Conduction
• PLASMA ARC: Ionized Gas At High Temperature Causes Gasification
And Molecular Dissociation Of Organic Wastes
Waste Is Subjected To 2000ºc

32. LAND DISPOSAL
•Compacting: reducing size and volume of waste
(useful for genral non hazardous waste)
•Shredding: breaking the material into smaller
pieces by grinding /cutting/granulation
•Landfill: oldest method of waste disposal
•Encapsulation :filling containers with waste
adding an immobilizing material (plastic foam/
bituminous sand/cement mortar/clay material) and
sealing containers

33. INERTIZATION
• Process: Mixing Biomedical Waste With Cement & Other Substance Before Disposal,so As
To Minimise Risk Of Toxic Substances Contained In Waste To Contaminate Ground/Surface
Water.
• Inertization Is Especially Suitable For Pharmaceuticals & For Incineration Ashes With High
Metal Constant.
• A Typical Compoition Of Mixture Is:
• 65% Pharmaceutical Waste
• 15% Lime
• 15% Cement
• 5% Water

34. • Thus refuse disposal cannot be solved without public
education.
• Individual participation is required.
• Municipality and government should pay importance to
disposal of waste economically.
• Thus educating and motivating oneself first is important and
then preach others about it.

36. बीमारियों को आस पास न पाले
कूडा कचिा कूडेदान में हीं डाले।