Bio medical waste disposal

Operation room
Waste Disposal
Anaesthesialogy Supervisor
S.Barge

Overview
• definition
• classification of Bio-Medical waste
• BMW harmful effects
• Why BMW management ?
• BMW objectives
• BMW Rules in India
• BMW management effective steps
• precautions
S . Barge | B.M.H.R.C.

definition

According to ministry of environment and
forest ,GOI
“Biomedical waste is defined as any
waste, which is generated during the
diagnosis, treatment or immunisation of
human beings or animals, or in research
activities pertaining thereto, or in the
production or testing of biologicals”

Different names for Bio-Medical waste are
Medical Waste, Clinical Waste , Bio-hazardous
Waste , Regulated Medical Waste (RMW),
Infectious Medical Waste , Healthcare waste

Classification of
Bio-Medical waste
on the basis of following :
1. Level of hazardness
2. Source of generation
3. WHO
4. Indian BMW rules

1. Level of hazardness

2. Source of generation

3. According to WHO
Bio medical waste in classified as :
• Infectious waste
• Pathological waste
• Sharp waste
• Chemical waste
• Pharmaceutical waste
• Cyctotoxic waste
• Radioactive waste
• Non-hazardous or general waste

Infectious waste :
• waste contaminated with blood and other
bodily fluids (e.g. from discarded
diagnostic samples)
• cultures and stocks of infectious agents
from laboratory work (e.g. waste from
autopsies and infected animals from
laboratories)
• waste from patients with infections (e.g.
swabs, bandages and disposable
medical devices)

Pathological waste:
human tissues, organs or fluids, body
parts and contaminated animal carcasses.
Sharps waste:
syringes, needles, disposable scalpels
and blades, etc..
Pharmaceutical waste:
expired, unused and contaminated drugs
and vaccines.

Chemical waste:
for example solvents and reagents used
for laboratory preparations, disinfectants,
sterilants and heavy metals contained in
medical devices (e.g. mercury in broken
thermometers) and batteries.
Radioactive waste:
such as products contaminated by radio-
nuclides including radioactive diagnostic
material or radio-therapeutic materials.

Cyctotoxic waste:
waste containing substances with
genotoxic properties (i.e. highly
hazardous substances that are,
mutagenic, teratogenic or carcinogenic),
such as cytotoxic drugs used in cancer
treatment and their metabolites.
Non-hazardous or general waste:
waste that does not pose any particular
biological, chemical, radioactive or
physical hazard.S . Barge | B.M.H.R.C.

According to Indian BMW rules
• Bio medical waste are categorized into
10 categories.
• BMW color coding, collection,
treatment and disposal.

Waste
category
Type of waste
Category
No. 1
Human Anatomical Waste
(Human tissues, organs , body parts)
Category
No. 2
Animal Waste
(Animal tissues, organs, body parts,
carcasses, bleeding parts, fluid, blood
and experimental animals used in
research, waste generated by veterinary
hospitals and colleges,discharge from
hospitals, animal houses)

Waste
category
Type of waste
Category
No. 3
Microbiology & Biotechnology Waste
(Wastes from laboratory cultures, stocks
or specimen of live micro organisms or
attenuated vaccines, human and animal
cell cultures used in research and
infectious agents from research and
industrial laboratories, wastes from
production of biologicals, toxins and
devices used for transfer of cultures)

Waste
category
Type of waste
Category
No. 4
Waste Sharps
(Needles, syringes, scalpels, blades,
glass, etc. that may cause puncture and
cuts. This includes both used and
unused sharps)
Category
No. 5
Discarded Medicine and Cytotoxic drugs
(Wastes comprising of outdated,
contaminated and discarded medicines)

Waste
category
Type of waste
Category
No. 6
Soiled Waste
(Items contaminated with body fluids
including cotton, dressings, soiled
plaster casts, lines, bedding and other
materials contaminated with blood.)
Category
No. 7
Solid Waste
(Waste generated from disposable items
other than the waste sharps such as
tubing, catheters, intravenous sets, etc.)

Waste
category
Type of waste
Category
No. 8
Liquid Waste
(Waste generated from the laboratory
and washing, cleaning, house keeping
and disinfecting activities)
Category
No. 9
Incineration Ash
(Ash from incineration of any biomedical
waste)
Category
No.10
Chemical Waste
(Chemicals used in production of
biologicals, chemicals used in
disinfecting, as insecticides, etc.)

Who is at risk?

BMW
harmful effects

Effects of improper disposal
• Infection and disease can spread in general
healthy public as well as staff and patients
in hospitals.
• Disposal untreated chemical waste in open
channels or river can contaminate water
sources.
• Hazardous gases and torching waste
openly pollute fresh air.
• Dumping BMW with general waste can
infect waste scavengers and animals.

BMW and diseases
• COVID-19
• Meningitis
• Parasitic infections
• Blood poisoning
• Infections of the skin
• Candida albicans
• Hepatitis
• Diseases from
vaccines
• Methicillin-resistant
Staphylococcus
aureus (MRSA)
• HIV
• Ebola
If mishandled BMW can lead to various diseases
as follows :

Why do we need
Bio-Medical waste (BMW)
management ?

• Due to increase in population the amount
of BMW generated is increasing.
• In absence of proper segregation, the
infectious waste becomes infectious poses
environmental threat to the society.
• spread of potential hazardous drug-
resistant microorganisms which spread
from health facilities into the environment.
example:.COVID-19

BMW
objectives

• To reduce the infectious and hazardous
nature of waste.
• Prevent procedure-related infections.
• Pretect community from infections that
originate in healthcare facilities.
• To ensure occupational satety and health
• Provide high quality safe services

BMW
Rules in India

Key features of BMW rule 2016
• Occupier shall be responsible of handling
of BMW.
• Standard labelling and color code system
for segregation.
• discard use of chlorinated plastic
bags,gloves and blood bags withing 2 yrs.
• Pathological , pharmaceutical and sharps
waste should be pretreated ,disinfected or
sterilized before disposal or reuse.

Contd..
• Conduct checkup and immunization of
worker every year.
• Report major accidents.
• Annual report of training program
should be maintained.
• Untreated human and animal
anatomical waste, soiled waste and
biotechnology waste shall not be
stored beyond a period of 48 hours.

Contd..
• The bins and bags should carry the
biohazard symbol indicating the nature
of waste to the patients and public.
• Label shall be non-washable and
prominently visible

BMW management
effective steps

Steps for biomedical waste
management
1. Segregation
2. Storage
3. Collection of biomedical waste
4. Transportation
5. Treatment of biomedical waste
6. Safety measures

1
Segregation

• BMW are segregated in 4 category based
on colours according to Bio-Medical waste
Management rules, 2016 and amendment
2018
• 4 colours are alloted i.e.
and black bins for general waste.

Yellow bag

Red bag

White bag

Blue bag

2
storage

Dustbins:
• It is very important to assess the quantity
of waste generated at each point.
• Dustbins should be of such capacity that
they do not overflow between each cycle
of waste collection.
• Dustbins should be cleaned after every
cycle of clearance of waste with
disinfectants.
• Dustbins can be lined with plastic bags,
which are chlorine-free, and colour coded
as per the law.

3
Collection

• The collection of biomedical waste
involves use of different types of
container from various sources of
segregated biomedical wastes like
Operation Theatre, laboratory, wards,
kitchen, corridor etc.
• Sharps must always be kept in
puncture-proof containers to avoid
injuries and infection to the workers
handling them.

4
Transportation

• The waste should be transported for treatment
either in trolleys or in covered wheelbarrow.
• Manual loading should be avoided as far as for
as possible.
• The bags / Container containing BMWs should
be tied/ lidded before transportation.
• Before transporting the bag containing BMWs,
it should be accompanied with a signed
document by Nurse/ Doctor mentioning date,
shift, quantity and destination.

• Different forms with biomedical waste rule 2016

5
Treatment

Treatment of Medical Waste
There are mainly five technology options:
1. Chemical processes
(ex. Autoclave , hydroclaving )
2. Thermal processes
(ex. incineration , plasma torch technology)
3. Mechanical processes
(ex. Mutilation, shredding)
4. Irradiation processes. ( ex. Gamma exposure)
5. Biological processes. ( ex. deep burial)

Autoclaves
• It is a sterilization method that uses high-
pressure steam in a closed pressure chamber.
• Used to sterilize equipment and supplies that
are again reused after came in contact with
BMW. i.e. surgical equipment, laboratory
instruments, pharmaceutical items, and other
materials.
• Involves exposure to high temperature steam
(usually around 132C or 270F) in 15 psi
pressure for about 20-30 minutes.

Incineration
• it involves the combustion of organic
substances contained in waste
materials
• waste materials converts the waste
into ash, flue gas and heat.

6
Safety measures

Personnel safety devices
Gloves:
• Heavy-duty rubber gloves should be
used for waste handling by the waste
retrievers.
• This should be bright yellow in colour.
• After handling the waste, the gloves
should be washed twice.
• The gloves should be washed after
every use with carbolic soap and a
disinfectant.
• The size should fit the operator.

Aprons, gowns:
• Apparel is worn to prevent
contamination of clothing and protect
skin.
• It could be made of cloth or
impermeable material such as
plastic.
Masks:
• Various types of masks, goggles,
and face shields are worn alone or in
combination, to provide a protective
barrier.

Boots:
• Leg coverings, boots or shoe-
covers provide greater protection to
the skin when splashes or large
quantities of infected waste have to
be handled.
• The boots should be rubber-soled
and anti-skid type. They should
cover the leg up to the ankle.

Precautions
What you can do?
• Use only disposable syringes. After use
throw the syringes after breaking them
• Bandages, cotton and other blood stained
materials should not be thrown with
general garbage
• Use specified coloured plastic bags to
dispose biomedical wastes.
• Keep trash out of reach of small children
and infants

Ensure
1. that the used product is mutilated.
2. that the used product is treated prior to
disposal.
3. that the used product is segregated
Do not
1. reuse plastic equipment.
2. mix plastic equipment with other wastes.
3. burn plastic waste.

Refer for more
• http://www.cpreec.org/pubbook-biomedical.htm

Bio medical waste disposal

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