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Biomedical Waste Management
(Segregation, Storage and Transportation)
Dr. Latha Venkatesan
Principal
Apollo college of Nursing
Chennai
Dr. Latha Venkatesan
Principal
Apollo college of Nursing
Chennai
Hospital Waste Or Biomedical Waste
Any waste generated during health care, diagnosis,
treatment, Immunization, research, testing or related
procedures on Human beings or animals conducted in
hospitals, clinics, Laboratories or similar establishments
Dr.Latha Venkatesan
Bio medical waste consists of
• Human anatomical waste like tissues, organs and body
parts
• Animal wastes generated during research from
veterinary hospitals
• Microbiology and biotechnology wastes
• Waste sharps like hypodermic needles, syringes,
scalpels and broken glass
• Discarded medicines and cytotoxic drugs
• Soiled waste such as dressing, bandages, plaster casts,
material contaminated with blood, tubes and catheters
• Liquid waste from any of the infected areas
• Incineration ash and other chemical wastes
Dr.Latha Venkatesan
What is the quantum of waste that is
generated by a hospital?
• The quantum of waste that is generated in India
is estimated to be 1-2 kg per bed per day in a
hospital and 600 gm per day per bed in a
general practitioner’s clinic. e.g. a 100 bedded
hospital will generate 100 – 200 kgs of hospital
waste/day.
• It is estimated that only 5 – 10% of this
comprises of hazardous/infectious waste (5 –
10kgs/day)
Dr.Latha Venkatesan
Waste generated in the hospital
Dr.Latha Venkatesan
Infectious waste 15%
General waste (80 – 85%)
 Non infectious & Non
hazardous
 Municipal disposal
General waste (80 – 85%)
 Non infectious & Non
hazardous
 Municipal disposal
Biomedical waste (15 – 20%)
 Infectious waste – 15%
 Non infectious but hazardous – 5%
Biomedical waste (15 – 20%)
 Infectious waste – 15%
 Non infectious but hazardous – 5%
Dr.Latha Venkatesan
Hospital waste management programme
• Identification of waste types
• Segregation of waste
• Transport & storage of waste
• Proper disposal of waste
• Implementation of contingency plans
• Identify the need for use of personal
protective equipment
Dr.Latha Venkatesan
Segregation
• 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.
Dr.Latha Venkatesan
Identify the suitable bins to dispose
these wastes
Dr.Latha Venkatesan
Benefits of segregation
• Segregation reduces the amount of waste needs special
handling and treatment
• Effective segregation process prevents the mixture of
medical waste like sharps with the general municipal
waste.
• Prevents illegally reuse of certain components of medical
waste like used syringes, needles and other plastics.
• Provides an opportunity for recycling certain components
of medical waste like plastics after proper and thorough
disinfection.
Dr.Latha Venkatesan
• Recycled plastic material can be used for non-food
grade applications.
• Of the general waste, the biodegradable waste can be
composted within the hospital premises and can be used
for gardening purposes.
• Recycling is a good environmental practice, which can
also double as a revenue generating activity.
• Reduces the cost of treatment and disposal (80 per cent
of a hospital’s waste is general waste, which does not
require special treatment, provided it is not contaminated
with other infectious waste.
Dr.Latha Venkatesan
Dr.Latha Venkatesan
Major differences between
BMW Rules – 1998 & 2016
Dr.Latha Venkatesan
Dr.Latha Venkatesan
Dr.Latha Venkatesan
Categories Of Bio Medical Waste (India)
Dr.Latha Venkatesan
Segregation of Waste
Segregation should happen at source, with proper segregation
protocols to
– Reduce the risk of infecting workers
– Reduce costs of treatment of waste
– Reduce the risk of infecting the community at large
– Recycle waste that is non-infectious
Dr.Latha Venkatesan
How to Segregate ?
• The type, placement and size of the container is usually
ascertained on the waste stream in that area
• Bins should be of the same color as for segregation
• All bins must be lined with bags of same colour and
must also have the Biohazard symbol
Dr.Latha Venkatesan
Handling infectious waste
• Minimum handling
• Segregation should be done at source
• Transfer and repeated handling should be avoided
• Infectious waste should never be mixed with non-
infectious waste
• All bags having international bio-hazard symbol should
be tied securely and labelled
Dr.Latha Venkatesan
Handling waste
• When to change or remove bag from the bin
- Bags must be replaced when three fourth full or twice
a day
- In case of theatre, it may be good to replace the bag
after every procedure
- The bag must be securely tied and labelled
• Do not mix any infectious waste with non-
infectious waste
Dr.Latha Venkatesan
Dr.Latha Venkatesan
Biomedical Waste Management
1)Yellow cover in
yellow bin
2)Red cover in red bin
3)White puncture
proof container
4)Card board box
with blue marking
1)Yellow cover in
yellow bin
2)Red cover in red bin
3)White puncture
proof container
4)Card board box
with blue marking
Dr.Latha Venkatesan
Yellow – Soiled Waste, Tissues, Microbiology and Laboratory Waste,
Cytotoxic Drugs
Dr.Latha Venkatesan
Dr.Latha Venkatesan
Red – Gloves, Plastic tubing, Catheters, bags, IV fluid bottles,
syringes, vacutainers
Cardboard box with blue marking
Dr.Latha Venkatesan
Glass bottles
Vials
Ampoules
Metallic implants
Blue
marking
Puncture Proof Container - Sharps
Dr.Latha Venkatesan
Handling sharps
• Sharps are generated in almost all departments
– Theatres, labs, injection rooms, wards…etc
• Cause cut or puncture
• Most injuries occur between the point of use and disposal
• Segregate sharps from rest of the waste at the point of
generation
• Clipping, bending, recapping or breaking of needles must
not be practiced
Dr.Latha Venkatesan
DO’S
• Do minimize use of injections
• Do segregate infectious sharps waste
• Do collect in a white transparent container
• Do train & educate all categories of staff in proper
segregation & handling of waste
• Do use hub cutters & needle destroyers
• Do use authorized persons/agencies to handle/dispose
the needles
Dr.Latha Venkatesan
Handling sharps
Do nots
• Don’t throw sharps in the trash/ non puncture proof
containers
• Don’t recap the needle
• Don’t disconnect the needle from syringe by hand
• Don’t use open buckets for infectious waste /sharps
Dr.Latha Venkatesan
Handling sharps
Needle Puller Hub cutter
Point of use DevicesPoint of use Devices
Needle Pullers & Hub CutterNeedle Pullers & Hub Cutter
Dr.Latha Venkatesan
Portable
Dr.Latha Venkatesan
Current industry standard is
1 quart flat top….
Visibility, with clear high top… Helps
prevent overfill, helps user identify
hazards.
Functionality, with easy to use temporary
closure for security between uses.
Accommodation, with handle for safe
transport of filled collector……added
volume & height accommodates larger,
bulkier safety needle devices.
Current industry standard is
1 quart flat top….
Visibility, with clear high top… Helps
prevent overfill, helps user identify
hazards.
Functionality, with easy to use temporary
closure for security between uses.
Accommodation, with handle for safe
transport of filled collector……added
volume & height accommodates larger,
bulkier safety needle devices.
Dr.Latha Venkatesan
Liquid waste
Liquid waste should be treated with 1% sodium
hypochlorite for 30 minutes and
Should be flushed in to the sewer which goes to the
effluent treatment system (ETP)
Dr.Latha Venkatesan
Major Considerations
Dr.Latha Venkatesan
Generation
Monitoring &
Record
Maintenance
Storage
Segregation
Treatment & Disposal
Transportation
Collection of BMW
• The collection of biomedical waste involves use
of different types of container from various
sources of biomedical wastes like Operation
Theatre, laboratory, wards, kitchen, corridor etc.
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.
Dr.Latha Venkatesan
Transportation within the hospital
• Containers: puncture proof, leak proof,
• Bags: sturdy, properly tied
• Transport trolleys: designated & timely
• Staff protection: provided with protective clothing and
other items
• Never put hands in a bag. Manual loading should be
avoided as far as for as possible.
• Before transporting the bag containing BMWs, it should
be accompanied with a signed document by Nurse/
Doctor mentioning date, shift, quantity and destination.
Dr.Latha Venkatesan
BMW waste collection & Transport
Dr.Latha Venkatesan
Dr.Latha Venkatesan
Waste storage
• Closed covered area
• Away from the normal passages
• Easily accessible for transportation
• Radioactive waste special containers/
special treatment and disposal
Dr.Latha Venkatesan
Dr.Latha Venkatesan
Storage
•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.
Dr.Latha Venkatesan
Transportation from hospital to treatment
facility
Special vehicles must be used so as to prevent access to,
and direct contact with, the waste by the transportation
operators, the scavengers and the public.
The transport containers should be properly enclosed.
The effects of traffic accidents should be considered in the
design, and the driver must be trained in the procedures he
must follow in case of an accidental spillage.
It should also be possible to wash the interior of the
containers thoroughly.
Dr.Latha Venkatesan
Transportation
Dr.Latha Venkatesan
Contd…
Dr.Latha Venkatesan
Dr.Latha Venkatesan
Personal protective equipments
Dr.Latha Venkatesan
Shadowing
• From hospital to treatment facility
• To monitor over loading, spillage and
diversification of BMW.
Dr.Latha Venkatesan
FAQ
• Should we use the same colour code for bins or can we
choose?
• Each bed should have bins or common in wards?
• The bin and liner should be same colour or bin alone is
enough?
• What should be the size of the bin?
• Washing of bins
• How long we can store the BMW in wards/in central
storage area? Who will check appropriate disposal?
• Diversification during tranportation
Dr.Latha Venkatesan
Proper Disposal Of
Hospital Waste –
Every One’s Responsibility
Dr.Latha Venkatesan
Dr.Latha Venkatesan
Dr.Latha Venkatesan
Hands that heal should never harm nor get
harmed

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Bio Medical Waste Management

  • 1. Biomedical Waste Management (Segregation, Storage and Transportation) Dr. Latha Venkatesan Principal Apollo college of Nursing Chennai Dr. Latha Venkatesan Principal Apollo college of Nursing Chennai
  • 2. Hospital Waste Or Biomedical Waste Any waste generated during health care, diagnosis, treatment, Immunization, research, testing or related procedures on Human beings or animals conducted in hospitals, clinics, Laboratories or similar establishments Dr.Latha Venkatesan
  • 3. Bio medical waste consists of • Human anatomical waste like tissues, organs and body parts • Animal wastes generated during research from veterinary hospitals • Microbiology and biotechnology wastes • Waste sharps like hypodermic needles, syringes, scalpels and broken glass • Discarded medicines and cytotoxic drugs • Soiled waste such as dressing, bandages, plaster casts, material contaminated with blood, tubes and catheters • Liquid waste from any of the infected areas • Incineration ash and other chemical wastes Dr.Latha Venkatesan
  • 4. What is the quantum of waste that is generated by a hospital? • The quantum of waste that is generated in India is estimated to be 1-2 kg per bed per day in a hospital and 600 gm per day per bed in a general practitioner’s clinic. e.g. a 100 bedded hospital will generate 100 – 200 kgs of hospital waste/day. • It is estimated that only 5 – 10% of this comprises of hazardous/infectious waste (5 – 10kgs/day) Dr.Latha Venkatesan
  • 5. Waste generated in the hospital Dr.Latha Venkatesan Infectious waste 15% General waste (80 – 85%)  Non infectious & Non hazardous  Municipal disposal General waste (80 – 85%)  Non infectious & Non hazardous  Municipal disposal Biomedical waste (15 – 20%)  Infectious waste – 15%  Non infectious but hazardous – 5% Biomedical waste (15 – 20%)  Infectious waste – 15%  Non infectious but hazardous – 5%
  • 7. Hospital waste management programme • Identification of waste types • Segregation of waste • Transport & storage of waste • Proper disposal of waste • Implementation of contingency plans • Identify the need for use of personal protective equipment Dr.Latha Venkatesan
  • 8. Segregation • 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. Dr.Latha Venkatesan
  • 9. Identify the suitable bins to dispose these wastes Dr.Latha Venkatesan
  • 10. Benefits of segregation • Segregation reduces the amount of waste needs special handling and treatment • Effective segregation process prevents the mixture of medical waste like sharps with the general municipal waste. • Prevents illegally reuse of certain components of medical waste like used syringes, needles and other plastics. • Provides an opportunity for recycling certain components of medical waste like plastics after proper and thorough disinfection. Dr.Latha Venkatesan
  • 11. • Recycled plastic material can be used for non-food grade applications. • Of the general waste, the biodegradable waste can be composted within the hospital premises and can be used for gardening purposes. • Recycling is a good environmental practice, which can also double as a revenue generating activity. • Reduces the cost of treatment and disposal (80 per cent of a hospital’s waste is general waste, which does not require special treatment, provided it is not contaminated with other infectious waste. Dr.Latha Venkatesan
  • 13. Major differences between BMW Rules – 1998 & 2016 Dr.Latha Venkatesan
  • 16. Categories Of Bio Medical Waste (India) Dr.Latha Venkatesan
  • 17. Segregation of Waste Segregation should happen at source, with proper segregation protocols to – Reduce the risk of infecting workers – Reduce costs of treatment of waste – Reduce the risk of infecting the community at large – Recycle waste that is non-infectious Dr.Latha Venkatesan
  • 18. How to Segregate ? • The type, placement and size of the container is usually ascertained on the waste stream in that area • Bins should be of the same color as for segregation • All bins must be lined with bags of same colour and must also have the Biohazard symbol Dr.Latha Venkatesan
  • 19. Handling infectious waste • Minimum handling • Segregation should be done at source • Transfer and repeated handling should be avoided • Infectious waste should never be mixed with non- infectious waste • All bags having international bio-hazard symbol should be tied securely and labelled Dr.Latha Venkatesan
  • 20. Handling waste • When to change or remove bag from the bin - Bags must be replaced when three fourth full or twice a day - In case of theatre, it may be good to replace the bag after every procedure - The bag must be securely tied and labelled • Do not mix any infectious waste with non- infectious waste Dr.Latha Venkatesan
  • 22. Biomedical Waste Management 1)Yellow cover in yellow bin 2)Red cover in red bin 3)White puncture proof container 4)Card board box with blue marking 1)Yellow cover in yellow bin 2)Red cover in red bin 3)White puncture proof container 4)Card board box with blue marking Dr.Latha Venkatesan
  • 23. Yellow – Soiled Waste, Tissues, Microbiology and Laboratory Waste, Cytotoxic Drugs Dr.Latha Venkatesan
  • 24. Dr.Latha Venkatesan Red – Gloves, Plastic tubing, Catheters, bags, IV fluid bottles, syringes, vacutainers
  • 25. Cardboard box with blue marking Dr.Latha Venkatesan Glass bottles Vials Ampoules Metallic implants Blue marking
  • 26. Puncture Proof Container - Sharps Dr.Latha Venkatesan
  • 27. Handling sharps • Sharps are generated in almost all departments – Theatres, labs, injection rooms, wards…etc • Cause cut or puncture • Most injuries occur between the point of use and disposal • Segregate sharps from rest of the waste at the point of generation • Clipping, bending, recapping or breaking of needles must not be practiced Dr.Latha Venkatesan
  • 28. DO’S • Do minimize use of injections • Do segregate infectious sharps waste • Do collect in a white transparent container • Do train & educate all categories of staff in proper segregation & handling of waste • Do use hub cutters & needle destroyers • Do use authorized persons/agencies to handle/dispose the needles Dr.Latha Venkatesan Handling sharps
  • 29. Do nots • Don’t throw sharps in the trash/ non puncture proof containers • Don’t recap the needle • Don’t disconnect the needle from syringe by hand • Don’t use open buckets for infectious waste /sharps Dr.Latha Venkatesan Handling sharps
  • 30. Needle Puller Hub cutter Point of use DevicesPoint of use Devices Needle Pullers & Hub CutterNeedle Pullers & Hub Cutter Dr.Latha Venkatesan
  • 31. Portable Dr.Latha Venkatesan Current industry standard is 1 quart flat top…. Visibility, with clear high top… Helps prevent overfill, helps user identify hazards. Functionality, with easy to use temporary closure for security between uses. Accommodation, with handle for safe transport of filled collector……added volume & height accommodates larger, bulkier safety needle devices. Current industry standard is 1 quart flat top…. Visibility, with clear high top… Helps prevent overfill, helps user identify hazards. Functionality, with easy to use temporary closure for security between uses. Accommodation, with handle for safe transport of filled collector……added volume & height accommodates larger, bulkier safety needle devices.
  • 33. Liquid waste Liquid waste should be treated with 1% sodium hypochlorite for 30 minutes and Should be flushed in to the sewer which goes to the effluent treatment system (ETP) Dr.Latha Venkatesan
  • 34. Major Considerations Dr.Latha Venkatesan Generation Monitoring & Record Maintenance Storage Segregation Treatment & Disposal Transportation
  • 35. Collection of BMW • The collection of biomedical waste involves use of different types of container from various sources of biomedical wastes like Operation Theatre, laboratory, wards, kitchen, corridor etc. 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. Dr.Latha Venkatesan
  • 36. Transportation within the hospital • Containers: puncture proof, leak proof, • Bags: sturdy, properly tied • Transport trolleys: designated & timely • Staff protection: provided with protective clothing and other items • Never put hands in a bag. Manual loading should be avoided as far as for as possible. • Before transporting the bag containing BMWs, it should be accompanied with a signed document by Nurse/ Doctor mentioning date, shift, quantity and destination. Dr.Latha Venkatesan
  • 37. BMW waste collection & Transport
  • 40. Waste storage • Closed covered area • Away from the normal passages • Easily accessible for transportation • Radioactive waste special containers/ special treatment and disposal Dr.Latha Venkatesan
  • 41. Dr.Latha Venkatesan Storage •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.
  • 42. Dr.Latha Venkatesan Transportation from hospital to treatment facility Special vehicles must be used so as to prevent access to, and direct contact with, the waste by the transportation operators, the scavengers and the public. The transport containers should be properly enclosed. The effects of traffic accidents should be considered in the design, and the driver must be trained in the procedures he must follow in case of an accidental spillage. It should also be possible to wash the interior of the containers thoroughly.
  • 48. Shadowing • From hospital to treatment facility • To monitor over loading, spillage and diversification of BMW. Dr.Latha Venkatesan
  • 49. FAQ • Should we use the same colour code for bins or can we choose? • Each bed should have bins or common in wards? • The bin and liner should be same colour or bin alone is enough? • What should be the size of the bin? • Washing of bins • How long we can store the BMW in wards/in central storage area? Who will check appropriate disposal? • Diversification during tranportation Dr.Latha Venkatesan
  • 50. Proper Disposal Of Hospital Waste – Every One’s Responsibility Dr.Latha Venkatesan
  • 53. Hands that heal should never harm nor get harmed