The document provides information on bio-medical waste management rules in India. It discusses that bio-medical waste is waste generated from healthcare facilities and includes human tissues, blood, chemicals, sharps etc. The rules classify waste into different color coded categories and prescribe standards for segregation, collection, storage, transport and treatment of waste. It highlights that improper management of bio-medical waste poses health and safety risks. The rules have been amended over time to better regulate waste management. Strict adherence to the waste management procedures outlined in the rules is important to ensure safety of health workers and the public.

1. Bio-Medical Waste Management
(Rules 2016)
DR. DINESH JAIN
DR. SANDEEP GUPTA
Government of india
Ministry of Enviornment, Forest and Climate change
New Delhi

2.  “Bio-Medical waste” is the waste that 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/ liquid waste including its container and
any intermediate product, which is generated during the
diagnosis, treatment or immunization of human
beings or animals”. 2

3. CONTINUE
 According to the environment protection act 1986, Biomedical
Waste (Management and Handling) Rules, 28 July 1998 And it
was amended in 2000 & 2003. the bio medical waste rules in July
1998, subsequently revised in 2011 & now the “bio medical waste
 management rules in 2016” are in the attestation to the commitment
of the Gov. of India. (bio medical waste
Management Amendment 2018)
 Waste in India - 484 tonnes/day of bmw from 1,68,869 health care
centres
 Average 1-2kg/bed/day.
3

4. WHO’S AT RISK
11
 Doctor’s & Nurses
 Patients
 Hospital support staff
 support staff Waste collection &
disposal staff
General public and the
Environment

5. NEED FOR BMW MANAGEMENT
TYPE OFWASTE Health HAZARD
Human/ Anatomical waste/ soiled waste HIV, HBV, Cholera, T.B, Pneumonia Rabies
e.t.c.
Sharps HIV, HBV, HCV, Injuries
Cytotoxic/ radioactive Cancer, Birth defect
Chemical waste Poisning, dermatitis, conjuctivitis
4
The hospital waste, in addition to the risk for
patient & personal who handle these
waste poses a threat to public health &
enviroment.

6. 5
Need of BMW Management

7. PRESENT SENERIO
Acc. To the M.O.E.F. & CC (Ministry of
Environment, Forest & climate change )-
 Gross generation of BMW in india is 484
tone/ day from 1,68,869 health care
facilities (hcf), out of which 447 tone/ day
is treated, which means that almost 38 tone/
day of the wastes is left untreated & not
disposed finding its way in dumps or water
bodies & re-enters our system. 6

8. BIO-MEDICAL WASTE MANAGEMENT & HANDLING
RULES NOTIFICATIONS AND AMENDMENTS
 On 20th July 1998 Ministry of Environment and Forests
(MoEF), Govt. of India, Framed a rule known as ‘Bio-
medical Waste (Management and Handling) Rules,
 1st Amendment Dated 06/03/2000
 2nd Amendment Dated 17/09/2003
 The MoEF&CC has notified the new BMW (M) Rules, 2016
on 28TH March, under the Environment (Protection) Act,
1986 to replace the earlier Rules (1998) and the
7
amendments thereof.

9. If you are not measuring
it, you are not
managing it.
9

11. General waste

12. Other Waste

13. WHO ESTIMATES
1
3
 85% of hospital waste is non hazardous
 10% is infectious
 5% is non-infectious
 Any infectious or non infectious Bio hazardous waste mixed
with general waste renders the whole bio hazardous waste .

14. 85%
10%
1%
3%1%
Bio-Medical Wastes
Non Infectious waste 85%
Pathological & Infectious
waste, 10%
Chemical &
Phermaceutical waste, 3%
Sharps, 1%
Radioactive, Cytotoxic &
heavy metals, 1%
1
4

15. BIO HAZARDOUS WASTE
 Infectious waste – 10% (sharp, non sharp, plastics, disposables,
liquid
waste)
 Non infectious waste – 5% (radioactive waste, discarded
glass, chemical waste, incinerated waste)
 WHO has estimated that 16 billion injection are administered
every
year. Not all needles & syringes are disposed properly.
 Despite this progress, In the year 2010, unsafe injection were
still responsible for as many as 33,800 new HIV infections,
1.7 million hepatitis B infections & 3,15,000 hepatitis C
infections.
 Any infectious or non infectious Bio hazardous waste mixed
with general waste renders the whole bio hazardous waste .
10

16. SOURCES OF BIO-MEDICAL
WASTE
16
Major Sources Minor Sources
Clinics (Dental &
Ayu.) Cosmetic
clinics
Home care
Paramedics
Funeral
services
 All Hospitals
 Labs
 Research centers
 Animal research
 Blood banks
 Nursing homes
 Mortuaries
 Autopsy centers

17. HOSPITAL WASTEDISPOSAL
17
Basic principal is that the wastes are disposed in most
hygienic & cost effective manner, by methods which at
all stages, minimize risk to healthy environment, Govt. of
India has prescribed certain procedures and guidelines as
follows:
 Source Segregation
 Collection of wastes
 Storage
 Transport
 Treatment
Disposal

18. BIO MEDICAL WASTE MANAGEMENT RULES
Schedule – 6 18
Acc. To BMW Rules of 1998 The duty of every “occupier”
i.e. A person who has the control over the institution or its
premises, to take all steps to ensure that waste generated is
handled without any adverse effect to human health &
environment. It consists of six schedule-
Schedule – 1
Schedule – 2
Schedule – 3
Schedule – 4
Schedule – 5

19. Color Coding & Type Of Container/Bags to
Be Used For Waste Segregation &
Collection

20. WASTE SEGREGATION
Waste should be segregated at source
Waste segregated in different coloured bags

21. Category Type of Waste Type of Bag or
Container to be used
Yellow (a) Human Anatomical Waste:
Human tissues, organs, body parts and fetus below the viability period
Yellow coloured non-
chlorinated plastic bags
(b)Animal Anatomical Waste :
Experimental animal carcasses, body parts, organs, tissues, including
the waste generated from animals used in experiments or testing in
veterinary hospitals or colleges or animal houses.
(c) Soiled Waste:
Items contaminated with blood, body fluids like dressings, plaster
casts cotton swabs and bags containing residual or discarded blood and
blood components.
(d) Expired or Discarded Medicines:
Pharmaceutical waste like antibiotics, cytotoxic drugs including all
items contaminated with cytotoxic drugs along with glass or plastic
ampoules, vials etc.
Yellow coloured non-
chlorinated plastic bags
or containers
(e) Chemical Waste:
Chemicals used in production of biological and used or discarded
disinfectants.
Yellow coloured
containers or non-
chlorinated plastic bags

22. (f) Chemical Liquid Waste :
Liquid waste generated due to use of chemicals in
production of
biological and used or discarded disinfectants,
Silver X-ray film
developing liquid, discarded Formalin, infected
secretions, aspirated body fluids, liquid from
laboratories and floor washings, cleaning, house-
keeping and disinfecting activities etc.
Separate collection system
leading to effluent treatment
system
(g) Discarded linen, mattresses, beddings
contaminated with blood or body fluid.
Non-chlorinated yellow plastic
bags or suitable packing
material
(h) Microbiology, Biotechnology and other
clinical laboratory waste:
Blood bags, Laboratory cultures, stocks or
specimens of microorganisms, live or attenuated
vaccines, human and animal cell cultures used in
research, industrial laboratories, production
of biological, residual toxins, dishes and devices
used for cultures.
Autoclave safe plastic bags or
containers

23. Red Contaminated Waste (Recyclable)
(a) Wastes generated from disposable items
such as tubing, bottles, intravenous tubes and
sets, catheters, urine bags, syringes
(withoutneedles and fixed needle syringes) and
vaccutainers with their needles cut) and gloves.
Red coloured non-
chlorinated plastic bags or
containers
White
(Transluc
ent)
Waste sharps including Metals:
Needles, syringes with fixed needles, needles
from needle tip cutter or burner, scalpels,
blades, or any other contaminated sharp object
that may cause puncture and cuts. This
includes both used,discarded and contaminated
metal sharps
Puncture proof, Leak proof,
tamper proof containers
Blue (a) Glassware:
Broken or discarded and contaminated glass
including medicine vials and ampoules except
those contaminated with cytotoxic wastes.
Cardboard boxes with blue
colored marking
(b) Metallic Body Implants Cardboard boxes with blue
colored marking

24. SCHEDULE – 1 NEW 8 CATEGORIES OF BMW IN 1998
CATE TYPE OF WASTE
GORY
PANCHA-
KARMA
WASTE
TREATMENT &
DISPOSAL
Catego
ry 1
Human anatomical wastes Vomitus Incineration/ deep burial
Catego
ry 2
Animal wastes Incineration/ deep burial
Catego
ry 3
Microbiology & biotechnology
waste, Liquid wastes,
waste from Laboratory,
blood banks, hospitals,
house etc.
Blood Local autoclaving/
microwaving/
incineration/
Disinfection by
chemicals
Catego
ry 4
Waste sharps like needles,
syringes, scalpels, blades,
glass etc.
Needle Disinfection
(Chemical/autoclavin
15
g/
micro waving &
mutilation/shredding)

25. CATEG
ORY
TYPE OF WASTE PANCHA-
KARMA
WASTE
TREATMENT &
DISPOSAL
Catego
ry 5
Discarded Medicines &
cytotoxic drugs
Incineration/
destruction & disposal
in land fills
Catego
ry 6
Soiled wastes
Items contaminated with
blood, body fluids including
cotton, dressings etc
Cotton,
Dressing
material
Incineration,
autoclaving,
microwaving
Catego
ry 7
Solid wastes like catheters,
IV sets etc
Catheter Disinfection by chemical
treatment/autoclaving/
micro waving and
mutilation & shredding
Catego
ry 8
Liquid Waste Disinfecting by
chemical T/t and
discharge into dra
1
in
6
s

26. CATEGORY TYPE OF WASTE PANCHA-KARMA
WASTE
TREATMENT &
DISPOSAL
Category 9 IncinerationAsh Disposal in
municipal landfill
Category 10 Chemical wastes Oil Chemical
treatment &
discharge into
drains for liquid
and secured land
fills for solids.
17

27. Colour Coding Type of container to
be used
Waste Category
Number
Treatment
Yellow plastic bags Category 1,2,3,6
Red Disinfected container
/ plastic bags
Category 3,6,7
Incineration,
Deep burial
Autoclaving,
Microwaving,
Chemical T/t
Blue /
white
plastic bags/
puncture proof
container
Category 4&7 Autoclaving,
Microwaving,
Chemical T/t &
Black plastic bags Category 5,9,10
Shredding
18
Disposal in
secured landfill

28. 19

29. 20

31. 31

33. 21

34. 34

35. 35

36. 36

37. SCHEDULE- 3
LABEL FOR BIO-MEDICALWASTE
CONTAINERS/BAGS (PART- A)
27
BIO HAZRDS
SYMBOL
CYTOTOXIC
SYMBOL
BIO HAZARDS WASTE
WITH CARE
NOTE - LABLE SHALL BE NON WASHABLE&
PROMINANTELY VISIBLE

38. Day ............ Month .............. Year ...........
Date of generation ...................
Waste category ........
Waste class Waste description
Sender's Name & Address
Phone No...........Telex No .... Fax No .................
Receiver's Name & Address
Phone No ……..Telex No ...........Fax No ...............
Contact Person ........ In case of emergency
38

39. SCHEDULE - 5
39
Standards for T/t & disposal of bio
medical wastes standards for incinerators.

40. SCHEDULE - 6
40
Schedule for waste T/t facilities like
incinerator/ autoclave/ microwave system.

41. PRECAUTIONS
41
 Medical, Paramedical & Sanitation staff should be vaccinated against
Hepatitis B
 Using especially heavy duty gloves,Aprons, Masks, Boots 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.

42. 33
BAD- Don’t carry waste in open bag’s &
never carry it through crowded area
GOOD- Always carry the wastein
secure sealed container/ bags

43. 36

44. PROTECTIVE GEARS

45. HANDLING DEVICES
32
 Trolleys
 Wheelbarrows

48. TRANSPORTATION
 Untreated bio medical waste should be transported in
specially designed vehicles
 Trolley or in covered wheel barrows.
 Manual loading should be avoided as far as possible.
 The bags /container containing biomedical waste should
be tied /lidded before transportation.
 Before transportation, signed document by doctor /nurse
maintaining date, shift, quantity & destination.
 Special vehicle must be used to prevent access direct
contact with the transportation operators, the scavengers
& the public. 34

49.  The transport containers should be properly enclosed.
 Driver must be trained regarding the procedures
followed during the accidental spillage.
 Wash the interior of the containers thoroughly.
 Biohazard symbol should be painted on the trolley.
35

50. Record Keeping

52. WASTE TREATMENT PROCESS
CATEGORIES
 Five broad categories:
(1) Mechanical processes
(2) Thermal processes
(3) Chemical processes
(4) Irradiation processes
(5) Biological processes.
52

53. MECHANICAL PROCESSES
53
 Used to change the physical form or
characteristics of the waste
 To facilitate waste handling or to process the
waste in conjunction with other treatment steps.
 Includes- compaction
- shredding
- land fill and burial

54. CONTINUE
 Compaction- compressing the waste into containers to

reduce its volume.
Shredding – includes granulation, grinding, pulping &
the like, is used to break the waste into smaller pieces.
 Health & safety reasons and good practice prohibit
compacting/shredding untreated medical waste, because
of concerns of aerosoling /spilling of micro-organisms.
 However, there are no ill effects if waste is sheredded
after it has been decontaminated in order to make it
unrecognisable. 39

55. SANITARY & SECURED LAND FILLING
55
 Deep burial of human anatomical waste, when the
facility of proper incineration is not available.
 Disposal of autoclaved /hydroclaved /microwaved
waste.
 Disposal of sharps.
 Disposal of incineration ash.

56. PIT FOR DEEP BURRIAL
56
 Depth 2 meter
 Waste fill 1 meter from bottom
 Cover of lime- 50 cm
 Galvanized iron/ wire mesh at the top
 Secure the area

57. THERMAL PROCESSES
57
 Sterilize or destroyes medical waste.
 Two categories-low heat systems & high heat systems
 Low heat systems-use steam, hot water or
electromagnetic radiation to heat & decontaminate the
waste.
 High heat systems-combustion, pyrolysis & high temp.
plasmas to decontaminate & destroy the waste.

58. CONT.
58
Hot air oven:
Temp. OF 160 degree for 2 hour or 170 degree for 1 hour, for
glass ware, & metallic instruments.
Incineration:
Destruction of contaminated materials in the incinerator.
Autoclave
steam sterilisation under pressure by bringing the
Steam into direct contact with the waste material to sterilize it.

59. CHEMICAL PROCESSES
59
 Most chemical waste treatment systems use a
disinfectant solution in combination with shredding to
provide decontamination & disfigurement.
 1% hypochlorite solution with a minimum contact
period of 30 min.
 Pre-shredding of the waste is desirable for better contact
with the waste material.

60. IRRADIATION PROCESS
60
 Ionizing- Xray, gamma ray, cosmic rays.
 Non ionizing- infra red, ultra violet.
 Swabs, plastic materials, oil, metal foils, etc.
 These system requires post-irradiation shredding to
render the waste unrecognisable.

61. AUTOCLAVE
Principle:
 When water is heated in a closed vessel under
pressure, the boiling point of water rises above 100
degree.
 Water is heated at 2 atmospheric pressure and the
boiling temperature will be 121 degree or at 3
atmospheric pressure and the boiling temperature
will be 134 degree.
61

62. AUTOCLAVING IS HIGLY EFFICIENT BCOZ
 High temperature.
 High penetrating power of the steam under
pressure.
 When steam condenses on the articles, it liberates
latent heat to the articles to be sterilized.
 Non toxic
 Not time consuming.
62

63. INCINERATION
63
 Incineration fundamentals:
-incineration comes from a greek word meaning
burn to ashes.
-initially incinerators were just uncontrolled single
chamber fire boxes provided with smoke stocks.
-now modern incineration systems are well
engineered, well designed, well controlled, well
monitored

64. CONT.
64
 Incineration is a high temperature thermal process
employing combustion of the waste under controlled
condition for converting them into inert material &
gases.
 This can be oil fired/electrically powered/
combination.

65. MICROWAVE TREATMENT
65
 Radiations produced by the microwave are
involved to break apart molecular chemical bonds
& thus disinfect infectious waste.
 Temp-97◦-100◦C
 Cycle time-40-45 min.
 Advantage of disinfecting the waste
 No hazardous emissions.
 Can not be used to treat body parts & tissues.

66. ADVANTAGES :
 However, the investment costs are high atpresent.
66
 Absence of harmful air emissions- environment
friendly.
 Absence of liquid discharges.
 Non-requirement of chemicals.
 Reduced volume of waste (due to shredding &
moisture loss)
 Operator safety-worker friendly

67. RESPONSIBILITY
52
Infection control is everyone's business.
You are not only protecting yourself,
but also those around you

68. CONCLUSION
53
 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………………………….. ALLCLEAN.

69. LET THE WASTE OF THE “SICK” NOT
CONTAMINATE THE LIVES OF
“THE HEALTHY”

70. 54
LET THE WASTE OF THE “SICK”NOT
CONTAMINATE THE LIVES OF
“THE HEALTHY”