This document discusses occupational health risks associated with biomedical waste management. It notes that health care, housekeeping, and waste handling personnel are at highest risk of exposure. Sharps injuries are a particular risk, with annual injury rates of 10-20 per 1000 for some groups. Exposures can cause physical, chemical, biological, and psychosocial hazards. Physical hazards include noise, vibration, and lifting injuries. Chemical exposures include cleaners, sterilants, and expired drugs. Biological hazards include pathogens from waste. Psychosocial risks include stress, overwork, and limited career opportunities. Proper training, personal protective equipment, vaccination, medical surveillance, and adherence to biomedical waste management rules can help reduce risks.

1. Occupational Health Risks of
Biomedical Waste Management
– An overview
by
Dr. Vidhya Venugopal
Professor
Department of Environmental Health Engineering
Sri Ramachandra University
Porur, Chennai - 600 116

2. In India-
1-2 kg/bed/day with variation among
Govt. and Private establishments.
Approximately 506.74 tons/ day wastes
generated
Out of which only 57% waste undergoes
proper disposal
Biomedical waste Statistics

3. Categories of Bio-Medical Wastes

4. Cytotoxic
drugs
Genotoxic
waste
Chemical waste
Pharmaceutical Waste
Sharp Waste

5. Gas
cartridges
Gas cylinders
Aerosol cans
PRESSURISED
CONTAINERS
5

6. Waste with high content
of heavy metals
Worn out batteries
Blood pressure guages 6

7. Radioactive waste
7

8. OCCUPATIONAL HAZARD
Who is at risk?
 Health-care & house-keeping personnel,
waste workers
 Doctors, nurses and technicians
 Waste recyclers and rag pickers
 Visitors
 In- and out-patients
 General public

9. Real time Statistics
Sharps (Annual injury rate)
 House-keeping personnel & nurses - 10-20/1000
 Cleaning dept. and waste handlers - 180/1000
Needle stick injuries
 Risk of Hepatitis B – ROT = 6-30%.
 Risk of HIV infection – Avg. TR = 0.3% (3/1000)

10. TYPES OF OCCUPATIONAL HAZARDS
 Physical
 Chemical
 Biological
 Ionising/non-ionising radiation
 Psychosocial
 Ergonomical

11. From Hazard to Disease
EXPOSURE UPTAKE EFFECT DISEASE
H
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Occupational
EnvironmentalEnvironmental
Exposure Assessment Health Surveillance

12. OCCUPATIONAL HAZARDS (Physical)
Types:
Noise, Vibration, Radiation, Heat, Physical
injuries, Lifting heavy objects
EFFECT:
Hearing loss, nervous problems, backache,
physical disability, heat exhaustion, Musculo
skeletal disorders, genetic damage, cancers
etc.,

13. OCCUPATIONAL HAZARDS (Chemical)
SOURCE: Chemical cleaners, sterilizers,
anaesthetic chemicals, expired
pharmaceuticals, gluteraldehye, latex,
Mercury, heavy metals, volatiles and plastics.
EFFECT: Irritation to sensory organs, headaches,
nausea, vomiting, systemic illnesses,
Neurological and GI disorders, cardiovascular
disorders, immune dysfunction, reproductive
& personality disorders, disability and
possibly death

14. OCCUPATIONAL HAZARDS
(Ergonomical)
SOURCE:
Repetitive motions, awkward postures,
twisting, ergonomically unfriendly working
conditions, bending and lifting weights
EFFECT:
Osteoarthritis of wrist, epicondylitis elbow,
back pain, low back pain, shoulder
tightening (temporary and permanent)

15. OCCUPATIONAL HAZARDS (Radiation)
SOURCE:
Radiotracer in therapy, cancer treatment,
radiopharmaceutical waste, waste from
radio medical procedures, discarded laser
equipments
EFFECTS:
Burns, Radiation sickness, cataract,
reduction in blood cells, Chromosomal
aberrations, tumours, skin erthyrema/
cancers, sterility.

16. OCCUPATIONAL HAZARDS (Biological)
SOURCE:
Bioaerosols, body fluids, soiled linen,
bandages sharps, needle stick, Biowaste
EFFECT:
H1N1, Hepatitis B, HIV, Infections due to
other pathogens, Common infections,
compromised immune system due to
repeated exposures, disability and/or
death in acute cases.

17. OCCUPATIONAL HAZARDS
(Psychosocial)
SOURCE:
Fatigue, Workload demand, Problematic
interpersonal relationships, Limited career
opportunities, poor remuneration, Monotony of
the job, Stress due to fear, Poor/limited training
in BMW.
EFFECT:
Personality disorders, low self-esteem, Anxiety,
low motivation, imbalanced work-life balance,
Depression, alcohol/drug abuse, Violence

18. Laws of Biomedical Waste Management
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, 1998,’
Provides uniform guidelines and code of
practice for Bio-medical waste management.
Government initiatives……

19. SAFETY/PRECAUTIONERY
MEASURES

20. VULNERABLE POPULATION
 Pregnant Women
 Work group above 45yrs
 Disabled or with previous illness.
 With respiratory illnesses
 High exposures

21. Hazard Control Principles
 Hierarchy of Controls

22. Source Controls
Substitution
Enclosure or
Isolation
Adequate Safety
Program
Audits

23. Pathway Controls
Housekeeping
Distance
Continuous Area
Monitoring
Reduce exposure

24. Receiver (Worker) Controls
Training & Education
Rotation
Enclosure of Worker
Personal Protective
Devices
Strong org. policies

27. SPILLAGE
 3 MAJOR TYPES OF SPILLAGE
 BLOOD SPILLAGE
 MERCURY SPILLAGE
 CHEMICAL SPILLAGE

28. PRECAUTION S FROM BLOOD
SPILLAGE
Wear Personal Protective Equipment
 Mark the area.
 Add 5%sodium hypo chlorite to the
spillage and keep it for 10-15 minutes.
 Collect the spillage using waste cloth
or cotton.

29. MERCURY SPILLAGE
 Wear personal protective Equipment
 With the help of two cardboard pad,
collect the spillage and with an ink filler
absorb mercury
 It is then transferred to a water filled
container.
 It is then transferred to a seal proof bag
and taken to clinical pharmacist
DO NOT BROOM OR VACCUM

30. No take home Mercury

31. CHEMICAL SPILLAGE
 Whenever a chemical spillage occurs, remove
contaminated clothing.
 Flush eyes/skin with water at least for 15-30
mins. Use soap for cleaning.
 Protect yourself and remove injured persons
(if any) to fresh air.
 Notify concerned personnel
 If flammable vapors are involved, do not
operate electrical switches.
 Do not touch the spill without PPE.
 If unknown chemical evacuate room and
wait for spill team

32. OTHER TIPS FOR BASIC OSH
 Safe Hand washing Techniques
 Personal hygiene and habits
 Never eat, drink or apply cosmetics in the
work area
 Avoid touching your face, mouth or eyes
 Never suck pens or chew pencils
 Separate area for eating and drinking
 Visual remainders of hazards
Do’s and Don’ts pictorial

33. Hand
Washing

34. Pictorial Labels with Agent, Concentration
&
Hazard Warnings
 Examples of hazard labels:

35. Communicate about Workplace Hazards
Job description
Posters on doors
Labels on hazards
Give feedback on use
of PPE and disposal in
evaluation
Role model safe use
and disposal
Contact point who is
responsible

36. Successful prevention requires:
 Information on the causal relationship between
risk factor and health outcome,
 Knowledge of the mechanism of action of
hazardous factors and conditions,
 Knowledge of how the causal relationship can
be broken,
 Resources and tools for the implementation of
measures,
 Political, managerial and target group support
for a preventive programme.
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Preventive health (OEH)

37. Ground reality I - Risk Assessment

38. Ground reality II- Risk perception

39. Let the waste of the “sick” not contaminate the
lives of “The Healthy”
39